Sunday, August 9, 2020

The Life Rationing Problem

The Life Rationing Problem Introduction: Keeping up with political news this month has, paradoxically, become a rather depressing pastime of mine. Sometimes, its fun to vanish into a world somewhat tangential to reality, somewhat well-defined, somewhat abstract, and entirely distracting. This is a more fleshed out version of a powerpoint literary presentation I gave at Alpha Delta Phi a while ago. So without further ado (keeping in mind that this is all very theoretical and somewhat subjective), lets dive in, shall we? We will examine scenarios in which some life must be lost, (a more specific case of the general rationing problem in which some people must lose out on what is being rationed) and will argue for how to resolve the life allocation problem ethically. In particular, we will argue that there is likely no rigorous moral principle that completely solves the problem, but that we can strongly depend on the moral measure of intuition to arrive at a solution. Careful Formulation To begin, we will attempt to find a moral principle that solves the problem. If such a principle exists, it should be able to account for differing intuitions in variants of the life-rationing problem. Suppose we simplistically define the problem as, “Given two scenarios, either of which will result in loss of life, what scenario is the more moral option to choose?” The problem is not very interesting, prima facie, if each scenario results in equalâ€"say 1â€"loss of life. Without further facts, we will be unable to make a meaningful decision. Is this true if we extend the situation to an unequal loss of lives depending on the scenario? Our intuition will be to simply pick the scenario that saves the greatest number of lives, a utilitarian approach at heart, but we will show this is not so straightforward by formulating two variants of the problem: The Organ Variant: Five people need organs or they will die. A doctor decides to grab a healthy patient who shows up for a checkup. He takes the patient’s organs and saves the five with them. The Scarce Medicine Variant: Five sick people each need a small dose of medicine or they will die. One other sick person needs a large dose of this medicine or will die as well. The doctor chooses to give the five the small doses rather than the one the large dose. We intuitively find the organ variant morally impermissible, and the scarce medicine variant morally permissible, despite their equal life-saving outcome. Thus our original moral intuition that we simply pick the case that saves more peopleâ€"call this the maximum principleâ€" requires refining. Saving the moral good The first important thing about the maximum principle is that it operates independently of the specifics of the scenarios, and thus doesn’t care enough about certain properties. What might it care more about, to be more effective? To see this, let’s consider the original uninteresting case where either scenario results in loss of precisely one life. The maximum principle will be unable to choose one over the other in this case. In particular, choosing one life over another will require a concept of deservednessâ€"one person deserving to live over the otherâ€"that the maximum principle doesn’t account for. Ethically, the only way the principle might possess a principle of deservedness were if it could give one person greater weight over the other. It seems plausible that such a weight would have to be a moral one. If one scenario involved saving a hardened murderer, the other a humanitarian, then the case seems clearer. Thus, for the maximum principle to be effective in cases of equality, we might refine it to the maximum goodness principle, which calls for the scenario that saves the maximum number of morally good people. In the humanitarian versus murderer situation, the result of this principle is certainly intuitively pleasing. It is also pleasing in the scarce medicine variant. In particular, we will have to assume a sort of equal morality among all people involved, in the absence of any other information, and thus saving the five instead of the one, saves five morally good people as opposed to one morally good person, which satisfies the maximum goodness principle. If however, these five were hardened murderers, and the one was a humanitarian, it doesn’t seem morally repugnant to save the one over the five. There are however three problems with this principle. Firstly, it requires that we have an independent system of morality, wherein moral goodness and badness can be defined and assigned. I claim this is necessary howeverâ€"in particular, if we are to prefer saving a person over another in a morally-directed life-rationing problem, a relevant weighting to consider seems to be their individual moralities. The problem of course is that we assume positive morality is an inherently good thing, but there is no truly universal system for gauging which actions are morally positive, and thus which kind of people are morally positive. To not be bogged down by this, we will have to grant the existence of some morally sound system, X, which simultaenously enforces and black-boxes (i.e. hides the internal workings of) moral weightings. Secondly, there is a convincing argument that can be made for the concept of moral luck, wherein a person’s moral rightness or wrongness might be entirely out of their handsâ€"perhaps a result of genetics or a terrible upbringing, and thus scenarios which necessarily work against them, such as the maximum goodness principle, form a system of double injusticeâ€"punishing a person even more for an already bad situation they are unable to control. However, there are two alternatives: choosing the morally positive person to die, which forces the same problem of punishing a person for a situation they are unable to control, and choosing randomly, which might be possible, but turns a blind eye to the significance of positive morality over negative morality. In particular, the existence of moral luck does not mitigate the expected negative consequences associated with a morally repugnant person, and it seems plausible to save the morally positive person, simply because of the value placed on moral positivity, a value that should be independent of moral luck. Finally, and crucially, the maximum goodness principle does not account for the organ variant. In particular, it would require that we kill the one healthy patient to save the five, if prima facie, we assume equal morality among everyone. But this is intuitively unappealing. Even more problematically, supposing the one patient whose organs we choose to harvest was to some slight degree more morally repugnant than the other five patients, we still find it intuitively problematic to kill him and take his organs. This suggests that the maximum goodness principle must be further refined. A similar scenario To make any potential moral principles we come up with even more appealing, we will bring up a third and popular variant of the life-rationing problem: The Train/Trolley Variant: Five people are bound to a rail, and an incoming train approaches. You stand nearby, and hold a switch which if pulled, directs the train to a different rail, which happens to have one person on it. You pull the switch anyway, saving five to kill the one. This seems morally permissible, and is in line with the result of the maximum goodness principle. However, note the similarity of the train variant with the organ variant. In both instances, ?Five people are in danger of death on the one hand. ?On the other hand, one person is not strictly in danger of death. ?If you do nothing, this one person survives. ?If you perform an action (*), you save the five. What makes the difference then is this action (*), despite these glaring similarities. In one case, you pull a switch. In the other, you harvest the organs. Thus, whatever moral principle may account for these intuitionsâ€"and whatever refinement our maximum goodness principle makesâ€"must be dependent solely on some property of these actions. What could this property be? Three candidates come to mind. 1)There is a moral distinction between killing a person (by collecting their organs) and letting them die (by pulling the switch). 2)Killing the patient involves introducing a new threat to him, whereas pulling the switch only redirects an existing threat. 3)Killing the patient involves a severity of action that affects our sensibilities. Pulling a switch is less macabre. We account for each of these theories in turn. The one person bound to the other rail in the train variant could plausibly attack (1) by insisting that pulling the switch is necessarily a killing action. They can plausibly insist that pulling the switch can’t quite be thought to be letting die, because they don’t die if you don’t pull the switch, and it is your action that is strictly responsible for their deathâ€"a marked distinction from, say, letting a “Do Not Resuscitate” patient die by doing nothingâ€"in which your inaction allows their death. This insistent life-frightened person could similarly attack (2) by analogous argument: that there is no threat to their lives, and that you knowingly introduce this threat by pulling the switch, and directing the train toward them. In the absence of the pulled switch, there is a complete absence of threats. As for (3), one would have to examine exactly what the grimness or macabre nature of the death has to say about the morality of the cause of death. In particular, if we say that the doctor who kills his patient has done something so reprehensible, we are in effect saying one of two things: a) that the manner by which he killed his patient is reprehensible or b) that the very act of killing his patient is reprehensible. Of course, we are trying to figure out what about killing the patient is so intuitively disturbing, and thus b) makes our argument circular, by claiming that killing the patient is what makes killing the patient reprehensible. On the other hand, a) redirects our question elsewhere, as we are concerned with the very nature of the killing, rather than the mechanics of the act itself. To see this, observe that if we know that pulling the switch will cause the train to have a greater impact on the one person it hitsâ€"inflicting a bloody and painful death worse than would be felt by the patient whose organ is harvestedâ€"it doesn’t change the result of our intuition that we should pull the switch (supposing not pulling still kills the five). Thus, the severity of death is independent of the problem we are trying to solve. We have thus considered three rather plausible theories, but none of them have failed to account for the three variants of the life-rationing problem, which would make us seem closer to the thesis statement of this blogpost. I claim we should not give up quite so easily. In particular, we will now proceed by supposing that there is indeed some unknown refinement we can make to the maximum goodness principle that can account for all three variants. We already established that such a refinement must depend on some property of the action performed, and thus we have a new principle, the modified principle: “the scenario to choose is the one that maximizes the moral goodness saved, subject to some constraint Y.” The modified principle can account for all three variants: the maximum goodness portion of it can account for our intuitions in the train and scarce medicine variant, whereas the “constraint Y” portion of it can account for why we don’t harvest the organs of an innocent personâ€"because such an action disobeys the Y constraint. This is, for now at least, the best we can do, supposing we can find Y. However, we could at this point spend our effort producing a counterexample to the modified principle, despite the vagueness of Y. How can we accomplish such a task? Well, observe that the modified principle does make a statement: it places a constraint on a specific actionâ€"harvesting the organs of a healthy patient against their will to save othersâ€"and thus, it suffices to come up with a hypothetical situation in which this seemingly awful action is certainly permissible. Three attempts We could be heinously unfair, and say: “How about if you had to choose between forcibly harvesting the organs of five people, versus harvesting the organs of one?” In this case, the prima facie morally plausible action to take is to forcibly harvest the organs of one person, but when either choice forces the Y-violating action, we are being deliberately obtuse. Thus, we must model a situation in which one action to take is the organ harvesting one, but the other option to take preserves the vagueness of Y, and is not necessarily in violation of it, and yet the better action to take would violate Y. This second attempt could go along the lines of: “Suppose you had a town of 1,000 people, all of whom have mistakenly ingested some deadly poison. Suppose a tourist mistakenly swallowed the only cure, thinking it were a piece of fruit. However, this cure can be extracted if this tourist was killed, and the liquids of his organs secreted.” To save 1,000, it definitely seems plausible to kill the tourist and take his organs, which violates the constraint placed by the modified principle. However, you could have the following reasonable objection: that the modified principle could theoretically strike a tradeoff between the amount of moral goodness preserved, and the strictness of the Y constraint, and thus in extremes like this, the amount of moral goodness to be preserved by killing the tourist is of such high value that the Y constraint can safely fail in this case, without breaking the modified principle. This certainly holds weight, as if we reduced 1,000 people to just two people, it is not clear that killing the tourist should be permissible. Put differently, we have cheaply taken advantage of the sort of extremism that can make reasonable philosophical arguments crumble. For instance, a reasonable-sounding principle like “Killing a baby is morally wrong” can be made to sound implausible by invoking extremes such as “What if the baby would end up as Hitler, or worse”. Hence, if our modified principle can be allowed to account for extremes, we need a hyp othetical example in which the scenarios don’t push the principle to its extremity and force the Y constraint to fail. I try to do this with a third attempt at a reasonable hypothetical situation that invalidates the modified principle. To construct one, I will attempt to take advantage of the similarities between the train variant and the organ variant. The modification will certainly sound (and be) absurd, but it suffices. Suppose as usual that the train were coming at high speed toward five rail- bound people. Suppose however that instead of a switch, I have a button, which when pushed, transports a random person in the world, say Eric, toward me, rips out his organs, and flings these organs toward the train in such a way that the train derails and crashes, killing no one. Eric of course dies. It is not clear to me that the pushing the button is morally impermissible, but doing so would violate the modified principle on basis of the Y constraint. If you find this logic fishy, then perhaps you are inclined to think that pushing the button is impermissible, which preserves the Y constraint (since then, you are not harvesting the organs of some innocent fellow), and keeps the modified principle intact. However, this case seems too closely similar to the train variant, whose intuition suggested that pulling the switch (and analogously, pushing the button) was the right call to make. It thus seems that there is no clear moral principle to account for all three variants, and more generally, the life-rationing problem, but I think we can come up with a theory, not strictly moral, that can account for all three of them. This is in fact a theory we have actually assumed accounted for all three of them so far, one we have based our search for a satisfactory moral principle on: the perceptiveness of our intuition. Intuition and self-preservation Thus far, we relied on the fact that our intuitions reacted positively to the train and scarce medicine variants, and negatively to the organ variant to guide our search for moral principles. Does this suggest that we can somehow rely on it even further for a more definitive explanation? The most crucial problem with such an attempt however, is the problem of self- preservation, in which the results of our intuition when self-preservation is a factor are at odds with the results when it isn’t a factor, all other things being equal. For instance, logic dictates that any principle which accounts for choosing 5 over 1 in the scarce medicine variant, prima facie, should operate independently of their identity (and moreso be directed by their characteristics). In particular, if we gave them the same general features, then the choice to make might have to be, in part at least, a game of numbers, which the maximum goodness (and modified) principle harken to. Our intuition supports this…until we are the ones at risk. Suppose in the scarce medicine variant, you were the one person who had to receive the large dose while five others died. The intuitive reaction to such a problem would be to preserve yourself, to want the large dose regardless of the five. Even if you’re hard-pressed to believe you would make such a selfishâ€"but perhaps not irrationalâ€"choice, there are statistics that shed illuminating light on this. For instance, a Time psychology article reported on results of a survey of 147 people asked about a slight variation of the train problem. 90% of them responded intuitively that they would pull the switch, but only about one-third of them would pull if the one person on the rail was someone loved (an extension of self-preservation). This suggests that any accounting principle should be developed independently of intuition, but this is to ignore the role intuition played in directing our search for such principles, as well as the role intuition plays in even more general moral principles. A simple example, which might at first seem counterintuitive, is to suppose that an alien colony exactly like Earth has to either destroy Earth, or be destroyed by Earth. Despite the self-preservation component of intuition, I don’t think we would deem it intuitively clear that the moral option to take is to destroy the colony (although this might certainly be the case). Even more concretely, if you were newly added to the waiting list for an organ you desperately need, and were bumped 100 spots ahead, jumping over others who had been waiting for years on the sole basis that whoever calls the shots is romantically interested in you, it is intuitive that the moral option to take is to reject such a move, even at the detriment o f self-preservation. Thus, intuition is not a strictly moral dictator as, with the organ variant case, it can push toward you taking the large dose, but it isn’t morally blind either, and seems to be a driving force for a lot of our moral principles. Earlier, I mentioned a moral system X that might be necessary in determining the relative moral weights of people in either scenario of a life-rationing problem. It seems that were we tasked to develop such a system, we would rely very strongly on the measure of our intuition. To then summarize, a careful and diligent search for a moral principle that accounts for the three variants of the life-rationing problem failed to yield such a principle. It is quite likely that there are things we overlooked, more corners to be excavated, more arguments to be strengthened. On the other hand, it seems that we do not strictly require this moral principle to exist. Our intuition seems to possess some degree of moral aptitude, and in so far as moral principles exist to direct moral actions, such as what decision to make in a life-rationing problem, then thoughtful reliance on this intuition could be a very rational way to go. ** An Elegant Response Finally, to close off, I would like to present the most elegant solution to the train variant Ive ever seen:

Saturday, May 23, 2020

Effects of Media on Body Image - 855 Words

Effects of Media on Body Image Discussion This study was conducted to analyze the impact of media, mainly fashion magazines, on how women perceived the idealized body weight and shape as well as the impact of media on the decision to diet or initiate an exercise program. Twenty working class women were given questionnaires at different times. The exposure to fashion magazines was assessed by determining whether the participant was a high level frequency viewer of fashion magazines, viewing them once per week up to daily, or a low level frequency viewer, from never viewing them to viewing only once per month. The impact of media on feelings about weight and shape were assessed. The results were also assessed on whether participants agreed that going on a diet or initiating an exercise program was due to the impact of pictures and articles from the fashion magazines. Pie charts and graphs were done to assess the associations between levels of frequency of the media and losing weight influenced by the media. The participants were asked to assess body type by categories of thin, athletic, normal, and overweight. The outcomes were measured against the prediction that fashion magazines would have a major influence on womens body dissatisfaction, idea of perfect body shape, dieting to lose weight, and encouraging an exercise program. The results showed that fashion magazines articles and pictures had a strong influence on the perceptions of weight and body shape andShow MoreRelatedThe Effects Of Media On Body Image1484 Words   |  6 Pages Media has developed to become omnipresent in the day to day lives of the westernized societies. The media is considered a gigantic umbrella that houses a plethora of different outlets underneath it such as television, music videos, magazines, commercials, video games and social media. In this paper, the effects of media and various media types are examined to understand their potential outcomes. Focusing on how and if media affects body image in girls and women, the themes of dieting awarenessRead MoreMedia Effects Body Image1656 Words   |  7 PagesKoenig April 6, 2014 The Effects of Mass Media on African American Women Body Images Over the past 10 years, mass media and the access to social networks has evolved substantially causing the effects of negative self-image and what is considered beautiful. Body image expectations for both African-American male and female share the battles of society’s expectations, yet African American women body images come with a stricter and more unhealthy stigma; growth of social media such as Facebook, InstagramRead MoreMedia Effects On Body Image Essay1648 Words   |  7 PagesSpecific age groups and mostly women have been studied regarding media effects on body image. These studies did not test the external stimuli created by peer groups that have an impact on a person’s self-idealization. This study addressed individual age groups divided by gender in order to determine how much media effects body idealization and if gender peer group opinions impact self-idealization when viewing media models. Methods The methods used in this study incorporated individuals into groupsRead MoreThe Effects Of Media On Body Image1424 Words   |  6 PagesMedia holds such high standards in today s society, and media as a whole has gotten so much power throughout the years. There are so many different forms of media in today s world: newspapers, magazines, televisions, the hundreds of websites on the Internet, social media applications, computers, and novels. Media advertises thousands of different things, but something that has stayed consistent over the years is advertisement on body image. Media advertises a specific body type, pushes differentRead MoreThe Effects Of Media On Body Image1453 Words   |  6 Pagestoday that media and body image are closely related. Particularly, how the body image advertising portrays effects our own body image. It has been documented in adolescents as they are more at risk for developing unhealthy attitudes toward their bodies. They are at a time where they re focu sed on developing their individual identities, making them susceptible to social pressure and media images. A major reason many people have a negative body image is because of the impact that media has had onRead MoreEffects Of Media On Body Image1544 Words   |  7 Pages Bayer, A.M, Body image is the internal representation of one’s outer appearance which reflects physical and perpetual dimensions. For the purpose of this paper, body image can be defined as a person s perception, thoughts and feeling about her body, this can be altered by significantly altered by social experiences. This paper explores my personal experience and findings of empirical studies that examine the effects of media on body image in young women. Internalization of body ideals that areRead MoreThe Effects of Media on Body Image and Body Dissatisfaction.3566 Words   |  15 Pagesadverts in relation to body image in the media than realistic. Also, whether or not there were a higher number of unrea listic adverts in female media in relation to body image than in male media. This was carried out by looking at a number of adverts in different male and female health magazines and scoring the amount of unrealistic or realistic adverts found. The results found that there was no significant difference between the amounts of unrealistic/ realistic adverts on body image in the female magazinesRead MoreEssay on Media Effects on Body Image617 Words   |  3 PagesWith the tremendous effect the media has on men womens body image/self-esteem, there are things the media and those being effected can do to limit the impact. The media can change the portrayal of models in magazines, television, billboards, etc. By portraying unrealistic models, studies can conclude that it causes a negative effect on men and women leading to eating disorders, self-esteem problems, and possibly even sometimes more dramatic actions such as suicide (Groesz, Levine, and MurnenRead MoreMedia s Effect On The Bo dy Image902 Words   |  4 Pagesalready confined with how the media set unrealistic standards for the female population. This leads girls to harm their own body, including eating disorders such as bulimia, and anorexia. The most prominent cause of these acts is advertisements. Advertisements are everywhere and they have the power to promote, sell, encourage, and give unrealistic ideals of the common people. Advertisements and media images have a negative effect on the way women view their body image which leads to self-harm. EveryRead MoreThe Effect Of Media On Womens Body Image1247 Words   |  5 Pagesresearch on how the role of media affects how women perceive body image. I was interested in knowing the ways in which the media influenced the ways in which they perceive themselves and their beauty. In order to perform my research, I conducted surveys of female students ranging from ages 18-28, carried out experimental research on them to test whether they feel worse about their bodies after being exposed to thin media models than after being exposed to other types of images as well as conducting secondary

Tuesday, May 12, 2020

Social And Economic Policy Decisions Impact Income Equality

Social and economic policy decisions impact income equality, which has an effect on the health of Canadians. Those with lower incomes are directly affected while income inequality affects the health of all Canadians through weakening of social structure (Raphael, 2002). Contrary to reports of rising net worth, a new report has been released by an Ottawa-based think tank to show Canada’s inequality problem. The top 10 percent of Canadians have seen their net worth grow by 42% since 2005 to 2.1 million in 2012. However, the bottom 10 percent saw their net worth shrink by 150 percent (Flavelle, 2014). With this new report, it challenges the idea that suggests Canadians are getting wealthier laterally (Flavelle, 2014). This paper will examine†¦show more content†¦For example, the reduction of deaths from infectious diseases such as influenza, diphtheria and typhoid were due to improvements in general living conditions rather than medical cures (Raphael, 2002) It is hypot hesized that lifestyle differences are the reasons for the incidence of stroke, heart disease and cancer. Health and Poverty Vulnerable populations including immigrants, Aboriginal peoples, single parent families and the elderly make up a growing percentage of the lower extreme of the socioeconomic scale (Turnbull, J. Podymow T, 2002). While we are quick to consider the costs of aiding the poor, we rarely consider the costs that poverty and income inequality inflict on our society. To achieve improved health, it is critical to improve income security through good jobs, income supports and fairer taxes (Barnes et al., 2013). There are two broad strategies that focus on alleviating the effects of poverty on health: 1) directly reducing poverty and socio-economic inequality 2) intervening in pathways connecting poverty and health. These interventions have been identified as upstream and downstream. Downstream policies refer to those that have an explicit health purpose and tend to be targeted at those that are already suffering from increased health risk, while upstream refers to the wider influences on health inequalities such as income distribution, education and housing. While these approaches fall

Wednesday, May 6, 2020

Abstracts 4 Articles Decision Making Free Essays

string(29) " lack of a proper education\." Reading 1. 3 Jackall, R. (1988) Theories of decision-making process deliver to managers many essential tools such as risk and cost/benefits analysis, etc. We will write a custom essay sample on Abstracts 4 Articles Decision Making or any similar topic only for you Order Now which in tern routinizes administration. These tools cannot be used appropriately to manage of incalculable entities. The functional rationality approach is when activities precisely planned and estimated to reach some goal. This method is unlikely to be used by top managers because another important factors are involved such as ego or personal altitude. If there is no special procedure for a particular problem, manager should focus on how to turn a situation into the right way in accordance with expectations from their boss. Some managerial people cannot make their own judgments. Instead, they are looking up and looking around for someone else’s opinion and finally they rely on it because of personal fears or inexperience. Another example of it is the mid-level decision-making paralysis in many American companies when a manager is trying to avoid of making a decision. In the case of inevitable decision, he or she would engage as many colleagues as possible for self-protection. Many examples of recent administrative and economic problems within American companies have showed the tendency that managers are oriented to the short-term period when making decisions. This is due to the fact that MBA programs provide tools which are focuses mostly on a short-term attitude. The second reason would be that managers are under pressure for annual, quarterly, monthly and daily results and these factors push they out of thinking about the future, even though they realise that today’s minor difficulties could be tomorrow’s big crises. Managers are also aware of blame time and when things go wrong it is necessary to be protected from consequences. This is the reason why they gravitate towards this fear being punished rather than reflecting critically. Bureaucracy disrupts working processes into parts and the results of the work therefore disconnected with the decisions, which had been made. Manager’s productivity depends on the position within management circle or their supervisors. There is no codes or systems for tracking personal responsibilities to be established. To be successful manager means to move quickly within the levels of managerial hierarchy. It protects from going into problems too deeply at every level. Example I worked for four years as an instrument engineer in the Natural gas industry in Russia. I was involved into the decision making process associated with planning resources and finances for further projects and discussions about engineering-related difficulties. Firstly, when the question was complicated and involves financial resources, I checked the parameters of equipment many times and sent the results to my boss. When I received the confirmation from him, I printed it out and managed the necessary signatures on it. I did not want to be responsible for any inconvenience because my boss has to carry out this kind of responsibility. It was extremely important for me as a lower-level manager to have the document that proves that all things are done in time and approved by middle-level manager. In case of inconveniences such as the late commissioning phase of facilities I showed the documents that all the steps were completed by me on time. Reading 4. 2 Â  Reason, J. (1990) The general view on accident’s causes within complex technological systems includes theoretical framework which is not only provides the data on how dangerous factors could be combined themselves, but also where and how to predict these tendencies and take necessary measures beforehand. There are many elements of production, which are also involved into accident causation. Fallible high-level manager’s decisions are a major contributing factor to an increase in risk, followed by the lack of line management, which in turn causes dangerous preconditions and unsafe acts (intended and unintended). The latter are based on human’s psychological characteristics and conditions and are described as a combination of both potential hazards and errors, which could cause injury or damage. Likewise, a trajectory of an opportunity includes all these factors plus safeguards and productive events. Each of these has a window of opportunity in terms of an accident incidence. Therefore damage is highly possible when this trajectory is crossing all the windows at all the stages of production. The safe operation control consists of two features – feedback and response. The theory points out that the most successful approach to manage the safety is by taken into consideration the failure types rather than the failure tokens. According to Westrum (1988) there are three groups of auctions – denial, repair and reform. The successful organization is taken actions in responding to safely data from the reform (bottom level). The fundamental distribution error relates to a personal incompetence of employee while on the other hand the fundamental surprise error is the situation when personal observation differs to a reality. Thus, taken into consideration these terms and experience from the past major accidents such as Chernobyl, the nature of a malfunction has to be considered not only as pure technical but also as socio-technical. The people’s contribution to accidents is dominating the machine failure risk. Example I investigated many serious accidents related to the natural gas transportation process. For instance, one emergency stop of the 3. 2-megawatt gas turbine was caused by the malfunction of a frequency meter. After an analysis of reports I concluded that technical maintenance of this device was conducted improperly. A responsible worker forgot to finish one procedure related to the metrology accuracy of this piece of equipment. Another example is when other gas turbine was stopped by alarm during normal working cycle. The reason for that was unplanned and uncoordinated upgrade of its automatic control system (ACS). From my point of view, the modern technology is very reliable and ACS is highly faultness but social factors as well as poor decision making are of the major reasons for emergency situations. For instance, social factors in Russia are included a low salary and the lack of a proper education. You read "Abstracts 4 Articles Decision Making" in category "Essay examples" Reading 6. Beach (1993) A descriptive Image theory focuses on people’s individual decisions rather than group ones, and it is directly opposite to prescriptive classical theory of making decisions. There are also three decision-related images (structures), which have to be possessed by a decision maker. The value i mage is based on personal principles, behavior and beliefs. These are the source for generating goals. Thus, the ultimate criteria for this is when the decision maker consider the values to be relevant. Therefore potential goals and actions, if they are inconsistent with the relevant principles, will be refused. The second image, which is called the trajectory image, includes potential goals, which have to be set and the third one, the strategic image, focuses on actions and plans that have to be performed for achieving targets. The important parts of the third image are tactic and forecast, which would be a crucial factors for monitoring a realisation progress of a particular goal. Decision-making process consists of two types of decisions such as adoption and progress which include the implementation of the compatibility and profitability tests. The compatibility test is based on both types of decisions and compares candidates to three images, whereas in contrast the profitability test relates to the adoption decision only and uses the outcome after performing the compatibility test. For instance, the compatibility test selects few candidates, who successfully crossed through a selection criteria and the profitability test therefore chooses the best candidate from the previous sorting. Another important part of the Image theory is the process of framing decisions which is the action when the goal is identified and the plan is alled back if one exists. The data from the practical research suggests that it is unlikely that the decision maker tend to change the selection criteria without changes in principles, goals and plans. Example I was involved into the process of interviewing new workers within the Natural gas industry. I had to employ personnel with sufficient technical knowledge and skills because they have to work with in hazardous areas and on potentially dangerous equipment. As a team leader I was hoping to find highly qualified workers with extensive experience for an average amount of salary. After performing several meetings and consultations with potential staff within this salary category I concluded that no one was able to pass the criteria and possess theoretical knowledge and practical achievements from previous work experience. Because of that I decided to change the working images by changing the criteria. Therefore, I focused on workers who possess theoretical knowledge with engineering ideas in complex. Although they did not have extensive experience, they satisfied basic criteria and were able to perform tasks within their role (maintenance and repair). And after this correction of principles I recruited staff for my team successfully. Reading 7. 3Â  Janis (1971) Groupthink is a way of thinking when members behave with a high level of concurrence and tend to adopt a soft line of criticism on colleague’s ideas or even on every critical issue. This is why they make inhumane decisions easily with serious consequences such as the huge number of people’s deaths. The more cohesive the group, the more the risk that the decision will be proposed without the deep analysis of other choices. There are eight major symptoms of groupthink such as invulnerability, irrationality, ignorance of moral principles, stereotyped and unrealistic positions, group pressure against any critical views, member’s self-censorship, unanimity tendency within a group and the mind guard which is to protect the decision from any kind of the feedback. These indicators are typical for a bad decision making process which in tern may results the inhumane decision with serious consequences. Several steps could be adopted to prevent any group from group thinking. In this case criticism should be accepted not only by members but also by a leader. Wide range of alternatives should also be taken into account as possible options. In a case of vital decisions several groups with different leaders should be established to work on the same problem. Before the final decision is made each member should discuss considerations in its unit of organisation and then provide a final response to the group. An outside expert should be invited to all meetings. One decision-maker within the group should criticise a position of the majority. In the case of consensus the group should organise the final meeting for listening and discussing any doubts against the final decision. Although these actions have also drawbacks. For instance, when growing crisis requests an immediate solution there is no time for discussions and implementing many steps for decision making. Another example might be that the risk of the leakage of vital information would significantly increases when outside specialists are involved. All in all, it seems to be clear that top priority should be given in the prevention of any policymaking unit from the group thinking. Behavioral scientists should also be involved into these processes. Example During my work in Russia a groupthink was played a crucial role because of many factors. Firstly, my colleagues were really close to each other and the company’s social policy was developed for this purpose. Therefore, we spent some days playing games and sports altogether. This resulted in the number of small close-connected teams within the group. Another point is that my boss had a top role during all the process of discussion. Therefore, I had een many examples of bad decision-making. For instance, the only criticism from experienced and old colleagues was taken into account despite obvious things that were given by young professionals. Another factor is that the small teams did know how to play games within this environment and how to speculate. From my point of view, taking into consideration the long-term period, most of the final decisions were satisfactory but insufficient. It means that the p rojects were performed according to the rules and practices within timelines. But it can be clearly seen that due to the lack of criticism, for example, the total cost of the projects was increased. This way if the rules and steps of good decision practice were implemented, the cost and efficiency would significantly increase. Reading 8. 2Â  Callon (1987) The development of the technology has been explained by many social scientists using different available methods but they have not taken into account the point that the issue of the technology itself can also be represented as a sociological tool for an analysis. This also leads to the changes in understanding the dynamics of technology. There are two sociological views on the dynamic of consumption, which were developed by sociologists Touraine and Bourdieu. Touraine showed that French consumers’ behavior mostly dictated by large monopolies and industry, whereas in contrast Bourdieu pointed out that competition between social classes within French society taken the first place in terms of consumption of goods and services. Therefore these theories were shown by battle between engineers of two powerful French companies in the early 1970s: Electricite de France (EDF) and Renault. Despite the fact that both of them successfully proposed the concept of an electric car (VEL), the EDF’s theory failed because of unsolved technological difficulties related to the area of science and economy of the VEL, but the Renault did survive in the market because it focuses on not only the technological factors but also on rational views. This is the controversial result, because from the sociological point of view Renault’ specialists won this battle by a chance nor by implementing genius technological ideas. This experience of engineers-sociologists is possible to use as a new methodological tool for exploring large sections of society as well as researching within the value of role of social movements in the progress of consumption. There is also a helpful tool which is named the actor network. It is the case when company’s technological strategy supported by many sections of society. It describes the dynamics of society in completely different way without using sociological explanations. Firstly, in the case of implications of radical innovations within a technological sector engineers must mix technical and scientific analysis with sociology. Secondly, the actors network approach is efficient because it takes into account outside factors, which are related to common concepts of systems. Example I was responsible for implementing the concept of using compressed natural gas (CNG) as fuel for private cars and municipal buses instead of regular petrol. I was focused on the public transport such as buses because of the potential reduction of pollutions as well as the decrease of the total cost of fuel consumption. Moreover, it was easier to install the necessary equipment on buses because the government agreed to subsidise the cost of these modifications. Whereas in contrast I concluded that private car owners would not agree with this idea because the Siberian region in Russia is a large area and the number of CNG filing stations was limited to only 7. Thus, it was clear for me that using CNG fuel people could not travel between major cities which is crucial factor. This approach was based on social behavior of people and their habits. Therefore, the main target for our new policy was a municipal transport within major cities. How to cite Abstracts 4 Articles Decision Making, Essay examples

Saturday, May 2, 2020

To Far Ahead of the It Curve free essay sample

Should the CEO approve a shift to risky new technology or go with the time-tested monolithic system? by John P. Glaser F Daniel Vasconcellos after their squash game, Max Berndt drank iced tea with his board chairman, Paul Le? er. Max, a thoracic surgeon by training, was the CEO of Peachtree Healthcare. He’d occupied the post for nearly 12 years. In that time the company had grown – mainly by mergers – from a single teaching hospital into a regional network of 11 large and midsize institutions, supported by ancillary clinics, physician practices, trauma centers, rehabilitation facilities, and nursing homes. Together, these entities had nearly 4,000 employed and af? liated physicians, who annually treated a million patients from throughout Georgia and beyond. The patients ranged in age from newborn to nonagenarian; represented all races, ethnicities, lifestyles, and economic conditions; and manifested every imaginable injury and disease. Paul – like other board members and some in Max’s management inner circle – was applying constant pressure on Max to follow the example of others in the health care industry: Push ahead on standards and on the systems and processes to support them. We will write a custom essay sample on To Far Ahead of the It Curve or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page â€Å"You’ve got all the hospitals doing things differently. You’ve got incompatible technology that’s held together by sweat and ingenuity and, possibly, prayer. Just do what other institutions are doing. Common systems, broad standardization†¦ It’s the competitive reality, and it’s the right long-term play! So, what the hell are you waiting for? But then the iced tea ized practices could have scary patientsafety consequences, and physicians had to be free to form their own judgments about which treatments were best for which patients. Lately, however, worrisome developments were eroding Max’s con? dence that he could hold out against Paul’s brute-force prescription. Remember The African Queen? Days before, there had been a meltdown of the clinical information system at Wallis Memorial Hospital in Decatur. (Wallis was Peachtree’s most recent addition. ) Since Max had been lunching with his chief information of? er, Candace Markovich, when the alarm came through to her PDA, he drove her over to Wallis to investigate. On the way, Candace reprised her concerns about ensuring uptime and performance quality across Peachtree’s patchwork infrastructure. â€Å"More and more, I feel like Humphrey Bogart in The African Queen, trying to keep the blasted engine running on the boat,† she said. â€Å"So much of our energy and budget goes into just treading water. And the more we grow, the worse it gets. † At Wallis, Max saw cold panic on the faces of the IT staff as they rushed around trying to repair and reboot the system. Doctors and nursing supervisors stood around looking helpless or angry, sometimes a mix of both. Clinicians, having ? nally been persuaded to use information technology as a primary tool in delivering care, now depended on it to work reliably. When it didn’t cooperate, they – and their patients – were basically screwed. Now Max witnessed the routine nightmare that many doctors recoiled from. Talented, hardworking, highly paid people were being kept from doing their jobs by the too-unremarkable failure of what had become an indispensable tool. Although everyone in IT was working diligently to ? x the problem, diligence wasn’t enough to keep disgust at bay. Wherever Max looked, he saw pain. â€Å"You’ve got incompatible technology that’s held together by sweat and ingenuity and, possibly, prayer. Just do what other institutions are doing. Common systems, broad standardization. † of Wyndham Trust, the region’s leading retail bank and mortgage lender. Having overseen Wyndham’s rapid growth through mergers and acquisitions, he was an avid believer in brute-force standardization. His management team had honed the art of isciplined conversion, changing everything from signage to systems and processes in very short order, â€Å"like ripping off an adhesive bandage. † Squash courts weren’t the only thing vanishing from Max’s universe. So was a comfortable management consensus about Peachtree Healthcare’s long-term aims and how best to John P. Glaser is the chief information of? cer for Partners HealthCare System, in Boston; a senior adviser to the Deloitte Center for Health Solutions, in Washington, DC; and president emeritus of the eHealth Initiative, whose mission is to improve the quality, safety, and ef? iency of health care through information and IT. He is a coauthor of Managing Health Care Information Systems (Jossey-Bass, 2005). arrived, and Max used the interruption as an excuse not to answer Paul’s question. They’d been having this conversation for several months – sometimes informally, other times in full board or committee meetings. Max listened, to a point. Eventually, he always fell back on his clinical experience. â€Å"You can standardize the testing of ball bearings for manufacturing defects,† he said. But as far as I know, you can’t – at least not yet – standardize the protocol for treating colon cancer. † As a physician, Max believed that the last word in all matters of patient care should rest with the doctor and the patient. But as a CEO he believed in best practices. So his compromise position was to favor selective (Max called it â€Å"surgical†) standardization. Indeed, many areas of clinical treatment – immunizations, pharmacy record keeping, aspects of diabetes care – could safely be standardized around best practices over which there were few disagreements. In other areas, though, standard- 30 Harvard Business Review | July–August 2007 | hbr. org And yet Max was also that rarity in medicine – a physician leader who recognized and embraced the value in technology. An early enthusiast of telemedicine, he had participated in longdistance, computer-assisted research conferences and consultations on behalf of his own and other doctors’ patients. He had easily been converted to the view that computerized, consolidated patient records were vastly superior to manila ? le folders scattered throughout various specialists’ of? es, subject to eccentric clinical and record-keeping habits. As CEO, he had shown consis- tent leadership in visibly championing IT-based innovation. And he enjoyed a close, positive working relationship with Candace. Even so, all he was hearing from Candace lately was that the IT infrastructure was consuming so much maintenance energy that further technical innovation was becoming a luxury, an afterthought. At Wallis, Max had gotten to see the nature of the problem up close and personal. Luckily, the situation ended up being resolved without major consequences to patients – this time. But Max was now convinced that something urgently needed to be done. The African Queen was headed toward the rapids. Medicine Is Different The day after the squash match, Max sat in a budget meeting in his of? ce attended by Candace and Peachtree CFO Tom Drane. Max wanted to know what it was going to cost to rearchitect technology across all of Peachtree’s facilities. Candace and Tom cataloged the results of a request for information Candace had put out earlier in the year.

Sunday, March 22, 2020

36 Hours at UC Davis

Thinking of applying to University of California, Davis? Come visit the campus and get a feel for the college town vibe! Here are some of the highlights of Davis brought to you by a senior at UCD! Lunch Downtown Davis has many of eateries to choose from, and the best part is that downtown is right next to campus! The busiest restaurant in downtown is Burgers and Brew. Not only do they serve delicious burgers and beer, they have a relaxing atmosphere that is perfect for enjoying a meal with friends and family I recommend the buffalo burger! For a more affordable option, try Sams Mediterranean Cuisine right next to campus for delicious shawarmas, kebabs, and wraps. I always get their lamb shawarmas! Tour Information Session Register for a tour here. Your experience consist of a 30 minute presentation and a one hour walking tour led by a student ambassador. You will see the central core of UC Davis and learn about academic excellence, student services, organizations, clubs, as well as research and internship opportunities at UC Davis.If you get the chance, talk to a few students you walk by during the tour, ask them questions about campus life and the student body. It will help you better understand if the school is right for you! Fun fact, UC Davis is the second largest UC campus, encompassing over 5,300 acres of land! No wonder students get around by bike. Dinner Many UC Davis students frequent Thai Canteen for dinner. This is my go-to spot for pad thai and beef noodle soup. Its everyones comfort food, and you really cant beat their $1 thai iced tea during happy hour! For a more refined dining experience, you can try The Mustard Seed, an unpretentious upscale American restaurant not far from the heart of downtown. With exclusive California wine to go with your grilled aged rib eye steak and herb mustard encrusted rack of lamb, Mustard Seed offers the perfect ambiance for all occasions. Where to Stay There are numerous hotels in Davis to choose from. Be sure to book a room as soon as possible or months in advance, especially for orientation or graduation. Stay at the Hyatt Place UC Davis, a hotel thats right on campus. Amenities include fitness centers, a heated outdoor pool, and free Wi-Fi.If youre looking for a hotel in downtown, Best Western PLUS Palm Court Hotel is an excellent choice. For a more affordable option, stay at the Econo Lodge in downtown. Breakfast Theres no shortage of breakfast options in Davis!Go to Crepeville any time of day for delicious crepes, omelettes, and sandwiches. Their Mexican hot chocolate is scrumptious. Other popular American breakfast destinations include Black Bear Diner and Cafe Bernardo. For a vegan-friendly option, try Delta of Venus Cafe and Pub. Coffee Need a break and process everything you learned on your campus tour? Make a pit stop at Mishkas Cafe! They only serve coffee that is fair trade and organic. There are many seats for students to either study or sit down and relax. I also recommend Dutch Bros. Coffee. Its open 24/7 and has a drive thru! If its your first time visiting UC Davis, I highly recommend trying something new, but if you want to stick to want you know, Starbucks and Peets are on campus too! Entertainment You can go see new movies with friends at Regal Cinemas in downtown Davis (2 locations: one on F Street and the other on G Street).For independent and/or indie films lovers, definitely check out Varsity Theater which first opened in 1950. This movie theater features â€Å"streamline moderne† architecture; one glance at Varsity Theater is like glancing into the past. Where to Visit Dont forget to stop by the Arboretum on the south side of campus. Occupying over 100 acres of land, the Arboretum is a public garden with over 2,400 kinds of native trees and plants. Its the perfect place to relax, go on a walk, have a picnic, and enjoy the beauty of nature. Where to Next? If you still have time to visit other college campuses during your trip to Davis, consider visiting Sacramento State University, UC San Francisco, and UC Berkeley!

Thursday, March 5, 2020

A detailed description of the pharmacological treatments used in Alzheimer’s disease The WritePass Journal

A detailed description of the pharmacological treatments used in Alzheimer’s disease Introduction A detailed description of the pharmacological treatments used in Alzheimer’s disease IntroductionReferencesRelated Introduction The nervous system is involved in the transmission of signals for communication and for coordination of body systems. The principle cell of the nervous system is a neuron, the neuron components are a cell body, dendrites, axon, synaptic terminals and myelin sheath (not always). The cell body component of the neuron integrates signals and coordinates metabolic activities. Dendrites are the branched projections of a neuron that act to conduct the electrochemical stimulation. The axon in the neuron conducts the signal and the synaptic terminals transmit the signals. The myelin sheath is the coating on some neurons that that acts as an insulator to speed the conduction of nerve impulses, usually around only the axon of a neuron. The transmission of a nerve impulse along a neuron from one end to the other occurs as a result of chemical changes across the membrane of the neuron. The membrane of an unstimulated neuron is polarized- that is, there is a difference in electrical charge between the outside and inside of the membrane. The inside is negative with respect to the outside. Such polarization is established by maintaining an excess of sodium ions (Na+) on the outside and an excess of potassium ions (K+) on the inside. Na+/K+ pumps in the membrane actively restore the ions to the appropriate side. Other ions, such as large, negatively charged proteins and nucleic acids, reside within the cell. It is these large, negatively charged ions that contribute to the overall negative charge on the inside of the cell membrane as compared to the outside. In addition to crossing the membrane through leakage channels, ions may also cross through gated channels. Gated channels open in response to neurotransmitters, changes in membrane potential, or other stimuli. The following events characterize the transmission of a nerve impulse. Resting potential: The resting potential describes the unstimulated, polarized state of a neuron. Graded potential: A graded potential is a change in the resting potential. A graded potential occurs when the stimulus causes Na+ or K+ gated channels to open. Na+ channels open, positive sodium ions enter, and the membrane depolarizes (becomes more positive). If the stimulus opens K+ channels, then positive potassium ions exit across the membrane and the membrane hyperpolarizes (becomes more negative). Action potential: An action potential is capable of traveling long distances. If a depolarizing graded potential is sufficiently large, Na+ channels in the trigger zone open. In response, Na+ on the outside of the membrane becomes depolarized (as in a graded potential). Repolarization: In response to the inflow of Na+, K+ channels open, this time allowing K+ on the inside to rush out of the cell. The movement of K+ out of the cell causes repolarization by restoring the original membrane polarization. Soon after the K+ gates open, the Na+ gates close. Hyperpolarization: This is when K+ channels closes and more K+ has moved out of the cell. As a result, the membrane becomes hyperpolarized. Refractory period: The membrane is polarized, but the Na+ and K+ are on the wrong sides of the membrane. During this refractory period, the axon will not respond to a new stimulus. To re-establish the original distribution of these ions, the Na+ and K+ are returned to their resting potential location by Na+/K+ pumps in the cell membrane. Once these ions are returned to their resting potential the neuron is ready for another stimulus. Transmission of Nerve Impulses between Neurons: The nerve impulse (action potential) travels down the presynaptic axon towards the synapse, where it activates voltage-gated calcium channels leading to calcium influx, which triggers the simultaneous release of neurotransmitter molecules from many synaptic vesicles by fusing the membranes of the vesicles to that of the nerve terminal. The neurotransmitter molecules diffuse across the synaptic cleft, bind briefly to receptors on the postsynaptic neuron to activate them, causing physiological responses that may be excitatory or inhibitory depending on the receptor. The central nervous system (CNS) is that part of the nervous system that consists of the brain and spinal cord. The central nervous system is one of the two major divisions of the nervous system. The other is the peripheral nervous system (PNS) which is outside the brain and spinal cord. The peripheral nervous system (PNS) connects the central nervous system (CNS) to sensory organs (such as the eye and ear), other organs of the body, muscles, blood vessels and glands. The hippocampus is one of the first regions of the brain to suffer damage; memory problems and disorientation appear among the first symptoms. Damage to the hippocampus can also result from oxygen starvation (hypoxia), encephalitis, or medial temporal lobe epilepsy. People with extensive, bilateral hippocampal damage may experience anterograde amnesia- the inability to form or retain new memories. Cholinesterase is a family of enzymes that catalyze the hydrolysis of the neurotransmitter acetylcholine into choline and acetic acid, a reaction necessary to allow a cholinergic neuron to return to its resting state after activation. Cholinesterase inhibitors work by increasing levels of acetylcholine, a chemical messenger involved in memory, judgment and other thought processes. Certain brain cells release acetylcholine, which helps deliver messages to other cells. After a message reaches the receiving cell, various other chemicals, including an enzyme called acetylcholinesterase, break acetylcholine down so it can be recycled. Alzheimers disease (AD) is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception. Alzheimers disease is a result from an increase in the production of beta-amyloid protein in the brain that leads to nerve cell death. The only way to know for certain that someone has AD is to examine a sample of their brain tissue after death. The following changes are more common in the brain tissue of people with AD: Neurofibrillary tangles which are twisted fragments of protein within nerve cells that clog up the cell. Another change which is common in brain tissue of a patient with AD is neuritic plaques (containing beta-amyloid protein) mentioned above. This results in abnormal clusters of dead and dying nerve cells, other brain cells, and aberrant protein deposits. When nerve cells are destroyed, there is a decrease in the chemicals/electrical signal that helps nerve cells send messa ges to one another, which are called neurotransmitters. As a result, areas of the brain that normally work together become disconnected. The probability of having Alzheimers disease increases substantially after the age of 70 and may affect around 50% of persons over the age of 85. However Alzheimers disease is not a normal part of aging and is not something that certainly happens in later life, many people live to over 100 years of age and never develop Alzheimers disease. Fig 1 (alz.org/brain/images/09a.jpg) In fig 1 above is a view of how massive cell loss changes the whole brain in advanced Alzheimers disease. This illustration shows a crosswise slice through the middle of the brain between the ears. In the Alzheimer’s brain, the cortex shrivels up, damaging areas involved in thinking, planning and remembering. Shrinkage is especially severe in the hippocampus, an area of the cortex that plays a key role in formation of new memories. The ventricles spaces grow larger. The risks factors implicated in Alzheimer’s disease are age, ApoE4, Down’s syndrome, head injury, low education and also family history i.e. genes. The main risk factor for Alzheimers disease is increased age. As a population ages, the frequency of Alzheimers disease continues to increase. Studies show that 10% of people over 65 years of age and 50% of those over 85 years of age have Alzheimers disease. There are also genetic risk factors for Alzheimers disease. Most patients develop Alzheimers disease after age 70. However, 2%-5% of patients develop the disease in the fourth or fifth decade of life (40s or 50s). At least half of these early onset patients have inherited gene mutations associated with their Alzheimers disease. Also a child of a patient with early onset Alzheimers disease who has one of these gene mutations has a 50% risk of developing Alzheimers disease. Other risk factors for Alzheimers disease include high blood pressure (hypertension), coronary arter y disease, diabetes, and possibly elevated blood cholesterol. Individuals who have completed less than eight years of education also have an increased risk for Alzheimers disease. These factors increase the risk of Alzheimers disease, but this does not mean Alzheimers disease is necessarily expected in persons with these factors. The onset of Alzheimers disease is usually gradual, and it is slowly progressive. Problems of memory, particularly for recent events (short-term memory) are common early in the course of Alzheimers disease. Mild personality changes, such as less spontaneity, apathy, and a tendency to withdraw from social interactions, may occur early in the illness. As the disease progresses, problems in abstract thinking and in other intellectual functions develop. Further disturbances in behaviour and appearance may also be seen at this point, such as agitation, irritability and a deteriorating ability to dress appropriately. Later in the course of the disorder, affected individuals may become confused or disoriented. Eventually, patients will be unable to engage in conversation, become erratic in mood, uncooperative, and lose bladder and bowel control. In late stages of the disease, persons may become totally incapable of caring for themselves, and a result of this could be death. Those who develo p the disorder later in life more often die from other illnesses (i.e. heart disease). Fig 2 Deaths from Alzheimers disease: (alz.org/downloads/Facts_Figures_2011.pdf) From Fig 2 Alzheimer’s disease is the sixth-leading cause of death in the country and the only cause of death among the top 10 in the United States that cannot be prevented, cured or even slowed. From the data in the graph, death rates have declined for most major diseases while deaths from Alzheimer’s disease have risen 66 percent during the same period. Unfortunately, there is no cure for AD. However there are goals in treating AD, these goals are to slow the progression of the disease (although this is difficult to do), manage behaviour problems, confusion, sleep problems, and agitation, modify the home environment and support family members and other caregivers. Cholinesterase blockers are one of the main treatments of AD. Cholinesterase inhibitors are prescribed to treat symptoms related to memory, thinking, language, judgment and other thought processes. The different cholinesterase inhibitors are Donepezil, Rivastigmine, Galanthamine, Tacrine and Memantine. The three main drugs currently licensed for the treatment of AD are Donepezil, Rivastigmine and Galanthamine. Donepezil is the generic name and the brand name is Aricept. Donepezil is approved at all stages of Alzheimer’s disease. However the side effects of this drug are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Galanthamine, brand name Razadyne, is approved for the mild to moderate stages of AD. The side effects of Galanthamine are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Memantine (brand name Namenda), is approved for moderate to severe stages of AD, The side effects of this drug are headache, constipation, confusion and dizziness. Rivastigmine (brand name Exelon), approved for mild to moderate Alzheimer’s, the side effects of Rivastigmine are nausea, vomiting, loss of appetite and increased frequency of bowel movements. Tacrine (also known as Cognex), this was the first cholinesterase inhibitor and was approved in 1993 but is rarely prescribed today; this is because of associated side effects which i nclude possible liver damage. Cholinesterase inhibitors work by increasing levels of acetylcholine, a chemical messenger involved in memory, judgment and other thought processes. Certain brain cells release acetylcholine, which helps deliver messages to other cells. After a message reaches the receiving cell, various other chemicals, including an enzyme called acetylcholinesterase, break acetylcholine down so it can be recycled. But Alzheimer’s disease damages or destroys cells that produce and use acetylcholine, thereby reducing the amount available to carry messages. A cholinesterase inhibitor slows the breakdown of acetylcholine by blocking the activity of acetylcholinesterase. By maintaining acetylcholine levels, the drug may help compensate for the loss of functioning brain cells. The benefits of cholinesterase inhibitors are that people taking the cholinesterase inhibitor medications performed better on memory and thinking tests than those taking a placebo, or inactive substance. In terms of overall effect, most experts believe cholinesterase inhibitors may delay or slow worsening of symptoms for about six months to a year; although some people may benefit more dramatically or for a longer time. Namenda is approved to treat moderate-to-severe Alzheimers disease. Namenda works by a different mechanism than other Alzheimers treatments; it is thought to play a protective role in the brain by regulating the activity of a different brain chemical called glutamate. Glutamate also plays a role in learning and memory. Brain cells in people with Alzheimer’s disease release too much glutamate (Alzheimer’s Association 2007). Namenda helps regulate glutamate activity. Namenda works by blocking the receptors for the neurotransmitter glutamate. It is believed that glutamate plays an important role in the neural pathways associated with learning and memory. In brain disorders such as Alzheimer’s disease, overexcitation of neurons produced by abnormal levels of glutamate may be associated with neuronal cell dysfunction (resulting in cognitive and memory deficits) and eventual cell death (leading to deterioration and collapse of intellectual functioning). By selectively blocking a type of glutamate receptor (NMDA receptor) while allowing for normal neurotransmission, Namenda may help reduce the excitotoxic effects associated with abnormal transmission of glutamate. (psychatlanta.com) Namenda may have increased benefit when used with Aricept, Exelon, Razadyne, or Cognex. Memantine, a voltagegated and uncompetitive NMDA antagonist with moderate affinity, can protect neurons from excitotoxicity. It was approved for treatment of the patients with moderate to severe AD.   (Alzheimer’s Association 2007) A growing body of evidence suggest that drugs indicated for other conditions may also possess preventive efficacy for AD. Among the most promising are antioxidants, nonsteroidal, statins, certain anti hypertensive agents, alcohol, fish oil and possibly estrogen. Antioxidants have been recommended for prevention of dementia. The use of natural antioxidants may inhibit damage to the muscarinic receptors caused by free radicals, possibly by preventing or treating AD. High dietary intake of vitamins C and E lower the risk of AD. Estrogen is a weak antioxidant, it is biologically plausible that hormone replacement therapy (HRT) could protect against AD (Zandi PP et al 2002). AD is more likely to develop in a person with atherosclerotic cerebrovascular disease (Postiglione 1995). Antiatheroscleotic pharmacotherapies are used to treat atherosclerotic cerebrovascular disease, which then prevents AD from occurring (John B et al 2004). Folic acid is a AD preventer and is effective against AD. Folic acid is effective because it reduces homocysteine concentration, increased levels of homocysteine concentration increases the risk of AD. Statins is very effective at reducing the risk of AD. Statins reduce the risk of AD by reducing the cholesterol levels by interfering with the activity of enzyme. Moderate take of alcohol and intake of N-3 fatty acids reduces the risk of AD. Studies have shown that intake of N-3 fatty acids and weekly consumption of fish can decrease the risk of AD by 60 %. Pharmacological treatments of Alzheimers disease are limited. Recent observational studies have shown that use of non-steroidal anti-inflammatory drugs (NSAIDs) may protect against the development of the disease, possibly through their anti-inflammatory properties.  Ã‚   (Mahyar et al 2007) The results from research which has been carried out has been varied. Caffeine can be used as a treatment in Alzheimers disease (Chuanhai et al 2009). Caffeine causes most of its biological effects via antagonizing all types of adenosine receptors (ARs), as does adenosine, exerts effects on neurons and glial cells of all brain areas. In consequence, caffeine, when acting as an AR antagonist, is doing the opposite of activation of adenosine receptors due to removal of endogenous adenosinergic tonus. Caffeine, through antagonism of ARs, affects brain functions such as sleep, cognition, learning, and memory, and modifies brain dysfunctions and diseases i.e. Alzheimer’s disease. (Gary W et al 2009). Studies shows that people that take regular supplements decrease the risk of AD. Many people take folate (vitamin B9), vitamin B12, and vitamin E. However, there is no strong evidence that taking these vitamins prevents AD or slows the disease once it occurs. Recent studies have shown that people believe that the herb ginkgo biloba prevents or slows the development of dementia. However, high-quality studies have failed to show that this herb lowers the chance of developing dementia. Treatment of ancillary symptoms of Alzheimer disease has improved as well. Techniques have evolved to treat depression, sleeplessness, agitation, paranoia. Also family support is a cure in its own why which gives the patient a feel good feeling to overcome AD. References Volume 20, Supplement 1, 2010 Therapeutic Opportunities for Caffeine in Alzheimers Disease and Other Neurodegenerative Diseases (Guest Editors: Alexandre de Mendonà §a and Rodrigo A. Cunha) Pages 3-15 Volume 20, Number 3, June 2010 Special Issue Basics of Alzheimer’s Disease Prevention (Editor: Jack de la Torre) Pages 687-688 Supplement 3, November 2010 Anesthetics and Alzheimers Disease (Guest Editors: Pravat K. Mandal and Vincenzo Fodale) November 2010 Pages 1-3 Recommendations for the diagnosis and management of Alzheimers disease and other disorders associated with dementia: EFNS guideline Volume 14, Issue 1, pages 1–26, January 2007, From mild cognitive impairment to prodromal Alzheimer disease: A nosological evolution J.L. Molinuevo, C. Valls-Pedret, L. Rami, Volume 1, Issue 3, June 2010, Pages 146-154 G. Waldemar; B. Dubois; M. Emre; J. Georges; I. G. McKeith ; M. Rossor; P. Scheltens; P. Tariska; B. Winblad, Article first published online: 9 JAN 2007, European Journal of Neurology Mahyar Etminan et al 2003,Effect of non-steroidal anti-inflammatory drugs on risk of Alzheimers disease: systematic review and meta-analysis of observational studies   doi: 10.1136/bmj.327.7407.128, BMJ. 2003 July 19; 327(7407): 128. Gary W Arendash, Takashi Mori, Chuanhai Cao, Malgorzata Mamcarz, Melissa Runfeldt, Alexander Dickson, Kavon Rezai-Zadeh, Jun Tan, Bruce A Citron, Xiaoyang Lin, Valentina Echeverria, and Huntington Potter. Caffeine Reverses Cognitive Impairment and Decreases Brain Amyloid-%u03B2 Levels in Aged Alzheimers Disease Mice. Journal of Alzheimers Disease, Volume 17:3 (July 2009) Chuanhai Cao, John R Cirrito, Xiaoyang Lin, Lilly Wang, Deborah K Verges, Alexander Dickson, Malgorzata Mamcarz, Chi Zhang, Takashi Mori, Gary W Arendash, David M Holzman, and Huntington Potter. Caffeine Suppresses Amyloid-%u03B2 Levels in Plasma and Brain of Alzheimers Disease Transgenic Mice. 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