Milnacipran Hydrochloride (MIL) Uses in Medicine

Milnacipran Hydrochloride (MIL) Uses in Medicine Milnacipran hydrochloride (MIL) is a selective serotonin and norepinephrine reuptake inhibitor. It was originally developed and manufactured by Pierre Fabre Medicament in France, and was approved in that country as an antidepressant in 1997 [1]. It has since been approved for this indication in multiple countries and currently marketed for this indication in over 45 countries worldwide including several European countries. Cypress Bioscience bought the exclusive rights for approval and marketing of the drug for fibromyalgia purpose in the United States and Canada in 2003 from the manufacturer Pierre Fabre Laboratories [2-3]. In January 2009 the U.S. Food and Drug Administration (FDA) approved MIL only for the treatment of fibromyalgia, making it the third medication approved for this purpose in the United States [4]. Some of the drug information and properties are listed below: 2.1 Physical and chemical properties Chemical name : MIL is chemically designated as (1R,2S)-rel-2(Amino-methyl)-N,N-diethyl-1-phenyl-cyclopropanecarboxamide hydrochloride and its structure is shown in Figure 2.1. Synonyms : F-2207; Ixel; Toledomin; Dalcipran; Milnacipran Hydrochloride. Empirical formula : C15H22N2O. HCl Molecular weight : 282.8 CAS No. : 101152-94-7 Melting point: 179Â °C Physical description : MIL is a white to off-white, odourless, crystalline powder. Dissociation constant (pKa) : 9.65 Permeability coefficient (Log P) : 1.42 Solubility : It is freely soluble in aqueous buffers over the entire physiological pH range. It is freely soluble in water, methanol, ethanol, chloroform, and methylene chloride and sparingly soluble in diethyl ether [5-6]. BCS class : Class I, highly soluble and highly permeable drug. 2.2 Pharmacological properties Mechanism of Action Milnacipran blocks 5-HT and norepinephrine (NE) reuptake into the neuron, thereby increasing 5-HT and NE extracellular concentrations. This activates 5-HT and NE auto and heteroreceptors culminating in a decreasing 5-HT and NE neuronal firing rates, synthesis, and release. On Chronic use MIL continues to block 5-HT and NE transporters without desensitization, but 5-HT and NE auto- and heteroreceptors are desensitized and thus, down regulated. Firing rates of 5-HT and NE return to normal, and the amount of 5-HT and NE released per nerve impulse is increased [7]. MIL has no significant affinity for ÃŽ ±- and ÃŽ ²-adrenergic, muscarinic (M1-5), histamine (H1-4), dopamine (D1-5), opiate, benzodiazepine, or ÃŽ ³-aminobutyric acid (GABA) receptors. MIL has no significant affinity for Ca2+, K+, Na+ and Cl– channels and does not inhibit the activity of human monoamine oxidases (MAO-A and MAO-B) or acetylcholinesterase [8-9]. One of the main differences between the various antidepressants and MIL is its equal preference and activity on the uptake of NE and 5-HT. The exact mechanism of the central pain inhibitory action and effectiveness in fibromyalgia symptom are unknown in Humans [10-11]. 2.3 Therapeutic Indications Treatment of depression Major Depression, also known as major depressive disorder or unipolar depression, is a highly debilitating disorder that has been estimated to affect up to 21% of the world population [12]. It is a CNS disorder characterised by a combination of symptoms that interfere with a persons ability to work, sleep, study, eat, and enjoy pleasurable activities [7,12]. Despite the advances in the treatment of depression with selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs), there continue to be many unmet clinical needs with respect to both efficacy and side effects. These needs range from efficacy in treatment resistant patients, to improved onset, to reductions in side effects such as emesis or sexual dysfunction. To address these needs, there are numerous combination therapies and novel targets that have been identified that may demonstrate improvements in one or more areas [12]. Management of Fibromyalgia Fibromyalgia (FM) is a complex syndrome characterized by chronic musculoskeletal pain which is often accompanied by multiple other symptoms, including fatigue, sleep disturbances, decreased physical functioning, and dyscognition. Due to these multiple symptoms, as well as high rates of comorbidity with other related disorders, patients with FM have a reduced quality of life. The reduced serotonin and norepinephrine levels observed in patients with FM suggest that medications which increase the levels of these neurotransmitters, such as serotonin and norepinephrine reuptake inhibitors (SNRIs), may have clinically beneficial effects in FM and other chronic pain conditions. MIL is an SNRI that has been approved for the management of FM [8, 13]. MIL was viewed as a wonderful new weapon in the fight against both depression and pain. Treatment of Lupus Recent studies proved that MIL is also useful against lupus. Lupus is a chronic autoimmune disease in which the immune system turns against the body and harms healthy cells and tissues. It is a rheumatic disease which can affect many parts of the body including the joints, skin, kidneys, lungs, heart or brain. Some of the most common symptoms include extreme fatigue, painful or swollen joints, unexplained fever, skin rashes, and kidney problems. Scientific evidence indicates that lupus is caused by a combination of genetic and environmental factors. Lupus is characterized by periods of increased or intensified disease activity, called flares [14-15]. Tolerability and side effects MILhas demonstrated numerous adverse reactions in human clinical trials with tolerability decreasing with an increasing dose. In the placebo controlled trials in patients with fibromyalgia, the most frequent spontaneously reported adverse events were as follows: nausea, palpitations, headache, constipation, increased heart rate and hyperhidrosis, vomiting, and dizziness [16]. Discontinuation due to adverse reactions was generally more common among patients treated with 200 mg/day compared to 100 mg/day. The adverse effects can originate from the fluctuation in the plasma drug concentrations of an active substance following administration and subsequent metabolism and/or elimination from the body. Most of the reported adverse events were reduced or disappeared with the discontinuation of treatment [17]. 2.4 Pharmacokinetics The pharmacokinetic profile of MIL is as summarized in Table 2.1 [1,5]. Absorption MIL is well-absorbed after oral administration. Absolute bioavailability is about 85-90 %. It is not affected by food intake. The peak plasma concentration is about 120 ng/ml achieved in 2 hours after a single 50 mg dose. Inter-subject variability is low. Plasma concentrations are linearly proportional with dose over the range of single acute doses of 25 to 200 mg as shown in Table 2.2 [1,2]. Distribution Protein binding is low (13%) and not saturable. The volume of distribution of MIL is about 5 litre/kg with a total clearance of about 40 litre/hour. Renal and non-renal clearances are equivalent [1]. Metabolism MIL is metabolized mainly by conjugation (Glucoronisation). Active metabolites have been found at very low levels without clinical relevance. Cytochrome P450 2D6 is involved in the metabolism of many psychotropic drugs and its inhibition is frequently a cause of drug-drug interactions. This enzyme has no impact on the metabolism of MIL and no oxidative metabolites of MIL have been detected in humans [1-3]. The pharmacokinetics of MIL are not modified in subjects who are deficient in the CYP2D6 isoenzyme (slow sparteine-like metabolisers). Furthermore, MIL does not interfere in-vivo with other isoenzymes of cytochrome P450 [1, 18]. Elimination Plasma elimination half-life is about 8 hours. Elimination occurs mainly via the kidney with tubular secretion of the product in unchanged form. After repeated doses, MIL is totally eliminated in 2 to 3 days after termination of therapy. The liver and kidneys are both involved in the elimination of MIL as illustrated by renal and non-renal clearances with values of 23.8 Â ± 7.3 and 16.4 Â ± 3.1 l/h, respectively. This balance between renal and non-renal clearances may be an advantage in patients presenting with moderate renal insufficiency [3,5]. 2.5 Dosage and administration The recommended dose titration schedule for MIL is 12.5 mg once on Day 1, then 12.5 mg twice a day on Days 2-3, and then 25 mg twice a day on Days 4-7, and then 50 mg twice a day after Day 7. Recommended maintenance dose is 50 mg twice daily. In clinical trials, MIL was evaluated with a dose titration schedule. The daily dose may be increased to 200 mg (or 100 mg twice a day) based on individual response. Dosing should be adjusted in patients with severe renal impairment (CrCl 2.6 Marketed formulations There are various brands of MIL are available with dose of 12.5 mg, 25 mg, 50 mg and 100 mg immediate release tablets or capsules as shown in Table 2.3 [19-21].

Middle Eastern airline Emirates has appointed Chemistry

Middle Eastern airline Emirates has appointed Chemistry Communications to handle its direct marketing account. The agency replaces DDA and is tasked with developing customer management strategies, as well as other direct activities. Emirates has appointed VCCP and sales promotion agency Gasoline to its roster to work on as-yet unspecified projects. The appointment follows the Dubai airline’s decision to hire Grey London to create a global advertising campaign for its business-class service. Emirates will offer daily non-stop flights between Los Angeles and Dubai on September 1.The new flight runs a distance of 8,339 miles, taking 16 hours and 35 minutes from Dubai to California; the duration of the return flight will be slightly shorter at just under 16 hours.Emirates currently flies twice daily to New York and once daily to Houston.  Emirates is to promote its new Dubai-Sao Paulo service through a digital campaign that will include the longest ad ever.  The advert will al so air on cable TV, allowing it to be recognised as the longest ever by Guinness World Records. Emirates has ended its management contract with Sri Lankan Airlines, fuelling speculation that it may sell its 43.6% stake in the Dubai-based carrier.Emirates has valued its share at $150 million, with Mr Clark saying its purchase would be one â€Å"hell of an opportunity† for a regional carrier  The Emirates Group has posted a 23.5% rise in group net profits to  £500 million backed by a record  £424 million profit at its airline. The government-owned airline added 3 million passengers over the financial year ending 31 March, 2007.  During the 2006-07 financial year Emirates added 12 new Boeing 777-300ER aircraft and launched new services to Nagoya, Tunis, Bangalore and Beijing, while increasing frequency to existing destinations like Dusseldorf and ZurichEmirates Airline, the government-owned Dubai carrier, has reported a 29% increase in year-on-year net profit to AED1.2 b illion ( £171.6 million) for the fiscal first half ended 30 September 2006.  Passenger revenue rose 31% for the period, with the number of passengers increasing 20% to 8.39 million.  Emirates announced that it has launched service to 10 cities since January 2006, with its total network now standing at 87 destinations.Almost four months after its initial announcement that the new A380 superjumbo would suffer launch delays in June 2006, after which point several further postponements have been tabled, Airbus parent company EADS has issued a â‚ ¬4.8 billion profit warning, more than double that mooted when the first problems occurred. The figure works against EADS’ â€Å"baseline plan† for the period between 2006 and 2010, and will be recorded as a shortfall in operating profits.Separately, the A380’s biggest advance order customer, Emirates, which has requested 45 of the total 159 ordered aircraft, has said that as a result of the latest delays, which put the A380’s release at no earlier than August 2008, it is â€Å"reviewing its options.†On 25th October 1985, Emirates flew its first routes out of Dubai with just two aircraft—a leased Boeing 737 and Airbus 300 B4. Then as now, our goal was quality, not quantity, and in the years since taking those first small steps onto the regional travel scene, Emirates has evolved into a globally influential travel and tourism conglomerate known the world over for our commitment to the highest standards of quality in every aspect of our business.Though wholly owned by the Government of Dubai, Emirates has grown in scale and stature not through protectionism but through competition—competition with the ever-growing number of international carriers that take advantage of Dubai’s open-skies policy. Not only do we support that policy, but we see it as vital to maintaining our identity and our competitiveness. After making its initial start-up investment, the Govern ment of Dubai  saw fit to treat Emirates as a wholly independent business entity, and today we are thriving because of it. Our growth has never been lower than 20 per cent annually, and the airline has recorded an annual profit in every year since its third in operation.Continuing our explosive growth while continually striving to provide the best service in the industry is the secret of Emirates’ success. The Emirates Group announced record net profits of Dhs  3.5 billion (US$  942 million) for the financial year ended 31st March 2007. The 28.8 per cent increase in profits versus the previous year speaks  of a  promising future of an airline we feel is greater than the sum of its many parts, which now include: ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An award winning international cargo division ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A full-fledged destination management and leisure division ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An international ground-handler ·Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An airline IT developer.With a fleet of 113 aircraft, we currently fly to  over 100 destinations in  62 countries around the world, and our network is expanding constantly. Nearly  800 Emirates flights depart Dubai each week on their way to destinations on  six continents. In fact, Emirates' flights  account for nearly 40  per cent of all flight movements in and out of Dubai International Airport, and our aim is to increase this market-share to 70 per cent by 2010 without compromising our reputation for quality.  Toward this end, Emirates has made numerous significant announcements regarding the future of its already state-of-the-art fleet.In 2001, Emirates demonstrated its confidence in the industry’s future growth by announcing the largest order in aviation history, valued at US$15 billion. A staggering 58 new aircraft, a mix of Airbus and Boeing, were to join the rapidly expanding fleet.  In 2005, Emirates announced the largest-ever or der for the Boeing 777 family of aircraft – 42 in all – in a deal worth Dhs 35.7 billion (US$ 9.7 billion).At the 2006 Farnborough Air Show, Emirates signed a Heads of Agreement for 10 of Boeing’s new 747-8F aircraft, to be powered by General Electric’s GEnx jet engines, in a deal worth US$ 3.3 billion.  At the Dubai Airshow in November 2007, Emirates announced a historic civil aviation aircraft order when it signed contracts for a 120 Airbus A350s, 11 A380s, and 12 Boeing 777-300ERs, worth an estimated US$34.9 billion in list prices. The agreement with Airbus comprises firm orders for 50 A350-900s and 20 A350-1000s, plus 50 options for the A350-900s. The first A350 will be delivered to Emirates in 2014.Emirates also firmed up orders on the eight A380s for which it had signed letters of intent earlier this year, and placed firm orders for an additional three of the double-decker aircraft, bringing its total firm order for the A380s to 58.References:http s://www.emirates.com/uk/english/about/history.aspx [Cited 14 March2008]http://academic.mintel.com/sinatra/oxygen_academic/†¦Ã¢â‚¬ ¦..[Cited 14 March2008]https://www.emirates.com/ua/russian/ [Cited 14 March2008] Stephen J. Porth (2003) Strategic Management: A cross- Functional Approach. Second edition Hamel, G. (2002). Leading the revolution: How to thrive in a turbulent time by making innovation a way of life

Differences and Similiraties Between Dickens and Hardy Essay

Dickens was born in Portsea, in 12. His father, John Dickens, was a kind and likeable man, but incompetent with money, and due to his financial difficulties they moved to Camden when Dickens was nine. When Charles was twelve his father was arrested and taken to the debtors’ prison in Southwark. He started working at Warren’s blacking-warehouse and its strenuous working conditions made an impression on him, later influencing his fiction. He became interested in writing (and acting) and, after having learnt shorthand in his spare time, he began working as a freelance reporter at the Parliament and the Old Bailey. Under the nom de plume Boz he published the eponymous Sketches (36), a collection of short pieces concerning London scenes and people. In 36 he married Catherine Hogarth, the daughter of a fellow editor, yet this union proved to be an unhappy one and, though she bore him ten children, he decided to separate from her after 22 years, having fallen in love with an 1 8-year-old actress, Ellen Ternan. This fact often constituted a reason of doubt, regret and depression for his Victorian frame of mind. The Sketches were immediately followed by the Posthumous Papers of the Pickwick Club, a publication in installments which confirmed his success as a humorist and satirist. His rise to fame continued with Oliver Twist (38), David Copperfield (49-50), Little Dorrit (57), all influenced by his childhood memories (he purportedly had a near-photographic memory), and his journalistic career. By means of subtle irony, he denounced the exploitation of children in the slums and factories. His later novels Bleak House (53), Hard times (54) and Great Expectations (60-1) revolve around various social issues, emphasizing the difficult condition of the working class and the poor. Throughout his life he edited several newspapers and magazines, e.g. Household Words or All The Year Round, which hosted serializations of many prominent novels. His last years were marked by numerous reading tours, even in America, and the foundation of charities to help the poor. After his death in 70 his remains were b uried in the Poets’ Corner in Westminster Abbey. Above all, Dickens was a storyteller, as he was influenced by the Bible, fairy tales, fables and nursery rhymes as well as 18th-century essayists and Gothic novelists. His novels have been praised – from Tolstoj to Orwell – for their realism and good story planning. On the other hand, Wilde and Virginia Woolf complained of their episodic nature and artificial vein of saccharine sentimentalism. Of course the publication in monthly or weekly installments imposed strict terms, preventing unified plotting and creating pressure on Dickens to suit the taste of the audience. Most of his novels are set in London, a city he knew well and of which he gave vivid and realistic sketches. In Dickens’s first works, his characters are taken from the bourgeoisie, although often satirized, whereas in the latter novels he presents a more radical point of view on society, still without being a revolutionary thinker. His awareness of the increasing spiritual and material corruption as a consequence of industrialization made him more and more critical of society. His mature works managed to draw popular attention to public abuses, evils and injustices by means of the juxtapositions of terrible descriptions of London desolation and crime and hilarious sketches of the city. He created caricatures by exaggerating and ridiculing the distinctive social characteristics of the middle, lower and lowest classes in their own voices and conversations. His female characters are feeble, and either completely good or irrecoverably evil (a black-and-white morality possibly derived from his difficult relation with his mother). He sympathizes with the poor and the outcast: he shifts the perspective from the upper middle-class world of 18th-century fiction to the life of the lower orders and the working class. Children are often the most relevant characters in his works, a means to fictionally invert the natural or der of things, as their good-natured personality makes them more likely to be the moral teachers than the pupils of the adults (either into insignificant parents or hypocritical grown-ups), the exempla than the imitators. He succeeds not only in making his readers sympathize with the children, but also in proposing them as models of the correct way people should behave to one another. His aim lies in teaching a moral lesson to the reader. To accomplish this he uses the most effective language, i.e. a careful selection of adjectives, lexical and syntactical repetitions, juxtapositions of images and ideas and hyperbolic and ironic comments, thus achieving the most vivid depictions of life and character ever attempted by any novelist. In Coketown, a fictitious industrial town, Thomas Gradgrind, an educator firmly believing in facts and figures, has founded a school based on the suppression of imagination and feelings, the same theories by which he raises his children Louisa and Tom. His daughter is compelled to marry Josiah Bounderby, a wealthy banker thrice her age, and she accepts so that her brother can be apprenticed at Bounderby’s bank, yet the marriage proves to be unhappy. Tom, grown up to be dissipated and self-interested, robs his employer, initially managing to make everyone suspect an honest laborer, Stephen Blackpool , then discovered and snuck out of the country by his sister. Hard Times is composed of three books of three chapters each: Sowing, about the seeds planted by means of the Gradgrind/Bounderby method, Reaping, showing which fruit the plants have borne (Luisa’s unfortunate marriage, Tom’s dishonesty/hedonism which leads to Stephen’s framing) and Garnering, disclosing further details. Hard times revolves around the dichotomy in Dickens’s age between the rich and the poor. The Hands are forced to work interminable shifts for terrible wages in squalid and dangerous factories, with no hope of improving their living or working conditions due to their lack of education and job skills. Through his characters and stories he denounces this gap, thus criticizing the money-oriented and narrow-minded nature of Utilitaria nism, the prevalent approach to economics in Victorian England, which, according to Dickens was transforming humans into machines by forbidding the development of any form of emotion or imagination. In fact, Gradgrind indoctrinates the children of the school, as well as his own, into his system of facts, whereas Bounderby considers his laborers nothing more than emotionless objects to be exploited at his own liking. Mr. Gradgrind argues that nature is a measurable, quantifiable entity entirely dominated by rational principles, and strives to transform the pupils of his school into little machines unquestioningly following these rules. Dickens’s objective lies in showing how dangerous allowing the â€Å"mechanization† of humans can be, hinting that with no compassion and imagination life would be unendurable. The extract is centered on the description of the Victorian industrial Coketown, a fictitious Northern-English mill-town whose name, the town of coke (coke being a fuel derived from the distillation of coal) is meaningful as it hints at the contribution of industrial pollution to the blackening of buildings. This town is an unpleasant place, where everything is a triumph of fact (all fact, workful): it is not only polluted, as demonstrated by â€Å"the unnatural red and black† and the â€Å"river than ran purple with ill-smelling dye†, but also noisy, due to the never-ending â€Å"rattling and trembling† of the steam-engine (one of the symbols of industrialization). Dickens employs metaphors and similes connected with nature, yet they all have negative and unsettling undertones, as the savage is war-donned, the serpents never-uncoiling, the elephant in â€Å"melancholy madness† (i.e. in musth). Therefore life in Coketown is not only marked by unpleasant alienation as well as by a fundamental opposition to the laws of nature and common sense. The whole place is monotonous as not only the streets are very similar to one another, but also the people, synchronized in all their activities. Even public buildings are standardized, looking like factories with â€Å"no taint of fancy† as artistic expression is contrary to Utilitarianism. Dickens was an important denouncer of the vices and injustices of Victorian England, employing fiction as a means to condemn public evils and abuses. He drew popular attention to the cruelty of some schools, to the squalid misery of London slums and its criminal underworld by means of his social/humanitaria n novels. He greatly influenced the contemporary reform movement, yet he was not a revolutionary per se, as he never questioned the pre-constituted order of his time, as noted by Orwell. He advocated a change not in the whole society but in the single individual, who is the real target of his moral, not political or revolutionary, message. He argued that if men behaved decently, the world would be decent, and made good win over evil in his novels as a sign of his fundamental optimism. Hardy was born of a humble family in Upper Bockhampton , a hamlet in Dorset, in 40. He became apprenticed to a local architect at sixteen and then moved to London. He read a lot, including the works of Comte, Mill, Darwin and Schopenhauer, who all influenced his novels, especially Schopenhauer, from whose The World as Will and Idea he adopted the notion of Immanent Will. His first success was Far from the Madding Crowd, published in installments throughout 74. His fame increased even further with a series of tragic novels: the Mayor of Casterbridge (86), the Woodlanders (87), Tess of the d’Urbervilles (91) and Jude the Obscure (95). The last book caused an outrage due to its nihi lism and immorality: dubbed Jude the Obscene by some, it was publicly burnt by the bishop of Wakefield. Its negative reception induced Hardy to turn his efforts exclusively to poetry. After his death in 28 his ashes were buried in the Poets’ Corner in Westminster Abbey. Hardy’s characters are defined through their surroundings. His works are set in Wessex, a semi-fictional county in South West England corresponding to Dorset based on the eponymous Saxon medieval reign (as stated in the Preface to Far from the Madding Crowd). Being an architect, he had an exceptional sense of place, which allowed him to describe medieval ruins as well as important landmarks like Stonehenge or the college of Oxford. His early life in Dorset granted him with an extensive knowledge of the folk traditions connected with country gatherings or fairs. In his novels the rural group assumes a role similar to that of ancient Greek choruses, commenting on the actions of the character, either to provide the reader with an interpretation or a form of light relief. In the village of Marlott, the poor pe ddler John Durbeyfield is stunned to discover that he is descended from the D’Urbevilles, a once-wealthy aristocratic Norman family now extinct. The difficult conditions of his family worsen after the death of their horse caused by their eldest daughter Tess, who consequently agrees to go to the D’Urberville estate and â€Å"claim kin† (unaware of its non-existence). She gets a position as a poultry maid thanks to Alec, the mistress’s lascivious son who constantly makes undesired advances on her. He eventually takes advantage of her after a fair. She returns home and gives birth to a sickly child, who is christened Sorrow just before his death. After a year she seeks employment far from her past, i.e. in a distant valley, becoming a milkmaid at the Thalbothays Dairy. There she re-encounters Angel, a reverend’s son apprenticing as a farmer. They fall in love, yet Tess is uncertain whether to reveal him her past and resolves to slip a confessional letter under his door, which unfortunately ends under the carpet. The marriage goes smoothly nevertheless when on their wedding night they confess each oth er their past Angel is struck dumb, and resolves to leave her, boarding a ship for Brazil. Tess experiences many sufferings and difficulties and is obliged to accept a job at an hardscrabble farm. During a walk she overhears a wandering preacher who turns out to be none else than Alec, converted to Methodism by Reverend Clare. Tess eventually accepts his proposal to support her family after her father’s death. However, Angel returns from Brazil and seeks Tess to ask her forgiveness, but she stoically refuses. Heartbroken to the point of madness, she stabs Alec to death and flees to Angel. She is arrested at Stonehenge, where she felt asleep on a large rock, and is eventually executed. He is the most important pessimistic novelist of late Victorian England due to many reasons: first of all, he was born in the Hungry 40s, a period in which the price of bread was kept high by the Corn laws and many people starved to death; secondly his first marriage was an unhappy, childless one, though he felt remorseful after his wife’s death; lastly he was influenced by Darw in and his vision of life as a never-ending struggle for the survival of the fittest as well as by Schopenhauer ‘s universe governed by the blind â€Å"Immanent will†, and he started to put into discussion his religious faith. Furthermore, he was profoundly touched by the collapse of the rustic world, which he loved and experienced first-handedly since his birth. In fact his county, Dorsetshire, in South West England, was suffering from the consequences of the mechanization of agriculture, the severe economic crises of the 70s and the mass-migration to the towns. Hardy argues that life is a struggle for survival against wicked impersonal powers. Love is a destructive natural instinct. In fact man is in thrall to fate, i.e. an impersonal unforeseeable entity governing over both the inside and outside of man (personality and surroundings). Therefore human life is nothing but a useless, excruciating struggle with destiny, also known as Immanent will as per his reading of Arthur Schopenhauer . It is a kind of Anti-Providence, an unstoppable apparatus operating through a series of unfortunate coincidences. According to Hardy, the universe is at the mercy of Chance, blindfolded casualness either unconcerned or antagonistic to man. As a matter of fact, in Tess this malignant power amuses itself by tormenting her to death. â€Å"Justice was done, and the President of the Immortals, in Aeschylean phrase, had ended his sport with Tess†. Tess, and, more generally, man, is a marionette in the hands of Chance, a worthless varmint in the universe. Tess is fated to sorrow and death from the very moment she came into being. There are three important themes in his works: the difficulty of being alive; nature, unaffected by man’s fate yet co-protagonist with him; Victorian hypocrisy, which is criticized as well as conventional moralism, in particular as far as women are concerned: in fact Tess, a falling woman as per Victorian morals, is presented as a pure, guiltless vict im of chance and her love interests. His language is measured, abundant in details and symbolism. The metaphors, similes and personifications he employs reflect his love for nature. The language of sense impressions is central to his writing, as objects are perceived through touch, sight, sound and smell. Though his novels were composed during a period of literary experimentation, he persevered in employing the Victorian omniscient narrator, who is always present, sometimes commenting on the characters or events by expressing his opinions and view on life. Furthermore, he anticipates the cinema in that he employs narrative techniques alike to the camera eye and the zoom (e.g. in Far from the madding crowd).

Essay about Computers in the Medical Field - 1420 Words

â€Å"Computers play a key role in almost every sphere of life† (Berry, Terrie). Without them, everything would be different. People all around the world own or used a computer. Whether you are a professional in technology or just an average person, computers are still very important in your everyday life. â€Å"No other technology has accessed the world like computers and the use of the Internet have† (Maddox, Amanda). Without computers, consumers would not be able to do half the things as quickly as we can. Advances in computer design have increased its use for different industries, especially in the medical field. Computers help out hospitals and pharmacies very much. Pharmacists use computers to keep a record of medications and the dosage to†¦show more content†¦Some surgical procedures are computer-guided. These types of surgeries mean that the patient has less downtime since the procedures are more straight-forward. Storing information using computers has changed the way in which the world works. The computer has helped the medical field as much as or more than other fields (Maddox, Amanda). In every medical office there are various uses of computers. They contribute a lot to the hospital administration; all the administrative processes are kept in computers. Staff records, incoming and outgoing time of the staff, the holiday records of the staff, anything to do with the staff, are all examples of how computers are used in a medical office. If the doctor were to hand-write every little thing, to keep track of such things, it would be very difficult, but with computers, the task uses less time and the process is simplified. In most medical offices, accounting is also computerized; it helps you keep the daily records of the financial transactions. It also can reduce the chances of money related frauds because all the data is stored into a computer and can be used for future reference. Computers also help in recording the names and contact details of the doctors and associated people and also the patients. It is useful when it comes to recording the medical history of the p atient, such as, previous treatments and tests, diagnosis and symptoms, surgeries, etc. Such informationShow MoreRelatedComputer and Medical Field3625 Words   |  15 Pagesï » ¿ No Content Page 1 Introduction 2 2 History 3 3 Computer Software 4 4 Computer Hardware 6 5 Function and Application In Medical Field 8 6 Advantage 10 7 Disadvantage 12 8 Precaution 13 9 Conclusion 16 10 Reference 17 INTRODUCTION The first use of the word â€Å"computer† was recorded in 1613 in a book called â€Å"The yong mans gleanings† by English writer Richard Braithwait. It referred to a personRead More Computers In Medical Field Essay971 Words   |  4 Pagesthings in history that have influenced our lives more than a computer. Today, there cannot be any field that is absent of the influence of computer applications. From farming to rocket science, computers have a huge role to play. The use of the computer has been on the increase for some time in many fields. Medicine is one of the many fields that have made tremendous strides in the twentieth century due to the advent of computers. Computers are used in medicine in almost all areas. Whether it isRead MoreBrain-Computer and Brain-Machine Interfaces Applied to the Medical Field1780 Words   |  7 PagesOver the years, brain-computer interfaces (BCIs), or brain-machine interfaces (BMIs), have advanced into a technology that can be regularly be applied to the medical field. BCIs have been used for rehabilitative purposes, such as patients suffering from loss of speech and motor functions. Every year, approximately 795,000 people suffer a stroke. Out of these people, 600,000 of these are first attacks and 185,000 are recurrent attacks [9]. Stroke patients often suffer from paralysis and loss of speechRead MoreTechnology And The Medical Field Essay1404 Words   |  6 Pagesbeings more than the computer. There c annot be any field devoid of the effect of computer applications ranging from education, agriculture, and security; computers play crucial roles in all sectors. According to Silva (1), the introduction of computers in the medical arena has brought about transformative effects on how medical practices are being conducted and method of provision of health care. From medical procedures, patient diagnosis and administrative tasks, computers have simplified servicesRead MoreImportance of Computers in Medicine794 Words   |  4 PagesComputers play a key role in almost every sphere of life. They facilitate storage of huge amounts of data, they enable speedy processing of information and they possess an inbuilt intelligence, which if supplemented with human intellect, can work wonders. 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There are particular skills needed to do well in this, which include being well-organized, good communicationRead MoreEssay on Use of Computers in Medicine919 Words   |  4 PagesUses of Computers in the Medical Field By: Tashauna Roberts Introduction In today’s society, there is a wide range of computer use. Almost everywhere you go today you are required to have some sort of basic understanding of how a computer is operated. In my report, I am going to tell you how computers are used in the field of medicine. There is a wide variety of use and need for a computer in the medical field. Their uses include storing patient related data, scanning and imaging the body, andRead MoreThe Impact of Computer Science on Health Care Medicine1283 Words   |  6 PagesThe Impact of Computer Science on Health Care amp; Medicine Abstract Computer science can be defined as the systematic study of algorithmic processes, their theory, design, analysis, implementation and application. Its functions in the modern society today expand far beyond the uses one could even begin to imagine. Specifically, there is an increased influence in its practical application in the field of medicine. In recent times, an interdependent relationship between medicineRead MoreUse of Computers in Education1199 Words   |  5 PagesUse of Computers in Education Computers have become an inseparable part of our lives to a great extent. Particularly in the field of education, their uses are manifold. Let us understand them further. Over the years, computers have changed the way the world works. They have proved to be an asset not only for the corporate sector, but also in other sectors such as medicine, architecture, communication, research, sports and education. Speaking of which, computers have taken over the field of educationRead MoreAre we too Dependent on Computers?1091 Words   |  4 Pagesdependency at the same time, one may directly think of computers due to their remarkable capabilities to make humans dependent on them because these machines reduce work pressure as well as the time needed to finish a specific task. Computers are programmable machines, their main characteristic is responding to a specific set of instructions (Wikipedia). It is arguable that computer dependencies is not as bad as some think. Noticeably, computers play a huge role in supporting humans to overcome daily