To Cut or Not to Cut Routine Infant Circumcision Essay

To Cut or Not to Cut Routine Infant Circumcision - Essay Example His birth itself makes him a Jewish or a Muslim; depending on the family he has taken birth into (Gollaher 24). However, in recent years, the ethics of an unnecessary surgical procedure which essentially disfigures normal male anatomy and may, in fact, create sexual problems down the road for an otherwise healthy male, has groups across the country lobbying to get the procedure outlawed (Fleiss et al 364). Even though a prominent group of pediatricians believes that the advantages of circumcision are more numbered than the risks involved, the American Academy of Pediatrics believes that the medical gains of circumcision are not up to that extent that the risks involved may be overlooked and it (circumcision) may be recommended (Somerville 20). According to the American Academy of Pediatrics, â€Å"the topic cuts across many paradigms in your life – cultural, religious, ethnic, family tradition, aesthetic. We are not in a position to make recommendations on those paradigmsâ₠¬  (Freedman). Moreover, in countries like Canada a physician might land himself in legal problems if he/she undertakes the circumcision of a child even though it is with the consent of the child’s parents (Somerville 34). Some scholars believe that the reasons behind the circumcision practice are different than being religious. Like for example David Gollaher claims that male circumcision has its origins from the practice of castration done on male attendants of the ‘harems’ in order to keep them inoffensive and harmless. The main aim was to preserve the chastity of the female inmates of the ‘harem’. Gradually, the castration was transformed to circumcision and it became a practice which some people wrapped in a religious cover. Gollaher further claims that girls were circumcised in order to diminish their sexual urge on puberty. This again was done in order to keep their chastity intact. Due to this very reason, there still are areas where girl ci rcumcision is practiced as a custom (Gollaher 194). But Abusharaf does not agree with this view. According to him, such actions cannot guarantee chastity. It is the upbringing and the will power of the girl that will reflect in her actions (her chastity). Moreover, it is against the teachings of Christianity to harm or tyrannize one’s body in order to achieve certain virtues (Abusharaf 184). The parents’ decision regarding circumcision of their children should be regarded as final. Parents may consult their doctors for proper advice. They should properly understand the pros and cons of circumcision and only then should they decide about circumcision. As compared to the 1970s and 1980s, when the rate of circumcision was about 80 percent, by the year 2010, the rate had drastically fallen down to 55 percent. It is worth mentioning here that some studies have warned that such lower rates of circumcision might lead to elevated rates of sexually transmitted diseases. It is a stonishing to note the findings of the study that within the next 10 years or so, such infections might cost the exchequer of the United States health department billions of dollars (Freedman). Some people have opposed the practice of circumcision simply due to the reason that it mutilates an important male organ and decreases sexual sensation. Freedman strongly refutes such claims as being baseless and inadequately studied.There are certain common problems, even though of lesser importance, that may arise due

Resume Essay Example for Free

Resume Essay If it has been more than three months since you attended an educational institution, please describe what you have been doing in the interval? As described in my resume, after receiving my Masters Degree at Columbia University, I have been working on various research projects. Immediately after graduation, I had great pleasure to work with Pr.  Doran Warren as Research assistant, researching urban conflicts around Wal-mart. This opportunity has given me an excellent chance to apply my analytical and quantitative skills in professional setting. Further, this research opportunity has become a solid ground for my own research efforts and interests that has resulted in developing and working on my first professional academic essay. During my time off since graduation I have also been provided with opportunity to work as a legal aid assistant for common ground in New Orleans helping families who have lost their homes and can’t afford to handle paper work and to pay lawyers who are needed to navigate the bureaucracy of property rights issues. Also I have been involved in my own community of Bronx New York, where I have worked as a Volunteer and Organizer educating my community about the upcoming presidential elections (the details of my duties are described in my resume).

Food Culture in Malaysia and Japan

Food Culture in Malaysia and Japan The growing, rearing and processing of foodstuffs seems to have held a special fascination since the nineteenth century. Food and beverage industry has really growth and moving positively if compare to the preceding years, which is from the number of restaurant that opens day by day. There is a vast variety of restaurants with the different types of cuisine in Malaysia that representing different country and culture by offers an exciting array of food outlets, from fast food to fine dining and everything in between. Local food alone offers Malay, Cantonese, Szechuan, Indian and Nyonya cuisine while international food covers the gamut from Japanese to Middle-Eastern, Italian and American. Today, more people are excited to experiment and explore each restaurant that just opened. Moreover, due to the lifestyle and trends, more people are eating out rather than cook at home. For instance: Recently, more and more Japanese restaurants have been opened around Malaysia. Every restaurant trie s to bring up a new concept and originality to their brand. As the time goes by, people are more selective nowadays. They would like to choose a good quality food, with a good portion, with a good branding, and willing to pay with a reasonable price. There are some students are willing to pay high price for one meal because they want to try a new restaurant or a new cuisine with a good quality of the food. Thus, all restaurants have to try their best to meet the customers expectations. Besides that, they also have to recognize every aspect of their business has an impact on customer service because involve face to face customer contact and the supply in food has growing day by day. Each restaurant has to boost them self to improving customer service that involves making a commitment to learning what our customers needs and wants are, and developing action plans that implement customer friendly processes. The writer finds this issue interesting because nowadays people often ask the simple question like Where are we going to eat? I love Japanese foods especially sushi. Where can I get a delicious sushi with ideal price, good service and good place to hang out? When people decide to choose a Japanese restaurant, there are some factors that influence their decision making, such as customers emotion, satisfaction and brand loyalty. It is very important to know customers behavior in order to build a long term relationship. Therefore, the writer has chosen the title An assessment of Sushi Zanmai Malaysia popularity among university college students. There are three different concepts of Japanese restaurant that owe by SuperSushi Sdn Bhd Company which are: 1st Concept: Sushi Zanmai that began since in April, 1997, the genuine conveyer-sushi restaurant. There are several outlets of Sushi Zanmai which are in Sunway Pyramid, The Gardens, One Utama and Low-Yat. 2nd Concept: Sushi Zen that began since in September, 2007, a casual kiosk-style Japanese restaurant. 3rd Concept: Pasta Zanmai that began since in December, 2007, a Japanese Casual Pasta Restaurant. Within this short period, this company has developed the restaurant very fast, from one concept into another concept. The purpose of this research is: To identify factors that influence people selecting Sushi Zanmai as a sushi restaurant To identify current trends of Japanese food To recommend measures that could help to improve current condition PART 1: LITERATURE AND REVIEW 1.1 Food Culture in Malaysia Malaysia has a combined population of over 18 million people. Because of its central location, between the Indian Ocean and the South China Sea. Malaysia has traditionally been a meeting point for traders and travelers from both the East and West, it also has produced a most diverse culinary melting pot. As a result, Malaysia has a multicultural and multiracial population consisting of three main group which are Malays, Chinese, Indians and numerous indigenous peoples. With such a varying ethnic composition, it is no surprise that a great diversity of religions is prevalent throughout Malaysia. In Malaysia, eating out is really a gastronomic adventure. A blend ofcultural and ethnic histories which make up Malaysias diverse population is reflected in the broad range of influences and flavours found in Malaysian cuisine. And each state in Malaysia has something to offer in terms of culinary delights. For instance: Penang, the famous in hawker stall haven, where all the most delicious food requires that only costs as little as RM 3.50 per dish, such as Penang Char Kway Teow, Fried Oyster, Laksa, etc. Mallaca is also home to Baba Nyonya food, which served in quaint cafes in historical shop houses. Or in Kuala Lumpur, the most diverse offering of foods from all over the world, such as Chinese cuisine, Indian cuisine, Japanese cuisine, Thailand cuisine, Vietnamese cuisine, European cuisine, Arabian cuisine, etc. With mixed origins, there are certain ingredients common to many dishes in Malaysia. Multiple varieties of rice and noodles, which are from local or imported from Thailand, Japan or India, are often used as a base. The Malays include a lot of seafood in their diet, like fish, squids, prawns and crabs that used to show up in Malay dishes. And most of Malaysian dishes use fish sauce or fish paste because fish live is around the shores of Malaysias islands. Fresh herbs and roots are commonly used to cook Malays food.ÂÂ   Indian and Thai curry spices with regional varieties are often used to create rich and spicy curry dishes. A dried spice is also form an important component of Malays cooking. Moreover, in a city of Malaysia which is Malacca was one of the great trading centers of the spice in the fifteen century. And Coconut is another favorite ingredient which is also common found in countless dishes. For instance: Santan(the coconut milk), to make creamy curries. It is to add sa vory sweetness of the dishes and to cool the fire of hotter spices. Today, rice is the staple for almost half the worlds population, particularly in parts of China, India, Indonesia, Japan and Southeast Asia. According to historians, they believe that is was first domesticated in the area covering the foothills of Eastern Himalayas (Northeastern India), and stretching through Burma, Thailand, Laos, Vietnam, and Southern China. From here, it spread in all directions and human cultivation created numerous varieties of rice. According to the International Rice Research Institute (IRRI), based in Philippines, there are 120.000 varieties of rice worldwide. Over the centuries, there are three main types of rice developed in Asia, depends on the content of the grain which is: Amylase means an enzyme that breaks starch down into sugar Rice has divided into three (3) which are long grain, medium grain and short grained varieties. In this case, different populations, consumer different varieties of rice. Foods through the day in Malaysia are three meals a day and rice is almost always included, even at breakfast. For instance, Nasi Lemak. A typical meal consists of rice served with soup, curries, and a few vegetable stir-fries and also eaten fruit for dessert. A typical of Malay lunch and dinner was all dishes are placed in the center of the table to be shared by all the diners and usually the Malay food is often eaten with the hands. There are similar eating pattern within Japanese and Malaysia, which the main staple is rice and it is eaten with almost every meal. The meal features is quite same, such as the tastes of sweet, sour, spicy, bitter and salty. Like Chinese style wheat noodles served in meat stock known as Ramen have become extremely popular over the last century and Malaysian like to consume noodles. Follow by seafood, as Japan is surrounded by sea as same as Malaysias islands. Therefore, When Japanese cuisine comes to Malaysia, the food itself easily accepted by Malaysian. 1.2 Background of Japanese Food Culture The rice-centered food culture of Japan evolution follows the introduction of wet rice cultivation from Asia more than 2000 years ago. The cultivation and consumption of rice has always played a central role in Japanese food culture. The tradition of Japanese is usually rice served with seasonal vegetables; fish and other marine products reached a highly sophisticated form in the Edo period (1600-1868) and remains the vibrant core of native Japanese cuisine. In the century and a half since Japan reopened to the West, Japan has developed an incredibly rich and varied food culture which includes not only native Japanese cuisine but also many foreign dishes. Some adapted to Japanese tastes and some imported more or less unchanged. In the 6th century, introduction of Buddhism to Japan became the official religion of the country and the eating of meat and fish were prohibited. The first recorded decision prohibiting the eating of cattle, horses, dogs, monkeys and chicken was issued by Emperor Temmu in A.D.675. Laws and emperor eliminate the eating of almost all flesh of animals and fowl because based on Buddhism are prohibiting to killing. In the 15th century, many of the foods and food ingredients eaten by Japanese nowadays, for instance: miso, tofu or soy sauce. In the 16th century, the combination of Spanish and Portuguese frying technique with Chinese method for cooking vegetables in oil led to the development of tempura, the popular Japanese dish in which seafood and many types of vegetables with deep fried method. In the early 19th century, the development in Edo, the introduction of sushi has started. Todays, most of people are familiar with that dishes. It made from vinegar rice top or combined with raw fish and shellfish. And during that time, sushi was sold from stalls as a snack food, and that stalls were become the starter of todays sushi restaurants. In the mid 19th century, many of new cooking and eating customs were introduced where the most important being eating the meat. Consider of Japanese dish, Sukiyaki that consist of beef, vegetables, tofu and other ingredients cook at the table in a soup stock of soy sauce, sweet sake and sugar was first served in Western style restaurants. Another dish that popular during this period is Tonkatsu, means a deep fried bread pork cutlets. In the early 20th century, using Indian curry powder, Japanese curry rice (kareraisu) became very popular dish which consisted vegetables, meat or seafood with a thick curry sauce and served with rice. In generally at sushi restaurants, costumers will sit at the counter and call out their order item to a sushi chef. Or sit at Conyever belt where the customers can grab small plates in front of you, or call a special order if you do not see what you want on the belt. Or customers can sit on tatami mats. And as like Chinese, Japanese also ate with chopsticks to transfer the food. The rice bowl is not held as closely to the mouth. Soups are consumed directly from the bowl and the only dish eaten with a spoon is an unsweetened egg custard which known as chawanmushi. There are several ways to describes the differ of Japan cuisine from other cuisine, First, portion of the dish are small because it is to capture the diners attention with the freshness, natural flavor, the beauty of each dish, the atmosphere and the whole meal. Second, the food for a meal is served at once, so diners receive their own portions on individual plates and bowls instead of serving family style from large bowls in the middle of table. Third, Japanese use less oil which to emphasize the light and natural flavor of the food. And now, development of Japanese restaurant that opened more and more in Malaysia. It can be cause of the trends between among the Malaysia. There is similarity between Malaysia cuisine and Japanese cuisine that makes Malaysia is easier to accept. Other reason is Malaysian are quite open minded with those culture. 1.3 Food affecting consumers towards selection of food There are numerous factors that affect consumers towards selection of food, whether it is made by individuals or other parties. Food choices are influenced by many interacting factors which are income, culture, the concern about health, values, religion or even genetic. Many operational models have been developed to describe these influences that including The Lifestyle Model of dietary habits (Pelto, 1981), which attempts to explain how these factors interact to result in specific food behaviors. Societal Factors: Food Production and Distribution System is responsible for the availability of foods which differs from region to region and country to country. Food availability influences and in turn is influenced by the socio-economic and political systems. These serve to control the production and distribution of food in culture. Government policy may also be involved with the purchasing power of consumers through programs such as the oversight of food quality through safety standards, nutrition labeling requirements and other production programs (JoslingRitson, 1986) Lifestyle Factors: Income (limits what foods can be purchased) ÂÂ ® Occupation (influences food habits in several ways, for instance: the location of the job also influence meal patterns) ÂÂ ® Education (the status and self-realization phase of food use are usually, through not always dependent on higher levels of education) ÂÂ ® Nutrition Knowledge (may or may not translate into knowledge based behavior, and greater influence over what someone eats than what the person knows about nutrition) ÂÂ ® Ethnic identity (a distant heritage that has been modified or lost over the generations through acculturation) ÂÂ ® Rural-Urban (place of residence may affect which foods people eat) ÂÂ ® Religious Beliefs (depends on what religion, may have a great impact on food habits or may have no influence at all) ÂÂ ® Health (specific foods are often credited with health promoting qualities, such as ginseng in Asia) ÂÂ ® Physiological (age,gender,body image, and state of health)A ll of influence lifestyle factors are affects food habits. 1.4 Factors affecting popularity of Japanese food towards university college student The marketing mix is the set of marketing tools which often summarized as the four Ps that the firm uses to achieve its objectives in target markets (McCarthy, 2001). And most marketing professionals would say that the right marketing mix is the one that maximizes customers satisfaction and results in the highest sales or market share. Product It is defined as anything that can be offered to a market for attention, acquisition, use or consumption that might satisfy a need or a want. Step one; this product emerges will come from an analysis of its strengths, weaknesses, opportunity and threats. There are two classifications of product: Tangible product Goods Intangible product Services For a restaurant, the goods are food and beverage outlets offered and the service is the customer service. Consequently, it is logically to include services within the definition of the product. (David Jobber) Step two; is a detailed analysis of the target market to assess the nature of the opportunity, what is its size and potential? How strong is the competition and how is it likely to evolve in the future? Step three; is research into the needs of prospective customers, what is it that customers actually want? According to Hamel and Prahalad, 1991, today, this goes beyond merely asking customers, what are the customer looking for, but creatively seeking to discover needs that customers cannot articulate because the customers are unaware of the possibilities offered by new technologies and the changing environment. People will always seek a restaurant that offering excellent food, especially when the restaurant have a good service, value and ambiance. People satisfy their needs and wants with products. Thus, the product is the main thing for a company because without products there is nothing to market or sell. And when a customer decides to buy a product, the customer will look for certain characteristics. The customer will want to know how many different products that offered by restaurant, which one provides a more interesting savings and what is included in the product. Product must have the power to leave a good impression and interest so the customer will not hesitate to visit the restaurant for the second time. Price It is defined as what the product or service costs to the customer or the amount that customers are willing to pay for a product and service. In order hand, price is the only element in the marketing mix that produces revenue. And setting a price for a product is very important. Price has a very strong impact on sales volume and market share; empirical studies (reviewed in Tellis, 1988; and Sethuraman and Tellis, 1991) have shown that, for most products, price elasticity is substantially higher than advertising elasticity. The company will need to set a price that the customer can afford and willing to pay and at the same it will help the company to achieve a good level of profits. When a customer asks about the price of a product, the customer also interested in knowing is there any discounts or special promotions. Therefore, no matter how good the product, how creative the promotion or how efficient the place or distribution, unless price covers costs the company will make a loss. (David Jobber, 2004) For instance, if the price is expensive, regular students will not be able to afford it and will think to have their meals in other restaurant. Nowadays, customers are concern about the price of their food and tend to compare the price to another restaurant. The customer will evaluate whether the value of the product is worth the amount that the customer are paying, because customers are always strongly influenced by price. Price often fulfills two functions simultaneously: it reflects the sacrifice that the buyer must make in order to acquire the product or service involved and it also acts as a signal of the quality of the product (Monroe, 1990) Another consideration is where pricing have the relationship between price and perceived quality, because many people use price as an indicator of quality. According to David Jobber, the more value a product gives compared to that of the competition, the higher the price that can be charged. Price should accurately key to the value to the customer. The sacrifices that made by the customer is in order to experience the benefits of a product, thus from the restaurant itself have to give the best for the customer. Place It is defined as place or distribution as a set of interdependent organizations involved in the process of making a product available for use or consumption by customers. Or the company activities that make the product available to target customers. The dimensions of place are channels, assortment, location, inventory and transport. (Borden, 1984) For instance: Location, where customer can obtain the product so distribution channels are the key to this area. And in fact, many restaurant companies believe that location has become the most important factor to success. Warnaby and Dominic, 2004 highlight the advantages of shopping in town centers. Thus, the company will need to find ways to bring the products to customers and make the product easy to access to the customers. For instance: Convenience that is also important issue in food outlet patronage which the time and speed service is required, in order to satisfied the customers need and want. Place or distribution considerations play a major role in influencing customer motives. In the marketing of consumer goods, the role is to ensure that the product is available to the consumer when and where it is needed and in sufficient variety and quantity. Promotion It is defined as the activities that communicate the merits of the products and persuade target customers to buy or use the products. Company need to plan promotional activities properly in order to create awareness of potential customers. It is where advertising and communications are used to encourage customers uptake of the product or service. Promotion has several types of tools which are: Advertising, Sales promotion (discounts, coupons), Publicity, Word of Mouth, Personal Selling, Merchandising, Sponsorship and etc. The main reason why promotion is so important is to communicate with individuals, groups or organizations. Through promotion, the message like information about products or services can be communicated to existing and potential customers. Promotions can strengthen brand positioning. A 1985 study by Frankel and Co. and Perception Research Services found that, following exposure to adverts featuring promotions for a brand, consumers opinion of the brand( issues like quality, value and caring about customers ) improved by over 8 percentage compared to those exposed to only brand sell adverts. In other words, it must have the right facilities and services (product) and make them easily accessible to guests (place) with the proper amount of promotion and the right price. (David Abbey, 2003) Japanese food-Korean food Japanese and Korean foods are popular and are made of similar ingredients. However, the foods have their own taste, recipe and way of eating. Even though Korean food and Japanese food seems to be similar, both of them have their specialties. Japanese food and Korean food seems to be similar because they use same ingredient. For example, both of them use onions, green onions, red peppers, raw fish, and rice. Koreans and Japanese enjoy eating raw sliced fish, which are sushi and sashimi. Sushis ingredients are boiled rice, and raw sliced fish and sashimis ingredient is just as raw sliced fish. In addition, Korean and Japanese rice is the same. However, Korean and Japanese food is not totally same. Koreans tend to make food spicier and saltier than Japanese food. The price of Japanese food is higher than that Korean food. When people eat a meal at a Japanese restaurant, they should pay lots of money for their meal. For example, the basic foods like rice, sashimi, and some sea food cost thirty-five dollars per person. However, Korean basic foods, rice, main stew, and lots of side dishes cost just ten dollars per person. Japanese fresh seafood has high valuable, so most people prefer going to a Japanese restaurant like Benihana. Nevertheless, it is expensive. Every person has his/her own appetite, someone want to eat Japanese food and the other want to eat Korean food. Both foods may seem to be similar, because they are made of almost same ingredients. However, each of them has their own recipe, taste, and style of eating. Even though Japanese food is expensive, people like to eat Japanese food.

Use of Medium & Elements :: Drama

Use of Medium & Elements During performing scenes from A Dolls House by Henrik Ibsen. We used two different types of Styles. Naturalistic and Non Naturalistic. We worked in groups on each style. Naturalistic is a form of drama which is realistic. Not many strategies can be used doing this form. Non Naturalistic drama can contain many explorative strategies, such as, Hot seating, Still image, and thought tracking. The first style we worked on was Non Naturalistic. We chose to the scene where Krogstad confronted Nora. We made Krogstad two people to try and show Krogstad's power over Nora. We alternated the lines between two actors. (Use of spoken language) Krogstad was wrapped in a big black blanket to represent a black hole that Nora had fallen into. A hole of lies and deceit, towards Torvald. Nora was dressed in white to represent her innocence that she thought she had. We used these colours for symbolism in this production. This is a drama medium. Using symbolism showed me how different art forms react with other art forms. (E.g. colour and script) The script changed for me from then on. The white and black was a contrast that is widely used in the world. White is used for angels black is used for hell. White is used for a wedding black is used for a funeral. White is day. Black is night. People are scared of the night but never the day. During this scene we used space wisely. Nora moved backwards as Krogstad moved forwards. Using movement Krogstad would fly the black blanket around over Nora head trying to suck her under it. Nora would back away though trying to resist the dark side. (The outside of the house). Towards the end of scene where Krogstad dominates Nora and gets the truth out of her They exchanged blanket. Nora is now wrapped in black, which symbolises the outside world and the lies and deceit. It shows the viewer that Nora has no way of escaping what she has done. Using Non- Naturalistic drama to produce a scene from A Dolls House helped me understand the script a bit more. It certainly helped me figure out how scary the outside world was for Nora and Torvald. The symbolism in the blankets were a great help also in portraying how Nora had lied and it had caught up with her. Carrying the black blanket did help me imagine what the outside world must be like for the Helmer household. Holding the blanket and moving it closer to Nora who was a big sheet of white pure innocence felt quite evil yet

Rheumatoid Arthritis The Problem Health And Social Care Essay

Rheumatoid arthritis is an ague, systemic inflammatory upset that causes chronic redness of the articulations. It is besides known as an autoimmune disease, the status such that the organic structure ‘s immune response sends out incorrect signals to assail the organic structure itself. It may impact other variety meats like eyes and lungs every bit good. It progresses in three phases. ( 1 ) The first phase is the puffiness of the joint ; the 2nd phase is the rapid division and growing of cells which causes synovial membrane to be thickened and the last phase is the loss of motion. Figure 1: Normal joint vs. articulation affected by Rheumatoid Arthritis The loss of motion is caused by the enzymes that released by the inflamed cells that may digest the bone and gristle causes the involved articulation to lose its alliance and form. ( 2 ) The swelling in the articulations of the custodies and carpuss is normally the first symptom to be noticed. ( 3 ) Figure 2: Joint malformations caused by rheumatoid arthritis hypertext transfer protocol: //www.google.com.sg/imgres? imgurl Until now, the cause of the disease is still an unknown. However, there are scientists who believe that the immune system, gender, familial and infection may be the factors of the disease. ( 4 ) . Prevalence is more common in adult females than in work forces in the ratio of 3:1. Figure 3: Arthritis / Rheumatism prevalence: by age and sex, GB, 2003. ( hypertext transfer protocol: //www.statistics.gov.uk/cci/nugget.asp? id=1331 ) Temporary, there is no remedy for this disease. So, what are the current interventions that are available to relieve the symptoms of this disease? I will discourse about them in this study.A Possible SolutionDisease Modifying Anti-Rheumatic Drugs ( DMARDs )DMARDs are a combination of drugs normally used to handle patients with arthritic arthritis. They interfere with the devising or working of immune cells that cause joint redness. ( 5 ) By and large, biological DMARDs are non used in combination with other biological DMARDs because several of these combinations have shown increased toxicity. There are besides some agents that are synthesised through familial technology such as tumour mortification factor alpha ( TNF I ± ) blockers and Interleukin 1 ( IL-1 ) blockers. ( 6 ) The consequence is different and may be more delayed in oncoming than other medicines which are why sometimes they are called slow moving anti-rheumatic drugs ( SAARDs ) . So, I think it is rather of import to g et down DMARD agents every bit early as possible one time RA has been diagnosed and confirmed. ( 7 ) DMARDs could be one of the possible solutions because there are a batch of beginnings saying that its early usage is effectual in alleviating the symptoms as the quotation mark shown: ( 8 )Surveies have shown that early debut of these drugs may be good, with betterment in hurting, joint tonss, and disablement.( hypertext transfer protocol: //www.arthritis.co.za/dmard.html )In malice of its effectivity, there are several factors need to be considered included phase and badness of the joint status, the balance between possible side effects and benefits, and patient penchant ( 9 ) while doing the pick of which DMARDs drugs need to be taken. From my point of position, the patients need to seek a assortment of combinations of drugs to cognize that which combination give themselves the best consequence and the lowest hazard of side consequence with the aid of rheumatologist. Sometimes, mer ely one DMARD is used. However, there are many beginnings demoing that combination of DMARDs works better for the patients as the quotation mark and table below shown:Current grounds suggests that combinations of DMARDs are more effectual, and likely less toxic, than monotherapy. ( http: //www.patient.co.uk/doctor/Disease-Modifying-Antirheumatic-Drugs- ( DMARDs ) .htm )Figure 7: Comparison of combination therapy with individual drug therapy in early RA ( hypertext transfer protocol: //images.google.com.sg/imgres? imgurl=http: // ) From Figure 7, the consequences shown that the combination of drugs was approximately two times more effectual than the individual drug therapy for those who got remittal after one twelvemonth and two old ages of the intervention. Even though DMARDs plays a critical function in arthritis intervention, nevertheless, some of them are used more common than the others. For illustration, amethopterin ( MTX ) is the most normally used DMARD due to its higher efficaciousness but lower toxicity. ( 10 ) Figure 2: The construction of the metrothexate ( hypertext transfer protocol: //en.wikipedia.org/wiki/Methotrexate ) Metrothexate ( MTX ) , acts by suppressing an enzyme involved in the metamorphosis of folic acid, dihydrofolate reductase ( DHFR ) which is involved in the synthesis of tetrahydrofolate. They act by changing the organic structure ‘s usage of folic acid, which is a sort of vitamin and is needed for cell growing. Higher affinity of MTX to DHFR inhibits the transition of dihydrofolate to the active tetrahydrofolate, which means the synthesis of DNA, RNA and proteins are inhibited. It is to believe that this intervention with folic acid makes methotrexate benefit in arthritic arthritis as it inhibits the proliferation of the inflammatory cells in the articulation of the patient. Etanercept aims to command the redness and to retard the patterned advance of terrible RA as good but it is for RA patients which non wholly antiphonal to other drugs. It works by barricading the receptor for TNF-alpha. However, for most RA patients, amethopterin ( MTX ) is now considered the most first line DMARD agent. It is even more effectual when used in combination with other drugs such as Infliximab or Etanercept. ( 11 )Social & A ; Economic DeductionsBased on a research by Dickens and Creed in 2001, the people with RA are twice every bit likely to endure from depression. ( 12 ) Sometimes, they get upset because they merely do non experience the betterment in their organic structures even though they have taken the medical specialty prescribed. In my sentiment, their household members have to be supportive and be able to give them audiences when they need it. An probe in 1993 even found out that some patients need to take 5 old ages for themselves to accommodate to their statu s. In some instances, the disease may even interfere with their day-to-day activities, limit their occupation chances or interrupt the joy and duties of household life as the quotation mark below suggested: ( 13 ) The people with arthritic arthritis ( RA ) have been described as a ‘tightrope between freedom and a life sentence ‘ . ( 14 ) — Maycock, 1988. There are about 20000 new instances of arthritic arthritis in UK every twelvemonth and there are around 400000 grownups in the UK with this disease. From an economic point of view, this brings economic impact on the people today as the life cost presents is high and if they lost the occupation due to inability to travel around easy so their life disbursals including their medicine cost will be a large job for them. The transit fees to hospital on a regular basis, holding food markets delivered and the demand to purchase particular apparels and places add disbursals to their life cost. Extra money is besides spent on the complementary intervention and auxiliary merchandises. ( 15 )â€Å" If other members are acquiring sick, they may desire to pull resources off from the arthritic arthritis patient. † — Alan Mozes ( hypertext transfer protocol: //www.medicinenet.com/script/main/art.asp? articlekey=116607 )When there is a pick needed to be made, RA patients in a household will be given up doing them non be able to go on their intervention as the quotation mark above shown. Figure: Age-specific mortality rates ( per 100,000 ) for adult females with arthritic arthritis in 2009 hypertext transfer protocol: //arthritis-research.com/content/11/3/229/figure/F3? highres=y The mortality rate has non decreased steadily over the past 30 old ages. I think authorities should take this affair earnestly and take some stairss to turn this status better. Here, I unfeignedly hope that authorities can be financially stable and subsidy for those hapless patients who are non low-cost to travel through the intervention to the full. This could take down the mortality rate for arthritic arthritis patients.Benefits and HazardsI think the displacement to sing DMARDs as the new front line intervention is rather good as it may cut down the demand for other medicines as the quotation mark shown below:A DMARD may besides profit the patient by cut downing the demand for other medicines, e.g. corticoids and NSAIDs, which may hold a greater potency for toxicity than the DMARD. ( hypertext transfer protocol: //medsafe.govt.nz/profs/PUarticles/dmards.htm )This may cut down the intervention cost and increase the efficaciousness at the same clip. Methotrexate ( MTX ) has been sho wn to be the most effectual drug used in decelerating down the patterned advance rate of the eroding and devastation of the joint compared to the others DMARDs as the abstract below shown: ( 16 )Methotrexate outperformed other DMARDs in a meta-analysis of surveies comparing efficaciousness with toxicity, and more patients remained on amethopterin after five old ages than on other DMARDs.( hypertext transfer protocol: //medsafe.govt.nz/profs/PUarticles/dmards.htm )Besides, in footings of long periods, it has been shown to be safe and even can be applied on kids. ( 17 ) Normally the good effects from these agents merely last for a few old ages so I suggest that a good planning or scheme of utilizing them consecutive or even in combination is needed. However, several possible inauspicious reactions are at that place which needed to be taken attention of including timeserving infections, oral cavity ulcers and tummy jobs. Figure: Opportunist infections caused by Etanercept and Infliximab ( DMARDs ) hypertext transfer protocol: //images.google.com.sg/ Other than this, liver harm is another side consequence of this drug if this drug is taken orally every twenty-four hours. Alternatively of making so, from my point of position, the drug should be taken intermittently one time a hebdomad so the liver has adequate clip to retrieve. The existent status is nevertheless, the benefits of taking the drugs outweigh its hazards. So, I think this intervention should still go on but at the same clip, the patients who are taking the drugs need to be monitored on a regular basis. Some steps can be taken such as taking folic acid to cut down the side consequence of amethopterin as many beginnings have suggested.The usage of folic acid with the drug is used to cut down side effects.( hypertext transfer protocol: //www.arthritis.co.za/dmard.html )Alternate SolutionsNon-steroidal Anti-inflammatory Drugs ( NSAIDs )Nonsteroidal anti-inflammatory are besides known as ‘first line ‘ medicine in the instance of RA. Examples of drugs including acetylsalicylate ( acetylsalicylic acid ) , ibuprofen ( Advil, Medipren, Motrin ) and etodolac ( Lodine ) . I choose NSAIDs as an alternate solution because they can cut down the symptoms and thereby bettering maps. However, these drugs entirely do non alter the class of the disease or prevent joint devastation. ( 18 ) There are two chief types of Nonsteroidal anti-inflammatory: selective and non-selective. They work by suppressing enzymes, called Cox, COX-1 and COX-2 which participate in the production of prostaglandins. Even though the prostaglandins cause redness and hurting but they besides have critical functions in care of normal organic structure maps. So, the COX-2 inhibitors act by selectively block the prostaglandins produced through the COX-2 which have involved in redness. ( 19 ) Since the drugs merely aim to cut down the hurting and puffiness, so I suggest that they need to be combined with the other agents in DMARDs to do certain the disease is under control.SurgeryAno ther sensible attack that I suggest is to transport out surgery. Its primary intent is to cut down hurting, better the affected articulation ‘s map, and better the patient ‘s ability to execute day-to-day activities. However, from my point of position, a surgery is merely carried out when the medicine can non repair the structural harm or the disease does non react to the physical therapy. As any surgery is serious and involves complications, it is normally delayed until it is necessary. Furthermore, surgical intervention may non be an option for all of the affected articulations. ( 20 ) There are plentifulness of factors need to be considered such as the patient ‘s overall wellness, the status of the joint or sinew that will be operated on, and the ground for, every bit good as the hazards and benefits of, the surgical process. Cost may be another factor. Surgery picks:ChoicesFunctionsFinger and manus surgeries To rectify joint jobs in the manus. Arthroscopy To take dust or inflamed tissue in a joint through a little lit instrument. Synovectomy To take inflamed joint tissue. Arthroplasty To replace portion or all of a joint in the hip or articulatio genus. Cervical spinal merger To handle terrible cervix hurting and nervus jobs. Resection of metatarsal caputs To take distorted bone in the pess. Figure: The articulatio genus cap and the damaged portion are removed and the bipartite prosthetic device, which is normally metal is implanted during surgery as the diagram shown.hypertext transfer protocol: //arthritis.about.com/od/rheumatoidarthritis/ss/pictures_photos_6.htmEvaluationKate Lorig, the writer of the book The Arthritis Helpbook, who is besides the Director of the Stanford Patient Education Research Center and Professor of Medicine in the Stanford School of Medicine. She is a really reputable research worker in the field of developing self-management classs for patients with chronic diseases and she had published several books sing this rubric. So, I think there would be no biased in the fact that stated in the book about the intervention of DMARDs drugs should be commenced every bit early as possible which is besides supported by the quotation mark from the article of the web site & lt ; hypertext transfer protocol: //www.medscape.com/viewarticle/406508_5 & gt ; : The current intervention scheme hence involves the early usage of DMARDs to restrict joint harm and preserve map. Methotrexate is proved to be more effectual when used in combination with other drugs such as Infliximab or Etanercept than itself entirely from the web site & lt ; hypertext transfer protocol: //arthritis.about.com/cs/mtx/a/mtx.htm & gt ; . This beginning is said to be dependable as many other beginnings agree with this statement every bit good such as the web site & lt ; hypertext transfer protocol: //www.medicalnewstoday.com/articles/74289.php & gt ; and the undermentioned infusion: Study leader Dr Cornelia F. Allaart commented: â€Å" Our findings indicate that clinical remittal from RA is accomplishable provided effectual intervention – such as the Remicade amethopterin combination we used in the 4th arm of this survey – is administered early in the class of the disease. † Besides, the informations collected was at EULAR 2007, the Annual European Congress of Rheumatology in Barcelona, Spain. The European League against Rheumatism ( EULAR ) , which is a trust able organisation that represents the patient, wellness professional and scientific societies of rheumatology of all the European states. This statement is besides supported by the abstract: The efficaciousness of combination therapy with a biological agent is superior to methotrexate monotherapy for remittal. from the web site & lt ; hypertext transfer protocol: //ard.bmj.com/content/69/7/1298.abstract & gt ; .

The Femme Fatale: Ambiguity and Death

The Femme Fatale: Ambiguity and Death In cinema, the femme fatale is an enticing, exquisitely beautiful, erotic character who plays the ultimate trick of nature: she displays her beauty, captures the man and goes in for the kill. Unfortunately for this poisonous flower, male dominated western society interferes and kills the female predator in the end. In western cinema, the femme fatale can never survive, and can never â€Å"win† in the battle of the sexes. But why must this be so? What makes the femme fatale such a dangerously curious character for the hero as well as the viewer? In E.Ann Kaplan’s’ Women in Film Noir, Richard Dyer states â€Å"†¦women in film noir are above all else unknowable. It is not so much their evil as their unknowability (and attractiveness) that makes them fatal for the hero. † (Dyer, p. 92) Dyer’s observation alludes to the connection between the ambiguous female and the desperate need for the male to reveal her in order to possess her; it is the fear of the â€Å"unknowable† woman that makes her a direct target. This essay will explore the notion of ambiguity as a source of life as well as the ultimate reason for the death of the femme fatale.Before delving into the idea of ambiguity and its power of life and death for the femme fatale, an exploration into the actual women behind the character-type is crucial. The actress who portrays an ambiguous woman must herself, possess ambiguity, or she will never be believable and the fantasy of the femme fatale character is broken. Once we can see through the â€Å"bad girl† act, the portrayal becomes completely unsuccessful. Two actresses became infamous for their portrayals of two of the most well known femme fatales: Louise Brooks as Lulu and Rita Hayworth as Gilda. In G. W.Pabst’s Pandora’s Box (1929) Louise Brooks plays Lulu, a young woman who infects men (and women) with her erotic gaze and causes much mayhem in a 192 0’s Weimar Germany. The actress who would play Lulu had to be able to truly depict the kind of femme fatale that Pabst envisioned and would successfully capture on camera. The character of Lulu is a hedonistic carefree spirit who is well aware of her feminine wilds and understands the politics of sex. In the film, we watch as she manipulates many people with her beauty and eroticism and even plays with us, the viewer, as if she is aware we are watching her perform.But the woman we are watching is not Lulu; she is Louise Brooks frolicking on camera. Brooks possess the ambiguity of the Lulu character as opposed to just portraying ambiguity on behalf of the role. Before the film even begins Louise Brooks is presenting an ambiguous persona, being an American actress starring in a German film, the audience is already simultaneously perplexed and intrigued. Molly Haskell writes in her book, From Reverence to Rape: The Treatment of Women in the Movies, that Pabst â€Å"in his searc h for the ideal Lulu for Pandora’s Box, found [Marlene] Dietrich, his ‘countrywoman,’ too ‘old’ and too ‘knowing. †(Haskell, p. 83) Pabst needed an actress who was unknowable and unknown so that the mystery of the Lulu character would always be present. The audience is wondering who Lulu is as well as who Louise Brooks is; such a game keeps the viewers attention always on Lulu/Louise. If Pabst had used the already famous Dietrich in Pandora’s Box, the initial sense of ambiguity would no longer exist, as Dietrich is a recognizable German actress and the femme fatale that is Lulu, would not be passable.Contributing to the allure of female ambiguity, Molly Haskell writes that directors and critics alike â€Å"find their erotic fancies tickled by women who are at opposite sides of the sexual-cultural pole from themselves. † (Haskell, p. 82-3) The sexual appeal of the â€Å"exotic† woman is apart of the racial ambiguity th at both Louise Brooks- an American actress playing a femme fatale in Germany, and Rita Hayworth- playing an American living in Argentina share.This idea that the men who create these films have a personal sexual investment in the choosing of the actresses who will play these dangerous beauties is a very interesting point Haskell brings about. If Marlene Dietrich couldn’t play Lulu because she isn’t ambiguous enough for Germany, her huge popularity overseas in America seems logical given the ambiguity she possess in front of an American audience. This is where Rita Hayworth’s side of the spectrum plays out in an interesting way. Rita Hayworth was an American actress in the 1940’s and portrayed the classic femme fatale in Gilda (1946) directed by Austrian-born Charles Vidor.Rita Hayworth’s emergence into Hollywood included a grueling physical transformation to, in a sense, â€Å"tone down† her mixed race background of Spanish and Irish parents . What resulted was a lethal combination of exoticism and refined beauty; Rita Hayworth had the physical ability to be racially ambiguous enough to keep people’s attention but not so much as to truly raise questions about her Latin background. She had the curves, lips and sexualized mannerisms of a fantastical Latin woman, mixed with beautiful red hair and fair skin.As Gilda, Hayworth was made for the part of a femme fatale. Hayworth may even possess an ultimate ambiguity because her look remains unique in many parts of the world; her racial ambiguity is transportable. Louise Brooks and Rita Hayworth both brought with them, to their respective film set, their own ambiguities. The rest of the mystery behind these two dangerous female lead characters lies within their stories. In Pandora’s Box, Lulu is a very youthful spirit who emerges on screen and remains on screen with a presence that is dreamlike.Her â€Å"spell† that she seems to cast on all those around her is the elimination of wrongdoing, consequence, sin, etc. All that surrounds Lulu is attention and unexplainable adoration, which she uses to try to maneuver her way out of trouble when she accidently shoots her new husband after a fight over the gun. Lulu effortlessly convinces a group of friends to help her escape the law and run away from all consequence. Lulu carelessly manipulates by seducing the people around her, all to help herself and her own desires.She is an enchantress of sorts, and even as a viewer, watching this from the outside, I found myself growing fond of this whimsical femme fatale. When things don’t turn out well for Lulu, she is starving with her â€Å"father† and her dead husband’s son who’s helped her run away, Lulu doesn’t learn her lesson on being a proper de-sexualized, grounded lady. When starved and stranded in London, she applies make-up to her face and wanders the street for another victim to charm, and on her last vo yage out into the cold, she meets her death at the hand of Jack the Ripper.The character of Lulu is ambiguous in many ways, and the first is in terms of her class. When we first meet Lulu, she is the kept woman of Schon (her soon to be dead husband), and is kept very well in a fancy flat just for her, for whenever he wants to see her. He appears to be of the upper-middle or upper-class and is a media-tycoon, where she eventually gets a part in his son’s production. Contrary to this comfortable life Lulu leads as Schon’s mistress, Lulu’s â€Å"father,† Schigolch, is a sloppy drunk who she tells Schon was her first patron, and helps him whenever he comes to her.Lulu teeters between two very clear class lines: the rich and the very poor, and we as the viewer want to consider her only one of those two categories. The ambiguity of Lulu’s class is interesting when you observe that she probably comes from a poor background, yet she acts like a spoiled lit tle rich girl throughout much of the film. Class ambiguity is also found in the Gilda story. Gilda emerges onto the screen as a game-changer for the main character, whom she sets out to destroy; a cheat gambler turned trusted casino manager named Johnny.Gilda represents the new rock wedged between Johnny and the casino owner Ballin, who doesn’t know that his new wife Gilda and Johnny were an item back in the United States before both coming separately to Buenos Aires. The social and class ambiguity that Gilda has here is that between her wealthy European husband, her ex-beau Johnny who came from next to no money (at the start of the film, Johnny nearly gets robbed of money he scams off of some sailors), and the local South American men she speaks to in Spanish and sings to in the very late hours of the night.She has an unexplained relationship to an older employee of the casino, whom she calls Uncle Pio and is very fond of. Gilda’s ambiguous class ties are no doubt lin ked with Rita/Gilda’s racial ambiguities as she can easily blend in and can clearly function, knowing the language, in the South American country alone from Johnny or Ballin. Sexual ambiguity is found with Lulu’s character, as she has the ability to cast spells on woman as well as she does with men, in particular one friend of Lulu’s, the Countess Geshwitz.Throughout the film when the Countess is present it is very obvious that she is being seduced by Lulu in such a way that it appears the Countess is acting alone, and the vision of Lulu calling on the Countess simply a mirage. The Countess appears more sincere, wanting to dance with Lulu at her wedding to Schon in such a way; it looks as if Lulu and the Countess were the bride and groom. The Countess also gives Lulu money and helps her with whatever Lulu asks when she is on the run. Both Lulu and Gilda’s character’s share an ambiguity on their origin.We, the viewer, have no sense of where these fe mmes fatales came from, and this fact has significance when breaking down the character of the femme fatale. Not having a past is a very large part of Gilda. In a few parts of the film, Gilda, Johnny, and Ballin talk about this idea that they three are beginning anew and that there is no past for Gilda and Johnny before Ballin came into their lives. They toast to the new group of three at dinner one night (referencing an earlier toast before Gilda entered the picture, between Johnny, Ballin, and Ballin’s sword-tipped cane) and this signifies the removal of any history of all three of them.In Lulu’s case, we never learn about her origins either, and with the chaos of the events during much of the film, we don’t seem to care about where she came from. The only key to a past we have of Lulu comes from her first patron, Schigolch. From that we may draw the conclusion that she may have come from the very low class up until she met Schon. But all of this is merely gue ssing, as nothing is really given away and Lulu remains ambiguous and only in the present tense. The persona of the femme fatale is that much like the Greek myth of Pandora’s box and the male anxiety that surrounds the dangerous woman.In fact, Laura Mulvey writes in Fetishism and Curiosity that, â€Å"Pandora is the prototype for the exquisite female android and, as a dangerous enchantress, she is also the prototype for the femme fatale† (Mulvey, p. 55-6). Pandora was made to by the Greek Gods to be brought to man in order to deliver all the evils of the world, which she held in a small box. She was told to never open the box, but was told this with the God’s knowing her curiosity would get the best of her, and she opened the box. Chaos escaped out of the box and the only thing that remained was hope.The femme fatale is a manufactured, cosmetic woman who is placed in a film noir to bring about destruction to the main male character while appearing to seduce him. The femme fatale may go even further and entice the audience, and in a few cases she succeeds- there is an admiration of this figure by both men and women and some to the degree of fetish- but the femme fatale can never live without meeting her demise. This happens in Pandora’s Box with Lulu’s fatal demise, as well as with Gilda in a metaphorical sense.In Gilda, after Ballin skips town abruptly, Johnny and Gilda get back together but only for a brief time until Johnny begins to get controlling. Gilda flees only to return for the famous striptease scene, and later Ballin returns again to avenge the pair for betraying him. When Ballin dies, Johnny and Gilda make up, and Gilda completely changes from this rebellious firebird we’ve watched for three-quarters of the film to a quaint and very quiet woman, ready to go home with Johnny. Here, the femme fatale dies in a figurative sense, as if Gilda were simply wearing a mask and Johnny tore it off her face to reveal he r true wholesome self.So why the abrupt endings in both films? It is possible the directors of both films wanted to keep the fantasy going for as long as possible, feeding into the male and female desire that is being explored on screen yet keep true to western convention and punish the â€Å"bad† while rewarding the â€Å"good. † It is also quite possible that the male dominated western world couldn’t handle the femme fatale winning the battle because as Mulvey observes, â€Å"within this aesthetic, masculine desire is caught in an oscillation between erotic obsession with the female body and fear of the castration that it signifies.It is, of course, the fear of castration, and subsequent disavowal of the woman’s body as castrated that Freud saw as the cause of male fetishism. † (Mulvey, p. 59) It is interesting to think the male dominated film industry at the time of these films may have been playing with an image of woman that could figuratively castrate men while visually pleasing them, creating what Mulvey says Freud observed as earl fetishism. The femme fatale must then represent an object that arouses sexual desire up until the point of castration, and then the femme fatale will always die in order for the male to survive. She was created to please and then destroy, just like Pandora.Works Cited 1) Mulvey, Laura. Fetishism and Curiosity. London: British Film Institute, Indiana University Press, 1996. Print. 2) Haskell, Molly. From Reverence to Rape: The Treatment of Women in the Movies. Canada. Holt, Rinehart, and Winston of Canada, 1973,1974. Print. 3) Dyer, Richard. â€Å"Resistance through charisma: Rita Hayworth and Gilda. † Women in Film Noir. Ed. E Ann Kaplan. London: British Film Institute, 1978, 1980. 91-100. Print.