Thursday, October 31, 2019

Relationships Between Nursing, Health, and the Policy Processes Article

Relationships Between Nursing, Health, and the Policy Processes - Article Example This is because several laws and policies within the country support abortion. The woman also indicated that her health was in danger because the pregnancy affected her psychological well-being because she conceived under duress. The policy that best typifies the case study is Access to Abortion Services that give women rights to abort. This right allows women to access abortion services, as well as support within health care units. The act also creates access routes, and prohibits derogatory actions such as harassments. Some of the access routes include the health care facilities, physicians’ offices, and other service providers (College of Registered Nurses of British Columbia, 2013). Additionally, individuals receiving abortion services and issuing financial and emotional support are protected. The legalization of abortion has been controversial in the United States for the past 200 years making it difficult for the process to enjoy the protection of the law (Simmonds, 2013). Currently, women in the United States have legal abortions right granted throughout the pregnancy period. Furthermore, the women have the right to abort in almost all situations especially after Supreme Court announced the inc orporation of abortion rights into the constitution. This implies that any lawful barriers that will hinder the females from having abortion are unconstitutional (Abort73.com, 2009). This policy involves the nursing process because the service providers include the nurses who offer the abortion services and care based on the provisions of the act. This means that it is illegal for nurses to refuse to give abortion services to females especially when the circumstances are justifiable. I supported the nurses’ decision in the case study. This is because the elements of the abortion policy contradict religious practices. According to my religion, abortion is sin because it constitutes murder.

Tuesday, October 29, 2019

Gay Marriage Outline Essay Example for Free

Gay Marriage Outline Essay In early times, same-sex marriage was not considered taboo and in many cultures, it was encouraged. Random History (2011) explains that in the early civilizations of Mesopotamia and ancient Egypt, the union between couples of the same-sex was recognized by the kingdom. During Greek’s early years, attraction between a man and another man was normal and was considered an expression of love. â€Å"The main considerations in same-sex relationships in early history were often love, beauty, and excellence of character rather than gender† (Random History, 2011, p. 1). Same-sex marriages were often believed to be more pure than a heterosexual marriage. Marriage was believed to be the union of two people based on love. A marriage consisting of two males or two females, if women had the right to get married, was not frowned upon. It was not until the rise of Christianity that a negative attitude towards same-sex marriage became introduced. The belief that marriage was based on procreation and any relationship that was non-procreative began to increase in many societies. Random History’s 2011 research describes how Eastern religions varied in their views about homosexual marriages. Japanese Buddhism records the most tolerant attitude toward homosexuality, praising it for its mystery. Today, there are no religious or political limitations on homosexual behavior in Japan. Sexuality is considered a private matter and lacks any restrictions. â€Å"The sacred texts in the Hindu tradition, the Vedas, did not restrict homosexuality, but rather viewed it as perverse† (Random History, 2011, p.1). Other things, such as mixed race relationships were considered more offensive than homosexuality. Random History (2011) also explains how in the thirteenth century, the first laws banning sodomy were introduced and were strictly enforced. Through the next centuries, homosexual behavior became deviant and was punished. Due to the belief that homosexual behavior was wrong, the belief that heterosexual relationships were normal became popular among the majority of countries. By the nineteenth century, heterosexuality became the most believed standard for relationships. Although the debate for same-sex marriage became noticeably public in the late twentieth century, it was not until 1993 during a Hawaiian case, that the issue became national news. The ruling of the case stated that the restriction of marriage and its benefits to  opposite-sex couples were unconstitutional. â€Å"The Defense of Marriage Act, which was introduced in 1996, was almost a direct response to the Hawaiian case, declared that no state would be required to recognize a same-sex marriage from another state, and also defined marriage as a union between one man and one woman† (Axel-Lute, 2002, p.1). By that same year, a majority of states passed laws prohibiting same-sex marriage. Since then, states have defined their own definition of marriage. Despite the fact that the debate over same-sex marriage is relatively new in the United States, five states have made same-sex marriage legal, as well as Washington D.C. According to the Florida’s Domestic Partnership (2010), currently, there are only two states that recognize same-sex marriages, New York and California. In California, the marriage is only recognized if it was before proposition 8. Ballot Pedias 2008 research explains how proposition 8 is a statewide ballot proposition in California. The people of California voted for the illegalization of same-sex marriage. Though some people are against same-sex marriages for religious reasons, not allowing same-sex marriages is discrimination. Same-sex marriages should be legalized because the discrimination same-sex couples receive is emotionally traumatic, and unfair. The most influential reason against same-sex marriage is based on religion. Many people believe that procreation is the ideal reason for marriage. Their belief is that same-sex couples do not have the capability to produce children which is the basis for marriage. However, when two of the most influential religious icons dis cussed marriage, child bearing was not a reason for two people to get married. â€Å"It is highly significant that Jesus and Paul, while both referring to the creation story, never once mention procreation or physical sexual difference in their teaching about marriage† (Sullivan, 1997, p.79). Both men stressed how the quality of a relationship was the most important aspect for marriage. If marriage is reserved for having a child, then same-sex marriages are not an issue. â€Å"There are countless ways to ‘have’ a child. Not all of them amount to doing the same thing† (Meilander, 1996). Many same-sex couples employ artificial insemination to conceive a child. Liz Tracy’s 2011 article interviews Maria and Vivian, a lesbian couple who were married in New York last year. The two have a 21 year old daughter by artificial insemination. During a marriage ceremony, the church’s only engagement is to  give its blessing. â€Å"The church does not, in fact, marry anyone. People marry each other. The state, not the church, defines the nature of legal marriage† (Sullivan, 1997, p.68). Sullivan (1997) also states how the church has blessed fields when crops have been planted, MX missiles, new houses, and warships whose sole purpose is to kill and destroy. There is no reason the church should not bless a relationship in which two people vow to be faithful and love each other for all eternity. Supporters of same-sex marriage believe the bill to allow same-sex marriage should be crafted in a specific way that will help win votes from people of faith. â€Å"The measure would not force religious organizations to grant marriages to same-sex couples, a move that would make the government benefits of marriage equal for gay and straight couples but still allow the sacrament of marriage to be defined by churches† (Groeninger, 2012, p.2). If the bill was written and carried out in a certain way, the church would not have any association with same-sex couples getting married because the process would be carried out in a courtroom. The American gay rights movement, which became heated in the 1970’s, defined marriage as oppressive, sexist, and a heterosexual institution, according to the National Organization of Women’s 2012 studies. By the government prohibiting same-sex couples from getting married, they are denying them rights that every other American has. â€Å"Marriage is a unique legal status conferred by and recognized by governments all over the world. It brings with it a host of reciprocal obligations, rights and protections† (National Organization of Women, 2012, p, 1). There are numerous rights and responsibilities that are associated with marriage. Same-sex couples are being discriminated against because they are not allowed any of these rights. The National Organization of Women’s 2012 research details many of the 1,138 federal rights, protections and responsibilities that come along with marriage, which same-sex couples are denied. Social Security benefits upon death, disability or retirement of spouse, as well as benefits for minor children, workers compensation protections for the family of a worker injured on the job, exemptions from estate taxes when a spouse dies, exemptions from federal income taxes on spouses health insurance are all denied to same-sex couples. The discrimination and denial of marriage and its benefits of same-sex couples can be emotionally traumatic at times. â€Å"Because literally hundreds  of important legal, economic, practical, and social benefits and protections flow directly from marriage, the exclusion from this central social institution wreaks real harm on real life same-sex couples everyday† (Sullivan, 1997, p. 129). Same-sex couples are denied the right to make decisions regarding their partner’s health or medical treatment. Sullivan (1997) also explains how same-sex couples are not allowed to adopt their partner’s children or how lesbian mothers are often denied custody of their children. One of the most common arguments against same-sex marriage is society’s image of the ideal family. â€Å"The public acceptance of homosexuality subverts the stability and self-understanding of the heterosexual family† (Sullivan, 1997, p.146). Conservatives believe that the ideal family includes one father and one mother. Both of the parents influence their children in a certain way. Many believe that a same-sex couple cannot raise a child properly because the child is not raised with both fatherly and motherly qualities. However, Sullivan (2012) also discusses how even though some parents may be disappointed that their child will not produce a grandchild, they would still prefer to see their child find someone to love and live with and share his or her life with. If a child is surrounded by two parents who love them, they will develop and grow as any other child would. Many states have legalized civil unions since 2000. Although civil unions provide legal protection to same-sex couples, they are only recognized at the state level. Many believe legalizing same-sex marriage is not an urgent issue because civil unions are becoming legal in more states. â€Å"Giving same-sex couples the right to visit a loved one in the hospital, make end of life decisions and inherit property through civil unions was considered the middle ground† (Groeninger, 2012, p.1). There is a vast amount of differences in a marriage and civil union. Debatepedia’s 2011 research explains how civil unions are separate and unequal because people in a heterosexual relationship have access to civil unions, yet same-sex couples do not have access to marriage. Civil unions are unequal because they are not recognized state to state. A same-sex couple in a civil union is denied the all of the rights that come with marriage. Also, civil unions do not receive any federal benef it. â€Å"Because the federal government does not respect civil unions, a couple with a civil union will be in a kind of limbo with regard to governmental functions  performed by both state and federal governments, such as taxation, pension protections, provision of insurance for families, and means-tested programs like Medicaid† (National Organization of Women, 2012, p.1). The debate over same-sex marriage will forever rage until it becomes legalized. Same-sex relationships have been a part of history since the ancient times. Not allowing same-sex marriage is discrimination. Couples are denied financial benefits heterosexual couples receive. Same-sex marriage should be legalized so couples will have the right to make decisions regarding their partner’s health and medical treatment as well as allowing them to adopt one another’s children. Designing the bill a certain way will enable to church to stay uninvolved, since religious reasons are the most common reason fo r people being against same-sex marriage. Legalizing same-sex marriages will create equality for all people in a relationship and defeat the injustice among same-sex couples.

Saturday, October 26, 2019

History Essays French Revolution Violence

History Essays French Revolution Violence French Revolution Violence When historians and others engage in discussion of the French Revolution, they often begin with discussions about why the French people became unhappy and turned towards popular violence as an effective means of dismantling the Ancient Regime. Popular violence became an enduring form of achieving the population’s goals, just as it helped to bringing about a violent abolition to France’s monarchy on August 10, 1792. The French Revolution’s aims however, were not solely focused on replacing the King of France, Louis XVI with an alternative government, but also to completely recreate French Society. The events that occurred following August 4, 1789, were matters focused on religion and politics, and set in motion the Revolution detaching itself from the liberal ideas originally intended for a constitutional monarch, and instead heading down the path of violence and bloodshed. At the heart of the problem, is that the revolution collapsed from within, because of a document presented to a stunned population. This document, the Civil Constitution of the Clergy, created the French Catholic Church as a branch of the new revolutionary government. Previously, the Church and State government had acted in synchronicity. People throughout France were unhappy with this fundamental change to their Church, and millions began to desert the ideas of the revolution for the sake of their religion. Ultimately, this would lead to an escalation of violence that would cause the French Revolution to become progressively bloodier. The Civil Constitution of the Clergy introduced a division between Church and State and the Revolution in such a way that it increased the level of violence and executions to harrowing levels. The Civil Constitution of the Clergy was proclaimed by the National Assembly on July 12, 1790 (Desan 5). The document was the product of the ecclesiastical body of the assembly (Desan 5). The impetus behind its creation was to create a document that would add a â€Å"rationalized structure† to the Church that would cause the Church to operate separate from the government, and to eliminate its financial discretion over the people of France (Desan 5). The document reflects the thinking of the assembly’s ecclesiastical body by reason of what it attempted to accomplish, but it reflects the inexperience of the group in matters of politics. The document essentially turned the bishops and priests of France into state employees because it created their responsibility to the state where none had previously existed (Desan 5). This might have met the satisfaction of the low echelon church priests, but it would not have been to the satisfaction of the bishops. Most of the bishops in France were from families who had previously been members of the Second Estate. The document would have essentially not just the authority that they exerted over the populations residing within their parishes, but it would greatly impair their relationship with the Papacy and, in some cases, mitigate the ambitions of the bishops. As state employees, the bishops would have been reported to the government on their communications with Rome. It would have been necessary to discuss applicable Church doctrine with the state official or department that was put in charge of the state employees. More importantly, however, is that the Civil Constitution of the Clergy was a blow to the Church’s finances. It eliminated certain sources of revenues, such as the fees charged by the Church to perform certain services in the community (Desan 5). Suzanne Desan (1990) states that while the bishops and clerics were probably willing to work with the revolutionaries to make the Constitution work for them, the vast majority of the clergy were fundamentally against it (Dessan 5). To some extent, Desan says, the bishops and clerics agreed with the reform represented by the Constitution (Desan 5). However, they still could not take affirmative action in that direction without guidance from Rome (Desan 5). While everyone waited for Rome to respond, the assembly grew impatient and acted without Rome’s authority or guidance and imposed the Constitution on the Catholic bishops and clergy (Desan 5). Whether or not the assembly predicted that Rome would withhold its approval is unclear. However, the events as they unfolded might suggest that Rome recognized that the potential for division amongst the revolutionary forces if the Pope withheld comment and let the events unfold as they would. The assembly also attempted to force the bishops and clergy to take an oath to the document, the King (who sanctioned the document), and to France. It is here that it might appear, as Desan suggests as well, that the French Revolution began to go wrong (Desan 6). â€Å"The incidence of oath taking was highest in the center, the Ile-de-France, and the southeast. In those regions later known for a high level of religious practicethe northwest, northeast/east, and the Massif Centralwell over half the clergy refused the oath. 8 Historians have frequently seen the requirement of the oath as one of the critical errors of the Revolution, for it provoked unending controversies among the clergy and laity alike and persuaded many villagers to oppose the Revolution (Desan 6).† There were conflicts within the assembly on the document as well. F. A. Aulard says that Robespierre and the ecclesiastics differed because Robespierre held that religion was an individual choice. He envisioned the government of France as one that was non-religious and focused on matters of state. The idea that the people of France would pursue their religious choices and obligations independent of their state responsibilities was truly revolutionary (Aulard 45). This was very much a Girondist sentiment, and quite different than that held by Couthon. It was Couthon who wanted to see a religious state where the â€Å"Supreme Being,† was at that center of State and Church policy. With that, The Civil Constitution of the Clergy was intended to deal with what the revolutionaries perceived to be a dangerous situation with which they were faced (Thompson 1952 22). The Catholic Church was not just the wealthiest institution in France, it was also the most powerful (22) The revolutionaries were faced with a need to take that power away from the church, but in a way in which the National Assembly would be able to absorb and make use of the power themselves (22). The holdings owned by the Church were rich and extensive in land, buildings and endowments (22). The wealth held by the Church was badly needed by the revolutionaries in order to continue moving towards their democracy. That too remained precarious, because in the first year of the revolution there was what anyone should have anticipated as chaos as people sought to bring to a violent end France’s monarch and wealthy (22). In the second year, the year in which the Constitution of the Clergy was created, there was a need to create infrastructure within the revolutionary government; as well as the desire by the vying parties to gain leadership roles in the new government (22). To allow the Catholic Church to continue to hold greater wealth and power than the revolutionaries was contrary to their movement, and it could not be allowed to happen (22). This is the way in which the National Assembly was divided in religious ideology. The Jacobins were philosophical in nature, and, as reflected in Robespierre’s ideas, saw the state independent of religious influence. Robespierre especially wanted France independent of Catholic Church influence because it stood in stark opposition to the ideological state he envisioned. Regardless of Robespierre’s aspirations for France, â€Å"The republic, once it was Montagnard, became a religion; it had its martyrs and its saints (Aulard 125).† It is at this point where the assembly began to divide, with the Jacobin and the other ideologies separate sides. This division arose out of the Constitution of the Clergy because it revised the Church in policy, and it revised the relationship the Church had with the state and with the French people. Considering that these factions existed within the assembly prior to the Constitution being imposed upon the State, it might be concluded that some of the assembly members saw potential conflict as predictable because of the relationship that the provinces had with the Church. The conflict would present for the assembly members the opportunity they needed to wrest control of France away from the Jacobins. Since Robespierre was in large part behind the Constitution of the Clergy, it was predictable, too, that the response of the people to the altered relationship between themselves and the Church would be a mitigating factor in Robespierre’s popularity. Robespierre had been raised a Catholic, but his goal was, Thompson says, to unite the country in faith if not religion â€Å"freed from Catholic dogma and clerical fanaticism (Thompson 24).† Robespierre was at heart a classical Republican, dedicated to equality, a constitutionally guaranteed order of freedoms and a document that served as a direction for the government. In dire need of cash, and on behalf of the state, Robespierre began to auction off confiscated church properties â€Å"bit by bit (Thompson 25).† The state also devised a scheme that was innovative for its time, allowing people to buy in co-owners of national properties (Thompson 25). The government program created a new class of landowner, and, more importantly, that their newfound status and land came out of the revolution meant that those people felt a loyalty to the government, and to Robespierre. It meant, too, that they would fight to prevent the nobility and royalty from returning to their previous status in France, because it would mean they would lose their newfound positions and property (Thompson 25). The Civil Constitution of the Clergy served as the basis for allegations that it was atheist in nature, and that was a document intended to further the cause and position of France’s Jewish population (Van Kley 1994 121). These two elements served as the prongs with which to separate the revolutionists, and to fuel the Church’s own quest to regain some of the power it lost to the government by the Constitution of the Clergy. By late 1791 the Constitution of the Clergy began showing the cracks of its weakness. Many people believed that the traditional Church had a place in the new government of France (Van Kley 416). As unrest spread, more attention was being focused on the Civil Constitution as undermining the people of France. That rhetoric, encouraged by Robespierre’s enemies, permeated the minds of the people who associated with the document with an anti-faith notion and with officially empowering Jews in a way that had never been done before in France. Because of this, the people of France grew restless, became agitated, and began to turn again to popular violence as a means of achieving their goals (Van Kley 417). France’s population in the provinces was feeling especially agitated and defiant. â€Å"Religious rioters mixed the sacred and the violent in powerful ways (Desan 1990 165).† After this point, the Civil Constitution of the Clergy began to fall apart with what it meant to accomplish. Disgruntled Catholics who were convinced that the revolutionary government was moving towards atheism grew angry, and mob mentality permeated the countryside. Robespierre’s government based on philosophy, which left room for the monarchy had role as did the Church began crumbling under the weight of the very document intended to help ensure a government representing greater freedoms for everyone in France. Rather than swear an oath under the Civil Constitution, a majority of bishops in France had taken flight or gone into hiding. This break in relationship with the people with whom they had built constituencies left a void in the lives of those French people who had close ties to their Church and religious leaders. Albert Soboul (1988) says that enlightened reformism does not maintain the same shape in the sovereign setting (Soboul 2). That remains true even today (Soboul 2). Suggesting that Robespierre’s ambitions for France never took the form necessary to withstand the trials and tribulations of church and state. The research of John Markoff (1996) involved creating tables for violence that Markoff directly relates to the Constituion of the Clergy (231). Violence against clerics in religious events was 58%. Violence against â€Å"old regime roles† of priest, bishop, canon, and monks was at 7% in connection with religious events, and 18% against baillages in connection with religious events (Markoff 231). Violent acts committed against nonjurors in connection with religious events was 14% (Markoff 231). Violent acts against nonjurors bailliages in connection with religious events was 34% (Markoff 231). Violence resulting in the damage to constitutionals during religious events was 26%, and those events against the constitutionals associated with bailliages was 20% (Markoff 231). The percentage to monasteries from violence or even total destruction of the monastery was 18%, and the events of violence damaging or destroying monasteries in connection with billiages was 36% (Markoff 231). Across Markoff’s chart, the events of violence and the destruction associated with the violence was greater than those incidences of violence associated with non-religious events. Markoff found that the attacks by the people related to anti-tax events were 25%, while the attacks on anti-tax ballialages was 40% (Markoff 234). Attacks on person or property of tax collectors was 30% s compared to 41% on tax bailliages (Markoff 234). Violent attacks on â€Å"all indirect taxes,† were highest of the overall anti-tax related violence (although Markoff does not define those any clearer) at 61% for anti-tax evens and 66% for anti-tax billiages events of violence (Markoff 234). The figures are consistent, and the incidence of violence that Markoff has identified as arising out of those events directly related to the Civil Constitution of the Clergy are more numerous than the events he identified as related to anti-tax incidences of violence. Markoff says that the sources he relied upon for his information in compiling the figures are reliable and thorough in recounting the events he has charted (Markoff 235). His conclusion is that the violence of the revolution was a greater reflection of the change in the relationship between the church-state-population than it was about taxes. It would suggest, too, that the pre-Civil Constitution of the Clergy relationship of between the church-state and people was such that it might even have served as a circumvention of public reaction to other matters, such as taxes. Markoff also cites documentation from Philippe Goujard which demonstrates that the rural petitioners expressed sentiments indicating that they respected the taxes but did not support the revolutionary government’s enforcement of seigneurial rights (Markoff 235). This would explain the higher percentage of attacks on local jails, police, military camps, or other type office during the post Civil Constitution of the Clergy period. Markoff cites Eugen Weber, who held that it was late in the nineteenth century that French peasantry began to look beyond their own parish and be interested in the politics and events going on elsewhere (Markoff 241). Markoff says that his work has demonstrated that it was much earlier than Weber had originally believed, and that it was really the degree to which the peasantry expressed an interest that Weber was detecting (Markoff 241). Whereas, Markoff says, his events tables show that the peasantry was responding earlier (Markoff 241). As Desan points out, there was a difference in perspective held by those people in the cities and the rural peasants (Desan 123-124). For Catholics during the Directory, liberty meant the freedom of religious expression (Desan 123-124). It is clear that the goals of the rural countryside were not as philosophical as those of the Parisians. That it was widely miscalculated as to what the rural populations were most passionate about, and that the religious relationship the rural people had with their local parishes went a long to satisfying their total philosophical curiosity. The response of the rural peasantry was one that became increasingly violent, and directed towards individuals that Markoff describes as â€Å"frequent mismatch of clerical and communal political leanings, violence against clerics rose sharply (Markoff 506).† The likelihood, Markoff says, of personal in religious clashes is, as demonstrated by the statistics cited above, much higher than any other issue arising out of the revolution (Markoff 506). There were surely to be people who anticipated some of the reactions that led to more and more violent responses on the part of the rural peasantry, and who hoped to exploit that violence to their own benefit. However, it would be a fair conclusion to say that based on the evidence presented by Markoff in his statistical tables of violence and events, that post Civil Constitution of the Clergy, as a result of that document, by way of the changes that it ushered in, the counterrevolution was indeed much more violent than it might have otherwise been had not those changes in the relationship between the people of France and their parishes taken place. Works Cited Aulard, A. The French Revolution: A Political History 1789-1804. Trans. Bernard Miall. Vol. 2. London: T. Fisher Unwin, 1910. Aston, Nigel, ed. Religious Change in Europe, 1650-1914: Essays for John McManners. Oxford: Clarendon Press, 1997. Desan, Suzanne. Reclaiming the Sacred: Lay Religion and Popular Politics in Revolutionary France. Ithaca, NY: Cornell University Press, 1990. Markoff, John. The Abolition of Feudalism: Peasants, Lords, and Legislators in the French Revolution. University Park, PA: Pennsylvania State University Press, 1996. Soboul, Albert. Understanding the French Revolution. New York: International Publishers, 1988. Thompson, J. M. Robespierre and the French Revolution. London: English Universities Press, 1952. Van Kley, Dale, ed. The French Idea of Freedom: The Old Regime and the Declaration of Rights of 1789. Stanford, CA: Stanford University Press, 1994.

Friday, October 25, 2019

What´s Rituximab Therapy? Essay -- Alternate Treatment, Biology, Antib

A relatively newer biologic, rituximab provides an alternative strategy for treating the presenting patient. A genetically engineered chimeric anti-CD20 monoclonal antibody, rituximab exerts it therapeutic action by selectively targeting CD-20 positive B-cells1212, 18. As CD-20 is expressed exclusively on pre-B and mature B lymphocytes; stem cells and plasma cells are not implicated in rituximab therapy. The over expression of B-cells expressing the CD-20 surface antigen in the synovium of RA-affected joints has been well established18. The potential mechanisms by which these B-cells contribute to the immunopathogenesis of RA are as follows: they can act as antigen presenting cells, secrete pro-inflammatory cytokines (including tumour necrosis factor-alpha), and generate rheumatoid factor (RF) and other auto-antibodies whilst also activating T cells12. Hence, the rituximab mediated depletion of B-cells is thought to prevent these potential mechanisms from occurring thus controlling the progression of the disease18. Rituximab therapy consists of two 1000mg infusions, given two weeks apart at intervals of no less than 2 weeks. The projected cost of a single course of rituximab therapy is around  £349211 and if clinically efficient would offer the patient a more convenient dosing schedule compared to Anti-TNF therapy. The annual cost does however depend on how often the patient is required to undergo a course of rituximab therapy11. An RCT aimed at investigating different rituximab dosing regimens in methotrexate resistant patients referred to as the DANCER trial, provides significant evidence conveying the potential benefit of rituximab therapy19. As part of the trial, patients received rituximab 500MG, rituximab 1000mg or placeb... ...50 (7): 754--766. 27. Kaneko A. Tocilizumab in rheumatoid arthritis: efficacy, safety and its place in therapy.Therapeutic advances in chronic disease. 2013; 4 (1): 15--21. 28. An M, Zou Z, Shen H, Zhang J, Cao Y, Jiang Y. The addition of tocilizumab to DMARD therapy for rheumatoid arthritis: a meta-analysis of randomized controlled trials. European journal of clinical pharmacology. 2010; 66 (1): 49--59. 29. Schmitt C, Kuhn B, Zhang X, Kivitz A, Grange S. Disease--drug--drug interaction involving tocilizumab and simvastatin in patients with rheumatoid arthritis. Clinical Pharmacology & Therapeutics. 2011; 89 (5): 735--740. 30. Ding T, Ledingham J, Luqmani R, Westlake S, Hyrich K, Lunt M, Kiely P, Bukhari M, Abernethy R, Bosworth A, Others. BSR and BHPR rheumatoid arthritis guidelines on safety of anti-TNF therapies.Rheumatology. 2010; 49 (11): 2217--2219.

Wednesday, October 23, 2019

Philosophy †Religion Essay

Explain and illustrate two criticisms of the claims that the universe shows design Many philosophers have suggested that world shows design to the extent that there can be no other conclusion other than there is a God who created it. This argument has come to be known as the teleological argument (from the Greek ‘telos’ meaning ‘purpose’). The argument is an inductive one, a posterior (knowledge gained from experience) and is put forward to prove the existence of God. Design can refer to qua regularity and qua purpose. The former focuses on order and regularity in the world and the latter focuses on purpose and beauty but does this hold up to scrutiny? One criticisms was put forward by Hume in his Dialogues Concerning Natural Religion says that there is no evidence for order in the world. In fact the evidence given seems to suggest an evil creator; the arbitrary destruction in the world that affects everyone included innocents seems to suggest that there is no design or order in the world. Tsunamis, hurricanes and earthquakes can all be cited in Hume’s attack. This is made even more apparent from the fact that modern physics isn’t as ordered as the predominant supporter of the design argument, William Paley. Paley gave examples such as the planets and seasons and even gives backing from science saying that Newton’s laws govern the very body of nature. However this has been proved to be wrong by Princeton University and their study called ‘The Dome’, the study in itself shows that Newton’s law’s are non-deterministic meaning that a ball can drop from any apex (as did in the experiment) without a cause. This shows that even science isn’t ordered as Paley made out. Another criticism is which is also put forward by Hume is that Paley’s argument (that there is, indeed, design in the world) is that this is a disanalogy. Paley gave the example of watch stating that it had purpose (it could tell us the time), regularity (evident through second, hour and minute hand) and design (the mechanisms) and he claims that this is analogous to the world. However this is a clear disanalogy according to Hume; for we have experience of watches and we know that they have designers and thus know that they must be designed, we can not however say the same for the universe, as we only have one and we are contained within it. If we were transcendent and had access to more than one universe or even if we had witnessed them being designed we may have been able to accept Paley’s claims. Hume also says that it’s not analogous because a watch’s purpose is axiomatic but this is unlike the universe where it is subjective. For a Christian, the purpose of life is to create a relationship with God so that they can be eschatologically reunited and the universe allows this (it’s purpose) however a humanist would say that the universe has no purpose and that we are here to live our lives to the full. Thus Paley’s claims are left redundant. To conclude, these two criticisms have shown that there is question as to whether there is design in the world. Hume has shown that design qua (in relation to) purpose and regularity are merely positions which are nothing more than falsities. Explain and illustrate two claims that God’s existence is incompatible with the existence of evil Evil has come to pose one of the single largest threats to theism, indeed, many such as John Stuart Mill and David Hume concluded that God no longer existed because of the existence and the incompatibility of it. Evil has been defined to be the â€Å"absence of good† by Aristotle but it mainly refers to two types, either natural evil which entails natural disasters such as tsunamis or moral which refers to morally wrong actions and intents taken by humans such as infanticide or examples such as the Holocaust. Some try to reconcile the ideas of evil and God (in what has come to be known as theocies) but it is questionable whether they have succeeded. Hume puts the first criticism forward which is known as the logical problem of evil, a deductive argument, by first reissuing the statements as a theist would accept them; 1. God is omnipotent. Omniscient and omnibenevolent 2. Evil (and thus suffering exist) Hume claims that the one and two are incompatible. For if he loved us then he would stop suffering and thus he can not be omnibenevolent. Hume developed his argument through his ‘inconsistent triad’ which states that God is either unable to stop evil which means they he is not omnipotent; that he does not know about the evil which means he is not omniscient. This leads us to the conclusion that God’s existence is logically incompatible with the existence of evil and Hume to say that one of the sides of triangle (attributes of God, considering that evil objectively exists) and so Hume says that it is the â€Å"death† of classical theism. The answer to this could be that evil exists so that we can allow us to spiritually grow, for it is true that we can not become courageous unless an instance of danger arises, similarly we can not gain compassion without suffering. So the criticism is solved through God wanting us to experience suffering so we can go though a process of soul-making (this marks the basis for Iraneus’ theodicy). However this leads to the second criticism which is predominantly put forward by William Row, Charles Darwin and David Hume says that even if we were to accept that evil should exist and it is compatible, the sheer amount and the distribution of it shows that the existence of God and evil is less probable. This inductive argument cites points in history that show that the distribution doesn’t seem to amount justification for soul-making; it can accept the death of an adult, but what of the Gulag and Holocaust? Rowe also notes that there are evils which do not lead to spiritual growth such as people who never recover such as child who has had his whole family burned. Rowe also gives the example of a fawn who burns in a forest but no one is around to see it, who is growing spiritually, what compassion has been encompassed? This anthropocentric approach (by implication) also fails because it leaves animal suffering unanswered. Thus, the view that evil and God’s existence is compatible is made redundant not only in the face of the incompatibility of God’s very nature and the existence of evil but the sheer amount and distribution of it.

Tuesday, October 22, 2019

Circuit City Essays

Circuit City Essays Circuit City Paper Circuit City Paper Circuit City is currently the number two store in the consumer electronics industry and the number three seller of consumer electronics products. Circuit City operates exclusively in the United States.  Circuit City has been falling into trouble in the past few years. There have been extensive layoffs as well as reconfiguring of the management system in order to cut costs.  The external force that is greatly affecting Circuit City is the economic times; the disposable income of the consumer is key to the consumer electronics industry. There is intense pressure from rivals Best Buy and Wal-Mart, without change Circuit City will continue to fall below its competitors. In the internal environment of Circuit City the marketing aspect of the supply chain is very weak. The service aspect is where the value is located. For Circuit City to fully take advantage of their core competency it is necessary for them to create more value in the marketing segment.  Circuit City must address the customers, competitors, suppliers, and economic forces in order to succeed in the consumer electronics industry. Strategic alternatives that will address these issues include updating and controlling technical and operating systems, shifting management from top-down to bottom up, and creating an identifiable brand. The key strategic alternative that Circuit City must address in order to succeed in the industry is creating a brand. A marketable image must be created that will create loyalty among consumers. In order to successfully implement this Circuit City must update its image, create buzz, increase marketing efforts, and create their own niche.  If Circuit City successfully implements and carries though the recommendations to re-brand itself, they will succeed in the consumer electronics industry. By creating a new image they will successfully secure the number two spot behind Best Buy, with distant goals of surpassing their competitor. Issues and Outlook Profile Budi In a year of 2000, Circuit City has a physical store in 45 different states. Circuit City operates more location in more than any other consumer electronics specialty retailer. The company has more than 600 retail outlets, 7 service centers, and 10 distributions center. In a year of 2002, Circuit City Stores, Inc. completes the separation of CarMax. The separation eliminates the companys tracking stock structure and two common stock series Circuit City Group Common Stock and CarMax Group Common Stock. Effective October 1, 2002, the Circuit City Group Common Stock is renamed Circuit City common stock and represents an ownership interest only in the Circuit City business, and CarMax, Inc. becomes an independent, separately traded public company. In a year of 2003, given the strong sales lift and internal rate of return seen with relocated stores after their first six months, Circuit City accelerates its relocation program. In fiscal 2004, Circuit City relocates 18 stores and opens eight new stores. In a year of 2004, Circuit City agrees to sell its private-label credit card operation, including both its private-label Circuit City credit card accounts and its co-branded Circuit City Plus Visa credit card accounts, to Bank One Corporation. Circuit City and Bank One will enter into an ongoing arrangement under which Bank One will offer private-label and co-branded credit cards to both new and existing customers. Circuit City announces it has purchased the assets of MusicNow, a leading digital music platform. InterTAN, Inc., a leading consumer electronics retailer of both private-label and internationally branded products with headquarters in Barrie, Ontario, becomes a subsidiary of Circuit City following a tender offer in which Circuit City acquired the outstanding shares of InterTAN, Inc. As part of its store revitalization program, Circuit City plans to open 60 to 70 new Superstores with a fairly even split between store relocations (circuitcity.com/cccareers /about/history .html). Recently in 2007, Circuit City Stores Inc., which is cutting jobs and restructuring to fend off competition, swung to a fiscal first-quarter loss and withdrew its financial forecast for the year.The results came a day after rival Best Buy Co. reported sharply lower first-quarter profit and downgraded its 2008 earnings outlook. Both retailers say shoppers are turning away from high-margin items such as flat-screen televisions. Circuit City said sales fell 4.3% in the quarter ended May 31; sales at stores open at least a year fell 5.6%.The Richmond, Va., company said in March it would replace 3,400 highly paid workers with lower-paid employees. In the first quarter, the amount of change that we introduced to the company led to significant volatility, which we expect to continue through the summer, Chief Executive Philip Schoonover said. Combined with an uncertain macroeconomic environment, for the time being, it is difficult to project sales and earnings performance for the balance of the fiscal year, he said. Circuit City said it still expects to open 60 to 65 new and relocated domestic stores this fiscal year. It said more than half of them would be in a 20,000-square-foot format. UBS analyst Brian Nagel said the results show Circuit City is still struggling to turn around. We remain disappointed with the continued slow pace of recovery at Circuit City, he wrote to clients. The loss is the latest dismal news for the company, which has lost several top executives while battling for market share with Best Buy. The companies and others engaged in a price war during the holiday season and slashed prices, particularly on LCD and plasma televisions. Goldman Sachs analyst Matthew Fassler called the results predictably problematic. Circuit City is experiencing the same problems as Best Buy, but at amplified levels, across sales growth and margin rate, Mr. Fassler wrote to clients. Moreover, as Circuit City invests aggressively in systems, an understandable priority, it subjugates near-term results to longer term investment. In the most recent quarter, consolidated gross profit margin narrowed to 22.5% from 24.5% in the same period last fiscal year. At the end of March, the retailer turfed 3,400 employees in the U.S. and Canada because it thought they were overpaid and announced plans to replace them with cheaper workers. Betty Owen, 56, of El Paso, Texas, was one of them. Owen, a part-time worker logging full-time hours, was pulling in $10.10 per hour (all figures U.S.).According to published reports, the company decided to get rid of workers whose wage level was at least 51 cents above Circuit Citys established pay rates. From a dollars and cents perspective, the move seems to make sense. Take 3,400 workers, assuming they work 40 hours per week, slash their wages by the lowest amount (51 cents) and the company will save at least $3.6 million every year in labor costs. Thats not small change. Or is it? Considering Circuit City had 42,000 workers and $11.6 billion in revenue in 2006 and net income of $162.5 million, $3.6 million doesnt seem like much. And from a public relations standpoint, its a disaster. The announcement was met with calls to boycott the store and at least one lawsuit. Three employees in California have filed an age discrimination suit theyre trying to have certified as a class-action lawsuit. Fighting that battle alone could dissolve the savings from the wage cuts. The repercussions are bound to echo beyond bad PR. Most of the workers being let go have been on the job awhile, and their experience is walking out the door with them. Training costs will increase and customer service will undoubtedly suffer. And exactly what kind of workers are going to be filling these roles? When it made the very public announcements about wage cuts and terminations, Circuit City might as well have hung a sign on all its stores stating that, good, talented workers need not apply. But thats the new reality in retail, right? The Wal-Martization of the business means retailers have to keep wages low to stay competitive and theres no room for good HR practices, right? Wrong. A little outfit called Costco is punching all kinds of holes in that thinking. The Issaquah, Wash.-based warehouse club pays its workers generously. By some reports, they start at about $10 per hour and their earnings rise to about $44,000 per year after four years. They also get a strong benefits package. The result is low turnover and a very loyal staff. In 2004, Business Week decided to put Costcos labor practices to the test. It compared Costco to Sams Club, the membership warehouse operated by Wal-Mart. It found that by compensating employees generously to motivate and retain good workers Costco actually keeps its labor costs lower than Wal-Marts as a percentage of sales. Costco pulled in $13,647 in operating profit per hourly employee versus $11,039 at Sams Club. Jim Sinegal, Costcos CEO and founder, has resisted pressure from investors to cut costs, shrugging off comments that its better to be an employee at Costco than a shareholder. We think its good business. In the final analysis, you get what you pay for. Better employees mean higher productivity. Weve proven that with our business model. We want to turn our inventory faster than our people, he said. (Paying low wages) doesnt keep employees happy. It keeps them looking for other jobs. Plus managers spend all their time hiring replacements rather than running your business. The lesson? Better paid employees are more productive and happy, and that translates into a healthy bottom line. Thats an idea that seems to be lost on Circuit City.