Environmental Ethics Essay Example | Topics and Well Written Essays - 500 words - 2

Environmental Ethics - Essay Example Additionally, Aristotle observes that ethical living calls for application of wisdom that depends upon the situation at hand rather than the mere application of the set laws. He referred to this kind of as practical wisdom or prudence which is different from the theoretical wisdom(Kamtekar, 2004). On the contrary, Friedrich Nietzsche looks at ethics as untenable phenomenon. Nietzsche argues that ethics is deleterious and can just be relevant in the case of the highest types of human beings (Katsafanas, 2011). This is because ethics requires a high degree of consequentialist perfectionism of good. One thing to note however is that Nietzsche is a not a critic of morality in totality. He for example agrees with the notion of a higher morality that informs the living of higher men both of which he attacks and praises. Nietzsche offers an analysis of the existing values in a way that appeals to some morality of some kind. Nietzsche advocates for similarity of all people, free will and transparency(Katsafanas, 2011). However, Nietzsche argues for the harm of the highest men while advancing the interests of the lowest men. Further, Charles Darwin brings about the concept of evolutionary ethics which has two broad perspectives of normative ethics and descriptive ethics. Regarding descriptive ethics, it consists of biological ethical approaches anchored upon the role of evolution in determining human behaviour and psychology. Darwinism ethics is based on the scientific aspects of ethology, socio-biology and psychology with a focus on explaining and understanding preferences of ethics or choices (Lillehammer, 2010). On the other hand, normative ethics of evolution depicts a more independent attempt to singlehandedly use evolution to justify ethics in a society. Descriptive evolutionary ethics delve on the beliefs and moral attitudes. The ethical underpinnings discussed on this ethical

The role of HR planning in the resourcing process Essay

The role of HR planning in the resourcing process - Essay Example Presently, demographic shifts, technological changes, environmental instability and global competition have led to a new role for HR planners since resourcing process have grown to be complex than before. Ulrich and Brockbank (2005) pointed out that HR planning involves continuous and systematic process of analyzing a business human resource needs under changing conditions. In addition, it involves development of workforce policies that are consistent with long range effectiveness of a business. HR planning involves forecasting HR needs and designation of the necessary actions involved in the resourcing process such as recruitment, career development and training. HR planning helps to forecast the right numbers of employees and more so in getting the right kind of personnel at the right place within the right time. According to Robertson and Smith (2001), HR planning coordinated the enumerated elements and helps to gather resources the business needs in both long term and short term. HR planning is a vital component for organizational success in the long-run. This paper will discusses role of HR planning in the resourcing process, importance on job analysis, internal and external recruitment tools and selection techniques, importance of effective induction and appropriate retention strategies in respect of recruitment of a cinema manager while at the same time reviewing the current state of the United Kingdom employment market. The following are ways in which HR planning facilitate the resourcing process: The facilitation of pre-recruitment review is a process that involves provision of professional advice as to whether the internal staff should be taken into consideration in filling the vacant positions. A process is then followed in evaluating the staff’s suitability. The staff who were working under the former cinema manager should, therefore, be evaluated to determine if anyone is capable of filling the vacant position. The provision of guidance and expert advice is used in the initial stages of recruitment especially in defining the vacant position, preparing advertisements, advising on and identifying proper channels for advertisement among other important recruitment activities. As such, the HR planners will be resourceful in defining the roles of a cinema manager, identifying the right advertisement channels among other recruitment activities. The HR planner acts as an expert adviser to the selection committee throughout the selection process. This involves briefing the committee members on the appropriate interview techniques and providing

Helicobacter Pylori Treatment and Rosacea

Helicobacter Pylori Treatment and Rosacea Running title: Helicobacter Pylori Treatment and Rosacea Parviz Saleh1, Mohammad Naghavi-Behzad2, Hamdieh Herizchi3, Fatemeh Mokhtari3, Mohammad Mirza-Aghazadeh-Attari2 , Reza Piri4* 1- Chronic Kidney Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2- Students Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran 3-Department of dermatology, Tabriz University of Medical Sciences, Tabriz, Iran 4- Medical Philosophy and History Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Effects of Helicobacter pylori Treatment on Rosacea: a Single Arm Clinical Trial Study Abstract: Rosacea is a chronic dermatologic disease. Helicobacter pylori has been discussed as one of its causative factors. In this clinical trial study, it was tried to evaluate the effect of H. pylori standard eradication protocol on the rosacea clinical course. In this single-arm clinical trial, patients with approved H. pylori infection based on serological studies were assessed to examine rosacea existence. Then, the patients with concurrent rosacea and H. pylori infection were included in the study and underwent a standard Helicobacter pylori eradication therapy. Rosacea was evaluated using Duluth rosacea grading score at beginning, 2 months later, and at the end of the trial (day 180). Of 872 patients with positive H. pylori, 167 patients (19.15%) manifested the clinical features of rosacea. The patients with concurrent rosacea were younger (p Keywords: Rosacea, Helicobacter pylori, Prevalence, Eradication, Treatment Effects of Helicobacter pylori Treatment on Rosacea Introduction: Rosacea is a chronic dermatological disorder mostly affects facial convexities, which is characterized by telangiectasia, flushing and papulopustular changes (1, 2). These findings tend to be in cluster patterns, which allow identification of different subgroups of patients. In other words, rosacea includes a wide spectrum of dermatological manifestations with different severities (3-5). Pathogenesis of rosacea is thought be related to vascular changes, but the main process of pathogenesis for rosacea is still unknown. A combination of dermal connective tissue damage and vascular dysfunction consisting endothelial damage, impaired reactivity, and autonomic dysfunction has been proposed (5-9). So researchers have always tried to reveal the pathophysiology process by proposing possible pathogenic factors such as solar irradiation, sensitivity to noxious stimuli, change in redox status, and the presence of parasitic mites (Demodex folliculorum) (10-14). The role of Helicobacter pylori related gastritis in the pathogenesis of rosacea has been also a subject of controversy. Diverse prevalence of H. pylori infection has been reported among rosacea patients (15-21), ranging from zero to 100%. Some studies have suggested that rosacea could be considered as an extra-gastric symptom of H. pylori infection or reported improved rosacea clinical course post H. pylori eradication (22) (23), while others concluded no significant relationship between H. pylori infection and rosacea (24, 25). Based on our literature review, no confident and precise conclusion has been made about any change in the clinical course of rosacea after H. pylori eradication yet today. So the present clinical trial aimed to evaluate changes in the clinical course of rosacea after H. pylori eradication by standard treatment protocol. Subjects and Methods Study design In this single-arm clinical trial which was conducted in clinical-educational centers of Tabriz University of Medical Sciences (Tabriz, Iran) from May 2013 to November 2015, patients with proved H. pylori infection based on serological study were screened for evaluation of concurrent rosacea disease. Then, the patients with concurrent rosacea clinical presentation and H. pylori infection were enrolled into the study. Considering sample number limitation, sampling was performed during a year to calculate sample size, then study power was calculated 0.85 according to that number of samples. Rosacea severity was graded using Duluth rosacea grading score (26) before and after H. pylori eradication protocol. Finally, the patients were examined 2 and 6 months after medication, to compare dermatological findings of rosacea with primary findings. All participants were provided an informed written consent, and the study protocol was in compliance with the Helsinki Declaration and was approved by the Ethics Committee of Tabriz University of Medical Sciences. In all stages of study patients information were anonymous and based on codes and patients could refuse to take part in the study at any stage. This study is registered at Iranian Registry of Clinical Trials (IRCT2015051418946N3). Study population All patients who were 20-65 years old, with confirmed H. pylori infection and active rosacea, attending clinical-educational centers of TUMS were included in the study. Prior H. pylori eradication treatment, the existence of any other dermatologic problem, allergy to clarithromycin or omeprazole, antibiotic therapy within past 2 months, topical treatment of rosacea in past 3 weeks, history of hospitalization in past 6 months, pregnancy and breastfeeding, patients were considered as exclusion criteria of the study. H. pylori infection evaluation H. pylori stool antigen test was implicated to confirm H. pylori infection before enrolling the patients into this study (day 0) and to confirm H. pylori eradication (day 60). Stool samples were collected in a standard container. In the laboratory, using an applicator stick 4-5 mm of stool was transferred in a diluent vial, then it was vortexed for 20 seconds. Then, 4 drops of vial were dispensed in ImmunoCard STAT HpSA kit (Meridian Diagnostics, Inc., OH, USA); positive predictive value of this test was 89.3% based on literature (27). The positive and negative results were concluded based on the manufacturers recommendation. Rosacea evaluation Rosacea severity was evaluated using Duluth rosacea grading score (26) at beginning (day 0), 2 months later (day 60), and at end of the trial (day 180). Dermatology team examined rosacea based on detecting primary and secondary signs and symptoms of rosacea and graded them as absent, mild, moderate, or severe (0-3), based on the Duluth scoring system. Primary features of rosacea included: flushing (transient erythema), non-transient erythema, papules and pustules, telangiectasia. Secondary features included: burning or stinging, plaques, dry appearance, edema, ocular manifestations, peripheral location (present or absent), phymatous changes. Finally, rosacea condition was compared in day 0, day 60, and day 180 by the same team. H. pylori treatment Standard two-week triple therapy was administered to eradicate H. pylori, including metronidazole 500 mg orally twice per day, clarithromycin 500 mg orally twice per day, and pantoprazole 40 mg orally per day. Primary and secondary outcomes The primary outcome was the severity of rosacea before and after H. Pylori eradication. Secondary outcomes were H. Pylori eradication rate and prevalence of rosacea among patients with H. Pylori and demographic differences between H. Pylori positive patients with rosacea and without rosacea. Demographic and outcome measurement All demographic information was collected at patients enrollment time. Patients rosacea stage was evaluated on day 0, 60, and 180, then they were compared. Same dermatology team reevaluated clinical course of rosacea to decrease inter-observer error. Statistical methods Statistical analysis was performed by SPSS software package, version 16.0, for windows (SPSS Inc.). Quantitative data are presented as mean  ± standard deviation (SD), while qualitative data are demonstrated as frequency and percent (%). Paired sample t-test, chi-square, and Friedman test were used for analysis of data. Mann-Whitney U test was used to compare between groups and Wilcoxon ranked sum test was used to compare within groups. Probable confounding factors were considered as inclusion and exclusion criteria. However, some factors which could have been confounding factors were analyzed using multivariate analysis but they were not presented in results the section. P value less than 0.05 was considered statistically significant. Normal distribution of data was assessed using Kolmogorov-Smirnov test. Results In the present study 872 patients with positive H. pylori stool antigen were assessed by dermatologists team. Of 872 patients, 167 patients had clinical features of rosacea. Some demographic information about patients is shown in Table 1; of all patients with a positive test for H. pylori, patients diagnosed with rosacea had lower ages (p>0.001) and the difference in gender composition was also statistically significant (p=0.034); in this conclusion, multivariate analysis was used. Based on the results, rosacea prevalence among patients with positive H. pylori stool antigen was 19.15% (167/875). Of 167 patients with positive H. pylori stool antigen and rosacea, 17 patients rejected to take part in the study while 150 patients agreed. Of 150 patients who underwent H.pylori eradication therapy, 138 (92%) had negative H. pylori stool antigen (successful treatment) at the end of the trial. Rosacea Duluth score at day 0, 60 and 180 was 15.55 ±4.34, 14.11 ±3.96 and 12.57 ±3.62, respectively; the differences between all stages were statistically significant (p Based on Wilcoxon signed-rank test, comparison of primary and secondary features of rosacea between stages of study is shown in table 3; Of secondary rosacea features, burning or stinging, plaques, dry appearance edema and ocular manifestations the difference between two stages of study were mostly significant; but the differences for peripheral involvement and phymatous change were mostly not statistically significant. Discussion Rosacea as a chronic dermatological disease, with an almost unknown pathogenesis process so far, has been the subject of many studies. One of the proposed pathogenic processes attributed to rosacea is gastric infection with H. pylori, so many researchers have tried to examine this association by trying to investigate the correlation between H. pylori infection and rosacea or by observing changes of rosacea after H. pylori eradication. Based in the present study, Prevalence of rosacea among H. Pylori positive patients was 19.15% in this study, which seems as twice as the highest reported rate in other populations, ranging from 1-10% (2, 28-31). This different has been correlated to various variables including race, culture and diet of these. In a study by Argenziano et al. potential association between rosacea and serological evidence of H. pylori infection was investigated and they concluded that there is a significant association between rosacea and H. pylori infection (32), while A bram et al. evaluated several suspected risk factors for rosacea and concluded that there was no statistically significant differences between rosacea patients and those of control group (33). Patients with rosacea and H. pylori infection had female gender predominance and lower age in comparison to those suffering only H. pylori infection. H. pylori cure rate after routine triple therapy was 92%. During 6 months of follow-up, H. pylori eradication among those who had rosacea and H. pylori infection led to a significant improvement in rosacea condition based on Duluth score grading. There was a significant decrease in intensity of almost all primary and secondary criteria except phymatous changes, telangiectasia, and peripheral involvement; this difference in phymatous changes, telangiectasia, and peripheral involvement might be due to the more time taking nature of these criteria to be resolved. Based on the literature, diverse conclusions have been made regarding rosacea resolution after H. pylori eradication. In a study by Szlachcic et al. investigating the link between Helicobacter pylori infection and rosacea, it was concluded that after H. pylori eradication therapy among patients with rosacea and H. pylori infection, H. pylori cure rate was 97%, and in 85% of patients the symptoms of rosacea decreased markedly or disappeared within 2-4 weeks (22); although H. pylori cure rate in the present study is less than that reported in this study, the effect of H. pylori eradication on rosacea is similar in both of the studies. In another study conducted by Rojo et al. on the role of H. pylori in rosacea and chronic urticarial, it was concluded that H. pylori eradication led to a significant improvement both in rosacea (75.6%) and urticarial (85.7%) when compared with control group (22%) in 4 weeks (34); results of that study is similar to what was concluded in the present study, although no precise description of clinical features of rosacea was presented after treatment. On the hand, Bamford et al. in a study investigating effect of treatment of H. pylori infection on rosacea concluded that rosacea was significantly improved after H. pylori eradication, although this improvement was also significant in control group, the difference between the improvement of rosacea was not statistically significant between intervention and control group (35); this fact that both groups had significant improvement in rosacea totally undermined the association of H. pylori infection and rosacea which was concluded in the present study, also in this article the improvement was attributed to probable placebo effect. In another study by Herr et al. relationship between H. pylori and rosacea was examined by evaluating the response of patients with rosacea to H. pylori eradication, and they concluded that there was no statistically significant change in rosacea condition both in intervention and control group, although papulopustules had significantly decreased in interven tion group comparing baseline and follow-up (36), which is the only improvement detected after H. pylori eradication in this study, but in the present study besides improvement of papulopustules, almost all the other clinical manifestations of rosacea had improved. In a study by El-khalawany evaluating the effect of H. pylori eradication in rosacea subtypes it was concluded that H. pylori eradication led to a significant improvement in rosacea, where papulopustular subtype improved significantly more than erythematotelangiectatic subtype (37); these results are similar to the results of present study, since in the present study almost all clinical manifestations of rosacea had decreased while no statistically significant change was shown about telangiectasia. According to the mentioned literature, different conclusions have been derived from studies about the efficacy of H. pylori eradication in rosacea treatment; ranging from significant improvement in rosacea (22) or significant improvement between baseline and follow-up but not when compared to control group (35) to no significant improvement in rosacea. One of the reasons which might be responsible for these diverse conclusions is multifactorial nature of rosacea where ethnic group, bacterial subtypes or genetics might be other confounding factors. One of the main limitations of this study was lack of control group, so it might have affected this study to prevent coming to a precise and confident conclusion, also this might have led to undermining probable placebo effect of administered treatment. The main thought behind not including a control group was not willing to deprive patients of H. pylori treatment where their H. pylori infection had already been proved. Another factor which could have resulted in a more precise and reliable conclusion was including possible confounding factors such as gender, ethnic groups, and occupational environment status and analyzing rosacea improvement while taking confounding factors into account. In conclusion, the present study indicated that prevalence of rosacea among patients with H. pylori infections is slightly more than what literature attribute to different populations, it also showed a statistically significant improvement in rosacea when Duluth scores were compared between baseline and follow-up. Considering the present controversy about the association of H. pylori infection and rosacea, it is suggested that further clinical trials considering multifactorial nature of rosacea take all possible confounding factors into account, also as far as rosacea is a dermatological condition with different manifestations, recognition of alterations in the dermatological pattern of rosacea might lead to a more confident conclusion. Acknowledgments: This Study was supported by Tabriz University of Medical Sciences. Conflict of Interests: No conflict of interests are declared References: 1.Plewig G, Kligman A M. Acne and rosacea: Springer Science Business Media: 2012. 2.Powell F C. Rosacea. New England Journal of Medicine 2005: 352: 793-803. 3.Tan J, Blumeà ¢Ã¢â€š ¬Ã‚ Peytavi U, Ortonne J, et al. An observational crossà ¢Ã¢â€š ¬Ã‚ sectional survey of rosacea: clinical associations and progression between subtypes. British Journal of Dermatology 2013: 169: 555-562. 4.Tan J, Berg M. Rosacea: current state of epidemiology. Journal of the American Academy of Dermatology 2013: 69: S27-S35. 5.Steinhoff M, Buddenkotte J, Aubert J, et al. Clinical, cellular, and molecular aspects in the pathophysiology of rosacea. In: Journal of Investigative Dermatology Symposium Proceedings: Nature Publishing Group, 2011: 2-11. 6.Del Rosso J Q. Advances in Understanding and Managing Rosacea: Part 1 Connecting the Dots Between Pathophysiological Mechanisms and Common Clinical Features of Rosacea with Emphasis on Vascular Changes and Facial Erythema. Journal of Clinical Aesthetic Dermatology 2012: 5. 7.Fimmel S, Abdel-Naser M B, Kutzner H, et al. New aspects of the pathogenesis of rosacea. Drug Discovery Today: Disease Mechanisms 2008: 5: e103-e111. 8.Pouralibaba F, Babaloo Z, Pakdel F, et al. Serum level of interleukin 17 in patients with erosive and non erosive oral lichen planus. J Dent Res Dent Clin Dent Prospects 2013: 7: 91. 9.Naderi N J, Tirgari F, Esmaili F, et al. Vascular endothelial growth factor and Ki-67 antigen expression in relation to age and gender in oral squamous cell carcinoma. J Dent Res Dent Clin Dent Prospects 2012: 6: 103. 10.Tisma V S, Basta-Juzbasic A, Jaganjac M, et al. Oxidative stress and ferritin expression in the skin of patients with rosacea. Journal of the American Academy of Dermatology 2009: 60: 270-276. 11.Guzman-Sanchez D A, Ishiuji Y, Patel T, et al. Enhanced skin blood flow and sensitivity to noxious heat stimuli in papulopustular rosacea. Journal of the American Academy of Dermatology 2007: 57: 800-805. 12.Marks R. The enigma of rosacea. Journal of Dermatological Treatment 2007: 18: 326-328. 13.Lacey N, Delaney S, Kavanagh K, et al. Miteà ¢Ã¢â€š ¬Ã‚ related bacterial antigens stimulate inflammatory cells in rosacea. British Journal of Dermatology 2007: 157: 474-481. 14.Golfroushan F, Azimi H, Ali E T H. Comparison of Efficacy of Topical Combination Solution of Salicylic Acid% 2 and Erythromycin% 4 with Topical Solution of Erythromycin 4% Alone in Mild to Moderate Acne Vulgaris Treatment: A Double-Blinded Randomized Clinical Trial. Medical Journal of Tabriz University of Medical Sciences Health Services 2013: 34. 15.Zandi S, Shamsadini S, Zahedi M, et al. Helicobacter pylori and rosacea. Eastern Mediterranean health journal= La revue de sante de la Mediterranee orientale= al-Majallah al-sihhiyah li-sharq al-mutawassit 2002: 9: 167-171. 16.Hernando-Harder A C, Booken N, Goerdt S, et al. Helicobacter pylori infection and dermatologic diseases. European Journal of Dermatology 2009: 19: 431-444. 17.Elà ¢Ã¢â€š ¬Ã‚ khalawany M, Mahmoud A, Mosbeh A S, et al. Role of Helicobacter pylori in common rosacea subtypes: a genotypic comparative study of Egyptian patients. The Journal of dermatology 2012: 39: 989-995. 18.Bhattarai S, Agrawal S, Rijal A, et al. The study of prevalence of Helicobacter pylori in patients with acne rosacea. Kathmandu University Medical Journal 2014: 10: 49-52. 19.Prelipcean C C, Mihai C, Gogălniceanu P, et al. Extragastric manifestations of Helicobacter pylori infection. Revista medico-chirurgicala a Societatii de Medici si Naturalisti din Iasi 2006: 111: 575-583. 20.Yousefi L, Ghotaslou R, Akhi M T, et al. Frequency of Helicobacter pylori blood-group antigen-binding adhesion 2 and sialic acid binding adhesion genes among dyspeptic patients in Tabriz, Iran: H. pylori babA2 and sabA genes. Journal of Analytical Research in Clinical Medicine 2015: 3. 21.Salehi M R, Aboei M S, Naghsh N, et al. A comparison in prevalence of Helicobacter pylori in the gingival crevicular fluid from subjects with periodontitis and healthy individuals using polymerase chain reaction. J Dent Res Dent Clin Dent Prospects 2013: 7: 238. 22.Szlachcic A. The link between Helicobacter pylori infection and rosacea. Journal of the European Academy of Dermatology and Venereology 2002: 16: 328-333. 23.Tà ¼zà ¼n Y, Keskin S, Kote E. The role of Helicobacter pylori infection in skin diseases: facts and controversies. Clinics in dermatology 2010: 28: 478-482. 24.DakoviĆ¡ Z, VesiĆ¡ S, VukoviĆ¡ J, et al. Ocular rosacea and treatment of symptomatic Helicobacter pylori infection: a case series. Acta dermatovenerologica Alpina, Pannonica, et Adriatica 2007: 16: 83-86. 25.Mayr-Kanhà ¤user S, Krà ¤nke B, Kaddu S, et al. Resolution of granulomatous rosacea after eradication of Helicobacter pylori with clarithromycin, metronidazole and pantoprazole. European journal of gastroenterology hepatology 2001: 13: 1379-1383. 26.Wilkin J, Dahl M, Detmar M, et al. Standard grading system for rosacea: report of the National Rosacea Society Expert Committee on the classification and staging of rosacea. Journal of the American Academy of Dermatology 2004: 50: 907-912. 27.Chisholm S A, Watson C L, Teare E L, et al. Non-invasive diagnosis of Helicobacter pylori infection in adult dyspeptic patients by stool antigen detection: does the rapid immunochromatography test provide a reliable alternative to conventional ELISA kits? Journal of medical microbiology 2004: 53: 623-627. 28.Kyriakis K P, Palamaras I, Terzoudi S, et al. Epidemiologic aspects of rosacea. Journal of the American Academy of Dermatology: 53: 918-919. 29.Tan J, Berg M. Rosacea: Current state of epidemiology. Journal of the American Academy of Dermatology: 69: S27-S35. 30.McAleer M A, Fitzpatrick P, Powell F C. Papulopustular rosacea: Prevalence and relationship to photodamage. Journal of the American Academy of Dermatology 2010: 63: 33-39. 31.Abram K, Silm H, Oona M. Prevalence of Rosacea in an Estonian Working Population Using a Standard Classification. Acta Dermato-Venereologica 2010: 90: 269-273. 32.Argenziano G, Donnarumma G, Arnese P, et al. Incidence of antià ¢Ã¢â€š ¬Ã‚ Helicobacter pylori and antià ¢Ã¢â€š ¬Ã‚ CagA antibodies in rosacea patients. International journal of dermatology 2003: 42: 601-604. 33.Abram K, Silm H, Maaroos H I, et al. Risk factors associated with rosacea. Journal of the European Academy of Dermatology and Venereology 2010: 24: 565-571. 34.Rojo-Garcia J M, Munoz-Perez M A, Escudero J, et al. Helicobacter pylori in rosacea and chronic urticaria. Acta dermato-venereologica 2000: 80: 156-157. 35.Bamford J T, Tilden R L, Blankush J L, et al. Effect of treatment of Helicobacter pylori infection on rosacea. Archives of dermatology 1999: 135: 659-663. 36.Herr C, Hee You C. Relationship between Helicobacter pylori and Rosacea. J Korean Med Sci 2000: 15: 551-554. 37.El-khalawany M, Mahmoud A, Mosbeh A-S, et al. Role of Helicobacter pylori in common rosacea subtypes: A genotypic comparative study of Egyptian patients. The Journal of Dermatology 2012: 39: 989-995. Tables: Table 1. Demographic information about patients with positive H. pylori stool antigen (%) Variables Patients with* P value + HPA without rosacea (N=705) +HPA with rosacea (N=167) Age (years old) 54.38 ±10.71 43.21 ±9.84 Gender 337 (47.81%) female, 368 (52.19%) male 95 (56.89%) female, 72 (43.11%) male 0.03 Marital status Single, Divorced or widowed (643(91.2%)), Married (62(8.8%)) Single, Divorced or widowed (145 (86.82%)), Married (22 (13.18%)) 0.1 +HPA: Positive H. pylori antigen * U Mann-Whitney test was used. **Data are shown as Mean  ± Standard Deviation and number (%) Table 2. Rosacea Duluth grading of patients at day 0, 60 and 180 of trial (N=138)*. Variables Day 0 ** Day 60** Day 180** P value Primary Features Flushing 2.28  ± 0.71 2.02  ± 0.51 1.82  ± 0.52 Non-transient erythema 2.34  ± 0.54 1.9  ± 0.64 1.42  ± 0.72 Papules and pustules 1.8  ± 0.59 1.71  ±0.51 1.58  ± 0.52 Telangiectasia 1.78  ± 0.93 1.72  ±0.67 1.74  ± 0.84 <

Abortion Can Never Be Justified :: Papers

Abortion Can Never Be Justified Christians all react differently to the issue of abortion. Some would say that abortion is murder because they would believe that life starts from the moment of conception. This follows a Roman Catholic Church view but not all Roman Catholics would agree. The mainstream Roman Catholic view is that life is sacred. They would say that life is God given and the only person who has the right to take life is the one who created it (God). If God has created all life then God is the only person who can take it away. So if a woman was raped then the Roman Catholic view would be to raise the child by "loving her enemies" Mark 12:29-31. This would mean that she would be loving her enemy, which would be the baby from her oppressor and love the child to give it a healthy way of life. Roman Catholics would support giving her help and aid to raise the child by giving the mother money and if needed a secure living environment. Even if she could not look after it herself most Roman Catholics would accept her putting the child into adoption, that way the child is not murdered and can be loved and cared for. But not all Roman Catholics as I mentioned before have this opinion on abortion. Some would adopt their own opinions or those of other churches. The Church of England say that abortion is wrong unless having the child is putting anybody's life in danger. They see that life does not begin until birth. Anything before that is only potential life, therefore to have an abortion is not murder but it is still not acceptable to have one for any other reasons. They would explain in the case of rape that abortion of the oppressor's child would be seen as the lesser of two evils and should be accepted. The Church of England still recognise that human life is valuable as it is created in the image of God but they would argue that life does not start at

Honesty: Lie and Personal Responsibility

Being Honest with Yourself Honesty is the best way to succeed in future endeavors, both in relationships and business. Though being honest can hurt others it is beneficial to succeeding in life. This is a personal responsibility any individual should have both in education and in everyday life. When it comes to being honest in school, plagiarism is one of the biggest lies a person could do.Plagiarism means â€Å"an act or instance of using or closely imitating the language and thoughts of another author without authorization and the representation of that author's work as one's own, as by not crediting the original author†(Dictionary. com,2013). Plagiarizing someone’s work is not being honest to the instructor, but most of all not being honest to your own work; it is not showing that you have that personal responsibility to the school work. Researchers have a personal responsibility to be honest on their work.Sometimes when the research is being conducted, the writer wi ll add other more honorary titles into that research; this is less than honest when it comes to a research. When the researchers add extra information that is not valid to the paper it starts to become a lie. In childhood a young child has that personal responsibility to be honest to their parents. If they were not honest with them, normally they would be disciplined for lying. While in school a child will learn how to be honest on their school work and to be honest with their peers.In both aspects they would need to show that they know what honesty is, and that they are responsible for proving that they truly understand what that honesty is. Sometimes when growing up and being taught that being honest is the way life should be and that the individual should always be honest. Honesty does have its time and place. â€Å"Do theses pants make my butt look fat†, for gentlemen this is an all-time question, tell the truth and let your wife know, yes those pants make you look fat, o r say honey no you look amazing in those pants.Some honesty could be a little too much for a woman already feeling insecure about her body. So the individual will tell a little white lie and things seem to continue to run smoothly throughout the day and night. Now if the person were a snitch, say for the FBI, this could be a deadly ordeal for that person. Tell the truth only to the FBI and take that chance of being caught by a gang of some sorts, and be killed for saying secret information. Then again if that snitch never gets caught, there might be an amazing award for that person.Going to another country or state might become their haven, and they can continue a normal and productive life. Some views on honesty are that a person is a snitch, or maybe they just do not know how to tell a lie. Either way, honesty is a personal responsibility that most would view as an important aspect to everyday life. Whether it is in school or in everyday life honesty is the best policy. References Sharma, B. , & Singh, V. (2011). Ethics in writing: Learning to stay away from plagiarism and scientific misconduct.Lung India, 28(2), 148-150. doi: http://dx. doi. org/10. 4103/0970- 2113. 80337 Steneck, N. H. (2011). The dilemma of the honest researcher. EMBO Reports, 12(8), 745-745. doi: http://dx. doi. org/10. 1038/embor. 2011. 134 Victoria Talwar, Angela M. Crossman, Children’s lies and their detection: Implications for child witness testimony, Developmental Review, Volume 32, Issue 4, December 2012, Pages 337-359, ISSN 0273-2297, 10. 1016/j. dr. 2012. 06. 004. (http://www. sciencedirect. com/science/article/pii/S0273229712000251) Honesty: Lie and Personal Responsibility Being Honest with Yourself Honesty is the best way to succeed in future endeavors, both in relationships and business. Though being honest can hurt others it is beneficial to succeeding in life. This is a personal responsibility any individual should have both in education and in everyday life. When it comes to being honest in school, plagiarism is one of the biggest lies a person could do.Plagiarism means â€Å"an act or instance of using or closely imitating the language and thoughts of another author without authorization and the representation of that author's work as one's own, as by not crediting the original author†(Dictionary. com,2013). Plagiarizing someone’s work is not being honest to the instructor, but most of all not being honest to your own work; it is not showing that you have that personal responsibility to the school work. Researchers have a personal responsibility to be honest on their work.Sometimes when the research is being conducted, the writer wi ll add other more honorary titles into that research; this is less than honest when it comes to a research. When the researchers add extra information that is not valid to the paper it starts to become a lie. In childhood a young child has that personal responsibility to be honest to their parents. If they were not honest with them, normally they would be disciplined for lying. While in school a child will learn how to be honest on their school work and to be honest with their peers.In both aspects they would need to show that they know what honesty is, and that they are responsible for proving that they truly understand what that honesty is. Sometimes when growing up and being taught that being honest is the way life should be and that the individual should always be honest. Honesty does have its time and place. â€Å"Do theses pants make my butt look fat†, for gentlemen this is an all-time question, tell the truth and let your wife know, yes those pants make you look fat, o r say honey no you look amazing in those pants.Some honesty could be a little too much for a woman already feeling insecure about her body. So the individual will tell a little white lie and things seem to continue to run smoothly throughout the day and night. Now if the person were a snitch, say for the FBI, this could be a deadly ordeal for that person. Tell the truth only to the FBI and take that chance of being caught by a gang of some sorts, and be killed for saying secret information. Then again if that snitch never gets caught, there might be an amazing award for that person.Going to another country or state might become their haven, and they can continue a normal and productive life. Some views on honesty are that a person is a snitch, or maybe they just do not know how to tell a lie. Either way, honesty is a personal responsibility that most would view as an important aspect to everyday life. Whether it is in school or in everyday life honesty is the best policy. References Sharma, B. , & Singh, V. (2011). Ethics in writing: Learning to stay away from plagiarism and scientific misconduct.Lung India, 28(2), 148-150. doi: http://dx. doi. org/10. 4103/0970- 2113. 80337 Steneck, N. H. (2011). The dilemma of the honest researcher. EMBO Reports, 12(8), 745-745. doi: http://dx. doi. org/10. 1038/embor. 2011. 134 Victoria Talwar, Angela M. Crossman, Children’s lies and their detection: Implications for child witness testimony, Developmental Review, Volume 32, Issue 4, December 2012, Pages 337-359, ISSN 0273-2297, 10. 1016/j. dr. 2012. 06. 004. (http://www. sciencedirect. com/science/article/pii/S0273229712000251)

John Paul Vann

John Paul Vann is the central character of Sheehan's book, the character around whom the whole Vietnam War seems to turn. Fearless, misguided, Vann appears to stand for America itself. American ambassador and commanding general were informing the Kennedy administration that everything was going well and that the victory was theirs. Vann saw Vietnam War otherwise. In the end Vann was killed when his helicopter crashed and burned in rain and fog in the mountains of Vietnam's Central Highlands, leaving behind a most extraordinary legend.He succeeded in imposing himself as the real commander of a whole region in Vietnam, and the Pentagon, in an unprecedented move, gave him authority over all U. S. military forces in his area. He commanded as many troops as a major general. Vann never hesitated to use whatever level of force was necessary to achieve his ends, but considered it morally wrong and stupid to wreak violence on the innocent (another reason for his popularity with the anti-war p eople). The influence he wielded both within the U. S.civil-military bureaucracy and the Saigon government made him, by general agreement, the most important American in Vietnam after our ambassador and commanding general, a position recognized at his Arlington funeral, attended by the entire Washington military establishment. Neil Sheehan's book is now popular with both critics and public, and Hollywood would even think of making a film portraying an American military hero from the Vietnam War with such sympathy. DEVELOPMENT OF THEME Both John Paul Vann and Neil Sheehan went to Vietnam in the early 1960s, Vann as a military advisor, Sheehan as a reporter for United Press International (UPI).As the months passed, Vann’s disillusionment with the war’s progress eventually led him to share his frustrations with Sheehan and other reporters, and the advisor became one of the correspondents’ most valuable sources of information on the true dynamics of the situation ou t in the countryside. In the mid-1960s Sheehan left Vietnam for assignments in the United States, but Vann remained and, after assuming a civilian position, rose to become one of the most powerful Americans in the country.In 1972, a short time after Vann’s death in a helicopter crash, Sheehan began work on a biography of the soldier. Sixteen long years later, the book was finally published to a chorus of critical praise. John Paul Vann went to Vietnam in March 1962 at age thirty-seven. A lieutenant colonel in the U. S. Army, he served as senior advisor to the South Vietnamese Army’s 7th Infantry Division, which was headquartered at My Tho in the Mekong Delta south of Saigon. An intelligent, fearless man possessed of terrific stamina and a deeply held belief in the legitimacy of U.S. involvement in Vietnam, Vann was an ideal advisor in many respects. Sheehan wrote in A Bright Shining Lie that the military man’s character and education had ‘‘combined t o produce a mind that could be totally possessed by the immediate task and at the same time sufficiently detached to discern the root elements of the problem. He manifested the faith and the optimism of post–World War II America that any challenge could be overcome by will and by the disciplined application of intellect, technology, money, and, when necessary, armed force. (134)’’But as the months passed and the Army of the Republic of Vietnam (ARVN) troops that he was advising continued to flounder, Vann’s frustration grew. South Vietnamese commanders proved reluctant to commit troops to confrontations because of political concerns back in Saigon and their own instinct for self-preservation, and the rosy forecasts of American policymakers troubled him as well. Moreover, Vann felt that both the South Vietnamese government and U. S. officials did not appreciate the significance of the social problems plaguing the country, and he argued that U. S.bombing po licies and the Strategic Hamlets program (in which peasants were forcibly removed from their homes and placed in group encampments) were eroding already tenuous support for the Diem regime out in the countryside. By the end of his first year in Vietnam, wrote Sheehan, ‘‘Vann saw that the war was being lost. The ambassador and the commanding general in South Vietnam were telling the Kennedy administration that everything was going well and that the war was being won. Vann believed then and never ceased to believe that the war could be won if it was fought with sound tactics and strategy† (102).Sheehan and the other members of the Saigon press corps bucked attempts by U. S. and Vietnamese officials to spoon-feed the media information on the war’s progress, and relations between the camps quickly deteriorated. Within a matter of months, however, the adventurous UPI reporter had developed an effective network of independent sources and established a productive p artnership with David Halberstam of the New York Times. One of the correspondents’ best sources in the U. S. military was John Paul Vann.Writing in A Bright Shining Lie, Sheehan described the relationship between Vann and the reporters in similar terms: ‘‘Vann taught us the most, and one can truly say that without him our reporting would not have been the same†¦. He gave us an expertise we lacked, a certitude that brought a qualitative change in what we wrote. He enabled us to attack the official optimism with gradual but steadily increasing detail and thoroughness’’ (254). Sheehan noted that he and most of the other correspondents initially supported America’s presence in Vietnam.‘‘We believed in what our government said it was trying to accomplish in Vietnam, and we wanted our country to win this war just as passionately as Vann and his captains did,’’ (211) Sheehan said. But the reports of Vann and other sourc es, coupled with their own firsthand observations out in the field, convinced the press corps that the U. S. prosecution of the war was fundamentally flawed. While attending the funeral for John Paul Vann in 1972, Sheehan was struck by the stature of those in attendance (from General William Westmoreland, who served as a pallbearer, to Ellsberg, who had been one of Vann’s closest friends).Upon returning home, Sheehan secured a two-year leave of absence from the New York Times, along with a contract from a publisher, and began work on a biography of Vann. The writer felt that by studying Vann’s life, he would also be able to examine America’s role in Vietnam. As he wrote in A Bright Shining Lie, ‘‘The intensity and distinctiveness of his character and the courage and drama of his life had seemed to sum up so many of the qualities Americans admired in themselves as a people. By an obsession, by an unyielding dedication to the war, he had come to person ify the American endeavor in Vietnam.He had exemplified it in his illusions, in his good intentions gone awry, in his pride, in his will to win† (325). As the 1970s blurred into the early 1980s, Sheehan’s obsession with Vann’s story grew. Month after month passed by as the writer tried to reconcile Vann’s dark secrets (a troubled childhood, a sexual appetite that doomed his army career) with the honorable soldier he had known in the Mekong Delta. And over it all lay the shadow of the war itself, the contradictions of which Sheehan continued to see encapsulated in Vann. Sheehan fell into a reclusive routine in which his waking hours were dominated by the book.In August 1986 Sheehan finally completed the manuscript for A Bright Shining Lie. Over the course of the next year, the author pared the book down to 360,000 words, still a massive work. In 1988—sixteen years after Sheehan began work on the Vann biography—A Bright Shining Lie was finally published. Paralyzed by our own Newtonian paradigm, we defeated ourselves by persistently viewing the Vietcong as being different from us in degree, when in fact they were different in kind. Underestimating them as being different only in degree, the U. S.military often contemptuously referred to them as â€Å"those raggedy-assed little bastards† (205). To Americans, the Vietcong simply had less technology to fight with; but the Vietcong knew they had a different kind of technology – the land, and they used it to great advantage against U. S. technology. In his A Bright Shining Lie, Sheehan relates a story that perfectly expresses how the Vietcong used nature in concert with their kind of technology. A Captain James Drummond is told by a prisoner that â€Å"the most important Vietcong training camp in the northern Delta is located in clumps of woods above a hamlet.When he gets there, Drummond finds . . . four thatched-hut classrooms furnished with blackboards under th e trees . . . † (88). The very idea that â€Å"blackboards under the trees† – a virtual oxymoron in American thinking -could be used to defeat the United States, is, once again, â€Å"unthinkable. † It represents what psychiatrist Charles J. Levy calls â€Å"inverted warfare,† which Gibson explains as â€Å"the sense in which American common sense on how the world operates was reversed or inverted in Vietnam†.A Bright Shining Lie confirms, that the core of the U. S. news operation in Vietnam during the crucial years from 1961 to 1963, came under the influence of a mid-level U. S. Army adviser, Lieutenant Colonel John Paul Vann, who was convinced that he had solved the riddle of how to galvanize what was essentially a fifteenth-century South Vietnamese army into a twentieth-century fighting force: Get rid of South Vietnamese President Ngo Dinh Diem, and have the United States take over the war, in toto.On January 2, 1963, the ARVN 7th Infantry Division, which was under the command of General Huynh Van Cao, carried out orders to destroy a Vietcong radio transmitter located in the hamlet of Tan Thoi in the Mekong Delta. Acting on intelligence that indicated that the transmitter was protected by a force of about one hundred Vietcong in nearby Ap Bac, Vann and his staff settled on a plan of attack that featured his usual precise calculations. ‘‘Vann saw an opportunity to use the ARVN’s advantages in mobility, firepower, and armor to destroy a Viet Cong unit,’’ noted Harry G.Summers, Jr. in the Historical Atlas of the Vietnam War. But instead of wreaking havoc on the guerrillas (whose hit-and-run tactics had frustrated the American advisors over the preceding months), the operation proved disastrous for Cao’s troops. Larger-than-expected Vietcong forces at Ap Bac and Tan Thoi were ready for the attack, having intercepted radio messages concerning the upcoming operation. When the raidâ⠂¬â„¢s first helicopters arrived, they were met with withering ground fire, and three of the H-21 helicopters and one Huey (UH-1) gunship were promptly downed.The first few minutes of the battle set the pattern for the rest of the clash. As the hours dragged by, ARVN forces committed a series of strategic blunders—some over the objections of Vann and his staff—that served to further deteriorate their position. Finally, Vann felt that Cao’s forces showed little appetite for battle, a factor that further contributed to the debacle. By the next morning the Vietcong guerrillas had slipped away, leaving behind eighty ARVN dead and another one hundred wounded. Significantly, three Americans had been killed as well.Later in the morning, Cao ordered a fraudulent air strike on the area, nearly killing Sheehan and two other Americans who were surveying the long-abandoned battlefield. In the battle’s aftermath, U. S. and South Vietnamese officials tried to call the clash at Ap Bac a victory, but Vann and his staff quickly disabused the press corps of any such notions. Enraged by the whole operation, Vann called the ARVN effort ‘‘a miserable damn performance,’’ and even though correspondents who used the quote did not reveal his identity, U. S. officials familiar with Vann knew whose voice it was.‘‘As a battle it did not amount to much, but Ap Bac would have profound consequences for the later prosecution of the war,’’ wrote Summers. ‘‘Prior to Ap Bac,’’ Sheehan pointed out, ‘‘the Kennedy administration had succeeded in preventing the American public from being more than vaguely conscious that the country was involved in a war in a place called Vietnam†¦. Ap Bac was putting Vietnam on the front pages and on the television evening news shows with a drama that no other event had yet achieved’’ (421). Vann retired from the army several mont hs later.When those who knew him learned of his departure, many assumed that he had selflessly sacrificed his military career so that he could comment on the war with greater freedom, and his reputation was further enhanced. His admirers were unaware that Vann’s myriad sexual indiscretions (including a valid statutory rape charge that he ultimately beat) had permanently scarred his record, effectively limiting his advancement anyway. In 1965 Vann returned to Vietnam as a civilian, serving as a provincial pacification representative for AID (the Agency for International Development).As American involvement in the war expanded, Vann’s authority increased, even though he continued to be an outspoken critic of some aspects of the war’s prosecution. ‘‘His leadership qualities and his dedication to the war had assisted his promotion, as had a realization by those in power in Saigon and Washington that his dissent over tactics or strategy was always meant t o further the war effort, not hinder it,’’ wrote Sheehan (436). In May 1971 Vann was promoted to an advisory position that gave him authority over all U. S. military forces in Vietnam’s Central Highlands and adjacent provinces along the central coastline.The unprecedented arrangement gave Vann more power than he could have ever wielded had he stayed in the army. By this point, some people who knew Vann felt that the years of involvement in the war had changed the man, and not for the better. They noted that Vann had adopted a much more lenient philosophy about appropriate methodologies for winning the bitter war. Those who recalled his harsh criticisms of bombing strategies earlier in the conflict for the toll that they exacted on civilians found that he had become an enthusiastic proponent of intensive bombing campaigns.Sheehan wrote about an exchange between Vann and Washington Post reporter Larry Stern that dramatically reflected Vann’s change of heart : ‘‘Anytime the wind is blowing from the north where the B-52 strikes are turning the terrain into a moonscape, you can tell from the battlefield stench that the strikes are effective,’’ (365) Vann reportedly told Stern. In March 1972, North Vietnamese forces launched the three-pronged Easter Offensive, a bold effort to overwhelm South Vietnam by attacks on three strategic regions.All three thrusts were ultimately turned back, however, as the NVA (North Vietnamese Army) was handed a major setback. Vann was widely credited with being a key figure in the defense of An Loc, a site seventy-five miles north of Saigon that had been one of the NVA’s primary targets in the offensive. In June of that year, however, Vann was killed in an air crash when his helicopter, flying low over an otherwise treeless valley at night, hit a small group of trees standing over a primitive Montagnard cemetery (Montagnards are aboriginal tribespeople who make their homes in so me of Vietnam’s more mountainous areas).EVALUATION OF THE THEME AND BOOK PRESENTATION As the months passed, and disastrous events such as the Ap Bac debacle and the Buddhist uprising erupted, Sheehan emerged as one of the war’s finest—and most controversial—correspondents. He did so despite struggling with an almost paralyzing certainty that death would claim him when he went out into the field. When he first arrived in Vietnam, Sheehan had been exhilarated by violent, dangerous excursions out in the countryside, but the events at Ap Bac changed his attitude in dramatic fashion.While surveying the scene of the battle, Sheehan and two others (reporter Nick Turner and Brigadier General Robert York) had nearly been blown apart by General Cao’s fraudulent attack against the abandoned Vietcong positions in the area. In June 1964 Sheehan left UPI for the New York Times. A year later he returned to Saigon, where he stayed until 1966, when he was transferr ed to Washington, D. C. That same year he wrote an article, ‘‘Not a Dove, but No Longer a Hawk,’’ that reflected his growing disillusionment with America’s involvement in Vietnam. In the late 1960s he served as the newspaper’s Pentagon and White House correspondent.By 1971 Sheehan had come full circle; he emerged as a critic of the war. In 1971 Ellsberg’s disenchantment with U. S. policies led him to give Sheehan a massive collection of confidential government memorandums and reports on the war that came to be known as the Pentagon Papers. To opponents of the war, the records in this archive—commissioned by Defense Secretary McNamara back in 1967, they included reports dating back to the 1940s—provided stark evidence that U. S. involvement in Southeast Asia had too often been characterized by deceit, misjudgments, and bureaucratic arrogance.Sheehan’s massive tome garnered many awards (Pulitzer Prize, National Book A ward for nonfiction, Columbia Journalism Award, Robert F. Kennedy Book Award, and others) and laudatory reviews in the months following its publication. Boosted by the recognition, the book became a best-seller. Reviewers were almost unanimous in their praise for Sheehan’s work (the harshest dissent with the critical consensus appeared in the National Review). New York Times Book Review critic Ronald Steel commented that if there is one book that captures the Vietnam War in the sheer Homeric scale of its passion and folly, this book is it.Indeed, reviewers recognized that the book worked in large measure because of its choice of subject matter. Critics felt that, in John Paul Vann, Sheehan had found a larger-than-life figure whose experiences in Vietnam offered valuable insights into the character and nature of American involvement in the conflict. Making more sense of what happened in the conflict than most books, this is a thoughtful, well-made work. References Sheehan, Nei l. (1988). A Bright Shining Lie: John Paul Vann and America in Vietnam. New York: Random House.