Labeling theory Essay Example for Free

Labeling theory Essay Please complete the following exercises, remembering that you are in an academic setting and should remain unbiased, considerate, and professional when completing this worksheet. Part I Select three of the identity categories below and name or describe at least 3 related stereotypes for each: †¢ Race †¢ Ethnicity †¢ Religion †¢ Gender †¢ Sexual orientation †¢ Age †¢ Disability. |Category |Stereotype 1 |Stereotype 2 |Stereotype 3 | |Race |Asians are genuises |African Americans are amazing at |All white people are racist | | | |all sports | | |Gender |Woman are moody |Women can’t drive |Men are rude | |Disability |Disabled people are not smart |Disabled are weak |Disabled need help with everything| Part II Answer each question in 50 to 100 words related to those stereotypes. Provide citations for all the sources you use. What are the positive aspects of stereotypes, if any? o I do not think that there any positive aspects of stereotypes. I know that there are positive stereotypes, but in general stereotypes are opinions and are negative most of the time. Just about every stereotype that is out there is offensive to someone and can hurt someones feelings. For example, a stereotype that hurts me is my weight. People automatically assume that since I am heavier that I am lazy and do not take care of myself or my kids and that is far from being true. What are the negative aspects of stereotypes? o There are many different negative aspects of stereotypes. One negative aspect is that a lot of stereotypes are highly offensice to some people and can cause people to become upset or angry. Another negative aspect is that as long as we have stereotypes people are going to continue being prejudice. Part III Answer each question in 50 to 150 words related to those stereotypes. Provide citations for all the sources you use. Define stereotypes and prejudice. What is the difference between stereotyping and prejudice? Use examples to illustrate the differences. o Stereotypes are unreliable assumptions that are made towards a certain group without taking individual differences into mind. Prejudice is simply a negative attitude towards a group of people. The difference between prejudice and stereotypes is that stereotypes are made towards everyone involved in a certain group whether the opinion be positive or negative stereotypes links everyone in that group to be the same even though they are not. For example, a stereotype would be something like saying all gay guys are wimps. Prejudice on the otherhand is completely negative and affects an entire group such as a racial or religious group. An example of prejudice would be something like someone saying they hate all African Americans because their skin is a different color. What is the relationship between stereotyping and prejudice? o The relationship between stereotyping and prejudice is that both of them affect an entire group of people without taking into consideration the individual differences. Prejudice is the beginning circle of this negativity. People are prejudice and split different people into different groups. Once this is done stereotyping comes into play where people sort those groups into smaller categories by making opinions of the groups without seeing the differences. What can be done to prevent prejudice from occurring? o There are a few different ways that we can try and prevent prejudice from occurring. One way is education and research. If people took more time to learn about different people and the diversity that we have in this world I think that they would see all of the interesting things in others and would help prevent some of the prejudice. Another way that we can try and prevent prejudice is by eliminating stereotypes and not labeling people.

History of Cocaine Use Medical and Recreational Uses

History of Cocaine Use Medical and Recreational Uses Cocaine through the ages: from elixir to poison. Abstract: Cocaine, a plant alkaloid derived from coca leaves is a potent stimulant of CNS and has local anesthetic action as well. Historically, it was ingested in the form of chewing coca leaves, to suppress hunger and fatigue. With discovery of its local anesthetic properties, cocaine was introduced into world of medicine and a local anesthetic, but over last few decades, gained popularity as drug of abuse. Cocaine carries with it great potential for addiction and abuse. It is administered through various routes, smoking free-base crack and intranasal inhalation being most popular. Its primarily metabolized in liver and distributed to all body tissues. Due to lipid nature it tends to concentrate in brain and adipose tissues with chronic administration. Its mainly eliminated through kidneys, but saliva and stools are also routes of excretion. A number of health hazards have been shown to be associated with cocaine use including, cardiac abnormalities, psychological disturbances, addiction pot ential and renal failure with or without rhabdomyolysis. Acute and chronic cocaine toxicities with sufficient collected data are included. Techniques for detecting cocaine in blood including enzyme linked immunoassay and POCT (Point of care screening tests) have also been discussed. An analysis of recent trends in cocaine uses have been studied and presented along with graphical illustrations of epidemiological evidence to support the data. Introduction and objective: Objective: to display how cocaine has evolved through time in its uses and available forms, from simple coca leaf chewing custom of South Americans in 2500 BC to modern forms of freebase-coke among others as one of the most commonly abused toxic drug. Methodology: Data was mainly collected from electronic resources, but text on immunology and pharmacology was also consulted. From electronic sources, I mainly used search engines using a number of keywords including ; history of cocaine, crack, pharmacokinetics of cocaine, mode of action , coca leaf, acute cocaine poisoning, chronic cocaine toxicity, Karl Koller, Sigmund Freud, Immunoassay, etc. I also went through a number of journals available online, and a number of researches conducted which related to cocaine. My aim was to find changes in cocaine use from its discovery to date, and show, with help of collected data, that it has moved in a negative direction. Brief history: Cocaine, use of which, according to some sources, date back to at least 1200 years, has now, rightfully, earned itself a place in drugs of abuse list among others like Caffeine, Nicotine, Amphetamine, etc. To date, cocaines uses have evolved from gaining popularity as topical anesthetic agent, and as component of energizing drinks to becoming one of the most abused drugs in the world. It is a powerfully addictive stimulant drug, which acts by interfering with cerebral and peripheral synaptic transmission among neurons. Mode of action has been described in greater detail later in pharmacodynamics section, but for brief introduction, it interferes with reuptake of, and thereby enhance duration of action of, monoamines, dopamine, serotonin and nor epinephrine Brain PF et.al (1989). It also produces membrane stabilizing effect, more commonly referred to as local anesthetic effect. Latter is achieved through modulation of voltage gated sodium channels and consequent blockade of sensory im pulses conduction from that part of the neuron to central nervous system. Brain PF et.al (1989) Earliest records of cocaine use reveal it to be a part of South American custom of chewing coca leaves. This use is believed to date back to 2500BC. Steven Cohen (1981) Practice of chewing mixture of tobacco and coca leaves was defined by Nicolà ¡s Monardes, in 1569, to induce â€Å"great contentment†. Cocaine is the active component of coca leaves, which also contains nicotine. Karch SB (1998). In 1859, Italian doctor, Paulo Montegazza, after witnessing coca use by natives of Peru, and getting mesmerized by it, decided to study the effects of cocaine on himself. After his studies he concluded his findings into a paper in which he declared cocaine to be medically useful in treating furred tongue in the morning, flatulence and whitening the teeth. Steven R. King (1992). In 1863, French chemist, Angelo Mariani, introduced popular cocavine, Vin Mariani. Vin Mariani wasproduced from mixture of 6 mg coca leaves per fluid ounce of Bordeaux wine. Courtwright DT (2001) Angelo Mariani, creator of Vin Mariani, which later became the hallmark of cocavines was honored with Vatican gold medal by Pope Leo XIII for this achievement. Ethanol, a component of vin mariani, is believed to extract cocaine from coca leaves. In 1884, the concept of cocavine was adopted by John S. Pemberton, with introduction of Pembertons French Wine Coca. After prohibitions imposed on cocaine use and manufacture of cocaine-containing products including cocavine in 1885, Pemberton introduced carbonated, non-alcoholic form of Vin Mariani and called it Coca-cola. Richard Ashley (1975). From 1906 onwards, however, after Pure Food and Drug act was passed, decocainised forms of coca were used for manufacture of coca-cola. In 1884, Austrian physician Sigmund Freud, recommended cocaine for treatment of morphine and alcohol addiction. A strategy that was later employed in 1879 when cocaine was used to treat morphine addiction. Steven Cohen (1981). In his published word, ÃÅ"ber Coca, Sigmund defined effects of cocaine in following words: â€Å"exhilaration and lasting euphoria, which in no way differs from the normal euphoria of the healthy personYou perceive an increase of self-control and possess more vitality and capacity for work.In other words, you are simply normal, and it is soon hard to believe you are under the influence of any drug.Long intensive physical work is performed without any fatigueThis result is enjoyed without any of the unpleasant after-effects that follow exhilaration brought about by alcohol.Absolutely no craving for the further use of cocaine appears after the first, or even after repeated taking of the drug† In 1985, use of cocaine for induction of spinal anesthesia was accidentally discovered by American neurologist Leonard Corning while he studying the effects of cocaine on spinal nerves in a dog and accidentally pierced the dura matter. Corning JL (1885) Cocaine was, however, not used as anesthetic in spinal surgery until 1989 when first planned cocaine induced spinal anesthesia was administered in a surgery, by August Bier. A. Bier, (1899) Coca leaves have traditionally been used as suppressants for fatigue, thirst, and hunger. Its use has now been limited to Andean countries, where coca leaf chewing and coca tea consumption are still practiced. Industrially, coca leaves serve as source of drug cocaine, and in some cosmetic and food industries, including coca cola. Richard Ashley (1975) From 1980s to date, cocaine has gained popularity as drug of abuse, and has widely replaced heroin and other narcotics as drug of abuse, being used in different forms and administered via various routes. Richard Ashley (1975) Discovery: Discovery of cocaine, as local anesthetic, is claim to fame for Austrian ophthalmologist, Karl Koller. Kollers name is credited with demonstration of anesthetic effect of cocaine, in 1884. Karl Koller was a close associate of Sigmund Freud who in same year recommended cocaine to be employed in treatment for morphine and alcohol addiction. Hruby K (1986). Koller studied effects of cocaine on eye by applying the drug to his own eye and later pricking it with pins. He presented his findings to the Heidelberg Ophthalmological Society in same year. Hruby K (1986) After successfully experimenting on himself, Koller used cocaine as local anesthetic in eye surgeries, a use that continues to this day. Cocaine was later employed in other fields including dentistry for induction of local anesthesia, Today, however, cocaine has largely been replaced by other local anesthetic agents like lidocaine, xylocaine, bupivacaine, etc, which produce local anesthetic effect as efficiently and do not carry potential for abuse.Hruby K (1986) Isolation: Friedrich Gaedcke, aGerman chemist, was first person to successfully isolate cocaine from coca leaves, in 1855. An improved isolation process was, however, developed by Albert Niemann, who was enrolled as a Ph.D. student at a German university, University of Gottingen , in 1859. Niemann wrote a dissertation describing steps of isolation which was published in 1860 and was entitled, â€Å" ÃÅ"ber eine neue organische Base in den Cocablà ¤ttern† (On a New Organic Base in the Coca Leaves). F. Gaedcke (1855) Formal Chemical Name (IUPAC) for cocaine: (1R,5S)-methyl 8-methyl-3-(phenylcarbonyloxy)-8-azabicyclo[3.2.1]octane-2-carboxylate. Chemical structure of cocaine: Structure of cocaine molecule was first defined by Richard Willstà ¤tter in 1898. Medicalisation and popularization: Ever since its discovery, cocaines medical uses were quickly exploited through research and experimentation. Spanish physicians described first medical uses of cocaine as early as 1596, but the use of cocaine did not become more widespread until 1859, when Albert Niemann isolated the drug from coca leaves. Soon after it was isolated, cocaine was used to try to cure almost all the illnesses and maladies that were known to man. (Albert Niemann 1860) 1859s Montagezzis discovery about cocaine being useful in treating furred tongue in the morning, flatulence and whitening the teeth, was one of the earliest recorded studies that signified possible medical importance of cocaine. In 1879, Vassili von Anrep, of the University of Wà ¼rzburg, demonstrated analgesic properties of cocaine in an experiment that he conducted on a frog. He prepared two separate jars, one containing cocaine-salt solution, other containing salt water serving as control. One of frogs legs was submerged in cocaine solution and other in control followed by stimulation of leg in different ways. Reactions in two legs varied considerably. In the same year, cocaine began to be used in treatment of morphine addiction. The commercial production of purified cocaine gained momentum only in the mid-1880s. Its greatest medical value was in ophthalmology. Eye-surgery stood in desperate need of a good local anesthetic. This was because in eye operations it is often essential for a conscious patient to move his eye as directed by the surgeon without flinching. Karl Kollers demonstration of anesthetic properties of cocaine in 1884 was an important breakthrough establishing cocaines importance, medically when it was introduced in Germany as local anesthetic for eye surgery. (Altman Aj et.al 1985) Kollers discovery was later followed in 1985 by Leonard Cornings accidental demonstration of cocaines use in induction of spinal anesthesia, which became formally employed in spinal surgery in 1989 when first planned cocaine induced spinal anesthesia was administered by August Bier. Medical use of cocaine has largely been restricted to induction of local anesthesia. Even as local anesthetic agent, discovery of hazardous effects of cocaine use led to early development of safer alternative drugs like lidocaine, etc. One of its first non medical uses of cocaine was in military. In 1883 Theodor Aschenbrandt administered cocaine to members of the Bavarian army. It was found that the drug enhanced their endurance on maneuver. His positive findings were published in a German medical journal, which brought the effects of this wonder drug to a wider medical audience, including Sigmund Freud. Following is taken from â€Å"On cocaine† by Sigmund Freud. â€Å"A few minutes after taking cocaine, one experiences a certain exhilaration and feeling of lightness. One feels a certain furriness on the lips and palate, followed by a feeling of warmth in the same areas; if one now drinks cold water, it feels warm on the lips and cold in the throat. One other occasions the predominant feeling is a rather pleasant coolness in the mouth and throat. During this first trial I experienced a short period of toxic effects, which did not recur in subsequent experiments. Breathing became slower and deeper and I felt tired and sleepy; I yawned frequently and felt somewhat dull. After a few minutes the actual cocaine euphoria began, introduced by repeated cooling eructation. Immediately after taking the cocaine I noticed a slight slackening of the pulse and later a moderate increase. I have observed the same physical signs of the effect of cocaine in others, mostly people my own age. The most constant symptom proved to be the repeated cooling eructation. This is often accompanied by a rumbling which must originate from high up in the intestine; two of the people I observed, who said they were able to recognize movements in their stomachs, declared emphatically that they had repeatedly detected such movements. Often, at the outset of the cocaine effect, the subjects alleged that they experienced an intense feeling of heat in the head. I noticed this in myself as well in the course of some later experiments, but on other occasions it was absent. In only two cases did coca give rise to dizziness. On the whole the toxic effects of coca are of short duration, and much less intense than those produced by effective doses of quinine or salicylate of soda; they seem to become even weaker after repeated use of cocaine.† Cocaine was sold as over the counter drug until 1916. It was widely used in tonics, toothache cures, patent medicines, and chocolate cocaine tablets. Prospective buyers were advised (in the words of pharmaceutical firm Parke-Davis) that cocaine could make the coward brave, the silent eloquent, and render the sufferer insensitive to pain. Cocaine was a popular ingredient in wines, notably Vin Mariani. Coca wine received endorsement from prime-ministers, royalty and even the Pope. The Vatican gold medal that Angelo Mariani received for it will forever signify the popularity of cocaine through that period of time. By the late Victorian, era use of cocaine had appeared as a vice in literature, for instance, Arthur Conan Doyles fictional Sherlock Holmes. Number of admissions to drug treated programme in each year is plotted against time for both cocaine and heroin. Graph clearly displays the shift in trend from use of heroin towards cocaine. A combination gaining popularity is speedball, which is formulated by mixing heroin with cocaine. From 1980s to date, cocaine has gained popularity as drug of abuse, being used in different forms and administered via various routes, as evident by figure above which displays the escalation in crack / cocaine usage with concomitant reduction in heroin use. Prohibition: In first part of the twentieth century, with addictive properties of cocaine becoming more apparent with studies, cocaine found itself legally prohibited. Harrison Narcotics Tax Act (1914) outlawed unauthorized sales and distribution of cocaine incorrectly classifying it as a narcotic. In United Nations 1961 Single Convention on Narcotic Drugs, cocaine was listed as Schedule I drug, thereby making its manufacture, distribution, import, export, trade, use and possession illegal unless sanctioned by the state. In 1970s controlled substances act, cocaine was listed as a Schedule II drug in United States. It carries high abuse potential but also serves medicinal purpose. It is a class A drug in the United Kingdom, and a List 1 drug of Opium law in the Netherlands. Modern Usage: In late 90s and early 2000s, crack became very popular among Americans and in past few years has also taken its toll on UK. According to an estimate, U.S cocaine market exceeded $ 70 billion in year 2005, demonstrating the popularity of this menace. News reports are flooded with celebrity arrests on charge of cocaine posession or use. A section on recent facts and figures related to cocaine discusses the modern trends in greater detail later. Addiction potential: Along with amphetamine, cocaine is one of the most widely abused drugs in the world. Powerful stimulant properties of cocaine are beyond doubt. By inhibiting neuronal reuptake of excitatory neurotransmitters, dopamine, serotonin and norepinephrine, cocaine enhances synaptic concentrations of these neurotransmitters in specific brain areas; nucleus accumbens and amygdala which are referred to as the reward center of brain. During 1980s, cocaine widely replaced heroin as drug of abuse, due to its euphoric properties, wide availability and low cost. Different forms and Routes of administration of cocaine: Smoking: Crack, freebase or smokable form of cocaine, was produced and became popular drug of abuse in 1980s. Earliest reports of crack use indicate an epidemic in Bahamas from 1980. By 1985, crack gained popular ranking among drug users across America.Crack is produced by mixing 2 parts cocaine hydrochloride with one part baking soda (sodium bicarbonate). It differs from cocaine hydrochloride in being more volatile, a property that makes it better suited for inhalation administration (smoking) than cocaine hydrochloride. Smoking freebase cocaine releases methylecgonidine, an effect not achieved with insufflation or injection (described later), thereby making it a specific test marker for freebase cocaine smokers. Studies suggest that methylecgonidine is more harmful to heart, liver and lungs than other byproducts of cocaine. Inhalation leads to rapid absorption of cocaine into bloodstream via lungs, reaching brain within five seconds of ingestion. Following rush exceeds snorting in intensity but does not last long. Oral: Ancient tradition of South Americans to chew coca leaves in same manner is tobacco, is another method of cocaine consumption. Alternatively, coca leaves may be consumed like tea by mixing with liquid. Coca leaf consumers have raised a controversy over whether it should be abandoned or not. Rationale behind this controversy is that strong acid in our stomach hydrolyzes cocaine, attenuating its effects on brain; therefore, unless it is taken with an alkaline substance, such as lime, which neutralizes stomachs acid, cocaine intake should not be criminalized. Cocaine is also used as oral anesthetic, both medically and unofficially. Cocaine powder is applied to gums to numb the gingiva and teeth. Colloquial terms for this route of administration are; numbies, gummies and cocoa puffs. Another method for oral administration, commonly known as snow bomb, is to pack cocaine in rolled up paper and swallowing it. Insufflation: Colloquial terms for which are; snorting, sniffing, or blowing is believed to be most commonly employed method of cocaine ingestion in west. Cocaine is poured on a flat, hard surface and divided into fine powder before being insufflated in â€Å"bumps†, â€Å"lines†, or â€Å"rails†. Devices used as aid in insufflation are known as â€Å"tooters†. Anything small and hollow, such as straws cut short, can serve as a tooter. Injection: This achieves the greatest bioavailability, 100%, in shortest span of time, since drug is directly administered into bloodstream saving time and reduced bioavailability that occurs with drug absorption from site of drug administration into bloodstream. Resultant rush is intense and rapid. Risk of contracting blood-borne infections is greatest. â€Å"Speedball†, a mixture of cocaine with heroin used intravenously is a popular and dangerous method of cocaine ingestion. It claims credit for many deaths, including celebrities like John Belushi, Chris Farley ,Mitch Hedberg, River Phoenix and Layne Staley. ADME Pharmacokinetics: Absorption, Distribution, Metabolism and Excretion of Cocaine. Before beginning discussion about pharmacokinetics or ADME of cocaine, table below summarizes the relationship of route of administration with onset of action, time taken to achieve peak effect, duration of action and half life. (Clarke, 1986) Route of administration Onset Peak effect (min.) Duration (min.) Half-life (min.) Inhalation 7s 1-5 20 40-60 Injection 15s 3-5 20-30 40-60 Nasal 3min 15 45-90 60-90 Oral 10min 60 60 60-90 Absorption: Absorption refers to movement of drug from site of administration into bloodstream.As with any drug, absorption of cocaine depends on various factors and varies considerably with them. Factors which influence drug absorption include; drug formulation, route of administration, lipid solubility, pH of the medium, blood supply and surface area available for absorption. As evident from tabulated figures above, cocaine differs greatly in onset of action varying between 7 seconds up to 10 minutes from one route of administration to another. This is a factor of absorption of drug which depends on route of administration. Each route is separately discussed below in greater details. (Clarke, 1986). Orally administered cocaine: Cocaine induces vasoconstriction in vessels supplying oral mucosa and resultant reduction in blood supply slows down its absorption by decreasing surface area from which drug is absorbed. Therefore when orally administered, drug is slowly absorbed into bloodstream, taking roughly 30 minutes. Absorption is also incomplete; roughly one third of administered dose is absorbed. Due to slow absorption, onset of action is also delayed and peak effect is, however, not achieved until about 50-90 minutes after administration. Effect is, however, longer lasting, roughly 60 minutes after attainment of peak effect. Another factor affecting absorption of orally administered cocaine is pH of the stomach. As previously mentioned, stomach acid hydrolyzes cocaine, resulting in inadequate and incomplete absorption. To improve absorption it is common practice to take cocaine along with an alkaline liquid to neutralize acidic pH. Insufflations: Insufflations results in coating of the mucosa covering sinuses with cocaine, from where it is absorbed. Absorption is similar to that from oral cavity, cocaine induced vasoconstriction beneath mucosa results in slow and incomplete absorption (30-60%). Efficiency of absorption increases with concentration of drug. According to a study, time taken to reach peak effect via this route of administration averages 14.6 minutes. Injection: Injected cocaine is directly administered into bloodstream eliminating need for absorption. According same study, as mentioned for insufflation, time taken to reach peak effect of cocaine through injection averaged 3.1 minutes, roughly five times less than time for insufflation. Smoking: Smoking crack delivers large quantities of the drug to the lungs, resultant absorption is rapid and effects created are comparable to intravenous administration. These effects, which are felt almost immediately after smoking, are intense and last for 5-10 minutes. According to Perez-Reyes et al, 1982, volunteers who smoked 50 mg of cocaine base in a controlled study experiment achieved rapidly elevated plasma cocaine level compared to intravenous cocaine administration. Distribution: Following absorption into bloodstream, cocaine is distributed, via blood, to all body tissues including vital organs like brain, lungs, liver, heart, kidneys and adrenals. It crosses both blood-brain and placental barrier. Being lipid soluble, it easily traverses biological membranes via simple diffusion. It is believed to accumulate in brain and adipose tissue with repeated administration, owing to its lipid nature. In an experiment, distribution and kinetics of cocaine in human body were studied using Positron Emission Topography (PET) technique with radioactively labeled (carbon-11) cocaine on 14 healthy male subjects. Rate of uptake and clearance were found to vary among organs. Following results were obtained for time, in minutes, taken by radioactively labeled cocaine to reach peak value in following organs: Lungs: 45 seconds. Heart and Kidneys: 2-3 minutes. Adrenals: 7-9 minutes. Liver: 10 minutes. Liver, which is the key site for metabolism of cocaine is where distribution is most sluggish, increasing the half-life of cocaine. The Journal of Nuclear Medicine ( 1992 ) Metabolism: As already mentioned, cocaine is primarily metabolised in liver. It is estimated to get metabolized within two hours of administration. Half-life varies between 0.7 1.5 hours (Clarke, 1986), depending on route of administration among various other factors. There are three possible routes for bio-transformation of cocaine. Ester linkages in cocaine are hydrolyzed by plasma pseudocholinesterases and hepatic enzymes, human liver carboxylesterase form 1 (hCE-1)and human liver carboxylesterase form 2 (hCE-2). Benzoyl group is eliminated to produce ecgonine methyl ester. This is the major route for metabolism of cocaine. A secondary route, suggested by Fleming et al. 1990, proposes spontaneous hydrolysis, possibly non-enzymatic, followed by demethylation to produce benzoylecgonine. N-demethylation of cocaine is a minor route which leads to formation of norcocaine. Final degradation of metabolites yields ecgonine. Principal inactive metabolites are; benzoylecgonine, ecgonine methyl ester, and ecgonine itself. Norcocaine is an active metabolite and may reveal itself in acute intoxication. Metabolism of cocaine may be influenced by a number of factors: Alcohol:When cocaine is co-administered with alcohol a compound called Cocaethylene is formed. Cocaethylene is associated with an increased risk of liver damage and premature death. Pregnancy. Liver disease. Aged men. Congenital cholinesterase deficiency. In all the aforementioned conditions, except alcohol, rate of cocaine metabolism is reduced, leading to elevated levels and duration of action of cocaine, enhancing its harmful effects of on the body. Following is a schematic representation of metabolic pathways of cocaine. According to Andrew (1997) have found that the continuous use of alcohol with cocaine produce cocaethylene which is similar in the action of cocaine but it has more blood stream concentration by three to five times than cocaine as a result of its high half life. Its much attractive to be used for abuse as a result of slower removal from the body. Different types of side effects are associated with cocaethylene like liver damage, seizure and immuno compromised functioning . Cocaethylene has more possibility for sudden death by 18 25 times than using cocaine alone . Butyrylcholinesterase (BChE) has been implicated as being important in metabolism of cocaine, even though it has limited capacity to fully hydrolyze cocaine. BChE is specially essential for cocaine detoxification. A lot of research has been done to study the effect of employing this enzyme in cocaine detoxification and in anti-cocaine medications. The rate at which human BChE hydrolyzes cocaine is slow; however, scientists at Eppley Institute and Department of Biochemistry and Molecular Biology, University of Nebraska Medical Center, Omaha, Nebraska, have developed a mutant (A328Y) of human butyrylcholinesterase, which promises four fold greater efficiency in accelerating cocaine metabolism. Elimination or excretion: 1-9% of cocaine is excreted unaltered in urine along with metabolites, ecgonine methyl ester, benzoylecgonine, and ecgonine. Unchanged cocaine may also be eliminated through GI tract and/or be excreted in saliva. Most of the parent drug is eliminated from plasma within 4 hours after administration but metabolites may remain detectable for up to 144 hours after administration. Elimination of cocaine via kidneys is enhanced by acidification of urine. As already mentioned, cocaine easily traverses placental barrier, and the active metabolite, norcocaine is believed to persist in amniotic fluid for up to 5 days. In lactating mothers, cocaine and benzoylecgonine are excreted into maternal milk and can be detected up to 36 hours after administration. In smokers, cocaine is rapidly eliminated through exhalation of vapor. Ambre J et.al (1988) In an experiment, the effects of chronic oral cocaine administration in healthy volunteer subjects with a history of cocaine abuse were investigated. There were sixteen daily sessions of oral cocaine administration while subjects were kept in a controlled clinical ward. In every session subjects received five equal doses of oral cocaine at one hour interval. Throughout sessions, cocain

University Tuition Costs are Too High Essay -- College Costs Are Out O

The cost of tuition for higher education is quickly rising. Over half of college freshmen show some concern with how to pay for college. This is the highest this number has been since 1971 (Marill and O’Leary 64-66, 93). The amount of college graduate debt has been rapidly increasing also. With limited jobs available because of the high unemployment rate, college graduates find themselves staying in debt even longer. Although grants and financial aid are available to students, students still struggle to pay for their college tuition. Higher education costs are prohibitively expensive because the state’s revenue is low, the unemployment rate is high, and graduates cannot pay off their student loans. One reason that higher education is not affordable is that the states’ revenue is low and the states are in debt. Because of their decreasing tax revenues, many states need to make cuts in their budget. As a result of this, tuition is rising and other changes are happening throughout colleges. Some of these changes include: higher student to faculty ratios, less but larger classes, and fewer on-campus jobs that normally support students (Hulsey 24). These changes affect students and impact their view and decisions of certain colleges. The tuition rate has also â€Å"been rising at about 6 percent a year for most of the past ten years† (Marill and O’Leary 64-66, 93). This percent inevitably makes it harder for students to find an affordable college. High tuition prices also keep some people from attending their dream college. All of these changes have an effect on the students and the rising tuition prices. Another result of the different states being in debt is that they are giving colleges less financial help. â€Å"Prior to ... ...or all students. One reason for this is that the states’ revenue is low. High unemployment rates also contribute to this problem. Another cause of this is the inability of students to pay off their loans. Nearly two-thirds of college freshmen feel concerned about how to pay for college and almost the same amount graduate with debt (Marill and O’Leary 64-66, 93). Since high tuition and loans drastically affect a person, many students feel forced to take this into consideration when making plans for their future. Many plans and dreams that high school students have become altered when reality hits them about the cost of continuing their education. Therefore, students just cannot afford higher education.

The Oppressing Face Of Madness In The Mirror Of Society :: essays research papers fc

The Oppressing Face of Madness in the Mirror of Society For centuries women in life and literature were often portrayed as submissive, docile, and obedient to men. Focusing primarily on the nineteenth century, literature of the period often characterized women as victims oppressed by society, culture, as well as by the male influences in their lives. Many of the female characters suffered the effects of isolation brought on by constant oppression and subservience driving them insane and mad. The views of women in early literature were often silenced and their opinion’s disregarded by a dominant patriarchal society. One could argue that the men’s influence on society forged the distinctions between sanity and madness. This obsessive position to shape reality proved to be unhealthy and destructive but it was rarely acknowledged among the company of men. A Spanish writer Miguel de Cervantes (1547-1616) once quoted, â€Å"Too much sanity may be madness, and maddest of all, to see life as it is and not as it should be!† (h ttp://www.quoteworld.org.) Madness even though taboo and troublesome, seemed common in many female literary protagonists of the period. Thus far in the course we encountered the role of madness in such literary works as â€Å"The Story of an Hour,† and â€Å"The Yellow Wallpaper.† The role of madness and oppression in the works can be better examined in three aspects of: the causes of the induced madness, how each female character deals with the insanity, and how the similarities in madness link the texts to common social issues. The conclusion will show the significant roles madness and oppression played in the selected fictional stories echoing the real life torment women lived in. Speaking in an aesthetic tone, one will see that though the Yellow Wallpaper and The Story of an Hour are similar, however, tale by Gilman proves to be a better argument for portraying the role of maddens and oppression as a mirror of society of the time period.   Ã‚  Ã‚  Ã‚  Ã‚  Few works in fictional literature embody the portrayal and effects of madness better than Charlotte Perkins Gilman’s â€Å"The Yellow Wallpaper.† Readers are presented with the tale of a woman suffering from a mental illness whose problems are compounded by the imprisonment she must endure. Set in a similar time period as the already discussed works, many of the same isolation and autonomy issues reside behind the conflict of Gilman’s narrative. The story presents the madness associated with the oppression of women during the era coupled with the unforgiving patriarchal view of society.

Summary of Middlemarch Essay -- essays research papers

After their parents die, Celia and Dorothea Brooke go to live with their uncle Mr. Brooke at Tipton Grange in Middlemarch, a small town in the English countryside. Dorothea, the beautiful, clever sister, immediately attracts the attention of Sir James Chettam, but with her always present desire to be useful, Dorothea has eyes only for the older, scholarly Mr. Casaubon. Against the desires of many in the Middlemarch community, Dorothea and Casaubon are married. In the meantime, the lives of another pair of would-be lovers becomes quite complicated. Fred Vincy, by nature a somewhat wild and undisciplined young man, finds himself in debt. He has accepted credit from unreliable sources and must find a way to repay the debt, if he does not, the father of Mary Garth, Fred's only true love, must pay the debt for him. Fred's only hope is that his old, dying uncle Peter Featherstone will leave him money in his will. When Featherstone dies, he leaves two wills. The first promises a large sum of money to Fred, but the second and more recent will leaves the entire estate to Mr. Joshua Rigg, Peter Featherstone's son, thus effectively crushing Fred's expectations. As a result of the disappointment, Fred becomes violently ill. The Vincys call in young Dr. Lydgate, a doctor who hopes to reform medical practices in England. In the process of attending to Fred, Lydgate finds himself captivated by Rosamond Vincy, Fred's sister. On their honeymoon in Rome, the newly married Casaubons find things not to be as happy as they had expected. Mr. Casaubon spends his time doing research for his book The Key to All Mythologies, Dorothea, who desperately wants to help him in his scholarly pursuits, finds herself shut out from his work. One afternoon as she... ...e support of a wealthy widow is another step towards restoring Lydgate's name. Dorothea also visits Rosamond, convincing her that Lydgate loves her and that the two of them should be happy together. In the process, though, Dorothea realizes her own love for Will Ladislaw. Much to the dismay of Sir James Chettam and others, Dorothea renounces her fortune and marries Will. The novel ends with a vision of the futures of the different characters. Rosamond and Lydgate build a marriage and a medical practice, their lives are generally happy though not without occasional problems. Fred Vincy and Mary Garth are married and live happily as hard working tenants at Stone Court, the land that Fred had once hoped to inherit from his uncle Featherstone. Dorothea and Will Ladislaw move to London where they build a happy family and Dorothea continues to look for ways to be useful.

Nanomedicine Essay

Nanomedicine: Obtaining the Benefits, Managing the Risks The phrase â€Å"small is beautiful† has taken on new meaning to Some nanomedicine drug-delivery systems and anti-cancer drugs those involved in the scientific field known as nanotechnology, are already in use. Many other applications are in various phases which involves engineering and utilizing materials at the nano- of clinical or pre-clinical testing, and, if found safe and effective, meter scale – that is, as small as one-billionth of a meter. Reduced may reach the market in five to 12 years. More advanced nano- o these minute dimensions, substances often undergo significant medicine products – such as biocontainers for medical diagnostics changes – for example, carbon becomes stronger than steel and and cell treatment – are in earlier stages of development. copper is transparent. The increasing ability of science to compress materials to the submicroscopic level is affecting many fields of human endeavor. Current and emerging nanotechnology applications include advanced energy generation and storage systems, as well as new chemical additives and industrial materials.More than 300 products with nano-scale ingredients are already on the market, ranging from sunscreens to bowling ball coatings. Regulatory and Risk Issues Despite the accelerating pace of nanotechnology progress, many fundamental regulatory issues are only now being addressed by the U. S. Food and Drug Administration (FDA). These include defining what constitutes a nanotechnology product, establishing regulatory authority over various types of products, adopting labeling requirements, and calculating the health and environmental impact of emerging applications.One rapidly developing area of nanotechnology research is nanomedicine, the process of â€Å"using molecular tools and molecular knowledge of the human body† for the purpose of diagnosing and treating illness. (Freitas, R. , Nanomedicine, V ol. 1: Basic Capabilities, Georgetown, Texas: Landes Bioscience, 1999. ) The swift progress of nanomedicine research makes it necessary to understand the risks and begin the process of limiting potential exposure. Risk assessment is one of the major challenges facing the FDA, as techniques designed for macroscopic materials may be unreliable for nanotechnology products.A National Research Council report (available at http://www. nap. edu/catalog. php? record_id=11752) noted that until the risks associated with nanotechnology are more clearly understood, â€Å"it is prudent to employ some precautionary measures to protect the health and safety of workers, the public Nanomedicine Applications and the environment. † Nanomedicine may potentially revolutionize our ability to screen, This precautionary philosophy applies equally to healthcare organ- diagnose and treat conditions ranging from cancer to cardio- izations. While the promise of nanomedicine is bright, the risks ascular disease to diabetes. Scientists are at work on the following and ethical questions posed by these advances must be consid- projects, among many others: ered carefully. Major potential risks include – infection and genetic testing tools that are faster, more accurate and less invasive than conventional methods – nanoneedle and pulsed laser surgery that alters cell structures without damaging surrounding areas – targeted drug-delivery systems that transport the drug exactly where needed and monitor its effect – nanotube-based biosensing devices that provide in vivo iagnostic testing capabilities, such as tracking electrolyte and blood glucose levels – gold-coated nanoparticles that destroy individual tumor cells while leaving nearby healthy cells unharmed – â€Å"intelligent† synthetic biomaterials that mimic body – possibly heightened toxicity of free nanoparticles, which may be able to bypass the body’s defenses a nd interfere with basic biological processes – genetic alteration, as some therapies operate at the chromosomal level and hence raise complex ethical questions, ranging from informed consent of the unborn o the prospect of genetic enhancement for the few to the issues surrounding stem cell research – environmental and workplace impact, as the particles are often too small to be trapped by available filtration systems and may accumulate in water, air or plants, with unpredictable consequences tissues and may eventually enable organ regeneration AlertBulletin A R i s k M a n a g e m e n t U p d a t e f ro m C N A H e a l t h P ro 08 issue 6 – healthcare paradigm shift, as new technologies possibly result in obsolescence for some established therapeutic modalities, creating new financial and administrative emands in terms of equipment, care settings, and staff training and competencies. Strategies As the nanomedicine revolution unfolds, healthcare organizations must find effective ways to ensure patient safety and reduce the liability risks inherent in adopting cutting-edge diagnostic and treatment techniques. The following proactive measures can assist your healthcare organization in maximizing the potential benefits of nanomedicine while minimizing associated risks: – Create a nanomedicine task force composed of clinical and administrative leaders with a high level of scientific ophistication to research nanomedicine prospects, benefits, costs and risks, and incorporate the group’s findings into the strategic planning process. – Undertake prospective risk analysis to address areas of potential enterprise liability, including adverse outcomes, environmental hazards, and implicit warranties or guarantees contained within marketing materials. – Initiate a discussion with the ethics committee regard- ing emerging nanomedicine issues, including use of stem cells and the question of genetic enhancement. – Develop a risk posture vis-a-vis nanomedicine, in collabo- ation with legal counsel, and ensure that risk and insurance coverage issues are factored into decisions involving nanomedicine. Recognize that insurers may not be able to make a blanket generalization concerning coverage for nanomedicine risks, which at this point are difficult to predict and/or quantify. As with all legal causes of action, nanomedicinerelated claims would be assessed on an individual basis. – Adapt your organization’s informed consent policies to the new realities, taking into account the generally low state of consumer awareness regarding nanomedicine and he unknowns that accompany a radically new technology. Specifically, your informed consent process for nanomedicine therapies should encompass an extensive educational component for patients and acknowledge the limitations of current knowledge and experience in this area. – Strengthen policies and systems designed to track patie nts within the institution, report adverse events, and monitor equipment and suppliers. Designate those responsible for reporting incidents to the FDA and/or the manufacturer and ensure that personnel understand internal reporting rules and procedures. Revise competency and credentialing models for pro- viders and staff to include emerging technologies and approaches. Ensure that staff members are familiar with policies regarding nanotechnology applications and acceptable off-label uses. – Manage the product supply chain and establish policies regarding the presence of vendor representatives in clinical settings where treatment is rendered. – Advocate for more basic scientific and safety research on nanomedicine and nanotoxicology, as sound regulation and more manageable risk will require a deeper level of theoretical and empirical knowledge.Resources Ebbesen, M. , Jensen, T. â€Å"Nanomedicine: Techniques, Potentials and Ethical Implications. † Journal o f Biomedicine and Biotechnology, 2006, Article ID 51516, pp. 1-11. Available at http://www. hindawi. com/getarticle. aspx? doi=10. 1155/jbb/2006/51516. Freitas, R. â€Å"Current Status of Nanomedicine and Medical Nanorobotics. † Journal of Computational and Theoretical Nanoscience, 2005, Volume 2:1, pp. 1-25. Available at http:// www. nanomedicine. com/Papers/NMRevMar05. pdf. Nanotechnology: A Report of the U. S. Food and Drug Administration Nanotechnology Task Force, July 25, 2007.Department of Health & Human Services. Available at http://www. fda. gov/ nanotechnology/taskforce/report2007. pdf. â€Å"Nanotechnology: Untold Promise, Unknown Risk. † ConsumerReports. org, July 2007. Available at http://www. consumerreports. org/cro/health-fitness/nanotechnology7-07/overview/0707_nano_ov_1. htm. Walker, B. , Mouton, C. â€Å"Nanotechnology and Nanomedicine: A Primer. † Journal of the National Medical Association, December 2006, Volume 98:12, pp. 1985-1988. 1. 888 . 600. 4776 www. cna. com/healthpro/ CNA HealthPro, 333 S.Wabash Avenue, Chicago, Illinois 60604 Published by CNA. For additional information, please call CNA HealthPro at 1-888-600-4776. The information, examples and suggestions presented in this material have been developed from sources believed to be reliable, but they should not be construed as legal or other professional advice. CNA accepts no responsibility for the accuracy or completeness of this material and recommends the consultation with competent legal counsel and/or other professional advisors before applying this material in any particular factual situations.This material is for illustrative purposes and is not intended to constitute a contract. Please remember that only the relevant insurance policy can provide the actual terms, coverages, amounts, conditions and exclusions for an insured. All products and services may not be available in all states. CNA is a service mark registered with the United States Patent an d Trademark Office. Copyright  © 2008 CNA. All rights reserved. Printed 11/08.

Literature Coursework Essay

The play a View from the Bridge is a modern day Greek tragedy, which tracks the downfall of one individual. This is Eddie Carbone, an Italian man, with the beliefs of the Italian culture. Eddie, with his wife Beatrice and niece Catherine, live in Redhook, Brooklyn, a slum as the people there calls it and now it is known as that. Brooklyn has a large Italian community. Many people who live in Redhook are mostly Italian. The arrival of Beatrice’s cousin Marco and his brother Rodolpho two illegal immigrants who must be kept a secret form the Immigration authorities, in America to live an ‘American Dream’, makes the whole play catalyst. The play is a tragedy and so a lot of aggression is included. The tragedy focuses on the private and social life of Eddie Carbone. The traditional, cultural beliefs of how to be an Italian man is a downfall. The belief’s on how to be a real Italian man is to get back justice, if you get hurt. This is exactly what happens to Eddie. If any of these Italian beliefs weren’t in place the play wouldn’t have ended as such a â€Å"bloody course†. The whole play is changed when the two brothers arrive in the slum neighborhood. Eddie, who is Catherine’s uncle, but acts like a father to her, is so protective over her and tells her what to do and what not to do. But Beatrice thinks that Catherine is old enough to go out to work, and to attract the attention of young men as she walks down the street. Alfieri who is a lawyer knows both sides of the story and also knows what is going to happen next in the play. Alfieri is the kind of man who is not bad tempered. He tries to control everything what goes on, and doesn’t want anything to go wrong. He knows what Eddie will get in the end, by acting the way he is. This includes being jealous, and not being happy for Catherine, the way she is. In this essay I am going to examine the ideas of manliness, hostility and aggression. I will examine how these are connected. During most of the tragic play, Marco is talked of very positively. This is shown as Marco works day and night very hard, and with physical strength. Marco is thought of positively by a few people at the start of the play, when they arrive, in America, as immigrants. Eddie is one of the people that think very positively as he says: â€Å"Marco goes around like a man; Nobody kids Marco†. This quote is showing that Eddie thinks very positively of Marco. He believes that as a man you should be physically strong. He is saying that Marco is serious; he wants to do work and send money he earns home, to his wife and children. Marco has come to America to do work, and that’s what he does do. Nobody kids around with Marco. Marco shows much more masculinity when he says he cares so much about his family in Italy, that he is going to send everything, straight to them. He says this to show his masculinity: â€Å"I send everything†. He says this quote when he is talking to Beatrice about his wife. He shows masculinity he talks about sending money home, and that’s why he has come to America, to work for his family. It suggests to us he is a man, because he sends money to feed his wife and children. It tells us that he is the man of the house. Marco doesn’t show off much of his masculinity, but at one point, he sticks up for his brother, Rodolpho and gives Eddie a challenge. Eddie is challenged by Marco and this is a point where he shows his masculinity. The point where Marco tells Eddie to lift the chair: â€Å"Can you lift this chair? † Eddie knows that at this point he has been challenged. He thinks he can lift the chair. He gives it a go, trying to show his physical strength, but unfortunately fails two times, to meet Marco’s standards. Marco then shows off his physical strength by lifting the chair over his head. Marco doesn’t like to really show off, in front of people, but at this point he defends his brother by making Eddie do something. Eddie’s view of how to be a real man and show the masculinity you have is to do certain things. He talks about these when he is talking to Alfieri or Beatrice. He considers a lot of things to be very manly. He refers mainly to Rodolpho when he says things to Alfieri. He wants authority and he acts like he is the man of the house. Eddie likes manliness to mean, physical strength, hard working and authority. But when he is talking to Beatrice, he implies that Rodolpho is gay. Of course we don’t know this for sure, but he says it so it makes us believe that he is gay. It says that he cooks, sings and even makes dresses. Eddie certainly doesn’t’ approve of him, especially when Catherine is attracted to him. Eddie thinks he does a lot of women jobs. Eddie shows authority, this is shown, because when Catherine is going out with Rodolpho he doesn’t let her. This is shown in the scene with a stage direction: He moves to Catherine. This shows that Eddie is protective. He stops Catherine from going out, with high heels on. He tells her to take her shoes off. Eddie wins the argument as Catherine listens and she takes off the high heels. This shows that Eddie has his authority. If he doesn’t get this he includes physical aggression. Eddie is saying that men should have control of what women do. Eddie also tells us what as a man you should do. He points out this when he is talking to Beatrice. She doesn’t agree with something what Eddie says about Rodolpho. Eddie wants authority and so he shows this by saying that a wife should agree with what her husband has to say: â€Å"A wife is supposed to believe he husband. If I tell you the guy ain’t right, don’t tell me his is right†. By saying this he means that Beatrice should agree with what the husband has to say, so if he says that Rodolpho ain’t right, Beatrice should agree that Rodolpho ain’t right. He is showing he has authority and is man of the house. The ways in which Rodolpho during the play doesn’t conform to the Italian beliefs of masculinity is when he says and does things those only women do. These included cooking, singing and making dresses. Eddies point of view is for men to work hard and be serious. Rodolpho tries to show his masculinity, but fails dramatically. This is clearly shown, when Rodolpho has been told to leave by Eddie, and Catherine says that she will also leave. Rodolpho gets quite angry and decides to tell Eddie, that he wants Catherine to be his wife. Eddie doesn’t agree at all. It’s obvious why, because he thinks Rodolpho is gay. Eddie doesn’t conform of his masculinity at all. This is because Rodolpho doesn’t at all show much masculinity. The consequence of this is that when Rodolpho gets angry, he tries to attack Eddie. He does not succeed in doing that and so Eddie pins him down. This is told by a stage direction: