The Problem Of Illicit Drugs - 1714 Words

Would it be morale to legalize drugs, and would it be right to do. The questions that I am going to look at from the point of view of the ethical principles of Mills , Kant , and Rawls, are is it moral for what are presently considered illicit drugs to become legally produced in the US. The next question will be is it moral for individuals to consume what are presently considered illicit drugs. I will also be stating my best arguments for my views on this subject and wither a criminal organization should be held responsible for supporting these problems. The first question that I am going to look at is it moral for what are presently considered illicit drugs to become legal produced is the US. Starting out with†¦show more content†¦For the reason that drugs do bring some kind of happiness even though it does cause pain later down the line. Drugs bring happiness by allowing people to escape their pain in their lives for a certain amount of time. So you can state that since d rugs do bringing the highest happiness to someone’s life even if it ruins their life it does bring the highest balance of pleasure to pain while you use the drugs. Also from the article it would be moral because you would be taking money and power away from the Mexican drug cartel which brings happiness because they produce drugs illegally and kill people for it. The happiness that could be gained from the financial gains can also not be ignored because with it being legal it brings another revenue stream in and taking out the cost of fighting the drug wars could be put to something that brings society a better happiness. (Article Page one, two) The next principle I am going to apply to the question is Kant and his Categorical Imperative which is a binding moral agreement no matter the situation. The other parts of Kant’s ethical principle is universalizability which is when the person’s reasons for acting must be reasons that everyone could act on at least in principle. The next part of the principle is Reversibility which is the person’s reasons for acting must be

The Onset Of A Disability Essay - 970 Words

Disability The onset of a disability at any stage can greatly affect how one develops through life. According the Newman (2015), â€Å"if the conflict of a stage is handled well, a new sense of mastery and competence emerges† (pg. 66). Along with dealing with the predictable psychosocial crisis (generativity vs. stagnation), Sam was facing three unforeseen stressors. These stressors included the loss of employment, his daughter starting her own family, and the untimely tragic death of his son. Due to these stressors, Sam began to suffer from depression. According to Newman (2015), one who is chronically depressed and facing stagnation may lose their will to live. It was evident though the interview, that Sam’s depression impacted his sense of self worth and hopes for the future. If major depression is left untreated as one transition into later adulthood, one may see a further decline in activity engagement. One can also speculate that if the depression continue s, it will begin to affect a person’s physical health (Blazer, 2003). One could surmise that Sam was once in a state of generativity as he was the â€Å"bread winner† of the household and took an active parenting role with his children. He was actively attaining a level of generativity through his employment and by raising his children. Unfortunately, a series of events derailed Sam’s role and with the onset of depression, he entered a state of stagnation. Sam was forced to retire which made it very difficultShow MoreRelatedAn Assessment Of Natural History1377 Words   |  6 Pagespatients showed episodic progression of both sign and symptoms with intervening stability, yet around 2/3 of patients showed subtle clinical decline during the period of stability. In 20% of patients, there was slow and steady deterioration. 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Perhaps as a consequence of these additional influences, family caregivers of children with disabilities can be at increased risk to experience depression, physical health problems, andRead MoreMost Common Auto Immune Disease1708 Words   |  7 Pages1 is identified as a rare type, with no radiographic progression, type 2 is a slow or moderate onset with increasing progression, type 3 is a moderate-to-fast onset with stable progression, type 4 is a fast onset with a decreased progression rate, and type 5 is a slow onset with acceleration in progression, then deceleration (Graudal et al, 2004). Having any of the five types of RA can cause disability as a result of joint damage, lo wers quality of life, and can lead to other comorbidities such as

Decision Support Tools Conditional Profits

Question: Discuss about theDecision Support Tools forConditional Profits. Answer: The conditional profits as calculated by the manufacturer can be shown as: p(s1) = 0.3 p(s2) = 0.7 s1 s2 a1 30,000 16,000 a2 10,000 24,000 Table 1: The Conditional Profits (source created by author) Part a From the decision support tools we can use the method of Expected value with perfect information criteria (EVPI). By using the method of EVPI For the method For the method In comparing the EVPI for the production methods a1 and a2 we find that the EVPI of a1 is 20,200 and a2 is 19,800. The EVPI of a1 is greater than the EVPI of a2. Hence the manufacturer should choose a1. Part b According to the marketing consultant considering prior probabilities the demand being good s1 is 0.35 and the demand being poor s2 = 0.65 p(s1) = 0.35 p(s2) = 0.65 s1 s2 a1 30,000 16,000 a2 10,000 24,000 Table 2: The Decision tools with prior probabilities (source created by author) Using the EVPI method: For the method For the method Thus with the condition of prior probabilities the EVPI for the method a1 is more than a2. The EVPI for a1 is 20,900 and for a2 is 19,100. Thus with the condition of prior probabilities the management should choose method a1. Part c According to the marketing consultant considering posterior probabilities the demand being good s1 is 0.80 and the demand being poor s2 = 0.20 p(s1) = 0.80 p(s2) = 0.20 s1 s2 a1 30,000 16,000 a2 10,000 24,000 Table 3: The Decision tools with posterior probabilities (source created by author) Using the EVPI method: For the method For the method Thus with the condition of posterior probabilities the EVPI for the method a1 is more than a2. The EVPI for a1 is 27,200 and for a2 is 12,800. Thus with the condition of prior probabilities the management should choose method a1. Part d In all the above three methods when the management has made has done his own calculations, with the prior and posterior probabilities (as defined by the consultant) the method a1 provides the maximum benefit to the manufacturer. Thus we do not find any reason to hire the consultant (Kerzner, 2014). Step 1 The first step is to calculate the cumulative probabilities for both the time between arrivals of the patients and the service time of the patients. The random numbers are generated for the cumulative probabilities. Figure 1: Screenshot of the Simulation 1 (source created by author) From the above simulation we see that the first patient arrives 25 minutes after the service starts. Since the nurse is then free hence the service of the patient starts immediately. The service nurse was then waiting for 15 minutes. For the first patient the time taken by the nurse was 25 minutes. The service time for the patient ends 40 minutes after the start of service. The second patient arrives at 40 minutes. Since by this time the nurse has finished her work with the first patient, she can start her nursing with the 2nd patient immediately. The nursing activity on the 2nd patient takes place for 30 minutes. She finishes her work at 70 minutes after the start of the service. The 3rd patient arrives 65 minutes after the start of service. Since the nurse has not finished her task with the 2nd patient hence the 3rd patient has to wait for 5minutes before activity on the patient can start. From the simulation, we can see that from 65 minutes till 120 minutes there is a patient always waiting since the nurse has not finished her activity with the previous patient. Thus there is a requirement of a second nurse accordingly (Render et.al., 2014). References Kerzner, H.R., (2014). Project Management 2.0. John Wiley Sons Render, B., Ralph, M.S.J, Hanna, M.E., Hale, T.S. (2014). Quantitative analysis for management. 12th Ed. Pearson Education

Americans visit the movies everyday in search of a Essay Example For Students

Americans visit the movies everyday in search of a Essay couple hours filled with mind blowing entertainment. Is it the digitally re-mastered sound, the out-of-this-world special effects, or tear jerker dramas? New movies are released every week, but what movies are the top grossing movies of all time? What is it that got these movies to the top twenty? The following is a list of the top twenty grossing movies of all time: Movie Year Total Gross (Millions) 1. Titanic 1997 $601 2. Star Wars 1977 $461 3. Star Wars: Episode I 1999 $431 4. E.T. 1982 $400 5. Jurassic Park 1993 $357 6. Forest Gump 1994 $329 7. Lion King, The 1994 $313 8. Star Wars: Episode VI 1983 $309 9. Independence Day 1996 $305 10. Sixth Sense, The 1999 $294 11. Star Wars: Episode V 1980 $290 12. Home Alone 1990 $286 13. Jaws 1975 $260 14. Batman 1989 $251 15. Men In Black 1997 $250 16. Toy Story 2 1999 $246 17. Raiders of the Lost Ark 1981 $242 18. Twister 1996 $240 19. Ghostbusters 1984 $239 20. Beverly Hills Cop 1984 $235 As more and more movies release, what type of movies make it to the top twenty? Judging from the top twenty list, about 60% of the top twenty can be considered Action movies. A majority of the movies in the top twenty are Action/Adventure/Sci-Fi. 40% can be considered Horror/Thriller movies, and only a mere four movies out of twenty can be considered a Comedy. Americans would find more enjoyment from an Action packed Sci-Fi Thriller than a family fun Comedy. The Top Twenty Grossing Movie list is made by highest grossing point, which means total money made. Each decade more and more movies reach the top twenty. In the top twenty, 2 movies released in the 70s, 7 from the 80s, and 11 from the 90s. A major factor that caused this is inflation. The #1 Top Grossing Movie, Titanic, topped off at $601 million, each movie ticket for Titanic was around $5-$8 per ticket. Lets say that Gone With the Wind, #31 on the Top Grossing Movie List, was released at the same time Titanic was, instead of 1939. The total gross sales for Gone With the Wind would top the charts destroying Titanic. Inflation has such an impact on the list , maybe the list should be based on an equal inflation. Not many sequels ever make it to the top twenty. One set of sequels in particular had all of its sequels in the top twenty list. All of Star Wars sequels have made it to the top twenty, and two of the movies take #2 and #3 on the list. The only Sequels to make it to the top twenty, besides Star Wars, is Toy Story 2. Americans do not seem to be attracted to sequels as much as an original movie. Many factors, such as types of movies, story line, and sequels, go into the Top 20 All-Time Grossing Films list , but none effect it clearly as much as inflation. .

College Essay Scholarship - Tips To Find One

College Essay Scholarship - Tips To Find OneWhen you are looking for a sample for essay scholarship, you might think you are better off finding some other grant source. While there is merit to this, you would be surprised at the lengths to which people will go to in order to get money. After all, you do not have to be rich to qualify for these types of scholarships.The first thing that you want to do when you are searching for a college essay scholarship is to talk to the person who has accepted your application. Make sure you ask if they really had to select you based on your scholarship application. Sometimes the college's equity officer selects students based on their essay. In either case, it's important to find out why they did this so that you can ask the same question.Often, the scholarship committee will start by asking a student how well their essays speak to the needs of the school. This is one of the things that they will look at to determine if they are deserving of a sch olarship.The second thing that you will want to ask the college essay committee is whether or not your essay made them decide to select you over another student. The reason that this is important is because if they selected you over someone else because of their essay, then you stand to make a good case to them for getting more money. If they were thinking about your other credentials, chances are they were going to pick you.Remember that even though they don't select a student based on their essay, they still have to read and critique it. They may have found a lot of flaws and it may help them decide to do a re-write. Even if they decide that your essay is okay, you can still ask if they have any other research that they would recommend.You should also be prepared to ask if they do not use these essays to choose their students. You may think that they would go to the very best essay writer in town but the truth is that they use a computer program to choose a few points. There is no thing wrong with this because it is a method that works for them.The last thing that you want to do when you are searching for a scholarship is to give yourself a good chance of getting the scholarship. It is okay to write a lot of essays. If you do all the writing yourself, you can make a good case for yourself.In order to find a college essay scholarship, you need to research the grant company and find out what they are looking for. Make sure that you choose the ones that fit what you are trying to do. In many cases, this means that you need to be highly qualified and highly motivated.

The Sullivans matrix report Essay Example

The Sullivans matrix report Essay Sullivans matrix introduces different ways to classify the IT/IS environment of an organisation. Within this matrix, there are four environments: Traditional, Opportunistic, Complex and Backbone. The idea of this report is to describe how the IS/IT environment of Inditex fits into Sullivans matrix. According to Ward Peppard (2002) organisations with a traditional IT/IS environment have a highly centralised control of their IT resources. IS is not critical to the business and IT is solely used to improve efficiency on a system-by-system basis. McAfee (2004) raises many points in his article to suggest that the IT/IS of Inditex fits into this Traditional environment. Inditex see IT as merely an enabler for their business. McAfee (2004) confirms this theory as he states that The role of IT, then, is to support the process (McAfee, 2004). Ward Peppard state that within a Traditional environment, IT is simply used to support business processes and to improve the efficiency of the organisation. Another point which supports the theory is that Inditex have an excellent IT and business alignment. business goals always shape the companys use of technology, never vice versa (McAfee, 2004). This portrays Inditex as being entirely business-led where organisational goals invariably define technological innovation. This ethos confirms their desire not to waste money on new systems which do not provide a business value or solution to a specific business problem. McAfee relates to this theory as an inside-out approach. To sum up the arguments, Inditex has one principle which fully shows that their IT/IS environment is Traditional: computerisation is standardised and targeted. You can see this on the low IT budget which is estimated 0. We will write a custom essay sample on The Sullivans matrix report specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on The Sullivans matrix report specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on The Sullivans matrix report specifically for you FOR ONLY $16.38 $13.9/page Hire Writer 5% of revenue and the IT staff of 50. Despite Inditexs focus on the Traditional environment, there are also subtle undertones of Sullivans other three IT/IS environments displayed within the organisation. For example, there are factors which show that elements of Inditexs IT/IS environment is Complex. They are dependent on their PDAs which can also be difficult to manage. In addition they are also largely decentralized, because each store manager has to manage his PDA. This is also the case with regards to their POS systems. Inditex is a company with branches around the world. This makes it difficult to manage each POS in every store. In some points, the IT/IS environment of Inditex also displays Opportunistic aspects. In the case of Inditex the attributes for a Complex and Opportunistic environment are very similar. However, one of the more important factors to consider is the teamwork and cooperation conducted within Inditex. Their success is mainly based on the decision making abilities of their staff. This strategy is ensured as technologists work with line managers to understand what the business requires and then start proposing solutions which shows that the workforce is closely integrated and dependent more upon teamwork and decision making than IT capabilities. This type of culture is defined by Ward Peppard (2002) as being an Opportunistic trait as they state that integration of systems occurs due to user-user cooperation occurs within this type of environment. We also examined whether Inditex had aspects of a Backbone IS/IT environment. This may be a factor as the business processes are highly customised, thus the stores may be dependent on PDAs for instance. However, we do not have enough information from the article to be sure whether traits of the Backbone environment exist within their structure. In the late 1990s when other organisations spent vast sums of money on new technologies, Inditex withheld a Traditional framework. Great success has ultimately been achieved while The relative absence of computers throughout Inditex is nothing short of amazing (McAfee, 2004). Inditex has minimized the use of technology to their business needs and therefore they perform efficiently. In our opinion it is not important to classify which IT/IS environment Inditex has. It is more important that the IT/IS environment matches the business environment and the business needs so that IT can become a value creator in the organisation. There are different types of information, which organisations have to handle. Examples of such information types include business process information (which documents any information about the processes of the organisation), information relating to physical-world observations (which relies on new technologies like GPS or RFID) and biological data containing biometrical information of their customers or employees. Government institutions also use public data like CCTV for public surveillance but the most important data types are those which indicates personal preferences or intentions which is often used by those within the retail market. Once these types of information have been collated, an organisational culture must be established to determine the way in which information should be stored, managed and shared within the organisation to adhere to the goals and objectives set out within the information strategy. Essential for the success of any information management strategy is the existence of an appropriate information culture. An information culture can be defined as the values, attitudes and behaviours that influence the way employees at all levels in the organization sense, collect, organize, process, communicate and use information. (Ward Peppard, 2002 p470) There are four types of information culture defined by Marchand (1995): Functional Culture Within this culture it is the managers prerogative regarding which information is made available to the staff. It also follows a hierarchical structure regarding information sharing. Sharing Culture In this culture there is flat structure which is utilised to encourage trust and openness in order to share information between management and staff members. This culture is based on emotions such as trust which can be either advantageous or detrimental to the operation of the organisation or department as these emotions can frequently change. Enquiring Culture This culture may be used as an effective prediction to provide guidance for future developments. It is based on a sharing culture where managers and staff collaborate while it enables the organisation to reduce the time-to-market of their products. Discovery Culture This culture adds to the enquiring culture and focuses on analysing the gathered information. This helps to provide the organisation with a view of changing environments, competitor performance, areas of possible expansion and potential market entry for the future etc. These cultures are mostly found as combinations in organisations. Organisations have different information assets and their staff members have different information needs. Therefore, in order to use these information assets appropriately you need a customised culture which is aligned to the information needs of the organisation. Tesco provide us with a good example of this cross-over in culture definition as information is generally produced at the managerial level and distributed amongst the workforce while it can also be shared amongst line managers and employees at all levels throughout the organisation. An enquiring culture is also used to develop certain areas of the business to enable future profitability while a discovery culture is in place for Tescos attempted entry into markets such as insurance, banking and Internet broadband. All of these points convey Tesco as a multi-culture organisation where different sectors of their business follow different cultures. As we have discussed, the behaviours and attitudes of a workforce can have a profound effect on the success of an organisations performance. For this reason, the information culture must match the requirements of employees in order to facilitate a successful information strategy. Trust and receptiveness are just two behavioural traits which must be monitored in order for employee acceptance. The importance of considering these factors is agreed by Ferguson et al. who state that sustainable competitive advantage will rely on two very human characteristics: insight and trust (Ferguson et al. , 2005 p58). From this point, we can conclude that the consideration of human aspects is vital for the strategic success of information and without an information culture, it can be very difficult to monitor and influence the behaviour and attitudes of the workforce. References Ferguson, G., Mathur, S., Shah, B. (2005). Evolving From Information to Insight. MIT Sloan Management Review, 46(2), 51-58. Marchand, D.A. (1995, 8 December). What is your companys information culture? Financial Times, pp. 10-11. Ward, J., Peppard, J. (2002). Strategic Planning for Information Systems. West Sussex, England: John Wiley Sons

Health Dissertation ideas - Applied Musculoskeletal Podiatry The WritePass Journal

Health Dissertation ideas - Applied Musculoskeletal Podiatry Introduction Pathology that causes metatarsalgia Health Dissertation ideas Applied Musculoskeletal Podiatry ). Patients often describe their feeling of â€Å"lump† on the foot’s bottom. Significantly, these symptoms may rise when the infected carries out a weight-bearing activity. Reports indicate that closed-toed shoes, particularly the tight-fitting ones can lead to increase in symptoms, and patients report relief after they remove or change their shoes (Summers, 2010). Relief may also be experienced when the patient massages their foot or moves the toes around. Aetiology of this condition and how it would be recognised clinically Research has established that Morton’s neuroma is unique in terms of clinical diagnostic requirements or needs (Drury, 2011). This is because although patients frequently report symptoms such as numbness, there is evidence that sensory deficit may or may not be found when the patient goes through examination. Drury (2011) observes that there may be a demonstration of splaying or divergence of the digits when clinical presentation is carried out, and that more often than not little or no edema or inflammation can be observed clinically. Typically, reproducing pain with palpation to the intermetatarsal space is a normal activity, but care must be taken to put the pressure in the space, and avoid the metatarsal heads. There have been various clinical strategies to assist clinicians effectively diagnose Morton’s neuroma. Schreiber et al (2011); Faraj and Hosur (2010) report that patients may demonstrate a Mulder’s sign, which is provoked by squeezing the forefoot and conducting application of plantar and dorsal pressure. In other words, clinical test for Morton’s neuroma has all along been to   compress the foot by applying pressure to the medical and lateral aspects of the foot at the metatarsophangeal joints, which in turn puts pressure on nerves (Pastides, El-Sallakh and Charalambides, 2010: 503). A positive clinical test outcome involves a pop or click that can be felt and heard at the same time. This pop or click is usually painful to the patient. There is a possibility of replicating symptoms of Morton’s neuroma in a process involving Gauthier’ test, where the forefoot is squeezed and medial to lateral pressure is applied (Beltran et al., 2010). Mayo Clinic (2010) has subsequently described a test consisting of hyperextending the toes and rolling the thumb of the examiner in the area of symptoms, a process that may identify a tender, thickened, and longitudinal mass of flesh. Clinical findings also indicate that Morton’s neuroma may also show Tinel’s sign as well as Valleix phenomenon (Berry, Gonzalez and Bowman, 2012). The other pathway for detecting Morton’s neuroma is diagnostic testing. This process involves plain radiography, ultrasound, and magnetic resonance imaging (Summers, 2010). Radiographs are routinely ordered to rule out musculoskeletal pathology, even though rise in proximity of the adjacent metatarsal heads is believed to result in increased pressure of the intermetatarsal nerve. Furthermore, Hause (2010) found no significant correlation between radiographic findings and the clinical presence of neuromas. In addition, there is the recommendation to use ultrasound in the diagnostic evaluation of the interspaces (Hause, 2010). Drury (2011: 19) observes that there is a likelihood of a neuroma appearing as an ovoid mass with hypoechoic signal-mass to the long axis of the metatarsals. . Adams (2010), however, advises that although MRI is a useful diagnostic tool, it should always be reserved for atypical presentations or to eliminate multiple neuromas. Significantly, neuroma can be best identified on T1 weighted images, and it’s likely to come out as a well-demarcated mass with minimal signal intensity.   In summary, clinical diagnostic approach to identify Morton’s neuroma can be achieved by ensuring that examination and diagnostic testing has ruled out any other etiologies of symptoms. Conservative treatment intervention for Morton’s neuroma No best treatment interventions have been identified in the literature for treatment of Morton’s neuroma. Conservative intervention for Morton’s neuroma is considered to be one of the best treatments alternatives for the condition. However, some of the common conservative treatment options involve changing shoe type, use of metatarsal pads, and use of non-steroidal anti-inflammatory drugs, administering sclerosing alcohol injections, and surgically transposing the offending nerve (Summers, 2010). Many doctors and physical therapists have recommended that patients are put to rest for a specific period of time, and reduce activities that may elicit pain (Pastides, El-Sallakh and Charalambides, 2012). Injections as an intervention Various clinical studies have exposed the need to consider injection as a better treatment option for Morton’s neuroma over other non-surgical treatment options available. In a study conducted by Drury (2010) different conservative treatment measures often produce similar results. In a small randomised prospective study of 23 patients, the researchers compared reduction in neuroma pain when supinatory or pronatory insoles are used. In the study, there was no explicit inclusion or exclusion criteria other than clinical diagnosis, and no participant or evaluator was considered blind to the intervention allocations. The study had 13 percent of the participants (two patients) drop out after one month into the experiment. After 12 months, pain in the supination and pronation insole groups reduced by 50 percent and 45 percent, respectively- a reduction considered insignificant. In another study, a physically active 25-year-old female with diagnosed symptomatic Morton’s neuroma was put through a massage therapy sessions. The six-session massage therapy involved a 60-75 minute weekly massage exercise involving postural alignment in addition to localised foot and leg treatment. The patient was also put to complete at-home daily exercise, with a weekly monitoring of change by the therapist who reassessed the patient’s posture and ensuring the client fills out a pain survey based on a Visual Analog Scale. The results indicated progressive change on the side of the client in terms of pain character. Specific patient report indicates that the pain character changed from burning and stabbing to dull and pulsing sensation after three sessions. There was also a reduction in pain during exercise. Although this study suggests that massage therapy is a significant treatment for Morton’s neuroma, its weakness is based on the fact that the treatment only involved one client. No study has indicated the effectiveness of the method on a larger randomised control studies. In a prospective randomised study involving 82 patients, the researchers compared steroid injections alone based on shoe modifications (Berry, Gonzalez and Bowman 2012). Some of the recorded primary outcomes were patient satisfaction, which is basically the presence or absence of pain, the pain intensity, and return of pain afterwards. The results of the study indicated that steroid injections yielded better outcome in terms of patient satisfaction, compared with other conservative options such as shoe   modifications alone. In this study, 23 percent of shoe-modification patients achieved complete satisfaction after one month of intervention. This was significantly lower than the 50 percent of patients who experienced significant pain reduction after one month of steroid injection. After six months, 28.6 percent of the participants experienced satisfaction with shoe modification, significantly lower than 73.5 percent satisfaction amongst those who had received injection. Although the difference was significant lower after one year with 63 percent satisfaction with shoe modification and 82 percent with injection, the reduction could have occurred because patients were allowed to cross over after six months. The researchers observed that no complications were reported, although the study was limited by a high cross-over rate from shoe modification group to injection group after 6moths. Some studies have investigated other techniques such as the use of sclerosing effects of alcohol (Pastides, El-Sallakh and Charalambides, 2012; Schreiber, 2011; Beltran, 2010; Pace, Scammell and Dhar, 2010), where delivery is done by multiple injections guided by ultrasound techniques over time. Improvements were reported in term of clients’ satisfaction with no long-term adverse effects   in various case series. It is mostly recommended that even as an injection is used as the chosen treatment option, other supplementary management options such as shoe adjustments and calf-stretching exercises should also be implemented concurrently. However, in case the conservative interventions fail to work, many patients may be advised to undergo surgery to remove the neuroma or just to release pressure from ligaments. Studies have, however, indicated that 15 to 20 percent of these surgeries will not relieve the patient from pain, and may also lead to various complications such as local post-surgery infections, scar tissue, and damage of soft tissues which may affect normal foot functions. It has also been established that there is a possibility of neuroma recurring after the surgery. Conclusion Whilst the exact cause of Morton’s neuroma is not known, the common belief is that it is caused by hypermobility of the metatarsals. This may also be aggravated by repetitive motions involving grinding of nerve bundle. The common symptoms are patients describing their feeling of â€Å"lump† on the foot’s bottom. These symptoms may increase when the patient engages in weight-bearing activity. Research has established that symptoms that may be associated with Morton’s neuroma may not necessarily mean a person is suffering from the complication. This is why clinical diagnosis is often recommended. One of the most common clinical strategies that may be beneficial to clinicians diagnosing Morton’s neuroma is patients demonstrating Mulder’s sign. A positive clinical test outcome involves a pop or click that can be felt and heard at the same time. Clinical findings also indicate that Morton’s neuroma may also show Tinel’s sign as well as Valleix phenomenon (Berry, Gonzalez and Bowman, 2012). Although there are various conservative therapies used to manage Morton’s neuroma complications including rest, weight loss, and exercise for muscle strengthening, orthotics, massage therapy, physiotherapy, and manipulation, these methods are found to be very effective. It’s against this backdrop that injection is found to be a more effective way of managing the complication as reported by clients’ satisfaction studies. Injection may involve steroid injection, local anaesthetic injections or sclerosant injections. Injections have been found to yield better outcome in terms of patient satisfaction, compared with other conservative options such as shoe modifications alone. It has also been established that there are no complications reported in injections. Medical practitioners, however, recommend that patients may be advised to undergo surgical intervention in case conservative interventions fail to yield desired results. References Adams WR. (2010). Morton’s neuroma. Clin Podiatr Med Surg., (2)7: 535-545. Beltran LS, Bencardino J, Ghazikhanian V, Beltran J. (2010). Entrapment neuropathies III; lower limb. Semin Musculoskelet Radiol, 14: 501-111. Berry K, Gonzalez P, and Bowman RG. (2012). Physical Medicine and Treatment for Morton Neuroma. Available from: http://emedicine.medscape.com/article/308284-overview [Accessed November 17, 2014.]. Bronfort G, Haas M, Evans R, et al. (2010). Effectiveness of manual therapies: the UK evidence report, Chiropractic Osteopathy, 18(3):1–33 Drury AL. (2011). Use of homeopathic injection therapy in treatment of Morton’s neuroma. Altern Ther Health Med, 2(1) 17-48. Faraj A, and Hosur A. (2010). The outcomes after using two different approaches for excision of Morton’s neuroma. Chinese Medical Journal, 12 (3): 2195- 2198. Hauser R. (2011). A retrospective observational study on Hackett-Hemwall dextrose prolotherapy for unresolved foot and toe pain at an outpatient charity clinical in rural Illinois. J of Prolotherapy 2 (3): 543-551. Mayo Clinic. (2010). Morton’s Neuroma. [Accessed September 16, 2010]. Available from: mayoclinic.com/health/mortons-neuroma/DS00468. Published Updated October 5, 2010. Pastides P, El-Sallakh S, Charalambides C. (2012) Morton’s neuroma: A clinical versus radiological diagnosis. Foot Ankle Surg, 18: 22-4. Pace A, Scammell B, Dhar S. (2010). The outcome of Morton’s neurectomy in the treatment of metatarsalgia. Int Orthop, 3 (4):511-5. Schreiber K, Khodaee M, Poddar S, Tweed EM. (2011). Clinical Inquiry. What is the best way to treat Morton’s neuroma? Int Orthop, 60: 157-158. Summers A. (2010). Diagnosis and treatment of Morton’s neuroma. Emerg Nurse, 1(8): 16-17.