Mass and Chemical Reactions Lab Essay Example for Free

Mass and Chemical Reactions Lab Essay Relationships in a Chemical Reaction Lab Introduction: This lab focused on mass relationships within a chemical reaction. To understand this lab first, it is necessary to understand the reaction that is going on in the reaction. The Copper (II) chloride hydrate reacts with Aluminum to produce Aluminum chloride, copper, and water. Theoretical yield and various other forms of yield must be understood too, theoretical yield is what amount of the product you should get theoretically according to your calculations; experimental yield is the product you get after you finish the experiment. Because of error usually your experimental yield will be off from your theoretical yield. Percent yield is the efficiency of the reaction to get to the theoretical yield. Data Collection And Processing: Raw Data: Table #1 : Substance / Object and Mass Table Substance / Object| Mass (Â ± 0. 01 g)| 200mL beaker| 67. 38 Â ± 0. 01 g| 200mL beaker + Copper| 69. 39 Â ± 0. 01 g| Copper| 2. 01 Â ± 0. 01 g| 200mL beaker + Dried Copper| 68. 01 Â ± 0. 01 g| Dried Copper| 0. 63 Â ± 0. 01 g| Qualitative Data: Before the reaction, the Copper (II) Chloride hydrate is a blue crystallized substance, the Aluminum was shiny and made crinkly sounds, it has a smooth metallic feel to it. During the reaction initially when stirred the water the water turns blue. When the aluminum is placed into the hydrous CuCl? the water becomes a darker murky substance. Steam is coming out of the water and aluminum is visibly dissolving. The aluminum is also turning black and vapor is forming along the sides. Foam like red pieces are forming and dropping. As the solid turns completely red the liquid is becoming clear again and is colorless.

Since X Ray Was Discovered Health And Social Care Essay

Since X Ray Was Discovered Health And Social Care Essay Since x-ray was discovered by Roentgen in 1895, its medical application has grown to be a fast and dynamic imaging modality. Todays imaging department consists of an impressive array of diagnostic and therapeutic devices from x-ray machines, CT Scan, PET Scan, linear accelerator, which mainly use ionizing radiation for diagnosis and treatment of illnesses; and with the addition of ultrasound and MRI that use sound waves and magnets for diagnosis instead of x-rays. Thus, radiology is considered as the window of the healthcare institution and the radiologic technologists are the persons behind these state-of-the art machines. In the x-ray department, one of the divisions of radiology department, the x-ray machines are used for diagnoses of illnesses. For 100 years the film-screen system has been the imaging system of choice. This system uses radiographic film, screen and wet chemistry to generate an image just like conventional photography. Every RTs goal is to provide high quality images for accurate diagnosis; therefore each step is very critical. The RT must be equipped with knowledge and skills from anatomy, positioning and exposure techniques. One slight mistake can imperil the image and yields an unacceptable radiograph which entails repeat examination that primarily means additional radiation dose to the patient. This is one of the disadvantages of a film-screen system wherein once the film has been processed; there is no way to alter it. What you see is what you get. Fortunately, with the growing technology of imaging modalities came the introduction of digital imaging which follow the same concep t as digital cameras wherein brightness and contrast of the image can be changed and images can now be cropped. Its advantage compared to film-screen is very obvious, since images can be altered, repeat examinations, oftentimes is no longer necessary. The technology is superb and its debut has grown the curiosity of every RT whether it is efficient compared to the traditional system. And of course, it is. However, as with every other technology has its drawback. Since the new technology primarily uses computer and computer-aided equipments oftentimes do the entire job. The question lies wherein will the competence of the RT in terms of exposure technique factors be same as using the conventional way? Several international studies stated that because of the convenience of the system, the RTs using the machine oftentimes fail to consider the standard protocols in every technique selection because images can be manipulated later. Alteration of images from time to time should not be a daily scenario because manipulation sometimes interfere accurate diagnosis. As of the researchers knowledge, there are no known local related studies in the decline of RTs competence in using CR. One of the reasons may be this modality is still in the stage of introduction in the Philippines and that its implication is not yet intensively studied. But this does not stop the researchers to seek of finding out if there is indeed a decline in RTs competence with the new system. This study is a comparative-correlational research in determining the level of radiographic competence between film-screen system and CR on exposure technique factor selection. The main objectives of the researchers are to compare if there is a significant difference in terms of radiographic competence in the RT who uses film-screen from CR and to determine if the respondents profile and agency has a significant relationship in terms of radiographic competence. Base on the result of the study, the researchers will be able to assess the essential skills needed for the profession. Technolo gy indeed has helped us in many ways. However, without the competence of the professional manipulating the equipment is futile. This means that the technologist who has the sole responsibility of manning the state-of-the art equipment should not rely from technology, instead technology should rely on them. REVIEW OF LITERATURE This study primarily aims to compare the level of radiographic competence on exposure technique factor selection between film-screen system and computed radiography (CR). Exposure technique factor selection is an important foundation for these two types of image receptor (IR) or imaging system. Image receptor is a device that converts x-rays into visible light. Competence should not vary whether the radiologic technologist (RT) is using the conventional or digital system, otherwise, it will defeat the intensive study of the exposure techniques during the undergraduate years. Furthermore, providing appropriate exposure techniques is paramount in the profession since these techniques also mean radiation dosage on the part of the patient. According to Fauber Johnston (2012), the radiographers actions at the control panel directly determine the nature and the make-up of the x-ray beam. This means that the selected exposure technique factor is directly proportional to patient dose. In ad dition, it is the responsibility of the radiographer to learn the philosophy, factors and methods that minimizes ionizing radiation exposure to the patient (Callaway, 1996). This also means that an RT is providing quality patient care when he/she gives an adequate and necessary amount of radiation to the patient. Competence in Radiologic Technologist Klemp (1980) defined competence as an underlying characteristic of a person which results in effective and/or superior performance on the job. A competent person is imbued with the right knowledge, skills and attitude on a particular task. Other authors define competence as a cluster or related knowledge, skills, and attitudes that reflects a major portion of ones job, which has a relationship in the performance on the job that can be measured with well-accepted standards, and that can be improved with training and development (Parry, 1996). In radiologic technology, for example, an newly licensed RT already possess cognitive and motor skills at an entry level, however, it can only be enhanced through proper and consistent training in a chosen specialized field during the course of his/her work as an RT. Knowledge, Skills, Attitude As mentioned, competence is a combination of knowledge, skills and attitudes. These components are essential as a whole because the absence of one component greatly affects ones performance. According to Dowd (1996), knowledge as part of competence includes theories and concepts which were gained as a result of the experience of performing certain tasks. Furthermore, in the field of radiologic technology he added that knowledge includes job-specific terminology, methods of organizing information and an understanding of principles and generalizations. On the other hand, Hans Reynold in 1928 defined skill as combined mental and physical qualities which make it useful to industry. Knowledge if combined with skills is important in the workplace. Furthermore, one cannot develop a skill without knowledge and at higher levels, knowledge are converted to skills (Klieme, 2004.) The last component that determines competence is the attitude. The attitude such as beliefs, values, traits, and motives is a part of competence because it indicates the persons response to a particular event or situation. Attitude refers to the predisposition or mental state of individuals/users towards a product, ideas, or attributes. It also implies on mental readiness on a particular object or his attributes toward an object or his preferences. (Hulse Dowd, 1996). In the field of radiologic technology, competence does not only mean that the RT is equipped with the knowledge and skills but RT is also imbued with the right attitude and judgment to provide each patient with quality care On Radiographic Competence In the field of radiologic technology, one aspect of the profession requires competent skills in radiographic exposure factor technique. The said competence is essential especially in the diagnostic x-ray imaging, wherein exposure factors are the key to accurate diagnosis and providing radiation dosage to minimum level. For 100 years, film-screen technique has been the method of choice in radiographic imaging (Bushong 2009). Film-screen system uses radiographic films, radiographic intensifying screens and wet chemistry to make the image visible. Furthermore, this conventional system should adhere to the standards of the darkroom requirements. Film-screen system has the same concept as a typical conventional camera. In a film-screen technique, radiologic technologist should be certain on the exposure factors to be applied in a particular exposure because improper selection of exposure factors can lead to overexposure or underexposure of the film. Overexposure or underexposure degrades image quality and therefore, it can lead to rejection of film, thus necessitates the need for repeat examination. Repeat examination provides unnecessary dose to the patient and additional costs to the department. On the other hand, as with the other innovations in technology, diagnostic imaging has shifted its course from conventional to digital. Computer applications are employed nowadays in diagnostic imaging modalities. An appropriate analogy that is easy for most people to understand is the replacement of typical film cameras with digital cameras: images can be taken, immediately examined, deleted, corrected, and cropped, and subsequently sent to a network of computers. Computed radiography system (CR) is an affordable solution to digital imaging. Instead of the film, CR employs an imaging plate to capture x-rays and makes it visible when the plate is scanned into a computer and digitized it. Once the image is converted to data, it can be recorded on a laser printed film or can be transmitted and stored digitally. It has special features like manipulation or enhancement of the image. Its specialized software is used to image viewing with enhanced functions similar to film-screen system, s uch as contrast, brightness, and zoom. (dicomsolutions.com, 2011). Computed radiography has practical technical advantages compared with conventional techniques, such as wide contrast dynamic range, post-processing functionality, multiple image viewing options, and electronic transfer and archiving possibilities. In this system, image quality can be achieved because of the post-processing techniques that are not possible with film-screen system. This system is convenient for the technologists because the RT can compensate for exposure technique inaccuracies by adjusting the technique during post-processing phase of the image rather than that time of exposure. In radiologic technology field, competence means that the RT is equipped with the knowledge, skills, attitude and judgment to provide each patient with quality care. According to Olavidez (2005), competence is essential in the field of Radiologic Technology because RT is a fast growing profession; RT deals with human lives and most of all, the RT curriculum is not enough to prepare the students to be equipped with the skills necessary for the profession especially in the special fields of radiologic technology. For an RT to become competent, he/she should have undergone formal educational background followed by specialized training in their chosen field that takes months. As an RT, he/she should have comprehensive knowledge and skills in patient care, radiologic procedures and radiation dosage. Exposure Technique Factors Exposure technique factors influence and determine the quantity and quality of x-radiation to which the patient is exposed (Bushong, 2009). Kilovolt peak (kVp), milliamperage (mA), exposure time and source-to-image distance (SID) are the principal exposure technique factors. Furthermore, the said factors also affect image quality. Milliamperage and exposure time are the exposure factors that affects the quantity of radiation. Milliampere is the measure of x-ray tube current, whereas milliampere-second (mAs) is the produce of exposure time and exposure tube current. They directly affect the optical density (OD) of the film. Optical density is the overall blackening of the film. The darker the film, the higher number of x-rays is given to the patient. The higher the number of x-rays that are the given to the patients, the greater the radiation dosage they receive. Source-to-image receptor distance also affects the quantity of the radiation. The closer the patient is to the x-ray source, the higher dosage the patient gets. For chest x-ray, the standard SID is 72 inches, while for the other x-ray examinations, the standard SID is 40 inches. Kilovoltage peak (kVp), directly affects the quality of radiation. kVp is the maximum electric potential that travels across the x-ray tube. Since kVp affects the quality of th e x-ray beam, it also affects the quality of the radiographic image. Kilovoltage directly affects contrast. Contrast is the variation of densities on the film. The advantage of using higher kVp is that the patient will receive lower dosage of radiation because it will not be absorbed. However, higher kilovoltage produces more scatter radiation, thus increases the transmission of x-rays to the image receptor and degrades image quality. The best techniques to prevent scatter radiation are using beam restrictors such as collimator to filter low energy x-rays and to cut-off low energy rays using radiographic grids. By employing beam restrictors and grid will enhance image contrast because scatter radiation will be prevented. Furthermore, scatter radiation will also provide unnecessary dose to the patient. Therefore, exposure technique factor selection is essential. To provide quality radiographs and to limit patients to radiation should be a goal for every RT. According to Bushong (2009), RTs are required to use their skills to produce the best possible image with single exposure (Bushong, 2009). Otherwise, repeat examination will provide unnecessary radiation dose to the patient. Therefore, it is necessary for the RT to be equipped with knowledge and skills to manipulate these exposure technique factors to produce desired optical density, contrast, and image detail on the finished radiograph. RT in Film-Screen System In conventional film-screen system, before each examination, the radiologic technologist must select the optimum radiographic technique factors- kVp, mA, and exposure time (Bushong 2009). There are many considerations to determine the value of each factor and they are complexly interrelated. Contrast and Density are the photographic factors of the radiograph and it functions to make the image visible. Visibility of image is important so that anatomical image will appear for proper diagnosis. After each exposure, there is no way to manipulate its contrast and density and thats what makes film-screen system difficult as inadequate contrast or density entails repeat examination. Since manipulation of the image is not possible in this system, the RT should be certain with the technique factors prior to the exposure; otherwise, miscalculations can result to underexposure or overexposure. In a film-screen system, overexposure and underexposure of the image is considered unacceptable becaus e the important structures are not visible and thus it is not a tool for proper diagnosis. In other words, image quality is dependent on exposure factors. RT in Computed Radiography In CR system, image quality is not dependent on exposure factors. Digital image is unrelated to dose, kVp becomes less important. Since, image quality is not dependent on exposure factors, image can be manipulated. In a conventional system, the film serves as both image acquisition and display medium. With CR, the image plate serves as the acquisition medium but does not display the image. Since these functions are separate in CR, the digital signal can be altered to compensate for underexposure or overexposure and an acceptable image can be displayed on the monitor (Shephard, 2003). With CR system, post-processing is possible that helps enhance image thus allowing the RT to alter image contrast and density. Since image can be manipulated or modified, underexposure or overexposure is no longer a problem with this system, because it can usually salvage variations from the optical technique, whereas technical error with a screen-film system often requires a repeat exposure (Pizzutiello , 1993; Cesar, 1997). Therefore, with CR, technical errors are eliminated because of exposure variances that are possible with salvageable results, assuming adequate kilovoltage is used (Ballinger, 1999). On Assessment of RT Competence In order to know the competence of a professional, assessment plays a vital role. Assessment is important so as to evaluate if the RT is still competent to do the job. Since we are in the era of rapid technology, it may come to a point that we will just put our confidence on computers rather than our competence. According to Olavidez (2005), competence is an observable ability and it can be measured against set of standards. Assessment of competence is a combined knowledge, skills, and attitudes that reflect the current work practice. Furthermore, it can bridge the gap between workplace requirements and standard. Selection of exposure technique factor is of extreme importance because RT deals with exposing patients to radiation. Exposure technique factor is equivalent to the quality and the quantity of radiation that exits the patient, therefore, the RT should be precise in giving exposure technique factors. Providing appropriate radiation dose is necessary to prevent the patients from the hazards of the ionizing radiation, therefore prior to the exposure of the patient, accurate exposure techniques should be practiced. The issue of providing accurate techniques lies in a digital system, wherein images can be manipulated during post-processing. According to Fredrick Walker (medicalimagingmag, 2008), a radiologic technologist at Sharp Rees-Stealy in San Diego, CA, he pointed out if the image is too dark, we can manipulate the image using post-processing techniques like windowing or shadowing or to adjust contrast without having to repeat the examination. Furthermore, since image can be manipul ated during post-processing, it can encourage complacency rather than accuracy with exposure techniques which can result in overexposed or underexposed images (Medicalxray, 2010). In addition, according to Enfinger (2012), that it is true that the image can be adjusted, however, it is not recommended because the raw data from the initial exposure will contain information from scatter radiation that degrades image quality even if it is manipulated later. According to Shephard (2003), it is likely that digital imaging will replace conventional screen-film radiography in many modern medical imaging centers in the near future. It has already been stated that even if the image can be manipulated during post-processing, this should not be a practice because somehow it can deteriorate image quality which results in inaccurate diagnosis. One retrospective analysis of patients who had undergone lumbar spine radiographs for the diagnosis of osteoporosis compare diagnostic accuracy with screen-film versus digital radiography. The authors suspected that bone mineral loss could be more easily visible with screen-film imaging due to the fact that image contrast cannot be adjusted with this modality, whereas CR (and DR) images undergo digital post-processing techniques to maximize contrast. This could result in misleading results that confound diagnostic strength in osteoporosis. Therefore, this is a challenge now for the RT to maintain their competence amidst the aid of technology. Competence of RT is the foundation of providing quality patient care by providing appropriate radiation dose for accurate diagnosis. Synthesis The focus of the literature and studies cited was the radiographic competence of RT between film-screen system and computed radiography and it is through this study that the researchers can identify and compare whether their competence will differ based on the image receptor that is being used. In addition, competence in exposure technique factors is essential because this will also mean radiation dose to the patient. It has already been affirmed that the concept has been there for the past few years and therefore the present study is certainly not a new concept. Nevertheless, the researchers deemed it necessary to conduct a study assessing the competence of the RT for the benefit of the institution where they belong because the researcher wants to propose a professional program that could strengthen the foundation of the RTs. It is also important for the school to offer the programs since almost the RT from the different hospitals in Davao City are products of this institution. This study is similar to the other studies cited in this section because it stated on the effects of digital imaging on the radiographic competence of the RTs. Furthermore, previous studies dealt with the effects of image manipulation on image quality and it indirectly link to the competence of the RTs. Conceptual Framework In this view, the researchers attempted to assess the level of radiographic competence of the RTs in terms of knowledge, skills and attitude. Through assessing the competence of the RTs, the researchers are able to determine the level of radiographic competence; their strengths and weakness of radiographic techniques. On the other hand, the researchers identified the factors that can affect their competence, such as the respondents demographic profile in terms of age, sex, number of years in service and educational attainment and the profile of institution such as agency and its classification are also considered. To have a vivid picture of the study, Figure 1 served as the research paradigm SCHEMATIC DIAGRAM Independent Variables Dependent Variables Factors Respondents Profile Age Number of years in service Agency Private Public Image Processing Film-Screen System Computed Radiography Level of Radiographic Competence Knowledge Skills Attitude Figure 1 Schematic Diagram showing the relationship between the independent and dependent variables STATEMENT OF THE PROBLEM The study aims to compare the level of radiographic competence in using a film-screen system and computed radiography on exposure technique factor selection; specifically it aims to answer the following questions: What is the respondents profile in terms of: Age Number of years in service What is the agency of the healthcare institutions in terms of: Private Public What is the level of the respondents radiographic competence in using film-screen system on exposure technique factor selection in terms of: Knowledge Skills Attitude What is the level of the respondents radiographic competence in using computed radiography on exposure technique factor selection in terms of: Knowledge Skills Attitude Is there a significant relationship between the respondents profile and the level of radiographic competence in terms of: Knowledge Skills Attitude Is there a significant relationship between the agency of healthcare institution and the level of radiographic competence in terms of: Knowledge Skills Attitude Is there a significant difference in the level of radiographic competence between film-screen system and computed radiography in terms of: Knowledge Skills Attitude HYPOTHESES There is no significant relationship between the respondents profile and the level of radiographic competence in terms of: Age Number of years in service There is no significant relationship between the agency of the healthcare institution and the level of radiographic competence in terms of: Public Private There is no significant difference in the level of radiographic competence between film-screen system and computed radiography in terms of: Knowledge Skills Attitude DEFINITION OF TERMS Accuracy- refers to the degree of conformity of a measured or calculated value to its actual or specific value. Computed Radiography- is an affordable solution of digital imaging system that uses a photostimulable phosphor as the image receptor. Digital Radiography- an all-digital technique in which x-ray absorption is quantified by assignment of a number to the amount of x-rays reaching the detector; this is also called as cassetteless system. Exposure- measure of ionization produced in air by x-rays or gamma rays. Exposure Factor Selection. It is the factor set by the radiographer (kVp, and mAs) to produce visibility of structures in the radiograph. Film Screen System- is the conventional image receptor that uses radiographic film, radiographic intensifying screen and wet chemistry to visualize the image in the radiograph. Image receptor- is a device that converts x-ray beam into visible image. Level of Radiographic Competence- refers to the measure of the level of competence of the radiologic technologist in achieving goals and objectives in providing quality radiographs with minimum radiation dose to patients. Private hospital- is a hospital owned by a profit company or a non-profit organization and privately funded through payment for medical services by patients themselves. Public hospital- is a hospital which is owned by the government and receives government funding. SIGNIFICANCE OF THE STUDY This study seeks to determine if there is a significant difference on the level of the respondents radiographic competence in exposure technique factor selection between film-screen system and computed radiography; and to determine if there is a significant relationship on the level of radiographic competence between respondents profile and agency. Based on the results of this study, the researchers can identify the strengths and weaknesses of the RTs and if it shows significant decline in the competence of the RT in the CR system, the researchers will propose an enhancement program for the professionals. The said program will also be a part of the Continuing Professional Education (CPE), and it will be added to the CPE units needed to renew RT licenses. This study will be most helpful to the radiology department of the hospital to enhance Health Care Delivery by limiting radiation dose to the patients. Furthermore, determining the attitude toward the imaging system will help the department to reevaluate the mental and the emotional state of the RTs. Mental and Emotional state of the RT are important since they are dealing with patients. It is the responsibility of the RT to render quality patient care by providing appropriate radiation dose. Furthermore, this study will also be of most helpful to the schools offering radiologic technology as to intensify the foundation of the students in terms of exposure technique factors. Based on the result of the study, there may be a need to revise the curriculum to further intensify the skills of the RT students. Computed Radiography is not a part of the standard RT curriculum, and it may be one factor that affects the decline of competence on the part of the professional as well as the students. Chapter 2 METHODOLOGY This portion discusses the research design used, the research locale where the study will be conducted, the description of samples and the sampling technique, the instrument used, the details of procedure and the statistical analysis to answer the research problem. Research Design The study will employ a comparative-correlational research. To determine the difference between the level of competence in film-screen system and computed radiography, comparative study will be used. Furthermore, to determine the relationship between the respondents profile and agency between the levels of the radiographic competence, correlational design will be employed. Setting The study will be conducted from the selected hospitals in Davao, Digos and Tagum City employing either film-screen system and computed radiography. The hospitals using film-screen system are the following: Alexian Brothers Health and Wellness Center, Km. 4, McArthur Highway, Matina, Davao City; Davao Regional Hospital, located at Apokon, Tagum City 8112 and Davao Del Sur Provincial Hospital which is located at Lapu-lapu St. Digos, City Davao Del Sur. On the other hand, the hospitals using the computed radiography system are the following: Davao Doctors Hospital (DDH), E. Quirino Ave., Davao City; Southern Philippines Medical Center (SPMC), J.P Laurel Ave., Bajada, Davao City and Davao Medical School Foundation and Hospital (DMSF), Medical Drive, Bajada, Davao City. Participants The respondents of the study are the Registered Radiologic Technologists and Associate X-ray Technologists coming from the selected hospitals in Davao City employing a film-screen and computed radiography system. Moreover, the qualified respondents should be at least six months in service at the time of the evaluation. Measures The research assessment is composed of four parts. The first part of the assessment consists of questions pertaining to the profile of the respondents and hospital. The second part consists of questions on the respondents level of knowledge on exposure technique factor selection. The questions are specifically structured in such a way that assesses the respondents acquired knowledge on technique selection. Based on the results, the attitude in terms of respondents response in both film-screen and CR system will be categorized as follows depending on their mean score: Points Obtained Qualitative Description 30-25 Very High 20-24 High 15-19 Moderately High 10- 14 Low 13- 0 Very Low INTERPRETATION The aforementioned assessment form that will be used as instrument of the study is constructed and designed by the researchers as to measure the basic knowledge in exposure technique factor selection regardless of the imaging system used. Its validity and reliability was attested by experts of the field. Moreover, the third part of the assessment is an actual evaluation wherein the respondents are observed during x-ray examination. They will be assessed in the actual selection of the exposure technique factor and the outcome of the image. The said assessment is a point system; the appropriate the RT performs in technique factor selection and the acceptable the image, the higher the points. Based on the results, the level of radiographic competence in terms of respondents skills will be categorized as follows depending on their mean score: Points Obtained Qualitative Description 10 Very high level of radiographic skills 7-9 High level of radiographic skills 4-6 Moderately low level of radiographic skills 1-3 Low level of radiographic skills Low level of radiographic skills means that the respondents were not able to perform the appropriate exposure techniques and came up with an unacceptable radiograph. Moderately low level of radiographic skills me

Tuskegee Syphilis Study Ethics

Tuskegee Syphilis Study Ethics Abstract The Tuskegee Syphilis Study was a forty year-long study in which researchers observed the natural progression of syphilis in 399 African-American men. Despite medical advancements and the discovery of successful penicillin treatments for syphilis, researchers involved in the Tukegee Syphilis Study took extreme measures to ensure participants remained unaware of life-saving intervention (Jones, 1993). The deceptive and manipulative nature of the Tuskegee Syphilis Study resulted in public uproar and legislative action to ensure the protection of human rights and prevented future unethical practices in research involving human subjects. Although there are strict federal regulations for research ethics, underrepresentation of minority groups in clinical research continues to exist even forty years after the cessation of the Tuskegee Syphilis Study. Research suggests that the maltreatment and unethical practices of the Tuskegee Syphilis Study may have fostered distrust in health care prov iders resulting in unwillingness to participant in clinical research (Shavers, Lynch, Burmeister 2000). The implications of the Tuskegee Syphilis have helped shape the American Psychological Associations Ethical Code of Conduct (2002) and influenced the current standard of care expected of health care providers involved in research. Keywords: Tuskegee Syphilis Study, research ethics Research Ethics: The Tuskegee Syphilis Study The Tuskegee Syphilis Study is one of the most infamous and controversial studies executed in the last century. In 1932, the United States Public Health Service in conjunction with the Tuskegee Institute initiated a 40 year-long study to observe racial differences in the development of syphilis. Syphilis is a sexually transmitted disease that gradual spreads throughout the body and may cause physical deformities, dementia, paralysis, and even death (Center for Disease Control [CDC], 2012). Researchers from the Tuskegee Institute recruited 600 African-American men from Macon County, Alabama, 399 of who had untreated syphilis in the latency stage (Reverby, 2001). The researchers coerced participants into the study by telling them they had â€Å"bad blood†, a term used to describe multiple illnesses within the black community at that time. To persuade participants even further, researchers provided them with regular meals, free transportation to and from the clinic, and funeral s tipends for their families (Carmack, Bates, Harter, 2008). Furthermore, research directors hired African-American doctors and nurses in order to acquire and maintain the participants trust throughout the study (Corbie-Smith, 1999). Despite medical advancements and the 1943 discovery of penicillin as a successful treatment for syphilis, participants in the Tuskegee Syphilis Study were not privy to life-saving interventions. Furthermore, researchers prevented participants from knowing about viable treatment options by prohibiting medical screenings during the World War II draft, monitoring participants who went to other medical facilities, and intervening with other health care providers who tried to treat participants (Reverby, 2001; Rothman, 1982). By taking such extreme measures throughout the study, more than 100 men who suffered from syphilis succumbed to the curable disease (Corbie-Smith, 1999). Although several government agencies and healthcare providers knew of the Tuskegee Syphilis Study, in 1972, the New York Times released an extensive article detailing the unethical treatment of African American men with untreated syphilis. The article generated public disgust and caused nationwide uproar, inevitably resulting in the 1973 termination of the Tuskegee Institute’s syphilis research by the Health and Scientific Affairs Review Board (Carmack, Bates, Harter, 2008). The unethical practices committed by researchers at the Tuskegee Institute led to the 1974 National Research Act, which mandated the use of Institutional Review Boards for research that receives federal grants (Rencher Wolf, 2013). Despite the cessation of the study in 1973, it was not until May 16, 1997 that President Clinton issued an apology on behalf of the United States Government to the victims of the Tuskegee Syphilis Study. At this time, the United States Government recognized their role in the c ontinuation of the study and the ethical negligence that took place (Fairchild Bayer, 1999). Throughout the duration of the Tuskegee Syphilis Study, generations of researchers who undertook the study continued to rationalize their work based on scientific grounds and the importance of understanding the biological progression of the disease. They justified any ethical concerns by suggesting that researchers could never replicate the magnitude of such data or have the ability to acquire such a large group of untreated individuals (Rothman, 1982). The validations given by researchers to continue mistreating patients stress the importance of creating ethical boundaries when conducting research. Acknowledging the deficient treatment and research decisions made by health care providers in the past helps influence the direction of patient care for the future. The Tuskegee Syphilis Study, along with many other unethical research practices in our country’s medical and psychological history, including eugenics and maltreatment of the mentally ill in asylums, have helped shape the ethical requirements that are now expected from all health care providers. The ethical violations committed throughout the course of the Tuskegee Syphilis Study have influenced the inclusion of many standards outlined in the APA Code of Ethics involving patient care, therapeutic practice, and research protocols. Ethical Concerns General Principles The unethical foundation and practices carried out throughout the duration of the Tuskegee Syphilis Study violated the General Principles outlined in the 2002 American Psychological Association Ethical Code of Conduct including: Beneficence and Nonmaleficence, Fidelity and Responsibility, Integrity, Justice, and Respect for Human Rights and Dignity. In terms of Beneficence and Nonmaleficence, which describes the importance of avoiding and minimizing patient harm (APA, 2002), the researchers involved with the continuation of the Tuskegee Syphilis Study harmed their participants as well as the participants’ families who had to care for them as their health deteriorated due to the progression of the disease. Furthermore, researchers neglected to discuss the transmission of syphilis and preemptive measures that would prevent others from contracting the disease, which caused harm to those who had sexual relationships and children with untreated participants (Corbie-Smith, 1999; Jon es, 1993). The principle of Fidelity and Responsibility focuses on building and maintaining a trusting relationship between the patient and health care provider as well as the obligation to serve in accordance to the patient’s best interest (APA, 2002). The Tuskegee Syphilis Study violated this principle and in many ways relied on deception to give the impression of trusting relationships between researchers and participants. For instance, in order to gain the trust of the participants, researchers hired an African-American nurse named Eunice Rivers for the duration of the forty year-long study. She would often transport them to and from the clinic, act as a cultural liaison, and provide devoted support to the participants (Corbie-Smith, 1999). Although this encouragement and assistance was important for the participants throughout the study, the formation and maintenance of such a trusting relationship may have inhibited the participants from making well-informed decisions about their c ontinued involvement in the study. In this regard, Eunice Rivers may have unintentionally acted as a mode of deception rather than of trust by not upholding the participants’ best interest and inadvertently obstructing informed consent. The Integrity and Justice Principles involve the importance of upholding honesty, avoiding misrepresentation, and ensuring access and benefit from services (APA, 2002). In regards to the Tuskegee Syphilis Study, the violations of these values are apparent due to the dishonest, manipulative, and immoral nature of the study. Researchers went to great lengths in order to prevent participants from learning about life-saving treatments for syphilis including informing the Alabama Health Department not to treat participants, interceding with other health care providers, and prohibiting medical screenings for participants drafted to fight in World War II (Reverby, 2001). The resources that researchers used to maintain the study’s objective indicates the unethical practices that occurred throughout the duration of the study in the name of science. Lastly, the principle of Respect for Human Rights and Dignity concerns the protection of human rights and overall welfare of a patient’s well-being (APA, 2002). Throughout the course of the Tuskegee Syphilis Study, researchers violated several human rights and exploited the vulnerability of a community affected by a potentially fatal disease. Researchers took advantage of a population that lacked affluence and quality education for American-Americans by giving participants incentives such as funeral stipends and hot meals, which inevitably impeded their ability to make informed decisions about participating in the study (Carmack, Bates, Harter, 2008; Corbie-Smith, 1999). Furthermore, during the period in which the Tuskegee Syphilis Study took place, social prejudices against African-Americans may have influenced the basis and continued justification of the study (Bhopal, 1997). Informed Consent The standards outlined in the American Psychological Association are expectations pertinent to all health care providers who are assessing, treating, or researching patients. The standard related to informed consent regarding research discusses the importance of disclosing the purpose, potential risks, and expected duration of the study in order for participants to make educated decisions about their participation in research (APA, 2002). From a historical perspective, at the time of the Tuskegee Syphilis Study the APA Code of Conduct was not a comprehensive list of standards, research guidelines, and protocols. However, the importance of informed consent is paramount in Tuskegee Syphilis Study and influences the expectations for patient care that are applicable today. The African-American subjects involved in the Tuskegee Syphilis Study were primarily impoverished and uneducated sharecroppers, which presents ethical concerns regarding the ability for participants to make informed decisions due to desirable research incentives or an inability to comprehend the extent of their involvement in the study. Researchers also used the term â€Å"bad blood† to recruit participants rather than informing them of their actual medical condition. The lack of information provided to the participants regarding the nature of the study and treatment options indicates the inadequacy of informed consent that caused harm to many individuals involved in the Tuskegee Syphilis Study. In addition, there remains to be controversy regarding how informed the participants were throughout the study. In 1972, a Center of Disease Control officer reported that participants in the Tuskegee Syphilis Study had knowledge of the study’s nature and knew they could withdraw at any time. Conversely, Dr. Williams, an intern who worked at the Tuskegee Institute during the study, stated neither interns nor participants knew of the study’s objectives (Jones, 1993). The conflicting accounts indicate the deceptive characteristics of the study, which may have caused confusion to the participants and subsequent mistrust of health care providers that is still prevalent today. Deception in Research The APA Ethical Code of Conduct prohibits researchers from deceiving participants in research that may potentially â€Å"cause physical harm or severe emotional distress† (p. 11). The detrimental effects caused by the Tuskegee Institute violated this standard in several ways. For instance, researchers told participants they had â€Å"bad blood† and offered treatment and incentives for ongoing participation. Medical staff involved in the study never told participants their true medical diagnosis. Charles Pollard, a Tuskegee subject stated, â€Å"All I knew was that they just kept saying I had bad blood- they never mentioned syphilis to me, not even once† (Jones, 1993, p. 278). The participants used in the Tuskegee Syphilis Study all had syphilis in the latency stage, which can be very dangerous if left untreated. Many with latent stage syphilis may not experience the external symptoms of syphilis including sores and rashes; however, they may be susceptible to develop paralysis, blindness, dementia, or fatal damage to internal organs (CDC, 2012). Despite the debilitating and life-threatening effects of syphilis, participants never received counseling on how to prevent the transmission of disease or that their disease was contagious at all. Consequently, this exacerbated the spread syphilis and contributed to 40 wives contracting syphilis from sexual interactions and 19 children born with congenital syphilis (Jones, 1993; Perkiss, 2013). Although the Tuskegee participants believed they were receiving treatment for â€Å"bad blood†, researchers actually prevented participants from gaining access to life-saving treatment and watched as participants health slowly deteriorated. Researchers continued to justify this active neglect in fear of losing â€Å"valuable† research data due to the longevity of the study. The harm caused by the omission of information in the Tuskegee Study, especially the severity and cause of syphilis is irrevocable and continues to have ethical implications in research studies. Research Implications The unethical practices of researchers and health care providers throughout the Tuskegee Syphilis Study have led to legislative, political, and social implications that continue to affect research protocols. Due to the public upset caused by the revelation of the Tuskegee Syphilis Study, legislators passed the National Research Act in 1974 in hopes of avoiding unethical practices in future research endeavors (Rencher Wolf, 2013). The National Research Act led to the formation of theNational Commission for the Protection of Human Subjects of Biomedical and Behavioral Research who were responsible for recognizing and enforcing the ethical standards regarding professional conduct when using human subjects in research. By doing so, the Commission also established guidelines for researchers to abide by in order to protect human rights and preserve human dignity (The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1979). The National Research Act also mandated institutions who receive government grants to establish and submit research proposals to local Institutional Review Boards. The Institutional Review Boards are required to evaluate research studies and ensure that informed consent, research methods, and objectives adhere to the ethical guidelines and uphold human rights. Moreover, the Institutional Review Boards are responsible for yearly evaluations to ensure r esearchers remain in accordance to all ethical guidelines. (Rencher Wolf, 2013; Corbie-Smith, 1999). Due to the legal and ethical implications of the Tuskegee Syphilis Study, many research institutions became overly cautious about including certain groups in their research in fear of causing another public protest. Excluding particular groups from research limited generalizability and the application of research findings to a diverse population, which consequently hindered scientific progression. This concern led to the 1993 National Institutes of Health Revitalization Act, which required researchers to include minorities and women as research subjects. However, the ability to acquire these populations for clinical research, especially ethnic minorities, continues to be troublesome (Corbie-Smith, Thomas, Williams, Moody-Ayers, 1999). Although federal regulations have mandated ethical guidelines for research, the effects of the Tuskegee Syphilis Study and other unprincipled practices throughout history may be a factor in the underrepresentation of minorities participating in research and the perpetual mistrust in health care providers (Freimuth et al., 2001). Based on a report from the Center of Disease Control, African-Americans have higher rates of medical conditions including heart disease, stroke, HIV/AIDS, diabetes, and hypertension (CDC, 2011). However, due to the low census of participants in medical research, health care providers face challenges when trying to identify the physiological, cultural, and sociological reasons contributing to the high prevalence of African-Americans suffering from medical conditions. Researchers suggest that the extensive history of unethical treatment by health care professionals, including that of the Tuskegee Syphilis Study may affect the low frequency of minorities willing to participate in research (Freimuth et al., 2001). For instance, a study conducted by Shavers, Lynch, Burmeister (2000) indicates that knowledge of the Tuskegee Syphilis Study would negatively affect African-American participation in biomedical research based on distrust of researchers. Although awareness of the Tuskegee Syphilis Study was not the only factor influencing minority participation, 51% of African-Americans were less trusting of medical research because of their knowledge of the Tuskegee Syphilis Study. Furthermore, of the 51% who distrusted researchers, 46% reported that knowledge of the Tuskegee Study would affect their participation in medical research and 49% reported being unwilling to participant in research studies. Misconceptions regarding the nature of the Tuskegee Syphilis Study which suggests that researchers intentionally injected participants with syphilis in order to observe the natural progression of the disease may also be a contributing factor as to why minorities are hesitant to trust researchers or health care providers (Freimuth et al., 2001; Shavers, Lynch, Burmeister 2000). Furthermore, parental influence and socialization may have also had an indirect influence on more recent generations who were unaware of the discreditable history of research methods for scientific advancement (Poythress, Epstein, Stiles, Edens, 2011). The influence of cultural perspectives regarding research may reinforce reluctance to participate in research and perpetuate mistrust in health care providers. Conclusion The ethical research concerns surrounding the Tuskegee Syphilis Study continues to influence the revisions of the APA code of conduct, the standard of care expected for all patients, legislative orders to protect human rights, and social perspectives of health care providers. Despite the cessation of the Tuskegee Syphilis Study in 1973 and the enforcement of strict federal regulations, the underrepresentation of minorities in research continues to be a concern. The lack of participation limits generalizability and impedes the validity and application of research findings. In order to facilitate change, it is important for researchers and health care providers to address the misconceptions of the Tuskegee Syphilis Study, recognize the development of ethical standards throughout recent decades, and emphasize the value of accurate representation of minorities in research.

Ernest Hemingway After Fitzgerald :: Biography Biographies Essays

Hemingway After Fitzgerald Hemingway after Fitzgerald continued to be the man everyone expected him to be, superficially at least. He was famous, adventurous, had affairs with women, and continued to dominate the literary world. In the end, however, these very characteristics brought him into a state of depression that would ultimately defeat him. In the words of Kelly Dupuis, "[Hemingway's] final years were haunted by some of the same ghosts that haunted Fitzgerald: alcoholism, mental illness (in this case his own) and a creeping sense of diminished self-worth"1 Hemingway did not attend Fitzgerald's funeral after his death on December 21, 1940. It is not known when or how he had received word while in Cuba and Hemingway made no public statement regarding Fitzgerald's death.2 After The Last Tycoon was released to warm receptions that deemed Fitzgerald as capable of more "mature" work, Hemingway remained unmoved with the stories, saying "Scott died inside himself at around the age of thirty to thirty-five and his creative powers died somewhat later...the book has that deadness...as though it were a slab of bacon on which mold had grown" (Bruccoli, Dangerous 210). At this point in his life Hemingway had moved to a house outside Havana, Cuba with his wife Martha. While his public image continued to expand (seemingly at the expense of his work), he continued working on several writing projects that would later become Islands In The Stream and The Garden Of Eden. In 1942 (in one of the most bizarre stories I could imagine) Hemingway began an undercover operation with some friends and professional operatives to hunt down German submarines in the Atlantic ocean off the coast of Cuba. He used his own boat, Pilar, and attached radio equipment and extra fuel tanks, hoping that, in the offchance he found a German sub, he could "drop a bomb down the hatch". They called themselves the "Crook Factory." Nothing ever came of their sub hunts except a good time fishing and drinking together, in the process irritating Martha who thought Hemingway was avoiding the responsibilities as a great writer to report the real war then raging in Europe".3 From May of 1 944 to March 1945 Hemingway served in London and France as Collier's correspondent. There he met his fourth wife, Mary Welsh, who he married in 1946. Throughout the 1950's Hemingway's reputation grew as a celebrity as his public image dominated the literary world with every new book he wrote. Ernest Hemingway After Fitzgerald :: Biography Biographies Essays Hemingway After Fitzgerald Hemingway after Fitzgerald continued to be the man everyone expected him to be, superficially at least. He was famous, adventurous, had affairs with women, and continued to dominate the literary world. In the end, however, these very characteristics brought him into a state of depression that would ultimately defeat him. In the words of Kelly Dupuis, "[Hemingway's] final years were haunted by some of the same ghosts that haunted Fitzgerald: alcoholism, mental illness (in this case his own) and a creeping sense of diminished self-worth"1 Hemingway did not attend Fitzgerald's funeral after his death on December 21, 1940. It is not known when or how he had received word while in Cuba and Hemingway made no public statement regarding Fitzgerald's death.2 After The Last Tycoon was released to warm receptions that deemed Fitzgerald as capable of more "mature" work, Hemingway remained unmoved with the stories, saying "Scott died inside himself at around the age of thirty to thirty-five and his creative powers died somewhat later...the book has that deadness...as though it were a slab of bacon on which mold had grown" (Bruccoli, Dangerous 210). At this point in his life Hemingway had moved to a house outside Havana, Cuba with his wife Martha. While his public image continued to expand (seemingly at the expense of his work), he continued working on several writing projects that would later become Islands In The Stream and The Garden Of Eden. In 1942 (in one of the most bizarre stories I could imagine) Hemingway began an undercover operation with some friends and professional operatives to hunt down German submarines in the Atlantic ocean off the coast of Cuba. He used his own boat, Pilar, and attached radio equipment and extra fuel tanks, hoping that, in the offchance he found a German sub, he could "drop a bomb down the hatch". They called themselves the "Crook Factory." Nothing ever came of their sub hunts except a good time fishing and drinking together, in the process irritating Martha who thought Hemingway was avoiding the responsibilities as a great writer to report the real war then raging in Europe".3 From May of 1 944 to March 1945 Hemingway served in London and France as Collier's correspondent. There he met his fourth wife, Mary Welsh, who he married in 1946. Throughout the 1950's Hemingway's reputation grew as a celebrity as his public image dominated the literary world with every new book he wrote.

Frank Lloyd Wright :: essays papers

Frank Lloyd Wright Frank Lloyd Wright was an architect who was a pioneer in modern style, and he is considered one of the greatest figures in architecture in the 20th-century. In Richland Center, Wisconsin on June 8, 1867 Wright was born. 17 years latter at the University of Wisconsin his interest in architecture had already shown itself. He enrolled in civil engineering because the university didn^t offer any classes for his chosen field. He gained some practical experience by working on a construction project for the university part time. He left school and went to work for the firm of Adler and Sullivan in 1887. Louis Sullivan from the firm had a profound in Wright work. He left the firm and went to make his own office in Chicago in 1893. Organic architecture was a philosophy created by Wright. It means that a building should be developed out of it^s natural surroundings. Originality was shown in his designs for public and private structures. The ornate neoclassic and Victorian styles favored by conventional architects was the kind of thing Wright rebelled against. Wright was opposed to the mechanical imposition of preconceived styles. The particular function of the building, it^s environment, and the type of materials employed in the structure should be the things that ultimately determined the architechtual form is what Wright believed in. One of the many fundamental contributions was the use of building materials for their natural colors s well as structural characteristics. With the open planning of one room flowing into another his interiors emphasize the sense of spaciousness. Precast concrete blocks reinforced with steel rods was one of the many new techniques Wright initiated. Air conditioning, indirect lighting, and panel heating were a few of the numerous innovations Wright invented. One of Wright big feats was to make the Imperial Hotel in Tokyo. The building was made to withstand earthquakes. One year after being completed it suffered no damage from a disastrous earthquake. Architects who were more conventional then Wright were against his different ways all thorough out his career. He went into exile for a year in Europe because of personal difficulties and professional antagonisms. Upon his return he began a new career of ever widing-achivments. Some of his later works are the Millard House; the Kaufmann House; called Falling Water; The Johnson Wax Company Administration Building; the First Unitarian Church; the V.C. Morris gift shop; and the Price

Compare and Contrast the Renaissance with the Middle Ages

Romantic poetry began with French Revolution in 1789. Romantic period is based on freedom of thought. The transition from structured form to imagination and individualism. Romanticism is means return to nature. Another means we can say ; everything take place around nature. In that period supernatural things is our imagination. Nature is the most significant subject in this period. Writers inspire from the nature. In that period William Wordsworth one of the most important poet in romantic period. ‘Romanticism (also the Romantic era or the Romantic period) was an artistic, literary, and intellectual movement that originated in Europe toward the end of the 18th century and in most areas was at its peak in the approximate period from 1800 to 1850. Partly a reaction to the Industrial Revolution, it was also a revolt against the aristocratic social and political norms of the Age of Enlightenmentand a reaction against the scientific rationalization of nature. It was embodied most st rongly in the visual arts, music, and literature, but had a major impact on historiography, education and the natural sciences. Its effect on politics was considerable and complex; while for much of the peak Romantic period it was associated with liberalism and radicalism, in the long term its effect on the growth of nationalism was probably more significant.’ In that paragraph it is told about romanticism. When we read that paragraph we will understand how the improve and which area the improve romanticism.William wordsworth is one of the most important poet in romantic period. He use simple / clean language. His poem are based on nature. William wordsworth beliefs in healing / cureing power at nature. According to William wordsworth ; Nature is the best teacher. We may learn everything from nature. For instance ; He wrote I wandered lonely as a cloud. I wandered lonely as a CloudI wandered lonely as a Cloud That floats on high o'er Vales and Hills, When all at once I saw a crowd A host of dancing Daffodils; Along the Lake, beneath the trees, Ten thousand dancing in the breeze.The poem is rich with imagery and in the first stanza, he describes the scene as he wonders ‘as lonely as a cloud.’ He compares himself to a solitary could that is floating over valleys and the hills and then he sees a ‘crowd’ of golden daffodils which are under the trees and beside a lake and dancing in the breeze. He is admiring the beauty around him and capturing a beautiful snatched moment in time that nature has presented to him. So that he issues love of the nature.Willam wordsworth wrote Lyrical Ballads with Samuel Taylor Coleridge. Lyrical Ballads is a collection of poems. Its first edition was first published in the 1798. ‘The most of the poems in Lyricall ballads were written by wordsworth , four poems were contributed by Coleridge including his most poem ‘The Rime of Ancient Mariner.’’ The Lyrical ballad is said to ha ve begun the movement of romanticism in english poetry , the basic idea was to take the art of poetry into the reach of common people , in aspect of language and feelings.‘Its second edition was published in 1800’ , contains some more poems by Wordsworth , in this edition he also added a preface in which he described his thoughts and understanding on poetry. The Lyrical Ballads hold a very important place in english literature, as it significantly tried to change the course of english poetry and made it to be easily understood by common people. Here I am pasting both the first and the second edition of Lyrical ballads , which are freely available on my places on many places.

Vermont Teddy Bear Brief

Vermont Teddy Bear Company From Wikipedia, the free encyclopedia Jump to: navigation, search Vermont Teddy Bear Company Type Privately held company IndustryManufacturing, retail Founded1981 HeadquartersShelburne, Vermont ProductsTeddy bears Owner(s)The Mustang Group Subsidiaries Calyx & Corolla Gift Bag Boutique PajamaGram TastyGram WebsiteVermont Teddy Bear Company The Vermont Teddy Bear Company is one of the largest producers of teddy bears and the largest seller of teddy bears by mail order and Internet. The company handcrafts each of its teddy bears and produces almost 500,000 teddy bears each year.The company was formerly traded on the NASDAQ stock exchange under the ticker symbol BEAR, but was taken private by The Mustang Group, a Boston-based private equity firm, on September 30, 2005, partially to avoid the reporting requirements of the Sarbanes-Oxley Act. The company was founded in 1981 by John Sortino, who sold handcrafted teddy bears in an open-air market in Burlington, Ve rmont. Sortino happened upon the idea of packaging and selling bears through the mail when a tourist visiting Burlington wanted a bear mailed to her home.The concept was called the â€Å"Bear-Gram†, which features the customized teddy bear placed in a box (complete with an â€Å"air hole†) and stuffed with other goodies. By 1995, the company moved into its new headquarters in Vermont's Champlain Valley. The company has two factories: one in Shelburne and one in Newport. The Shelburne factory is an especially popular tourist destination, and also served as a concert site for the annual Vermont Mozart Festival. The company also maintained two retail locations in Vermont – Shelburne and on the main road between Waterbury and Stowe.VTB acquired Calyx & Corolla, an upscale flower company headquartered in Vero Beach, Florida in 2003. Ironically, one of Vermont Teddy Bear's marketing slogans claimed that sending a teddy bear is â€Å"a creative alternative to sending flowers. † In 2005, the company launched a new sister company, Gift Bag Boutique, which offered handbags and purses along with many make-up accessories. Along with PajamaGram, which sold gift pajamas, and TastyGram, which offered gourmet food gifts, the creation of this sister company brought the total number of companies under the Vermont Teddy Bear umbrella to five.Gift Bag Boutique and TastyGram stopped accepting orders as of June 26, 2008. [1] â€Å"Crazy† Controversy For Valentine's Day of 2005, Vermont Teddy Bear caused widespread controversy by offering a â€Å"Crazy for You† Bear. The bear was offered dressed in a white strait jacket with a red heart embroidered onto the front of the jacket. A tag entitled â€Å"Commitment Papers† came with the bear. The tag read â€Å"Can't eat, can't sleep, my heart's racing. Diagnosis – crazy for you. â€Å"[2] Mental health groups from all over the U. S. sked for the bear to be pulled out of production and removed from VTB's website. Many groups called for a boycott of the company. They claimed that the bear made light of the suffering caused by severe mental illness and contributed to the stigma that people with mental illness often encounter. The company's response was that there was no offense intended and it was merely a play on the phrase â€Å"I'm crazy about you. † The company claimed that the bear was intended to be a light-hearted depiction of the sentiment of love.When asked to remove the bear from their inventory, VTB responded by keeping their existing stock up for sale although they stated that they would not make any more in the future. The price of the bears from VTB was US$69. 95. After the company sold out, which happened within just a few days of the story hitting the news, the eBay bids reached several hundred dollars. Elizabeth Robert, the CEO and CFO of VTB was serving as a member of Vermont's largest hospital, Fletcher Allen Health Care, at the time o f this incident.In response to the significant controversy she resigned from the board. [3] Advertising VTB was listed amongst â€Å"‘a broad range of direct marketers' pitched by the show’s hosts themselves† who were taking out more ads on talk radio in 2010, according to Dan Metter, director of talk-radio sales of Premiere Radio Networks. Conservative radio hosts were seeing an uptick in listener numbers and advertising in the lead-up to the year's midterm elections. Premiere is the syndicator of the top three talk-radio shows — hosted respectively by Rush Limbaugh, Sean Hannity and Glenn Beck. [4]