The irrepressible conflict chapter 7 in the imperiled union, by Essay

The irrepressible conflict chapter 7 in the imperiled union, by kenneth stampp(pages 191 to 245) - Essay Example In the social science, historical theories and concepts are criticized by current scholars in search of new knowledge. If new evidence is discovered, scholars critically analyze it in consideration to the past evidence provided. The reason for revisionism is history relies on past distant events, and very little evidence is used in postulating of theories, therefore, when more evidence is found, it call for revision of the earlier theories or critic their explanation to the past event. This essay focuses on the civil war and the views of the revisionist via a Vis Stampp disapproval of them. How and why do revisionists argue that the civil war was a needless or repressible war? The proponent of revisionism argued that the case for a civil was a moral judgment of whether slavery was right or wrong. In addition, the agitators for antislavery had questionable attitudes towards the issues of slavery as political issues. As Steven Douglas argued, slavery was an issue of the southern people , and it did not affect people in the north. Therefore, the issues of slavery were better left to the white in the south to deal with and not engage in an unnecessary war. Moreover, revisionist says that the moral indifference of slavery was not a big issue to fight over it. Men and women are created sane and would solve their differences in a sane manner and avoid unnecessary bloodshed. According to Ulrich Philips, the black people had no problem being slaves because, in their nature, they were submissive, amiable, and light-hearted, imitative, ingratiating, and they were not progressive by the fact that they were Negroes. Philips also argues that the case for the plantation system among the slave was nothing ethical but nostalgia. Therefore, slavery was not a cause for the alarm, to instigate civil war because it had nothing to excite (Stampp 191-245). Another revisionist, Frank L, Owsley says that slavery was a moral issue and was not economic determinism of civilization in the s outh. He says that the issue of slavery has been dragged in the wrong case of the causes of a civil war. Furthermore, Randall believed that the black slave in the south had adapted to bondage without much resistance, and performing their tasks cheerfully. Randall also argues that, the southern slaves were abused, and this amounted to mistreatment, but it was a lenient way of treating slave by their slave owners. Randall says that, in reality the slave’s owners were more enslaved than the black by the set out institutions (Stampp 191-245). Craven brought his assertion that the different between the West and East were much greater than that of the North and South. Craven argues that abolition of slavery hindered the understanding of the effect of slavery to the modern employee –employer relationship. According to Craven, the life American worker today is much like that of the slave. Craven note that, even during the debate of the relevancy of slavery in the south, the pa tient blacks continued with their tasks unconsciously never minding the merits of the system he was working. David Potter in his analysis of revisionism says that, the facts that slave were left to live and even to grow and expand in a new world, was better off than engaging in a war. David concedes that emancipation of four million slaves was of great value, but he says it came at a greater cost. According to David, for every

Experiential Exercise Case Study Example | Topics and Well Written Essays - 500 words

Experiential Exercise - Case Study Example This happened due to several reasons. The most important reason behind this was the switch of female employees to other organizations. When Metropolitan Hospital founded Task Force on Retention and Advancement of Female Executive Positions, it identified three main causes for leaving by female workers: Answer: Duncan Green (2014) has highlighted many benefits of addressing the underlying problems of organizational diversity issues. The changes addressed the underlying problems in a very effective and professional way. Among the three main causes for leaving of Metropolitan Hospital by female workers, the first two were so much important for Metropolitan Hospital and these problems were directly linked with the operations of Metropolitan Hospital. So they ran a retooling program to address these top two concerns. They provided proper guidance, attention and growth prospects to both males and females. In addition to addressing the first two problems, Metropolitan Hospital also tried to solve the third problem that was more linked with the personal lives of the women rather than the professional lives. Metropolitan Hospital offered flexible work time, reduced workloads, and flexible work arrangements to address the family issues and engagements of women. All these restructuring of di versity program delivered good results after some time. Answer: There are certain attributes and functions that are required by managers to successfully implement a diversity program. Department of the Interior Diversity and Inclusion Strategic Plan (2012) highlights the following priorities and actions required by managers to successfully implement a diversity program: Mangers should run a competitive recruitment process comprising on qualified and experienced group of potential candidates. This principle is important to get high performing workforce drawn from all segments of society Cultivate the seed of an organizational culture in which

The Views of Hilary Clinton and Barrack Obama Essay Example for Free

The Views of Hilary Clinton and Barrack Obama Essay Hilary Clinton and barrack Obama are the two Democrat presidential candidates who are on the race to the White House. They latest reports indicate a tightly held contest and an equally intense campaign to clinch the Democratic Party nominations. Both hold almost similar views as far as how the economy should be and issues about war and mostly on terrorism. They also hold different opinions in health matters. The candidate that musters more delegates is the one that will be the Democrat presidential candidate facing Mc Cain, the Republican presidential candidate in the 2008 election. My main interest in this essay is to analyze on their views on the economy, war and health issue. The two candidates have tried to portray themselves as different from each other, they are however both protectionists when it comes to the trade agreements. Clinton is sounding to be more anti-trade than how Obama sounds. Already Clinton is opposed to the proposed economic terms on trade on Colombia, Panama and South Korea. There are times where both agree on some points, for example they are both opposed to the idea of having a free trade with the Dominican Republic and the Central America in 2005. Obama is for the idea of America doing business with other nations. He believes that this is the only way through which the American economy would be strengthened . He promised that if he were elected as the president of U.S.A. he would try his best to provide and protect the free trade. He will open up more job opportunities by creating foreign markets. He will also set proper job and environmental standards for all nations in the world to follow and resist the idea of free trade that is being advanced by the Central American nations. Obama also promised to review the North American Free Trade Agreement if he will be elected the US president. He is not opposed to the idea of making Mexico and Canada to cooperate with American workers. This will address the issue of workers so that they could adapt to the dynamics of the economy. He will also make amendments to the trade adjustments assistance if elected the president come this 2008 presidential election so that workers would have refresher courses to live up to the times, giving them a competitive edge and job security. On the other hand, Hillary Clinton pledged to strengthen the small enterprises that she believes are the economy’s growth engine. She will dedicate her efforts towards creation of jobs for Americans. Hillary Clinton said that if elected the president, she would strengthen the manufacturing industries as the country is dependent on them and by doing this, Americans will have better living standards. She said that she would fully utilize the nation’s innovation and capital investment to widen economic base for the country. Clinton also pledges to strengthen the rural economy to reverse the trend of urban migration as these areas also contribute to the economy. To achieve this she said she would initiate programs that would enhance the rural economic growth. She also pledged to increase research and technology funding. She would ensure schools; homes and libraries will be equipped with the latest technologies so that they would be competitive in the global market. She criticized Bush’s administration of mismanaging the economy making the gap between the rich and the poor to widen but she promised to solve this problem once elected. She will also help the middle class Americans to stabilize in the economy. On the issues of health care both have similar opinions although in some issues they differ. According to Hillary Clinton she will ensure that every American will be entitled to health insurance but Barrack Obama does not share the same sentiment, as he believes the focus should be on children who should be provided with free insurance. He will also extend health care for the adults who are currently uninsured. Clinton estimates that the cost of implementing her plans would be a hundred and ten billion U.S dollars while Obama’s proposal ranges from 50 to 65 billion U.S dollars. The truth of the mater is that neither of them will provide full insurance cover for every American but both aspire to make this work. While attacking Obama, Clinton criticized his plan saying it is only targeting fifteen million Americans while hers will ensure most of the Americans have free health care. She said most Americans die because they cannot afford quality health care. In her plan, all drivers will be required by law to have auto insurance and promised that all families will be given tax credits so that they would meet their health insurance. If she will be voted in, all households would be able to meet the required health premium. The federal government according to Clinton will subsidize the health insurance for all those families that cannot afford it while businesses and organizations will be required to provide their workers with health insurance. She is quick to add that this plan will not affect small businesses but what will be required is that they will provide these businesses with tax credits to motivate them to do so. The health care providers will be required to pay for those people with huge bills without asking them for more money. Americans, according to Clinton, will be provided with similar private health care that the congress receives and this will be provided to citizens through the employees benefit program that will be a public program similar to that of Medicare. Obama on the other hand pledged to strengthen Medicare and Medicaid so that they would continue taking care of the vulnerable members of the society. These programs mostly target those citizens that are poor and uninsured. He pledged to amend the National Medic Act so that patients who are injured as a result of medical negligence would be compensated. He will also increase funds on research and development so that HIV/AIDS would be contained both in USA as well as in other parts. Both Clinton and Obama have taken issues with the Iraq war. Clinton is currently accusing Obama of not being consistent with opposing the Iraq War, as he was when he assumed the post of a senator. Obama has promised to withdraw American troops from Iraq if he becomes the next president in 2008 election. Obama was not opposed to all wars but was particularly opposed to the Iraq war. He accused president Bush of starting another war instead of finishing that on Osama but Clinton supported Bush to resort to military action if other methods such as diplomatic means failed to restore order in the nation. Currently, she is also advocating for the withdrawal of US troops from Iraq. We have seen that the two Democrat presidential candidates do agree and disagree on some issues. For example, they both agree that health care for all Americans would be vital but they differ in how the program would be implemented. They both promised to strengthen and widen the country’s economic base so that the quality of life of the Americans would improve and to end the war on Iraq and they both promised to end it once they will assume power. Work Cited. Associated Press. Hillary Clinton blasts Bush economy. May 29, 2007.Accessed at http://www.politics.com/news/stories/0507/4230.html on March 25, 2008 Friel et al. Obama: Most liberal senator in 2007. National Journal 31st Jan 2008; 16 Accessed at http://nj.nationaljournal.com/voteratings on March 25, 2008 Kelly P. Politics. New York Times. January 22, 2008.Retrieved an http://www.nytimes.com/2008/0122/us/politics/22clinton.html on 25 March 2008 Johnson G. Obama-Clinton politics of Health Mandate now playing in mass. Associated Press. Insurance Journal. 2008. Sklar R. Micro Debate: Clinton and Obama on Health care. Huffington Post

Drugs Affecting the Central Nervous System (CNS)

Drugs Affecting the Central Nervous System (CNS) Drugs acting in CNS were among the first to be discovered by primitive humans and are still the most widely used group of pharmacologic agents. In addition to their use in therapy, many drugs acting on the CNS are used without prescription to increase ones sense of well being. The mechanism by which various drugs act in the CNS have not been clearly understood. In last three decades, however, dramatic advances have been made in the methodology of CNS pharmacology. It is now possible to study the action of a drug on individual cells and even single ion channels with synapses. The information obtained from such studies is on the basis for several major developments in studies of the CNS. These are the classification of CNS acting drugs. In addition to many medical uses, drugs acting on the cns are using worldwide i.e. alcohol, nicotine, caffeine with various degrees of societal controls due to production of addiction or dysfunctional behaviours. We know that CNS acting agents mainly exert their effects by modulation of synaptic transmission of information between neurons. These actions alter the electrical exciteability of nerve cells by changing the movement of chemical ions across  nerve and neuron cell membrane. In general, these drugs ct on a receptor to directly or indirectly open or close ion channels in the cell membrane and thus make the nerve cell more exciteable with regard to its ability to send information. ION CHANNELS: The membrane of nerve cells contain two types of channels defined on the basis of the mechanism controlling their gating: voltage-gated and ligand-gated channels.Voltage gated channels see Table-1 are respond to changes in the membrane potential of the cell.In nerve cells, these channels are concentrated on the initial segment and the axon and are responsible for the fast action potential,which transmitthe signal from cell body to nerve terminal. There are many types of voltage-sensitive calcium and potassium channels on the cell body, dendrites and initial segment, which act on a much slower time scale and modulate the rate at which the neuron discharge. CHANNEL TYPE MODE OF TOXIN ACTION:  Tetrodotoxin VOLTAGE-GATED:  Blocks channel from outside MODE OF TOXIN ACTION:  Betrachotoxin VOLTAGE-GATED:  Slows inactivation MODE OF TOXIN ACTION:  Apamin VOLTAGE-GATED:  Blocks small Ca-activated K-channels MODE OF TOXIN ACTION:  Agatoxin VOLTAGE-GATED:  Blocks p-type channels MODE OF TOXIN ACTION:  Omega-conotoxin VOLTAGE-GATED:  Blocks n-type channels MODE OF TOXIN ACTION:  Charybdotoxin VOLTAGE-GATED:  Blocks big Ca-activated K-channels IDENTIFICATION OF CENTRAL NEUROTRANSMITTER: Because drug selectivity is based on the fact that different pathways use different transmitters, a primary goal of neuropharmacologists is to identify the transmitter in CNS pathways. Establishing that a chemical substance is a transmitter has been far more difficult for central synapses than for peripheral synapses. The following criteria have been established for transmitter identification: LOCALIZATION: Approaches prove that a suspected transmitter resides in the presynaptic terminal of the pathway uder study include biochemical analysis of regional concentrations of suspected transmitters and immunocutochemical techniques for enzymes and peptides. RELEASE: To determine whether the substance is released from a particular region, local collection of the extracellular fluid can sometimes be accomplished. In addition, slices of brain tissue can be electically or chemically stimulated in vitro and the released substances measured. To determine whether release is relevant to synaptic transmission, it is important to establish that the release is calcium-dependent. SYNAPTIC MIMICRY: Finally, application of the suspected substance should produce a response that mimics the action of the transmitter released by nerve stimulation. Furthermore, application of the selective antagonist should block the response. The excitatory neurotransmitter released from these cells is in most instances. The information is typically phasic and bursts of action potential. Microionophoresis, which permits highly localized drug administration, has been a valuable technique in assessing the action of suspected transmitter. Because of the complexity of the CNS, specific pharmacologic antagonism of a synaptic response provides a particular powerful technique for transmitter identification. DRUG CONCENTRATION AND INTESITY OF ITS EFFECTS: Intensity of pharmacological effect is given as, Intensity of effect= DRUGS ACTING UPON CNS: CAFFEINE: Caffeine and the chemically related xanthenes, theophylline and theobromine Decreases in the order given in their stimulatory action.They are over-the-counter drugs, used to block adenosine receptor as an antagonist. AMPHETAMINE: The stimulation caused by excessive release of norepinephrine from storage sites in the peripheral nervous system. It is not known whether the same action occurs in the CNS. Two other theories regarding for their action are that they are degraded slower than epinephrine or that they could act on serotonin receptor sites. NARCOTICS: Narcotic agents are potent and effective for the relief of severe pain. Analgesics are selective cns drug to reduce pain.Long term administration produces tolerance, pstchic and physical dependence. CENTRAL NERVOUS SYSTEM DEPRESSANTS AND STIMULANTS: CNS DEPRESSANTS: CNS depressants slows down normal brain functions. In higher doses, some CNS depressants can become general anesthetics. Tranquilizers and sedatives are example of CNS depressants. CNS depressants are based on two groups such as: CNS STIMULANTS: Stimulants increase alertness, attention and energy which are accompanied by increases in blood pressure rate and respiration. Stimulants were used to treat asthma and other respiratory problems, obesity, neurological disorder and a variety of other ailments. As their potential for abuse and addiction became apparent to wane. Now, stimulants are prescribed for treating only a few health conditions, include attention deficit hyperactivity disorder and depression that has not responded to other treatment. It is also used for short-term treatment of obesity and for patients of asthma. INTODUCTION TO SEDATIVE-HYPNOTIC: Interms of drugs, sedative refers to a substance that moderates the activity and excitement while inducing a calming effect, while hypnotic effect refers to a substance that causes drowsiness and facilitates the onset and maintenance of natural sleep. The term anxiolytic is sometimes applied to a sedative-hypnotic; however, be aware that many drugs especially the selective serotonin secretion reuptake inhibitors are useful as a chronic anxiolytic dug demonstrated by their efficacy in certain psychiatric disordres like generalized anxiety disorder. THERAPEUTIC EFFECTS OF SEDATIVE-HYPNOTICS: SEDATION: All drugs in this class produce sedation,, with relief of anxiety. Benzodiazepenes also exert anterograde amnesic effects (i.e the inhability to remember events occuring during the drug action ) at sedative doses. The amnesic action is a primary reason some benzodiazepenes ( i.e., midozam ) are commonly used for short duration invasive procedures. They donot provide pain relief however, and must be used in conjunction with analgesics. HYPNOSIS: Sedative-hypnotics promote sleep onset and increase the duration of sleep. All of the sedative-hypnotics will induce sleep if given in high enough dose. Rapid eye movement ( REM ) sleep stages are usually decreased at high doses. REM rebound can be detected following termination of sedative-hypnotics. ANESTHESIA: At high doses, sedative- hypnotic produce a loss of consciousness with amnesia at high level and a suppression of reflexes. Anesthsia can be produced by most barbiturates and some benzodiazepene, which is generally used frequently as a induction agent for general anesthesia. Only three, diazepam, midazolam and lorazepam are formulated I.V. ANTI-CONVULSANT AGENT: Most barbiturates and some benzodiazepene suppress seizures activity at high dose. However, often this occur along with marked sedation. Selective have anti-convulsant activity and can decrease the spread of epileptiform activity without CNS depression. Some are administered intravenously to treat status epilacticus. MUSCLE RELAXATION: Most sedative-hypnotics causes muscle relaxation at high doses. Diazepam is effective at sedative doses and is useful for treating specific spasticity state including cerebral palsy. TOLERANCE AND DEPENDENCE: TOLERANCE: Decreased responsiveness to a drug following repeated exposure commonly occurs with the continuous use of sedative-hypnotics. The mechanism of action of sedative-hypnotics are not well known. DEPENDENCE: Psychologicaaly dependence usually occurs wit h most of the sedative-hypnotics with leads to the compulsive use of these agents to reduce anxiety. Physical dependence is the development of withdrawal syndrome occurs when the drugs are discontinued. Withdrawal syndrome includes, tremors, hyper reflexia, and seizures. These symptoms occur most commonly with shorter acting drugs. EFECTS ON CNS WITH INCREASING DOSAGE: Calmness or drowsiness (sedation) Sleep (pharmacological hypnosis) Unconsciousness Coma Surgical anesthesia Fatal respiratory/ cardiac depression INTRODUCTION TO ANALGESICS: An analgesic also known as a painkiller is any member of the group of drugs used to relieve pain. Analgesic drugs act in various ways on the peripheral and central nervous system they include paracetamol and acetylaminophetol also known in the us as acetaaminophen, the NSAIDs such as the acetyl salicylic acid and opiods drugs such as morphine and opium. They are distinct from anesthesia who reversibly eliminate sensation. In choosing analgesics, the severity and response to the medication determines the pain ladder is originally developed in cancer-related pain is widely applied to find suitable drugs in a step wise manner. The choice is also determined by the type of pain, for neuropathic pain, traditional analgesics are less effective and there is often benefit from classes of drugs that are normally not considred analgesics such as tricyclic anti-depressants and anti-convulsants. WHAT IS PAIN ? Pain is physiological process that can be classified interms of its intensity ( mold, moderate, severe) its duration (acute, convulascent, chronic) its mechaism ( neurologic, nociceptive, physiologic) and its clinical context ( post surgical, malignancy) pain detection or nocicepter requires activation of specialized transducers called nociceptor, see Table-2, which are activating following thermal, mechanical or chemical tissue injury and initiate different transmission of action potential to the dorsal horn of spinal cord. Category:  Physiological Cause:  Brief exposure to a noxious stimulus Symptoms:  Rapid, yet brief pain perception Example:  Touching a pin or hot object Category:  Nociceptive Cause:  Somatic or visceral tissue injury with medication impacting on intact nervous system Symptoms:  Moderate to severe pain, described as crushing, stabbing, usually worsen after the first 24 hours Example:  Surgical pain, traumatic pain, sickel cell crisis Category:  Neuropathic Cause:  Damage of dysfunctional of peripheral nerves or CNS Symptoms:  Severe lancinating, burning or electrical shock like pain Example:  Neuropathy, chronic regional pain syndrome, postherpetic neuralgia Category:  Mixed Cause:  Combined somatic and nervous tissue injury Symptoms:  Combination of symptoms, soft tissue pain and radicular pain Example:  Low back pain, back surgery pain Analgesics are a class of drugs used to relief pain. The pain relief by analgesics occurs either by blocking pain signals or by interfering with the brain interpretation of the signalwithout producing anesthesia or loss of consciousness. There are basically two kinds of analgesics: KINDS OF ANALGESICS: It should be noted that some reference include aspirin and other non-steroidal anti inflammatory drugs (NSAIDs) in the class of analgesics because they have some analgesic properties. Aspirin and NSAIDs primarily have an anti-inflammatory affect, as opposed to being solely analgesic. NON-NARCOTIC ANALGESICS: Acetaminophen is the most commonly used over-the-counter, non-narcotic analgesic. Acetaminophen is a popular pain reliver because it is both effective for mild and moderate relief of pain and relatively inexpensive. It must be emphasized though that the safety of acetoaminophen is tied to proper use of the drug (use according to specific prescribed instructions). If acetoaminophen is not used according to the directions on the label, serious side effects and possible fatal consequences can occur. For example, taking more than 4000 mg/day or using it long term can increase the risk of liver damage. The risk of liver damage also increased by ingesting alcohol. Many people donot realize that acetoaminophen is found in more than 600 OTC. It can be found in combination with other active ingredients in many cold, sinus and cough medications. The commulative effect of acetaminophen must be considered if you are taking multiple drugs which contain acetaminophen. NARCOTIC ANALGESICS: There are two types of narcotic analgesics: The opiates (found in alkaloid, opium) The opioids (derivatives of opiates) Opiods are any medication which binds to opioid receptors in the CNS or gastrointestinal tract. There are four broad classes of opioids: Endogenous oopioids peptides (produced in the body: endorphins, dynorphins, enkephalins) Opium alkaloids (morphine, codeine, theibaine) Semi-synthetic opiods ( heroin, oxycodone, hydrocodone, dihydrocodeine, hydromorphone, oxymorphone) Fully synthetic opioids (pethidine, methadone, fentanyl, propoxyphene, buprenorphine) Opioids are used in medicine as strong analgesics, for relief of severe or chronic pain. There is no upper limit for the dosage of opioids used to achieve pain relief, but the dose must be increased gradually to allow for the development of tolerance to adverse effects ( for eg. Respiratory depression). According to emedicine: some people with intense pain get such high doses would be fatal if taken by someone who was not suffering from pain. PHARMACOLOGY OF SYSTEMIC ANALGESICS: Systemic administration of analgesic drugs is still the most widely used method for providing pain relief in acute painful situations. Opioids may be selected on the basis of their physicochemical characteristics and their diffusion index to the brain. But in clinical practice, their very steep concentration-analgesic effect relationship remains a critical aspect of opioid therapy. Thus, small fluctuations in plasma concentrations of opioids may lead to profound fluctuations in analgesic effect when their plasma and effect-site concentrations are near the minimum effective analgesic concentration (MEAC). Combining drugs acting on different mechanisms of nociceptive modulation offers benefits from additive/synergistic effects and will decrease the incidence of their adverse effects. Evidence-based reviews showed that effective pain relief using non-opioid analgesics relied on paracetamol supplemented with non-steroidal anti-inflammatory drugs (NSAIDs). The role of COX-2 selective inhi bitors (CSIs) in acute pain relief still requires further evaluation. NSAIDs, CSIs and paracetamol share the property of morphine sparing in situations of severe (post-operative) pain. CSIs may be beneficial in patients in whom post-operative bleeding is a major surgical risk as the effects of NSAIDs on coagulation may last for days. Finally, low-dose ketamine infusions remain a worthwhile addition to opioid therapy. Analgesic concentrations of ketamine are 1/5th to 1/10th the anaesthetic concentration and exert significant inhibition on N-methyl-d-aspartate (NMDA) receptor activation. There have been debates over the additine potential of opioids vs. the benefits of their analgesic properties for treating non-malignant chronic pain such as chronic arthritis. Some experts believe opioiods can be taken for years without addiction or toxic side effects. The enhanced quality of life which opioids may provide the patient must considered. Common SIDE EFFECTS and ADVERSE REACTION: Nausea Vomiting Drowsiness Dry mouth Miosis (contraction of pupil) Urinary retention Constipation or fecal impaction Orthostatic hypotension Less common SIDE EFFECTS and ADVERSE REACTION: Confusion Hallucinaation Hives Itch Bradycardia Hypothermia Raised intracranial pressure Tachycardia Flushing Muscle rigidity Most severe SIDE EFFECTS and ADVERSE REACTION: Respiratory depression Fatal overdose INTRODUCTION TO ANTI-SEIZURES: After stroke, epilepsy is the second common disorder of CNS affecting about 1% of the population worldwide. Most (80%+) cases can be well controlled with anti-seizures drugs. However, that leaves many characterized by periods of abnormal firing of CNS neurons and can be caused by many neurological conditions (i.e. tumors, injury, infection). In some cases, there is also agenetic predisposition to epilepsy. Anti-seizures medication were originally designed to help people who have epilepsy, but the nerve-calming quality of some of these drugs can also help quiet the burning, stabbing or shooting pain often caused by nerve damage. Nerve damage (neuropathy) can be caused by many factors, including: DIABETES: High blood sugar levels, common in diabetes, can damage the nerves throughout the body, but the first symptomatically is numbnessand pain in the hands and feet. SHINGLES: Anyone who has had chicken pox is at risk of shingles a rash of blisters that can be painful or itchy. A condition called postherpetic neuralgia occurs if shingles pain persists after the rash disappears. Because the risk of shingles increases with age, evryone everyone everyone age 60 or older should receive the zoster vaccine which can help prevent this painful condition. CHEMOTHERAPY: Some chemotherapy drugs can damage nerves causing pain and numbness that typically begins in the tip of toes and fingers. HERNIATED DISK: Nerve damage can occur if a herniated in your spine squeezes a nerve passing through your vertebrae too tightly. INHERITED NEUROPATHIES: Some neuropathies are passed on genetically and affects different nerves, depending upon the type of disorder. The most common hereditary neuropathy is Charcot-Marie-Tooth disease which affects motor and sensory nerves. MECHANISMS OF ANTI-SEIZURE DRUGS: Exact mechanism of anti-seizues drugs are not well understood but tese medications appear to interfere with the over react transmission of pain signals sent from damaged nerves. Some anti-seizures work particularly well for certain conditions. Carbamazepine is prescribed for trigeminal neurolgia, a condition that causes facial painn appears as electrical shocks. It is important note that FDA has issued a warning that all anti-seizures associated with a slight increased risk of suicidal thoughts or actions. Talk to your doctor if you are experiencing feeling of depression or suicidal thoughts. GABAPENTIN: Used with other epilepsy drugs to treat partial and some generalized seizures. Few lasting side effects. During the first week of treatment, a person may experience tiredness and dizziness. PHENYTOIN: Controls partial seizures and generalized tonic-clonic seizure. Also can be given by intravenously in the hospital to rapid control active seizures. Side effects include dizziness, fatigue, acne, slurred speech, rash, and increase hair. Over the long term the drug can cause bone thinning. VALPROIC ACID: Used to treat partial, absence and generalized tonic-clonic seizures. Common side effects include dizziness, nausea, vomiting, tremor, hair loss, reduced attention, depression in adults, irritability in children, a decrease in thinking speed. Over the long term, the drug can cause bone thinning, swelling of the ankles, liver damage, decreased platelets. INTRODUCTION TO ANTI-PSYCHOTICS: A person who is psychic out of touch with the reality. People with psychosis may hear voices or have strange and illogical ideas for eg, thinking that others can hear their thought or are trying to harm them or they are president o f us or some famous person. They may get excited or angry with no apparent reason, or spend lots of time by themselves or in bed, sleeping during the day and awake at night. The person may neglect appearance, not bathing or changing clothes, hard to talk to- barely talking or saying things that make non-sense. They often are initially unaware that their condition is an illness. These kinds of behavior are symptoms of a psychotic illness such as schizophrenia. Anti-psychotic drugs reduces these symptoms. These medications cannot cure the disease but they can take away many of the symptoms or make them mild. In some cases, they can shorten the course of episode of illness well. There are number of anti-psychotic medications available. These medications affect the neurotransmitter that allow communication between nerve cells. One such neurotransmitter, dopamine, is thought to be relevant to schizophrenia symptoms. All thes e medications have some effect for schizophrenia. The main differences are in their potency that is the dosage prescribed to produce therapeutic effect. Some people may think that thehigher doses of medication prescribed the more serious the illness but this is not always true. The 1990s saw the development of several new drugs for schizophrenia called atypical antipsychotics because they have fewer side effects than the older drugs, today they are often called and used as afirst line of treatment. The first atypical antipsychotic drug was introduces in 1990. In clinical trials, these medications were found to be more effective than conventional or typical Antipsychotic drugs in individuals with treatment-resistant schizophrenia, that is not responded to other drugs and the risk of tardive dyskinesia ( a movement disorder was lower). However because of the potential side effects of serious blood disorder -agranulocytosis, white blood cells loss that fight infection. Patient who are on clozapine must have a blood test on every 1 or 2 weeks. The inconvenience and cost of blood tests and the medication itself have made maintenance for adults for many people. Several other atypical antipsychotics have been developed since clozapine was introduced. INDICATIONS OF ANTI-PSYCHOTIC DRUGS: Common conditions with which antipsychotics might be used include schizophrenia, bipolar disorder and delusional disorder. Antipsychotics might also be used to counter psychosis associated with a wide range of other diagnoses, such as psychotic depression. However, not all symptoms require heavy medication and hallucinations and delusions should only be treated if they distress the patient or produce dangerous behaviors. For non-psychotic disorders: In addition, antipsychotics are increasingly used to treat non-psychotic disorders. For example, they are sometimes used off-label to manage aspects of Tourette syndrome or autism spectrum disorders. They have multiple off-label uses as an augmentation agent (i.e. in addition to another medication), for example in treatment-resistant depression essive, anti-impulsive, anti-suicidal and hypnotic (sleep) medications. Antipsychotics have also been increasingly used off-label in cases of dementia in older people, and for various disorders and difficulties in children and teenagers. A survey of children with pervasive developmental disorder found that 16.5% were taking an antipsychotic drug, most commonly to alleviate mood and behavioral disturbances characterized by irritability, aggression, and agitation. Recently, risperidone was approved by the US FDA for the treatment of irritability in children and adolescents with autism. Antipsychotics are sometimes used as part of compulsory treatment via inpatient (hospital) commitment or outpatient commitment. This may involve various methods to persuade a person to take the medication, or actual physical force. Administration may rely on an injectable form of the drug rather than tablets. The injection may be of a long-lasting type known as a depot injection, usually applied at the top of the buttocks. Those that are available in injectable form are haloperidol, olanzapine, and ziprasidone while those available as depot are haloperidol, flupenthixol, clopenthixol, and risperidone. Antipsychotics are among the biggest selling and most profitable of all drugs, generating $22 billion in global sales in 2008. By 2003 in the US, an estimated 3.21 million patients received antipsychotics, worth an estimated $2.82 billion. Over 2/3 of prescriptions were for the newer more expensive atypicals, each costing on average $164 compared to $40 for the older types. By 2008, sales in the US reached $14.6 billion, the biggest selling drugs in the US by therapeutic class. The number of prescriptions for children and adolescents doubled to 4.4 million between 2003 and 2006, in part because of increases in diagnoses of bipolar disorder. Due to the chronic nature of the treated disorders, antipsychotic medications, once started, are seldom discontinued, and the aim of the treatment is often to gradually reduce dosage to a minimum safe maintenance dose that is enough to control the symptoms. Only when the side-effects have become too severe and/or a patient have been symptom-free for a long periods of discontinuation carefully attempted. MULTIPLE MEDICATIONS: Antipsychotic medications can produce unwanted effects when taken with other medications therefore, doctor should be told about all the medications being taken including over -the-counter medications and vitamin, mineral, and herbal supplements and the extent of alcohol use. Some antipsychotic interfere with anti-hypertensive drugs (taking for high blood pressure), anticonvulsants (taken for epilepsy) and medicine used for parkinsons disease. Other anti-psychotic add to the effect of a alcohol and other CNS depressants such as anti-histamines, barbiturates, anti-depressants, some sleeping and pain medications and narcotics. OTHER EFFECTS: Long term treatment of schizophrenia with one of the older, or, conventional antipsychotics may cause to develop tardiye dyskinesia. Tardiye dyskinesia is a condition characterized by involuntary movements, most often around the mouth. It may range from mild to severe. In some people, it cannot be reversed, while others recoverd partially or completely. Tardiye dyskinesia is sometimes in people with schizophrenia who have never been treated with an antipsychotic medications is called spontaneous dyskinesia however, it is most often seen after long term treatment with older antipsychotic medications. The risk has been reduced with newer atypical medications. There is a higher incidence in women, and the risk increases with the age. The possible risks of long-term treatment with with an anti-psychotic medications must be weighed against the benefit in each case. The risk of TD is 5% per year with older medications. It is less with newer medications. PSYCHOTIC DISORDER CAUSES: Functional causes of psychosis include the following: Drug abuse amphetamines, cocaine, marijuana, http://en.wikipedia.org/wiki/Alcoholismalcohol among others. Brain damage Schizophrenia, schizophreniform disorder, schizoaffective disorder, brief psychotic disorder Bipolar disorder (manic depression) Severe clinical depression Severe psychosocial stress Sleep deprivation. Some traumatic events. DOSAGES AND SIDE EFFECTS: Some medications are very potent and prescribed in low doses, others are not as potent and higher doses are prescribed. Most side effects of antipsychotic drugs are mild. Many common ones lessens or disappear after the first week of treatment. these includes drowsiness, rapid heart beat and dizziness when posture changes. Some people may gain weight while taking medications and need to pay extra attention to diet or exercise to control their weight. All anti-psychotic drugs tend to block D2- receptors in the dopamine pathways of the brain. This means that dopamine released in these pathways has less effect. Excess release of dopamine in the mesolimbic pathway has been linked to psychotic experiences. It is the blockade of dopamine receptors in the pathway that is thought to control psychotic experience. Typical antipsychotic are not particularly selective and also block dopamine receptors in the mesolimbic pathway, tuberoinfundibular pathway and the nigrostriatal pathway. Blocking D2- receptor s in these pathway is thought to produce some of the unwanted effects which typical antipsychotics produce. LITHIUM, MOOD STABILIZING DRUGS, AND OTHER TREATMENT FOR BIPOLAR DISORDER: Bipolar disorder once known as manic-depressive illness, was conceived of as a psychotic disorder distinct from schizophrenia at the end of the 19th century. Before that both of these disorders were considered part of a continuum. It is ironic that the weight of the evidence today is that there is profound overlap in these disorders. This is not to say that there are no pathophysiology important difference or that some drugs treatment are differentially effective in these disorders. According to DSM, they are separate disease entities while research continues to define the dimensions of these illnesses and their genetic and other biological markers. TYPES OF BIPOLAR DISORDER There are several types of bipolar disorder. Each type is identified by the pattern of episodes of mania and depression. The treatment that is best for you may differ depending on the type of bipolar disorder you have. Your doctor will look carefully to determine where your symptoms fit. Bipolar I Disorder (mania and depression) Bipolar I disorder is the classic form of the illness, as well as the most severe type of bipolar disorder. It is characterized by at least one manic episode or mixed episode. The vast majority o

The Role of the Gods in the Odyssey Essay -- Homer, Odyssey Essays

Religion was deeply intertwined the culture of the ancient Greeks. In their stories, they prayed to the gods to satisfy their needs and offer assistance in their endeavors, and the gods would occasionally appear to select Greeks to give counsel, gifts, or other forms of aid. Alternatively, if the desires or endeavors of a mortal or mortals displeased one or more of the gods, they would also interfere with the fulfillment of their goals. In Homer’s Odyssey, the gods appear to or interfere with both Telemachus and Odysseus, either to help or hinder them in their journeys. Although the gods are responsible the difficulty Odysseus faces returning from Troy, they are equally responsible for motivating and assisting Odysseus and Telemachus in their respective travels. If not for divine interference, neither Odysseus nor Telemachus would have journeys to make. The gods are first responsible for establishing the conditions under which the story begins. While the Greek soldiers had returned home from Troy, Odysseus remained trapped as â€Å"the brightest goddess, Calypso, held him her hollow grottoes† because â€Å"she wanted him as a husband† (Homer, Odyssey 1.5, Translation by Allen Mandelbaum). Calypso traps Odysseus on her island of Ogygia and â€Å"keeps the sad Odysseus there—although he weeps. Her words are fond and fragrant, sweet and soft—so she would honey him to cast far off his Ithaca† (1.7). He remains on Ogygia for years, leaving the care of his home to his wife Penelope and his son Telemachus. Because Calypso keeps him away for years, Odysseus is presumed dead and his absence invites suitors to his home. These suitors look to win the hand of Penelope, Odysseus’ wife. This state of affairs is the overall cause of Telemachus’ d... ...a, escaping Calypso and the island of Ogygia, and Telemachus from Ithaca to Pylos and Sparta in search of his lost father. While The Odyssey tells of the courage both men demonstrate during their respective travels, their quests are the results of the intentions and desires of gods. Odysseus is trapped in exile on Ogygia by the will of Poseidon, whose anger Odysseus attracts when he blinds the Cyclops Polyphemus, son of Poseidon, and by the love of Calypso, who wishes to make Odysseus her husband. He is released from Ogygia and permitted to return to Ithaca only by the command of Zeus, as delivered by Hermes. Telemachus, rather than being trapped physically, was detained emotionally, feeling helpless to repel the suitors wooing Penelope. Only through the motivation of the goddess Athena did Telemachus find the will and courage to embark in search of Odysseus.

Columbine Essay -- essays papers

Columbine The tragedy at Columbine High School is something that will be remembered and talked about for many years to come. People from across the nation have all heard about this event. But there are still a couple questions that people have. For instance who’s to blame? The kids alone, the parents for how they brought the children up, or even actually the students at Columbine? Most say that the parents are to blame, but who actually knows? In my opinion the only two people that can actually answer this question truthfully are both dead. Everyone wants answers. Did the kids have help? Who was it? Who sold them the weapons and why? Why did they do this? How could they do this? I had a class about the last question. Who could actually go into a room and commit a crime of massacre in a school of people that you know and have grown up with? Most of our class thought that they couldn’t ever get enough anger to do anything even remotely as bad, but when you actually think about it, if you had no friends and where made fun of all the time. It looked like your parents, teachers, and even all your own piers where against you. I think anyone could snap and maybe even do something as drastic as this (Why at Columbine High). Did the boys, Dylan Klebold, 17, and Eric Harris, 18, have any help doing this crime. As of yet no one has true evidence that proves they did except they did find who sold them the weapons. Police found around thirty small bombs and one twenty-pound propane bomb in the school, enough explosives to blow the school into almost nothing. For this reason people believe that the boys either had to have help or they had visited the school many times to plan this assault. No one talking though and no proof has been found. Their not only looking for information from someone that could point to someone that had helped they’re also looking for someone that had known that this was going to happen, so that they may find the answers to so many questions (The Colorado Shooting: Who Helped). Besides many bombs the police had also found a horrible suicide note. â€Å"Your children who have ridiculed me, who have chosen not to accept me, who have treated me like I am not worth their time are dead. THEY ARE (expletive) DEAD. I may have taken their lives and my own - but it was your doing. Teachers, parents, LET THIS MASSACRE BE ON YOUR SHOULDERS UNTIL ... ...no one except investigators and policemen in the school the police finally let them in. Everyone had something to get or look at, since the kids all had to leave their book bags in the school. A lot of the kids despised having to go back to school where many of their friends were killed or even injured (A Sad Homecoming at Columbine High). As of now in the little town of Littleton, the people are decided rather or not to destroy the old library and build a new one, for over three million dollars. They see the library as a horrible memory since ten of the students were killed and that’s where the boys committed suicide (Library Approval Delayed). This entire event got worse and worse as I read into it. Before now I never knew what was written in the suicide notes that they had written, but now that I do it’s really unbelievable that a human could think up such a thing and actually do it. It’s one thing to think about doing it, but strictly another going throug h with something so gruesome. I believe all of us feel left out sometimes, or maybe just seeing everything go wrong from them and that everyone’s against them, but I don’t see it in anyone to take that hated to these extremes.

Machiavelli

In the beginning of The Prince, Machiavelli outlines the different types of principalities which constitute all forms of government.   He then goes on to give advice on how a competent ruler would go about keeping a stronghold in the principality he had just conquered.   Although perhaps not as blatant as other political leaders’ attempts at gaining control after an invasion of a country, George Bush, taking action in 2003, decided to firmly plant an America influence in Iraq. â€Å"The Decider,† as the President recently referred to himself, chose a path which has clear parallels to situations outlined in The Prince.   Within the pages of The Prince, Machiavelli has given much advice as to how to deal with the current situation in which the President now finds himself.   Leaving out ethical consideration of the actions our President has taken and must take in the future, this paper will explore the relationship between the teachings found in The Prince and the current situation in Iraq and attempt to answer the question of what advice Machiavelli would give to President Bush to ease his current situation. In the beginning of The Prince, Machiavelli claims that all governments are either republics or principalities.   As he has already laid out what constitutes a republic, The Prince is concerned with only principalities.   As he explains, there are three different types of principalities; hereditary, new, and mixed. A hereditary principality is the sort that is passed from ruler to ruler in the same family.   It is the typical monarchial relationship in which a king, once no longer able to rule, passes his kingdom over to the next in line, usually his son.   New principalities are entirely new territories to be ruled over, and mixed principalities are new additions to existing territories.   It is this last kind of principality that this paper will be concerned with as it is most readily illustrated with the current situation in Iraq. To understand the relationship between Machiavelli’s ideas and what the Bush administration is currently involved in in the war there, it is necessary to understand the recent history of Iraq. Iraq was formed from three former Ottoman regions; Basra, Baghdad, and Mosul.  Ã‚   It was given to the United Kingdom at the end of World War I as a mandate.   The United Kingdom granted Iraq independence in 1932 but invaded in 1941 when it seemed that the government there was threatening European oil supplies.   The U.K then occupied the country for several years and installed a monarchy to rule the region. This monarchy lasted until a coup d’etat led by the Iraqi army overthrew it in 1958.   After this government was itself overthrown, the Iraqi Ba’ath party gained control and out of this rose Saddam Hussein.   Hussein ruled Iraq until removed from power by the United States in 2003.   (Wikipedia 2006) Although perhaps in the eyes of Hussein, Iraq could be considered a monarchy, it was more often considered a dictatorship.   And because when the United States invaded Iraq they were not invading a new territory, Iraq as a principality would, by Machiavellian standards, be considered not a hereditary or new principality, but mixed.   It is these sorts of principalities that, in Machiavelli’s words, â€Å"†¦are the ones that present problems.† Aside from the hereditary principalities, in which the people of the territory do not, as evidenced by their loyalty to the King’s family, mind the change in power, a mixed principality, because the people have been under the rule of one man (as in the case of Iraq), will not take well to the new ruler unless their situation improves.   Machiavelli’s musings on human nature bring out the idea that all people are generally looking out for themselves and those close to them. They are generally indifferent to politics when things are going well for themselves.   For this reason, if the people’s situation improves even a small amount and provides them the feeling of safety and security, it will not really matter to them who is in control.   As evidenced by the daily insurgent attacks, kidnappings and suicide bombings, President Bush has not created a feeling of security for the people of Iraq.   Is it any wonder that the vast majority of the Iraqi’s do not want us there?   President Bush has failed to accomplish even this first goal of competent rule laid out by Machiavelli. In The Prince, Machiavelli uses the analogy of rulers being like foxes and lions to prove a point about what constitutes a competent ruler. He mentions this in Chapter Eighteen: How Rulers Are to Keep Their Word.   As he states, â€Å"Everybody recognizes how praiseworthy it is for a ruler to keep his world and to live a life of integrity, without relying on craftiness.   Nevertheless, we see that in practice†¦ those rulers who have not thought it important to keep their word have achieved great things†¦Ã¢â‚¬  For this reason, Machiavelli believes it important to be able to rule and fight in two ways.   The first, the way men fight; by the rules.   The second is the way animals fight; no holds barred.   â€Å"Because you cannot always win when you respect the rules, you must be prepared to break them.   A ruler needs to know how to be both an animal and a man.† In Machiavelli’s view, because a ruler must at times display â€Å"beastly† qualities, it is important to know how to act like specific animals, namely, a lion and a fox.   The lion is powerful, and runs over his enemies with great mite, but has the disadvantage of not being able to avoid traps.   The fox, on the other hand, has the cunning to avoid those traps.   So it is important for the ruler to be able to act like both animals and to know when the situation calls for either brute strength, or quiet cunning. Although many people often make fun of the President, regarding him as not too bright, he did sell a war to the American people and the world based on lies.   As recently reported by Reuters, the White House had been informed by the CIA six months previous to the invasion of Iraq that there were no weapons of mass destruction.   This, along with countless other officials and documents have shown that the Bush administration knew what all of us know now; that Iraq was in no way the threat they were perceived to be. Of course, there was no way for him at the time to know that the world would find out that he was not telling to truth and if there was, maybe he would not have used the rationale of weapons of mass destruction but found another way to get enough support to invade Iraq.   Nevertheless, he was cunning enough to know when to use fear and manipulation to rally the people behind him and achieved his aims with the help of many countries. In Machiavelli’s time, there would not have been governmental leaks to the extent that we have today, and anyone courageous enough to speak out about ruling governments were more than likely going to be killed.   If Bush were ruling with circumstances similar to what they were in Italy in the time of Machiavelli, perhaps he would have been more successful. However, now that Bush finds himself in the position that he is in, the question could be asked what advice might Machiavelli give to our President.   The answer to this question lies in chapter five of The Prince: How You Should Govern Cities or Kingdoms That, Before You Acquired Them, Lived Under Their Own Laws.   As Machiavelli explains, â€Å"When the states one acquires by conquest are accustomed to living under their own laws and in freedom, there are three policies one can follow in order to hold on to them.†Ã‚   Although it could be debated whether Iraq was â€Å"free† the overall meaning of Machiavelli still applies. â€Å"The first is to lay them to waste.†Ã‚   With the advent of the international criminal court and the necessity of keeping the peace and favor of ones allies, President Bush could not view this first option as possible.   â€Å"The second is to go and live there in person.†Ã‚   I highly doubt President Bush has, or ever will consider such a measure. And, â€Å"The third is to let them continue to live under their own laws, make them pay you, and create there an administrative and political elite who will remain loyal to you.† This third option is the one the Bush administration is following.   Ã‚  Although the Iraqi’s are not paying taxes directly to the United States, once the infrastructure gets up and running again, I am certain we will take our payment in the form of oil. If someone from old Italy were familiar with Machiavelli and his works and were alive today, they would see much Machiavellian inspiration in the governmental tactics of the Bush administration.   Whether President Bush is aware of it or not, he is giving us a first hand account of what happens when Machiavellian principles are followed.   The interesting fact is that it seems these principles would only work today if the circumstances were just right. Nevertheless, many of Bush’s detractors would probably like to see him carry certain of Machiavelli’s ideas to a different level, namely the second option of ruling a newly acquired kingdom; move there. Works Cited Iraq. Retrieved April 22, 2006, from Wikipedia Web site: http://en.wikipedia.org/wiki/Iraq Reuters, (2006, April 22). CIA Warned Bush of No Weapons in Iraq. Retrieved April 22, 2006 Wootton, David (Ed.). (1995). The Prince. Indianapolis, IN: Hackett Publishing Company.