The Role of Word and Sacrament in the Life of Catholics

Catholics in the United States are the representatives of one of the largest religious groups, and Catholicism has deep roots in the country’s history. That is why, the Catholic tradition and the views of Catholics on Word and sacraments can be discussed as reflecting the visions of the majority of Americans.Advertising We will write a custom essay sample on The Role of Word and Sacrament in the Life of Catholics specifically for you for only $16.05 $11/page Learn More The role of Word and Sacrament in the life of those Catholics who follow their religious tradition strictly is significant because Word of God is associated with main religious doctrines and principles of Catholicism, and sacraments can be discussed as the main rites of passage which determine the major stages in the human life and accentuate the connection of an individual with the faith. Catholics focus on belonging to the community and church while following the fundamental relig ious principles and doctrines. The everyday life of Catholics should be based on spirituality, faith, and religious tradition. Moreover, Catholicism provides people with a set of moral norms and rules which are necessary to follow and live according to God’s laws (Allitt, 2003). The principles of Catholicism are meaningful for Americans because they depend on the aspects of the historic development (Hemeyer, 2010). According to Corbett and Hemeyer, â€Å"Catholics were among the first, if not the first, Europeans to set foot upon the shores of America† that is why it is quite usual for Americans to share the Catholic tradition (Corbett Hemeyer, 1997, p. 89). As a result, â€Å"the majority of people in the United States consider Catholics to be a part of consensus religion. Catholicism is not viewed as ‘out-of-the-ordinary’ religion† (Corbett Hemeyer, 1997, p. 92). From this point, the main tendencies of the American society’s development a re formed within the Catholic communities which can influence the life of a lot of Americans considerably. Thus, Catholics’ visions of Word and Sacrament become especially significant for discussing the Americans’ religious tradition and spirituality in relation to Christianity. The guidelines to find the principles of religion and rules to follow can be reached with references to Word of God presented in the Bible. Catholics are inclined to discuss Word of God as God’s will or even as the equivalent of God. Thus, God’s will make Catholics act according to this will and according to the specific doctrines and codes presented in relation to the dogmas of Catholicism (Hemeyer, 2010).Advertising Looking for essay on religion theology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Catholics follow Word of God because it can be discussed as the single truth presented directly by God. From this perspective, following Word, people have to provide the definite response to this will. Catholics react to Word of God with following the religious principles and building their life according to the Catholic tradition. God’s truth is reflected in Word that is why people can grow spiritually basing on the visions provided in the Bible (Allitt, 2003). Furthermore, Catholics can draw conclusions about the aspects of religion only referring to Word of God. However, to build the life according to Word of God and main Catholic principles, it is necessary to follow definite religious procedures known as sacraments. Thus, Word of God and Sacrament are the basic aspects of the Catholic worship. The American Catholic Church provides people with the opportunity to attend it as the centers for worship and for developing the community life (Hemeyer, 2010). Church is significant during the periods of trouble and when people experience crises in their life. Those Catholics who cannot find the answer to the quest ions of spirituality with the help of interpreting Word of God are inclined to act and follow sacraments which reflect the main stages or passages in the human life such as the process of adopting the religion or marriage (Corbett Hemeyer, 1997). Sacraments are the meaningful rituals which can deepen the individual’s faith and connect the person with God more closely, developing one’s spirituality. Thus, to accept God’s will and to participate in Sacrament, Catholics should follow a range of rituals. Moreover, the role of sacraments is incomparable because they help determine the main aspects of the life and accentuate the sacred fields of the human existence. Catholics determine seven main sacraments which are Baptism, Confirmation, Reconciliation, Marriage, Eucharist, Holy Orders, and Anointing of the Sick. According to Hemeyer, the first and the main sacrament that Catholics participate in is Baptism. Thus, Catholics believe that â€Å"baptism is necessary for the removal of the inborn sin that is a part of all persons simply because they are human† (Hemeyer, 2010, p. 99).Advertising We will write a custom essay sample on The Role of Word and Sacrament in the Life of Catholics specifically for you for only $16.05 $11/page Learn More To become a Catholic, it is necessary to be baptized according to the principles of this religion. Baptism is an important stage of cleaning the soul and body from the sins, and it is a kind of protection for a human provided by the religion. Baptized Catholics begin to celebrate God and his will fully. Eucharist is a ritual when Catholics share Christ’s Body and Blood in the form of bread and wine. It is an important stage of becoming closer to Christ spiritually. Sacraments are significant to teach Catholics the basics of religion according to God’s Word. Thus, God forgives the people’s sins, and Catholics are taught to forgive during the sacrament of Reconciliation (Hemeyer, 2010). To develop the mature spirituality, Catholics are expected to follow the ritual of Confirmation. Holy Orders help Catholics join Church and share the basic religious doctrines. Anointing of the Sick is a specific sacrament in which a priest usually uses oil to anoint a person â€Å"who is ill or in danger of dying from accident or old age†, and this sacrament is a way of â€Å"mediating the concern of Christ and the Church for the suffering person† (Hemeyer, 2010, p. 103). Marriage is one more Catholic sacrament. Getting married in front of God, Catholics state their belonging to their spouses and accentuate the religious power of the union of persons who love each other. Sacraments in the form of definite rituals and ceremonies help Catholics share the love of Christ and follow God’s will reflected in Word. Moreover, Word of God can be regarded as the single source of God’s will available for Catholics’ understa nding. The interpretation of Word of God presented in the Bible is the Catholics’ way to deepening their faith and spirituality. Furthermore, the Bible is the source of ethical rules and codes for the Christians.Advertising Looking for essay on religion theology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Thus, Catholics receive the knowledge of God with references to Word of God provided in the Bible. Sacraments are extremely significant for Catholics because these acts help people connect their lives with God. According to the religious visions, Catholics can feel God’s grace and love while following these sacraments. References Allitt, P. (2003). Religion in America. USA: Columbia University Press. Corbett, J. M., Hemeyer, J. C. (1997). Religion in America. USA: Prentice Hall. Hemeyer, J. C. (2010). Religion in America. USA: Prentice Hall. This essay on The Role of Word and Sacrament in the Life of Catholics was written and submitted by user Kaliyah S. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Medical Esthetics Essays

Medical Esthetics Essays Medical Esthetics Paper Medical Esthetics Paper Essay Topic: Medical Medical esthetics is an evolving field in the therapeutic and medical sphere. It specializes in the use of advanced cosmetic lasers and other treatments to treat a full spectrum of both cosmetic and medical conditions that range from vascular and pigmented skin imperfections, hair removal, skin rejuvenation, and collagen regeneration, to more physically and emotionally debilitating conditions such as cystic acne and acne scarring, Rosacea removal and scar reduction to name just a few. Medical estheticians adopt holistic approaches in treating their patients’ conditions. They look at the cause of a condition rather than just the symptoms to formulate an effective treatment plan. According to the American Medical Aesthetics (AMA) corporation, this concept is vital in order to deliver exceptional results for which medical esthetics have come to be known, with little or no downtime. The AMA Corporation says further, â€Å"Lasers are unique in their ability to specifically target tissues below the surface of the skin and transfer energy to the root cause. By understanding each laser’s purpose, we can treat the condition with just enough energy from the right combination of laser frequencies to precisely affect the tissue. We look for what is called the ‘therapeutic threshold,’ which is the exact amount of energy needed to get a desired result – eliminating the downtime that is associated with over treating an area. † Esthetics is a rapidly emerging profession which specializes in skin and body care. There has evolved two types of practice in relation to esthetics. One is cosmetic esthetics and medical esthetics. Though both are concerned with enhancing the beauty of a client’s skin, cosmetic esthetics is limited to using make-up/cosmetic ingredients, their chemistry and use, and some skin care treatments offered in salons. The procedures that cosmetic estheticians perform include the following: organic, European and American facials; waxing and exfoliation; face, hand arm massage; cleansing and toning techniques; enzymes, ampoules, finishing masks; makeup/cosmetic ingredients, their chemistry and use; the basic anatomy and physiology of the skin; skin analysis and special treatments; and use of electrical current and esthetics equipment. While career opportunities for cosmetic estheticians may be any one of the following: Commercial Makeup Artist; Skin Technician; Cosmetic Merchandising; Cosmetics Sales; Cosmetic Buyer; Product Promotion; Skin Care Salon Owner; Teacher of Esthetics; Cruise Ship Esthetician. Medical esthetics, on the other hand, is concerned about the effects of time, lifestyle stressors, and even environmental stresses that can harm the skin. Therefore, maintenance treatments are necessary to prolong and enhance healthier more beautiful skin. The Medical Aestheticians are licensed skin care practitioners who perform the critical function of performing extractions and skin nourishing treatments as well as designing a home care regimen for each patient that assists the patient in remaining engaged in long term care and maintenance. These medical estheticians also perform customized facials so treatment results are better. And with these, patients are handled with TLC or tender love and care. As patients are under the long-term care of medical estheticians, they are able to maximize the results achieved by laser procedures. Medical estheticians are considered specialists who invest heavily in the tools of their trade. They invest in multiple lasers, as well as the most advanced, state-of-the-art lasers for the purpose of treating a wide variety of conditions and skin types. Their approach in treating various skin conditions is holistic, meaning to be a medical esthetician is to be interested in getting to the root cause of a condition to treat it at the source, rather than just treating surface conditions that are often a temporary solution. And for them, education is an ongoing process for the benefit of their patients. They continually educate themselves about the latest modalities in skin care in order to deliver consistent results time and again. The medical estheticians also educate their patients so they may better understand how their treatment interacts with their whole body and thereby help them achieve significant results. The job market for medical estheticians is extensive. Medical estheticians may launch and build a medical esthetics practice by setting up their own clinics, manage a clinic, teach in the field of medical esthetics, become a patient coordinator; go into marketing management, and more. Due to expanded clinical responsibilities in plastic surgeons and dermatologists practices expert esthetic clinicians with broad educational backgrounds and the appropriate credentials are urgently needed and are in great demand. According to the Victoria L. Rayner’s Center for Appearance and Esteem, the critical deficiency in supply of properly trained medical estheticians for health care services is widely recognized as a serious problem by practicing physicians. This is because physicians tend to complain often of the limited competence of inadequately trained personnel. Hence, accredited estheticians that have been properly trained and certified are being sought and hired. Medical estheticians may perform various procedures and some of these are the following: HBOT or Hyperbaric Oxygen Therapy; computer complexion analysis; laser facelift; laser surgery procedure for pigmented discoloration of the skin such as color blending and age or sun spot removal; laser procedure for vascular discoloration like defined veins, broken capillaries, cherry angioma, generalized redness and microvasculature, and rosacea. They may also offer laser procedure for deep collagen regeneration and remodeling; laser procedure for â€Å"peel and resurfacing† or accelerated epidermal regeneration; and laser procedure for amber led photo-modulation. Other procedures performed include but are not limited to: pigmented lesion removal; age spot removal; age spot reduction; melasma reduction; cystic acne reduction / removal; spider vein laser removal (varicose vein removal / reduction); epidermal laser peel; dermal collagen remodeling procedures to remove surgical scars, acne scars, and stretch marks; permanent hair removal; dermal rejuvenation to treat wrinkles; Botox treatment; Restylane, an FDA-approved dermal filler; medical spas; and wrinkle reduction. Medical estheticians have more edge when it comes to knowledge and practice of esthetics. They may know what the cosmetic estheticians know and practice plus more. This is because medical estheticians become experts through training in cosmetically camouflaging and normalizing the appearance of disfigured patients aside from being knowledgeable in all aspects of camouflage therapy; they are also well equipped when it comes to dermatologic diagnosis and treatment methods, commonly prescribed medications for skin conditions (topical systemic), including the investigation of OTC medications. Other areas of expertise to medical estheticians which can be of more profit to them are the following: acne management; cellular rejuvenation; allergies and inflammatory disorders commonly seen by dermatologists; eczema and the medical estheticians role in its management; erythema and telangiectasia; positive and negative aspects of facial treatments; age associated skin changes, exploration of the causes of aging and how to minimize its effects; photosensitivity; pre-cancers of the skin; laser therapy; reactions to cosmetics; categorizing standard cosmetic formulations; the difference between drugs and cosmetics; facts about cleansing preparation; exploring micropigmentation; and indications of hormonal dysfunctions.

Marketing 4050 Essay Example | Topics and Well Written Essays - 250 words - 1

Marketing 4050 - Essay Example Marketing strategy aims for advertisers to maintain and increase customers for their product. The media on its part aim to be the advertisers and consumers favorite in covering the advert. The advert of alcohol promotion is essential and should be done regularly to keep consumers loyal. Many more consumers will prefer that drink to other liquor brands in the market. The ad quality influences the effectiveness it will have on the market (Ware, Baron and Edge). An ad structured in a persuasive, and credible manner will most certainly be more convincing to consumers. Ads have some consistent features that appeal to customers or discourage them. These include alcohol content percentage and drinking age limit. The alcohol content appeals to consumers according to their preference while the warning on age will limit those who are underage. The leading title article relates to the ad as it is on tax increase mostly on alcoholic drinks. This ad focuses on alcoholic consumers and those interested in the drink. It also targets at investors. The ad influences the reader to pledge its loyalty to it. There are many competitive ads competing both for space in the magazine and consumers. This is a smart investment because it does not only market the company’s product but also its image in

Was Ford Ethically Right in Its Decision to Design Improvements and Th Assignment

Was Ford Ethically Right in Its Decision to Design Improvements and Thereby Risk the Lives of Its Consumers - Assignment Example Ford was ethically wrong in its decision to forego the improvements and thereby risk the lives of its consumers. In any case, it certainly appears that Ford was rushing against time to capture the market and overcome its competitors in the compact car industry. On ethical and moral judgments, a decision informed by material benefits at the expense of human lives is certainly wrong and misguided. Worse still, the cost-benefit analysis conducted by Ford amounted to involving its consumers in a deal of which they were totally oblivious. For such a decision to qualify on ethical grounds, the automaker would have made public its decisions on the faults of the vehicle and the subsequent cost-benefit analysis so as to inform the potential buyers of Pinto. In such a case, the company would be exonerated from the faults that came as a consequence of the defect in the vehicle. Moral conduct regards human lives as totally absolute and should never be quantified with other material products.Huma n beings are generally risk-averse and would not really partake into evitable instances where their lives are put to risk. The passing on of the $11 to the customers comes after the maintenance has been made and the vehicle is devoid of the risk. In this case, the rationality of the customer does not, therefore, come in. their decision to buy the car is therefore pegged upon another thing like cost and taste but not a risk. It is therefore certainly much different from the case of the airbags which are optional and the consumer has to make a decision.

Workplace Discrimination Research Paper Example | Topics and Well Written Essays - 1000 words

Workplace Discrimination - Research Paper Example Humans have always developed ways of stereotyping their fellow human beings using age, race, gender, religion, or ethnicity as their basis. It is only in current days that individuals have taken the trouble to look at discrimination as a challenge instead of looking at it as a solution. For example, segregation on the basis of race was at one point taken to be part of the natural order. Moreover, the right to vote was withdrawn from people belonging to the members of the female population to protect the different communities, solely because females, by virtue of their appearance, were presumed not to posses the survival characteristics. In addition, there is no society which escaped the negative components presented by discrimination. Also, there is no society which can claim that it does not have elements of discrimination in its different structures today. Racial discrimination also has a long history, with a number of people seeing racial discrimination as a faultlessly natural fe ature of life. Nonetheless, in recent times, racial discrimination in the work place has become a more significant subject. Its increased presence may be the result of the opposition of different elements; the workforce that is still continuing to be racist, and a recession that places jobs at a premium and makes employers to be particularly choosy during employment (Feagin, 2006). This paper will look at racial discrimination in the modern workplace. The paper will accomplish this by analyzing a current case of workplace discrimination in drawing conclusions regarding the effects of discrimination on organizational productivity. In America, it is constitutionally unlawful to engage in any form of discrimination against employees based on any reason, but the cases and evidences of workplace discrimination seem to be increasing with every passing day. In today’s world of competition, it has become extremely important for organizations to stop workplace discrimination because i t is a factor that not only results in decreasing organizational productivity but also affects the quality of business processes. Although the government of the United States has implemented effective laws, such as, Title VII of the Civil Rights Act 1964 to stop workplace discrimination, there is still a lot more that needs to be done to keep this negative element out of the workplace. Nevertheless, the basic federal laws that deal with racial discrimination in the workplace can all be found in Title VII of the Civil Rights Act 1964. By and large, Title VII of the Civil Rights Act 1964 disallows employers from engaging in the following activities: refusing or failing to sign up an employee on the basis of their race; providing workers lesser benefits or paying a worker less because of the racial orientation; failing to give promotions, opportunities, or benefits to a worker because of their race; and segregating or not properly classifying applicants or workers by race (Memmi, 2000) . In addition, employment agencies are not allowed to reach decisions on work assignments on the basis of a person’s race. Also, labor representatives and unions cannot expel people or refuse membership to individuals because of their race. Discrimination on the basis of race in the workplace can be illustrated in a number of ways, some of which can be obvious or blatant. Nonetheless, racial discrimination can frequently be restrained and more difficult to notice, for example, an employer failing to promote an employee or higher an applicant because of their racial makeup. Therefore, it may be asserted that a worker who experiences unfavorable treatment because of his race is a victim of racial discrimination. Additionally, racial discrimina

Emerging Threat of Invasive Fungal Infections

Emerging Threat of Invasive Fungal Infections Introduction Emerging threat of Invasive Fungal Infections Invasive fungal infection continues to be a major problem associated with high morbidity and mortality mainly to immunocompromised patients as well as to immunocomptent patients but to a much lower extent. (1) Invasive fungal infection and fungemia are caused by a variety of fungal pathogens. The most commonly isolated yeasts are Candida species (spp.) and Cryptococcus spp. Aspergillus species remains the most common mould however, Fusarium spp., Scedosporium spp., Penicillium spp. and Zygomycetes are increasingly isolated.(2) Patients mostly become colonized during hospitalization however, very few patients who become colonized develop sever infection. Nosocomial fungal infections can represent up to 15% of all nosocomial infections.(3) The spectrum of opportunistic invasive fungal infections has increased substantially owing to the rapidly growing population of immunocompromised patients.(4) Due to lack of specificity of symptoms diagnosis of fungal infections can be challenging.(3 ) Candida infections are mostly prevalent in critically ill patients in intensive care units (ICUs) and very low birth weight infants. Candidaemia is highly fatal with a reported mortality in the range from 36% to 63%.(5) In the recent years, mortality rates in ICU patients have decreased substantially probably due to earlier initiation of antifungal therapy.(6) Conversely, aspergillosis is the most common fungal infection in immunocompromised most specifically in haematological malignancy and haematopoietic stem cell transplantation (HSCT) patients. Incidence of aspergillosis has increased considerably but mortality has decreased owing to better diagnosis and treatment.(7) Treatment of Invasive Fungal Infections Treatment and prophylaxis of invasive fungal infections involves systemic antifungal therapy. Historically amphotericin B and Flucytosine have been the only available antifungals; these were followed by the development of the older triazole antifungals; fluconazole and itraconazole in the late 1980s. More recent advances have led to the release of amphotericin lipid formulas, newer broad spectrum triazoles (voriconazole, posaconazole) and the newest class of echinocandins.(8) Amphotericin B either as a deoxycholate or in lipid formulations has been the backbone of antifungal therapy for many years. The triazole antifungals have also emerged as front-line treatment and prophylaxis for many systemic fungal infections. Triazole antifungals used systemically include fluconazole, itraconazole, posaconazole and voriconazole. Fluconazole has a major role in prophylaxis and treatment of both invasive and superficial fungal infection. Voriconazole is the drug of choice in invasive aspergillosis of the lung. Posaconazole is used as a salvage therapy for invasive aspergillosis as well as a prophylaxis in HSCT and neutropenic patients.(9) Itraconazole is active against most fungi except for Zygomycetes.(10) Terbinafine which is widely used in skin infections is also effective against systemic candidiasis including vulvovaginal candidiasis although less effective than fluconazole and itraconazole.(11,12) Flucytosine is used in combination with amphotericin B for treat ment of severe systemic mycoses and has also in combination with other antifungals for treatment of colorectal carcinoma.(13) Echinocandins Introduced Despite the advantages in medical practice and introduction of newer agents, mortality due to fungal infections remained high with mortality due to Aspergillus approaching 100% in HSCT patients.(14,15) There has also been a change in epidemiology of fungal infections with non-albicans species reaching up to 50% with no significant change in mortality in spite of these newer agents in two studies conducted 15 years apart.(16,17) Echinocandins is a newer class of systemic antifungals introduced after almost 15 years of no new agents. They work by inhibiting ÃŽ ²-D glucan in fungal cell wall. Echinocandins have favourable kinetics which allows their once daily dosing. (18) The first echinocandin product to be licensed is caspofungin (FDA approved in 2001), that was followed by micafungin (FDA approved in 2005), and anidulafungin (FDA approved in 2006). (19)The discovery of the echinocandin antifungals has provided a new alternative for patients with equal if not higher efficacy relative to older agents and apparently lower toxicity.(20,21) Echinocandins are extensively used in the treatment of invasive fungal infections mainly invasive candidiasis in neutropenic and critically ill patients.(22)They are also approved as a salvage treatment for invasive aspergillosis.(23) The major advantage of the echinocandins members is their higher efficacy against many candida species including C. glabrata and C. krusei res istant to fluconazole added to their lower toxicity rates compared to older antifungals.(20,21,24) The Infectious Diseases Society of America (IDSA) recommends echinocandins as first line treatment of Candidaemia while caspofungin is offered as an alternative to voriconazole for treatment of invasive aspergillosis.(22,23) Echinocandins showed equal efficacy to triazole antifungals and even superior efficacy in subgroup analysis since it demonstrates superior efficacy for prophylaxis in patients with hematologic malignancies and undergoing HSCT.(25) Echinocandins Safety Treatment of fungal infections is challenging and riddled with adverse events. (26,27) Echinocandins showed no difference in drug related adverse events and all-cause mortality as compared to triazole antifungals where both groups have shown to be generally well tolerated, nevertheless, echinocandins has significantly decreased adverse event related mortality compared to triazole antifungals.(25) Echinocandins have revealed hepatic toxicity in clinical trials yet the incidence is considered low.(28) The most commonly reported toxicities associated with echinocandins in clinical trials are rash, phlebitis, and nausea. The renal profile of this class appears to be superior to that of older agents.(29,30) Serious adverse events reported with echinocandins in the context of clinical trials are very few with atrial fibrillation and seizures in two cases treated with anidulafungin and disseminated intravascular coagulation in another one treated with micafungin.(31,32) Unfortunately, till now there is insufficient data on the frequency of hepatic and renal toxicities in normal clinical settings although they have already been reported in context of clinical trials. Moreover, as these agents became more widely used outside clinical trials, new adverse reactions are surfacing. Anidulafungin has been reported to be associated with alopecia in a female patient after several months of treatment.(33) Anidulafungin has also been associated with life-threatening haemodynamic stability in another patient during administration.(34) Three cases has shown a considerable drop in their cardiac index or a worsening of the mean arterial pressure, one following caspofungin administration and the other two post anidulafungin administration.(35) Echinocandins has also been associated with a decrease in cardiac contractility in few case reports and in vitro studies which warrant further investigations.(36,37) Further studies seem to be mandatory to investigate this po tential risk. Limitations on Detecting Risk Pre-marketing studies are incapable of detecting rare events. In addition due to their short duration they are also unable to detect delayed toxicities. It’s worth noting that to detect doubling of a 0.1% event with 80% power; more than 50,000 subjects need to be studied. This leads to drugs being authorized without serious rare events are adequately studied. One cannot also be sure that the safety profile demonstrated in the pre-marketing clinical trials with limited number of subjects remains unchanged when used by millions of patients in normal settings. This difference in safety profile demonstrated is not only attributed to difference in number of users but may also be due to choosing of healthier subjects to participate in clinical trials, providing better care to clinical trials participants in addition to shorter duration of exposure in clinical trials as compared to normal settings. This difference in safety profile may as well be attributed to the fact that participa nts in clinical trials are rarely representative to the general patient population. (38,39) Post Marketing Risk Detection Pharmacovigilance is defined as the continuous process of detecting, evaluating, communicating and improving safety of medicines under normal conditions.(40) Post marketing data on adverse events include spontaneous case reports, medical record databases, and data collected in prospective postmarketing studies.(41) Spontaneous reports are unsolicited reports of clinical observations originating outside of a formal clinical trial and that are submitted to regulatory agencies or drug manufacturers.(42) The report is considered important if it involves an ADR that is new, rare, serious or occurring at a higher frequency than expected.(43) Spontaneous reporting systems have a potential for detecting or ‘signalling’ new ADRS that have not been previously recognized in clinical trials.(38) The most crucial factor that determines the value of spontaneous reports is the quality of submitted reports and whether it has a complete description of the ADR, patient demographics, baseline characteristics other confounding factors or medication and temporal relation.(42) Signal detection using large postmarketing ADRs databases is the first step in detecting unknown and unexpected associations between drug exposure and adverse events which has to be followed by qualitative case-by-case analysis to identify signals that may be of value or warrant further investigation.(44,45) Safety evaluators usually look at common trends or patterns or and potential causal relations. (42) Advantages and Limitations of Spontaneous Reporting In all countries, the nation pharmacovigilance system relies on spontaneous reporting by healthcare practitioners, patients and manufacturers to the national coordinating center.(46) Spontaneous reporting is the only source of pharmacovigilance that provides the highest volume of data at the lowest cost.(47) The most important function of spontaneous reporting is early detection of signals which helps in hypothesis formulation that may lead to initiation of confirmatory investigations or regulatory actions that may end up with warnings, label changes or product withdrawal.(48,49) Large postmarketing databases are the most important source for mining of drug safety data, however, analysing data from these databases is very challenging owing to the limitations of these unsolicited reporting systems.(50) One of the most important limitations of spontaneous reporting is the quality of data since cases are mostly poorly documented with no follow up data which necessitates contacting the reporter for more data.(42) Another limitation is under-reporting whose extent is very hard to estimate and which depends on many factors including the severity of the reported ADR among many other factors.(51,52) Reporting rate also undergoes fluctuation along the drug life cycle with higher rates noticed when the drug is newly introduced to the market (weber effect). Higher reporting rates are also noticed for serious medical events or after negative publicity. (53) It’s estimated that FDA receives only 1% of ADRs in one study and 8% in another of all occurring ADRs which affects is reflected on the inability of spontaneous reporting system to estimate incidence of a specified ADR. (54,55) Role of Data mining in Pharmacovigilance The role of data mining in the field of pharmacovigilance is evolving. At the outset, it’s worth noting that data mining methods involve identifying the observed relation between a drug and a certain ADR. These relation identification methods are based totally on the frequency with which the drug and event are reported. The relations identified using these data mining techniques cannot be used to prove or negate a causal relation.(50) Data mining methods can elucidate complex drug issues such as concomitant medications or conditions that may not be investigated using traditional methods. However, this is usually confronted by the non-systematic attainment of background rates of adverse events and drug exposure data which hinder estimation of risk based on spontaneous reporting databases.(56,57) In the context of data mining, the term ‘signal’ is used to refer to a quantitative association between a drug and an event which exceeds a certain threshold set by the investigator that warrant further evaluation. The ‘signal score’ is the number reflecting the strength of the quantitative association which reflects how much the observed frequency differs from that expected.(50,56,58) The application of computational and statistical methods to large drug safety databases for identifying drug-event pairs disproportionately reported at higher frequency than expected by a statistical independence model is referred to as ‘Safety data mining’ and ‘disproportionality analysis’. Many data-mining methods are applied to pharmacovigilance; the ones that are most commonly reported in the literature are the proportional reporting ratio (PRR) and the reporting odds ratio (ROR) in addition to the Bayesian and empirical Bayesian methods.(59–62) Signal Detection Methods Disproportionality analysis is the main concept behind computerized pharmacovigilance methods. Disproportionality analysis is dependent on the construction of a 22 contingency table as shown in table (1). (63) Disproportionality methods differ in how they are calculated and how they account for low counts. They are generally classified into Frequentist and Bayesian approaches. Drug of interestOther drugs Event of interestab Other event cd Table 1: Statistical significance in spontaneous reporting is calculated using the frequencies in the table above Frequentist approaches Frequentist approach usually accompanied by hypothesis testing of independence using chi-square or Fisher’s exact test.(64) Proportional reporting rate (PRR) or Case/Non-case design PRR can be considered as an approximation of conditional probability and is calculated using the following equation: PRR= = a/(a+c) à · b/(b+d). Where a/(a+c) can be perceived as the probability of developing the event of interest given that the drug of interest is taken and an event in turn, b/(b+d) can also be perceived as the probability of developing the event of interest given that another drug is received given that any other drug is taken and an event occurred.(63) PRR is a valuable aid to signal generation which is easy to calculate and interpret with various refinements made possible.(59) Reporting Odds Ratio ROR is a ratio of two ratios and is calculated according to the equation: ROR= a/bà ·c/d where a/b is the ratio of the patients who had the event of interest a divided by the number of patients who had the event while taking other medications. This ratio in turn is divided by c/d which is calculated by dividing all patients who had the drug of interest but did not have the event of interest by all other patients who did not have the event of interest given that they took any other drugs. (63) ROR is not affected by general under reporting for a specific drug or as specific event.(65) It has been proposed that ROR may be less biased than other disproportionality methods being considered as the case-control studies analysis.(66) Nevertheless, others believe that in practice there is no difference in performance between ROR and PRR.(60,67) Bayesian approaches Bayesian approaches tries to account for uncertainty in disproportionality measure calculated from small samples by shrinking the disproportionality measure towards baseline case of no association. This shrinking is a reduction of spurious associations when there are not enough data to support it and is proportional to the variability in the disproportionality statistics.(64) The Bayesian approaches include Multi-item Gamma Poisson Shrinker (MGPS) which is currently used by the FDA.(68,69) MGPS is based on an empirical Bayes framework and its computed measure is called empirical Bayes geometric mean (EBGM) which is the Bayesian version of the Relative Reporting Ratio (RRR). RRR is the ratio of the incidence of the observed incidence rate of a drug-event pair to its expected rate under the assumption that the drug and event are independent.(70) Another Bayesian approach adopted by the WHO is called Bayesian Confidence Propagation Neural Network (BCPNN), which estimates a Bayesian version of the Information Component (IC). A positive IC indicates that based on all reports in the database the drug-event pair is reported more often than expected. (61) Postmarketing Safety Databases for Signal Detection Databases utilized in drug safety data mining are postmarketing databases maintained by manufactures, regulators and different consortia. These databases are different in their reporting guidelines, coding dictionaries and rules for data entry. These databases vary in size and may reach millions of reports. The analysis of these databases may yield different results and so a single database available to all stakeholders is needed. Ideally this database will not have duplicate reports or missing data and is consistently coded for drug and event name. A number of databases are commonly available for signal detection activities, however; they differ in accessibility. These include the database of the WHO International Drug Monitoring Programme and the FDA’s public release safety database (AERS).(50) WHO Safety Database The WHO safety database is a large database receiving AEs from the national collaborating centers participating in the WHO Drug monitoring program.(71) It has the advantage of having the drug names coded according to the Anatomical Therapeutic Chemical (ATC) classification and ADRS are coded using the WHO Adverse Reaction Terminology. However, data is accessible by subscription only.(68) European Medicines Agency EudraVigilance database The EMEA pharmacovigilance system is called the EudraVigilance. It has 2 modules one for clinical trials and another for post marketing surveillance. It has analytical capabilities and performs signal detection in terms of PRR and ROR. It has restricted access even to manufacturers who can only see reports that they have submitted to the EMEA.(72) US FDA Adverse Event Reporting System (AERS) AERS is the FDA’s postmarketing safety database. AERS database is intended to support the FDAs post-marketing safety surveillance program for drugs. It relies on unsolicited reports submitted by healthcare professionals and patients on adverse events and medication error reports as well as required reports by manufacturers and so represents a useful resource for investigating drug safety.(73) The public-release version of AERS is available beginning with January 2004 as quarterly data directly downloadable from the FDA website. The new FDA FAERS was launched in the 10th September, 2012, and replaced the Adverse Event Reporting System (also known as Legacy AERS).(74) The main aim of the current study is to: Map the safety profile of echinocandins antifungals.as compared to other drugs. Compare the safety profile of echinocandins to that of other systemic antifungals. Assess the effect of changing the reference group on the top signals identified. To achieve these aims data mining methods and disproportionality analysis will be employed to the FDA AERS to achieve these aims. This study will therefore add to the knowledge on the safety profile of this newer class of antifungals.

Hermann Hesse: A Classic Take on the Modern Age Essay -- Biography Bio

Hermann Hesse: A Classic Take on the Modern Age Hermann Hesse, writing in the twentieth century, extolled many of the virtues of the past. His unique style, dependent upon German Romanticism, adapted the issues of the modern age. Using subject matter from various sources, Hesse built fictional worlds that mirrored reality. In the novel Siddhartha, Hesse deals specifically with the spiritual quest. Although writing about the spiritual landscape of India, this work addresses the desire for meaning that the entire world felt after the events of World War I. Born in Germany in 1877, Hesse would live through the complete change in existence that occurred in the twentieth century. Coming from a family of devout Protestants, Hesse had been exposed to the traditional Christian existence. He began to write while still in his teens. A lifelong pacifist, Hesse would continue to fight against the violence of his age. The works of Hesse were always tinged with the notion of the outsider (The Steppenwolf) or the search for meaning (Siddhartha). Utilizing a higher artistic style than many of his colleagues, Hesse acknowledged Romanticism in his work. His subject matter could be highly simple in the case of Gertrude or extremely complex like Magister Ludi:The Glass Bead Game, for which he would win the Noble Prize in the year 1946. Until his death in 1962, Hesse would struggle to find meaning in the horrible events in his lifetime. Although Hesse concerns himself with the same issues of isolation and meaninglessness that Franz Kafka addresses, he utilizes a poetic writing style to bring out the beauty of his subject. The lofty style helps "with the construction of an ideal as an escape from his emotional crisis of the war years" (Ziolk... ...ction of the previous paths. Humanity could no longer be content with religion or with consumer needs. A spiritual truth had to be found, but it would require a long journey and many failures along the way. Mankind could learn as much about the beliefs of the past in order to discover "the condition of the present world and a revelation of the relationship of all things to one another" (Ziolkowski 154), the lesson that all things are interconnected. All of the past, present and future are inextricably linked as part of a continuous flow. Works Cited Freedman, Ralph. Hermann Hesse: Pilgrim of Crisis. New York: Pantheon Books, 1978. Hesse, Hermann. Siddhartha. New York: New Directions Publishing Corporation And Bantam Books, 1951. Ziolkowski, Theodore. The Novels of Hermann Hesse: A Study in Theme and Structure. Princeton: Princeton University Press, 1965.