The Importance Of Communication Of Nurses

The Importance Of Communication Of Nurses This essay will explore the importance of communication in nursing; define communication and look at the different modes of communication and barriers to communication. A reflective model will be used to describe how communication impacted on care delivery in practice. Although each person will bring their own experience of ways to communicate, it will discuss how student nurses can develop their skills that will assist them to ensure excellent communication and also how qualified nurses continue to learn communication throughout their profession. Baillie, (2009) indicate that It is predominantly imperative for a nurse to have and develop effective communication skills. A nurse will have contact with a wide range of individuals during nursing; this includes the patient and their relatives and also members of the healthcare team. (Thompson 2003, cited in Baillie 2009) suggests that communication is not only needed whilst transferring information from one person to another, it plays a significant role in relationships. Kenworthy et al. (2002) indicates that Communication comprises of three fundamental factors; the sender, the receiver and the message. Successful communication can be defined when the receiver is able to interpret the senders message whilst reflecting on their thoughts and feelings and the message received is almost accurate to that of the sender. There are various modes of communication that a nurse may use. For example, face to face contact, telephone calls, emails and letters. (Kenworthy et al. 2002) Daniels et al. (2010) explain that communication has two parts; a verbal and a non verbal message. Verbal communication is associated with speech and usually heard through the persons ears, however paraverbal cues for example, pitch, speech, inflection and volume can be associated with verbal messages changing the word meaning. Different cultures may find spoken language to be problematic to understand because paraverbal cues may differ from one culture to another. However, paraverbal cues such as a happy friendly smile or crying with grief are associated with different cultures and may help with a cultural barrier. (Daniels et al. 2010) The way in which a nurse speaks and the tone of voice can be very reassuring to a patient, however a patient can also misinterpret the tone as being demeaning or they may even become frightened. Another very important factor suggested by Corner and Bailey (2008) is the way in which a nurse may choose words ensuring that a patient will understand and not be confused with any medical jargon. A nurse requires excellent awareness of communication theories whilst giving verbal handovers in both hospital and community settings. A report will only become effective during handover if the nurse has a confident attitude, along with good verbal and non verbal skills creating an ideal environment for communication between the healthcare team to ensure continuity of care.(Thurgood [no date] ) Nurses are responsible for maintaining confidentiality. (NMC, 2008) Confidentiality is imperative in a therapeutic relationship with information only being shared between appropriate people. (Sundeen et al. 1998) Nonverbal communication is made up of all types of communication, with the exception of total verbal communication. Nonverbal communication is usually observed through the eyes however, other senses in the body can compliment this. (Kenworthy, 2002) Nonverbal aspects of a message can include kinesis, facial expression, gesture, touch, movement, body language and eye contact. (Baillie, 2009) Nonverbal communication can be divided in three ways; sign, action and object. Sign nonverbal communication can include hand gestures and sign language, action nonverbal communication can include how you move around, involving body movements that do not offer precise signals. Object nonverbal communication can include furnishings, hairstyles and clothing. (Sundeen et al. 1998) Written communication is certainly a significant method of communication and is crucial in a healthcare setting. The (NMC, 2008) states that it is imperative that all records are kept clear and accurate. This must include all information on assessments, discussions, treatment and the effect of them. Unfortunately, (Bailie, 2009) points out that written communication is an area that is often ignored, stating that good written communication is vital to protect the patients welfare, encouraging high standards of continuity and clinical care, ensuring healthcare team members receive accurate information. Bailie, (2009) suggests that there are different barriers that may prevent a nurse from communicating that may influence the development of a therapeutic relationship, arguing that Physical barriers may possibly include the surrounding environment, a patient who is in need of pain management or any speech, hearing or visual problems. Bailie, (2009) indicates that psychological barriers may include the emotional needs such as anxiety or personality issues such as a person being introvert or having different beliefs and social barriers can be caused if a person feels that their own social status is categorised by hierarchy, religious or culture beliefs. Students are encouraged to keep reflective journals of experiences whilst on clinical placements. Reflective journals enable students to learn from their experiences, enhancing their communication development. However, education should be a lifelong experience in that qualified nurses are also encouraged to keep journals. Journals are known as reflective practice and studies have shown that using these can lead to better practice. (Sully Dallas, 2005) I now plan to use Gibbs model of reflection (1988). This model of reflection is simple to follow for a first piece of reflective writing (please see appendix 1). The patient who has been used in this scenario will be referred to as Mr Jones. The reason for not using the patients real name is to respect the patients confidentiality. (NMC, 2008) On my second day of placement Mr Jones was transferred to the ward from the Accident and Emergency Department. During handover the nurse explained that Mr Jones had been referred from his general practitioner since he was complaining of pain in the throat area. As previously mentioned, Thurgood, [no date] states that a handover will only be successful if the nurse has good verbal and non verbal skills. Mr Jones general practitioner was also concerned as he had not eaten anything and drank very little over the previous two days. Past medical history revealed that Mr Jones had been diagnosed with mouth and throat cancer three months ago and was currently receiving chemotherapy treatment at another hospital. However, the nurse described that Mr Jones had become quite angry at times and that he removed his venflon out of his arm and refused fluids. My mentor asked if I would assist her whilst taking Mr Jones observations. The observations involved taking the patients temperature, pulse, respiration and blood pressure. Comparisons were then compared to the patient baseline and plotted on a chart. Baillie, (2009) suggests that all nurses who observe patients should have the necessary skills and knowledge to understand the measurements and take appropriate action. The medical team decided that the way forward with medical treatment was by firstly ensuring that sufficient fluids were given to Mr Jones. The doctor asked Mr Jones for consent to insert a venflon in his hand whilst explaining the importance of fluids in the body, yet he kept shaking his head. The (NMC, 2008) states that we must gain consent before any treatment and respect the patients choice. The doctors decided that they would prescribe Mr Jones a supplement drink. (Cancerhelp) suggests that Supplement drinks can be used if a patient has a poor appetite and not able to take in enough nourishment into the body. The medical team decided that the nurses on the ward should encourage Mr Jones with oral fluids over the following twenty four hours and assess from there. Mr Jones became quite angry with the doctors and started pushing his arms away, prompting them to leave. Once the medical team had left I volunteered to sit down with Mr Jones as he appeared to be quite upset. I introduced myself as a student nurse. Mr Jones seemed a very pleasant man however, I soon realised that Mr Jones found it very difficult responding to my questions due to his speech. Mr Jones became more upset and at this point he started to cry, I reached out for a tissue and passed it to Mr Jones, I also held his hand to comfort him. As mentioned previously, Bailie, (2009) suggests that non verbal communication such as touch can be reassuring to the patient. I felt quite nervous at this point, being a student and not experienced, I was not sure what to talk about next, so I stood up and told Mr Jones that I would be back in a minute. I walked to the toilet and became upset, I felt absolutely useless not knowing what to do and more so, to see a grown man similar to my own dads age crying. I put a small amount of cold water over my face and wiped my eyes before I went back on th e ward to prevent people from seeing that I had been upset. I spoke to my mentor and discussed with her that I thought Mr Jones was struggling to communicate with me as his speech was very poor and how upset he had become. (Maguire 1978, cited in Hanson 1994) states that a patient with cancer may find it difficult to communicate to show any worries that they might have. My mentor explained to me that speech more often does become deteriorated when people have mouth or throat types of cancer. I asked my mentor how she felt if I offered Mr Jones a pen and notepad to enable him to write things down or if that at any time he felt he could not communicate by speech comfortably. Baillie, (2009) indicates that speech problems can cause a physical barrier to a patient. My mentor said that she thought it was a good idea and that I could try if I wanted to. I returned to the bay and found that Mr Jones had pulled the curtains around his bed. I can understand that Mr Jones wanted privacy from the other patients and maybe staff as he was clearly upset. I popped my head around the curtain, smiled at Mr Jones and asked if he was happy for me to come and sit down with him. Mr Jones smiled and started tapping on the chair, gesturing for me to sit down. I sat down and asked Mr Jones if he found it difficult to communicate with his speech and he nodded. Speech disorder, (2009) suggests that Cancer of the throat can cause loss of the individuals voice and speaking ability. This can be problematic for a patient who would normally use verbal communication. I then continued to show Mr Jones that I had brought a note pad and pen, offering for him to use if he wanted. Mr Jones smiled at me and wrote down thank you. Mr Jones then started to open up, writing down that he felt secluded and on times felt patronised by the doctors because he used to live in Pakistan. I reassured Mr Jones and asked why he did he feel this way, he replied by saying that he was confused, there with things he did not understand, the doctors do not listen, he was very scared of dying and asked me if he going to die. Corner Bailey (2008) indicate that doctors prefer to use closed questions as opposed to open questions, concentrating on the biomedical model and not the emotional needs of the patient. I explained to Mr Jones that I would ask a member of the team to come along and have a chat with him and try to answer the questions that I felt I could not answer being a student nurse. At this point I asked Mr Jones if he would like to have a sip of water and he gave me the thumbs up. I felt really good with myself at this point, I was not experienced however, I had encouraged the patient to drink a small amount of water. I then discussed this with my mentor who agreed that this patient absolutely needed to be able to understand what the medical team were explaining to him and equally important that the medical team must listen to the needs of the patient. Corner and Bailey (2008) argue that it is important for a patient to have a balanced relationship, along with good doctor-patient communication to enable a patient to have faith in their professional opinion. My mentor asked me to be present with her, whilst she had a chat with Mr Jones and I agreed. My mentor came down to the patients level to ensure good eye contact and allowing the patient to answer many open questions, to enable us to get a good understanding of how he was feeling. Wiggens (2006) suggests that open questions will gain an enhanced assessment of the patient, allowing them to speak freely. Mr Jones felt much more at ease once my mentor had finished explaining the importance of fluid and nutritional intake that the body needs. Mr Jo nes was able to write down on the notepad any questions that he felt had been unanswered and anything that he wished to have a better understanding of. Gurrero, (1998) suggest that nurses must be willing to use other means of communication aids, for example white boards, writing pads and pens. The hospital had kept a food chart for Mr Jones since he had been admitted into hospital, clearly showing a very minimal amount of fluid intake and no nutritional intake. My mentor decided to show this to Mr Jones, fortunately he understood and consented to have a new venflon put back in his arm. Mr Jones continued to write down that he felt he was unable to swallow properly and that he would prefer to have fluids this way. My mentor phoned the doctor to come to the ward and Mr Jones happily consented. I felt totally powerless when seeing the frustration that Mr Jones showed towards the medical team during his first assessment on the ward. I could see that there was nothing that the medical team could do to encourage Mr Jones to have the venflon put back in. I believe that because of the breakdown in communication from the doctor, Mr Jones became very distressed. As previously mentioned Corner and Bailey (2008) argue that a doctor-patient relationship is needed for good communication. I felt very inexperienced and accepted the fact that the medical staff knew what they were doing however, I hoped that the doctors would have done something more, even though I understood that the patient had a right to say no to any form of medical treatment that was offered. I was concerned that Mr Jones would die if he did not eat or drink. The other nurses on the ward did not seem to be as anxious to the situation as me. This resulted in me becoming quite distressed over the whole situation, even questioning myself if nursing was for me. I discussed how I felt with my mentor and this left me feeling very positive. My mentor was a very experienced nurse who explained that nurses quite often find themselves in similar situations and most definitely feel the same way as I do. My mentor said that she felt I had done everything that I could have done with the patient and especially how I noticed that the patient was feeling angry and frustrated because he was having difficulties communicating. I found that my lack of confidence as a student nurse left me not knowing what to do if a patient is refusing treatment, eating and drinking. When Mrs Jones came to see her husband during visiting time, she told me that her husband had told her that he felt much happier that he now understood what was going on. Mrs Jones also said that the note pad was a fantastic idea for her husband to write things down and be able to communicate. If the situation arose again with a patient who has mouth or throat cancer, I would certainly ask during handover how well can the patient communicate, to ensure a good environment is created for the healthcare team and the patient. To conclude, I believe that there is nothing else that I could have done to help Mr Jones. However, I do believe that during the handover it would have been beneficial for everyone involved in the care of Mr Jones to be made aware of his difficulties with verbal communication. Nurses certainly need to communicate effectively with patients to provide safe and effective care, taking into consideration that there is difference and diversity and looking at every individual needs. Nurses who work with different cultures have a duty to learn the differences in cultural behaviour and patterns within these groups to prevent a cultural barrier. Listening, along with smiling at appropriate times, showing a positive and genuine interest towards the patient, and have good eye contact will help to prevent barriers in communication. Another important factor is the way in which a nurse positions themselves when talking to a patient. If a patient is sitting, it may be appropriate for a nurse to come down to their level as not to seem to be standing over them, as this could be very disturbing and disrespectful to some patients. Touch and gestures can also go a long way into reassuring a patient. Just by touching a patients arm if they are upset and frightened can mean a lot to a patient. Along with this goes body language and showing respect that will hopefully continue to trust. References Baillie, L., (2009). Developing Practical Adult Nursing Skills. 3rd ed. London: Edward Arnold (Publishers) Ltd. Cancerhelp,(2009).Coping with cancer [online]. Available at: http://www.cancerhelp.org.uk/coping-with-cancer/coping-physically/diet/managing/weight/high-calorie-drinks (accessed 13.01.2009) Corner, J., Bailey, C., (2008).Cancer Nursing. Oxford: Blackwell Publishing Limited. Daniels, R., Grendell, R., Wilkins, F., (2010). Nursing Fundamentals Caring and Clinical decision making, 2nd ed. USA: Delmar. Gibbs, G., (1988) Learning by Doing: A Guide to Teaching and Learning. London: FEU Guerro, D., (1998) Neuro-Oncology for Nurses. London: Whurr Publishers Hanson, E., (1994). The Cancer Nurses Perspective. Lancaster: Quay Publishing Limited Kenworthy, N., Snowley, G., and Gilling, C., (2002). Common Foundation Studies in Nursing, 3rd ed. Edinburgh: Churchill Livingstone. Nursing and Midwifery Council, (2008) The NMC code of professional conduct: standards for conduct, performance and ethics. London: Nursing and Midwifery Council. Speech disorder, (2009). Cancer cause speech disorder [online] Available at: http://www.speechdisorder.co.uk/cancer-cause-speech-disorder.html (accessed 13.01.2009) Sully, P., Dallas, J., (2005). Essential Communication skills for Nursing, London: Elsevier Mosby. Sundeen, S., Stuart, G., Rankin, E., and Cohen, S., 1998. Nurse-Client Interaction Implementing the Nursing Process, 6th ed. USA: Sally Schrefer. Thurgood, G.[no date]. Verbal handover reports: what skills are needed? [online]. Available at: http://www.internurse.com/cgi-bin/go.pl/library/article.cgi?uid (Accessed 02/11/2009) Wiggens, L., (2006). Communication in clinical settings. Cheltenham:Nelson Thornes Limited

Effects of Childhood Sexual Abuse in Adulthood :: Free Essays Online

Effects of Childhood Sexual Abuse in Adulthood Child abuse is a serious issue in today's society. Many people have been victims of child abuse. There are three forms of child abuse: physical, emotional, and sexual. Many researchers believe that sexual abuse is the most detremental of the three. A middle-aged adult who is feeling depressed will probably not relate it back to his childhood, but maybe he should. The short-term effects of childhood sexual abuse have been proven valid, but now the question is, do the long-term effects of childhood sexual abuse affect middle-aged adults? Many contradicting views arise from the subject of childhood sexual abuse. Researchers and psychologists argue on this issue. Childhood sexual abuse has the potential to damage a child physically, emotionally, and behaviorally for the rest of his or her childhood, and the effects have been connected to lasting into middle-aged adulthood. Research has been conducted on what type of children are the most at risk of being sexually abused. Childhood abuse has a greater chance of happening to children of certain backgrounds. One researcher states that "Child sexual abuse occurs more frequently in children from socially deprived and disorganized family backgrounds. Marital dysfunction, as evidenced by parental separation and domestic violence, is associated with higher risks of child sexual abuse" (Mullen 4). Mullen goes on to state that "The possibility has been raised that characteristics such as physical attractiveness, temperament, or physical maturity might increase the risks of children being sexually abused" (4). Many researchers link behavioral problems in adulthood to childhood abuse. One researcher says that "An adult who was sexually abused as a child has a greater chance of becoming violent, suicidal, and abusive to their children than an adult who was not abused sexually as a child" (Kliest 155). These characteristics could hinder a victim from living a normal lifestyle and having a family. Kliest also states, "Adults who were abused sexually as children will have a greater chance than those who were not of experiencing sexual dysfunction, such as flashbacks, difficulty in arousal, and phobic reactions to sexual intimacy" (156). Many researchers agree that childhood sexual abuse has a negative effect on an adult's personal relationships. Another researcher states, "A history of childhood sexual abuse (CSA) appears to have an adverse impact on the quality of adult intimate relationships, and they report avoiding the development of close adult relationships because of their fear of reject ion" (Whiffen 1103). Effects of Childhood Sexual Abuse in Adulthood :: Free Essays Online Effects of Childhood Sexual Abuse in Adulthood Child abuse is a serious issue in today's society. Many people have been victims of child abuse. There are three forms of child abuse: physical, emotional, and sexual. Many researchers believe that sexual abuse is the most detremental of the three. A middle-aged adult who is feeling depressed will probably not relate it back to his childhood, but maybe he should. The short-term effects of childhood sexual abuse have been proven valid, but now the question is, do the long-term effects of childhood sexual abuse affect middle-aged adults? Many contradicting views arise from the subject of childhood sexual abuse. Researchers and psychologists argue on this issue. Childhood sexual abuse has the potential to damage a child physically, emotionally, and behaviorally for the rest of his or her childhood, and the effects have been connected to lasting into middle-aged adulthood. Research has been conducted on what type of children are the most at risk of being sexually abused. Childhood abuse has a greater chance of happening to children of certain backgrounds. One researcher states that "Child sexual abuse occurs more frequently in children from socially deprived and disorganized family backgrounds. Marital dysfunction, as evidenced by parental separation and domestic violence, is associated with higher risks of child sexual abuse" (Mullen 4). Mullen goes on to state that "The possibility has been raised that characteristics such as physical attractiveness, temperament, or physical maturity might increase the risks of children being sexually abused" (4). Many researchers link behavioral problems in adulthood to childhood abuse. One researcher says that "An adult who was sexually abused as a child has a greater chance of becoming violent, suicidal, and abusive to their children than an adult who was not abused sexually as a child" (Kliest 155). These characteristics could hinder a victim from living a normal lifestyle and having a family. Kliest also states, "Adults who were abused sexually as children will have a greater chance than those who were not of experiencing sexual dysfunction, such as flashbacks, difficulty in arousal, and phobic reactions to sexual intimacy" (156). Many researchers agree that childhood sexual abuse has a negative effect on an adult's personal relationships. Another researcher states, "A history of childhood sexual abuse (CSA) appears to have an adverse impact on the quality of adult intimate relationships, and they report avoiding the development of close adult relationships because of their fear of reject ion" (Whiffen 1103).

Transportation 1788-1868 :: Free Essays Online

Transportation 1788-1868 The process of transporting convicted criminals to Australia came about as a result of Britain's defeat in the American War of Independence. With the loss of this colony, Britain also lost its primary depository for its surplus criminal population; and, for a time, these excess numbers were housed in floating jails - 'hulks' - moored on the Thames. This proved an unpopular policy and so, in 1787, a British fleet set sail to build a penal colony at Botany Bay in New South Wales - seventeen years after James Cook had landed there. Robert Hughes, in his study The Fatal Shore, describes this undertaking as 'a new colonial experiment, never tried before, not repeated since. An unexplored continent would become a jail.' The choice of New South Wales was an unusual one, for Cook had described it as barren, and A.G.L. Shaw notes in Convicts and the Colonies that 'it seemed wholly useless for trade'. It would appear that all the British government required was a place to dispose of its criminal classes and subsequently forget about them, ignoring commercial considerations. The inhospitable nature of the place seemed ideal for ne'er-do-wells, and its distant location meant that few were likely to return. Many crimes, from petty theft to murder, were deemed worthy of transportation, and there seems to have been little distinction made between types of criminal, which concerned social reformers of the time. Household Words expressed concern that 'hardened ruffians of the deepest dye were chained hand to hand, during a six month voyage, with simple country poachers, pickpockets of tender age, and sailor smugglers.' All prisoners were treated alike, and conditions were harsh; appalling living conditions, disease, hunger, floggings and general neglect were prevalent and many convicts died en route or upon arrival. However there was hope on the horizon for some prisoners; those who behaved well were hired out to emigrant farmers to become, like Dickens' Magwitch, 'sheep farmer(s), stock breeder(s) and other trades besides.' Thus convicts could make some sort of return to respectability. Not only that: those who had completed their terms were granted small plots of land, with the aim of boosting the local economy and ensuring that these undesirable - regardless of whether their crimes were 'worked out and paid for' - did not return to British shores. The response from the metropolitan centre to these emancipist settlers who flourished was one of outrage; they feared that transportation would be perceived as a great blessing by the criminal classes, rather than as a deterrent.

This Comfortable Cage Called America :: Personal Narrative Essays

This Comfortable Cage Called America    My brothers have a cage in which they keep two iguanas.   I'm sure these creatures were born in captivity, and I assume they will die in the same cage they are in now.   It's not a bad cage.   There are quite a few square feet for them to run around, there is a stick they can climb up and down, there is a heat rock they can relax on, and they have everything they need to survive at their clawtips.   They don't even need to hunt for their meals because their meal tickets (my brothers) provide them with four square meals a day.   They can see outside their cage, but have no idea what it would be like to live outside.   I often wonder, however, what would happen if we were to set these two animals free in what would be considered a natural habitat for most iguanas in the wild.   Would they be likely to adapt in no time at all, or would they look for a nice place with four glass walls and a stick to play on?   And how could this story about two lizards, even if used metap horically, apply to us as a race?   We are responsible for our entrapment within four similar glass walls, yet we are not aware of them.   Inside of a cage called America we sit, and though we have a great view of the rest of the world, that's all it is-a view.   If we could somehow find a way of recognizing and breaking out of this comfortable cage called life, we would be more capable of coming together as a human race and putting an end to a division so obvious that terms such as "first world" and "third world" are created to define the differences.   Although I will incorporate the use of a few references, the main section of this essay will focus on my own experiences of life in another country which, in its own way, was another world.      Ã‚  Ã‚  Ã‚   I was taught little in school or home about cultures and people other than my own.   Was theple other than my own.   Was there a reason I should have learned about a less productive people in some remote country?   There was nothing wrong with the land of the free and the home of the brave, and whether or not I was culturally diverse was of little importance in my life-until I went to live in a different country.

A Whale Hunt :: essays research papers

Envision the Makah nation before white men came to reduce their lands, diminished their way of life, and contaminate them with new diseases. The Makah tribe was once free to roam along the dark sandy beaches of the Olympic Peninsula and experience the fiery glow of the sinking sun creep into the depths of the vast Pacific Ocean. They are no longer able to undergo this majestic cycle in the same tranquility that their ancestors once did. After dealing with the inequities that were brought upon them by the European settlers, such as being forced to speak a new language and being confined to a minute area of land, that cannot compare to the greatness of the territory where they once lived. On top of that their traditional whale hunt was abstracted from their community. Now with the chance to hunt again, the Makah faced a difficult decision against the opposition. The Makah tribe decided to return to hunting the whale in attempt to restore their culture and traditions. They agreed not t o use the hunt for commercial purposes and to hunt the whale in the same way their ancestors did. I think the Makah nation should be able to hunt the whale as means of renewing their culture and pride. The whale hunt provides the Makah with the ability to restore their culture and traditions, provide reparations for America's mistreatment, all while following strict guidelines for the crew and the process of taking the whale. The Makah’s decision to hunt the whale produced hostile reactions among the many supporters of the whale. Protestors from around the world arrived in mass. They were very unsympathetic, rude, and even aggressive toward the Makahs. An example of this is shown by their behavior toward the Makahs: Very soon, a woman shouted at the crew, ‘Real men don’t kill animals! Only a coward kills whales! You are a coward and a sissy!’ Another woman shouted that the Makah shouldn’t have special rights just because they were Indians. Another woman said her soul was connected to the soul of the gray whale. (Sullivan 136) This shows the emotion that the protestors brought to the controversy against the hunt. Their argument is that the whale is sacred to them too, and that slaughtering the whale is a criminal act. Everybody involved in the hunt is not perfect, but everybody deserves a chance.

Ceremony: Native Americans in the United States Essay

In Leslie Marmon Silko’s Ceremony, the use of storytelling is quite prevalent. Within the framework of Ceremony there are references of the tradition of Native American storytelling along with the progression of telling a story. Storytelling within the Native American culture is oral, traditionally. The method of storytelling within Ceremony at the beginning lays down the framework of the entire book. Silko starts out the novel with a series of stories. The first of which is about Ts’its’tsi’nako (or more easily said) â€Å"Thought Women†, who thinks of things and they appear. She happens to be thinking of a story and it just so happens to be the story being told to us. This then leads us to the next story (1). The next story turns out to be a story about stories. This story tells us (the reader) the importance of stories, and that they aren’t merely for entertainment, but are used to fight off death and illness. The narrator then states, â€Å"You don’t have anything, if you don’t have the stories.† Thus telling us the true importance of the stories of Native American culture, seeing as everything was passed down orally, and not much was written down if any at all (2). Now, for Tayo, these stories embody the understanding of the Native American world Tayo grew up with. Only the army, the doctors, and the white schools try to convince Tayo that the stories are wrong. As Tayo recreates and recalls the old tales, he begins to reunite with the community, pulls through the trauma of war, and ultimately brings back the rain to his land. Tayo learns from these stories that he is not alone, because the stories are shared within a community, and because the contents of the stories show him that others have shared like experiences (Notes/Class Discussions). The rest of the stories within the text of Ceremony announce elements that will reoccur within the novel. As the story is told either by a single person or by a group of people, it can fashion between those people a sense of community. As stated previously, that stories have the power to fight of death and illness. The stories contain the ceremonies and rituals that have the ability to cure individuals and the communities. Stories are able to provide this ability by restoring the affiliations betwixt all things and people. The stories within Ceremony are an integral part of the story line. The stories within the novel show us how important they are to the Native American culture and way of life. They provide us with the impending points of the plot, of how a ceremony is what can cure the people. Bibliography: Silko, Lesie Marmon; Viking Peguin Inc. 1977

Investigation in Microtubule Dynamic Instability

Title: Investigation in microtubule dynamic instability Introduction Microtubules are important for maintaining cell structure, intracellular transport, formation of mitotic spindle, as well as other cellular processes. Investigation of dynamics of microtubule assembly and disassembly allow us to understand the malfunction of mitotic spindle formation or other cellular processes. This experiment is divided into two parts; we are going to find out the critical parameters for achieving greatest average length of microtubules in part one and achieving the greatest number of microtubules in part two.Principle In this experiment, we used a simulation programme to explore how various factors change the way microtubules grow out from centrosome, and the shrink back. Growth rate, shrink rate, catastrophe rate, rescue rate, release rate, minus end end depolymerization rate, nucleation rate and nucleation site are the factors we can adjust to see how them affects the average length and number of microtubules. The simulation time acceleration is set to 5x real time. Each time a parameter is varied and others are controlled factors.The record is taken when the simulation has reached steady state and graphs are plotted. Results Part1 – How to achieving greatest average length of microtubules Fixed parameter| Shrink rate| Catastrope| Rescue Release| MED| Nuc rate| Nuc sites| Variable Growth rate| 0. 263| 0. 042| 0. 064 0. 024| 0. 8| 0. 02| 180| Result| 1| 2| 3| 4| 5| Mean| 0. 14| 32. 9| 21. 12| 23. 93| 23. 95| 27. 54| 25. 888| 0. 16| 33. 19| 36. 82| 32. 5| 28. 83| 30. 15| 32. 298| 0. 18| 29. 79| 39. 11| 41. 19| 40. 8| 31. 54| 36. 486| 0. 2| 40. 77| 41. 19| 45. 94| 38. 28| 47. 66| 42. 768| 0. 22| 38. 6| 47. 49| 48. 53| 48. 55| 47. 96| 46. 238| 0. 24| 42. 25| 45. 31| 45. 25| 46. 81| 40. 95| 44. 114| Table1 Figure1 Fixed parameter| Growth rate| Shrink rate| Catastrop/ Release| MED| Nuc rate| Nuc cites| Variable Rescue| 0. 12| 0. 263| 0. 042 0. 024| 0. 8| 0. 02| 180| Resu lt| 1| 2| 3| 4| 5| mean| 0. 084| 23. 76| 22. 77| 26. 56| 30. 78| 25. 12| 25. 798| 0. 104| 18. 88| 19. 07| 17. 82| 20. 08| 17. 55| 18. 68| 0. 124| 19. 96| 16. 69| 17. 37| 19. 37| 22. 38| 19. 154| 0. 144| 21. 34| 19. 53| 20. 54| 21. 44| 21. 95| 20. 96| 0. 164| 20. 65| 18. 76| 21. 76| 16. 33| 19. 73| 19. 446|Table2 Figure 2 Discussion Each free tubulin dimer contains one tightly bound GTP molecule that is hydrolyzed to GDP after the subunit is added to a growing microtubules. When polymerization is proceeding rapidly, tubulin molecules add to the end of the microtubule faster that the GTP they carry is hydrolyzed, and the microtubule growth. [1] Varied the growth rate and kept other factors constant, the average length of microtubules should always increase. However, the average length of microtubules rises as growth rate increase from 0. 14 to 0. 22Â µm/sec and stop increasing at 0. 2Â µm/sec. It tends to level off rather than increase at 0. 22Â µm/sec. It means the growth rate is no longer the limiting factor. Some factors other than growth rate, may be the rescue rate, limited the increase of the average length. Rescue rate is the rate at which a shrinking microtubule switches to growing state. We assume the greatest rescue rate, the more the microtubules undergo polymerization. So that the proportion of growing microtubules would increase and the average length rise. Instead of increase, the average length of microtubules drops from 0. 084 to 0. 104Â µm/sec.Increase the rescue rate may trigger the mechanism that lowers the average length of microtubules. It remains at around 20Â µm from 0. 104 to 0. 164Â µm/sec means that that there is no correlation between rescue rate and the average length beyond a point among 0. 084 and 0. 104Â µm/sec. Part2 – How to achieve the greatest number of microtubules Fixed parameter| Growth rate| Catastrop| Rescue Release| MED| Nuc rate| Shrink rate| Variable #nuc site| 0. 12| 0. 042| 0. 064 0. 024| 0. 8| 0. 02| 0. 263| Result| 1| 2| 3| 4| 5| mean| 180| 47| 65| 42| 57| 68| 55. 8| 200| 70| 77| 66| 53| 68| 66. | 220| 71| 73| 86| 70| 68| 73. 6| 240| 82| 88| 85| 81| 84| 84| 260| 90| 93| 80| 81| 84| 85. 6| 280| 87| 107| 100| 97| 91| 96. 4| 300| 90| 101| 110| 92| 96| 97. 8| Figure3 Fixed parameter| Growth rate| Shrink rate| Catastrop| Rescue Release| MED| Nuc cites| Variable nuc rate| 0. 12| 0. 263| 0. 042| 0. 064 0. 024| 0. 8| 180| Result| 1| 2| 3| 4| 5| mean| 0. 02| 62| 57| 49| 54| 50| 54. 4| 0. 04| 95| 107| 85| 80| 86| 90. 6| 0. 06| 103| 110| 107| 113| 114| 109. 4| 0. 08| 120| 99| 112| 113| 115| 111. 8| 0. 1| 124| 134| 126| 116| 113| 122. 6| 0. 12| 120| 131| 130| 119| 136| 127. | 0. 14| 136| 128| 127| 130| 136| 131. 4| Table4 Figure4 Discussion Centrosomes contain ring-shaped structures formed from ? -tubulin, and each ? -tubulin ring serves as the starting point, the nucleation site, for the growth of one microtubule. The nucleation site acts as a preexisting microtubule structure for -tubulin dimers assembly. [1] We assume the more the nucleation site, the more the microtubules present. According to table3, the number of microtubules is always increasing with the number of nucleation site. There is no sign of level off or decline of the curve.It always is the limiting factor of the number of microtubules. The nucleation rate is the rate at which new microtubules are nucleated at the centrosome. The number of microtubules should be raised if the nucleation rate increase since new microtubules generated. Indeed, the number of microtubules is raised as the nucleation rate increased. From 0. 02 to 0. 06Â µm/sec, the increase of microtubules is sharp and starts to slow down afterward. The trend shows that the curve would level off at certain level eventually. It means there are some factors other than nucleation rate control the number of microtubules.The number of nucleation site may be the limiting factor as all nucleation sites are occupied by the microtubules, so that n o new microtubules generated. Limitations In actual cell, the number of tubulin dimer is limited. This factor is not shown in this simulation programme. The temperature and the pH may affect the configuration and polymerization of the microtubules. There are some microtubules not attached to the centrosome, but present in cilia and flagella. It is not clearly stated by the simulation programme whether these microtubules is counted. ConclusionsBesides the growth rate, there are other limiting factors controlling the average length of microtubules. We cannot achieve the greast average length of microtubules by consider growth rate is the only factor. We found that we should keep the rescue rate at 0. 084Â µm/sec or below. Also, more information about the rescue rate below 0. 084Â µm/sec should be obtained. Both nucleation site and nucleation rate are the factors controlling the number of microtubules. But the nucleation site is more critical than the nucleation site. The above show the nucleation rate is restricted by other factors but the nucleation sites does not.We should examine another set of data by varying the nucleation rate with more nucleation site. If the plateau of new obtain curve is above the original curve, nucleation site is limiting factor of the number of microtubules. Similar experiment should be established with different combination of parameters in order to obtain the best curve. In short, there is not enough information for us to draw conclusion for how to achieve the greatest average length and greatest number of microtubules unless we obtain more data. Reference 1. Alberts et al,. (2010) Essential Cell Biology, 3rd Garland Science, p. 579-580