Hypokalemia After Acute Acetaminophen Overdose Health And Social Care Essay

Aims: This survey intended to find the prevalence of hypokalemia and its clinical correlatives in acute psychiatric unwellness among hypokalemic and normokalemic patients after acetaminophen overdose. Methods: This is a retrospective cohort survey of infirmary admittances for ague Datril overdose conducted over a period of 5 old ages from January 1, 2004 to December 31, 2008. Demographic informations and different types of psychiatric unwellness were compared between hypokalemic and normokalemic patients. Hypokalemia was predefined by a serum concentration & A ; lt ; 3.5 mmol/ L. SPSS 15 was used for informations analysis. Consequences: Two hundred and eighty patients out of 305 admittances were studied. Hypokalemia was found in 63.6 % of patients with a higher prevalence in the presence of psychiatric unwellness ( 67.7 % ) . Hypokalemic patients were significantly associated with the presence of major depression ( P = 0.04 ) , adjustment upset ( P & A ; lt ; 0.001 ) , anxiousness ( P = 0.01 ) , and self-destructive efforts ( P = 0.04 ) . Decision: Hypokalemia was common among patients with psychiatric unwellness and ague Datril overdose. Cardinal Wordss: Acetaminophen ; Hypokalemia ; Overdose ; Potassium ; Psychiatric unwellness.IntroductionDeliberate self-poisoning ( DSP ) is recognized as a major cause of self-destruction around the world.1 Acetaminophen ( Paracetamol ) is the most common drug employed in DSP in many states, 2, 3 including Malaysia.4 Despite first-class safety in curative doses of Datril ; it is besides one of the prima causes of terrible hepatic necrosis.5 Acetaminophen overdose may be accompanied by electrolyte perturbations including hypokalemia, and these appear to be independent of the hepatotoxic effects.6 These electrolyte alterations appear to be due to the addition in fractional nephritic elimination of K, but the implicit in cellular mechanisms by which Datril might change electrolyte conveyance are still unknown.6-9 In some instances, hypokalemia may be terrible, making a degree of 2.3 mmol/ L after reported consumption of 48 g of acetaminophen.8 Hypokalemia, an easy identifiable and clinically of import status in clinical scenes, has received small attending from research workers worldwide. Not merely is hypokalemia associated with frequent cardiac and neuromuscular complications, but its consequence on mental map may besides worsen psychiatric disturbances.10, 11 Both anxiety12 and intense exercise13 addition go arounding adrenaline, which induces a ?2 – receptor-mediated inflow of K into skeletal muscle.14 As this status may be similar to the acute psychotic province, it was hypothesized that the diminution in serum K concentration could be associated with the presence of psychiatric unwellness during Datril overdose. To better our cognition of hypokalemia after acute Datril overdose, we carried out a five-year, hospital-based survey with the following aims: 1 ) to find the prevalence of hypokalemia in patients showing to infirmary after Datril overdose, and 2 ) to look into the clinical correlatives in acute psychiatric unwellness among hypokalemic and normokalemic patients after acetaminophen overdose.MethodsSettings and Study DesignThis is an experimental retrospective instance reappraisal of all patients with acute Datril overdose admitted to a 1200-bed infirmary located in the Northern part of Malaysia. The infirmary provides wellness attention and exigency intervention for all unwellnesss and accidents. All facets of the survey protocol, including entree to and usage of the patients ‘ clinical information, were authorized by the local wellness governments before induction of this survey.Participants and Data CollectionDatas were collected from January 1, 2004 to December 31, 2008. A co mputing machine generated list was obtained from the Hospital Record Office. We identified our instances harmonizing to the T-codes of the International Classification of Diseases-Tenth alteration ( ICD-10 ) . All patients with diagnostic codifications T 39.1 ( acetaminophen overdose ) were included in the survey. Specially designed data-collection signifiers were used to roll up informations refering age, gender, fortunes of overdose ( inadvertent or suicidal ) , stated day of the month and clip of poisoning to cipher the latency clip ( the clip of consumption to the clip the patient was presented at the infirmary ) , measure of Datril ingested, GI decontamination such as tummy wash, research lab trials including serum Datril concentration, and serum K concentrations during the first twenty-four hours of admittance and after a lower limit of 4 hours of consumption. Data on serum Datril concentration measurings were obtained from the infirmary ‘s curative drug supervising laboratory service. In add-on, informations related to the presence of psychiatric unwellness were obtained. psychiatric unwellness was defined as the presence of any perturbation of emotional equilibrium, as manifested in maladaptive behaviour and impaired operation, caused by familial, physical, chemical, biological, psychological, or societal and cultural factors such as depression, anxiousness, accommodation upsets, unprompted behaviours and emphasis reactions, either emotional or behavioural ; these causes were noted by the infirmary psychiatric specialist study..Hypokalemia was defined as a serum K degree of less than 3.5 mmol/ L.11 Patients with hypokalemia were classified into three groups based on K degrees: ( 1 ) mild/ grade 1 ( 3.0 – 3.4 mmol/ L ) , ( 2 ) moderate/grade 2 ( 2.5 – 2.9 mmol/ L ) and, ( 3 ) severe/grade 3 ( & A ; lt ; 2.5 mmol/ L ) .15 The charts of all patients identified through the hunt were reviewed and the information collected. Charts were excluded from analysis for the undermentioned grounds: ( 1 ) baseline K concentrations were non measured, ( 2 ) if patients had taken acetaminophen but the cause of consumption was unknown or undetermined, ( 3 ) the clip of consumption was non known or ( 4 ) the patients were on regular prescribed drugs that lead to hypokalemia, such as Lasix, and ( 5 ) the patients were kids under 13 old ages of age. Charts of patients who had research lab trials at or more than 4 hours post-ingestion were extracted for farther analysis.Statistical analysisDatas were entered and analyzed utilizing the Statistical Package for Social Sciences plan version 15 ( SPSS ) . Data were expressed as average  ± SD for uninterrupted variables and as frequence for categorical variables. The Chi square or Fischer ‘s exact trial, as appropriate, was used to prove the significance between categori cal variables. The independent samples t-test was used to compare agencies of uninterrupted variables. Variables were tested for normalcy utilizing the Kolmogorov-Smirnov trial. Variables that were non usually distributed were expressed as a median ( lower – upper quartiles ) . Statistical significance was considered at P & A ; lt ; 0.05.ConsequencesThree hundred and five instances of Datril overdose were identified. Of these, 25 patients ( 8.2 % ) were excluded. Baseline K concentrations were non measured in eight patients, one patient was given furosemide at admittance, five patients were less than 13 old ages old, the cause of consumption was unknown or undetermined in 11 patients, and hence, the survey population consisted of 280 patients ( 45 male and 235 female patients with a average age of 23.4  ± 7.1, giving a female: male ratio of 5.22: 1 ) . The bulk ( 72.1 % ) of instances of acetaminophen consumption were presented within eight hours. The average ( interquartile scope ) measure of Datril ingested was 10 g ( 6 – 15 g ) . Initial direction included tummy wash, which was performed in 181 ( 64.6 % ) instances. Activated wood coal was given while patients were in the Accident and Emergency section ; it was given as individual or multiple doses in 173 instances ( 61.8 % ) . Intravenous N-acetylcysteine ( NAC ) was given to 140 patients ( 50 % ) after Datril degrees were estimated. The average ( interquartile scope ) serum acetaminophen concentration was 55.6 mg/ L ( 14 – 120 mg/ L ) . During the survey period, 63.6 % ( 178 patients ; 33 males and 145 females ) had K degrees of less than 3.5 mmol/ L. For the hypokalemic patients, the average K degree was 3.1  ± 0.26 mmol/ L, while that for the normokalemic patients was 3.76  ± 0.35 mmol/ L. Most of the patients ( 129 ) were in mild phase hypokalemia and 45 patients were in moderate phase hypokalemia. Few patients ( 4 ) were in terrible phase hypokalemia. Psychiatrically sick topics were found to hold hypokalemia, and the prevalence was higher than that in non-psychiatrically sick topics ( 67.7 % versus 43.8 % ; severally, P = 0.002 ) ( Figure 1 ) . The most common clinical diagnosing among medically treated self-destruction triers was adjustment upset ( 45.7 % ) followed by unprompted behaviour ( 24.3 % ) , major depression ( 10.7 % ) , and anxiousness ( 2.1 % ) . Hypokalemia was significantly associated with the presence of major depression ( P = 0.04 ) , adjustment upset ( P & A ; lt ; 0.001 ) , anxiousness ( P = 0.01 ) , and self-destructive efforts ( P = 0.04 ) . However, normokalemia was significantly associated with unprompted behaviour ( P & A ; lt ; 0.001 ) , the absence of psychiatric unwellness ( P = 0.002 ) , and the presence of inadvertent overdose ( P = 0.04 ) ( Table 1 ) . One hundred and twelve patients with adjustment upset and six patients with anxiousness were found to hold hypokalemia, and the prevalence of hypokalemia among these patients was higher than that in the overall survey population and in patients with other psychiatric upsets ( 100 % and 87.5 % , severally ) . Similarly, their average K degree was lower than that of the overall survey population ( 3.16  ± 0.41 and 3.2  ± 0.21 mmol/ L, severally ) ( Table 2 ) . Eight hypokalemic patients ( 4.5 % ) were supplemented with unwritten K medicine, and 85 hypokalemic patients ( 47.8 % ) were treated with endovenous K chloride, and their K degrees were normalized in the following blood trial. Additionally, most of the treated patients ( 59 ) were in mild phase hypokalemia and 32 patients were in moderate phase hypokalemia. Few patients ( 2 ) were in terrible phase hypokalemia.DiscussionThis survey is the first of its sort in Malaysia and has been carried out to find the prevalence of hypokalemia in patients showing to infirmary after acute Datril overdose, and to look into the clinical correlatives in acute psychiatric unwellness among hypokalemic and normokalemic patients after acetaminophen overdose in 280 patients with acute Datril overdose collected retrospectively from a records register. In this survey hypokalemia was identified in 178 patients, and the prevalence of hypokalemia among hospitalized patients with acetaminophen overdose was 63.6 % . A old survey found that hypokalemia was common in medical inmate settings.16 About 20 % of shot, 10 % of myocardial infarction patients,17 21.2 % of psychiatric disorders,18 and about one tierce of ague Datril overdose patients suffered from hypokalemia.9 The high prevalence of hypokalemia after Datril overdose might be due to multiple hazard factors. The etiology of hypokalemia is complex. The degree of serum K depends on the balance between unwritten consumption, nephritic and GI losingss every bit good as the balance and motion between excess and intra-cellular compartments.11 A old survey found that 7.6 % of psychiatric patients had nutritionary jobs ; 19 unequal dietetic K consumption was comparatively rare unless day-to-day K consumption was less than 25 mmol.20 This survey found that it was the psychiatrically sick patients, instead than those patients with no psychiatric unwellness, who were more likely to develop hypokalemia. This determination is consistent with other published surveies that showed that hypokalemia was common among acute psychiatric inpatients.18, 21, 22 Adjustment upsets are frequently precipitated by emphasis reactions.23 For most people, emphasis is associated with higher hydrocortisone levels.24, 25 Previous surveies have suggested that high hydrocortisone degrees may be the chief cause of hypokalemia.26-28 In this survey, patients with anxiousness were enduring from a low mean K concentration and a high prevalence of hypokalemia. The exact mechanism was unsure. This determination is in understanding with another published survey that has shown little lessenings in serum K among 200 pre-operative patients who had an addition in anxiety.12 The account of this determination is that anxiousness increases the circulating adrenaline, 12 which induces a ?2 – receptor-mediated inflow of K into skeletal muscle.14 In the present survey, patients with major depression were enduring from a high prevalence of hypokalemia. This determination is similar to a old work that has shown patients with major depression had lower average serum K values and a higher incidence of hypokalemia than other upsets such as dysthymic upset and schizophrenic psychosis.18 This determination may be due to alterations in sympathomimetic thrust or in sensitiveness or denseness of the ?2-receptor. 18 Expected findings in our survey were the low incidence of hypokalemia in the patients with unprompted behaviour. These patients differed significantly from the other types of psychiatric unwellness and considered as a portion of the normal behavior.29 This is supported by findings that impulsivity is a type of human behaviour characterized by the disposition of an person to move on impulse instead than thought.30 It has been concluded in old survey that the reduced peripheral adrenaline degrees may be involved in pathophysiology of unprompted and overactive behaviors.31 This mechanism consequences in a reduced consumption of K by cells. In add-on, this survey found that it was the self-destructive patients, instead than those with inadvertent overdose, who were more likely to develop hypokalemia. Attempted self-destruction is assumed to be a hyper-adrenergic state.18 A retrospective survey carried out on patients with psychiatric upsets concluded that important differences existed among the attempted self-destruction group with respect to hypokalemia.18 ?-adrenergic receptor stimulation causes hypokalemia in experimental animate beings and humans.32 There is small uncertainty that one of the mechanisms of hypokalemia is a beta 2-receptor-mediated inflow of K into skeletal musculus, induced by go arounding epinephrine.18, 33, 34 It has been demonstrated that adrenaline causes inordinate activation of the sodium/potassium-ATPase pump as a consequence of ?2-adrenergic receptor stimulation.14, 33 This mechanism consequences in an increased consumption of K by cells, taking to a lessening in serum K degrees. As the influ ence of the sympathomimetic system on serum K is found in many psychiatric state of affairss, 18, 21, 22, 35 it may explicate why a high prevalence of the patients included in our survey were presented with hypokalemia. A high per centum of patients ( 47.7 % ) were still non being treated for low K degrees, seting their wellness in hazard. The common happening of hypokalemia in patients with acute Datrils overdose should alarm all clinicians to the importance of rectifying K loss, since most of the patients with an Datril overdose might hold received endovenous fluids or N-acetylcysteine in serum dextrose 5 % . However, this may hold altered serum K concentrations through endogenous insulin production induced by 5 % dextroglucose, ensuing in motion of K into the intracellular compartment. However, the extended usage of dextroglucose may expose the patients to higher hazards. This survey is the first one of its type in Malaysia to look into the clinical correlatives in acute psychiatric unwellness among hypokalemic and normokalemic patients after acetaminophen overdose. It is besides the first survey suggested that hypokalemia is related to psychiatric position after Datril overdose instead than the old studious that showed a dose-dependent relationship between autumn in serum K and serum Datril at presentation.6, 9 Our survey suffers from a few restrictions. First, farther hazard factors for hypokalemia were non taken into history in the analysis. A 2nd restriction is its retrospective nature and the deficiency of structured interview appraisal of the topics. Third, we can merely propose, instead than turn out, that the psychiatric province is responsible for the high happening of hypokalemia diagnosed in our population.Decisions and recommendationsIn decision, hypokalemia is extremely prevailing among psychiatrically sick patients and after acute Datril overdose. Therefore, monitoring of serum K concentration may be clinically of import on exigency admittance for all instances of ague Datril overdoses to forestall the effects of hypokalemia. Supplemental potassium disposal should be commenced every bit shortly as possible. Recognitions: The writers would wish to thank the Universiti Sains Malaysia ( USM ) for the fiscal support provided for their research. The aid of the medical and record office staff is appreciatively acknowledged. Conflict of involvements: We would wish to declare that there was no struggle of involvements in carry oning this research.

How Soon Until We Are Back At War? Essay

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The biggest problem the United States faces, is trying to uproot and destroy the Islamic State’s army in Iraq and Syria, by using American airstrikes and without any ground troops. Many national security experts are claiming Obama’s strategy of systematic airstrikes to eventually fail. Thus, increasing the possibility of ground forces being deployed. While President Obama has already sent over five hundred military officers to advise and assist with the fighting in northern Iraq. However, some politicians and analysts insist that the president must get ground troops closer to the fighting. Retired Army General John Keane, an architect of the 2007 Iraq War troop increase carried out by General David H. Petraeus, expressed the need of American advisors being closer to the battle. â€Å"If we don’t ultimately send in American combat troops, we’re going to lose†, Keane later added in his interview with Marie Harf of Fox News. General Keane is not the only one expressing the need for ground forces to fight ISIS. General Martin Dempsey, chairman of the Joint Chiefs of Staff, told the Senate Armed Services Committee that if the current situation with the fighting in Northern Iraq and Syria continue, he would recommend sending in ground troops to the president. President Obama has remained adamant in his stance of not deploying any U.S. ground troops to fight ISIS and will only useairstrikes to aid the fighting. President Barrack Obama discussing the situation in Northern Iraq with Joint Chief of Staff, Martin Dempsey (AP Photo/ White House) Many United States military officials have openly addressed the possibility of sending ground troops to the fighting. It is becoming more and more evident that we are slowly leaning towards eventually deploying troops back overseas. Thus, making Obama retract his statements about keeping U.S. troops out of the fighting against ISIS. Military officials are not the only ones publicly speaking against Obama’s use of airstrikes against ISIS. However, some Republicans have strongly urged the use of American ground troops, claiming it to eventually become necessary. House Majority Leader Kevin McCarthy, R-California, said on CBS News’ â€Å"Face the Nation† on Sunday that U.S. Special Forces will likely need to be deployed to determine how effective the air campaign is. â€Å"If we need Special Forces there – if that’s what the generals say, then we need to do it,† he later added. In a recent CBS News poll, it was found that sixty-five percent of Americans say that the United States will eventually have to use ground combat forces to remove the threat of ISIS in Iraq and Syria. But are Obama’s constant airstrikes considered an act of war? The poll resulted in 56 percent of American citizens who consider the current air campaign against ISIS a military action but not a war. As well as, 40 percent think that the United States are already at war. Republicans are more likely than Democrats to view U.S. airstrikes against ISIS as a war. It was also found that 53 percent of Americans are now concerned that U.S. intervention in Iraq and Syria will soon lead to a long and costly involvement in the area. How soon will it be before the United States has to establish a ground force to fight the threat of ISIS in Iraq and Syria? Retired Staff Sergeant Brad McVaugh, of Corolla, North Carolina, claimed the future deployment of U.S. combat troops to Iraq and Syria to be soon. â€Å"It is just a matter of time before ISIS adapts to the airstrikes and finds a new way to attack us,† he explained. McVaugh described how the militants would, â€Å"find a way to hide from the airstrikes and fire back at us.† McVaugh pointed out the impending fact, â€Å"Obama needs to do something before a future attack happens and before his term is over.† With the eyes of the world focusing on Iraq and Syria. Leaders are also looking to the United States for its next move. So far, President Obama remains firm on his stance of keeping troops at bay. However, as public opinion agrees with the eventual deployment of troops. Many military officials and politicians on Capitol Hill are becoming outspoken each day. On ABC’s segment â€Å"This Week,† Speaker of the House John Boehner spoke about the looming possibility of ground troops being deployed and how Obama’s airstrike strategy will soon fail. â€Å"At the end of the day, I think it’s going to take more than air strikes to drive them out of there. At some point somebody’s boots have to be on the ground,† he said. â€Å"That’s the whole point.†

A Way Of Thinking By Entrepreneurs Business Essay

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Sustainable Practices in FM - Assignment Example The Kyoto Protocol to the United Nations Framework Convention on Climate Change 1997 encourages countries to make an effort to reduce carbon emissions. Corporate social responsibility requirements for all businesses has now expanded to include a duty to reduce and control carbon emissions (Lee, 2008). In other words, as a business organization, this organization is bound by legal and corporate social responsibility requriements to reduce and control carbon emissions. This report will identify the ways in which a business’s carbon footprint is made up, why there is a need for this organization to manage and control its carbon footprint, options for appropriate renewable energy solutions, recommendations in light of the building’s condition, type and location. ... 5840). Teir 2 businesses are those that create emissions from the use of electricity and gas. Teir 3 businesses include the entire supply chain and could include both tier 1 and tier 2 businesses for which the tier 3 business is indirectly responsible for (Matthews, et al., 2008). In other words, a business can be both directly and indirectly responsible for carbon emissions. This business is a retail organization and although it does not directly consume carbon at the production gate, it does contribute indirectly by purchsing goods for retail from production gates that do. In the meantime, this business also directly emits carbon in the use of energy such as electricity from fossil fuels. All goods and services including food and household products as well as transport, business products such as ink, paper, computers and so on are produced with the emission of carbon (Hertwich & Peters, 2009). This organization provides household products and this is significant because a study con ducted by Hertwich and Peters (2009) found that worldwide, household consumption accounts for 72% of all carbon emissions. Therefore as a provider of household goods, this business indirectly contributes to the largest source of carbon emissions. In addition, this business as a retail business, retailers contribute to a carbon emission in a number of ways. There is the direct emision of carboms from using fuels to indirectly contributing through employee travel or via the supply chain (Minahan & Sands, 2012). The Need for Reducing the Business’ Carbon Footprint There are two significant changes occurring in the market. First, there are countries such as the EU and the US that have

Critical Thinking and Technology Essay Example | Topics and Well Written Essays - 1250 words

Critical Thinking and Technology - Essay Example Critical thinking also enhances the communication and presentation skills of employees, students and even employers as the information presented is thoroughly thought over and researched. With critical thinking, our ability to express our ideas, opinions and beliefs to other people is enhanced and this promotes cooperation and productivity in organizations that are dependent on technology. Creativity is important in success of individuals, organizations and institutions across the globe in this technology age. According to Plato (Pinliucci, 2011), critical thinking increases the inventive ability of people and this enhances entrepreneurship and business growth. To think critically, an individual must be able to develop a strong purpose and develop a problem upon which different questions will be used to understand it. The position of critical thinking in modern day world has remained a major issue as a result of the emergence of technology and more so, the internet (Whitney, 2010). Information technology and especially the internet improve critical thinking ability of students and employees as it enhances judgment and decision making processes. With information technology, data processing is enhanced due to the massive sources that readers are subjected to and this enhances critical thinking. The development of critical thinking skills is essential in the development of students and employees as it enhances the process of gathering information and developing skills. As a result, the questioning information presented to an individual enhances their understanding of the area and improves their discussion skills. The global economy is currently reliant on technology, an aspect of development that is dynamic and influenced by the level of knowledge of an individual. As a result, the development of flexible skills is essential, a process that can only be achieved through developing strong analytics skills found among critical thinkers (Taylor, 2012). Technology

Leadership Case analysis Study Example | Topics and Well Written Essays - 500 words

Leadership analysis - Case Study Example He links the employees with the employer, advocating for regulated working hours. Though he is close, WHP included mandatory checkups which might have sounded as unkind to the workforce. However, Teow covered the ruthlessness of this activity by including members from each department in the program’s management team. Teow expressed a positive character that portrayed high levels of compatibility with the workforce he was outgoing and very social. Teow led by example and maintained smallest distance possible between him and his employees. Notably, Teow comments that his goal of achieving a happy and engaging team that incorporated all department was achieved, portraying the desire to listen to every individual regardless of his job position. Teow sought stimulation of employees via improved health and openness to the best interst of the company. Teows success was based on his friendly and agreeability trait. WHP program, was n manged by several people including the Company’s Recreation committee. Teow respected opinions of these members and acted according to collective judgement. Evidently, Teow promoted payout bonus previously set by the management though he incorporated changes its implementation to include physical health. Moreover, Teow stands by his actions and embraces little sensitivity to emotions. The WHP program faced opposition in its initial stages. Despite having low employee participation, Teow never gave up or even implemented a forceful action, but emphasized on convincing by stating its importance. Additionally though Teow seems anxious about the results, he controls his anxiety and slowly sets small achievable goals. WHP made Teow appear as a dependable leader. The program’s success was accompanied by productivity improvement as well as achievement of company goals as it was anticipated in the beginning. Teow is a conscientious leader embracing on planned changes.

Source Analysis Assignment Essay Example | Topics and Well Written Essays - 500 words

Source Analysis Assignment - Essay Example Different decisions are necessary before making a bible interpretation such as allegory in which the reader must look beneath the surface of the text to get the real meaning. Reading the accounts of creation in genesis chapter 1 and 2 requires one to understand the deeper meaning of the text and avoid literal reading (Aageson, 2000). The message by the author of this reading is that the bible requires an in-depth reading to understand the actual meaning of its contents. Literal reading will not give a perfect interpretation of what the bible contains, as the language is figurative. All biblical material such an epistle, prophecies, apocalypse, and fable require the reader to make an accurate meaning of the word before making any interpretation. According to the author, historical facts need to have meaning, significance, and some biblical claims such as the death of Jesus on the cross for human redemption. Jesus death on the cross is a historical fact, but the argument that his death was meant to save the world from third sins does not have historical evidence. Evaluation of the truth concerning the bible material is not possible except by using the truth by definition. for instance, the statement "Jesus is God" (Aageson, 2000). The state can be taken as truth by definition and cannot be verified. Some of the biblical myths are mainly the Israelites ideas of covenant especially the Devine promise of land such as Canaan. Therefore, many biblical themes and stories fall under the mythical category rather than the truth and anything concerning God’s creation and his dominion over the world are all myths. The author gives critical contents of the bible to those that think that the bible has more hidden meaning and require critical analysis to establish the truth. According to the author, literal reading of the bible will not elaborate the statements or give the actual meaning to th ose who need a serious interpretation of the

Not My Business and District 6 compared Essay Example for Free

Not My Business and District 6 compared Essay The poem Not My Business is written by a Nigerian poet Niyi Osundare. This poem is a dramatic monologue and uses a fictional narrator to reflect upon how the Nigerian society is affected by the political and military misuse of power and authority in addition to the peoples rejection to revolt against injustice. The poet uses the narrators ignorant and selfish personality to display the abuse of power not only in Nigeria but also around the globe. The title Not My Business is short and simple to communicate the idea that South Africas socio-political status has not changed since the end of apartheid. The tone is very direct and shows the narrator to be ignorant and selfish. In addition to this, the structure of the poem emphasises his detachment with the people; the lines in which the narrator talks about himself are kept separate by the poet to stress his feeling of superiority over others. However, the narrator suffers the same fate at the end of the poem. The first stanza consists of Akanni being kidnapped. They picked up Akanni one morning. The poet uses the kidnapping to emphasise how the governments attitude towards the public is like. The use of they is an obvious indication of the military to the audience but is kept vague to engage the readers mind to the poem. Furthermore the poet uses stuffed him down the belly to make the reader feel as though the government are like predators waiting to leap at anyone who opposes them. Osundare also uses this stanza to elaborate on the soldiers relentlessness towards the people, beat him soft like clay. He uses this line to show the cruelty and injustice laid upon the people, because of the abuse of power and violence used to discourage individuals who resist them. The word clay helps to describe the methods of torture used to punish attempts at what the government calls transgression. The poet goes on to show the ignorance of some of the people, What business of mine is it so long they dont take the yam from my savouring mouth. The narrators selfishness is shown by the mention of yam which represents his food, comfortable home and self-occupied lifestyle, despite mentioning what happened to Akanni. Also, the poet uses the narrators eccentric personality to reach out to people who share a similar attitude. Additionally, the word savouring helps to illustrate the greediness and materialism of the narrator in the readers mind. The second stanza begins by showing the mysteriousness of the military, They came one night. This implies that the army can come at anytime and the people are never safe. The narrator further goes on to show the brutality of the military, booted the whole house awake, which suggests that the army has injected fear in the minds of people. An abrupt feeling is formed with the use of booted creating a sudden sentiment of fear. Furthermore vague terminology is used by the narrator to describe what happened to Danladi. Then off to a lengthy absence. This emphasises the narrators desire to distance himself from reality. The poet uses the phrase lengthy absence to show the narrators unwillingness to acknowledge that a threat is eminent from the government. Therefore the narrator regardless, lives with the atrocities that surround his society. In the third stanza Chinwe is fired from her job. Her job was gone. The poet once again shows the government can strike at anytime any day. Osundare uses the repetition of no to emphasise that Chinwe was sacked without legitimate reason. He does this further with a stainless record. This shows the influence and injustice of the government in the society as well due to the incident occurring in spite of Chinwes innocence. The refrain is used to make the reader feel that the narrator doesnt have any remorse or guilt for not caring about the other people around him. The last stanza involves the narrator himself being taken away, And then one evening as I sat down to eat my yam a knock on the door froze my hungry hand. The narrators tone is fearful and surprised. His hungry hand shows his selfishness and greed. The poet uses alliteration to put emphasis on this. Furthermore, the repetition of waiting creates tension in the readers mind and stresses the helplessness of the narrator when his own words come back to haunt him. It also coincides with the second stanza where the jeep is also waiting for danladi. Lastly, the structure of the stanza shows the irony of the narrators situation, that he also suffers the same fate as his neighbours. The poem District 6 is written after apartheid by Tatamkhulu Afrika who is a white South African poet and is a dramatic monologue. Afrika amplifies his anger at the situation of South Africa by using a black South African narrator to show that discrimination is still widely active. The narrator feels the post-apartheid period should have been different. Throughout the poem the poet voices his disappointment with the racism and discrimination. The poets attitude consists of anger and frustration which is reflected and emphasised at the end of the poem where the narrator want to resort to violence. District 6 is shown to now be a run-down levelled place, Small round hard stones. This quote displays to a certain extent how District 6 has not changed since the apartheid government destroyed the area. In addition, the poet uses the consonance in small round hard to depict the hostile and unpleasant environment. Furthermore, he uses a bitter tone, seeding grasses thrust bearded seeds. This is shown by thrust which carries an aggressive attitude making the statement resentful. This is emphasised by the continuous repetition of sss sounds used in this stanza. The narrator continues to stress District 6s destruction, trodden on, crunch in tall, purple-flowering amiable weeds. He repeats the same idea twice using trodden on and crunch for emphasis showing the unchanged situation of district 6. The poet further uses the narrator to show a sense of belonging to District 6 in the second stanza, my feetmy handsmy lungsmy eyes. Throughout the stanza the narrator emphasises his recognition and ownership of District 6 as if he grew up there. His defiant tone suggests that he is demanding back what is his and continues to do this with the repetition of my. At the end of the stanza anger is shown which shows his connection with District 6. The poet goes on to emphasise his anger at the contrast between races. Brash with glass, name flaring like a flag, it squats. He uses an aggressive tone to display his fury at the existence of a structure with thrives on racism. The rhyming ss sounds at the end of brash and glass help to fuel the effect of anger in the readers mind. Also, the narrator shows how active and unopposed racism thrives through, name flaring like a flag. This shows the freedom of racism specifically because the inn is located in District 6 due to its significance in South African history. Furthermore, a mocking tone is used for emphasis with it squats, suggesting the white are occupying the inn illegally. Tatamkhulu relates to the title in the fourth stanza, No sign says it is, but we know where we belong. The narrator conveys a mocking tone which echoes the idea and base of the poem, coming from the title Nothings Changed, that the situation of District 6 has been constant due to whites still occupying it since apartheid. The stanza is used to remind the reader of the cause of the destruction of District 6 which happened due to racism and discrimination. Furthermore, the poet uses the narrator to how his exclusion and separation from the white society, I press my nose to the clear panes. This shows the narrators curiosity, but also suggests the existence of an invisible barrier, clear panes, between him and the whites. In addition, the narrator anticipates and emphasises the lavish lifestyle, know before, I see them, there will be crushed ice white glass, linen falls, the single rose. The poet creates an atmosphere of luxury and beauty in the readers imagination. The use of single rose at the end of the stanza suggests an upper-class influence. The reader is made to feel anger and disposition to antagonism towards the unfairness and discrimination directed from the white society. The next stanza leans towards the inequality still overshadowing the non-white society, working man cafe sells bunny shows, take it with you, eat it at a plastic tables top. The blacks are shown to be a lower class which contrasts to the upper-class whites in the previous stanza, despite the end of apartheid. The narrator also uses plastic top to show the difference and neediness between blacks and whites. The last stanza reverts to the main picture of the poem, boy againhands burn, for a stone, a bomb to shiver down the glass. The use of boy again suggests that nothing has changed since the narrator was a boy and the word shiver reflects the frustration in the narrators mind. Furthermore, the use of stonebomb helps the reader to understand the possible causes of violence throughout South Africa to be like calls of anger against racism. To conclude, the poem Not My Business was written because the Nigerian public has no motivation to rebel and fight against injustice or tyranny enforced by the government. The narrator is shown as an example of what will happen to the people if they refuse to repel the injustice laid upon others and that they will eventually succumb to the same fate if they continue to be ignorant. In the second poem, Nothings Changed summarises that South Africa has not yet managed to overcome its issues of racism, injustice and inequality despite being in the post-apartheid era. The poem acts as a plea to all South Africans to come together and unite to create a civilised society with equal rights. In my opinion, both poems share the idea that the people should unite and act against injustice and oppression, though in different ways; the message is universal: Unity will bring peace and harmony amongst the people.

Policy Implications of Psychology Model of Mental Disorder

Policy Implications of Psychology Model of Mental Disorder This essay will review the article Policy implications of a psychological model of mental disorder (Kinderman, P., Sellwood, W. and Tai, S., 2007), and discuss how this article is relevant to my future career, by comparing the ideas that it espouses with those in other articles within the same field. The broad idea that underpins this article is that existing mental health service policy is predicated on the medical model of mental disorder, and that a psychological model of mental disorder could help to inform or even replace the medical model in terms of shaping policy. Kinderman et al’s (2007) article presents the view that mental disorders are â€Å"implicitly assumed to be biological disorders requiring treatment with variants on the traditional medical care systems†. The article presents evidence from a number of different sources, including the National Office of Statistics, and the charity Mind, in support of the view that people suffering from mental disorders often receive inappropriate care, and that the underlying reason is the assumption of medical rather than psychological models of therapy. The mediating psychological processes model of mental disorder (Kinderman, 2005, as cited by Kinderman et al 2007) is the psychological model proposed to enhance or replace the existing medical model. This model sees social and cultural influences, as well as biological factors as causing disturbances in the psychological processes of people suffering from mental disorders, as the diagram from Kinderman et al (2007) below illustrates; The benefits of using this model are that interventions would be designed to benefit the underlying psychological processes rather than to treat a diagnosed ‘illness’ as part of a generic medical response. The model suggests causation is external to the individual, and that mental disorder is a response to external factors. The difference with this model in relation to the medical model is that the medical model only considers biological factors, and ignores social and cultural factors. Interventions, from this perspective, would therefore be much broader, and would include in large part mental health workers, with less emphasis on the more medically inclined psychiatric approach, and more emphasis on a multi-disciplinary approach. Kinderman et al’s (2007) article goes on to look at how services could be structured around a social rather than medical framework and how existing organisational and operational structures would be altered across management and front-line departments. How users would engage with a service restructured around psychological concerns is looked at, particularly with respect to the stigma felt by patients that is currently associated with the medical model of mental ‘illness’, and the implications for patient recovery models. The more community-based, ‘quality of life’ approach to caring for people suffering from mental disorders is emphasised across all of these sections of the article. A breakdown of how the roles of specific mental health workers would be affected by adoption of Kinderman et al’s (2007) psychological model is also provided. The role of the mental health worker in this brave new world would be very much as part of a multi-discipl inary team. The role of psychiatrist focuses solely on biological interventions in terms of impact on psychological processes, and the traditional emphasis on psychiatry over other disciplines would be replaced by a more collaborative approach within a team of professionals across a number of disciples. Kinderman et al (2007) propose that nurses take on a broader role that encompasses psychological interventions, may carry more responsibility for clinical decisions, but still based on personal therapeutic relationships in both community and residential care settings. Psychologists are seen mainly as supervisors and trainers, and as formulating appropriate interventions as part of a multi-disciplinary team, rather than carrying them out. Social workers supply the social perspective to the team, and would be involved in socially based interventions, as opposed to psychological or biological interventions. Finally, occupational therapists also focus on the social aspects of care, speci fically social inclusion, and the article suggests that a closer relationship between occupational therapy and return to work advice may come about. I have attempted to place Kinderman et al’s (2007) article into context by reviewing literature related to this topic, so as to understand the issue of the medical model within the mental health services from different perspectives. Petrie, K., Broadbent, E., and Kydd, R. (2008) look at the affect of the patient’s own perception of their illness in terms of how the patient engages with mental health services and rehabilitative efforts. The self-regulation theory proposes that individuals form common-sense beliefs about their illness so that they can â€Å"understand and cope with health threats† (Leventhal et al., 1997; Leventhal, Nerenz, and Steele, 1984, as cited by Petrie et al 2008). Individuals actively try to understand their symptoms and their illness, which â€Å"†¦drives the patients coping and emotional responses to the health threat.† Petrie et al (2008) are arguing that the perceptions of the patient influence how they seek help, cope with interventions, rehabilitate, and respond emotionally to mental disorder. This view aligns to Kinderman et al’s (2007) view that social and cultural factors are as important as biological factors in how the mental health services engage with people suffering from mental disorders, and how well people respond to interventions. People’s perceptions of themselves are heavily contingent upon how they think other people see them, which is a social and cultural influence on an individual psychological construct. As an example of this Kondo, D. (1990), in reflecting as a researcher on her own experiences as a Japanese American describes how people â€Å"seemed to be constituted in and through social relations† and how the self is a dynamic construction. From this point of view, it is likely that an individuals’ perception of themselves, because it is a social construct, will change over time, and particularly with respect to how they perceive the state of mental disorder they suffer from, and how any intervention progresses (or not). This fits with Kinderman et al’s (2007) recognition that individuals are stigmatised through the application of the medical model to them, in the hands of the mental health service. Rose, Thornicroft, Pinfold, Kassam, (2007, as cited by Petrie et al 2008) point out that â€Å"the diagnoses used for mental health problems are more often associated with negative connotations.† Mà ¼ller DJ, Mandelli L, Serretti A, DeYoung CG, De Luca V, Sicard T, Tharmalingam S, Gallinat J, Muglia P, De Ronchi D, Jain U, Kennedy JL. (2008) carried out research into the influences of genetic and non-genetic factors on adult Attention Deficit Hyperactivity Disorder (ADHD). According to Muller et al (2008), there is â€Å"strong evidence that ADHD is highly heritable and has a neurobiological underpinning† (Faraone and Biederman, 1999, as cited by Muller et al 2008), and that â€Å"low socioeconomic status, parental psychopathology, and family conflict† (Scahill et al., 1999 and Biederman et al., 2002, as cited by Muller et al 2008) are all strong contributors to the risk of ADHD. This view aligns to Kinderman et al’s (2007) view that social and cultural factors as well as biological factors need to be incorporated into the model that underpins mental health services policy. Muller et al (2007) concludes that the inclusion of â€Å"environmental factors in genetic studies, [would help] to resolve†¦Ã¢â‚¬  inconsistencies in studies of ADHD and of â€Å"†¦other psychiatric disorders.† Again, the importance of social and cultural factors as well as biological factors in understanding mental disorder is emphasised. Much research has linked suicide, and having suicidal thoughts, to depressive disorders. For example, â€Å"most adolescents with depressive disorders report significant suicidal ideation, and a significant minority report having made a suicide attempt during the course of their depression (Myers, McCauley, Calderon, Treder, 1991, as cited by Brown, R., Antonuccio, D., DuPaul, G., Fristad, M., King, C., Leslie, L., McCormick, G., Pelham, W., Piacentini, J., Vitiello, B., and Brown, R. 2008). It can be argued that suicide is a profoundly individual act. According to Durkheim, the motives of an individual could be explained by psychology, but psychology did not provide a general explanation of suicide as a ‘social fact’ (Smith, M., 1998). In Suicide (1897/1952, as cited by Smith, M. 1998), Durkheim studied suicide rates across time and place, and found patterns between suicide rates and amongst other factors, the geographic location of people that committed suicide, and membership of religious groups. It would seem that social and cultural factors had a very real impact upon the state of mind of individuals, and that there may also be psychological factors at play. In relation to the article under review here, it would therefore seem that not only do social and cultural processes need to be taken into account when caring for people with mental disorders, but psychological factors also influence, or perhaps mediate how social and cultural factors influence, the individual. This is broadly in line with Kinderman et al’s (2007) model, although the relationship between biological and psychological factors is not clear, and could stand further research, notwithstanding the limitations of this particular essay. It would also seem that professionals and researchers across several disciplines and schools of thought relating to mental disorders agree with Kinderman et al’s (2007) article, in terms of the need to include social and cultural factors in understanding and caring for people with mental disorders. In terms of my own career, Kinderman et al’s (2007) article illustrates the inadequacies within the existing structure and approach of mental health services, and how the mental health services could be improved by broadening the focus of the underlying model to include social and cultural causation of disruptions to individual psychological processes. I am unsure of how biological processes and psychological processes interrelate in terms of Kinderman et al’s (2007) model, but I would assume that in line with the deterministic causation of social and cultural factors, that psychological factors were are derived from biological factors. As a student considering a career in the mental health services, I see Kinderman et al’s (2007) article as very relevant. I chose the Kinderman et al (2007) article for review as it was of personal interest to me, and relevant to issues I may have to confront both in my future studies, and in my chosen career. I am specifically in terested in how people are engaged with by the mental health services, and how effective that engagement is, in terms of promoting individual agency, and respecting individual differences. My own feelings and thoughts around how people shape themselves, how people are shaped by external factors, and how people should be treated by society and by the mental health services, tend toward equality and non-judgemental institutions, processes and workers. Kinderman et al’s (2007) article and the thinking it embodies is provocative and very interesting, as it challenges the status quo, and the accepted medical model; a model that sees people as merely organisms rather than people with their own feelings, thoughts, histories and needs. As someone planning to work in the mental health arena, I would prefer to work within a structure that aligned with my own ideals and values, rather than being constrained by the ideas and values of the institution, and not being able to work in a way that I thought was effective and valuable. In writing this essay, the academic skills I have used include summarising, picking out key points, selecting relevant materials relating to the article under review, and constructing a logical flow of argument. I read the article itself through several times, first just to get a broad idea of the thrust of the article, and then again more carefully, paying attention to the points raised, and any thoughts I had related to the points raised. I noted down all of the ideas I had about the article at each reading, and used them to formulate a list of subjects for searching under on-line. These subjects included the main ideas underpinning the article, which included terms like medical, biological, illness, sickness, treatments, diagnosis, social / cultural influences (family, environment, socio-economic) psychological disorders, and related ideas like mental health, mental illness, intervention, child development, genetics, and psychiatry. I accessed the Open University library and carri ed out key word searches using different combinations of the terms themselves until I found articles that I could relate to the Kinderman et al (2007) article under review, and read, summarised and picked out key points. I then wrote up a rough essay plan that threaded all of the articles together, incorporating the key points of each, and led to the conclusion I had in mind, that is, the article was relevant to me, and was more or less supported by the additional reading I had done. I find studying academic skills as a subject useful, in that I feel as if I am developing a technique for better comprehending information and better expressing myself, by utilising evidence to support my views. This helps me to feel confident in approaching tasks that I may have felt previously were challenging because I was not comfortable that I knew how to achieve the objectives. I think I understand more about the process of working through information and evidence, with a view to applying that evidence to what I need to achieve. I feel as if I can see a logical path, which will help me to understand something and apply it in the way that I need to. In reflection, I think that one of the skills I have learnt is to break down things into smaller chunks that are more manageable. Taking a more methodical approach allows me to make sure I understand something fully before I move on to the next thing. This makes me feel as if I am achieving something at each step, rather than just gr inding through a long task with no clear end in sight. It helps me to feel as if I am in control, and as if I know what I am doing, which I think is what makes me feel more confident. In conclusion then, studying academic skills makes me feel more confident about tackling difficult tasks for which I would not previously have had the skills or confidence to tackle, and I demonstrated this to myself in carrying out this assignment. Bibliography References Kinderman, Peter, Sellwood, William and Tai, Sara (2007)Policy implications of a psychological model of mental disorder, Journal of Mental Health,17:1,93 — 103 Kinderman, Peter, and Tai, Sara (2008)‘Psychological models of mental disorder, human rights, and compulsory mental health care in the community’, International Journal of Law and Psychiatry, Volume 31, Issue 6, December 2008, Pages 479-486 Petrie, Keith J. ; Broadbent, Elizabeth ; Kydd, Robert , (2008), Illness perceptions in mental health: Issues and potential applications, Journal of Mental Health, Volume 17, Issue 6 December 2008 , pages 559 564 Mà ¼ller DJ, Mandelli L, Serretti A, DeYoung CG, De Luca V, Sicard T, Tharmalingam S, Gallinat J, Muglia P, De Ronchi D, Jain U, Kennedy JL. (2008). Serotonin Transporter Gene and Adverse Life Events in Adult ADHD. American Journal of Medical Genetics Part B 147B:1461-1469. Kondo, D. (1990), Crafting Selves: Power, Gender and Discourses of Identity in a Japanese Workplace, Chicago, University of Chicago Press, pp. 9, 11-24 Brown, R.T.; Antonuccio, D.O.; DuPaul, G.J.; Fristad, M.A.; King, C.A.; Leslie, L.K.; McCormick, G.S.; Pelham, W.E. Jr.; Piacentini, J.C.; Vitiello, B. (2008), Depressive disorders and suicidality, in Childhood mental health disorders: Evidence base and contextual factors for psychosocial, psychopharmacological, and combined interventions.; pp. 69-85. Washington, DC, US: American Psychological Association. xii, 207 pp. Smith, M., (1998), Social Science in Question, London, Sage Publications in association with the Open University Press, p84

The anti-smoking media campaign among adolescents

The anti-smoking media campaign among adolescents INTRODUCTION In the 20th century, smoking has been established as the leading cause of many preventable diseases (i.e. cancer) and deaths. Antismoking ads started in the 1967, when FCC required broadcasters to air one antismoking message for every three cigarette (Siegal 1998). At first these ads were free until it became effective to the audience that it eliminated the free advertisings. Throughout these years, it provided a worldwide dispute to health of the community. Liu reports: â€Å"Since Minnesota introduced the first paid anti-smoking media campaign in 1986, many other states have used a proportion of their cigarette excise tax revenue to fund large-scale anti-smoking advertisement through the mass media. Those media campaigns try to provide the public with health information about the harmful effects of smoking on health, and, therefore, change peoples smoking behavior, based on the theoretical hypothesis that more informed people are more likely to choose healthy lifestyle† (Liu 2009, p.29). Constantly, advertisers are creating advertisements, such as billboards, commercials and other interesting promotions, for anti-drugs and anti-smoking. It is found in many different places that can be simply seen by the public, preferably among adolescents and teenagers, to get their attention. For example, â€Å"Florida has reported that its Truth advertisements attacking tobacco firms are effective, on the basis of surveys showing 40% and 16% declines in smoking among middle and high school students in the state, respectively† (Penchman 1999, p.2). Recent studies have argued various points that these ads are not working for our city and future generations. Clearly, the government is clearly spending a lot of money for these advertisements but past presidents such as, George W. Bush, tempted with the idea to cut spending because of no concrete answer for a positive outcome. In addition, news media in different markets indicated that teenagers are using more marijuana because of these popular ads that they are constantly seeing in the media. For example, many adolescents feel that marijuana is fashionable drug among their peers because it is popular usage in media such as movies, commercials and many other outlets. Not all people involved in media have agreed with this statement. Others have disagreed with their counterparts and stated that these advertisements are actually working for many people. Research studies done in the past have proved that these advertisements have been a significant positive change for less use of drugs among society. Recently, these advertisements have been getting realistic to the point that it might scare potential users away. In addition, past surveys have been conducted which stated that majority of the people that seen these types of ads are trying to quit from destroying their health. Research studies that found some type of evidence for the success of these media campaigns such as, reducing cigarette consumption and drugs use among adolescents and adults shows that several governments have cut the spending on their control programs. The lost of funding has been in use in other areas such as the recent hit of the economic recession which could have a serious influence on the future success of antismoking and anti-drug control initiations. In addition, policy makers have stated that there is a lack of evidence that these messages are working. This topic brings back to the debate that these ads are producing cigarette use instead of stopping it. â€Å"Many researchers have different ideas on whether advertising for antismoking should be used for tobacco use prevention, which depends on both its effectiveness and cost-effectiveness† (Pechmann 1999, p.2). Currently, theyre no significant evidence that these ads are actually working media. Others are confused if these ads are wasting taxpayers money and not benefiting our society. â€Å"For instance, significant amount of research has been done on this topic and little conclusive evidence of a direct link between advertising-only interventions and reduced adolescent smoking dominance. However, I do agree there is an indirect evidence for the effectiveness of antismoking and antidrug advertising† (Pechmann 2003, p.16). â€Å"Mass communication media play such a significant role in contemporary society, that we could not conceive it without their presence† (Televisa). Since the introduction of media, smoking was brought into new heights and established new audience to attract. Tobacco companies have taken advantage of the media, which they have, supplied billions of dollars on advertising of tobacco. These companies make smoking glamorous, fun and â€Å"cool† to the public. Along with the advertising in media, many include general surgeon message, which is in fine print that many viewers do not notice the health concerns of the use of cigarettes. Recently there has been a surge of cancer among people that antismoking campaigns have been created to end or to put a stop on these glamorous ads and tobacco companies. The opposing ads demonstrated the negative aspects of smoking, which is mainly targeted for adolescents along with statistics on the mortality rate cause by smoking. Along wi th tobacco advertising, parents were another influenced for young adults to start smoking. The rival ads such (thetruth.com) started to use parents, whom do not smoke, as the anti-smoking and anti-drug gear towards the adolescents. Over the past seven years, television ads have gotten increasingly graphic and even gruesome. In recent months, television ads have gotten more graphical which has been taken a page from a horror movie. These ads are trying to hit an objective goal of having 20,000 smokers to stop the routine. In addition, New York City has raise up the prices on its pack of cigarettes up to $10. Along with habit, it is costing New Yorkers $250 a month just on smoking cigarettes which can use that money for other needs. The government wants to reduce people from smoking and its trying its best to achieve its goal. New York Officials claim that the ads are fighting â€Å"fire with fire† when comes to widespread cigarette advertising. For instance, â€Å"The National Cancer Institute reports cigarette manufacturers spend some $37 million a day on average to hawk their product, a whopping $13.5 billion per year† (Inbar). The message that these anti-smoking campaigns are doing is expressing that someone might suffer and die from smoking but also, it may wreck someones family. In the present-day, media depicts drug use and smoking as a popular craze to do. Televisions shows and movies depict drugs and smoking as a good habit and do not state any negative consequences on the use of it. Todays audience watches these shows and movies, which get the sense that smoking and using drugs is a â€Å"cool thing to do†. For example, HBOs television â€Å"Bored to Death† and 90s cult classic movie, â€Å"Half-Baked†, depicts characters that continuous smoking marijuana throughout the whole act. Throughout these programming, it does not stated any negative aspect from smoking marijuana but instead glamorous as a drug that can be use for relaxation. Television ads depict the negative aspects of marijuana and cigerrette use as someone whom can lose their concentration, vision and can cause serious damage to their brain cells. According to Variety, Triplett writes, â€Å"A senior lawmaker, Ed Markey (D-Mass.), wants more action from Hollywood against smoking, and the Motion Picture Association of America pledged to try opening a direct dialogue on the issue. Markey wants to ask MPAA topper Dan Glickman to improvise on the following: Including antismoking public service announcements on DVDs. Certifying that no one involved during a production received anything of value for using or displaying tobacco in the film and eliminating tobacco brand imagery from movies† (Triplett). If adolescents see their favorite actors or actresses smoking, it will lead them to believe that smoking is a good thing to do or not harmful. But these changes in the movie industry will try to eliminate smoking from their movie scenes to not influence anyone about smoking. It is great idea because many adolescents look up to these celebrities as role models. INTERVENTION The intervention to reduced smoking habits has been on the community and its two aims. The reasons for the campaigns are to highlight the dangers of smoking in terms of health and to reduce the amount smoked and potential smokers in the community. The statewide tobacco prevention and education campaign launched to target audience from ages 12-17 to inform them about the harsh realities of smoking. The campaign was created along with group of teen advisors whom themselves were smokers or knew someone that smoke to get the best perception to help succeed with these ads. The funds come from tobacco tax dollars that purpose is to be used for prevention efforts. The idea for this campaign is the let the audience know that smoking can be addictive and hard to quick. Not all of the campaigns are true, as it seems. For example, Baram writes about a famous controversial spokesperson for antismoking campaign but continue to smoke after he filmed a commercial about the harm that smoking can do for a human body. Baram writes: â€Å"Skip Legault, with his tale of two heart attacks, strokes and an amputated right leg, has become the star of anti-smoking posters and commercials blanketing New York since December. But the 48-year-old former repairman isnt getting the message Legault said he still smokes up to a full pack of Marlboros every day. I cant stop smoking, Legault told ABCNEWS.com. Ive been smoking since I was 8, and Im afraid to quit. ABC†. This case of Skip Legault made national headlines because of the issue of quitting smoking is much harder than it seems† (Baram 2008). Even, addictive smokers admit that it is hard. Many people believe that they can quit on their will but it is different. The chemicals drive these smokers to smoke more because of the addiction. A marketing campaign that has been successful in getting its message across is thetruth.com. The 1997 Settlement Act mainly funded the company. It has been the number one protestor against smoking. The anti-smoking campaign consists of several ways to reach to the massive amount of audience. Each way is to attract audience on the hazards that smoking can happen to an individual. The ads are in English and Spanish, which include television ads, radio ads, posters, cinema advertising, online media, social media, and Internet advertising and original websites. FUNDING Before 1988, mass media campaigns relied on free advertising through public service announcements or short-term funding for specific campaign (Siegal 1998). These ads were not aired during prime time, which made little progress towards reaching the mass audience. The ads were heavily dependant on donation of advertising time by broadcasters. In 1988, the use of mass media for antismoking changed by voters in California approved Proposition 99. This election required that tobacco companies donated 20% of their revenue for the state to provide educational programs and increased of the state cigarette tax by 25 cents. As Warner reports, â€Å"The purpose is to demonstrate that, with various combinations of policy changes, mass media information, and smoking cessation programs, smokers can be encouraged to stop smoking, and young people can be prevented from starting to smoke† (Warner 1982, pg.378) A court settlement that changed everything for antismoking media is 1997 settlement. The background begins,in August 1997, when the Florida Gov. Lawton Chiles made an historical out of court settlement among all tobacco companies at that time. The massive payout of $11.3 billion dollars is the considered the day that the straw that broke Joe Camels back† (Grossman 1997 p.290). This settlement led to the creation of thetruth.com whom is an advertising company that campaign against smoking. In addition, the money was used to compensate the state for public health costs caused by smoking-related illnesses.† The main goal of this settlement is to provide a way to lower down the use of cigarettes among young adults and give a helping hand to adults to quit smoking. The main idea of the settlement is to educate non-smokers about the effects of smoking and the harm of its chemicals. In â€Å"Cigarette Taxes†, Grossman reports that the agreement calls on tobacco companies to: Pay billions of dollars for a host of public education and health programs; Reimburse states for the cost of treating tobacco related illnesses; Set aside a multi-billion dollar fund to compensate smokers who win individual lawsuits against the tobacco companies; and Severely curtail marketing and advertising cigarettes, especially to teenagers. All of theses changes made a significant progress in the campaign against smoking. Since the settlement, smoking has been a decline for many users as they reported that the main reason to quit were due to the informercials and mass media adverstiing. The adversiting has faced some roadblocks in the process of succeeding. For example, in 1992, Gov. Wilson suspended Californias media campaign for other purposes. In 1995 and 1996, he censored and pulled other commercials that went against tobacco companies. The motivated behind this act still remains unsolved but it would not be surprise if he were supporting tobacco companies in some form of way. Another example, Siegal reports, in 1996, Assembly Speaker Curtis Pringle introduced a bill that would have restricted the media campaign to messages dealing with health and disallowed spots attacking the tobacco industry (Siegal 1998). TYPES OF CAMPAIGNS In March of 2009, the New York State Department of Health released ads for antismoking which cost $1.2 million from the states budget. The campaigns are featured in medical journals, newspapers and other publications such as the Internet. These ads are encouraging healthcare providers to make quitting a main concern with their patients who smoke. These ads were photo-shopped that featured images of patients with oversized ears to demonstrated that smokers are willing to listen from their doctors about the hazards of smoking. The reason for these ads is to attract healthcare workers because many adolescents go for their annual physical exam. Somehow, adolescents interact with doctors and nurses and are convincing to help these young adults to stop or before they start smoking. In earlier years of advertising, anti-smoking groups and health departments have attempted to oppose the advertising of tobacco by creating their own ads to emphasize the negative effects of smoking. The commercials included smoking cessation, the increased risk of lung cancer and other hazards problems that were seen passive for other public members. However, over the years, the ads have become more aggressive and more combative against smoking. Now these ads are focused on decreased physical attractiveness such as erectile dysfunction and graphical messages such as losing fingers and black lungs. These campaigns are much targeted to the younger crowd than its predecessor. Around the globe, smokers know that smoking tobacco is bad for their nature but they continue to do it regardless of their hazards that come along with it. Current smokers that I have met stated that the number one reason that they cannot stop smoking because of they are addicted to smoking and/or the use of tobacco. Many smokers are addicted to the scent and the nicotine, whom several years ago, the tobacco companies have tried to cover it up to make more money of it. Nicotine is a stimulant form of factor that has been considered one of the worst addictions to break compare to cocaine and heroin use. It is not the only chemical involved with cigarettes but along with 4,000 chemicals is involved which can make an individual much harder to quit. Aside from the fact that cigarette smoking can damage the health of the one smoking but it can also pose serious health risks to other people in the surrounding area. A person that smokes within distance can promote second hand smoke to his peers. This situation can lead to others to walk away from the venue and/or to move away from the entire scenery. Since Mayor Bloomberg was elected, he banned all types of smoking in nightclubs; restaurants and other public places to decrease second-hand smoke and increased businesses for these places that people avoided because of the tobacco smell. Smokers should be educated on their smoking can be to those people around them, including children. This is one of the reasons that anti-smoking campaigns focused on. The campaigners wanted to stop second hand in the neighborhood to prevent cancer and asthma. The campaign for the anti-smoking will try not to use propaganda but instead promote facts about the hazards of smoking. The posters for the campaign against smoking are with feature graphics that is within accepted limits for the culture that it is intended as not to attract negative publicity. The ads do not have any racist overtones or anything that will offend the mass public. The campaign was design to attract peoples attention regardless of race, color, age, and sex. The preferred approach for advertisers is arousing fear because nothing is as vivid as violence and nothing translates as to film as horror. The tendency of media to control against open-mindedness is one of the dominant themes in media criticism. The only aim of the campaign is to distribute as much promotional campaign against smoking as possible within a very limited area. In reference from thetruth.com, they have listed celebrities and well-known actors to get the message across to viewers that smoking is not â€Å"cool†. The anti-smoking group believes that having celebrities and other well-known faces will attract a bigger audience than having a request from the government and its surgeon general. There are several message theme labels that are use in anti-smoking advertising across the border. Based on Penchmanns recent research, â€Å"The message theme labels are the following: disease and death (Smokers suffer from health effects), endangers others, (second-hand smoke), cosmetics, (unattractive side effects), smokers negative life circumstances (loser lifestyle), refusal skills role model (role models do not smoke), marketing tactics (image advertising), selling disease and death (tobacco firms use manipulation and deception to sell a product that causes harm), and substantive variation (several messages use to spread one meaning)† (Penchmann 1994, p.240). Each message theme is use in their ways by marketers and campaigners. It has proved that all of them methods none have made the effort that the â€Å"shock method† has produce. Since 2007, the New York City Department of Health launched a series of anti-smoking campaigns which included smokers quit hotline and free nicotine patch and gum clinics in certain areas at certain times throughout the year. The television ads promoted the damage smoking can do to the body. These ads were noted for their graphic nature as well as their effectiveness. Since 2008, a second series of ads launched that can be seen nearly in every subway train station. It is about â€Å"Marie† a Hispanic Middle-Aged woman whom describes the amputations and pain she has undergone in relation to developing a disease that was the effects of smoking cigarettes. Each day routine smokers die from smoking related diseases each day. In a single cigarette 4700 cancer-causing chemicals are found which are have general surgeon messages pasted on the cigarette cartons. Despite the warnings, smokers continue to smoke. Some of these chemicals include acetone, ammonia, formaldehyde and arsenic. It is disgusting that people are putting these chemicals in their bodies and lungs daily. It is a suicide waiting to happen. Earlier times, Men were to consider smokers more than women. Times have changed and now more women smoke to deal with stress or problems. In addition, social influences such as friends and partygoers are most likely to smoke. Most modern women today will agree that the demand and multiple roles they have taken on have grown over the years. It is no small wonder that many have turned to cigarettes to deal with stress. EFFECTIVENESS Although the main goal of anti-smoking media campaigns is to quit smokers to quit smoking, little evidence suggests that the role of these campaigns are helping to stop. The campaigns can provide a new insight for young people such as non-smokers and those smokers wanting to quit to lead a normal life. These campaigns cost less money than sending someone to be hospitalized or suffer severe consequences because of smoking. It is a healthier and more prosperous future for our younger generation but not all of antismoking ads are effective. Research study has shown that the most successful campaigns are exposing the tobacco industrys manipulation on young adults; focus on themes of second hand smoke and cigarette addiction (Siegal 1998). Campaigns that simply say, â€Å"do not smoke† are the least successful because it not reinforcing adolescents to experience making decisions and the ability to grow up. For example, â€Å"most adolescents want to appear mature, independent, sav vy, attractive, and cool, and many think that not smoking will help them realize these goals. Smokers Negative Life Circumstances messages suggest that smoking is a barrier to achieving [these] goals (Penchmann 2003, p.10). These ads are effective in their own ways that likely to change someones thoughts on the idea of smoking. STATUS AND IMPACT The question is, â€Å"Does anti-smoking ads work?† It is a tough question to answer because there is no direct link that it does work. As Ms. Garcia, whom I interviewed, stated that â€Å"these aids are not working and the campaigners should find other ways to attract its audience.† The antismoking ads offer two ways that it can spread it messages. The messages are if a person smokes than that person would not succeed in life and if you do not smoke, you would be successful in life. The Tobacco remains one of the most widely abused substances. After writing this report and reading other research articles related to this topic, I found there is at least a connection with anti-smoking campaigns and decreased use of smoking among adolescents. For example, smoking is at historically low among groups of ages over 12 years old compared to the late 1990s when the campaign started. Many people believe because of the increased advertisements and its graphical nature has made i nfluenced in these changes. Most of the advertisements are found on during times that young adults are at home usually after school programming to get their attention. Before, it used to seen at various times of day. I believe it has made impact among our future generation and as long the government keeps pumping money into the campaign, I feel lower down smoking use but never fade it away. These ads had made an impact in society. When people are asked about these anti-smoking ads, their first impression is to mention the graphical nature that it has. Even younger adults have stated that, â€Å"if their lungs are going to turn black because of smoking, might as well not even start†. But not everyone agrees that these ads are effective, as it seems to be. For instance, Pearman Parker writes, They can [be effective], though, when they reinforce the perception that their close friends listen and respond to the campaigns.† In addition, Parker reports that the ads have been effective on younger teens but not towards adults. Parker writes, â€Å"Adults know it is unhealthy and knows what can happen to them but that does not change their behaviors.† Overall, anti-smoking has made big impact since 1998 with its â€Å"shock method†, it keep evolving and changing as time goes by. The ads that are picture in the campaign can be viewed as personal testimonials from smokers whom are having the negative side effects from smoking. In these ads, real people tell their own stories about the negative impacts that have cause throughout their lifetime. The main message to get across the audience is provide a sadness or fear mood. Teenagers are more bound to learn from personal testimonials because it provides some sort of realness to the picture of the negative effects of smoking. CONCLUSION: POLICY RECOMMENDATIONS According Penchmanns recent study done in 2002, â€Å"our findings to date suggest that tobacco-marketing (anti-industry) advertisement may not be especially effective with adolescents, though such advertisements are popular, in part because of the apparent success of the Florida Truth campaign.† It has been proven that The Truth Campaign has been the most successful in decreasing smoking habits among adolescents. Anti-smoking campaigns have other free options to promote their cause against smokers and the tobacco industry. The funds that the campaigners get can be use to provide free addiction clinics and research studies to help smokers on how to quit. As newspapers are fading away such as, their revenues have fallen 23% over the last two year (The State of News Media). Anti-smoking campaigns can push for interactive ways using social media and social networking. They can promote and advertise on MySpace, Twitter and Facebook to get users to join the campaign and give awaren ess of the health hazard on tobacco. For instance, social networking can reach to the other audiences especially to the crowd that attracts the most of its first-users are the adolescents. Another way of social media that antismoking campaigners can use is YouTube to gain more audiences. According to Hempel, â€Å"YouTube is the largest video platform in the world (Hempel 37).† People behind the campaign can run concepts such as viral campaigns with homemade videos. The adolescent group is the most users of social networking and the anti-smoking campaign can promote their product with graphical ads that can catch their eyes. Using social media will be a great way to interact with young adults. For example, using Facebook Connect, the creators can create an ad that collects the users information and create a video on the hazards of smoking tobacco with the information use of the viewer. Only the viewer will get to see the commercial ad to avoid controversy with others watching it unless the person wants to show to the mass. In conclusion, anti-smoking advertisements have been a great topic to cover throughout the research. It has its positives and negatives on certain areas that affect various groups throughout the New York State and the nation as a whole. Many researchers oppose that the campaign has not been working because of the massive funds that the government invested since the 1997 settlement. In addition, many campaigners agreed that the campaign is positively proceeding to a certain extent because of the decline of smoking users have gone down. The percentage is not big but it shows that it is effective. The question to answer is what is the status and impact on adolescents by the anti-smoking campaign? The status is the campaign is still trying to attract adolescents not to smoke and the impact has that many young adults have been listening to these ads especially of the shock method nature of it. Will it succeed to stop people from smoking? The true answer is no because of the addictive chem icals involved in tobacco will make smokers hard to quit. As Penchman writes, â€Å"It is conceivable that advertising that is ineffective on its own becomes effective when combined with other effort.† The campaign needs to develop a strategy to help people to quit. As Ms. Karp from MSNBC reports, that the Internet outlet is the best source to use to expand advertising strategy. For instance, withdrawal clinics, nicotine patches, non-for-profit outpatient treatment can help smokers in many places that the campaign is not helping. Overall, the anti-smoking is making an impact among all people and the status of campaign will become stronger because it is here to stay. Bibliography 2009 Join us in our Anti Smoking Campaign because Its Time To Quit Smoking Healthy Living on Shine. Astrology | Horoscopes, Celebrity Horoscopes, Chinese Astrology, Compatibility Tools, and Gift Guides on Shine. Web. 01 Nov. 2009. . Baram, Marcus. Star of Anti-Smoking Campaign Still Puffs. ABC News. 11 Jan. 2008. Web. . Note: The article helps me understand it is hard to quit smoking. The fellow interviewed in the article was seen in an antismoking ad early in the year but still smokes today. The author writes about the hardships of quitting smoking and advertisements are not what it seems to be. Berger, Arthur Asa. Media and Communication Research Methods. SAGE 2000. Pgs 3 173. CBC. Anti-smoking campaigns apparently have little effect on youth. CBC.ca. CBC News. Web. 01 Nov. 2009. . Note: The article is based from Alberta, Canada. This website was helpful because it gave a different point of view from the ant-smoking campaign. It helps me understand the two sides from the debate and on the reasons on why it is not working. Elhart, Mary. Statewide Anti-Smoking Campaign Takes New Approach in Curbing Teen Smoking | Reuters. Reuters.com. Arizona Department of Health Services Bureau of Tobacco Education Prevention, 16 Feb. 2009. Web. 01 Nov. 2009. . Note: The author of this article discusses new ways that the antismoking campaigns can evolve. The author mentions different areas where the campaign is lacking and to make it stronger to decrease smokers. Grohol, John. Scare or Disgust Work Best in Anti-Smoking Ads | Psych Central News. Psych Central. 17 Nov. 2008. Web. 01 Nov. 2009. . Note: Grohol discusses the â€Å"shock method† message that can be seen in antismoking advertising. It is helpful because it mentions different ads in their shock message. The shock method is one of the most effective techniques found in advertising. Grossman, Michael and Frank J. Chaloupka. â€Å"Cigarette Taxes: The Straw to Break the Camels Back† Public Health Reports (1974-), Vol. 112, No. 4 (Jul. Aug., 1997), pp. 290-297. Association of Schools of Public Health Hall, Nicholas G., John C. Hershey, Larry G. Kessler, R. Craig Stotts. â€Å"A Model for Making Project Funding Decisions at the National Cancer Institute† Vol. 40, No. 6 (Nov. Dec., 1992), pp. 1040-1052 Source: Operations Research,