Comprehensive Geriatric Assessment Paper Research

Comprehensive Geriatric Assessment - Research Paper Example Presenting complaints For the past five years Mrs.Rozario had been having an increasing memory loss and difficulty to move around for her daily functions. Previously she could walk or board the bus to town for shopping or to church. Her memory too became poorer. Executive functions slowly dwindled and she was unable to do many things herself. Help was needed on occasions. Sleep became disturbed. Moreover she seemed to withdraw from her friends and family whom she used to meet frequently and spend her time laughing and conversing with in better days. Recently she had a fall and had broken her femur. This had upset her further though that phase had been successfully passed over. Winter aggravated her mobility problem. Even with multiple complaints and problems she had been reluctant to approach anyone for help. She attributed her complaints to aging. It was at the behest of her son that she had now agreed to come. With the son’s assistance, the problems were all hopefully reveal ed. Past Medical history It said that she had been taking anti-hypertensives for the last twenty years. She used to be regular in her appointments with the physician but had lost that regularity of late. Previous medical history did not reveal any significant issue. Her pregnancies terminated normally and she has two children. Significant childhood diseases or history of immunizations were not remembered. Hospitalization had been only for her deliveries and her recent fracture femur. With no history of allergies, she could take any medicine. She was on 25 mg. Atenolol daily and had antacids occasionally. Analgesics and pills for sleeping comfortably had been prescribed at the local care center as and when she found it difficult to walk because of pain or could not sleep. She had ill-fitting dentures as she had lost weight recently. Cognitive impairment was present. Nutrition Her diet included more of cereals and porridges with small quantity of fruits and vegetables. Her dentures di d not fit well due to her loss of weight and so she would rather have a diet easily swallowed. She was having a diminished appetite. The history of constipation was elicited. Her son claimed that financial resources were not a hindrance to nutrition as he was looking after her. However she was staying alone and inability to cook her meals and have them could be the reason for the limited nutrition. Current weight was 50 kg. while her expected weight was 65 kg with reference to the Body Mass Index. Recent change in body weight had been noticed after she recovered from the fracture of the femur. Her current medications could have affected her appetite or digestion. Loneliness could be a factor which had limited her nutritional status. Vitamin or mineral supplementation was not her habit. She had mild depression for which she was not being treated. She used to read widely but her vision was failing and she had not met an ophthalmologist for assessment and reading had been stopped. Ther e were no independent transportation facilities unless her son arrived. She was not motivated enough to look after herself. It could be due to her failing cognitive functions. Consumption of her anti-hypertensive drug or other medicines was irregular and consisted of more than 3 drugs. The nutrition assessment was completed with a checklist. Mrs. Rozario agreed to most of the suggestions in the checklist. She ate less than two meals

LIFE EXAMINATION PAPER Essay Example | Topics and Well Written Essays - 1000 words

LIFE EXAMINATION PAPER - Essay Example Somehow, innate mental and physical characteristics, and ethno-racial, religious and financial backgrounds certainly have their significance in development of likes, dislikes, and priorities. Personal views and philosophies about life appear to be absolutely different in people, even the siblings that not only belong to the same parental lineage but also have experienced the same socialization process and environment at large. Therefore, the criticism seems justified that individuals enter the world carrying divergent codes of mind that decide and determine their future life and activities actually. Somehow, the importance of social interaction could not be refuted altogether due to the very reality that it surely turns biological man into a social individual, and teaches him the norms, values, mores, traditions and conventions that have been in vogue in the culture and/or society the individual belongs to; the same is also applied to me. Like other members of my society, I also belo ng to one specific ethno-racial community, which makes me distinctive from the people belonging to other groups co-existing in society. Though sometimes these feelings create my affiliations with in-groups and apathy for out-groups, these feelings never adopt the form of hatred or prejudice for others. It is perhaps because of my belonging to a well-educated, groomed and responsible family that I have learned the universal message of love and respect for all members of my social establishment without discrimination. Similarly, I have faith in my God, who has created all humans out of rotten clay, so having feelings of superiority simply means deviating from the statutes of divine law, actually, which declares all humans to be equal. I remember the influence of religion on my thoughts; since I was regularly taken by my parents to church on every Sunday, I obtained the basics of Christianity at a young age of my life. The life and sayings of Jesus Christ left indelible imprints on my mind, and I developed the views of caring for all and sundry without taking his/her background into the slightest consideration. I obtained primary and elementary education at a well-reputed school and studied the basics of sociology, history, theology and Western philosophy at high school. I also studied conflicts and wars taken place between people belonging to rival factions and groups. It also infused the passion of fighting against my rival nations and communities for the political and economic uplift of my nation. However, my years at college turned out to be more productive in respect of bringing tremendous alterations in my views about wars and battles. At college, I was taught the basics of business finance and commerce, and the role played by currency and transactions. It was really a wonderful experience for me. Since I had already obtained the knowledge of the barter system and other ways of earning in the discipline of cultural anthropology, the idea of business ethics and corporate culture particularly fascinated me. I also learned the changing of the vast world into a small global village just because of the wonderful inventions made by the great minds for the

Fundamental Attribution Error Essay Example for Free

Fundamental Attribution Error Essay The human nature is an interesting subject to study, each individual has their own way of seeing things in their own perspective or ways of persuading others, in order to make sense of their own life’s. Fundamental attribution error being one important concept, this explains a persons behavior, how a person can underestimate circumstances yet overestimate ones characteristics. For example if a man didn’t hold the door for woman when walking into a store, the woman behind him might conclude that man doesn’t have manners or is uncivil. That woman interrupted the situation in her perspective without considering situational factors, such as, he might have been running late or he didn’t notice another person behind him. People will judge primarily on their experience with that individual without considering other factors or placing their selves in their situation. An important researcher known as Milgram, he challenged the demands of authority on obedience, and how far are people willing to conform to orders. Milgram analyses social compliance and obedience toward superior in his experiment. In the study there is a learner, teacher and administrator, each of whom play an important role in the experiment. The teacher is the one giving the questions to the learner and if the learner gets the answer wrong the teacher is obligated to shock the learner. The administrator has the authority to tell the teacher to increase the level on the shock generator. When the learner continues get an answer incorrect the shocks get stronger from 15 to 450 volts and so the learner refuses to continue because he cannot endure anymore pain. The teacher complies with the commands given by administrator to keep going even if the learner is hurt. Milgram experiment was successful and demonstrates how people obey to represent cooperativeness or by fear even if it goes against better judgment. The concept of fundamental attribution error and Milgram’s research on obedience takes an important role in David’s response to his history teacher’s question to why so many German people complied with Hitler’s order to systematically slaughter millions of innocent Jews. David’s response being, â€Å"because German’s were unusually cruel, sadistic people with abnormal and twisted personalities. † The fundamental attribution error in David’s response is when he penalized every single person in the German population for being all cruel, sadistic, abnormal and twisted personalities. He used Germans behavior as a significant factor as their external disposition to judge all Germans for their actions. Also in David’s response, the German population was responsible for the harm to the Jewish community, although Hitler was the prime leader and influenced the outbreak of the Nazi Party. Hitler’s leadership illustrates a great example of Milgram’s research, of abuse of power and obedience in German society. Milgram reveals how people, in this situation German citizens obeyed to higher authority either because of fear or collaboration. David was not able to see the underlining causation of Germany’s injustice, although this is common act, people are usually compelled to unrightfully circumstances and overestimating people.

Air Pollution In Trinidad And Tobago Environmental Sciences Essay

Air Pollution In Trinidad And Tobago Environmental Sciences Essay The contamination of the atmosphere by any toxic or radioactive gases and particulate matter as a result of human activity defines air pollution. (EMA State of the Environment Report 2000) Over the years Trinidad and Tobago has focus on industrialization developing several industrial estates but greater focus was made to the energy sectors. They current have three major energy based industrial sites. The Point Lisas industrial estate, Point a Pierre petroleum refinery and Liquefied Natural Gas plant (LNG) located in Point Fortin. Trinidad and Tobago is considered to be one of the most industrialized countries in the Commonwealth Caribbean region. We have been blessed with a vast array of natural resources ranging from oil, natural gas and asphalt to manufactured petrochemicals. Despite the fact that oil production and refining is one of our main industry, petrochemicals and to a lesser extent steel plays great importance in the company economic growth. Trinidad Tobago is worlds leading exporter of both methanol and ammonia, currently they supply the largest source of LNG is exported to the United States. Early views and realization of Air Pollution To the general public air pollution was considered to be chemical emissions and that suspension and secondary pollutants will just dissipate with the aid of the wind and rain. As the country moves into a second wave of industrialization with several proposed plans of building the next economic hotspot in the Caribbean (Invest in TT Downstream Energy), concerns has been made toward the quality of air what we live and breathe. It was only years later when technology began to play an important part in analyzing pollutants and air quality that it was realized that air pollution was just as important as water pollution. The industrial sector in Trinidad Tobago is one of the most dynamitic in the Caribbean and this is reflected in the diverse nature of its pollutants. Table 1 illustrates the numerous industry classes, commodities produced, production process and resulting in air pollutants. Map 1: Existing Proposed Energy Base Industrial Estates in Trinidad Table 1: Industry in Trinidad Tobago and air emission they emit INDUSTRY PRODUCTS SOURCES AIR POLLUTANT Petrochemical Menthol, ammonia, urea, ethanol, liquefied natural gas Fossil fuel processing, industrial processes Carbon Dioxide, Sulfur dioxide, nitrogen oxides, Carbon Monoxide Manufacturing Metals, cements, consumer products Manufacturing and extraction process, stock piling of raw materials, fossil fuel burning Carbon Dioxide, sulfur dioxide, nitrogen dioxide, nitrogen oxides, particulate matter PM (soot, dust, asbestos fibers, pesticides and metals). Volatile Organic Carbon (VOC) Transportation vehicles Incomplete combustion Carbon Monoxide, particulate matter Petroleum Refineries Refined oil, oil base products and sulfur /acids production Fossil fuel burning, extraction process, transportation process, storage process, Carbon Dioxide, sulfur dioxide, nitrogen dioxide, nitrogen oxides, methane, particulate matter (soot, dust, asbestos fibers, pesticides and metals) Agriculture Animal waste, plant waste Animal waste disposal/processing, rice paddies and wetlands, plant metabolism, land clearing Methane, Carbon monoxide, Carbon Dioxide, particulate matter (dust), VOC Electrical Power generation Electricity Fossil fuel burning, Particulate matters, Sulfur dioxide, nitrogen dioxide, carbon dioxide, nitrogen oxide, VOC Mining Quarrying Aggregate Blasting, mining, washing, extraction process Suspended Particulates Matters (SPM); Total suspended particles (TSP); Particulate matters. Wholesale and Retail All consumer products Service station operations, truck filling stations VOC Locations of Main Industrial Sectors With industrialization comes a need for people to benefit with the high level of employment in these areas. The demographic transition cycle in Trinidad and Tobago is fairly predictive with many of the populated areas following the same paths along the industrialized map. (Map 2)In the initial stages of industrial development focus was made on establishing industries in sparsely populated areas. The intention was also to take advantage of the favorable wind direction which would direct most of the air pollutant west ward over (for the most part) approximately 5 miles of uninhabited land space and then to the Gulf, with the intension that the vegetation would be affected in a minor way during the dry season and would be assisted by run off during the rainy season. This idea inadvertently leads to another pollution problem. This proved to be a short term imitative, as these areas soon became an attractive alternative to the long commute thus encouraging the establishment of make- shift villages and shanty towns. This was also fueled by the fact that the southern and eastern main road were in close proximity to these estates. Over time these villages soon became establish resistances acquiring basic utilities and official mailing addresses. The industries were now faced with a new obstacle. They now had to focus their attention to both the environment and the neighboring population. Table 2 identifies the main industrial pollutants found in Trinidad and Tobago and its effects on both the environment and humans. Map 2: Industries and major roadways Table 2: Main Industrial Pollutants and their Adverse Health and Environment Effects POLLUTANT EFFECTS ON HUMANS EFFECTS ON THE ENVIRONMENT Carbon Monoxide- CO It is absorbed through the lungs reducing the bloods capacity to transport available oxygen to the tissues. Depending on the exposure level it produces flu like symptoms usually not recognized and may results in death There is minimum effect on the environment. Sulphur Dioxides SO2 Depending on the exposure level it can cause: cause wheezing, chest tightness and shortness of breath, respiratory illness, alterations in the lungs, it aggravates existing cardiovascular disease. When SO2 combines with water, it forms sulfuric acid, which is the main component of acid rain. When acid rain falls it can cause deforestation, acidify waterways to the detriment of aquatic life. It also corrodes building materials. Acid rain changes the physical appearance of vegetation plants metabolism impaired Nitrogen Dioxide (NO2)/Oxides of Nitrogen NOx At low levels it has minimum or no effects on human health. However high levels NO2 can cause respiratory problem, increase a persons susceptibility to, and severity of infections and asthma. It can also affect the sensory system. It is harmful to vegetation, can fade and discolor fabrics, reduce visibility. Vegetation exposure to high levels of NOx can be identified by damage to foliage, decreased growth or reduced crop yield. Volatile Organic Carbon -VOC There are no general health effects of VOC because other gases make up VOCs however some gases may be toxic and/or carcinogen. Levels of exposure and time exposed can cause damage to the liver, kidney and central nervous system. It is known to cause cancer in animals. Suspended Particulates Matters (SPM); Total suspended particles (TSP); Particulate matters. Health effects on SPM in humans depend on the particle size and concentration can cause long term exposure increases the rates of respiratory illness and symptoms. Particulates can accelerate deterioration of surface and material. It has the potential to cause modification of the climate and contributes to acid deposition. Control Strategies Physical, Managerial and Legislative to Air Pollution The visionaries of the early industries focus little on health safety and the environment and this was reflected in the level of controls initiated by the industries. Controls were mainly one dimensional and fail to focus on the holistic views of health safety and environment. Public opinion and outburst resulting from the increasing number of medical complaints and the decrease quality of agriculture produce with allegations pointing towards the emission from these industries, prompted management to use technology to assist in the establishment of more stringent controls. This technology was also instrumental in pinpointing the actual adverse effects as a result of these emissions. Physical Controls The physical control represents the processes responsible for acquisition of raw material, storage, manufacturing and distribution processes. Use of Suppression Techniques The numerous pollutants that emit daily, through smokestacks petrochemical and petroleum industries together with major health effects, force industries to reduce the pollutant at the source. One of the proven ways of reducing these pollutants is installing scrubbers and in other cases bagging houses in the emission system. The use of end -of- pipe technology is being adapted by some industries, it is used to remove already formed contaminants in the air however it is proven to be very expensive and many industries internationally would rather pay the fines for higher emission levels than use this technique. In other words it is regarded as the less of two evils. These techniques force industries to adopt generic prevention strategies and solutions, only resorting to the more expensive techniques when face with dire consequences. Environmental Friendly Process With increasing pressure from environmental activists calling for industries to be more sensitive towards the environment, many industries have restructured their processes whereby recycling waste material as a new raw material to produce a second product. This process has been adapted by Methanol Holding Trinidad Limited (MHTL) were they have constructed an AUM plant. This plant is the first of its kind in Trinidad and Tobago being the most environmental friendly of the MHTL family. This plant comprises a diversified petrochemical complex to manufacture Urea Ammonia Nitrate (UAN) and Melamine using feedstock from integrated urea and ammonia plants. (MHTL) The local cement factory adopted several controls strategies to deal with the air pollution problem within its manufacturing process. A change from blasting to stripping of the main raw material (limestone) aided in the reduction of dust emissions that was affecting the neighboring community at their quarrying central Trinidad. The transportation of the limestone was also change from dry to wet thus also reducing the potential dust particles entering the atmosphere during transportation from quarrying to the process plant. At the out skirts of the processing plant itself major landscaping was done to create hills around the factory adorned by buffer trees with sole intension is to reduce the level of dust exposure to the neighboring community. Managerial Controls Self Regulation These controls consist of policies, systems and standards that govern and manage the organization. The establishments of the Key Performance Indicators (KPI) help management keep focus in order to sustain established targets. Company policies and procedures acts as guidelines to maintain order and structure within the organization. The introduction of ISO standards advertises the companys procedures to the industrial world thus ensuring that whatever measures initially introduced are sustained by the certification audits conducted annually by an international process auditors. Legislative Controls Currently in TT there is no legislation that refers directly to controlling of air pollutant emitted by industries. This is merely due to the fact that early monitoring system generally focus on water and land pollution the understanding of air pollution did not produce tangible evident because of technological short falls. The existing legislation addresses non specific air pollutants like the Petroleum Act (rev. 1980) section 29 (1) (j) prevention of air pollution and the Public health ordinance (1950), section 70 (1) (m) prohibits blacks smoke from chimneys. Even though the EMA was establish and is the countrys sole environmental body responsible for managing, regulating and coordinating environmental matters. The EMA has only managed to draft the Air Pollution Rules 2001 however to date 2010 these rules have not been made law. Trinidad and Tobago being a member of the Commonwealth and the United Nations has benefited from the research and technological advancement from these more developed countries (MDC). Initiatives such as the Montreal Protocol (1989 the control of CFCs) and the Kyoto Protocol (1997 the reduction of Greenhouse Gases) assisted the legislative process of TT by association. The only way legislative was establish was by piggy backing on the achievement of the more developed countries it seems that this was the only way the law maker could have had any impact on defaulters of air pollution in Trinidad. Only when legislation is pass the country can benefit from some effective control measures where polluters are prosecuted and emission limits are set for all industries. Conclusion Trinidad and Tobago historically is a nation of followers there have been very few instances where we were not promoted or assisted in some way or the other in achieving established goals and the topic of pollution is no exception. Have we ever wonder why the one establish air pollution laws stems from a diplomatic relations within the commonwealth and the United Nations or why we had to wait until the advent of OSHA to enforce existing safety laws in our country. The answer is simple we are still waiting to follow no wonder legislation spear headed by locals are treated with scan courtesy. Had these laws been establish in some first world convention they would have been rooted in the seams of our judicial system years ago? Many of the existing pollution laws governing the more develop countries were mainly as a result of international pressure, sadly Trinidad and Tobago is not view as a major polluting nation because of its geographical location and size. Evidence of pollution aware ness is mainly seen in the new establish manufacturing countries whose parent companies originate overseas. It is only amongst of fellow less develops countries and Caribbean members that Trinidad and Tobago is recognize as a polluting nation sadly these countries have little impact on global view. Despite our shortcomings, internally there has been an intensified effort to effectively monitor record, control and enforce pollution reducing systems and strategies. Internationally the over site of Trinidad and Tobago (a country that can easily fit into the Orinoco River with a population that barely exceeds large town in the United States) has not deterred local efforts to manage the levels of air emissions.

World Wide Consortium Essay -- Expository Internet Essays

World Wide Consortium Tim Bernes-Lee in 1989 created the World Wide Web, and in 1994 he and a few others established the World Wide Consortium. (a) The World Wide Consortium’s mission is â€Å"to lead the world wide web to its full potential by developing protocols and guidelines that ensure long-term growth for the web (a).† This is an international organization with a variety of members making up the organization. They all have a common goal which is to make the web standardized with rules and principles, and to date they have made over eighty recommendations.(a) The World Wide Consortium has had three long-standing goals. These are to provide universal access, a semantic web, and a web of trust. Universal access means â€Å"to make the Web accessible to all by promoting technologies that take into account the vast differences in culture, languages, education, ability, material resources, access devices, and physical limitations of users on all continents (a).† Semantic Web means to build a software setting that allows everyone to utilize the assets that are accessible on the World Wide Web. Web of trust means â€Å"to guide the Web’s development with careful consideration for the novel legal, commercial, and social issues raised by this technology (a).† In this paper I am limiting my discussion to universal access and the issues surrounding it. To help promote the three goals the consortium has also developed three design principles for the web. These principles are interoperability, evolution, and decentralization. For the web to have interoperability, a user needs to be able to use any hardware or software they want and still be able to access what’s on the web. When someone adds something to the web they need t... ...ortium and I knew nothing about the World Wide Consortium. It is good to know that there is a dedicated group setting guidelines and recommendation to achieve universal access to the web, making sure the web software is compatible o all users and is making the web a trusted way of doing business. I believe that this organization is helping the internet to continually grow successfully, and without this organization the internet probably would not be near as useful as it can be. People would probably just do what ever they felt like doing. I now realize how important it is to really think about a lot of issues when designing a website to make it universal accessible. Building a website is now not simply designing one, but also thinking about how everyone will be able to have access no matter what language they speak, how old they are, or if they have a disabled.

Death be not Proud and Do Not Go Gentle Into That Good Night :: Do Not Go Gentle into That Good Night

Death is an aspect of life that everyone becomes acquainted with sooner or later.   From my own experiences I am more familiar with death than I could ever want to be.   Poetry is something that is very difficult for me to follow, but when it deals with concept that I am familiar with, then I am able to associate with the soul of the writer.   Two poems that deal with the concept of death that I actually enjoyed reading and will compare to each other are "Death be not proud" by Dylan Thomas and "Do Not Go Gentle Into That Good Night" by Dylan Thomas.   Firstly, in "Death be not proud," Donne tells Death that it is not anything special.   That Death is a low being that deals with the pitiful aspects of life: war, disease, and murder.   Donne says that Death is nothing more than an aspect of life, just an event of the moment, "one short sleep past, we wake eternally."   Donne goes on to explain that we all will go through this door while on the way to another existence.   In comparison, "Do Not Go Gentle Into That Good Night" by Thomas is a battle cry against death.   To fight against it until the last breath of life is gone.   That to give up life is the coward's way.   To his father, who is dying from a protracted illness, Dylan says to show his love, that it is all right to cry even though he has never seen his father show the weakness of crying, just so long as he continues to fight against the coming end.   In both poems, the writers are against Death; however Donne writes of Death as a weak entity that has no real power, because after we die, we will never have to face the worry of Death.   Thomas, however, writes as if he doesn't believe in any kind of hereafter.   An example of this is the repeated cry "Rage, rage against the dying of the light."   These are two very different beliefs for an ineludible fact of life.   Death is something that I have faced and will eventually succumb to;

Attention-deficit Hyperactivity Disorder and Pharmaceutical Industry

Pharmaceuticalization can be defined as the â€Å"process by which social, behavioural or bodily conditions are treated or deemed to be in need of treatment, with medical drugs by doctors or patients† (Abraham 2010:604). According to Abraham (2010), pharmaceuticalization is currently on an upward spiral and this dramatic increase can be attributed to five different factors. These five explanations are biomedicalism, medicalization, pharmaceutical industry promotion and marketing, consumerism, and regulatory-state ideology or policy.Each of these explanatory factors are mutually interactive but competing and it will be explained how this is in the following paragraphs. The biomedicalization thesis is based upon the idea that advances in biomedical research can explain why there is an expansion of drug treatment in our society today. Biomedicalism theorists believe that people who were previously undiagnosed or untreated for certain disorders are now able to receive necessary me dication as a result of progression in medical science, but it is clear from his article that Abraham is not a biomedicalism theorist.Abraham provides surprisingly large amounts of evidence to back up his claim that the biomedicalization thesis is not a legitimate explanation for the increase in pharmaceuticalization. Abraham criticizes the fact that a lot of the scientific literature contains uncertainties and many studies lack replicability and therefore should be rendered unreliable. He also uses the example of Attention Deficit Hyperactive Disorder (ADHD) to farther emphasize his argument.He does this by making the point that the brain imaging done in these studies were supposed to be measuring the levels of dopamine in the brains of the subjects but these samples could not be taken from living people so were instead inferred from dopamine metabolites in the blood or urine. This poor quality of science that the biomedicalization thesis is based upon raises many questions and inc reases the likelihood that this is not a valid cause for the increase in pharmaceuticalization (Abraham 2010).Abraham believes that medicalization is a more reasonable explanation for the rise in pharmaceuticalization. Pharmaceuticalization and medicalization often overlap but are nonetheless distinguishable. Medicalization can be defined as a â€Å"process by which non-medical problems become defined and treated as medical problems, usually in terms of illness or disorders† (Abraham 2010:604). The thought behind the increase in medicalization is that social deviance has gradually become redefined in a way that makes medical disorders part of the norm.ADHD illustrates this idea because in the past 40 years, the criteria necessary to be diagnosed with this disorder has broadened drastically and some studies in the US found that almost 50% of children now meet this criteria. Another relevant disorder would be bipolar disease, which has increased 50-fold since 1980 when it was f irst entered into the Diagnostic and Statistical Manual of Mental Disorders (Abraham 2010). In our society today it is much more common to be diagnosed with a medical disorder and once consumers are made aware of a disorder’s existence, its regularity will skyrocket.The main way in which consumers are informed about new drugs or diseases is from marketing and promotion done by the pharmaceutical manufacturers. Drug companies are advertising their products much more now and are over exaggerating the benefits in hopes to establish a larger consumer base. They are putting all of their resources and funds into this marketing and even spending more on this than resource and development: â€Å"In the US, industry expenditure on marketing has been about double that on R&D- US$54 billion and US$26 billion in 200, respectively† (Abraham 2010:609).Pharmaceutical companies are even getting medical professionals on board to advertise their products either at medical symposia or in a television commercial by generously compensating them. This increased exposure to drugs makes consumers more informed about the availability of new drugs but not necessarily the risks that come along with them. In his article, Abraham mentions two forms of consumerism that have opposite effects of one another on pharmaceuticalization.The first type that he talks about is adversarial consumerism, which occurs when people are under the impression that they have been harmed by specific drugs and therefore pursue legal actions against pharmaceutical manufacturers. Adversarial consumerism is currently rising; in 2000, US plaintiffs received 4. 85 billion US dollars to settle 27,000 lawsuits against Merck and 894 million US dollars against Pfizer to settle lawsuits about various types of arthritis drugs. These figures can be compared with the mere 10’s of millions of dollars that Eli Lilly was charged with in the 1980s.This particular type of consumerism actually leads to a decr ease in pharmaceuticalization, which is sometimes referred to as de-pharmaceuticalization (Abraham 2010). The more powerful type of consumerism is called access-oriented collaborative and it is one of the reasons that there is an increase in pharmaceuticalization in our society today. This form of consumerism occurs when patients seek access to new drugs quicker than the Food and Drug Administration (FDA) can approve them. This puts a lot of pressure on the FDA and forces them to cut approval times for highly demanded drugs (Abraham 2010).