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By: Jonathan Handy

  • Consultant in Intensive Care Medicine,Royal Marsden Hospital,Honorary Senior Lecturer,Imperial College London

Although people commonly assume that Marx saw no place for religion medicine hollywood undead order trecator sc 250mg otc, this assumption is not entirely true medicine xyzal cheap trecator sc 250mg overnight delivery. Marx held that religion served as a sanctuary from the harshness of everyday life and oppression by the powerful symptoms for mono discount 250 mg trecator sc amex. Types of Religious Organizations All religious organizations involve communities of believers schedule 8 medications victoria discount trecator sc 250mg with mastercard. The most basic of these today are religious movements, denominations, sects, and cults. Religious movements and denominations A form of social movement, religious movements involve groups of people who join together to spread a new religion or to reinterpret an old one. Religious movements are large and typically "open" in their memberships, especially at the beginning of the movement. Examples of religious movements include the early Christian movement, the Lutheran movement that began the Protestant Reformation, the Reformed Jewish movement, and, more recently, the Islamic Fundamentalist movement. The agendas of many religious movements fade when their leaders lose influence, are replaced, or die. In other words, the movement may become a formal organization of adherents with established symbols, rituals, and methods of governance. Popular among some fringe Christian sects and cults, millennialists anticipate large-scale catastrophe, disaster, and social changes-perhaps in fulfillment of Scriptural prophecies. They may also look forward to the collective salvation for a particular group of believers-usually themselves. Denominations are large and established religious bodies that have a hierarchy of religious leaders operating within a formal, bureaucratic structure. Examples of Christian denominations include the Roman Catholic Church, the United Methodist Church, and the Antiochian Orthodox Church. Sects and cults Sects are smaller, less organized religious bodies of committed members. They typically arise in protest to a larger denomination, like the Anglicans originally did to the Roman church in the 1500s. Convinced that they have "the truth" and that no one else does (especially not the denomination against which they are protesting), sects actively seek new converts. As sects grow, they may mellow and become an institutional religious body instead of a protesting group. If a sect survives over an extended period of time, it will probably become a denomination. In contrast to sects, denominations normally recognize each other as legitimate churches (though doctrinally in error) and peacefully coexist. Cults, the most transient and informal of all religious groups, provide havens for people who reject the norms and values of larger society. The potential for abuse and other problems in such environments has led American society to give much negative press to cults, although not all cults are necessarily abusive. Social Correlates of Religion Religious persuasion seems to relate to political persuasion. Likewise, Jews tend to be more liberal than Catholics, who tend to be more liberal than Protestants. Membership of religious organizations also correlates positively with socioeconomic status. Baptists tend to be comparatively poor, whereas Anglicans, Presbyterians, and Jews tend to be wealthy. And Catholics, on average, have higher income than comparable members of Protestant denominations do. For example, some of the poorest people in the United States belong to the Roman Catholic church, and considerable differences exist among members of the Protestant churches. Some of the wealthiest people now belong to the Church of Jesus Christ of Latter Day Saints (the "Mormons"). The vast majority of Americans-around 95 percent-say they have some form of religious beliefs: in God, heaven, the divine inspiration of Scriptures, and so on.

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With regards to symptoms zinc deficiency husky purchase trecator sc 250mg without prescription ambu-bagging 98941 treatment code cheap 250 mg trecator sc free shipping, the Task Force and the Clinical Workgroups recommended that this form of ventilation should not be permitted at the acute care facility treatment xanthelasma purchase trecator sc 250mg fast delivery. From a clinical perspective medicine hat alberta canada best 250mg trecator sc, the 2009 Adult Clinical Workgroup did not recommend the use of ambu-bag as a feasible alternative for several reasons. The Workgroup was not convinced that this method of ventilation was effective against a severe pandemic viral strain of influenza. The complications associated with influenza likely would require a more powerful oxygen delivery system. Furthermore, the Clinical Workgroups agreed that the risk of infection would be very high, which could compromise the health and safety of the individuals bagging a patient and other staff at the facility. From a logistical perspective, it would not be feasible to permit ambu-bagging at the acute care facility. Hospitals may be overwhelmed with patients and there may not be physical space to house individuals who are providing this care. In addition, isolation/quarantine orders designed to limit the spread of infection may not permit access to those sick with the virus, which makes ambu-bagging impossible. Ambu-bagging requires an extensive use of resources ­ constant attention is required to ensure the bag is used correctly ­ which is not feasible during staff shortages. It consists of three parts: (1) bag, generally about the size of a football (for adults), (2) face mask, and (3) one-way valve that is between the bag and face mask. The mask is held tightly over the mouth and nose of a patient to ensure the air from the squeezed bag enters the lungs and does not leak out. Two people are required to ambu-bag efficiently, one to squeeze the bag and the other to hold the mask in place. Although family members and loved ones may have the best intentions of bagging a patient, the procedure requires non-stop attention. These individuals may be unable to walk away once the effort has begun and the effort is impossible for one person to sustain. Furthermore, if the manual ventilator effort is unsuccessful, those involved may feel personally responsible. Palliative Care Available forms of palliative care are offered to patients who are not eligible for ventilator treatment as well as patients who fail to meet clinical criteria for continued use of a ventilator. Palliative care is an interdisciplinary service designed to ease the discomfort that can accompany serious or life-threatening illness. Its provision respects the dignity of a patient who does not or can no longer receive ventilator treatment. Palliative care is aimed at providing comfort, both physically and emotionally, under the circumstances. Care should include pain management and nonpharmacological interventions, such as holding a hand or offering words of comfort. Providing the physical and emotional care required to keep a patient as comfortable as possible is important to both the patient and his/her family. In the ventilator withdrawal context, appropriate measures should be taken to prepare for and ease the process of withdrawal for patients and their loved ones. Palliative care providers are well-versed in the clinical implications of ventilator withdrawal as well as with the parameters of end-of-life decision-making, and therefore can help loved ones prepare both practically and emotionally. Preferences regarding extubation procedures, including agreed upon levels of sedation and pain management, should be respected and followed when appropriate and available. Standard protocols for extubation may offer guidance for appropriate medications and dosing, length of weaning process, and other associated procedures. Medical decisions should intend to provide comfort care and reduce the risk of shortness of breath appropriately as ventilator treatment is withdrawn. Transparency is a crucial element in adhering to ethical standards; clinicians should clearly document their rationale and decisions regarding the process of ventilator withdrawal. Logistics Regarding the Implementation of the Guidelines There are several non-legal issues156 to consider once the Guidelines are implemented, including communication about triage, and real-time data collection and analysis to modify the Guidelines based on new information. Communication about the Guidelines and Clinical Ventilator Allocation Protocol Implementation of the Guidelines requires clear communication to the public about the goals and steps of the clinical ventilator allocation protocol. Efforts will be made to inform and gather feedback from the public before a pandemic, and may include posting of the Guidelines on government websites; open comment periods; presenting the Guidelines at conferences, meetings, webinars, community meetings; and conducting tabletop exercises and focus groups.

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As economic woes increasingly plagued cities in the latter half of the 1900s conventional medicine generic trecator sc 250mg with amex, many families decided to treatment quadriceps strain purchase 250mg trecator sc move out of their inner-city neighborhoods and into the suburbs treatment jokes 250 mg trecator sc. Beginning in the 1970s medicine merit badge discount trecator sc 250 mg, most suburbs were largely "bedroom communities," which means that suburban residents commuted into the city to work and shop, and then returned to the suburb at night. Commuting presented a downside, but most people felt that escaping "urban ghettoization," or the tendency for the quality of life in inner cities to decline, was well worth any hassles, given the fact that suburbs tended to offer nicer and larger homes, better schools, less crime, and less pollution than cities provided. Offices, hospitals, and factories coexist with shopping malls, sports complexes, and housing subdivisions. In this way, many suburbs have essentially become small (and, in some cases, not so small) cities. Demographically, suburbs tend to attract "whiter" and more affluent residents than do cities. Others have chosen to return to and revive their cities by renovating and remodeling buildings and neighborhoods. Such an interest in urban renewal (also called gentrification) has turned some slums into decent areas in which to live, work, and raise a family. The vast urban complex known as a megalopolis was created as suburbs continued to grow and merge with other suburbs and metropolitan areas. That is, some suburbs and cities have grown so large that they end up merging with other suburbs and cities, forming a virtually continuous region. One example of a megalopolis is the hundreds of miles of almost uninterrupted urbanization from Boston to Washington, D. This includes television, radio, advertising, movies, the Internet, newspapers, magazines, and so forth. The Role and Influence of Mass Media Mass media is a significant force in modern culture, particularly in America. Sociologists refer to this as a mediated culture where media reflects and creates the culture. These messages promote not only products, but moods, attitudes, and a sense of what is and is not important. Mass media makes possible the concept of celebrity: without the ability of movies, magazines, and news media to reach across thousands of miles, people could not become famous. In fact, only political and business leaders, as well as the few notorious outlaws, were famous in the past. Only in recent times have actors, singers, and other social elites become celebrities or "stars. As recently as the 1960s and 1970s, television, for example, consisted of primarily three networks, public broadcasting, and a few local independent stations. These channels aimed their programming primarily at two-parent, middle-class families. Not only has availability increased, but programming is increasingly diverse with shows aimed to please all ages, incomes, backgrounds, and attitudes. More recently, the Internet has increased its role exponentially as more businesses and households "sign on. Legislatures, media executives, local school officials, and sociologists have all debated this controversial question. While opinions vary as to the extent and type of influence the mass media wields, all sides agree that mass media is a permanent part of modern culture. Three main sociological perspectives on the role of media exist: the limited-effects theory, the classdominant theory, and the culturalist theory. Limited-effects theory the limited-effects theory argues that because people generally choose what to watch or read based on what they already believe, media exerts a negligible influence. Studies that examined the ability of media to influence voting found that well-informed people relied more on personal experience, prior knowledge, and their own reasoning. How media frames the debate and what questions members of the media ask change the outcome of the discussion and the possible conclusions people may draw. Second, this theory came into existence when the availability and dominance of media was far less widespread. Those people who own and control the corporations that produce media comprise this elite. Advocates of this view concern themselves particularly with massive corporate mergers of media organizations, which limit competition and put big business at the reins of media-especially news media. Their concern is that when ownership is restricted, a few people then have the ability to manipulate what people can see or hear.

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The theory of integral social contract (Donaldson medications in canada cheap 250 mg trecator sc overnight delivery, 1982; Donaldson and Dunfee treatment neuroleptic malignant syndrome order 250mg trecator sc with mastercard, 1994 symptoms kidney stones discount trecator sc 250mg otc, 1999) take into account the sociocultural context and also normative and empirical aspects of management in a comprehensive manner medicine 0031 cheap trecator sc 250mg line. Under this theory, the social responsibility comes from the consent of the society. Finally the corporate citizenship analyzes the activities of the company to be considered legitimating before society (Davis, 1973; Altman and Vidaver-Cohen, 2000; Matten et al. Another block of research refers to the integrative theories that study the identification, channelization, training and response of firms before the social demands of the stakeholders. The second theory, proposed by Preston and Post (1975, 1981), define the principle of public responsibility as company policies that is not only based on the law and regulation, but also in broad pattern of social direction reflected in public opinion, formal legal requirements and implementation practices also Bouslah et al. The third theory focuses on the possible effects that business decisions can have on other interest groups in society (Rowley, 1997; Agle et al. Finally, the fourth theory is the corporate social performance that seeks to integrate certain aspects of the previous theories and, moreover, it includes research on the social legitimacy (Carroll, 1977; Wood, 1991). The normative theory of the stakeholder begins with Freeman (1984) and is based on the fact that the interests of all stakeholders are of intrinsic value, i. The theories of sustainable development were originally aimed at environmental issues (Russo and Fouts, 1997). However, this concept has been developed over time and has been including other factors such as the social (World Business Council for Sustainable Development, 2000). Finally, the approach of the common good argues that the company, like any other social group or individual in the society, has to contribute to the common good, because it is part of society (Carroll and Savannah, 2010). It is expected that the different stakeholders have different interests and different expectations, so the corporate reputation will depend on the crossing of these expectations with the real-world experiences resulting from compliance or noncompliance with the commitments made by the company. Evaluative school considers reputation as a competitive advantage for its interference in the financial value or by the short-term financial performance of the company (Williamson, 1985; Barney, 1991; Grant, 1995; Deephouse, 2000; Kotha et al. In this scenario, the relevant stakeholders are the shareholders, the managing director and the chief investment (Srisvastava et. The impressional school focuses on the emotional association of stakeholders with the company, which will influence on the financial performance in the long term. Also, this school believes that the reputation is evaluated as the perception of the employees and consumers instead of some financial indicator, as is the evaluative school. The relational school maintains that the corporate reputation includes the internal perspectives of the stakeholders (identity and desired identity) and external (image). These three elements represent the core of the relational school (Hatch and Schultz, 2001; Davies and Chun, 2002; Chun and Davies, 2006). Table 1 summarizes the contributions of the literature about the corporate social responsibility and corporate reputation, evidencing the absence of traslational researches between both of them, implying the existence of a breach within the research. Evaluative school the reputation is important due to its interference in the financial value or the short-term financial performance of the company (Barney, 1991; Hall, 1992; Grant, 1995; Dunbar and Schwalbach, 2000; Sabate and Puente, 2003; Eberl and Schwaiger, 2005). In this scene, the relevant stakeholders are the stockholders, the General Manager, and the Investment Head (Srivastava et. Impressionist school Emotional association of the stakeholder with the company (Balmer, 1997; Brown et al. Relational school Corporate reputation includes the perspectives of internal stakeholders (identity) and external (image) (Davies and Miles, 1998; Hatch and Schultz, 2001). This loss of reputation affects the perception that the social environment has on the company producing a direct or indirect loss in the value of the company (Rayner, 2003; March and Shapira, 1987; Bebbington, 2007). For example, a company that plans the closure of a plant will carry out communication campaigns with sufficient time to explain the reasons and try to minimize adverse reactions. According to the above, the corporate social responsibility has an impact on the risk of reputation provided. In addition, the company must manage its relations regarding these interest groups (Pfeffer and Salancik, 1978; Turban y Greening, 1997; Wagner et al. Companies invest in corporate social responsibility, which generates a capital stock of reputation which is used for two purposes: on one hand, it represents a launching pad for future opportunities and, on the other hand, safeguarding existing assets, acting as a damper against losses. This finding is not only theoretical (between the different conceptual approaches), but also empirical. A second conclusion is that among the different approaches of corporate reputation, one that emerges as the one that considers the perceptions of all stakeholders is the relational school (Hatch and Schultz, 2001; Davies and Chun, 2002; Chun and Davies, 2006).

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