Topic 7 Aging, Death, and Bereavement.pptx

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Aging is associated with declines in physical and brain health, including decreased brain weight and blood flow as well as increased amyloid plaques and tangles. Some memory problems may occur in normal aging along with changes in sleep patterns and increased anxiety or fearfulness. The process of dying typically involves stages of denial, anger, bargaining, depression, and acceptance according to Kübler-Ross. Bereavement or normal grief generally subsides within 1-2 years, though special occasions may trigger return of symptoms, while complicated bereavement resembling depression is characterized by more severe and long-lasting symptoms.

Design

Aging, Death, and
Bereavement
Lijodi Brenda

Somatic and neurologic changes in aging
 Strength and physical health gradually decline.
 Changes in the brain occur with aging. These changes include
 Decreased brain weight, enlarged ventricles and sulci, and decreased cerebral
blood flow.
 Amyloid (senile) plaques and neurofibrillary tangles are present in the normally
aging brain but to a lesser extent than in neurocognitive disorder due to
Alzheimer’s disease. Neurochemical changes that occur in aging include decreased
availability of neurotransmitters such as norepinephrine, dopamine, γ-
aminobutyric acid, and acetylcholine. These changes can be associated with
psychiatric symptoms such as depression and anxiety

Cognitive changes in aging
 Some memory problems m ay occur in norm al aging

Psychological changes
 In late adulthood, there is either a sense o ego integrity (i.e., satisfaction and
pride in one’s past accomplishments) or a sense o despair and worthlessness
(Erikson’s stage of ego integrity vs. despair). Most elderly people achieve ego
integrity.
 Psychopathology and related problems
 Depression
 Sleep patterns change, resulting in loss o sleep, poor sleep quality, or both
 Anxiety and ear ulness m ay be associated with realistic ear-inducing
situations (e.g., worries about developing a physical illness or alling and
breaking a bone).

Stages
 According to Dr. Elizabeth Kübler-Ross, the process of dying involves five
stages: denial, anger, bargaining, depression, and acceptance
 Denial. The patient re uses to believe that he or she is dying. (“The
laboratory made an error.”)
 Anger. The patient m ay become angry at the physician and hospital stay . (“It
is your adult that I am dying.
 Bargaining. The patient may try to strike a bargain with God or some higher
being. (“I will give half of my money to charity if I can get rid o this
disease.”)
 Depression. The patient becomes preoccupied with death and may become
emotionally detached

Stages
 Acceptance. The patient is calm and accepts his or her ate

BEREAVEMENT (NORMAL GRIEF) VERSUS
COMPLICATED BEREAVEMENT (DEPRESSION)
Characteristics of normal grief (bereavement)
 Grief is characterized initially by shock and denial.
 In normal grief , the bereaved m ay experience an illusion that the deceased
person is physically present.
 Normal grief generally subsides after 1–2 years, although some features may
continue longer. Even after they have subsided, symptoms m ay return on
holidays or special occasions (the “anniversary reaction”).
 The mortality rate is high or close relatives (especially widowed men) in the
first year of bereavement.

Normal vs abnormal bereavement
Normal Grief Reaction (Bereavement)
 Minor weight loss (e.g.< 5 pounds)
 Minor sleep disturbances
 Mild guilty feelings
 Illusions
 Attempts to return to work and social
activities
 Cries and expresses sadness
 Severe symptoms resolve within 2
months
 Moderate symptoms subside within 1
y
Complicated Grief Reaction
(Depression)
 Significant weight loss (e.g., >5% of
body weight)
 Significant sleep disturbances
 Intense feelings of guilt and
worthlessness
 Hallucinations or delusions
 Resumes few, if any, work or social
activities
 Considers or attempts suicide
 Severe symptoms persist for >2 mo

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able of ContentsIntroductionObjectives of Giemsa stainPrincipleReagents UsedProcedureStaining procedure 1: Thin Film stainingStaining Procedure 2: Thick Film StainingResultsInterpretation/ConclusionApplications Giemsa stainAdvantagesLimitationsReferencesFour Charged in Plot to Kidnap an Iranian Journalist in New YorkIntroductionGiemsa stain was a name adopted from a Germany Chemist scientist, for his application of a combination of reagents in demonstrating the presence of parasites in malaria.It belongs to a group of stains known as Romanowsky stains. These are neutral stains made up of a mixture of oxidized methylene blue, azure, and Eosin Y and they performed on an air-dried slide that is post-fixed with methanol. Romanowsky stains are applied in the differentiation of cells, pathological examinations of samples like blood and bone marrow films and demonstration of parasites e.g malaria. There are four types of Romanoswsky stains:Giemsa stainJenner StainWright stainMay-Grunwald StainLeishman stainObjectives of Giemsa stainTo accurately prepare the Giemsa stain stock solutionTo stain and identify blood cellsTo differentiate blood cells nuclei from the cytoplasmPrincipleGiemsa stain is a gold standard staining technique that is used for both thin and thick smears to examine blood for malaria parasites, a routine check-up for other blood parasites and to morphologically differentiate the nuclear and cytoplasm of Erythrocytes, leucocytes and Platelets and parasites.Like any type of Romanowsky stains, it composed of both the Acidic and Basic dyes, in relation to affinities of acidity and basicity for blood cells. Azure and methylene blue, a basic dye binds to the acid nucleus producing blue-purple color. Eosin is an acidic dye that is attracted to the cytoplasm and cytoplasmic granules which are alkaline-producing red coloration. The stain must be buffered with water to pH 6.8 or 7.2, to precipitate the dyes to bind simple materials.Classically, Giemsa stain is a differential stain which is made up of a combination of reagents (Azure, Methylene blue, and Eosin dye) used widely in cytogenetics and histopathology for the diagnosis of:Malaria, spirochetes and other blood parasitesChlamydia trachomatis inclusion bodiesBorrelia sppYersinia pestisHistoplasma sppPneumocystis jiroveci cystsReagents UsedMethanolGiemsa powderGlycerinWater (Buffer)ProcedurePreparation of the Giemsa Stain Stock solution (500ml)Into 250ml of methanol, add 3.8g of Giemsa powder and dissolve.Heat the solution up to ~60oCThen, add 250ml of glycerin to the solution, slowly.Filter the solution and leave it to stand for about 1-2 months before use.Preparation of Working solutionAdd 10ml of stock solution to 80ml of distilled water and 10ml of methanolStaining procedure 1: Thin Film stainingOn a clean dry microscopic glass slide, make a thin film of the specimen (blood) and leave to air dry.dip the smear (2-3 dips) into pure methanol for fixation of the

HCM 124 lecture 8 Malaria.pptx

elphaswalela

nd invade the genital ridges in the sixth week of development. here they form primitive sex cords. in the absence of tdf, medullary cords disappear and get replaced by a vascular stroma (ovarian medulla). cortical cords develop and surround one or more primitive germ cells. the germ cells subsequently develop into oogonia, while the surrounding epithelial cells form the follicular cells. this differentiates undifferentiated gonads into ovaries. stroma of ovary develops from basal mesenchyme. granulosa and theca cells develop from celomic epithelium. development of genital ducts development of genital duct system and the external genitalia occurs under the influence of hormones circulating in the fetus. sertoli cells in the fetal testes produce a nonsteroidal substance known as müllerian inhibiting substance (mis) that causes regression of müllerian ducts. androgen from the fetal testes causes masculinization of external genitalia. in the absence of mis, müllerian ducts develop and mesonephric duct system regresses. in the absence of androgen, external genitalia differentiate into female phenotype. the müllerian duct develops between the fifth and sixth weeks lateral to intermediate cell mass and wolffian duct. the müllerian duct has the following three parts: •cranial vertical portion that opens into celomic cavity. later it differentiates into fallopian tubes. •horizontal part crosses the mesonephric duct. •caudal vertical part that fuses with its partner from opposite side. this fused part later differ entiates into uterus, cervix, and upper one-third of the vagina. the dorsal celomic epithelium (which forms müllerian duct) remains open at its site of origin and ultimately forms the fimbriated ends of the fallopian tubes. at their point of origin, each of the müllerian ducts forms a solid bud. each bud penetrates the mesenchyme lateral and parallel to the wolffian duct. as the solid buds elongate, a lumen appears in the cranial part, beginning at each celomic opening. the caudal end of each müllerian duct crosses the way

HCM 124 lecture 6.pptx

elphaswalela

and invade the genital ridges in the sixth week of development. here they form primitive sex cords. in the absence of tdf, medullary cords disappear and get replaced by a vascular stroma (ovarian medulla). cortical cords develop and surround one or more primitive germ cells. the germ cells subsequently develop into oogonia, while the surrounding epithelial cells form the follicular cells. this differentiates undifferentiated gonads into ovaries. stroma of ovary develops from basal mesenchyme. granulosa and theca cells develop from celomic epithelium. development of genital ducts development of genital duct system and the external genitalia occurs under the influence of hormones circulating in the fetus. sertoli cells in the fetal testes produce a nonsteroidal substance known as müllerian inhibiting substance (mis) that causes regression of müllerian ducts. androgen from the fetal testes causes masculinization of external genitalia. in the absence of mis, müllerian ducts develop and mesonephric duct system regresses. in the absence of androgen, external genitalia differentiate into female phenotype. the müllerian duct develops between the fifth and sixth weeks lateral to intermediate cell mass and wolffian duct. the müllerian duct has the following three parts: •cranial vertical portion that opens into celomic cavity. later it differentiates into fallopian tubes. •horizontal part crosses the mesonephric duct. •caudal vertical part that fuses with its partner from opposite side. this fused part later differ entiates into uterus, cervix, and upper one-third of the vagina. the dorsal celomic epithelium (which forms müllerian duct) remains open at its site of origin and ultimately forms the fimbriated ends of the fallopian tubes. at their point of origin, each of the müllerian ducts forms a solid bud. each bud penetrates the mesenchyme lateral and parallel to the wolffian duct. as the solid buds elongate, a lumen appears in the cranial part, beginning at each celomic opening. the first time

Medical Mycology.pptx

elphaswalela

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Topic 7 Aging, Death, and Bereavement.pptx

1. Aging, Death, and Bereavement Lijodi Brenda

2. AGING

3. Somatic and neurologic changes in aging  Strength and physical health gradually decline.  Changes in the brain occur with aging. These changes include  Decreased brain weight, enlarged ventricles and sulci, and decreased cerebral blood flow.  Amyloid (senile) plaques and neurofibrillary tangles are present in the normally aging brain but to a lesser extent than in neurocognitive disorder due to Alzheimer’s disease. Neurochemical changes that occur in aging include decreased availability of neurotransmitters such as norepinephrine, dopamine, γ- aminobutyric acid, and acetylcholine. These changes can be associated with psychiatric symptoms such as depression and anxiety

4. Cognitive changes in aging  Some memory problems m ay occur in norm al aging

5. Psychological changes  In late adulthood, there is either a sense o ego integrity (i.e., satisfaction and pride in one’s past accomplishments) or a sense o despair and worthlessness (Erikson’s stage of ego integrity vs. despair). Most elderly people achieve ego integrity.  Psychopathology and related problems  Depression  Sleep patterns change, resulting in loss o sleep, poor sleep quality, or both  Anxiety and ear ulness m ay be associated with realistic ear-inducing situations (e.g., worries about developing a physical illness or alling and breaking a bone).

6. STAGES OF DYING AND DEATH

7. Stages  According to Dr. Elizabeth Kübler-Ross, the process of dying involves five stages: denial, anger, bargaining, depression, and acceptance  Denial. The patient re uses to believe that he or she is dying. (“The laboratory made an error.”)  Anger. The patient m ay become angry at the physician and hospital stay . (“It is your adult that I am dying.  Bargaining. The patient may try to strike a bargain with God or some higher being. (“I will give half of my money to charity if I can get rid o this disease.”)  Depression. The patient becomes preoccupied with death and may become emotionally detached

8. Stages  Acceptance. The patient is calm and accepts his or her ate

9. Bereavement

10. BEREAVEMENT (NORMAL GRIEF) VERSUS COMPLICATED BEREAVEMENT (DEPRESSION) Characteristics of normal grief (bereavement)  Grief is characterized initially by shock and denial.  In normal grief , the bereaved m ay experience an illusion that the deceased person is physically present.  Normal grief generally subsides after 1–2 years, although some features may continue longer. Even after they have subsided, symptoms m ay return on holidays or special occasions (the “anniversary reaction”).  The mortality rate is high or close relatives (especially widowed men) in the first year of bereavement.

11. Normal vs abnormal bereavement Normal Grief Reaction (Bereavement)  Minor weight loss (e.g.< 5 pounds)  Minor sleep disturbances  Mild guilty feelings  Illusions  Attempts to return to work and social activities  Cries and expresses sadness  Severe symptoms resolve within 2 months  Moderate symptoms subside within 1 y Complicated Grief Reaction (Depression)  Significant weight loss (e.g., >5% of body weight)  Significant sleep disturbances  Intense feelings of guilt and worthlessness  Hallucinations or delusions  Resumes few, if any, work or social activities  Considers or attempts suicide  Severe symptoms persist for >2 mo

Topic 7 Aging, Death, and Bereavement.pptx

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Topic 7 Aging, Death, and Bereavement.pptx