Le Noble Chevalier contre le Ballon Monstrueux †French 4 Essay

Le Noble Chevalier contre le Ballon Monstrueux – French 4 Essay Free Online Research Papers Le Noble Chevalier contre le Ballon Monstrueux french 4 essay On se trouve ici, au milieu de Founders Park, sur l’emplacement dun grand monument qui commà ©morera ceux que le nom de cet endroit honore – ceux qui ont à ©tabli notre facultà © il y a 125 ans. Ce sont eux qui ont en fait le droit de juger ce quon crà ©e en leur honneur, mà ªme sils ne vivent plus, car les à ©tudiants et les professeurs de cette università © ont la responsabilità © de parler leur nom, de dà ©fendre leurs idà ©es du savoir. On nous prà ©sente deux propositions qui marqueraient cet anniversaire: une noble statue dun ours californien avec un soldat de Troie sur son beau cheval, et un à ©norme ballon de football amà ©ricain. Il est à ©vident que celle-l honorerait le legs de la facultà ©, tandis que celle-ci ne pourrait que linsulter. On ne peut pas douter du fait que la statue de lancienne icà ´ne de notre à ©cole et des animaux est de loin le monument le plus approprià ©. Le chevalier de Troie est un symbole qui reprà ©sente toutes les facettes du caractà ¨re mà ©taphorique de là ©tudiant idà ©al quont prà ©vu les fondateurs. Le cheval sappelle le Savoir, sur lequel le jeune guerrier lutte contre les dà ©fis de son à ©poque, sur lequel il dà ©pend pour savancer vers la rà ©ussite. Il est fort – il lutte, mais il ne se rend pas avant sa mort. Et cà ´tà © de lui, il y a lours qui reprà ©sente cet à ©tat, la Californie, oà ¹ se trouvent tant doccasions et tant de beautà ©s qui attendent dà ªtre dà ©couvertes par les savants de cette facultà ©. Mais certains croient quil vaudrait mieux quon fasse un ballon monstrueux de football amà ©ricain pour honorer lhistoire de luniversità ©. Que cest ridicule! On passerait par ce parc chaque jour en voyant le jouet massif qui ressemble un ventre ballonnà © – il nous rendrait malades. La grande chose ridicule naurait ni valeur historique ni beautà © ( moins quon puisse trouver beau le bà ©ton simulant la peau de porc). Si on tient croire que le ballon reprà ©sente quelque chose dhistorique (notre à ©quipe de football), il faut considà ©rer ce quoi pensaient les fondateurs quand ils ont crà ©Ãƒ © la facultà ©: la culture du savoir – non pas la culture du corps. Le ballon devrait se trouver dans le jardin dun garà §on, pas dans une università ©. Cest le temps de se dà ©cider pour le monument qui honorera le mieux lhistoire de cette facultà ©. Il faut se souvenir du fait que ce monument restera toujours sur cet emplacement et quil nous rendra chaque jour soit fiers soit honteux. Il faut se souvenir des fondateurs, de leurs souhaits. Pour les honorer, on doit choisir la noble statue du chevalier de Troie et lours de la Californie. On ne peut quespà ©rer que lidà ©e de là ©norme ballon de foot tombera en oubli. Research Papers on Le Noble Chevalier contre le Ballon Monstrueux - French 4 EssayTrailblazing by Eric AndersonQuebec and CanadaHip-Hop is ArtThe Hockey GameAssess the importance of Nationalism 1815-1850 EuropeAppeasement Policy Towards the Outbreak of World War 2Definition of Export QuotasThe Effects of Illegal ImmigrationAnalysis Of A Cosmetics AdvertisementResearch Process Part One

Banana Chips

This provides an ample opportunity to a new entrant as the market is not dominated by some brands and with good quality and competitive pricing, it is possible to capture adequate market share. Production Banana Chips or Crisps are deep fried snack a small or casual meal. Cooking type bananas produce good Chips/Crisps. It is easy to make and the product is very tasty. The small-scale production requires but a few equipment, viz. A stove (Gas, Diesel fired or even a Firewood Stove), Kitchen knives, Peelers, Cutting boards, Plastic buckets, Cooking pots, Containers, Frying pan or Wok, Long Spoons or ladles, Cheese cloth, Colander, Trays and Baskets, Plastic Pouches, Candles amp; old Hacksaw blade or a small Electric Impulse Heat Sealer and Weighing scale. Production steps of Banana ChipsGood large size green cooking bananas slices are cut cross wise to give circular shape. Bigger size fruits are preferred to produce large size slices and an attractive product. Different varieties give products of different colour, flavour and taste. Crosswise slicing gives uniform, circular, attractive, product and is universally adopted for commercial production. This way as the slicing is faster the production increases. The steps involved in Banana Chips processing are: Selection: Good quality, green cooking bananas is preferred. Cutting and Peeling: Using a knife, banana bunches are separated from the main stem and individual bananas hands are separated from the bunches. Using a hand peeler, bananas are peeled and immediately sliced cross wise into thin, round slices. As some varieties with latex cause itching or irritation while handling, it is better to rub the hands with salt before peeling and slicing. Immersion in salt water: Immediately after slicing the slices are placed in salt water @ 3 to 5% of salt to the water. Added salt gets in to the slices and improves taste arid acceptability of the product. If slices are not placed in water, they turn Brown and later give an unacceptable dark product. Frying: Keep a large shallow Frying Pan or wok over a suitable stove (with adjustments for flame/heat control). The frying pan should be thick bottomed and with side rings for easy handling. Good edible vegetable cooking oil is used for frying. Bring the oil to fuming hot temperature. The long spoon or ladle used for taking out the fried chips from the wok can be either a big perforated one, of 8 to 12 inches in diameter and with long handle or of a large diameter wire mesh spoon with bamboo handle. The salt soaked slices are then dropped one by one manually into the hot oil in the frying pan. Never put the slices together in clusters into the oil as the slices being starchy stick to each other and are difficult to separate later. The normal practice followed is: Holding slices in left hand and dropping in rapid succession the separated slices one by one into the hot oil, or Slices taken out from the salt solution, separated and arranged either on a cheese cloth or on the dry big spoon itself and then carefully dropped into the hot oil. The frying temperature is maintained around 150 to 160C (just fuming) and frying time around 3 5 minutes depending on the slice thickness. Slices are deep-fried to golden yellow colour (till the bubbles seize) and taken out immediately using big perforated spoon. Over frying turns the chips dark and this will be considered an unattractive product. Draining of oil: Deep fried chips are put into perforated Colander for the excess oil to drain out and later transferred to a wide plastic or aluminum tray lined with craft paper or kitchen towel which absorbs/removes excess oil in chips and product is allowed to cool. Packing: Chips should never be packed while hot since hot air inside the pack condenses into water, which moistens the crisps resulting in soft, soggy chips. After cooling, chips are packed manually in plastic pouches and scaled airtight using either Hacksaw blade over candle flame or an electric impulse plastic sealer. Market PotentialDemand and SupplyThere is a very large market for banana chips and they can be sold at all such places where people assemble like theatres, picnic spots, bus stands or railway stations, traffic junctions etc. Retailing has to be done through small grocery shops as well as big departmental stores and super markets. There exists a strong demand for banana chips as most people enjoy eating snacks. While fresh cooking bananas are widely available, banana chips are not easily available in many parts of the country. Making chips increases the shelf life of the product in times of abundant harvest. Sales Location The owner has several options for selling the product as follows: At the local market; Through shops; and Through hotels amp; clubs. If the owner wishes to sell direct to the end customer, then the location with the highest traffic should be chosen. This will generally mean higher expenses in the form of rent. If the owner wishes to sell through shops, hotels or clubs, then the business can be started from your house. However, the owner will have to accept a lower mark-up to allow for a margin to be made for the shop owner. Costing the BusinessEquipment cost The following list represents a range of possible equipment needed for establishing a small scale banana chip producing business: Item | Quantity | Estimated Cost (Birr) | Purpose | Equipment | | | | Wok of frying pan | 1 | 500 | Fry chips | Gas Burners | 2 | 3000 | Stove top cooking | Plastic pots with lids | 5 | 200 | Storage | Knives | 3 | 60 | Cutting food | Spoons, wooden ladles | 5 each | 100 | Stirring for uniform frying | Cooling trays | 2 | 100 | Cooling hot fried chips prior to packing | Bag sealer | | 1600 | Packing fried chips | Total Equipment | | 5560 | | The prices used are estimated average cost based on Adama prices at the time this document was prepared. The above capital requirements are based on the principle of starting a small scale banana chip producing operation with minimum outlay of capital. This business can be of larger scale through the introduction of a deep fryer, and slicing machine. Staff CostA basic banana chip operation could be started by an owner helped by a family member. Position | Main responsibility | Monthly salary (Birr) | Owner | Manage business: decide prices, prepare chips, procure suppliers, supervise all staffs | 1500 | Helper | Assist in all areas | 700 | Total Staff Cost | | 2200 | Raw Material costYour major raw material is cooking bananas. Availability and price you pay for bananas will be determined to some extent by the weather conditions. In times of drought, availability will be less and price will be high. We will buy regularly from a few farmers. Once the suppliers know that we will be buying regularly, they will adjust their production to meet our demand and they should be willing to offer us a special price. Based on the costing and pricing part of this document, our raw material cost will be 1. 80 birr per 100 gram package. Raw materials include the raw banana, oil, salt, packaging and label. Raw material cost for one month consumption: Item | Quantity | Estimated Cost (Birr) | Raw Banana | 50kg | 600 | Edible Oil | 30ltr | 850 | Salt | 5kg | 15 | Packaging polythene/plastic | 1package | 200 | Total Raw Material Cost | | 1665 | License or Registration CostThe size and nature of this business does not require company registration and will be set-up as small and micro enterprise. For the purpose of this guide, the annual licence fee is estimated at 200 Birr. Operating CostA banana chip producing business has certain operational costs. Some of these costs are: Paid once when we establish services such as water, electricity ; Some are paid on a monthly basis. When we start our business we will usually need some working capital (money) to establish services, pay certain yearly expenses and to meet some of our monthly operational costs until the business can generate enough income to meet these costs. In the case of a banana chip producing business this should only be for the first month. The size and nature of this business probably will not warrant renting a new place. Electricity is not needed, but water is essential to the operation. Hence the operating costs listed below are on the basis of incremental costs incurred to run the business. For the purposes of this guide, it has been assumed that the product will be sold through a market stall. Below is a table showing the start-up and monthly operating cost associated with a banana chip producing business. Operational Cost | Initial Working Capital (Birr) | Monthly (Birr) | Rent (market stall) | 1000 | 500 | Water charges | 10 | 10 | Electricity | 50 | 50 | Gas | 200 | 200 | Cleaning supplies | 50 | 25 | miscellaneous | 100 | 50 | Total Operating Cost | 1410 | 335 | Startup Costs Item | Total (Birr) | Equipment | 5560 | Staff | 2200 | License and Registration | 200 | Raw Materials (First month) | 1665 | Operating expenses | 1410 | Total Start-up cost | 11,035 | The cost to start a banana chip producing business is around Birr 10,000. Costing and PricingIngredients: Bunch of cooking banana Water Salt Cooking oil Plastic bag Label Costing Ingredients | Quantity | Cost (Birr) | Cooking Banana | 100gms | 1. 35 | Salt amp; Cooking oil | | 0. 15 | Plastic Bag | | 0. 15 | Label | | 0. 15 | Total Cost per 100gm bag | | 1. 80 | Selling PriceObviously our selling price cannot be below Birr 1. 80. To determine our selling price we will try and investigate prices for similar items available. If there is a similar item, then our price will be close to that price. As we will be selling our product through shops, hotels or clubs, so we would have to allow a reasonable margin for the reseller. Probably a reasonable price for the above product will be Birr 2. 50. We will review prices if our product is not selling. ProfitabilityMonthly profit and loss | Breakeven Sales | Sale per day | 175 bags | Sales per month (25 days) | 4335 bags | Cost of raw materials | 1. 80birr/bag*4335 bag=7803 birr | Gross Profit | 2. 50birr/bag*4335bag-7803birr=3035 | Operational expenses/month | | Rent(market stall) | 500 | Wages | 2200 | Electricity | 50 | Gas | 200 | Water | 10 | Cleaning Supplies | 25 | Miscellaneous | 50 | Total | 3035 | Operating profit per month before tax | 0 | If we assume 2. 0 birr per bag unit price then the breakeven sales for this business is 175 bags per day. This means that if you sell less than 175 bags per day, you will make a loss. If you sell more than 175 bags per day at unit price of 2. 50 birr, you will make a profit. Financing the BusinessThe size and nature of this business is such that savings must necessarily be used for financing the business. In addition to our saving we will take a loan from Oromia Micro Finance Enterprise. Source of Finance | Amount (Birr) | Saving | 300 0 | Loan | 9000 | Total | 12,000 |

Silla Buddhism and Hwarang by Richard Essay Example | Topics and Well Written Essays - 1000 words

Silla Buddhism and Hwarang by Richard - Essay Example Korea Kingdom recognized the instituted hwarang that embraced Sinitic Mahayana Buddhism as the state religion. There was massive changes in the kingdom in the 6th century where Sinitic-style kingship was embraced and formation of strong government (54). This has kicked out huge debate as to whether the Korean Kingdom was founded on   the Sinitic Mahayana Buddhism dynasty or otherwise: the debate and research are still on.Richard argued added that Hwarang was got from information stored in Kim Pusik’s. The Confucian approach indicated that there was close relationship among theBuddhist monks and hwarang in the Silla kingdom.   Buddhist monks comprised of Haedong kosung, chon and Samguk yusa who demonstrated a link between Buddhist beliefs and the hwarang practices. Hwarang is demostrated as sketchy, laconic and suggestive, it was considered to bear different differentiation. Scholars also found that it was likely that hwarang were modelled by King Chinhung. Buddhism religio n was significant to the hwarang (55). The author presents the fact that Hwarang offered wilderness training in miltary to the youths where they also leant their culture. We can therefore argue that the Hwarang   was a very important tool that propagated the cultural practices throughout gernerations. They were interested in information regarding where they came from and the meaning of hwarang. Hwarang was understood as flower of youths even though many scholars do not agree.Hwarang is believed to originate from Samguk Sagi (56).

Leadership and Managment Assignment Example | Topics and Well Written Essays - 1500 words - 1

Leadership and Managment - Assignment Example This paper approves that the manager sees the existence of the conflict but deliberately tries to avoid it. The manager tries to ignore the sentiments raised by the team members. In as far as the aspect of accommodating is concerned, it can be seen that the other party tries to appease others through placing their priorities on top of his. The other aspect is related to compromising where each party tries to give up something as a way of resolving the conflict. this stage deals with behaviour where it can be seen that the conflict becomes visible in the organisation. In this case, the behaviour of the team members has negatively changed since there is low morale in the organization after the encounter described above. Communication involves the exchange of information between parties involved in a certain conflict. In order to solve group conflicts, there are certain steps that can be taken by the leaders. There are three ways of solving inter-group conflict namely: peaceful coexiste nce, compromise and problem solving. This essay makes a conclusion that in an organisation, it can be noted that conflict is inevitable but it can be solved amicably depending on the leader’s capability and interpersonal skills towards finding ways of resolving conflicts. In the scenario described above, it has been noted that the leader is too authoritarian hence he could not listen to the views of the members of the team. This created the conflict described above. Therefore, it is recommended that the leader should implement the following measures in order to avoid a similar situation in the future.

Week 4 question 8 Assignment Example | Topics and Well Written Essays - 250 words

Week 4 question 8 - Assignment Example On the other hand, an organization that focuses on cost minimisation like Wal-Mart should have a mechanistic structure. Through centralization of power and authority, it can be observed that the nature of business follows a particular routine and costs are minimised since there are few people involved in the decision making process that is vital for the operations of the organization as a whole. 2. Organizational culture refers to â€Å"a system of shared meaning held by the members that distinguishes the organization from the other organizations,† (Sanchez, 2014, p.4). In many ways, organizational culture is beneficial when it fosters innovation and risk taking. Organizational culture is also beneficial when the employees are innovative. More importantly, organizational culture is beneficial when it is people, organization and team oriented. Another sign that shows that organizational culture is beneficial is when it creates stability in the firm. However, organizational culture becomes a liability if it is resistant to change since it will be counterproductive. A culture that hinders diversity in the organization is also a liability. A diverse workforce is productive since the members can share their ideas and

Unethical Practices And Conflicts Of Interest In The Pharmaceutical Industry

Unethical Practices And Conflicts Of Interest In The Pharmaceutical Industry As Healthcare Reform develops and shape regulations within the healthcare industry, unethical practices and conflicts of interest in the pharmaceutical industry affirm the need for transparency and improved traditions. Conflict of interest from a legal standpoint is a conflict between the private interests and the official or professional responsibilities of a person in a position of trust. (Merriam-Websters Dictionary of Law, 2010) From a business perspective, conflict of interest is defined as a situation that has the potential to undermine the impartiality of a person because of the possibility of a clash between the persons self-interest and professional-interest or personal-interest. (BusinessDictionary.com) With the number of physicians operating private practices in the United States, the clinical drug trial kickbacks have become common practice and the ravenous patterns have been explicitly revealed. The frequency of such behaviors and exposure of financial gain are enough to further strengthen the necessity for health care reform. Each unscrupulous circumstance that is exposed brings about further insight to the widespread unethical conduct of the pharmaceutical industry. There is an abundance of scenarios and examples depicting behaviors as well as emergent methods to circumvent such conflicts of interest. Additionally, laws and processes are in place to further develop and establish parameters around acceptable and unacceptable practices for both pharmaceutical manufacturers and physicians alike. With the objective to deter, eliminate and expose conflicts of interest, various projects, acts and charitable trusts have been developed and comprised of committees of citizens, organizat ions, and donors who vigorously advocate patient safety through improved changes in the manufacturing and marketing of prescription drugs. So how does conflict of interest play a role in clinical drug trials? When discussing conflict of interest as it relates to clinical drug trials the scenario is usually one in which a researcher has a monetary rapport and research money, with the company that manufacturers the drug being studied. There is nothing fundamentally erroneous with these types of conflicts of interest, they are practically everywhere within drug trials because most of the trials are financed by the drug companies that produce the drugs being studied. In an article written by John H. Montgomery related to the examination of conflicts of interest, research was done by Dr. Roy H. Perlis on the outcome of drug trials and the relationship that the author or industry has to that outcome. Research shows that 397 trials were reviewed and of those, 162 random trials yielded positive results that were funded by the manufacturer of the drug being studied. These results give indication that conflict of interest is common and associated to the outcome of the trials. This is just one of many examples of how common conflicts of interest arise in the healthcare industry. Another study conducted looked at randomized controlled trials of NSAIDs (non-steroidal anti-inflammatory drugs) between 1987 and 1990 (Bodenheimer). This study found that relatively all of the trials in the three-year span were sponsored by the drug producer. The research also discovered that the drug being compared to the manufactured drug was equivalent in efficiency and in s ome cases was even better than the manufactured drug in every trial. The study also reported that the manufacturer-associated drug was safer than the comparison drug in 86% of the trials (Bodenheimer). Remember, these trials were funded by the drug companies sponsoring the trials. How can conflicts of interest be avoided? First, when a patient is registered in a drug trial, full disclosure of any financial relationships with the drug manufacturer should be given. This builds trust with the patient and also fulfills the patients right to know this information so they can make the decision as to whether or not they want to participate in the study. Second, disclosure statements should be offered to the participant and ought to be clear and simple; this will often entice the patient to ask questions. Finally, research planners should be sufficiently familiar with any conflicts of interest with the investigator or the institution so that patients questions can be answered appropriately and correctly. Disclosure may not always be what most patients are looking for but the aforementioned suggestions could help satisfy the patient and trust the research process. The investigator cannot be the only responsible party though patients must also do their homework before t hey participate in a clinical trial. The issue of whether or not conflict of interest is unacceptable when drug companies perform their own clinical drug trials is becoming an increasingly hot topic in the industry today. In an article written in BMJ magazine by Goldacre this topic is discussed. Goldacre talks about the NSAIDs study mentioned above and how impossible the results of that trial were. He notes that an organized evaluation found 30 studies that investigated whether or not industry support is connected with results that are beneficial for the sponsor. The result: studies sponsored by drug companies were more than four times as likely to have outcomes favoring the funder, compared with studies with other sponsors (Goldacre). How can this partiality be allowed to take place? Perhaps it is the way the trials are planned. For instance, in some studies the opponent drug is given at an insufficient amount which raises the side effects of the drug. This in turn makes the supporters drug look more appealing. Another known issue is that there is no standard for communicating results of drug trials. The industry has the ability to print whatever they would like to report. More often than not, the negative results from clinical drug trials remain unavailable. The most alarming concern about the clinical drug trial process is that data is not only used once, in some cases data was published within the results of 14 other trials. It is inevitable that issues like this will exist in the industry when there is no formal standard by which clinical drug trials must adhere to. Though there is no standard set the FDA has published guidelines that the industry must follow regarding financial disclosure in drug trials. The FDA Guidance for Industry on Financial Disclosure by Clinical Investigators requires that anyone submitting an application to market a drug, product or device disclose any financial relationship or compensation received by all investigators involved in the trial being set up. The FDA specifies requirements about what information is required to be reported and lists actions that the agency will take if these requirements are not followed. The FDA should not be the only one addressing conflicts of interest in clinical drug trials though. Physicians should be attentive when participating in the trials or when treating a patient that is currently or is eligible to participate in one. Physicians participating in drug trials or enlisting patients for trials should be aware of the following guidelines: Physicians should only consent to participate in trials that are within their range of capability and practice and they should be appropriately trained in performing research. Physicians should be knowledgeable of ethics and should only participate in trials that they are convinced have been evaluated by a review board, the participants in the study are not at risk of being harmed, and that government policies are followed during the course of the study. If a physician is treating patients that are enrolled in a study or are eligible to participate in a study, they will need to make sure the patient understands that they treat them under both pretenses but as both physician and investigator. Physicians should make certain that procedure include stipulations that will support the participants health care should difficulty arise as a result of the trial. The nature and source of funding and financial incentives offered to the investigators must be disclosed to a potential participant as part of the informed consent process (Managing Conflicts of Interest in the Conduct of Clinical Trials). The physician should make certain that there is no impediment in the publication of the results of the study by the sponsor of the trial. Conflict of interest is a growing concern in the health care industry today. The issues are reported on the news and in publications more and more frequently. Bringing attention to the matter and raising awareness will aid in the development and improvement of ethics in clinical drug trials. An example of one of the reformation objectives would be eliminating the behavior of a physician who treats a patient suffering from dementia and later bills Medicare; however, this same physician does not report the adverse impact on the patient, because the physician has been promised adequate compensation for evading details and touting benefits of the drug. The patient filed a malpractice suit against the physician. The attorney during discovery learned that the plaintiff was enrolled in a study and did not meet the criteria to be included in the study. It was also discovered that the medical assistant did not have any experience or training in coordinating studies and were paid a fee for each person enrolled. The study was not in compliance or conducted in conjunction with the FDA statutes and regulations. The IRB which once approved the Protocol and Informed Consent halted the study eight months earlier. An additional $5,000 per month was paid to the physician for consulting se rvices. These same payments were paid to the physician under the Clinical Trial Agreement creating a duplication of services. Medicare was billed by the physician as well for the same items and services which including the drug that for formally paid out by the sponsor in which the physician has previously been reimbursed. The Plaintiff signed the informed consent alone without any counseling even though the sponsor knew the subject was diagnosed as suffering from dementia. Dr. Joseph L. Biederman, professor of psychiatry at Harvard Medical School and the chief of pediatric psychopharmacology at Harvards Massachusetts General Hospital poses a prime situation of drug payments going to physicians. Children as young as two years old are now being diagnosed with having bipolar disorder thanks largely to Dr. Biederman. Many of the children were treated with combinations of powerful drugs known as cocktails that were never approved by the Food and Drug Administration (FDA). The FDA must approve any children below the age of ten for any purpose in a drug study trial. Physicians may legally use only drugs that have been previously approved for a particular purpose or diagnosis, for any other purpose there must be upheld published scientific evidence before administering drugs. That was not the case for Biederman. His studies advocated the drugs that treated childhood bipolar disorder and was summarized by an article in The New York Times. Biederman was paid $1. 6 million in consulting and speaking fees from 2000 and 2007 including drugs that he advocated for childhood bipolar disorder. Similar amounts were paid two of his colleagues. The president of the Massachusetts General Hospital and the chairman of its physician organization apologized and express sympathy to its beneficiaries after the conflicts of interest were revealed. Chair of Stanfords psychiatry department and president-elect of the American Psychiatric Association Dr. Alan F. Schatzberg is another example of drug payments to physicians. Schatzberg controlled and co-founded Corcept Therapeutics in which he owned more than $6 million worth of stock. The company tested the drug Mifepristone, otherwise known as RU-486 the abortion drug as well as the drug used for the treatment of psychotic depression. Schatzberg, principal investigator on a National Institute of Mental Health grant that included research coauthored three papers on the subject of mifepriston. Schatzberg was later replaced as principal investigator to avoid a conflict of interest of misunderstanding. The most shocking case of drug payments to physician is that of Dr. Charles B. Nemeroff. Nemeroff, chair of Emory Universitys department of psychiatry along with Schatzberg, both served as coeditors of the influential Textbook of Psychopharmacology. Nemeroff served as principal investigator of the National Institute of Mental Health grant that was worth $3.95 million over five years. Emory University received $1.35 million which was used as overhead to study several drugs administered by GlaxoSmithKline. Emory University had to comply with government regulators along with the university to disclose income received from GlaxoSmithKline. Emory had to report any payments over $10,000 per year per the National Institutes of Health. This was done to ensure and eliminate the conflict of interest. Emory University compared records with GlaxoSmithKline and Nemeroff failed to disclose approximately $500,000 of speaking and consulting fees promoting the companys drugs. Emory conducted its own investigation in June 2004 and multiple violations of policies were founded on behalf Nemeroff. Nemeroff responded by issuing a memorandum at Emory stating he has been in compliance however GlaxoSmithKline reported paying Nemeroff a salary of $171,031. Nemeroff reported only $9,999 to Emory. He under reported by one dollar in which $10,000 is the threshold for reporting per the National Institutes of  Health. As a result of Health Care Reform which was passed in 2010 and initiated by President Barack Obamas administration, the Pew Prescription Project is an initiative of the Pew Charitable Trust promoting consumer safety through health care reform in the approval of manufacturing and marketing of prescription drugs. These initiatives will encourage or force evidence-based prescribing. The Pew Prescription Project conducts nonpartisan research through rigorous federal oversight in relation to drug safety. The purpose is to better illuminate problems and potential solutions in the area of prescription drugs. The Pew Prescription Act current goal includes the passage of the Physicians Payments Sunshine Act and the Independence Drug Education and Outreach Act. This includes improvements to current federal laws and regulations while improving FDA oversights and drug manufacturing. The advancement of evidence-based prescribing practices and ensuring clinical safety of drugs for children is another goal. The Physician Payments Sunshine Act has been passed within the current health care reform legislation. The provisions require drug and device companies to publicly report any gifts and payments that are made to doctors. The information must be posted on their web sites and reported to the US Department of Human Services. Companies can be fined starting at $10,000 up to $100,000. Many of the provisions must be fully operational starting in 2013. The government believes patients deserve and have the right to know if their doctors are receiving money from drug companies. Congress has added much needed transparency to the financial relationships between the pharmaceutical industry and physicians.   The reporting requirements in the health care legislation will better protect patients and will help restore trust in our health care system. This new legislation will enhance the safety of consumers by increasing transparency while in no way restricting business or limiting innovation. (Jewett) Though pharmaceutical marketing strategies has taken a new enlightened turn in the world of advertising, previous tactics of physicians actually promoting through accompanying pharmaceutical sales representatives has resulted in essential stimulated scrutiny. Less face-to-face interaction between pharmaceutical sales representatives and physicians is underway to aid in eliminating the engagement as well as the hint of unethical proposals and initiatives. Rewarding physicians with branded-name gifts, meals, apparel, etc., did in fact strengthen the marketing concept and played a significant impact on the positive profitability of many pharmaceutical companies. However, the proof is in the patient. Other marketing techniques have included persuasive testimonials from respected physicians claiming to have realized improvements in their patients prognoses. Further marketing techniques consist of published promotional reporting from trusted colleagues where the tracking of physicians like s and dislikes are captured and substantiate biographical purchasing data. Prescribing under the influence is a term used as a result of the drug reps intoxicating the physicians, residents and interns with breakfast, lunch, pens, and other pharmaceutical logo branded apparel, etc. The general idea is for the pharmaceutical sales representatives to be granted another opportunity to educate physicians about the targeted drugs, which is part of substantiating marketing strategies. The pharmaceutical reps take advantage of the physicians empty stomachs with an offer of free lunch or breakfast and prey on their wandering eyes with the fancy pens, notebooks, calendars and other items that coerce physicians to agree to their objectives in increasing sales. However, when a physician is questioned about the effectiveness of this type of marketing they often respond, It doesnt influence me at all. Theyre not going to buy my soul with a laser pointer. (Morreim) Many studies support that this kind of advertising has proven vital to the steady increase in pharmaceutical sales. So, perhaps physicians need to reexamine just how much they are persuaded by the irresistible allure of free fresh baked cookies or the tiny thin tubes that hold inks that we all know as a pen. Often a doctor is not going to prescribe medication that they barely know anything about; its the responsibility of the drug representative to educate the physicians on the name of the drug and drug facts so that they can then feel comfortable prescribing it to their patients. Drug representatives have basically been buying physicians time with whatever little inexpensive knick knack and kick-back it may take to get the name of the drug into the physicians brain and onto his prescription pad. Whats even worse is that most physicians will not give the drug representatives the time of day without some type of bribe or induction that is surprisingly not considered a kickback (in ter ms of legalities). A letter in the Journal of American Medical Association attests to just how intoxicating the advertising of the drug reps can be. The story describes a patient who came into the emergency room for an insect bite. The patient was originally seen by an intern who wanted to prescribe an inexpensive antibiotic, however the decision to prescribe the inexpensive antibiotic was overruled due to the fact that another resident recommended prescribing an new antibiotic that cost $183 per day. This incident was investigated by the attending physician who supervised the house officers and found out that this particular intern had recently wined and dined the day before by a drug rep from the manufacturer of the new expensive antibiotic prescribed. This type of behavior validates the enormous impact that marketing has on gifts of persuasion. In a story posted in the New York Times magazine, titled Dr. Drug Rep. a well respected physician Dr. Joseph Carlat shares his experience in being solicited by Wyeth Pharmaceutical Company to be a spokesperson for their drug Effexor XR, which is used for treating depression. They made him an enticing offer, and told him that all he would have to do is speak with his fellow colleagues about the features and benefits of the drug. Wyeth would provide all the information and materials that he needed to educate the other physicians about the drug and in return Dr. Carlat would be paid $500 for a one-hour training session or $750 if he had to drive for an hour. Dr. Carlat thought this would be easy enough. He was reputable; he had a busy private psychiatry practice specializing in psychopharmacology. He was quite familiar with drug Effexor and had read different studies pertaining to its effectiveness. The drug Effexor was being promoted by Wyeth as a dual reuptake inhibitor meaning that it increased both serotonin and norepinephrine, another neurotransmitter. The theory promoted by Wyeth was that two neurotransmitters were better than one, and that Effexor was more powerful and effective than S.S.R.I.s. (Carlat) Because he had already prescribed Effexor to several patients and it seemed to work, Dr. Carlat did not feel like there was anything unethical about him talking to other doctors about the drug. Dr. Carlat subsequently attended a full, expense paid physicians conference in Boston. When he began socializing at the conference there were other physicians functioning as spokespersons for other drugs and pharmaceutical companies. One physician that stood out was Dr. Michael Thase, the researcher who single-handedly put Effexor on the map. Thase presented evidence from clinical trials of Effexor being more effective than any other antidepressant. He rebutted criticisms of him being a paid consultant of Wyeth quite convincingly which was important. He explained to the attendees that he had requested and received complete information, both advantagess and disadvantages of the research data and not just the advantages. This was a significant point, because companies sometimes withhold negative data from publication in medical journals. For example, in 2004, GlaxoSmithKline was sued by Eliot Spitzer, who was then the New York attorney general, for suppressing relevant data that hinted Paxil caused suicidal thoughts in children. The company settled the case and agreed to make clinical-trial results public. (Carlat) Was I swallowing the message whole? Certainly not. I knew that this was hardly impartial medical education, and that we were being fed a marketing line. But when you are treated like the anointed, wined and dined in Manhattan and placed among the leaders of the field, you inevitably put some of your critical faculties on hold. I was truly impressed with Effexors remission numbers, and like any physician, I was hopeful that something new and different had been introduced to my quiver of therapeutic options. At the end of the last lecture, we were all handed envelopes as we left the conference room. Inside were checks for $750. It was time to enjoy ourselves in the city. (Carlat) However, after a year of pharmaceutical detailing Dr. Carlat became disturbed concerning feedback that Effexor caused hypertensions in a small but significant percentage of patients. For that reason, amongst other ethical reasons, Carlat decided to sever ties with Wyeth. Looking back on the year he spent speaking for Wyeth, he asked himself, Did I contribute to faulty medical decision making? Did my advice lead doctors to make inappropriate drug choices, and did their patients suffer needlessly? He admitted that there was a huge financial incentive for physicians to partner with pharmaceutical companies. (Carlat) Although he still allows drug reps to visit his office because it helps him stay abreast of the growing trends, he keeps the visits short and does not accept their offers and invitations. Who says this type of marketing isnt effective? Do other physicians really think they are invincible from the powers of persuasion? How many doctors actually engage in this type of marketing for drug companies? What role do ethics play in the decision to speak or not to speak on behalf of the insurance company? The truth is that previously many physicians engaged in this type of pharmaceutical detailing. While the median physician salary of 140,000 annually may be representative of a good salary, the additional $30,000 in supplemental income is quite alluring. In addition, to the monetary earnings earning respect based on reputation is important among colleagues. At least 25% of U.S. doctors are still receiving drug money for lecturing to physicians or assisting drug companies in other ways. Many physicians engage in this type of career appendage and perhaps go in with the purest of intentions; nonetheless, ethics are being violated when the physicians are not relaying accurate and appropriate information about the new medications that they are pushing, and much of the information that they are giving is provided to them from the pharmaceutical companies. PhRMA, Pharmaceutical Research and Medical Practices of America are part of an ongoing effort to ensure that pharmaceutical marketing organizations practice with the highest ethical standards. In January 2009, the voluntary PhRMA Code on Interactions with Healthcare Professionals took effect and its focus was developed to keep representatives from drug companies and healthcare professionals centered on patient care. It is committed to making sure that drug representatives are provided with the most current, accurate, and reliable information to assist in their decision making on drug selection. Amongst its changes, prohibits distribution of no-educational items (Such as pens, mugs and other reminder objects typically adorned with a company or product logo). It prohibits company sales representatives from providing restaurant meals to healthcare professionals, but allows them to provide occasional meals in healthcare professionals offices in conjunction with informational presentation s. The Code also reaffirms and strengthens previous statements that companies should not provide any entertainment or recreational benefits to healthcare professionals. It includes new provisions that require companies to ensure that their representatives are sufficiently trained about applicable laws, regulations, and industry codes and practice. Companies are also asked to periodically access whether or not the representatives are abiding by the codes. (PhRMA) CEOs and Compliance Officers will have a process in place patterned after the Sarbanes Oxley compliance, other changes to the code reflects PhRMas support of transparency in relation to healthcare professionals. There is necessary education offered to interested parties regarding marketing techniques and physicians outlooks on pharmaceutical products, diagnoses and expected and proven outcomes. Since Pharmaceutical products must be marketed differently than other healtcare industry products for sale and there are distinct diversions for implementing successful marketing. The potential user or patient, must be granted a prescription from the prescribing physician. Proper use of the pharmaceutical is key which provides favorable or unfavorable outcomes. Within the public health sector, determinations on accessible drugs may very well be taken based on politics, which undoubtedly broadens the scope of advertising and marketing strategies in this field, replacing advertising by appealing via petitions through lobbyism. Various marketing schemes play into different levels of interests such as financial, scientific gain or even personal. Academic conferences and medical journals provide varying me diums for exposure. Ethical pharmaceutical trials developed arguments depends on knowledge, outcomes and concrete unbiased facts. This type of knowledge requires transparency, a level of transparency being sought after throughout the healthcare industry as a whole. The pharmaceutical industry requires skilled marketing experts to ensure that all aspects of reaching targeted audiences effectively are exceeded, not just met. Those regulations developed by the Pharmaceutical Research and Manufacturers of America and nofreelunch.org, which are not law, were developed to promote transparency. A doctor as a pharmaceutical representative shares his personal story about lecturing on a particular drug. There are ethical guidelines developed specifically for the healthcare industry that includes the pharmaceutical industry. AdvaMeds Code of Ethics, in particular, is a model for appropriate ethical behaviors within the healthcare industry that outlines specific recommendations for the drug industry. AdvaMed addres ses parameters covering educational grants, modest meals and hospitality, faculty expenses, and advertisements. In presenting the issues of unethical behaviors, it is imperative to understand the prevalence based on historical and current behaviors in society and the ever-evolving methods developed to discourage physician kickbacks in the pharmaceutical industry. Though AdvaMeds Code of Ethics regulations do not mandate their guidelines be adhered to, health care organizations are strongly urged to utilize and enforce their codes can assist in eliminating and curtailing unethical behaviors that lead to lawsuits that actually develop in to Case Studies. As long as viable codes of ethics are followed, fear of transparency can be removed. Acceptably ethical behaviors will indeed help aid in the inevitable reformation efforts that this nation continues to experience.

Free Othello Essay: The Disobedient Wife -- Othello essays

An Outspoken Wife as the Penalty for Dishonesty in Othello In William Shakespeare's Othello, the loyalty of a woman to a man includes being silent and obedient. Emilia clearly follows these guidelines of silence and obedience until her epiphany in which she learns of Iago's dishonesty. Shakespeare implies that the penalty for a man’s dishonesty is an outspoken, disobedient wife. Emilia literally causes Iago's downfall, which is brought on due to Iago's overestimation of Emilia's loyalty. "'Tis proper I obey him, but not now" (5.2.203). Because Emilia remains loyal to Iago throughout the play, Iago relies totally on the belief that Emilia will remain obedient to him. Emilia proves her loyalty to Iago by stealing the handkerchief that Othello gave Desdemona: My wayward husband hath a hundred times Wooed me to steal it, but she so loves the token-- .... I'll have the work ta'en out, And give 't Iago ... I nothing but to please his fancy. (3.3.308-309, 312-313, 315) In taking the ch...