Extensive Growth of Real Gross Domestic Product in the U.S Case Study

Extensive Growth of Real Gross Domestic Product in the U.S - Case Study Example The accelerated growth during the spring and summer period is an indicator that the economy has reached a stronger sustained growth point. In addition, this growth is the best reported after five years since the end of the Great Recession of the U.S. Gross domestic product considers the value of all goods and services produced by the U.S and the best measure of the economic health of the nation. Increase in consumer’s expenditure, investments in business equipment and the increase in the inventories were reported to be higher than the formers estimates. Therefore, the increased investments, inventories, and consumer expenditure accounted for the upward growth in the third quarter of the year 2014 (Market Watch, 2014). The surprising growth in the U.S economy resulted in a slight lift to the stock market. Actually, most of the economists polled by the MarketWatch expected the government to report a decreased growth of around 3.3 percent from the previous. Increase in consumer e xpenditure or spending reflecting more than two-thirds of economic activity of the U.S increased to 2.2 percent from the first read that was 1.8 percent. Households spent more money at retail stores and on auto fuels than in the previous report. One major source of the extensive growth was the increased investment in business equipment which rose from 7.2 percent to 10.7 percent. Companies’ inventories rose from $62.8 billion to $79.1 billion. Despite the fact that the overall growth was high in the third quarter, growth in exports reduced from 7.8 percent to 4.9 percent. The decline shows that the light growth in Asia and Europe is taking a part of the U.S economy. Imports of the U.S reduced at 0.7 percent annual rate a compared to the estimated growth of 1.7 percent.

Rough Draft Puritans Essay Example for Free

Rough Draft Puritans Essay In the middle of the 1600’s, from around the 1630’s to about the 1660’s the Puritans were fleeing to America for mostly religious reasons. Many of them came to set up what is called the Massachusetts Bay colony. John Winthrop was the leader of this colony. They believed religion was the key to the perfect community. Puritans had many influences on the political, economic, and social development of the New England colonies using their religious values. Puritans had so many influences on the political outcome of the New England colonies. The form of government they had created was almost like a theocracy, where God’s law is law. A lot of the New England colonies didn’t want this at all. Nathaniel Ward (doc G) was trying to tell them that the state laws needed to go along with the morals of the church, or a lot of bad things might happen. Even though Ward stated this, a lot of the colonies already had religious tolerance so they didn’t base the laws from the church morals. In â€Å"Limitation of Government,† John Cotton (doc H) is saying that the government shouldn’t be all that good because any ‘mortal’ man will abuse it. This is sort of like a democracy, which the New England colonies will develop a government almost like this. Roger Williams (doc F) says that states should only have one religion each. If they acquire more than one religion, it could only begin a war. This basically shows that puritans were not very tolerant of other religions. Quite a few people believed there should be religious tolerance, people like Roger Williams, who was sent to Rhode Island by the Puritans. Then Rhode Island became one of the first colonies to obtain a separation of religion and state, which made it a colony for freedom of religion.

Portrayal of Women in The Good Earth :: Good Earth Essays

Portrayal of Women in The Good Earth The Good Earth focuses around the life of a Chinese peasant, Wang Lung, who struggles to overcome a poverty-stricken life. The accounts of Wang Lung's life portray traditional China. One prominent aspect of this story is how women were depicted in society. The role of women in China is woven throughout the novel. Depending on their social status, each female character within the novel gives readers a different perspective of a woman's role during this period. In addition to their roles, the author includes the trials and tribulations these women must face as well. As a whole, the importance of these female characters are based upon their contribution to the ego's of the male protagonists and as being providers of support to both family and order in society. In Pearl S. Buck's The Good Earth, women are depicted to be consistent with the authentic Chinese culture of that period. Paul A. Doyle, a literary critic, remarks that Buck's stories were improbable and simplistic (Chauhan, 1994, 120). He later adds: "In structure, The Good Earth uses a chronological form which proceeds at a fairly regular pace. Buck's stories take the epic rather than dramatic form, that is to say, they are chronological narratives of a piece of life, seen from one point of view, straightforward, without devices; they have no complex plots, formed of many strands skillfully twisted, but belong to the single-strand type, with the family, however, rather than the individual as a unit (Buck 35). As Wang Lung and his father begin this family strand, one by one characters are introduced from Wang's viewpoint. In regards to women in his society, he objectively portrays them for what they are worth. In spite of his smooth surface, the novel shows a complicated feminism. On the one hand, the woman's situation is clearly, almost gruesomely, presented: Chinese village society is pat riarchal, oppressive, and stultifying to women (Hayford, 1994, 25). The clearest illustration of this occurs through O-lan, the wife of Wang Lung. O-lan comes about in the first chapter of the novel. At the age of ten, her parents sell her off to the Great House of Hwang, where the village's wealthiest landowner resides.

I. Brief Overview of different sculpture styles A. Egyptian Sculpture

Egyptian sculpture is distinct in their symbolic formality based on an ancient set of rules for three-dimensional works of art and were not meant to capture or memorialize a certain event or point in time. Egyptian sculpture is primarily used for religious purposes, mostly to guard over the dead. It is typically hewn from stone and figures preserve the cubic form of the original slab.The figures are always deliberately facing the front and much of the detail is hewn to represent characteristics of the frontal image, and is usually painted with vibrant colors.Later Greco-Roman influence later transformed the detail of the face to more closely approximate a realistic representation of the human face. (â€Å"Egypt†) B. Greek Sculpture The most important samples of Greek sculpture deal with religious themes, although civic, domestic and sepulchral themes are also common. When dealing with human subjects, realism tempered by idealism is the order of the day. Some were large, others small enough to place on a pedestal. Subjects include iconic figures such as the Greek gods and goddesses, priests, sacred animals and others of votive character.The most popular type of Greek sculpture is the bas relief and in the round. Greek sculpture was also used to honor civic events such as treaties and national games. These memorials are mythopoetic in character. In general Greek sculptures in marble, stone, terracotta, bronze or wood are distinct in its grace and beauty, its hint of action and value as a record of dress and fashion of the era. Finishing included liberal applications of oil, wax and color for a more life-like sheen except for those made of marble, where color was added only for emphasis.(â€Å"Greek sculpture – part I†) C. Roman Sculpture Sculpture as an art form developed late in Roman society because Romans considered all forms of art from a practical point of view and held it in contempt as work only slaves should do. Much of the work done in sculpture in the 2nd and 3rd Century B. C. was likely done by Etruscans. During the reign of Augustus (63 B. C. – 14 A. D. ), Romans began drawing away from mostly decorative and utilitarian subjects of sculpture to more mythological themes.The conquest of the Greeks shifted the material of choice from bronze to marble, and a shift from in the round to relief sculptures. Masses of Greek works of art were transported to Roman strongholds and excited much admiration but no desire to produce their own. Wealthy Romans commissioned copies of the more famous works for display in their homes. With Augustus, there was a dawning approximation to the Greek attitude towards art which did not survive his demise, but which did produce some of the more beautiful pieces of Roman sculpture such as the Altar of Peace (erected c. 12 B. C. ).(â€Å"Greek and Roman Art†) Only the development of relief on sarcophagi continued and outperformed Greek in this instance, and is evident in th e many extant samples such as the arch at Beneventum. The distinct Roman robustness and flavor is more evident in larger pieces of work rather than individual pieces. (â€Å"Roman sculpture†) II. Descriptions of the selected works of art A. The Indian Triumph of Dionysus (Late 2nd Century, Marble) This relief was used as one side of a Roman sarcophagus representing the triumphal return of Dionysus, the Greek god of wine after his sojourn in India and the East.Known as Bacchus in Roman mythology, he is portrayed here in a reclining fashion amidst what appears to be a procession or festival celebrating his return. He is as usual portrayed with grapes about his head, signifying wine. He is surrounded by men, women, children as well as a herald and he is apparently being carried by soldiers. Satyrs are also present, as well as panthers, which are often associated with this mythological figure. There is at least one elephant and a horse. The whole relief is a study in movement, ev en dancing.Not one of the figure is in repose, and there is much going on. Each figure contributes to the richness of the representation, from the fruits in the basket, to the two children astride the elephant. All elements are on the move, even the draperies of the women. This is a classic example of the expertise developed by Roman sculptors for this particular form of art, and illustrative of the Greek influence, from the subject of the relief to the style of the dress. B. Portrait Figure of a Ruler (Roman c. A. D. 200—225, Bronze)This bronze figure is a rare example of the period before marble became the material of choice for sculpture in-the-round. It is speculated that this was in emulation of Augustus, who in turn followed the example of Alexander the Great who declared himself a god. Probably once contained in the temple of an Asia Minor emperor, this is missing the head, the right leg midway to the calf and the left foot. It is a muscular yet graceful figure, striki ng a pose of some authority and arrogance, as if declaiming to his adoring public or announcing some important news.It is also incredibly detailed, somewhat embarrassingly so in this instance as the figure is quite large and the details stand out somewhat. The head was probably cast separately from the body as the break looks clean, as if from a joint. It is a magnificent specimen of manhood, and the face was probably as beautiful. It would probably benefit from some cleaning. C. Monumental Statue of the Pharaoh Ramesses II Enthroned (Egypt, New Kingdom, 1386-1349 BC and 1279-1212 BC, Grandiorite) This monument to Ramses II (c. 1290-1224 BCE), who is said to have ruled over Egypt for almost 67 years, are found in Nubia, near the Sudan.â€Å"There are figures of Ramses II with the prime gods of the New Kingdom, including Ptah, the Memphis creater god, Re-Harakhte, the sun god of Heliopolis and Amun Re, the great god of Thebes†. Together they guard the entrance to the temple de dicated to these figures. The Great Temple of Ramses II is on the left while the Temple of Hathor/Nefertari is on the right. They were cut into natural rock, and at 20 meters high are considered colossi. (Sullivan) There are four figures in all, although the figure on the right of Ramses II is missing a torso. The rock is pinkish in tinge.The figures are sitting on thrones facing front, all the hands on their laps. The figures are rigid although the expression on the Ramses’s face is placid, with even a hint of a smile. The features are well-formed, incredible considering how it has been exposed to wind and sand for all these years. Inscriptions are carved in the arms. At their feet between the legs are smaller figures standing upright, perhaps representing servants or priests. In between each colossi are women figures are dressed finely, and are perhaps royalty. There is much vandalism, names and dates scratched into the stone as far back as 1875.The podium is inscribed with hieroglyphics and the rightmost figure had lost the beard. There appears to be figures of baboons over the entrance of the temple. III. Comparison of the three sculptures The Roman works of art are good representative examples of the two kinds of sculptures popular during that period: relief in marble and sculpture in the round in bronze. The colossi Ramses II is a typical example of the three-dimensional Egyptian style. There appears to be nothing less similar than the two art types. The composition for one thing is completely different.In Roman sculptures, the lines are never linear. The single subject appears about to move or speak, so dynamic is the pose. In the relief, there is visible interaction among the elements of the sculpture, and each figure tells a different story. It memorializes a moment and an occasion. The figures themselves are idealistically and naturally constructed, celebrating the Roman idea of beauty of form and structure. In the Egyptian sculpture, the figu res are stiff and formally posed. No movement is implied, and the pose is strictly linear and frontal, as traditional for Egyptian sculpture.The figures themselves are stylized, showing no definition of muscles or other details but with some emphasis on the face and the ornaments such as the headdress and the clothes, which are as stiff and immobile as the body. It memorializes the figures as immovable and permanent, hence the size of the statues and the fact that it was hewn right out of solid rock. The use of hieroglyphics is also prolific, taking the place of visual representation in telling the story of the figures. Yet there are similarities, mostly in the theme, which is divinity.Ramses is portrayed as side by side the most important gods of the New Kingdom, while the single sculpture deified the emperor and the relief treated the subject of a god celebrated, Dionysus. IV. Conclusion While this paper does not include a specimen of Greek sculpture, it has been discussed earlier that the Romans closely followed the Greek style of sculpture, mostly by using imported sculptures as a basis for copies for their own sculptures. A cursory glance at extant Greek sculpture in the round will immediately reveal how closely the Roman versions mimic the Greek style, from material to posture to subject.Ancient sculptures are representative of the society in which they were produced. They are lasting monuments to the great civilizations which spawned them, and while each is stylistically different, they provide valuable insights into how the ancient Romans and Egyptians lived and how they chose to be remembered. Works Cited â€Å"Egypt . † Ancient Arts. n. d. Detroit Institute of Arts. 24 July 2007 . â€Å"Egyptian Sculpture – Part 1. † Old And Sold. n. d. 24 July 2007 .â€Å"Greek and Roman Art. † Amazon. com. 2007. 24 July 2007 â€Å"Greek Sculpture – Part 1. † Old And Sold. n. d. 24 July 2007 . â€Å"Roman Sculpture. † Old And Sold. n. d. 24 July 2007 . Museum of Fine Arts Houston. 2007. 24 July 2007 . Sullivan, Anne. â€Å"The Great Temple of Ramses II. † Bluffton University. 2001. 24 July 2007 .

Free Will and Religion: A Nietzsche Perspective Essay

Free will has been studied for many centuries and has still puzzled ordinary people, many thinkers, scholars, theories, literary figures, and theologians worldwide. It has been confused with so many factors such as necessity or determinism from which the individual wonder whether his actions are based on self will or driven by conditions he cannot control. Other scholars linked it with moral responsibility and faith in God claiming that there is really no free will since it is influenced and manipulated by many factors (Kane 2). For many essentialists, free will is not recognized as an independent concept but rather a dynamic and essential context (Sack 79). Over the decades, ancient doctrines had been made recognizing the existence of free will; however many philosophers questioned it such as Friedrich Nietzsche who was one of the known philosophers to criticize free will. In the ancient and medieval studies of free will, a theological dimension has been recognized by many philosophers as a connection to ‘free will’. St. Thomas Aquinas and St. Augustine, whom Nietzsche share similar conclusions, considered free will as a gift from God and by possessing it means that we are beyond animals. More thinkers were intrigued by free will such as Descartes, Hume, and Kant who offered several solutions, a metaphysical framework, and a dichotomy of passion and reason to explain its dynamics. Free will becomes even more problematic as more ideas and concepts were linked to it such as ‘determinism’ and ‘causality’ offered by Schopenhauer and Freud (Dilman 2). These studies seemed to accept that many factors influence free will yet free will still exists. However, for Nietzsche free will is not affected by the course of events, fate, and it has no law (Dworkin 178). Nietzsche criticized â€Å"free will† by differentiating Christian free will and aristocratic free will. He believed that it is just an idea used to make an individual feel guilty particularly as a Christian religion control mechanism over the people. He argued that the â€Å"will† is not free because it is commanded within by the â€Å"I† and that the â€Å"I† and the power within the will is not the same. Additionally, he argued that the actions expressing the will are incorrectly connected to the human will; the power behind willing is separable from external events. Hence, free will is just a matter of â€Å"strong† and â€Å"weak† will (Dworkin 178). In Beyond Good and Evil: Prelude to a Philosophy of the Future published in 1886, Nietzsche continued to explore about his previous work—Thus Spoke Zarathustra. His arguments attacked on moral consciousness which led to the human presuppositions of â€Å"self-consciousness†, â€Å"truth†, including â€Å"free will†. Instead, he offered the idea of will to power as a concept to explain human behavior and concluding that there is no universal morality. He criticized philosophers and suggested qualities for new philosophers: creation of values, originality, imagination, self-assertion, and danger. He arrived at a concept of the perspective of life which he called â€Å"beyond good and evil† (Nietzsche, Faber, and Holub). The assumptions in Beyond Good and Evil are disturbing and unsympathetic to the traditional moral and philosophical assumptions. Nietzsche strongly suggested an â€Å"aristocratic† perspective of life as he probed on the history of moral values and the demise of strong cultures. These made his work attractive especially the chapters On the Prejudices of Philosophers, The Free Spirit, The Religious Essence, On the Natural History of Morals, and What is Noble (Spinks 167). Nietzsche disagreed with free will but he did not explicitly approve that the will is â€Å"unfree† either. Some wills are strong and some are weak. Given a tautology â€Å"the light shines†, there will be no light unless it shines and that the light does not have a free choice whether to shine or not to shine at all. Hence, the power in will is manifested only through the action or on how it is manifested. Nietzsche further argued that will cannot be free or unfree such that a power has no free choice whether to materialize itself in mild or severe fashion. However, this kind of perspective was not perceived by a common consciousness among people and the notion of strong and weak will is not accepted (Kazantakis and Makridis 28). According to Nietzsche, free will is an idea created by the weak so that they could elevate themselves as an equal to their masters. If the status or worth of an individual is not measured according to the quantity of power he possessed, the weak who use his power mildly becomes better or greater to an individual who is able to manifest a deed in a mild or harsh manner. The strong accept this theory of free will but this indicates pride. One will consider that his actions have undivided responsibility, either â€Å"good† or â€Å"evil,† and come up to a conclusion that his actions is independent and free from regulation of other wills (Kazantakis and Makridis 29). The metaphysics of â€Å"weakness† is explained by Nietzsche by referring to the soul, God, and free will which he described as words that refer to nothing. Will, on the other hand, is a complicated idea that is represented only by a word and commanded by a superior being within a man he assumes is able to obey. The soul, on the other hand, becomes a subject that is eternal, stable, and represents morality and emotions. The notion of stable entity proves the instability of reality and of the world. It cannot be avoided and experience through suffering particularly of the weak. Hence, there is weakness and the weak in return tries to invent an alternative to this kind of reality (Dudley 152). In Beyond Good and Evil, it is impossible to explain free will in relation to morality without the religious framework or a philosophy with God. During the time that famous scholars (including Nietzsche) dealt with free will, Christianity has been the prevailing religion all over Europe and its influence greatly manifested on numerous publications. God is hailed as the source of all morality and its meanings through holy writings such as the Bible, divine interventions, and intermediations. However, Nietzsche presented an overman that is beyond â€Å"good and evil†. The overman is independent, creates his own values, and disregards good and evil. Nietzsche reversed the reality instead by saying that God is created by people, they associated him with values, and followed its doctrines â€Å"as if these values had been decreed by divine will† (Earnshaw 51) As an essentialist, Nietzsche shared the same belief that people create and live by their own values. Hence, the definition of ‘good’ and ‘evil’ is relative to the people and their respective societies. Despite man’s lack of ability to discriminate between what is truth and imaginary, the â€Å"will to truth† is probably the highest â€Å"good†. The unfolding of will, which he described as neither free nor unfree, is perhaps an action of the will to what is true. Nietzsche presented another assumption that can be considered logical. He said that even though searching or willing for the truth is the highest, there are more fundamental matters behind this: affirmation of life, preservation of species, and so on. Therefore, â€Å"untruth† becomes a part of the will as â€Å"truth† is. If this is the case, then conventional philosophers are not seekers of the universal truth but simply rationalizing their prejudices (Earnshaw 52). Since Nietzsche did not accept either free or unfree will, his idea of will is reflected on his concepts of ‘will to truth’ and ‘will to power’. He found out that philosophers like him have an incredible role and impact in creating directing what to will for. Philosophers have great and creative minds and most of them are commanders and legislators. Through their knowledge, they can create; their creation leads to legislation; and their legislation push for will to truth. However, the meaning for will to truth is will to power. Hence, his idea of an overman who is beyond good and evil is externalized since philosophers can extend and reach visions that are not good or God oriented (Allen 71). Religion not only signifies an important role to explain Nietzsche’s â€Å"good and evil† and to describe what to will but also it can also be an instrument for the philosopher-legislator. As Nietzsche described human beings as â€Å"free spirits† or individuals having the â€Å"most comprehensive responsibility who has the conscience for the overall development of mankind†, he argued that a philosopher will use religion for his knowledge to be cultivated. Through religion, the philosopher’s creations can influence human beings and dictate their wills. However, the religion that Nietzsche is referring is a religion that is linked with philosophy and used merely for education and cultivation, a means among other means, but not the ultimate end. Otherwise, if religion is used separated from philosophy and as a legislator on its own, the effects are unexpected and dangerous (Allen 72). Fate, consequences, or course of events do not play significant roles in Nietzsche’s will. The act of willing is not similar to the power behind willing or the causal relationship brought by the natural science. No necessity can influence willing and unfree will is just a mythology. No law is bound to change will other than the power in other wills. The belief on the â€Å"unfreedom of the will,† or the idea that an individual might decide or act upon dictation or influence, is just a mere excuse used by individuals to prevent them from responsibilities and point the blame to other matters. Nietzsche’s argument on â€Å"unfree will† was similar to St. Augustine’s who argued that God indeed has ‘foreknowledge of events’ but gave man a ‘power to will’. If a man’s will is not successful in doing what it wills, fate is not the cause but a more powerful will. However, the weak often blame fate as the root of suffering instead hence Augustine said that â€Å"fate belongs to the weaker of two parties, will to the stronger. † (Dworkin 178). At first glance, Nietzsche argument on will can be vague, confusing, and challenging but given the mass of ideas presented in Beyond Good and Evil, readers and thinkers can get plenty of advice from a seemingly manual type for philosophers publication. In defining his analysis on will, Nietzsche began by attacking the conventional philosophers and philosophical assumptions. The assumptions can be pretty confusing and devastating to other philosophers and his views on God can be described as anti-Christ. Undeniably, he made a strong conclusion by saying that the â€Å"will to power†Ã¢â‚¬â€the strongest will of all that is driven by emotions and things that man is passionate of, can change numerous things in the world. In order to correct this kind of prejudice, Nietzsche offered a solution he called the â€Å"free spirit† which can be achieved through isolation and independence or living a different live, the difficult one. In order to grasps what he meant about â€Å"free spirit†, he further described morality and truth which can be confusing and might unacceptable to others. He said that the only real things in this world are man’s emotions, passions, and motivations. Nietzsche provided a doctrine that is simplified and meant to be understood by ordinary people. The shift is observable since his previous works were mostly misunderstood and used for destructive purposes. Nietzsche attack on Christianity and/or religion intrigued numerous scholars. He described religion as the cause of the distortion of people’s values, pushed many to become non-believers, and offer self-sacrifice. On the other hand, some found his assertions contradictory such as man’s inability to know the truth yet in his book he seemed to declare a lot of truths. He said that philosophers must avoid justifying their own opinions yet Nietzsche sounded like a dictator of his self-declared truths. Nevertheless, he is able to point out that truth is relative among people, that there is no universal truth, and that man should will for his own truth. Works Cited Allen, Douglas. Comparative Philosophy and Religion in Times of Terror. Lexington Books, 2006 Dilman, Ilham. Free Will: A Historical and Philosophical Introduction. Routledge, 1999. Dudley, Will. Hegel, Nietzsche, and Philosophy: Thinking Freedom. Cambridge University Press, 2002. Dworkin, Ronald William. The Rise of the Imperial Self. Rowman & Littlefield, 1996. Earnshaw, Steven. Existentialism: A Guide for the Perplexed. Continuum Publishing Group, 2007. Kane, Robert. Free Will. Wiley-Blackwell, 2002. Kazantakis, Nikos & Makridis, Odysseus. Friedrich Nietzsche on the Philosophy of Right and the State. SUNY Press, 2006. Nietzsche, Friedrich Wilhem, Faber, Marion, & Holub, Robert. Beyond Good and Evil. Oxford University Press, 1998. Sack, Robert David. A Geographical Guide to the Real and the Good. Routledge, 2003 Spinks, Lee. Friedrich Nietzsche. Routledge, 2003.

buy custom Chronic Obstructive Pulmonary Disease essay

buy custom Chronic Obstructive Pulmonary Disease essay Chronic Obstructive Pulmonary Disease is one of the major causes of death today. This is often translated into huge economic burdens in terms of the cost of treatment as well as the loss of productivity. Albuterol and levalbuterol are some of the drugs that are recommended for the treatment of COPD. It is worth noting that albuterol was introduced first and several studies conducted on this drug revealed that it contained several negative effects. This led to the approval of levalbuterol and indeed, studies have confirmed that this drug brings about less harmful effects compared to albuterol. However, these results are controversial, and thus, this paper intends to analyze the existing literature in order to assess which between the two drugs is appropriate. Based on the review of existing literature, this paper found out that levalbuterol produces less harmful effects, results in fewer hospitalizations, and the overall costs of treatment is cheaper, even despite the fact that albute rol is a cheaper drug compared to levalbuterol. This paper provides a good analysis of the two drugs, on the basis of which health practitioners can make their decisions when dealing with COPD. In addition, this write up provides important information that will build up on the existing literature in this filed. Basing on the advantages of levalbuterol over albuterol, this paper recommends that levalbuterol should be considered as the drug of choice when it comes to the treatment of COPD. In addition, the study recommends that further research should be conducted to provide support for the claim that levalbuterol contains a better efficacy compared to albuterol with regard to the drug composition. However, despite the differences between the two drugs, it is worth noting that levalbuterol and albuterol are actually similar in numerous aspects. Albuterol and levalbuterol are some of the drugs that are often used in the treatment of asthma and Chronic Obstructive Pulmonary Disease (COPD). These drugs are often confused, considering the fact that they have a similar classification and action as they are both classified as bronchodilators. Albuterol is often recommended as inhaled beta-2 agonist and can be used to deal with acute bronchospasm (Perrin-Fayolle et al., 1996). It is made up of a racemic mixture of (S)-albuterol that contains some slight or no bronchodilating action, and (R)-albuterol (levalbuterol), which is considered as an active pharmacological enantiomer in a ration of 50:50. It is worth noting that (R)-albuterol has been proved to exhibit a 100-fold more capability to bind to the beta-2 receptors compared to the (S)-albuterol (Perrin-Fayolle et al., 1996). Research studies show that albuterol has been in use for over 40 years and is still being used today (Ozminkowsk et al., 2007). However, it is worth noting that this drug has often been associated with various side effects, such as tremor. In 2005, levalbuterol was approved as a remedy for the same condition, and indeed, studies and even manufacturers have confirmed that using levalbuterol leads to fewer hospitalizations, improved respiratory parameters, fewer adverse effects, and thus, reduced overall costs of treatment (Perrin-Fayolle et al., 1996). However, these outcomes are not universal, considering the fact that some studies have confirmed that there are no distinctions when it comes to the clinical endpoints (Ameredes et al., 2009). This has, therefore, presented some controversies with regard to whether racemic albuterol or levalbuterol should be eliminated. This paper, therefore, seeks to analyze the literature on both albuterol and levalbuterol, examining what the studies suggest about these two drugs in order to make an opinion on what makes sense clinically and what does not. The paper will also look at its impact on the field as well as at the disease management. Description of the Disease Chronic Obstructive Pulmonary Disease (COPD) is a gradually progressive infection of the airways, often depicted by the lung function impairment. This basically happens when there is a co-occurrence of emphysema and chronic bronchitis, leading to the narrowing down of the airways. As a result, there is a limited airflow to the lungs and out, hence a shortness of breath, a condition that is medically known as dyspnea, is experienced (Perrin-Fayolle et al., 1996). However, it is worth noting that this condition is often irreversible and gets worse as times go by. COPD is normally caused by some noxious particles, particularly generated from smoking tobacco, hence prompting a response that leads to the inflammation of the lungs. It is important to note that some of the most common diseases that are associated with COPD include chronic bronchitis, emphysema, and chronic obstructive bronchitis along with the combination of highlighted conditions (Ozminkowsk et al., 2007). The diagnosis of COPD necessitates that tests are conducted regarding the functioning of the lungs. Some of the management strategies include the rehabilitation, vaccinations, drug therapy, smoking termination, and in some cases, patients are recommended to have lung transplantation. How the Drugs Work In the Body It is worth noting that both albuterol and levalbuterol contain the same properties, considering the fact that they both target the bodys beta-2 receptors. The two drugs serve to reduce the resistance in the airway as they are known to enlarge the diameter of the bronchi or the air passages (Ozminkowsk et al., 2007). In such a way, these drugs help to enhance the overall flow of the air both into the lungs and out. The drugs work on the beta-2 receptors resulting in the pulmonary smooth muscles relaxation. Research indicates that albuterol and levalbuterol work to increase the airflow and relax the pulmonary smooth muscle within a period of 30 minutes and are known to stay for between 4-5 hours (Perrin-Fayolle et al., 1996). Studiesthat have been conducted with regard to the metabolism of albuterol in the human tissues indicate a 5-11 fold better sulfoconjugation of the eutomer compared to the distomer within various human tissues (Perrin-Fayolle et al., 1996). A single dose of the a lbuterol dosage, whether taken orally or inhaled, results in a higher blood level within the distomer compared to the eutomer (Perrin-Fayolle et al., 1996). Perhaps, this indicates a predominance of the (s)-albuterol, an inactive product, after repeated dosing of the active (R)-albuterol. However, it is important to bear in mind that while albuterol helps in relaxing the smooth muscles and increasing the flow of air within the airways, they do not actually reduce the speed of the progression of the primary disease (Ozminkowsk et al., 2007). They only help in minimizing the signs and symptoms of exercise and wheeze limitations along with the shortness of breath, leading to a better life for the people living with COPD. Review of the Literature Albuterol is one of the most commonly recommended drugs for patients suffering from asthma and COPD (Perrin-Fayolle et al., 1996). However, due to the negative effects caused by the drug, levalbuterol was developed. This was based on various advantages, such as better tolerability, lesser cases of transient tachycardia, and in addition, it was noted to have a greater or similar efficacy with albuterol (Ameredes et al., 2009). However, some clinical studies indicate no significant superiority of levalbuterol, when compared to albuterol, though the effects of levalbuterol may be considered greater among the patients, particularly, when there is an overuse of albuterol (Ameredes et al., 2009). Nonetheless, Ameredes et al. (2009) highlight that numerous studies have been conducted to establish the difference between the two drugs, but the findings have always been to some extent heterogeneous. A study conducted by Purrin-Fayolle et al. (1996) found out that levalbuterol was more effectiv e in suppressing bronchospasm if compared to albuterol. The following studies indicated equivalencies of the two drugs, and some studies even found out that levalbuterols 1.25mg bronchodilatory effect was the same as that of the albuterol. Clinical trials in pediatric and adult patients who were diagnosed to have asthma have indicated a lower mean heart rate among the patients using levalbuterol compared to the ones using racemic albuterol. However, the degree of difference between these two drugs is modest, and thus, may be clinically significant for the patients suffering from cardiac conditions, which could even worsen in the case of tachycardia (Truitt et al., 2003). On the other hand, some studies have reported that there is no difference in the two drugs when it comes to the mean heart rate if these drugs are compared head-to-head (Ozminkowsk et al., 2007). This is because the negative result of increased heart rate is something that is common among all the drugs classified as beta-agonists (Ameredes et al., 2009). Therefore, the equimolar doses of both racemic albuterol and levalbuterol would probably lead to an equal magnitude of tachycardia, implying that the transient tachycardia that is often experienced with regard to these drugs is more dependent on the dose (Perrin-Fayolle et al., 1996). Additionally, the claim that levalbuterol is more tolerable compared to albuterol is also controversial. The harmful effects of racemic albuterol, particularly with regard to its overuse, include tachyphylaxis, hypokalemia, as well as the increased rates of mortality (Qureshi et al., 2005). It is worth noting that (S)-albuterol does not contain the bronchodilator activity, and when compared to levalbuterol, it is considered to be metabolized at a 10-fold slower rate (Qureshi et al., 2005). With this regard, some studies have theorized that it may also contain harmful effects, for instance, the pro-inflammatory effects or airway reactivity (Ameredes et al., 2009). This might lead to the preferential buildup of the (S)-isomer compared to (R)-albuterol, hence resulting in the condition known as paradoxic bronchospasm within the lungs (Qureshi et al., 2005). One study was conducted among the hospitalized patients suffering from the chronic obstructive pulmonary disease in an aim to compa re the effects of racemic albuterol (2.5 mg) treatment (every 1-4 hours) with that of nebulized levalbuterol (1.25 mg) treatment (every 6-8 hours) (Qureshi et al., 2005). Apparently, fewer levalbuterol nebulizations were needed, and the call for the rescue aerosol did not increase during the study period of hospitalization, which was basically 14 days. However, it is worth noting that the study findings highlighted that the outcome measures between the two groups being studied were alike, including the pulmonary function and costs studies (Qureshi et al., 2005). Furthermore, Truitt and his colleagues carried out a retrospective chart review of the patients diagnosed with COPD and hospitalized and came out with the same conclusions, highlighting that the outcomes of the two drugs are similar (Truitt et al., 2003). Ameredes et al. (2009) highlight that the advantage of levalbuterol over albuterol can be considered greater among the patients that have been subjected to the overuse of a lbuterol. It is also important to bear in mind that cost is one of the major factors highlighted when conducting a comparison of the two drugs (Quinn, 2004). Initially, the metered-dose inhalers, considered to be a generic formulation of albuterol, were widely used, regarding the fact that they were considered to be cheaper compared to the branded albuterol versions. However, the metered-dose inhaler formulations were banded on the grounds that most of them contained chlorofluorocarbons and were thus faced out of the market (Quinn, 2004). The branded albuterol cost is nearly the same as that of the levalbuterol. In addition, it is noted that the cost of levalbuterol nebulization is still higher than that of the generic albuuterol nebulization (Gawchik et al., 1999). Nonetheless, one study indicated that the overall cost savings related to the reduction in the number of days that the patients spend in hospital is less in those using levalbuterol compared to the ones using albuterol (Quinn, 2004 ). Generally, it is worth noting that levalbuterol is considered to slightly enhance the pulmonary function and lasts longer than albuterol. Basically, the pulmonary function improvement caused by 0.625 mg of levalbuterol is the same as that caused by 2.5 mg of albuterol. However, despite the differences present between the two drugs, it is worth noting that levalbuterol and albuterol are actually similar in numerous aspects, such as glucose levels, impact on blood potassium, and climax of drug action among other aspects (Quinn, 2004). What Makes Sense and What Does Not Make Sense Clinically Despite the fact that differences between levalbuterol and albuterol are rather controversial, it is worth noting that there are few aspects which make sense clinically while others are clearly senseless. However, it is important to note that levalbuterol is considered as a safer form of albuterol (Ameredes et al., 2009). Albuterol is most commonly associated with various negative effects, such as an increased heart rate and shakiness, and despite the fact that levalbuterol generates similar effects, most of the studies have noted that they are just minimal (Ameredes et al., 2009). Another important aspect to note is the fact that albuterol contains a shorter period of action, estimated to be 4-6 hours, while levalbuterol works for about 5-8 hours (Qureshi et al., 2005). Perhaps, this can be the reason behind the relatively higher cost of levalbuterol compared to that of albuterol. It is also important to bear in mind that when it comes to the period of hospitalization, levalbuterol is considered to be cheaper as its use is highlighted to result in lesser days of hospitalization compared to the use of albuterol. However, what does not make sense is the claim that levalbuterol contains a better efficacy compared to albuterol. Based on the composition of the two drugs, it is highlighted that albuterol contains both (R)-albuterol and (S)-albuterol in the ration of 50:50 (Qureshi et al., 2005). In addition, it is suggested that levalbuterol is purely made up of (R)-albuterol that gives it the bronchodilation effect. It, therefore, remains unclear with regard to how levalbuterol contains a better efficacy when compared to albuterol. It is important that more studies are conducted in this area in order to establish the truths behind these claims. Impact on the Field This paper is of a great important, considering the fact that it has expanded the available literature regarding the topic. This paper has highlighted some of the clinical issues that have to be considered with regard to the use of albuterol and levalbuterol. In addition, the paper has highlighted an area that requires more research. This is in consideration with the fact that several studies have highlighted that levalbuterol contains a better efficacy compared to albuterol, basing on the drug composition, while, in essence, there is no solid proof to support this claim. Thus, it is important that further research is conducted in this field to establish the fact behind this claim. Potential Impact on the Disease Management It is worth noting that COPD is today considered as one of the major causes of deaths globally (Quinn, 2004). However, it is feared that the rates might escalate, especially with the increase of smokers as well as major lifestyle changes. Thus, this results in huge economic burdens in terms of the loss of productivity as well as the costs of healthcare. This, therefore, explains the main reason as to why COPD has to be managed. It is important that the correct and effective medication is identified to ensure that the disease is put under control. This paper has, therefore, provided an analysis of the existing literature with regard to the two drugs that are most commonly used in dealing with the disease. From the analysis, it is clear that albuterol is considered to have a shorter duration of action, be cheaper, and to generate more negative effects if compared to levalbuterol. Therefore, health practitioners can consider these aspects when dealing with COPD. From the review of the existing literature in this field, the paper recommends that levalbuterol should be considered as the drug of choice when dealing with COPD. This is based on the facts that levalbuterol exerts fewer negative effects, causes fewer hospitalizations, and generates better respiratory parameters if compared to albuterol. Furthermore, it is highlighted that the use of levalbuterol is cheaper considering the fact that its use leads to fewer hospitalizations. However, this paper recommends that further research should be conducted to support the claim that levalbuterol contains a better efficacy than albuterol, basing on the composition of the two drugs. Most of the clinical studies aimed at determining the relative safety of albuterol and levalbuterol have often generated varied results. The conflicting results have even made it difficult to rule out which one among the two drugs should be administered in the treatment of COPD. This paper has analyzed some of the existing studies to come up with a recommendation as to which drug should be used. Most of the studies highlight that levalbuterol brings about less negative effects, results in fewer hospitalizations, and has lower overall cost of treatment. Based on the highlighted advantages, the paper recommends that levalbuterol should be opted for as a remedy for COPD. However, the study recommends a further research to support the claim that levalbuterol is more effective than albuterol basing on the drug composition. Buy custom Chronic Obstructive Pulmonary Disease essay

Small Group Reflection Essays

Small Group Reflection Essays Small Group Reflection Essay Small Group Reflection Essay Small group and team communication is basically the most imperative skill that any individual will ever have to learn. Communication consists of making contact with other individuals in verbal or nonverbal connection. Whether it is a group or team each individual has different background and customs, therefore he or she should be confident enough to deal with social diversity because there is no particular way in dealing with such diverse groups. The importance of team communication is vital for achievement because people learn from one another and share similar objectives. While classroom lectures provide students with volumes of information, many experiences can be understood only by living them. It is with the? workings of a small, task-focused group. What observations can I make after? working with my group? And what have I learned as a result? When meeting together and brainstorming ideas for our can drive there were many leadership roles and? the strengths of our individual group that became increasingly apparent. Although? early in our project Jeff was the key initiator and Casey largely an information? seeker, all of us group members eventually took on these functions in addition to? erving as recorders, gathering information, and working on coming up with ideas on how we would start and initiate this can drive. Every member coordinated the group’s work at some point, several made sure that? everyone could speak and be heard, and Casey was especially good at? catching important details the rest of us were oblivious to. Tyler and I frequen tly clarified or elaborated on information, whereas Andrea, Casey, and Jeffrey were good at contributing ideas during brainstorming sessions. Casey, Jeffrey and I brought tension-relieving humor to the group.? Just as each member brought individual strengths to the group, gender? differences also made us effective. For example, Andrea and Casey looked at the big picture and made intuitive leaps in? ways that the Jeffrey, Tyler, and I generally did not. Brilhart and Galanes have suggested that men working in groups? dominated by women may display â€Å"subtle forms of resistance to a dominant? presence of women† (p. 98). Our differing qualities complemented each other and enabled? us to work together effectively. The formation of our group developed in four stages. The first was the Forming stage in which we were uncertain about our roles and who to trust. This beginning stage is relatively where we as group members introduced ourselves. At this stage we were unsure how we would be able to use each other’s experience and abilities to come together as a cohesive group. The following stage was Storming, which is a time we learned about expectations discussed then confirmed by each one of us. The third stage of our development was Norming, a stage of working together to reach our goals. Lastly, the Performing stage is focused on solving any problems that arise. This stage is critical for getting the project done on time and completing the goal. Our group had a sense of unity that went through developmental stages. Each Learning Team member played a different role and it was important for us to perform his or her duties in order to get maximum cooperation between each member. Through these maintenance roles better relationships developed and improved morale of the group cooperation. In order for our group to develop into a well performing group organization we needed to have and maintain certain characteristics. We are a group of students with a vision working towards a common goal. The building of our team was complicated. We negotiated roles and tasks according to our strengths and interests. We worked well together, but far from perfect. Ideas were exchanged and meaningful productivity resulted. Good communication resulted from trust and respect. All of us members shared an equal participation, which made it easier for each individual to contribute to the success. Brilhart, J. K. , Galanes, G. J. (1998). Effective group discussion (9th ed. ). Boston:? McGraw-Hill.