The Kite Runner Essay Example for Free

The Kite Runner Essay I will be doing my book review on the book called ‘kite runner’, by Khalid Hosseini. The Kite Runner tells the story of Amir, a young boy from the Wazir Akbar Khan district of Kabul, who befriends Hassan, the son of his fathers Hazara servant. The story is set against a background of upcoming events, from the fall of Afghanistans monarchy through the Soviet invasion, the large number of refugees sent to Pakistan and the United States, and the rise of the Taliban regime. I am doing my book review on the Kite Runner because I think it is a marvellous and very interesting book. The author also describes the settings very well. Khalid Hosseini was born on 4th March 1965; he is an American novelist and physician from Afghanistan and he is an ethnic Tajik. Amir, a wealthy Pashtun boy, and Hassan, a Hazara who is the son of Ali, Amirs fathers servant, spend their days in the peaceful city of Kabul, kite fighting and roaming through the streets. Amirs father, a wealthy merchant, whom Amir affectionately refers to as ‘Baba’, loves both boys, but seems critical of Amir for not being manly enough. However, he has a kinder father figure in the form of Rahim Khan, Babas friend, who understands Amir better, and supports his interest in writing. Hassan and Amir are great friends. Hassan is also a very good kite runner. Five years later, the Soviet Union invades Afghanistan. Amir and Baba escape to Peshawar, Pakistan and then to Fremont, California, where Amir and Baba, who lived in luxury in an expensive mansion in Afghanistan, settle in a run-down apartment and Baba begins work at a gas station. Amir eventually takes classes at a local community college to develop his writing skills after graduating from high school at age twenty. Every Sunday, Baba and Amir make extra money selling used goods at a flea market in San Jose. Hassan is killed but his son is in trouble, so Amir goes back to Afghanistan to save him. The genre of this novel is action and adventure. Most of the action takes place in Afghanistan. The author described the place where Amir lived; you could almost picture his house in your mind. When you chose an adventure book people expect the story to be interesting, fascinating and settings to be described very well also. The novel fits the genre because they play all around Kabul, running away from the bullies and also it is about the life of Hassan and Amir, it has the up and downs of their lives. One triumphant day, Amir wins the local tournament, and finally Babas praise. Hassan runs for the last cut kite, a great trophy, saying to Amir, For you, a thousand times over. Unfortunately, Hassan encounters Assef. Hassan refuses to give up Amirs kite. Assef decides to teach Hassan a lesson by beating him half to death and then raping him. Amir witnesses the act but convinced himself that he is too scared to intervene; though its actually the fact that he needs the kite for Babas praise and approval and he knows if he does intervene, then he wont get the kite and he returns home ashamed, guilty for not being able to help his best friend. He feels that his cowardice in Hassans rape would destroy any hopes for Babas affections, so he says nothing. Afterward, Hassan and Amir keep a distance from each other. Amir reacts indifferently because he feels ashamed, and is frustrated by Hassans saint-like behavior. Already jealous of Babas love for Hassan, he worries that if Baba knew of Hassans bravery and his own cowardice, that Babas love for Hassan would grow even more. This part of the story showed how loyal and brave Hassan was. Amir like reading stories and is a storyteller. He and Hassan play with kites all the time. He is a little bit afraid of the other boys like Assef. I have enjoyed this book a lot it has been interesting, I felt sorry for Hassan because he was so loyal and his loyalty had cost his life. The novel was a great adventure story. It is one of the best books I have ever read. By Nima Tajali.

Town of Manchester Essay Example for Free

Town of Manchester Essay In the article â€Å"Kentucky Town of Manchester Illustrates National Obesity Crisis,† Wil Haygood demonstrates how the dangers of obesity are rampant in small towns. Specifically, how their surroundings are contributing to the alarming obesity rate in this charming little town of Manchester. While Haygood depicts how the locals â€Å"celebrate the joys of community closeness,† he also reveals how â€Å"it is one of the unhealthiest places of all†. In fact, he points out that an estimated 52% of the 2,100 residents are considered obese, and that a majority of those are young children. To illustrate, Haygood cites a research study conducted in Manchester and surrounding counties by Jill Day, a local resident. The findings revealed that â€Å"Of the 277 [children surveyed], eight of those fourth- and fifth-graders were underweight, 135 were healthy, 49 were overweight, and 85 were obese†. In other words, he is indicating that roughly 48% of children are suffering from this obesity epidemic. Haygood suggests the problem originates from having too many fast food restaurants without enough healthy alternatives; paired with the fact that there are not enough locations that promote activity or exercise. For example, Manchester has at least 8 fast food restaurants as well as a Wal-Mart that sells mostly snack food. The only place for exercise is a physical therapy office. He also addresses the notion that obesity is more hereditary than anything else. He quickly refutes this argument by simply quoting Jill Day: â€Å"Since 1980, obesity has tripled in children, so we can’t totally blame genetics for this increase†. Overall, Haygood highlights that while being from a small town is comforting and favorable, it may be just as damaging and detrimental.

Direct to Consumer Advertising of Prescription drugs

Direct to Consumer Advertising of Prescription drugs Abstract In Pharmaceutical industry, promotional advertisements are mostly targeted towards physicians but in recent years trend has shifted towards consumer advertisement. In many cases of Direct to Consumer Advertisement (DTCA) the pharmaceutical marketers and manufactures creates hype among patients towards disease and ultimately towards brand. It provokes the patients to seek additional information on the brand and push for its prescription generation. Objective of this study is to determine attitude of the physicians towards DTCA, and what extent patients request for particular brand leads to actual prescription generation of the advertised drugs. This study reveals that the doctors generally have positive attitude towards DTCA and are willing to provide relevant information to the patients and in some cases even provide sample of medicines or go for direct prescribing, if found relevant, as asked by the patient. This study justifies the pharmaceutical industry manufacturers sp ending in DTCA. It is also thought provoking for health policy makers that prescription drugs are being advertised directly which may lead to increased medication cost and misuse of medicine. Key words: Direct to consumer advertising, Direct to Consumer Advertised Brand, Over the counter drugs, Prescription drug. Physicians attitude. I INTRODUCTION Companies rely heavily on product detailing to physicians, which are the customer, (Zangla, 2004). To increase overall sales figures marketers started advertising directly to consumers of disease and even drug brands, (Amaldoss He, 2009). DTCA is not allowed specially for prescription drugs, (Donohue Berndt, 2010). One argument is that DTCA is a public service message about a particular disease and only plays a role as information provider and motivates people to seek proper treatment if required (Kuhn, 2006). Many researchers found DTCA good for General public health, (Bradford, Kleit, Nietert, Ornstein, 2005) and beneficial for patient care (Murray, Lo, Pollack, Donelan, Lee, 2004). So it is considered as DTCA has both merits and demerits, (Murray, 2003) 1.1 Research Objective In recent years Pharmaceutical Companies drastically increased their spending on Direct to Consumer Advertising (DTCA) (Herzenstein, Misra Posavac, 2005). In 1997 Federal drug authority (FDA) permitted DTCA and subsequently pharmaceutical companies started increasing their expenditure on direct advertisement to provoke consumers to ask their doctors about the drug (Green, 2007). Patient is more comfortable in using drug brand which is familiar to patient, (Zuvekas, 2008). Consumers have positive attitude towards DTCA and tries to find out additional information about Directly to Consumer Advertised Brand (DTCAB). To get additional information patient consults their doctor, (Herzenstein, Misra, Posavac, 2005). Asking questions by patients has strong influence on doctors selection criteria of drugs (Iizuka Jin 2005). General attitude of physicians towards DTCA its impact on prescription generation is still unknown (Herzenstein, et al., 2005). If physicians have positive general attitude towards DTCA, it may lead to actual prescription generation. Moreover if patients shows more likelihood of searching additional information tries to inquire additional information by asking questions from physician about DTCAB also leads to prescription generation (Herzenstein, et al., 2005). Information inquired from the physician about DTCAB of medicine is taken as second independent variable, pressurizes physicians towards prescribing that specific brand of drugs. Patients adherence influenced by DTCA motivates patients to seek additional information about the drug from physicians (Amaldoss Chuan, 2009). 1.2 Rationale of study 1.2.1 Increased spending on DTCA from pharmaceutical companies. Pharmaceutical companies have increased their spending in last decade, and they are planning to do more (Atherly Rubin, Feb 2008). Physicians are considered to be the best judge to decide medicine , keeping in view the patients and drugs characteristics. Due to information flow and access through electronic and print media, consumer tries to get more information about the drug and disease. With this the pharmaceutical companies started promoting prescription drugs directly to consumers. At the end of many advertisements it is advised to consult your doctor for further information, but ultimate goal is the prescription generation. These advertisements provokes patients to visit their physicians and asking information and if it is appropriate then whether it can be used or not. It is presumed by the companies that doctor will prescribe the medicine as per patient request, but it is still unknown that what is the general attitude of doctors towards direct to consumer advertisement This study will help marketers of pharmaceutical companies in finding the answer to the question, whether they are helping people in getting medication, from physicians perspective, and are they really making returns on this investment on DTCA. 1.2.2 Health policy makers. Drugs are classified in two categories, one is Over the Counter Drugs (OTC) and other is called Prescription drugs (PD). OTC drugs are usual drugs which have comparatively lesser side effects and can be used without consultation of physicians. Conversely the PD which are of either critical use or may be associated with serious side effects, and can only be used if advised by physicians. In like manner promotion of PD were made only to the physicians through detailing. Pertaining to the severity of life and death related to use of PD, DTCA should not be done for PD. But PD are being advertised under the head of Disease Advertising (DA). It should be the major concern for health policy maker either the PD are being used appropriately as per physicians advice or not. As extensive DTCA of PD may lead to misuse of medicine, increased treatment cost and unnecessary visits to physicians. DTCA should not have that much impact to generate prescription of DTCAB, if it is then specific policies should be developed to balance the usage of DTCA with its risks. 1.2.3 Knowledge contribution. It has already been explored in many researches that DTCA has both merits and demerits. Some physicians generally perceive that DTCA is good for patient overall health but from other school of thought it is just in favor of pharmaceutical companies, only physicians can better decide which drug to be used or not. In medical sciences the selection of medicine is based on mainly three factors, kind of disease, doctors judgment, patients affordability and liking or psychological experience factor of any brand (Prosser, Almond and Walley, 2003). In previous researches the impact of both physicians and consumers have been explored. But the combined impact of both variables has not been studied before. This study for the first time explores the combined effect of the two main independent variables. My research will find out the preference of physicians towards DTCA and whether information seeking by the patients leads to prescription generation. II LITERATURE REVIEW Pharmaceutical industry is heavily driven by customers (doctors) and very marketing and selling intensive (Scherer, 1990). Primarily the focus was only on doctors (customers) but recently the trend is also shifting towards addressing consumers directly (Matthews, 2001). The medium used for accessing consumers is electronic media including the internet and television advertisements, consumers are now able to freely access information about drugs and their brands which in some cases can lead to misuse of medicine and increased cost of treatment (Matthews et al., 2001). Pharmaceutical companies are now targeting advertisements towards patients which entice patients to ask for prescription of only advertised drug, the patients behavior is also effecting and directing the health systems. Matthews (2001) quoted Dr. Reardon, ex president of American Medical Association (AMA), has insightfully noted, Patients themselves are also creating a strong impetus for change. Disillusioned by restrictions on coverage and care, they are increasingly demanding choice of physician, hospital, and even type of health plan. More than ever, patients see physicians as the essential point of trust in a changing system, and demand choice and stability in their vital relationships with their doctors. At the same time, patients themselves are becoming better educated, not only about insurance options but also about medical treatments. Today, thanks to the Internet, trends in product advertising, and the massive proliferation of medical information, patients are better equipped to take part in their care than ever before. Rather than simplifying the physicians job, however, this increased patient knowledge base is creating new challenges. The other argument that supports DTCA says that it encourages hard to reach sections of populations to seek information about diseases, but it should be balanced against the increased cost of medicine from unnecessary requests generated by DTCA (Murray Pollack Donelan and Lee, 2003). DTCA has both positive and negative effects on health behaviors, health service utilization (Murray et, al., 2003). Almost five years back ads for prescription drugs were very rare but these are becoming very common in recent years, and are being advertised like any consumer goods, direct to consumer advertising (DTCA) has grown rapidly (Scherer, 2004). On the other side consumers behavior is supportive towards DTCA and would like to get more information and ask for a particular brand from physicians (Herzenstein, 2004). Another research shows that DTCA had no statistically significant effect on the choice of antidepressant (Donohue Berndt, 2004). There are three variables involved in prescription cho ice, one is Patient characteristic, second is features of medication and third is physicians preference for medication choice, moreover detailing is found to be the most effective in physicians preference for medication choice (Donohue Berndt, 2004). Increase in pharmaceutical pricing is due to increase in expenditure incurred on DTCA. 2.1 Conceptual framework Now the question arises that whether there is an impact of DTCA on sales or not (Scherer, 2004). It is also found that DTCA encourage patients to visit physicians and use specific brand medicine (Iizuka, 2005). It is agreed that DTCA has decreased the time between diagnosis and use of medicine and promotes the patients to consult their physician. 2.1.1 Inquiry about additional information or request for prescription. It has been argued that patient may demand the product just because of the attractiveness and persuasion of the advertisement, rather than look in to the effectiveness of the drug and go for proper consultation from doctor (Bradford, 2005). This is not unusual in pharmaceutical, as is a significant change from the traditional emphasis on physicians detailing, it has been found that the traditional selling of pharmaceutical brands to physicians is changing and prescription drugs is being marketed directly to consumers, as other consumer goods, as detailing and price are found to be complementary strategies for the firms in addition to the traditional detailing, (Brekkea, 2006) 2.1.1 Actual prescription generation. Still questions arises about the impact of DTCA on welfare of patients, if allowed then will lead to More visits to physicians, and they pressurizes to get prescription of desired medicine. (Brekkea et al., 2006). It is also shown that the pharmaceutical manufacturers are also facing challenges from DTCA because they has to do extensive detailing to physicians because of DTCA is also being done, so it should be banned as to keep focus on detailing (Brekkea et al., 2006). It will induce demand for new users of antidepressant medicines and can exaggerate the usage if already that medicine is being used, and will lead to misuse of brand (Chad Meyerhoefer, 2007). Direct to consumer advertising is very important and of course controversial part, advertising in journals, detailing and distribution of samples are used along with direct to consumer advertising which may leads to induce demand and generate more sales (Pasdirtz, 2009) III RESEARCH METHODOLOGY Research methodology is a system or methods followed by particular discipline of an inquiry or investigation into a subject in order to discover or revise facts, theories, applications etc. (Oxford Dictionary, 2007). This study is an applied form of research leading to the basic knowledge contribution, and is an extension of work done by Zachry, (2003). As pharmaceutical industry is very important, it has to play an important role, on one side it claims to be for better health of patients but no doubt they are making huge profits, here comes the role of health policy makers to make it justified. Moreover it is to find out the general attitude of physicians about DTCA and information asked by patients about any particular DTCAB, and its relation with actual prescription generation if asked by patient. 3.1 Problem Statement Hypothesis Pharmaceutical companies in Pakistan are promoting their brands directly to consumers (patients), now the question is What is the attitude of physicians towards DTCA, and do they provide relevant information and prescribe medicine if asked by patient. Positive attitude of physicians and information asked by patients of advertised medicine leads to prescription generation Now the objective of study is qualitative estimation of attitude, and what physicians are most likely to do if patient inquires information after exposure of pharmaceutical advertisement. Even patient may ask for prescription of specific drug, then what is the usual response of physician. 3.2 Hypothesis H-1 : Attitude of physicians towards Direct to consumer advertisement is positive. H-2: Physicians provides information of drug which is asked by patient after exposure to pharmaceutical advertisement. H-3: If found relevant, physicians prescribe the particular drug which is requested by patient on exposure to pharmaceutical advertisement. H-4: Positive attitude of physicians towards DTCA and query about information of a particular brand of medicine leads to actual prescription generation. ATTITUDE3.3 Model Independent Variable 1 PRESCRIPTION GENERATION Attitude of Physicians towards Direct to Consumer Advertising of prescription drugs Dependent Variable Actual Prescription Generation on request from patient of DTCAB medicine INFORMATION Reaction on request of information about particular DTCAB medicine Independent Variable 2 PRESCRIPTION GENERATION Dependent Variable Actual Prescription Generation on request from patient of DTCAB medicine 3.4 Data Collection Data was collected in field setting, respondent were general practicing Doctors/Physicians in hospital setting, as per previously done by (Friedman, 2006) to know the attitude of doctors. We selected hospitals because it has been found that hospitals play an important role in direct to consumer advertising (Adeoye Bozic, 2007),. 3.5 Sample and Population we choose leading hospitals of Rawalpindi/ Islamabad which have high patient turnover, i.e Pakistan institute of medical Sciences, Rawalpindi general hospital, Nescom Hospital and Shifa International. Within these hospitals we selected doctors on judgmental basis, as doctor who is dealing with more than 50 walk-in patients as previously done by (Taneja, Arora and Kaushik, 2007) and found appropriate. Sample size was taken 250, as per sample size taken by other researchers for the same kind of purpose (Bhanji, Baron, Benjamin, Lacy, Gross, Goin, Summner, Fischer, and Slaby 2008). 3.6 Instrumentation A questionnaire was adopted from two authors. Questionnaire has three parts, in first part general attitude of physicians towards direct to consumer advertising (Donhue Berndt, 2004), and in second part the likelihood behavior of physician if patient asks for more information related to drug being advertised directly, and in last part the likelihood of physician if patient asks for prescription of certain medicine (Zachry,Dalen, and Jackson, 2003). 3.7 Data Analysis These two were independent variable and one variable of prescription generation is dependant variable. Quantitative method were used, Microsoft Excel and SPSS was used to calculate percentages and relative comparison in questions through as per previous research done by Bhanji, 2008. IV FINDING AND ANALYSIS 4.1 Data Reliability and Normality Collected data is validated from Cronbachs-Alpha value which is used by many researchers like Zachry; Dalen, and Jackson, (2001,2003). The value came up to 0.8 which is acceptable as it should beis more than 0.6. Taneja, Arora and Kaushik, (2007) used descriptive statistical data analysis, I moreover used SPSS to regress two independent variable with dependent variable. 4.2 Descriptive Statistics of Respondents 4.2.1 Independent variable 1, attitude. In first part of questionnaire it is found that 40 % agree and 20 % strongly agree that it makes patients better informed and 46% agree with 32% strongly agree that it causes them to seek medical doctor. 40% agree that it also informs about side effects, although the data shows that there is increase in medication cost. Little agreement on suggesting medicine from patients. More that half percent of people suggested that it is good trend in health care, and causes more time spent in front of doctor while discussing disease. 42% agree that this also helps in increases motivation towards treatment. 39% think that it not only provokes patients to visit doctor for better health but also encourages, 41%, patients to talk to their doctor about right concern. 41% agree that it also helps in following treatment instructions and 58% with 7% strongly agree that it improves the understanding of medical conditions and treatment.1 is for strong agreement, 2 is for agreement, 3 is neutral and 4 is for disagreement while 5 is strongly disagreement.General description and frequency analysis is given in Table 4.1 OVERALL ATTITUDE OF PHYSICIANS TOWARDS DIRECT TO CONSUMER ADVERTISING ATTITUDE Questions Asked Variance Std Deviation Make patients better informed about their medical problems 1.18 1.08 Motivate patients to seek medical care 1.21 1.1 Provide enough information on other treatments 1.41 1.18 Do a good job of informing patients of side effects 1.3 1.15 Have less or no impact on increase in medication cost 1.08 1.03 Helps doctors in suggesting medicines from patients 1.06 1.02 Are a positive trend in health care 0.94 0.97 Increase in time spent with doctor 1 1.01 Increases motivation towards treatment, overall drug consumption 0.8 0.89 Increase more doctor visit for better health 1.47 1.21 Encourages patients to talk to their doctor about their right concerns 1 1 Encourages people to follow treatment instructions or advice from their doctors 1.15 1.07 Helps patients get treatments they would not otherwise get 1.16 1.07 Have less of no impact on driveing up the cost of prescription drugs 1.17 1.08 Improves peoples understanding of medical conditions and treatments 0.89 0.94 4.2.2 Independent variable 2, information. 44% agree that they become frustrated, 37% get annoyed but 52% agree and 32% strongly agree that they answer patient question about medication if asked. Only 35% agree that they provide more information. General description and frequency analysis is given in Table 4.2 LIKELLIHOOD OF PHYSICIANS WHEN ASKED FOR SPECIFIC BRAND DUE TO DTCA INFORMATION Questions asked Variance Std. Deviation You become frustrated with patient for asking for more information about disease or medicine 1.57 1.25 You become annoyed with patient for asking for more information about disease or medicine 1.42 1.19 Answer patient questions about the medication 0.79 0.89 Provide more information to patient beyond original inquiry 1.39 1.18 Attempt to change subject rather than discuss the medication 1.4 1.18 Explains that the information is probably beyond patients comprehension 1.42 1.19 4.2.3 Dependent variable, actual prescription generation. It is revealed from data that 37% get frustrated, 36% get annoyed if asked to prescribe certain brand and 36% feel uncomfortable with this request, and even less willing to communicate to the patient 33%, mostly 41% are neutral. With this if samples are available then 61% agree and 17% strongly agree to provide samples on patient request, it is also supported by agreement of 51% and strong agreement 24% that they will prescribe medicine if no medicine is available. But if found relevant, as while asking question of simply prescribing the medicine if is anyway relevant , to satisfy the patient then the agreement was 47% and only 8% with strong agreement. General description and frequency analysis is given in Table 4.3 LIKELIHOOD OF PHYSICIANS ON REQUEST OF PATIENT FOR SPECIFIC BRAND PRESCRIPTION GENERATION Dependent Variable Questions Asked Variance Std. Deviation Become frustrated with patient for asking to try the medication 1.13 1.06 Become annoyed with patient for asking to try the medication 0.96 0.98 Feel uncomfortable with the medication request 1.34 1.16 Communicate to the patient your discomfort with the medication request 0.87 0.93 Attempt to prescribe different medication to keep from promoting patient to ask for medication, if available 0.93 0.96 Provides samples of the medication, if available 0.73 0.86 Provide prescription of the medication if no samples available 1.2 1.09 Simply prescribes the medicine if is anyway relevant, to satisfy the patient 1.11 1.06 4.3 Correlation Regression Analysis SPSS was used to show the relationship between two independent variables i.e attitude of doctors towards DTCA and behavior likelihood if information asked by the patient and its impact on dependent variable which is actual prescription generation if requested by the patient. 4.3.1 Model summary and ANOVA. R value shows 40% relationship between dependent variable and independent variables. R square shows 16.6% of the variant in dependent variable can be predicted by the combination of two independent variable. Durbin Watson value is 2.08 showing that there is very less multicollinearity. ANOVA statistics shows overall model significance, f value is 15.09, and sig value is less than 0.00 which is less than 0.05, and is the indicator of significance, so that we can go for regression analysis of independent variables on dependent variables. Durbin Watson value should be between 1.5 to 2.5 means that there is no or less multicollinearity, here the value is 2.08, it shows less chances of multicollinearity. 4.4 If two independent variables combined collectively, Information + Attitude Data results with individual variables shows very weak relationship. with model significance. So It is considered combined effect of both independent variables on dependent variables. 4.4.1 Model summary and ANOVA. Model Summary shows overall model significance, which is less than 0.05, showing overall model fit, R value shows 78% dependence of dependent variable on independent variable. R square value is 0.61 showing magnitude of relationship between independent variable with dependent variable. 1% change in independent variable with 61 % change in dependent variable. Adjusted R square is the pure magnitude of relationship which is always less than the R square, 0.60. F Change statistics is 239.45 which is more than 1 then we can go for coefficients. ANOVA shows overall model significance with less than 0.05 value, it means the regression analysis be proceeded. Additionally according to second school of thought the regression sum of square should be greater then residual sum of square for better model fit. 4.4.1 Coefficient If t value is greater then 2 means it is significant. And significance value should be less than 0.05 to make a significant relationship. Here t value is 15.47, showing significant relationship, and sig value is less than 0.000. 4.2. Discussion This is similar finding with Ryan Vaithianathan, (2009). Which shows that the attitude of consumer is positive towards information provision to patient if asked and similar with the Brekke Kuhn, 2006 study which shows that the doctors rely on the information provided to them through DTCA. I accept the hypothesis that physicians have positive attitude towards DTCA. And it is accepted that the physicians are comfortable in providing information if asked by patents about any DTCAB. According to statistics shown by Data analysis I accept the hypothesis of positive relationship between general attitude of physicians towards DTCA and behavior of physicians if patient asks information has positive relationship and are correlated with actual prescription generation. Very interestingly it is found that information asking by physician and general attitude are weakly negatively correlated, it can be the area for further research that if more information is asked by patients about any brand may lead to negative attitude of physicians towards DTCA. It is found that through DTCA and patients, it is a way of putting pressure on physicians to change their prescribing behavior, (Ryan Vaithianathan, 2009) It was major concern showed by (Morgan, Mintzes barer, 2003) that the regularities authorities should consider DTCA regulations if it has impact on prescribing behavious, and in this study it has shown that the consumer advertising is creating impact in prescription choosen. This study is providing valueable information for pharmaceutical manufacturers and marketers. If more patients would ask for further information of specific drug, it may lead to the actual prescription generation. This study is also a thought provoking study for physicians that in choosing brands they are influenced by patients which may lead to increased cost and unnecessary medicines prescription. This study can be an eye opener for regularity authorities, DTCA is considered as good by physicians but it should be clearly monitored because it also creates pressure on physicians to prescribe certain brands. VI CONCLUSION Physicians have positive attitude towards DTCA and consider it supplementary in overall health care system. It stimulates patients to visit physician and seek appropriate treatment. Physicians feel comfortable in providing relevant information about DTCAB if asked, and they do not hesitate to prescribe the medicine if it is relevant to disease and patient economic characteristics. Focus of this study was to find the combined impact of attitude and information gathering on actual prescription generation. In future it may be further extended to specific disease area. However pharmaceutical companies should be monitored by regulatory authorities to check DTCA messages. Companies should focus on disease awareness rather on brand focused advertisements. REFERANCES Adeoye S, B. K. (2007 ). Direct to consumer advertising in healthcare: history, benefits, and concerns. Clinical Orthopaedics and Related Research , Volume 457, pp 96-104. Amaldoss, W., He, C. (2009). Direct-to-Consumer Advertising of Prescription Drugs: A Strategic Analysis. MARKETING SCIENCE , Vol. 28 (No. 3), pp. 472-487. Atherly, A., Rubin, P. (Feb 2008). The cost effectiveness of direct to consumer advertising for prescription drugs. Journal of Law Economics , pp. 08-28. Berndt, J. M. (2004). Effects of Direct-to-Consumer Advertising on Medication Choice: The Case of Antidepressants. Journal of Public Policy Marketing , 23 (2), 115-127. Berndt, J. M. (2004). Effects of Direct-to-Con sumer Advertising on Medication Choice: The Case of Antidepressants. Journal of Public Policy Marketing , 23 (2), 115-127. Bradford, D., Kleit, A. N., Nietert, P., Ornstein, S. (2005, August 8). The Effect of Direct to Consumer Television Advertising on the Timing of Treatment. Working Paper Series . Kurt R. Brekkea, Kuhnb, M. (2006). Direct to consumer advertising in Pharmaceutocal markets. Journal of Health Economics , pp. 102-130. Brekke, K. R., Kuhn, M. (July 2005). Direct to consumer advertising in pharmaceutical markets . Journal of Family medicine , Vol.18 (2) pp. 238-321 Donohue, J. M., Cevasco, M., Rosenthal, a. M. (2007). A Decade of Direct-to-Consumer Advertising of Presescription drugs. The new england journal of medicine , Vol . 81 pp. 357-673. E. Murray, L. Pollack, K. Donelan (2003), Direct-to-Consumer Advertising Physicians views of its effects on quality of care and the doctor patient relationship, JABFP, Vol. 16 No. 6 Pg. 513-524 Elizabeth Murray, P. M., Donelan, K., lee, K. (2004). Direct to Consumer Advertising Public Perception of its effects on Health Behaviours, Health Care, and the Doctor-Patient Relationship. The Journal of family Medicine, Vol.17 No. 1, pp. 6-18 Gould, M. F. (2007). Physicians attitudes toward direct-to-consumer prescription drug marketing. Journal of Medical Marketing , Vol. 7 (issue 1 ), 33-44. Green, R. M. (2008). Direct to consumer advertisment and pharmaceutical ethics The case of VIOXX. Journal of Business Ethics , Vol. 15, pp.749-759. Helen Prosser, S. A. (2003). Influences on GPs decision to prescribe new drugs-the importance of who says what. Journal of Family Practice , Vol. 20, (No. 1), 61-68. Herzenstein, M., Misra, S., Posavac, S. S. (2005). How Consumers Attitudes Toward Direct-to-Consumer Advertising of Prescription Drugs Influence Ad Effectiveness, and Consumer and Physician Behavior . Marketing Letters , Vol. 15 ( Number 4), 201-212. Iizuka, T., Jin, G. Z. (2005). The Effect of Prescription Drug Advertising on Doctor Visits. Journal of Economics and Management Strategy , 22 (3). Kurt R. Brekkea, Kuhnb, M. (2006). Direct to consumer advertising in Pharmaceutocal markets. Journal of Health Economics , Vol.19 (2) , Pg.102-130. Lack of Impact of Direct-to-Consumer Advertising on the

The Catcher In The Rye :: essays research papers

Holden’s Journey   Ã‚  Ã‚  Ã‚  Ã‚  As we pass through this life it is our duty to discover our destiny. Some of us go to college and become Doctors, Lawyers, Architects. Others of us cherish the finer things in life and find our places on farms and Dude Ranches. The point is, every living creature has a place in this world and we are ultimately steered in its direction. Holden Caulfield’s voyage began when his brother died of Leukemia. Holden was emotionally destroyed by the loss of not only his brother, but his best friend also. The fact that his parents couldn’t accept Holden’s pain and that they even sent him to a shrink for it, proved to Holden that his parents didn’t care as much as they were supposed to.   Ã‚  Ã‚  Ã‚  Ã‚  As Holden grew up, he found himself flunking out of school after school, never being able to stay in one place. This calamity was caused by either his overwhelmingly powerful hatred for people or because there was a conflict of interest between him and the school itself, about who they were trying to make him. Holden was also starting to view people as who they really were. Many of us in this world accept people at face value and never really take the time to see through the infinite masks that make up a personality, or a first impression. Holden however, took the time to understand who a person really was, and how fake they really were being. This changed his life enormously, as it would anybody’s, because as soon as he could understand how much of a phony a person was being and who they truly were, he didn’t have to feel inferior, scared or cast out by that person. I think these views of life could have actually been caused by his brother’s death. I think that when his brother died, his parents might have become phonies themselves. You must understand that when a parent loses one of their own creations they feel as if they have lost a part of themselves and cannot strive to go on. I think many parents find it easier to conceal their feelings inside of themselves, thus becoming what Holden could view as a phony. He didn’t understand why his parents had to bottle it all up (which he thinks is wrong) and why he was almost punished for expressing his feelings freely (which he feels is the right thing to do).

Childrens Ability to Differentiate Between Real and Fantastical Entiti

Introduction In the field of developmental psychology, children have become a popular interest. By studying such changes children go through in the early stages of childhood, researchers provide better knowledge and insight on how these changes influence the actions and behaviors of children. It has been identified by many that during these stages, children have rapid mental and cognitive development. Likewise, during this time children are thought to easily confuse reality and fantasy. This paper will consist of two reviews involving two different studies which assesses the children's ability to differentiate between fantasy and reality. One will determine how fantasy/reality distinction evolves with age, while the other investigates children's perception of storybook entities. Both focus on children's ability to categorize specified objects/people/events. Article One - Purpose, Hypothesis & Goal of Study It is believed that a basic component of human cognitive skills is the ability to differentiate between reality and fantasy. Traditionally, children were assumed to confuse the boundaries between them. Yet, previous research has shown that three year olds are able to make reality/non-reality distinctions. The first article, published in 2004 describes a study performed by Sharon & Woolley. They hoped to provide a new viewpoint at a preschooler's level of fantasy/reality differentiation. They believed that children have a better understanding of these boundaries than most people assume. Believing that children have an understanding of what is "human" and what is not, which they use to determine whether entities are real or fantastical. The main goal of their study was to show this possibility, by exploring what childr... ... impossible allows for a broader understanding of what can be considered as real or pretend. Both studies show that increased exposure to fantasy based activities, improve their ability to differentiate and likelihood to question the reality status of various entities/events. It is also important to note that environmental and social factors play a key role in what children believe is real, especially if "false truths" like Santa Claus are instilled by a dominant figure in the child's life. References Sharon, T. & Woolley, J.D. (2004). Do monsters dream? Young children's understanding of the fantasy/reality distinction. British Journal of Developmental Psychology, 22, 293-310. Woolley, J. D. & Cox, V. (2007). Development of beliefs about storybook reality. Developmental Science, 10 (5), 681-693. doi: 10.1111/j.1467-7687.2007.00612.x

The Fatal Grudge :: essays research papers fc

â€Å"For I have decided to send Ad Patres[Spanish for â€Å"to the fathers†] the feminists who have ruined my life.† -Marc Lepine, suicide note. It was the early evening of December 6, 1989; just nineteen day’s before Christmas. The students of Montreal’s Ecole Polytechnique were just finishing their classes when a stranger walked into the engineering building. Like a sadistic Santa he carried a Sturm Ruger Mini-14 automatic rifle, knives and bandoleers of ammunition. The stranger was Marc Lepine. At the end of the day he would be dead along with 14 women; leaving a suicide note blaming feminists for his actions. Marc Lepine’s brutal actions are a shocking reality check of the growing number of savage acts done by men towards women. There has always been a difference between men and women and how both treat each other. You could say the two genders secretly hold a grudge against one another. This grudge will on occasion surface and cause conflict between the two; either in a peaceful matter or violent outburst. What causes this resentment? In the women’s case many feel they do not have the same privileges that men have. On the other hand, some men say that women are now stealing the privileges which were hard enough to attain while competing with their own gender. Stevie Cameron also recognises this and states â€Å"Sharing power is not easy for anyone and men do not find it easy to share among themselves, much less with a group of equally talented, able women.† (2) This tension is then the hotbed from which these acts of violence must originate from. Women are considered by most men to be less physically inclined. Is this true? In the past men have always been the symbols of strength and fortitude, while the women represented the more gentler and timid qualities. This unfair outlook is alive and well in today’s day and age. Although it’s not nearly supported as strongly as it once was it still sits in our subconscious, dictating our actions as a society. For instance, if you took a 18 year old boy and a 18 year old girl, they have a very different set of rules to follow. These rules are set by their parents who make them based on the previous presumptions. So the girl will find it unfair that the boy, who is considered her equal, can go where he wants, when he wants.

Decision Tree Portfolio

Decision Tree Portfolio1 Decision Tree Portfolio Psy 410 Kathleen McCabe University of Phoenix January 21, 2012 Lara Ashbaugh Decision Tree Portfolio2 The Portfolio for my Decision Tree is concerning a residential fire. The first place that would be called is 911. The dispatchers in our area immediately contact the local and closest fire station(s) to respond. The following takes place after 911 has been called. The 911 dispatchers contact the police and fire departments arrive, the firefighters ensure the house has been vacated and all residents have been accounted for.If the family has pets they are accounted for as well, if possible. The first responders assist with contacting other agencies to find shelter for the family. One of our local agencies is The Community Action Partnership which can secure shelter for the evening and longer, provide clothing, food, medications, and hygiene supplies. Health and welfare services are contacted which include emergency health care and emerge ncy funds. If medical evaluations are necessary the support systems will ensure that the victims are taken to the hospital for care. What is the best way to access the organization’s services? The first responders are contacted through 911. The Community Action Partnership 1910 Industrial Way Coeur d’Alene, ID 83815 208-664-8757 * Is this the best number to call? Yes * What are the extents of the services offered? The Community Action Partnership (CAP) offers food through a food bank and for emergencies; they offer clothing, can assist with emergency medications and medical treatment and contact shelters for housing. * What are the criteria for clients to receive these services? Who is eligible?Community Action Partnership assists anyone in the community who meets the federal low income guidelines. However, they have emergency funds and staff to assist in emergencies such as fire. In the case of an emergency anyone qualifies for their assistance. * How does the organiz ation provide continuity of care to clients? The staff at the Community Action Partnership supervises their clients until the crisis is over. If the family of fire needs assistance for a month, the agency ensure they maintain shelter and food until their insurance company or another means is providing for them. What additional services will be available or offered to clients once they become involved with this organization? Once involved with CAP the clients only needs to sign a form verifying that the help is still necessary. Once the assistance is not needed the client simply lets the agency know and they are listed as inactive in the database. * Will you be able to have contact with your clients once they are involved with this service/organization? As long as the clients sign a release allowing me to contact CAP, then any other providers can contact them for information or to help assist the family. What is the organization’s policy on client follow-up? CAP follows up dai ly in the event of a fire until the family is secure with new home plans. If a client needs daily contact they will do so, they will also contact weekly, monthly is necessary. * What role do you or your agency play in responding to emergencies? The CAP plays a large role in assisting the community with emergencies. We provide as much assistance as is necessary and ensure no one goes without.