Tumescent anaesthesia describes the practice of injecting a very dilute solution of local anaesthetic combined with epinephrine and sodium bicarbonate into tissue until it becomes firm and tense (tumescent). It was initially described in the field of liposuction but now surgical applications for the technique are widely varied ranging across vascular surgery, breast surgery, plastic surgery and ENT procedures. It is widely used in both hospital- and office-based environments and may form the sole method of anaesthesia for surgery. Advantages include a reduction in blood loss through both epinephrine-induced vasoconstriction as well as hydrostatic compression from the tumescent effect. Sodium bicarbonate reduces pain associated with the injection of an acidic local anaesthetic solution. Due to the unique pharmacokinetic profile of this technique lidocaine doses of 35 mg/kg bodyweight have been shown to be safe for liposuction procedures. Tumescent lidocaine is absorbed very slowly from subcutaneous tissues producing lower, and more delayed, peak blood levels compared to other routes, as well as extended postoperative analgesia. Slow systemic absorption allows the rapid hepatic plasma clearance of lidocaine to maintain safe local anaesthetic blood levels. This slow absorption from subcutaneous tissue has been likened to a depot injection. Careful attention must be given to appropriate local anaesthetic dosage alterations in cases of co-administration with agents affecting hepatic drug clearance or conditions reducing liver blood supply. Adherence to these pharmacological principles has produced an exemplary safety record for this technique to date.

Google, Inc. announced that it would provide access to the internet in China through a new portal: Google.cn. At the same time, Google executives agreed to censor all search results that included content considered objectionable by the Chinese Government. This decision was announced in the wake of Google's recent refusal to provide user information to the US Government case against child pornography. Wall Street's response confirmed the profit potential of the venture, as the company's share price rose 3.6 percent in just one day (Ottawa Citizen, 2006). However, the company's announcement brought strong reaction from the press and human rights organizations as well. Within days, headlines across the USA and around the world accused Google of abandoning its principles in pursuit of profit.

Purpose Business organizations should strive to create ethical cultures to win consumer loyalty and thus safeguard long-term performance success. Management bears ultimate responsibility for promoting ethical behavior. By rewarding ethical behaviors and punishing transgressions, management will reinforce morally upright behavior and create a positive company culture. Successful promotion of corporate ethics, in turn, will boost employee morale, increase performance beyond bare minimums and retain employees in the long run. With a well-structured ethics code and strong reward system, management has all the tools necessary to create an ethical company culture. Design/methodology/approach This viewpoint paper, while advocating for a systematic approach to ethical behavior in a business organization, carefully reviews both well-established literature in this area as well as current best practices. The aim is to provide senior managers with a sense of how the best corporate ethics programs are organized and structured. Findings A successful corporate ethics program must involve all employees from executives to hourly wage workers, with each taking personal responsibility for his or her own performance and results. While no guarantees of success are offered, one reasonably certain path to failure is for an organization to post an ethics code and then ignore it. Ethics must be discussed, modified from time to time and actively integrated into the life of every organization that hopes to avoid ethical missteps. Originality/value This paper offers a fresh viewpoint on both the value and the organization of a potentially successful corporate ethics program. While time-honored ideas serve as the foundation for our discussion, a thorough review of current issues and best practices form the directional heading for the paper’s conclusions.

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This paper examines the process of corporate downsizing and its implications for communicating employee lay-offs. In an effort to please one set of stakeholders (investors, creditors, shareholders, analysts and others), management may be faced with difficult and unpleasant communication choices as they confront another set of stakeholders (employees, customers, community members and elected officials). The objective in each case is to restructure the organisation, control costs and return to profitability without alienating or traumatising the very people who helped create wealth and productivity for the organisation. This paper reviews current practice, an extended case example, and provides ten specific suggestions for planning and communicating employee lay-offs.