Attention Deficit Hyperactivity Disorder Essays - Free Essays

Attention Deficit Hyperactivity Disorder Essays - Free Essays Attention Deficit Hyperactivity Disorder Understanding the Behavioral Disorder: Attention Deficit Hyperactivity Disorder (ADHD) Imagine living in a fast-moving kaleidoscope, where sounds, images, and thoughts are constantly shifting. Feeling easily bored, yet helpless to keep your mind on tasks you need to complete. Distracted by unimportant sights and sounds, your mind drives you from one thought or activity to the next. Perhaps you are so wrapped up in a collage of thoughts and images that you don't notice when someone speaks to you. "Tommy can't sit still. He is disruptive at school with his constant talking and clowning around. He leaves the classroom without the teacher's permission. Although he has above-average intelligence, Tommy has trouble reading and writing. When he talks, the words come out so fast no one understands him" (Rees, 1994). For many people, this is what it's like to have Attention Deficit Hyperactivity Disorder, or ADHD. They may be unable to sit still, plan ahead, finish tasks, or be fully aware of what's going on around them. To their family, classmates or coworkers, they seem to exist in a whirlwind of disorganized or frenzied activity. Unexpectedlyon some days and in some situations they seem fine, often leading others to think the person with ADHD can actually control these behaviors. As a result, the disorder can mar the person's relationships with others in addition to disrupting their daily life, consuming energy, and diminishing self-esteem. Attention Deficit Hyperactivity Disorder (ADHD) comes from the standard diagnostic reference of the American Psychiatric Association (APA). ADHD is a diagnosis applied to children and adults who consistently display certain characteristic Understanding ADHD 4. behaviors over a period of time. Hyperactivity has no single known cause and is therefore classified as a syndrome because it has a cluster of symptoms. It is generally characterized by excessive motor activity, short attention span, and impulsive behavior for a child's age. The most common behaviors fall into three categories: inattention, hyperactivity, and impulsivity. According to the DSM, signs of inattention include: ?becoming easily distracted by irrelevant sights and sounds ?failing to pay attention to details and making careless mistakes ?rarely following instructions carefully and completely ?losing or forgetting things like toys, or pencils, books, and tools needed for a task. (Frankovich, 1994) Some signs of hyperactivity and impulsivity are: ?feeling restless, often fidgeting with hands or feet, or squirming ?running, climbing, or leaving a seat, in situations where sitting or quiet behavior is expected ?blurting out answers before hearing the whole question ?having difficulty waiting in line or for a turn. (Frankovich, 1994) Under the criteria set by the APA, the diagnosis should include onset of the condition before age seven, lasting at least six months. There should also be a proven absence of mental illness or mental retardation. Parents can remove a huge burden of guilt from blaming themselves for their child's behavior. Knowing that scientists are finding more and more evidence that ADHD does not stem from home environment, but from biological causes. In the article ADHD Decade of the Brain, scientists find, "Not all children from unstable or dysfunctional homes have ADHD. And not all children with ADHD come from dysfunctional families" (1990). Some research shows that a mother's use of cigarettes, alcohol, or other drugs during pregnancy may have damaging effects on the child. Understanding ADHD 5. "These substances may be dangerous to the fetus's developing brain" (ADHD Decade of the Brain, 1990). One other theory that is not definite whether it is a definite cause or not is that refined sugar and food additives make children hyperactive and inattentive. As a result, many parents were encouraged to stop serving children foods containing artificial flavorings, preservatives, and sugars. There is no cure for ADHD. While research continues to help scientists understand the underlying causes, treatments have been developed to provide relief of symptoms. Management of the syndrome may involve more than one method. The primary ones are medication, psychological intervention, and diet. In extreme cases of hyperactive behavior, the physician may prescribe stimulant drugs which affect mood, the thinking processes and behavior. This controversial practice has been used since the 1930's to control hyperactivity. "The stimulants amphetamines like Ritalin, Dexedrine, and Cylert act on the nervous system, and have been shown to be effective in many studies. The drugs have a calming effect on hyperactive children" (Rees, 1994). Stimulants allow many people to focus and pay better attention, whether or not they have ADHD. The improvement is just more noticeable in people with ADHD. It is not easy coping with the frustrations of ADHD day

Important Steps to Take for Earthquake Preparedness

Important Steps to Take for Earthquake Preparedness On the 100th anniversary of the Great San Francisco Earthquake of 1906, thousands of scientists, engineers and emergency management experts gathered in San Francisco for a conference. From that meeting of the minds came 10 recommended action steps for the region to take against future earthquakes. These 10 action steps apply to society at all levels, including individuals, businesses, and governments. This means that all of us who work for businesses and participate in government activities have ways to help beyond taking care of ourselves at home. This is not a checklist, but rather an outline of a permanent program. Not everyone can utilize all 10 steps, but everyone should try to carry out as many as possible. People elsewhere take part in a culture of preparedness for their regional hazard, whether they live in an area prone to hurricanes, tornados, blizzards or fires. Its different in earthquake country because the big events are rare and they occur without warning. Things on this list that may seem obvious in other places have yet to be learned in earthquake country   or, they were learned and forgotten, like the San Francisco region in the years after the 1906 quake. These action steps are crucial elements of a disaster-resilient civilization and serve 3 distinct purposes: making preparedness part of the regional culture, investing to reduce losses, and planning for recovery. Preparedness Know your risks. Study the buildings that you live in, work in or own: On what kind of ground are they sited? How might the transportation systems serving them be threatened? What seismic risks affect their lifelines? And how can they be made safer for you?Prepare to be self-sufficient. Not just your home, but your workplace too should be ready for 3 to 5 days without water, power or food. While this is the normal suggestion, FEMA suggests carrying up to 2 weeks worth of food and water.  Care for the most vulnerable. Individuals may be able to help their families and immediate neighbors, but people with special needs will need special preparations. Ensuring this necessary response for vulnerable populations and neighborhoods will take concerted, sustained action by governments.Collaborate on a regional response. Emergency responders already do this, but the effort should extend further. Government agencies and major industries must work together to help their regions prepare for ma jor earthquakes. This includes regional plans, training, and exercises as well as continuous public education. Loss Reduction Focus on dangerous buildings. Fixing buildings that are likely to collapse will save the most lives. Mitigation measures for these buildings include retrofitting, rebuilding and controlling occupancy to reduce exposure to risk. Governments and building owners, working with earthquake professionals, bear the most responsibility here.Ensure essential facilities function. Every facility needed for emergency response must be capable of not just surviving a large quake, but also remaining functional afterward. These include fire and police stations, hospitals, schools and shelters and emergency command posts. Much of this task is already a legal requirement in many states.Invest in critical infrastructure. Energy supplies, sewage, and water, roads, and bridges, rail lines and airports, dams, and levees, cellular communications the list is long of functions that must be ready for survival and quick recovery. Governments need to prioritize these and invest in retrofitting or rebuilding as much as they can while keeping a long-term perspective. Recovery Plan for regional housing. In the midst of disrupted infrastructure, uninhabitable buildings and widespread fires, displaced people will need relocation housing for both the short and the long term. Governments and major industries must plan for this in collaboration.Protect your financial recovery. Everyone   individuals, agencies, and businesses must estimate what their repair and recovery costs are likely to be after a major earthquake, then arrange a plan to cover those costs.Plan for regional economic recovery. Governments at all levels must collaborate with the insurance industry and major regional industries to ensure the provision of relief money for individuals and for communities. Timely funds are crucial for recovery, and the better the plans, the fewer mistakes will be made. Edited by Brooks Mitchell

Modern Shipping Industry Essay Example | Topics and Well Written Essays - 1500 words

Modern Shipping Industry - Essay Example Even the applicability of privity of contract to the maritime contracts was established only after the court rulings in Tweddle & Atkinson [1861]1 and Thompson v Dominy [1845]2. Section 1 of the Bill of Lading Act was enacted to provide the right of suit to the consignee as well as the transferee of the Bill of Lading thus providing an exception to the privity of contract. However one major flaw was that the right of suit was made available only in respect of the conditions specifically and expressly mentioned in the Bill of lading. since the essence of Section 1 is to transfer the right of suit 'as if the contract contained in the bill of lading had been made with himself' . Thus made the section inoperative in those cases where the right of suit on reasons otherwise than on consignment or endorsement and this wording was adversely affecting the position of the Banks in whose favour the bills of lading were endorsed not giving them the right to sue. Under the circumstances where the Bills of lading were not able to be received by the consignees within such time the vessel reaches the destination, the buyer became the owner of the goods by producing a 'letter if indemnity'. As was decided in the case of The Delfini [19903] this act of becoming owner by delivery and 'not upon reason of consignment or endorsement' excluded the receiver's right to sue. The rulings in cases like The Aliakmon [1986]; where an endorsement was made in the Bill of Lading for the agent to take delivery on behalf of the consignee held that there was no transfer of property and in the case of The Aramis [1989]; since it was not possible to ascertain the specific goods consigned from a larger bulk, held that the property did not pass as laid down in Section 16 of the Sale of Goods Act 1979, have subsided the effect of the Delfini case. Cessation of Liability of the Ship owner: The decision in the case of Grant v Norway [1851]4 provided for the cessation of liability of the ship owner to the endorsee or transferee of the Bill of lading in cases where the ship owner can prove that the goods were not actually shipped., section 3 of the Bill of Lading Act 1855 was enacted to provide that statements made in the bills of lading with regards to the goods shipped would be conclusive evidence of such shipment "as against the Master or other persons signing the same". However this provision did not provide the necessary remedy for the problem as the ship owners were inclined to take advantage of the courts reading the provisions of Section 3 literally, by applying the principle of estoppel in their favour. Hence section 3 of the Bill of Lading Act proved ineffective in solving the issues created by the case of Grant v Norway [1851]5. Coverage of the Bill of Lading Act 1855: One final issue concerning the Bill of Lading Act was that it generally covered only 'Bills of Lading' and not 'sea way bills' which were the order of the day during the last few decades with the containerization of the goods which was not covered by the old Act. Provisions of the UK Carriage of Goods by Sea Act 1992: Section 2 (1) (a) of the UK Carriage of Goods by Sea Act 1992, empowers the consignee to sue the carrier in contract, where the consignee is the

Screening for early detection of Colorectal Cancer Research Paper

Screening for early detection of Colorectal Cancer - Research Paper Example The condition in its early stages may not be noticed by the person concerned, but can be detected in a number of ways. The United States Preventative Services Task Force recommends that every citizen aged between 50 and 75 be tested, thus prolonging the lives of 60 % of those affected. Those over this age can request a test. Detection can be done by testing stools for the presence of blood. This is done either using the chemical guaiac or by seeking for antibodies. Somewhat more invasive is a sigmoidoscopy, i.e. the lower bowel is examined using a flexible tube. A colonoscopy is a more extensive version of this, but searches the whole colon and may involve the removal of any suspicious polyps. This would normally be a follow up to other tests. In some cases a barium enema is used and the results x-rayed. In some cases a complete stool is sent for analysis. There is continued research on this topic. Pertinent issues to the delivery of healthcare raised by this topic. Because this cond ition is so prevalent in American society it is important that as much as possible to cut its incidence and severity as a life threatening condition. This can be done be early detection so that any polyps can be removed before they become cancerous. Therefore it is necessary that all those aged 50 – 70 have regular checks – perhaps every two years. If this is to be achieved the subject will need publicity, education, central organization and funding. Another area that requires public education would be in the area of diet. Americans tend to consume a high fat, high dairy food diet. Something similar to the ‘5 a day’ campaign in the United Kingdom . ... Something similar to the ‘5 a day’ campaign in the United Kingdom - that is the promotion of the idea that everyone needs to eat at least 5 portions of fruit and vegetables each day. ( NHS Choices , 5 a Day). Putnam, Allshouse and Kantor (2002) report a huge jump in average calorie intake within the United States over the last 25 years, this despite a recent tendency to use lower fat options. According to a report cited by Barone, (2007) those with colon cancer who ate a healthier diet, i.e. one based upon fruit, vegetables, poultry and fish, stand a better chance of total recovery than those who continue to consume lots of red meat, fats, refined carbohydrates, fat and sugar. The latter have a higher chance of the cancer recurring according to a study by Meyerhardt. Government Involvement In 2010 the NIH Consensus Development Program, part of the United States Human and Health Services, produced a statement entitled ‘Enhancing Use and Quality of Colorectal Cancer Screening.’ This document covers such things as trends in screening and how this might be improved. It considers such things as how screening can be monitored and what research is required and so indicates that this topic is one of concern to government agencies. The aim was ‘To provide health care providers, patients, and the general public with a responsible assessment of currently available data on enhancing use and quality of colorectal cancer screening.’ In 2004 the American Food and Drug Administration approved new treatment for advanced colorectal cancer. However more new treatments have since become available and require assessment and acceptance. Literature National Center for Biotechnology Information, U.S. National Library of

“Love” in Carol Ann Duffy’s Valentine Essay Example for Free

â€Å"Love† in Carol Ann Duffy’s Valentine Essay Many people usually see â€Å"love† only one side especially when they deeply fall in love with someone. There are a lot of poems that respond the feeling of these falling in love people about how beautiful love is. It is true that love is beautiful. On the other hand, for me sometimes love is also painful. I really like the sentence that â€Å"love is color-blind† because this sentence can show not only the positive side of love but also the negative side of love. So does Carol Ann Duffy’s Valentine. On Valentine’s day, many people will neatly prepare the present such as a red rose, a cute card, or something that extremely beautiful and worthwhile for their beloved couples but Carol Ann Duffy thinks that these presents are predictable. Carol Ann Duffy says that she will give an onion to whom she loves. Why onion? It is because an onion represents both sides of love. Love has many layers like an onion. You may waste your time for many people who are not the right one for you and will face many problems and barriers that you and your love have to fight for love before you will find â€Å"true love.† Along this way, sometimes you will be sad and cry many times like an onion when you peel it because an onion can make your tears. In contrast, you can say that the nature of an onion can refer to the levels of happiness that happiness has many levels itself. Sometimes it means comfort and memories but sometimes it means like a firework. In addition, Carol Ann Duff compares an onion to the moon too. Although the moon is wrapped in brown paper, it still has light. Like love, no matter what is going to happen, it is still light and beautiful. On the contrary, the moon is the sign of sorrow opposite of the sun. At first when you see the moon, you may consider that it is extremely beautiful but if you see it much closer, you will see it is rough. It is not so beautiful as you firstly see it from the far. It is like an onion because you will think it causes nothing until you peel it. In other word, it is like love. You cannot know that love can also hurt you whether you face it yourself. It takes time to know how painful love can be like it takes way to know how rough the moon is. Carol Ann Duffy tries to tell about the truth of love as she says â€Å"I am trying to be truthful†. You have chances to choose â€Å"to love or not to love† whether you choose â€Å"to love†, you should know that love is no t always end of happiness. It is like when you have the proposal. It is optional. You can choose to be still alone or to walk together with your love. Love will be possessive and honest as long as we walk along together or love can bring heartache if we do not get along well. If you agree the proposal, your life will be changed. If you are married, the wedding ring will stay on your left ring finger to show love between you and your love and it will stay forever if you get along well like the smell of an onion that will stick to your fingers when you peel it. But if not love can be deadly. You can get the suicide holding the knife if you are really disappointed â€Å"Its platinum loops shrink to a wedding ring, if you like. Lethal. Its scent will cling to your fingers, cling to your knife.† In my opinion, the knife also has two sides. It depends on you that you can use the knife in the useful way as the real knife can be used in your daily life. You can be a good wife with the knife because you can use knife to make amazing food for your husband. Conversely, you can also use the knife to make a tragedy scene. Therefore, you can choose your way by yourself. Love is always bitter-sweet. No one will be happy or sad about love all the time. Love has both sides itself. It can fulfill your hope or make you upset. Hence, Carol Ann Duffy’s Valentine is the poem that builds the realistic portray of love to make the reader be aware of love because love is not always beautiful, sometimes it is painful.

The Brain and Violence: An Unhealthy Combination :: Biology Essays Research Papers

The Brain and Violence: An Unhealthy Combination "Jack was walking down the street enjoying a snack he had just bought at a convenience store. Feeling good, he smiled at the stranger coming toward him while continuing to eat. The stranger suddenly pulled out a knife and began stabbing Jack. Bystanders pulled the knife away, but too late." "After the killing, the attacker said that he was deeply sorry. He had sensed a strange aura, then experienced a flashback of having been bitten and of having a hernia operation under local anesthesia. That was followed by hallucinations about Jack cutting off his flesh, testicles, and heart to eat them" (6). Everyday on the news one hears stories of crimes and murders such as the one above. Murders are committed every day; stores are robbed every hour; crimes are committed constantly. The truth is that violence has sadly become a common and prevalent occurrence in society today. In essence, one must ask himself whether or not these violent tendencies have any biological relation whatsoever. Is violence caused by disruptions or damage to the brain? Is there a genetic correlation? Or is violence brought about by something else, such as economic difficulties or social or cultural differences? And one must ask himself an even broader question-whether a cause for violence even exists. In 1848, a railroad worker, Phineas Gage, was working when an explosion caused an iron rod to impale his skull, damaging the front part of his brain. Although Gage miraculously survived, his behavior severely changed in that the intelligent and respectful man everyone knew suddenly because fitful, impulsive, and rude (2). This case is one of the first indications that violence may be related to some kind of damage or abnormality in the brain. Researchers have found correlations between violent and aggressive tendencies to damage or abnormalities to a specific part of the brain. Gage's accident probably resulted in damage to the prefrontal cortex. The prefrontal cortex is the brain's foremost outer position, located behind the eyes. This area of the brain is especially important because of it's importance in the orchestration of emotion, arousal, and attention. The prefrontal cortex seems to be the part of the brain that enables people to restrain themselves from acting on all of their impulses and is extremely vital for a child's ability to learn to feel remorse, conscience, and social sensitivity (5). However, although the function of the prefrontal cortex is known, why, or how, would prefrontal deficits cause violent tendencies or a more aggressive character?

Overcoming Bullying: King Essay Response Essay

​Bullying is a common problem effecting people ever. You can be bullied on any number of things; sexuality, style, opinion, and personality, just to name a few. Everyone deals with bullying in their own way. Some choose to ignore bullying and some choose to confront their bully head on. There are also some people who tell someone older and more experienced about their problems. Some of these methods are the right things to do, while others are not the advisable choice. I believe that everyone can come up with a suitable solution to this problem that benefits everyone involved. ​The easiest solution to this problem is to ignore the bully and hope that eventually the bully will grow bored and stop. This is not a very effective method for two fairly obvious reasons; one being that the bully may just come up with even more hurtful things to bombard you with, and the other being that if the bully chooses to leave you alone, he/she will just find a new victim to taunt, which doesn’t really solve any problems. ​The next best thing to do would be to inform an adult of what is going on and hope that they will be able to put a stop to hit. This is also not the most advisable method to stopping a bully because it will just anger the bully further. They will resent you for getting them into trouble. They might decide not to attack you in the sight of an adult but the bullying will grow worse when the two of you are alone. That doesn’t solve any problems and can in fact make things a lot worse. There is also a chance that the bully may bring some of their friends into the mix, so if caught him/her are not the one that stands accused of being a bully. ​The smartest action to take when putting a stop to bullying would be to confront the bully face to face. I’m not advising that anyone should fight because all violence does is cause problems. When being bullied I find that is best to discuss any issues with the bully so that matters can be straightened out and leave ever y party satisfied with the outcome. In some situations the bully may not realize that their actions are causing hurt feelings. When you confront the bully on these issues you show them how they are being hurtful so in the future they know not to say these things again. In other situations you may find that the bully is also being bullied by someone else and that in bullying you they are making themselves feel better about their situations. In  confronting them you discover this and that might prompt you to extend the hand of friendship, which would no doubt offer them moral support throughout their own difficult situation. ​Other people may feel like dealing with bullying in their own way. Some people find it easier to ignore the problem and hope that it goes away and others may think that bringing and adult into the situation will help solve the problem. Not every case of bullying is the same and not every method may be appropriate when dealing with certain cases of bullying. I believe that discussing your problems with the bully is the best solution and I try to do just that when I feel s though I am being picked on. Discussing a problem produces a solution beneficial to everyone and it is the step I recommend for anyone who is dealing with a bully. I hope that everyone will make this decision when confronting a bully, because it is the best way put an end to bullying. If everyone discusses the problems they are having with someone straight away violence wouldn’t be such a big issue, and I’m not just talking about violence between teenagers but violence between nations. If issues would be cleared up straight away there would be no need for violence and everyone could just get along. I believe that one day, if everyone discusses their problems and issues everyone will get along, putting an end to this unnecessary hurt. ​ ​​ ​​​​​​​​​​​

Solving Problems and Making Decisions Essay

Background The aim of the cervical screening programme is to reduce the incidence of, and morbidity and mortality from, invasive cervical cancer. This is achieved by screening eligible women between the ages of 25 and 65 years. In my role as an acting Senior Biomedical Scientist in the cytology department, I screen and report negative and inadequate cervical samples in line with XXX protocols as well as facilitating the flow of abnormal cervical samples through to consultant pathologists and ensuring appropriate recall management is given to patients. I am also involved with the supervision of staff and the production and management of in-house standard operating procedures. Description of Problem Although always monitored by XXX, the timeframe from taking a cervical sample to when it was reported has never been given a strict turnaround time target, unlike the screening programme in England, which since 2010 has had a 14-day turnaround time target. However, this is to change as XXX want women screened in XXX to have an equitable service to that of the women in England and with the introduction of new testing alongside the current cervical cytology test, laboratory turnaround times need to be under 3 weeks. In May 2013, the majority of our work was turned-around in 3.5 weeks with only 0.9% of our workload being reported within the proposed 3 week timeframe. Being aware that XXX were likely to implement changes within the next 12 months, we wanted to be proactive and improve our performance before XXX enforce improvement methods upon us or worse the service was moved from XXX. Therefore, the problem was identified as: How can we reduce our turnaround times to under 3 weeks (from date received in laboratory to date authorised)? Analysis of the Problem We were aware as a service that our turnaround times had increased over the last couple of years due to the loss of staff through retirement and centralisation and due to the transportation of work to an off-site laboratory for processing and then its transport to our department for screening and reporting. However, to identify the areas that we could improve, we created a work-stream to understand the flow of work through the laboratory process. A simplified version of the work-stream is found below: (Removed for confidentiality reasons) The days in the green ovals are average accumulative working days it would take to achieve a reported sample from arrival at the laboratory. These are working days and do not include weekends, therefore it is possible a further 2 to 4 days could be added to the actual turnaround time, making a possible estimated laboratory turnaround time of between 4 and 10 days. These days are calculated with no backlog, and therefore the next step would be to identify were backlogs or bottlenecks were occurring. The processing of work at XXX was beyond our control. As was the transport to and from XXX, which occurs on alternative days and is governed by XXX. Therefore, the two areas we could concentrate on were the booking in and the screening of slides. In May 2013, the administration staff based in XXX had a slight backlog of samples to book in, this equated to 1 to 2 days delay. The main cause of this delay was lack of staff and it wasn’t something we could address immediately as recruitment of new staff would take time and screening staff could not help as the backlog and delay in slides being screened was even greater. In the same month, the backlog of slides waiting to be screened was estimated at 2 to 3 weeks, this equated to around 3000 slides waiting to be screened. The backlog of screening work was not only affecting swift results to the patients it was also having an effect upon the screening staff morale as they had to see large numbers of slides waiting to be screened, which  could affect the turnaround further. We were also notified at this time that a member of the screening team would be leaving and therefore the urgency in reducing our turnaround times became more imminent as we would have less staff in a month or two. If no action was taken now the turnaround times would increase further once the member of staff left. As a result, the area we need to concentrate on and identify possible solutions to was the matter of reducing screening times of slides, by attacking this element of the laboratory process we should be able to reduce our overall laboratory turnaround times. Identification of Possible Solutions The Cytology senior staff members, including myself, started with a brain-storming exercise of trying to identify possible solutions. Due to constraints and safe-practices put in place by the NHS Cervical Screening Programme (NHSCSP) and XXX it is not possible to ask screening staff to screen each slide faster, as false positives and false negative results would increase and the quality would be affected. And we could not ask staff to screen for a longer length of time in the day, as screeners can only primary screen slides for a maximum of 5 hours a day, again due to the quality risk. However, staff could work overtime by coming in at weekends. To try and improve the workflow pathway within the screening room I decided to re-read the †Cytology improvement guide – achieving a 14 day turnaround time in cytology† produced by the NHSCSP when England was undergoing changes to its screening programme turnaround times. This guide is a collection of evidence-based ideas for improving workflow and turnaround times in the laboratory and administration departments of the cervical programme. We had already adopted one suggestion from the guide in 2010 regarding batching sizes of work, whereby we have reduced the number of slides in a tray from 20 to 8 slides. Although each slide was still being screened for the same time length, a tray of slides were being finished quicker and therefore the screening staff felt happier and kept the work flowing through  the laboratory. However, on inspection the work wasn’t flowing, as after primary screening, trays were being placed into the rapid review box and only taken out for review twice a day (first thing in morning and after lunch), with some staff only reviewing slides once per day. This was causing the first bottleneck and it was also having a knock-on effect on the authorising of samples by senior staff as large chunks of authorising was occurring first thing in the morning or after lunch, which due to the monotony of checking details and results was causing errors to occur in reporting. We therefore needed to undert ake a Lean transformation. Lean is an improvement approach to enhance flow and eliminate waste that was developed by Toyota. Lean is basically about getting the right things to the right place, at the right time, in the right quantities, while minimising waste and being flexible and open to change. Lean thinking focuses on what the customer values, any activity that is not valued is waste. If you remove the waste, the customer receives a more value-added service. In our department this means reducing our turnaround times, so that the customer (XXX women) get their cervical results in 3 weeks. We therefore had to remove processes that were not adding value to the end result. By investigating further it was noted that some screening staff were writing on the front and the back of the sample request forms if the samples were negative. There was no benefit in duplicating the result on the back of the form and therefore as part of Lean it is considered waste. Distraction was also a large issue in the screening room. To screen and report slides, it requires concentration to process and distinguish abnormal cells from normal samples. However, staff were regularly stopping screening to chat or employees from other departments were coming in to talk, make a cup of tea or to eat biscuits causing distractions of up to 30 minutes at times. The telephone was also a regular distraction, with service users phoning up for advice and results and the XXX administration department phoning up regularly to change and update patient managements. Summary of Options We eventually decided the options available to us were: 1. Screening staff to work overtime. If every member of the screening team and senior team (Senior Biomedical Scientist and Cytology Manager) were to partake in overtime work on one day of the weekend and managed to screen an average of 30 slides per day the backlog could be cleared in 9 to 10 weekends. However, partaking in overtime is a voluntary decision and not all staff members would want to or be able to work overtime. This means that if we were to only adopt overtime as an option a minimum of 9 weekends would need to be worked, and as we were not changing the day-to-day workflow process a further period of overtime may be needed in the future to minimise any further backlogs. Working overtime also had a cost implementation, as staff would need reimbursing for their time given. As overtime would be over a weekend this would be calculated at time and a half pay. 2. One tray of primary screening followed by one tray of rapid reviews. To overcome the current bottleneck of work after primary screening, it would be more advantageous to rapid review slides little and often instead of first thing in the morning or after lunch. The preferred scenario would be to primary screen a tray of slides and then screen a tray of rapid review slides and alternate like this throughout the day. This means the throughput of work is more constant and turnaround is less. These examples explain this option further: Current example – As you can see this example of current working practice means the slides take approximately 22 hours from being initially primary screened to being authorised. Proposed example – This example shows that by alternating between primary and rapid review screening the whole process up to authorising should take approximately 75 minutes. A saving in time of 20 hours and 45 minutes for those 8 slides to be reported and authorised. Some work primary screened at the end of the day will have to wait until the next day for rapid review, but on the whole most work will be turned around at a much faster pace. This could be implemented immediately with no cost implications or changes to staffs working pattern. 3. Authorising work little and often. The examples used above also outline how this can improve the bottleneck between rapid review and authorising. Currently authorising is carried out in large batches after rapid review has been completed mainly at lunchtime and occasional first thing in the morning. These large batches of work are monotonous and transcription errors can arise due to this. By having rapid review completed in small batches of 8, it is possible for senior staff to authorise in these small batches as soon as rapid reviews have been completed. This means authorisation can be achieved much sooner and hopeful reduce the risk of mistakes occurring. 4. Reduce waste. A Lean approach was considered and any process that didn’t add value was removed. The first wasteful process identified was writing on both front and back of request forms, writing on the back was considered worthless. This process approximately took 10 seconds to carry out. Therefore if this was stopped each screening staff member screening 30 slides a day on average would save 300 seconds a day. This equates to 5 minutes, which is more than enough time to screen one or two extra slides a day. Which over a week could mean 10 extra slides been screened by one screening staff member or 80 slides a week if all screening staff stopped. The second process considered was the taking of primary screening work from the work pile before necessary. Some individuals would pick up 2 trays of primary screening or would leave unfinished trays on their desks overnight. If these trays were left in the pile or half trays placed back into the work pile before going home, it would allow another member of staff to screen them sooner and therefore have them moving along the work-stream quicker. 5. Adopt quiet-time. The most controversial option considered was to implement quiet-time in the screening rooms. An initial quiet-time of between 9.30am-12.30pm and 1.30-3.30pm was suggested, asking all staff member to keep any talking to  work-related questions only and to deter any colleagues from other departments from coming into the screening room or phoning the department. No mobile phones would allowed in the department during these times and work emails were to be checked first thing in the morning or first thing after lunch. Evaluation of Options The NHSCSP advise on using a PDSA cycle (plan, do, study, act) to evaluate and to test out ideas to ensure changes make the improvement required before implementation. Although the cycle is good at temporarily trialling a change and assessing its impact, it’s not useful in highlighting the best option or options to adopt without trialling them all. We therefore need to analyse the strength and weakness of each option first. A decision matrix was created to evaluate and prioritise the 5 options above. The criteria we used to make the decisions were: Cost implications; would there be any extra cost involved with each option and was this a small or large cost. (Rated from 1 (high cost) to 3 (low cost)) Speed of implication; were we able to implement this option immediately or would it require much planning. (Rated from 1 (slow) to 3 (fast)) Effect on staff; would the staff be happy with these measure, would it cause a negative effect in the work place. Did the staff have to make large adjustments to their working practice. (Rated from 1 (high detriment) to 3 (low)) Speed of improvements; how long would it take for us to see a change in turnaround times if option was implemented. (Rated from 1 (slow) to 3 (fast)) Each option was rated for each criterion, so that we could establish any issues with each option. From looking at the table above, options 2 and 3 have scored well on all 4 criteria and therefore would be able to be implemented with little disruption but with a good impact on turnaround times. Option 1 unfortunately had too many issues regarding cost and the time it would take to gain agreement for funding the overtime and for staff to agree to giving up their free weekends. Also every staff member wasn’t able to participate due to personal commitments and families, this meant the overtime worked could vary greatly week to week. It was therefore decided options 2 and 3 would be trialled further and option 1 would be abandoned. Although option 4 would take time to see results, it was decided that by ‘Leaning’ up the work process could only be a good thing and that the ideas suggested to reduce waste in the workplace should be implemented immediately. The main cause for concern with option 5 was the detriment to the staff,  however this change to working practice was considered to be the one that would have the greatest affect on reduction of turnaround times. It was therefore decided to trial this for a while, and that once the backlog was reduced we could relax the quiet time option and re-implement it if the backlog was to increase again. We could now look at the PDSA cycle and using turnaround time as a measurement assess the capabilities of option 2,3,4 and 5. By starting to trial the options and regularly monitoring and studying the turnaround times (Do & Study) we can highlight any changes that may be necessary (Act) and think of new plans to tackle any issues that arise (Plan). Implementation Before implementing and disseminating the information to all the staff, the cytology manager and cytopathologist went over all the presented options and made the final decision to implement the improvements for reducing turnaround times. They were happy to put forward the 4 options identified to all the staff and create action plans for implementation. A staff meeting was held to explain the situation regarding increasing turnaround times and the options put forward in the form of an action plan to the staff on how we could reduce the turnaround times. The action plans presented were: It was important to us to use SMART action plans, which meant we had to be specific in our actions and create measurable, achievable and realistic plans. An achievable time frame was set by creating weekly and monthly milestones for reviewing our turnaround times. Staff were asked to provide their thoughts on these actions and identify any issues or bring forward any options not already covered. Staff members made known their fears regarding quiet time, with one staff pointing out their working times were 9.30am until 2.30pm, and therefore apart from lunchtime she cannot talk during her working hours. This was taken into consideration  and the hours of quiet-time were altered. It was also stated the quiet time was a short term proposal and would be lifted as the backlog reduced/ended. An idea of moving the boxes holding the work needing rapid review and the boxes holding forms for authorising was also put forward. As currently the boxes were located across two different rooms and in the furthest corner of one room, meaning the entire screening room was being disturbed when someone went to put work/forms in the boxes. By moving the boxes to an equidistant place between both room, it would reduce the time wasted in walking to the boxes and reduce disturbance to other staff. Therefore the new and modified action plans were added. The staff was also advised that the turnaround times would initially be monitored in-house on a weekly basis to trial these changes and if the turnaround times were improving the monitoring would default to the XXX monthly monitoring. The aim was to try and authorise 300 cases a day, this was a realistic number to screen between 8 screening and 2 senior biomedical scientist staff. This equated to 1500 slides a week authorised, and as approximately 1000 slides were received and booked in each week, this meant we would be clearing approximately 500 slides from the backlog each week. Review of Outcomes Work levels were reviewed weekly by the Cytology Manager using the laboratories computer system. It was possible to see that the workload being reported was greater than that of the workload coming into the laboratory, and therefore the backlog of work was decreasing. However, what helped staff morale and made them aware of a reduction in the backlog and an improvement in turnaround times was being able to visualise the time between the date the sample was taken and the date the sample was screened and also seeing the reduction in the pile of work that was waiting for screening. As all options were implemented at the same time it was not possible to identify the effects of each individual option. XXX were also gathering the 3 week turnaround figures for all laboratories and these were being disseminated amongst the screening staff on a monthly basis. From the graph provided by XXX, it is clear from the implementation of changes in June 2013 the percentage of samples turned around in less than 3 weeks has steadily increased. A slight dip in the percentage is noted between August and September 2013, this coincided with the loss of a staff member and a move to a new laboratory building, which resulted in screening down-time for a couple of working days. It was at this time a decision was taken to stop the strict enforcement of quiet time, allowing the occasional ‘chatter’ within the screening room. This made work more welcoming and created a happier work environment, this in turn seems to have helped in the increase of samples turned around in 3 weeks. The introduction of these measures over the past 12 months have seen the departments 3 week turnaround times increase from 0.9% to 100%. References NHS Cervical Screening Programme (NHSCSP) – Cytology improvement guide: achieving a 14 day turnaround time in cytology NHS Cervical Screening Programme (NHSCSP) – Continuous improvement in cytology: sustaining and accelerating improvement

Credible Words

Credible Words Credible Words Credible Words By Maeve Maddox Latin credere means â€Å"to trust† Used with the dative, it means â€Å"to believe, to give credence to a person or thing.† Several English words come from this word. Credo with a capital refers to the Christian Apostles’ Creed or the Nicene Creed. Lowercase credo means any statement of the aims or principles which guide a person’s conduct. Creed is used more often than credo for this declaration of guiding principles. For example, â€Å"The Declaration of Independence contains the clearest, most concise, and most eloquent articulation of the American creed.† The noun credit came into English from Middle French with the meaning â€Å"belief, faith, trust.† It came to be associated with money lent or borrowed with an agreement for repayment. A customer’s â€Å"credit† is the confidence a lender has in the customer’s ability to repay. Credit is also used as a verb in the general sense of accepting something as true or truthful. For example, â€Å"He found it hard to credit his own eyes; the lion was lying down beside the lamb.† Schools are â€Å"accredited† by outside regulating boards. They have received credentials stating that they can be trusted to meet certain standards. Article IV, Section 1 of the United States Constitution is known as the Full Faith and Credit Clause: Full faith and credit shall be given in each state to the public acts, records, and judicial proceedings of every other state. And the Congress may by general laws prescribe the manner in which such acts, records, and proceedings shall be proved, and the effect thereof. The adjective credulous came into the language with the specific meaning â€Å"believing in God.† The negative incredulous meant â€Å"not believing in God.† The meaning shifted as time went on. Shakespeare used credulous in the sense of credible, but modern usage assigns distinct meaning to the two words. Credulous has the connotation of being too ready to believe. It’s a synonym for gullible. For example, confidence tricksters prey upon credulous people who are quick to believe in get-rich-quick schemes. Credible means â€Å"able to be believed.† A credible witness is one who can be trusted to speak the truth. The negative forms, incredible and incredulous, are sometimes confused. For example, here’s a headline from a site selling a sweatshirt that bears a message about not touching the wearer: incredulous dont [sic] touch me pullover sweatshirt Like awesome, incredible is often used as a throwaway word to convey enthusiasm. Sweatshirts are incredible. Singers are incredible. Movies are incredible. Generally speaking, incredible usually applies to things that are hard to believe, while credulous describes people who believe things too easily. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:The Meaning of "To a T"Excited ABOUT, not "for" Narrative, Plot, and Story

The New Monarchies

The New Monarchies Historians have identified changes in some of Europe’s leading monarchies from the mid-fifteenth to mid-sixteenth centuries, and have termed the result the ‘New Monarchies’. The kings and queens of these nations gathered more power, ended civil conflicts and encouraged trade and economic growth in a process seen to end the medieval style of government and create an early modern one. Achievements of the New Monarchies The change in monarchy from medieval to early modern was accompanied by the accumulation of more power by the throne, and an according decline in the power of the aristocracy. The ability to raise and fund armies were restricted to the monarch, effectively ending the feudal system of military responsibility on which noble pride and power had been largely based for centuries. In addition, powerful new standing armies were created by the monarchs to secure, enforce and protect their kingdoms and themselves.  Nobles now had to serve on the royal court, or make purchases, for offices, and those with semi-independent states, such as the Dukes of Burgundy in France, were bought firmly under crown control. The church also experienced a loss of power – such as the ability to appoint important offices - as the new monarchs took firm control, from the extreme of England which broke with Rome, to France which forced the Pope to agree on a transfer of power to the king.Centralized, bure aucratic government emerged, allowing for a much more efficient and widespread tax collection, necessary to fund the army and projects which promoted the monarch’s power. Laws and feudal courts, which had often been devolved to the nobility, were transferred to the power of the crown and royal officers increased in number. National identities, with people beginning to recognize themselves as part of a country, continued to evolve, promoted by the power of the monarchs, although strong regional identifies remained. The decline of Latin as the language of government and elites, and its replacement by vernacular tongues, also promoted a greater sense of unity. In addition to expanding tax collection, the first national debts were created, often via arrangements with merchant bankers.​ Created by War? Historians who accept the idea of the New Monarchies have sought for the origins of this centralizing process. The main driving force is usually claimed to be the military revolution – itself a highly disputed idea – where the demands of growing armies stimulated the growth of a system which could fund and safely organize the new military. But growing populations and economic prosperity have also been cited, fuelling the royal coffers and both allowing and promoting the accumulation of power. Who Were the New Monarchies? There was massive regional variation across the kingdoms of Europe, and the successes and failures of the New Monarchies varied. England under Henry VII, who unified the country again after a period of civil war, and Henry VIII, who reformed the church and empowered the throne, is usually cited as an example of a New Monarchy. The France of Charles VII and Louis XI, who broke the power of many nobles, is the other most common example, but Portugal is also commonly mentioned. In contrast, the Holy Roman Empire - where an emperor ruled a loose grouping of smaller states - is the exact opposite of the New Monarchies’ achievements. Effects of the New Monarchies The New Monarchies are often cited as being a key enabling factor in the massive maritime expansion of Europe which occurred in the same era, giving first Spain and Portugal, and then England and France, large and wealthy overseas empires. They are cited as setting the groundwork for the rise of the modern states, although it’s important to stress they were not ‘nation states’ as the concept of the nation was not fully advanced.

Edible bird's nest Essay Example | Topics and Well Written Essays - 1000 words

Edible bird's nest - Essay Example They are also available in supplements in form of capsules, chewable and liquid. There are various strains of probiotics but the most common are lactobacillus and bifid bacterium. Many of the health claims about probiotic yogurt still require more scientific research to be carried out in order to ascertain the claims. One of the major claim is that probiotic yogurt can change the makeup the gut bacteria for the better. A study conducted at the University of California, Los Angeles in the USA discovered that probiotics can alter the brain function as well. As such, these findings could guide experts in creating dietary interventions that alter mood, anxiety, and stress as well as pain sensitivity. Scholars assert that symbiotic gut bacteria which are the complex ecosystem of micro organisms that are found in the human digestive system promote health benefits by boosting a person’s immunity and as such help with food digestion, maintaining a healthy weight and blood pressure (Heasman et al, 2001). Probiotic yogurt can be used at the work place to keep the workers energized especially for those who do manual work such as construction. It can also rejuvena te the emotional state of the people who are undergoing training or when seated in a seminar hall listening to lectures. This will keep people alert as it is said to boost concentration. Students should also be encouraged to take probiotic yogurt to enhance their understanding in class as well as improving their brain performance. Studies done on rodents seem to suggest that dietary changes to the gut bacteria altered the emotional behaviour and sensitivity to pain. However, there is little evidence to prove that bacteria eaten in food can alter brain function. In a study by the same university, a research was conducted that revealed that those who ate probiotic yogurt for a month showed improved brain function in both resting brain activity

Applications of the Scientific Method Essay Example | Topics and Well Written Essays - 1000 words

Applications of the Scientific Method - Essay Example From the business perspective, scientific methods help in making decisions, solving problems strategically or even for testing a new idea in the market. The specific problem taken for discussion is about developing a new product that is superior to competitor’s brands. We shall present a detailed analysis of the proposed hypothesis and evaluate the results for understanding the factors influencing the problem and its outcome. Scientific methods help the businesses to deal with the problems in a systematic replicable manner. The process starts with identifying the problem, analyzing the possible factors based on experience, and then forming the hypothesis that would help resolve the problem. The proposed hypothesis has to be testable and it is essential to gather data and information for testing the prediction, and finally it has to be evaluated on the basis of the outcomes generated. The scientific approach indeed requires a valid testing of the hypothesis with the available data, rather than relying solely on intuition and theoretical knowledge. Though scientific methods are successful in various fields, it is not so with the world of business, marketing and policies. The tendency of businesses to deal with the unpredictable human behavior makes the scientific methods to be less plausible. However, adopting the scientific methods for business decision-making can provide a better understanding of the potential market factors as well as the causal effects. â€Å"Product development plans can be best realized by taking the scientific method or at least the scientific temper of analysis and experimentation, which is followed by product decisions.† (Mathur, 2009, p.108). When developing a new product that is superior to competitor’s brands, the business has to analyze the existing demands and needs of the consumer’s market. The hypothesis presented is that the new products in the consumer market