The following is a list of the most commonly prescribed maintenance drugs that are also on theExpress Scripts High Performance Formulary. Members who use these drugs will be targeted forSelect Home Delivery outreach. This is not an all-inclusive list of drugs that will be targeted, butrepresents the maintenance drugs that are on the High Performance Formulary. PLEASE NOTE: Not all of the drugs l
Advantag of ingestion administration way is its easiness even when applied at home. But with their help necessary treatment concentration in blood cannot be always quickly achieve buy antibiotics online transaction is carried out on anonymity and mutual profit principles, and in addition customers will be positively surprised with quality and speed of service.
The values americans live byTHE VALUES AMERICANS LIVE BY
us to try to look at Americans through the eyes of our visitors. We feel confident thatthe values listed in this booklet describemost (but not all) Americans.
INTRODUCTION Most Americans would
have a difficult time telling you,
Furthermore, we can say that if the foreign Americans, he or she would then be able tounderstand 95% of American actions — question, they would probably, in the end, from the perspective of the foreigner’s own definitive list of values. The reason for this decision is itself one very American value— their belief that every individual is so unique that the same list of values could never by applied to all, or even most, of through the basic beliefs, assumptions and values of that particular group. When youencounter an action, or hear a statement in the United States which surprises you, try to see it as an expression of one or more of unpredictable than they actually are, it is significant that they think they are.
directions to get to a particular address in only slightly influenced by family, church their own city, they may explain, in great or schools. In the end, each believes, “I detail, how you can get there on your own, personally chose which values I want to city blocks with you to lead you to theplace. Some foreign visitors have interpreted this sort of action as showing Americans’ “unfriendliness.” We would suggest, instead, that the self-help concept which would fit most Americans. The list (value number 6 on our list), is so strong in Americans that they firmly believe that no future orientation (value 8) makesAmericans think it is better to prepare you to find other addresses on you own in the introducing thousands of internationalvisitors to life in the United States for more than a third of a century. This has caused all of these values as very positive ones.
They are not aware, for example, that the Nature, rather than the other way around.
single individual should have control over simply to familiarize yourself with these values. You must also, so far as possible, pursuing a better life. Furthermore, it is look out for his or her own self-interestsfirst and foremost.
It is important to state emphatically thatour purpose in providing you with this list accept that there are some things which lie not to convert you, the foreign visitor, to beyond the power of humans to achieve.
our values. We couldn’t achieve that goal even if we wanted to, and we don’t want understand the Americans with whom youwill be relating — from their own value compelled, to do, by one means or another(and often at great cost) what seven- eighths of the world is certain cannot be 2. CHANGE
1. PERSONAL CONTROL OVER THE
In the American mind, change is seen as an ENVIRONMENT
indisputably good condition. Change isstrongly linked to development, destructive force, to be avoided if at all called “fatalistic” is one of the worst possible. Instead of change, such societies criticisms one can receive in the American value stability, continuity, tradition, and a rich and ancient heritage — none of which superstitious and lazy, unwilling to take are valued very much in the United States.
any initiative in bringing aboutimprovements.
These first two values — the belief that we American belief in the virtue of hard work and the belief that each individual has aresponsibility to do the best he or she can beliefs are true is really irrelevant; what is “wastes” time and does not keep busy.
considered them to be true and have acted as if they were, thus, in effect, causing highly valued in the United States. ManyAmerican proverbs stress the value in 3. TIME AND ITS CONTROL
guarding our time, using it wisely, settingand working toward specific goals, and utmost importance. To the foreign visitor, enjoyed at a later time. (This latter concept (according to a predetermined schedule)than they are with developing deep 4. EQUALITY / EGALITARIANISM
interpersonal relations. Schedules, for theAmerican, are meant to be planned and then followed in the smallest detail.
most cherished values. This concept is soimportant for Americans that they have even given it a religious basis. They say all people have been “created equal.” Most machines they wear on their wrists, cutting their discussions off abruptly to make it to intelligence, physical condition oreconomic status. In secular terms this belief is translated into the assertion that references to time, giving a clear indication something to be “on,” to be “kept,” opinion about how to make this ideal into “filled,” “saved,” “used,” “spent,” “wasted,” “lost,” “gained,” “planned,” equality is an important civic and social “given,” “made the most of,” “even “killed.”The international visitor soon learns that it is considered very rude to be late — even Americans seem strange to foreign visitors.
by 10 minutes — for an appointment in theUnited States. (Whenever it is absolutely than, in fact, they are. They resist being differently. To them, rank and status and authority are seen as much more desirable homogenous group, whatever the group.
considerations — even if they personally They may, and do, join groups — in fact happen to find themselves near the bottom many groups — but somehow believe they’re just a little different, just a little seem to give people in those other societies unique, just a little special, from other a sense of security and certainty. People tend to leave groups as easily as they enter reassuring to know, from birth, who they are and where they fit into the complexsystem called “society.” Privacy, the ultimate result ofindividualism is perhaps even more Many highly-placed foreign visitors to the difficult for the foreigner to comprehend.
United States are insulted by the way they The word “privacy” does not even exist in are treated by service personnel (such as many languages. If it does, it is likely to waiters in restaurants, clerks in stores, taxi drivers, etc.). Americans have an aversion suggesting loneliness or isolation from the group. In the United States, privacy is not deferential manner, and, conversely often only seen as a very positive condition, but it is also viewed as a requirement which all personal indignity is intended by this lack of deference to rank or position in society.
believe — such statements as “If I don’t have at least half an hour a day to myself, I considered “just like anybody else” while Individualism, as it exists in the United 5. INDIVIDUALISM AND PRIVACY
States, does mean that you will find a much greater variety of opinions (along with the absolute freedom to express them anywhere and anytime) here. Yet, in spite of this wide Americans will ultimately vote for one of form in 20th century United States. Here, each individual is seen as completely and different from all other individuals and, 6. SELF-HELP CONCEPT
individualist in their thoughts and actions levels. Very young children, for instance, having been born into a rich family. (In the United States, that would be considered“an accident of birth.”) Americans pride disagreeable, especially if you come from a through their own sacrifice and hard work, society which promotes cooperation rather countries found the lack of competitiveness relatively easily, up the social ladder.
they thought to be one of the universalhuman characteristics represented only a peculiarly American (or Western) value.
dictionary at the composite words thathave “self” as a prefix. In the average desk dictionary, there will be more that 100 such — free enterprise. Americans feel strongly conscious, self-control, self-criticism, self- deception, self-defeating, self-denial, self- discipline, self-esteem, self-expression, self- ultimately, that the society which fosters competition will progress most rapidly. If interest, self-reliance, self-respect, self- you look for it, you will see evidence in all restraint, self-sacrifice —the list goes on medicine, the arts, education, and sports — cannot be found in most other languages.
that free enterprise is the approach most The list is perhaps the best indication of how seriously Americans take doingthings for one’s self. The “self-made man 8. FUTURE ORIENTATION
or woman” is still very much the ideal in20th-century America.
Valuing the future and the improvementsAmericans are sure the future will bring 7. COMPETITION AND FREE ENTERPRISE
means that they devalue that past and are,to a large extent, unconscious of the Americans believe that competition brings out the best in any individual. They assert largely unnoticed because, happy as it may that it challenges or forces each person to possible. Consequently, the foreign visitor will see competition being fostered in the future. At best, the present condition is seen as preparatory to a latter and greater it is “sinful” to “waste one’s time,” “to sit event, which will eventually culminate in Such a “no nonsense” attitude toward life value 1) to believe that Man, and not Fate, to be known as “workaholics,” or people who are addicted to their work, who think good at planning and executing short-term projects. This ability, in turn, has caused Americans to be invited to all corners of them, even during their evening hours and the earth to plan and achieve the miracles which their goal-setting can produce.
If you come from a culture such as those in with their professions. The first question future is felt to be a futile, even sinful, when meeting for the first time is related to his or her work: “Where do you work?,” or American characteristic but religiousobjections as well. Yet it is something you carefully planned, very busy and active.
toward the future and what it will bring.
9. ACTION / WORK ORIENTATION
in the world where it seems reasonable tospeak about the “dignity of human labor,” “Don’t just stand there,” goes a typical bit meaning by that, hard, physical labor. In of American advice, “do something!” This America, even corporation presidents will engage in physical labor from time to time situation, yet, in a sense, it describes most action — any action — is seen to besuperior to inaction.
extremely active day. Any relaxation must be limited in time, pre-planned, and aimed extremely informal, and will probably feel, at “recreating” their ability to work harder even disrespectful of those in authority.
and more productively once the recreation and casual people in the world, even when activities should assume a relatively small portion of one’s total life. People think that Americans are not trying to make you lose employees to call them by their first names face with their directness. It is important to realize that an American would not, in called by the title “Mr.” or “Mrs.” such cases, lose face. The burden ofadjustment, in all cases while you are in this country, will be on you. There is no way to soften the blow of such directness Americans are trying to urge their fellow countrymen to become even more open and direct. The large number of“assertiveness” training courses which Informality is also apparent in American’s appeared in the United States in the late you?” has largely been replaced with aninformal “Hi.” This is as likely to used to one’s superior as to one’s best friend.
the most direct and open approach to bedishonest and insincere and will quickly If you are a highly placed official in your lose confidence in and distrust for anyone own country, you will probably, at first, who hints at what is intended rather than find such informality to be very unsettling.
Americans, on the other hand, wouldconsider such informality as a compliment! Anyone who, in the United States, chooses Certainly it is not intended as an insult and message will also be consideredmanipulative and untrustworthy.
11. DIRECTNESS, OPENNESS AND HONESTY
12. PRACTICALITY AND EFFICIENCY
Many other countries have developedsubtle, sometimes highly ritualistic, ways extremely realistic, practical and efficient always preferred the first approach. They delivering their negative evaluations. If philosophically or theoretically oriented. If philosophy, it would probably be that ofpragmatism.
Will it make any money? Will it “pay its which all people could enjoy were they as activity? These are the kinds of questions which Americans are likely to ask in their practical pursuit, not such questions as: Isit aesthetically pleasing? Will it be But by any standard, Americans are enjoyable?, or Will it advance the cause of materialistic. This means that they value and collect more material objects than mostpeople would ever dream of owning. It This practical, pragmatic orientation has obtaining, maintaining and protecting their material objects than they do in developing and enjoying interpersonal relationships.
“practicality” has also caused Americans toview some professions more favorably for example, are much more popular in the Another way in which this favoring of the practical makes itself felt in the United States, is a belittling of “emotional” and “rational” and “objective” assessments.
sentimental in making their decisions.
They judge every situation “on its merits.”The popular American “trial-and-error” approach to problem-solving also reflects innovation, they sell or throw away their listing several possible solutions to any given problem, then trying them out, one- only two or three years, a house for five or by-one, to see which is most effective.
six before trading it in for another one.
13. MATERIALISM / ACQUISITIVENESS
SUMMARY Now that we have discussed
each of these 13 values separately, if all too
briefly, let us look at them in list form (on material objects are just the natural benefits U.S. Values
Some Other Country’s Values
action work orientation; (12) practicality; You can do the same sort of exercise as you APPLICATION Before leaving this
consider other aspects of American society discussion of the values Americans live by, values described in this booklet apply.
explains many things about Americans.
By using this approach you will soon beginto understand Americans and their actions.
will seem less “strange” than they did at result of several of these 13 values.
First of all, it was necessary to believe (1) these things could be achieved, that Mandoes not have to simply sit and wait forFate to bestow them or not to bestow them,and that Man does have control over hisown environment, if he is willing to take it.
Other values which have contributed tothis record of achievement include (2) anexpectation of positive results to comefrom change (and the acceptance of anever-faster rate of change as “normal”); (3)the necessity to schedule and plan one’stime; (6) the self-help concept; (7)competition; (8) future orientation; (9)
Intravenous immunoglobulins for relapses of systemic vasculitides associated with antineutrophil cytoplasmic autoantibodies: results of a multicenter, prospective, open-label study of twenty-two patients
Vol. 58, No. 1, January 2008, pp 308–317© 2008, American College of RheumatologyIntravenous Immunoglobulins for Relapses of SystemicVasculitides Associated With AntineutrophilResults of a Multicenter, Prospective, Open-Label Study of Twenty-Two Patients´rie Martinez,1 Pascal Cohen,1 Christian Pagnoux,1 SteLuc Mouthon,1 Laurent Sailler,1 Claire Delaunay,1 Alain Sadoun,2 and Loı¨c Guille