Dose Adjustment in Renal Disease Free Essays

GENERAL APPROACHES FOR DOSE ADJUSTMENT IN RENAL DISEASE Renal insufficiency can markedly alter one or more of the pharmacokinetic parameters of a drug including oral bioavailability, volume of distribution, drug binding to plasma proteins, and most importantly the rates of metabolism and excretion, i. e. , drug clearance. We will write a custom essay sample on Dose Adjustment in Renal Disease or any similar topic only for you Order Now . To minimize drug toxicity and maximize therapeutic benefits, it is often necessary to adjust drug dosage in proportion to the degree of renal insufficiency. A drug will most likely require dose adjustment in renal disease if: 1. A substantial fraction ( 40%) of the drug dose is excreted by the kidney either unchanged or as an active (or toxic) metabolites. 2. The drug or its active metabolite has a narrow therapeutic window such that drug accumulation cannot be tolerated. 3. The kidney is a major site for the inactivation of the drug. This applies mainly to peptides like insulin, glucagon, PTH, and imipenem. 4. There is a significant drop in the binding of the drug to plasma proteins. For instance, a decrease in the protein binding from 99 to 95% results in a fourfold rise in the unbound, active drug concentration. Dose adjustment may involve one or a combination of the following measures: 1. Extension of the dosing interval. 2. Reduction of the maintenance dose. 3. Administration of a loading dose. 4. Monitoring serum drug levels. FACTORS IN CHOOSING OF DOSE ADJUSTMENT APPROACH: Factors to consider when choosing appropriate dose adjustment approach are the class of drug ,the amplitude of the peak-trough fluctuation relative to the therapeutic index, magnitude of the dose with respect to the dose strength to be marketed and practicality of calculated dosing interval. Pharmacokinetic simulations can be especially helpful in visualizing the impact of various dose and interval changes and interval changes on the concentration time (C-T) profile at steady state. Reduced elimination of a drug prolongs its half life (t? ) as well as the time required for the serum level to reach a steady state (4 times t? ). Therefore, whenever it is clinically desirable to rapidly achieve a therapeutic steady state level a loading dose should administered. To maintain a therapeutic level and, at the same time, avoid drug accumulation and toxicity in a patient with reduced renal function, the clinician must consider reducing the size of the maintenance dose or the dosing frequency or both. In general, this reduction should also be proportional to the degree of renal impairment , but should also take into account adaptive or compensatory changes in the metabolism and excretion of the drug through non-renal routes. MAINTENANCE DOSE REDUCTION METHOD: The maintenance dose reduction method is used whenever a more constant (less oscillating) serum drug level is therapeutically preferable (e. . , ? -lactam antibiotics) Let us assume that one has already defined a safe and effective dose regimen for use in normal patients. This normal dose regimen is then adjusted according to dose fraction by two basic procedures. First method termed as constant interval, dose-reduction (DR) reduces the dose (D) by a factor of the dose fraction. Dose interval is the same as that used in the health person. D renal failure = D normal Kf t renal failure = t normal INTERVAL EXTENSION METHOD The second method referred to as constant dose, interval-extension(IE) extends dose interval by inverse of dose fraction, a value referred to as the dose interval multiplier : t renal failure = t normal (1/ kf) D renal failure = D normal This type of dose adjustment strategy may also be implemented through the use of a nomogram where the dosage interval multiplier for this IE regimen is simply read off a plot of creatinine clearance Interval extension method is used for drugs for which a constant serum level is either unnecessary (eg, vigabatrin) or undesirable (e. g. , aminoglycoside antibiotics). This method is also used for drugs that normally have long elimination t?. However, a combination of the two methods is often used. In addition, for a drug whose therapeutic serum level range is known and routinely measured, dosage adjustment is often guided by monitoring the serum drug level and the patient’s response in terms of the therapeutic benefit and adverse drug reactions (toxicity). Reference:: http://www. hedrugmonitor. com/RIT97. html http://books. google. com. pk/books? id=qXw33GaQF9IC=PA288=PA288=general+approaches+to+dose+adjustment+in+renal+patients=bl=IKsqNAp2nU=jglKfgGimUFQ_xBN9cGKPPRsC2E=en=CxbTStLaAo-QkQX1_N30Aw=X=book_result=result=7=0CCMQ6AEwBjgK#v=onepage=general%20approaches%20to%20dose%20adjustment%20in%20renal%20patients=false http://www. gbv. de/du/services/toc/bs/380847361 http://books. google. com. pk/books? id=9324ILATCgMC=PA288=general+approaches+to+dose+adjustment+in+renal+DISEASE#v=onepage=general%20approaches%20to%20dose%20adjustment%20in%20renal%20DISEASE=false How to cite Dose Adjustment in Renal Disease, Papers

People have different ways of escaping the stress free essay sample

People have different ways of escaping the stress and difficulties of modern life. Some read, some exercise, and others work in their gardens. What do you think are the best ways of reducing stress? Nowadays, the word â€Å"stress† seems to be very common. Many people are under stress because of their modern and busy life particularly ones who pursue materialism. The reason why they become aggressive and sensitive with everything, and try to find the ways to escape the stress and difficulties. Then, a question arises what can we do to reduce stress? In my opinion, the best ways are doing exercise and listening to soft music. First, you should have a good habit of doing exercise yourself 30 minutes per day. It is not only good for your health but also relaxing your body. When you are running, cycling, walking etc†¦, your brain can release some hormones, receive more oxygen and the effect of stress is reduced. We will write a custom essay sample on People have different ways of escaping the stress or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page If you do not like to exercise lonely, the best choice for you is to take the yoga classes. Spending time meeting, chatting and doing exercise with other people, you will feel very relaxed and have energy for new day with challenges. However, many people cannot manage their time to do exercise, the another way for them to reduce the stress is to listen to some music. In term of relaxing with music, soft music is considered as the best one. In the middle time of work, when you have a break-time, you can choose some songs in your playlist, turn it on and let your body follow to the rhythm. Keep it cleansing your mind and thinking about nothing. Furthermore you can keep a pet and play with it in free time, which can make a little change in your time table that means going to bed early, having a deep sleep and wake up in the early morning. When you start the day energetically, stress of the day before is disappeared. There are some changes you can make that might result in avoiding the stressors. Now, with some ways to reduce the stress, you do not have to fly away to escape the work, you can stay in reducing stress and continuing to fight with your problem.

Free Essays on Describe The Religious Pendillum From Henry VIII To Elizabeth

Describe the religious pendulum from Henry VIII to Elizabeth Kim Moreland Arthur’s death meant that Henry now had a claim to the throne in 1509. Henry was announced as king at only 17 years of age. During this period England was in a time were people kept and carried out their own opinions about religion, this was as the previous king was no strong follower of religion. This however, was on the verge of changing now that Henry a strong Catholic was now in control. Early into his reign Henry married his late brothers widow Catherine of Aragon, he was forced to carry out this action in order to keep in close relations with Spain. Henry was in need of a son, if he was to put his mind at rest that he would be able to pass on the responsibility of king to one of his offspring. Catherine fell pregnant but did not produce him a son, she gave birth to soon to be ‘bloody’ Mary. Henry applied for a divorce but was denied this as the catholic pope did not believe in divorces. Whilst still married to Catherine Henry fell in love with a young Anne Boleyn. Henry began referring to himself as Cesar and soon the Catholic churches were forced to give into his requirements and so Henry was divorced from Catherine and free to marry Anne Boleyn. England was now a catholic country and Henry was the keen leader in this reformation. The pope was not seen as important as the King in England and so, this being a very big ego booster, Henry saw himself as the main leader of all the churches as well as the country. Before Henry’s reign all bibles were written in Latin until one man William Tyndale translated it into English. These bibles were banned from all the churches but still, people kept trying to smuggle these bibles into the churches. Tyndale and his bible were seen as a threat to the churches and to Henry. Due to the new English bible people could now make their own decisions and opinions about the bible and priests were no longe... Free Essays on Describe The Religious Pendillum From Henry VIII To Elizabeth Free Essays on Describe The Religious Pendillum From Henry VIII To Elizabeth Describe the religious pendulum from Henry VIII to Elizabeth Kim Moreland Arthur’s death meant that Henry now had a claim to the throne in 1509. Henry was announced as king at only 17 years of age. During this period England was in a time were people kept and carried out their own opinions about religion, this was as the previous king was no strong follower of religion. This however, was on the verge of changing now that Henry a strong Catholic was now in control. Early into his reign Henry married his late brothers widow Catherine of Aragon, he was forced to carry out this action in order to keep in close relations with Spain. Henry was in need of a son, if he was to put his mind at rest that he would be able to pass on the responsibility of king to one of his offspring. Catherine fell pregnant but did not produce him a son, she gave birth to soon to be ‘bloody’ Mary. Henry applied for a divorce but was denied this as the catholic pope did not believe in divorces. Whilst still married to Catherine Henry fell in love with a young Anne Boleyn. Henry began referring to himself as Cesar and soon the Catholic churches were forced to give into his requirements and so Henry was divorced from Catherine and free to marry Anne Boleyn. England was now a catholic country and Henry was the keen leader in this reformation. The pope was not seen as important as the King in England and so, this being a very big ego booster, Henry saw himself as the main leader of all the churches as well as the country. Before Henry’s reign all bibles were written in Latin until one man William Tyndale translated it into English. These bibles were banned from all the churches but still, people kept trying to smuggle these bibles into the churches. Tyndale and his bible were seen as a threat to the churches and to Henry. Due to the new English bible people could now make their own decisions and opinions about the bible and priests were no longe...

Palladium Facts - Periodic Table of the Elements

Palladium Facts - Periodic Table of the Elements Palladium  is a silvery-white metallic element with atomic number 46 and element symbol Pd. In daily life, its most often found in jewelry, dentistry, and catalytic converters for automobiles. Here is a collection of useful and interesting palladium facts: Essential Palladium Facts Atomic Number: 46 Symbol: Pd Atomic Weight: 106.42 Discovery: William Hyde Wollaston 1802 (England) Wollaston noted his discovery of the metal in 1802 and offered the purified element for sale in 1803, although there was some controversy regarding the discovery. Richard Chenevix believed Wollastons palladium to be a platinum-mercury alloy. Chenevixs palladium experiments earned him the 1803 Copley Medal, but its clear Wollaston did at least partially purify the element. He dissolved platinum order from South America in aqua regia, neutralized it with sodium hydroxide and precipitated out the platinum. Reacting the remaining material with mercuric cyanide formed palladium(II) cyanide, which was heated to yield the purified element. Electron Configuration: [Kr] 4d10 Word Origin: Palladium was named for the asteroid Pallas, which was discovered approximately the same time (1803). Pallas was the Greek goddess of wisdom. Properties: Palladium has a melting point of 1554 °C, boiling point of 2970 °C, specific gravity of 12.02 (20 °C), and valence of 2, 3, or 4. It is a steel-white metal which does not tarnish in air. Palladium has the lowest melting point and density of the platinum metals. Annealed palladium is soft and ductile, but it becomes much stronger and harder through coldworking. Palladium is attacked by nitric acid and sulfuric acid. At room temperature, the metal can absorb up to 900 times its own volume of hydrogen. Palladium can be beaten into leaf as thin as 1/250,000 of an inch. Uses: Hydrogen readily diffuses through heated palladium, so this method is often used to purify the gas. Finely divided palladium is used as a catalyst for hydrogenation and dehydrogenation reactions. Palladium is used as an alloying agent and for making jewelry and in dentistry. White gold is an alloy of gold which has been decolorized by the addition of palladium. The metal is also used to make surgical instruments, electrical contacts, professional transverse flutes, and watches. In photography, palladium is an alternative to silver, used in the platinotype printing process. Sources: Palladium is found with other metals of the platinum group and with nickel-copper deposits. The primary commercial sources are the Norilsk-Talnakh deposits in Siberia and the nickel-copper deposits of the Sudbury Basic in Ontario, Canada. Russia is the primary producer. It may be produced in a nuclear fission reactor from spent nuclear fuel. Health Effects: Palladium, like the other platinum group metals, is mostly inert in the body as a bulk metal. However, there are reports of contact dermatitis, particularly in persons allergic to nickel. This causes problems when palladium is used in jewelry or dentistry. In addition to these uses, environmental exposure to palladium comes from release by automotive catalytic converters, food, and workplace exposure. Soluble compounds of palladium are excreted from the body within 3 days (99 percent). In mice, the median lethal dose of soluble palladium compounds (e.g., palladium chloride) is 200 mg/kg orally and 5 mg/kg intraveneously. Palladium is poorly absorbed and its toxicity is considered low, but it may be carcinogenic. Most plants tolerate it when it is present in low concentrations, although it is lethal to water hyacinth. Palladium serves no known biological role. Currency: Palladium, gold, silver, and platinum are the only metals that have ISO currency codes. The codes for palladium are XPD and 964. Cost: The price for palladium continues to rise. In 2016, palladium cost about $614 per ounce. In 2018, it reached $1100 per ounce. Element Classification: Transition Metal PalladiumPhysical Data Density (g/cc): 12.02 Melting Point (K): 1825 Boiling Point (K): 3413 Appearance: silvery-white, soft, malleable and ductile metal Atomic Radius (pm): 137 Atomic Volume (cc/mol): 8.9 Covalent Radius (pm): 128 Ionic Radius: 65 (4e) 80 (2e) Specific Heat (20 °C J/g mol): 0.244 Fusion Heat (kJ/mol): 17.24 Evaporation Heat (kJ/mol): 372.4 Debye Temperature (K): 275.00 Pauling Negativity Number: 2.20 First Ionizing Energy (kJ/mol): 803.5 Oxidation States: 4, 2, 0 Lattice Structure: Face-Centered Cubic Lattice Constant (Ã…): 3.890 Return to the Periodic Table References Hammond, C. R. (2004). The Elements. Handbook of Chemistry and Physics (81st ed.). CRC press. ISBN 0-8493-0485-7.Meija, J.; et al. (2016). Atomic weights of the elements 2013 (IUPAC Technical Report). Pure and Applied Chemistry. 88 (3): 265–91. doi:10.1515/pac-2015-0305Wollaston, W. H. (1805). On the Discovery of Palladium; With Observations on Other Substances Found with Platina. Philosophical Transactions of the Royal Society of London. 95: 316–330. doi:10.1098/rstl.1805.0024Weast, Robert (1984). CRC, Handbook of Chemistry and Physics. Boca Raton, Florida: Chemical Rubber Company Publishing. pp. E110. ISBN 0-8493-0464-4.

Comparing the philosophies in Camus's The Stranger and Frankl's Man's Essay

Comparing the philosophies in Camus's The Stranger and Frankl's Man's Search for Meaning - Essay Example Meursault is a clerk, who seems to have no feelings and spends afternoons in lovemaking and empty nights in the cinema. He reaches self-knowledge by committing a crime - he shoots an Arab on the beach without explicit reason and motivation - it was hot, the Arab had earlier terrorized him and his friend Raymond, and he had an headache. Meursault is condemned to die as much for his refusal to accept the standards of social behavior as for the crime itself. In his great work, "The Stranger," Albert Camus exposes his readers to the existentialistic parts of philosophy. The existentialism within his work shapes his characters, by determining how they will act and respond to what is going on around them. However, due to the existentialism, the character stands out in a way unique to the characters in that work. Meursault, the protagonist in "The Stranger," is an insensitive individual. He shows no feelings towards anyone throughout the novel. It is this lack of feeling that strongly reflects the philosophy of existentialism. Meursault does not feel any sensations a normal human would have with members of the opposite sex, nor does anything important seem to interest him. This lack of feeling, Meursault does realize it is a problem, for he states himself, "I explained to him, however, that my nature was that my physical needs often got in the way of my feelings.(pg 65)" also sees no reason for change in his life. The common theme is that life will be meaningless if we don't put anything into it. Another good example would be after Maman's funeral, Meursault says that, "It occurred to me that anyway one more Sunday was over, that Maman was buried now, that I was going back to work, and that, really, nothing had changed." The work of Camus show the theme of absurdity that life is meaningless by death and an individual can't make sense of his experience. Work, a home, and a girl is what Meursault has, and he feels nothing more is needed. He is very existentialistic because of his fate. When the priest asks Meursault if he would like a different life, his response was that he would like one that would be exactly the same as this current one. The fate for the rest of his life rolls a rock to the top of a mountain, then stops and watches it roll back past him. There is no way we can control our fate, because it is predetermined. When he was asked whether he would like to move to Paris, Meursault responded that "people never change their lives, that in any case one life was as good as another and that I wasn't dissatisfied with mine here at all." FRANKL'S PHILOSOPHY In general Victor Frankl sees man as a free, self-determined agent who uniquely determines the meaning of his own individual life, having the potential for either great good or great evil. He stresses man's responsibility for his own life: "things determine each other but man is ultimately self-determining" (p.157). He asks, "How can we dare to predict the behavior of man"(p. 155). Yet he cautions that "freedom...is not the last word"(p. 155) but rather "is in danger of degenerating into mere arbitrariness unless it is lived in terms of responsibleness" (p. 156). Frankl sees the primary motivation of man as "the striving to find meaning in one's life" (p. 121). This is not

External business environment for Vodafone Essay

External business environment for Vodafone - Essay Example Moreover, the government has established the authorities which facilitate the mobile operators and network in UK. Vodafone has developed very good relationships with the government authorities and company also promotes the aim of such governmental bodies. For example, in order to provide advice on the security of communications and electronic data, UK government has established CESG which is a Government’s National Technical Authority for information assurance (Vodafone-central). Moreover, Government has established awards and quality marks to improve the quality of mobile operators. These rewards are independent from the regulations imposed by the Government. For example, Vodafone has recently won the award of quality mark for remote worker security solution (Vodafone-central). Economic The trends in GDP growth rate shows that GDP of UK has declined significantly in 2005. Although GDP growth rate improved in 2007 however, because of the financial crisis, GDP growth rate again declined in 2008. As the recession took on toll on telecommunication sector, Vodafone faced significant challenges and company reported total 500 layoffs throughout the UK to reduce the costs because of challenging economic conditions (The FT Times). Figure: Economic Growth of GDP Source: Chamberlin, 2008 Social Mobile penetration in UK is above than European average and the mobile subscriptions are increasing because of the increasing penetration of consumers in business-oriented devices such as BlackBerry, iPhone etc. Therefore, the mobile phone operators are facing strong competition and concentrating on bundled offers, mobile searching and line service promotions (Budde, 2011). Vodafone also recognises the changing social patterns of consumers; therefore, company is competing by offering the products that may meet the social needs of consumers. Vodafone has recently launched Betavine Social Exchange which is a site to provide mobile solutions in development and for social impac t (Verclas, 2009). Technological UK telecommunication industry is characterised by many recent technological developments such as advanced data services, regulatory controls on the charges of the mobile operators and bundling of mobile services (Budde, 2011). To remain competitive in the market, Vodafone is significantly investing in research and development both in individual activities and in collaboration projects. For example, Vodafone is collaborating with IBM to develop mobile private social network called BuddyCom. The current research of Vodafone is relevant to next generation of mobile technologies, new GSM based services, consumable software for mobile phones and electronic news media (Vodafone). Legal All telecom operators and providers in the UK are being regulated by two main laws including Landlord and Tenant Act 1954 and the Telecommunications Act 1984 (Telemaster). Being one of the largest mobile operators, Vodafone is very considerate about legal framework. The lega l framework provides Vodafone to fairly compete in the market, however, company is also facing significant challenges. For example, the communication regulators in the UK have recently allowed the mobile operators to trade spectrum and the merged T-Mobile and Orange UK is expected to be the first operator to trade its spectrum. Actually the regulators have restricted the operators by specifying the operators to bid for the particular ranges of spectrum (Bradshaw, 2011). Environmental All mobile operators are

Influence Of Female Pop Singers

Influence Of Female Pop Singers Female American-based pop-singers have become more popular over the years in America. Women in this position can be powerful role-models for the adolescent female population. However, concern has been raised over whether these artists use this influence positively or if they have a negative influence. Although there are a few artists who clearly use their influence in a positive way, the majority seem to affect girls negatively. Firstly, the life-style of female American pop-singers and the ideas they convey through their song lyrics reinforce materialism in adolescent girls. Secondly, these artists have a negative influence on the body image of teenage girls. Thirdly female pop-singers from America display self-destructive behaviour and are bad role-models. Consequently, female American pop-singers have a negative influence on teenage girls. Due to the life-style choices female American pop-stars make and the ideas they express in their song lyrics, female pop-singers from America reinforce materialism in teenage girls. Many of these pop-singers clearly express materialistic ideas in their songs. In the song Material Girl, written by Peter Brown and Robert Rans, Madonna sings: Because the boy with the cold hard cash / Is always Mister Right, because we are/ Living in a material world and I am a material girl. The song has been covered by several pop-culture icons like Britney Spears and Hilary Duff, introducing the song to new generations each time. Another example is Nicki Minajs song 1234: And I call Saks Fifth Ave-y home. That is where a real bad Barbie roam. By Saks Fifth Ave she means the store Saks, located on Fifth Avenue in New York City. Saks is a store which sells only the most expensive designer clothing. Nicki Minaj declares with these lyrics that girls who want to be cool, who want to be like her, should sho p at this particular store. By expressing this, she encourages materialism. What might be even more influential than their song lyrics are the life-style choices female American pop-singers make. Jennifer Lopez wore a 15000 dollar dress to last years Grammy awards. In 2011, the birthday present Beyoncà © bought her husband was a Bugatti worth two million dollars. Most of the handbags these women carry with them do not have prices under 3000 dollars. Teenage girls who look up to these women will start thinking that being like their idols includes having the same expensive items they have. The combined pressure of what female American pop-singers express in their songs and the life-style choices they make reinforce materialism in teenagers. Female American pop-singers influence the body image of teenage girls in a negative way. Some female pop artists start their career with an average body, but often succumb to the general beauty ideal in the world of stardom. A fitting example is the story of Demi Lovato, a young woman who started her career by singing and acting for Disney. She was often referred to as the fat Disney girl. By now Demi has admitted she started suffering from Anorexia Nervosa because the pressure of having to be thin became too much for her. Other female American pop-stars who suffered from eating disorders are Alanis Morissette, Britney Spears, Kelly Clarkson and Mariah Carey, and there are many more. All started out with an average body but lost weight until they were more like other celebrities in their environment. Teenage girls idolize these pop-singers and see them as their role-models; they will do almost anything to achieve a similar look to their idols. In her M.A. thesis on feminism Jodie Sim ons wrote: This appeal to adolescent girls to conform to strict hegemonic norms of beauty is not simply embodied in the artists appearance but is also sung about in their songs. An example of such a song is Katy Perrys California Gurls. In the music video of this song Katy Perry is either naked or she is wearing a miniature bikini. She herself is the ultimate California girl. The appearance of American female pop artists, as well as the message about beauty they convey in their lyrics, is unrealistic and are a negative influence on adolescent women. Female American pop-singers often display self-destructive behaviour and are bad role models because of this. Since they are celebrities, their choices and behaviour are constantly watched by the media. Magazines and television channels rather show bad behaviour than good behaviour because it is more interesting to the public and thus brings in more money. The world of female pop artists is very competitive; there is always fresh talent. This competitiveness causes artists to try to stay in the spotlight at any cost. The artists also have more occasions on which they will be inclined to make bad decisions than young adults without these resources or circumstances. Yet, these artists are role-models and should act like they are. Rihanna, now 24, is a perfect example of a bad role model. Rihanna expresses very graphic sexual ideas in some of her songs, which are degrading to women. She also claims in her songs that women should invite men to have sex with them. Rihanna confessed she ha d a sex-addiction herself. There are several nude photos of her on the internet that are easy to find. In February 2009, Rihanna was brutally beaten by her partner, Chris Brown, a few weeks ago it became official that she is involved with Chris Brown once again. Rihanna gives her younger fans graphic ideas about sexuality, she degrades femininity and she indirectly claims it is forgivable when a woman is beaten by her partner. This year Rihanna was named one of the most influential people in the world by Time Magazine. Being so influential Rihanna is a bad role-model for the millions of adolescent girls who adore her. Another example is Miley Cyrus, a Disney child-star who wanted a more adult image and started dancing with a stripper pole, with barely any clothes on in one of her music videos. This left parents with teenage daughters horrified, since their childs idol had suddenly transformed into a bad role-model. There are certainly female pop artists in America who are decent or good role-models. However, they are overshadowed by a majority of bad role-models. Female pop artists in America are always role-models, but because of the self-destructive choices they make and the bad behaviour they display they become bad role-models. To conclude, the life-style of female pop artists from America and the suggestions in their song lyrics strengthen materialism in young girls. Secondly, female American pop-singers have a negative influence on teenage girls. Thirdly, these pop artists are bad role-models partly because of the self-destructive behaviour they exhibit. Although there are female pop artists in America who do not influence girls in such a way, the extent of their colleagues who do have this negative influence is much greater. In general, female American pop-singers have a negative influence on teenage girls.