GWF Hegel and the Development of Moral Integrity Essay Example for Free

GWF Hegel and the Development of Moral Integrity Essay Moral integrity is the core and purpose of Hegel’s moral writing. The point is to reconnect mankind with the nature and purpose of their development, something that Bookchin shares. Moral integrity is a process, a process that develops only through institutions, and hence, is perfectly a part of this paper: ethical integrity is a social integrity, both created by and mediated by institutions (Horowitz, 1966, 8). For Hegel, these institutions are three-fold, the family, the civil (economic) society, and the state itself. These three things work together to form to integral personality and mediate it through the various elements of day to day life. While often highly rarified and theoretical, it seems that Hegel, in reality, is the most practical of all the writers we have examined. The moral personality as an integral unit is mediated through, first, the family. Initially the moral personality is seen as the opposite of integral: completely and absolutely free to adopt any end whatsoever. This is not a good things, but is the very source of capriciousness and arbitrariness. The entire point of building the morally integral person is to provide this otherwise empty will with purpose and content. The first institution to do this is the biological family. In this first and vital institution, the human person is shaped to love and to see oneself in the other. Mutual aid is a fact in the family, and such mutual aid seeks no profit, but exists in and of itself, helping and assisting for the sake of loving (Horowitz, 1966, 12). But this institution, as significant as it is, is not self-sufficient. In order to function and survive, it needs to be a part of the broader society and its productive capacities, hence, it passes over into what Hegel calls â€Å"civil society. † This second institution is similar to Locke’s principle of productive property. This is the realm of free action, of the drive to manifest one’s personality in work. Here, it is morally legitimate and useful for a person to seek gain and profit. The family was the arena for love and self-sacrifice, civil society is the arena for its opposite. But, just as the family is not self sufficient, neither is the market. The market leads to oligarchy ane the domination of capital. If unchecked, as Bookchin reminds us, the market will take on a life of its own, and all things will be valued on the basis of their monetary value. Hence, the economic life of the people will finally resolve itself into the state, a far more complex manifestation of the family, headed by the king, a patriarch (Yack, 1980, 710-712). The state manifests the universal mind of the people. Locke and Proudhon hold that the true nature of the natural law has its repository in the people: here, it is the people coming together in the state, the state as the ultimate integral individual. So while all three of the above writers saw the state as a problem, Hegel views it as the solution. If natural law and moral integrity are a single concept with basically a single content, then the central state becomes all important as the physical manifestation of this. What is significant is that all four of these writers got to their conclusions in the very same way, through the application of natural law in the construction of morally integral beings. 5. Conclusion All four of these writers used natural law. All four denounced the world of market capitalism that is not restrained by natural law. All four sought to define the integral individual. Locke sought to define this in the property owner, virtuous in the respect that he would not judge in his own case, but he will be a part of a limited state that would objectively apply civil law to criminal cases. Proudhon rejected the state, and defined the integral person as a producer, a part of a guild or organization based around economic function, operating in a free arena where goods and services are exchanged via contract. The morally integral person, then, functioned as an honest broker, one who maintains his promises and promotes the good of all in so doing. For Book chin, the morally integral person was a real citizen: the balance between market goods, the natural world, political rights and communal responsibility. The morally integral person limits his needs to what is good for the community and what preserves the natural beauty around him. Lastly, Hegel sees the morally integral person as a developmental entity: someone who has all his natural attributes, the lover and the fighter, synthesized in the state and the national culture. Bibliography: Bookchin, Murray (1993) â€Å"What is Social Ecology? † in Environmental Philosophy: From Animal Rights to Radical Ecology. ME Zimmerman, ed.Prentice Hall Forde, Steven. (2001) â€Å"Natural Law, Theology and Morality in Locke. † The American Journal of Political Science 45, 396-409 George, William (1922). â€Å"Proudhon and Economic Federalism. † The Journal of Political Economy. 30, 531-542 Horowitz, Irving. (1966) â€Å"The Hegelian Concept of Political Freedom. † The Journal of Politics. 28, 3-28 Proudhon, Pierre (1977) The Principle of Federation. The University of Toronto Press. Seliger, M. (1963) â€Å"Locke’s Natural Law and the Foundation of Politics. † The Journal of the History of Ideas. 24, 337-354 Yack, Bernard (1980) â€Å"The Rationality of Hegel’s Concept of Monarchy† APSR 74, 709-720

Using gentamicin in the management of sepsis

Using gentamicin in the management of sepsis Sepsis is defined as the inflammatory response toward an infection (1). It is either simple or severe sepsis depending on the organ dysfunction involved as a result of the infection and other factors (2). In terms of the pathophysiology of severe sepsis, a cascade of inflammation and activation of the coagulation system associated with impaired fibrinolysis causes changes in microvascular circulation associated with organ dysfunction, severe sepsis, multiple organ dysfunction syndrome, and death (3). In terms of definitions of other sepsis-associated symptoms, it was generally agreed at the International Sepsis Definitions Conference which was convened in 2001 and the following definitions of sepsis syndromes were published in order to clarify the terminology used to describe the spectrum of disease that results from severe infection. Sepsis is the presence of infection in association with meeting the Systemic inflammatory response syndrome (SIRS) criteria (Box 1 (2)). The clinical significance of meeting SIRS criteria in the absence of organ dysfunction or shock is still unclear. Severe sepsis is defined as evidence of end-organ dysfunction such as altered mental status, episode of hypotension, elevated creatinine, or evidence of disseminated intravascular coagulopathy. Septic shock is defined as persistent hypotension despite adequate fluid resuscitation or tissue hypoperfusion manifested by a lactate greater than 4 mg/dL. Bacteremia is defined as the presence of viable bacteri a within the liquid component of blood (1). Acute pyelonephritis is defined as an acute infection of one or both kidneys; usually, the lower urinary tract is also involved (4). Antibiotic regimen of choice for Sepsis that is associated with urinary tract infection is Co-amoxiclav 1.2g 8 hourly intravenously together with Gentamicin IV dose of 5mg/kg once daily (5). Although that is controversial whether to use the ideal body weight (IBW) or to obtain blood samples indicating Gentamicin level to get the optimal dosing regimen for Gentamicin in obese patient due to risk of accumulation with Aminoglycoside and the fear of oto- and nephrotoxicity (6). Other supportive measures depend on the patients status; table 1 (1) contains helpful measures that indicate markers of organ dysfunction. Case Summary Our patient, C.M., is a 56 years old female who was admitted to the Accident and Emergency department (AE) due to an increased urinary frequency and a high temperature of 40.5 °C. Other complaints were back pain and shortness of breath (SOB). Also, the patient had reported a fall the night before admission. Moreover, the patient had vomited the night before and in the morning of admission. C.M. is a previous smoker who had stopped smoking several years ago and she lives with a partner. She is clinically obese weighing 100kg and her height is 152.4cm. Giving this, her ideal body weight (IBW) comes to 49kg. The only known allergy for this patient is microspores tapes. The patients past medical history (PMH) included asthma, non-insulin dependent diabetes mellitus (NIDDM) and fibromyalgia. She was on one puff daily of each Symbicort Turbohaler 200/6  µg and Ventolin Accuhaler for the management of her stage 3 asthma. Metformin 1g daily was prescribed for her diabetes control; however, its formulation was not mentioned (whether it is a sustained release tablet or a normal release one!). For her fibromyalgia, she was taking 300mg of Quinine sulphate daily together with 150mg of Amitriptyline daily (which is a very high dose; low dose of tricyclic antidepressant (T CA) is recommended i.e. 20-30mg of Amitriptyline). For her pain, the patient was on Co-codamol tablet as required (strength, dose and frequency were not mentioned). Having that she is a diabetic patient over 40 years old, a dose of Simvastatin 40mg daily was prescribed as a primary cardiovascular disease (CVD) protection measure. In addition, Omeprazole 20mg daily was one of her regular m edications with unclear indication. Investigations On admission, an Electrocardiography (ECG) was performed and indicated sinus tachycardia; which could be related to the high temperature, pain or sepsis. The patients vital signs were abnormal having a respiratory rate (RR) of 22 breaths per minute (normal is ~ 12bpm), a heart rate (HR) of 117 beat per minute (normal is ~ 70bpm) and a blood pressure (BP) of 142/65 mmHg (target for diabetic patients is Her laboratory investigations were almost normal except for some parameters. The Sodium level was a bit low which could be a result of the frequent urination or an Amitriptyline hyponatremic effect. Glucose and C-reactive protein (CRP) levels were high which might indicate the presence of infection. Thrombocytopenia may be caused by Quinine or Simvastatin administration! Impression and related Management Plan The patient was diagnosed as a pyelonephritis and sepsis case; so empirical antibiotic regimen was initiated with 1g Amoxicillin intravenously six hourly and 500mg ciprofloxacin orally once daily. Also, 1g Paracetamol intravenously six hourly and one liter Normal Saline intravenously over 24hours was started. Urinalysis on the first day indicated the presence of leucocytes, nitrites, glucose, ketones and blood which means a presence of infection. On the second day, blood culture showed a growth of E. coli which is sensitive to Gentamicin, therefore, 400mg Gentamicin intravenously every 24 hour was prescribed and ciprofloxacin was discontinued. Gentamicin plasma level was requested 6-14 hours after administration of the first dose. In addition to the patients regular medications, 50 mg of Cyclizine eight hourly and 20mg of Citalopram once daily were added, paracetamol IV was switched to orally in the second day and 30mg of oral codeine as required was prescribed ; but the patients Salbutamol Inhaler had been stopped for unclear reason. Discussion Revising the management plan for this patient and in comparison to the local guidelines for the management of pyelonephritis and sepsis patients, we would notice that 1.2g intravenous Co-Amoxiclav is the first-line choice of Penicillins, not Amoxicillin, together with Gentamicin. However, if the ideal body weight is required to obtain the appropriate dosing of Gentamicin for obese patients, so in this case, 245mg of Gentamicin supposed to be prescribed instead of 400mg which is the maximum daily dose (Although that some infectious diseases specialist would recommend going to the maximum dose to make sure that we get the maximum benefit; but we must consider patient status and severity of infection!). Also, it is essential to check the optimal timing for monitoring each drug plasma level, in our case, Gentamicin therapeutic drug monitoring (TDM) has not deviated from the local guidelines recommendation for the once daily dosing of Gentamicin i.e 6-14 hours after giving first dose. Having a patient with increased urination and vomiting, we must consider fluid replacement. Replacing with one liter Normal Saline (NS) might have not met the patients requirement! So it is recommended to check patients need to ensure appropriate replacement i.e. at least 2.5-3 liter daily. We could have recommended giving 2 liter NS each over 8 hours plus the addition of 500ml 5% Dextrose to ensure calories intake if the patient cannot tolerate oral intake. Considering the patients asthma control, we must confirm that Salbutamol inhaler was not mistakenly missed after admission. Since that SOB was one of the patients complaints, we must ensure that it was relieved, if not, consider 5mg of Salbutamol nebulizer four times daily to be added to the regimen and if nebulizer is not necessary, ask for Salbutamol inhaler to be charted as if required basis (6). Also, blood gases were not mentioned so it is probably safer to ask for the oxygen and carbon dioxide saturations to consider if oxygen therapy is needed! Confirm that the patient and nursing staff are aware of inhalers techniques. The patient is on Amitriptyline 150mg orally daily which is considered an old practice for the treatment of fibromyalgia (high dose TCA) and the current recommendation states 20-30mg of Amitriptyline daily for 8 weeks (6) so it is better to re-consider dosing or to change regimen. Low dose Sertraline or high dose Venlafaxine therapy may be effective (6) so consider changing if no further benefit of the use of Amitriptyline. For the associated pain, Paracetamol with Tramadol has better efficacy than Co-codamol. Pregabalin (150-300mg every 12 hours) may improve pain especially if combined with Tramadol; it also improves sleep and morning stiffness (6). So, knowing the patients control with the current medication would be helpful to consider treatment change or modeling to get the most of pharmacologic treatment. Suggesting alternative ways to manage symptoms is also recommended, e.g. spa therapy, physiotherapy, stress management, acupuncture or diet (6). NICE guidelines for the management of type II diabetes mellitus state that Metformin is the first line choice for obese patients. Choosing appropriate formulation that suits the patients lifestyle is essential to ensure patients compliance. Once daily dosing of sustained release formula could provide 24 hour control over glucose, but in this case the present of infection interfered with having accurate reading so it is logical to check the HbA1c to check the glycemic control over the last 8 weeks to consider any therapy modification. Also, pre- and post-prandial glucose level monitoring is required to avoid both hyper- and hypoglycemia using the current regimen. Statins must be prescribed for all diabetic patients who are over 40 years old (6) and having any risk factor of Coronary Vascular Diseases (CVD). The patient was on Simvastatin 40mg daily but no Cholesterol level obtained (consider Ezetimibe if high Cholesterol). Monitoring liver function tests (LFTs) and any muscular side effect is important. Also, having a high BP on admission, checking that BP is normal after sepsis reveals is vital. If persistent high BP, consider adding ACE inhibitors, having the benefit of BP control and protecting the heart in patients susceptible to Vascular Diseases. Weight loss in this patient is advisable so consider dietitian and physiotherapist review to consider going on diet and exercise. Also, annual eye check is recommended to control retinopathy due to DM. Cyclizine was prescribed on regular basis, so we better check if the patient is really on need of a regular anti-emetic, otherwise, consider changing it to as required basis. Regarding Paracetamol, it was prescribed on as needed basis but it was not put clear not to exceed the maximum daily dose, so it is recommended to clarify that to not give the patient more than 4g per day. It is safer to contact the patients GP to confirm the indication of Omeprazole and to consider discontinuation if no clear indication was obtained. Additionally, the patient was thrombocytopenic, which could be a side effect of administration either Quinine or Simvastatin, so monitoring the platelets count is highly recommended to prevent any complication, although DVT prophylaxis is not needed as long as the patient is mobile. Conclusion In conclusion, the overall patient management had no much deviation from the current guidelines recommendation except for some practice that need to be reviewed considering the current patients status. Therapeutic monitoring should be carried on because the patient is under risk of many complications or side effects. Lastly, patients awareness of her clinical condition and treatment requirement for each problem is helpful to prevent or reduce future health problems. Appendix 1: PATIENT MEDICATION PROFILE Patient details Name C.M. Consultant General Practitioner Address Gender Female Weight 100 kg Height 152.4 cm Community Pharmacist Date of Birth (Age) 56 y.o. Known Sensitivities Micropores tapes Social History Previous smoker, lives with partner Patient hospital stay Presenting complaint in primary care / reason for admission Admission date 2008 Increased urinary frequency Back pain Shortness of breath Vomiting Fall (the night before) Fever (40.5 °C) Discharge Date Discharged to Relevant medical history Relevant drug history Date Problem Description Date Medication Comments Asthma Symbicort 200/6 Turbohaler 1 puff daily Ventolin Accuhaler 1 puff daily Non-insulin dependent diabetes mellitus Metformin 1g daily Formulation? Fibromyalgia Co-codamol PRN Strength? Amitriptyline 150mg daily Too high! Quinine sulphate 300mg daily Duration? Simvastatin 40mg daily 1ry CVD prevention Omeprazole 20mg daily Indication? Relevant non drug treatment Prescribed Medication Start Stop Clinical/Laboratory Tests Result 1 Paracetamol 1g IV 6 hourly Day 1 Day 2 ECG Sinus tachycardia 2 0.9% sodium chloride 1000ml IV over 24 hours Day 1 HR 117 bpm 3 Amoxicillin 1g IV 6 hourly Day 1 BP 142/65 4 Ciprofloxacin 500mg PO OD Day 1 Day 2 RR 22 bpm 5 Metformin 1g PO OD Day 1 Urine analysis Leucocytes, nitrites. Glucose, ketones, blood +ve 6 Omeprazole 20mg PO OD Day 1 Blood culture E. coli 7 Quinine sulphate 300mg PO OD Day 1 Na 134 (135-145) 8 Simvastatin 40mg PO OD Day 1 CrCl 145.3 (78-120) 9 Amitriptyline 150mg PO OD Day 1 Glucose 8.9 (3.9-5) 10 Symbicort 200/6 inhaler 1 puff daily Day 1 CRP 180 ( 11 Codeine phosphate 30mg PO PRN Day 1 Bilirubin 35 (3-16) 12 Citalopram 20mg PO OD Day 1 PT 17 (12-15) 13 Cyclizine 50mg PO 8 hourly Day 1 APTT 39 (20-30) 14 Gentamicin 400mg IV 24 hourly Day 2 Platelets 70 (150-400) 15 Paracetamol 1g PO PRN Day 2 Clinical management Diagnosis Pharmaceutical Need Pyelonephritis Evidence-based treatment Sepsis Treatment according to guidelines Care Issue/Desired Output Action Output Confirm drug history + reconcile drug history Ask patient how and when she takes her medication and the indication for each medicine. Compare with GPs DHx + Phone GP for indications for amitrip., omep. and quinine, and when they were initiated. All regular meds have been charted except prn salbutamol. Patient is SOB; advise Dr to chart it prn. Confirm antibiotic regimen for pyelonephritis/sepsis in addition to TDM Check the local guidelines that amoxicillin is first-line for the indication (culture sens. to gent.).Calc. her ideal body weight and CrCl.Calc. gent. dose based on ideal body weight and compare to 400mg iv od (max dose).Check local guidelines whether 6-14 post dose gent. level is correct procedure. Chase level. Monitor BP, Temp, Pulse, RR for signs of resolving sepsis whilst on current regimen. Co-amox 1.2g iv tds is first-line with gent 5mg/kg (max 400mg, ideal body wt 49kg, CrCl 71ml/min). Recommend switch to co-amox because she needs 7/7 iv + oral. Recommend 245mg gent iv od Obtain level before 2nd dose is given+TDM for gent is correct. Review need for gent in 48h Fluid requirements possibly not being met by 1L N. saline in 24hours Request a running fluid balance chart due to vomiting + increased urinary frequency. Ask patient if she can tolerate oral liq. or if feels thirsty. Assess if iv is necessary (2.5L daily + replace losses) Advise doctor to amend first bag to 8 hours and chart 1L N.saline over 8hours + 500ml glucose 5% over 8 hours if patient cant tolerate oral liq. Is her current SOB being treated appropriately? If patient is still wheezy, ask for PaCO2 + PaO2. Request salbutamol nebs 5mg qds + O2 60% to be charted. If not currently SOB, ask for accuhaler to be charted prn. Assess inhaler technique for both inhalers when breathing ok Is her fibromyalgia regimen in-line with current evidence? Check Brit. Soc. Rheum for current guidance on fibromyalgia. Check that citalopram is the SSRI of choice in fibromyalgia since it has been started on admin. Review quinine; if has been in use for 3 months with no benefit consider stopping it High dose TCA is an old practice; current evidence states 25mg/day for 8 weeks. Advise a review of Amitrip. Low dose sertraline has better evidence for use in Fibro. Advise switch + show evidence to prescriber. Tramadol with paracetamol has better efficacy than co-codamol. Suggest trial switch and monitor for dizziness due to recent unexplained fall. Consider pregabalin. Lifestyle advice: stress management, diet, physiotherapy/massage, etc. Is her type II diabetes under control? Check SIGN guidelines on diabetes for current management. Request HbA1c test to determine control over last 2-3/12 Monitor glucose pre/post-prandial and random. Ask patient how she takes the metformin and how regularly Metformin is first-line in obese type II. From lab results, assist endocrinologist in determining whether metformin dose should be increased + which preparation suits patients lifestyle. Is her CVD primary prevention needs being met? Check SIGN guidelines on CVD primary prevention. Check BP + Cholesterol. Next UEs ask for urine albumin + protein levels. Ask patient about current diet and exercise plan (obese) + last eye test. Simvastatin 40mg charted. Check cholesterol. If it is high, may need ezetimibe 10mg od. LFTs ok BP 142/65, upon resolving sepsis recheck BP and initiate ACEi if appropriate. Advise dietician review (obese) + physiotherapy review (or GP) for plan (30mins exercise 5/7). Advise eye test once a year Regular cyclizine may be unnecessary Endorse chart for paracetamols maximum daily dose Reassess patients need for a regular anti-emetic and re-chart cyclizine as prn instead of regular if required Max 4g in 24 hours (e.g. 1g QDS) Highlight patients thrombocytopenia No need for DVT prophylaxis if patient is mobile. Mention that quinine or simvastatin could be the cause of low platelets. Suggest trial withdrawal of quinine if not planning on stopping anyway. Monitor Platelets level if continued. Indication for omeprazole Determine indication from GP and patient. Consider trial withdrawal if indication unknown. Appendix 2: Box 1. Consensus Conference of the American College of Chest Physicians and Society of Critical Care Medicine definitions for the various manifestations of infection.   Ãƒ ¢Ã¢â€š ¬Ã‚ ¢ Systemic Inflammatory Response Syndrome (SIRS): Manifest by two or more of the following conditions: 1. A temperature >38oC or 2. A heart rate >90 beats per minute 3. A respiratory rate >20 breaths per minute or a PaCO2 4. A white blood cell count >12,000/mm3 or 10% immature forms. à ¢Ã¢â€š ¬Ã‚ ¢ Infection:Microbial phenomenon characterised by an inflammatory response to the presence of microorganisms or the invasion of normally sterile host tissue by these organisms. à ¢Ã¢â€š ¬Ã‚ ¢ Bacteraemia: The presence of viable bacteria in the blood. à ¢Ã¢â€š ¬Ã‚ ¢ Sepsis (Simple): The systemic response to infection, manifested by two or more of the SIRS criteria pus an infection. à ¢Ã¢â€š ¬Ã‚ ¢ Sepsis (Severe): Sepsis associated with organ dysfunction, hypoperfusion, or hypotension. Hypoperfusion and perfusion abnormalities that may include, but are not limited to lactic acidosis, oliguria or an acute alteration in mental status. à ¢Ã¢â€š ¬Ã‚ ¢ Septic shock: Sepsis-induced hypotension despite adequate fluid resuscitation, along with the presence of perfusion abnormalities that may include, but are not limited to lactic acidosis, oliguria or an acute alteration in mental status. Patients who are receiving inotropic or vasopressor agents may not be hypotensive at the time that the perfusion abnormalities are measured. This is a subset of severe sepsis. à ¢Ã¢â€š ¬Ã‚ ¢ Sepsis-induced hypotension: A systolic blood pressure 40 mmHg from baseline in the absence of other causes for hypotension. Adapted from Bone RC et al. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest 1992; 101: 1644-1655. Appendix 3: Table 1. Clinical and laboratory markers of organ dysfunction. Organ System Clinical Laboratory Cardiovascular Tachycardia Hypotension Cardiac arrest Arrhythmias Haemodynamic support Altered CVP, PCWP Reduced cardiac output Endocrine Weight loss Hyperglycaemia Hypoalbuminaemia Haematological Bleeding Thrombocytopenia Increased D-dimers Abnormal white cell count Abnormal clotting profile Gastrointestinal Ileus GI bleeding Acute pancreatitis Acalculous cholecystitis Decreased intestinal pH Elevated amylase Hepatic Jaundice Hyperbilirubinaemia Increased PT Elevated LFTs Hypoalbuminaemia Neurological Delirium Confusion Altered consciousness Altered EEG Renal Oliguria Anuria Renal replacement therapy Elevated creatinine Elevated urea Respiratory Tachypnoea Cyanosis Mechanical ventilation PaO2 SaO2 PaO2/FiO2 Immune Pyrexia Nosocomial infection Altered white cell count Impaired white cell function Adapted from Balk RA. Pathogenesis and management of multiple organ dysfunction or failure in severe sepsis and septic shock. Crit Care Clin 2000; 16: 337-352.

Marshall McLuhans Understanding Media Essay -- McLuhan Understanding

Marshall McLuhan's Understanding Media In his groundbreaking work, Understanding Media, Marshall McLuhan posits that technologies in the â€Å"electric age† rendered it impossible for the individual to remain â€Å"aloof† anymore . Over the course of the late 19th to early 20th centuries, while an increasing presence of electric machines in daily life irrefutably signaled our nation’s arrival into the electric age, society’s â€Å"central nervous system [was] technologically extended to involve [each individual] in the whole of mankind,† McLuhan states (20). Previously disconnected, isolated individuals and groups suddenly became compressed, involved in each others’ lives, and unified into a network. As opposed to the preceding mechanical age, this was an age that sought â€Å"wholeness†-- an aspiration that McLuhan refers to as a â€Å"natural adjunct of electric technology† (21). McLuhan believes that great progress was made in the electric age; that wholeness was sought and worked towards eagerly. However, at the turn of the century, three individuals—the philosopher, historian, and writer Henry Adams, the author Henry James, and the escape artist Harry Houdini—seemed to believe society was falling short of the goals that McLuhan claims it held. To these artists, the dreams of making everything seem attainable and everyone reachable were unrealistic; complete global unification, involvement, and wholeness served as a foil for disintegrating interpersonal relations. These American artists saw technology not so much as a device that brings individuals together, but rather as a means of escaping each other, individual social lives, as well as the constraints of the natural world. The Autobiography of Henry Adams, first printed privately in 19... ... not yield wholeness, grant individual freedom, and give Americans the infinite mobility they dream of. On the contrary, technology may cause separation, destruction, and confinement. The question of whether future technologies will unite individuals peacefully or destroy civilizations ruthlessly is just as relevant, if not in fact more pressing today, at the turn of the 21st century, with a global presence of weapons of mass destruction haunting America, than it was at the turn of the 20th century. Based on his law of acceleration and increased danger, Adams might be surprised that America withstood two world wars and even entered the 21st century. But since we have, there is reason to hope that individuals and fellow nations may continue to defy Adams’ fears; that we may continue to â€Å"jump† headfirst into the future, and in doing so, eventually make progress.

Othello the Outsider Essay -- Othello essays

Othello the Outsider   Ã‚  Ã‚  Ã‚  Ã‚   Shakespeare's tragic hero, Othello, was a man whose gifts far outnumbered his weaknesses. On the battlefield, he was accomplished; in his profession, he was highly ranked; and, in his life, he was blissfully married. Despite these great advantages, however, Othello's destiny was ruin. Everything he had so carefully made for himself would be destroyed by one flaw: his fear of remaining an outsider. He feared this fate, yet he harped on it continuously, tearing himself between his identity as a foreigner and his desire to live as a normal citizen. Even so far back as his first public speech, perturbations caused by this internal unrest surfaced, and it was unrest that would ultimately lead to his horrible and complete undoing.      Ã‚  Ã‚  Ã‚  Ã‚   Othello's first speech is an address to the Venetian council, through which he introduces himself to the council members. Brabantio, Desdemona's angered father, has accused Othello of bewitching his daughter and stealing her away into marriage, and Othello is defending himself against these charges. To start his case, he begins thusly, "Most potent, grave, and reverend signors, / My very noble and approved good masters, / That I have ta'en away this old man's daughter, / It is most true; true I have married her" (page 19). Just by itself, this is perhaps the most poetic stanza of the play to this point, yet he continues it in short order with, "...Rude am I in my speech, / And little blessed with the soft phrase of peace" (page 19). Now, only seven lines into Othello's first public text, he has already made use of his outsider status. By humbling himself amidst spectacular oration, he is appearing non-threatening to the judges, while still making a great case. T. .. ... true; true I have married her. The very head and front of my offending Hath this extent, no more. Rude am I in my speech, And little blessed with the soft phrase of peace; For since these arms of mine had seven years' pith Till now some nine moons wasted, they have used Their dearest action in the tented field; And little of this great world can I speak More than pertains to feats of broils and battle; And therefore little shall I grace my cause In speaking for myself. Yet, by your gracious patience, I will a round unvarnished tale deliver Of my whole course of love - what drugs, what charms, What conjuration, and what mighty magic (For such proceeding I am charged withal) I won his daughter.    Works Consulted    The Tragedy of Othello the Moor of Venice, William Shakespeare, I.III.76-94   

Abortion is Not the Reason for Lower Crime Rates Essay -- Argumentativ

What is wrong with the ivory tower? The appointment of Peter ("Death to Disabled Newborns!") Singer to the bioethics faculty at Princeton University has generated considerable controversy. Recently, University of Chicago economist Steven Levitt and Stanford University Law School professor John Donohue III created a furor with their research paper "Legalized Abortion and Crime." The authors contend that legalized abortion fueled the drop in crime in the 1990s because a new subclass of humanity they've identified- "women most at risk to have children who would engage in criminal activity"-have higher abortion rates, thus preemptively executing the would-be felons. This subclass, we are told, is populated predominantly by women who are teens, single and/or African American. Talk about your prenatal racial profiling! The American public is supposed to be grateful to have been spared the cost of not only the crimes, but due process, trial by jury, incarceration, appeals and execution. Â   The paper footnotes even the title with "preliminary and incomplete," and contains all manner of caveats on the "well recognized potential shortcomings of the [crime] data" and concedes the general impossibility of ever proving the asserted causal link with any degree of certainty. Yet it brazenly attempts to put a happy face on the achingly personal and national tragedy that is abortion. That is why articles extolling the findings are popping up throughout the pro-abortion press, while indignant editorials are questioning the authors' eugenicist leanings. It was, after all, Planned Parenthood founder Margaret Sanger who established contraceptive clinics in ghettos so that "defectives" and "human weeds" could be eliminated. Â   Wi... ...gnant, compared to 20 percent of girls in the same age group in D.C. public schools. About 10 percent of the Best Friends participants ages 12-18 had had sex, compared to 72% of their peers. Â   Why the decline in crime in the 1990s? Many plausible explanations have been reported (and given short shrift by the authors), including higher conviction rates and longer prison terms which are keeping repeat offenders off the streets, more police and better policing strategies, decline in the crack cocaine trade and higher expenditures in victim precautions like security guards, alarms, car theft devices, etc. Â   Might I suggest another avenue of research? Let's determine what conditions lead families to produce academics who have no sense of the sanctity and dignity of human life. Some early childhood intervention in values education might really pay off.

Globalization Test Questions

Chapter 1 Expanding abroad: Motivations, means, and mentalities True/False 1. The largest MNEs are equivalent in their economic importance to less developed economies such as Tanzania, Estonia or Sri Lanka. Answer: False (Sales of the largest MNEs exceed the GDPs of less developed countries. ) Difficulty: Easy Page: 4 and Table 1-1 on page 3 Topic: MNE scope and influence 2. The process of internationalization followed by most firms is usually well-thought out in advance and typically builds on a combination of rational analysis, planning and implementation.Answer: False (It is more likely a combination of rational analysis, opportunism, and luck. In regards to opportunism, several studies have found that most firms begin exporting due to an unsolicited export order. ) Difficulty: Moderate Page: 9 Topic: Internationalization process3. A joint venture is a contractual mode of foreign entry involving a high level of resource commitment by all partners. Answer: False (A JV will not typically require as high a resource commitment as we would see in wholly owned subsidiaries. In addition, there is significant variability in the level of resources contributed by partners. ) Difficulty: Moderate Page: 10 Topic: Foreign entry mode4. Emerging motivations for internationalization include the desire to enhance the firm’s competitive position and the desir e to develop global scanning capabilities. Answer: True Difficulty: Easy Page: 6-7 and ppt slide 1-6 Topic: Motivations for internationalization5. For an MNE to exist, first foreign countries must provide location-specific advantages to attract the company to invest there, second the company must have ownership-specific advantages that counteract its liability of foreignness, third the company must have the organizational capability to leverage its strategic advantages more effectively internally than externally. Answer: True Difficulty: Moderate Page: 7-8 Topic: Prerequisites for internationalization6. An MNE with a ‘multinational perspective’ will typically be managed as a coordinated federation. Answer: False (It will typically be managed as a decentralized federation. ) Difficulty: Moderate Page: 11-12 and ppt slide 1-13 Topic: The evolving mentality: international to transnational7. An MNE with a ‘global perspective’ will typically manage its operation s centrally. Answer: True Difficulty: Moderate Page: 12-13 and ppt slide 1-13 Topic: The evolving mentality: international to transnational8. An MNE with a ‘transnational perspective’ will typically be managed as an integrated network. Answer: True Difficulty: Moderate Page: 13-14 and ppt slide 1-13 Topic: The evolving mentality: international to transnationalMultiple Choice9. Which of the following correctly describes the sequential evolution in management thinking with respect to the strategic role of foreign operations in emerging MNEs? a. global mentality, multinational mentality, international mentality, transnational mentality. b. international mentality, global mentality, transnational mentality, multinational mentality. c. multinational mentality, global mentality, international mentality, transnational mentality. d. international mentality, multinational mentality, global mentality, transnational mentality.Answer: d (a, b, and c are incorrect because, although they describe the different ways of management thinking regarding the strategic role of foreign operations in emerging MNEs, they do not describe the evolution of this thinking in the correct sequence. ) Difficulty: Moderate Page: 11-14 Topic: Evolving mentality toward strategic role of foreign operations10. A franchise, such as McDonald’s, is a _________ mode of foreign entry. a. low commitment, low control b. low commitment, moderate control c. low commitment, high control d. moderate commitment, moderate controlAnswer: b (a, c, and d would describe indirect export, contract manufacturing, and joint venture foreign modes of entry respectively. ) Difficulty: Moderate Page: 10 (figure 1-2) Topic: Foreign entry mode11. A joint venture is a _________ mode of foreign entry. a. low commitment, low control b. low commitment, moderate control c. low commitment, high control d. moderate commitment, moderate control Answer: d (a, b, and c would describe indirect export, franchise, an d contract manufacturing foreign modes of entry respectively. ) Difficulty: Moderate Page: 10 (figure 1-2)Topic: Foreign entry mode12. Pashpa Co. is a new manufacturer of home appliances. Pashpa wants to go international. Some of the traditional motivations for pursuing internationalization include: a. securing key supplies, seeking new markets, and raising global scanning and learning capabilities b. securing key supplies, seeking new markets, and improving competitive positioning c. securing key supplies, seeking new markets and accessing low-cost factors of production d. securing key supplies, improving competitive positioning, and accessing low-cost factors of productionAnswer: c (a, b, and d are incorrect because ‘raising global scanning and learning capabilities’ and ‘improving competitive positioning’ are not traditional motivations for pursuing internationalization, they are emerging motivations. ) Difficulty: Moderate Page: 4-6 Topic: Motivations f or internationalization13. One motivation behind internationalization is to sustain the firm’s competitive position. To pursue a sustainable competitive position relative to its rivals in the athletic clothing industry, Nike attempts to: a. reempt markets, capture global scale, and secure raw materials b. capture global scale, access scarce knowledge, and match competitors c. match competitors, capture global scale, and preempt markets d. exploit factor cost differences, preempt markets, and match competitors Answer: c (a, b, and d are incorrect because ‘securing raw materials’, ‘accessing scarce knowledge’, and ‘exploiting factor cost differences’ may give a company a temporary competitive advantage but not a sustainable competitive advantage. ) Difficulty: Hard Page: 4-7Topic: Motivations for internationalization14. _________ suggests that in the first stage innovations are produced in the home developed country; in the second stage th ey are exported to other similarly developed countries; in the third stage, they start being produced in these developed countries; in the fourth stage they start being produced in low-wage developing countries. a. Vernon’s product cycle theory b. Johanson and Vahlne’s stages theory c. Dunning’s eclectic theory d. Levitt’s globalization theory Answer: a Difficulty: Moderate Page: 5-6, 8 Topic: Motivations for internationalization15. Which of the following constitutes a list of foreign entry modes that involve the MNE to make a foreign investment a. Greenfield, acquisition, joint venture and capital participation b. Greenfield, acquisition, joint venture and license c. Franchising, acquisition, joint venture and capital participation d. Greenfield, acquisition, cooperation agreements and capital participation Answer: a (Licensing, franchising, and many forms of cooperation may not entail an MNE making an investment. Difficulty: Easy Page: 9-10 Topic: Forei gn entry modes16. OfficeWare Corp. is an MNE that produces and sells office equipment. If the company’s CEO employs a ‘global mentality’ toward the strategic role of the company’s foreign operations, then we would expect that OfficeWare: a. regards its overseas markets as a portfolio of local opportunities. b. leverages its domestic capabilities worldwide. c. regards the world as a single unit of analysis. d. simultaneously responds to local needs, global demands and cross-border learning opportunities.Answer: c (a, b, and d would represent multinational, international, and transnational mentalities respectively. ) Difficulty: Moderate Page: 11-14 Topic: The evolving mentality: international to transnational Essay17. The CEO of Paragon Ltd. wants to take his company international. What are the three big questions he must answer before expanding abroad? Answer: The three questions this CEO must answer before expanding abroad are: a. What market opportunitie s, sourcing advantages or strategic imperatives will drive the company’s international expansion? . How will the company expand its foreign presence – through exports, licensing, joint ventures, wholly owned subsidiaries or some other means? c. How will the attitudes, assumptions and beliefs of Paragon’s employees impact the probability of the company succeeding in its efforts to internationalize? Difficulty: Moderate Page: 1 (box insert) Topic: Internationalization18. Rana manages an Italian fashion design company. What would motivate Rana’s company to internationalize? Answer: i) Traditional motivations might include: securing key supplies, seeking new markets and accessing low-cost factors of production (e. g. labor, capital, etc. ); (ii) Emerging motivations might include: increasing scale economies to offset significant R&D investments, shortening product life cycles, improving a company’s competitive position and enhancing a company’s global scanning and learning capabilities. Difficulty: Easy Page: 4-7 Topic: Motivations behind internationalization19. Briefly explain the product cycle of personal computers using Raymond Vernon’s product cycle theory. Answer:This theory suggests that early in a product’s life-cycle, all the parts and labor needed to manufacture the product will be sourced from the locale in which the product was invented. As the product is increasingly adopted and distributed in global markets, production gradually shifts away from the point of origin. In some cases, the product ultimately becomes a good that is imported into the country in which it was originally invented. For example, in the case of personal computers, during the new product stage, the computer was produced and purchased by consumers in the United States and little export trade occurred.During the maturing product stage, mass-production techniques were developed and foreign demand (in developed countries) expanded . At this point, the U. S. began to export the product to other developed countries. In the standardized product stage, production moved to developing countries, which then export the product to developed countries. Difficulty: Moderate Page: 5-6 Topic: Product cycle theory20. Briefly compare and contrast the Uppsala Internationalization Model and the Born Global Model. Under what circumstances is each model most applicable?Give examples to support your arguments. Answer: According to the Uppsala Model, companies internationalize in an incremental fashion. Typically, they start by utilizing foreign entry modes that require low levels of resource commitment and low levels of control over foreign activities (e. g. exporting). The model conceptualizes subsequent stages in the internationalization process as requiring higher levels of resource commitment and providing higher levels of control over foreign activities (e. g. wholly owned subsidiary). The experience of Toyota is consistent with the Uppsala Model.According to the Born Global Model, some companies are born global, establishing significant international operations immediately or shortly after the company is launched. These firms do not employ an incremental approach. Instead, these firms aggressively pursue internationalization due to their internal orientation or the need to move quickly due to the nature of their products or services. The experience of many internet companies is consistent with the Born Global Model. Difficulty: Moderate Page: 9-10 Topic: Process of internationalization21.Roy is the CEO of a multinational apparel company. How would he conceptualize the strategic role of his firm’s foreign operations if he possessed a ‘global mentality’? If he possessed a ‘multinational mentality’? Answer: If Roy possessed a global mentality, he would view the world as a single unit of analysis and he would centralize the management of the firm’s foreign operatio ns. Thus, he would drive the firm to create products for a world market and manufacture them on a global scale in a few highly efficient plants, often located at the corporate center.However, if Roy possessed a multinational mentality, he would regard foreign markets as a portfolio of local opportunities and manage his company as a decentralized federation. Thus, he would recognize and emphasize the differences between national markets and operating environments and modify his products, strategies and management practices on a country-by-country basis. Difficulty: Moderate Page: 11-13 Topic: Mentalities toward internationalization22. What is an MNE? Give examples to explain the difference between companies that are considered MNEs and those that are not. Answer:An MNE is a company that engages in the active management of substantial direct investment in one or more foreign countries and that considers those investments/operations as integral parts of the company, both strategically and organizationally. Thus, companies that solely rely on import-export business are not considered MNEs. They may be considered international companies but not multi-national enterprises (MNEs). Moreover, companies that passively manage an investment portfolio (as opposed to those that actively manage foreign assets) are not considered MNEs. Difficulty: Easy Page: 2 Topic: MNE definition23.Briefly compare and contrast the four mentalities toward internationalization. Answer: Companies that have an international mentality produce products for the domestic market and only subsequently sell these products overseas. They transfer innovation and knowledge from the parent company to the foreign operators. These companies view themselves essentially as domestic with some foreign appendages. Companies that have a multinational mentality modify their products, strategies, and management practices country by country. These companies view themselves as nationally sensitive and responsive, thu s the term multinational.Companies that have a global mentality create products for a world market and manufacture them on a global level in a few highly efficient plants. These companies view the world, not just individual national markets, as their unit of analysis. Companies that have a transnational mentality are responsive to country-level operations; however, they coordinate these operations to sustain competitive effectiveness and economic efficiency. These companies view themselves as an integrated network. Difficulty: Moderate Page: 11-14 Topic: Mentalities toward internationalization

People With Disabilities

The nature, causality, assessment, prevention, accommodation, and my personal reflection of the hearing loss will be discussed in my paper. I. Nature of the Exceptionally: According to Gallaudet University, approximately 1 of every 1,000 infants is born deaf while 6 of every 1,000 are born with some degree of hearing loss. Permanent hearing loss at birth annually affects 24,000 infants in the USA. In other words, 6 infants per 1,000 will have a hearing loss in a least one ear that will affect communication, cognition, and educational development. Twenty to thirty percent of hearing loss in children occurs during infancy and early childhood. Some will suffer hearing loss in one ear or possibly both. There are different types of hearing loss. A conductive hearing loss occurs in the middle ear. This is where three small bones involved in hearing are located. A hearing loss that occurs in this part of the ear is usually temporary. A chronic or recurrent ear infections may cause a hearing loss in the middle ear. There are cases where there is a malformation in this area that can be improved or corrected through surgery. There are occasions when a problem in the middle ear can not be corrected. A sensori-neural hearing loss occurs in the middle ear and indicates that there is nerve damage. This type of loss is not reversible. In summary, there are different natures of hearing loss some that can be corrected or others that are irreversible. II. Etiology/Causality: Parents sometimes ask Why did this happen to my child In some cases, the cause of a childs hearing loss may be easy to trace. There may be a family history of deafness, a congenital condition, an illness, an accident, a prescribed edication, etc. that may obviously be cause of the hearing loss. In many cases, there may be no obvious reason for the hearing loss. Parents must come to understand that they may likely never know the cause of this hearing loss. In my case, Meningitis was the cause of my hearing loss. When I was one year old, I was not responding to my parents calls. They took me to the hospital to get tested and found that I had Meningitis. III. Assessment Many birthing facilities in our country have currently adopted the Universal Testing of all infants for hearing loss. The two most frequently used measures for testing infants are the ABR (Auditory Brainstem Response) and Otoacoustic Emissions (OAEs). Both measures can be made on an infant while he or she is sleeping and requires no response from the child. The ABR monitors brain activity. It looks specifically, however, the activity that happens in response to sound. OAEs are a quick, non-invasive probe measure that determines cochlear, or inner ear, function. The importance of early childhood development is critical for a child with a hearing loss. Early diagnosis and intervention of hearing loss can mean the difference etween toddlers entering school with severe language and concept delays versus children with age appropriate language and concept development. Early hearing screening paves the way for children to be able to begin life on an equal footing with their hearing peers. Recent research at Gallaudet University indicates that children whose hearing losses are identified in the first 6 months of life, and who receive intervention services, developed language within the normal range. IV. Prevention/Remediation/Accommodation: The law mandates that public schools are responsible for providing an appropriate education ithin the childs neighborhood school. School districts are required to educate students the least restrictive environment with the related services necessary to allow for their success. Some counties/states will have what is called cluster programs. This is when classes for the deaf or hard of hearing are located in specific schools. Students can be in an environment with a teacher of the deaf and hard of hearing and deaf and hard of hearing peers but also be in a regular school setting. Another options for family is a school for the deaf. Most schools for the deaf now offer different communication options rom which a family can choose. Schools must take language and communication needs, opportunities for direct communications with peers and professional personnel in the childs language and communication mode, academic level, and full range of needs, including opportunities for direct instruction in the childs language and communication mode into consideration. This does not mean that the peer will also have a hearing loss but should be able to communicate in the deaf or hard of hearing childs mode of communication. Many parents choose to have their children in a setting where other deaf and hard of earing students are also in attendance thereby allowing for friendships with other deaf and hard of hearing students to develop naturally. Teacher may need to adjust their classroom to meet the students needs. The teacher must focus on reducing background noises as much as possible. To reduce background noises the classroom can have carpeting, area rugs, or drapes. If the classroom do not have drapes, tennis balls can be attached to the bottom of chair legs to stop chairs from scraping on the floor. Noise absorbing material such as a corkboard can be added to the classroom as well. The teacher should consider background noise when choosing the childs seating placement. The school should adjust their teaching strategies to accommodate their students needs. When teaching in the classroom, the teacher needs to remember that a hearing aide do not correct hearing in the same way that eyeglasses correct vision. When speaking to the class, the teacher needs to be in a distance where the child will be able to understand speech and speak at a normal tone. They need to remember that the deaf or hard or hearing child may have fluctuating hearing oss as a result of colds or ear infections changing what we can hear from day to day. There are communication options that teachers can use in the classroom. American Sign Language (ASL) is a manual language that is distinct from spoken English. Extensively used within and among deaf community. English is, however, taught as a second language. Closed Captioning is way of communication used on the television set. Words appear on the bottom of the screen to communicate to a deaf or hard of hearing student. Another form of communication is an interpreter. Interpreters are used for deaf and hard of hearing students to communicate in ASL what the teacher is discussing. Total Communication is the philosophy of using every to communicate with deaf and hard of hearing students. The child is exposed to a formal sign-language system, finger spelling, natural gestures, speech reading, body language, oral speech, and use of amplification. The idea is to communicate and teach vocabulary and language in any manner that works in the classroom. V. Personal Reflections: When I wrote this paper, I have never given my culture background any thought. Deaf culture is part of my ife. I have basically been raised in more of a hearing culture setting then a deaf culture setting. I went to school with my hearing peers but yet had many deaf friends. I went through the nature, causality, assessment, and the accommodation discussed in this paper. I have experienced this first hand and am lucky to have this support. Deaf and hard of hearing has their advantages. We have a right to sit up front at a concert or event. We can also shut people out by just switching off our hearing aides. Being part of the Deaf community is a great experience and I would not change that for the world.