Assessment of the Moral and Legal Responsibilities and Rights of Case Essay

Assessment of the Moral and Legal Responsibilities and Rights of Case Parties - Essay Example First we determine the moral and legal responsibilities of Rick Reynolds. In essence he acted in bad faith, acting for his own benefit and gain, and to the detriment of the interests of Mr. McLean. That there was an agreement between the two is verified in the beginning of the case. Rick acted in bad faith in the construction of the facilities, cutting corners and under the table deals to enrich himself, with the end result being that the facilities were subpar, and caused harm to a resident, when faulty wiring caused a fire that in turn caused the injury to the resident. Rick likewise acted in bad faith in procuring medical equipment and supplies, enriching himself by selling some of the procured goods and keeping the proceeds. Morally he is culpable for fraud and deceit. Legally he is liable for a host of crimes. Under the law, Rick can be considered as either a substituted agent or a sub-agent, and as such, there are legal precepts that can hold Rick accountable for his crimes as if he were the primary agent or principal, acting alone. He can thus be held liable for misrepresenting himself as a manager of the company, and for intentionally duping the pharmacies into providing the goods to the company, where some of the goods ended up being sold by Rick for his own financial gain. Where there is a contractual agreement between Mr. McLean and Rick, moreover, Rick is answerable for his acts to Mr. McLean, who under the law can sue Rick for his fraudulent activities, under the legal precepts concerning the legal rights of the principal towards his substituted agent. In particular, there was fraud in the way Rick went about contacting the different parties involved in building the facility, and for such fraud Rick can be sued by Mr. McLean (The Lectric Law Library, 2012; PreserveArticles.com, 2011). Mr. McLean himself can be said to be morally and legally liable for some of the acts of Rick, such as those that pertain to the acquisition of supplies. While it may be true that Mr. McLean may not have authorized the procurement of the goods on credit from the pharmacies, there are legal precepts that may hold Mr. McLean accountable for the acts of Rick. In other words, though there may have been fraud in the way Rick procured the supplies, Mr. McLean may be sued by the pharmacies if the former does not honor the supply contracts and reneges on the payment for the goods bought on credit. For one, a case may be made for the way Rick's actions procuring the supplies may be construed as constituting part of his job responsibilities, and part of the roles that he was authorized to play as an agent of Mr. McLean. There are clear legal principles that may prevent Mr. McLean from running away from the legal consequences of the actions of Rick, such as those that pertain to the company paying for the goods that Rick bought on credit and with intent to commit fraud. Clearly the law in some instances stipulate that even when an agent commits acts that ar e criminal, and without the express consent of the principal, the principal, in this case Mr. McLean. The pharmacies may argue that there would have been no way for them to discern that Rick was acting on his own behalf rather than on behalf of Mr. McLean, given that Rick, to them, seemed to have the

Sara Lee Coursework Example | Topics and Well Written Essays - 2500 words

Sara Lee - Coursework Example Sara Lee also employs 137,000 persons worldwide. Key initiatives regarding manufacturing and quality processes need a higher level of reliability across every bakery, whereas an apparent business objective, constancy across each field operation brings considerable challenges. Challenges: â€Å"In The Netherlands, the Shop Account Managers of Sara Lee International keep in close contact with their retail channels. Due to the competitive nature of the retail market, it is of the utmost importance that the sales force is supported with a customer relationship management solution which is agile and responds to their requirements† (Lee, 2007). Retrenchment Strategy Assessment: Subsequent to Sara Lee’s retrenchment, the business is capable to give attention to its food service, food and beverage and worldwide businesses. Sara Lee’s key aims for its remaining business are to give attention to customer requirements and operating excellence, and at the same time in generating a physically powerful brand through wide modernizations and competitive pricing. The business successfully employs its retail meats, by selling them to its foodservice clientele. Its meat business has enlarged in sales and operating revenue, while professionally it has benefited by modernizations in grocery items. These modernizations boosted sales over $100 million, even while its core products’ sales were flat. The business holds 20% market share in a rising industry of approximately $10 billion. Sara Lee is one of the most significant market leaders in North America in retail breads. Sara Lee has positioned itself in mounting divisions and stalling unconnected segm ents in its body care product and household lines. These divisions function separately from core food items of Sara Lee’s businesses. The products of Sara Lee comprise bakery, household items, and beverage body care brands etc. Majority of the sales segment of sales is made in the western part of Europe. Sara Lee has a 9%market share of coffee, making it the second highest on earth. Its sales are exceed $1.7 billion, with the introduction of the most excellent selling coffee invention in Europe. While the continent has very strong needs for specialty coffees in that area, Sara Lee altered its most excellent selling coffee pans to dish up espresso and cappuccino drinks. The bakery line for the business has not been as flourishing throughout Europe. Customers choose extremely fresh-baked bread; on the other hand, Sara Lee can only offer packaged bread. While packaged bread merely creates 12% of the bread in market situation, it is expected to enlarge to 25% by 2015. Sara Leeâ⠂¬â„¢s bread also has been flourishing in Spain, while, where it dominates the nations with a 54 % market share. Sara Lee is at present not in an attractive market situation but if increase the packaged bread it may be capable to capture a huge market share. While it offers low-calorie food and desserts to its clientele, Sara Lee has met the requirements of its clientele and captured a bigger market share. Sara Lee’s holds the number one brand name of product Kiwi, shoe polish, which accumulates a worldwide market share of around 63%. And also its shoe polish reports for approximately 16% of the unit’s sales. Although Sara Lee’s has the leading brand of shower, the market is gradually rising at 1%. This averts the business from taking benefit of potential incomes in the market. The company possess almost 28% market share in the production

My School Essay Example for Free

My School Essay I,________,have been a part of the _________School District my entire life. For me school has been a mixture of emotions. Some years I loved school and learning and other years I hated school and felt as if I would never amount to anything. The movie Stand and Deliver made me wonder how much better of a student I could have been if all my teachers cared as much as Mr. Escalante. In elementary school I had mixed emotions. I loved school up until about 3rd grade but then I started to hate school. It became harder for me to get good grades and I felt dumb. Many of my teachers also had my sister, who was an A+ student so they would always make statement about how I should follow in her footsteps and such. But I was never as smart as her or good at school like she was. Once I was in the 3rd grade I began to struggle with all subjects except reading, once this struggle began I started to care less about school and grades. Middle school is where things began to turn around for me. In the 6th grade I had Mr. Pollock as one of my teachers. He was the most caring teacher I have ever had,  he showed me I could do anything I put my mind too and he pushed me to succeed the way Mr. Escalante pushed his students. In the movie Mr. Escalante says â€Å"Students will rise to the level of expectations† and this is exactly what my teacher did to me, he set the expectations high and then pushed me to exceed them. High school was another good experience. I always was a â€Å"teacher’s pet† and got good grades without really trying. I never studied while in high school and was very involved in extracurricular activities. This was good for me then but has caused me problems now. Now that I am in college and have to study and really work hard I don’t do as good as I would like. In my opinion my past schooling has set me up to fail in college. Even though I was taught the things I needed to be taught. I didn’t learn to push myself. I got by either just barely or passing with flying colors I, Thanh Nguyen, I have been grown up in Vietnam, so I went to elementary, middle, high school there. And the education is a lots harder here in States. For me school has been a mixture of emotions. Some years I loved school and learning and other years I hated school and felt as if I would never amount to anything. In elementary school I had mixed emotions. I loved school up until about 5rd grade but then I started to hate school In my opinion my past schooling has set me up to fail in college. Even though I was taught the things I needed to be taught. I didn’t learn to push myself. I got by either just barely or passing with flying colors

World War Two Essay Example for Free

World War Two Essay After World War Two, the United States government faced a problem. Against Soviet pressure in Asia, Africa, and Latin America, it wanted to convince the world, especially new nations emerging from colonialism, of America’s moral leadership. Often, it found that its most exasperating opponents were some of its own people. The Unites States was profoundly racially segregated. In many states, blacks were legally relegated to separate and profoundly unequal schools. Businesses followed social or legal rules which barred or degraded blacks. Courts often functioned with a callousness and brutality of authoritarian regimes. In Cold War Civil Rights, Mary Dudziak shows how international needs prompted the United States to respond to its racial problems. In America’s long struggle to deal with race, leaders had often brought foreign influence to bear. Frederick Douglass had appealed for help in England, arguing that the whole human family needed to address this problem. 1 During World War I, the war to make the world safe for democracy, black leaders had sought to make America safe for Americans, but to little avail. World War Two marked the turning point. Fighting against regimes that spouted racist ideologies while still segregating its armed forces, America found it had to confront its own moral dilemma (pp. 7-8. ), especially as this dilemma took on strategic implications: Axis propaganda mocked the notion that non-whites could expect justice from racist America. (Pp. 8-9. ) While some voices were raised, the problem went largely ignored. America had not yet committed itself to the ideals that it had sacrificed so much to secure for others. (Pp. 9-11) The Cold War hobbled the use of foreign influence to aid the civil rights effort. Anyone airing domestic issues overseas might now be linked, often wrongly, to communist agitation. (P. 12) Still, a space remained, in which civil rights was driven by international concerns. America found it had to project an increasingly detailed image abroad. International pressures forced the United States to show itself confronting its racial problems. Often, this meant that international concerns drove the federal government and major social and political leaders to deal with domestic racial issues. (Pp. 13-14) Inherently, national leaders in international affairs were thrust into prominence in civil rights struggles. Professor Dudziak points out that her emphasis on the roles of leaders â€Å"should not be seen as an effort to privilege a top-down focus as ‘the’ story of civil rights history. † (P. 14) The vignette with which she opens the book illustrates how leaders were involved. In 1958, a black handyman in Marion, Alabama was charged with stealing less than two dollars in change from a white woman. Charged solely with robbery, he was convicted by an all-white jury and sentence to death. The case caused an outcry around the world. American businessmen overseas feared losing substantial market leverage if the death sentence was carried out. From around the globe, the United States heard calls to overturn the sentence. In the American government, this international pressure was focused on the American official charged with such concerns, the Secretary of State. John Foster Dulles probably did not care about a black handyman from Alabama, but he could not ignore the dispatches pouring in from American consular offices. He telegraphed the governor of Alabama, and the governor reported himself ready to respond to the outpouring of interest in the case. The sentence was quickly commuted. (Pp. 3-6) Turning to the story of how international pressure and domestic race relations shaped one another, Dudziak combine colorful details with a command of the big picture. She begins with Truman, who came to office facing racial concerns. Southern whites fought to defend a way of life threatened by the changes the war had wrought. (Pp. 19-23) Eventually, his reelection effort forced Truman to press the civil rights issue. Hoping he would win voters from the Republicans and the Progressives, Truman’s advisors urged him to speak out on civil rights. His advisors gambled that this would attract black voters, and reasoned that the south would stay safely Democratic. (Pp. 24-25) Accepting this advice, Truman called for civil rights measures that he knew he could not get through Congress. (Pp. 25-26) To his chagrin, southern Democrats bolted and formed their own party, but the strategy worked. Truman carried critical states, polling better among blacks than Roosevelt had done four years earlier. (P. 26) Truman’s key issue was the Cold War, and Truman found that America’s enemies made racial relations a major story. How could the United States claim that to be a model for emerging nations when America was so segregated? Throughout the world, the news media stressed racial issues. A California court decision striking down an antimiscegenation law was widely reported in the Philippines. (Pp. 32-33) American race problems were constant news in India. (P. 32) Communists focused on race issues, trying to embarrass the United States. (Pp. 38-39)2 And America embarrassed itself internationally when foreign diplomats were barred from various facilities. 3 To beat the bad foreign coverage, the United States tried to tell its own story. (Pp. 44-46) As Dudziak shows, some efforts foundered because the world did not share America’s zeal for anti-communism. Pp. 54-60) Even people the government wanted to enlist in its efforts sometimes balked. Sadly, blacks who failed to meet expectations established and enforced by zealous officials often faced serious pressure, as shown by the cases of Paul Robseon (pp. 61-62), Louis Armstrong (pp. 66-67), and Josephine Baker (pp. 67-77). President Truman desegregated the American military. Frustrated that Congress would do nothing on civil rights, Truman used his executive authority to order the military to integrate. (Pp. 82-90) Important as this action was, Dudziak argues that Truman made an even greater contribution by supporting the efforts of the NAACP’s legal attacks on desegregation. Through its briefs amicus curea and other arguments, the government pushed back the color line, often by showing the courts how important these cases were to American international prestige. (Pp. 82-114)4 President Eisenhower was frankly reluctant to endorse the great legal case of Brown v. Board. But in September 1957, he had to decide if Arkansas was part of the United States. Orville Faubus called out the Arkansas national guard. In naked defiance of the Supreme Court, he ordered that blacks be kept out of Little Rock’s schools. He argued that tensions were so high that if the schools were forced to integrate, violence would follow. To protect the black students, he would keep them segregated. (P. 116) As Eisenhower knew, the world was watching Little Rock, and America’s prestige stood in the balance. Huge teams of correspondents from around the world reported each steps of the strange dance of Washington and Arkansas. (Pp. 115-44) After tolerating three weeks of stalling, Eisenhower acted. The 82nd Airborne Division, with fixed bayonets, surrounded Central High School and escorted nine black student inside. (P. 129) Just nine days later, American prestige took another blow: the Soviets launched Sputnik. (P. 145) Roused, the United States dealt with both problems using a single tactic: decisive action. Space programs were accelerated, and the government moved ahead in Arkansas. (Pp. 145-46) On the legal front, the Supreme Court ruled that the rights of blacks could not be sacrificed to whites who would use violence or the threat of violence to hold them back. (Pp. 146-47)5 John Kennedy came to office as an activist. Unfortunately, he failed to grasp the need for activity in the field of civil rights. Hoping to concentrate on international relations, he was embarrassed and felt undercut by the Freedom Riders trying to desegregate buses in the south embarrassing. (P. 158) Initially he largely placated southern Democrats. (P. 156) Slowly, however, he learned with newly formed African nations, American standing required pressing civil rights. (Pp. 162-63) Kennedy did act decisively when riots broke out at the University of Mississippi , and much of the world applauded. (Pp 163-66) Still, African diplomats continued to face embarrassments in traveling to and from Washington. (Pp. 152-54, 1167-69) In 1963, Birmingham. Alabama police used brutal tactics to try to suppress civil right marches. Television images of police brutality (pp. 169-70) raised cries, especially in Africa, that racists were barring all legal change. As Kennedy pressured Alabama, the world applauded. (Pp. 175-78) Feeling the impatience of civil rights activists at home and abroad, in May 1963, Kennedy tried to change the American legal system, which faced new defiance from southerners even as he realized that under traditional American law, the federal government was powerless to act in many civil rights matter. He appeared before a joint session of Congress and called for of bold civil rights laws. (P. 180) This speech galvanized the civil rights movement at home and abroad. (Pp. 181-83) Throughout the world people praised this new initiative. (Pp. / 185-86) At home, the civil rights movement made the first great march on Washington. Even as new problems arose, it seemed that Kennedy was ready to deal with them. (Pp. 198-99) In the wake of Kennedy’s assassination, Lyndon Johnson pressed new civil rights measures through Congress, giving the federal government sweeping powers to enforce civil rights. (Pp. 203-20) Simultaneously, the federal courts abolished travel restrictions that had limited Americans’ rights to travel overseas. (P. 220) One American who traveled during this period was Martin Luther King, going to Norway to accept the 1964 Nobel peace prize. (Pp. 222-26)6 When Dr. King returned to lead marches from Selma, Alabama, he had a firm and supportive governmental response, communist criticism of American civil rights faltered. (Pp. 234-39 But even then, the civil rights movement was destroying itself. Urban riots brought violence and despair rather than movement. Dr. King was assassinated. Robert Kennedy was assassinated. The United States fought a war in Vietnam in which its overwhelmingly non-Asian army seemed totally oblivious to the issues of occupying an Asian nation. (Pp. 242-48) The story that Dudziak tells in this book is important to American history. Civil rights and world events did one another during this period. Now, with globalization and the Internet making the entire world essentially local, America needs to consider this period, learn from it, and learn how to apply those lessons to the present. ENDNOTES

IOP Spike Control after Intravitreal Anti-VEGF

IOP Spike Control after Intravitreal Anti-VEGF In ophthalmology many ophthalmic procedures are there in which there is a spike of intraocular pressure after the procedures. Cataract surgery, argon laser trabulectomy (ALT), yag laser capsulotomy, yag laser iridotomy, trabulectomy, pars plana vitrectomy are few to be named. The new anti VEGF therapy is an addition to the prior list. Many IOP lowering drugs have been used in different procedures to stop these spikes. For ALT 1% apraclonidine, an alpha agonist has been found to be the most effective against the IOP spikes, but 0.5% has also been found to be equally effective. Brimonidine an alpha 2 adrenergic agonist has also been shown to be effective and safe choice. For cataract surgery different drugs have been used treat the postoperative increase in IOP. These include carbonic anhydrase inhibitors, prostaglandin analogs like latanoprost, alpha agonists like apraclonidine and brimonidine, beta-blockers and miotics (intracameral carbachol and acetylcholine). Similarly intravitreal injection of triamcinolone has been complicated with a rise of IOP and have been controlled effectively by beta blockers, but some may need aggressive treatment. Different researchers have worked on the control of acute spikes after the intravitreal injection of anti-VEGF, showing varied result. Some have advocated the use of IOP lowering medicine while other negating the need all together. Lim Young et al showed that the prophylactic use of fixed dorsolamide/timolol combination eye drops before the intravitreal anti-VEGF injection was a safe method of preventing IOP spikes occurring immediately after the intravitreal injection of anti-VEGF. He showed that the mean IOP at 5 minutes and 30 minutes postoperative was 14.12 Â ± 4.18 mm Hg and 10.87 Â ± 1.58 mm Hg in group 1 using IOP lowering medication while it was 28.21 Â ± 3.16 mm Hg and 17.48 Â ± 2.34 mm Hg in control group 2, respectively.9 He showed that there was a significant lowering of mean IOP at each reading at 5 minutes of interval. Frenkel et al showed the use of IOP-lowering medication prior to injection of pegaptanib, ranibizumab, or bevacizumab had little effect on the IOP spike. The failure of lowering the IOP spike was implicated to be due to the inability of these medications to counteract the volume-related mechanism of the IOP spikes after anti-VEGF injections. However, it was stated that there might be benefit to lower the IOP before intravitreal injection. In their study 2 cases of sudden loss of vision were reported due to the high IOP spike which prompted them to do anterior chamber paracentesis.8 It was also stated that the prophylactic use of medication in patients with advanced glaucoma receiving pegaptanib intravitreal injection or patients receiving 0.1 ml of bevacizumab could be considered because their study showed that it lowered IOP at the 3- to 10-minute interval in these patients. In another study done in 2013 the IOP lowering effect of Dorzolamide/Timolol and Brinzolamide/Timolol were compared with a control group. They measured the IOP after every 5 minutes for the first half hour and the next day and week after that. For all the 3 groups, the changes relative to the baseline at 5 and 30 minutes after intravitreal injection was found to be significant. Also when the groups were broken down as to whether receiving bevacizumab or ranibizumab, again the mean decrease of IOP compared to the control group was found significant. El Chehab et al have also found that the prophylactic use of fixed combination of timolol with brimonidine or dorzolamide and of 1% apraclonidine could not only reduce the IOP spikes but also their duration; and both the combination and 1% apraclonidine had equal effect. However the use of oral acetzolamide 20 minutes prior to the intravitreal injection was not proven to be effective. Evaluating the efficacy of timolol 0.5 % and brimonidine 0.2 % eye drops as a fixed combination in preventing IOP spikes Theoulakis et al found that twice a day instillation on the day before and before the time of injection in eyes which were scheduled for intravitreal ranibizumab was a safe and also effective in controlling the IOP spikes. IOP LOWERING MEDICATIONS Most of the IOP lowering medicines are administered topically. They are absorbed through the cornea and conjunctiva; mainly acting locally on the eye. Many anti glaucoma medicines have been used. The main groups of drugs are as following: BETA- ADRENERGICANTAGONISTS They are the most prescribed drugs of IOP control. There are a total of five topical beta-adrenergic antagonists which are currently FDA approved for managing high intra ocular pressure. They are timolol betaxolol, carteolol, metipranolol, levobunolol. Betaxolol is selective beta1 selective antagonist, and is safe to use this drug in patients with pulmonary and cardiac problems. The mechanism of action is to reduce IOP by decreasing the production of aqueous by inhibiting the production of cyclic adenosine monophosphate (cAMP) in ciliary epithelium. The IOP reduction is upto 20 to 35%. The effects of beta blockers occur within an hour after its instillation. Timolol is available in the market in concentrations of 0.1%, 0.25% and 0.5%. The recommended dosage is 1 drop two times a day. Burning, allergy and corneal epithelial erosions are the main ocular side effects. It can be absorbed systemically and can cause systemic side effects like bronchospasm, bradycardia, hypotension, respiratory failure. Timolol maleate has a molecular weight of 432.50. It is an odorless, white, crystalline powder that is soluble in methanol, water and alcohol. It is compounded as an isotonic, sterile, buffered solution available in two strengths: 0.25% Timolol maleate eye drops contains 2.5 mg of timolol (about 3.4 mg of timolol maleate). It has a pH of approximately 7.0, and an osmolarity of 274-328 milliosmole. And each ml of 0.5% Timolol Maleate eye drops contains 5 mg of timolol (about 6.8 mg of timolol maleate). The Inactive ingredients are usually monobasic and dibasic sodium phosphate and sodium hydroxide to adjust pH. Preservative used is Benzalkonium chloride 0.01%. PARA SYMPATHOMIMETIC AGENTS They act by stimulating sphincter pupillae and ciliary body by acting on the muscarinic receptors. They cause the contraction of the ciliary muscles which thus increases the aqueous outflow through the trabecular meshwork. Pilocarpine is the commercially available drug in this group and is compounded in concentration of 1%, 2%, 3%, and 4% and the recommended dosage is 1 drop 4 times per day. Ocular side effects are miosis, induced myopia with brow ache, retinal detachment, and cataract. Systemic side effects after its absorption can be of diarrhea, vomiting, abdominal cramps and bronchial spasm. CARBONIC ANHYDRASE INHIBITORS (CAIs) The enzyme required for aqueous formation is carbonic anhydrase. The CAIs cause inhibition of this enzyme and thus cause a decrease in the aqueous humor secretion by the ciliary epithelium. Carbonic anhydrase is required for catalyzing the reaction of CO2 to H2CO3 which further splits into HCO3 _ and H+. The bicarbonate ions are pumped along with sodium ions into the posterior chamber along with diffusion of water for the formation of aqueous humor. Carbonic anhydrase is present in ciliary body in excess. 99.9 % of the enzyme must be inhibited before a significant decrease in IOP can occur. Dorzolamide and brinzolamide are the commercially available eye drops in market. They have a good corneal penetration, and are also water soluble. These agents are able to reduce IOP upto 14-17%. Adverse effects of topical CAIs are burning and stinging of eyes on instillation, conjunctivitis, blephritis, corneal allergy, corneal punctuates keratitis and can also cause bitter taste. The systemic used CAIs are methazolamide and acetazolamide. They also cause inhibition of carbonic anhydrase in ciliary epithlium thus reducing the reduction of aqueous humor. As it is taken orally systemic side effects of CAIs include metabolic acidosis, leading to alkaline diuresis which result in hypokalemia. So potassium levels should be regularly checked in patients using CAIs on long term basis and oral potassium supplement should be recommended to all these patients. Other side effects include renal stones formation and central nervous system side effects like numbness and tingling of hands and feet, depression, anorexia, and nausea. Dorzolamide hydrochloride has a molecular weight of 360.91. It is a white to off-white in colour, in a crystalline powder form, which is also soluble in water, methanol and ethanol. ADRENERGIC AGONISTS Adrenergic agonists act by increasing the uveoscleral and trabecular meshwork outflow thus causing decrease in IOP. Epinephrine has a mixed action of being an alpha and a beta agonist. Its effect usually begins at 1 hour and reaches a maximum at 2-6 hours. Topical epinephrine drops usage has been stopped due to frequent systemic side effects of headache, palpitation and cardiac arrhythmias. The main ocular side effect is cystoid macular edema and black pigmentation of conjunctiva. Commercially available topical form is dipivefrin hydrochloride 0.1%eye drops, which is a prodrug of epinephrine. It is converted by the enzyme esterase into epinephrine in the cornea. Because of its high lipid solubility and corneal penetration a low dose is required as compared to epinephrine and thus has less side effects. The selective alpha 2 agonist apraclonidine and brimonidine are indirect acting adrenergic agonist which act by decreasing aqueous production and also the episcleral venous pressure and thus improving the trabecular outflow. Apraclonidine is associated with tachyphylaxis while brimonidine has less of this problem. Brimonidine tartrate is available commercially in 0.25 and 0.15% eye drops. Its reduces IOP by 26% at 2 hour of interval. PROSTAGLANDIN ANALOGUES Prostaglandin analogues are relatively a new class of IOP lowering drugs. Four prostaglandin analogues have been approved by the FDA for clinical use. Latanoprost was the pioneer drug to be developed and used in this group. Others are travoprost, bimatoprost, and unoprostone. Latanoprost is a pro drug which penetrates the cornea and then is turned into active form. It enhances the uveoscleral outflow and thus lowers the IOP upto 25-35%. The dosage is one drop per day which makes the compliance of the patient better. The main ocular side effect is darkening of the iris and the periocular skin, by increase in the number of melanosomes in the melanocytes. Other side effects include conjunctival hyperemia, hypertrichosis, uveitis and cystoid macular edema. Systemic side effects are flu like symptoms, skin rash and uterine bleeding. OSMOTIC AGENTS Osmotic agents act by decreasing the vitreous volume by removing the liquid out of the eye into the circulation. The osmotic agents can be given orally or intravenously. Oral agent is glycerin while urea and mannitol are given intravenously. The osmotic activity is dependent upon the number of particles in the solution which cannot cross over and maintains the osmotic gradient between the compartments. Mannitol is given intravenously because it cannot be absorbed from the gastro-intestinal tract. A rebound increase in IOP and local tissue necrosis limit the use of urea. Glycerin is most commonly used oral osmotic agent which is given along with cracked ice to dilute its nauseating feeling. In patients with diabetes a non-metabolized sugar isosorbide can be used instead. Several fixed combinations have been developed which are available in markets used for IOP-lowering. Most of these fixed combinations contain timolol (dosed once or twice daily) combined with either adrenergic agonists, prostaglandin analogs, and CAIs. COMBINATION Fixed combination timolol maleate 0.5% with dorzolamide hydrochloride 2% was first introduced in market in 1998. Each milliliter of drug consisting of 6.83 mg timolol maleate and 22.26 mg dorzolamide hydrochloride. Timolol inhibits aqueous humor production by down-regulating adenylate cyclase by inhibiting ÃŽ ²2-adrenergic receptor sites on the ciliary process . While dorzolamide acts as a selective inhibitor of Carbonic anhydrase II enzyme, present on the ciliary process. The local bicarbonate production is slowed down, which as a result decreases sodium and fluid transport and, finally, decreases the aqueous humor production thus lowering the IOP. Because the mechanisms of action of both the drugs differ, they provide an additive effect when used together. Fixed combinations of drugs have been found to improve the compliance of the patient by reducing the number of eye drops used daily. Moreover the IOP-lowering effect of fixed combination timolol and dorzolamide was found to be greater than that of either drug instilled as monotherapy. In addition the load of preservative is also reduced along with any wash out of drug when the drugs in monotherapy are instilled one after the other.

America Must Regulate Nanotechnology Essay -- Technology Physics Mecha

America Must Regulate Nanotechnology Definition of Nanotechnology Nanotechnology involves the â€Å"art of purposefully manipulating materials on at atomic scale or molecular scale†[1] (also referred to as â€Å"nanoscale†), as compared to processes governed by the laws of physics that carry out naturally occurring actions, such as chemical reactions and changes in state. At the nanoscale level, the laws of quantum mechanics take over, pushing aside what most are familiar with via Newtonian mechanics. Because of the fundamental shift in how work is done, nanotechnology has the potential to affect and change everything in existence. Future Implications of Nanotechnology Nanotechnology will affect everything, and likely change everything to significant degrees. The future implications of nanotechnology exist along all frontiers of science, culture, commerce, economy, business, law, ethics, medicine/health, religion, and life. The end result of these changes will, however, either advance human civilization several orders of magnitude forward and thus achieve â€Å"utopia† if properly managed and regulated, or bring an end to human civilization if not properly controlled, studied, and managed, akin to â€Å"Pandora’s Box† of ancient Greek mythology, but several orders of magnitude worse! Some significant implications as a result of nanotechnology include[2]:  · Nearly free consumer products  · PC's billions of times faster then today  · People live longer with virtual ends to illness and aging  · No more pollution and automatic cleanup of existing pollution . End of famine and starvation  · Superior education for every child on Earth These implications could become reality in the near ... .../view/library/aliens/article/70558.html [12] â€Å"Library-Technology – Nanoprobes†, StarTrek.com, http://www.startrek.com/startrek/view/library/technology/article/3963.html [13] National Nanotechnology Infrastructure Network, http://www.nnin.org/ [14] National Nanotechnology Initiative, http://www.nano.gov [15] Center for Responsible Nanotechnology, http://www.crnano.org [16] â€Å"Everything or Nothing Overview†, http://www.commanderbond.net/Public/Stories/2279-1.shtml [17] â€Å"Nanotechnology Now – Ethics of Nanotechnology†, http://nanotech-now.com/ethics-of-nanotechnology.htm [18] Rob Fixmer, "The Soul of the Next New Machine: Humans", New York Times on the Web (November 5, 1999), http://cseserv.engr.scu.edu/NQuinn/ENGR019_301Winter2004/HWBCCCU.htm [19] â€Å"Telecommunications Act of 1996†, Federal Communications Commission, http://www.fcc.gov/telecom.html

The Psychological Effects of Gender Roles Essay -- Gender Roles Equali

The Psychological Effects of Gender Roles â€Å"Let the boys be boys.† You’ve heard this phrase before. Often repeated by parents regarding their little boys. So what makes a boy, a boy? Rambo like characteristics? Muscles? Short hair? Wearing blue? Wearing T-shirts and jeans or playing with sporting equipment? Well last I remember, the main characteristics boys shared were penises. The role gender association play in the lives of our children can sometimes affect them negatively. The messages that gender roles send, is that in order to be part of society, you must fit into the norm or the status quo or most importantly what society deems as acceptable. But all the while, trying to incorporate individuality and establishing ones sense of self. Two conflicting ideas that can confuse a child and also alter the way they live their lives. There are two colors that are designated to babies that serve one purpose and one purpose only. Most infant boys were the color blue and girls wear pink. Seeing that it is difficult to determine the sex of an infant without general exposure to the genitals, most parents choose to clothe they’re young child in the respective colors so people will know whether it is a boy or a girl. After all, what male infant wears pink? When the children grow older, do they still continue the practice the color identification game? This is wear it changes. When boys reach the age wear they start dressing themselves and start buying their own clothes, they will continue to wear the blues and the greens and even yellows and reds, but not pink or violet, cause those are â€Å"girly† colors. Girls on the other hand, when they reach the same age still continue to wear the pink and violets and can even wear the blues, yellows, blacks, and greens. So why can girls make the â€Å"cross-over† without being teased or mocked but boys cant without being called a gay or a fagot. The clothing issue goes farther than that. The fashion industry does make boundaries with clothing. There is women’s clothing and men’s clothing. Women can wear men’s clothing, and at times its the stylish thing to do. Young girls can dress like boys or wear boys clothing and at times will only be called a tom-boy, but that is acceptable to society. Let’s see a man in public wearing a dress, and we stop and go out of our way to break our necks just so we can get a good look.... ...d am able to observe what is going on and what can happen. I’m am in no way implying that making your infant son wear blue is bad and if he wears pink as he gets older, it your fault. I know that I probably wouldn’t be to happy about the fact that my little boy is wearing pink either, but its how you approach and deal with the situation the can have an effect on your child. Many parents would probably tell their children this type of situation, â€Å" Pink is for girls, take it off. What are you gay or something. Are you a sissy? Act like a boy.† (Finaut) It is brought upon so negatively and makes the child feel low and incompetent, especially if they are told this by their fathers. Not everyone will agree with my point of view and that is something I understand, but its all about being open-minded which is obviously not the message gender roles send. Works Cited Finaut, Jim. Personal Interview, 11, July 1999. Hales, Dianne. Invitation to Health: Power of Prevention, eighth edition. California: Brooks/Cole, 1990. Richards, Orland. Personal Interview, 13 July 1999. Tannen, Deborah. You Just Don’t Understand: Women and Men in Conversation. New York: Ballantine, 1990.