The limitations in Diagnosing Colorectal Cancer Essays

The limitations in Diagnosing Colorectal Cancer Essays The limitations in Diagnosing Colorectal Cancer Essay The limitations in Diagnosing Colorectal Cancer Essay Colon malignant neoplastic disease is the 2nd prima cause of malignant neoplastic disease decease. Most of the instances are sporadic but several familial familial syndromes account for around 5 % of all colorectal malignant neoplastic diseases ( CRC ) . The most common of these syndromes are familial adenomatous polyposis ( FAP ) and familial non-polyposis colon malignant neoplastic disease ( HNPCC ) which is besides known as Lynch syndrome. These make up 3 % of the familial syndromes. Other syndromes include Peutz-Jeghers syndrome and Juvenile polyposis syndrome. This essay will concentrate on the most common familial CRC s. The cistrons that are involved in FAP and HNPCC have been identified. Therefore familial testing can be offered to test for bearer position in these syndromes. Designation of persons who have a sensitivity to CRC is of import to be able to offer them adequate testing to observe tumors at an early phase. FAP FAP is dominantly inherited and is extremely acute demoing a perpendicular transmittal through a household lineage. Its classical phenotype involves the growing of 100s of adenomatous polyps along the colonic mucous membrane. If the polyps are non removed there is near a 100 % opportunity of colon malignant neoplastic disease. The mean age of polyp development and colon malignance is 16 and 39 old ages severally. FAP is found in ~1 per 7-10,000 births in the United States population and histories for less than 1 % of all CRC ( Davidson, 2007 ) . FAP is a monogenetic disease and is caused by the mutant or omission of the adenomatous polyposis coli ( APC ) cistron which is found on chromosome 5. 95 % of APC mutants that lead to FAP is either bunk ( 28 % ) or truncating frameshift ( 67 % ) ( Burt and Neklason, 2005 ) . The staying 5 % is caused by big omissions or rearrangements. The APC cistron is a tumour-suppressor cistron and the APC protein is portion of the Wnt-signalling tract, involved in cell growing control ( Burt and Neklason, 2005 ) . Mutants in the APC cistron hence cause activation of the Wnt-signalling tract and uncontrolled cell growing. There is another discrepancy of FAP known as Attenuated signifier of FAP ( AFAP ) , it has a ulterior age on oncoming ( gt ; 40 ) , less adenomatous polyps ( A ; lt ; 50 ) and a lower hazard of CRC. Some of these patients will hold a mutant in the extreme of the 3 or 5 terminal of the APC cistron compared to those who have extreme polyposis where mutants tend to be in the mid-portion of exon 15. It is of import to be able to separate between the types of FAP to cognize where to test for mutants and how to handle the status. It is besides of import to see a patient s nationality when they present to clinic. This can find their heritage hazard and aid to turn up the mutant. For illustration Ashkanazi Jews have a high prevalence of the I1307K mutant ensuing in a life-time hazard of CRC between 10-20 % . Diagnosis Familial testing is of import in households who are at hazard of FAP due the dominant and high penetrance phenotype. As there is a classical phenotype, FAP is easier to name in clinic. In FAP about all mutants consist of shortnesss of the APC protein. This occurs by point mutants, doing either a frameshift by an interpolation or omission, or a nonsensical codon. Familial Testing for FAP is done by bespeaking the presence of a disease doing mutant by a Protein Truncation Test ( PTT ) . Then the location of the mutant on the APC cistron is found by Conformation-Specific Gel Electrophoresis ( CSGE ) , Single-Strand Conformation Polymorphism ( SSCP ) or Denaturing Gradient Gel Electrophoresis ( DGGE ) . Once the location of the mutant is localised the APC cistron is sequenced to place the disease-causing mutant. For those big omissions and rearrangements, Southern Blotting, Array CGH and MLPA can be used for designation. If all of these methods fail to place the mutant, linkage proving to the APC cistron can be done. As it has become cheaper to sequence the APC cistron late many clinics skip the procedure of turn uping the country of mutant and sequence the whole cistron. Deductions The APC cistron is big and the mutants spread along it. This can do it hard to turn up the mutant. As many households have alone mutants it may be hard to make up ones mind if the mutant found is really infective. In fact in patients showing with phenotypical classical FAP, known infective mutants are merely found in 85 % of them. The remainder, although they may hold alterations in the APC cistron it is unknown what these alterations mean. As this information is uninformative it is non possible to give patients a hazard of acquiring CRC or to test their households to be able to except those who are non at hazard. All of the molecular trials used for FAP have their advantages and disadvantages. PTT fails to observe shortnesss that occur at the very terminal or beginning of a cistron and big mutants. Additionally it can non observe missense mutants. However, if it does happen a mutant it is ever disease doing. CSGE does observe more than 90 % of mutants present. SSCP detect s between 60 % -95 % of mutants and DGGE can observe up to 90 % of sequence alterations. Array CGH will lose little omissions and MLPA can non observe balanced translocations and is sensitive to drosss. Therefore some mutants are being missed. Linkage analysis can be between 90 % -95 % effectual in households that have multiple members affected by the disease. The consequences of linkage give symptomless household members the hazard they have of transporting the mutant. However, if these hazards are non below 5 % or above 95 % they are non really utile in clinic. Furthermore non all households will hold multiple affected members to be able to transport out linkage. Additionally decreased protein look may give rise to disease but causative mutants can be really hard to happen because they may be in regulative countries ( Burt and Neklason, 2005 ) . If a patient presented to clinic with FAP phenotype but when tested no mutant could be found on the APC cistron it is deserving proving the MYH cistron for mutants. The phenotype of MYH-associated polyposis ( MAP ) is similar but less terrible than FAP and it is inherited recessively. It is of import to separate between these different types so that the mutants can be identified so other members of the household can be screened. It is besides of import to handle the patient accurately. 25 % of instances of FAP arise as self-generated APC mutants ( Davidson, 2007 ) . Merely kids of these patients would be at hazard of being a bearer of the mutant. However as these patients will hold no household history an inexperient clinician may non recognize the status as being FAP. HNPCC Persons with HNPCC have an increased hazard of developing CRC. It is the most common signifier of familial CRC accounting for between 3-5 % of all instances ( Davidson, 2007 ) . It is an autosomal dominant status and people who inherit the status have early oncoming of colon malignant neoplastic disease ( A ; lt ; 40years ) . Tumours develop chiefly in proximal colon and a individual affected often has household history of colon malignant neoplastic disease or other associated malignant neoplastic diseases such as endometrial, ovarian, encephalon, little intestinal, pancreatic and urinary piece of land ( Davidson, 2007 ) . However there is no typical signifier of phenotype for HNPCC. It is of import though, due to the higher life-time hazard of developing these malignant neoplastic diseases, to name households affected, so that preventive showing can be offered. Diagnosis The first measure to name HNPCC is when a patient nowadayss in clinic. A standard known as the Amsterdam standards was devised over 15 old ages ago which must be met for an person to be clinically diagnosed. This method has been criticised as being excessively stiff. There are now adopted versions of this standard, such as the Modified Amsterdam and Modified Bethesda. These other standards are more inclusive but less specific for HNPPC. When a household is identified as potentially holding HNPCC, they are eligible for diagnostic showing. HNPCC causes a higher hazard of CRC due to a germline mutant of a mismatch fix ( MMR ) cistron. The cell is so unable to treat DNA fix. Mutation bearers exhibit a characteristic phenotype termed microsatellite instability, characterised by enlargement or contraction of short repetition sequences of Deoxyribonucleic acid at multiple venue ( Syngal et al, 1999 ) . Pathogenic mutants have been found at four mismatch fix cistrons ( MSH2, MHL1, PMS2 and MSH6 ) , but so far most HNPCC instances are caused by mutants in either MLH1 or MSH2 ( Muller et al. , 2004 ) . High microsatellite instability is a signal that the MMR cistron is lacking. A tumor is considered MSI high or unstable if more than 40 % of the venue show instability ( Burt and Neklason, 2005 ) . If an MMR-high reading is found, a farther diagnostic trial, Immunohistochemical staining can be used to place which cistron is most likely to be mutated. This looks for the MMR proteins MSH2, MLH1 and MSH6 in the tumour tissue. In 50 % -70 % of instances, mutants in mismatch fix cistrons can be found by DNA sequencing and the larger omissions and rearrangements which tend to be common in HNPCC can be found by Southern Blotting. Southern Blotting will happen the mutant in a farther 10 % -20 % of people, where sequencing could non. Deductions In clinic a diagnosing is dependent on a patient s household history. If the household history fits the Amsterdam or any of the modified standards so they can be identified as potentially holding HNPPC. However this method of naming has possible defects. A elaborate household history may non be given by the patient as they may non be in contact with other household members or they may go forth out information that they do non believe is critical, such as endometrial malignant neoplastic disease. The sensitiveness of the Amsterdam standards is between 54 % -91 % and the specificity is between 62 % -84 % . This means that a significant figure of HNPCC households could be excluded from proving and testing. The sensitiveness of MSI trials are 62 % . Therefore excess cautiousness should be used when construing consequences, particularly negative consequences. In 15 % of sporadic instances of CRC, MSI can be detected. This occurs due to methylation of the 5CpG island in the boos ter part ( Muller et al. , 2004 ) . The consequence of this trial may take you to believe that the proband has HNPPC and therefore them and their households would be at higher hazard of developing CRC. However this is non caused by a heritable mutant in the germline. In add-on this phenomenon exposes a corresponding restriction in the usage of IHC because MLH1 protein look is lost in tumor every bit good ( Lynch et al. , 2007 ) Additionally, dependable consequences for MSI can merely be obtained if adequate cells are right amplified to look at the microsatellite venue. These trials do non pick up all instances of HNPCC as approximately 10 % of IHC trials will be falsely negative, i.e. protein discoloration is present even though the related cistron is mutationally inactivated ( Burt and Neklason, 2005 ) . This could take to the bar of early sensing. Diagnostic intervention can besides give false positive consequences ; this can take to people having testing that do non necessitat e it and this may take to unneeded psychological emphasis. MSI and IHC trials complement each other and therefore both should ever be taken into history. When the cistron is identified that is likely to be mutated, sequence analysis or Southern Blotting can be performed to place the mutant. However this consequence is non ever informative for households as it can be hard to clearly specify a infective mutant. This means that it is non possible to test other household members for a known mutant. Besides in up to 10 % of people a mutant may non be found. Finally when taking an index instance to look for the mutant, the youngest affected individual should be chose. The older a patient is the more likely their malignant neoplastic disease is sporadic. However in a household the youngest affected individual may non hold to be tested. This leaves it harder to accomplish the consequences wanted. Decision The most hard portion of proving for CRC is cognizing who to prove. In FAP there is a clear phenotype but there are discrepancies such as AFAP and MAP. These besides benefit from proving. HNCPP has no clear phenotype and is much harder to estimate who would profit from proving. There are standards set in topographic point to assist this procedure but as mentioned some people are over looked. For both conditions no individual trial is sufficient to place the mutant. Some mutants may non even be identified and therefore it is of import that a adviser non merely measure the patient on their trial consequences but besides on their clinical diagnosing. Trial consequences are non required for disease direction but are helpful for placing other household members who are at hazard. Mentions Burt, R. A ; Neklason, D. , W. ( 2005 ) . Familial Testing for Inherited Colon Cancer.Gastroenterology128: 1696-1716 Davidson, N. , O. ( 2007 ) . Familial testing in colorectal malignant neoplastic disease: who, when, how and why.Keio Journal of Medicine56 ( 1 ) : 14-20 Lynch, P. , M. ( 2007 ) . New Issues in Genetic Counseling of Hereditary Colon Cancer. Clinical Cancer Research 13: 6857s-6861s Muller, A. , Giuffre, G. , Edmonston, T. , B. , Heinmoller, E. , Brodegger, T. , Tuccari, G. , Mangold, E. , Buettner, R. , A ; Ruschoff, J. ( 2004 ) . Challenges and Pitfalls in HNPCC Screening by Microsatellite Analysis and Immunohistochemistry.Journal of Molecular Nosologies6 ( 4 ) : 308-315 Syngal, S. , Fox, E. , A. , Li, C. , Dovidio, M. , Eng, C. , Kolondner, R. , D. , A ; Garber, J. , E. ( 1999 ) . Interpretation of Familial Test Results for Hereditary Nonpolyposis Colorectal Cancer: Deductions for Clinical Predisposition Testing.Journel of the American Medical Association282 ( 3 ) : 247-253 Bibliography Boultwood, J. A ; Fidler, C. ( 2002 ) .Molecular Analysis of Cancer, Humana Press, New Jersey. Chen, S. , Watson, P. A ; Parmigiani, G. ( 2005 ) . Accuracy of MSI Testing in Predicting Germline mutants of MSH2 and MLH1: a instance survey in Bayesian meta-analysis of diagnostic trials without a god criterion.Biometricss6 ( 3 ) : 450-464 Kerr, D. , J. , Young, A. , M. A ; Hobbs, F. , D. , R. ( 2002 ) .ABC of Colorectal Cancer, BMJ, London. Taylor, I. , Garcia-Aguilar, J. A ; Goldberg, S. , M. ( 2002 ) .Colorectal Cancer 2nd edition, Health Press, London Tomlinson, I. , Ilyas, M. A ; Novelli, M. ( 1997 ) .Molecular Geneticss of Colon Cancer. Cancer and Metastasis Reviews 16: 67-69 Walther, A. , Johnstone, E. , Swanton, C. , Midgley, R. , Tomlison, I. and Kerr, D. ( 2009 ) . Familial Prognostic and Predictive Markers in Colorectal Cancer.Nature Reviews 9: 489-499

Understanding the Appeal to Force Fallacy

Understanding the Appeal to Force Fallacy The appeal to force fallacy is a rhetorical fallacy that relies on force or intimidation (scare tactics) to persuade an audience to accept a proposition or take a particular course of action. Understanding the Fallacy In Latin, the appeal to force fallacy is referred to as argumentum ad baculum, or, literally, argument to the cudgel. Its also sometimes referred to as the appeal to fear fallacy. Essentially, the argument appeals to the possibility of undesired, negative consequences that are often - though not always - tied to some sort of frightening or violent outcome that listeners will wish to avoid. In arguments that utilize this fallacy, the logic is not sound, nor is it the sole basis of the argument. Instead, there is an appeal to negative emotions and possibilities that have not been proven. Fear and logic become tied together in the argument. The fallacy occurs when a negative consequence is assumed without definitive proof; instead, an appeal is made to the possibility of the consequence and a false or exaggerated assumption is made. This fallacious argument may be made whether or not the person making the argument truly subscribes to their own argument. For instance, consider two factions at war. The leader of Faction A sends a message to their counterpart in Faction B, requesting a parlay to discuss the possibility of negotiating peace. During the war so far, Faction A has treated captives from Faction B reasonably well. Leader B, however, tells their second-in-command that they must not meet with Leader A because Faction A will turn around and brutally kill them all. Here, the evidence is that Faction A conducts themselves with honor and would not break the terms of the temporary truce, but Leader B discredits this because he is afraid of being killed. Instead, he appeals to that shared fear to convince the rest of Faction B that he is correct, despite the fact that his belief and current evidence are in conflict with each other. There is a non-fallacious variation of this argument, however. Lets say that Person X, who is a member of Group Y, lives under an oppressive regime. X knows that, if the regime discovers they are a member of Group Y, they will be put to death. X wants to live. Therefore, X will claim to not be a member of Group Y. This is not a fallacious conclusion, since it only says that X will claim to not be part of Y, not that X is not part of Y. Examples and Observations This kind of appeal is undoubtedly persuasive in certain circumstances. The robber who threatens a persons life will probably win the argument. But there are more subtle appeals to force such as the veiled threat that ones job is on the line.(Winifred Bryan Horner, Rhetoric in the Classical Tradition, St. Martins, 1988)The most obvious sort of force is the physical threat of violence or harm. The argument distracts us from a critical review and evaluation of its premises and conclusion by putting us into a defensive position. . . .But appeals to force are not always physical threats. Appeals to psychological, financial, and social harm can be no less threatening and distracting. (Jon Stratton, Critical Thinking for College Students, Rowman Littlefield, 1999)If the Iraqi regime is able to produce, buy, or steal an amount of highly-enriched uranium a little larger than a single softball, it could have a nuclear weapon in less than a year.And if we allow that to happen, a terrible line would be crossed. Saddam Hussein would be in a position to blackmail anyone who opposes his aggression. He would be in a position to dominate the Middle East. He would be in a position to threaten America. And Saddam Hussein would be in a position to pass nuclear technology to terrorists. . . .Knowing these realities, America must not ignore the threat gathering against us. Facing clear evidence of peril, we cannot wait for the final proof - the smoking gun - that could come in the form of a mushroom cloud.(President George W. Bush, October 8, 2002)

(Risk Management -Global Perspectives on Risk) Q- Globalisation has Coursework

(Risk Management -Global Perspectives on Risk) Q- Globalisation has led to a significant degree of convergence in markets and in - Coursework Example "Globalization" is understood as a source to bring in major increases in the world trade along with trade exchanges within an open, integrated economy that would span across borders. Remarkable growth has been observed in such form of trade or exchanges that had been observed not only within the traditional international trade of goods and services, but was also observed in the exchanges of country currencies, in various capital movements and many more. One aspect featuring the extent in globalization has been the volume in international financial transactions that peaks over $1.2 trillion every day as per the New York currency markets (Intriligator, 2003, p.4). Globalization has also led to greater openness within the international economies resulting in integration across worldwide markets. A second aspect of globalization has been the liberalization of trade and other different forms in economic liberalization. This has resulted in reductions in the trade protection norms thus est ablishing a more free world trading system (Intriligator, 2003, p.5). The third aspect of globalization has been the changes as seen in the institutions where the organizations had wider reach apart from the technological advancements and the wider horizons for the managers that were facilitated by the advances made in communications (Intriligator, 2003, p.6). ... d trend in bringing together the lower economies of the world by increasing world trade would contribute in capital mobility as well as the global operations in the multinational companies that would propel technological changes, even out the wage and productivity differences across economies. The term â€Å"convergence† has been found to have an ambiguous definition. As had been mentioned by Daniel Drezner â€Å"the scholarly work on this subject is spread across multiple disciplines, including law, economics, political science and sociology. The problem leads to a certain redundancy in theory building, as disciplinary boundaries prevent ideas from spreading across fields† (GAHAN, et al. p.8). The increase in the imports and the exports seen in the overall output level provides a clear picture of the extent the globalization has spread across the goods markets. Foreign goods are now available in all countries today than was not seen previously. This was the proof for t he product market expansions due to globalization. Though globalization has led to an integration of the global markets and reducing labor costs, it is also believed in some literature that that globalization had increased the unemployment situation and widened the levels of income disparity (Slaughter & Swagel, 1997, p.6). An important trend that has been observed in the labor markets present in the advanced countries has been the rapid shift in the demand moving from less skilled workers to the better skilled ones. This trend had led to a dramatic increase in wages and the income inequality observed between the two sets of workers found in some country, along with the unemployment levels as amongst the less skilled workers in different countries. What explains the differences in outcomes for wages and

The Democratic Republic of Congo Research Paper

The Democratic Republic of Congo - Research Paper Example This paper is a critical evaluation of the country’s history, specifically, of the armed conflict which occurred between 1998 and 2003, as well as of the two most recent general elections that have been conducted in the country. The Second Congo War (1998-2003) The Democratic Republic of Congo (DRC) is a country which has had a share of civil conflicts, most importantly, the Second Congo War. This is a war that started in August 1998 and ended in 2003, and at which more than 5 million people lost their lives (Prunier, 2008). It is believed that a significant number of these victims died as a result of hunger and malnutrition as well as of diseases such as malaria and diarrhea among others. Some sources term this war as the African World War based on the fact that the fighting was not exclusively among the Congo people. It may be important to state that other countries such as Rwanda, Uganda, Zimbabwe, Angola, Sudan, Chad and Namibia were actively involved in this conflict, hen ce the reason why some refer it to as the African World War in comparison to WW1 and WW2 whereby different countries formed coalitions to support each other (Prunier, 2008). The root causes of this war were largely based on the events of the first Congo war (Turner, 2007). Zaire, as the country was previously called, was under the authoritarian rule of Mobutu Seseseko for the period between 1965 and 1997, and this had motivated the formation of rebel groups with the intent of overthrowing Mobutu. During this period, too, Rwanda, a neighboring country, experienced a genocide which resulted in the fleeing of members of the Hutu community into the then Zaire, who resided in refugee camps. These people were the prime targets of violence orchestrated by the Tutsis and after fleeing into Zaire, they formed rebel groups, especially Interahamwe, which continued to level attacks on Tutsis in Rwanda. Later, the Zairian forces joined hands with these militia groups to attack Tutsis in Zaire, a nd this compelled the Rwandan government to provide military aid to the antigovernment forces in Zaire in order to remove Mobutu from power, after which someone friendly to them would be installed as president so as to be able to crush the rebel groups (Prunier, 2008). This person happened to be Laurent Kabila, who had been in the forefront for a long time in the fight to remove Mobutu from power. On the other hand, Uganda was interested in the vast resources present in the country and therefore, they also wanted Mobutu to be out of the picture and to achieve this, they joined rebel forces and other politicians in a military campaign to overthrow the then government whose popularity, in the region, was dwindling day after day (Clark, 2002). In May 1997, Mobutu lost the battle and fled the country, after which Laurent Kabila declared himself as president and changed the country’s name from Zaire to DRC. However, after the successful removal of Mobutu from power, the Rwandan an d Ugandan forces remained in the country, which made it difficult for Kabila to exercise authority as president. This was made worse by the fact that Kabila’s government was full of Tutsis, whom he had appointed to senior positions such as the chief of staff, his personal secretary, and minister for foreign affairs among others. Due to internal pressure and his suspicion that the Rwandan gover

Human Trafficking in Houston Essay Example for Free

Human Trafficking in Houston Essay Texans and Americans alike need to be aware of ongoing human slavery that tarnished the I-10 freeway and they need to know how they can stop the plague of Human Trafficking on Houston Texas. This past January, President Barack Obama recognized Human Trafficking Awareness month. In a published statement the President said he wanted to, â€Å"recognize the people, organizations and government entities that are working to combat human trafficking,† and â€Å"recommit to bringing an end to this inexcusable human rights abuse. † According to the U.S. Department of Justice human trafficking is one of the fastest growing criminal industries, with 14,500-17,500 individuals trafficked in the United States each year and 800,000 globally. With a number of contributing factors, including a diverse immigrant population and major roads for domestic and international travel, Houston is a hotspot for human trafficking in the U.S. According to Religion Link, â€Å"Nongovernmental organizations and nonprofits are now enlisting the aid of religious groups in the fight against human trafficking.† In Houston, organizations like the YMCA, the Houston Rescue and Restore Coalition, Free the Captives and Redeemed Ministries are all part of an entrenched alliance of non-profits, both secular and religious, fighting human trafficking in Houston. Constance Rossiter of the YMCA said, â€Å"These partnerships with religious organizations and other non-profits are essential to combatting human trafficking.† â€Å"There are many levels, it’s like a puzzle,† she said, â€Å"fighting human trafficking takes a community of partners including non-profits, churches, synagogues and law enforcement.† Each entity has its role to play, whether it be prevention, lobbying for legislation, advocation, awareness or enforcement, said Rossiter. Free the Captives, a Houston based Christian non-profit, does it all. Having long been involved in education and counseling for at-risk teenagers and potential pimps, Free the Captives is also active in trying to go after suppliers an d buyers in the human trafficking market. Working with attorneys, Free the Captives seeks to shut down trafficking locations by using nuisance abatement laws and other tactics. Taking the fight one step further, the organization recently began lobbying the Houston mayor’s office and local and federal law enforcement to focus on the demand side of the trafficking trade. Calling it the â€Å"Reduce the Demand Campaign,† the non-profit believes it is the primary solution in ending human trafficking. â€Å"To make an impact on domestic sex trafficking you have to go after the buyers,† said a representative from Free the Captives, whose identity is protected due to recent threats made by traffickers. â€Å"It does not matter how many pimps and landlords there are if the buyers are still willing to pay and there is money to be made,† said the anonymous source, â€Å"other pimps and landlords will pop up. You can’t stem the tide without going after the source.† For their part, the Mayor’s Office and the Houston Police Department believe that human trafficking is a major problem and are sincere in enforcing existing laws. In a letter from 2010, Mayor Annise Parker acknowledged the growing problem and said, â€Å"Houston is a hub for Human Trafficking where approximately twenty percent of all human trafficking victims will pass through our city at some point of their enslavement.† The Mayor’s Office recently reiterated the importance of fighting human trafficking and in a response to Free the Captives said, â€Å"Controlling sex trafficking remains of great concern. The governmental focus on landlords and illegal business has brought results. In the last year and a half the Houston Police Department has recovered 73 juveniles, arrested 21 pimps and two â€Å"Johns,† or buyers,† said Lieutenant Andy Lahaye. To do more the police are training their patrol offices to identify trafficking situations and be able to respond or pass on a tip for the vice department to investigate. However, Lahaye commented that it is difficult to go after the buyers and said, â€Å"It’s an underground world, we can’t just put an undercover officer out there as a decoy to catch a ‘John.’† â€Å"It’s all very subsurface, so we are going after what is out there for us to see, even though we want to cut it off at the source. That’s the struggle we are battling.† Free the Captives continues to demand the focus be shifted to the buyers. Although, many of the domestic victims in the world are not being pimped out in spaces that need landlords. While the mayor and law enforcement focuses on landlords they are almost entirely missing vulnerable American teens in private locales. They remain in bondage. Prevention is a key component to the fight against human trafficking and more organizations, not just faith based organizations like Free the Captives, need to focus their energies on prevention and curbing the supply of victims being exploited. In addition to existing enforcement the lobbying efforts of everyday citizens are paying dividends. While there are some great efforts to end human trafficking in Houston, organizations cannot function without active members. There is always something to help with.

Essay --

PATIENT CONFIDENTIALITY Patient Confidentiality is where a patient's medical information should be kept confidential. This concept can even be dated back to the Hippocratic Oath. When a patient goes to see his or her doctor, that patient expects to have his or her information kept confidential. They trust the medical practitioner to keep the information between them and related medical practitioners. For instance, you do not want people to find out about a disease you have and you to be affected by their knowledge of this.This establishment of trust along with medical ethical guidelines dictates this to be a duty for the doctors. Also, a person’s medical laws are meant to be kept confidential and not to be shared with anyone as dictated by law. This law is known as Health Insurance Portability and Accountability Act (HIPAA). There are many instances where a medical practitioner can release this information without your consent, but none of these reasons should benefit the physician in any way. When you buy health insurance, you need to authorize the release of medical records to the...

Evil Lives are meaningless lives? Essay

Profound though it may seem we often ask this very basic question:   What is the meaning of our life? This is one question that has existed for a long as humanity has.   It is one mystery that has fascinated many of the great philosophers.   Although many will find it absurd, pretentious even, that we want to answer this question, Julian Baggini thought otherwise. This is proven by his treatise in the book entitled What’s It All About: Philosophy and the Meaning of life.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Indeed, while many people will shy away from bursting forward with this question, Mr. Baggini was brave enough to try to answer it. He attempted to break down several issues plaguing people – some of which are helping others, serving humanity, being happy, becoming triumphant – and successfully delivered his views without making his ideas sound so ostentatious and metaphysical.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The essential issue in the book actually deals with the question of whether there is a profound and mysterious meaning to life.   It also asks what the ultimate purpose of our existence is. Mr. Baggini argues that there really is no single meaning to our existence. He says that every little thing that we do has meaning in itself so it is pointless to look for one whole package of meaning.   Indeed, the first-two chapters examine if and why the existence of God should make a difference into determining the meaning of our life. The remaining chapters then evaluate the claims of some people as to what they find significant in their life.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   By planting his feet firmly on the ground and dealing with specific issues, I think that Mr. Baggini effectively shows us that the quest for the meaning of our existence is right here with us everyday.   We don’t need to travel to far places to look for it.   We don’t need to serve in the UNICEF to render ourselves useful to humanity.   Most importantly, we don’t need legislation to render ourselves empowered.   The answer we have always been looking for in our life is in our own hands.   It is how we cope with our everyday existence that will truly define the life that we have lived.   The outside forces are just mere accompaniment, whereas our actions and reactions are the essential factors that will judge us in the end.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Corollary to this, the meaning of our life cannot be found in books and idealistic treatise. We don’t need to look for its meaning in our neighbor’s house; it is right at the tip of our nose. Mr. Baggini shows us that we can value happiness even as we accept that it is not everything. We can see the value of success without drowning ourselves in it.   We can even shout â€Å"Carpe Diem† to the whole world even as we help others lead fruitful lives.   In the end, it is still love that powerfully motivates us all. Indeed, Mr. Baggini shows us that the search for meaning is very personal and within our power to find. He supports his stand by drawing from actual experiences drawn from real life of real people.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In many ways, those who have read this book will deduce that Mr. Baggini qualifies himself as a modern-day heir of Bertrand Russel. In his own way, he shows us that we can find the meaning of life if we can only be more philosophical and rational.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In the Chapter 4 of the book subtitled Here to help, Mr. Baggini discusses the proper place of altruism if we are to pursue meaningful lives.   â€Å"If the meaning of life is to help others, then only those doing the helping can lead meaningful life.   The people being helped are thus mere instruments to the end of giving purpose to the altruists.† (65)   Of course, Mr. Baggini does not brush off altruism as a useless virtue. It is still needed if we have to co-exist peacefully with others.   However, he emphasizes that altruism should be put in its proper perspective and that people should make sense in defending values which go beyond itself. Altruism in itself is a virtue but it should not used to define one’s life.   It is just but one part of our existence, not the whole of it.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Chapter 7 subtitled Becoming a contender, Mr. Baggini writes â€Å"To raise a happy family, or live your life pursuing your passion, no matter which recognition you get, should be seen as a success.†(123) This in itself shows the kind of philosophical sense that Mr. Baggini follows in this book.   He does not aim for huge successes but makes one feel that no matter how small the achievement is, it is still worth noting because it has helped one become the kind of person that he is today. It is therefore important for us to do our best in every thing we do because these small things can also enrich our life.   Indeed, it does not matter whether the good deeds we have done are great or small.   The most important is we did it.   This is what life should be all about.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In Chapter 9 subtitled Lose yourself, Mr. Baggini emphasizes that we don’t need a Maya Angelou or a Deepak Chopra to lead us to the real meaning of our life.   He strongly criticizes the promises of religious and ideological beliefs; consequently convincing us that we really don’t need vast esoteric knowledge or a time-tested guru to find the meaning of our life. Here, Mr. Baggini argues that we just have to look into our self and we will find everything that we have always been looking for. Resorting to ideological beliefs may only pose greater danger of losing one’s proper perspective, thus, this is highly discouraged.   Apparently, Mr. Baggini believes that each person is unique and lessons learned from one’s experiences may not be uniform for everyone.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Mr. Baggini’s main purpose for writing this book is actually to show us that philosophy – rather than our average New Age psychobabble — is a better tool to analyze life’s little mysteries with. This is the reason why he purposely puts forward a largely down-to-earth approach to the issues being raised in the book. In a world where existentialism has morphed into an alienated version of the â€Å"I and me† culture, utilitarianism offers rational discourses where once we had heaven for guarantor.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Like the movie Dead Poets Society, Mr. Baggini encourages us to seize the day. Each day is a chance for us to define the life we lead.   It is therefore essential that we have to live our life to the fullest everyday.   Of course, he admits that defining our life this way is not an easy task but there is nothing impossible if we only go back to our very selves. In this aspect, Mr. Baggini dislikes paradox and hyperbole and anything too extreme.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   What’s It All About: Philosophy and the Meaning of Life ends up being a rational and secular inquiry into the meaning of life. Although it is obviously a prà ©cis of Mr. Baggini’s personal views on life, he hopes that this is something many philosophers would mostly agree. Several times in the book he would refer to past experiences as he draws lessons from them. In spite of his bold statements, however, Mr. Baggini takes a cautious approach.   This stance disappoints because at the end of the book, there is little to disagree with. His supposition that the meaning of life is really â€Å"quite humdrum† only sums up his attitude to the question.   In this aspect, he shows that life is just a mirror that reflects back the image of whoever seeks its meaning.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   To his credit, Mr. Baggini tries to sum up the meaning of life in fewer than 200 pages – a big achievement in itself.   However, it is also because of this that his argument suffers greatly; being that its supporting discourses have been so squeezed together. This problem is apparent in the chapter on the loss of selfhood, where he points out that New Age ideas are quite â€Å"nonsense.†Ã‚   He says that anyone who professes to lose his ego during meditation is being self-righteous.  Ã‚   Anyone who professes to lose his ego during meditation is being smug and self-righteous.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Mr. Baggini then saves the best for last when he declares that â€Å"we should forget about the meaning of life and just get on with it.†Ã‚   The analysis made on life stems from a rationalist and humanist perspective. As I said earlier, he proceeds to his main thesis with utmost caution even as he answers each question thrown his way with distinctive directness.   The outcome of this is that the readers are left to form their own conclusion based on the framework that Mr. Baggini has constructed.   Each reader will be able to form his own meaning to life – one that will be personal, more meaningful and sociologically moral.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   If a reader has majored in philosophy, this book will be viewed as a bit simplistic.   However, for ordinary readers like me, it makes for an easy comparison of the various isms in life. Sure, it does not dole out definitive answers to specific questions. Still, it’s a good read for someone who is literally searching for a meaning of his existence. For me, Mr. Baggini’s insistence that our life should be led on an everyday basis is congruent to the fact that we should live it in peaceful co-existence with our neighbors.   Doing otherwise (or by being evil) will render our life meaningless.   In a nutshell, Mr. Baggini offers us ideas about life that are balanced, good and practical. The bottom line here is that living itself, for its own sake, is what truly the only thing that gives life meaning.   All the other ascriptions are, at best, plain spices to make the journey fun and enjoyable.    References: Baggini, Julian. (2005) What’s It All About: Philosophy and the Meaning of Life. Granta Publishers, Inc. Williams, Peter. (2003) Sorting the wheat from the chaff http://www.damaris.org/content/content.php?type=5&id=319