The Gospel Of Wealth By Andrew Carnegie Essay - 918 Words

Since the nineteenth and twentieth century, there has always been a division between the wealthy and unfortunate. During these times the higher class continued to prosper while the lower class remained at the bottom, the separation continues to grow. Three men vocalize their views on the social division, capitalism, and individualism. Andrew Carnegie, an industrialist, believed the rich should distributed their wealth to benefit society while they’re alive. Carnegie elaborates this idea in his article, The Gospel of Wealth, written in 1889. Russell Conwell, a philanthropist, expresses in his speech, Acres of Diamonds, men should utilize their surrounding opportunities to make themselves wealthy. Edward Bellamy, a socialist, wrote Look Backward about a wealthy young man, Julian West, who enters hypnotic sleep in 1887 and awakes 113 years later. Although, the men state similar matters their views contrast, Carnegie and Conwell would most likely be critical to Bellamy’s vision. Julian West is educated and the third generation of his family to have great fortune. West’s life of luxury succeed through â€Å"support from the labor of others, rendering no sort of service in return (Bellamy).† When West enters hypnotic sleep and awakes in 2000 he realizes the 20th century is very different from the 19th. Bellamy’s Looking Backward was vastly popular particular among the middle class. His vision is desired by the middle class because it’s better than today’s world. Bellamy’s visionShow MoreRelatedAndrew Carnegie And The Gospel Of Wealth957 Words   |  4 PagesAndrew Carnegie (1835-1919) is a prime example of the phrase, from rags to riches. During his early and teenage years, Carnegie went through poverty. After coming up with crafty investments and going through various jobs, he rose to great prosperity. Because he has experienced poverty and knows that it is a well-known problem, â€Å"Carnegie sought to u se philanthropy to provide opportunities for individuals to help themselves.† Unlike Carnegie, William Graham Sumner (1840-1910), an influential professorRead MoreAndrew Carnegie Gospel Of Wealth1161 Words   |  5 Pages Andrew Carnegie was a Scottish immigrant, born in 1835. His first foray into the world of work was as a bobbin boy, at the age of 13, where he earned $1.20 per week. Carnegie quickly gained skills and proved his work ethic, until he landed a job with the Pennsylvania Railroad, and was promoted to superintendent by the age of 24 (Carnegie.org, 2015). From there, Carnegie’s vision and success grew exponentially, and now his name is often mentioned alongside the likes of Henry Ford, ThomasRead MoreThe Gospel Of Wealth By Andrew Carnegie1180 Words   |  5 PagesWealth can be defined as a surplus. This surplus is distributed among a society. The distribution creates associations among the people of the society with respect to wealth. The Gospel of Wealth, written by Andrew Carnegie, describes two classes and the association of wealth between them. Adam Smith’s passage, Of the Natural Progress of Opulence, similarly, includes a reciprocal relationship of production between the town and country. Unlike the other essays, Marx’s, Communist Manifesto, debunksRead MoreAndrew Carnegie The Gospel Of Wealth Summary1044 Words   |  5 PagesAndrew Carnegies The Gospel of Wealth: Why Now? Makayla Newberne, The Times’ Editor in Chief In case you missed reading the June, 1889 issue of the North American Review, Andrew Carnegie submitted some words of wisdom entitled â€Å"The Gospel of Wealth†. In this article, Carnegie shares his beliefs as to what the moral obligations of the wealthy are to their fellow citizens. Andrew Carnegie, a Scottish immigrate to the United States in 1848, is a self-made millionaire and agreeable one of the richestRead MoreEssay on The Gospel of Wealth, by Andrew Carnegie975 Words   |  4 PagesIn the â€Å"Gospel of wealth†, Andrew Carnegie argues that it is the duty of the wealthy entrepreneur who has amassed a great fortune during their lifetime, to give back to those less fortunate. Greed and selfishness may force some readers to see these arguments as preposterous; however, greed is a key ingredient in successful competition. It forces competitors to perform at a higher level than their peers in hopes of obtaining more money and individual wealth. A capitalist society that allows thisRead MoreAndrew Carnegie on the Gospel of Wealth1250 Words   |  5 PagesAndrew Carnegie was born in Dunfermline, Scotland in 1835. His father, Will, was a weaver and a follower of Chartism, a popular movement of the British working class that called for the masses to v ote and to run for Parliament in order to help improve conditions for workers. The exposure to such political beliefs and his familys poverty made a lasting impression on young Andrew and played a significannot role in his life after his family immigrated to the United States in 1848. Andrew CarnegieRead MoreAdam Smith And Andrew Carnegie And The Gospel Of Wealth1260 Words   |  6 Pagescontinuous disparity of wealth and income can cause constant economic problems within a society. Although it is not apparent all the time, there are few benefits of discrepancy itself such as individual wealth, capital, and labor. Both Smith and Carnegie have distinct beliefs about wealth that differentiate from one another, yet are similar in certain ways. Adam Smith confined all his ideas about the common man in his â€Å"Wealth of Nations†. Whereas, in the â€Å"Gospel of Wealth,† Andrew Carnegie had distinct beliefsRead MoreAnalysis Of Andrew Carnegie s The Gospel Of Wealth1950 Words   |  8 PagesOld Money Spoils There are many dangers of leaving great sums of inheritance money to the children of those who accumulated their own fortunes. Andrew Carnegie, a self-made philanthropist millionaire who gave away $350 million and built 2,509 libraries before his death in 1919, sees this as a great problem as well and writes about it in â€Å"The Gospel of Wealth;† along with how he believes that the highest obligation of those who have amassed a great fortune is to return their money to the societies whereRead MoreEssay about The True Gospel of Wealth: Andrew Carnegie.698 Words   |  3 PagesTrue Gospel of Wealth: Andrew Carnegie The True Gospel of Wealth, an article written by one of the richest, most powerful men of the 19th century, is a guide to a nation virgin to mass amounts of wealth, and power. Carnegie is a self made millionaire, who immigrated to the United States with less than a dollar in his pocket. This fact would serve important in Carnegies epic rise to fortune, also in developing such philosophical understandings as, The True Gospel of Wealth. Andrew CarnegieRead MoreJessica Avalos Avalos 1. Professor1114 Words   |  5 Pagesindustrialist, such as Andrew Carnegie, there were many differences of opinions on the execution of capitalism between these industrialists and their workers. Andrew Carnegie expressed his ideas and views in article, â€Å"The Gospel of Wealth,† in which he outlines the duties of industrialist to better the life of their workers and community. On the other hand, a working man wrote â€Å"A Work Mans Prayer,† a sarcastic response to Andrew Carnegies â€Å"The Gospel of Wealth,† clearly against what Andrew Carnegie believes and

Influence of the Media in the Anti-War Movement of the...

During his testimony to the Senate Committee of Foreign Relations, John Kerry mentioned that in his opinion, â€Å"there is nothing in South Vietnam which could have happened that realistically threatens the United States of America.† In that same testimony, Kerry discussed that most people â€Å"did not even know the difference between communism and democracy. They only wanted to work in rice paddies without helicopters strafing them and bombs with napalm burning their villages and tearing their country apart.† The Fulbright hearings were an eye-opener to the millions of Americans who watched them. They convinced many that opposing the war and patriotism were compatible. The movement against the Vietnam War could be said as one of the greatest†¦show more content†¦Similar to African Americans, women disliked the draft because it disenfranchised generation of young men from better opportunities. Moreover, when the Johnson administration employed the search-an d-destroy military in Vietnam, search-and-destroy became associated with negative connotations of Americans. On top of that, Operation Rolling Thunder introduced the application of napalm; this led many women in America sympathizing with the Vietnamese civilians. Women protested the use of napalm, a flammable weapon created by the Dow Chemical Company and used as a weapon during the war, by boycotting Saran Wrap, another product made by the company. Women mobilized to create several antiwar groups, such as Women Strike for Peace (WSP), and Another Mother for Peace; these groups allowed women to become proactive and paved the way for the liberation of women. Arguably the largest source of discontent regarding the Vietnam War came from the students. Students joined the antiwar movement because they were morally opposed to all wars and did not want to fight in a foreign civil war. The students had credibility in their disapproval, because most of those subjected to the draft were too young to vote and therefore did not have a say in the direction of the war. The best-known national student organization for opposing the warShow MoreRelatedPopular Culture And Music Affect U.s. Public Opinion On The Vietnam War2148 Words   |  9 PagesTo what extent did popular culture and music affect U.S. public opinion on the Vietnam War? I.B. Internal Assessment Chavez, Miguel History HL Port Chester High School Word Count: 2,131 May 2016 â€Æ' Table of Contents Part A: Plan of Investigation†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Page 3 Part B: Summary of evidence†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦...Page 4 Part C: Evaluation of sources†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Page 7 Part D: Analysis †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦....†¦Ã¢â‚¬ ¦Page 9 Part E: Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Read MoreAmerican Presidential Election Vs. The President Of The United States Of America Essay1661 Words   |  7 Pagesin 2016. Secondly, the media in both America and Canada has an extreme bias to put their own views forward and suppress that of the opposition, slandering any politician, especially Trump, who isn’t from the left wing. Not only is the media biased, but there is a small group of companies that have a monopolized these biases which we easily learn from the radio, television and internet. Finally, to emphasize the point of ideological diversity, I compare the recent movement in America, that I haveRead MoreEmerging From The Restrictive Culture Of The 1950 S Essay1765 Words   |  8 Pagesculture of the 1950’s, the counterculture of the 1960s challenged the prescribed n orms, roles and expectations of the previous generations that outcasted youth found restrictive and alienating. Baby Boomers retained the abstract goals of mainstream society; they sought individual freedom and opportunities for self-determination. But their vision of the American dream widened the traditional definitions of freedom to include bodily, psychological, and political freedoms. 60’s counterculture disagreedRead MoreWho Has Access to the American Dream1152 Words   |  5 Pagesendowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.† Today the â€Å"Dream† is more of a struggle for success. For some it’s a fantasy while for others, it is a long term goal. The media defines society today, thus it’s only natural that it defines the American Dream, one which is no longer focused on freedoms or liberty, but rather money and success. The American Dream not only calls for financial success but also emotional successRead MoreIn A World Filled With Hate, There Are A Select Few That1884 Words   |  8 Pagesthey believe in. For many years individuals have fought for the peace movement. People will go to extraneous lengths to send their message of peace. Some might ask what is peace, well as defined in a lecture on January 4th by Dr. Collin Macollough peace is and can be a variety of different things.†Peace is an attractive concept, something that is openly discussed, even while preparing for war.Can be defined as â€Å"the absence of war† – implies that it is an irregular state o f affairs.Peace is a process:Read MoreControversial Themes in Black Popular Music Essay1767 Words   |  8 PagesControversial Themes in Black Popular Music Controversial themes have always been explored in popular Black music. Because Black experiences influence Black mainstream culture (as with any culture), the social climate of historical eras influence how these themes are explored in popular culture, specifically in the form of music. The presence of controversial themes like racisms, sex and violence in black forms of music like the Blues, Ramp;B/ Soul, Disco, Funk, and Hip-Hop are shaped by the happeningsRead MoreWomen s Rights Movement : Lucretia Mott3104 Words   |  13 Pagesthis gave women a financial status and freedom. Many women who were active in the abolitionist movement then became interested in the women’s rights movement. Women were already discriminated because of their sex. Now some of these brave women wanted to help the African Americans gain their freedom and their right to vote as well. â€Å"Female abolitionists sometimes faced discrimination within the movement itself, which led to their politicization on the issue of women’s rights† (National Women’s HistoryRead MorePopular Culture at the Beginning of the 1960s Essay3766 Words   |  16 PagesPopular Culture at the Beginning of the 1960s The early 1960s was a period of time where standard of living was rising and there was more consumer goods to buy and people were on higher wages so could now afford luxury items which they would of never thought of buying. The 1960s was a period of great change, particularly in the younger generation of people. A good quote from the Prime Mister at the time sums up the early 60s in a way which many would agree with, youveRead MoreStruggle for Black Americans: Civil Rights Movement Essay2552 Words   |  11 PagesReconstruction, long before the civil rights movement would be headlining in the 1950’s and 1960’s. The struggle would not just be for freedom but also in terms of education and employment from the police brutality and general day to day discrimination. This abuse would compel individuals, such as the more famous Black civil rights leaders to launch efforts to assert their constitutional rights and improve their standing in society; through the use of media, that through time would be shown right inRead More The Myths of Vietnam Essay5554 Words   |  23 Pagesversions of the Vietnam War and the antiwar movement began to develop even before the war ended. The hawks version, then and now, holds that the war was winnable, but the press, micromanaging civilian game theorists in the Pentagon, and antiwar hippies lost it. . . . The doves version, con trarily, remains that the war was unwise and unwinnable no matter what strategy was employed or how much firepower was used. . . Both of these versions of the war and the antiwar movement as they have come down

Marijuana Legalization an Annotated Bibiliography Free Essays

Colin Morris Ms. Morgan English 102-053 1 March 2013 Is it time for the Federal Government to Bud out of States’ Rights? : An Annotated Bibliography Cohen, Micah. â€Å"Marijuana Legalization and States Rights. We will write a custom essay sample on Marijuana Legalization: an Annotated Bibiliography or any similar topic only for you Order Now † FiveThirtyEight Marijuana Legalization and States Rights Comments. The New York Times, 8 Dec. 2012. Web. 28 Feb. 2013. Summary: This article starts off by asking a new question about the legalization of marijuana. It doesn’t ask whether or not it should be legal, but if the government should change it’s laws on drug enforcement. The polls show that in most of them polls, half of the pollsters believe that it should be left up to the states that have legalized marijuana to decide the laws. It concludes by stating that even though some believe it should be left up to the states, 49% of those people are still opposed to legalization. Analysis: This article makes some very interesting points that are not really brought up in a normal legalization debate. The issue of states’ rights brings a whole new side to the debate. He also does a very good job of keeping his bias out of the article. There are some places in his writing where his bias could have shown but he kept it out. Cohen’s numerous polls do all come to one conclusion; not everyone believes marijuana is a bad thing. Those supporting the issue of states’ rights could help turn the tide in this ongoing debate. What he lacks in this article is a way that pro-legalization leaders could use this new strategy to help their cause. A way to do this would be to show that there are average Americans who could have a say in this debate and not just stoners. Peterson, Bo. â€Å"Legal Pot in South Carolina? DonAt Hold Your Breath. † The Post and Courier. The Post and Courier, 13 Nov. 2012. Web. 28 Feb. 2013. Summary: This article draws support from unions and civil rights advocates in the Charleston area. These groups all agree that South Carolina should follow with Colorado and Washington. But these groups are countered by senators who believe this issue not only has no ground, but has no chance of happening with this current legislation, due to it’s conservative nature. Analysis: Looking at this article as a South Carolinian, it just shows how for as long as I can remember, our state legislature has had a hard time getting anything accomplished. This article points out the ever growing gap between the people and the government in this state will be the main reason why marijuana will have a hard time being legalized. Bias is not an issue in this article, the writer addresses both sides and draws support from both sides. Even though this article has the general idea that legalization will not happen in South Carolina for awhile, the fact that there are people who think that it should happen, helps the cause as much as it can. Robillard, Kevin. â€Å"Medical Marijuana Bill Unveiled in House. † POLITICO. POLITICO, 25 Feb. 2013. Web. 28 Feb. 2013. Summary: In this article, a bill was brought before congress that would help lay out a plan for the government to eventually legalize marijuana. Oregon Democrat Earl Blumenauer did this in an effort to shed some some light on the federal pot policy. Surprisingly this bill has 13 co-sponsors. These sponsors happen to come from both parties, one is a Republican from California. Though his bill isn’t likely to pass, bills in New Hampshire, Illinois, New York and Maryland are expected to pass to make medicinal marijuana legal. Analysis: This article does nothing but give hope to the pro-legalization crowd. These bills that are circulating through various state Houses are nothing but good news. This writer does a nice job of bringing in people for sources who are actually close to the issue. One of these sources has the idea that medicinal marijuana could help troops with post-traumatic stress. That would be affective but would require a motion from not only people within legislature, but an idea could be to bring in some military execs to help back their claims. But the issue still remains that there are still people a lot of pro-legalization people who do not have a voice. But until there is one solid voice for this issue, it will not go anywhere in the House or the Senate. Pack, Lauren. â€Å"Marijuana Summit Counters Legalization Movement. † Dayton, Ohio Network News, Weather, Traffic, Sports. WHIOTV, 28 Feb. 2013. Web. 28 Feb. 2013. Summary: This article was on a regional marijuana summit in Ohio. This event brought in people from all sides of the issue, from the business, medical, education, law enforcement and government. Since there are 18 states that have legalized pot, Ohio is looking to push into that group. The usual arguments were brought up from the pro crowd, but the anti-legalization brought up a valid point, 10 percent of card holders in those states actually have a legit reason to have them, but 90 percent use them for headaches etc. But the summit came to the conclusion that if it is about business then they can support it. Analysis: This kind of summit is something that tends to be happening more and more across the country. These summits bring people together who can actually make a difference when the legalization issue comes up. What people don’t realize is that when there is an issue that needs attention all it takes is important people in numbers getting behind then. This kind of summit could actually help progress the pro-legalization cause. The smartest part of the way this summit is constructed was by bringing in people who held power in all parts of the local government. If this method was used across the country, the pro-legalization group would have a much better chance of succeeding. Ludwig, Mike. â€Å"Is America ready to Legalize Marijuana?. † Truthout. Truthout, 7 Feb. 2013. Web. 01 Mar. 2013. Summary: This article tracks another bill that is circulating from the House rather than the Senate. The democratic Rep. from Colorado is proposing a bill that would help lay out a plan that could start a motion to legalize marijuana within the next few years. Support is drawn from polls that are stating that slightly more than half of all Americans belief that adults should be able to purchase marijuana like they do alcohol or tobacco. The bill proposes to remove pot from the Controlled Substance Act. Analysis: This article like most others on the subject, gives marijuana users hope that one day they will not be discriminated. Seeing that there is more than one person in Congress trying to make this works makes users believe they can use freely soon. The more that I look into these articles, the more I find that there really are a good amount of people who actually want to make this happen. By bringing in the idea that we are spending too much money on the war on drugs, the argument for pro-legalization grows new legs. By laying out a plan for all of the money America could be saving, more people could gather around this idea that the debt that keeps going up, could eventually come down to a more manageable amount. Hale, Gary. â€Å"What Is the Best Regulatory Framework for Legalized Marijuana? † Baker Institute Blog. N. p. , 31 Feb. 2013. Web. 01 Mar. 2013. Summary: In this article, the writer addresses the issue of what exactly would be legal when it comes to the future of marijuana. It addresses the issue of the new business side as well Dispensaries would have to gather numerous permits and would rapidly increases in numbers in just a few months. But first the government would have to remove marijuana from the Controlled Substance Act. Until that happens, all of this talk is just speculation. Analysis: This article brings some new ideas to the table as well as some more roadblocks that are not normally talked about. With marijuana being on the banned drugs list, that is the largest hurdle that is left for marijuana to be totally legalized. Right now it is in the same category as LSD and heroine, some people would find that a little excessive. In my opinion marijuana does not even come close to being as dangerous as LSD or heroine. The writer does a nice job at keeping his bias out of his writing. He does an even better job at making hard to detect what side of the argument he falls on. But outside of that the article lays down so pretty interesting ideas that the pro legalization crowd could use in later arguments. How to cite Marijuana Legalization: an Annotated Bibiliography, Papers

The Importance of Accountability free essay sample

INTRODUCTION This essay will seek to explore the importance of accountability in a world where no-one and everyone is in charge. There are many different types of accountability that apply to government each of which empathises a different value such as legal, political, professional, managerial, financial and so on (Boston and Gill, 2011). Whatever the type there is a fundamental requirement in a democratic system for accountability at all levels of government, so that they act in ways that are broadly approved by the community. After all, government organisations are created by the public, for the public, and need to be accountable to the public. Accountability within governments means that there is someone within an organisation who can accept ‘praise or blame for a particular decision or action (Hughes, 2003). This easy will explore the importance of government accountability and reveal the expectations of citizens. The Debelle Royal Commission 2013’ is the case study that is used in this essay; it reveals how simple procedural, communication and accountability failures by departmental staff can impact on the integrity of government departments. We will write a custom essay sample on The Importance of Accountability or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page ACCOUNTABILITY Businessdirectory. com defines that accountability is the obligation of an individual or organisation to account for its activities, accept responsibility for them, and to disclose the results in a transparent manner. CITIZENS ACCOUNTABILITY EXPECTATIONS A study by the Australian Bureau of Statistics (A Measure of Australia’s Progress) in relation to people’s expectations in ‘Democracy, Governance and Citizenship Progress’ reveals that the wellbeing of society can depend on factors such as the fairness of our political system, the health of our democracy and the confidence that people have in government and public institutions. A healthy and stable democracy needs citizens who care and are willing to partake in shaping the common agenda of society. Public trust in government fragile, further evidence of public disharmony has been from the public opinion polls that have provided increasing evidence that citizens trust in politicians and government is in decline. The Australian Collaboration reports a growth in government ‘protest parties’ such as One Nation and the Australian Greens and political slogans such as ’Keep the Bastards Honest’ are all reactions to this mistrust. Better citizen engagement and participation procedures have been identified as measures that could reduce community anger and frustrations that promote benefits for both the citizens involved and the governments and authorities which serve them. GOVERNMENT ACCOUNABILITY Accountability is essential to the good of government and is one of the cornerstone values of a democratic society; it has become an ever increasing and important factor for governments of the day. Corruption and integrity scandals are media sensations which have toppled the careers of politicians and government employees. It is therefore in the government’s interest that all levels of government promote standards of professionalism, accountability and transparency. Leaders of government are responding to the concerns and demands of citizens, this has been addressed by both the former and current Prime Ministers. In April 2008, then Prime Minister Kevin Rudd stated in an address to senior executives and agency heads that the government’s agenda included â€Å"rebuilding a culture of accountability across all levels of government†. Prime Minister Rudd identified the need for public servants to meet the expectations of the community, he discussed seven future visionary elements for the public service, which included ‘strengthening the integrity and accountability of government’. Current Prime Minister Tony Abbott has pledged that his government will â€Å"restore strong, stable and accountable government†, with changes that will â€Å"simplify the management of government business, create clear lines of accountability and ensure that departments deliver on the government’s key priorities. † (Thornhill, 2013) The responsibilities of federal government are set out in section 51 of the constitution; the states have residual power to cover other areas of responsibility. Local governments are not included in the constitution; they are generally controlled through state legislation and are accountable to the state. There is an unavoidable overlap of responsibility between state and federal government, however federal power has the upper hand, financially due to vast funding capabilities and legally due to federal legislation over ruling state powers. There are state and federal accountability organisations and also extensive legislative powers to investigate all manner of corruption. These agencies operate both overtly and covertly utilising extensive powers to obtain evidence and uncover wrongdoing. The Independent Corruption against Corruption ICAC) in NSW choses to hold very public corruption hearings, the ICAC website media releases contains details of operations Jasper and Acacia in 2013 which revealed corruption within the mining industry involving ministers and members of parliament. This resulted in the ICAC making 26 several recommendations including accountability reforms to govern the conduct of NSW parliamentarians. The newly formed ICAC, the corruption watchdog in SA will conduct all of its hearings in private. The commissioner of the ICAC will determine what matters will be released into the public domain. Persons breaching the confidentiality of processes related to the ICAC face legal penalties under the ICAC legislation. Interestingly SA in 1972 was the first state to have an Ombudsman and the last state to have an independent body to investigate government corruption which opened its doors in August 2013. Corruption agencies however are expensive costing governments millions of dollars in funding. During the debates regarding the formation of an ICAC in SA former Premier Mike Rann remained unconvinced that it was a cost effective way to prevent or reveal corruption. He stated In other states, ICACs have been proven not to be a cure-all in upholding and maintaining public integrity in our government bodies, most of them cost tens of millions of dollars a year to run, spend far too much time investigating vexatious claims and are inefficient (Dornin, 20111). Achieving accountability can have some negative impacts, in a paper by Bovens in 2010 notions were raised that accountability obligations have progressed well beyond the point of diminishing returns and more accountability does not necessarily produce better government. Accountability overkill discourages innovative and entrepreneurial behaviours in public managers who get better at meeting requirements posed by accountability measures to the detriment of policy making and public service delivery (Bovens, 2010). ACCOUNTABILITY RESPONSIBILITIES FOR GOVERNMENT EMPOYEES The Royal Commission into Public Service Administration in 1979 (The Coombs Report) recommended improvements for accountability within the public service. The Howard government implemented legislation in 1999 for federal government, state and local governments throughout Australia soon followed with various legislation of their own, Singleton et al (2007). As in most employment institutions federal, state and local government employees are all governed by codes of conduct and or ethics. The Public Service Act 1999 (section 13), Public Sector Management Act SA 2009 (section 4) and the Local Government Act 1999 (part 4) are examples of the legal obligations of employees. Government departments are divided into two areas, by departments which contain other departments, branches and sections and by employment grading, classification or occupation. Actions, conduct and decisions made by government employees can be investigated or revealed through a variety of means such as citizen complains, complaints or reports by government employee’s, revelations through internal and external audit processes or maybe through media attention or reporting. Investigative journalism has proven to be an incredible tool for shaming governments and their employees at all levels. Freedom of Interest legislation has been around for over 30 years, it was eventually introduced after 10 years of political and parliamentary debate after fist being mooted in 1972, Singleton et al (2007). It was seen as an important breakthrough allowing for the scrutiny of government and government information a measure to prevent secrecy and promote transparency. FOI requests are time consuming and costly, with applicants paying only nominal process charges. Today government departments generally fail to meet specific process related deadlines due to the ever increasing number of requests. Government employees are also legally required to report instances of wrong doing within government, a difficult and daunting task when you are an employee. Whistleblower protection legislation is aimed at affording a whistlblower protection from liability, dismissal and from being identified. As reported by the Australian Collaboration in relations to the protection of whistleblowers sadly, due to inadequate protection whistleblowers in total contradiction to the purpose of the legislation can and do face reprisals and punitive action. Interestingly, the Commissioner of the ICAC in SA has recently been appointed by the Attorney General to conduct a review of the operation and effectiveness of the Whistleblower Act in SA. The ICAC website invites interested parties to make written submissions, and adverts have also been recently published in the Adelaide Advertiser. Administrative Appeal Tribunals,, this is a tribunal process which can review a wide range of decisions made by government ministers, departments, agencies and other tribunals. It takes a fresh look at a decision and decides if it should stay the same or be changed. This process is independent of the person lodging the appeal or the organisation that made the decision There is a broad variety of accountability mechanisms available today in addition to what is detailed in this essay. Governments are responding to accountability demands releasing more and more information into the public domain also by utilising modern methods of communication such as blogs, twitter, and facebook to inform, discuss and engage with citizens. TYPES OF ACCOUNTABILITY There are many terms used to describe accountability relationships, two important types of accountability are the vertical and horizontal systems which govern the relationships within government Vertical accountability represents the system of power or hierarchy, when others are responsible or accountable to a person for a particular task, for instance staff within a department can be accountable to the departmental head, who in turn can be ultimately responsible to a Minister, Ministers are answerable to Parliament, and Members of Parliament are answerable to voters. Horizontal accountability sits more at an organisational level where people are more or less equal; this has developed more due to agencies interacting more with other bodies, communities and non-government organisations (Boston and Gill 2011). One way of coming to grips with the broad and various levels of accountability is for every public sector manager having a duty to be accountable upwards, outwards, downwards and inwards (Corbett, 1996). CASE STUDY, A FAILURE TO BE ACCOUNTABLE The following case study is an example of accountability, or rather a lack of it. This is an issue that developed within the Department of Education and Child Development (DECD). Arrogance, rigidity and suggested bullying tactics of staff within DECD contributed to a matter that could and should have been easily resolved. The events which resulted in the royal commission clearly identify how more effective communications and engagement with community groups can avoid high profile and costly inquiries that are embarrassing and damaging. In December 2010 a child in attendance at an Out of Hours School scheme (OSHC) revealed that she had been the victim of sexual abuse by an educator. The educator was swiftly arrested and charged by police, and was later convicted at court. Members of the school governing council were informed of events soon after the educators arrest and suspension; many council members were parents of children who attended the school. The council members felt that parents of children at the school had every right to be informed that a person employed at the school to care for children had been charged with a serious sexual assault. They set about on a course of action to release a letter to duly inform to the school community. In pursuit of this the council were misinformed, misguided, bullied and threatened during their interactions with DECD staff. Information provided by DEDC led the council and others to believe that they were legally prevented from releasing information to parents. The council made several requests for DECD to review and reconsider their decisions particularly when the educator was convicted, sentenced and named in the media. Council member Ms Danyse Soester (Ms Soester) led the councils campaign and endured obstacles including being turned away by eight law firms, a refusal of support by the legal aid commission and limited support from the Ombudsman’s office. Throughout Ms Soester’s persistence it has since been revealed that DECD assumptions and belligerence were from in-house discussions and decisions based on incorrect information and a limited understanding of the confidentiality processes surrounding sexual offence cases. DECD failed to seek any legal advice or guidance (Norvak, 2013). Over two years after the event the school community were eventually furnished with a letter providing them with information about the sexual assault. The determination and persistence of Ms Soester eventually led to this matter entering the public arena. It attracted much media attention and the then Minister for Education and Child Development Gail Portelisi was questioned in Parliament; unfortunately her responses were based on inaccurate information which caused further controversy and anger. Ms Portelisi after much pressure called for a Royal Commission. DEBELLE ROYAL COMMISSION, 2012-2013, REPORT OF INDEPENDENT EDUCATION INQUIRY On 1 November 2012, the Hon Bruce Debelle AO, QC was appointed by Minister Portelisi to inquire into the events and circumstances relevant to this matter. The terms of reference included a review of the circumstances, events and issues relating to the non-disclosure of the sexual assault allegations to the school community. The inquiry took seven months, ninety-eight persons gave evidence and more than 560 exhibits were gathered, the cost of the inquiry reached $442,695. Mr Debelle reported that DECD had failed to inform parents, failed to adequately manage the events throughout this matter, failed to provide correct and accurate advice, failed to obtain legal advice, failed to reconsider its position, failed to provide accurate information to the SA Ombudsman and the Minister, and that some tactics used in correspondence with the School Governing Council and its members were considered to be threats or at least a form of pressure. Mr Debelle made a total of 43 recommendations, he also identified how powerless and disadvantaged the council were having little procedural knowledge and no access to funds to support them in their quest. One of the recommendations was that funds be made available to ensure that community groups such as this can have access to funding if required (Debelle, 2013). The Debelle findings were eagerly awaited; DECD have provided a public catharsis, to help bring this public failure to an end. This is an important secondary effect after something like a royal commission (Bovens, 2010). The chief executive officer Keith Bartley publically apologised to school council members who tried to tell us we were wrong and whom we failed to heed and also to the parents and the particular school community at the centre of the report who should have been informed and were not, we apologise, (Norvak, 2013). Mr Bartley and other executive members have since resigned amid the fallout; other members of DECD face disciplinary action. CONCLUSION ‘Accountability’ and ‘accountable’ have strong positive connotations; they hold promises of fair and equitable governance, political officials and public organisations sometimes free ride on these evocative powers of accountability (Bovens, 2010) Accountability needs to be real and not just government promises and propaganda, there needs to be a continuous commitment to accountability and effective frameworks so that governments can respond to and manage the expectations that citizens have. Governments are no longer immune from scrutiny as they once were. Over the last decade in particular there has been a dramatic increase in accountability measures to ensure and promote greater integrity, transparency and accountability including promises for continued improvement from the former and the current Prime Ministers. To conclude this essay I include a straightforward quote by Behn (2001) ‘the managers and employees of any public organisation have been entrusted with something quite valuable – with entrusting our mutual commitment to fairness. Thus, they have the responsibility to treat all citizens absolutely fairly. They ought to be held accountable for doing so. When they don’t, they ought to be punished’. Word count 2,649

Polaroid Stories Essays - , Term Papers, Research Papers

Polaroid Stories I have never been to a live play performance before, but I have seen one on video. I loved it as though I was reading a great storybook; being able to stop at anytime and pick up where I left off, but I never thought about the relationship between the performers and the audience. Nor did I think of the impact of all of the aspects that deal with creating a play and giving a great performance. For my first live play I went to go see Polaroid Stories; a play I thought would not be so shocking to a first time audience member. I was wrong; this play almost literally looked me in the face and slapped me. The play had the look of a run down playhouse that had little funding and little direction, but I later pieced it together that they made it part of the play, and obviously you are not supposed to see those who are back stage directing. Additionally, I over looked the performers' costumes, the stage lighting, and set design; everything I took for granted. I thought I could see the props and everything that was strategically placed or used, but I missed them all. I was surprised at how these people in charge took the look of a run down playhouse and made it their stage. This was life on life's canvas and it was totally different from watching television. Everything became so tangible and real. For a moment I lost my self and really got into the play. I didn't think I was watching a group of people on a set acting for my entertainment, I felt I was actually watching life. As if I stepped out of my body for a moment and walked the streets seeing the life of these street kids. You can't exactly get that from television; your mind is constantly running when you watch this play. The fact that the stage was right in front of me does not compare to television. If I took one step forward I would have been on stage, if I wasn't already. One of the actors I felt breeze by me, and I could smell the smoke of another actor's cigarette. I kept having the feeling I was there, that the whole stage was really outside. The stage was the one aspect that kept me believing. The way everything was setup, the closeness it brought between the performers and the audience, and the sounds it created when the actors walked across it or banged on it. I felt apart of the stage and I guess that is why I felt so close to the action of the stories, and how I got lost in them. Going to this play was a new experience, but watching this play was a crash course in the emotion you can actually get from the way everything is setup. This new media had an impact on me that you can not get from television. And I've come to the assumption that you can save lots of money by going to good theatres like this, than by purchasing surround sound for television. You can hear the closeness with all the speakers you need, but you'll never get that tangible feeling as if the performers or the stage are really there.

Hindus Practice Many Rituals Collectively Known As Sansakaras Religion Essay Essays

Hindus Practice Many Rituals Collectively Known As Sansakaras Religion Essay Essays Hindus Practice Many Rituals Collectively Known As Sansakaras Religion Essay Essay Hindus Practice Many Rituals Collectively Known As Sansakaras Religion Essay Essay Hindus pattern many rites jointly known as Sansakaras. These rites or sanskaras depict events in the life rhythm of a Hindu individual. Harmonizing to the ancient texts in Hinduism, most important events in the life rhythm include Birth, Marriage, and Death. These Are Explained as Follows: Mix Christianity presentation Initiation Birth: In Hinduism, birth of a kid is considered a spiritual ceremonial, and involves many rites. Some of the common rites, practiced by about all Hindus at the clip of birth of a kid, and their significance are discussed below. These rites initiate a kid into Hinduism and are jointly referred to as birth rites. The first 1 is Garbhadhana or Impregnation rites. This ritual includes a planned sexual intercourse, between a hubby and his married woman, performed in a certain manner, to gestate the best possible babe. The sex during Garbhadhana is non for pleasance but for developing a good or godly psyche in the uterus of the married woman. Garbhadhana is strictly religious, and is considered to be really indispensable. It is required to dwell the universe with good psyches. This is explained by Lord Krishna in Bhagavad Gita, Sexual activity aimed at making godly kids is every bit good as God Himself. balam balavatam caham A kama-raga-vivarjitam A dharmaviruddho bhutesu A kamo smi bharatarsabha I am the strength of the strong, devoid of passion and desire. I am sex life which is non contrary to spiritual rules, O Godhead of the Bharatas ( Hindu ) . Jatakarma is the ritual performed to welcome the babe into this universe. It is performed right before the umbilical cord is cut. In this ritual, male parent of the kid feeds honey to the babe and chant supplications or mantras in babe s ear. This ritual is supposed to increase the aptitude of the kid and spiritually assist him or her to take a long and healthy life. In add-on, it represents that the presence of the kid is desired and appreciated in the household. Namakarana, intending to give a name, is the rite in which the kid is given a name, which is meaningful and animating. A good name is really of import for the kid because its significance reminds him of a intent or an aim in life and inspires him to carry through that aim. By and large there is a get-together, in which, Sweets are distributed among household and friends after a name has been given to the babe. Mundan is the ritual where, first haircut of the kid is performed. In this ritual, all the hairs on kid s caput are removed and poured into the nearest holy H2O organic structure. The remotion of these hairs signifies the remotion of any lacks in the kid, and is considered to excite growing of the nervous system. Another induction rite, called as Upanayana, is performed for male childs in Hinduism. It is carried out right before the pubescence starts. This ritual marks the 2nd birth of the kid as he begins his journey of religious self-construction. In this ceremonial, the male child acknowledges his responsibilities towards his faith and his privileges ensuing from Hinduism. During Upanayana ceremonial, a sacred yarn is tied around the waist of the male child. This thread consists of three separate symbolic togss intending to, worship God, show love and regard to parents, and learn from the spiritual instructor ( Hindu ) . Although, a kid is born into Hinduism by assorted birth rites, a male child kid is once more initiated into the faith through Upanayana ritual. Christian religion on the other manus, has few important specific rites for birth. One common pattern in Roman Catholics is where the female parent goes to the church, certain yearss after giving birth to a kid, to thank God for a successful birth. By making this, she re-enters her spiritual community after gestation, and therefore this pattern is sometimes referred to as a purity rite. The most important ritual associated with birth is baptism of the babe. It represents the babe s beginning into Christianity. It is by and large performed from 0 to 6 months after the birth of the babe. It is by and large performed by the curate of the church, when he pours the holy H2O and says, I baptise you ( or, The retainer of God ( name ) is baptized ) in the name of the Father, and of the Son, and of the Holy Spirit ( see Matthew 28:19 ) . Harmonizing to bible, baptism is a demand for redemption ( Mark 16:16 ; Titus 3:5 ) . Baptism pictures the decease and entombment of our old ego and our Resurrection to a new life in Jesus Christ as Romans 6 Tells us: Or do you non cognize that every bit many of us as were baptized into Christ Jesus were baptized into His decease? A Therefore we were buried with Him through baptism into decease, that merely as Christ was raised from the dead by the glorification of the Father, even so we besides should walk in newness of life. For if we have been united together in the similitude of His decease, surely we besides shall be in the similitude of His Resurrection, cognizing this, that our old adult male was crucified with Him, that the organic structure of wickedness might be done off with, that we should no longer be slaves of wickedness. For the decease that He ( Jesus ) died, He died to transgress one time for all ; A but the life that He lives, He lives to God. A Likewise you besides, reckon yourselves to be dead so to transgress, but alive to God in Christ Jesus our Lord. ( Romans 6:3-6, 10-11, NKJV ) ( biblestudy ) . This poetry and its description in biblestudy.org clearly demarcates that the wickednesss of a individual are forgiven and washed off by acquiring baptized because through baptism, the individual symbolizes that he is sorry for all his wickednesss but now he has complete religion in Jesus, and is willing to populate a good life under the shadow of Jesus Christ. Although, infant baptism is performed shortly after the birth of a kid, it can be compared to the Hindu induction rite of Upanayana because of the similar intents of the two rites. After baptism, a Catholic kid is regarded as a member of the church and a complete relationship is established between the kid and the church. Therefore, it is clear that like Upanayana, Baptism marks the beginning of spiritual instruction. Confirmation to baptism occurs when the immature individual can knowingly and freely choose Christian religion, ( 21 cite this ) . This happens at an age similar to the age of Upanayana ritual in Hinduism. For both these rites, a cardinal alteration takes topographic point in the life of the individual undergoing the ritual, and this alteration is considered a metempsychosis as a fresh individuality with new religion, responsibilities, and privileges. Harmonizing to Christianity, a individual can non achieve redemption without being baptized, and baptism can be considered as an induction towards redemption by taking a good life and following the way of righteousness. Likewise, Upanayana ceremonial in Hinduism is the induction on the route to spiritual instruction that finally leads to salvation through good karma. However, unlike baptism, Upanayana rite is performed merely for male childs. In add-on, if an grownup wants to change over to christianity Marriage Death Beliefs Hindooism Christian religion Decision Hindu Child Birth, Rituals Related to Hindu Birth, Hindu Birth Samskars. Hindu Religious Portal, Hinduism, Hindu Religion. Web. 08 Nov. 2010. lt ; hypertext transfer protocol: //www.religiousportal.com/HinduChildbirth.html gt ; . What Does Baptism SYMBOLIZED? BibleStudy.org: You Have Questions. The Bible Has Answers! Web. 02 Nov. 2010. lt ; hypertext transfer protocol: //www.biblestudy.org/question/what-does-baptism-symbolize.html gt ; .

Supreme Court Decision Essay Example | Topics and Well Written Essays - 500 words

Supreme Court Decision - Essay Example The evidence culled through these text messages intercepted by the police, when considered, does establish beyond any doubt that the accused was indeed engaging in unreasonable activities, which jeopardized the lives of the innocent citizens. Thereby the initiation of the interception of the text messages of the accused by the police, considering the fact that the police was under an immense pressure to act in time, to avoid any further loss of life of the innocent citizens, was no way unreasonable. This act of the police when seen in the larger context seems totally reasonable. It does need to be mentioned that the â€Å"trespass doctrine† facilitated by Olmstead v. United States (1928) if applied to the situation under consideration, validate the interception of Doe’s text messages by the police without invoking any violation of the Fourth Amendment Rights, as the police while doing so no way violated the essential dignity of the accused as a human and as a citizen. Besides, the two pronged test propounded in Katz v. United States (1967), when applied to the issue under consideration does nullify the appeal made by the accused. While exchanging the text messages associated with his illegal activities, the accused was no way exhibiting an expectation of privacy as he was well aware that he was exchanging these text messages with the intention to facilitate his unlawful activities, and thereby, through the exercise of commonsense, was well aware that such messages and communications would attract the well deserved attention of the law and order machinery. Doe was well aware that he was relying for the exchange of these text messages on the services sold by the local cell phone carrier, and in the light of United States v. Miller (1975), Doe’s rights were not infringed upon if the company as a third party, entrusted his text messages to the police, guided by the belief that it was its legal and constitutional duty to help the police. Beside s,

What if Alexander Graham Bell Did Not Invent the Telephone Essay

What if Alexander Graham Bell Did Not Invent the Telephone - Essay Example High-end communication devices at present are products of a gradual and consistent innovation of telephone to become cellular phones or the so-called wireless communication devices. Now, consumers are no longer satisfied with the primitive capacity and purpose of telephones or cellular phones which is to be able to hear and talk to important people. With the invention of Internet by Tim Berners-Lee, phones are now capable of surfing the Web, tracking locations, and capturing images. Now, we ask, would we have the kind of luxury and convenience in doing our everyday tasks if, first and foremost, no one invented the telephone? What if Alexander Graham Bell did not think of creating a magnificent machine that allows people to speak to people separated by geographical distance? Well, the answer might vary and would depend on probabilities, like other inventors in the likes of Joseph Henry, who invented the electric telegraph, or Thomas Edison, could actually thought of inventing the tele phone. A reluctant response might be that cellular phones are impossible to surface, and the Internet remains a mystery to the humanity. This essay attempts to present the possibilities if Alexander Graham Bell had never created the electric telephone, and highlights the importance of this invention to humanity’s history. ... Meucci, among other telephone inventors, was reportedly the first â€Å"to have a functioning electric telephone† which he attempted to patent (Meucci 9). Then there was Elisha Gray who was also regarded as the one who first patented the telephone close with Bell’s filing of patency in 1876 (Evenson 3). There were conspiracies regarding who really is to be credited for the telephone’s invention, but the federal government credited Alexander Graham Bell for patenting the telephone’s creation (Evenson 3). Alexander Graham Bell undoubtedly has been part of the pages of world history. Bell is a notable inventor, scientist, and teacher. Born on March 3, 1847 in Edinburgh, Scotland, Bell was known for his pet name Alec (Feinstein 1). His contemporary, Samuel Morse, also invented a communication device, which was the telegraph, which enables the transmission of electrical impulses that result in dots and dashes (Feinstein 10). These dots and dashes represent the letters of the alphabet and can be interpreted using the Morse code (Feinstein 11). Although he received a patent in 1840, Morse’s electric telegraph had certain shortcomings. It did not cater the needs of ordinary people since it cannot be connected to their respective homes, and second, it was quite expensive. Feinstein wrote that, while the telegraph was a big leap towards the advances in communication, Alexander Graham Bell’s telephone â€Å"truly conquered time and distance† and â€Å"create a world in which people were as close to each other as the nearest phone† (19). 3.0 Period of Natural Science and Technology Early and late nineteenth century was a period marked by the fall of European and Asian empires and the rise of the German, British, American, and Japanese

Business strategy Essay Example | Topics and Well Written Essays - 2750 words - 3

Business strategy - Essay Example has conceded to the popular consensus that there is room for the larger iPhone in the world. This case study features iPhone 6/6+ product of the Apple Inc. and takes deeper analysis its business unit about the company’s external environment, its competitive position, and the value-addition proponents. Porter (1985) asserts that there are three major categories of the generic strategies; cost leadership, differentiation, and focus. As for Apple Inc., the focused differentiation and cost leadership strategy are the best for the company in adapting to the competitive environment while implementing the value adding activities. The cost leadership strategy has been strongly pursued by the Apple Inc. in its continued efforts to ensuring successful competitiveness. The cost leadership strategy has enabled the company to be cost efficiency while ensuring sustainable development of the company. By pursuing cost the leadership strategy, the company has been able to determine the prices of its products and services at competitive prices. Nilsson and Rapp (2005) on the other hand states that when a company can sustain the profits above its expected income then the company can be termed as having gained the competitive advantage over its rivals. Apple Inc. Introduced the iPads to act as the more portable version of their range of the personal computers; an intermediate between the Smartphones and laptops. The introduction of the iPhone 6/6+ by Apple Inc. creates the impression of the company’s continued adoption of the differentiation strategy. Capon (2008) asserts that differentiation strategy is the clever way for the business in the establishment of the large market share owing to the fact that buyers perceive the quality of the services or products in regard to the price. Apple Inc. has made sure that its iPhone possess its line of the applications that can be bought directly installed on the phone. The company has ensured that the iPhone

Role of Metformin for Treatment of Type Ii Diabetes Mellitus

Role of Metformin for Treatment of Type Ii Diabetes Mellitus The role of metformin in the treatment of type II Diabetes Mellitus Introduction: Diabetes mellitus is a sever inherited or acquired disease which occurs when either pancreas does not produce enough insulin, which characterises type I diabetes and it is most commonly diagnosed in children, or the insulin that has been produced does not get used by the body effectively, type II diabetes and therefore patients will have abnormally high level of glucose. Type II diabetes was previously called non-insulin-dependent or adult-onset diabetes (World Health Organisation, WHO website). The latest estimate of the number of diabetics worldwide in 2001 by the World health Organisation (WHO) is 171 million and this figure is likely to be doubled by 2030 (WHO website). A recent study conducted in the UK using the General Practice Research Database (GPRD) illustrate that the mortality rate is twice as high for patients with diabetes type II than those without it (Mulnier et al, 2006). The prevalence of type II diabetes is increasing rapidly both in the UK and worldwide. It has increased by 54% (from 2.8% to 4.3%) and the incidence has increased by 63% over the past decade (Gonzalez, 2009). In most of the cases Type II diabetes is associated with another disorder, obesity, (Krentz et al, 2008). Hence such high increase in the incidence rate for type II diabetes could be due to the increased rate of obesity over past few years as the life style of the population is generally getting poorer and 20% of the population is now obese (UK Obesity Statistics). Understanding and treatment of diabetes has advanced throughout the twentieth century and since insulin has been discovered, many antidiabetic therapies and oral agents such as, Sulphonylureas and Biguanides have been developed to improve glycaemia. Sulphonylurea was the first oral therapy to be discovered for diabetes. It is insulin secretagogues and hence it combats the abnormally high level of blood glucose but it also causes hypoglycaemia and weight gain as it can prolong insulin secretion (Warrell et al, 2006). Biguanides is a class of drugs that are considered antihyperglycemic agents. Metformin is a primary member of this class and it has surpassed sulfonylureas as the most prescribed oral antidiabetic drug in the UK and most parts of the world (Filion, 2009). Metformin is now the most popular treatment for diabetes type II as a study carried out using The Health Improvement database from 1966 to 2005 in the UK shows that only a small number of patients were treated with insul in and its use did not change significantly over the time of study period, in 1966 Sulphonylurea was the most common drug and metformin was relatively less common but by 2005 the use of Sulphonylurea had decreased remarkably and there had been a parallel increase in the use of metformin as a therapy for diabetes (Gonzalez, 2009). In 2006 the American Diabetes Association recommended it as the first drug of choice for patients. In the 15th edition of the Model list of Essential Medicine by WHO, metformin is one of the only two antidebetic oral drug agents (the other is glibenclamide) stated there (WHO, 2007). The other members of biguanides drug class are phenformin and buformin however these two drugs are no longer used in many countries because it carries a very high risk of lactic acidosis. Historical development: In medieval times, French lilac or Goats rue known as Galega officinalis was used as a remedy for intense urination associated with the disease that is now known as diabetes mellitus and the active ingredient in the French lilac that had blood glucose lowering properties was discovered as galegine or isomyleneguanidine, but later on it was discovered that this ingredient was toxic in the plant that caused death of grazing animals (Witters, 2001). In 1918, guanidine was discovered to be blood glucose lowering agent but then it was also found that it is too toxic to be used as a therapy (Foye, 2007). Whilst guanidine itself and some of its other derivatives were considered to be too toxic to be used for diabetes mellitus treatment, the biguanides, two linked guanidine, proved to be safe and effective for the treatment of diabetes (Witters, 2001). In the 1920s, in a search for these guanidine-containing compounds with antidiabetic activities, phenformin, buformin and metformin were discovered. Although they were known to have glucose lowering properties it was not until 1957 when these biguanides were tried on man and introduced clinically in Europe (Gottlieb Auld, 1962, Reitman Schadt, 2007). For the first time in a medical literature by Ungar et al (1957, as cited by Oubre et al 1997) biguanides were described as an efficacious new class of oral drug for the treatment of diabetes. Phenformin which is similar to metformin in structure was very popular in 1960s but in early 1970s it was found to be associated with lactic acidosis and by 1976 clinical studies proved that the hazards of phenformin treatment outweighed its benefits and therefore, phenformin and all the products containing phenformin were withdrawn by the Ministry of Health and buformin was also withdrawn from many countries for the same reason (WHO, 2003). Howe ver, metformin was proved to be safer and did not have same risk of lactic acidosis if appropriately prescribed, and it took another twenty years after a safe and effective use in the Europe until United States Food and Drug Administration (FDA) approved it for use in the United States (Reitman Schadt, 2007). Glucophage the trade name of metformin, formulated by a drug company called Bristol-Myers Squibb, was the first brand to be marketed in the United States (U.S. FDA). Metformin used to be only prescribed for diabetes but then studies published in European journal of clinical investigation 1998 proved that metformin can have a significant effect on reducing weight as well (Paolisso et al, 1998). Meformin has now been used for over 50 years and it has established to be first-line drug of choice for the treatment of diabetes type II, but to get its maximum effect in the anticipation to reduce insulin resistance, weight loss and also to contribute in the improvement of cardiovascular diseases,the American Diabetes Association and the European Association for the Study of Diabetes strongly recommend to use metformin along with lifestyle intervention (Papanas Maltezos, 2009). Mode of Action/ Physiological Effects: Metformin is an antidiabetic oral drug that belongs to a class of drugs called biguanides. It acts by lowering the amount of glucose that liver makes on its own in the body hence it has antihyperglycaemic effects. It was licensed as antihyperglycaemic medication in Europe in 1970s, at that time there was only little known about the mode of action and its physiological effects on body. Despite metformin being in use since 1950s, its cellular mechanism of action is not definite. It primarily acts by inhibiting gluconeogenesis in the liver and hence it reduces the hepatic glucose output; it has also been shown to enhance glucose uptake in the muscles and improve peripheral insulin sensitivity (Ronco et al, 2008). Insulin is a very powerful anabolic hormone and it is involved in the synthesis and storage of glucose, lipid, and amino acid/protein. When blood glucose level rises, insulin is produced by the beta cells of the pancreas. As described by Gropper et al (2008) in their book, it stimulates the uptake of glucose by muscle cells and adipocytes, it also inhibits the gluconeogenesis by the liver to bring about an overall decrease in plasma glucose level. Insulin binds to a specific receptor on the plasma membrane of muscle cells and adipocytes which initiates a cascade of second messenger system that stimulates the tubulovesicle-enclosed GLUT4 glucose transporters to be translocated to the plasma membrane. Insulin also activates the enzyme glycogen synthase and inhibits glycogen phosphorylase and together they help store glucose in the form of glycogen. Hence this way glucose is removed from the blood circulation and is brought to normal level (Gropper et al, 2008). The majority of individuals with type II diabetes are insulin resistant. They have plenty of insulin circulating but their body is not able to respond to it either by having defective or insufficient number of insulin receptors therefore, glucose cannot enter the cells resulting in increased level of plasma glucose. Pancreas continues to produce more insulin in an effort to lower the increased level of glucose and eventually when an individual can no longer produce enough insulin to compensate for the rise, type 2 diabetes develops (Kaufman, 2008). Figure 1shows an overview of antihyoerglycaemic effect of metformin in type II diabetes mellitus. Metformin has various metabolic effects on lowering the hyperglycaemia. It partially acts by improving insulin action and partially by non-directly insulin dependent effects (Krentz Bailey, 2005). Metformin suppresses the hepatic glucose output by decreasing gluconeogenesis, glycogenolysis and fatty acid oxidation and this is the most evident principal blood glucose lowering mechanism and it does so by mainly increasing insulin sensitivity (Krentz Bailey, 2005). In the skeletal muscles metformin increases the insulin mediated glucose uptake and glycogen formation (glycogenesis), it also reduces the fatty acid oxidation. These changes in the muscle cells increase glucose transporters to move to the plasma membrane surface so that glucose can enter the cells (Krentz Bailey, 2005). Another way in which metformin lowers hyperglycaemia is via increasing the anaerobic metabolism of glucose which produces lactate as a by-product and this contributes in lowering the amount of glucose available to move to the serosal side from the lumen, lactate is taken to the liver via portal system (Bailey et al, 2008). Another way in which metformin works independent of insulin action to lower glucose is via increasing the splancchic glucose turn over (Krentz Bailey, 2005). The effect of metformin on skeletal muscles and adipose tissues in improving glucose utilisation in them appears to work through improved binding of insulin to its receptors on the plasma membranes of these cells and therefore, metformin seems to be ineffective without some residual functioning islet cells (Porte et al, 2002). Metformin has no direct effect on insulin secretion in contrast to other antidiabetic drugs such as sulfonylureas, therefore it does not cause hypoglycaemia rather in clinical practice it shows anti-hyperglycaemic actions (Porte et al, 2002). The level of glucose throughout the day changes, it is typically higher after eating and lower in the fasting state. The fasting plasma glucose concentration is measured by the HbA1c test, HbA1c is a glycosylates haemologlibin that is glucose attached with hamemoglobin so the higher the concentration of glucose the higher the level of HbA1c ( Medline Encyclopaedia, 2009). A fasting glucose level lower than 6mmol/l or 7% is normal in non-pregnant individuals and an elevated level shows that either the patient is diabetic or the patient has impaired fasting glucose/impaired glucose tolerance (Bupas health information factsheet, 2008; American diabetes association, 2009). It is important for type II diabetes patients to achieve normal or near-normal glycaemic control with their oral anti hyperglycaemic medications. There are numerous studies that show the effect of metformin decreasing the fasting plasma glucose level. Such as a study by Lozzo (2003), done on type II diabetes patients over 26 weeks with metformin increased the whole-body insulin sensitivity and that was likely to be determined by the reduction in HbA1c and body weight. A similar study done on patients with newly diagnosed Type II diabetes mellitus showed that adding metformin to insulin therapy effectively decreased the HbA1c level from 10.8 to 5.9% and 100% patients achieved an HbA1c less than 7% (Lingvay, 2007). Metformin has also been suggested to work by a biochemical pathway through activation of a protein kinase enzyme 5 adenosine monophosphate-activated protein kinase (AMPK). Its activity is regulated by the depletion in ATP (Adenosin tri-phosphate) and raised level of AMP when energy demand increases, such as in a exercising muscle, thus it is a â€Å"metabolic stress-sensing enzyme† that regulates the energy demand and energy production balance by modulating various metabolic pathways that bring about glucose, protein and fatty acid metabolism homeostasis (Hawley Zierath, 2008). In order for metformin to be effective in the inhibition of the production of glucose, activation of AMPK is required (Zhou, 2001). Kim et al (2008) published a study in 2008 that further described the mechanism of metformin through the activation of AMPK. This study was done on hepatocytes and it showed that through AMPK-dependant pathway metformin increased the gene expression of small heterodimer pa rtner, (SHP), SHP protein represses the transcriptional activity of a number of nuclear reptors including hepatocyte nuclear factor, and that in turn inhibits the expression of the hepatic gluconeogenic genes PEPCK and Glc-6-pase, these are the two enzymes that perform a key role in the homeostatic regulation of blood glucose levels and inhibition of these enzyme gene expression lead to the hepatic glucose production in vivo. Metformin has advantageous effects on atherosclerosis by decreasing Low Density Lipoprotein levels by about 0.26 mmol/L (10 mg/dL), whereas other oral agents appear to have no obvious effects on LDL cholesterol levels (Bolen et al, 2007). Recent prospective and retrospective studies confirm this drug not only being safe for its glucose lowering effects but also indicate its potential anti-atherosclerotic and cardioprotective effects (Scarpello Howlett, 2008). In the UKPD (United Kingdom Prospective Diabetes Study) a randomised trial on obese and overweight patients with initial metformin monotherapy showed a significant reduction in myocardial infarction and diabetes related deaths, it showed 39% decrease in heart attacks and 36% decrease overall mortality rate; metformin was found to be more effective than any other medication with regards to the strokes and overall mortality rate in overweight patients (Krentz Bailey 2005). Kooy et al (2009) investigated whether metformin had sus tained beneficial effects on metabolic control and risk of cardiovascular disease. After a follow-up period of 4.3 years it was found that metformin added to insulin in type II diabetic patients improved body weight, glycaemic control and it reduced the risk of macravascular disease. A 2007 systematic review evaluating antidiabetic agents and outcomes in patients with both diabetes and heart failure showed that metformin is the only antidiabetic agent that is not associated with harm in patients with heart failure and diabetes. In this systematic review and meta-analysis of controlled studies, two of three studies showed association of metformin with reduced all cause mortality and no association with increased hospital admissions. (Eurich et al, 2007) Pharmacokinetics The chemical name of biguanide is  1-(Diaminomethylidene)guanidine (chemical  formula C2H7N5) and it includes compounds that  have biguanide structure. Figure 2 shows the  molecular structure of metformin that has  biguanide structure with two methyl groups  added on the amine group of the first carbon  atom therefore its chemical name being  1,1-dimethylbiguanide and chemical formula  C4H11N5 (Porte et al, 2002). Metformin is taken orally so it has to pass through the digestive system in order to get into the systemic circulation. It is absorbed from the small intestine and does not get metabolised, under fasting conditions the Bioavailability of metformin ranges between 40%-60% (Foye, 2007). From the gastrointestine it gets completely absorbed after 6 hours of oral administration and after absorption it is rapidly distributed and in the plasma it is completely undetectable after 24 hours; the plasma concentration of metformin reaches its peak value within three hours of its oral administration (Papanas maltedoz, 2009). Unlike other biguanides such as phenformin the binding of metformin to plasma protein is negligible and therefore it does not seem to interact with highly plasma protein bound drugs such as sulphonamides and is excreted unchanged (Foye, 2007). Metformin does not get metabolised by the liver and therefore is excreted in the urine from the body as unmetabolised drug through the active tubular excretion and about 30% of an oral dose is excreted through faeces that may be unabsorbed metformin and that retain in the gastrointestinal tract (Porte et al, 2002). It has plasma half life of about 2 to 5 hours in patients with normal renal function but and renal function impairments may lead to retention of metformin in the blood plasma (Foye, 2007). According to Diabetes UK the daily dosage of metformin should be started from 500mg and then gradually increased to a maximum of 2550mg per day but it is entirely individualistic that it depends on the health of individual to consider what dosage is required. Generic metformin is sold in the form of tablets. A slow or extended release preparation of metformin (Glucophage XR ®), introduced in 2004 can act over 24 hours, it has been designed to release metformin slowly over a longer period of time than standard metformin (acts over 8-12 hours) and so its half life is increased to four to eight hours. Timmins et al (2005), in their study on 16 volunteers with 1000mg standard metformin dose twice a day or 2000mg Glucophage XR ® once a day, found out that the pharmacokinetics parameters are similar in Glucophage XR ® to standard metformin, but Glucophage XR ® it is evident to report fewer gastrointestinal side effects than standard metformin so patients who cannot tolerate standard metformin can switch to Glucophage XR ® (Feher et al, 2007). Side effects and contradictions When prescribed appropriately the most common adverse side effects of metformin include a change in taste, nausea or vomiting, abdominal distension or gas, loss of appetite, diarrhea, skin rashes or urticaria, rare – Lactic acidosis (Warrell et al, 2006). These problems are usually mild and occur in the first few weeks for taking the medication but it may discourage the patient from taking the drug, starting the medication in low dosage and increasing it slowly help reduce these side effects (Warrell et al, 2006). In clinical trial done on a total of 286 subjects, 141 were given metformin and the rest were put on placebo. This trial found that 53.2% of subjects who were given Metformin reported diarrhea in comparison with 11.7% for those on placebo, and 25.5% subjects on metformin reported nausea/vomiting compared with 8.3% for those on placebo (Drug Facts and Comparisons, 2005). Compared with any other antidiabetic oral drug metformin is most associated with gastrointestinal distress (Bolen et al, 2007). Phenformin was withdrawn from its theraputical use because of its association with lactic acidosis. Metformin which is similar in structure to phenformin has also been associated with lactic acidosis; however the risk associated with metformin is ten times lower than phenformin (Warrell et al, 2006). A case control analysis on the study population of 50,048 type 2 diabetic subjects using the U.K – based General Practice Research Database found out that the rate of incidence of lactic acidosis per 100,000 person-years is 3.3 cases amongst metformin users (Bodmer et al. 2008). Lactic acid is a by-product of metabolism and it becomes toxic if it is not neutralised fast enough. Lactic acidosis associated with metformin is a very severe and potentially fatal condition that can be avoided easily if the drug is prescribed carefully (Fitzgerald et al, 2009). It arises by the mode of action of metformin, that is the inhibition of hepatic gluconeogensis- a process that consumes lactate, produced by glycolysis, continuously to produce glucose (Warrell et al, 2006). Adopted from Fitzgerald et al. BMJ 2009 In normal conditions during respiration glucose is broken down into two pyruvate molecules in the first step (glycolysis), in the presence of enough oxygen mitochondria oxidises the pyruvate into CO2 and H2O through Kreb cycle by the use of pyruvate dehydrogenase enzyme. But if there is not enough oxygen present, the mitochondria cannot oxidise all of pyruvate so this excess amount of pyruvate is converted into lactate by the lactate dehydrogenase and this lactate is then used in the process of gluconeogenses in the liver. (Fitzgerald et al, 2009; Nicks A, 2009) As shown in figure 3, at site A metformin decreases the activity of pyruvate dehydrogenase and the conversion of pyruvate into CO2 and H2O, therefore at site B it enhancing the anaerobic metabolism even in the presence of enough oxygen and resulting in the increased production of lactate and as metformin inhibits the process of gluconeogenses in the liver, the lactate is not used up and is built up to the toxic extent. Lactic acidosis is the built up of lactate level in the blood (usually >5 mMol/L). (Nicks A, 2009; Fitzgerald et al, 2009) As indicated in figure 3, lactate is excreted 70% by liver, 5% by kidneys therefore liver or renal dysfunctions lead to the retention of lactate and hence to a severe form of lactic acidoses even in the absence of metformin and because metformin is excreted by kidneys if kidneys do not function properly then metformin builds up and hence the severity of lactic acidosis is even greater (Misbin, 2004). The most common contraindications to the use of metformin in people with type II diabetes are renal and liver dysfunctions, congestive heart failure and advanced age, ≠¥ 80 years, and the mortality rate of lactic acidosis is close to 50% (McCormack et al, 2005). But although heart failure has long been known as a contraindication for metformin use a systemic review 2007 showed that metformin is the only anti-diabetic drug that is not associated with any harm in patients withheart failure Eurich et al, 2007). A Medline searched review on the evidence for the use of metformin in the presence of these contradictions concludes that metformin treatment alone does not result in lactic acidosis unless other contributing factors exist as well (Tahrani et al, 2007). However if ingested in toxic doses or in the presence of renal elimination impairment, lactic acidosis does occur (Fitzgerald et al, 2009). The renal function of patients using metfomin should be regularly monitored. It showed be withdrawn if there is any disturbance in the renal function found. Figure 4 shows the current recommendations on contraindications and guidelines for the withdrawal of metformin. Metformin dose should be reviewed if serum creatinine level is greater than 130  µmol/l and a cut-off serum creatinine level above which metformin should be stopped is 150 µmol/l (Fitzgerald et al, 2009). It should be withdrawn during suspected tissue hypoxia that is a condition in which body tissues are deprived of adequate oxygen so cells are forced to respire anaerobically. Patients aged greater than 80 years are at greater risk because they are more likely to have heart problems and kidney or hepatic dysfunctions and patients should be more careful about their alcohol intake while they are on metformin because alcohol can seriously harm liver and that can lead to lactic acidosis (Tahrani et al. BMJ 2007). Metfor min should be withdrawn before any radiographical procedures involving iodinated contrast and should remain discontinued until after three days as this contrast dye may temporarily impair kidney function and cause the retention of metformin indirectly leading to lactic acidosis (Thomsen andMorcos, 2003) â€Å"Review dose of metformin * If serum creatinine is >130  µmol/l or estimated glomerular filtration rate is Stop metformin * If serum creatinine is >150  µmol/l or estimated glomerular filtration rate is Withdraw metformin* * During periods of suspected tissue hypoxia (such as myocardial infarction, sepsis) * For three days after use of contrast medium that contains iodine * Two days before general anaesthesia *Reinstate when renal function stabilises Contraindications * Renal dysfunction * Congestive cardiac failure needing drug treatment * Hypersensitivity to metformin * Acute or chronic metabolic acidosis * Impaired hepatic function Precautions * Age >80 years until renal dysfunction ruled out * Acute myocardial infarction * Radiological studies involving iodinated contrast * Surgical procedures * Alcohol intake † Salpeter et al (2003), in a system review considered 194 studies published between 1, 1959, and March 31, 2002 that evaluated metformin mono therapy or in combination with other treatments for at least one month, in data from these 194 studies there were no fatal or nonfatal lactic acidosis cases found in 36,893 patient-years in the metformin group or in 30,109 patients-years in the nonmetformin or placebo group. It also did not find any difference in lactate levels in metformin therapy and placebo or other non-biguanide therapies. This systemic review concluded that there is no evidence to support association of metformin therapy with increased risk of lactic acidosis or increased lactate level compared with other antihyperglycemic treatments provided that the drugs are prescribed in a suitable dose and all the contraindications are taken into account. Another side effect to the use of metformin is that when it is used in long term it is associated with malabsorption of vitamin B12 (Ting et al, 2006). Combination with other antidiabetic drugs Metformin monotherapy works well with life style interventions in type II diabetic patients but when Type II Diabetes is not controlled with Metformin monotherapy adequately it is often combined with other antidiabetic drugs to maximise its effect. The combination of metformin with rosiglitazone as a single product is known as Avandame, itwas approved by the FDA in October 2002 for the treatment of diabetes and although it has not been appraised by the National Institute for Clinical Excellence (NICE) yet it is often prescribed to patients with type II diabetes who fail to control their glycaemia despite the maximum dose of metformin (Diabetes UK, 2009). The active constituent of Avandamet, metformin and rosiglitazone,have different mechanism of action complementing the action of each other. The tolerability profile of Avandamet is similar to that of metformin, it is more effective in terms of lowering the HbA1c level than metformin or rosiglitazone (Wellington, 2005). Pooled data from two double-blind studies that involved 550 patients randomised to be given metformin with rosiglitazone or placebo patients were divided into obese, overweight or non-overweight. Patients from all groups improved their level of HbA1c and fasting plasma glucose (FPG) to a clinically important extent but the greatest improvement was found in the obese group, these patients improved their glycaemic control, beta cell function and insulin sensitivity with the addition of rosiglitazone to metformin than those who received placebo/metformin (Jones et al, 2003). Metformin can be combined with glyburide which is a member of sulphonylureas and it acts by enhancing insulin release from the cell of pancrease. The combination of these two drugs is proves to be successful in improving the glycaemic control in patients with type II diabetes Studies, such as sixteen week multicenter, randomized, double-blind, 4-arm and parallel clinical trial study (Chien et al, 2007) that involved a total of 100 Chinese patients with type II diabetes and out of which 76 were randomly given metformin 500mg, glyburide 5mg, glyburide/metformin 2.5 mg/500 mg or glyburide/metformin 5.0mg/500mg. After 16 weeks, those who received a combination of both drugs had a greater decrease in both fasting plasma glucose and HbA1c compared with those who received either metformin or glyburide. Insulin therapy alone sometimes fails in patients for the treatment of type II diabetes so metformin can be added to improve the sensitivity of insulin and this combination of two drugs results in superior glycaemic control compared with metformin or insulin alone and it also minimizes the weight gain in insulin therapy ( Wulffele et al, 2002). Continued use of metformin after insulin introduction patients with type II diabetes not only reduce weight and improve glycaemic control but have beneficial effect on cardiovascular outcomes (Kooy, 2009). Addition of pioglitazone to metformin is another combination for the treatment of type II diabetes, this is shown in double-blind, placebo-controlled, clinical trial done by Kaku (2009), compared with metformin monotherapy patients who received pioglitazone plus metformin improved their HbA1C by mean 0.67% and they significantly improved their fasting glucose level and other important markers such as free fatty acids, adiponectin and HDL, that are linked with increased insulin resistance and cardiovascular risks. Metformin can also be combined with other antidiabetic oral agents as a triple therapy for diabetes type II. In a study which was supported by Bristol-Myers Squibb Pharmaceutical Research Institute, 365 patients who were given metformin/glyburide treatment prior to a 24-week double-blind treatment were either assigned to rosiglitazone or placebo while carrying on with metformin, 40% of those patients who received rosiglitazone in addition to metformin/glyburide were able to achieve final HbA1c less than 7.0% and this study concluded that combination of rosiglitazone to metformin/glyburide is â€Å"an effective therapeutic strategy† for those who are unable to control their glycaemia and this treatment is beneficial for lowering HbA1C and fasting plasma glucose levels (Dailey et al, 2004). Who should be treated? Metformin is a very effective antihyperglaecamic drug for patients with diabetes type II and the American Diabetes Association (2006) recommended it as the first drug of choice for patients. Metformin is a preferred treatment for obese diabetics. In most of the cases Type II diabetes is associated with another disorder, obesity (Krentz et al, 2008). Obesity increases the risk of developing type II diabetes and many antidiabetic drugs increase body weight whereas, metformin demonstrates a significant weight loss in type II diabetic patients, Golay (2007) in his review on summarising the effect of metformin on body weight confirms that metformin has been shown to induce weight loss in nondiabetic obese patients, although long term studies on these patients are very rare. Therefore patients with obesity and on the risk of developing diabetes type II should start on metformin. Metformin is also effective with regards to strokes in obese/overweight patients i.e. those on the risk of developing diabetes. UKPD showed a significant reduction in myocardial

Tumors or Lesions to the Hypothalamus Patient :: Neurology Neurological Papers Research

Tumors or Lesions to the Hypothalamus Patient The Hypothalamus is a small area near the base of the brain just ventral to the thalamus. It has widespread connections with the rest of the forebrain and the midbrain. Partly through nerves and partly through hypothalamic hormones, the hypothalamus conveys messages to the pituitary gland, altering its release of hormones (Kalat, 2003). Any type of damage to a hypothalamic nucleus, such as tumors or lesions, may lead to abnormalities in one or more motivated behaviors, such as feeding, drinking, temperature regulation, sexual behavior, fighting, or activity level. The exact cause of hypothalamic tumors is not known. It is likely that they result from a combination of genetic and environmental factors. In children, most hypothalamic tumors are gliomas. Gliomas are a common type of brain tumor that results from the abnormal growth of glial cells, which are a type of cells that support nerve cells. Gliomas can occur at any age but they are often more aggressive in adults than children. In adults, tumors in the hypothalamus are more likely to be metastatic (resulting form the spread of cancer form another organ to the hypothalamus) than they are when they occur in children. Peter Heage, of Colorado, was diagnosed with a hypothalamic brain tumor. He said that he was having headaches too often, and they were different from most headaches he had in the past. He would forget things, and then forget more often. He said he had a vague feeling that something just wasn’t right. One day he had a seizure while he was at work. After seeing his physician, he told him that he had some of the common symptoms of a brain tumor. Brain tumors have a variety of symptoms ranging from headache to stroke. Seizures may be the initial manifestation of a brain tumor, and eventually as many as 30% of patients with brain tumors will develop seizures. Gradual loss of movement or sensation in an arm or leg may occur. Unsteadiness or imbalance, and double vision may occur, especially if it is associated with headache. Loss of vision in one or both eyes

Children in Foster Care Essay

Statement: Upon ageing out of the foster care system, foster kids end up either dead, homeless or incarcerated due to lack of independent living skills and lack of knowledge about programs in their communities! Due to many children being so displaced and neglected, it is hard to provide for children because foster homes are overcrowded. Due to lack of financial stability roughly 20,000- 100,00 children in the United States are discharged to live on their own while approximately 1,100 young adults are discharged and left to fend for themselves throughout the country.† Having reached the age, they are presumed to be productive, self reliant and fully self sufficient† (Retrieved January 2, 2013, from www.childrenaidsociety.org). Unfortunately, these young adolescents are looked at as a failure before even given a chance in society due to not growing up under the best circumstances. Already troubled by their childhood experiences of neglect, abandonment and abuse, the vast majority of young people leave the system without knowledge, skills, experience, habits and relationships that can engage them in connective and productive programs within their communities. With this in mind, it also stops them from being connected members of society. According to statistics â€Å"foster children that age out of the system are far more likely to encounter poverty, homelessness, compromised health, unemployment and incarceration† (Retrieved December 29, 2012, from www.angelsfoster.org). Having access to both resources and programs during and aftercare can help alleviate alot of tension that children in the system encounter when trying to maintain and survive on their own. If the United States government help foster care agencies foster more programs and provide adequate funding in the right areas, then foster children would have more knowledge and skills when it comes down to independency. Without any friends, social workers, or dependent foster parents to turn to for help or assistance, these young people are pre dominantly at greater risk of becoming homeless, jobless, incarcerated or dead. According to statistics, young people discharged to themselves in different states have high numbers of poor preparation and independent living skills. â€Å"12-30 percent struggled with homelessness, 40-63 percent did not complete high school, 25-55 percent were unemployed and those employed had earnings far below the poverty line. 31-41 percent were arrested, 18-26 percent were incarcerated 12-18 months after leaving the system† ( Retrieved January 2, 2013 from www.whitehousetaskforceondisadvantagedyouth).

The Language of War.An analysis of how understanding and sup essays

The Language of War.An analysis of how understanding and sup essays An analysis of how understanding and support of war is constructed through media texts specifically newspapers. In 1982 I was not old enough to fully understand what was happening when my country went to war with Argentina over a group of islands called The Falklands. However, I was old enough to understand the comments of my parents when they discussed the situation, as well as the headlines they had read in the papers. One such comment being something I have since heard repeated time and time again from various people; this being on the Sun newspapers headlines throughout the conflict. One of these headlines was GOTCHA, splashed over the front page when the first major incident happened the sinking of the Belgrano on May 2nd 1982 (Greenslade, 2002); an event that cost many Argentine lives. In this paper I am going to discuss the ways in which newspapers report on war and terrorism, using language such as the Suns example above, and the impact that they are able to achieve on their readers. I am going to argue that newspapers, along with other media, are a tool for constructing both support and understanding of any conflict, thus being a major propaganda machine, without this ever being fully noted by the mass audience. I will begin by making historic reference to propaganda in the First World War, as discussed by Noam Chomsky, going on to look at more recent conflicts that have seen the use of media propaganda specifically The Gulf War. I will draw together the information discussed by looking at the most recent examples of press propaganda on the war in Afghanistan, in the aftermath of the World Trade Centre attacks on 11th September 2001. The Dean of American Journalists, Walter Lippmann is quoted in Chomsky as saying, ...a... revolution in the art of democracy could be used to manufacture consent, i.e. gain public agreement on things...