Sunday, May 24, 2020
Case Study Analysis: IDEO Product Development The business model for IDEO began as an open-minded place to design, develop and manufacture new products. The last 20 years of proven product design driven by innovation has translated into profit margins for their clients and continuous refinement for IDEOÃ¢â¬â¢s process. IDEO pioneered Ã¢â¬Å"concurrent engineeringÃ¢â¬ where design and engineering work together to produce aesthetically pleasing products that are also highly functional. This was different from many other similar companies that placed more emphasis on the industrial design than the engineering. IDEOÃ¢â¬â¢s strengths grew out of the ability to master this ability with high tech clients. Corporations came to IDEO because they had a provenÃ¢â¬ ¦show more contentÃ¢â¬ ¦IDEO further enriches these teams by being very selective in their hiring practices of individuals coming into the firm and when new divisions of IDEO are launched. Applicants are narrowed down through a rigorous interviewing process consisting of several 1-hour interviews. If an applicant passes through this formality they are next thrown to the team for further scrutiny. This last phase is critical because in the end it is the team, the whole, which makes IDEO strong not the individual. When the 2000 case was written, IDEO was in demand. They had the luxury of handpicking top clients they wanted to work with on projects. Even with this type of reputation and client selectivity, a successful product design must come from a partnership between the client and the firm. Kelley promoted and exploited the awards given the company and IDEOÃ¢â¬â¢s exemplary innovation practice to continue to evolve and elicit additional business. With regard to the article, Ã¢â¬Å"Choosing to Learn, Learning to ChooseÃ¢â¬ , IDEO seeks out clients that can supplement their intellectual equity. IDEO does not agree to do work that involves only decorative or low transferable knowledge project development. They want to engage with clients that have the tough problems Ã¢â¬â the clients that are pushing technology and accepted norms. IDEO could definitely be called a Ã¢â¬Å"knowledgeShow MoreRelatedIdeo Case Study1532 Words Ã |Ã 7 PagesCase Study Analysis: IDEO Product Development The business model for IDEO began as an open-minded place to design, develop and manufacture new products. The last 20 years of proven product design driven by innovation has translated into profit margins for their clients and continuous refinement for IDEOÃ¢â¬â¢s process. IDEO pioneered Ã¢â¬Å"concurrent engineeringÃ¢â¬ where design and engineering work together to produce aesthetically pleasing products that are also highly functional. This was different fromRead MoreCase Study: Ideo Product Development4900 Words Ã |Ã 20 PagesAbstract This report is based on a case presented by Harvard Business School, titled Ã¢â¬Å"IDEO Product Development.Ã¢â¬ The goal of this report is to examine whether an engineering design company, IDEO, should have requested more time to complete a design for a Personal Data Assistant (PDA) that was to be called the Handspring Visor. The key events take place between March 1996 and September 1999. IDEO is an unconventional Silicone Valley based company, and the hiring company was the then newly formedRead MoreIdeo2254 Words Ã |Ã 10 PagesMEMORANDUM TO: Dennis Boyle, Senior Project Leader and Studio Manager SUBJECT: Visor product, Handspring Executive Summary Handspring, the client, is asking IDEO to design Visor product in approximately 10 months. The design needs to be fully compatible and less expensive version of Palm V, development of which took two years. Such short development time would require IDEO to compromise on its proven development process and sacrifice the emphasis on innovation. Further more, Visor needs to be superiorRead MoreDesigning A New Product Design Essay1454 Words Ã |Ã 6 Pagesservice or product. It is heavily used when it comes to a new product design since it helps to identify opportunities for the creation of a new products themselves, through observation of a need that consumers themselves donÃ¢â¬â¢t realize, but it can also be applied to the improvement of an existing product or service. Empathic Design is a response to the design attitude of designing for user experience which is the idea that user-centered design would help in producing services or products that are simpleRead MoreBBVA CASE STUDY ANAL YSIS3220 Words Ã |Ã 13 PagesOPERATIONS MANAGEMENT CASE STUDY ANALYSIS Innovation at BBVA: A review of the BBVA Case with some reflection on how BBVA moving towards an Open Innovation model 18 October 2013 The following document contains a very brief analysis of the BBVA case followed by some thoughts on an open innovation approach bringing together some of the concepts discussed during our lectures in Operations Management. Innovation at BBVA Operations Management Contents 1. IntroductionÃ¢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¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Ã¢â¬ ¦Read MoreSummary Critique About Article the Science of Desire Essays2066 Words Ã |Ã 9 Pagesdefeat competitors. Then, depending on the research, Sirius launched its new product, the Sirius S50. Later, as the companyÃ¢â¬â¢s wish, the S50 became one of the hottest sellers in that season. How does ethnography work in business? Many examples show brainstorms often happened with the guidance of ethnographers because ethnographers can find out what is peopleÃ¢â¬â¢s missing in their lives and help designers to improve products and services to satisfy customers. The key of ethnographerÃ¢â¬â¢s work is a deeperRead More3).1802 Words Ã |Ã 8 Pagesand is light weight. This product can also be used as a chair because it has a seat in the front of the bag. The product has great stability so the golf clubs will not come out of the bag even if the golf course has many ups and downs. This product has an aesthetic factor (availability in different colors) so people would want to buy it. The disadvantages of using such a product is that it cannot be used if any mechanical part has a failure or gets damaged. This product is made of plastic so it canRead MoreBanczero Case Essay2050 Words Ã |Ã 9 Pagestechnological change. We focus on how the success of technological innovat ionsÃ¢â¬ânew products, processes, and servicesÃ¢â¬âdepends on the firmÃ¢â¬â¢s business model. Other key topics include intellectual property rights and the management of technological uncertainty through organizational arrangements such as corporate venturing, spinoffs, and alliances. Technological change is a fundamental driver of economic development and performance, not only at the level of firms and industries but also economies.Read MoreRisky Business : Corporate Governance And Risk Management2358 Words Ã |Ã 10 Pagescurrent literature, opinion and supported by a few key case studies. Case Studies Case studies are an effective measure in building theory, according to Eisenhardt (1989). It is a research strategy that can be used to support propositions with empirical evidence drawn from numerous sources of data (Eisenhardt, 1989; Yin, 1994). For the purpose of this paper, two key examples have been chosen to examine the key issues in detail. The first case study used in this paper is that of British Petroleum. ARead MoreInnovators Dna84615 Words Ã |Ã 339 PagesSony Walkman, StarbucksÃ¢â¬â¢s beans and atmosphere drown traditional coffee shops, Skype uses a strategy of Ã¢â¬Å"freeÃ¢â¬ to beat ATT and British Telecom, eBay crushes classiÃ¯ ¬ ed ads, and Southwest Airlines Ã¯ ¬âies under the radar of American and Delta. In every case, the creative ideas of innovative entrepreneurs produced powerful competitive advantages and tremendous wealth for the pioneering company. Of course, the retrospective $1 million question is, how did they do it? And perhaps the prospective $10 million
Wednesday, May 13, 2020
How was political grandeur and dignity articulated through early 19th century civic architecture in Paris? Use specific examples. In the wake of the French revolution and King Louis XVI of FranceÃ¢â¬â¢s execution in 1773, 19th century France was a time of immense political, economic and social uncertainty as new political parties competed for power and attempted to reform Frances governing systems. The civil architecture and forms that were built during this period reflect these upheavals, as commissioned architects turned to new styles, city plans and construction methods in order to serve the political ambitions of the governing party. Architecture provided a means of articulating political grandeur and dignity both clearly and creatively,Ã¢â¬ ¦show more contentÃ¢â¬ ¦Due to the instabilities caused by the Napoleonic Wars a new style of architecture did not develop during Napoleons rule, resulting in the continuation of pre-French Revolution classicism. With the intention of articulating imperialistic grandeur and referencing France as the Ã¢â¬Å"new Roman EmpireÃ¢â¬ , an emphasis was placed on neoclass ical elements and the use of columns and arches becoming more liberal. Jean ChalgrinÃ¢â¬â¢s Arch de Triomphe provides an example of politically motivated neoclassical architecture. The triumphant arch was commissioned by Napoleon in 1806 to serve as an honorary monument and rallying point for the French military . Inspired in part by the Arch of Titus in the Roman Forum, decorative high-relief sculptures celebrating military victories from the French Revolution and the Napoleonic Wars adorn the structure . It is evident that Napoleon believed that as an empire that had annexed and made most of Europe into its satellites, the First French Empire deserved to have its grandeur reflected by a monument that referenced one of the worldÃ¢â¬â¢s largest and most successful ancient Empires. Through large and imposing monumental structures, Napoleon sought to reminded French society of the military and political successes that had been achieved under his rule and consequently idealise his leadership, The First
Wednesday, May 6, 2020
In this study, I intend to provide an overview of the air traffic controllersÃ¢â¬â¢ strike that occurred in 1981. This strike came at the peak of increased tension between the air traffic controllers union, PATCO, and the FAA, a federal agency charged with overseeing the management of all civil air flights. The strike occurred on August 3, 1981. We will write a custom essay sample on The Air Traffic Controllers Strike of 1981 or any similar topic only for you Order Now On that day, approximately 12,000 air traffic controllers went on strike, effectively crippling the civil air industry. As members of PATCO, these individuals certainly felt they had the right to strike; however, under the terms of certain laws affecting federal employees, the air traffic controllers, in fact, did not have this right. As a result, President Reagan immediately threatened that any air traffic controller not back at work within 48 hours of the start of the strike would lost his or her job. Three days later, the FAA issued 12,000 dismissal notices and the strike officially came to an end (Spector, 1982, p. ). Of particular interest to me is not only the details and particulars of this strike, but also the structural circumstances that precipitated it and why compensation negotiations were ineffectual. Therefore, I will focus the remainder of this overview on several key points: the internal and external environmental forces that led to the strike, specific human resources issues that made air traffic controllers apt to strike, and a review of the negotiation process and the failed proposals on both sides. In the course of this evaluation, I will discuss some of the major players in the strike, analyze some of the fundamental causes of this strike, and even present at least one alternative solution that was proposed at the time and should have probably been implemented without fail. In this, I intend to illustrate the nature of the air traffic controllersÃ¢â¬â¢ strike of 1981 and the factors that made it all but inevitable. To begin with, letÃ¢â¬â¢s consider some of the major players who were involved in the air traffic controllersÃ¢â¬â¢ strike. First, there is the FAA. This is the federal agency that was established in 1958 to manage all civilian air flights in the United States. At the time of the strike, all air traffic controllers in the United States were trained, certified, and employed by the FAA (Spector, 1982, p. 1). In other words, the FAA had a literal stranglehold on the market for air traffic controllers in the United States. To work in the United States as an air traffic controller, thus, meant that one had to work with the FAA and abide by their prescriptions for how air traffic controllers should be employed. Second, we should consider PATCO, or the Professional Air Traffic Controllers Organization. This group was affiliated with the AFL-CIO and was created in 1968. It was, in short, a union of air traffic controllers. During the 1970s, in particular, PATCO grew at a tremendous rate (Spector, 1982, p. 2). By the time the potential strike rolled around, most of the air traffic controllers in the United States were members of PATCO. Third, we should consider the head of PATCO, the man who lead the organization down the more militant path towards strike and whose ultimate negotiations with the FAA would precipitate the strike in the first place. Robert Poll took the reins at PATCO in 1980, partially in response to attitudes within the organization that felt a more aggressive stance was needed towards the FAA on the part of unionized air traffic controllers (Spector, 1982, p. 2). In this context, we can see that Poll and PATCO were immediately at odds with the FAA, which as an organization naturally wanted to maintain its monopolistic control over the supply of air traffic controllers. The conflict between the two primary players in this strike-the FAA and PATCO-was only exasperated by certain pieces of federal legislation that prohibited federal employees from using strikes, sit-ins, or work slow downs to affect changes in their employment status. Legislation such as the Federal Relations Labor act prevented federal unionized employees to use their union status for anything other than collective bargaining (Spector, 1982, p. 2). This structural component of the issue further tied the figurative hands of PATCO and the air traffic controllers. It may even have precipitated a strike if the air traffic controllers felt cornered and desperate in their dealings with the FAA. If the air traffic controllers did not think there was any possibility of seeing their demands met-and how could they, if they were not permitted to use the threat of a strike? -then it is possible that they would have instigated the strike in desperation. There were a number of other issues that certainly led to a strike-style conflict between the FAA and PATCO. For example, of the 17,275 air traffic controllers employed in July 1981, all had to take part in a seventeen-week training course and then participate in on-the-job training for an additional two to four years. The FAA estimated that the total cost of training an air traffic controller amounted to $175,000 (Spector, 1982, p. 4). From the perspective of the FAA, labor negotiations were unlikely to result in higher pay rates or other forms of compensation. From the federal perspective, a significant amount of money had already been invested in these individuals; more was not a viable option. For the air traffic controllers, however, increased pay was the least of their concerns. As air traffic controllers knew all too well, the job of managing dozens of aircraft from the ground simultaneously was not easy. When PATCO went to the negotiation table with the FAA prior to the strike, they listed a number of concerns and problems that they wanted to see corrected. These included, but were not limited to, the following. One, PATCO was concerned about access. The FAA gave unfettered access to airports at any time, to anyone. The result was extremes of traffic during peak and off hours of the day or week. PATCO also cited poor supervision from individuals who were often paid more than the air traffic controllers to do nothing more than shift paperwork around. Safety responsibility was also a concern-given the demands of the job and the life-or-death nature of it, some air traffic controllers felt that there should be a better system of managing and accepting responsibility. Finally, the air traffic controllers were concerned about their pay scale, especially lost overtime hours according to federal mandate (Spector, 1982, p. 10-11). Salaries for air traffic controllers were reasonable for the period, however some federal regulations placed a cap on the amount that any individual could earn as a federal employee. Additionally, limitations were made regarding the amount of pay that could be awarded during any two week period, regardless of hours worked. This fact, combined with the extremely stressful nature of the job, upset many at PATCO (Spector, 1982, p. 4,6). The fact that the FAA rated as one of the poorest employers of air traffic controllers worldwide in terms of hours worked per week, vacation days, and sick leave only made matters worse (Spector, 1982, p. 5). Thus, when the FAA and PATCO went to the negotiation table in the days and weeks preceding the strike on August 3, there were a number of issues that had to be resolved between them. The air traffic controllers felt overworked, overstressed, and under appreciated in general. The FAA felt that it had the upper hand because the air traffic controllers were unable, by federal law, to go on strike. For this reason, the eventual strike-in hindsight-seems all but inevitable. In fact, the assumption that the FAA had the upper hand in the negotiations may have led directly to their counter offer which was much more conservative than the original PATCO demands. PATCO wanted an increase in salaries, a new maximum salary limit, a reduction in the work week, earlier retirement benefits, and cost of living adjustments to be made twice a year. The FAA negotiator, John Helms, estimated that this package would cost the government around $744 million the first year. He countered with a proposal that would only cost $40 million the first year, but which was a significantly watered down version of PATCO demands (Spector, 1982, p. 10). The union rejected this offer and went back to the negotiation table. When the second counter offer from the FAA was also not to their liking, they voted 95% in favor of going on strike (Spector, 1982, p. 11). The consequent strike on August 3, 1981 cost most of PATCO members their jobs and ended up costing the aviation industry, as well as associated industries such as tourism and hotels, millions of dollars in lost profits. Given these myriad environmental forces, symptoms and causes, and the inherent conflict between the FAA and PATCO, it is little wonder that a strike was the ultimate result between the negotiations between the FAA and PATCO. But what might have been done differently, what other solution might have worked in the past to alleviate the problems that occurred? For an answer I turn to Lane Kirkland of the AFL-CIO who said at the time, Ã¢â¬Å"The air traffic control system is a purely subsidized service the government is providing for the private airline industry. Under the Reagan doctrine of getting the government off peopleÃ¢â¬â¢s backs, youÃ¢â¬â¢d think they might try to turn the whole thing over to the industry to run instead of using the might and majesty of the government to suppress a strikeÃ¢â¬ (Spector, 1982, p. 4). In fact, this is exactly the solution that I would have suggested at the time and would advocate today as a solution to the mess that the FAA found itself in in 1981. If the FAA had been privatized, the concerns and issues that air traffic controllers were having could have been easily resolved between PATCO and the airline industry, in whose best interest it would have been to resolve the matter to keep planes in the air and profits in the black. Instead, the government used an ineffective law to force almost 12,000 people out of work who were simply trying to use the power of the strike to leverage themselves better working conditions. Especially when we consider the magnitude of the job that air traffic controllers did (and do) and the safety of countless lives that could have been at stake, it is even amazing that the government responded to the legitimate concerns of air traffic controllers in the way that it did. How to cite The Air Traffic Controllers Strike of 1981, Essay examples
Monday, May 4, 2020
Question: Discuss about the Lithium Clinical Considerations in Internal Medicine. Answer: Introduction Lithium is the third element of the periodic table which shares certain properties with elements such as sodium and potassium (1, 2, 14). Lithium is majorly used in the hospital for treatment of mental disorders specifically as the mood stabilizer in treatment and maintained of bipolar diseases (1, 2, 3, 4, 12, 14, 16). The effectiveness of therapy of bipolar disease was discovered in 1949. In addition, lithium has remained as a drug of choice in bipolar treatment as it is said to reduce the risk of suicide in such patients (4, 6, 9). Furthermore, lithium is used in the treatment of depression, schizophrenia, schizoaffective disorder and other mental illnesses (1, 2, 3, 6, 7, 8). This drug profile seeks to demonstrate the mechanism of action, side effects and toxicity, clinical uses, drug formulation, chemical structure, pharmacokinetics, requirements for therapeutic drug monitoring and consideration when using lithium in special population. Mechanism of Action The specific mechanism of action of lithium is not well known especially as a mood stabilizer (2, 4, 7, 9, 12,). Lithium can alter the sodium transport across the cell membranes of the nerves; it can also alter serotonin and catecholamine metabolism and intracellular signaling using the second messengers (9). Lithium can also reduce proteins kinase C activity which can affect genome expression associated with neurotransmission (12). Lithium may increase cytoprotective proteins activating a cascade of growth factors that might increase the gray matter and in that matter enhancing neurogenesis activation and trophic actions that usually maintains synapse (12). Mediated by monoamine neurotransmitters, lithium can change synaptic transmission and in that case increasing the time of the presynaptic destruction of catecholamines thus inhibiting transmitters release at the synapse and reducing postsynaptic receptor sensitivity (9, 12). Various studies have shown that lithium has a tendency of increasing the release of serotonins by brain neurons. By inhibiting 5-HT1A and 5HT1B receptors, lithium has demonstrated to enhance the release of serotonin to the synapse making it have an antidepressant effect (6). Lithium has also be seen to interact with Nitric Oxide which in turns signals the pathway in the neural system that plays a significant role in neural plasticity (12, 13). Through modulation of glutamate levels, lithium is also believed to provide long-term mood stabilization. This is due to its competing actions with magnesium towards glutamate receptors. During the manic episodes, there is a rise in dopamine transmission that when regulated using hemostasis can lead to depression (12, 16). The G-proteins receptors are typically responsible for postsynaptic actions of dopamine. In that case, lithium is believed to alter some G-proteins sub-units that are associated with dopamine as part of the mechanism of actio n (12). Adverse effects/ Toxicity The most common adverse effects of Lithium with occurs in more than ten percent of all treated patients include headaches, hyperreflexia which involve a patient having highly responsive reflexes, muscle weakness, increase in number of white blood cells, nausea, muscle twitching, increase thirst and urination , weight gain, vertigo, confusion, low memory, constipation, diarrhea, and hand tremors ( 1, 2, 8, 11, 15,). Other adverse effects occur between 1-10 % of patients treated with lithium which includes hypothyroidism, acne, hair loss, extrapyramidal side effects like muscle rigidity and parkinsonism and goiter (1 2, 3, 4 , 5 8, 9, 14, ). There are others side effects that are very rare and mostly occur below 1 % of all patients treated with lithium which include seizures, edema, renal toxicity, sinus node dysfunction, coma, Brugada syndrome which is a heart conduction abnormality, elevated levels of magnesium, calcium, thyroid and parathyroid hormones and rise in intracranial press ure (1, 3, 13, 15, ). Clinical Uses The primary and most common clinical uses of lithium are in bipolar disorders where it is used as a mood stabilizer( 1, 2, 3, 4, 5, ). Lithium is normally used in acute manic episodes, bipolar prophylaxis, and treatment of acute bipolar depression. In acute manic episodes, lithium can be used to stabilize the mood of patients without combining with other adjunctive treatments like the use of benzodiazepines or antipsychotics (13). In acute bipolar depression, Lithium can be utilized as a first line treatment as a mood stabilizer without even using antidepressants. Antidepressants are only combined with lithium when a fast effect is required ( 8). When acute episodes of bipolar disorders dissolve, lithium is continued as a prophylaxis drug of choice. In addition, Lithium can be used for the treatment of resistant depression as an augmentation of antidepressants ( 14). Other than that, lithium uses has demonstrated to reduce suicidal attempts in bipolar disease. Dosage and Available Formulation The usual form of Lithium medicine in tablet form which are in different milligrams. Some of the common milligrams include 300mg, 150mg, 450mg and 600mg. Lithium can also be in a vial of 5 milliliters which contains 300mg of lithium (4, 5,). The dosage of Lithium is prescribed according to the condition and the age of the patient. Adults or anybody above 12 years receive a full dose as compared to children below 12 years (4, 5). The usual adult dose for patients suffering from acute mania is 1800mg per day with regular doses of 600mg orally divided into three times a day and an extended dose of 900mg orally twice a day. The long-term control of mania includes a maintenance dose of 900mg per day and a conventional formulation of 300mg orally four times a day( 4, 5) . The usual treatments for adulthood in bipolar disease are similar to that of acute mania. However, dosing must be given in accordance to response to treatment and lithium serum levels (5). In addition, there is an alternative treatment dose in the extended formulation of 600mg four times a day for long-term control (5). The dosage for pediatrics over 12 years is also similar to that of an adult ( 4). The only difference is on alternative extended formulation where the dosage is reduced to 300mg four times a day in long-term control (5). In severe renal impaired patients, only the extended release formulations can be given. It is important to avoid lithium in pregnancy where possible (5). Chemical Structures Related to Pharmacokinetic Parameters Li+ b) Li2CO3 Above a) is the chemical structure of Lithium which commonly occurs as Lithium carbonate with a chemical structure shown at b) (6) Lithium ion is absorbed completely in the gastrointestinal tract. The complete absorption takes place in about first 8 hours where the peak concentration in the serum starts at about 2 to 4 hours on an oral dose (7). Due to slow release preparations of lithium carbonate, there is a much slower rate of absorption which readily decreases the early plasma serum peak. Lithium ions are first distributed to extracellular fluids before it enters into the tissues (7). Other structures of lithium salts that can be used as drugs include Lithium lactate and lithium salicylate as shown in the below figures respectively (7). Lithium Lactate and Lithium salicylate The lithium lactate when absorbed in the gastrointestinal tract reach in the plasma levels at 2 hours but the peak is usually at 24 hours, and it is later eliminated rapidly (8). Lithium salicylate, on the other hand, reaches the peak by 48 hours and it is eliminated slowly(8). A study was done by Smith et al. showed that lithium carbonate normally has a larger bioavailability as compared to the high other Lithium salts( 8). Interesting pharmacokinetic parameters and clinical implications In slow and controlled release forms of lithium, the serum pick period after absorption in the gastrointestinal tract is about 4 to 5 hours(13,15). However, Lithium is rapidly absorbed in regular preparation with serum levels peaking at around 2 hours. Since the drug is not metabolized in the liver, it is not highly affected by the first past effect in the alimentary canal (14). Different from other antipsychotic agents, Lithium has no metabolites or clinically crucial binding properties to proteins (9). The renal clearance of the drug is about 20% of the creatinine clearance since most of the Lithium is reabsorbed in proximal convoluted tubules. Lithium is almost entirely excreted by the kidney but there some small traces excreted through feces and sweat(2,3,). The elimination half-life of lithium is about 24 hours. The half-life in elderly patients is a bit longer due to a decrease infiltration rate at Bowmans capsule and shorter in youths (3). The drug has no protein bound charact eristic, and around 80% is reabsorbed in proximal convoluted tubules( 1). The levels of Lithium in serum usually increase when the sodium levels decrease in serum which is accelerated during dehydration(1,3). Requirement for Therapeutic Drug Monitoring (TDM) A report was written by Ratanajamit et al. in 2008 indicated there was appropriateness for therapeutic drug monitoring of lithium between 2004 and 2005 lithium treatment of psychotic disorders (3). The study showed that of all the participants 41.8 % had suspected toxicity, there were about 27% who required various tests without specific indications, serum lithium levels were reported in 91. 2% of all patients who had not taken lithium drug for about five days during the treatment period(3). In addition, 44. 6% of these required dosage alterations (3). Before giving the Lithium treatment, certain parameters such complete blood count, electrocardiograph, baseline creatinine levels and thyroxin stimulating hormones should be checked. Lithium used if the first term of pregnancy has been associated with Ebstein anomaly where 1 out of 1000 is affected and therefore should be monitored during pregnancy(1, 14). The patients under treatment using lithium should receive regular serum levels test, kidney function test, and thyroid hormones levels as they interfere with water and sodium regulations in the body(9,16). This is the major and underlying cause of dehydration in patients under lithium treatment. The dehydration in the body normally increases the lithium levels(8). This dehydration is primarily brought by inhibition of antidiuretic hormone by increase in lithium levels thus inhibiting water reuptake in the kidney(11,13). This in turn led to the loss of water exhibited by thirst. The monitoring of lithium can be performed by measurin g lithium concentration in serum, blood, and urine and use the results as a guide to therapy. The standard serum concentration of Lithium is usually between 0.5 to 1.4 mmol/l (4). When it accumulates over a certain duration of time, mostly after five days, the level increases up to between 1.8 to 2.5mmol/l. During an overdose, the levels can go up to 3 to 10 mmol/l (4). At this time, the dosage required should be adjusted, and the patient monitored in facilities where plasma ratio can be easily be seen (5). Dosages are adjusted to achieve the normal values which are usually to lower in aged patients and to increase in young patients (5). Factors that indicate that lithium is in accordance with the correct therapy and normal values include the absence of adverse effects, no psychosis, and classic mania (16). Consideration of Lithium in Special Population In renal dose adjustments, mild and moderate renal problems do not need any adjustments to the dosage. However, severe renal problems require only the extended release formulation where small doses are started slowly with close monitoring of toxicity (4, 5). The immediate release formulations are contraindicated in severe renal dysfunction. The serum levels should be checked prior to the next dose (4). This is commonly done between 10 to 12 hours from the previous dose. The acute episodes of increase in lithium levels are determined, and dose changed after three days. The long term dose adjustment can be changed after two months (5). Caution should be taken and doses adjusted in patients suffering from cardiovascular disorders (4,5). Lithium should be avoided in pregnancy as it causes cardiovascular problems, especially in the first trimester (1). In infants, lithium should be avoided as it causes drowsiness, cardiac and other permanent side effects to a child(2). Weight gain is a ma jor adverse effect of lithium since it has some metabolic effects on carbohydrates (2, 9). In that case, caution should be taken in obese patients as lithium will normally increase weight. Extended releasing formulations should be used (13) References Lithium: Clinical Considerations in Internal Medicine . Available from: https://www.sciencedirect.com/science/article/pii/S0002934305010582 Oruch R e. Lithium: a review of pharmacology, clinical uses, and toxicity. 2015. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24991789 Ratanajamit C e. Appropriateness of therapeutic drug monitoring for lithium. 2013. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17205880 Lithium: Drug Uses, Dosage and Side Effects , 2017. Available from: https://www.drugs.com/lithium.html Lithium Dosage Guide with Precautio, 2017. Available from: https://www.drugs.com/dosage/lithium.html LITHIUM AMIDE | H2LiN . 2017. Available from: https://pubchem.ncbi.nlm.nih.gov/compound/lithium_amide#section=Chemical-Vendors Lithium DrugBank 2017 [Internet]. Available from: https://www.drugbank.ca/drugs/DB01356 Smith A, Kim S, Tan J, Sneed K, Sanberg P, Borlongan C et al. Plasma and brain pharmacokinetics of previously unexplored lithium salts. 2015. Ayano G. Bipolar Disorders and Valproate: Pharmacokinetics,Pharmacodynamics, Therapeutic Effects and Indications of Valproate: Review of Articles. Bipolar Disorder: Open Access. 2016;02(02). Gitlin M. Lithium side effects and toxicity: prevalence and management strategies. International Journal of Bipolar Disorders. 2016;4(1). New Data on the Effects of Lithium Beyond Mood Stabilization. Bipolar Disorders. 2016;18:33-33. Herv D. Inhibition by lithium of glycogen synthase kinase-3 (GSK-3): Possible mechanism of therapeutic action of lithium. European Psychiatry. 2014;29(8):669-670. Lum G. Lithium Self-Intoxication Treated with Hemodialysis. Laboratory Medicine. 2007;38(11):667-668. Toker L, Belmaker R, Agam G. Gene-expression studies in understanding the mechanism of action of lithium. Expert Review of Neurotherapeutics. 2012;12(1):93-97. Oruch R, Elderbi M, Khattab H, Pryme I, Lund A. Lithium: A review of pharmacology, clinical uses, and toxicity. European Journal of Pharmacology. 2014;740:464-473. Hu Q. Lithium: The Literature Regarding Its Uses in Chemistry, Psychiatry, and the Engineering of Materials and Batteries. Science Technology Libraries. 2012;31(2):190-199.
Sunday, March 29, 2020
Saturday, March 7, 2020
Things Fall Apart Okonkwo, for all his strength, possesses many weakness, which slowly led him down the road of grief and pain; and ultimately to suicide. This main character in Chinua AchebesÃ¢â¬â¢ novel, Things Fall Apart, lives his life on a stage. He lives for the respect and approval of others, which is his first fault. Secondly, he lives trying to make up for his Fathers failures by becoming as successful as he can. Thirdly, he is rash and impulsive. His faults lead him to a life of unhappiness. His fear of failure and appearing weak, in time, make him weak. His weaknesses and most of all his impulsive personality drive him to suicide. OkonkwoÃ¢â¬â¢s own nature becomes responsible for his death. OkonkwoÃ¢â¬â¢s world consists of nine villages. To him, there is nothing beyond this nine-village realm. Each one of these villages posses their own beliefs, practices, standards, and form of government. One of the standards set for men in OkonkwoÃ¢â¬â¢s village is to be manly and command as much respect as possible. Okonkwo succeeds in this pursuit and thus receives the respect he so desperately desires. As read on the first page of the novel, Ã¢â¬Å"Okonkwo was well known throughout the villages and even beyond. His fame rested on solid personal achievements.Ã¢â¬ (Pg. 1) The achievement of most importance was beating a wrestler, who for seven years, had never been put on his back. More achievements come as Okonkwo continues in his quest for the approval and admiration of others. This shallow pursuit makes Okonkwo impatient of those who are not Ã¢â¬Å"as greatÃ¢â¬ as he. For example, in a meeting of the tribeÃ¢â¬â¢s elders, Okonkwo calls a man womanly and states that; Ã¢â¬Å" this is a meeting for men.Ã¢â¬ Okonkwo did this for a few reasons. He did it because he knew that he was of status also the man he insulted did not posses any titles and thus Okonkwo felt as if he were better than this man, and therefore had the right to insult him. The reader sees how O... Free Essays on When Things Fall Apart Free Essays on When Things Fall Apart Things Fall Apart Okonkwo, for all his strength, possesses many weakness, which slowly led him down the road of grief and pain; and ultimately to suicide. This main character in Chinua AchebesÃ¢â¬â¢ novel, Things Fall Apart, lives his life on a stage. He lives for the respect and approval of others, which is his first fault. Secondly, he lives trying to make up for his Fathers failures by becoming as successful as he can. Thirdly, he is rash and impulsive. His faults lead him to a life of unhappiness. His fear of failure and appearing weak, in time, make him weak. His weaknesses and most of all his impulsive personality drive him to suicide. OkonkwoÃ¢â¬â¢s own nature becomes responsible for his death. OkonkwoÃ¢â¬â¢s world consists of nine villages. To him, there is nothing beyond this nine-village realm. Each one of these villages posses their own beliefs, practices, standards, and form of government. One of the standards set for men in OkonkwoÃ¢â¬â¢s village is to be manly and command as much respect as possible. Okonkwo succeeds in this pursuit and thus receives the respect he so desperately desires. As read on the first page of the novel, Ã¢â¬Å"Okonkwo was well known throughout the villages and even beyond. His fame rested on solid personal achievements.Ã¢â¬ (Pg. 1) The achievement of most importance was beating a wrestler, who for seven years, had never been put on his back. More achievements come as Okonkwo continues in his quest for the approval and admiration of others. This shallow pursuit makes Okonkwo impatient of those who are not Ã¢â¬Å"as greatÃ¢â¬ as he. For example, in a meeting of the tribeÃ¢â¬â¢s elders, Okonkwo calls a man womanly and states that; Ã¢â¬Å" this is a meeting for men.Ã¢â¬ Okonkwo did this for a few reasons. He did it because he knew that he was of status also the man he insulted did not posses any titles and thus Okonkwo felt as if he were better than this man, and therefore had the right to insult him. The reader sees how O...
Thursday, February 20, 2020
Viking - Essay Example Simpson (1967, p11) propounds, "In medieval Scandinavian languages, a vikingr is a pirate, a freebooter who seeks wealth either by ship-borne raids on foreign coasts or by waylaying more peaceful seafarers in home waters. There is also an abstract noun viking, meaning 'the act of going raiding overseas'". This definition hints to the historic approach of delineating the term Viking by referring to them as the looters and raiders of the lands of Scandinavia. It takes one to an era in history when Europe was under constant attack of these raiders often referred to as Vikings. These people were pirates by nature and looted the wealth of most of the British coastal lands including England, Scotland, Ireland and Netherlands etc. However, this approach does not identify all of the people from Scandinavia as the Viking, rather it points to certain activities as raiding, pirating and plundering to identify them. Hence, a Viking according to this definition is a person engaged in brutal attac ks at the foreign lands by the seaways in the quest of wealth contained in those areas. Gibson (1987, pp11-15) also relates to the word 'Viking' as those pirates who were born to fight, made to break and fostered for bloodshed. Hence he refers to the era when a great part of Europe was under the raid of the Vikings coming mainly from Norway, Sweden and Denmark. He says, "The Vikings are a mighty nation with huge bodies and great courage. They do not know the meaning of the word defeat, they never turn their backs on their enemies, but slay or are slain". This definition is a bit closer to the one presented at first and only different in the sense that it ties the term not with individuals but with a nation or a race of people with regard to the historical event during 750 and 1066 C.E. Gibson (1987) signifies the term Viking with those sturdy people of Scandinavia who were fearless and stood bravely in the face of war and death. They considered warfare as a symbol of courageousness and even associated these feats with their religious faiths. The connection between these two definitions is that both relate to history and illuminate the term in its specific context. The same people and the same individuals indulged in raiding Europe in retrospective. Whatever might be their objectives, circumstances and consequences; they were driven by the availability of wealth in specific areas of Europe leading them to brutal invasions. After having learnt the basic definition of the word Viking or assessing the idea encompassed with its usage, one also comes across some contradictory views on its illustration. Goldsmith (2004) illuminates that the word 'Viking' is misunderstood many times owing to the history that encompasses the word. She says that some might associate the term with violence, brutality and savagery, while in the linguistic sense it means simply a 'merchant or a warrior'. Therefore, the term 'Viking' simply means someone who travels or an alien. In other words, she attempts to state that the word does not necessarily indicate someone brutal or vicious. It simply signifies that if the term 'Viking' is to be taken in pure linguistic form, irrespective of the history associated, it plainly refers to a traveller rather than a brutal tribesman or a raider of North. Conclusion All the above-mentioned definitions and approaches concerning the term Viking, apart from its linguistic sense, refer to the tribesmen of North who were mainly