Pharmacokinetics and pharmacodynamics of oral Metoprolol Essay Example for Free

Pharmacokinetics and pharmacodynamics of oral Metoprolol Essay The patient, Roger Smith, is a forty year old man and came to the doctors office yesterday morning presenting a chief complaint of on and off headaches. Every now and then he felt dizzy and would complain about blurred vision. He mentions that he does not have any allergies to food or medicines. He admits that he doesnt do any regular exercise. He favors salty food and eats plentiful of it everyday and prefers to drink alcohol two to three times per week. He was an only child and both his father and mother are deceased. The patients mother had hypertension and so did his mothers father. When he was a child he only had varicella zoster. He also mentioned that he sought medical attention a year ago and was diagnosed with essential hypertension. After that, the patient did not visit his previous doctor for a follow up on his medical health. The patient confesses that he did not follow his previous doctor’s prescription. Dr. Robert Jones, took the patients blood pressure and it read as 140/90 mm Hg. The patient was asked to undergo laboratory test for the patients blood creatinine (National Kidney Function, 2008). On the following day, Dr. Robert Jones, measured the patient’s blood pressure again and it read 140/90 mm Hg. The patient told the doctor that he took note of his blood pressure several days ago and it also had the same reading and it never went down. The doctor asked the patient to present him the laboratory result for the patients glomerular filtration rate. The glomerular filtration rate is the test to measure the patients kidney functions level. It is important to find out what the result is to prevent the progression of a kidney disease due to hypertension (National Kidney Function, 2008). The patients glomerular filtration rate value (GFR) was 72 mL/min/1.73 m2. The doctor interpreted to the patient that his glomerular filtration rate is normal and his kidneys are not affected yet by the hypertension. The GFR is calculated by the serum creatinine of the patient which is 1.4 mg/dL, the age of the patient is forty years old, the patients race is African American and the gender is male. The normal glomerular filtration rate value is 70  ± 14 mL/min/m2 for the male and 60  ± 10 mL/min/m2 for the female (National Kidney Function, 2008). The doctor explained that essential hypertension or primary hypertension is the blood pressure thats consistently higher than the normal value, 120/80 mm Hg, and there is no cause found for the high blood pressure. It can be controlled with normal exercise, a well-balanced diet, proper treatment and constant monitoring of the blood pressure. If it is left untreated, it will lead to heart attack, heart failure, damage to the kidney and it might cause the patient to lose his vision. (PSMHMC, 2006). The patient needs to lower the systolic and diastolic blood pressure (BP) to treat his hypertension as this is an important cardiovascular risk factor (Koenig, 2001). The doctor educated the patient to maintain his weight level near to the normal and eat a well-balanced diet. He was instructed to limit the salt intake everyday to 2,000mg or even lower. Exercise regularly and avoid drinking too much alcohol and limit the intake of caffeine. All these are needed to be followed to control the blood pressure. The patient was also educated about taking care of his blood pressure because it will cause the kidney to fail. In order to prevent this from happening, his blood pressure must be controlled (DailyMed, 2006). The doctor prescribed the patient to take metoprolol tartrate 100mg for the first four weeks and then increased the dose to 200mg for another four weeks. The patient is instructed to orally take metoprolol once daily (Koenig, 2001). Metoprolol is a beta-adrenergic blocking agent that decreases the heart rate, decreases the contraction force of the heart muscle and it lowers the the blood pressure. Metoprolol targets the sympathetic nervous system by blocking its action in order to stimulate the heart beats pace. (Hildemann, et. al., 2002). The doctor further explained that metoprolol helps relax the blood vessels and will help the heart beat at a more regular rate. In this way, high blood pressure is reduced. Other heart diseases, for example stroke or heart attack will be prevented (Koenig, 2001). The medicine is taken through the mouth and will pass through the digestive tract before it can reach the bloodstream for absorption. The onset of action of metoprolol as an anti-hypertensive if taken orally is 1 1/2 to 4 hours. It will last for ten to twenty hours and will be absorbed at a percentage of 95%. For its metabolism, it is extensively hepatic through CYP2D6; significant first-pass effect. The half-life elimination period is three to four hours (Koenig, 2001). Metoprolol will be excreted through the urine with the percentage of 3% to 10% as an unchanged drug (DailyMed, 2006). According to the explanation of the doctor, metoprolol is metabolized in the liver by the cytochrome P450 2D6. Therefore, metabolization of the drug depends on the genetic polymorph that determines the hepatic hydroxylation rate. Metoprolol is excreted by the kidney as metabolites and is absorbed within seventy-two hours by glomerular filtration. The patient is further informed that while he is taking metoprolol, he is advised not to take in any other medicine. He should follow the correct dosage at the right time, in other words, the patient is not allowed to change the dosage or the time hes supposed to take the medicine. The medicine should not be taken in with an antacid (DailyMed, 2006). The patient will feel fatigue or dizziness. He should inform the doctor any changes like unusual weight gain or muscle fatigue, swellings of any part the extremities, constipation or should he develop a cough. The patient should maintain a blood pressure of less than 140/90mm Hg. He should take his pulse prior to taking metoprolol orally. The patient will be able to keep himself healthy and fit if he continues to follow the doctors prescription. The systolic and diastolic blood pressure (BP) will be lower when the patient follows the intake of metoprolol as prescribed by the doctor (Koenig, 2001). After eight weeks, the patient came to visit Dr. Robert Jones and had his blood pressure is already 120/80 and his glomerular filtration rate value remains at the normal level. The patient is instructed by the doctor to constantly maintain a healthy diet, regularly exercise and take note of his blood pressure everyday (Koenig, 2001). References: Dailymed (2006). METOPROLOL TARTRATE and HYDROCHLOROTHIAZIDE   Ã‚  Ã‚  Ã‚  Ã‚   TABLETS, USP50 mg/25 mg, 100 mg/25 mg and 100 mg/50 mgBeta   Ã‚  Ã‚  Ã‚  Ã‚   Blocker/Diuretic Antihypertensive. Retrieved February 8, 2008, from   Ã‚  Ã‚  Ã‚  Ã‚   http://dailymed.nlm.nih.gov/dailymed/fda/fdaDrugXsl.cfm?id=2522type=display Indian Journal of Pharmacology. (2008) Metoprolol Pindolol: A comparative study in   Ã‚  Ã‚  Ã‚  Ã‚   essential hypertension. Retrieved February 8, 2008, from http://www.ijp-online.com/article.asp?issn=02537613;year=1990;volume=22;issue=2;spage=85;epage=88;aulast=Gugli;type=0 S.K. Hildemann, H. Fischer, D. Pittrow, V. Bohlscheid (2002). Metoprolol Succinate SR Plus  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚   Hydrochlorothiazide (Beloc-Zok ® Comp) in Patients With Essential Hypertension in   Ã‚  Ã‚  Ã‚  Ã‚   General Practice. Medscape Today. Retrieved February 10, 2008, from   Ã‚  Ã‚  Ã‚  Ã‚   http://www.medscape.com/viewarticle/444414_1 Penn State Milton S. Hershey Medical Center College of Medicine (2006). Essential   Ã‚  Ã‚  Ã‚  Ã‚   Hypertension. Retrieved February 10, 2008, from   Ã‚  Ã‚  Ã‚  Ã‚   http://www.hmc.psu.edu/healthinfo/e/essentialhypertension.htm National Kidney Function (2008). Glomerular Filtration Rate (GFR). Retrieved from   Ã‚  Ã‚  Ã‚  Ã‚   February 10, 2008, http://www.kidney.org/kidneydisease/ckd/knowGFR.cfm Wolfgang Koenig, on behalf of the Multicentre Study Group, Department of Internal   Ã‚  Ã‚  Ã‚  Ã‚   Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany   Ã‚  Ã‚  Ã‚  Ã‚   (2001). Efficacy and Tolerability of Metoprolol Tartrate in Patients With Mild-to-   Ã‚  Ã‚  Ã‚  Ã‚   Moderate Essential Hypertension: A Randomised, Double-Blind, Multicentre   Ã‚  Ã‚  Ã‚  Ã‚   Trial. Retrieved from February 10, 2008, from   Ã‚  Ã‚  Ã‚  Ã‚   http://www.medscape.com/viewarticle/406240

Benefits of Systems Thinking

Benefits of Systems Thinking INTRODUCTION Systems thinking is a well organised approach of understanding the dynamic relationship between components of a system, so that we can make better choices and avoid unintentional consequences. It’s a conceptual framework for problem-solving which understands and considers the problems in their entirety (Hall, 1999 and Senge 1990). In other words, it can be defined as a view which looks at the ‘system as a whole’ first with its fit and relationship to external environment being a primary concern as compared to the constituent elements that make up the system (Morgan, 2005). It can be used to understand how systems work and how individuals can deal with them, while looking for patterns of interaction and underlying structures which shapes the systems behaviour. As system is a combination of several parts people who understand systems thinking keep one eye on the big picture (i.e. system as a whole) and one on the detail (i.e. constituent’s components), as the y recognise that problem in one part of the system can impact other parts and forces patterns of behaviour in the system that lead to crisis (Morgan 2005). Systems view is a way of positioning and looking into an organisational or systems issue where system boundaries are to be set to determine what parts are contained inside the system and what parts are considered external environment. The environment will certainly influence the problem solving capabilities of the system, but it’s not the part of the whole system (Ackoff, 1971). Outcomes will depend heavily on how a system is defined because system thinking investigates relationships between various parts of the system and its external environment (Montano et. al, 2001). ADOPTION OF SYSTEMS THINKING A number of methods, tools and principles cover the concept of systems thinking with a common goal of understanding relationships within the system, as systems thinking works on the hypothesis that there are certain evolving properties of systems that do not exist when systems are disintegrated into individual parts. For example consider a driver who is constantly hitting red lights on the road. If the driver is only noticing one part of the system i.e. red lights, then he will simply decide to speed up to in-order to make the next light before it turns to red. But, if he considers other parts of the system i.e. his car, condition of the road, driving style and the distance between two lights, he will notice that every time he tries to speedup to make a light, it changes to red. His speed is tripping the lights to force him to drive slower. So if he is observing this pattern, he can simply reduce his speed to drive thorough all green lights. In systems view, the focus spreads in a variety of different directions compared to the conventional linear style of thinking. It focuses on processes, patterns and relationships and their flow and movement and puts much emphasis on understanding the effects of the interactions in the system as opposed to putting efforts to predict the outcomes (Morgan, 2005). It’s argued that the emphasis on systems view should begin when a project is started and should continue till the final lessons have been learnt even after completion (Stewart and Fortune, 1995). Advantages of Systems Thinking Adopting a view of system thinking can complement conventional styles of research in projects in certain ways: It suggests different levels of analysis and synthesis for different kinds of problems, ranging from the simple activity levels to the more complex hierarchical levels. Systems thinking complements reductionism (the principle that everything can be reduced to its individual parts), analytical analysis (breaking down a system to its smallest components), cause and effect thinking (environment-independent, linear but without feedback loops, closed and defined boundaries), complete determinism (illusion of control) with complexity (a sub-system of larger network), blended structure (explaining the whole system in terms of functions and inter-relationship between parts), circular contributing effects (explaining external environmental influences, performance and feedback) and belief in uncertainty which leads to probabilistic thinking (Schiuma et.al, 2012). It provides a conceptual framework which utilizes different theories, tools and techniques like the Soft Systems Methodology (SSM), which helps in constructing a holistic, reliant perspective and practise aimed at disclosing the relationships characterizing a system (Joham et al., 2009 and Pourdehnad, 2007). Such approaches use a non-linear model where different elements are connected through cyclical rather linear cause-and-effect chains. This shows how a system is structured and also shows the nature of interactions among components of the system, which helps in understanding the behavioural patterns characterizing the system under investigation (Schiuma et.al, 2012). Having a reductionist thinking tends to push the project towards a closed systems view of the environmental i.e. the different phenomenon could be explained as individual and isolated events, which shows that the system and the context are separate, deterministic and predictable. In addition, the casual relationship between different elements is linear in the sense that A affects B which affects B, so such a approach can be used as a process or procedure to track and access results and performance on a operational level rather than on a broader system level. Project managers can use systems thinking to assist them in the scoping of a project where the project and its relationship to the environment are examined to underline potential risk areas and also to look at the project performance and thus to facilitate organizational learning (Stewart and Fortune, 1995). Disadvantages of Systems Thinking Although adoption of systems thinking/view is beneficial in some aspects while executing consulting projects, there are still certain problems which are associated with this approach. Some of them are as follow: Concept of systems thinking totally ignores or much worse destroys the most important aspects of human systems, for e.g. the interconnections or inter-relationships amongst and between the constituent sub-systems (Morgan, 2005). The project and its sub-tasks are totally ignored. Reductionism is no longer appropriate for dynamic projects which comprises of mostly human activities. It encourages fragmentation and isolation of the project which causes undue concern with the individual project activities or sub-systems. This method is makes us smart in micro-level thinking with regard to projects whereas on the other hand it’s allowing us to be dumb on the macro-level analysis. Under this thinking the project management loses the capability of making sense of how and why things work in a certain patter/manner. Reductionism can’t be implemented in every project. It tries to deal with the issues of the project one at a time, which leads to the problem of backing up which make things much worse. Also it is not helpful in dealing with multiple or delayed causality, as it is leading us to the simplistic way of thinking where individuals instead of focusing on the core problem focus on ‘either-or’ choices and blame mentality (Morgan, 2005). The simple approach to cause and effect can’t be implemented in consulting projects with high level of complexity, as it can’t keep up with the complexity of the project. As systems thinking focus on dealing with symptoms of the problem, interventions aimed at fixing things can end up sometimes making things better in the short run but worse in the long term. The over-reliance on reductionism will create an imaginary environment in which individuals think that prediction and control are the usable approaches to deal with complex projects. Endless varieties of tools and frameworks would be applied to ensure project success and when all such things fail they will try to explain the causes of system failure using the reductionist explanations of personal failure, resistance to change etc. So, the cycle goes on repeating itself and people, organisations get trapped into fixes which are doomed to fail. Having a systems perspective enables the project to exert control over people and its processes. But such a view tends to act against innovation and adaptation which are fundamental qualities for long-term effectiveness. Adopting a systems view can threatens some of the established policies and procedures in managing consulting projects, for e.g. in areas like monitoring and evaluation, performance management and assessment. Most of the practitioners have doubted its operational use, as it has not provided specific answers to the cases when the system has encountered problems. Some of its ideas such as emergence can be unattractive with project management teams, who are constantly under pressure to give results in short run. Systems view can also have a disengaging effect on people and organisations that are used to a structured system where projects are planned and targets are met. So, adopting a system thinking view can increase the effect of uncertainty in project consulting and management rather than reducing it. System thinking can also be demanding in terms of intellectual resources as it requires multi-disciplinary approaches to handle wide range of issues and patterns. It requires a significant investment in terms of skills, organisational structure where people are trained across a series of interrelated issues to make systems thinking work, because if they give up on the practise of systems views they will probably get back to much easier conventional approaches (Morgan, 2005). Conclusion The implications of systems thinking can be far reaching as it’s not clear how it will fit with other methods of analyzing situations. Questions will be asked about its contribution to monitoring and evaluation as the some of the sub-systems may be inadequate in generating data needed for analysis which leads to reluctance in trusting the conclusions (Morgan, 2005). Though it’s best in synthesis, it needs help in terms of practical analysis, so the question arises that can it supplement present methods of doing things or does it have to replace them in some way? In conclusion, adopting a systems view can contribute in planning and controlling the complexity and uncertainty by embedding flexibility in consulting activities. When implemented and aligned properly, systems view can alleviate the flaws present in the existing frameworks to produce a more general framework which includes both prescriptive and descriptive elements (Montano et. al, 2001). Also, it facilitates the links between project management initiatives and the strategic goals and objectives of an organisation helping in maintain a clear vision of what is being done and why it is being done (Ackoff and Emery, 1972).

Impact of HIV on Society

Impact of HIV on Society The human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pandemic is one of the most serious contemporary sexual health related issue affecting the human race today. By the end of 2009, it was approximated that 34 million people were living with the HIV virus and deaths related to AIDS were about 1.8 million people. HIV/AIDS has been the worst pandemic since its discovery; having claimed over twenty five million lives by 2005 with the Sub- Saharan Africa being the most affected (Douek, Roederer Koup, 2009). This paper focuses on the impact psychosocial, cultural and economic of HIV/AIDS and its related sexual health problems on the individual as well as the community. HIV/AIDS has a huge impact on the infected individuals family unit and the community they live in. The impact is dependent on the mode in which the virus is transmitted among communities (and who it infects), the diagnosis of infection, and the community setting in which the individual and family live. Introduction Human immunodeficiency virus (HIV) is a retrovirus that causes acquired immunodeficiency syndrome (AIDS). Two strains of the virus, HIV-1 and HIV-2, have been described. AIDS is a human disease in which there is gradual failure of the bodys defence (immune) system thereby leading to severe and fatal opportunistic infections and cancers (Douek, Roederer Koup, 2009). Infection with HIV occurs through coming in contact with infected body fluids such as blood, breast milk, and sexual fluids such as pre-ejaculate, semen and vaginal fluids. The key modes of transmission are unsafe sex with infected person-both heterosexual and homosexual, contaminated items such as needles and razors, breastfeeding, and infected mothers infecting the newborn during birth. Blood and blood products screening for HIV has greatly eradicated infections transmission through infected blood and blood products transfusions. HIV eventually progresses to AIDS; the individuals mostly succumb to opportunistic infectio ns or malignancies resulting from progressive weakening of the immune system. Different individuals infected with HIV develop AIDS at different rates depending on the host, viral, and environmental factors; many develop to AIDS within ten years but in some it may be earlier or later. There is no cure for HIV/AIDS; treatment involves life-long use of a combination of anti-retroviral drugs and a cocktail of other drugs to treat any opportunistic infections (Douek, Roederer Koup, 2009). Infection with HIV usually has a huge physical, mental, social and economic impact on infected individuals, their families as well as the community in which they live. Stigmatization by other community members aggravates this impact; it hampers the prevention and management of HIV and impedes social support and disclosure of HIV status. The family units mostly affected by the HIV scourge are those of low socioeconomic status, such as drug users, asylum seekers and emigrants. The long-term impacts of living with HIV due to invention of better HIV care and management such as HAART (Highly Active Anti-Retroviral Therapy) have also evolved and changed many social aspects such as parenthood, disclosure HIV status and long term effects of the use of HAART on the individual. Another impact of the HIV is depicted in the inequality and discrimination individuals living with HIV experience when it comes to matters such as securing or sustaining employment and vital services like life assurance . Children have been known to bear the greatest impacts of HIV especially those orphaned and those infected with HIV. The number of orphans has been on steady rise due to AIDS-related deaths of the guardians and the fact HAART is ensuring infants born with HIV can live with the virus till they reach adolescence or beyond. All these factors collectively affect the community around them both socially and economically. The Physical, Psychological and Social Impact of HIV on Individual and Families Infection with HIV/AIDS leads to numerous bodily, mental and social issues that affect the individual and impacts on their families and communities at large. In the contemporary society, the definition of a family shifts from the traditional structure of biologically related members to include socially chosen relationships, for instance, close friends, partners, and close external family relationships such as homosexual men (Green, 2011). Before the discovery of anti-retroviral drugs, infection with HIV meant death within a short period of time. However, after the invention of HAART over a decade ago, there has been a gradual decline on the number of individuals succumbing to AIDS-related diseases in Australia, Europe and the United States. Currently, families have to deal with HIV infection as a chronic disease to be coped with for the life span of the infected individuals (Zuniga, Whiteside and Ghaziani, 2008). The requirement to take complex regime of many drugs is the foremost bu rden for the HIV-infected individual; many patients suffer anxiety, frustration, depression and hopelessness especially when the drugs do not accomplish or maintain the perceived benefits expected from the treatment regime. This could be due to virus mutation and individual resistance to the drugs (Zuniga, Whiteside and Ghaziani, 2008). It is documented that even when the treatment is effective, patients have other form uncertainties and distress. The impact of the HIV treatment is further aggravated by other factors such as worry about employment, sexuality, the prospects of relationships, and the social reactions of other community members. HAART has numerous side-effects, such as cardiovascular diseases and several of which have psychosocial consequences like lipodystrophy (Zuniga, Whiteside and Ghaziani, 2008). Members of the family may also be burdened by giving care to the infected as the disease advances, and they may be distressed by the stigma often associated with HIV infection. Another impact of HIV is the stigma and discrimination against persons living with HIV/AIDS. Apart from having to endure treatment with severe side-effects, they constantly have to cope with rejection and social discrimination. People with HIV/AIDS have to put with being labelled as victims a term that implies defeat, helplessness and dependence upon help from othersÂÂ  (Matic, Lazarus Donoghoe, 2006). The forms of stigma and discrimination vary geographically. Many nations have regulations that control the travel, entry and residence of persons living with HIV/AIDS. By the end of 2010, individuals living with the virus were restricted on long stays of over three months in sixty countries and eighteen of these even applied limitations on short term residence (Stutterheim et al, 2009) In healthcare sector, the common examples of stigma and discrimination experienced are being denied access to facilities and drugs, mandatory HIV testing without individual consent, and breach of c onfidentiality over the persons status. In the workplace, stigma from employers and fellow workers include social isolation and mockery, or experience biased practices, such as dismissal or denial of employment (Stutterheim et al, 2009). Others instances include denial of entry into a country, forced eviction from residence by their families and rejection by colleagues and friends. Stigma and discrimination associated with HIV/AIDS greatly hinders efforts to successfully battle the HIV and AIDS pandemic. This fear of discrimination frequently averts individuals from seeking treatment and management of AIDS or from publicly disclosing their HIV status. On numerous occasions, the stigma associated with HIV/AIDS can extend to the family and siblings of the infected individual, creating an emotional burden on those left behind. HIV/AIDS-related stigma modifies over time as infection levels, understanding of the disease and treatment availability vary. For instance, in the Netherlands, the community response to persons with HIV/AIDS is quite positive; understanding of HAART was linked to perception of lower risk, with a positive attitude towards gay people, less fear, and a greater readiness to have personal contact with people with HIV/AIDS. However, in Eastern Europe, discrimination may be more severe, particularly of specific groups, such as gays (Stutterheim et al, 2009). Economic Impact of HIV HIV/AIDS has had the greatest negative effect on the economies of many countries all over the world. The pandemic has been devastating for many nations where it has caused deep poverty both to the individual, families and community. The magnitude of economic and demographic impact of HIV/AIDS infection in third world countries is pronounced due to the fact that it affects persons in the most economically able and productive age. Besides, it is also weighing down on the economic and health gains made in the last few decades. People with HIV/AIDS create a profound burden for public finances, especially in the sector of health. In a number of Caribbean countries, HIV/AIDS patients take up as many as a quarter of existing hospital beds (Green, 2011). The sub-Saharan Africa is the most affected with southern Africa leading with the effects of the virus. The World Bank approximation shows that gross domestic product (GDP) of South Africa reduced by twenty percent in 2010 due to the effects of the deadly virus (Salinas Haacker, 2006). Many other countries are using huge portion of their economic resources in providing treatment and care for people with HIV/AIDS. A research carried out by the University of the West Indies shows that the GDP of countries such as Trinidad and Tobago will drop by over five percent and that of Jamaica by 6.4 percent as a result of HIV/AIDS. The economic impact is poverty, a reduction in investments and savings, and rise of unemployment in vital industries such as agriculture and manufacturing (Salinas Haacker, 2006). The economic impact of HIV is greatly felt by the individual and their families. HIV/AIDS in many cases results in loss of income of the breadwinners and increase in expenditures as a result of caring for the infected. Families affected by HIV deplete their savings and assets in order to cope with increased expenditure and income shocks. Firm profits, savings and investments may reduce due to increase AIDS-related expenditure and lower labour productivity (Whiteside, 2008). According to ILO estimates, close to thirty seven million persons worldwide who are engaged in productive economic activities are HIV-positive. The mortality of these adults leaves the children as orphans and in cases where they were the sole bread winners; the children are left destitute (Green, 2011). Impact of HIV on Parenthood and Children The development of HAARTs has had an impact on pregnancy planning among people living with HIV. In the pre-HAART era, HIV-positive women were faced with their HIV status and the expected bleak outcome of death. The number AIDS-related deaths, however, has drastically gone down in women living with AIDS due to HAART; they now live longer healthier lives. Among the women in the reproductive age who are living with HIV, the decision about pregnancy is becoming an important one; this due to reduction of the risk of vertical transmission of the virus to the newborn (Noroski, 2009). Gains in prevention of mother to child transmission have led to emergence of new dimensions in the way communities view parenthood. Parenthood in HIV infected people is still eliciting many physical and social effects especially due to stigma and discrimination associated with the virus. Noroski (2009) outlines that concerns that might determine parenting decisions among people living with AIDS are the aspirati on for parenthood, religious beliefs, children one had before, the position of spouse and health care providers, and apparent spouse capacity to parent successfully. HIV/AIDS has greatly changed parenthood. Research findings shows that close to seventy percent of all HIV infected parents regarded their family planning to be over, since they did not plan bear any more children, sixteen percent were undecided, while fourteen percent had an explicit longing to have more children (Wacharasan and Homchampa, 2008). Children who are infected with HIV either during birth or later through breast milk now have a chance to survive up to adolescence owing to better treatment regimes. This means that more adolescents increasingly have to cope with the virus. Children living with HIV/AIDS have a high risk of death from opportunistic infections. The virus affects the children psychologically and leads to neurological impairment; as a result they have pronounced cognitive insufficiency or diminished cognitive abilities, have behavioural difficulties, and have a general low quality life. Children living with HIV may also experience challenges in leading a normal life due to the medication they must use regularly as well as problems that result from disclosure of their HIV status (Noroski, 2009). The other main impacts of HIV on motherhood are ethical concerns about the possible danger of spreading the virus to the newborn, the socioeconomic impact, concerns and stigma associated with bringing up a child by a parent who has a potentially fatal disease. The HIV/AIDS pandemic has greatly contributed to increase in the number of orphans universally. In Africa alone, there are over twelve million children orphaned by AIDS pandemic. The children are left destitute; at times the elder adolescents have to take up the parenting roles while majority are taken care of by their extended family members or foster parents. This long term care causes economic difficulties as financial resources are strained. The children become fully deprived of the care, guidance and protection of their parents and social problems begin to crop up. The children find themselves prematurely out of school. Statistics show that many of these children have to drop their education due to lack of resources, stigma and discrimination or simply to take up the role of premature parenting resulting from death of their parents. These effects are more pronounced especially after death of both parents. HIV/AIDS in the long term leads to numerous social impacts on the communit y such increase in crime rates, poverty, drug abuse, illiteracy, reduced productivity and eventual collapse of social system. Impact of HIV on Caregivers and Healthcare Sector The major burden of caring for the people living with AIDS rests with the family and the health care providers. In the era before anti retroviral therapy, this used to be an immensely stressing task because most of times the health of the infected patients deteriorated rapidly, they were bedridden and has to be taken care of. The advent of HAART has greatly improved the need for round the clock help since the patient can now lead a healthier life without need for much help. Important care givers are mainly the family, close friends and health workers. The major impact of HIV on the caregivers is stigma; usually referred to as secondary stigma or stigma by association. Parents of people living with HIV may be held responsible for the immoral behaviour that led to infection of their children with HIV. Wacharasan and Homchampa (2008) reported stigmatization as a primary concern for the caregivers. Rather than face stigmatization, caregivers may try to conceal their care giving activities by withdrawing from social relationships. In clinical practice, family caregivers may exacerbate demands of care giving by driving long distances to avoid community awareness of their care recipients HIV status. Some informal caregivers even avoid employing the professional home services of home health care, infusion therapy hospice, and hospice providers to avoid HIV/AIDS disclosure in their communities. Nurses working with informal caregivers fearful of status disclosure must be sensitive to the familys caregivers fear of discrimination and stigma (Wight et al, 2006). Nurses, knowledgeable of HIV friendly referral agencies with well established histories of providing confidential services can play a role in meeting the need for professional home-centred services and bringing solace to an informal caregiver fearful of HIV stigmatization. Caregivers of HIV-infected children also face stigma. Thampanichawat (2008) found primary caregivers of children with HIV infection dealt with the stigma of AIDS while managing their anxiety and fear of loss. Bore much burden of care and faced many difficulties because of limited resources. Similar studies report increased financial difficulties, problems in child care and support and compromised help-seeking due to stigma. These findings emphasize the need to develop interventions to enable caregivers to seek out and identify financial resources and child care to support and empower caregivers to deal with stigma. Health care providers also may fears stigmatization in their work with HIV-positive patients. Caregivers, both formal and informal, commonly experience stigma from their association with HIV/aids and people living with it. This stigma may influence their willingness to work with those with HIV/AIDS or make their work more difficult. Conclusion Annually, across Australia and the world, many individuals get infected with HIV; thousands living with HIV develop AIDS. The impact of contracting and living with this virus hugely challenging and depends on the society the infected person lives in. The impact may determine the effectiveness of the management program, adherence to the treatment regimen and prevention of new infections. The major challenges are to encourage HIV testing for the risk groups, encourage status disclosure, availing a timely and effective management and care to all people living with HIV/AIDS, to endeavour in developing contemporary prevention methods that consider the variable patterns of the pandemic, and to eradicate the economic, physical and psychosocial impacts of HIV infection. Policies should incorporate the needs of individuals, families and the community in order to effectively address the impact of HIV on various sectors.

Confession :: essays research papers

con ·fes ·sion   Ã‚  Ã‚  Ã‚  Ã‚  Ã¢â‚¬Å"Forgive me Father, for I have sinned.† This simple phrase from Roman Catholic dogma conjures up images of famous Hollywood confessions and dramatizations, but the real root of the phrase has a much more obscure past. Not only found in modern Catholicism, the confession of sin, along with the confession of faith, can be seen in religious practices throughout the world. The simplest definition Webster gave the confession of sin is â€Å"a written or oral statement acknowledging guilt, made by one who has been accused or charged with an offense† (Bookshelf). However, Webster also recognizes the less thought of definition of the confession of faith as â€Å"an avowal of belief in the doctrines of a particular faith; a creed† (Bookshelf).   Ã‚  Ã‚  Ã‚  Ã‚  The double-edged meaning of the word â€Å"can be partially explained by the etymology† (Eliade 1). The word confession derives from the Latin word confiteor which means to â€Å"confess a sin or fault,† but in a more general since the word can also mean â€Å"to acknowledge or avow.† Thus, with the understanding of the Latin root, one may speak of the sinner who confesses his sin, or of the martyr who confesses his faith. Regardless of which usage is being applied, the religious rules of the confession must be followed. It must take place in front of a recipient, or one who hears the confession. â€Å"In many cases, it is preformed in the interest not only of the one confessing but also of the community to which both the confessing person and the recipient belong† (Eliade 1). With an understanding of the underlying meanings of the confession one may begin to explore the development of the phenomenon and its function in modern religion.   Ã‚  Ã‚  Ã‚  Ã‚  A common way to view the confession of sin is as one part of the entire sacrament of penance. The confession along with the elements of prayer, sacrifice, and penance lead up to the act of absolution or forgiveness ( Gentz 280). In early Christian religion the confession began as a â€Å"ritualized group avowal of sin as part of Sunday worship;† moreover, in Judaism it developed into the annual congregational confession of sins known as Yom Kippur, the Day of Atonement (Gentz 290). Both examples of early confession resemble today’s modern idea of publicly professing one’s faith and acknowledging one’s sins before a recipient, in this case being the congregation as a whole, but it wasn’t until later in Eastern and Western Christianity that the individual confession emerged.

The Cold War :: History, USSR, The Space Race

Imagine a world where everyone has nothing, this was the USSR during the Cold War. The Cold War was a 40 yearlong war between the USA and the USSR. The US and the USSR never had any direct contact, but what they did do was have "races". These "races† were the Nuclear Arms race and the Space race. The Nuclear Arms race was not so much an arms race as it was a defense race. This is because with both sides have nuclear bombs, both of them would have enough bomb power to retaliate (Hart 440) The Space Race was, as the name says, a race to see who could get up in space first. Amazingly nuclear arms helped fuel man to get up in space. The Cold War was a war between the USSR and the US. Even though they never fought directly there were many wars between democracy and communism. Most of the wars between 1950-1990 were part of the Cold War (BrianPOP). For example, the Korean War (1950-1953) and the Vietnam Conflict (1955-1975) are two well-known wars that happened because of communism. (Wikipedia). The Korean War was a war fought between North and South Korea. North Korea was Communist and Soviet backed, while South Korea was part of the UN (Dolan 9). Like the Korean War the Vietnam Conflict was a war fought between North and South Vietnam. Also like the Korean War the South was democratic while the north was communist (Wikipedia). Some of the wars fought between Communism and Democracy happened in a smaller scale. For example, in Germany 1938, the Soviet Union limited transport into the city of Berlin. Germany at this time was split into two sections, Democratic and Communism. The French, British, and America controlled the West, while Russia controlled the East (HowStuffWorks). The city of Berlin was divided between the two sections, East and West Berlin. In 1938, Stalin stopped transport into the city by putting up blockades, blocking all roads and railroads that led out of the city (Hart 438). Stalin was doing this to starve out the Allies so they would get out of the city. The Allies didn’t move, but what they did do was fly planes into the city of Berlin and dropped off food and supplies (Hart 438). Ten months later Stalin gave up on the blockade and took it down (Hart 438). During the Cold War, Berlin was hit again by the influences of Stalin.

Medicine and Mental Illness

K272 TMA01 Consider the usefulness of a holistic model in explaining the experience of mental health. A holistic approach to mental illness means that the user’s physical, mental and spiritual health along with the user s state of mind, lifestyle and social factors will all be taken into consideration when analysing them. Holism refers to treating the whole person. This means that holism feels disease doesn’t just affect the body, but also the mind and spirit as well. It’s said that the five dimensions are all inter related and so if one is c hanged then the other dimensions will all be impacted in some way or another. In a sense I feel that holism is practical as it explores several avenues in order to treat mental illness rather than the bio-medical approach which uses only one. The World Health Organisation (1946), define health in the following way ‘a state of complete physical, mental and social wellbeing and not merely the absence of disease and infirmity’. This definition of health supports both the medical and social models. In suggesting that wellbeing is the key to health the definition embraces the idea that in the treatment of illness all factors, social, mental and physical must be taken into account. If this definition is what professional’s base their treatment of mental health upon, then it could be seen that the medical and holistic models are intertwined and should in fact work in harmony. Yet one model holds dominance over the other. It is the medical model which is predominantly used in the treatment of mental health (Bentall, 2003) The Biomedical Model The bio medical model evolved as a response to diseases in the 19th century. German psychiatrists then used this model, based on their beliefs and not hard evidence, to categorize the symptoms of mental distress into distinct conditions, one of which was Schizophrenia (Bentall, 2003). The model suggests that mental health is an illness, characterised by specific symptoms that have a pathological base. This came about because research supported the notion that mental ill health was due to chemical imbalances, body dysfunction or injury (McCullough et al, 2005, Pritchard, 2006). However there is another suggestion that mental health is a hypothetical construct† (Boyle, 2002: 14). The fundamental focus of this model is that the individual is the source of their mental illness. Therefore the person can be treated and as with most illness the medical model will look at medication as the way forward (Beresford, 2005). Within this model the body is seen as a device rather than a person and as an appliance its functions will often need repair (Giddens, 2006). This thought process is damaging, it can encourage a poor relationship. When the ‘person’ becomes lost and is seen as a list of symptoms, they become stigmatised and labelled. This labelling can cause further mental distress and so more ‘symptoms’ may be seen (Thompson, 2006). The medical model sees mental illness as a brain malfunction, an imbalance, a set of symptoms, to restore mental health the medical experts will endeavour to adjust the imbalances with a variety of drugs. The use of drugs often does give a quick fix to some symptoms; however the use often creates a dependence, which may last until death (Harris et al, 2007). This dependence on drugs will give further credence to the medical model. Many researchers point out that this reliance on medication causes further mental distress, as the side effects can be many and enduring, adding further problems to those with a diagnosis of mental illness(Wallcraft, 2005,Usher et al, 2006). The Holistic Model As we know the holistic model is not the most popular model, it is however very important as it represents a way of thinking and understanding mental distress and gives a positive approach to working with and supporting people experiencing mental illness. Each person’s experience of mental illness is unique. Seedhouse (2000, pp 59-60) suggests that holism makes two main claims: that the whole cannot be fully understood separately and that they separate parts cannot be understood apart from the whole. Holism has many available methods including counselling, and congestive behaviour therapy. Although all of these aspects work together each promotes its own therapeutic power, which doesn’t really take a holistic perspective as it claims to. This can be very confusing and distressing for a user who has only ever encountered the biomedical model. A good example of this is (Taussig, 2002, p10) â€Å"the recovery from breakdowns has always been slow and painful, and each one has brought a different treatment ranging from C. B. T therapy to psychoanalysis. On each occasion when I called on the providers to help me out of the dark, each stood proudly alone protesting their own therapeutic power and efficacy†. Holism allows users to see how the body and mind are connected by letting them reflect. Reflection matters because it is continuous with practise. How you think about what you are doing affects how you do it, or whether you do it at all. It may direct your research or your whole attitude to people who do things differently, or indeed your whole life. (Blackburn 1999) However holistic approaches can bring the mind-body divide to the forefront as its been proven that reflecting on emotions can bring on physical distress such as raised heartbeat, headaches, and pains. Bringing supressed thoughts to the surface can also cause people to become dependent on such things as alcohol and drugs which need some biomedical intervention. Mind-body relations are always mutual and bidirectional-the body affects the mind and is affected by it. mind and body are so integrally related that, in practise], it makes little sense to refer to therapies as solely â€Å"mental† or† physical†, rather mind-body could perhaps be best regarded as an overall process that is not easily dissected into separate and distinct components or parts. (Seedhouse 2002, p55). . Whilst there are arguably opposing principles within the medical and holistic model it can be suggested that the diversity can be productive. There are aspects of both models that may help with the diagnoses of mental illness. The bio medical model through research will continue to strive for a specific, pathological base. Medicine aims to prevent mortality, with a high incidence of morbidity within the group of people diagnosed with mental illness, on-going research is a must (Muir-Cochrane 2006). The holistic model will strive to ensure, that the person with mental distress will have an individual programme tailored to their needs and therefore a selection of treatments may be the answer. The Hippocratic Oath which is fundamental in medicine suggests that interventions delivered from the medical profession of which psychiatry belongs ‘do no harm’ Sokol (2008). If the so called experts used the model to treat service users with a diagnoses mental illness in a way that caused no harm they would strive to ensure that when assessment was undertaken all aspects of the medical and holistic models of mental distress would be taken into account. The complex nature of mental illness would be identified and a more impartial framework of support could be supplied. It could look at solutions and ways of coping, rather than problems and illness. It would value the service user with mental distress, building a relationship and remembering that ‘mental illness’ it is not just an illness, a list of symptoms, there is a person present that needs to be respected. Perhaps the unification of these two models would enable the treatment for mental illness to be more people centred and unique. Service users could define what help was needed, and the balance of power would be with the expert. (Warren, 2007). References Beresford, P. (2005) Social Approaches to Madness and Distress: User Perspectives and User Knowledge, In J Tew (Ed), Social Perspectives in Mental Health: Developing Social Models to Understand and Work with Mental Distress, London: Jessica Kingsley. Bentall, R. P. (2003) Madness Explained: Psychosis and Human Nature, London: Penguin. Blackburn, (1999) Bowen, P. (2007) Blackstone’s Guide to the Mental Health Act 2007, Oxford: Oxford University Press. Boyle, M. (2002) Schizophrenia: A Scientific Delusion, London: Routledge. Giddens, (2006) Harris Et Al (2007) McCullogh Et Al (2005), Pritchard (2006) Muir-Cochrane (2006) Seedhouse (2000 P59-60) Seedhouse (2002 p55) Sokol (2008) Thompson (2006) Toussig (2002 p10) Usher Et Al (2006) Warren (2007) Word Count -1750 including references

Louis Vuitton Malletier V Dooney & Bourke Inc

Louis Vuitton Malletier v Dooney & Bourke Inc. In this famous case known as the â€Å"Battle of the Handbags† Louis Vuitton (LV) sues Dooney & Burke (D&B) for trademark infringement of its multicolore line. The Plaintiff, Louis Vuitton Malletier ,is a French fashion house founded in 1854 by Louis Vuitton. The famous label is well known for its LV monogram, which is featured on most of its products. Louis Vuitton is considered as one of the world’s most valuable and prestigious brands. The LV monogram was created in 1896 by Louis’ son Georges Vuitton who invented the symbol and the letters represent his father’s initials.The logo is a Japanese-inspired flower motif which initially was created as a way to prevent counterfeiting. This memorable logo is now synonymous with luxury, brilliance and indulgence. It is the world's 29th most valuable brand and is estimated to be worth over $19 billion USD. Unfortunately, Louis Vuitton is one of the most counterfeited brands in the fashion world due to its image as a status symbol. The company takes counterfeiting seriously, and uses all its possible resources to fight counterfeiting. The Defendant, Dooney & Bourke, is an American company founded in 1975 by Peter Dooney and Frederic Bourke.The company specializes in fashion accessories and is best known for its high quality handbags, accessories, and travel luggage. Their Signature and Mini Signature handbags consist of the â€Å"DB† initials interlocking in a repeating pattern. The founders of the company started off with two introductory products: surcingle belts and suspenders for men. Their products became very popular due to their unique design and color. Now Dooney & Bourke is a well-known brand in America and has a good reputation for making quality products. The defining look of Dooney & Bourke is elegant and sophisticated, but above all, it is timeless.Its classic designs make these handbags the perfect accessory for any outfit d ue to the superior quality and unique form. In 2002, the designer Marc Jacobs invited the Japanese artist Takashi Murakami to come up with a fresh take on the Louis Vuitton †toile monogram† famous entwined LV logo intermixed with flower shapes for a new line of bags. This led to the creation of the Monogram Multicolore design, in 33 colors, displayed on handbags in a repeating pattern against a white or black background. The bags made their debut on Paris runways in October 2002 and were then presented in prestige retail outlets in March 003, where they sold for up to $3,950. Previously LV registered its famous LV monogram design pattern and the individual unique shapes as trademarks with the United States Patent and Trademark Office. In July 2003 D in collaboration with Teen Vogue developed a new line of handbags for teenagers. It was launched as the â€Å"It Bag† collection. The pattern on the purses consisted of the entwined â€Å"DB† initials printed in contracting colors on variety of colored backgrounds and white and black background. D released handbag line looked similar to Louis Vuitton's trendy model, but the price was significantly lower.Considering the fact that Louis Vuitton fights counterfeiting very aggressively, not surprisingly, the matter ended up in the courts. LV immediately viewed the â€Å"It Bag† as a copy of their design. When Louis Vuitton gathered with legal counsel on their options to file suit against Dooney and Bourke, they became aware of the alternatives that were available to them in order to move forward. For designers and manufacturers in the American Fashion industry, there are four possible avenues to explore: 1) Copyright protection, 2) Patent protection, 3) Trade Dress protection and 4) Trademark protection.Copyright protection covers a range of categories including literacy, musical, dramatic, choreographic, pictorial and architectural works. Within this range, the only one that is applica ble to fashion designs is pictorial, as it shields two- and three- dimensional works. Patent protection shields any â€Å"new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof†. Since the design in the fashion industry rarely creates a new process, machine or manufactures, they have a separate statute specifically for them for new, original and ornamental design for an article of manufacture.Trade dress protection is addressed under the Lanham Act to defend the design and appearance of the product as well as that of the container and all elements making up the total visual image by which the product is presented to customers. Colors have also been addressed under the Trade dress protection in which the United States Supreme Court has stated that the color and designs of a product are only protected under the Lanham Act if a secondary meaning has been demonstrated.Color and design must be associated by the customer fo r that particular product over time. In 2004, the legal team decided to advance with option 4: Trademark protection. They claimed trademark infringement, trademark dilution, as well as unfair competition and false designation. Trademark infringement harbors a manufacturer or seller’s product to include a word, slogan or symbol. For instance, Apple is an example of a word that cannot be used in relationship with software or computers as it will cause confusion from a consumer’s perspective.Nike holds the trademark of the slogan â€Å"Just Do It† that is associated with its product and McDonald’s hold trademark of the golden arches symbol. In some instances this protection can extend to other properties such as its color or even its packaging. For trademark dilution claims, the distinctive quality of a mark must be diluted by blurring or tarnishment. However, the likelihood of confusion is not necessary. Unfair competition and false designation is character ized as likely to cause confusion, mistake or deceive the consumer.Section 43(a) states â€Å"any person who on or in connection with any goods or services, or any container goods, used in commerce any word, term, name or symbol, or device, or any combination therefore, or any false designation of origin, false or misleading description of fact, or false or misleading representation of fact which a) is likely to cause confusion, or to cause mistake, or to deceive as to the affiliation, connection, or association of such person with another person, or as to the origin, sponsorship, or approval or her goods, services, or commercial activities by another person, or (b) in commercial advertising or promotion, misrepresents the nature, characteristics, qualities or geographic origin of his or her or another person's goods, services or commercial activities, shall be liable in a civil action by any person who believes that he or she is or is likely to be damaged by such act. † In a ddition under sections 32 and 43(a) of the Lanham Act, trademark protection extends above the registered trademarks to the unregistered trademarks from misuse or reproduction in commerce. Once a trademark is established as fundamentally distinctive or to have developed secondary meaning, as well as protection under the Lanham Act, one can then address the likelihood of confusion under trademark infringement.Statutes require a sense of clear case situation as well as a specific element of which the claim can be proven as a violation of the law. This means that sequential evidence is needed, as this poses the validity of the claim and further makes the justification of the case. Without this evidence, the case could be deemed as void, as there is no possible evidence that can prove the claim. Statutes also require the clarity of the case, which means the details of the case or the violation should be given in chronological order so that the justifications set for the claim as well as the laws that could be used to make it more justified could be legally provided.There is actually a varied definition on how violations of laws happen. There are times when a crime committed may not be a violation of the law, or the violation of the law is not a crime. This happens when the crime being claimed is not part of the scope of the statute, or there is no existing law for such crime. Therefore this results in deliberating on whether the action indeed is a crime or a violation of the law. Situations such as this often arise from actions where the defendant is ignorant of the law which he has violated. In addition, the claimant can be the one who is ignorant of the law when he laid evidence on the ‘crime’ allegedly committed by the defendant.Now that we have a thorough understanding of the applicable laws, the rules that govern those laws and what are required by the statutes to prove a violation of law we can examine how the case unfolded. As previously stated, Vuitton filed suit against D&B in April of 2004 in the United States District court for the Southern District of New York, claiming trademark infringement, unfair competition and false designation, and trademark dilution. Vuitton moved for a preliminary injunction against D&B which would have stopped sales of the â€Å"it bag† until the case was resolved. The District court ruled in favor of D&B and Vuitton was not granted the injunction. In determining trademark infringement the court applied the two prong test required of Section 43 of the Lanham Act.First the test looks to whether or not the mark merits protection by determining if the unregistered trademark is distinctive or has achieved secondary meaning. In this case the district court did find that Vuitton’s design was distinctive and had garnered secondary meaning in the market place. The second part of the test involves deciding whether the defendant’s use of the mark is likely to cause consumers confu sion as to the origin or sponsorship of the defendant’s goods. Accordingly the court then examined the eight factors weighed in determining likelihood of confusion: 1) the strength of the mark, 2) the similarity between the marks, 3) the proximity of the roducts, 4) the likelihood that the plaintiff will bridge the gap between the markets of the two marks, 5) actual confusion, 6) the defendants good faith in using his or her mark, 7) the quality of the defendant’s product, and 8) the sophistication of the customers. The district court ruled that there was no likelihood of confusion based on its evaluation of the 8 factors and thus denied the injunction. In addition, the district court found that Vuitton was unable to prove trademark dilution. LV appealed the injunction denial to the Second Circuit Court of Appeals hoping to force the court into making a more broad judgment with regard â€Å"design piracy†. Unfortunately for Vuitton the court was not in the mood to make a statement in favor of protecting designers.Rather than make its’ own ruling on the case, based on the facts laid out before the court, the Second Circuit instead focused on a mistake by the district court in its application of the standard of likelihood of confusion. The Second Circuit had previously held in Louis Vuitton Malletier v. Burlington Coat Factory that courts must use a sequential market place comparison rather than a side by side comparison when applying the standard of likelihood of confusion. The district court had used a side by side comparison that the Second Circuit deemed improper. In addition, the Second Circuit agreed with the district court that LV was not able to prove trademark dilution at the federal level.In order to prove trademark dilution the plaintiff must demonstrate the following; â€Å"its mark is famous, the defendant is making commercial use of the mark in commerce, the defendants use began after the mark became famous, the defenda nts use of the mark dilutes the quality of the mark by diminishing the capacity of the mark to identify and distinguish goods and services†. Vuitton was able to prove the first three requirements but was unable to prove actual dilution. While the court did agree that LV could not prove actual dilution (the federal requirement) they vacated the injunction at the state level due to the fact that it only requires LV to show likelihood of dilution.The Second Circuit decided to remand the similarity of the marks factor back to the district court for reconsideration. This meant that the district court would use the sequential market place comparison when examining the similarity of the marks and hold onto all other previous analysis of the likelihood of confusion factors. Even if the market place comparison had an effect on that one factor it was very unlikely to affect the outcome of the district court’s ruling because the similarity of the marks was just one of eight weight ed factors. The Second Circuit was essentially making a statement with its handling of this case that it was not prepared to make a precedent setting ruling on the lack of protection for â€Å"design piracy† in the fashion industry.Even if they desired to address the topic, strictly following the established law would have prevented them from coming up with a different result. The court may have felt that any perceived or real injustice plaguing the fashion industry should be handled through the adoption of written law rather than legislated from the bench. Ultimately in May of 2008 the district court granted summary judgment to D&B on all claims. The court found that Louis Vuitton did not have adequate evidence to present with regards to the trademark infringement or dilution claims. While the outcome of the case disappointed many people because D&B did copy the design, the court based its decision on the interpretation of the law.Another example of a trademark infringement case that could have implications is European Trademark v Google. Originally LV sued Google in France claiming trademark infringement from Google’s AdWords program and the French court ruled in LV’s favor. The court held that Google was committing trademark infringement and diluting the trademark when it decided to sell the LV name to other companies in order for their site to pops up upon a search. Unfortunately for LV the European Court of Justice later ruled that Google in fact was not guilty of trademark infringement. There is a silver lining for LV. The court stated that advertisers using a trademark as a keyword can be held liable for infringement.The court specifically stated that â€Å"such use of a trademark by the advertiser adversely affects the source-indicating function of the trademark if the advertisement does not enable normally informed and reasonably attentive internet users to ascertain whether goods or services referred to by the ad originate from the proprietor of the trademark or, on the contrary, originate from a third party†. Thus, a company like Louis Vuitton does have legal recourse if it finds misleading advertisements from searches of its brand. In addition, Google can be held accountable if it was aware of the improper use of the trademark and did not take the ad or content down.The ruling could have impacted a case like Louis Vuitton Malletier v Dooney & Bourke Inc. , but instead has gone farther towards protecting companies in the fairly unregulated internet market place. In closing, companies like LV will have to continue to be extremely aggressive through the use of lawsuits in order to protect their brand. Once more laws are applied to specific industry, such as the fashion industry, it will become easier to convey. The courts can only interpret the law, not create laws to safeguard these specific industries. The courts, as well as the citizens, have to trust that the legislative branch will step up and ad dress these complex issues.