HRM Practice Essay Example | Topics and Well Written Essays - 1000 words

HRM Practice - Essay Example This kind of behavior not only posed a threat to the reputation of the company but the unregulated stream of affairs also affected the children in a negative way. Motivation theories state that different factors affect why people go to work and their performance and efficiency is determined by these factors. These could be fulfillment of physiological, security, relationship, self esteem or self actualization needs according to Abraham Maslows hierarchy of needs. Other motivational factors would include Expectancy, Instrumentality and Valence according to Victor Vrooms theory of motivation. Absence of these factors of motivation could easily lead to low performance and efficiency. Absenteeism would have been a problem if employees were assigned fixed days but since the job demanded a fixed number of hours therefore employees preferred to report to the institution but work with a lax attitude. The low performance levels at social service could also be directly linked to the job characteristic model. Workers should be enthusiastic about the job they perform. They should have a certain level of intrinsic motivation which is related to the skill variety, task identity and task significance. Feedback from a job and consequences and results of workers activity also result in work effectiveness. Absence of these would decrease performance. It could be clearly observed that most of the motivational factors were absent from the job. The workers or the employees were not receiving any direct monetary compensation from the job and were ignorant about its true purpose; the betterment of the society. Thus they could not relate to the real intention of the job. There was a pressure to attend but there was no regulator of the quality of work. There was absolutely no job related instrumentality of social work as there were no identifiable outcomes in form of promotions or

Misuse Of Opiates Health And Social Care Essay

Misuse Of Opiates Health And Social Care Essay The misuse and abuse of illicit and prescription opiates is a growing problem in the United States. Even though Americans make up less than 5 percent of the worlds population, we consume close to 100% of the worlds supply of hydrocodone and nearly 80% of the worlds supply of legal and illegal opiates . Because of the vast availability of drugs and its impact on many facets of healthcare and the economy, it is imperative that health care providers and policy makers understand what drugs are being abused, who uses these drugs, where the drugs come from, and the health and economic burden on the United States. It is becoming exceedingly important for those directly involved with substance abusers to understand the physiological consequences, psychosocial consequences and withdrawal consequences of drugs. Opiates and opiate derivatives in particular, whether illicit (such as heroin) or prescription (such as Oxycontin) are being heavily abused across the country. These drugs can have serious health implications during use and during abrupt cessation (detoxification or withdrawal). This paper will present a review of the literature on the epidemic of heroin and prescription opiate abuse. Through a critical review, concepts such as the prevalence of the problem, the physiologic consequences of abuse, the current trends in management of the problem and implications for nursing and healthcare will be explored. Background Before proceeding, it is important to briefly discuss the basic pharmacology of opiate drugs. Opiates, otherwise known as narcotics, include the drugs heroin, morphine, codeine, oxycontin, hydrocodone, methadone and other chemically-related derivatives. All opiates are considered dispensable only by prescription in the United States with the exception of heroin, which is illegal in all circumstances. Opiates wield their effects by activating pleasure centers in the brain. The neurobiochemical model of addiction suggests that over time, the brains chemistry changes so that it yearns for the substance when it is not there and can produce physiologic effects of withdrawal when stopped. Heroin for example, which is chemically-related to morphine (the chemical name for heroin is diamorphine) readily crosses the blood-brain barrier to cause a rapid spilling of dopamine into the dopaminergic receptors of the brains neurons. For this reason, the drug is easily addictive and absence of the dr ug causes a sensation of craving and can cause feelings of illness, such as nausea and diarrhea, when stopped abruptly. . Prevalence of the Problem Several researchers in the nursing, allied health and economics disciplines have explored and discussed the prevalence of prescription opiate abuse and hypotheses of the origin of the problem. However, there is a large gap in the literature related to the prevalence of illicit drug abuse (heroin) among different populations. The prevalence data for heroin abuse in the US is largely reported by national survey trends, such as the National Institute of Drug Abuse (part of the National Institutes of Health) Survey on Drug Use and Health (NSDUH). Even so, the massive survey document pays little attention to the problem of heroin abuse and reports only two percent of the 67,500 survey respondents using heroin in the month preceding the survey (National Survey on Drug Use and Health, 2009). The etiology of prescription drug misuse and abuse is discussed more heavily in the literature than is heroin abuse. According to the NSDUH, in 2009 4.8% of the survey respondents aged 12 and older reported using prescription opiates for non-medical reasons. Of those, over 55% reported obtaining the drug for free from a friend or relative, and 4.8% reported purchasing the drug from a dealer on the streets (National Survey on Drug Use and Health, 2009). Researchers at Columbia University surveyed adolescents aged 12 to 17 in 2005 and found that 9.3% reported the misuse of prescription opiates over the past month. In exploring the adolescents motives for abuse, the researchers found that the most commonly reported motives were ease of attainment and affordability . Among young adult college students, prevalence of non-medical prescription opiate abuse has been reported between seven and nine percent in the past month to twelve to fourteen percent lifetime prevalence . One of the most at-risk groups for misuse of and addiction to prescription opiates is the chronic pain population. When used appropriately, opiate pain medications are a gold standard of care for serious pain-related conditions (such as post-operative pain, neuropathic pain and so on). In an effort to better manage pain, the number of prescriptions for opiate medications increased 154% in the ten-year period from 1992 to 2002, even though the population of the United States increased by only 13% . Although prescription opiates have been used to treat pain and improve the quality of life among acute and chronic pain patients, the advent of the drugs misuse has led to a wide body of literature on prescriptive practices and monitoring of opiate drugs. There delicate balance between managing pain adequately and the risk for misuse, addiction and diversion has been discussed in the literature recently, largely among the adolescent/young adult and chronic pain populations. Although there is a general lack in the literature of the number of people prescribed opiates for chronic pain . There is a large body of literature which suggests that the increased number of prescription opiates for chronic pain patients has contributed significantly to the drug abuse problem. In studies to investigate the use of prescription opiates for chronic pain, it has been found that pain treatment plans are sparse, good documentation on the patients health history and history of substance abuse is rare, and opiates are sometimes improperly utilized or not indicated at all . Health Consequences of Opiate Abuse Both prescription and illicit opiates have the potential to exert a myriad of acute and chronic negative health effects for the user. Neurological decline, vision changes, cardiac abnormalities, vascular complications, pulmonary disorders and mortality have been studied and reported. In a study of over 500 opiate addicts, electrocardiographic changes were documented in 61% of the sample. These ECG changes included ST-segment elevation, which may indicate ischemic heart damage (or lack of oxygen-rich blood to the myocardium) and QTc prolongation (seen mostly with methadone addicts). Prolonged QTc intervals may lead to inappropriate triggering of the ventricles and may lead to potentially lethal ventricular tachycardia . The use of heroin and other drugs by injection with non-sterile or reused needles may produce powerful toxins in the bloodstream leading to endocarditis, left ventricular hemorrhage and death. Researchers in Ireland reviewed the autopsy findings from eight cases of heroin users and found rapid fatal illness caused by the endotoxin Clostridium novyi which caused fatal subendocardial hemorrhage, spleen enlargement and pulmonary edema in all of the subjects studied . Heroin can cause significant acute peripheral and central nervous system complications such as neuropathy and hearing loss. In a study six of intravenous and intranasal heroin users admitted to the hospital for acute illness, five had documented rhabdomyolysis between three and 36 hours after administration of the drug. In each of the five cases, there was no documented trauma. Typically rhabdomyolysis occurs after a traumatic, compression-type injury where enzymes spill into the musculature and cause rapid neurological decline, loss of muscle tone and coma. In each of the subjects studied, no trauma or compression injury occurred . In a group of patients with a reported history of speedballing (or mixing heroin and cocaine), 2 of the 16 studied experienced sudden, bilateral sensorineural hearing loss four hours after speedballing which resolved within three days. One additional participant experienced sudden hearing loss after speedballing but unilaterally. The mechanism by which th e hearing loss occurred was described as a possible cochlear toxicity or autoimmune reaction related directly to the drugs . Injection of drugs of any type can cause vascular complications, skin and soft tissue infections and infectious diseases such as hepatitis and HIV . In the most severe cases, opiate abuse may lead to death, generally from overdose. Heroin has been related to 1.65 deaths per 100,000 people in the Florida population alone over the last decade and in Alabama between 1986 and 2003, a review of medical examiners reports revealed those whos cause of sudden death was undermined were 5.3 times more likely to have a history of drug abuse . Researchers in the United Kingdom have further investigated heroin deaths and concluded that overdose related to heroin rarely occurs after the use of heroin alone- in 50% of the cases they reviewed, alcohol was also involved . Although studies have been published on the health effects of abuse itself, a review of nursing, medical and allied health literature shows a significant lack of studies on the health consequences of withdrawal (abrupt cessation) of opiate drugs. Several studies have been found relating to the use of pharmacotherapy to treat opiate addiction (such as methadone and similar programs) but no studies have explored the physiologic effects of withdrawal without medication assistance. Searching online databases for relevant articles on opiate withdrawal does not yield any studies other than those using medication-assisted withdrawal therapies (such as methadone and buprenorphine). This is important to populations such as inmates in a correctional facility where pharmacotherapy is not generally used during detoxification and requires further attention . In sum, the potential health-related consequences of opiate abuse can negatively affect a myriad of body systems. The risk of potentially fatal infectious disease, neurological and cardiovascular complications and death by overdose creates a public health problem that demands attention. Health care providers in all arenas must be able to rapidly and appropriately identify those at risk. Implications for Advanced Nursing Practice Nurse practitioners are allowed prescriptive authority in almost any state across the country. Depending on the practice setting, they may prescribe opiates to treat pain. Opiates are the gold standard for treating moderate to severe pain in both acute and chronic pain syndromes . There has been some discourse in the literature on the dilemma to treat or not to treat pain with opiates. On the one hand, effective pain management is not only ethical but also opiates are effective for many patients for pain management and on the other hand there is a fear of misuse, dependence and addiction issues . The ability for advanced practice nurses to identify drug-seeking behavior, issues with addiction and possible diversion of opiates is crucial to the problem of opiate abuse. As it has been documented in the literature, diversion of prescription opiates generally occurs with the patient selling, trading or giving away the medication to another. According to Annie Gerhardt, emergency room nu rse practitioner, drug seekers become victims of their own disease, becoming involved in a tangled web of addiction, drug-seeking, drug diversion and criminal behavior that escalates over time with increased drug use . Gerhardt (2004) suggests monitoring patients treated with opiates for refilling meds before their follow up appointments, patient reports of losing medications, attempting to see different providers for pain medications (which can usually be identified by pharmacies), and scamming providers for more medications by complimenting the provider or the office staff or displaying increased levels of pain in order to procure more medication. When prescribing opiates to treat pain in patients already known to have addiction issues, using sustained-released formulations may reduce dependency while adequately treating pain. Sustained-release formulations usually have a reduced street value and are less likely to be sold and diverted, and the withdrawal from sustained-release op iates is typically not as severe . In terms of advanced practice nursing, prescribers have the unique ability to screen for potential addiction issues, monitor those who are prescribed addictive medications and potentially control diversion of those medications to others for whom they are not prescribed. Ultimately, the knowledge of drugs of abuse and health-related consequences is important for nurses at all levels to possess. Implications for Research To further add to the body of literature on the subject of opiate drug abuse, addiction and withdrawal, several areas still need to be explored. First, patterns of drug use in individual populations and communities should be investigated. The types of drugs most commonly used, the routes of administration of these drugs and their negative health-related consequences should be studied in a variety of communities, both urban and rural, to gain a better understanding of the patterns of use across the country. More research is needed beyond simple prevalence studies on the number of people who use to expand on the actual patterns of abuse. Similarly, the psychosocial consequence of drug use across different populations needs further investigation in order to articulate the negative impact on individuals and communities. Because the abrupt cessation of opiate drugs without medication assistance occurs frequently in specific settings, more research needs to be done on the physiological effects of non-assisted detoxification. The patterns of symptoms of withdrawal and negative health effects among populations such as the incarcerated and the hospitalized need to be explored. The potential for the development of evidence-based protocols for the management of abuse and withdrawal in these settings can occur once the patterns of symptoms and health consequences are documented. Conclusion In sum, the problem of drug abuse (which extends far beyond even opiate drugs) has been reported in multiple sources, and prevalence studies seem rampant in the literature. However, much more work needs to be done on the consequences of drug abuse from a healthcare perspective across a variety of populations in different settings to begin to understand the impact of drugs on communities.

Oil and its Economics :: Economy Petrol

Supply of Oil â€Å"Since 1974 oil-exporting nations have substantially increased their imports in order to finance development plans and to pay for highly technical military training, equipment, and sophisticated defense systems such as the airborne warning and control system, AWACS. From 1972 to 1983, OPECs imports increased approximately sevenfold. Furthermore, exports to OPEC from OECD as a percentage of the latter's total exports increased from 4.1 percent in l972-73 to 8.8 percent in 1975-82, then to 8.4 percent in 1983; and it dropped to 7.1 percent in 1984.† (http://www.georgetown.edu/users/johnsonj/oweiss/petrod/increase.htm) â€Å"Dynamic forces of oil supply and demand led to all excess supply in world markets since 1980, which in turn led to a de facto decline in the price of oil even before OPEC's London agreement of March 1983 in which the official price was reduced by approximately 14 percent. This oil glut in world markets was the result of at least three mutually dependent dominant forces: high oil prices, increase in production, and reduction in demand.† (http://www.georgetown.edu/users/johnsonj/oweiss/petrod/since.htm) â€Å"First, following the initial leap of 1973 the price of oil was once again drastically increased in l979. This rise led to a substitution of other sources of fuel and a reduction in real income, which contributed eventually to a decline in the demand for oil after a three-year time lag.† â€Å"A second factor in the oil glut was the increase in world oil production--a predictable economic consequence of rise in its price.† â€Å"A third factor in the oil glut was decreased demand for oil. The 1980 economic recession, which had plagued the world economy and which had markedly reduced the productive capacity of industrial nations by its greatest percentage decline since World War II, was a dominant force in reducing the demand for oil yet further. As their gross national products headed downward because of the recession, industrial nations reduced their imports. This, in turn, led to a reduction in foreign exchange earnings of the less-developed countries. These had, therefore, to curtail their purchases from abroad, including imports of oil. A multiplier effect of all such factors had a marked effect on the demand for oil in world markets.† (http://www.georgetown.edu/users/johnsonj/oweiss/petrod/since.htm) DEMAND Demand for Oil over Time (http://www.georgetown.edu/users/johnsonj/oweiss/petrod/time.htm) â€Å"A conventional downward-sloping demand curve is not, in [Dr. Oweiss’]opinion, sufficient to explain the interaction of oil prices and quantity demanded over time. In studying the dynamics of international oil markets which differentiates between upward and downward trends in prices. A small rise in the price of oil, from its low, pre-1973 level, will not change the quantity demanded, for demand at such a low level may he regarded as perfectly inelastic.

Beowulf: Sigemund Episode

Analysis of the Sigemund Episode Within Beowulf One of the best literary devices the author of Beowulf uses is the use of episodes and digressions. Each of these episodes and digressions tell another story apart from the main plot of Beowulf, but sets up an introduction to the main plot. One such episode, the Sigemund episode, tells of valiant King Sigemund who received glory and honor through his killing of the dragon and possession of the hoard. Sigemund became a noble and experienced king, only to be betrayed and brought to his downfall.Beowulf was much the same as Sigemund, and both were great examples of heroes. The Sigemund episode introduces a comparison to Beowulf, foreshadows Beowulf’s downfall, and parallels the irony of Beowulf’s shortcomings. As we see in the following lines: â€Å"Sigemund’s name was known everywhere. / He was utterly valiant and venturesome, / a fence round his fighters and flourished therefore† (897-898), the author introduc es Sigemund as an excellent comparison to Beowulf. The author uses the Sigemund episode to set up a better understanding of the character of Beowulf by describing a king much like himself.This allows the reader to understand the character of Beowulf and know what a noble and valiant character he was. The author presents Sigemund as a brave warrior who defeated the dragon, much like the victorious warrior that Beowulf was. And within the Sigemund episode, Heremod is introduced as a wicked king, an exact opposite of Sigemund and Beowulf. This allows the reader to compare the three kings, and promote Beowulf as a noble king such as Sigemund. Another purpose of the Sigemund episode within Beowulf is to foreshadow Beowulf’s defeat and downfall.Sigemund is a noble and mighty king, but is led to his defeat in the following lines: â€Å"†¦ The king was betrayed, ambushed in Jutland, overpowered / and done away with† (901-903). This defeat of Sigemund foreshadows Beowulfâ €™s defeat and death during the battle with the dragon. As Sigemund and Beowulf are both valiant kings, they both are led to their failure and death. This part of the Sigemund episode gives the reader a glimpse of what is to come for Beowulf in the rest of the poem. From this episode, the author uses irony that Beowulf will become a great and mighty king, but also will come face to face with his destruction.The author uses this irony to connect the characters of Sigemund and Beowulf. Not only does the Sigemund episode foreshadow the downfall of Beowulf, but it also sets up a choice that Beowulf has to make. Beowulf has to either chose to be like Sigemund, a courageous and noble king, or take the path of Heremod, an evil king. This gives the reader a sense of uncertainty of the choice Beowulf will make. As the reader, the choice that Beowulf will make is obvious, but this is a huge choice of character for Beowulf.It gives a chance for Beowulf to prove his character, and allows th e reader to understand the trustworthiness of Beowulf once he does chose to be a noble king. Among the various episodes and digressions within Beowulf, Sigemund’s episode sets up the best foreshadowing of Beowulf’s life. In all, Sigemund’s episode clues the reader in with what type of character Beowulf is. Sigemund is the perfect comparison to Beowulf, and this allows the reader to expect what is to come for Beowulf. Sigemund’s hymn apart from the main plot of Beowulf accomplished the task of introducing and setting up the destiny for Beowulf.

Stryker Corporation

Stryker Corporation is a Fortune 500 medical technologies firm based in Kalamazoo, Michigan. Stryker's products include implants used in joint replacement and trauma surgeries; surgical equipment and surgical navigation systems; endoscopic and communications systems; patient handling and emergency medical equipment; neurosurgical, neurovascular and spinal devices; as well as other medical device products used in a variety of medical specialties. In the United States, most of Stryker's products are marketed directly to doctors, hospitals and other healthcare facilities.Internationally, Stryker products are sold in over 100 countries through Company-owned sales subsidiaries and branches as well as third-party dealers and distributors. Business Segments – Stryker segregates their reporting into three reportable business segments: Reconstructive, Medical and Surgical, and Neurotechnology and Spine. Reconstructive products consist primarily of implants used in hip and knee joint re placements and trauma and extremities surgeries.MedSurg products include surgical equipment and surgical navigation systems (Instruments); endoscopic and communications systems (Endoscopy); patient handling and emergency medical equipment (Medical); and reprocessed and remanufactured medical devices as well as other medical device products used in a variety of medical specialties. Stryker Neurotechnology and Spine products include a portfolio of products including both neurosurgical and neurovascular devices.Their neurotechnology offering includes products used for minimally invasive endovascular techniques, as well as a line of products for traditional brain and open skull base surgical procedures, orthobiologic and biosurgery products including synthetic bone grafts and vertebral augmentation products, as well as minimally invasive products for the treatment of acute ischemic and hemorrhagic stroke. Stryker also develops, manufactures and markets spinal implant products including cervical, thoracolumbar and interbody systems used in spinal injury, deformity and degenerative therapies.Contents: 1 History †¢2 Corporate governance †¢3 Recent acquisitions †¢4 Sponsorships †¢5 Regulatory controversies †¢6 References †¢7 External linksHistoryThe Orthopedic Frame Company, precursor of Stryker Corporation, was formed on February 20, 1941 by Dr. Homer Stryker, a Kalamazoo, Michigan based orthopedist. Stryker developed the Turning Frame—a mobile hospital bed that allowed for repositioning of injured patients while providing necessary body immobility, the cast cutter—a cast cutting apparatus that removed cast material without damaging underlying tissues, and the walking heel, among others.In 1964, the company name underwent revision and was officially changed to Stryker Corporation. [2] In 1979 Stryker made an initial public offering of stock and later acquired Osteonics Corporation, entering the replacement hip, knee, and ot her orthopaedic implants market (Stryker). In 1999 annual sales reached $2. 1 billion and in 2000 Stryker was included in the S&P 500 and the Forbes Platinum 400 for the first time. In 2002 sales reached $3.0 billion and Stryker was listed in the Fortune 500 for the first time.In 2003 Stephen P. MacMillan joined Stryker as President and COO. In 2005, annual sales reached $4. 9 billion and John W. Brown transitioned to the single role of Chairman of the Board while Steve MacMillan became President & CEO. By 2007, Stryker sold its Physiotherapy Associates division to private equity firm Water Street Healthcare Partners for $150 million. In February 2012, Mr.  MacMillan resigned and Curt R. Hartman was named Interim Chief Executive Officer and Vice President and Chief Financial Officer.Mr. William U. Parfet was named Non-Executive Chairman of the Board. On October 1, 2012 Mr. Kevin A. Lobo was appointed as President and Chief Executive Officer. At the end of 2012, Stryker had approxi mately 22,000 global employees, annual sales of $8. 7 billion, and 35% of those sales were outside the U. S.Stryker Roll-In-StretcherAs of a 2012 global market overview of top medical technology firms, Stryker maintains a number 10 locus with total portfolio sales in excess of $8. 6 billion. Moreover, the firm maintains 35% worldwide reconstructive market share; 50% worldwide MedSurg market share; 15% worldwide Neurotechnology and Spine market share. The company was recognized in by Hermann Simon as a role model for other small to medium sized business in his book Hidden Champions.Corporate governance As of 2013, members of the board of directors of Stryker Corporation are: †¢John W. Brown, Chairman Emeritus †¢Kevin A. Lobo, President & CEO †¢William U. Parfet, Non Executive Chairman †¢Howard E. Cox, Jr. †¢Srikant M. Datar, Ph.D. †¢Dr. Roch Doliveux †¢Donald M. Engelman, Ph.D. †¢Louise L. Francesconi †¢Allan C. Golston †¢Howard L. La nce †¢Ronda E. StrykerRecent acquisitionsIn 1998, Stryker purchased Howmedica, the orthopaedic division of Pfizer, for $1. 65 billion. Howmedica became Stryker Orthopaedics. In August 2000, Stryker acquired, with stock, Guided Technologies, Inc. , a developer and manufacturer of optical localizers purposed for use in healthcare and industrial.   In August 2004, Stryker acquired, for $120 million, SpineCore Inc. , a company involved in the development of artificial spinal disks. About two years preceding this date, in June 2002, the firm acquired the Spinal Implant Business of Surgical Dynamics Inc.for $135 million. In March 2006 Stryker absorbed the Haifa, Israel based Sightline Technologies Ltd. into its operations. Sightline, a manufacturer of gastrointestinal endoscopy apparatuses, propelled Stryker into the flexible endoscopy market. In February of the same year, the firm acquired eTrauma. com Corp. , a privately held entity involved in the development of software for Pic ture archiving and communication system (PACS); the company was incorporated into Stryker Endoscopy Business. December 2005 marked the company’s acquisition of PlasmaSol Corp. for $17. 5 million.PlasmaSol produces technologies allowing sterilization of various MedSurg equipments. In 2009, Stryker acquired Ascent Healthcare Solutions, Inc. the market leader in the reprocessing and remanufacturing of medical devices in the U. S. In Jan 2011, Stryker acquired the Neurovascular Division of Boston Scientific, which includes products used for the minimally invasive treatment of hemorrhagic and ischemic stroke. In June 2011, Stryker purchased Malvern, Pennsylvania-based Orthovita, a biomaterials company specializing in bone augmentation and substitution technologies.The Orthovita business now makes up the Stryker Orthobiologics division, which specializes in biomaterials for all Stryker divisions. In July 2011, Stryker completed the acquisition of privately held Memometal Technologi es S. A. (Memometal). France based Memometal develops, manufactures and markets products for extremity indications based on its proprietary methods for preparing and manufacturing a shape memory metal alloy. In August 2011, Stryker signed a definitive agreement to acquire privately held Concentric Medical, Inc. (Concentric) in an all cash transaction for $135 million.Concentric's products include devices for the removal of thrombus in patients experiencing acute ischemic stroke along with a broad range of AIS access products. In November 2012, Stryker acquired the Tel Aviv, Israel based Surpass Medical Ltd. a company developing a flow diversion stent technology to treat brain aneurysms using a mesh design and delivery system, for $135 million. [10] In March 2013, Stryker acquired Trauson Holdings Company Limited (Trauson). Trauson is a trauma manufacturer in China and a major competitor in the spine segment.SponsorshipsStryker maintains relationships with, but not limited to, the fo llowing professional and trade organizations:†¢The Advanced Medical Technology Association (AdvaMed) †¢The Medical Devices Manufacturing Association (MDMA) †¢The Orthopedic Research and Education Foundation (OREF) †¢National Electrical Manufacturers Association (NEMA) †¢European Federation of National Associations of Orthopaedics and Traumatology (EFORT) †¢International Society of Orthopaedic Surgery and Traumatology (SICOT) †¢International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) †¢Foundation for Orthopaedic Trauma; Speaking of Women’s Health †¢Arthritis Foundation and American Academy of Orthopaedic Surgeons (AAOS) †¢Association of Perioperative Registered Nurses (AORN) †¢American Orthopaedic Society for Sports Medicine (AOSSM) Additionally, the following athletes publicly endorse Stryker Orthopaedics products: †¢Johnny Bench †¢Fred FunkRegulatory controversiesOn Jan 27, 20 00, Stryker Corporation restated its operating results for the year ended December 31, 1998 to reduce acquisition-related charges by $30. 9 million. Since early 2007 the company has received three Warning Letters from the Food & Drug Administration citing issues in compliancy. The first of these, a seven-page correspondence, named various issues at an Ireland-based manufacturing facility such as untimely fix of failures and procedural noncompliance in the testing of failed or otherwise problem-prone devices.The second, sent November 2007, cites issues at the firm’s Mahwah, N. J. facility including poor fixation of hip implant components, in some instances requiring mitigation by revision surgeries; exceeded microbial level violations in the cleaning and final packaging areas of the sterile implants; and failure to institute measures in prevention of recurrence of these and other problems. The final warning letter, sent April 2008, cites issues at the firm’s Hopkinton, MA biotechnology facility.Again, issues relate to quality and noncompliance including falsification of documents relevant to the selling of products to hospitals which are to be sold under a limited, government-mandated basis. Stryker maintains that employees involved in the falsification of documents have since been terminated. In the Fall of 2007, Stryker, along with the related companies: Biomet, Zimmer Holdings, DePuy Orthopaedics and Smith & Nephew, were involved in civil ligation with the U. S. Department of Health and Human Services, Office of Inspector General.This litigation called for a net payout of $311 million as the governmental department maintains the aforementioned companies engaged in unlawful kickbacks to physicians who urged hospitals to purchase their respective products. Stryker, however, having cooperated early in the investigation, was not fined. As of February 2008, a dispute exists between Stryker Corp. and the U. S. Department of Justice concerning a subpo ena linking the company to aforementioned misconduct in sale of products.Since governmental filing of the injunction, Stryker notes that it has produced in excess of 300,000 pages of documentation in compliance with the mandate. U. S. Government counters, however, that the documentation was not proper in scope and format. Law officials expect the investigation to continue for several months. Stryker recalled several models of medical vacuums sold under the Neptune Waste Management System brand in June and September of 2012. The devices, some of which had not been approved by the Food and Drug Administration, caused a fatal accident when the vacuum was mistakenly used to suction a passive drainage tube.