Evangelism is following the example of Jesus

Christianity is, without doubt, one of the most prominent religions on earth. Derived from the word Christ, Christians have tried to emulate the works and behaviors of the founder of the faith. However, with changing times, there have developed notable differences in the way doctrines and practices within the faith have been practiced.Advertising We will write a custom essay sample on Evangelism is following the example of Jesus specifically for you for only $16.05 $11/page Learn More For instance evangelism in early Christians was, to some extend, different from what we experience in contemporary Christianity. This paper intends to compare and contrast evangelism in the early church and the present day’s evangelism. Evangelism in definition is the process of sharing giving out a message concerning a particular faith to other people who don’t adhere to that faith. This term is mostly used in Christian circles (Green 3). In the early church, there was no running away from the community you were called to serve. The evangelist was compelled to carry out his commission to the assigned community without failure. Therefore we see that they evangelized through constant presence. It therefore implies that this church mingled with the community thereby bringing that purpose of enhancing the gospel. Furthermore evangelism in the early church depended on the Holy Spirit. This means that the Holy Spirit caused them to preach and evangelize without fear or intimidation. They spoke the word d of God boldly. The apostles spread up beyond borders and declared the word of God, going ahead to baptize new converts in water and the Holy Spirit. Many people therefore spoke in tongues and were convicted to the gospel. Despite the situation, compromise was not a part of the early church’s evangelists. In the midst of persecution and trials it’s so evident that no apostle could deny the faith he had. This in it own way is evan gelizing (Green 14). They never compromised the gospel with the situation they were in. The apostles went ahead to hostile environments with the constant message declaring the word of God. The early church had a convicting boldness that highly depended on prayer and the Holy Spirit. They never relented on this two things and that is why there was massive evangelism. Regardless of not having worldly possession, the church still never backed out in testifying the resurrection of the Lord Jesus.Advertising Looking for essay on religion theology? Let's see if we can help you! Get your first paper with 15% OFF Learn More In evangelizing, they knew that life can be taken away at any time. This however did not make them fearful. It instead gave them courage. In evangelizing, they never feared death nor ever deny their faith. Through this, it is so evident that the gospel went all round and many people became convicted with the message they carried (Earley Wheeler 125). In e vangelizing, Jesus used some key points to win the hearts that were lost. As it is seen at the well in Samaria, Jesus met this Samaritan woman. He took the first initiative of going to her and not waiting for an invitation. He takes the initiative of a starting a conversation. Jesus went on to break the barriers that were set at that time. Jews could not speak to Samaritans; religious men were not allowed to talk to women. Further more, godliness and sin were not to get mixed. Jesus also breaks culture by coming to earth from heaven; he comes to this earth like a small poor Jews boy. He thus crosses barriers and culture to prepare in delivering the gospel. In the example of Jesus, we see that after doing this you need to change the topic immediately into spiritual matters by getting a point to act as a stepping stone. Here Jesus asks for water and goes ahead to ask her if she wants water of life. Jesus also listened to her and did not allow her to get off the hook. In his way of eva ngelism, he stays focused on the spiritual needs. Pointing out the sins of the woman is what Jesus undertook to do. It is important to note that the woman was immoral. She asked Jesus to give her the living water, but then Jesus confronted her sins first. Jesus attacked the sinful part of the woman but in a more sensitive manner. This made the woman want to know more and she disclosed her life fully. Jesus in evangelizing pushes one from the point of worship to whom to worship. He pulls her on track to understand that the place of worship is not important but what is important is the person you worship. At this point, Jesus is aware not to be sidetracked by non eternal things but pushes the woman into receiving the living water by submitting her life and worship the father in spirit and in truth. Here, Jesus wins the woman’s soul as she greatly accepts after Jesus introduces himself (Hybels 10).Advertising We will write a custom essay sample on Evangelism is following th e example of Jesus specifically for you for only $16.05 $11/page Learn More The disciples of Jesus evangelized too. We know that they walked with Jesus and as he left them for heaven, he promised to send them a helper. When time came, they received the Holy Spirit that would enable them evangelize without fear or intimidation. They shared the gospel in words and deeds, never to forget being in direct contact with the community. The disciples had a constant message and that was proclaiming the word of God. They never feared neither death nor persecution but made sure that the great commission bestowed to them by Jesus was fulfilled. In today’s local church, there are marked differences. People regard the temples as church not knowing that our bodies are the temple of the leaving God. Often, believers will want to practice like in the Old Testament and forget that we are leaving by the New Testament. It is difficult to find church leaders sending out me mbers so as to plant new congregation. In the early church, Christ commissioned the disciples to go into the world to preach the good news. In our present world, individuals are afraid to preach and spread the gospel (Stiles 54). People are ashamed of the gospel. If given a choice of dying for Christ or leaving if you denounce Christ, people now will choose the later. This is because they are afraid to die. The early church never denounced Christ. They were ready to die for the sake of the gospel. Furthermore, unlike Jesus going to the lost to evangelize to them, present day evangelists wait for the lost to come to them for salvation. Before giving salvation to the Samaritan woman, Jesus first pointed out her sins and called upon her to repent. Contrarily, current day evangelists forget about pointing out sins and calling for repentance and preach prosperity gospel. They concentrate on teaching their people how to become rich. Evangelism therefore is important if we want the whole w orld to hear the gospel. There are many parts of the world that have not yet heard the gospel. It therefore requires that people come out to take the gospel to the nations and preach the good news of Christ.Advertising Looking for essay on religion theology? Let's see if we can help you! Get your first paper with 15% OFF Learn More Christians should stand firm and defend the gospel regardless of persecutions or death. If one is ashamed of Christ he will also be ashamed of him on the Day of Judgment. Works Cited Earley, Dave and David Wheeler. How to Share Jesus with Passion and Confidence.  Nashville, TN: B H, 2010. Print. Green, Michael. Evangelism in the Early Church. Grand Rapids, MI: Eerdmans, 1970. Print. Hybels, Bill. Just Walk Across The Room: Simple Steps to Pointing People to Faith.  Grand Rapids, MI: Zondervan, 2006. Print. Stiles, J. Mack. Speaking of Jesus – How to Tell Your Friends the Best News They Will  Ever Hear. Downers Grove, IL: IVP, 1995. Print. This essay on Evangelism is following the example of Jesus was written and submitted by user Cruz White 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.

Profile of Andrei Chikatilo, Serial Killer

Profile of Andrei Chikatilo, Serial Killer Andrei Chikatilo, nicknamed The Butcher of Rostov, was one of the former Soviet Unions most infamous serial killers. Between 1978 and 1990, he is believed to have sexually assaulted, mutilated, and murdered at least fifty women and children. In 1992, he was convicted 52 counts of murder, for which he received a death sentence. Fast Facts: Andrei Chikatilo Also Known As: The Butcher of Rostov, The Red RipperKnown For: Serial killer convicted of 52 counts of murderBorn: October 16, 1936 in Yabluchne, UkraineDied: February 14, 1994 in Novocherkassk, Russia Early Years Born in 1936 in Ukraine, to impoverished parents, Chikatilo rarely had enough to eat as a boy. In his teens, Chikatilo was an introvert and avid reader, and attended rallies and meetings with the Communist Party. At 21, he joined the Soviet Army and served two years, as required by Soviet law. By the early 1970s, Chikatilo was working as a teacher, and that was when he committed his first known sexual assault. Both Chikatilo and his wife, as well as at least one former girlfriend, stated he was impotent. Crimes In 1973, Chikatilo fondled the breasts of a teenage student and then ejaculated on her; a few months later there was a repeat offense against another student. Despite complaints by parents, as well as rumors that he repeatedly masturbated in front of pupils, he was never charged with these crimes. Within a few months, however, the schools director finally told him to either resign or be fired; Chikatilo opted for voluntary resignation. He drifted from one school to another over the next several years, until his career ended in March 1981, when he was accused of molesting students of both sexes. Still, no charges were filed, and he took work as traveling supply clerk for a factory. By this time, he had already committed at least one murder. In December 1978, Chikatilo kidnapped and attempted to rape nine-year-old Yelena Zakotnova. Still suffering from impotence, he choked and stabbed her, and then threw her body in the Grushevka River. Later, Chikatilo claimed that he had ejaculated while stabbing Yelena. Police investigators found several pieces of evidence connecting him to Yelena, including blood in the snow near his home, and a witness who saw a man matching his description speaking to the child at her bus stop. However, a laborer who lived nearby was arrested, pushed into a confession, and convicted of the girls murder. He was eventually executed for the crime, and Chikatilo remained free. In 1981, twenty-one-year-old Larisa Tkachenko vanished in the city of Rostov. She was last seen exiting the library, and her body was found in a nearby forest the next day. She had been brutally attacked, beaten and strangled to death. In his later confession, Chikatilo said he had attempted intercourse with her but had been unable to achieve an erection. After killing her, he mutilated her body with a sharp stick and his teeth. At the time, however, there was no link between Chikatilo and Larisa. Nine months later, Lyubov Biryuk, thirteen, was walking home from the store when Chikatilo leaped out of the bushes, grabbed her, tore off her clothes and stabbed her nearly two dozen times. Her body was found two weeks later. Over the next few months, Chikatilo escalated his homicidal urges, killing at least five more young people between the ages of nine and eighteen before the end of 1982. His typical modus operandi was to approach runaways and homeless children, lure them to an isolated location, and then kill them either by stabbing or strangulation. He violently mutilated the bodies after death, and later said that the only way he could achieve orgasm was by killing. In addition to adolescents of both sexes, Chikatilo also targeted adult women working as prostitutes. Investigation A Moscow police unit began working on the crimes, and after studying the mutilations on the bodies, soon determined that at least four of the homicides were the work of a single killer. As they interrogated potential suspects - many of whom were coerced into confessing to a variety of crimes - more bodies began to surface. In 1984, Chikatilo came to the attention of Russian police when he was spotted trying to repeatedly talk to young women at bus stations, often rubbing himself up against them. Upon delving into his background, they soon discovered his past history and the rumors about his teaching career years earlier. However, a blood type analysis failed to link him to evidence found on the bodies of several victims, and he was largely left alone. By the end of 1985, after more murders took place, a man named Issa Kostoyev was appointed to lead the investigation. By now, more than two dozen homicides had been linked as the work of a single person. Cold cases were re-examined and previously questioned suspects and witnesses were interrogated again. Perhaps most importantly, Dr. Alexandr Bukhanovsky, a noted psychiatrist, was given access to all the case files. Bukhanovsky then produced a sixty-five page psychological profile of the as-yet unknown killer, the first of its kind in Soviet Russia. One of the key traits in the profile was that the murderer most likely suffered from impotence, and could only achieve arousal by killing; the knife, according to Bukhanovsky, was a substitute penis. Chikatilo continued to kill for the next several years. Because many of the victims remains had been discovered near train stations, Kostoyev deployed both undercover and uniformed officers along miles and miles of rail lines, beginning in October 1990. In November, Chikatilo murdered Svetlana Korostik; he was observed by a plainclothes officer as he approached the railway station and washed his hands in a nearby well. In addition, he had grass and dirt on his clothes, and a small wound on his face. Although the officer spoke to Chikatilo, he had no reason to arrest him, and let him go. Korostiks body was found nearby a week later. Custody, Conviction and Death Police placed Chikatilo under surveillance, and saw him continuing to attempt conversations with children and single women at rail stations. On November 20, they arrested him, and Kostoyev began interrogating him. Although Chikatilo repeatedly denied any involvement in the murders, he did write several essays while in custody that were consistent with the personality profile described by Bukhanovsky five years before. Finally, police brought Bukhanovsky himself in to talk to Chikatilo, since Kostoyev was getting nowhere. Bukhanovsky read Chikatilo excerpts from the profile, and within two hours, he had a confession. Over the next few days, Chikatilo would confess, in horrifying detail, to thirty-four murders. He later admitted to an additional twenty-two which investigators had not realized were connected. In 1992, Chikatilo was formally charged with 53 counts of murder, and was found guilty of 52 of them. In February 1994, Andrei Chikatilo, the Butcher of Rostov, was executed for his crimes with a single gunshot to the head. Sources â€Å"Andre Chikatilo: The Rostov Ripper.† Crime Investigation, 10 Aug. 2017, www.crimeandinvestigation.co.uk/crime-files/andre-chikatilo-the-rostov-ripper.Kent, James. â€Å"Darkness Visible.† The Guardian, Guardian News and Media, 7 Aug. 1999, www.theguardian.com/theobserver/1999/aug/08/life1.lifemagazine.â€Å"Russian Serial Killer Had a Disturbed Past.† Google News -, New Straits Times, 20 Apr. 1992, news.google.com/newspapers?idJMFUAAAAIBAJsjidf5ADAAAAIBAJpg4499,3916322.Treen, Joe. â€Å"A Monster Caged at Last.† PEOPLE.com, Time Inc, 19 Oct. 1992, people.com/archive/a-monster-caged-at-last-vol-38-no-16/.

Differences between Basic Trauma Life Support and Advanced Trauma Life Research Paper

Differences between Basic Trauma Life Support and Advanced Trauma Life Support - Research Paper Example This has been attributed to the increase a number of diseases to young people, increase in disability cases and a great loss of young productive life, which in turn has brought about socio-economic losses to the society at large. This great loss of life has attracted public interest as well as public health community and civic organizations attention to come up and formulate strategies that can prevent or improve the damages caused by injuries (Cales, 1-8). Differences between Basic Trauma Life Support and Advanced Trauma Life Support Among the strategies that have been formulated to decrease injury burdens are the health care provisions. These have reduced the rate of deaths from injuries as well as the rate of disability caused by these injuries. In the last decade most high income countries have witnessed reductions in trauma mortality of up to 15%-20%. This has been attributed to improved systems of trauma care within the health communities. In many developed countries, health co mmunities have introduced and are implementing trauma life support systems. This is pre-hospital care that includes both the basic trauma life support and advanced trauma life support. This has been due to the fact that most patients with injuries arrive at the hospital by means of private transport and need a lot of pre-hospital care hence it’s being adopted by health communities in many countries (Cales, 1-8). ... This paper however is more concerned with noting the difference between the basic trauma life support and the advanced trauma life support as well as those patients that are exposed to basic trauma life support and advanced life support in California (Isenberg and Bissell, 265-270). Empirical studies show that pre-hospital care is classified into two categories. The basic trauma life support and advanced trauma life support. These two categories are mainly differentiated by the methods used in their application. In the case of advanced trauma life support, sophisticated methods such as airway management, intravenous fluids infusions, synchronized cardio version, cardiac monitoring, electrocardiogram interpretation, medications and intubation are used (Klemen and Grmec, 1250-1254). On the other hand, in the cases of basic trauma life support, simple noninvasive methods such as cardiopulmonary resuscitation, bleeding control, splinting broken bones, artificial ventilation, basic airway management and administration of oral or rectal medications are used to prevent further injuries. In the case of transportation of a patient, advanced trauma life support requires a ground ambulance or a helicopter with physicians or paramedics (Lee et al., 815-819). On the other hand, basic trauma life support can be applied within any means of transportation as well as given by paramedics or emergency medical technicians since it does not require the sophisticated methods used in the advanced trauma life support. Although basic trauma life support does not use the same methods as advanced trauma life support, advanced trauma life support does use the

Priority List Essay Example | Topics and Well Written Essays - 250 words

Priority List - Essay Example In the list, Air force Plant 85 appears as number 1 with site identity number by EPA being OH1170090004, Allied Chemical & Ironton Coke appears as number 2 with site identity number by EPA being OH043730217 and Bowers Landfill listed as number 8 with site identity number by EPA being OHD980509616 (EPA, 2012; EPA, 2011; EPA, 2013). Hazardous chemicals listed in the inventory and associated with Allied Chemicals & Ironton Coke include benzene, ammonia, cyanide, naphthalene and Polynuclear Aromatics Hydrocarbons (PAHs) and phenolics (EPA, 2011). The ground water within the site contains all the listed chemicals, which are dangerous to human health. In the inventory list, Air Force Plant 85 characterizes with chemicals that include chlorinated solvents, trichloroethylene, PCBs and hydrocarbons. The site also suffers from contamination with dangerous metals like mercury, chromium and cadmium (EPA, 2012). The groundwater under the site has contaminations of the metals and chemicals, and unhealthy for human consumption. The inventory also features Bowels Landfill site as contaminated with contaminants such as barium, manganese, pesticides, volatile organic chemicals (VOCs), phthalates, lead, polychlorinated biphyenyls (PCBs) and arsenics, which have also infiltrated into the groundwater and making the water unsafe for human consumption (EPA, 2013). The chemicals and metallic substances within the sites infiltrate underground, contaminate and make the underground water unsafe for human consumption. Buying home within the sites can be the least decision considering that residing in the areas is tantamount to deliberate risking of one’s health and life especially if the areas rely on groundwater as primary source of water. However, if municipal authorities connect piped water into the areas surrounding the sites, then one can

Acting Out Culture by James S. Miller Essay Example | Topics and Well Written Essays - 750 words

Acting Out Culture by James S. Miller - Essay Example However I believe these beliefs are wrong due to the fact that religion is alive and being practiced on a daily basis. In the critical and incisive essay â€Å"The Wages of Sin† by Francine Prose she described the Arrogant Fat Police and their assistants who perceive overweight people as a strain of overstuffed outlaws have chosen a religious dialect and metaphor to split the social order into two parts: The narrow, slender and healthy souls guaranteed to have a place in heaven and the shockingly overweight souls guaranteed a place hell. To put more emphasis on this divergence, the overweight Police not forgetting self-loathing overweight individuals themselves, emphasize primary controlling of â€Å"overweight behavior,† which would means introduction of fat taxes. These taxes she believes should be subjected to fans of movie popcorn, massive burritos, enormous masses of ice cream, soda, and all other junk food that predisposes one to becoming overweight or excessively fat. The Overweight Police and their devotees have also evangelized the notion that ethical immorality, â€Å"immoral self-indulgence,† causes one to indulge in activities that predisposes one to becoming obese. It is therefore true to say that overweight people are not destitute victims of the surroundings or hereditary traits but the consequence of their individual laziness, greediness, and gluttony. One more group that indemnifies overweight individuals from experiencing the brand of stigmatization is the world’s shared opinion that plump overweight people can only blame themselves for their condition which is lack of self-control when it comes to consumption of food.   She exemplifies her discomfort disgust of the fact that when overweight people are trying to enter, fit or exit public transportation vehicles such as buses, commercial plains and the subway they almost all the time have to brush their fleshy bodies with everyone (Francine). He displays that their condition is discourteous and self-centered. He finds fat people so over-sized that them and their overweight colleagues and allies are supposed to fee for at least two commercial plane or bus permits to provide accommodation for their lumbering rumps.    Lastly according to â€Å"Wages of Sin†, if overweight people can be protected from themselves, it will be mandatory for them to leave their selfish desires of the flesh that have transformed them into overweight persons and turn to God and spiritual intervention and repent for their sins. She talks of Twelve Step to be followed; evangelistic gospel zones and other inspirational implements entrenched in the language of God, the devil, sin, and divine providence that these people should follow. Although in the â€Å"Wages of Sin† the author focuses on overweight people and their food consumption habits, in â€Å"Add Cake, Subtract Self-Esteem,† by Caroline Knapp, she mostly focuses on the way women view thems elves and their bodies. This is mostly concerned with their weight, appearance and general overall look. Women are very concerned with the way they look and their self body image. They are very conscious of the way people perceive them and therefore they always want to ensure what they see in the mirror will appeal to everyone else. According to Caroline the eating habits of women in the world today has greatly changed whereby women are judged with what they eat and the way they eat. Women are expected to eat very

Cutaneous Tuberculosis Disease: Challenges of Treatment

Cutaneous Tuberculosis Disease: Challenges of Treatment CHAPTER -1 CUTANEOUS TUBERCULOSIS INTRODUCTION: In this innovative world while progress in medicine has helped up to deal with many diseases Tuberculosis and Cutaneous Tuberculosis is still a challenge for doctors. A resurgence of Cutaneous Tuberculosis in areas of high HIV incidence, drug resistant present in patients with pulmonary tuberculosis and in immunosupressed patients are the main challenges for clinicians. (6) Cutaneous TB is caused by Mycobacterium tuberculosis, Mycobacterium bovis, Bacillus Calmette-Guerin (BCG) vaccinations and the Tuberculids whose pathogenesis is poorly understood. Cutaneous TB is very variable in its clinical presentation, significance prognosis. Factors which effect on variability are: The pathogenesity of the organism involved. The Previous treatment given. The Immune status of the patients which can be related to the presence of Acquired Immunodeficiency Syndrome (AIDS) or Immunosuppressive therapy. The Port of infection. Any Local factors like, the recent Trauma, the lymphatic drainage, the vascularity of area and the proximity to lymph nodes). PREVALANCE: Thirty years ago it was assumed world wide that tuberculosis would be eradicated in the developed countries, as its incidence increased only on by average 6 % in the United States and 10% in Europe between the years 1953 and 1985. However, in 1983 tuberculosis was declared a global emergency by the world Health Organization because of a sharp increase in incidence. (9) Among infectious diseases, Tuberculosis is an important cause of death. Tuberculosis was responsible for 6% of deaths worldwide. Global prevalence of TB currently is greater than 32%. More than 50% of new patient occurrences were in 5 Asian countries, i.e. India (largest worldwide patient load), China, Indonesia, Bangladesh, and Pakistan(ref ?) The current global burden of Tuberculosis is mind boggling. In 1997, the incidence of new Tuberculosis patients approached 8 million in addition to more than 16 million patients already diagnosed. Around 2 million people died of Tuberculosis in 1997 with a global fatality rate of 23%, fatality rates exceed 50% in some African countries in which there is a high HIV incidence. Approximately 8% of tuberculosis patients are HIV infected. (2) Prevalence of tuberculosis infection in 1985, 1995 and 2005 (10) Prevalence of tuberculosis has increased between 1985 and 2005.According to the World Health Organization case reports statistics, in 1985 there were around 3 million patients of tuberculosis of all types with the highest no of cases in Asia and Africa. In Asia the highest numbers of cases were in India, Pakistan, China, Philippines, Bangladesh, Afghanistan and Vietnam. In Africa the highest number of case were in Ethiopia, Nigeria, South Africa, Congo, Morocco and Tanzania. (10) During the last two decades the number of cases increased all over the world. In 1995 the total number of cases increased to 4.6 million and in 2005 to 7.5 million worldwide. In Asia in 2005 the highest numbers of cases were in India, China Pakistan. In Africa in 2005 the highest numbers of cases were in South Africa, Ethiopia Congo. (10) There is an increasing rate of tuberculosis in the developing countries is approximately 500/100,000/y. Great alarm has been the progressive increase in numbers of strains of tuberculosis that are resistant to antibiotics. Since 1984, that incidence of extra pulmonary tuberculosis has increased at even faster rate than that of pulmonary tuberculosis and is considered to be a diagnostic criterion in the case definition for AIDS. Because immunocompromised individual are at increased risk of extra pulmonary tuberculosis, so dermatologist are renewing their historic role in the diagnosis of cutaneous lesions of tuberculosis. (11) EPIDEMIOLOGY: Epidemiological analysis is used to detect the changing trends in the incidence and prevalence of mycobacterial disease in the community. The main objectives of these methods are to determine the natural behavior of disease and factors which affect his behavior and to calculate future trend if possible to help in the design of any control measures and to assess the usefulness of these measure.(8) Even though 1 of 3 individuals on this planet is infected with tubercle bacillus, the incidence of Cutaneous TB appears low. In areas such as India or China where TB prevalence is high, cutaneous manifestations of TB (overt infection or Tuberculids) are found in less than 0.1% of persons seen in dermatology clinics. The frequency of patients with Cutaneous Tuberculosis seen between 1980 and 1993 in a hospital dermatology clinic in Madrid was 16 per 10,304 which was 0.14%. In a ten year retrospective survey of patients seen in governmental dermatology clinics in Hong Kong between 1983 and 1992, the detected incidence of Cutaneous Tuberculosis among patients was 179 per 267,089 which was 0.07%. Among patients with Cutaneous Tuberculosis only15% had classic Cutaneous Tuberculosis and 85% had tuberculids. In that classical cutaneous tuberculosis approximately 5% had lupus vulgaris, 5% had Tuberculosis Verrucosa cutis and 5% had scrofuloderma. (2) In a tertiary-care hospital in northern India, 0.1% of dermatology patients seen between 1975 and 1995 had Cutaneous Tuberculosis. Lupus vulgaris was the most common manifestation around 55%, followed by scrofuloderma 27%, TB Verrucosa cutis 6%, tuberculous gumma 5%, and tuberculids occurred in 7%. (2) FREQUENCY: USA: In the United States, tuberculosis cases decreased from 84,304 cases in 1953, when national reporting was first began, to 22,201 in 1985.   This represented fairly steady decline of about 5.8% per year. However, the turn down in tuberculosis cases stopped in between 1985 and 1992. In 1992 the annual number of cases increased by 20% to 26,673 cases. (12) The increases were concentrated geographically in several states, with over 90% of the 14,871 cases in California, Florida, New Jersey, New York, and Texas and demographically tuberculosis occurred in racial and ethnic minorities, in people aged 25 to 44, males and in those born abroad. Especially troubling, and indicative of increasing transmission of new infections, was a 36% increase in tuberculosis among children 4 years old or younger. Tuberculosis appears to be on the decline again in the United States as numbers with only 14,871 cases in 2003. (12) Reported tuberculosis cases in United States, 1982-2002 (12) The percentage of Tuberculosis patients who were born abroad individuals was 42%. People born in Mexico, the Philippines, and Vietnam account for one half of born abroad Tuberculosis patients in the United States. The Tuberculosis rate among born abroad people was 4 to 6 times higher than for US-born peoples. Minimum estimates of the proportion of TB patients with coincident HIV infection were approximately 10-15%. Among people aged 25-44 years, this proportion increased to 20-30%. (12) The fundamental origin of this new Tuberculosis epidemic in troubled states reflects a minimum of four major factors including (1) the involvement of Tuberculosis with the HIV epidemic, (2) the increased migration from countries where Tuberculosis is common, (3) the spread of Tuberculosis in congested settings (health-care facilities, prisons, homeless shelters), and (4) the worsening of the basic health-care infrastructure. (2) Molecular typing of Mycobacterium tuberculosis isolates in the United States in a restriction fragment-length polymorphism study suggests more than one third of new patient incidence results from people-to-people transmission, and the remainder result from reactivation of latent infection. Approximately 1 of 13 Mycobacterium tuberculosis isolates currently shows a form of drug resistance. (2) The modern introduction of biological agents that block tumor necrosis factor-alpha in the treatment of rheumatoid arthritis, psoriasis, and several other autoimmune disorders has additional raised about the necessity of the identification of patients with latent Tuberculosis. At present, several hundred cases of Tuberculosis have been reported in patients who receive these tumor necrosis factor-alpha antagonists. (2) HISTORY: Tuberculosis has an ancestry which can be traced to the earliest history of mankind. It was recognized as a contagious disease by the time of Hippocrates and Aristotle in 350 BC. Signs of skeletal Tuberculosis were identified in Europe since Neolithic times and in ancient Egypt around 3700 BC in mummified bodies. Evidence of TB appears in Biblical scripture, in Chinese literature dating back to around 4000 BC, and in religious books in India around 2000 BC. (5) During1600s and 1800s tuberculosis was known ass the Great White Plague in Europe.   Other names for Tuberculosis were Phthisis which was from Greek term phthinein, meaning to waste away, scrofula which were used for swellings of the lymph nodes of the neck and consumption which were used as progressive wasting away of the body.(2) In 1826 Laennec first reported cutaneous tuberculosis which he called PROSECTOR WART. Following Laennec, Rokitansky and Virchow described the histological features in detail comparing them to those of visceral tuberculosis. (6) The Incidence of TB increased with population density and urban development so that by the Industrial Revolution in Europe in 1750, it was responsible for more than 25% of adult deaths. Indeed, in the early 20th century, TB was the leading cause of death in the United States. In 1882, a German biologist ROBERT KOCH presented his discovery of the organism that caused TB. NEIL FINSEN won the Nobel Prize in Medicine in 1903 for introducing UV light into the treatment of skin TB. (2) With the help of better living conditions and the introduction of the antibiotic streptomycin on 20th November 1944, the number of reported TB patients in the United States steadily declined around 126,000 TB patients in 1944, 84,000 in 1953, 22,000 in 1984, and 14,000 in 2004.(2) MODE OF TRANSMISSION: Tuberculosis is an airborne contagious disease that occurs after inhalation of infectious droplets expelled from patients with laryngeal or pulmonary Tuberculosis during coughing, sneezing, or speaking. Each cough can generate more than 3000 infectious droplets. Droplets are so small around 1 to 5 micro meter, that they remain airborne for hours. (2) The likelihood that disease transmission will occur depends upon the infectiousness of the tuberculous patient, the environment in which exposure takes place, and the duration of exposure. Roughly 20% of people in the infected household contact develop infection. Micro epidemics have occurred in closed environments such as transcontinental flights and submarines. Tuberculin sensitivity develops 2 to 10 weeks after infection and usually is lifetime. (2) Because Tuberculosis induces a powerful immune response, individuals with positive tuberculin reactions are at a considerably lower risk of acquiring new tuberculous infection. In HIV-infected individuals, active Tuberculosis is more likely to occur from reactivation of existing disease than from superinfection with a new mycobacterial strain. (2) Without treatment, an estimated 10% lifetimes possibility exists of developing active disease after tuberculous infection, 5% occurs within the first 2 years and 5% thereafter. An Increased risk of acquiring active disease occurs during HIV infection, Intravenous drug abuse, diabetes mellitus, silicosis, immunosuppressive therapy, cancer of the head and neck, hematological malignancies, end-stage renal disease, intestinal bypass surgery or gastrectomy, chronic malabsorption syndromes and low body weight. Infants younger than two years are associated with increased risk. (2) 1) DIRECT INHALATION: The most common mode of entry via portal in to the lungs usually resulting from the Inhalation of airborne droplets containing a few bacilli, expectorated by individuals with â€Å"open† pulmonary disease.(8) 2) INDIRECT INHALATION: A) Ingestion: Less often bacilli may be swallowed and lodge in to the tonsil or in the wall of the intestine. These infections are chiefly related to the consumption of contaminated milk products. (8) 3) INOCULATION: Cutaneous tuberculosis manifestations depend upon the method of cutaneous inoculations, which may be exogenous that is from an out side source, may occur by autoinoculation, or may be by endogenous .Direct exogenous inoculation in an individual not previously infected with tuberculosis causes primary tuberculosis infection, will led to the tuberculous ‘chancre or to tuberculosis Verrucosa cutis depending upon the immune status of the patient. Another example of exogenous transmission is lupus vulgaris at the site of BCG vaccination. (9) Endogenous transmission can occur by continuous extension of tuberculous process underlying the skin as in scrofuloderma, by the way of lymphatic as in lupus vulgaris and by hematogenous spread as in acute miliary tuberculosis or lupus vulgaris. (9) Infrequent mode of transmission is direct implantation in to the skin through cuts and abrasions. These troubles usually in persons, working with infected material or cultures of tubercle bacilli. These skin lesions were called as â€Å"Prosector warts† (8) CLASSIFFICATION OF CUTANEOUS TUBERCUCLOSIS: Cutaneous tuberculosis clinical manifestations comprise a considerable number of skin changes, usually sub classified in to more or less distinct disease forms. Classification depends on morphology more recently mode of transmission or the immunological state of host, but none of them satisfies completely. 1)INOCCULATION TUBERCUCLOSIS (Exogenous Source) Tuberculosis chancre Warty tuberculosis(Verruca cutis) Lupus vulgaris(some) 2) SECONDARY TUBERCULOSIS (Endogenous source) A) Contiguous spread Scrofuloderma B) Auto-inoculation Orifical tuberculosis 3)HAEMATOGENOUS TUBERCULOSIS Acute miliary tuberculosis Lupus vulgaris(some) Tuberculous gumma 4)ERUPTIVE TUBERCUCLOSIS (Tuberculids) A) Micropapular Lichen scrofulosorum B) Papular Papular/Papulonecrrotic TB C) Nodular Erythema induratum(Bazin) Nodular Tuberculids (CLASSIFICATION OF TUBERCULOSIS, MODIFIED FROM beyt et al) (4) CHAPTER-2 CLASSIFICATION OF MYCOBACTERIA: Tuberculosis is an infectious disease which is caused by the Mycobacterium species. Mycobacteria are acid fast, non-sporulating, non-motile weakly gram positive organisms. TEM micrograph of Mycobacterium tuberculosis Table 3: Kingdom Bacteria Phylum Actinobacteria Order Actinomycetales Suborder Corynebacterineae Family Mycobacteriaceae Genus Mycobacterium Scientific classification by Lehmann Neumann. (3) In 1950s Runyon classified the atypical mycobacteria according to their ability to form pigment, their rate of growth colony characteristics. This classification also includes obligate human pathogens and facultative human pathogens. (1) Today more then 60 species of mycobacteria are identified. Around 41 of these were included in the approved lists of bacterial names in 1980. (9) 30 species of mycobacterium are known that can cause disease in humans. The most common causative organism includes: Mycobacterium tuberculosis Mycobacterium Leprae. Atypical mycobacteria. The species which produce disease in tuberculosis primary complex include: Mycobacterium tuberculosis. Mycobacterium Bovis. Mycobacterium Africanum. Sometimes Bacillus Calmette Guerin (BCG) may also cause disease. (1) MEDICAL CLASSIFICATION: For the purpose of diagnosis treatment mycobacteria can be classified in several major groups. Mycobacterium tuberculosis complex, which can cause tuberculosis by the pathogens Mycobacterium tuberculosis, M Bovis, M Africanum M microti. Mycobacterium Leprae, which causes Hansens disease. Nontuberculous mycobacteria are the mycobacteria which can cause pulmonary disease, lymphadenitis, and skin disease disseminated disease. SLOW GROWING MYCOBACTERIA RUNYON GROUP 1)Obligate human pathogens M. tuberculosis-bovis group including bacillus Calmette-Guerin(BCG) M Africanum (not included in runyon classification 2)Facultative Human pathogens M. kansasii I M. marinum I M. simiae I M. scrofulaceum II M. szulgai II M. gordanae II M. avium-intracellualr complex III M. haemophilum III M. Ulcerans III M. xenopi III 3) Nonpathogens M. flavescen II M. terrae complex III M. trivale III M. gastri III RAPIDLY GROWING MYCOBACTERIA 1))Facultative Human pathogens M. fortuitum I V M. chelonae I V M. abscessus I V 2) Nonpathogens M. smegmatis I V M. phlei I V M. vaccae I V others STAINING CHARACTERISTICS OF MYCOBACTERIA: Mycobacteria are aerobic, facultative, intracellular non-spore forming and non-motile curved rods measuring 0.2- 0.5 by 2-4 um. Mycolic acid rich long chain glycol lipids and phospholipoglycans, a mycocides present in the cell wall of mycobacteria protect them. (2) Mycobacteria do not gram stain readily but their most valuable staining characteristic is Acid Fastness. This ability retains carbol fuchin dye after washing with acid or alcohol occurs because of the high content of cell wall mycolic acids, fatty acids other lipids. Other staining methods used include Dietrele, auramine-Rhodamine and phenolic acridine orange stains. Nocardia rhodococcus, legionella dadei, isospora cryptosporidium also share acid fastness. (1) The Ziehl-Neelson acid-fast stain, while highly specific for mycobacteria, is relatively insensitive, and recognition requires at least 10,000 bacilli per mL; most clinical laboratories currently use a more sensitive auramine-rhodamine fluorescent stain (auramine O). Routine culture uses a nonselective egg medium called Lowenstein-Jensen or Middlebrook 7H10 and often requires more than 3-4 weeks to grow because of the 22-hour doubling time of mycobacterium tuberculosis. Radiometric broth culture, BACTEC radiometric system of clinical specimens significantly reduces time 10 to 14 d for mycobacterial recovery. DNA probes specific for mycobacterial ribosomal RNA categorize species of clinically significant isolates after recovery. In tissue, polymerase chain reaction (PCR) amplification techniques can be used to detect Mycobactereria tuberculosis-specific DNA sequences and thus, small numbers of mycobacteria in clinical specimens. (2) The cell wall of mycobacteria consist of: (3) Outer lipids Mycolic acid Polysaccharides(arabinoglactan) Peptideglycan Plasma membrane. Lipoarrabinomannan(LAM) Phosphatidylinositol mannoside. Cell wall skeleton. PATHOGENESIS: The most common site for Tuberculosis disease is lungs and 85% of TB patients present with pulmonary symptoms. The most common sites of extrapulmonary disease are mediastinal, retroperitoneal, and cervical lymph nodes, vertebral bodes, adrenals, meninges, and the GI tract. Pathology of these lesions is similar to those in the lung. Extrapulmonary TB can occur as part of a primary or late generalized infection or as a reactivation site that may, coexist with pulmonary reactivation. (2) Mycobacterium tuberculosis is an obligate pathogen. It is a slender aerobic rod, characterized by high lipid content. This lipid is responsible for resistance to phagocytosis. Identification of organism is easy in tuberculous chancre, scrofuloderma, orificial lesions and the miliary variant. This may be difficult to find or absent in lupus vulgaris, gummata and warty tuberculosis. The organism is highly resistant to drying to drying and therefore can retain infectivity by inoculation or contamination of minor wounds. (19) The reaction of the bacterium depends on: the size of inoculum. the virulence of organism. <

The Common Good in Hobbes, De Tocqueville and Marx :: Philosophy Politics Papers

The Common Good in Hobbes, De Tocqueville and Marx Political philosophies are those theories and ideas that seek to study the impact of various political idealisms on society, and their impact in the shaping of social, political, and economic ideas. The questions which political philosophy seeks to turn its attention towards range from describing what the state of Man actually is at the existential level, to the types of social regimes, which are necessary to tame and organise that nature. In this context, there is a measure of truth in the suggestion that the answers, or visions they give are not, necessarily, entirely original. Plato, the student of Socrates, was himself keenly interested in political philosophy and set himself the task of conceptually evolving a society which would function properly. Plato's ideal society was comprised of rulers, guardians, and the masses. All these various strands within society are moulded at a young age to play a societal role, in order that they might contribute positively and affirmingly to t he betterment of their own social arena. Within the context of the history of political philosophy, Plato emerges as one of the more gifted political theorists, if not, perhaps, the best. While closely examining the needs of society, he was able to recognise the needs of society as well as the needs of the individual. He humbled the ego of Man when he acknowledged that one individual could not survive on his own and that all people are dependent on others to survive. His idea of an organised community has been the focus of many political philosophy debates and has been the stepping-stone by which many political philosophers have created their own ideal social environment. Though their theories may not be identical to those of Plato, signs of his structures are definitely present. Thomas Hobbes, the seventeenth century political philosopher, had some theories and ideas keenly similar to those of Plato. Hobbe's view of the state of nature was a very primitive one: he felt that in the state of nature there was a war of every person against every person. In the natural state justice was impossible, because without set limits and structures, everyone has the right to do whatever they wish and anarchy is almost inevitable. The only ay to escape the unfortunate state of anarchy was for everyone to agree a covenant. The conditions of the covenant were to give the sovereign full discretion in dealing with citizens.