Euthanasia and Physician Assisted Suicide - Free Essay Example

Sample details Pages: 5 Words: 1648 Downloads: 10 Date added: 2019/05/27 Category Law Essay Level High school Tags: Assisted Suicide Essay Euthanasia Essay Did you like this example? Introduction Physician Assisted Suicide has been one of the most controversial subjects for years. Stemming all the way back to 1997, when the state of Oregon became the first state to legalize it. Physician Assisted Suicide is known as euthanasia and has raised many different questions throughout time. Don’t waste time! Our writers will create an original "Euthanasia and Physician Assisted Suicide" essay for you Create order One of the biggest questions raised however is this; Is euthanasia ethically acceptable? Suicide in its self is considered wrong in ethical views, for one must honor the value of a human life. One must think about the terminally ill patients that are suffering though. Even if it might hurt other people, but it puts the patient at rest, is it ethically acceptable for a patient to receive physician assisted suicide? If one fully analyzes euthanasia using the ethical theory of utilitarianism, then one would conclude that John Mill would solve the dilemma by asking if this act would result in happiness free of pain. What is Euthanasia? Euthanasia is defined as the humane and painless killing of a patient that is suffering from a life ending and painful disease. Currently legal in only eight U.S. jurisdictions, it is a highly controversial topic. Euthanasia is only legal for the patient however. A physician may prescribe the lethal drugs, but there are no circumstances under which they are able to administer the drugs themselves. The steps to administer the medication are not sweet and simple though. There are various parameters that a patient must meet before a doctor is allowed to prescribe the life ending medication. The first rule that must be met is that the patient must be an adult. Two independent physicians must then verify the patientrs terminal diagnosis. Both of them must be fully convinced that the patient has no hope of getting any better. A written request must then be signed by the patient in front of two witnesses. This request attests that the patient is in a healthy mental state and that they are d oing this voluntarily. If there is any question about the mental state of the patient, then the physician may require the patient to be counseled. Once all of these parameters have been met, then the physician will prescribe the drug. As stated above, the physician in no case is allowed to administer the drug, but he/she prescribes it and the patient picks it up from the pharmacy. None of 1the laws on physician assisted suicide state which drug the doctor prescribes, but according to the article FAQs Physician-Hastened Death, most doctors prescribe an oral dosage of a barbiturate (FAQS-Physician-Hastened Death, par 14). Barbiturates are a drug that are used as depressants of the central nervous system (Barbiturates Drug Profile, par. 3). The brain controls the central nervous system, it tells the lungs to breath and tells the heart to beat. When it is suppressed a little it can be beneficial by lowering anxiety and making a person more relaxed. If it is suppressed too far, which is what happens with barbiturate, the whole system begins to shut down. The patient soon becomes unconscious and shortly after the heart stops beating and the lungs stop breathing, resulting in death. The Dilemma As stated by Michael Cholbi, Suicide is wrong because it violates our moral duty to honor the value of a human life (Cholbi, par. 25). Viewing life in the terms of Utilitarianism, John Stuart Mill was one of the most influential philosophers of the 19th century. Millrs core belief is that a person should try to reach happiness. He defines happiness as this, a person should do what brings them pleasure without any pain. By this he means that a person should do what pleases them without bringing pain to others. In the view of assisted suicide this view can be a little two-sided. When a terminally ill person wishes to end their life, on their terms and in the place they wish to be, it could bring happiness and a sense of satisfaction to them, However, the people around them, friends and family, might be affected. Many of them may wish to keep their dying loved one in their life for as long as possible. Many patients that are terminally ill however discuss assisted suicide with their lo ved ones before they make the decision. The people closest to them would know from personal experience how much pain that they are in, they would know how much suffering they go through every day. Death isnt something anyone can post-pone. Everyday people die, suddenly and unexpected, and then there are the cases where it is slow and painfully expected. However, can it ever be considered morally correct to end a human life? Now the question every person has to ask themselves is this; if it was known that death was ahead, and there was nothing more the doctors could do to save this life, with immense amounts of pain, would suffering with no more energy and hope left to fight be worth it? Each person will have their own independent views on the morality of physician assisted suicide, but how would it be viewed in utilitarianism? Utilitarianism Utilitarianism is the ethical theory that determines whether an action is right or wrong solely on the consequences of the actions. It does not simply focus on one personrs interests, but instead it looks at how an action might affect the people around them, close friends and family. So if an action is going to hurt the people that are closest to that person then the action would be considered morally wrong, however, if the action had no affect on others or it had a positive affect on others then it would be considered morally correct. In the terms of physician assisted suicide, it could go either way on whether it is right or wrong considering the conditions of the situation. Many factors could make physician assisted suicide, in the views of utilitarianism, morally correct. If a patient was all alone for instance, no family or friends, no one that could be hurt by their death, then it would be considered morally ok. By the patient taking the drug and ending their life, with no one there that could be affected or hurt, there are no reasons that it would be wrong. Sure, there is the part of suicide is wrong because a person isnt valuing a human life, but if the human life is deteriorating and coming to an end as is, then where is the problem? Another way that assisted suicide could be considered morally ok is if the patient actually sits down and talks with their family and friends. So many people are terminally ill and suffering day to day waiting for the end to come. This isnt a life anyone would want to live, and when considering it, its not a life you would want a loved one suffering through. If the patient were to discuss their wish with their loved ones and give them time to prepare and understand then it could be considered ok. Death is going to hurt people no matter what, it hurts when someone that youre so close with is no longer in your life. It also hurts seeing someone youre so close with suffer day in and day out. If the patient and the loved ones were to agree that it was best for physician assisted suicide to occur, then there wouldnt be a moral problem in the view of utilitarianism. Physician Assisted Suicide can be considered morally wrong in the views of utilitarianism as well. Its one of those if/then situations. If the patient were to go about physician assisted suicide without the family or friendrs knowledge, thatrs where a morality problem would come in. A patient that legally ends their own life, with only the knowledge of the doctors, while leaving the loved ones completely in the dark, would have performed a morally unjust act. The family and friends would be even more hurt with this type of death than with a natural death. As said before death hurts no matter what, but with the chance to say goodbye and make peace it wouldnt be as bad. In the above case where the patient talked with the family the situation was different. The family and friends were given time to prepare, they agreed to losing the patient earlier than expected, but they knew, and they were ready. In a case where friends and family didnt know until after the fact, so much more pain and suffering would be experienced. Taking it upon their self to end their life, without giving the people that would be affect most a chance to prepare, and hurting them so much more, would make physician assisted suicide extremely wrong in the views of morality and utilitarianism. A sense of happiness may have occurred for the patient, but so much more pain would have been experience by those closest to them. Conclusion Every life is considered to be sacred, a value that one should hold above all others. Everyday people die, and everyday people are born, but everyday there are also people that suffer from a terminal illness. Getting access to physician assisted suicide is no easy act, and not just any person can do it. A life is always sacred and should always be valued, but the purpose and happiness in that life should also be taken into consideration. Utilitarianism is an if/then theory when it comes to moral values. If the action results in happiness free of pain it is morally correct, if it results in happiness but pain to others it is morally wrong. In the case of assisted suicide, it is a complex subject with so many different variables that can affect the moral value of the act. Every decision one makes and the results which occur decide whether this act is morally ok in Utilitarianism.

Social Development Is The Backbone Of Learning - 1885 Words

Introduction As humans, the range of emotions we feel daily can be anywhere from two to twenty. These â€Å"feelings† that we have are normally a reflection of our environment or our temporary surroundings. But are they all true emotions or just our reaction to how we feel about something? The term emotion is nothing near black and white. Many Psychologists tend to define it by a combination of cognition, physiology, feelings, and actions (Kalat, 2014, 2011, pg. 385). By saying this, it is hard to pin point where emotion generates apart from the physiological aspect of a human. We can track how people are influenced in their early lives and see how this plays out into adulthood. You can also see how as a child, the affects ofAuthor and Psychologist, Lev Vygotsky has theorized that social development is the backbone of learning so to speak. He believed that you learned by your surroundings before you learned anything from a typical classroom setting. I believe that along with this theory, e motion and personality tend to form from a human’s surroundings rather than being taught one on one how to feel or act, especially from a young age. Throughout this paper I plan on discussing how Vygotsky’s theories intertwine with the development of emotion in human beings, how emotions can develop from the way a child is nourished from infancy, how surroundings affect the outcome of normalcy in a adult from adolescence and in what ways the subject of massive redundancy, i.e. the brain, worksShow MoreRelated##t, Piaget And Vygotsky, Repactivism And Constructivists731 Words   |  3 PagesWhile the backbone of cognitivism may come from the work of Jean Piaget, Piaget and Lev Vygotsky are constructivists. Constructivism is based on the premise of subjectivism or relativism. Truth is not absolute; it is relative because it is commonly created or shared within a community. 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Many feel that self-esteem and self-imageRead MoreThe Current System Of Medical Education1584 Words   |  7 Pagescollaboration, several faculty members have been trained at Yale University School of Medicine and Western Connecticut Health Network (WCHN). KazanSMU was one of the first medical universities in Russia to participate and implement the Stanford Faculty Development Model, incorporate mandatory evidence-based medicine elective into curriculum and participate in tri-partite global health electives. Objectives and Methods In this paper we attempt to focus on the postgraduate medical education in Russia, the

The Cons of Marijuana Usage Free Essays

The legalization of marijuana is one of the most highly debated about subjects facing Americans today. Advocates of legalization use two major arguments in their effort to have marijuana legalized. First, which is by far the biggest argument is that marijuana has a significant medical use. We will write a custom essay sample on The Cons of Marijuana Usage or any similar topic only for you Order Now The second argument is that marijuana does not cause harm to those that smoke it. Both of these arguments can be easily discounted by the numerous studies that have been done on the effects of marijuana both medicinal and recreational. In the following paragraphs we will explore the hard facts of marijuana that will discount the validity of the previously mentioned arguments as well as some common fallacies. I will focus first on the medical fallacy. There currently exists a great debate concerning smoking marijuana as a medicine. Many well-intentioned leaders and members of the public have been led misled by the well-financed and organized pro-drug legalization lobby into believing there is merit to their argument that smoking marijuana is a safe and effective medicine. A review of the scientific research, expert medical testimony, and government agency findings shows this to be erroneous. There is no justification for using marijuana as a medicine. The movement to legitimize smoking marijuana as a medicine is not encouraged by the Federal Food and Drug Administration, health and medical associations, or medical experts; but instead by groups such as the National Organization for the Reform of Marijuana Laws (NORML) and the Drug Policy Foundation (DPF). These organizations have little medical expertise and favor various forms of legalizing illicit drugs. The studies cited by the marijuana advocates have been found to be unscientific, poorly researched, and involved pharmaceutical THC, not marijuana. An advocate that claimed he was an expert, testified at the 1987 federal hearings to reschedule marijuana, was in fact a wellness counselor at a health spa who admitted under oath to using every illegal mind-altering drug he ever studied. Another â€Å"expert† admitted he had not kept up with new medical or scientific information on marijuana for over 18 years. Another doctor claimed there was voluminous medical research on the effectiveness of marijuana but under oath, when asked to cite the number of the studies, he replied, â€Å"I would doubt very few. † The fact is that there is not one reliable scientific study that shows smoking marijuana to be a safe and effective drug. The majority of the marijuana advocates’ â€Å"evidence† comes from unscientific, non-scrutinized or analyzed anecdotal statements from people with a variety of illnesses. It is unknown whether these individuals used marijuana prior to their illness or are using marijuana in combination with other medicines. It is also unknown whether they have had recent medical examinations, are justifying their use of marijuana, experiencing a placebo effect, or experiencing the intoxicating effect of smoking marijuana. The main psychoactive ingredient in marijuana (THC) is already legally available in pharmaceutical capsule form by prescription from medical doctors. This drug, Marinol, is less often prescribed because of the potential adverse effects, and there are more effective new medicines currently available. Marinol differs from the crude plant marijuana because it consists of one pure, well-studied, FDA-approved pharmaceutical in stable known dosages. Marijuana is an unstable mixture of over 400 chemicals including many toxic psychoactive chemicals, which are largely unstudied and appear in uncontrolled strengths. The manufacturers of Marinol, Roxane Laboratories Incorporated, do not agree with the pro-marijuana advocates that THC is safe and harmless. In the Physician’s Desk Reference, a good portion of the description of Marinol includes warnings about the adverse effects. Seriously, doesn t common sense dictate that it is not good medical practice to allow a substance to be used as a medicine if that product is ingested by smoking, not FDA-approved, made up of hundreds of different chemicals, and self-prescribed and administered by the patient. The federal government, over the last 20 years involving a number of administrations from both political parties, has determined that smoking marijuana has no redeeming medicinal value, and is in fact harmful to health. These governmental agencies include the Drug Enforcement Administration, the Food and Drug Administration, and the U. S. Public Health Service. Their latest finding, as recently as 1994, was affirmed in a decision by the U. S. Court of Appeals in Washington, DC Since the pro-marijuana lobby has been unsuccessful in dealing with the federal government, they have targeted state and local governments to legitimize smoking marijuana as a medicine. A careful examination of their legislative and/or ballot proposals reveals they are written to effectively neutralize the enforcement of most marijuana laws. Crude, intoxicating marijuana under their proposals would be easier to obtain and use than even the most harmless, low-level prescription drug. Major medical and health organizations, as well as the vast majority of nationally recognized expert medical doctors, scientists and researchers, have not accepted smoking marijuana as a safe and effective medicine. These organizations include: the American Medical Association, the American Cancer Society, National Sclerosis Association, the American Glaucoma Association, American Academy of Ophthalmology, National Eye Institute, National Cancer Institute, National Institute for Neurological Disorders and Stroke, National Institute of Dental Research, and the National Institute on Allergy and Infectious Diseases. There are thousands of studies available documenting the harmful physical and psychological effects of smoking marijuana. The harmful consequences include but are not limited to premature cancer, addiction, coordination and perception impairment, a number of mental disorders including depression, hostility and increased aggressiveness, general apathy, memory loss, reproductive disabilities, impairment to the immune system, numerous airway injuries, and other general problems associated with intoxication. So far I have shown why marijuana should be disregarded as medicinal now I intend to discount some more common fallacies that marijuana advocates like to throw around as well as the argument that marijuana causes no harm to the smoker. First, advocates for marijuana like to say laws against alcohol and drugs don t work so why have them. They often use prohibition in the early 1900 s as an example. Even though prohibition was unpopular and only in effect for about fourteen years, it did impact the use of alcohol. Alcohol use, alcohol-related deaths, and admissions to hospitals for other alcohol related illnesses were all reduced approximately 50 percent. Also, contrary to what you hear, there’s no evidence of a big increase in crime. That probably makes for good gangster movies, but little else. Prohibition was rescinded because alcohol historically had been part of our lives, and the majority didn t support prohibition. Drugs, on the other hand, have not been part of our everyday lives, and over 80 percent of Americans favor drug prohibition A second fallacy is that legalizing marijuana would reduce the number of crimes and would free up prison space for more violent offenders. First of all there are 12 million arrests made annually out of which 1 million are for drug violations, of these only 12 percent are sentenced to prison. Most of the criminals that are locked up already have rap sheets a mile long for different crimes anyways. Now if we legalize marijuana the arrests would stop because of the change in the criminal code but the criminals wouldn t change their behavior and become law-abiding citizens. They will continue to commit crimes to pay rent, buy cars, go to concerts, buy clothes, eat, and buy legal drugs. Thirdly, most advocates like to use the Netherlands as an example of marijuana being legalized and not having any problems. The Netherlands has begun experiencing a variety of problems including a rise in crime, welfare, unemployment, and addicts from other countries migrating there to indulge their drug appetites. A fourth common fallacy is that if we legalize marijuana we would save at least 20 billion dollars annually that is now used towards law enforcement. What this fallacy assumes is that there would be no governmental costs associated with distribution, regulation, and control of legal drugs. Using alcohol as a model, we know these costs can be substantial. Knowing government, there is very little they do that is cost effective. In 1965, when we started Medicare, Congress projected that it would cost this country $12 billion by 1990. The actual costs that year were $110 billion. In 1968 food stamps cost $173 million annually, and now, less than 30 years later, the price tag is $24 billion. And, finally the greatest fallacy that marijuana does not harm the user. The fact remains that marijuana and hashish are intoxicating substances that make the user high. The degree of mental and physical impairment depends on the amount and strength of marijuana smoked. There is a substantial difference between the 2 to 5 percent THC weed of the ’70s and the 10 to 20 percent THC in today’s weed. There is a definite reason why the higher grade is more desirable and expensive, and that’s simply because it gives the user a more powerful high. Studies show marijuana can and often does cause apathy, diminishes mental capacity, causes difficulty in concentrating, decline in performance, and lost motivation. Thousands of studies also show marijuana use adversely affects the brain, reproduction process, immune system, respiratory system, cardiovascular system, and remains in the body for extended periods of time. In addition, marijuana use often impairs normal thought processes, distorts reality, reduces self-control, and releases inhibitions, all of which increase the chance of harmful and criminal behavior. Many times the user is unaware he or she is being affected unless told by others. A Stanford Medical School study showed pilots to be impaired 24 hours after smoking one joint, even though they felt they were functioning normally. In conclusion, the bottom line is, whenever persons are under the influence, they pose a threat to themselves and others. We don’t need more intoxicated people on our streets, at public events, or driving on our highways. Traffic fatality studies clearly demonstrate a disproportionate number of deaths caused by drivers under the influence of marijuana. Why would we want to make a substance like that legal, inexpensive and readily available to satisfy he desires of a few who already choose to violate our laws? Haven’t the advocates learned anything from our experience with drunkenness? How to cite The Cons of Marijuana Usage, Essay examples

West Germany and the Soviet Invasion of Czechoslovakia free essay sample

A description of West German attempts to open political and economic relations with Eastern Europe brought about by the Soviet invasion of Czechoslovakia. This paper deals with the Soviet invasion of Czechoslovakia. The author examines the historical relationship between West Germany and the former Soviet Union from the Cold War period. The paper discusses the opening of economic ties between West Germany and the rest of Western Europe. From the paper: The war in Vietnam greatly increased US government spending on weapons and other supplies, the demand for which American industry could not fully meet. To fill the rest of the orders, the US turned to the other Western industrialized countries, in many cases West Germany and Japan. This increased spending helped jumpstart the economies of these countries, moving both West Germany and Japan from debtor to creditor nations as they achieved large trade surpluses. As it grew more powerful economically, West Germany took a more independent path politically. We will write a custom essay sample on West Germany and the Soviet Invasion of Czechoslovakia or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page

Definition of Being a Man

There Is no Single Viewpoint Every male in the world tries to define being a man at least once in his life. Some researchers state that the first attempt takes place at the age of three in the majority of cases when a boy learns about certain peculiarities of his body. Of course, men try to understand what it is like to be a man much later. It goes without saying that men have different viewpoints on the matter. However, in the majority of cases they contemplate similar categories.Advertising We will write a custom essay sample on Definition of Being a Man specifically for you for only $16.05 $11/page Learn More Therefore, it is possible to draw a universal definition of being a man when these categories are analyzed. Though, such category as physical features (e.g. strength) should be taken into account, it cannot be the principal one. There are more important categories that make a man ‘man’. These major categories to analyze are as follow s: social role, relationships in a family (interaction with females) and ethnic identity. Social Roles In the first place, it can be important to look at the way men identify themselves in the society. Interestingly, there are certain stereotypes concerning men in this respect. For instance, men often try to hold leading positions. They try to fit the image of a tough guy who can reach his aims and who can reach the top. Therefore, men often try to measure their ‘masculinity’ (or other male’s ‘masculinity’) with the help of this category. The higher post a man holds, the more manlike he seems. It is also important to note that many often think that men have no right to be sentimental when reaching their aims. However, these are only stereotypes. Now men are not expected to be sharks in the human society. Though, masculinity is still associated with a high social position, men are not expected to make their way over corpses. Now such feature as respon sibility is more important. Men are regarded as human beings who are responsible when it comes to making decisions. Being a man presupposes being responsible for various projects and for various people involved. Now this is the most important measurement for males. It is also important to state that masculinity has always been associated with competitiveness. Thus, men have always tried to prove they are ‘tough’. Now this competitiveness is also associated with responsibility. Men do not simply try to win the race; they are supposed to be responsible. Men cannot lose self-control. Thus, masculinity presupposes responsibility, competitiveness and self-control.Advertising Looking for essay on gender studies? Let's see if we can help you! Get your first paper with 15% OFF Learn More Relationships with Females Admittedly, there are loads of stereotypes when it comes to relationships between men and women. Historically, males were supposed to dominate females. Several centuries ago males were regarded as superior creatures. They could suppress their women and their children. Being a man could be synonymous to being cruel to a woman. Husbands were regarded as masters of their wives and their kids. Therefore, masculinity was measured by the level of his woman’s obedience. This stereotype is still prevailing in many societies. However, many understand that this stereotype is outdated. Nowadays men do not need to show how strict they are with women. Marriage has transformed into the institution of two equal partners who take care of their children. Of course, it is important to note that these partners have a bit different roles. Thus, masculinity is not synonymous to superiority now. Men do not try to suppress their wives (or partners). Now an ideal husband is supportive and caring. He is also responsible. Notably, responsibility is important in this category as well. Being a man presupposes being responsible. Men should care about cl ose people. They still should be strongholds of their families. Masculinity is now traced in the ability to be strong enough to admit that women are equal to men. Remarkably, this ability can be traced in men’s attitude towards feminist movements or even feminist ideas. Now many people understand that only weak and unconfident men try to prove that women should fulfill tasks that they have been carrying out throughout centuries. Such men do not want to let women hold high positions in the society. These men think that the institution of masculinity is in danger if women become in charge of men. On the contrary, really tough guys accept the changes which took place. They welcome women who can successfully hold the high position. Competitiveness is one of the most common features of masculinity. Real men welcome a deserving competitor, even if it is a female competitor. Therefore, responsibility is one of the most important features of masculinity when it comes to relationships with females, too. Ethnic Identity Ethnic identity is also one of the most important categories to analyze. Being a man means to be responsible for the entire group of people. This category is a bit similar to the previous one. Men often associate themselves with the entire nation. They feel ties between members of the group.Advertising We will write a custom essay sample on Definition of Being a Man specifically for you for only $16.05 $11/page Learn More It is possible to state that they also feel responsible for the future of the entire nation. Admittedly, this can be compared to one of the basic instincts which make people continue their race. Likewise, men are supposed to be strongholds of their families. Thus, responsibility appears in the category of ethnic identity, too. Universal Definition On balance, it is possible to state that men have different viewpoints on masculinity. Likewise, there are many definitions of being a man. Nonetheless, it is still possible to come up with the universal definition. Thus, being a man means being committed and responsible for those who are dependent. Being a man also presupposes ‘healthy’ competitiveness which leads to development of the society Finally, being a man means being able to accept equality. Of course, it is important to note that this universal definition touches upon the major features of the real man. There are many other qualities that make a man â€Å"man†. Nonetheless, if a male is not characterized by such features as responsibility and ‘healthy’ competitiveness, he cannot be called the real man. This essay on Definition of Being a Man was written and submitted by user Texas Twister to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Dental Clinic Database Essays

Dental Clinic Database Essays Dental Clinic Database Essay Dental Clinic Database Essay Our clinic was established on the year 1965 after taking the board exam. It was started with a modest dental chair and makes our living room as dental office. After several years of practice and after gaining the confidence of my patient the dental clinic expanded with two modern dental chairs. OBJECTIVES OF THE STUDY The objective of this working group was to assess and make specific recommendations to improve the quality of reporting of clinical research in implant dentistry and discuss ways to reach a consensus on choice of outcomes. BACKGROUND OF THE STUDY Many dental procedures are performed in the dental hygiene clinic. The highly skilled and professional staff performs services which include preventive treatment. Health History (including blood pressure screening), Oral Cancer Screening, Periodontal Assessment, Oral Hygiene Education, Necessary Radiographs (X-rays), Pain control (topical/local anesthetic), Oral Prophylaxis (scaling, root planting polishing if needed), Flouride Treatment, Cleaning of Dentures, Smoking Cessation Education, Study Models, Tooth Desensitization and Home Care Aids are included. Procedures are done by first and second year dental hygiene students under the supervision of dental hygiene faculty who are registered dental hygienists and licensed dentists. SIGNIFICANCE OF THE STUDY Since the mid-1990s, the focus of studies on tooth wear has steadily shifted from the general condition towards the more specific area of dental erosion; equally, a shift has occurred from studies in adults to those in children and adolescents. During this time, understanding of the condition has increased greatly. This paper attempts to provide a critical overview of the development of this body of knowledge, from earlier perceptions to the present. It is accepted that dental erosion has a multifactorial background, in which individual and lifestyle factors have great significance. Notwithstanding methodological differences across studies, data from many countries confirm that dental erosion is common in children and young people, and that, when present, it progresses rapidly. That the condition, and its ramifications, warrants serious consideration in clinical dentistry, is clear. It is important for the oral healthcare team to be able to recognize its early signs and symptoms and to understand its pathogenesis. Preventive strategies are essential ingredients in the management of patients with dental erosion. When necessary, treatment aimed at correcting or improving its effects might best be of a minimally invasive nature. Still, there remains a need for further research to forge better understanding of the subject. SCOPE AND LIMITATION Modern orthognathic surgical procedures allow correction of bony disproportion in almost any part of the face, but are limited in the fine tuning of tooth position and occlusion. However, carefully planned combined surgical and orthodontic treatment can produce dental and skeletal results of a high standard. If a GDP is presented with a malocclusion beyond the scope of normal orthodontic treatment, then referral to an oral surgery/orthodontic clinic is indicated. This article provides an overview of what the team on such a clinic can achieve. ORGAZINATIONAL CHARTÂ  Of MAYOR DENTAL CLINIC Dr. REGINO C. MAYOR Dra. GLORIA C. MAYOR DENTIST DENTIST Dr. ROMULO Y. MAYOR Dra. ROSELLE C. MAYOR DENTIST DENTIST Dra. MEG RIVERA Dra. ODETTE MARCELO-MAYOR DENTIST DENTIST LYN RODRIGUEZ ASSISTANT CHAPTER I Company Background CHAPTER II DATABASE DESIGN (Tables and Fields) DATABASE DESIGN (Tables and Fields) SUMMARY At this point, you should have forms created that allow the user to enter/edit data for Dentist, Dental Assistants, Patients, Procedures and Appointments (including the details of the appointments such as the procedures performed). CONCLUSION As the overall health of the dental office relies on monies being received and distributed, it is necessary to understand proper protocol and procedures. All of the numerous financial records should be protected for the patients, employees, and employer(s) alike. It is important for the office to receive fees quickly and attribute monies to the proper patient accounts. When those tasks are performed efficiently, office bills and employee payroll can be distributed. These duties can be performed swiftly and professionally via the use of a computer and the corresponding dental software, but also by using traditional manual methods and specialized office forms. CHAPTER III SUMMARY FINDINGS TASK DISTRIBUTION Joselito Poblete * Documentation Creator * Designer Jonathan Martinez * Encoder * Layout Neil Dela Cruz * Researcher * Data Gatherer DOCUMENTATION PICTURES COMPANY PICTURES CHECK UP STATION OPERATION ROOM WAITING AREA

This paper is a Historical Monograph paper of Jonathon I. Israel's Term

This is a Historical Monograph of Jonathon I. Israel's European Jewry in the Age of Mercantilism 1550-1750 - Term Paper Example â€Å"the notion†¦ of a specifically Jewish commerce served a vital function in Western thought. It served to abstract various types of activities from the generality of economic life and, through their association with stigmatized Jews, make them vehicles for expressing widely felt anxieties about commerce in a manner that was politically safe and psychically tolerable.† As a result, there were changes that improved social interactions and developed the economy. Israelites incorporated the changes in the third edition where they talked about the new issues that affected their life, ranging from judgments and figures involved. According to the Europe History in the years 1550 to 1750, the old system were being faced off and replaced by the elites, and modern techniques of conducting business in the society. As a result, there were arguments that modernization in the communities brought changes in the human way of living. This was evidence when it affected the morals, unif ication, and the peace the society had initially. The Jewish argument had some implication that could bring new and positive changes to the Jewish communities and their economy. This could also bring equality in the activities they carried out, how they conducted themselves, and ways to make funds to eliminate their traditional believes. Based on Israel’s views, â€Å"the Jews’ commercial identities served as a barometer of shifting general attitudes toward commerce, money, and credit as a whole.† This was clear when the Jewish through business managed to unite with the Jews who were isolated and worked with them tolerating each other carrying on with their politics in a safe way. Results found by the Historians and science researchers revealed that, both the credit from the government and non-government organizations promoted the social interactions, changes in the economy and politics in Europe. Their commerce activities progressed when they decided to abandon segregation especially when it came to religion. The author also tries to figure out how neutral the European community was especially when they were trying to absorb the modern way of living in their society. Different questions were posed in line with the situation that, Europe was in leaving traces in the political firms and Judiciary. For example, the manner in which educated persons and the normal people coped with impersonal businesses. According to many scholars, there were certain forms in which there was interconnection between social and legal aspects in credit matters. The author also uses a legend to instill information in his evidence. The details that pertains the legend are that, the Jews dismissed this historical belief from France when the bills that were exchanged by then still existed. The legend was spread in the entire Europe during the 17th and 18th century but in this age, only few people talk about it. Credit was perceived to make one wealthier or even take away the riches. This could be realized through the bills of exchange that could show the advantages and disadvantages of the credit. It also made it easier for payments to be done in different states and to enhance more duration for the credit that expired for a short period. So far, this showed improvements in

Geographical Differentials Research Paper Example | Topics and Well Written Essays - 500 words

Geographical Differentials - Research Paper Example Even a cursory overview of unemployment rates within the United States reveals the fact that unemployment is ultimately tied to a lack of infrastructure development, a lack of resources, and oftentimes a lack of educational achievement on the part of the individuals that live within a given region.   As such, the â€Å"why† and the â€Å"where† for unemployment within the United States can ultimately be answered through such an approach.  Ã‚   However, as was discussed within the introduction, the â€Å"what† of unemployment is perhaps the more effective question to answer. In seeking to answer the what of unemployment, the reader must focus upon the fact that unemployment in and of itself does not only mean a lack of opportunity, it also has a direct level of connotation with the lack of ability to engage in work. Through such an understanding, unemployment can also have the tangential definition of the physical and/or psychological unpreparedness of the ind ividual, or, in the worst case of all, a lack of motivation and/or laziness that prohibits them from engaging in useful work. Evidence of the way in which each of these factors can impact upon unemployment rates can be seen with regards to Elkhart, Indiana. Although it Elkhart, Indiana can oftentimes be understood as indicative of nearly any city within the United States, it is unique due to the fact that it has built its economy almost entirely upon the production of recreational vehicles; and industry that took one of the hardest and most definitive economic.

Organisational Behavior Research Report Assignment

Organisational Behavior Research Report - Assignment Example This part of the paper will highlight the workforce changes of the recent time and the possible implications for organizational policies to cater to these trends. Increased globalization and the minority population in the key developing world bring us to the first trend of diversity. Skilled labor from different parts of the world isattractedtowards thedeveloped world for employment as they offer a better environment for them to grow professionally as well as financially. With greater workforce equality and empowered employees, it has become almost necessary to take into account workplace diversity, whether it is females, blacks, handicapped or other ethnocentric groups, at the time of employment. A healthy organization boasts of a diverse workforce that treats all its employees equally(Dol.gov 2014). With trends like feminism, racial equality and minority rights groups, organizations have to keep an out for possible accusations that may lead to a bad name. Narrowing gaps between minorities and an increase in the number of female employees stepping into the professional world has made it imperative that they are made to feel equally welcome and acknowledged. Gone are the days when men were the sole bread earners in the family and women were responsible about family. With women stepping out and equally contributing to the financials of a family, it has become a responsibility of both the men and the women to take care of the family and kids. Thus, it has become important for both the sexes to have job flexibility that allows them to give reasonable time at home and meet family challenges that are now equally shared by the parents. With the advent of technology, workplaces have become more automated. Thus, the most sought after skill is web and computer orientation, making manual labor obsolete. In order to keep up with the pace of change in

Medication Adherence And Treatment Satisfaction In Patients Nursing Essay

Medication Adherence And Treatment Satisfaction In Patients Nursing Essay Abstract Background and Objective: Medication adherence and treatment satisfaction are important for successful therapeutic outcome. The objectives of this study were to (1) assess antipsychotic medication adherence using 8-item Morisky Medication Adherence Scale (MMAS), (2) assess treatment satisfaction using Treatment Satisfaction Questionnaire for Medication (TSQM 1.4), and (3) correlate adherence and satisfaction with psychiatric symptoms measured using 24-item expanded Brief Psychiatric Rating Scale (BPRS-E) in patients with schizophrenia. Methodology: This is a cross sectional study Admin2010-12-25T10:07:00 Also, You should mention your design of study inside the textcarried out at governmental out-patient psychiatric unit in Nablus/ Palestine during summer 2010. Two hundred and sixty seven schizophrenic patients were registered at the clinic. Patients included in the study were those whose medications have not been changed in the past six months and those who did not have an acute attack in the past year. Data were entered and analyzed using SPSS 16 for windows. Results: One hundred and fifty patients Admin2010-12-25T12:46:00 In cross sectional study, you should calculate the sample size to give a good precision for reliability and validity. These terms increase the quality and acceptance rate of articles.out of 267 registered schizophrenic patients met the inclusion criteria. Nineteen patients refused to participate while 131 patients agreed giving a response rate of 87.3%. The mean  ± SD of MMAS was 6.1  ± 1.7 in which 44 patients (33.6%) had low rate, 58(44.3%) had medium rate 29 (22.1%) had high rate of adherence to their antipsychotic medications. The means of satisfaction with regard to effectiveness, side effects, convenience global satisfaction were 72.6  ± 20.5, 67.9  ± 31.47, 63.2  ± 14.3 63.1  ± 18.8 respectively. The mean BPRS score of the patients was 68.4  ± 24.5 with 14.4  ± 6.7 13.7  ± 6.1 means for positive and negative symptoms scores respectively. Pearson correlation showed that there was a positive and significant correlation between effectiveness (P = 0.002, r = 0.27), side effects (0.006, r =0.24), convenience (P Discussion and Conclusion: conclusions can be summarized as follows: First, the majority of the patients had low to medium rate of adherence. Second, adherence was positively and significantly correlated with satisfaction. Third, adherence was significantly but negatively correlated with most psychiatric symptoms. Fourth, no significant difference in adherence was found among patients receiving various antipsychotic therapeutic regimens. Finally, various antipsychotic regimens significantly differ in side effects satisfaction domain only. Key words: adherence, satisfaction, psychiatric symptoms, antipsychotics Introduction Schizophrenia is a chronic psychiatric disorder that impairs the quality of patients life and requires pharmacological and non-pharmacological interventions (Palmer et al., 2002; Pinikahana et al., 2002; Sharma and Antonova, 2003). Antipsychotic drug therapy is considered as the key element in schizophrenia management and has been reported to minimize the frequency of acute schizophrenic episodes and hospitalization (Awad and Voruganti 2004; Campell et al., 1999). Adherence (compliance) to antipsychotic medications is necessary in order to achieve these therapeutic goals. Furthermore, adherence has been reported to lead to considerable cost savings (Damen et al., 2008). However, non-adherence (non-compliance) to antipsychotic medications is common and is considered as an integral barrier to the successful treatment of schizophrenia (Dolder et. al, 2003; Weiden 2007; Byrne et al., 2006; Kim et al., 2006). There are several factors that can cause treatment non-adherence in schizophreni c patients. Such factors include those derived from schizophrenic disorder itself, patient characteristics, those associated with the health-care system, and the antipsychotic treatment regimen (Svestka Bitter 2007; Misdrahi et al., 2002). Patients related factors contributing to non-adherence include gender, age, socio-economic status, race, and religion (Lowry 1998; Borras et al 2007). Cultural differences might be a potential factor for non-adherence. For example, a review article about psychotropic medications found that rates of non-adherence were higher among Latinos than Euro-Americans and clinical and research interventions to improve adherence should be culturally appropriate and incorporate identified factors (Lanouette et al., 2009). Although patients satisfaction with treatment regimen is crucial for medication adherence (Atkinson et al., 2004; Taira et al. 2006), few studies had examined the relationship between adherence, treatment satisfaction and therapeutic outcome in patients with schizophrenia (Fujikawa et al.; 2004; Freudenreich et al., 2004 Watanabe et al, 2004). Therefore, the objectives of this study were to: (1) Assess the degree of adherence to antipsychotic medications among schizophrenic outpatients using eight-item Morisky Medication Adherence Scale (MMAS), (2) Assess the degree of patients satisfaction with their treatment regimen using Treatment satisfaction Questionnaire for medication (TSQM 1.4), (3) Evaluate patients clinical symptoms, Positive Symptom Score (PSS) Negative Symptom Score (NSS) using Brief Psychiatric Rating Scale (BPRS), and finally (4) Investigate relationships and correlations between medication adherence, subjective patients treatment satisfaction and psychiatric symptoms in patients with schizophrenia. Methodology 2.1. Patient selection: This study was conducted between July 2010 September 2010 at Al-Makhfya psychiatric Health Center in Nablus, Palestine. Approval to perform the study was obtained from the Palestinian ministry of health and IRBAdmin2010-12-25T10:09:00 Define this abbreviation committee at An-Najah National University. Patients who met the following criteria were invited to participate in this study: 1) their age was between 20 65 years, 2) they were diagnosed with schizophrenia as defined by DSMAdmin2010-12-25T13:29:00 Define this abbrev.-IV, 3) they had not been suffering from an acute attack of illness during the past year, and 4) their drug regimen had not been changed in the past 4 months. 2.2. Assessment and measures The instrument used in this study consisted of three parts: part one collected socio-demographic and medication data from patients medical files; part two was the Arabic version of the validated eight-item Morisky Medication Admin2010-12-25T13:31:00 . The final version of the Arabic questionnaire should be assessed to know if the Arabic version is reliable and valid to be used in your population. This a routine question by high impact journal Also, I suppose you are the first who use this score in Arab country, and this is good for you because you can write new article related to validity and reliability and it is preferred to be published before this article.Adherence Scale (MMAS) (Morisky et al., 2008, Morisky et al., 1986) and part three was the Arabic version of Treatment Satisfaction Questionnaire for Medication (TSQM 1.4) which the researchers obtained from Quintiles Strategic Research Services. The English version of the MMAS was translated into Arabic and was approved by professor Morisky through e-mail communication. The translation process was carried out according to the following procedure: 1) A forward translation of the original questionnaire was carried out from English to Arabic language to produce a version that was as close as possible to the original questionnaire in concept and meaning. Translation was carried out by two qualified independent translators; both native speakers of Arabic and proficient i n English. Each translator produced a forward translation of the original questionnaire into Arabic language without any mutual consultation. The corresponding author, who is a native Arabic speaker, reviewed the two primary versions and compared them with the original. (2) A back translation from Arabic language to English was carried out by two different translators after lengthy discussion between the translators and the corresponding author. (3) The back translated questionnaire was approved by Professor Donald Morisky through e-mail. The Arabic version of MMAS is an 8-item questionnaire with 7 yes/no questions while the last question was a 5-point likert question. Based on the scoring system of MMAS, adherence was rated as follows: high adherence (= 8), medium adherence (6 The TSQM 1.4 is a 14-item psychometrically robust and validated instrument consisting of four scales [Bahramal et al., 2009]. The four scales of the TSQM 1.4 include the effectiveness scale (questions 1 to 3), the side effects scale (questions 4 to 8), the convenience scale (questions 9 to 11) and the global satisfaction scale (questions 12 to 14). The TSQM 1.4 domain scores were calculated as recommended by the instruments authors, which is described in detail elsewhere (Atkinson et al., 2004; Atkinson et al., 2005). The TSQM 1.4 domain scores range from 0 to 100 with higher scores representing higher satisfaction on that domain. Psychiatric symptoms, positive and negative schizophrenic symptoms were evaluated by a psychiatrist and well trained psychologists using the expanded Brief Psychiatric Rating Scale (BPRS-E) (Overall and Gorham, 1962; Overall 1988; Lukoff et al., 1986; Ventura et al, 1993) at the same visit. The BPRS-E consists of 24 items measuring psychiatric symptoms. It measures four different dimensions: manic excitement/ disorganization, positive symptoms, negative symptoms, and depression/ anxiety (Ruggeri et al., 2005). Positive symptoms were the followings: grandiosity, suspiciousness, hallucinations, unusual thought content and conceptual disorganization. Negative symptoms included disorientation, blunted affect, emotional withdrawal, motor retardation, and mannerism and posturing. 2.3. Data analysis Continuous variables like Morisky score, satisfaction domain scores, BPRS, positive and negative symptoms scores were expressed as mean  ± SD. Correlation between continuous variables was carried out using Pearson correlation test. Difference in means was carried out using one-way ANOVA test. All statistical analyses were conducted using Statistical Package for Social Sciences (SPSS; version 16.0) for Windows. The conventional 5 percent significance level was used throughout the study. Results Demographic and clinical characteristics of patients One hundred and fifty patients out of 267 registered schizophrenic patients met the inclusion criteria. One hundred and thirty one (131) patients agreed to participate giving a response rate of 87.3%. Of the 131 patients, 40 (30.5%) were female and 91 (69.5%) were male. The mean age of the patients was 42.9  ± 10.3 years (range = 20 65 years). The mean duration of illness was 16.23  ± 9.59 years. Eighteen patients (13.7%) had other non-psychiatric diseases mainly diabetes mellitus (10 patients; 7.6%). Smoker schizophrenic patients represented 55% (72 patients) of the sample. None of the patients were reported to have any type of drug abuse. Details regarding demographic and clinical characteristics of the studied patients are shown in Table 1. Regarding treatment regimens, patients were grouped into 7 categories based on the type of antipsychotic medications they were using: Twenty four patients (18.3%) had been treated with oral typical antipsychotics only, 8 patients (6.1%) were using combination oral typical antipsychotics, 19 (14.5%) had been treated with typical depot injections only, 37 (28.2%) had been treated with typical oral and depot injections, 18 (13.7%) had been treated with oral atypical only, 12 patients (9.2%) had been treated with typical and atypical oral antipsychotics, and finally 13 patients (9.9%) had been treated with atypical oral and typical depot injection combination. The most common oral typical antipsychotic used by the patients was chloropromazine while the most common atypical antipsychotic was clozapine. Based on MMASAdmin2010-12-25T13:34:00 It is preferred to classify the characteristic of patients according to the adherence groups. Also, indicate if there is differences between the 3 groups , 44 (33.6%) of patients were rated as having low adherence, 58 (44.3%) were rated as having medium adherence 29 (22.1%) were rated as having high adherence to their antipsychotic medications. The average adherence score (6.1  ± 1.7) for the patients generally indicates medium rate of adherence. Upon investigation using 8-item Morisky scale (questionnaire ), we found that about 33.6% of patients forgot to take their medications; 15.3% of patients missed taking their medication for reason other than forgetting in the past two weeks before the interview; 13.7% stopped taking their medication without doctor counseling when they felt worse upon taking them; 16.8% forgot to take their medications with them when they leave home for long time; 10.7% didnt take their medication in the day before interview; 26% stopped taking their medica tion when they felt that their health is under control; and 55.7% felt hassled about sticking to their treatment plan. As for remembering to take their medications; 27.5% of the patients faced a difficulty in doing this once in a while; 6.1% of the sample sometimes had difficulties in remembering to take their medications; 6.9% of patients usually found difficulties; while 0.8% of schizophrenic patients faced these difficulties all the times. However 58.8% didnt show any difficulty in remembering to take their medication on time. Response to each question in the modified Morisky questionnaire is shown in Table 2. The average score of satisfaction with regard to effectiveness, side effects, convenience global satisfaction was 72.6  ±20.5; 67.9  ± 31.5; 63.2  ± 14.3; 63.1  ± 18.8 respectively. The mean BPRS score of the patients was 68.4  ± 24.5 with 14.4  ± 6.7 13.7  ± 6.1 means for positive and negative symptoms scores respectively Correlation between adherence scores and other variables There was a significant positive correlation between age and adherence (P = 0.028; r = 0.19Admin2010-12-25T13:35:00 As recommended, when correlation is less than 0.25 this considered as no or week correlation, 0.25-0.50 considered fair correlation. You can take this comments in your consideration. ). However, no such correlation was observed with the duration of illness (P = 0.13). Furthermore, no significant difference in the means of adherence was found between male and female (P = 0.76). Patients having other chronic diseases have significantly higher adherence score compared to those who do not, but the significance was at the borderline (P = 0.049). Pearson correlation showed that there was a positive and significant correlation between all satisfaction domains like effectiveness (P = 0.002, r = 0.27), side effects (P= 0.006, r =0.24), convenience (P Adherence, Treatment Satisfaction and type of antipsychotic regimen Adherence score was not significantly different (P = 0.6) among patients having different antipsychotic therapeutic regimens. Analysis of satisfaction based on the antipsychotic drug regimens showed that there was a significant difference in satisfaction with regard to side effects among different antipsychotic regimens ( P = 0.006, F = 3Admin2010-12-25T13:35:00 When you use one way ANOVA, it is recommended to use the Tukey post-hoc test to test the differences in the means between categories. To determine which group or groups are significant. ). Patients on atypical antipsychotic drug therapy showed the highest satisfaction with side effects (86.5  ± 4.8) compared with (51.3  ± 5.17) to those on typical antipsychotic mono-therapy. No significant difference with regard to other satisfaction domains (effectiveness, convenience and global satisfaction) among patients with different psychiatric regimens. Similarly no significant difference was found in BPRS scores (P = 0.6), positive (P = 0.6) and negative symptoms (P= 0.8) among different antipsychotic drug regimens. Details regarding adherence scores, BPRS, positive and negative symptoms with different antipsychotic drug regimens are shown in Table 4. Discussion This studyAdmin2010-12-25T13:36:00 This study is the first of its type in Palestine and the first study used an Arabic version for Morisky. You can add this points as originality of the article was conducted to assess medication adherence and treatment satisfaction among schizophrenic outpatients. The conclusions of the study can be summarized as follows: First, the majority (78%) of the patients had low to medium adherence rate. Second, adherence was positively and significantly correlated with treatment satisfaction. Third, adherence was significantly correlated with positive but negative psychiatric symptoms. Fourth, no significant difference in rate of adherence was found between patients using typical or atypical antipsychotic therapeutic regimens. Finally, patients on typical or atypical antipsychotic medications had similar scores in all domains of satisfaction except for that of side effects. Regarding rate of adherence, several studies have shown that up to 80% of all schizophrenic patients discontinue antipsychotic medications and that non-adherence rates ranging from 20% to 89%, with an average rate of approximately 50%, have been reported (Fenton et al, 1997; Lacro et al 2002, Young et al, 1986). Differences in rate of adherence among different reports might be attributed to different instrument used to assess adherence, social and cultural differences among different countries and differences in healthcare systems (Breen et al., 2007). In our study, younger patients had significantly lower adherence score than elderly patients. This finding is in agreement with other researchers who reported that younger schizophrenic patients have lesser adherence than older patients (Sajatovic et al 2007; Hui et al reported that younger age is a predictor for discontinuation of antipsychotic therapy (Hui et al.; 2006). However, other researchers reported equal non adherence among m iddle aged and elderly patients (Jeste et al., 2003) . Many factors have been cited as a potential cause for poor adherence. Side effects are key factors influencing compliance with antipsychotic medication (Weiden et al., 2004). (Liu-Seifert et al., 2005; Fleischhacker et al., 2003). There are few reports suggesting that treatment satisfaction is positively associated with antipsychotic medication adherence [Gharbawi et al., 2006,], improved clinical outcomes [Masand and Narasimhan, 2006], and quality of life [Hofer 2004,]. Our results give further support that treatment satisfaction is positively associated with adherence and symptom improvement, particularly psychotic positive symptoms. A study by Maneesakorn 2008 indicated that antipsychotic medication adherence has positive impact on psychiatric symptoms and satisfaction with medication (Maneesakron et al., 2007). Furthermore, Mohamad et al 2009 demonstrated an association between positive attitudes toward medication among schizophrenia patients and lower rates of study discontinuation (Mohamed et al., 2009). Thus, it is important to accurately evaluate patient satisfaction with medication treatment using validated instruments that can be utilized in clinical trials and practice. Medication non-adherence had a significantly negative impact on treatment response, highlighting the importance of adherence to achieve satisfactory treatment outcome (Lindameyr et al., 2009). A study by Liu-Seifert et al 2005 has found that discontinuing of treatment may lead to exacerbation of psychiatric symptoms and undermining therapeutic progress (Liu-Seifert et al., 2005). In these studies, poor response to treatment and worsening of underlying psychiatric symptoms, and to a lesser extent, intolerability to medication were the primary contributors to treatment being discontinued. Fewer extrapyramidal symptoms and tardive dyskinesia of atypical compared to typical antipsychotics led researchers to speculate that patients receiving atypical antipsychotics will show greater adherence, satisfaction and psychiatric improvement compared to patients receiving typical antipsychotics (Kane et al., 1988; Tollefson et al., 1997; Marder et al., 1994; Small et al., 1997 Jeste et al., 1999; Marder SR, 1998). However, our findings regarding adherence, satisfaction and psychiatric symptoms measured by BPRS-E were similar between patients on typical and atypical antipsychotic medications. Rosenheck and colleagues evaluated medication continuation and regimen adherence in 423 patients taking haloperidol or clozapine as part of a double-blind, randomized trial. Although the patients who received clozapine continued their medication significantly longer, the treatment groups did not differ in the proportion of pills returned each week (Rosenheck et al., 200). Olfson and colleagu es examined the effect of antipsychotic type on adherence 3 months after 213 inpatients with schizophrenia or schizoaffective disorder were discharged while receiving typical (84.5% of patients) or atypical (14.5% of patients) antipsychotics. A non-significant trend toward increased adherence was reported among patients with prescriptions for atypical antipsychotics (Olfson et al., 2000). Cabeza and colleagues retrospectively studied the relationship of adherence to antipsychotic type in 60 inpatients with schizophrenia. No significant association was found between adherence and type of antipsychotic (Cabeza et al., 2000). Dolder reported that patients on either typical or atypical had similar low rates of adherence (Dodler et al., 2002). Gianfransessco et al 2006 indicated that none of the atypicals showed treatment durations significantly different from the typical (Gianfransessco et al 2006). A study by Jones et al, 2006 has found that in people with schizophrenia whose medicatio n is changed for clinical reasons, there is no disadvantage across 1 year in terms of quality of life, symptoms, or associated costs of care in using FGAs rather than nonclozapine SGAs (Jones et al., 2006). Schulte et al concluded that, in general, very few or no advantages are to be gained from using SGAS rather than FGAS and the clinical effectiveness is not increased, but the side-effects are different. (Schulte et al 2010). In contrast, Al-Zakawani reported that atypical antipsychotic users were significantly more adherent to therapy, and had lower rates of office, hospital and emergency room utilization (Al-zakawani 2003). Actually, efficacy variations within SGAs and FGAs result in overlaps between the two groups and classification of antipsychotics into the two groups is no longer useful (Volvoka 2009). One might argue that cost of atypical antipschyotics is the barrier for medication adherence (Gibson et al., 2010). However, in our study, all patients had governmental insura nce and therefore cost of medications was not a reason of poor adherence of atypical antipsychotics. Regarding results of depot IM antipsychotic injections, we found no difference between oral and long acting antipsychotics with regard to adherence, satisfaction or psychiatric symptoms. Some researchers reported similar or better adherence, satisfaction and outcome with long acting injection than oral antipsychotics (Olivares et al., 2009; Gutierrez et al., 2010; Kane and Garcia 2009; Haddad et al., 2009). In contrast, vehof reported that patients on depot antipsychotics were less adherent and have more side effects than oral antipsychotics (Vehof et al., 2008). Our study has few limitations. The sample size might be relatively small to draw conclusions for assessing adherence, satisfaction and psychiatric symptoms. Instruments that we used to assess adherence, satisfaction and BPRS are might not be the gold standard for this purpose. A third Admin2010-12-25T13:16:00 Must be preceded by first and secondpotential limitation of our study is that the patients selected were homogenous in that all of them had governmental insurance and tends to use similar medications. Non-adherence among schizophrenic patients might be inherent in the context of the disease itself. Despite these limitations, results of this study were useful in understanding adherence, satisfaction and psychiatric symptoms. ReferencesAdmin2010-12-25T10:45:00 The number of references is too much, after delete the repeating ref. the number still 75 Al-Zakwani IS, Barron JJ, Bullano MF, Arcona S, Drury CJ, Cockerham TR. Analysis of healthcare utilization patterns and adherence in patients receiving typical and atypical antipsychotic medications. Curr Med Res Opin. 2003;19(7):619-26. Arana GW: An overview of side effects caused by typical antipsychotics.J Clin Psychiatry 2000; 61:5-11 Atkinson MJ, Kumar R, Cappelleri JC, Hass SL: Hierarchical construct validity of the treatment satisfaction questionnaire for medication (TSQM version II) among outpatient pharmacy consumers. Value Health 2005, 8(Suppl 1):S9-S24. Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes. 2004 Feb 26;2:12 Awad AG, Voruganti LN. Impact of atypical antipsychotics on quality of life in patients with schizophrenia.. CNS Drugs. 2004;18(13):877-93. Review Bharmal M, Payne K, Atkinson MJ, Desrosiers MP, Morisky DE, Gemmen E. Validation of an abbreviated Treatment Satisfaction Questionnaire for Medication (TSQM-9) among patients on antihypertensive medications. Health Qual Life Outcomes. 2009 Apr 27;7:36 Borras L, Mohr S, Brandt PY, Gillià ©ron C, Eytan A, Huguelet P. Religious beliefs in schizophrenia: their relevance for adherence to treatment. Schizophr Bull. 2007 Sep;33(5):1238-46 Breen A, Swartz L, Joska J, Flisher AJ, Corrigall J. Adherence to treatment in poorer countries: a new research direction? Psychiatr Serv. 2007 Apr;58(4):567-8 Byrne MK, Deane FP, Caputi P. Mental health clinicians beliefs about medicines, attitudes, and expectations of improved medication adherence in patients. Eval Health Prof. 2008 Dec;31(4):390-403 Cabeza IG, Amador MS, Lopez CA, Chavez MG: Subjective response to antipsychotics in schizophrenic patients: clinical implications and related factors. Schizophr Res 2000; 41:349-355 Campbell M, Young PI, Bateman DN, Smith JM, Thomas SH The use of atypical antipsychotics in the management of schizophrenia.. Br J Clin Pharmacol. 1999 Jan;47(1):13-22. 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Oligopolists :: essays research papers

Oligopolists There are four market structures in our economy today : Perfect competition, monopolistic competition, oligopolies and monopolies. This essay shall describe the oligopoly market.   Ã‚  Ã‚  Ã‚  Ã‚  The definition of an oligopoly states that in an industry, a small number of firms dominate the market. There are a low number of firms in the industry, becasue and adding to the barriers to entry. The barriers of entry to an oligopolistc market include the financial resources needed to enter and such regulations from the government or patents.   Ã‚  Ã‚  Ã‚  Ã‚  In this market, there is a high degree of differentiated products, and so with all of the above factors combined in this market, the competition is of sales, not of price. There is also a factor of concern from the firms in an oligopolistic market - where the actions of one firm will subsequently effect the other firms in the industry. This results in each oligopolist watching its competitors closely, and is a method of competition between the firms, other than by price wars.   Ã‚  Ã‚  Ã‚  Ã‚  The Kinked Demand Curve, is the economical graph that shows why oligopolists tend to adopt a common price -to achieve the greatest price and output.   Ã‚  Ã‚  Ã‚  Ã‚  The Hilmer committe, estabilished 1993, is a government body who acts in the interests of recommendations of National Competition policies.   Ã‚  Ã‚  Ã‚  Ã‚  In 1995, the Trade Practises Act (T.P.A.) was introduced. The T.P.A. sets out the general responsibilities of sellers, such as the firms of oligopolies, and out laws actions that may be unfair to the consumers. This includes misleading advertising, market sharing and collusion. Collusion is where the firms of an industry meet a set, common price, or agree not to come into each other in the market area. Oligopolists :: essays research papers Oligopolists There are four market structures in our economy today : Perfect competition, monopolistic competition, oligopolies and monopolies. This essay shall describe the oligopoly market.   Ã‚  Ã‚  Ã‚  Ã‚  The definition of an oligopoly states that in an industry, a small number of firms dominate the market. There are a low number of firms in the industry, becasue and adding to the barriers to entry. The barriers of entry to an oligopolistc market include the financial resources needed to enter and such regulations from the government or patents.   Ã‚  Ã‚  Ã‚  Ã‚  In this market, there is a high degree of differentiated products, and so with all of the above factors combined in this market, the competition is of sales, not of price. There is also a factor of concern from the firms in an oligopolistic market - where the actions of one firm will subsequently effect the other firms in the industry. This results in each oligopolist watching its competitors closely, and is a method of competition between the firms, other than by price wars.   Ã‚  Ã‚  Ã‚  Ã‚  The Kinked Demand Curve, is the economical graph that shows why oligopolists tend to adopt a common price -to achieve the greatest price and output.   Ã‚  Ã‚  Ã‚  Ã‚  The Hilmer committe, estabilished 1993, is a government body who acts in the interests of recommendations of National Competition policies.   Ã‚  Ã‚  Ã‚  Ã‚  In 1995, the Trade Practises Act (T.P.A.) was introduced. The T.P.A. sets out the general responsibilities of sellers, such as the firms of oligopolies, and out laws actions that may be unfair to the consumers. This includes misleading advertising, market sharing and collusion. Collusion is where the firms of an industry meet a set, common price, or agree not to come into each other in the market area.