He Nurse' Responsibility in the Prevention of Medication Errors Essay

He Nurse' Responsibility in the Prevention of Medication Errors - Essay Example It is estimated that, at least one in ten inpatients have faced an incident of medication error, leading to severe injuries. Nurses have a very critical responsibility in the identification, reduction, and prevention of any foreseeable medical risks in hospital settings and other environment of medical care. To counter the increasing cases of medical errors, nurses and other practitioners should view every medical error as a complex system failure rather than an individual failure. As a result, effort towards the development of defenses to eradicate errors is more likely to advance patient safety rather than blaming individual responsibility. Medication errors entail preventable events (harm or death) caused by inappropriate medication or treatment procedures. Introduction The recent medical errors not only cost individual lives and health but also have a very extraneous financial burden that ranges from 21 billion to 37 billion dollars every year. Frequent medical errors lead to a r eduction in the level of satisfaction and trust in nurses and the entire healthcare system by the society. Safety concerns among patients constitute the main cause for patients seeking alternative care. Health practitioners have the responsibility of complying with the five main rights to safe medication, right route, right patient, right drugs, and right time. As stated by Ball (2010), in 2010, there are between 78 000 to 120, 000 reported cases of deaths caused by preventable and unnecessary medical errors annually. Additionally, thousands of inpatients are affected by nonfatal medical errors. Medication errors also lead to psychological and physical errors among the affected patients. Nurses have an incredibly decisive role in reducing cases of medication errors. They have the responsibility of ensuring that other health professionals do not make unnecessary mistakes and that they too do not make obvious mistakes. Thesis Statement The main role of any health professional is to pr otect and improve patients’ health. Nurses have the key responsibility of reducing cases of medication errors in health sectors. They have the mandate of utilizing all the available resources, strategies, and mechanisms to mitigate increased deaths and harm caused by medication errors. The cooperation between all involved players in the health sector can record significant improvement in-patient health Owing to increased deaths and physical injury caused by nurses’ medication errors, nurses have come up with a variety of strategies and measures to counter the alarming death rate. At present, there are several suitable methods for reducing the impact of medication errors. For starter, drug selection is extremely crucial especially among vulnerable people in the society. Nurses should avoid ordering drugs on Beers Criteria for patients who are 65 years and above. The Beers Criteria points out the drugs that should be avoided by aged patients who have a specified medical condition. The use of trailing zero after decimal in a dosage is another core reason for medication error. For instance, it is possible for health practitioners to misinterpret 1.0g with 10 g in the situation where the decimal is not legible. According to the existing medication regulations, zero is

Where Are You Going, Where Have You Been Essay Example | Topics and Well Written Essays - 750 words - 1

Where Are You Going, Where Have You Been - Essay Example The story describes Connie as a young and beautiful girl who grows up in the Suburbia in the years between 1960. During this period, the author describes there were few beautiful girls who would be determined to expose their beauty to the entire society. Although the young girls were beautiful, most of the parents opted for their daughter to remain indoors. Joyce Carol Oates the author of the story, â€Å"Where Are You Going, Where Have You Been† illustrates that since Connie was young, she spend most of her time in front of a mirror confirming her beauty. This made Connie’s mother irritates and pissed off since her daughter was wasting time in confirming her beauty instead of concentrating on other life aspects (Oates 1). At some point, the author, Joyce quotes in the story â€Å"Where Are You Going, Where Have You Been† that, â€Å"stop wasting time and gawking at yourself, who do you think you are, you think your pretty†. Joyce identifies that the mother was provoked with the number of times her daughter wasted time in confirming and bragging her beauty. Connie also had an elder sister, June but she was not as beautiful as the young and attractive Connie appeared. Although June was the eldest of the two, one would mistake Connie to be the first-born. June was older at the age of twenty-four and still lived with the parents. She worked in a high school as the secretary and saved the maximum money she could to rescue the family (Oates 4). June was innocent and never made any trouble to the family as Connie did to the rest of the family. June always listen to her mother’s words and followed every instruction given. This was totally contrary to the sister, Connie, who decides to listen to the friends. In the story, â€Å"Where Are You Going, Where Have You Been†, the author, Joyce identifies that Connie continued with her trends and even started going out with friends. This made the situation even worse after she was introduced to

Controversy And Criticism At The Nestle Company Commerce Essay

Controversy And Criticism At The Nestle Company Commerce Essay In past ten years Nestlà © Company was accused by many of experts and organisations around the world for unethical business practices in the way the company does its business, the company was involved in serious boycotts which ruined the company overall reputation in past years. In this essay we have discussed and analysis some of the most serious Nestlà © unethical business practices (Phdinparenting, 2010). One of the most critical issues that Nestlà © has been criticised for during past 15 years is the promotion of the use of infant formula to mothers across the world. Many believe that Nestlà © strategy for promoting its infant formula was misleading and harmful that violates both International Code of Marketing of Breast milk Substitutes and WHO Code regulating the marketing of breast milk substitutes (Mcspotlight, 2002). Nestlà ©s marketing campaign encouraged mothers across the world for bottle feeding instead of breast feeding, they used free sample to pursue this mission in addition Nestlà © implies that malnourished mothers and mothers with twins have not the ability to Breastfeed their child, despite many international health organisations claimed that there is no evidence to support this statement which could put both the mothers and babies life in danger (Corporatewatch, 2003). There have been numerous reports of direct advertisement targeting mothers across the world in countries such as Malaysia, South Africa and Ireland as a result advocacy groups and health organizations accused Nestlà © of unethical methods of promoting its milk and demand the company to immediately stop its marketing strategies (Mcspotlight, 2002). One of the Health organisations that criticised Nestlà © for its marketing strategy was IBFAN which believed Nestlà © is harming misleading mothers by offering them a free sample of milks as they are in hospitals, because as mothers are released from hospitals they have to continually buy Nestlà ©s formula since babies get adapted to the Nestlà ©s milk. IBFAN also claimed that Nestlà © uses humanitarian aid to create markets by offering attractive gifts and different sponsorships to influence health officials to market and promote its products by targeting young mothers who have given birth (Corporatewatch, 2003).. 2.2 Using Suppliers That Violate Human Rights Another controversy issue faced by the company during past years was using suppliers that violate human rights, in 2009 BBC reported that Nestlà © buy its milk from a farm seized from its white owners which is now owned by the wife of Zimbabwes President Robert Mugabe, they supply between 10% to 15% of Nestlà ©s local milk supply (Corporatewatch, 2003). However the company denies the proclamation and claims that the only reason they purchase their milk supply from its African supplier is to help meet the food needs of Zimbabwean consumers (BBC, 2009). 2.3 Exploiting Farmers In 2001, Nestlà © faced huge criticism for purchasing cocoa from the Ivory Coast and Ghana suppliers, which may have been produced using child slaves. An investigation by BBC showed that hundreds of children who lived in Mali, Burkina and Togo were being purchased from their parents and sent to countries such as Ivory Coast and Ghana to be used in production of coca (BBC, 2001). Most of the children who work in coca farms are ranged between 12 to 14 years old, and are forced to work 80 to 100 hours each week while they are not paid fairly, barely fed and beaten regularly (Corporatewatch, 2003). After the widespread of these reports Nestlà © Company faced huge criticism from health and labour organisations around the world to put a stop to these anti-humanities act, as a result the company did not have any choice except to express its concern over the use of child labour in coca farms to, however the company never confirmed that non of its chocolate products derived from these anti-humanities resources (Mcspotlight, 2002). 2.4 Union Busting In late 2001, labour organisations accused Nestlà © for denying its worker right; one of the countries that most of the accusation came from was Columbia, in which eight worker of the company got assassinated because they were part of food and drink labour union called SINALTRAINAL; however there have been no evidence linked Nestlà © to these assassinations. In another example involving Nestlà © union busting, in 2001 the management of Nestlà © subsidiary Comestibles La Rosa threatened the company worker that they must either renounce their union membership or they should leave the company (Corporatewatch, 2003). 2.5 Promoting Unhealthy Food Nestle was recently exposed after a report by the UK consumers association claiming that 7 out of 10 of the Nestlà ©s breakfast cereals containing the highest level of fast, sugar and salt water. The company is accused for denying the role of corporate responsibility in promoting its product to public (Corporatewatch, 2003). 2.6 Illegal Extraction of Groundwater The company was also accused for abusing and ruining water resources in Brazil and United State. In the region of Serra da mantiqueira in Brazil which is known for its vulnerable groundwater resources, Nestlà ©s over pumping action has resulted in depletion and long term damages to the region water resources (Corporatewatch, 2003). Nestlà ©s was accused because people of the Serra da mantiquira believ that the company action has changed the taste of their drinking water and also the over pumping has caused complete dry out on the main region water resources. Nestle used these water resources for its mineral water product called Pure Life bottled water (Phdinparenting, 2010). 3.0 Solae Company 3.1 Solae History Solae LLC is an international soy supplier which is based in Louis, Missouri. This company is the world leader in developing and producing innovative soy technologies, meat and other nutritional products. The company was founded in 1958 by producing just industrial soy protein products; however Solae started producing other food product (such as baked goods, meats, beverages and nutrition bars) in 1973 after DuPont and Bunge created Solae Company as a joint venture (Solae, 2010). Solar use soybean resources around the world in order to create nutritious and great-tasting ingredients including baked goods, meats, beverages and nutrition bars which are used by thousands of customers in more than 100 countries around the world. The company has approximately 2,400 employees in different parts of the world including North America, Asia, Europe and Latin America (Solae, 2010). Solaes commitment to innovation and development has resulted in production of new soy product tag along by more than 98 patent and 338 patents pending which is more than any other soy provider in the world (Solae, 2010). On 26 of March 2010, Solae Company was recognized by the Ethisphere Institute as one of the worlds most ethical companies. Each year Ethisphere Institute prepares a list of 100 companies which it believes are the most ethical companies in the world on basis of attitude and future refinement (Ethisphere, 2010). The world most ethical companies are recognize not only making statements about doing business ethically but also translating those statements into action. Solae was ranked among on of the 100 most ethical companies in the world along with giant companies like Pepsi, Nike, Ford, Xerox, Henkel and LOreal in addition the company was positioned at top 5 most ethical companies in food and beverage industry joined by Campbell, Mills and PepsiCo (Ethisphere, 2010). 4.0 Solae Ethical and Decent Practices Solae ethical and moral practices are inspired by the companys core value which mostly concentrate on what the company is and what it is stand for, Solae top executives believes the strength of the company begins with a deep commitment to ethics from the top to bottom in the company, ethical behavior is one of the core values at Solae, which is important in both the companys professional and personal lives. According to Solae officials, at Solae ethic codes are designed to make sure that each of the companies personnel are constantly upholds the companys standards and objectives. Any act that deliberately violates the law or regulation to screen non-compliance with this Code of Conducts, or company overall policy is an ethical violates (Solae code of conduct, 2010). 4.1 Safety and Health Solae Company believes that in doing business all occupational illnesses, environmental incidents and injuries are preventable and can be controlled by implementing the right business practices along with providing the best and high quality foods to consumers. The companys overall goal is zero for incidents, meaning that safety and health are one of the most important aspects of Solae Company (Solae, 2010). Every employee at Solae is responsible for acting in reliance with safety and health law which was developed to prevent any incident involving employees and other Solae personnel. Managements in each department are responsible for training, educating and motivating employees to understand and act accordingly to applicable safety and health laws. 4.2 Sustainable Practices for Society Solae core value of environmental custodiantion is a major example of the companys commitment for people in different societies. At Solae employees are expected to compete lawfully at all manners, they are also expected to protect the environment and to be a good keeper of the company operations, services and products (Ethisphere, 2010). 4.3 Environmental Practices Since the company was founded, Solae mission has been to be the preferred universal partner in the expansion and delivery of nutritional and efficient solutions for its customers, the Company is constantly committed to promise to conduct business and operations with respect and care for the Mother Nature. Since Solae main business is product of soybean resources, the company pays a great respect and attention to environmental practices which helps to keep our nature green and un harmful. At Solae managers at each corporate level are held responsible for educating, training, motivating and instructing employees to understand the important of Solaes commitment to protect environment in addition each employee at Sola company has the responsibility to meet and fulfil the terms of Health and Environment which were developed to guide each employee in pursuing the companies mission and vision (Solae code of conduct, 2010). Solaes commitment to environment is one of the core value developed by the company which has allowed the company continually improve and implement main manufacturing process and activities to reduce its impact on Mother Nature, It is believed that Solae track its activities across all manufacturing department in order to replicate successful improvement where it is needed. The company has received several awards because of its environmentally friendly business practices around the world. For example: In 2009, the company headquarter in StLous was given a LEED Green Building Certificate (Leadership in Energy and Environmental Design) for having the most energy efficient, greenest and high productive building in the region (Solae, 2010). In 2005, Solae received two awards from different non-profit organisations for reducing total energy consumed by the company by more than 10 percent and decreasing greenhouse emissions by 7.7 produce by the company (Solae, 2010). 4.4 Ethical Competition Law Practices It is believed that, Solae competes forcefully in the marketplace to best supply its customers needs and preferences. Solae Company has gain most of its reputation as a result of its Competition Laws which the company follow in most of the countries that operates, these laws are compound and can vary from country to country depending to its market place competition condition and pressure (Solae code of conduct, 2010). 4.5 Water and Energy Consumption Solae is well known around the world for its efficient water and energy consumption in compare with other companies involved in food industry. Soy uses less water than other kind of proteins such as meat, milk and eggs. In addition soy is known to be an efficient source of protein based on return amount of energy use in compare with other resources of proteins. C:UsersArmanDesktopvirtuawater.jpg C:UsersArmanDesktopenergyefficiency.jpg USDA; FAO/ UNICEF, USA Protein Advisory Group (2005) 4.6 Equal Opportunity Non Discrimination Solae Company is against any discrimination regarding any employee or new application who wants to join the group because of race, sex, age, colour, national origin, marital status, expression or ancestry (Solae, 2010). Conclusion To sum up, Core values are particularly critical in these days as we operate in markets around the world and aiming to serve customers with different needs and ideas. Obviously at Solae Company the central attention is to understand responsibilities and obligations toward individuals and environment. As experiment has shown us a companys success is pretty much dependent on ethics and moral which builds a long term reputation for both the company and industry. Unfortunately, after analyzing Nestlà ©s corporation act, clearly ethics has no place in the company long term strategy. This fact has greatly influenced companys reputation and has ruined its position in food industries around the world. As a result the concept of ethics has become one of the most important aspects of management duty. For companies as big and successful as Solae and Nestle training employees to follow ethical and social principles are key success factor and has to be observed and practice continually. Many businesses are interested in making money, and that is the bottom line or in other words they just want to be in business; on the other hand there are many businesses that making money does not mean everything to them, but doing the right thing and having responsibility and commitment toward society have far more importance. Solae has to continue its effort in practicing ethical principles in all company levels and Nestle has to change its long term strategy and pay attention to what is right and wrong.

Free College Essays - Self-Revelation in Their Eyes Were Watching God :: free essay writer

Their Eyes Were Watching God   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Self-Revelation    Their Eyes Were Watching God, by Zora Neale Hurston, is a novel about one woman’s self-revelation. It began when this woman was a very young girl. At first she was being pushed, then she was being chosen, and finally, she was able to choose. Born a victim of circumstance, Janie, the main character, was subject to her position in life. She was raised to uphold the standards of the early African-American generation. From the beginning, she was taught to be passive and subject to whatever life gave her. As she grew older, she began to realize that she must give in to her desires and not suppress them. Janie was set up for her journey of self-discovery by her grandmother. Nanny set a goal for Janie’s life by saying, â€Å"Ah wanted you to look upon yo’ self. Ah don’t want yo’ feathers always crumpled by folks throwin’ up things in yo’ face.† ***SITE THIS?*** Janie’s grandmother pushed Janie into a marriage, which she considered a â€Å"safe† place for Janie. Though hesitant, Janie agreed to marry Logan Killicks. He was a farmer who married Janie shortly after she completed school. Killicks   was the first antagonist that Janie encountered in the story. He was there for one purpose, to destroy Janie’s new sense of self-awarenes. Logan demanded things of Janie that she did not wish to do and tried to push her into his mold of a perfect wife. Janie did not love Logan, nor did he love her. She did not   know what she wanted, but she was sure   that she did not want Logan Killicks. Joe Starks appeared in Janie’s yard one afternoon. He said the sweet things that Janie wanted to hear. Though Janie hardly knew the man, being young and gullible, she was taken by his words. She took another step in her journey, leaving Logan the next day and travelling to Eatonville with Joe Starks. Aspiring to be the mayor of Eatonville, Joe Starks was a man concerned with little except power. He wanted it, and he was going to use Janie to get it. She wore nice dresses during this marriage because Joe wanted her to stand out from the rest of the town. He used her as an icon of his prosperity and power. He was cruel to Janie and stomped out all of her free will.

Shashi

Brilliant Exam Engine Answer Key with Hint Total time :40 Min Maximum mark: 120 Subject :Demo Test Mark for True answer: 4 Chapter :One Dimensional Motion Mark for Wrong Answer: -1 1. A particle starts from the origin, goes along x-axis to the point (20m, 0) and then returns along the same line to the point (-20m, 0). The distance and displacement of the particle during the trip are A)40m, 0 B)40m, 20m C)40m, -20 m D)60m, -20 m E)+20m, -40 m Hint: Distance = 20 + [20 – (-20)] = 60 m Displacement = -20 – 0 = -20 m 2.Choose the correct statement from the following A)The magnitude of velocity of a particle is equal to its speed B)The magnitude of the average velocity in an interval is equal to its average speed in that interval C)It is impossible to have a situation in which the speed of the particle is never zero but the average speed in an interval is zero D)It is possible to have a situation in which the speed of particle is zero but the average speed is not zero E)Both A and B 3.Which of the following is not an example of linear motion A)A book at rest B)A body in uniform circular motion C)Wheel rotating at uniform speed on road D)A body rolling down an inclined plane E)None 4. The correct statement from the following is A)A body having zero velocity will not necessarily have zero acceleration B)A body having zero velocity will necessarily have zero acceleration C)A body having uniform speed can have only uniform acceleration D)A body having non-uniform velocity will have zero acceleration E)All the above 5.When two bodies move uniformly towards each other the distance between them decreases by 8 m/s. If both bodies move in the same direction with different speeds the distance between them increases by 2 m/s. The speeds of two bodies will be A)4 m/s and 3 m/s B)4 m/s and 2 m/s C)5 m/s and 3 m/s D)7 m/s and 3m/s E)8 m/s and 4 m/s Hint: 6. A car runs at a constant speed on a circular track of radius 100m, taking 62. 8 sec on each lap. What is avera ge velocity and average speed on each lap A)10m/s, 10 m/s B)0, 0 C)0, 10 m/s D)10 m/s, 0 m/s E)10m/s, 5 m/s Hint: . Distance travelled by a body is directly proportional to time, then the speed of the body A)increases B)decreases C)first increases and then decreases D)is zero E)remains the same 8. A car moving with a speed of 40 km/h can be stopped by applying breaks after at least 2m. If the same car is moving with a speed of 80 km/h, the minimum stopping distance is A)8 m B)2 m C)4 m D)6 m E)10 m Hint: A)Acceleration B)Velocity C)Displacement D)Distance E)Mass 9. 10.The distance travelled by a body falling freely from rest in first, second and third seconds are in the ratio A)1 : 2 : 3 B)1 : 3 : 5 C)1 : 4 : 9 D)1 : 4 : 5 E)1 : 1 : 1 Hint: A)6 sec B)8 sec C)10 sec D)4 sec E)Cannot catch the bus 11. Hint: 12. A)Uniform acceleration B)Uniform retardation C)Non-uniform acceleration D)Zero acceleration E)Non-uniform retardation Hint: 13. A)Directly towards the target B)5 cm above the t arget C)10 cm above the target D)15 cm above the target E)5 cm below the target Hint: A B C D E 14. Hint: 15.With doubling the speed of a vehicle the distance required to stop it becomes A)Doubled B)Halved C)Tripled D)Four times E)Five times Hint: A B C D 16. E 17. A B C D E 18. A B C D E 19. A B C D E 20. If displacement of a particle is zero, distance covered by it A)may be zero or may not be zero B)must be zero C)must not be zero D)all are true E)all are false 21. The distance travelled is given by A)area under speed – time graph B)area under distance – time graph C)slope of velocity – time graph D)slope of velocity – time graph E)None 22. A B C D E Hint: 23.A ball is thrown upward. After it has left the hand, its acceleration A)decreases B)increases C)is zero D)remains constant E)will increase during descending and decrease during ascending 24. A)20 m B)25 m C)30 m D)45 m E)40 m Hint: A B C D E 25. Hint: 26. A body is thrown upwards and reaches its ma ximum height. At that position A)its acceleration is minimum B)its velocity is zero and acceleration is also zero C)its velocity is zero but acceleration is maximum D)its velocity is zero and its acceleration is the acceleration due to gravity E)both A and B 27.A)Velocity – displacement relation B)Position – time relation C)Time – Velocity relation D)Time – displacement relation E)Acceleration displacement relation 28. A)Velocity B)Acceleration C)Displacement D)Speed E)A and B 29. Speed is a: A)vector quantity B)scalar quantity C)neither vector nor scalar D)sometimes vector sometimes scalar E)none 30. A particle moves with uniform velocity. Which of the following statements is true: A)Its speed is zero B)its acceleration is zero C)its speed is variable D)its acceleration is opposite to velocity E)its velocity is negative

Monsters Are Real Donnie Darko

In storytelling, monsters are used to express the fears and worries of humans. They allow us to discover our values by questioning our morals through imagination and illusion. In both Donnie Darko and Pan’s Labyrinth illustrating real-life monsters Captain Videl and Jim Cunningham enhances our fear of monsters. These villains symbolize the vulnerability we feel as we identify ourselves with the victims of the attack. We can relate each example of monsters to an evolution of our fears throughout our lives. The fear we have of monsters stems from the idea that our moral imaginations shape the danger inside these beastly beings.As children, our vulnerability came from our fears of losing security. The monsters hiding under our beds taunted us with the threat that we’d be eaten and would never see our parents or that our most valued possession would be taken from us. This juvenile fear is illustrated in Pan’s Labyrinth through Captain Videl. He encompasses the threat s we felt as children by being controlling and dominating, as he manipulates Pan and she loses her innocence. As we mature and the limits of our moral boundaries widen, the term â€Å"monster† evolves into something more complex.As we enter into adolescence, and later into adulthood, our fears become something less to do with security and more to do with a threat to our happiness. Our moral imagination evokes fears of defeat and failure, a fear that we formulate in ourselves. As we grow older, we also fear the world and others that we cannot control. In Donnie Darko, Jim Cunningham, embodies our fears of a predator. He is the real-life monster we fear everyday with his complex, dark and twisted secrets. Ultimately, both Donnie Darko and Pan’s Labyrinth effectively embody our illusions of fear from childhood to adulthood.

The Truth Behind the Monster Essays

The Truth Behind the Monster Essays The Truth Behind the Monster Essay The Truth Behind the Monster Essay Does nurturing children have a positive outcome on their life? Or is it genetics that make children the way they are? Questions similar to these are addressed in the debate of nature vs Nurture. This argument centers around what controls our outcome: our environment or our genes. In Mary Shelley Frankincense, Victors creation, the intention of which was to help understand the concept of life and death, results in nothing more than destruction of his own life. Victor did not nurture the monster, even though it was eager for love and compassion the second Victor created it. After being repeatedly abused and rejected by others, the creature becomes evil. Both children and the creature in Frankincense share the basic psychological needs of love and affection that must be met in order for them to become active members in society. The nature vs Nurture dichotomy is an ongoing debate in psychology which centers around genetic inheritance and environmental factors to human development (Richardson 16). The main question is, are we shaped by our genes or by our environment? Many believe that individuals mold environments. Others say environments mold individuals. Genera Cherry, author of Everything Psychology, wonders when people accomplish tremendous academic success, did they do so because they are genetically predisposed to be successful or because of an enriching environment? Nurturing children has been proven to be one of the most effective ways for them to become successful and prosperous adults. The nurture side of the nature vs Nurture refers more to personal experience and childhood. According to Keith Richardson, author of Developmental Psychology, a supportive nurturing can enable each child to succeed happily within the parameters of his or her own impairment (Richardson 31). Most people are a product of their own circumstances. If a person grows up with no nurturing, or family, never knowing what it is like to have his or her basic needs met, he or she is less likely to show love to anyone. Kids who are born into a life of crime continue the life of crime because they do not know any other way. The social learning theory of psychology states that if a child observes aggressive behavior between parents, siblings, or both, he or she often copies this behavior, creating a cycle. Children need to be loved in order to how love. Jesse K. Denominated is a convicted murderer. He allegedly raped and murdered his seven-year-old neighbor, Megan Kane, in Hamilton New Jersey on July 29, 1994. He lured Kane into his house by offering to show her a puppy. He then proceeded to rape her. Denominated later strangled her with a belt. He placed the body in his truck, and assaulted her an additional time before placing Megan in a wooden toy chest and dumping it near Mercer County Park. When they searched Jesses house that night, he was very nervous, sweaty, and kept mixing up his stories. The next day, Denominated eventually confessed to his crimes and lead the police to the spot of Means body. Evidence of blood stains, hair, and fiber samples were found by police outside of Detainments home. Authorities also found a bite mark matching Megan Kansas teeth on his hand, leading him to be found guilty of kidnapping, four counts T aggravated sexual assault, Ana two counts AT Talons murder. He Tact penalty and a minimum of 30 years in prison (Glassblowers). All throughout his life, Jesse Denominated never knew what it was like to truly be loved and cared for. His mother, an alcoholic, who had ten different children with several men, never cared for Jesse. His father, a violent drinker with a criminal background, sexually abused Jesse and his brother day after day. Jesse also reported watching his father rape a seven year old girl. According to Carol Chock, a forensic social worker, Detainments father tortured and killed their pets, and that he once forced the brothers to eat their pet rabbit. The family also lived in poverty for a long period of time, and Jesse never sought proper medical attention for his clearly histrionically childhood. Under those terrible circumstances, could the murder of Megan Kane have been a result of Jesse Denominated lack of nurture as a child? When Frankincenses creation first came to life, he was deformed, but not necessarily a monster. His murderous actions turned him into one, but only after he was repeatedly abused and rejected by humans (Baldric 201). When the monster goes into hiding because Victor rejects him, he observes a family across the way and sees how people interact with each other. He sees affection and love, but he also sees hat everything is not always perfect. The monster responds strongly to the love the De Lackeys have for each other, and to Felids obvious sadness (Baldric 201). Frankincenses creation builds up the courage to tell the De Lackeys about what is happening to him. They immediately reject him because he is not a human, and he looks deformed. Even after Victor abandons him and Felix assaults him, the monster tries to save a drowning girl. However, because of his appearance, the girls father tries to kill the monster. The monster shows the romantic notion that good nature ND kindness are inherited qualities in human beings (Bloom 201). The monster knows that people despise him because of his horrible appearance. He also learns that society does not always accept people who look differently. The monster even says, all men hate the wrenched (Shelley 81). When he kills William, Frankincenses brother, its because he wants Victor to feel the same pain he does. He doesnt do it because of the nature in which he was created. The monster hopes that if Victor feels his pain, he will create a partner monster to love him. Victor refuses, making he monster even more upset. Victor willingly accepts responsibility for the creatures existence, but he fails to understand that his own actions after the creatures birth, as well as the treatment of the creature by other humans, are responsible for the creatures malevolent behavior (Killed 186). Victor is ignorant when it comes to whom to blame for Williams death. The monster did nothing wrong until he was denied by society. Similar to Denominated, Victor Frankincense lacked the proper nurture as a child. Although not thoroughly described in the book, his father spent his younger days perpetually occupied by the affairs of his country (Bloom 178). His mother died of Scarlet fever Just weeks before he left for Inconstant. Victor was also in love with his adopted cousin, Elizabeth, and had further plans to marry her. Victors childhood was not ideal, and having his mother pass shortly before his experiment could have greatly effected the outcome. In the beginning of Victors experiment at Inconstant, Victor hoped that by creating the monster, he would gain a better understanding of Tie. However, little 010 en Know, ten monster would Instead destroy Nils Tie. E monster kills William, Victors family is in danger of being killed, but Victor does not warn anyone. Victor also knows the creature killed William but refuses to step forward when Justine is being questioned because he doesnt want his family to think he is crazy. The monster may have killed William, Henry, and Elizabeth, but Victor created the monster. Victor also knew who killed William and never said a word when Justine died. So, who is the real monster here? Jesse Detainm ents committed the crimes he did because he followed the example his father set for him. He didnt mean to hurt a young innocent girl, but his father mentally corrupted him. Jesse observed the aggression and sick behavior of his father as a child; therefore, he was more likely to repeat them. Never knowing what a stable family life was like, Jesse committed a horrible crime on account of his fathers atrocious parenting. So, who is to blame in these situations? Jesses father set him over the edge, and Victor ignored the monster, giving him no love or attention whatsoever. Therefore, the monster went to drastic measures. Because their basic psychological needs were not met, both Jesse and Frankincenses creature acted rashly and without reason. Despite his unnatural birth, Frankincenses creation exhibits the same attitude of a young child discovering the ups and downs of life. An example of this can be seen when the monster discovers fire, I found a fire which had been left by some wandering beggars.. In my Joy I thrust my hand into the live embark but quickly drew it out again with a cry of pain (Shelley 89). The monster has no life experiences and no one to show him right from wrong. The Delays can be named the monsters first returns. Although they may not have known it, they made him aware of human relationships and emotions. He eventually feels the need of physical pain and hunger and starts to steal the Delays food. The monster says he stops stealing the food because he found out that in doing this he inflicted pain on the cottagers (Shelley 96). The Delays first teach him kindness, love, and the bonds of family and friends. If he truly was a monster, he would have no capacity for love and companionship. Both the monster and Jesse Detainments never knew what it was like to love ND be loved. Although they may have witnessed different forms of the thought of love, they both never felt it for themselves. They went to catastrophic measures to find the nurture their life had lacked. Both of their actions may have been wrong, but Victor and Jesses parents take part in their rash decision making. It is important for children to be nurtured in order for them to succeed. Without nurture, their basic needs may not be met and this can lead to a corrupt adulthood. Sometimes it is not about what youve done, but how youve gotten there.

Free Essays on Tuesdays With Morrie Reaction

on a page. That’s all it is. Right. Right Apparently it was more. There were several aspects that drew me to this book. First off, it was easy reading right from the start. As for the content, right off the bat, I was hit with death as the clear topic. Not exactly a fun topic, but nonetheless, the book flowed easily right to the point, no bull shit lead in for twenty pages. That’s what kept me reading initially. Well, that... and, I had to, but it didn’t take long before it wasn’t a chore any longer. Another thing I found appealing was the easily relatable personality of Mitch. There are several easily identifiable sides to his character; his tendency to be emotionally reserved, his fear of receiving a similar fate as his uncle, getting caught up in his work and forgetting what really mattered: all very understandable. Having Morrie talk out all of his problems with him was almost as if someone was talking to me personally about it, without having to go through the tough experience Mitch did, literally seeing his mentor slowly wither away and die week by week. Another strong point of this book was the short and clearly separated chapters. I’d hate to be discussing such ridiculous aspects of this book, when there’s so much more to get out of it than â€Å"ease of reading†. Howev... Free Essays on Tuesdays With Morrie Reaction Free Essays on Tuesdays With Morrie Reaction It’s not often that I care about a book – or, about much of anything, for that matter. In fact, I’ve convinced myself that only a handful of worth while books even exist, most of which I don’t bother to get involved with for one reason or another. This book is an exception to almost everything I’m accustomed to. The moment I finished the last page, I began typing, making sure to capture the emotions generated by this book before they vanished. Though I didn’t cry, I was put into an interesting emotional state that is not easily or frequently stirred within me. I’m not even completely sure why. I mean, words on a page. That’s all it is. Right. Right Apparently it was more. There were several aspects that drew me to this book. First off, it was easy reading right from the start. As for the content, right off the bat, I was hit with death as the clear topic. Not exactly a fun topic, but nonetheless, the book flowed easily right to the point, no bull shit lead in for twenty pages. That’s what kept me reading initially. Well, that... and, I had to, but it didn’t take long before it wasn’t a chore any longer. Another thing I found appealing was the easily relatable personality of Mitch. There are several easily identifiable sides to his character; his tendency to be emotionally reserved, his fear of receiving a similar fate as his uncle, getting caught up in his work and forgetting what really mattered: all very understandable. Having Morrie talk out all of his problems with him was almost as if someone was talking to me personally about it, without having to go through the tough experience Mitch did, literally seeing his mentor slowly wither away and die week by week. Another strong point of this book was the short and clearly separated chapters. I’d hate to be discussing such ridiculous aspects of this book, when there’s so much more to get out of it than â€Å"ease of reading†. Howev...

Band, Bend, Bind, Bond, and Bund

Band, Bend, Bind, Bond, and Bund Band, Bend, Bind, Bond, and Bund Band, Bend, Bind, Bond, and Bund By Mark Nichol One of the joys of researching word origins and usage is discovering facts such as that the five English words formed on the frame of b_nd, with different vowels, are cognates, all stemming from a common proto-Indo-European ancestral verb meaning â€Å"restrain.† Band, meaning â€Å"a flat strip† or â€Å"something that binds,† came to refer not only to an object with either or both of those characteristics but also to an organized group of people, perhaps from the use of uniform pieces of cloth worn by affiliated warriors. This usage extended to refer to a group of musicians attached to a military unit, from which derived the use of the word for a civilian ensemble. Band is also a verb, meaning â€Å"bind† or â€Å"fasten† in one sense or â€Å"join† in another. Bend began as a verb describing fettering, or restraining of a person’s or animal’s feet, and the similar action of stringing a bow; from there it came to refer to any turning of a straight line or object and, as a noun, to a physical turn. To bind originally meant to tie something or someone up, as if to fasten or restrain, or to dress a wound, and later acquired the figurative meaning of â€Å"commit,† â€Å"oblige,† or â€Å"require.† The noun bind usually applies to the figurative sense, often with the connotation of being placed in an awkward situation, although someone may place someone else in a physical bind, as in wrestling. Bond, meanwhile, developed as a variant of band and describes physical adhesions, forces, and restraints as well as financial or legal documents, plus figurative connections, such as that described in the phrase â€Å"bonds of matrimony.† Like the related words above, it has a verb form as well. The last and least common word in this family is bund, taken directly from the German word for a confederacy or league, used in English to refer to a political organization, especially one for German-Americans, such as a pro-Nazi group that flourished before World War II. There is no verb form for this word. Also, the word describes a type of levee-type embankment often used in Asia; this term, ultimately from Persian, may be distantly related to the other terms. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:Is She a "Lady" or a "Woman"?60 Synonyms for â€Å"Trip†25 Idioms with Clean

Recovery of the China Stock Market and Challenges in the Post-Crisis Essay - 1

Recovery of the China Stock Market and Challenges in the Post-Crisis Era - Essay Example In fact, an outflow of approximately US$25 billion was experienced by China in December only, and at some point in the fourth quarter of 2008 a sum of US$150 billion was pulled out from the country, according to the report of the Bank of China (Min-Chan 2009, 43). The dramatic economic growth of China has to a certain extent been fuelled by its thriving export-driven production. Nevertheless, the export of China by mid-2008 diminished to a ‘negative 20-percent growth rate from the positive 20-30 percent rate in previous years’ (Platt 2009, 50). Because of these developments some financial analysts predicted that China would confront a financial crisis in 2009 and 2010. The prediction happened and this forced the Chinese government to initiate a set of stimulus package (Yao & Zhang 2011). These attempts of China to recover from the global financial crisis will be analyzed in this paper. The end of 2007 witnessed the sharp rise of China’s stock markets; however, the end of 2008 witnessed the bubbles’ remarkable rupture. The SSECI showed a decrease from 6,135 in 2007 to 1,608 in 2008 (Yao & Zhang 2011, 26). It has improved to some extent, but has been wrestling to swing around 3,000 from the period of the bubble disintegration. The SSECI showed 2,900 at the end of 2010 (Yao & Zhang 2011, 26). These changes are shown in the figure below: China exposed the avenues to new share offerings, letting loose a stream of initial public offerings (IPOs) to aid in the absorption of surplus liquidity and calm a raging stock market. What began as a drop of IPOs became a surge, with numerous companies primed to register in the Shanghai Stock Exchange (Platt 2009). According to Michael Guillen, professor of international management and director of the Lauder Institute, in his remark about the recovery attempts of China’s stock market in the Financial Times (2009), â€Å"During the last two years, monetary policy has

Is the desire to obtain a degree simply another example of objet petit Outline

Is the desire to obtain a degree simply another example of objet petit a - Outline Example This paper seeks to explore whether the desire to obtain a degree is simply another example of objet petit a or not and in doing so the theoretical perspectives of Lacan on desire and fantasy are also analysed. The objet petit a, in fact, operates due to the fascination of the subject towards the object and the internal and external perspectives of the subject also are significant. It is therefore imperative to analyse the fascination of the subject towards attaining a degree in the case of a person who wishes ardently for this object. The effects of objet petit a intensify as this fascination grows. However, one should bear in mind that â€Å"the object petit a, or at least the fascinating effect the object which bears it has upon the subject who is under its thrall, has no â€Å"objective† reality independently of this subject† (Sharpe 2005). Thus, Lacan purports that the subject never losses the object as he/she has never possessed it in reality. On the other hand the objet petit a is the desire for a fundamentally lost object. An individual who fails to accomplish his long cherished dream of obtaining a degree is subject to the fascinating effect of the object. On the oth er hand, it is quite evident that the subject cherishes a very strong desire for this fundamentally lost object (objet petit a) towards attaining the degree. One needs to distinguish between Lacan’s conception of fantasy and objet petit a. The fundamental fantasy of an individual stems from â€Å"small unconscious rebellions of subjects against the losses that they take themselves to have endured when they acceded to socialization† (Sharpe 2005). Thus, every individual tends to fantasise a lost object and for Lacan this lost object is nothing but the objet petit a-the object cause of desire. Here, the subject too experiences ‘small unconscious rebellions’ against his loss of the

The shortage of nurses in the NHS Scholarship Essay

The shortage of nurses in the NHS - Scholarship Essay Example 6. Work Climate, which includes: a. Dissatisfaction with pay b. Increase in workload c. Lack of empowerment d. EU Legislation e. Poor working conditions 7. Poor Perception of Nursing as a profession The dissertation also discusses solution to this problem like better workforce planning, recruitment effort, focus on international recruitment and improvement of nursing as a profession. 1. Introduction As pointed by O'Brien-Pallas et al (2001) state that "the cycles of shortages and surpluses, which have been a source of frustration for nurses in practice, planners, researchers, administrators and funders, are intimately linked with the quality of nurses' work life, the health of nurses and the quality of care they are able to provide. The quality of work life can affect not only the system's ability to recruit and retain nurses, but also overall system costs related to the productive use of available nursing resources". And therefore a need to study this phenomenon of shortage of nurses, its causes and possible solutions is important. It is widely acknowledged that NHS has been facing a growing shortage of nurses. While some parts are experiencing shortage at a higher rate than others (London for example), it has been accepted that there is a national shortage. It is believed that UK may be a on a downhill road on the issue of lack of nursing staff and that it is no more a problem of organizations alone, but that of the leaders and law makers of the country. It is said that NHS is unable to deliver good quality healthcare due to the pressure it faces on account of lack of nursing expertise. Need for nurses is depicted as cyclical in nature. Mullen (2003) points out that that the Department of Health recognizes this... It is widely acknowledged that NHS has been facing a growing shortage of nurses. While some parts are experiencing shortage at a higher rate than others (London for example), it has been accepted that there is a national shortage. It is believed that UK may be a on a downhill road on the issue of lack of nursing staff and that it is no more a problem of organizations alone, but that of the leaders and law makers of the country. It is said that NHS is unable to deliver good quality healthcare due to the pressure it faces on account of lack of nursing expertise. Need for nurses is depicted as cyclical in nature. Mullen (2003) points out that that the Department of Health recognizes this problem and NHS has revisited its targets to increase the nursing workforce in all clinical professions in 2000. Mullen (2003) points out that "a report published by the Audit Commission (2002) drew attention to the seriousness of the workforce shortage, stating that '' the biggest constraint the NHS f aces today is no longer a shortage of financial resources. It is shortage of human resources" (p.346). The previous three decades have seen a fluctuation in the nursing workforce strength in UK. There was a dearth of nurses till the 80's and then a sharp rise from 80's through the 90's.

Performance Pay at Safelight Auto Glass Case Study

Performance Pay at Safelight Auto Glass - Case Study Example The installer’s problem as identified in the PPP was related to the turnover rates. It has been found that the turnover rate of the company has been quite high because the glass installation was a seasonal business. The busy periods were spring and summer and it was found that at this time, the competition for new hires was mounting. However, the demand for the windshield replacement troughed and as a result the repair shops found it necessary to lay off many of their workers and hire them back during spring and summer. In addition to this, another biggest problem was associated with technicians who were lured by other companies’ offer, which promised to pay them a fraction more than what they were currently receiving. Therefore, as a result it was evident that the installers were changing their jobs since they were paid a Dollar more an hour and were allowed to take the company’s truck home during night. In order to reduce the turnover rate, Safelite also offere d truck privileges for a time being, but then stopped it later. It was a matter of concern for the recruiters in HR with regards to getting technicians from other companies to come to Safelite. These were the problems that the PPP had tried to identify which were affecting the company’s productivity. Question Two Pros and Cons of Switching From Wage Rates to Piece Rates After going through the case study, it can be revealed that Performance Pay Plan was revised for both the managers as well as the technicians. It was decided to pay the technicians according to the piece rate system rather than the wage rate system which was previously being practiced. The plan was implemented for the technicians to receive the piece rate for every windshield that they installed. According to this plan, the number of windshield that the technician would install in a week would be accumulated. As a result, the technicians’ pay for the week was decided to be based upon the number of insta llations. The new plan brought both advantages and disadvantages to the technicians. Previously, the technicians received $10-$12 an hour. However, it was analyzed that according to the new PPP, the technicians would receive $15.22 per hour. Therefore, it can be examined that there would be a substantial hike in the salary of the technicians. However, the disadvantages of the plan for the technicians was that for the first twelve weeks of the plan, if the technician did not reach a weekly average which was equal to his previous hourly wage, then he would receive the hourly wage as a guaranteed rate. After that first twelve-week period, his guarantee rate would lower by 30% so that he gets encouraged to work towards the PPP rate. This is quite demotivating for the technicians. This may even discourage the technicians to improve the productivity. The other disadvantage has been that the installers were paid different rates depending on the area of the country in which they lived. It w as also apparent from the case study that the technicians were at times asked to remove a work shield while the auto body work was being completed on a vehicle and then replace it later. The Safelite installers can be considered as good

Fundamentals of Strategic Planning in Complex Organizations Essay

Fundamentals of Strategic Planning in Complex Organizations - Essay Example To realize the desired outcome that accounts for the interests of all stakeholders in the health sector, strategic trends in the health care environment are highly characterized by operational changes. One of the strategic trends observed in the health care environment is the persistent bid to make healthcare services more affordable, and subsequently enhance universal coverage. This trend is consistent with the social, economic, and political goal of improving the social welfare of the disadvantaged population. Another strategic trend relates to increased number of public and private health care operators. The motive is to implement strategic plans that make it possible for health care organizations to take their services closer to the people. Over and above this, government regulation of health care organizations, health care financiers, and all other relevant parties involved constitute a critical strategic trend in health care markets (Harrison, 2010). This move is valid in the s ense that the end-user or the consumer remains protected from exploitation as the health care sector grows and expands. While health care organizations have been quick to identify emerging opportunities in the health sector, most of them do not utilize their full potential. ... Final Project Proposal: Strategic Plan for a Residential and Day Treatment Facility for Individuals with Mental Illness and/or Mental Retardation Background The growth and development of healthcare facilities has been enormous over the years, and societies across the globe has benefited from this trend. Health complications also keep changing, making it necessary for health care operators to keep at par with changes in the health care environment. Providers of healthcare services have responded swiftly to health care market trends for both existing and emerging health issues. In general, stakeholders in the health sector are collaborating in formulating and implementing strategies that are designed to improve the health welfare of the society. Amid the vibrant activities, plans, and strategies that have rocked the health sector, it has become necessary to address specific health issues in a certain way as opposed to another. In other words, it is essential to narrow down major health issues and/or complications, and ultimately address them as a singled out aspect of the larger health care environment (Levin, Petrila & Hennessy, 2004). Doing so provides a better ground for dealing with specific health issues intensively, as opposed to addressing diverse and dynamic health complications all at the same time. In this respect, the ultimate focus in this project is directed towards a residential and day treatment facility for individuals with mental illness and/or mental retardation. Although majority health care facilities have mental illness and/or mental retardation departments, not all facilities cater for all-round needs of the patients. On the same note, there are health care facilities that are primarily set up for persons with mental illnesses and/or mental

Problem list Assignment Example | Topics and Well Written Essays - 250 words

Problem list - Assignment Example 17). Unfavorable material price variance is majorly caused by the purchase of better quality and expensive raw materials than the budgeted ones, damage of materials after arrival requiring an urgent reorder on a rush basis. All these factors work to raise the price of raw materials causing an unfavorable price variance. The individuals who should be held responsible for unfavorable material price variance is the purchase manager since he is the one having control over price paid for goods and any other price variations. Unfavorable labor efficiency variance on the other hand is caused by poor quality of raw materials, poorly trained workers, faulty equipments, poor supervision of workers, and poorly motivated workers among others. The person responsible for labor efficiency variance is the production manager, production manager in case he orders the purchase of poor materials and the work center managers responsible for workers in the various departments. Ethical principles of confidentiality and integrity require that employees of the organization should act in the utmost benefit of the company’s interest. In addition the management accountants of any organization are required to maintain the highest standards of ethical conduct in their duties. In this respect they should not use any information about their company for their selfish gain, since confidentiality principle requires them not to disclose any confidential information they have acquired from the company in the course of their work with them. Being Tastee Fruit Company’s Accountant, Adams is exposed to some vital information about the company for example the prices in which it buys its raw materials. By the fact he disclosed this information to his friend; Adams has appeared to and has used the confidential information about the company for an unethical advantage of his friend, a third party to the organization. In addition, if he were to suggest a cheaper supply of

Fundamentals of Strategic Planning in Complex Organizations Essay

Fundamentals of Strategic Planning in Complex Organizations - Essay Example To realize the desired outcome that accounts for the interests of all stakeholders in the health sector, strategic trends in the health care environment are highly characterized by operational changes. One of the strategic trends observed in the health care environment is the persistent bid to make healthcare services more affordable, and subsequently enhance universal coverage. This trend is consistent with the social, economic, and political goal of improving the social welfare of the disadvantaged population. Another strategic trend relates to increased number of public and private health care operators. The motive is to implement strategic plans that make it possible for health care organizations to take their services closer to the people. Over and above this, government regulation of health care organizations, health care financiers, and all other relevant parties involved constitute a critical strategic trend in health care markets (Harrison, 2010). This move is valid in the s ense that the end-user or the consumer remains protected from exploitation as the health care sector grows and expands. While health care organizations have been quick to identify emerging opportunities in the health sector, most of them do not utilize their full potential. ... Final Project Proposal: Strategic Plan for a Residential and Day Treatment Facility for Individuals with Mental Illness and/or Mental Retardation Background The growth and development of healthcare facilities has been enormous over the years, and societies across the globe has benefited from this trend. Health complications also keep changing, making it necessary for health care operators to keep at par with changes in the health care environment. Providers of healthcare services have responded swiftly to health care market trends for both existing and emerging health issues. In general, stakeholders in the health sector are collaborating in formulating and implementing strategies that are designed to improve the health welfare of the society. Amid the vibrant activities, plans, and strategies that have rocked the health sector, it has become necessary to address specific health issues in a certain way as opposed to another. In other words, it is essential to narrow down major health issues and/or complications, and ultimately address them as a singled out aspect of the larger health care environment (Levin, Petrila & Hennessy, 2004). Doing so provides a better ground for dealing with specific health issues intensively, as opposed to addressing diverse and dynamic health complications all at the same time. In this respect, the ultimate focus in this project is directed towards a residential and day treatment facility for individuals with mental illness and/or mental retardation. Although majority health care facilities have mental illness and/or mental retardation departments, not all facilities cater for all-round needs of the patients. On the same note, there are health care facilities that are primarily set up for persons with mental illnesses and/or mental

Northern and Southern British Colonies of North America Essay Example for Free

Northern and Southern British Colonies of North America Essay The views of Northern and Southern British Colonies of North America developed different culturally factors including economically and political views, education, and religious instruction. Colonies in the north and south developed their own characteristics making them significant for the main land, and later becomes the new nation itself. Economic wise, the colonies had more differences than similarities. The North had small farms while the south had larger plantations. The northern colonies developed important trades on furs, timber, and other natural resources. The northern colonies developed into shipping center at New York, which originally belonging to the Dutch until 1664, where goods were stored. The English develop the harbors around New York and it became a major shipping center of the colonies. Meanwhile, the south developed important trades on agriculture, cotton, rice, and tea. At the time, the south had fewer raw materials than the North and mostly traded cotton. The cotton crop was the most important trade to the Southern colonies, it was nicknamed King Cotton. The reason of the South’s plantation out-sizing the North’s plantation was because the social aspect of each side. The Northern colony life mainly revolved the church members, when the south had more focus on the wealthy land owner. However, The North and south economics were similar to each other as well; for example, Tobacco and slavery. The North and South both also supported the use of indentured servants, people who came to America and was placed under contract to work for land owners for over a period of time, usually about seven year. Politically, the North and South had differences on who had the bigger voice in the society. In the North, Church membership was the only way to be accepted in to the colony. The church in the north controlled the laws and were the most accepted in the colony. Meanwhile, in the South, instead of the church members being superior, the land owners who wealthiest had control over the law. The Southerners tended not to be very religious due to the number of churches and religious institution in the south. Almost all the population of the South live on plantation and the plantation were very important to them more than the religious beliefs. Since The North was large on plantation, thousands of slaves were forced to work on the plantations. Politics in the colonies were empowered by charter called The General Court. The General Court made laws and governed the company. The colonists adapted the general court concept and used it to rule their colonies. The General Court ruled that freeman could only be male and a church member in order to make sure only religious men could decide government issues. The southern colonies were ruled by the oldest legislative called the House of Burgesses. The House of Burgesses established for judicial and administration which will runs by the representatives from each region in the colonies. Mercantilism played an important role in the lives of New Englanders because it was an economic theory and system that supported the establishment of the colonies. New England adopted the policy of mercantilism in order to control over the trade of the colonies. The colonies were influenced by the mercantilism policy due to the numerous trading prohibitions and taxes that applied on goods. The first mercantile regulation was the Acts of Trade and Navigation which established three main rules for colonial trade. Firstly, trade between the colonies could only be transported on English or colonial-built ships and operated by English or colonial crews; secondly, all goods could only pass through English port; and thirdly, certain numbered goods from the colonies could only be exported to England, including tobacco and sugar. But in the Southern Colonies, the Navigation Act had lowered tobacco prices which made the economies suffered. The slave population in the South vastly increased in order to maintain their wealth that dominated trade and politics throughout the colonies. Later on, there will be more similar acts to those of trade and navigation, such as the Staple Act of 1663, The Duty Act of 1673, and the Wool Act of 1699 which limited trade of good. Over time, the concept of mercantilism would rehabilitate due to the changing ideas and theories of various economic scholar such as Adam Smith, Abraham Lincoln, and Alexander Hamilton. Educations also played such an important role in the lives of New Englanders because people were really religious in the American colonies. In the New England colonies, the Puritans built their society based on the principles of Bible. The Puritans valued education because they believed that Satan was keeping those who couldn’t read from the scriptures. Education in this time period enabled people to read the Bible; therefore, parents able to teach their children to read the Bible, which was often the only book they had. Wealthy families usually sent their older children to study at colleges and universities. Girls usually learned their education in household skills at home. The education in the southern colonies, children normally began their education at home. Because farms and plantations created difficulty, plantation owners usually hired tutors to teach their children math, science, geography, history, and plantation management. Girls in the South usually taught to learn enough reading, writing, and math to run a house household and to attract a husband. As we speak of Education, The King James Bible had influence the culture of these two diverse regions because it was the only English translated book from the bible. The King James Bible established at Jamestown, Virginia in 1607; for the next few hundred years, just every English-speaking American grew up knowing the King James Bible better than any other book. It was the only book that has over one billion copies in print. Because of the well-known bible at its era, both colonies were persuaded the children to learn from King James Bible either from homeschooled or universities. The impact of the King James Bible on English language and western culture is beyond estimation; therefore, Education of the North and the South were always involved with the King James Bible. Works Cited. Channing, Edward. The Navigation Acts. Thenagain.info. Thenagain.info, n.d. Web. 31 Jan. 2013. Grischy, Janet. The Economic and Social Differences between the North and the South as a Cause of the Civil War. Helium. Helium, 23 Apr. 2009. Web. 30 Jan. 2013. Hockett, Homer C. Political and Social Growth of the American People 1492-1865. (New York: The Macmillan Company, 1940). KIRSCH, ADAM. Heirs to the Throne. The New Republic. Www.newrepublic.com, 11 May 2010. Web. 25 Jan. 2013. The King James Version: Its Influence on English and American History. The King James Version: Its Influence on English and American History. N.p., n.d. Web. 30 Jan. 2013.

Kappa Agonists in Management of Pain and Opioid Addiction

Kappa Agonists in Management of Pain and Opioid Addiction Joseph Nguyen Abstract Hypothesis: Opiates mediate pain via opioid receptors, which consist of several subtypes. One subtype, the kappa opioid receptors (KOR), has also been shown to prevent addictive behaviour. Potential novel therapeutic compounds acting on KOR include U50488, CR665, and CR845. It is hypothesized that selective kappa opioid receptor agonists are effective at controlling pain while managing opioid addiction. Methods: Studies for this review were obtained through the PubMed database using a keyword search strategy. Only articles in English published from December 2006 until December 2016 were considered. Results: Kappa agonists are able to decrease inflammatory, visceral, and surgical pain, but are unable to inhibit behaviour-depressing aspects of pain. Kappa agonists also decrease field potential and long-term potentiation in the basolateral amygdala. Additive anti-nociception with mu opioids has been observed as well as decreased fentanyl use, morphine tolerance development, and morphine withdrawal symptoms. Conclusions: Kappa agonists can be effective analgesics while also preventing abuse and addiction to mu opioids. Some evidence also suggests kappa agonist activity in the basolateral amygdala can inhibit affective components of pain. Abstract Word Count: 175 Keywords: kappa agonist, pain, analgesia, anti-nociception, tolerance, dependence, withdrawal, addiction Ultramini Abstract: This study reviewed current research on the analgesic and anti-addictive properties of selective kappa agonists for their use in pain management while preventing addiction. Introduction Opioids are one of the most powerful analgesics available with an increasing trend of prescription in the United States. Prescriptions per capita increased 7.3% from 2007-2012 with 259 million prescriptions in 2012, enough for one bottle of opioids per adult (Dowell et al., 2016). On the other hand, use of opioids presents risks including dependence, abuse, addiction, and overdose which lead to negative health, social and economically impacts. From 1999 to 2014, over 165,000 people have died from opioid overdose and in 2013; an estimated 1.9 million people abused or were dependent on prescribed opioids (Dowell, Haegerich Chou, 2016). However, pain treatment should not be ignored as there are clinical, psychological, and social consequences associated with chronic pain including limitations in complex activities, lost work productivity, reduced quality of life, and stigma, emphasizing the importance of appropriate and compassionate patient care (Dowell et al., 2016). The CDC has recently released a guideline, aimed at primary care settings, suggesting prescriptive protocols as well as methods to evaluate risk of patient substance abuse and addiction. However, the majority of evidence reviewed by the guideline had significant limitations. Although the CDC guideline still has value in preventing exacerbation of pre-existing risk of abuse, results and implementation remain to be seen. Efforts have been made to deter abuse through novel drug formulations, barriers, and pharmacokinetics. Nevertheless, nothing can prevent an addicted person from taking multiple doses at once. This may be a result of the inherent nature of the drugs to activate reward pathways in the brain along with its analgesic effects though mu receptors. Another opioid receptor, kappa-opioid receptor (KOR), has been shown to limit motivational properties of drug abuse (Lalanne, Ayranci, Keiffer Lutz, 2014). This has sparked interest in development of kappa agonists as novel analgesics with low abuse potential. Examples of known selective kappa agonists include U50488, CR665, and CR845 among many others including those continuing to be developed. However, questions still remain about analgesic efficacy and complications for patients already addicted to mu opioids transitioning to kappa agonists. This literature review explores the anti-nociceptive efficacy of kappa agonists and their ability to m anage opioid addicted patients. Balancing adequate pain control with risk of future abuse has been a difficult endeavour for physicians as well as patients. This topic was chosen to investigate the possibility of a potent pain medication without addictive properties as an alternative to traditional mu opioids. Surely, this would be a major instrument in the treatment of chronic pain. This study will be done under the hypothesis that kappa agonists are effective in management of pain and opioid addiction. Methods A search was performed for published literature on PubMed. Search terms were selected to assess analgesic properties and anti-addiction properties of kappa agonists on opiate use (Table 1). The search terms used included: pain, chronic pain, kappa opioid, kappa agonist, pain control, anti-nociception, withdrawal, dependence, addiction, and tolerance. This study looked at articles in English published between December 2006 and December 2016. Articles of all levels of evidence were considered and included review, preclinical, and clinical data. The initial search produced 574 results. These resources were then screened with the following exclusion criteria: articles not involving kappa agonists/receptors, articles on opioids without kappa receptor selectivity, articles on opioids with dual agonist activity, articles on kappa agonist interaction with drugs that were not analgesics. Abstract reviews of the remaining articles were performed to select for articles on analgesic efficacy or anti-addictive properties of selective kappa agonists. The resulting collection of evidence was organized into an evidence table (Appendix). Table 1-Keyword Search Strategy Population Intervention Comparison Outcome Pain OR Chronic Pain Kappa opioid OR Kappa agonist Analgesia OR Analgesic OR Pain control OR Antinociception OR Anti-nociception OR Withdrawal OR Dependence OR Addiction OR Tolerance Results A final total of 11 articles were included in this study, the majority being animal studies on mice or rats. One study involved rhesus monkeys. There was one study that involved a human clinical trial. Also, there was one review using human clinical trials focused only on peripherally selective kappa agonists. Table 2-Summary of Study Designs Reviewed Study Design # of Studies Animal Models 9 Clinical Trials 1 Review 1 Analgesic Efficacy An animal study by Auh and Ro (2012) induced inflammation in rat hindpaws with injections of complete Freunds adjuvant. After 3 days, when mechanical hyperalgesia was well developed, local injections of kappa agonist U50488 were given at different doses and mechanical threshold for hindpaw withdraw response was measured. The results showed dose-dependent increase in mechanical threshold by local injections of U50488 (Auh Ro, 2012). A time effect was also observed where increasing doses of U50488 prolonged the anti-hyperalgesia effect. The role of kappa opioids in inflammatory pain was also studied by Moon et al. (2016) in a research on the effects of peripheral kappa opioid receptors and arthritic pain. Arthritis was induced in rats using 1% ÃŽÂ »-carrageenan injected into the knee. After nociceptive behaviour was maximally expressed (reduced weight-bearing in ipsilateral joint), U50488 was injected into affected joints. A two-way repeated-measure ANOVA showed significant recovery of reduced weight-bearing in the affected limb in comparison to saline. In addition to inhibited nociceptive behaviour, U50488 was also found to reduce mechanosensitive afferent nerve fibre activity in the carrageenan-induced inflamed knee using nerve recording techniques. Aside from inflammatory pain relief by U50488, the peripheral kappa opioid CR665 was found to significantly increase pain threshold to esophageal distension in a study by Arendt-Nielsen et al. (2009). This randomized, double blinded, controlled study compared the effects of CR665 against oxycodone on skin, muscle, and visceral pain stimulation in healthy males. Although CR665 increased pain threshold to esophageal distension, oxycodone had the same effect with addition to increased pain threshold to cutaneous pinch pain, cuff pressure pain, and thermal stimulation. A number of other clinical trials, on peripheral kappa agonist CR845, were reviewed by Albert-Vartanian et al. (2016). A randomized, double-blinded, placebo-controlled study was conducted on elective hysterectomy patients for analgesic efficacy before and after the procedure, using a 10 cm visual analog scale for measurement of pain intensity. If pain persisted after 24 hours, rescue medication (IV morphine) was given. Significant differences were observed in comparison to patients who only received placebo. Less use of rescue medication as well as a 2-fold decrease in pain intensity was found in patients that received CR845 before and after the surgery. Albert-Vartanian et al. (2016) also discussed a phase 2, randomized, double-blinded, placebo-controlled clinical trial in patients electing bunionectomy surgery with fentanyl as rescue medication. Over a 48 hour period, pain was measured regularly using a visual analog scale. The study used a sum of pain intensity difference from baseline levels over 24 hours (SPID ­0-24) as a measurement for efficacy along with SPID0-36 and SPID0-48. In patients who completed the study, there was a statistically significant reduction in SPID0-24 and SPID0-48 in those treated with CR845 compared to placebo. However, there was no significant difference in the modified intent-to-treat group. In another phase 2 trial, patients with moderate to severe osteoarthritis pain (>4 out of an 11 point scale) were given an oral form of CR845 with acetaminophen as a rescue drug over 2 weeks (Albert-Vartanian, 2016). A dose-dependent reduction in average pain score of 25-34% was observed. Among patients receiving the highest dose of CR845, 50% had a reduction of †°Ã‚ ¥30% in their reported pain score at the end of the 2 weeks with an 80% reduction in requirement for acetaminophen. Analgesic Efficacy with Other Measures of Pain Aside from sensory components of pain, there are affective and behavioural components of pain as well. An electrophysiological experiment conducted by Huge, Rammes, Beyer, Zieglgansberger, Azad (2009) looked at the effects of kappa opioid receptors activation on mice basolateral amygdala, an area of the brain that is involved in pain processing and pain memory formation. The field potential amplitudes were measured at baseline and under induced long-term potentiation using high frequency stimulation and the effects of kappa agonist U50488H were studied.   The experiment found that U50488H decreased baseline levels of field potential amplitude as seen in Figure 1, while these effects were inhibited by kappa receptor antagonist norbinaltorphimine (nor-BNI). Figure 1. Effects of Kappa Agonist and Antagonist on Field Potential Amplitude of Mice Amygdala. Baseline (BL): 100 ±0.5%; U50488H: 86.3 ±2.4%, nor-BNI: 100 ±4.2%. Data points show average field potential (FP)  ± Standard Error. Reproduced from Huge et al., 2009, p. 125. Prior application of U50488H before high frequency stimulation was also found to inhibit induction of long term potentiation (Figure 2) in comparison to long term potentiation induction with no drug (Figure 3). Figure 2. Effect of Kappa Agonist Pre-treatment on High Frequency Stimulated Long Term Potentiation of Mice Amygdala. U50488H: 100 ±4.1%; High Frequency Stimulation (HFS): 102.6 ±7%. Data points show average field potential (FP)  ± Standard Error. Reproduced from Huge et al., 2009, p. 126. Figure 3. Long Term Potentiation Produced by High Frequency Stimulation. Baseline (BL): 100 ±2%, High Frequency Stimulation (HFS): 119 ±4%. Data points show average field potential (FP)  ± Standard Error. Reproduced from Huge et al., 2009, p. 126. Although pain-stimulated behaviours are often used as a measure of pain, such as a withdrawal or writhing response, complementary measures are behaviours that diminish in the presence of pain stimuli (Negus, OConnell, Morrissey, Cheng Rice, 2011, p. 506-507). An experiment by Negus et al. (2011) studied the effects of peripheral and central kappa agonists compared to ketoprofen on rats trained to evoke intracranial self-stimulation using a lever, a behaviour that is depressed by pain. Intraperitoneal lactic acid injection acted as a pain-inducing stimulus, with a stretch response being a pain-stimulated behaviour to contrast with the pain-depressed behaviour of intracranial self-stimulation. It was found that the central kappa agonist (salvinorin A), peripheral kappa agonists (ffir and ICI204448), and ketoprofen all inhibited lactic acid induced stretching. However, only ketoprofen inhibited lactic acid induced depression of intracranial self-stimulation. Salvinorin A had actually i ncreased depression of intracranial self-stimulation while ffir and ICI204448 had no appreciable effect. Similar results were found when Negus et al. used depression of nesting in mice as a measure of pain (2015). Kappa agonist U69593 failed to both inhibit and reverse depression of nesting induced by intraperitoneal lactic acid and intraplantar complete Freunds adjuvant (Figure 4A 4B). However, 1-way ANOVA analysis (pFigure 4A 4B). U69593 was shown to actually depress nesting when administered independently (Figure 4C) and this effect was not able to be reversed by neither ketoprofen nor morphine (Figure 4D). Figure 4. Effects of Ketoprofen, Morphine, and U69593 on Nesting under Different Conditions. Panel A: Nesting depressed by intraperitoneal administration of 0.32% lactic acid. Panel B: Nesting depressed by intraplantar administration of complete Freunds adjuvant. Panel C: Nesting under no treatment. Panel D: Nesting depressed by U69593. Nesting represented as the number of zones cleared of nesting material. V represents drug vehicle only. Darkened points represent significant difference from drug vehicle under given condition. Reproduced from Negus et al., 2015, p. 18.       Interactions with Mu Opioids There is evidence suggesting kappa agonists have anti-addictive effects (Lalanne et al., 2014). However, it is important to evaluate the effects of kappa opioids in concurrent use with mu opioids. A study on interactions of fentanyl and U69593 in rhesus monkeys showed a decrease in the rate of drug self-administration when the kappa agonist was added to fentanyl compared to fentanyl alone (Negus, Schrode Stevenson, 2008). This effect increased with greater proportions of U69593 in the mixture (Figure 5). Using a conditioned response for food as a measurement for activity, both fentanyl and U69593 alone depressed the behaviour while mixtures showed a less than additive effect. Furthermore, at the lowest proportion tested (0.22:1 U69593/fentanyl), U69593 reduced the behaviour depressing effects of fentanyl. Figure 5. Rate of Self-Administration of Fentanyl vs. Dose of Fentanyl, U69593, or Mixture. Reproduced from Negus et al., 2008. Negus et al. also demonstrated additive thermal anti-nociception, using tail withdrawal threshold from heated water, with the fentanyl/U69593 mixtures at all proportions tested (2008). More evidence of additive effects of kappa and mu opioids was shown by Sakakihara, Imamachi, Saito using a similar method in mice (2016). Intrathecal injection of kappa agonist TRK-820 combined with morphine resulted in a stronger anti-nociceptive effect compared to morphine alone. Compared to morphine alone, kappa agonists also have benefits regarding the development of tolerance. It is well known that repeated use of mu opioids quickly develops tolerance. The addition of a kappa agonist has been shown to inhibit the development of tolerance to morphine (Hamabe, Yamane, Harada Tokuyama, 2008). Mice treated daily with subcutaneous morphine for 5 days developed reduced analgesia from morphine from days 3 to 5. However, daily administration of kappa agonist U50488H 5 minutes after injection of morphine attenuated the onset of tolerance (Figure 6). Additionally, pre-treatment of kappa receptor antagonist nor-BNI inhibited the tolerance-blocking activity of U50488H. Figure 6. Effect of Kappa Agonist U50488H on Morphine Tolerance. Each point show means  ± standard error. AUC: Area under curve. #: P Although U50488H inhibited the development of tolerance it was unable to inhibit morphine withdrawal (Tao et al., 2008). However, Tao et al. demonstrated that another kappa agonist, LPK-26, may be able to. Chronic doses of morphine, kappa agonist (LPK-26 or U50488H), or both were administered to mice over 5 days and induction of withdrawal was achieved by subcutaneous injection of naloxone 2 hours after the final dose of morphine. Chronic treatment with LPK-26 did not produce a withdrawal response. However, chronic treatment with morphine produced a strong withdrawal response in the form of withdrawal jumping. Furthermore, chronic treatment with morphine along with pre-treatment with LPK-26 had a significant reduction in withdrawal response in a dose dependent manner (Figure 7A). Body weight was also measured before and after naloxone withdrawal induction (Figure 7B). Only LPK-26 showed significant reduction of morphine-induced weight loss. Figure 7. Effects of LPK-26 and U50488H on Withdrawal Jumping and Weight Loss. Data set shown as mean  ± standard error. Reproduced from Tao et al., 2008, p.310. Discussion Analgesic Efficacy of Kappa Opioids Side effects of selective kappa agonists mainly stem from its activity in the central nervous system. These side effects are the main hindrance for pharmacologic use of kappa opioids and include dizziness, dysphoria, confusion, sedation, hallucinations, diuresis, and even psychotic symptoms at high doses (Walsh, Strain, Abreu, Bigelow, 2001). Strategies to minimize these unwanted effects revolve around limiting the activity of kappa agonists to peripheral sites of action. Local injections have been shown to reduce inflammatory pain in animal models through reduced activity of afferent nerve fibres (Auh Ro, 2012; Moon et al., 2016). Although the analgesic results mentioned were limited to animal models, in humans, intravenous administration of peripherally selective formulation CR665 also shows evidence of analgesia for visceral and surgical pain (Arendt-Nielsen et al., 2009; Albert-Vartanian et al., 2016). Furthermore, oral formulations CR665 have been shown to reduce inflammatory osteoarthritic pain in humans (Albert-Vartanian et al., 2016). Continued pain treatment is required if kappa opioids are to be considered as an alternative to mu opioids and research shows viability of kappa opioids in different formulations and routes of administration for the treatment of pain in traditional measures. The components of pain include affective elements as well, which is especially important in chronic pain. Pain affect is comprised of the unpleasant emotions associated with pain as well the emotions towards future implications of having chronic pain. The latter is based on reflections of pain memory and is known as secondary pain affect. As a consequence, chronic pain states can lead to depression and anxiety, which lowers well-being and quality of life (Price, 2000). The amygdala is a crucial structure in the brain involved in emotional learning, pain processing, and constructing of pain memories (Huge et al., 2009). Kappa opioids are able to reduce the activity and inhibit long-term potentiation in the basolateral amygdala. As long-term potentiation is considered a cellular model for learning and memory formation, kappa opioids may be able to prevent or extinguish pain memory and treat affective components of pain. However, this experiment, at the moment, is limited to mice and fu rther study is required to assess whether the results can be translated to human.   Furthermore, these results may be due to structurally specific central actions on the amygdala as other studies show evidence of dysphoric effects from central kappa opioid receptor activation (Lalanne et al., 2014). Although kappa agonists have regularly been shown to provide analgesia in assays using pain-stimulated behaviours as measurements of pain, there is contrast when pain-depressed behaviours are observed instead. Pain-depressed behaviours are behaviours that are decreased due to pain. Some examples that have been tested in animal models are feeding, movement, and reinforced behaviours. In humans, it is analogous to mood or functionality. When pain-depressed behaviours are studied, not only do centrally active kappa agonists fail to relieve pain of this aspect, they may worsen it (Negus et al., 2012; Negus et al., 2015). It should be noted that peripherally active kappa agonists relieve pain in pain-stimulated assays without affecting pain in pain-depressed assays and may be safer than centrally active kappa agonists (Negus et al., 2011). In comparison to kappa opioids, conventional analgesics such as mu opioids and nonsteroidal anti-inflammatory drugs do relieve such components of pain in addition to pain-stimulated behaviours (Negus et al., 2011; Negus et al., 2015). Even so, kappa agonist still have value as they have been shown to reduce pain in human trials as discussed previously. The studies on pain-depressed behaviours have limitations to animal models and further studies are needed to understand how clinically relevant the effects may be for humans. Managing Addiction Some of the major problems of using mu opioids for pain control are the development of tolerance, dependence, and drug abuse, which may all contribute to addiction. Although there are many other drugs that also relieve pain, the difficulty lies in managing addiction at the same time. Kappa agonists, aside from having low abuse potential, have been shown to decrease self-administration of fentanyl in animal models (Negus et al., 2008). These results are promising evidence for kappa agonists being agents to prevent opioid abuse. Also, kappa agonists have additive analgesic effects with mu opioids (Negus et al., 2008; Sakakihara et al., 2016). This possibly reduces the amount of mu opioid required for effective pain management while also reducing addiction and abuse liability due to less use. Increased usage of mu opioids may be due to the development of tolerance, requiring increased dosage to maintain analgesia. The high addictive potential of mu opioids makes this a concerning issue. However, addition of kappa agonists during administration of mu opioids may be able to significantly inhibit the development of tolerance (Hamabe et al., 2008). It may be possible to prevent the development of physical dependence and addiction to mu opioids by adding kappa agonists to drug regimens of chronic pain patients. As for those who are already affected by physical dependence on mu opioids, there is evidence that kappa opioids can inhibit withdrawal symptoms and reduce dependence (Tao et al., 2008). However, some kappa agonists, such as U50488H, do not have any significant effect. It has been suggested that the inconsistency may be due to varying affinities for different subtypes of kappa opioid receptors. Nonetheless, this study demonstrates potential for kappa agonists in managing opioid addiction through modulating dependence and withdrawal. Future studies may provide better understanding on subtype functions and improve designs for desired effects while minimize side effects. Also, as the studies regarding kappa agonist interaction with mu opioids are mainly done on animal models, further investigation is required to see whether results can be extended to humans. One important point to distinguish is non-selective versus peripherally selective kappa agonists. As mentioned previously, activation of kappa receptors in the central nervous system can lead to many side effects. Peripherally selective kappa agonists still produces analgesia, but it is uncertain whether the effects of the kappa agonists on abuse, tolerance, and dependence are due to central or peripheral activity. If these effects are due to central activity, the benefits of kappa agonists for addiction management will be limited by their undesired side effects. Still, in a study involving a peripherally selective kappa agonist and its effects on nicotine, there is some evidence suggesting that activation of peripheral kappa receptors do inhibit symptoms of withdrawal and dependence by inhibiting activity of central kappa receptors. Conclusion In conclusion, this study found that selective kappa agonists provide analgesia to inflammatory, visceral, and surgical pain. In contrast, they were not effective inhibitors of behaviour-depressing effects of pain. Specific activities of kappa receptors in the basolateral amygdala, however, may inhibit affective components of pain.   In managing addiction, kappa agonists may able to prevent mu opioid abuse, prevent the development of tolerance, inhibit the symptoms of withdrawal, and reduce physical dependence. The additive effect with mu opioids and the inhibition of tolerance development can reduce the required amount of mu opioids for effective analgesia, thus reducing abuse and addiction likelihood. Overall, selective kappa agonists are a good prospect for managing pain while combating opioid abuse and addiction. Appendix Evidence Table First Author Date of Publication Study Design Level of Evidence Study Population Therapy or Exposure Outcome/Results Albert-Vartanian 2016 Review 1 Human CR845 CR845 reduced pain with less abuse potential Arendt-Nielsen 2009 Clinical trial 1 Healthy males CR665, Oxycodone CR665 is effective on visceral pain Auh 2012 Animal model 0 Rats U-50488 Local kappa agonist attenuated inflammatory mechanical hyperalgesia Hamabe 2008 Animal model 0 Mice Morphine, U-50488H Analgesic tolerance to morphine is prevented by U-50488H through suppression of PKC Huge 2009 Animal model 0 Mice U-50488H Activation of kappa receptors decrease synaptic transmission and long term potentiation in the amygdala Moon 2016 Animal model 0 Rats U-50488, Nor-BNI U-50488 inhibits nociception in arthritic knee joints of rats Negus 2008 Animal Model 0 Rhesus Monkey Fentanyl, U69593 Addition of kappa agonist to fentanyl demonstrated additive anti-nociception and decreased drug self administration Negus 2011 Animal Model 0 Rats Ffir, ICI204448, Salvinorin A Kappa agonists do not inhibit pain-depressed behaviours Negus 2015 Animal model 0 Mice Morphine, Ketoprofen, U69593 Morphine/Ketoprofen inhibited pain-depressed behaviours whereas U69593 failed to do so Sakakihara 2016 Animal Model 0 Mice Morphine, TRK-820, Nor-BNI Addition of kappa agonist to morphine may have additive anti-nociceptive effects Tao 2008 Animal Model 0 Mice Morphine, LPK-26, U50488H LPK-26 is a potent analgesic with low dependence and inhibits morphine withdrawal

Queen Elizabeth I - Family, Religion, and Politics Essay -- essays res

Born of a king whose most disappointing day was that of her birth, Elizabeth Tudor’s life seemed almost made for trials and controversy, both personally and politically. Although she had, at times, a horrible temper and a disagreeable personality, and suffered through many physical and psychological problems as an adult, Elizabeth proved to be one of the most remarkable monarchs in English history. Firstly, I will discuss Elizabeth’s family (including her many stepmothers), and then I will talk about her relationship with her siblings under their power. Thirdly, I will examine religion and how it affected her opinions and politics during her reign. Lastly, I will look at foreign politics of the time and some of Elizabeth’s decisions affecting England’s position in the world. Elizabeth was born in 1533 to Henry VIII and Ann Boleyn. Anne was Henry’s second wife, after having divorced the first (Catherine of Aragon) for having failed to produce a male heir to the throne. (On Catherine’s death, her daughter Mary’s birth was declared illegitimate.) Ann had been Catherine’s lady-in-waiting. After Elizabeth’s disappointing birth, Ann Boleyn had two miscarriages. The king was growing impatient for a son. During Ann’s fourth pregnancy, she discovered Henry in bed with her lady-in-waiting, Jane Seymour. Her anger brought on premature labour, and she gave birth to a dead boy. Henry had her arrested and taken to Tower Hill. She was charged with having committed adultery and incest, and was beheaded. The King married Jane Seymour thenext morning. Elizabeth was only three years old at the time. In 1537, Jane Seymour gave birth to a boy, Edward. Jane died a week later. The king remarried quickly (to Ann of Cleves), but the marriage en... ...lso proved to be a wise political move, for she flirted incessantly, and â€Å"not to marry always left the door open to the possibilities of marriage, and that was an asset.... which she did not care to lose† (Read, 162). Though, near her death, more problems were caused by a new generation looking for change (more people were executed in those last few years than all of the other years of her reign put together), Elizabeth Tudor’s name will echo in history books for many years to come as an important figure in English history. References Jenkins, E. (1965). Elizabeth the Great. London: Victor Gollancz. Morris, C. (1955). The Tudors. London: Fontana/Collins. Read, C. (1936). The Tudors: Personalities and Practical Politics in Sixteenth Century England. New York: Henry Holt and Company. Rowse, A.(1950). The England of Elizabeth. London: Macmillan and Co.