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pneumonia case study Department of Pediatrics, University of Hawaii John A. Burns School of Medicine. Chapter VI.11. Pulmonary Infections. Return to Table of Yhst-67750632302622_2267_509780775 Contents. A previously healthy 4 year old boy is - Application For Annual brought to an urgent care center by his mother for difficulty breathing for Yhst-67750632302622_2267_509780775 one day. Creates Storyboard! Three days prior he had developed a runny nose, cough, and low grade fevers with a temperature maximum of 101 degrees F (38.3 degrees C). He continued to Yhst-67750632302622_2267_509780775, take liquids well, but his solid intake has decreased. His temperature this morning was 103 degrees F (39.4 degrees C) and he was breathing fast and working hard to breathe. He does not have any ill contacts. He has never been hospitalized or had any surgeries.

He was born at term without any complications. He is Poster not taking medications other than acetaminophen. His immunizations are up to date for Yhst-67750632302622_2267_509780775 his age (except he had not received the pneumococcal conjugate vaccine). Loss Plan News! His parents and 10 year old sister are healthy and the remainder of his family history is non-contributory. There are no smokers in the household, and he has not traveled recently. He does not have a history of choking or vomiting. He has not had frequent ear or skin infections. He does not have a history of Yhst-67750632302622_2267_509780775 foul-smelling stools.

Exam: VS T 40 degrees C (104 degrees F), P 130, RR 40, BP 100/70, oxygen saturation 87% in room air. His height and weight are in the 50th percentile for his age. | Free Templates & Backgrounds! He is awake and alert, in moderate distress. His conjunctiva and TMs are normal. His nasal mucosa is erythematous with yellowish discharge. Yhst-67750632302622_2267_509780775! His lips and For Tv Spot mucous membranes are dry. His neck is supple, with several small anterior cervical lymph nodes.

Lungs: Moderate subcostal, intercostal, and supraclavicular retractions, symmetric expansion, dullness to Yhst-67750632302622_2267_509780775, percussion at the right base, increased vocal fremitus over the right base, decreased air entry over right lower lobe with crackles, no wheezes. Fresh Essays - Application Letter Vacation! Heart: Tachycardia, regular rhythm without murmur. Pulses are 2+, and capillary refill time is 3 seconds. His abdomen, skin, and neurological examinations are unremarkable. CBC WBC 20,000, 70% segs, 11% bands, 15% lymphs, 3% monos, 1% eos. Hemoglobin 12.4, platelet count 280,000. Yhst-67750632302622_2267_509780775! Chest x-ray (CXR): Right lower lobe opacity consistent with a round pneumonia (technically air/space disease, commonly called infiltrates by most physicians). Because of the hypoxia, he is I Write Letter For My - Template given supplemental oxygen (with subsequent improvement in oxygen saturation), as hospitalization arrangements are made. A 20 cc/kg infusion of normal saline was given through an intravenous (IV) line and then maintenance fluids are started. A blood culture is obtained and Yhst-67750632302622_2267_509780775 he is started on IV cefuroxime. He improves over the next day.

His respiratory distress slowly resolves and he is weaned off supplemental oxygen over the next two days. His blood culture shows no growth. He is Fresh - Application Vacation discharged home on high dose amoxicillin for a total of 10 days of therapy. His discharge diagnosis is Yhst-67750632302622_2267_509780775 probably pneumococcal pneumonia. Acute childhood respiratory infections cause significant morbidity and mortality worldwide. Mortality is high in developing countries with up to one-third of Draft An Employee deaths in children less than 5 years caused by acute respiratory infections (ARI) (1). The disparity in mortality is due to the severity of infection (perhaps due to differences in nutrition, overall health, immunization practices, and medical care availability) since the incidence of acute respiratory infections is similar between developed and developing countries with infants experiencing about 4-8 episodes per year (1). In the US, mortality from Yhst-67750632302622_2267_509780775, ARIs has declined since 1968 (1,2). There are 2 basic classification systems used for acute respiratory tract infections: the case-management classification system used by the World Health Organization (WHO) and the traditional clinical classification system (1). The case management system divides ARIs by symptoms (i.e., stridor, wheezing, and no wheezing) and their severity (i.e., mild, moderate, severe, and very severe). How To 13 Steps! The traditional system classifies ARIs by upper respiratory tract infections (e.g., acute otitis media, pharyngitis), middle respiratory tract infections (e.g., croup and epiglottitis), and lower respiratory tract infections (e.g., bronchiolitis, bronchitis, pneumonia).

Therefore, studies evaluating ARIs are not uniform and use different definitions from clinical findings alone to clinical findings in combination with other various ancillary tests (e.g., chest radiography). Of the acute respiratory infections, pneumonia has the Yhst-67750632302622_2267_509780775, highest mortality rate accounting for approximately 70% of the Templates | Free Poster, worldwide 4.5 million deaths from acute respiratory infections (4). Although mortality from pneumonia in children in the United States has declined by Yhst-67750632302622_2267_509780775 97% between 1939 and 1996 (5), pneumonia continues to be a leading cause of morbidity in A Cover Letter For My Resume - Template children. The risk of acquiring pneumonia is highest in children less than 5 years of age (1). The etiology of pneumonia varies and depends on: the age of the child, where the pneumonia was acquired (i.e., community vs. nosocomial), local epidemiology (e.g., influenza epidemics), host factors (e.g., immunologic status, recent or intercurrent antibiotic use, vaccination, and overall health status of the child), and environmental factors (e.g., travel, season of the year, daycare, or crowded living conditions) (4,6-9). Determination of the precise etiology of pneumonia often requires invasive testing (e.g., lung biopsy), and therefore, this is done infrequently. Rather the etiology of pneumonia is usually based on generalizations in Yhst-67750632302622_2267_509780775 the relevant clinical setting. In the Poster Templates Poster Templates & Backgrounds, neonatal period, the most common cause of bacterial pneumonia is group B beta-hemolytic streptococci (GBS) and gram negative enteric bacilli (e.g., E.coli), the same organisms associated with neonatal sepsis (4). In infants and children outside of the neonatal period, viruses are the most common cause of pneumonia (4,6,10-11) and Yhst-67750632302622_2267_509780775 respiratory syncytial virus (RSV) is one of the most common causes in infancy, especially in premature infants (9,12).

Of the bacterial pathogens, Streptococcus pneumoniae (pneumococcus) occurs most frequently (6,9,11,13); however, the Physicians Loss News & Event, studies isolating S. Yhst-67750632302622_2267_509780775! pneumoniae were performed prior to the licensure of the pneumococcal conjugate vaccine (6). Outcome analysis of the 7-valent pneumococcal conjugate vaccine demonstrated that up to 33% of chest radiograph confirmed pneumonia were prevented in immunized patients compared to those who were not immunized (14). Therefore, a different bacterial pathogen may supersede S. pneumoniae as the most common cause of bacterial pneumonia in the coming years. Other organisms to consider are Chlamydia trachomatis in infants 3-19 months of age (4) and Mycoplasma and Poster Templates | Free Poster & Backgrounds Chlamydia pneumoniae in children and Yhst-67750632302622_2267_509780775 adolescents (8-9,11-12). In special cases, for example, patients with neuromuscular impairment and How Do Letter Resume - Template impaired swallowing, aspiration pneumonia with anaerobic bacteria should be considered (15). Yhst-67750632302622_2267_509780775! The etiology of pneumonia varies in other conditions including immunosuppressed patients, nosocomial infections, cystic fibrosis patients, and anatomic airway anomalies (e.g., tracheostomies). In addition, the etiology of pneumonia is complicated since mixed infections (e.g., viral-bacterial) can occur in 16-34% of patients (7,11,13). The lower respiratory tract in healthy persons is Fresh Leavesample sterile (16). Yhst-67750632302622_2267_509780775! Bacteria access the respiratory tract by inhalation, microaspiration, or by hematogenous spread. Marco Schaaf, Swiss Creates! If bacteria gain access to alveoli, host immunologic systems begin to work on Yhst-67750632302622_2267_509780775 eliminating bacteria.

There are 2 major mechanisms by which lung defenses work to keep the airways sterile: physical defenses (i.e., mucociliary clearance and lymphatic drainage) and mechanisms that destroy bacteria (i.e., opsonization, specific immunoglobulin G antibody (IgG), alveolar macrophage ingestion, or complement mediated bacterial lysis) (17). If these mechanisms fail, polymorphonuclear leukocytes (PMNs) are recruited with a resultant inflammatory response. Schaaf, Illustrator, Creates For Tv Spot! Perpetuation of this inflammatory response leads to pneumonia. There are 4 major histologic steps seen in pneumococcal pneumonia described by Tuomanen, et al (18): engorgement, red hepatization, grey hepatization, and resolution. Yhst-67750632302622_2267_509780775! Engorgement is associated with presence of Form 7246 bacteria in Yhst-67750632302622_2267_509780775 the alveoli and an associated serous exudate. This then progresses to red hepatization secondary to leakage of erythrocytes into the alveoli. The next phase, grey hepatization, results from leukocyte migration to the affected area with intravascular fibrin deposition disrupting perfusion to the area. The final phase results in resolution, with phagocytosis of Letter Leavesample pneumococci and Yhst-67750632302622_2267_509780775 clearance of fibrin and other debris.

Outside of the neonatal period, pneumonia is suspected in patients with clinical signs and symptoms suggestive of impairment of the lower respiratory tract. Distinguishing bacterial from other causes of pneumonia cannot be accomplished by clinical findings alone (7). Symptoms of I Write A Cover For My Resume pneumonia are nonspecific and include: fever, ill appearance, cough, fatigue, decreased appetite and sometimes, abdominal pain. Signs of Yhst-67750632302622_2267_509780775 lower respiratory tract involvement include: tachypnea (greater than 50 breaths/minute in children less than 12 months, and greater than 40 breaths/minute for older children) (4), cyanosis, increased work of breathing (i.e., use of accessory muscles, grunting), pleuritic pain, and abnormal auscultatory findings. These signs do not differentiate a viral from An Employee Agreement:, bacterial process.

A chest radiograph is Yhst-67750632302622_2267_509780775 used to verify the clinical suspicion of pneumonia and characterize the disease process, but may not be performed on every patient. Physicians Weight Loss | Diet Plan News! Viral respiratory tract infections are often associated with hyperinflation, perihilar peribronchial infiltrates, segmental or lobar atelectasis, and hilar adenopathy (19). Lobar consolidation and fluffy alveolar infiltrates with air bronchograms are more characteristic of bacterial infection (13). Yhst-67750632302622_2267_509780775! However, there is overlap between these two groups (13). Computed tomography and ultrasound of the chest are used in special circumstances (e.g., evaluate for pleural effusion, adenopathy, improved imaging of lung architecture) but these are not routinely obtained (4). Commonly used screening laboratory tests such as white blood cell count with differential, erythrocyte sedimentation rate (ESR), and Fresh Essays Leavesample the C-reactive protein (CRP) are not accurate in differentiating between bacterial, viral, mixed, or idiopathic causes of childhood pneumonia (7). Determination of Yhst-67750632302622_2267_509780775 precise etiology of pneumonia is difficult due to the lack of sensitive and - Application Leavesample Vacation specific tests. Many clinicians treat pneumonia empirically with minimal laboratory or radiographic evaluation and thus up to 80% of non-bacterial pneumonia may be treated with antibiotics (6). This approach is satisfactory when clinical risk is deemed to Yhst-67750632302622_2267_509780775, be low.

When a more precise diagnosis is required, more invasive techniques are required. Bacteria found in the blood, pleural fluid (thoracentesis), or lung tissue is considered diagnostic in a patient presumed to have pneumonia (4). Blood cultures are only positive in 1-8% of pneumonia (11) but continue to be recommended (4). Some question the necessity of blood culture after cost-based analyses (6, 11). Transthoracic needle aspirates, transtracheal aspirates, and open lung biopsy (the gold standard for diagnosis) are rarely performed due to the risk involved for these procedures (11,20), except in How Do I Write A Cover Letter - Template severe cases or in immunocompromised hosts (4).

Sputum is often contaminated with organisms unrelated to the specific etiology (16) and is difficult to obtain in children less than 8 years old (4). A sputum sample that may be helpful is characterized by many polymorphonuclear cells and a bacteria of single morphology on gram stain (4). Bronchoalveolar lavage from bronchoscopy is difficult to Yhst-67750632302622_2267_509780775, interpret as well. The results are non-specific (i.e., higher neutrophil counts than lymphocyte counts in How Do A Cover Letter For My Resume - Template patients with infection) and the organism found may or may not be the etiologic agent (16). Bacterial serology and Yhst-67750632302622_2267_509780775 bacterial antigen testing are often difficult to interpret (4,6). Bacterial cultures of the nasopharynx or throat correlate poorly with lung tissue cultures and are not helpful in establishing a diagnosis (16). Specific viral antigen testing, along with cultures for suspected pathogens, serologies for Mycoplasma and Chlamydia, and PPD skin testing for tuberculosis may be helpful (6).

Pneumonia is Fresh Essays For Annual Vacation treated with antimicrobials when the clinical suspicion for bacterial etiology is high. Greater pneumonia severity and findings that are consistent with bacterial pneumonia (e.g., lobar consolidation, leukocytosis, high fever) are more likely to Yhst-67750632302622_2267_509780775, warrant antimicrobial treatment. Young infants, unreliable parents, poor access to medical care, and more severe infections often require hospitalization. Treatment of pneumonia is often empirically based and thus, information on How Do A Cover Letter Resume - Template antibiotic resistance patterns and mechanisms of resistance is important to determine the most appropriate treatment. For S. Yhst-67750632302622_2267_509780775! pneumoniae, the most common mechanism of resistance to How Do Resume - Template, penicillins is alteration of Yhst-67750632302622_2267_509780775 penicillin-binding sites that can be overcome with higher doses of the How Do A Cover Letter Resume, drug (6). For macrolides, alteration to Yhst-67750632302622_2267_509780775, the 50S ribosomal binding site of the macrolide inhibits binding of the antibiotic and thus, prevents protein synthesis inhibition (6). In addition, there is also an increase in efflux pumps for macrolides and this property can be overcome by using macrolides that achieve high tissue concentrations at the site of infection (e.g. azithromycin) (6). Penicillin resistant pneumococci are often resistant to multiple drugs including macrolides and trimethoprim-sulfamethoxazole (21). Therefore, high-dose amoxicillin and/or azithromycin are recommended for empiric treatment of community-acquired pneumonia in children (6,8-9,11-12,20). Some clinicians will use clinical factors and ancillary tests in & Backgrounds aggregate such as age, exposures, CXR pattern, fever, and leukocytosis, to stratify the risk to favor pneumococcus (high dose amoxicillin would be better) or Mycoplasma/Chlamydia (macrolide would be better). For those children requiring hospitalization, a second or third generation cephalosporin, occasionally in Yhst-67750632302622_2267_509780775 combination with a macrolide, is Marco Swiss Illustrator, For Tv generally recommended (8,20).

Most treatment regimens are continued for a total of 7-14 days although this is based on little evidence (4). Pneumonia due to Staphylococcus aureus is uncommon, but particularly severe. S. Yhst-67750632302622_2267_509780775! aureus pneumonia usually results from inhalation of organisms, but it may also occur in Templates & Backgrounds patients with a cutaneous source (e.g., impetigo, boils, abscesses) with hematogenous spread or staphylococcal bacteremia from another source (e.g. osteomyelitis, central line infection). If S. aureus pneumonia is Yhst-67750632302622_2267_509780775 suspected, vancomycin should be started empirically. Marco Illustrator, Creates Storyboard For Tv! Culture and sensitivity data permits changing to an alternate antibiotic later. Yhst-67750632302622_2267_509780775! Pleural effusion (empyema), pneumothorax, and pneumatoceles often complicate S. aureus pneumonia. Pleural effusions can be classified in | Free Templates several ways. They can be a transudate or an exudate based on their protein content. A subpulmonic effusion versus an empyema is more clinically relevant. The former implies a transudate which is Yhst-67750632302622_2267_509780775 usually sterile, while the term empyema is usually used to describe pus (purulent exudate) with a positive gram stain and culture.

The overall outcome in children with pneumonia is excellent. The majority of children will recover without complications (11). Follow up chest radiographs are not required routinely, but should be performed for patients with complicated pneumonia, persistent respiratory problems, pleural involvement, and neonates (4,22). About 80% of Weight Loss | Diet News & Event Calendar infiltrates on CXR will resolve by Yhst-67750632302622_2267_509780775 3-4 weeks and the remainder will usually resolve by How To Agreement: 13 Steps 3 months (22). Recurrent pneumonia with radiologic clearance between episodes requires further evaluation (e.g., immunodeficiencies, gastroesophageal reflux, pulmonary anomalies, etc.) (4). Bronchiolitis is the leading cause of hospitalization for respiratory tract infections in young children (4,23-25). Respiratory syncytial virus (RSV) is the primary cause of Yhst-67750632302622_2267_509780775 bronchiolitis, but parainfluenza virus, human metapneumovirus, and adenovirus may also cause bronchiolitis (23-24). In the United States, the majority of RSV infections occur during the months of November to Marco Creates Storyboard, March (4,23).

RSV infections account for a significant amount of morbidity and health care expense in the young age group (24). RSV is transmitted by direct contact with large droplets or fomites. Transmission can be limited by good handwashing (23). RSV bronchiolitis results from the spread of RSV to the lower respiratory tract after an incubation period 2-8 days where the virus undergoes replication in Yhst-67750632302622_2267_509780775 the nasopharynx (23). The infection results in & Event infiltration of the Yhst-67750632302622_2267_509780775, respiratory epithelium with resultant inflammation and Form 7246 necrosis, sloughing of the epithelium and increased mucus production causing airflow limitation in the small airways leading to the hallmarks of the disease (23). Thus, affected infants have signs of airflow limitation including hyperinflation, atelectasis, and wheezing. The diagnosis is often made on clinical grounds during the RSV season. Diagnostic testing can be done by immunofluorescence and Yhst-67750632302622_2267_509780775 enzyme-linked immunoabsorbent assay (ELISA) tests if the diagnosis is unclear. Therapy is often supportive which may include: supplemental oxygen, fluids, and Fresh Essays - Application Letter upright positioning.

Aerosolized ribavirin is the only known proven therapy for RSV infection, but its expense, potential toxicity, difficulty of Yhst-67750632302622_2267_509780775 administration, and lack of conclusive evidence for its efficacy (24,26) limit its use. Schaaf, Spot! The use of bronchodilators and corticosteroids are controversial and may only be mildly effective at best (i.e., not been proven to be highly efficacious) (24-26). For those with moderate to Yhst-67750632302622_2267_509780775, severe disease, helium-oxygen mixtures or nasal continuous positive airway pressure may be beneficial in improving gas-exchange and symptomatology (27-30). Montelukast, a leukotriene antagonist, has recently been reported to make a difference in future wheezing episodes (31). Form 7246! Prophylaxis with palivizumab (RSV monoclonal antibody) or RSV-IVIG is given to select pediatric populations recommended by the American Academy of Pediatrics during RSV season to reduce RSV infection risk (32). Growing premature infants and infants with congenital heart disease and other chronic lung conditions are at increased risk for Yhst-67750632302622_2267_509780775 RSV pneumonia, apnea and respiratory failure. Fresh Essays - Application Letter Vacation! Healthy term infants with RSV usually develop mild bronchiolitis. Older children, teens and adults with RSV will usually have cold symptoms. Bronchiolitis is Yhst-67750632302622_2267_509780775 usually a self limited disease and complete resolution takes about 4-8 weeks. Poster Templates! In neonates and young infants, bronchiolitis may present with apnea and minimal respiratory symptoms, but the apnea is usually short-lived (33).

Although bronchiolitis self-resolves, patients with RSV bronchiolitis may be predisposed to future episodes of wheezing (34). RSV infection can recur since there is an Yhst-67750632302622_2267_509780775 incomplete and Marco Schaaf, Illustrator, Creates Storyboard poorly sustained immune response (23). In summary, bronchiolitis and pneumonia significantly impact the pediatric population. Determining likely etiologies of Yhst-67750632302622_2267_509780775 pneumonia and understanding effective treatment modalities will improve patient outcomes. Acknowledgments: I would like to How To Draft An Employee, thank Edward Fong, MD, Leslie Barton, MD and John Mark, MD for their critical review of the chapter. 1. Which of the Yhst-67750632302622_2267_509780775, following is the most common cause of Schaaf, Storyboard Spot pneumonia outside of the neonatal period? 2. S. pneumonia resistance to penicillins is due to: . . . . . a. Production of beta-lactamase. . . . . . b. Yhst-67750632302622_2267_509780775! Alteration of penicillin binding proteins. . . . . . c. Increased efflux pumps.

. . . . . Loss News Calendar! d. Low tissue bioavailability. 3. True/False: Nasopharyngeal and throat cultures are useful in determining etiology of Yhst-67750632302622_2267_509780775 bacterial pneumonia. 4. True/False: Lobar consolidation on chest x-ray provides conclusive evidence for bacterial pneumonia. 5. Which factor does not appear to Fresh - Application For Annual, affect the etiology of pneumonia? . . . Yhst-67750632302622_2267_509780775! . . How To Agreement: 13 Steps! b. Vaccination status. . . . . . c. Current antibiotic use. 6. Yhst-67750632302622_2267_509780775! The most common cause of bronchiolitis is: . . . An Employee Noncompete 13 Steps! . Yhst-67750632302622_2267_509780775! . a. Respiratory syncytial virus.

. . . . Weight Loss & Event! . b. Human Metapneumovirus. 7. True/False: Bronchiolitis may initially present with apnea and minimal respiratory symptoms. 8. Treatment of bronchiolitis should include all of the following except: a. Supplemental oxygen for infants with hypoxia. b. Intravenous fluids and Yhst-67750632302622_2267_509780775 close monitoring of nutritional status. c. Good handwashing. d. Antibiotics. 9. True/False: Corticosteroids and bronchodilators are highly efficacious therapies for RSV bronchiolitis. Pneumonia case presenting with abdominal pain: Yamamoto LG. Abdominal Pain with a Negative Abdominal Examination. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Schaaf, Illustrator,! Radiology Cases In Pediatric Emergency Medicine, 1994, volume 1, case 3. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v1c03.html. Staph pneumonia case: Yamamoto LG, Young LL. Tachypnea and Abdominal Pain.

In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 2, case 5. Yhst-67750632302622_2267_509780775! Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v2c05.html. Series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. Essays - Application! In: Yamamoto LG, Inaba AS, DiMauro R (eds). Radiology Cases In Pediatric Emergency Medicine, 1995, volume 3, case 20. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v3c20.html.

Another series of pediatric chest radiographs: Yamamoto LG. Test Your Skill In Reading Pediatric Chest Radiographs. In: Yamamoto LG, Inaba AS, DiMauro R (eds). Yhst-67750632302622_2267_509780775! Radiology Cases In Pediatric Emergency Medicine, 1996, volume 4, case 5. Available online at: www.hawaii.edu/medicine/pediatrics/pemxray/v4c05.html. 1. & Event Calendar! Graham NMH. The Epidemiology of Acute Respiratory Infection in Children and Yhst-67750632302622_2267_509780775 Adults: A Global Perspective. Epidemiol Rev 1990;12:149-178. 2. National Center for Health Statistics. National Vital Statistics report (www.cdc.gov) 2001;49(1):14. 3. Dixon RE.

Economic Costs of Respiratory Tract Infections in Weight Loss | Diet Plan News Calendar the United States. Am J Med 1985;78(6B): 45-51. 4. Miller MA, Ben-Ami T, Daum RS. Chapter 39-Bacterial Pneumonia in Neonates and Older Children. In: Taussig LM, Landau LI (eds). Pediatric Respiratory Medicine, first edition. 1999, St.

Louis: Mosby, pp. 595-664. 5. Dowell SF, Kupronis BA, Zell ER, Shay DK. Mortality From Pneumonia in Yhst-67750632302622_2267_509780775 Children in the United States, 1939 Through 1996. N Engl J Med 2000;342(19):1399-1407. 6. Bradley JS. Management of Community-Acquired Pediatric Pneumonia in an Era of How Do A Cover Letter Resume - Template Increasing Antibiotic Resistance and Conjugate Vaccines. Pediatr Infect Dis J 2002;21(6):592-598. 7. Nohynek H, Valkeila E, Leinonen M, Eskola J. Erythrocyte Sedimentation Rate, White Blood Cell Count and Serum C-reactive Protein in Yhst-67750632302622_2267_509780775 Assessing Etiologic Diagnosis of Acute Lower Respiratory Infections in Children. Pediatr Infect Dis J 1995;14(6): 484-490.

8. Nelson J. Community-Acquired Pneumonia in Children: Guidelines for Treatment. Pediatr Infect Dis J 2000;19(3):251-253. 9. Heiskanen-Kosma T, Korppi MN, Jokinen C, et al. Etiology of Childhood Pneumonia: Serologic Results of a Prospective, Population-Based Study. Weight | Diet News & Event Calendar! Pediatr Infect Dis J 1998;17(11):986-991. 10. McIntosh K. Community-Acquired Pneumonia in Children. N Engl J Med 2002;346(6);429-437. 11.

Ruuskanen O, Mertsolon J. Childhood Community-Acquired Pneumonia. Sem Resp Infect 1999;14(2):163-172. 12. Yhst-67750632302622_2267_509780775! McCraken, GH Jr. Etiology and Treatment of Poster Templates Pneumonia. Pediatr Infect Dis J 2000;19(4):373-377. 13.

Korppi M, Kiekara O, Heiskanen-Kosma T, Soimakallio S. Comparison of Radiological Findings and Microbial Aetiology of Childhood Pneumonia. Yhst-67750632302622_2267_509780775! Acta Paediatr 1993;82: 360-363. 14. Overturf GD, Committee on Infectious Diseases, American Academy of Pediatrics. Technical Report: Prevention of Pneumococcal Infections, Including the Use of Pneumococcal Conjugate and Polysaccharide Vaccines and Antibiotic Prophylaxis. I Write A Cover Resume! Pediatrics 2000;106(2):367-376. 15. Brook I, Finegold SM. Bacteriology of Aspiration Pneumonia in Children.

Pediatrics 1980;65(6):1115-1120. 16. Laurenzi GA, Potter RT, Kass EH. Bacteriologic Flora of the Lower Respiratory Tract. N Engl J Med 1961;265:1271-1278. 17. Green GM, Kass EH.

The Role of the Alveolar Macrophage in the Clearance of Bacteria from the Lung. Yhst-67750632302622_2267_509780775! J Exp Med 1964;119:167-175. 18. Tuomanen EI, Austrian R, Masure HR. Pathogenesis of Pneumococcal Infection. N Engl J Med 1995(19);332:1280-1284. 19. Wildin SR, Chonmaitree T, Swischuk LE. Roentgenographic Features of Common Pediatric Viral Respiratory Tract Infections.

Am J Dis Child 1988;142:43-46. 20. Essays - Application! Hart CA, Duerden BI. Yhst-67750632302622_2267_509780775! Respiratory Infections. J Med Microbiol 2002;51:903-914. 21. Whitney CG, Farley MM, Hadler J, et al. Fresh Essays Letter Leavesample Vacation! Increasing Prevalence of Multidrug-Resistant Streptococcus Pneumoniae in Yhst-67750632302622_2267_509780775 the United States. N Engl J Med 2000;343(26):1917-1924. 22. Grossman LK, Wald ER, Nair P, Papiez J. Roentgenographic Follow-Up of Acute Pneumonia in Children.

Pediatrics 1979(1);63:30-31. 23. Hall CB. Respiratory Syncytial Virus and Parainfluenza virus. N Engl J Med 2001;344(25):1917-1928. 24.

Greenough A. Respiratory Syncytial Virus Infection: Clinical Features, Management, and Prophylaxis. Curr Opin in Templates Pulm Med 2002;8:214-217. 25. Jartti T, van den Hoogen B, Garofalo RP, et al. Yhst-67750632302622_2267_509780775! Metapneumovirus and Acute Wheezing in Children. Lancet 2002;360:1393-1394.

26. Patel H, Platt RW, Pekeles GS, Ducharme FM. A Randomized Controlled Trial of the Effectiveness of Nebulized Therapy with Epinephrine Compared with Albuterol and Saline in Infants Hospitalized for Acute Viral Bronchiolitis. J Pediatr 2002(6);141:818-824. 27. Hollman G, Shen G, Zeng L, et al.

Helium-Oxygen Improves Clinical Asthma Scores in Children with Acute Bronchiolitis. Crit Care Med 1998;26(10):1731-1736. 28. Martinon-Torres F, Rodriguez-Nunez A, Martinon-Sanchez JM. Heliox Therapy in Marco Schaaf, For Tv Infants with Acute Bronchiolitis.

Pediatrics 2002(1);109:68-73. 29. Beasley JM, Jones SEF. Continuous Positive Airway Pressure in Bronchiolitis. British Medical Journal 1981;283:1506-1508. 30.

Soong W, Hwang B, Tang R. Continuous Positive Airway Pressure by Nasal Prongs in Bronchiolitis. Yhst-67750632302622_2267_509780775! Pediatr Pulmonol 1993;16:163-166. 31. Bisgaard H for the Study Group on Montelukast and Respiratory Syncytial Virus. A Randomized Trial of Montelukast in Respiratory Syncytial Virus Postbronchiolitis. Am J Respir Crit Care Med 2003;167:379-383. 32. Halsey NA, Abramson JS, Chesney PJ, et al.

American Academy of Fresh Essays - Application For Annual Vacation Pediatrics: Prevention of Respiratory Syncytial Virus Infections: Indications for the Use of Palivizumab and Update on Yhst-67750632302622_2267_509780775 the Use of RSV-IGIV. Pediatrics 1998;102(5):1211-1216. 33. Bruhn FW, Mokrohisky ST, McIntosh K. Apnea Associated with Respiratory Syncytial Virus Infection in Young Infants. J Pediatr 1977;90:382-386. 34. Sigurs N, Bjarnason R, Sigurbergsson F, Kjellman B. Respiratory Syncytial Virus Bronchiolitis in Infancy is an Important Risk Factor for Asthma and Allergy at Age 7. Am J Respir Crit Care Med 2000;161:1501-1507. Answers to questions. 1.c. Overall, viruses cause the Form 7246, majority of Yhst-67750632302622_2267_509780775 pneumonias in children; however, the incidence of viral pneumonia decreases with age, becoming less common in older children and adolescents. 4.False.

Lobar pneumonias are more likely to be of bacterial etiology, but this is not definitive since some lobar pneumonias will still be viral.

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London, 2008, Sept 12. 6. | Free & Backgrounds. Print. Note: Do not forget that while you are listing a book cited in your MLA essay, you have to italicize the title of a book, and in the case of a periodical, italicize the title of the periodical and not the title of the article. The month of publication has to Yhst-67750632302622_2267_509780775, be abbreviated (For example, Jan., Dec., etc.). How To Agreement:. Only May, June and July are never abbreviated. The qualified writers of P rof E ssays.com will help you to Yhst-67750632302622_2267_509780775, format your MLA essay according to the adopted rules. The general rules of formatting on-line sources in MLA style written essays coincides with that established to Physicians | Diet Calendar, formatting books and periodicals. The former requirement of representing the URL address of cited on-line source is Yhst-67750632302622_2267_509780775, simplified in Plan News & Event, the last edition of the MLA format rules. However, if your instructor still wants to see the Yhst-67750632302622_2267_509780775 URL in Poster Templates | Free Poster Templates, your MLA format reference list, you may include this information. The URL has to be indicated as additional information after the author’s name, article title, publisher’s name and Yhst-67750632302622_2267_509780775, year of Weight | Diet Plan News Calendar edition.

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Though the preferable format of a MLA essay includes the in-text citation, the Footnotes and How To Draft An Employee 13 Steps, Endnotes may still be used in the custom essay, research or term paper that is Yhst-67750632302622_2267_509780775, written in the MLA style. Footnotes and Physicians Loss Plan Calendar, Endnotes are marked out in the text by Arabic numbers in Yhst-67750632302622_2267_509780775, superscript. The footnotes are indicated at the foot of every page and Form 7246, the endnotes are indicated at Yhst-67750632302622_2267_509780775, the end of your paper on a separate page. Custom essay writing service providers, such as P rof E ssays.com , will help you to format the MLA footnotes and endnotes and to write an excellent custom essay, research or term paper. Please do not confuse headings with a header ! A header with author’s name is typed next to the page number at the top of each page. Poster Poster. While heading refer to the title of Yhst-67750632302622_2267_509780775 your paper and the the Fresh - Application Leavesample titles of its sections. MLA does not have strict regulations regarding the use of headings, just some general norms: The headings of the MLA essay are usually typed in same font and size as the Yhst-67750632302622_2267_509780775 rest of the paper, however you are free to Poster Templates, italicize them or type in Yhst-67750632302622_2267_509780775, bold. The title of the MLA paper should be centered.

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It should go without saying, but make sure your resume is free and clear of typos. And don’t rely on spell check and grammar check alone—ask family or friends to take a look at it for you (or get some tips from an Agreement: editor on how to perfect your own work ). If emailing your resume, make sure to always send a PDF rather than a .doc. That way all of Yhst-67750632302622_2267_509780775, your careful formatting won’t accidentally get messed up when the hiring manager opens it on his or her computer. To make sure it won’t look wonky when you send it off, Google’s head of HR Laszlo Bock suggests, “Look at it in both Google Docs and Word, and then attach it to an email and open it as a preview.” Ready to I Write A Cover Letter For My Resume - Template, save your resume and send it off? Save it as “Jane Smith Resume” instead of Yhst-67750632302622_2267_509780775, “Resume.” It’s one less step the hiring manager has to How Do A Cover For My, take. Carve out Yhst-67750632302622_2267_509780775, some time every quarter or so to pull up your resume and make some updates. Have you taken on new responsibilities? Learned new skills? Add them in. When your resume is Poster Templates | Free Poster Templates, updated on a regular basis, you’re ready to pounce when opportunity presents itself. And, even if you’re not job searching, there are plenty of Yhst-67750632302622_2267_509780775, good reasons to keep this document in tip-top shape.

Photo courtesy of Hero Images / Getty Images . Erin Greenawald is a freelance writer, editor, and content strategist who is passionate about elevating the standard of writing on the web. Erin previously helped build The Muse’s beloved daily publication and led the company’s branded content team. If you’re an individual or company looking for help making your content better—or you just want to go out to tea—get in Physicians Weight Loss Plan & Event, touch at eringreenawald.com. Hmmm, seems you#39;ve already signed up for this class. While you#39;re here, you may as well check out Yhst-67750632302622_2267_509780775, all the Physicians Weight | Diet News, amazing companies that are hiring like crazy right now.

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Adam, the Fall, and Original Sin: A Review Essay. Stephen N. Williams. Stephen Williams is professor of Yhst-67750632302622_2267_509780775 systematic theology at Union Theological College in Belfast, Northern Ireland, and served as general editor of Themelios from 1995 to 1999. The contributors to Adam, the Fall, and Original Sin rightly maintain the | Free Templates & Backgrounds traditional view of the Yhst-67750632302622_2267_509780775 historicity of Adam and the entry of Form 7246 sin into the world through him. However, the account displays three weaknesses. Firstly, the inerrant authority of Scripture is sometimes interpreted as entailing that the Ancient Near Eastern context of Genesis sheds no light on how it should be read. Secondly, the question of why humans are justly condemned for the sin of Adam is never answered. Thirdly, no ground for Yhst-67750632302622_2267_509780775, dialogue with science is provided. Draft Noncompete! It is Yhst-67750632302622_2267_509780775, more successful in indicating what we should affirm than in grappling with the difficulties of affirming it. Tritely told, the Form 7246 story goes like this. Yhst-67750632302622_2267_509780775! Religious belief, in How To Draft its very principle, is a matter of opinion, and when opinion is converted into dogmatism, that has been and is a recipe for Yhst-67750632302622_2267_509780775, social conflict.

Scientific belief may, in practice, also be a matter of opinion, but it possesses what religious belief does not: the capacity to be based on evidence which may amount to knowledge. It provides a basis for social well-being. Science is the Agreement: product of reason; religion is the Yhst-67750632302622_2267_509780775 product of Agreement: 13 Steps faith. So much for principle. As for application, Darwinism has long demonstrated the broad scope and mechanism of our evolutionary history and decisively undermined biblical anthropology. There is a choice: a faith-based religious anthropology or a reason-based neo-Darwinian anthropology. It is obvious which constitutes the intellectually responsible option. Yhst-67750632302622_2267_509780775! An historical Adam, fall and original sin does not.

Hans Madueme and Michael Reeves have gathered together a team of authors resolved to combat this position, not in the spirit of those who merely do not wish to cede this particular piece of Schaaf, Swiss Creates Storyboard For Tv territory but with the conviction of those who regard this combat more or less as a battle for the existence of Christianity.1 Their aim is to persuade, but the audience is strictly limited; one of the essayists, Carl Trueman, justifiably says that he assumes ‘that this volume is Yhst-67750632302622_2267_509780775, aimed primarily at a Protestant evangelical readership’. It is aimed at Draft Noncompete Agreement: 13 Steps, this audience because self-regarding evangelicals are now among those taking up positions once associated with non-evangelicals, specifically when they question the Yhst-67750632302622_2267_509780775 historicity of Adam and Eve. Hence, in part 1, the contributors deal with Adam and Eve in the Bible. Rather than jump from that point into Form 7246, original sin in Scripture, an essay on ‘Adam and Modern Science’ closes this part before the second part of the volume traces the doctrine of original sin in the history of theology. Then come four essays which concentrate on the substantive theological question of original sin in our day before a fourth and final part deals again with biblical materials not in order to investigate their witness to the historicity of Adam but to examine what they say about the fall. The closing essay is on ‘Adam, History and Theodicy’. I am grateful for the invitation to write an article review of this volume. It is a little unusual for someone whose published commendation of Yhst-67750632302622_2267_509780775 a volume appears on the volume itself to be reviewing it. On the Loss | Diet Plan & Event Calendar basis of correspondence extending over two or three years, by now, Hans knows that we differ on some significant points and it is not only gracious but also a sign of transparency on his part to promote this exchange in Yhst-67750632302622_2267_509780775 Themelios . If I concentrate on points of Marco Schaaf, difference, it is only because this best serves our present purpose. Some essays are stronger than others, but I shall not be trumpeting my opinion on the quality of individual essays.

It is as well to Yhst-67750632302622_2267_509780775, place my commendatory cards on the table from the outset. On the question of the historical existence of Adam and the entry of sin into the world through him, I believe that the Fresh For Annual Leavesample tradition both rightly interprets Scripture and Yhst-67750632302622_2267_509780775 rightly stands theologically by its teachings. Here, I find that the volume is persuasive, and I am now happy to A Cover, say so. C. John Collins and Robert Yarbrough get us off to a good start, their chapters laying down the solid foundations on which subsequent theological exploration can be built. After a study of Genesis 1–5, Collins describes the way in Yhst-67750632302622_2267_509780775 which ‘the rest of the Old Testament refers to, evokes, or presupposes the story of Adam and Eve’ (p. 5). Letter Resume! Crucial to this argument is the claim that OT materials demonstrate this reference even when the Yhst-67750632302622_2267_509780775 story is not explicitly cited. A sample of extra-biblical Jewish writings from the Second Temple period interprets the Genesis story similarly, so ‘the whole Old Testament story presupposes the historical significance of Adam and Eve as the fountainhead of humanity and Marco Schaaf, Creates For Tv Spot as the doorway by which sin came into God’s world’ (p. 5).

Robert Yarbrough follows this through in Yhst-67750632302622_2267_509780775 relation to - Application Letter Vacation, the NT, establishing the continuity between Pauline and OT presuppositions in relation to the role of Adam in the entry of sin into the world. Their common hermeneutic enables these two essays to provide a united front; as Yarbrough puts it, ‘paucity of direct reference to Adam is no necessary indicator of his significance’ (p. 41). I have plunged into this account off the springboard of my published commendation of this volume. Yhst-67750632302622_2267_509780775! Let me now plunge into Poster Templates | Free, demurral, a rather nasty-sounding metaphor which is not designed to signal a nasty-spirited response. While Collins and Yhst-67750632302622_2267_509780775 Yarbrough persuasively show why we should demur from Peter Enns’s conclusion that Paul is giving an account of Adam discontinuous with that of the OT, the essay which sets out most deliberately to tackle Peter Enns, namely James Hamilton’s later contribution on ‘Original Sin in Biblical Theology’ in the third part of the volume, fails to come to effective grips with Enns’s reasoning in some key areas. Schaaf, Illustrator, Creates Storyboard Spot! As Enns figures prominently in the preface of Yhst-67750632302622_2267_509780775 this volume, it is appropriate to linger here.

Consistently with the earlier essays, Hamilton emphasizes against Form 7246 Enns the distinction between telling and Yhst-67750632302622_2267_509780775 showing and the way in which narratives work. He is surely right, as he is to challenge Enns’s exegetical dogmatism on such a text as Hosea 6:7 (pp. 201–2). However, it seems to me that there are three difficulties in Hamilton’s criticism of Enns. Firstly, it is Templates, misleading to say that Enns ‘ignores the way the Yhst-67750632302622_2267_509780775 biblical authors are assuming and operating within the How Do A Cover Letter For My world as Moses has defined it’ (p. 204).

Enns does not ignore it; the fact of the matter is that, on Yhst-67750632302622_2267_509780775, critical grounds, he has a different view of Pentateuchal authorship and Form 7246 dating from that of Hamilton, whose view he regards as demonstrably improbable in the extreme. As far as Enns is concerned, we do not know who wrote, e.g., Deuteronomy; it could have been anyone up to and including Ezra.2 If we do not understand the OT as a whole in its post-exilic setting, on which there is Yhst-67750632302622_2267_509780775, considerable scholarly consensus, we shall not understand what it is trying to do and that includes what is Form 7246, going on in its opening chapters. In sum, since Moses did not define the world in which the biblical authors are operating, there is nothing to ignore. Yhst-67750632302622_2267_509780775! That is Enns’s position. Secondly, there seems to How Do I Write For My - Template, be a vast methodological gulf between Hamilton and Enns and it seems to Yhst-67750632302622_2267_509780775, me that Hamilton is on the wrong side of that gulf, so that his earlier hermeneutical gain is offset by hermeneutical loss. I allude to Hamilton’s claim that ‘[t]he only access we have to For My Resume - Template, what the biblical authors thought or assumed is what they wrote’ (p. 189). This is deeply problematic. If the claim were that, de facto , we know too little about the ANE background of the OT for it to cast any light on what biblical authors thought or assumed, that would be one thing and contentious enough at that. However, the point seems to be one of methodological principle and, as such, presumably amounts to the claim that the Bible is an exception to rules of general hermeneutics. Yhst-67750632302622_2267_509780775! This seems to rule out groundlessly and mistakenly the possibility of interpreting biblical authors in their cultural (ANE) context.

There is certainly plenty to discuss in relation to Poster | Free Poster Templates & Backgrounds, how ANE and canonical contexts should be related, but why should a ‘high’ view of biblical inspiration entail the Yhst-67750632302622_2267_509780775 claim that a writer’s thought or assumptions is accessible only through what he writes? If space prevents Hamilton from giving a hermeneutical account, at least the hermeneutical disagreement with Enns ought to be couched explicitly not only in Marco Swiss Illustrator, Creates Storyboard For Tv Spot terms of the distinction between telling and showing, but also in terms of reading Genesis against its ANE background. Certainly, Enns emphasizes ANE background, observing that ‘[i]t is routinely understood, even by conservative interpreters, that the cultural context of Scripture informs our understanding of Scripture’.3. Have I fairly represented Hamilton’s position? If I am missing something, at least my comments bring into view an apparently similar attitude by Yhst-67750632302622_2267_509780775, a later essayist. Noel Weeks, in his essay on ‘The Fall and Genesis 3’, refuses to Physicians Weight Loss | Diet & Event Calendar, interpret the early chapters of Genesis in Yhst-67750632302622_2267_509780775 conjectural terms derived from ANE Egyptian or Mesopotamian texts. Weight Loss News & Event! He states his principle like this: ‘Rather than conjectures, we have to go to the text itself to know what it means. Yhst-67750632302622_2267_509780775! Belief in the divine inspiration of A Cover For My Scripture would lead us to that approach anyway’ (p. 292).

This is to Yhst-67750632302622_2267_509780775, confuse issues of For Annual authority with issues of interpretation. Belief in the divine inspiration of Scripture is Yhst-67750632302622_2267_509780775, belief in Form 7246 its authority, but such a belief neither prescribes nor suggests such a hermeneutic. True, we should not build anything on conjecture, but that is different from apparently dividing up the hermeneutical world into Yhst-67750632302622_2267_509780775, what is conjectured and what is in the text. The same problem arises when Weeks proceeds to Poster Templates Poster Templates, comment that he is Yhst-67750632302622_2267_509780775, not ‘adopting the I Write A Cover For My canonical approach of Brevard Childs, for that method presupposes an earlier chaotic history for the text but ignores that history because it leads into a chaos of conjecture from which no meaningful interpretation can emerge’ (p. 292). Certainly, when it comes to Yhst-67750632302622_2267_509780775, the de facto critical investigation of the OT, there has long been sufficient chaotic speculation out there to tempt us to think that the whole enterprise is Marco Swiss Illustrator, For Tv Spot, radically unstable de jure . However, the proper response is a rigorous appropriation and hermeneutical use of ANE and extra-biblical materials, not what looks like an attempt to seal off the biblical world hermeneutically, an impossibility in any case if we are going to read the original languages. Thirdly, returning to Hamilton, it is tendentious and emotive to say that Enns seeks the kind of Yhst-67750632302622_2267_509780775 synthesis between the Bible and evolution ‘where the Bible bows the knee to evolution’ in practice (p. 196). In context, this claim is Form 7246, connected with the first two points and Yhst-67750632302622_2267_509780775 it is worth adding that Enns’s treatment of universality and particularity in the relevant Genesis account is a little more nuanced than Hamilton implies.4 Enns certainly does highlight the evolutionary factor in his approach to the biblical text.

This review is not the How To Draft 13 Steps place to Yhst-67750632302622_2267_509780775, evaluate the way in which he sets about a synthesizing operation. To be useful, such an evaluation would have to be suspended on an account of how this synthesizing procedure is related both to his exegetical practice and to his view of the nature of biblical authority. Templates Templates & Backgrounds! I note here only that it is one hermeneutical thing to read the Bible against its ANE background, knowledge of which might directly inform our reading of the text, another hermeneutical thing to read it against the background of a scientific view, knowledge of which should not directly shape our reading. For example, in principle the ANE material may help me to interpret the Yhst-67750632302622_2267_509780775 biblical material by Letter Resume, disclosing to me the world of the biblical writer; contemporary scientific views do not attain that. However, if I am convinced both of some current scientific position and of biblical inerrancy, I shall believe that a prima facie reading of the biblical text which contradicts that scientific position has to be revised. Yhst-67750632302622_2267_509780775! This, as such, is not to bow the knee; it is to seek the integration of beliefs and to An Employee Noncompete 13 Steps, allow that it is my interpretation of the Bible, not the Yhst-67750632302622_2267_509780775 Bible itself, that needs correction. How Do I Write A Cover Resume - Template! What science can do is to help me to read the Bible on its own terms (which includes in its own context); it does not dictate the reading. It goes without saying that this operates equally vice versa : if I am convinced both of biblical inerrancy and the correctness of a biblical interpretation, it is the prima facie scientific account that has to Yhst-67750632302622_2267_509780775, be reassessed in the event of collision.

I am not comprehensively evaluating here what Enns is doing overall; the question of his attitude to biblical authority in this context is most tellingly focussed on his treatment of Paul. But what would Hamilton make of the accusation that to Marco Schaaf, Swiss Illustrator, Storyboard For Tv Spot, deny that Joshua really meant that the sun stood still is to bow the knee to Yhst-67750632302622_2267_509780775, post-Copernican heliocentricity? In point of fact, there is no conflict whatsoever between biblical observation-language about the movement of the sun—language which we continue to How To Noncompete Agreement: 13 Steps, use in the third-millennium—and the conviction that the sun does not move around the Yhst-67750632302622_2267_509780775 earth. The question is this: suppose someone is as convinced of evolution in the sense opposed by Hamilton as Hamilton is (presumably) convinced of heliocentricity. How Do I Write A Cover Letter For My! In that case, is Enns’s way of proceeding fairly described as a matter of bowing the knee? Is it that Enns is Yhst-67750632302622_2267_509780775, wrong in his attitude here or, rather, that he and Hamilton have different estimates of the status of I Write A Cover Letter For My a particular scientific view? Hamilton wonders ‘why evolution is so authoritative in Enns’s reckoning’ (p. 206); Enns will presumably equally wonder how it can fail to have that authority. Of course, whatever scientific authority a scientific proposal has, its hermeneutical status remains to be properly described and that, in turn, will lead us into the different discussion of the Yhst-67750632302622_2267_509780775 nature of apostolic authority.

However, the Essays Leavesample Vacation question of whether the evidence for the relevant kind of evolution is Yhst-67750632302622_2267_509780775, as strong as the evidence for a heliocentric view of the Fresh Essays - Application Letter For Annual Leavesample world is surely what really lies behind the question of whether there is knee-bowing going on.5. Concentrating on Hamilton’s essay risks giving the unfair impression that he is unrepresentative of his fellow-authors in carrying the burden of Yhst-67750632302622_2267_509780775 these criticisms, but that seems not to be the Schaaf, Illustrator, For Tv case, even if he is not always representative of all. To reiterate: it is only because of his engagement with Enns and Yhst-67750632302622_2267_509780775 only because much is made of Enns in the introduction to the whole volume that I have singled out How To this essay.6 As do the essayists in this volume, I demur both from Enns’s interpretation of the relationship between Pauline and Old Testament perspectives on Adam and his theological perspective on the historicity of Adam, so I am accompanying the essayists to first base.7. Suppose, then, that we are persuaded that the essayists give a fair account of how things stand biblically with Adamic historicity. How, now, do things stand theologically with original sin? There is plenty of good material in the essays in part 2, which deal with it historically. In the first of these, Peter Sanlon outlines Augustine’s thought, defending Augustine against the accusation that he invented the ecclesiastical doctrine of original sin. However, when Sanlon turns to a brief account of the Pelagian objection, trouble begins to brew which will later bubble up pretty fiercely with pressure on the theological defence of original sin in part 3. Sanlon notes the Pelagian objection that it is unjust to condemn Adam’s descendants for his sin. Judging by the silence of the essay, Augustine had no response this. Yhst-67750632302622_2267_509780775! On human will and on divine mercy Augustine has plenty to say, but here there seems to be nothing.

Will Lutheranism step into the breach and fill the void? There is Templates | Free Poster Templates & Backgrounds, no essay on Yhst-67750632302622_2267_509780775, medieval thought in this volume, so Lutheranism is next in line and we have a characteristically informed account of original sin in the Lutheran tradition by Robert Kolb. Noncompete Agreement:! On the Yhst-67750632302622_2267_509780775 one hand, we should beware the danger of failing to attend properly to that tradition in its own right by reading his essay as though its agenda must be set by Augustine’s contribution. On the other, Lutheranism entered into A Cover Letter - Template, mainstream Augustinian inheritance on the matter at hand and we are entitled to wonder whether the question of the justice of the condemnation of Adam’s progeny will rear its head and, if so, whether it will be addressed. The question of Yhst-67750632302622_2267_509780775 justice indeed arises, but Augustinian silence on Poster Poster & Backgrounds, it remains unbroken. In Kolb’s essay, we learn again of the human will and of divine mercy, but again not of how our condemnation for the sin of Adam can be regarded as just. Yhst-67750632302622_2267_509780775! Of course, this is accounted for in part by the sixteenth century context of Form 7246 Lutheran theology. For example, when Martin Chemnitz examines Tridentine teaching on original sin, the question of fundamental justice is not what is at issue.

Yet, when Melanchthon tells us that it is the Yhst-67750632302622_2267_509780775 theological responsibility of the church to unfold and explain its brief doctrinal statements, we might expect something more; but Melanchthon does not offer it in the form which should interest a reader of Form 7246 this volume and where Melanchthon does not go, Chemnitz is Yhst-67750632302622_2267_509780775, unlikely to Form 7246, go.8 When, then, Kolb describes in laudatory tones Luther’s achievement and his grasp of paradox, the Yhst-67750632302622_2267_509780775 Augustinian problematic remains stonily untouched and unmoved in the scenic background. Fresh - Application Letter! Perhaps the tacit assumption is that if we acknowledge paradox in our talk of Yhst-67750632302622_2267_509780775 original sin and human responsibility, paradox must play its part in our understanding of divine justice. Is that the way to read the How Do I Write Lutheran appropriation of Augustinian teaching? However we answer that question, in Yhst-67750632302622_2267_509780775 any list of unlikely accusations against Letter For Annual Leavesample Calvin, the accusation of Yhst-67750632302622_2267_509780775 refusing to grasp the nettle and of being silent when speech is owed should come pretty high up. Physicians | Diet Plan News! Accordingly, if we expect the tradition which he inaugurated to Yhst-67750632302622_2267_509780775, address our concerns, we shall not be disappointed.

Donald Macleod guides us helpfully through it. After taking us through the theological development of the Poster covenant of works, he faces the Yhst-67750632302622_2267_509780775 question head-on: ‘How, in accordance with justice, could the one sin of one man have such calamitous consequences?’ (p. 137). Once the Templates Templates & Backgrounds question is Yhst-67750632302622_2267_509780775, introduced, it dominates. Macleod supplies the Augustinian (Augustine’s own) answer, which Sanlon does not: by virtue of the fact that we are one with Adam. In what sense are we one, not for Augustine, but for the Reformed tradition? The answer is: by federal unity. Macleod traces the debates on immediate and mediate imputation that surround that answer, in which context the question of justice is lively. Federal union secures the justice of our condemnation. What is both interesting and Templates | Free Templates & Backgrounds significant is that, at the end of his essay, Macleod observes that, in the Reformed tradition, we are still left with the question (among others): exactly ‘[w]hy, for example, should the sin of Adam involve all his offspring in Yhst-67750632302622_2267_509780775 guilt?’ (p. 146).

Against the background of this essay and of the Augustinian inheritance, it is a question which patently embraces the issue of divine justice. As a theologian, Macleod may have his answer; as a historian—and that is his role here—he is implying that his account of A Cover Letter For My federal union in the classical tradition of Yhst-67750632302622_2267_509780775 Reformed theology has not laid that question to rest. It may be worth adding one footnote to this account. Macleod mentions that the one man who withstood the standard Reformed view of the federal relationship between Adam and posterity was W. G. T. Shedd, who adopted the position that human nature and all humans were present in Adam. My supplementary observation is that it is precisely the issue of Form 7246 justice which apparently drove Shedd to make his proposal. Shedd believed that the imputation to his posterity of the sin of Yhst-67750632302622_2267_509780775 a vicarious representative violates the order of justice.9 We may and, I believe, should reject the theological substance of Shedd’s position, but how should we respond to its guiding purpose? Perhaps the Wesleyan tradition will tell us. Again, preoccupation with the question of justice should not be allowed to prevent that tradition from speaking on Form 7246, its own terms and, in a fine essay, Thomas H. McCall permits it to do just that. Yhst-67750632302622_2267_509780775! Wesley was a federalist and the federal tradition is largely kept up in mainstream Wesleyanism until the late nineteenth century. It is a lively and Schaaf, Swiss Illustrator, Storyboard For Tv Spot enquiring federalism which incorporates into its developments the question of divine justice in relation to our damnation for the sin of Adam.

It also becomes a federalism rejected within the tradition, along with other components of the doctrine of original sin. Yhst-67750632302622_2267_509780775! It is just as interesting that McCall makes a studious theological proposal as it is that Macleod shows a studious theological restraint. After noting the modern turn against the classical Wesleyan understanding of original sin as embracing original guilt, McCall proposes two possibilities for those who want to retain the principle. The first is a fresh working of the notion of Poster Templates Poster mediate imputation. The second is to combine a version of that principle with other principles whose theological upshot is that, by ratifying what Adam did in his representation of us, we are guilty both for Yhst-67750632302622_2267_509780775, our corruption and for our actions. These suggestions are briefly set out at Form 7246, the conclusion of the essay. When, then, we have read Carl Trueman’s essay on ‘Original Sin and Modern Theology’, which concludes this part of the volume, we might conclude that the Christian tradition had left modern theology with significantly unanswered questions on Yhst-67750632302622_2267_509780775, the doctrine of Fresh Essays Leavesample Vacation original sin. Whatever theological insights modern theology may yield—Trueman considers Schleiermacher, Rauschenbusch, Barth, Bultmann, Reinhold Niebuhr and Pannenberg—they are vitiated by rejection of the historicity of Adam.10 However, as far as our reading of Madueme and Reeves’s volume is concerned, we are bound to Yhst-67750632302622_2267_509780775, ask to what extent modern theological thinking on this question is the product of the failure of I Write For My Resume - Template orthodoxy to establish the theological credibility of its tenets. Trueman refers to Yhst-67750632302622_2267_509780775, ‘the typical modern concern for the idea of one person being considered guilty because of the failure of another’ (p. 180), but the earlier essays have shown that it is certainly not a distinctively modern concern attributable simply to those who reject some basic elements in the Christian tradition.

Accordingly, when the co-authors of this volume arrive on the scene in - Application For Annual its third part, they have given themselves a pretty demanding theological job to do. Their contributions are sandwiched between those of James Hamilton and Daniel Doriani (the latter on ‘Original Sin in Pastoral Theology’). Yhst-67750632302622_2267_509780775! In a joint essay, Madueme and Reeves tackle ‘Original Sin in Templates | Free Systematic Theology’ and, in an independent essay, Hans Madueme tackles ‘Original Sin and Modern Science’. I trust that my discussion hitherto has indicated the propriety of giving some space to these contributions quite independently of the appropriateness of Yhst-67750632302622_2267_509780775 doing so because Hans Madueme is responding to this article. In the joint essay, the Poster | Free Poster & Backgrounds authors argue for the dual necessities of belief in originating and Yhst-67750632302622_2267_509780775 originated sin.

If we do not believe in the former, we cannot avoid the conclusion that evil is a part of creation, and this is Templates | Free Poster, drastic. If we do not believe in the latter, interpreted as hereditary descent from the first human pair, the salvation from Yhst-67750632302622_2267_509780775, my sin wrought by Jesus Christ in countermanding the transgression of Adam is imperilled. Ontological union with Christ rescues me from ill-fated ontological union with Adam. The force of Madueme and Reeves’s first point (on originating sin) is hard to I Write Letter For My Resume - Template, avoid; the Achilles’ heel of the position which denies an historical fall is the Yhst-67750632302622_2267_509780775 theological implications for our view of Fresh Essays - Application For Annual evil in creation. Yhst-67750632302622_2267_509780775! In this context, we should also welcome the authors’ rescue of An Employee 13 Steps Irenaeus from those interpretations which make him an ally of that denial, although it is a pity that the historical account in Part 2 begins with Augustine and Yhst-67750632302622_2267_509780775 not with Irenaeus.

The second contention—on originated sin—is more troublesome. There are two difficulties here. One is the claim that, without monogenesis, God’s imputation of Adam’s sin to Adam’s race ‘seems unfair and arbitrary since it is not grounded in an antecedent natural reality’ (p. 217). However, this claim lacks force unless it can be shown that ontological union with Adam defuses the charge of unfairness and arbitrariness in the imputation of sin. Form 7246! Madueme and Reeves produce no argument to that effect. The second is the claim that I cannot know for sure that Christ has assumed ‘ my “human” nature’ (p.

216) unless I am monogenetically related to Adam and that ‘[d]enying that we inherit Adam’s original sin [understood in the sense of hereditary union] meant denying that sin has any real depth in us’ (p. 218). However, it is one thing to argue the exegetical case for the authors’ claim about an ontological link, quite another to argue its theological necessity in this fashion. I confess that I am reminded of the argument that if you deny the Yhst-67750632302622_2267_509780775 historicity of Adam, then belief in the historicity of Jesus Christ is unsafe. As though belief in Weight Loss Plan News the historicity of Jesus depended on belief in the historicity of Adam! Rather similarly, I know for sure that Christ has assumed my human nature and died for my sin; I know the unfathomable depth of Yhst-67750632302622_2267_509780775 my sin and dire corruption of Poster Templates my nature through the gospel or, if you like, through the New Testament witness.

I know it unshakeably while I may puzzle over how to understand it theologically, how to interpret Romans 5, or how to Yhst-67750632302622_2267_509780775, regard the relative claims of monogenism and polygenism.11. This brings me to a weakness in the volume as a whole, manifested especially in this essay. In rejecting interpretations of Genesis judged compatible with polygenesis, those interpretations which accept the Poster Poster contemporaneity with Adam of ‘humanlike contemporaries’, Madueme and Reeves aver that this looks like a ‘blatant contradiction to the biblical teaching’ and that ‘[o]ne looks in vain for any indication in Genesis 2–3 that there were any humans, or humanlike beings, other than Adam and Eve’ (p. 216f.). What is puzzling here is the total silence not only in Yhst-67750632302622_2267_509780775 this essay but in the whole volume of a key passage in this discussion: Genesis 4:14–17. The index to the volume indicates hundreds of biblical texts cited in this work, but Genesis 4:14–16 never turns up at all and Genesis 4:17 turns up only Marco Swiss Illustrator, Storyboard once in connection with 4:17–22, without hint of its significance for this debate (see p. 10). This, of course, is Yhst-67750632302622_2267_509780775, where we learn that Cain, after expressing the fear that his expulsion from the land which he was working will make him a wanderer liable to be murdered, settles down in Nod and gets married. It looks as though the text places him in a populated world. Of course, it cannot clearly be doing so, because of what has preceded it in Schaaf, Storyboard For Tv Genesis 2 and Yhst-67750632302622_2267_509780775 3. Then how should the chapters be related?

The possibilities are many. They are ignored in this volume. Madueme and Reeves also ignore the fact that they are committed to the goodness of original incest as the Schaaf, Illustrator, Storyboard For Tv Spot means of propagation according to God’s design, whether between siblings or between Adam and his daughters, Eve and her sons and Yhst-67750632302622_2267_509780775 so forth onto the possibility of Fresh Essays Letter For Annual Vacation uncles and aunts until the whole thing is (should we not say, mercifully?) avoided. Yhst-67750632302622_2267_509780775! Had the Form 7246 authors said that they were willing to accept this; had they explained why the affirmation that Cain’s wife must have been his sister does not really strain the text; had they added that neither is it strained by the supposition that those feared by Cain as he wandered away must have been his own kin and that he was either initially alone in Nod with his wife or had been joined by Yhst-67750632302622_2267_509780775, other unmentioned kin—had they said all this, the reader could have weighed the How Do Letter For My Resume - Template words and agreed or disagreed. As it is, the reader is made to feel like Walter de la Mare’s traveller at the moonlit door.12. Quite apart from what we might conclude about the literary genre of Genesis 2–3 (or 1–3, for that matter) studied in its own right, we must ask what light Genesis 4 throws on our reading of the preceding chapters just as we must ask to what reading of Yhst-67750632302622_2267_509780775 Genesis 4 those chapters point us.

These are questions arising from the text, but the significance of the possibility that Genesis 4 indicates Cain’s presence in Form 7246 a populated world bears on our ruminations on scientific (evolutionary) anthropology. This brings us to Madueme’s essay, ‘“On the Most Vulnerable Part of the Yhst-67750632302622_2267_509780775 Whole Christian Account”: Original Sin and Modern Science’. Madueme sets out in four steps to Marco Illustrator, Creates Storyboard For Tv Spot, answer the Yhst-67750632302622_2267_509780775 question of whether modern science compels either the abandonment or the How To Draft An Employee Noncompete 13 Steps radical revision of the traditional doctrine of original sin. First, he briefly describes the Yhst-67750632302622_2267_509780775 relevant post-Darwinian science-religion conflict; then, he looks at theological attempts to resolve it; third, he offers a methodological proposal ‘for how to begin resolving these problems in dialogue with Scripture and tradition’ (p. 227); finally, some concrete suggestions are made. I shall not comment here either on the brief historical remarks on Darwinian conflicts (the first step) or on Madueme’s account of unsatisfactory moves, including what commonly goes under the description ‘theistic evolution’ (the second step). The ‘jackpot’ question, says the I Write Resume author (p. 238), is the methodological one tackled in his third step. To the jackpot, then, we shall go.

The third step is executed in three moves. The first—strictly a ‘commitment’ rather than a ‘move’ (p. 241)—is an Yhst-67750632302622_2267_509780775, affirmation of biblical inerrancy. The second is an affirmation of Physicians Calendar ‘pneumatic certainty’, the testimony of the Spirit to the truth of Scripture. The third is an eclectic approach to scientific theories, testing them according to Scripture, which may or may not mean conflict. This means rejecting ‘the scientific consensus when it conflicts with the doctrine of originating sin’ (p. 245) and entering into dialogue with science in relation to originated sin.

An example of this latter is the way in which we might accept biological explanations of Yhst-67750632302622_2267_509780775 human behaviour which ‘prompt some conceptual clarification in hamartiology’ (p. 246), forcing us to distinguish between biological and moral explanations of certain human behaviour. What are we to make of this proposal? Well, if (a) commitment to Poster | Free & Backgrounds, biblical inerrancy is warranted and (b) we can be pneumatically certain that the Bible is the Word of God, then (c) an Yhst-67750632302622_2267_509780775, eclectic approach to scientific theories seems to How Do I Write Letter For My Resume, follow. What does not follow, at least in this account, is the Yhst-67750632302622_2267_509780775 possibility of dialogue. What Madueme calls ‘genuine dialogue with science’ (p. 248) is something quite different from that; it is, as he puts it himself, just a case of ‘[s]cience offering us data for theological reflection’ (p. 247). I confess that I cannot see how we have a methodological proposal here for resolving anything. The so-called resolution of the science-religion conflict lies in identifying what Scripture says and affirming that what Scripture says can be known to be true. So be it; but it just does not amount to a methodological proposal for a dialogue.

As it stands, it is just a statement of faith. So is there no dialogue in the volume? Its subtitle is: Theological, Biblical and Scientific Perspectives on (the title) Adam, the Fall, and Original Sin . Except in one essay, we do not really get a scientific perspective and this essay has a further intriguing distinction, that of being written pseudonymously. It also ‘aims to bring the traditional doctrines of Adam and the fall into conversation with the scientific data by outlining the expectations we harbor for the human fossil record based on the biblical witness and Loss | Diet Plan News & Event Calendar comparing these expectations with current data and theories of paleoanthropology’ (p. 54). A priori , then, ‘all humankind is connected by a line of ancestry to a single pair of specially created humans . . . there is no ancestral lineage that links humans reproductively with any other living or extinct animal species, including the apes and any fossil apelike creatures’ (p. 55, emphasis original). Correspondingly, William Stone (the pseudonymous author) expects the paleoanthropological record to show two things: (a) ‘that humans belong to a distinct “kind” from Yhst-67750632302622_2267_509780775, other primates’, and (b) ‘consistency with a single human lineage’ (p.

55). We approach the scientific evidence knowing beforehand what we expect to For My Resume - Template, find and not to find. And what do we find? We find that Adam is probably to be located at the root of the homo erectus to homo sapiens lineage almost 2 million years ago and Yhst-67750632302622_2267_509780775 that his progeny divided into different species. The latter is not really biblically or theologically problematic and the key move is to illustrate scientifically the discontinuity which we have expected theologically between the genus Homo and australopithecine genera. Of course (says Stone) this leaves problems unsolved. What do we do with the prima facie Bronze Age context of Genesis 4–5 or with Noah’s flood? We do not know; but we can expect to get there some time.

I leave it to properly qualified scientists to comment on Stone’s handling of the scientific data. Although there are occasional allusions to genetics, it is Poster Templates | Free & Backgrounds, fossils rather than genetics that interest William Stone; consequently, we have no essay in Yhst-67750632302622_2267_509780775 the volume which tackles crucial questions in scientific biology. Swiss Illustrator,! I shall cut to the chase by omitting also any discussion of the scientific reasoning involved in the essay and ask the question: what shall we make of Yhst-67750632302622_2267_509780775 Stone’s method of approach and its effect on the possibilities of conversation between Scripture and How Do A Cover Letter For My Resume - Template science? Certainly, if ‘x’ is known to be the case or if there are strong grounds for believing ‘x’, it is not only in Yhst-67750632302622_2267_509780775 order to bring that knowledge or belief into our evaluation of Physicians | Diet Plan News & Event Calendar any claims and Yhst-67750632302622_2267_509780775 theories—it is Physicians Weight Plan, necessary. That is the case whether the knowledge or belief is Yhst-67750632302622_2267_509780775, religious or scientific or anything else. Schaaf, Swiss! Methodologically, there is no objection in principle to a person bringing his or her religious beliefs to bear on Yhst-67750632302622_2267_509780775, scientific investigation; to say otherwise is to affirm that the outcomes of scientific investigation are, in principle, more certain than those of religious reasoning and that such an affirmation might take the form of a methodological commitment every bit as a priori as that of Stone. If there is & Event Calendar, a problem with what Stone does, it does not lie at this very general level.

Rather, it will lie in what happens in this case when his method is Yhst-67750632302622_2267_509780775, applied. Let the range of scientists tell us both what does happen here and what would happen if the field of genetics were treated in the same way.13. We know, of course, what the overall evaluation of How Do A Cover For My Resume Stone’s conclusions will be in mainstream science (at least in general; I do not myself know what will be made of Yhst-67750632302622_2267_509780775 every detail in the argument). How Do A Cover For My Resume! Here, we are in the neighbourhood of an issue which Madueme also faces in his essay: just how secure do scientific ‘findings’ have to be in Yhst-67750632302622_2267_509780775 order to overthrow theological conclusions? Madueme is willing to An Employee, allow that, in principle, scientific evidence may be so compelling that it forces us to revise the traditional doctrine of original sin. However, he believes that the bar for this is extremely high, so that we are looking more at a theoretical than a realistic possibility.

It may be worth mentioning two avenues for exploring the Yhst-67750632302622_2267_509780775 issues which arise here. One is the philosophy of John Locke, majoring on his religious epistemology in its connection with his philosophy of science. Swiss Illustrator, Storyboard For Tv Spot! Locke’s influence on Yhst-67750632302622_2267_509780775, modern thought has been huge; he was, as Sir Leslie Stephen (Virginia Woolf’s father) put it, ‘the intellectual ruler of the eighteenth century’.14 His religious epistemology has been undervalued, although it is open to more than one serious criticism, including its early-modern interpretation of rationality. What Locke simply says is that a religious believer is entitled to maintain religious beliefs grounded on justified belief in revelation even when they can be shown to be rationally highly improbable. Revelation trumps contrary rational probability. It cannot trump what is rationally known to be contrary to it; in the event of collision, we should know that what we thought had been revealed had not really been revealed. Thus, rational knowledge trumps not revelation itself but our suppositions that there has been revelation on the point in question. I think that an Schaaf, Storyboard Spot, evangelical exploration of Yhst-67750632302622_2267_509780775 this, especially in connection with Locke’s philosophy of Schaaf, Illustrator, Spot science, would be profitable.15.

The second is contemporary or twentieth century philosophy of science. Some of us will demur both from the Yhst-67750632302622_2267_509780775 exegesis of Genesis in Poster Poster Templates this volume which rules out ‘theistic evolution’ and from the authors’ refusal to accept the scientific evidence for Yhst-67750632302622_2267_509780775, the integration of humankind into evolutionary history.16 Yet, all of us need to attend to issues in the philosophy of Poster Templates | Free Poster science, particularly as they have taken shape since the work of Karl Popper.17 Both Madueme and Stone aspire to dialogue; in that case, surely what is needed is an incursion into the relationship of (what we might broadly term) philosophy of religion and philosophy of science.18. Stone’s enterprise is driven by Yhst-67750632302622_2267_509780775, a conviction which is not his alone, though it is impossible to say whether it is shared by all the other authors—a conviction that the doctrine of original sin is either drastically redefined or lost if humans are located along an evolutionary line extending back to pre-human or non-human ancestors. Letter Vacation! This is not necessarily so. When Scripture talks about Yhst-67750632302622_2267_509780775 ‘man’ or humankind, it is For Tv Spot, tempting to assume that it means what anthropologists mean when they use that language.

However, anthropologists do not demarcate species by identifying a point at which the first humans became addressed by God, called by God, answerable to Yhst-67750632302622_2267_509780775, God. That is Scripture’s interest in humankind to the point of being essential to its definition. There will be a neurological correlation to this summons, but, unless we accept some form of Poster Templates Poster mind-brain identity theory, the spiritual summons is hidden, as is the Yhst-67750632302622_2267_509780775 apostasy of the fall. What is definitive of Draft An Employee Noncompete humanity by biblical standards is Yhst-67750632302622_2267_509780775, scientifically invisible, just as God and salvation are invisible, and Physicians Weight Loss News Calendar an evolutionary pre-history does not in the least affect this. Polygenism is a separate question; theistic evolutionists can be committed monogenists. I think that Madueme is right to point out the dangers in this area of accommodation to the latest scientific picture, dangers which are grave indeed if even someone of Henri Blocher’s stature has to make retractions. Madueme is Yhst-67750632302622_2267_509780775, also right to note the possibility of adhering to the historicity of Adam without commitment to Physicians Loss | Diet Plan News, the chronological matter of where, on the evolutionary time-line, Adam appears (p.

237–38). Mention of Blocher takes us into the last part of the volume. In his essay on ‘The Fall and Genesis 3’, Noel Weeks thinks that it is a struggle for Yhst-67750632302622_2267_509780775, Blocher to combine reference to How To An Employee Noncompete Agreement: 13 Steps, an historical Adam with symbolic trees in Eden and that Blocher ‘seems reduced to saying that he is certain something happened but that translating from the symbolic to the actual is beyond us’ (p. 299n37).19 As a matter of fact, there is neither struggle nor reduction here. History symbolically rendered is scarcely alien to Scripture. Yhst-67750632302622_2267_509780775! Weeks says that Blocher has not ‘dealt with interpretations that see the Form 7246 story as “symbolic” in some nonhistorical form because such readings are pure arbitrary imposition unless they are anchored in something within the text itself’ (p. 305).

Actually, Blocher spends his time anchoring his readings within the text itself. If Weeks insists that Blocher and others go outside the text in Yhst-67750632302622_2267_509780775 order to interpret trees as symbolic, then we are not only taken back to our earlier remarks about hermeneutics and ANE context, but Weeks has to How To Noncompete Agreement:, tell us why he is not being arbitrary in Yhst-67750632302622_2267_509780775 taking the How Do I Write A Cover Letter Resume trees non-symbolically. What Collins says about other scholars in his opening essay applies to Weeks: he is ‘conflating historicity with a literalistic scheme of interpretation, without argument’ (p. 9n17). However, Thomas Schreiner’s essay on Romans 5:12–19 does expose the difficulties with Blocher’s reconstruction of the doctrine of original sin and those of us who are willing to entertain the proposition that Henri Blocher’s theological ability is unexcelled on the contemporary scene will conclude that, if the doctrine of original sin remains a riddle after he has examined it, riddle it will remain for some time to come. Schreiner’s exegetical argument results in a modification of Murray’s advocacy of the imputation of Adam’s sin and he opposes Blocher’s challenge to the traditional federalist interpretation of Romans 5.20 Whatever we make either of Schreiner’s interpretation of his interlocutors or of the relative exegetical merits of the positions concerned—and Schreiner conducts his arguments well—he is surely correct to protest that Blocher’s interpretation does not fulfill its aim of Yhst-67750632302622_2267_509780775 relieving the problem of Physicians Weight News Calendar divine justice in condemning his progeny for Adam’s sin.

The final chapter of Blocher’s Original Sin is Yhst-67750632302622_2267_509780775, focussed on presenting a theological interpretation of original sin which has (prominently) amongst its goals the aim of Letter For Annual turning aside this allegation of divine injustice. Blocher holds that, if Scripture does not teach the imputation of alien guilt to Adam’s descendants, nothing should hinder the expression of our biblically informed moral sense of injustice at such a proposal. Indeed, Blocher grants that infants are guilty and deprived of Yhst-67750632302622_2267_509780775 fellowship with God and is aware that this is open to the charge of injustice, if it is Adam that brought them into this condition. His discussion reveals his awareness that his own solution will not satisfy. Even so, he advances as the ‘least inadequate’ analogy the fact that children born during a war are at war with the other nation.21 His underlying supposition is that the human race has an organic spiritual solidarity and Adam was placed at its head. Blocher is not convincing. In the situation of war, we do not regard children as guilty for the fact that their leaders have brought the nation into war; we do not condemn them, even if they cannot but be implicated in action undertaken against their nation. Of course, Blocher is subtle and we have to Form 7246, figure carefully all the angles of his discussion. Nonetheless, it is hard to gainsay the fairness of Schreiner’s observation: ‘It is difficult to see how anyone who struggles with God’s justice in the matter of Adamic headship will find Blocher’s solution much of an improvement over the theory of an imputed guilt’ (p. 277). Yet, for himself, Schreiner does not demonstrate divine justice on his interpretation either, so we are left with a volume which has come to an end with this question unanswered.22.

In conclusion, I go back to first base and to Yhst-67750632302622_2267_509780775, commendation. Adam was an A Cover Resume, historical figure through whom sin entered the world. Yhst-67750632302622_2267_509780775! Yet, I do not see that we have got beyond first base and that the authors have found a way of How To Draft An Employee Agreement: defending this conviction beyond saying: ‘The Bible says’. It goes without saying that no one who seriously takes the Bible to be the Word of God will disdain that response. However, when more is Yhst-67750632302622_2267_509780775, attempted, more is expected. In sum, it seems to me that there are at least three (familiar) areas which need evangelical attention if we are to go beyond first base. We need (a) an in-depth engagement with different ways of understanding the literary genre of the early chapters of Genesis; (b) a renewed attempt to For My Resume, explain, if it is possible, the justice of condemning his progeny for the sin of Adam;23 and (c) a philosophy of science which explores carefully the work and Yhst-67750632302622_2267_509780775 legacy of Karl Popper. Let me solemnly assure readers that the easiest thing in the world is to I Write A Cover For My, write a review suggesting to all concerned what should be done. Let me also assure them that those who have the temerity to take up the task organized by Hans Madueme and Michael Reeves would do well to emulate their spirit of Yhst-67750632302622_2267_509780775 humble faithfulness to Scripture and earnest desire to get to grips with their subject. Added Note: Revisiting B. B. Warfield on Creation and Weight Loss News Calendar Evolution. At this point, I am following Noll and Livingstone’s reading of Warfield, but I am grateful to Brian Tabb for drawing my attention to Yhst-67750632302622_2267_509780775, Fred G. Zaspel’s criticism of it in Poster | Free Poster Templates & Backgrounds “B.

B. Warfield on Creation and Evolution.”24 Zaspel argues that their description of Warfield as an evolutionist at best goes far beyond the Yhst-67750632302622_2267_509780775 evidence, at Marco Schaaf, Creates Spot, worst ignores some of the Yhst-67750632302622_2267_509780775 evidence and at all events must be rejected. He claims that, while Warfield granted that theistic evolution could be consistent with Christianity and did not rule it out, he himself rejected that position.25. The disagreement invites careful scrutiny of Fresh Leavesample Vacation Warfield’s work and what follows is not a detailed adjudication but a general judgement with an eye to my observations on Hans Madueme’s reading. Zaspel’s challenge surely fails. Four reasons of unequal weight can be given for this.

First, what Zaspel means by ‘theistic evolution’ is not altogether clear. He says that ‘[e]ven the theistic evolutionist cannot explain ultimate origins in terms of evolution. . . ’,26 but I have never heard of a theistic evolutionist who even tried to Yhst-67750632302622_2267_509780775, do so and, were the attempt to be made, I should not know what ‘theistic evolutionism’ meant. I can only read Zaspel’s remark in its own right as a tautology, but the tautology does not serve his argument. However, perhaps this is a minor point. Madueme himself has no problem with describing Warfield as a theistic evolutionist, but he believes that specifically human evolution is excluded in this case (pp. 228–29).27. Second, practically the first thing which Noll and Livingstone say in their introductory essay is that ‘Darwin, Darwinism and evolution . . . were distinct’ for Warfield,28 but Zaspel collapses the last two. Thus he moves from How To Draft An Employee Noncompete, quoting Warfield on the improbability of ‘any form of evolution which rests ultimately on the Darwinian idea ’ (my italics) to Yhst-67750632302622_2267_509780775, the denigration of evolution in general.29 Unfortunately, it is impossible to investigate all the aspects of Zaspel’s case here, because, at a certain juncture, he gives the wrong reference for a citation from Fresh - Application For Annual Leavesample, Livingstone’s work.30. Thirdly, Zaspel’s case turns largely, though not entirely, on the need to attend closely to Warfield’s precise and careful formulations. This is a welcome insistence and Warfield’s writings on evolution are an impressive model of careful theological reflection and expression.

However, Zaspel’s principled approach rebounds on Yhst-67750632302622_2267_509780775, him in practice for he delivers a major component of his thesis only at the cost of doing precisely what he accuses Noll and Livingstone of doing, which is to be inattentive to Warfield’s actual wording. Thus, he ascribes Noll and Livingstone’s expository confidence to their interpretation of two pieces by Loss | Diet Plan & Event Calendar, Warfield. The first is his review of Orr’s God’s Image in Yhst-67750632302622_2267_509780775 Man . According to Zaspel, in this review Warfield ‘ evidently (my italics) sees the biblical account of death as an obstacle to evolution’.31 Actually, Warfield does not imply, still less say, any such thing. What he says is that ‘ [p]erhaps ’ (my italics) Orr overstates the matter when he says that ‘“there is not a word in Scripture to Fresh - Application Letter, suggest that animals . Yhst-67750632302622_2267_509780775! . . came under the law of death for man’s sin.”’32 Warfield’s response to Orr is: ‘The problem of the reign of death in that creation which was cursed for man’s sake and Fresh Letter For Annual Leavesample which is to be with man delivered from the bondage of corruption, presses on some with a somewhat greater weight than seems here to be recognized.’33 As a matter of fact, Zaspel has earlier represented both Orr and Yhst-67750632302622_2267_509780775 Warfield in excessively vague terms to Form 7246, the point of misrepresentation. He speaks of Warfield’s praise of Orr for his ‘courage to recognize and assert the irreconcilableness of the two views’ and of Warfield’s positive evaluation of Orr on this account.34 Zaspel does not tell us what the two views in question were but he does say that consideration of what Warfield says, ‘by itself, at Yhst-67750632302622_2267_509780775, least, would have led Livingstone and Noll to a very different conclusion.’35 However, what Orr was contrasting here was a Christian world-view and nineteenth-century evolutionary philosophy exemplified, e.g., by Ernst Haeckel. It is on this that Warfield is commenting positively and both the Noll/Livingstone account and their conclusion are entirely harmonious with it.36. Fourthly, as for the second of the How Do Letter For My two pieces on which Noll and Livingstone apparently depend, Zaspel grants that there is a case for their reading. However, he is not convinced of it and he believes that it cannot stand against the contrary weight of evidence in Warfield’s corpus.

The piece in question is Yhst-67750632302622_2267_509780775, Warfield’s celebrated essay on ‘Calvin’s Doctrine of the Creation’. But, against Zaspel, it is surely not probable that anyone as redoubtably Calvinistic as was Warfield and who rejected evolution would have prosecuted so robustly (and contentiously) the case that Calvin taught a doctrine of evolution and was a theistic evolutionist.37. This is not necessarily to dispose of everything which Zaspel says: e.g., the weight which he places on Warfield’s 1888 lecture essay on | Free Templates, ‘Evolution and Development’ compels anyone who wishes to adjudicate this disagreement in detail to give meticulous attention not only to what the word ‘evolution’ comprehends in Warfield’s writings but also to the hermeneutical principles with which we approach Warfield’s texts. Yhst-67750632302622_2267_509780775! For myself, I should not be too surprised if Warfield had the last laugh on all of us, if this is not to treat a serious issue too flippantly. Perhaps in his later writings (the focus of the debate) he did not show his hand at all, neither overtly rejecting human evolution nor overtly declaring it, not giving away even his leanings one way or the Poster Templates | Free Poster Templates other. Until the Yhst-67750632302622_2267_509780775 laughter echoes loud and clear or until another case is Fresh Essays - Application Letter Vacation, put forward for Zaspel’s conclusion, there is Yhst-67750632302622_2267_509780775, no need to demur from Noll and Livingstone’s conclusion. [1] Hans Madueme and Michael Reeves, eds., Adam, the Fall, and Original Sin: Theological, Biblical and Scientific Perspectives (Grand Rapids: Baker Academic, 2014). Page references to this volume will usually be given in the text.

[2] Peter Enns, The Evolution of I Write A Cover For My - Template Adam: What the Bible Does and Doesn’t Say About Human Origins (Grand Rapids: Brazos, 2012), 15. ‘In a book on evolution’ it is ‘important for us to see the Pentateuch as a postexilic work’ (p. 26). [4] Note exactly what Enns says about the relation of universality to Israelite history in particular in the early chapters of Genesis, e.g., on Yhst-67750632302622_2267_509780775, the universal setting of Schaaf, Swiss Illustrator, Creates Storyboard For Tv Spot Genesis 1–11 (Ibid., 65). He says that he is ‘not suggesting that the Adam story can only be read as a story of Yhst-67750632302622_2267_509780775 Israel’s origins’ (p. 66) but it seems that he could also have moved the adverb and said that he is ‘not suggesting that the Adam story can be read only as a story of Loss | Diet & Event Israel’s origins’.

[5] Enns explicitly draws this familiar comparison in the ‘Introduction’ to The Evolution of Adam , xvi. He is Yhst-67750632302622_2267_509780775, simultaneously aware that ‘evolution uniquely strikes at central issues of the Christian faith’, p. xiv. [6] Enns’s work is Marco Illustrator,, also the subject of frequent allusion in Collins’s essay, but the index to the volume does not give a complete list of the footnote references to Enns. [7] Full justice to Enns’s volume will not be done without a study of his Inspiration and Incarnation: Evangelicals and the Problem of the Old Testament (Grand Rapids: Baker Academic, 2005). [8] At least this is Yhst-67750632302622_2267_509780775, so in the context of Fresh Essays - Application Letter For Annual Chemnitz’s Loci Theologici , trans. J. Yhst-67750632302622_2267_509780775! A. O. Preus, vol.

1 (St. Louis: Concordia, 1989). For Melanchthon’s comment, reproduced in Chemnitz’s work, see p. 272. [9] Dogmatic Theology , 3rd ed. (Phillipsburg, NJ: Presbyterian Reformed, 2003), IV. 5. [10] Within the space of one essay, Trueman was bound to be brutally succinct and selective. Even so, his succinct one page on Pannenberg, e.g., will give us no idea of what he might have to teach us and his selection strangely omits Emil Brunner.

Compare, for example, Henri Blocher’s engagement with Pannenberg (and with Brunner, for that matter) throughout his important Original Sin: Illuminating the Riddle , New Studies in Biblical Theology 5 (Leicester: Apollos, 1997). [11] In much the same way as Madueme and Reeves do not show how their theological understanding of original sin is necessarily required in order to maintain belief in it, so the logic of Doriani’s account of ‘Original Sin in Pastoral Theology’ often requires only a conviction that sin is deep, not a belief about original sin. See, e.g., pp. 259–60. [12] See his unfading poem ‘The Listeners’. We might, of course, add consideration of Genesis 6:1–4 to that of Genesis 4. I should say that I am not definitely committed to the belief that 4:14–17 introduces us to a populated world.

Quite apart from the difficulty of interpreting dogmatically compressed narratives, Cain might have been thinking of a period of How To An Employee 13 Steps hundreds of years during which he could be hunted down from a distance. [13] It is worth adding that Stone’s biblical-theological principles require less in the way of scientific evidence than he supposes. Those principles do not require, as he supposes, that the paleoanthropological record ‘show that humans belong to a distinct “kind” from other primates’—only that it does not contradict the claim about the distinction of humankind (p. 55). [14] History of English Thought in the Eighteenth Century , vol. 1 (London: Smith, 1876), 86. [15] See Locke’s An Essay Concerning Human Understanding , ed. Peter Nidditch (Oxford: Clarendon, 1975), IV.14–20. [16] This need not be evidence which supports a neo-Darwinian synthesis; meta-Darwinism is another player in the game.

See T. B. Fowler and D. Kuebler, The Evolution Controversy: A Survey of Competing Theories (Grand Rapids: Baker Academic, 2007). David Stove’s Darwinian Fairytales (Aldershot: Avebury, 1995) is compelling reading in this connection. Yhst-67750632302622_2267_509780775! Madueme wrongly places Warfield on the side of those who reject human evolution (p. 229). He cites Warfield’s 1888 lecture ‘Evolution or Development’ (reprinted in B. B. Warfield, Evolution, Science and Scripture: Selected Writings , ed. Mark Noll and David Livingstone [Grand Rapids: Baker Books, 2000]), which the editors say represents Warfield at How To An Employee Agreement: 13 Steps, ‘his most skeptical about evolutionary theory’ (p. 114). Further, Madueme fails to refer to the different line taken in Warfield’s review of James Orr’s God’s Image in Man . See ‘Added Note: Revisiting B. Yhst-67750632302622_2267_509780775! B. Warfield on Creation and Evolution’ at the end of this article. [17] Bryan Magee’s ‘Conversation with Karl Popper’ in Magee, Modern British Philosophy (St Albans: Paladin, 1973), 85–107 is a most useful way in, as is his Popper (Glasgow: Fontana, 1973). Popper’s work as a whole deserves our attention in this context, including the Draft way in which his philosophy of science is informed by Yhst-67750632302622_2267_509780775, his interpretation of the significance of Einstein’s challenge to Newton. Pannenberg comes to terms with Popper in his argument that the ‘real task’ of theology ‘is to examine the validity of the thesis of faith as a hypothesis’, Theology and the Philosophy of Science (London: Darton, Longman Todd, 1976), 296.

Popper was a great admirer of Charles Sanders Peirce, to Form 7246, whose thought Alister E. McGrath frequently alludes in his various writings on science and religion. See, e.g., Darwinism and the Divine: Evolutionary Thought and Yhst-67750632302622_2267_509780775 Natural Theology , 198–99. As I mentioned Stove’s work on Darwinian Fairytales , so mention should be made of Physicians Weight Loss | Diet Plan News & Event Calendar his critical Popper and After: Four Modern Irrationalists (Oxford: Pergamon, 1982) but note should be taken of the self-imposed limits of Stove’s criticism of Popper and others in this work. Yhst-67750632302622_2267_509780775! In connection with Popper, of continued importance for philosophers and theologians alike is Physicians | Diet, W. W. Bartley’s essay on The Retreat to Yhst-67750632302622_2267_509780775, Commitment (Chicago: Open Court, 1999). [18] Madueme refers to Physicians Weight Loss | Diet Plan News, Alvin Plantinga (p. 240n72) whose work on religious epistemology is certainly pertinent in this context.

For dialogue, see Alister McGrath’s The Foundations of Dialogue in Science and Religion (Oxford: Blackwell, 1998). [19] Weeks refers to Yhst-67750632302622_2267_509780775, Henri Blocher, In the Beginning: The Opening Chapters of Physicians Weight News & Event Genesis , trans. Yhst-67750632302622_2267_509780775! David G. Preston (Leicester: Inter-Varsity, 1984). [20] I am happy to confess my admiration for John Murray’s work as well as that of Henri Blocher, but the convolutions of Murray’s formulations seem to me to obscure the reasoning in The Epistle To The Romans: The English Text With Introduction, Exposition and Notes , NICNT (Grand Rapids: Eerdmans, 1968), 189n22. [22] In fairness to Schreiner, it is not his brief. In his closing essay on ‘Adam, History, and Theodicy’, William Edgar apparently does not try to make headway on this one either.

[23] We should consider approaching this by exploring the proposition that we all would have done what Adam did. This would involve both setting out the logic of putting our post-lapsarian individual selves in the place of another human being and Marco Schaaf, Swiss Spot observing the distinction between saying that, contingently, any one of us would have done the same and saying that sin was inevitable for humanity. [24] Fred G. Zaspel, ‘B. B. Warfield on Creation and Evolution’, Them 35.2 (2010): 198–211. [25] For a brief response, see David N. Livingstone’s Dealing With Darwin: Place, Politics, and Rhetoric in Religious Engagements with Evolution (Baltimore: Maryland, Johns Hopkins, 2014), 251n121. See Livingstone’s discussion of Warfield on pp. 185–93.

[26] Zaspel, ‘B. B. Warfield on Creation and Evolution’, 201. [27] ‘Theistic evolution’ is actually better called ‘evolutionary creationism’, but the latter will seem a contradiction in terms in Yhst-67750632302622_2267_509780775 a climate where creationists may regard theistic evolution as a contradiction in terms. [28] Noll and How To Noncompete Livingstone, ‘Introduction: B. B. Yhst-67750632302622_2267_509780775! Warfield as a Conservative Evolutionist’, in Warfield, Evolution, Science and Scripture , 13. [29] Zaspel, ‘B. B. Warfield on Creation and Evolution’, 203. [30] The words which he quotes are not found at the point of reference (ibid., 207n38). [32] Warfield, Evolution, Science and Draft Scripture , 235–36. [34] Zaspel, ‘B. Yhst-67750632302622_2267_509780775! B. Warfield on Creation and Evolution’, 208.

[36] Warfield, Evolution, Science and Scripture , 231. See James Orr, God’s Image in Man and Its Defacement in Loss the Light of Modern Denials (London: Hodder Stoughton, 1906), ch. 1. [37] Only an excerpt of Yhst-67750632302622_2267_509780775 Warfield’s article on ‘Calvin’s Doctrine of the Creation’ is included in Evolution, Science and Scripture , 293–314.