Effective and non-effective medications used to treat OxyContin Research Paper

Effective and non-effective medications used to treat OxyContin addiction - Research Paper Example Effective and Non-effective Medications Used to Treat OxyContin and Opioid Addiction OxyContin is an extended release form of oxycodone, which was approved by the Food and Drug Administration in 1995 for the treatment of chronic pain. The FDA approval of this drug has played a role in overdose and death, as well as addiction, in the recent past (Okie, 2010). The molecular structure of OxyContin is similar to that of morphine, and is a member of the Phenanthrene family of compounds. OxyContin, or oxycodone, is a schedule II drug according to the Drug Enforcement Agency, and is used to treat moderate to severe pain and is DEA listed as a highly addictive medication. The drug itself, and not the metabolites, is the main cause of analgesia (Trescot et Al., 2008). Oxycodone and morphine were compared for similar psychotropic effects and dosage in healthy humans. It was found that the dosage ratio of oxycodone and morphine was approximately 3:1, as had been established in previous studies, but that the subjects experienced more pronounced psychotropic effects with oxycodone. The relief of pain, however, was similar with both drugs. Psychomotor impairment was similar with both drugs as well (Zacny and Lichtor, 2007). Intravenous administration of oxycodone, hydrocodone, and morphine was studied in healthy individuals to determine effects and potency. It was discovered that all three drugs had similar effects inducing dysphoria. However, potency was determined to be greatest in oxycodone, then morphine, then hydrocodone (Stoops et Al., 2010). The effects of oxycodone were compared to those of lorazepam and morphine in healthy individuals. Psychotropic effects were more pronounced in oxycodone treated patients compared to those treated with lorazepam. Unpleasant effects as determined by the patients were greater in oxycodone treated patients compared to those of lorazepam (Zachney and Gutierrez, 2002). Opioid withdrawal suppression was examined in healthy individuals wi th tramadol. After a regimen of oxycodone higher doses of tramadol suppressed withdrawal effects, as studies indicated. Feelings of sickness and nausea were initially associated with these effects, followed by suppression of oxycodone withdrawal effects. It was suggested that tramadol may be an effective drug for treating oxycodone withdrawal effects in humans (Lofwall et Al. 2007). Tramadol has low rates of diversion and abuse and mixed pharmacologic actions, including modest opioid agonist activity, and is an unscheduled atypical analgesic. To characterize the opioid withdrawal suppression efficacy of oral tramadol was the purpose of the study. Opioid dependent, residential adults were maintained on morphine for approximately six weeks. Substituting placebo for scheduled morphine doses 17.5 hours before experimental sessions that occurred twice weekly was the method for producing spontaneous opioid withdrawal. Under double-blind, double- dummy, randomized conditions, the acute eff ects of placebo, tramadol, naloxone, and morphine were tested. Outcomes included physiologic indices, psychomotor/cognitive task performance, and observer- and subject-rated measures. Prototypic opioid antagonist and agonist effects were produced by naloxone and morphine, respectively. Effects most similar to placebo were produced by Tramadol 50 and 100 mg. Tramadol 200 and 400 mg initially produced significant dose-related increases in ratings of â€Å"

Text Set-Literacy Curriculum Research Paper Example | Topics and Well Written Essays - 500 words

Text Set-Literacy Curriculum - Research Paper Example This leaves no room for ambiguity for students at the same time in understanding the subject matter. It is rather suggested that teachers should undertake activities in class where students will have to select short text as per their choice. However, a limitation is there in this regard i.e. teacher’s obligation for reading each and every story that the students pick as a short text. For this, it can be said that short text is much manageable in reading (Fletcher & Portalupi, 2001). It immediately finishes up in one sitting rather than longer novels that are continued for some days. Looking at the real life examples of reading habits of general public, short text such as tweets, how-to articles, cookbooks, announcements, online forums are read more than longer books. Therefore, there is an avid need of making reading interesting for peers that is possible with the help of short text selection (Cohen,

The Exploration of Womanhood in All About My Mother Essay Example for Free

The Exploration of Womanhood in All About My Mother Essay In his critically acclaimed 1999 character-driven drama film All About My Mother (1999); writer-director Pedro Almodovar cements his reputation as an expert on the complexities and intricacies of womanhood. The film features several complex and multi-layered female characters that are portrayed with great emotional depth. Throughout the course of the film, these characters are forced to struggle with impediments such as loss, betrayal and societal prejudice. Yet, in the end, they triumph over these obstacles and take control of their lives. The protagonist of the film, Manuela, suffers the loss of her son, Esteban, early in the film and is prompted to go on a journey to Barcelona, where she meets other women who are dealing with their own issues in life. Through the events that take place in Manuela’s life and the relationships she forms with these other female characters following Esteban’s sudden and tragic death, the film explores the trials and tribulations women universally face and the various ways in which they cope and deal with these ordeals. The film also pays homage to two of the most influential representations of female characters in cinematic history: All About Eve (1950) and A Streetcar Named Desire (1951). The plot structure of the film serves to outline the various stages that take place in Manuela’s life at the wake of Esteban’s death, and, by extension, exposes the anatomy of how one in general deals with loss and tragedy. The film follows a linear plot structure that begins right before the death of Esteban and ends a few years later, when Manuela manages to overcome the tragedy. During the exposition, the character of Esteban and his relationship with his mother are introduced and built up. This contributes to the great shock and sympathy the audience feels when he unexpectedly dies in a car accident immediately after. The exposition also addresses the issue of suffering the loss of a loved one through sequences involving the reactions of the family members of recently demised individuals. Manuela’s subsequent journey to Barcelona signifies her immediate reaction to delve into the past and inability to move on in her life. Her goal is to locate Esteban’ s father and inform him of his death. However, upon reaching there, she appears to begin the process of forgetting her sorrows and beginning a new life. When she returns on the same train to Madrid, her priorities shift to her new adopted son, also named Esteban. In the concluding segments of the film, frequent jumps in time are used to display how life begins to move faster once Manuela is no longer holding on to her loss. In the closing sequence, when Manuela visits Barcelona again, all the characters are shown to have overcome the struggles of their past and moved on in life. The structure of the narrative is quite unconventional and serves to explore the intricacies of the characters rather than present much action. Initially, the plot seems to be goal-driven and based on uncovering Manuela’s quest to find Lola – Esteban’s father. From the beginning of the movie, suspense is created about the father, when Esteban repeatedly inquires about him. However, as Manuela reaches Barcelona and her life gets intertwined with other women who are trying to cope with their own problems, the plot loses a sense of purpose a nd no longer has a clear direction. This lack of focus parallels Manuela’s state of mind. Manuela is in a period of self-discovery and does not have a specific goal in life at this point in the narrative. It also allows the film to freely explore the lives of these different women and achieve a level of emotional depth into their characters, and the issues they face. The audience, however, is gradually made aware of Manuela’s past and her relationship with Lola. In addition, she does end up meeting Lola, even though her priorities have changed by this point. Manuela’s past is revealed to be full of betrayal and loss, which puts her struggle to overcome it during the course of the movie into context. It is the struggles and triumphs of the characters in the film, led by the protagonist Manuela, that drive the narrative and keep the audience engaged. The film employs a first-person point of view, as we witness the events of the plot through the eyes of Manuela. This provides an emotional connect between the audience and Manuela while she faces the loss of her son and endeavors to recover from it. During her train journeys between Madrid and Barcelona, Manuela’s inner thoughts are revealed though voice-over narrations. Each time she boards the train, she is at a different stage in her recovery process and her thoughts drastically change over time. The voice-overs help to reveal details from her past to the audience as well as her plans for the future. Although Manuela acts as the protagonist of the narrative, there are several peripheral characters in the film that help to move it forward. Upon reaching Barcelona, Manuela’s life is intertwined with many different female characters that are struggling with their own problems. As Manuela gets progressively more involved in the lives of these characters, she begins to leave her own sorrows behind. These characters also represent the different kinds of problems women face. Manuela, Agrado and Sister Rosa are linked by the fact that the same man, Lola, has adversely affected all three of their lives. Manuela also gets entangled in the lives of Huma and Nina, when she becomes their secretary. The wide variety of problems these women face includes betrayal, neglect, societal prejudice and drug addiction. The ways in which they each deal with these problems also differs. They also end up helping each other in different ways to get over their troubles. These characters represent every woman. They play the roles of mothers, sisters, lovers and friends. They also come from different backgrounds; a prostitute, a nun and an actress. With Manuela at the center, the relationships that develop and grow between these female characters changes the nature of the plot from a search for Esteban’s father to a celebration of womanhood. It also provides hope for the future, through the solidarity of their friendship. At one point, the plot becomes increasingly complex, with Manuela acting as a nurse to Sister Rosa, secretary to Huma and trying to get over her son’s loss all at the same time. Yet, the manner in which these inter-relationships are presented is seamless. The script includes several recurring motifs and cultural allusions that reinstate the challenges faced historically by women and suggest different mechanisms that they have used to cope with these hardships. It is often said that life and art have a reciprocal relationship; while art is usually based on life, life is in turn often influenced by art as well. This idea is highlighted throughout the script of All About My Mother (1999). In particular, two cinematic classics that deal with gender issues; All About Eve (1950) and A Streetcar Named Desire (1951), are strongly woven into the narrative of the film. In fact, the title of the film is a reference to the title All About Eve (1950). Moreover, Almodovar draws numerous parallels between his narrative and the plots of these two films. Manuela is forced to depend on the â€Å"kindness of strangers† on many occasions, just like Blanche in A Streetcar Named Desire (1951). In addition, she acts as an understudy for the role of S tella, usually played by Nina, and ends up giving a stellar performance; similar to the way Eve steals the role of her idol Margo in All About Eve (1950). Long sequences with scenes from a television broadcast of All About Eve (1950) and enactments of A Streetcar Named Desire also make their way into the script. These works, through the characters of Eve Harrington, Blanche DuBois and Stella Kowalski, represent three diametrically opposite ways of dealing with the injustices faced by women. While Eve displays a ruthless ambition and drive to overcome the traditional prejudices of the theatre establishment against women actors, Blanche distorts her view of the world as a means of escape and Stella displays a submissive acceptance to the status quo tries to adapt with the harsh realities of traditional gender roles. The female characters of All About My Mother, and especially its protagonist Manuela, adopt all three of these different stances at different periods of time in the film. Sister Rosa, much like Stella, accepts her fate without questioning when when she contracts HIV. In contrast, Agrado shows great Eve-like courage when she attempts to take control of her life through plastic surgery and when she remains unaffected by the physical and psychological violence of her clients. Yet, there is a part of each of these fictional icons and their ideologies in all of these characters, and in every woman in general. Art in various forms, such as theatre and cinema, also acts as a structuring motif in the film. The concept of art and storytelling are touched upon through Esteban’s ambitions of becoming a writer, Manuela’s past as an actor and the productions of A Streetcar Named Desire starring Nina and Huma. The role of art as a source of inspiration for women and its power to influence their lives is encapsulated by Huma’s confession, â€Å"I started smoking because of Bette Davis†. Moreover, the potential of art to be used as a means of escapism is exhibited through Manuela’s repeated viewings of A Streetcar Named Desire after the death of Esteban. The idea of escapism as a means to cope with the harsh realities of life is further exemplified through Nina’s heroin addiction. One of the most important motifs presented by the script is the train that Manuela takes to travel between Madrid and Barcelona. Each time she travels in the train, she enters a new phase of her life. The train symbolizes her ability to leave the past behind and move on. Through All About My Mother (1999), Almodovar pays tribute to the female gender and its cultural icons. The film is a celebration of all that it means to be a woman. It is also reminiscent of the strong and influential female characters in film history. In fact, he expressly conveys these sentiments in the acknowledgments at the closing of the film, â€Å"To Bette Davis, Gena Rowlands, Romy Schneider. To all actresses who have played actresses, to all women who act, to men who act and become women, to all people who want to become mothers. To my mother.† By closely blending a unique plot structure, strong character building and the use of cultural allusions, Almodovar creates a film that is unconventional, yet , simple.

Middle Childhood Sexuality Education

Middle Childhood Sexuality Education Andrew Wilson Abstract Sex education is must for all students but it is vitally important to begin the education as soon as possible. Thus, it is best to start the sex education when normal education begins at the five to nine years of age or middle childhood. Beginning education at this age allows the child to easily assimilate his or her education without a fuss, embarrassment, or a feeling of strangeness. Sex education becomes matter of fact; just like studying history or math. The education should start with very basics of anatomy, reproduction, relationships, sexual behavior, gender roles and sexual health. Middle Childhood Sexuality Education Middle childhood sex education is geared toward age’s five to nine. Sex education can never be started too early and when regular school education begins is the best time to start the sex education curriculum. If presented at this age in a matter fact way, sex education will be received without embarrassment, unwillingness to share, and ask questions. It should address age appropriate topics in the following areas: human development, sexual behavior, relationships, personal skills, sexual health, and society. During the education, the goals of being at ease with their own body, awareness of sexual health, and sexual orientation should be kept in mind (Implementing). Human development must be presented first so each child understands their own human anatomy. Understanding the basic functions of your own body and that of the other sex is essential to understanding all other components of sex education. The following areas will be presented under the heading of human development: reproductive anatomy that discusses the names of body parts and the differences between boy and girls; the reproduction act including intercourse, conception, the uterus, and the result of a baby; body imagine includes discussion of shapes, sizes, and colors of people young and old; identity and orientation includes homosexuality, heterosexuality, appropriate labels and the respect for all sexual orientations (KidsHealth). Handouts with labeled body parts for both girls and boys will be handed out. The instructor will have an overhead with transparency for each sex. As the instructor names the body part, the children will follow along and color the named part the color the instructor desires, such as, the breast is pink. Following the coloring and naming section, the children will then have the chance to see and touch actual female and male models of the genitalia. Next, a discussion on the body’s diversity will be held with the children sitting in a circle around the instructor, as, the instructor ask the children to name how we are different –for example: male/female, black/white, skinny/heavy/normal, tall/short/average with the different development groups of infant, child, adolescent, young adult, middle-aged, and the elderly. Giving out pictures of the different body diversities to the children when they call them out as a reward and encouragement for participation will be done. The reading of a book concerning and explaining sexual intercourse, conception, development of the fetus and birth of the baby will be done. A good book for this is the book, You Were Born on Your Very First Birthday. After reading of the book, the instructor will encourage the children to talk about and ask questions concerning the sexual act and its result. The next reading will be to cover sexual orientation, in regards to gay and lesbian sexuality, to introduce the children to these alternate sexual orientations. An acceptable book that covers these areas is, Love Makes a Family. Again, the follow up of the book should include time for questions and discussion between the instructor and the children. Following the presentation of human development, the subject of relationships will be discussed. Families, friendships, love, dating, marriage and/or lifetime commitment, and the raising children or the decision to not have children will be broken down further in to subtopics. Under families a discussion will be conducted concerning the different kind of families found, how the family can change, and the roles of care for each other, and the different kinds of love within the family. The topic of friendships will cover the components of sharing, forgiving, hurting, and apologizing within the structures of various friendship structures. The importance of showing and sharing love and the different ways to show that love will be discussed. Dating will be defined and who dates, indicating teenagers, unmarried adults, and the single parent. Under marriage and lifetime commitments the reasons for marriage and divorce will be touched on. Under raising children, the instructor will cover the many reasons for having children, the effort and commitment it takes to raise children. Adoption will be discussed with the reasons and the desire for adoption will be discussed (Kids’). The next step will be to have the children share the composition of their own families and tomake a â€Å"flow chart† on the blackboard as the children describe their families. From that chart add friends, who their older brother, sister or even whom their parent is dating or living with, who they love, for example, grandparents, their neighbors, their baby sitter, any pregnancies in their immediate and/or extended family, divorce parents, step-parents, step brothers and sisters. Finally, define and describe family morals and values to the student. Have the children role-play expressing their feelings – happy, sad, confused, afraid, etc. Last discuss who they should trust and who to go to when they are afraid, confused, or need help. The next level to cover will be sexual behavior. These concepts of how the body feels good, curiosity of their body, acceptable masturbation practices will be defined. That is, who and where, shared sexual behavior is acceptable in regards to touching, hugging, kissing, and appropriate sexual behavior. Stressing that the sexual response is normal and healthy and how each sex is more alike than different (Davis). Sexual health will discuss contraception and abortion delving into wanted and unwanted pregnancies and who gets to make the choice. Sexual Transmitted Disease coverage will speak about the definition and causes, ways of getting STDs and ways to prevent STDs. Sexual abuse will cover body rights, appropriate touching and nudity, who to turn to if you feel you have been abused, stressing that the child is never at fault for the abuse and that boys and girls both can be abused. Reproductive and genital health will speak of the need for washing, cleanliness, doctor visits, the avo idance of alcohol, drugs, and smoking (Sex). The instructor will talk about when we enjoy our bodies alone or with others, such as, swimming, playing ball, and hugging. Make sure they understand that their feelings are normal, healthy, and good. Masturbation will be described as a normal activity but it should be conducted in privacy noting that privacy does not mean in secret, as if it is something to be hidden (Davis). Have the children tell how each boy and girl’s bodies are vary. An open talk about health ideas, smoking, drinking, drugs, cleanliness, doctor visits, germs and illness will be conducted. The instructor will continue by describing the underlying themes of STDs while stressing that they can only get sexual transmitted disease from sex (Lets). The final stage of discussion will cover gender roles, sex and religion, diversity and the sex coverage in the media. Gender roles will include similarities and difference between boys and girls, gender expectations of boys and girls, and parental roles. Sex and religion will involve similar yet different values (Coates). Sexual diversity is comprised of how differences are important, what stereotypes are and what sexual discrimination entails. Sexuality in the media contains both aspects of fiction and truth on television, in the movies, and on the internet. Age appropriateness in those medias will be portrayed (Lets). Have the class chat about gender roles and the way that they and their brothers and sisters have learned these roles. Ask questions, such as, â€Å"How do girls get treated?† and â€Å"How do boys get treated?† Give very general and basic instruction to the children that different religions have different ideas about sex. Encourage them to speak with their parents about any specific questions they have concerning sex and religion. Discuss stereotypes and sexual discrimination; plus, have the children share their ideas and thoughts about these subjects. Then talk about what sexual and stereotypical things they see on television and at the movies (Coates). In summary, the instructor needs to evaluate their effectiveness by the student’s ability to recognize the basic sexual genitalia and explain in very simple terms how reproduction happens. The students should then be able to describe basic relationships and when and whom to ask for help if necessary. The children should be able to verbalize how to take care of their health and define what a sexually transmitted disease is. Finally, the child should be able to convey the above information in a comfortable fashion and with the lack of embarrassment. References Coates, Nigel. (2008). Youthideas.co.uk.Retrieved from http://www.youthideas.co.uk/yw/talk/ Davies, Melanie. (2000). Tips for Talking with Kids about Masturbation. Retrieved from http://www.advocatesforyouth.org/parents/2027-tips-kids-mast Implementing Sex Education. Planned Parenthood. (2014). Retrieved from http://www.plannedparenthood.org/resources/implementing-sex-education-23516.htm KidsHealth. (2014). Sexual Orientation. The Nemour Foundation. Retrieved from http://kidshealth.org/parent/emotions/feelings/sexual_orientation.html Kids’ Ideas about Love. Rinkworks. Retrieved from http://www.rinkworks.com/said/kidlove.shtml Let’s Talk. Planned Parenthood of Indiana. Retrieved from http://www.ppin.org/education/education_documents/parent_packet.pdf Sex Education – Primary School Children. (2013). Better Health Channel. State Government of Victoria. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Sex_education_primary_school_children

What Are the Arguments In Favour Of Private Health Care? Essay

What Are the Arguments In Favour Of Private Health Care? Privatisation is a word which is commonly used to describe the practice of medical patients 'going private' and paying for the services of GPs, hospital doctors or hospital provision, rather than using the NHS. Privatisation can also be used to describe the charge imposed for such health care services such as drugs, appliances, dentures and spectacles. There are many arguments which are in favour of private health care in Britain, such as that private treatment is not the luxury that most people seem to think it is. Most people believe it is a treatment that only rich people can afford. This however, is simply not true as patients in the independent sector now represent a cross section through group insurance schemes. Another positive side to private health care is that a lot of pressure is taken away from the NHS when people turn to private medicine. The NHS receives much needed additional income from private patients who use their 'pay beds'. Also, a number of hospitals offer courses in basic nurse training and post qualification specialist training. This can also benefit the NHS as these nurses can leave the private sector at any time to work for the NHS if they wish. Private practices enable hospital consultants to receive enough earnings similar to those they could gain from working the same job abroad. This helps prevent the so-called 'brain drain' of our much needed hospital consultants. Additionally private hospitals and private insurance companies have, in the past, donated pieces of equipment to the to the NHS hospitals, to be used by both the public and private patients. Another factor that supports the argument of private heal... ...tates that PFI is a vital part of its plans to expand and modernise the public sector and that using the private sector can mean better value for money. PFI has now become Labour's favourite way of paying for new schools and hospitals and they are soon to expand it to cover projects such as roads and bridges. The government have promised that under PFI, the extra cash the government is pouring into the NHS and other public services, will not be wasted and they will also make it possible to buy back buildings when PFI contracts expire and return them to public control. As you can see, there are many advantages to private health care and PFI, despite the number of people who continually criticise the system. As with all projects, there are disadvantages and flaws, however the government are continually working on ways in which to improve the organization.

Cardiovascular Death Essays -- Health, Treatment

Introduction Every year an estimated 184,000 to 400,000 Americans die from sudden cardiovascular death due to left ventricular (LV) systolic dysfunction (Cesario & William Dec, 2006). One of the treatments of choice for the patient with a life-threating ventricular tachyarrhythmia is the automated implantable cardioverter defibrillator (AICD). Studies have shown that the placement of an automated implantable cardioverter defibrillator (AICD) in patients with LV systolic dysfunction significantly reduces overall mortality (Cesario & William Dec, 2006; Henyan et al., 2006). Background and Significance Over the past 20 years the AICD have become more complex due to technological advances and software sophistication. Today, the indication for implantation of the AICD is rapidly expanding (Schoenfeld, 2007). The use of these devices in managing a diverse population of cardiac patients is increasing. The National ICD Registry annual report for 2008 noted that the average age of patients receiving the device was 65 years old and more than 75% of the patients have 1 or more comorbid diseases (Kaufman, R. S., Mueller, S. P., Ottenberg, L. A. & Koening. A. B., 2011; Zhan, C., Baine, B. W., Sedrakyan, A., & Steiner, C., 2007). These factors contribute to the increasing numbers of patients with AICD devices in the United States. In 2008, 339,076 Americans received the device, compared to 75,000 implantations in 2001 and 34,000 in 2000 (Kaufman et al., 2011). The implication for the increasing number of patients with AICDs is that anesthesia providers will be more likely to encounter thi s patient population presenting for elective or emergency surgical procedures. While it is the anesthesia provider’s duty to provide safe and compe... ...mproved dramatically. Due to an aging population, increasing prevalence of cardiovascular disease, and expanding indications for AICD therapy, the number of patients with AICDs presenting for surgery will continue to rise. Areas of concern for the anesthesia provider with this patient population include preoperative device interrogation, perioperative reprogramming, disabling of the antitachydardia function, and post operative device interrogation. While there are currently no set standards in providing anesthesia care for this patient population, the result of this evidence based project demonstrate that patients with AICDs presenting for surgery can be safely cared for during the operative period. It is the responsibility of the anesthesia provider to be aware of the best evidence with regard to patients with AICDs in place that require anesthetic management. Cardiovascular Death Essays -- Health, Treatment Introduction Every year an estimated 184,000 to 400,000 Americans die from sudden cardiovascular death due to left ventricular (LV) systolic dysfunction (Cesario & William Dec, 2006). One of the treatments of choice for the patient with a life-threating ventricular tachyarrhythmia is the automated implantable cardioverter defibrillator (AICD). Studies have shown that the placement of an automated implantable cardioverter defibrillator (AICD) in patients with LV systolic dysfunction significantly reduces overall mortality (Cesario & William Dec, 2006; Henyan et al., 2006). Background and Significance Over the past 20 years the AICD have become more complex due to technological advances and software sophistication. Today, the indication for implantation of the AICD is rapidly expanding (Schoenfeld, 2007). The use of these devices in managing a diverse population of cardiac patients is increasing. The National ICD Registry annual report for 2008 noted that the average age of patients receiving the device was 65 years old and more than 75% of the patients have 1 or more comorbid diseases (Kaufman, R. S., Mueller, S. P., Ottenberg, L. A. & Koening. A. B., 2011; Zhan, C., Baine, B. W., Sedrakyan, A., & Steiner, C., 2007). These factors contribute to the increasing numbers of patients with AICD devices in the United States. In 2008, 339,076 Americans received the device, compared to 75,000 implantations in 2001 and 34,000 in 2000 (Kaufman et al., 2011). The implication for the increasing number of patients with AICDs is that anesthesia providers will be more likely to encounter thi s patient population presenting for elective or emergency surgical procedures. While it is the anesthesia provider’s duty to provide safe and compe... ...mproved dramatically. Due to an aging population, increasing prevalence of cardiovascular disease, and expanding indications for AICD therapy, the number of patients with AICDs presenting for surgery will continue to rise. Areas of concern for the anesthesia provider with this patient population include preoperative device interrogation, perioperative reprogramming, disabling of the antitachydardia function, and post operative device interrogation. While there are currently no set standards in providing anesthesia care for this patient population, the result of this evidence based project demonstrate that patients with AICDs presenting for surgery can be safely cared for during the operative period. It is the responsibility of the anesthesia provider to be aware of the best evidence with regard to patients with AICDs in place that require anesthetic management.

Global Marketing Leadership Essay

Global marketing leadership and ethical issues have become a more frequent occurrence give the increased business participation the ever growing global economy. Even though some people think that culture is fragile and when compromised will cease to exist, marketing can be both the preserving measure of a culture or its compromising factor. Marketing of products stems from a more economically developed and open market societies such as countries like: The United States, Europe, and Australia to name a few. The marketing ethics and leadership dilemma begins with how to translate an open market to economical underdeveloped countries and how to market with cultural sensitivity without losing the ethical integrity of what the business stands for and actually engages in. The question to be posed and answered by the ethical leadership and marketing of globally participator businesses is if cultural sensitivity the driving force behind the study of global ethics and leadership or is this just as adaptable as the open market for business is today? With increased globalization come increased cross-cultural ethics issues. Modern marketing is viewed as that compromising factor that westernizes cultures globally, however, advances cultures as well. The focus of ethical marketing is how to respect the cultural practices and views of ethics and market a business product effectively. Cultural divides should not create a dilemma in the globalized economy; however, the sensitivity to cultural ethics should warrant a business to have integrity and pride in their products while adhering to often hard to adapt cultural ethical views. Culturally we are different and should be respected however; cultural differences should be celebrated and adapted too in order to really see a unified global marketing perspective. Another question to be answered by ethical marketing should be how does a business effectively differentiate and anticipate the ethical and the cultural sensitivities from country to country they wish to secure a market share in? Cultural Marketing Sensitivities As businesses enter and seek to sustain their market positions in the ever growing global market, the tactics of marketing used must be adapted to been seen as ethical to the cultures presented but not so adapted that the integrity of the business is lost. To achieve this balance Aristotle’s mean doctrine focuses on the â€Å"moral virtues† that are identified as the middle ground between selfish motive and an indifferent motive. The moral and ethical differences also need to be addressed as the act of engaging in marketing for a business is to satisfy, anticipate and identify customer product requirements profitably (Carrigan et. l. , 2005). A goal of marketing is to identify consumer requirements of a product as their largest vote globally is the dollars in which they use to purchase various products. Globally, standards vary and must be addressed through the interface of marketing ethics that joins the buyer preferences with overall company profitability aspirations on the demand of their products and services. The culture of a country plays a large role in the way the members of that society relate ethics in marketing and the socialization of what is viewed as acceptable behaviors (Pires et. al. , 2002 ). To better understand Pires et. al. (2002) continues to explain that ethics is a compromised set of four classical philosophical questions that relate to the phenomenon of global marketing ethics: (1) what is the first principle of things? (Metaphysics), (2) what is true? (Epistemology), (3) what is beautiful (Aesthetics), and (4) how to persuade or influence others? (Rhetoric) (Pires et. al. , 2002) All four of these questions lend themselves to the understanding of the urgency of fundamental understanding of how ethics, leadership, marketing and the global markets relate to each other. Ethics of Marketing Metaphysics: What is the first principle of things? Metaphysics as a constructed by Kant as metaphysics of morals is an ethical point of view of morality in reference to self-interest over community as applied to the ethical dilemma of globalized marketing. Kant (1788) metaphysics view on ethics and morality utilized a utilitarian theory and focused on the duties of the business not being associated with complete self-interest (Carrigan et. al. , 2005, p. 481). Metaphysical morality when applied to global marketing directs businesses to seek to satisfy objectives other than business interest. Kant’s study continues to reveal that businesses have a duty to satisfy and deliver benefits through ethical marketing strategies sensitive to the cultures they are trying to influence (Carrigan et. al. , 2005, p. 481). The pay-off and ultimate moral imperative for a business is securing the sale of the items marketed globally. The businesses’ utilization of Kant’s metaphysical morality can lead to ncreased market presence as the business appears ethical to the global consumer. The first principle of global marketing is to appear acceptable in behavior, ethical and culturally sensitive during the marketing process. While appearing ethical in marketing, businesses must also adhere to varying truth standards for each global market the business enters. Epistemology: What is true? Epistemology as a marketing ethics and leadership compo nent is demonstrated in the study of knowledge and justified beliefs (Carrigan et. al. , 2005). Marketing on a global scale must make normative moral decisions when presenting the business version of the truth within its adverting. Product safety and the correlated marketing global advertisements must be presented in a non-controversial way and with sensitivity towards the ethical boundaries of the global markets. Western ethics vary defiantly and operating globally will involve a quest through epistemological â€Å"objective† reality (Pires et. al. , 2002, p. 111). The introduction of an objective reality is in stark contrast to the Japanese culture fueled by tradition that is not as flexible to outside influence. The United States has the ability to find truth for many small and integrated cultural groups while justifying the objective reality as a normative moral marketing tactic acceptable within the United States culture. In contrast to Japan that is rooted is aesthetics and normative moral conduct based around what is considered respectable. The cultural views of beauty can often be taboo in cross-cultural marketing and businesses are charged with presenting a beautiful, ethical and aesthetically acceptable by each global market’s standards. Aesthetics: What is beautiful? Beauty ethics in marketing is as very important as it translates desirability of the product and sells the benefits of a product through visual artistry. An example of the aesthetic marketing manipulation power as explained by Carrigan et. al. (2005) is: in order to market and develop a market for tobacco products, tobacco companies were distributing promotional cigarettes to anyone in Taiwan despite of age or gender by beautiful young girls creating a luring effect on the culture (Carrigan et. l. , 2005). The use of aesthetically pleasing young girls can be seen as an unethical way to promote a health harming product, especially without requirements of age. Marketing within western culture is considered ethical and within cultural boundaries as the marketing use of young beautiful girls is common place and accepted as normal behavior. Nudity is common in Western culture as we celebrate beauty and stardom, which is not, accepted everywhere as close as J apan. A culture bathed in tradition, nudity is not acceptable behavior and in reference to marketing ethics would be considered unethical and in poor taste. Kant explained aesthetics as an appreciation in terms of delight or aversion of an object or person; delight being known as beautiful (Dobson, 2010). The aesthetic ethics is not utilitarian, however does create a corporate aesthetic style (Dobson, 2010). The consumer is the most foundational relationship the business desires to build as the marketing campaigns demonstrate an overall business and product aesthetic. Beauty creates a visual representation of the marketing campaign; however the rhetoric of the marketing tends to be what sticks with the desired audience. Rhetoric: How to persuade or influence others? Rhetoric ethics is a utilitarian ethical theory that reviews the power of influencing others. Culturally, international marketers are in control of a majority of the marketing mix allowing them the potential to shape political power, changing social structures, and influencing economic development (Dobson, 2010). The utility of participating in a globalized marketing campaign has to produce benefits that outweigh the cost to comply with cultural difference in ethics and leadership. Persuasion and agreement has to be forthcoming and evaluated on the basis of societal cost if safety concerns or recalls surface for the products being marketed. Given the power to persuade, companies should never try to justify any actions to the consumer that hurt or harm them, however the marketing company should strive to maintain a high set of ethical standards within the rhetoric of their marketing (Dobson, 2010). Ethical marketing and global leadership relies on firms accepting global responsibility for the claims made in advertising to spark consumer interest and ultimately their commitment to patron the business. Conclusion In a global marketing scenario the utilitarianism view would be comfortable in reviewing and weighing the cost of a possibly culturally insensitive and unethical marketing campaign if it secured sales and interest for a business. Marketing serves society’s needs without ethical strings or boundaries as explained by Carrigan et. al. (2005) referencing the explanation given by Fineman. Within multi-national companies that participate globally, there is Fineman, as quoted by Carrigan et. al. (2005) details how apart from the lapses with gun marketing, pornography, Breadshaw and Palfreman presented marketing as a neutral system or tools of management that serve the market with good (Carrigan et. al. , 2005, p. 83). Culturally, the globalization of the market has empowered leaders to seek an ethical foundation that is uniform when engaging in promoting their business. The ethical dilemma enters when cultures vary so significantly that the definitions of acceptable behavior are polar opposites. Dunfee et. al (1999) posed the research thesis of finding a normative moral foundation for marketing that provides a framework of resolve for the ethical issues that arise in global marketing. The commonality of Kantian, virtue, rights, justice utilitarianism and social contract theories of global marketing is the perspective of impartiality and marketing morality. Moving forward as the global economy continues to grow, the overall ethical fibers of the marketing profession will need to adapt with the ever changing cultures of the world. As the consumer’s taste change, so will the marketing ethics and leadership strategies in order to remain effective and acceptable culturally.