God Has Made Provision For Everything He Created - 855 Words

God has made provision for everything He created. The parish ministry, as a minister was predestined for such time in the local church. As a minister, the task of an Elderly Care Ministry overseer and spiritual mentor are two areas for future prosperity. All ministries are God’s ministry, therefore, God timing is an important aspect in venturing to reach any goal in ministry. God is looking for people who are sold out for His purpose, people who are willing to stand tall and do whatever is required to get the job done. He is looking for some spiritual risk takers and by all means, He knows who meets the condition to do so. The direction and guidance are not always easy to understand or figure out; however, God has everything arranged for each step for the destination ahead. Paul declares, but just as it is written, â€Å"Things which eye has not seen and ear has not heard, and which have not entered the heart of man, all that God has prepared for those who love Him, (1 Cor. 2 :9, NASB).† Staying faithful to God is not an option for a believer, but it does takes practice. The practice must entail true worship and recognition to the God of sovereignty, whom the service is due. With this in mind, the calling of Elderly Care Ministry is grounded in serving the surrounding community elders in their homes of current care. The group consist of a Deacon and spouse, lay person, and self (Minister). This task was brought forth in August of 2015 and still active. This service involveShow MoreRelatedThe History Of Rasselas, Prince Of Abyssinia By Samuel Johnson Essay1707 Words   |  7 PagesA worldview is a mental model of reality. It is the idea and attitudes towards the world, life, and us as individuals. Each individual has their own unique worldview. 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To Moses at Mount Horeb, God said, â€Å"I AM WHO I AM (English Standard Version, Ex. 3:14 ), and those everlasting words still applyRead MoreMy Worldview Can Best Be Described As An Overflow1011 Words   |  5 Pages My worldview can best be described as an overflow. In the end, it is what I believe about God that spills out of the goblet of my life, staining every facet of my existence. I am a Christian. I believe that God and His words are the ultimate measuring stick by which all other claims of truth are evaluated. God is the rock. He is unmovable and unshakeable. To Moses at Mount Horeb, God said, â€Å"I AM WHO I AM (English Standard Version, Ex. 3:14 ), and those everlasting words still apply today. Read MoreA Prophet Among You1703 Words   |  7 Pagesfrom the hands of God, each was a perfect being. 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He was known for creating the two Greek epics The Odyssey and The Iliad, which. The Odyssey tells of the ten-year journey by Odysseus to Ithica from Troy to be reunited with his beloved wife. The Odyssey was written in a with illustrative language. The Iliad was written in a. It depicted the end of the Trojan War and the siege of Troy. This event occurred centuries before Homer was assumed to have been born. Although both epics were writtenRead MoreJesus Christ Made A Voluntary Sacrifice Essay1544 Words   |  7 PagesAtonement is an ecclesiastical theory which explains human being’s reconnection with God. This allows the sinful nature of man to be forgiven, and reconciled with grace of God. Forgiveness of sin through the sacrifice given through the death of Jesus and later his resurrection, is the understanding of atonement. Jes us Christ made a voluntary sacrifice to later allow the possibility of reconciliation between man and God. â€Å"God so loved the world, and gave his only begotten son† (Bible – King James version

The Destructive And Wrongful Use Of Solitary Confinement

Jessica Charan Psoras, Koula ENG 4U1 September 30th, 2015 The Destructive and Wrongful Use of Solitary Confinement Very few prison systems and prison facilities use the term â€Å"solitary confinement:, instead referring to prison â€Å"segregation† or placement in â€Å"restrictive housing† (Solitary Watch, FAQ). Solitary confinement is the total isolation of inmates who are feared for being a â€Å"danger† to â€Å"society,† — the prison system itself - for 23 hours a day from days to even decades. Solitary confinement was established in the 1800’s, where it initially started off as an experiment but is now being used as a â€Å"first resort† — instead of being used for the worst possible scenarios — for many correction facilities in North America to this present day. Prisoners are becoming mentally ill and are extending their time in segregation by participating in self-inflicted harm. Another word for the term jail is, correction facility. Solitary confinement is a form of cruel and unusual punishment and should be re-evaluated for overseeing the human rights of the inmates being held. Throughout the time of being placed into the â€Å"solitary confinement† unit, many inmates continuously become more and more disturbed. As a result of being kept in polity confinement for extensive amounts of time, prisoners begin to feel like they have â€Å"nothing left to lose†, thus, participating in self destructive behaviours. According to The Canadian Medical Association Journal, â€Å"14 of 30 prison suicide in theShow MoreRelatedDeveloping Management Skills404131 Words   |  1617 Pagespermission should be obtained from the publisher prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means, electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street, Upper Saddle River, New Jersey 07458. Many of the designations by manufacturers and seller to distinguish their products

Interest Groups vs. Social Movements free essay sample

A comparison of the goals and aims of interest groups versus social movements, with a focus on specific public policy distinctions. The following paper examines the distinction between interest groups and social movements which are sometimes hard to distinguish. This paper argues that interest groups are usually more narrowly focused and depend on organized supporters of otherwise loosely mobilized citizens within a larger social movement. Elections are formal procedures for choosing officers or making binding decisions concerning current and future policies. Elections are widely held in private organizations, such as corporations, church groups, or labor unions. Public institutions hold elections to select officers, to choose representatives, and to settle specific policy questions. Elections also may take place within specific governmental bodies or institutions as, in the United States, when members of a state legislature elect a speaker of the house. The discussion that follows, however, will focus on public elections for officers of governmental units or to decide public policy issues. We will write a custom essay sample on Interest Groups vs. Social Movements or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Such elections commonly have a larger number of persons entitled to participate and are part of the total political process within the governmental system.

Management and Supply Function free essay sample

It should be emphasised from the outset that purchasing and supply management is executed as an integrated part of the firms broader management (as part of the logistics management or supply chain management approach) *Purchasing and supply PLANNING is part of the firms general planning, mainly because the continuous supply of raw materials components services is of a strategic importance to the enterprise. The supply market is just as important for the firms survival continued profitability as the sales market is the firms own product. Firms general planning must be integrated. *The ORGANISATIONAL STRUCTURE of the purchasing and supply function should be aimed mainly @ linking into the firms overall structure in the most effective way. The purchasing and supply function primarily renders a service to the enterprise. *Purchasing and supply COORDINATION should be aimed @ harmonising and aligning the activities of the purchasing and supply function with those of the other business functions. We will write a custom essay sample on Management and Supply Function or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When a firm vests the authority for the purchasing and supply function in 1 person or team. Advantages: gt;Standardisation of materials and products is possible because purchases are made at one point gt;Purchasing and supply staff are afforded the opportunity to become experts gt;Control over all aspects of the purchasing and supply function is improved gt;Administrative costs are reduced by eliminating duplication DECENTRALISED PURCHASING SUPPLY ORGANISATIONAL STRUCTURE Purchasing by different departments, branches or plants, while each of them enjoys an important measure of autonomy of decision making regarding the purchasing and supply function. Advantages: gt;Better liaision can be effected between decentralised purchasing and supply functions and the user functions of individual plants served by the purchasing and supply function gt;The needs users can be better satisfied because the purchasing and supply function knows them better gt;Different plants maintain their autonomy. Plant managers are often fully responsible  for the profitability of individual plants. According to the combined approach, common requirements of the different plants such as equipment and certain categories of raw materials, are purchased centrally head of office. The plants purchasing and supply functions are assisted by corporate   purchasing and supply in developing policies, procedures, and control measures, recruiting and training staff, auditing the   purchasing and supply performance of the plants. The main coordinating mechanisms of purchasing and supply management with other functions in the organisation, and with suppliers and customers, are definitely computer systems such as electronic data interchange(EDI), materials planning (MRPII) and distribution requirements planning (DRP). TWO TYPES OF COORDINATION Between purchasing and supply and other functional areas Purchasing coordination is lateral acts in an advisory/support method to the other functions in the enterprise. Between p and s and the supplier system Two dimensions to the coordination between p and s function and the supplier system. Firstly there is coordination with the whole supplier system and secondly with the individual suppliers. The flow of products and services from the supplier has to be effective, the p and s function has to ensure that coordination between them and the supplier ensures this occurs. This can be achieved by means of supplier alliances, integrated systems and inter-organisational teams. The supplier must become an extension of the buying enterprise. The chief coordinating mechanisms available to p and s management are open communication, strategic alliances, integrated systems, the conscious motivation of suppliers and standardisation of specifications, purchasing documents and purchasing procedures. CONTROL : PERFORMANCE EVALUATION OF THE PURCHASING AND SUPPLYFUNCTION Control may be defined as a systematic attempt to reach objectives or set standards that accord with the enterprises goal, to observe actual perform- ance and compare it with the set standards, and to take corrective steps with a view to achieving the mission and goals of the enterprise. Objectives and basic principles of performance evaluation P and activities are complex, needs to have a control system. Feedback   on actual performance(measured against quantitative norms). This ensures that the p and s strategy is implemented at the various levels in the company. With this the p and s manager can monitor and improve the functions actual performance. Control ensures that all the other functions with p and s work optimally.

Flexibility of Employee Work Hours free essay sample

A discussion regarding how employers currently treat their employees with respect to working hours and family life with specific statistical references. In this paper the author addresses the issue of how the work environment, particularly in large companies, can meet the demands of family life. He looks at the different areas that people work in and assesses how accommodating employers are to the needs of the employees with specific reference to flexible working hours. The author also looks at how employers treat employees returning to work after maternity leave and allowing parents to attend to children during regular working hours. The author then moves on to discuss stress levels at work and how this directly relates to hours worked and time that the employee can spend with the family. From the paper: However, despite the fact that todays work/life movement has its roots in dependent care, the percentage of companies that provide assistance for dependent care remains remarkably low. We will write a custom essay sample on Flexibility of Employee Work Hours or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For example, only half (50%) have set up pre-tax accounts that help employees set aside money for child care or elder care expenses. One-third (36%) provide employees with information that help them locate child care in their communities. As we might expect, less than 1 of every 10 workplaces either has a child care center at or near the work site (9%) or helps defray some of the costs of child care (9%).

Bowel cancer is the third most common cancer in the United Kingdom The WritePass Journal

Bowel cancer is the third most common cancer in the United Kingdom Introduction Bowel cancer is the third most common cancer in the United Kingdom IntroductionReferences Related Introduction Bowel cancer is the third most common cancer in the United Kingdom with approximately 35,000 new cases diagnosed each year.   1 in 16 men and 1 in 20 women will develop colorectal cancer at some point in their lives. It is also the second most common cause of cancer death, with just over 16,000 (approximately 9,000 men and 7,000 women) deaths per year (ONS, 2010) Incidence rates for colorectal cancer increased by 28 per cent for men and 11 per cent for women between 1971 and 2007.   Rates peaked at 57 per 100,000 in men in 1999 and 38 per 100,000 women in 1992. In the ten year period from 1998 to 2007, incidence rates for men and women have remained relatively stable (ONS 2010). Being overweight, having an inactive lifestyle and a low fibre diet can increase the risk of colorectal cancer. Eating red and processed meat, and insufficient amounts of fruit and vegetables, smoking and drinking excess alcohol are contributing factors. People with Crohn’s disease in the colon, ulcerative colitis, polyps in the colon or a family history of colorectal cancer may also be at an increased risk (Department of Health, 2000). More than four out of every five new cases of colorectal cancer are diagnosed in people aged 60 and over, with most cases presenting in the 70-79 age group in men and in the 75 and over age group in women (ONS, 2010). Survival from cancers of the colon and rectum has doubled in 30 years.   For colon cancer, five-year survival was 50% for men and 51% for women diagnosed in 2001-2006 and followed up to 2007.   Five-year survival for those diagnosed in 1971-1975 and followed up to 1995 was 22 per cent for men and 23 per cent for women (Rachet et al 2009). Differences in survival rates are based on how early, or at what ‘stage’, a patient presents for treatment.   This ‘staging’ is a method (first developed in 1932) of evaluating the progress of the cancer in a patient. The classification considers the extent to which the cancer has spread to other parts of the body. Once established, the best course of treatment is then decided.   There are currently for categories: Dukes Stage A: The tumour penetrates into the mucosa of the bowel wall but no further Dukes Stage B: The tumour penetrates into, but not through the muscularis propria (the muscular layer) of the bowel wall. Dukes Stage C: The tumour penetrates into, but not through the muscularis propria of the bowel wall; there is pathologic evidence of colon cancer in the lymph nodes. C2: tumour penetrates into and through the muscularis propria of the bowel wall; there is pathologic evidence of colon cancer in the lymph nodes. Dukes Stage D: The tumour, which has spread beyond the confines of the lymph nodes (to organs such as the liver, lung or bone). Five year survival rates according to the Dukes’ stage of classification are:   Dukes’ Stage A 85–95%, B 60–80%, C 30–60%, D less than 10%.   These significant differences in survival rates were the basis for the introduction of a national screening programme for bowel cancer (Rachet et al 2009). The NHS Bowel Cancer Screening Programme in England began in July 2006, as part of the NHS National Cancer Plan (2000).   Patients aged between 60-69 were initially offered screening every two years and people 70 and over could request it via their GP. The criteria has since changed (from January 2010) with screening now offered to those aged 70-75 years. The objective of bowel screening is to detect bowel cancer at an early stage and get these identified patients into an appropriate treatment pathway.   The screening programme can also detect polyps, which, although are not cancers they may develop into cancers over time. They can easily be removed which reduces the risk of bowel cancer developing. This essay outlines the process of the UK bowel screening programme and from this provides a critical analysis of the test, performance and cost-effectiveness leading to a broader discussion considering   whether to implement the screening programme in relation to UK NSC criteria. Description and critical analysis of the evidence about the test performance (15 marks) Screening is defined by Raffle Gray (2007) as; ‘The systematic application of a test, or inquiry, to identify individuals at sufficient risk of a specific disorder to warrant further investigation or direct preventive action, amongst persons who have not sought medical attention on account of symptoms of that disorder.’ There is a distinct difference between screening and case finding (e.g. NHS Health Check) In clinical practice, patients approach healthcare professionals to ask for medical advice and help, in contrast with screening programmes, where professionals actively encourage people to undergo an investigation on the basis that it may benefit them. The performance of a screening programme is based on its ‘sensitivity’ and ‘specificity’.   The sensitivity of a screening test is the percentage of the screened population that has the disease and tests positive.   For instance, a sensitivity of 70% means that for every ten participants with the disease, seven will test positive and the other three will be false negatives.   A test with poor sensitivity results in a high percentage of the population with the disease escaping detection. These people will be falsely reassured and could delay presenting important symptoms. The specificity of a test is the percentage of the screened population that is disease free and also tests negative. For instance, a specificity of 80% means that eight out of ten people who do not have the disease will have a negative result. Two out of ten will have a false positive result and require further assessment before the possibility of disease can be eliminated.   A test with poor specificity will have an important effect for the individual, including increased anxiety and unnecessary clinical follow up. The ideal screening test would have a high sensitivity (to reduce the number of false negatives) and a high specificity (to reduce the number of false positives). It is usually difficult to achieve this as there is a trade off between the two measures; limiting the criteria for one results in a decrease in the other. Another key feature of a screening test is the predictive value for which there are two key aspects. The positive predictive value (PPV) of a test is the percentage of people who test positive who have the disease. The negative predictive value is the percentage of those who test negative who are disease free. The predictive value is influenced by both the sensitivity and specificity of the test, as well as the prevalence of the condition being screened for. In the UK the screening test used for the bowel screening programme is the ’faecal occult blood test’ (FOBT).   In terms of operational delivery there are approximately 20 Hubs across the country responsible for coordinating the screening programme, each Hub sends out letters of invitation to the eligible population, explaining about bowel cancer screening.  Ã‚   Standard practice ensures that within a week of receiving a letter a FOBT kit will be sent to patients.   The kits are used by the patient, samples taken and returned to the Hub, who then send normal results to individuals, and inform GPs via a standards letter.   For positive tests, the Hub contacts the individual directly, and an appointment is them made for the patient to have further investigations (colonoscopy) with the commissioned provider of colonoscopy services. The test and the framework for its operational delivery are based on a number of large scale trials which were undertaken to assess whether FOB testing of asymptomatic people could be useful in detecting individuals with early bowel cancer the largest trial conducted in Nottingham. The trials and the subsequent UK pilots (2008) found: uptake of approximately 60%, subsequent pilots returned a lower uptake which decreased with deprivation sensitivity was approximately 60% for cancer and 80% for adenomas biannual testing was as effective as annual testing screening of asymptomatic 55-75-year-olds reduced mortality from bowel cancer by 16%   overall, or by 25% in those 60% of individuals who return an FOBT there was no reduction in all-cause mortality from FOB screening. These results meant that FOBT can detect 60% of all colon cancers.   Alternatively, this also means that 40% are not routinely detected.   This lower sensitivity rate is a trade off based on the fact that FOBT screening is non-invasive, easily performed without the need for bowel preparation, and can be performed on transported specimens and of low cost.   A higher sensitivity rate could be achieved through once-only flexible sigmoidoscopy screening in prevention of colorectal cancer but uptake, patient acceptability and cost would be a barrier to population roll-out. Description and critical analysis of the evidence about the cost-effectiveness (15 marks) There are a number of research publications that compare specific models of bowel screening through the application of different these will be described, but from a public health perspective, this essay will also consider the wider opportunity cost in relation to bowel screening. Agreement relating to how cost-effective an intervention is depends on what the intervention is being compared against. For instance, a starting point in the evaluation of the UK pilot for Bowel Screening Cost-effectiveness (2003) states ‘Analysis found that the cost-effectiveness of a national programme compared well with other forms of cancer screening such as breast and cervical cancer screening.’ This statement is all about comparison with associated interventions that are deemed reasonable and safe with a generally fair return on investment this is more about acceptable levels of investment producing acceptable levels of return compared to similar interventions of the same type rather than considering whether the programme can be delivered more efficiently or could the resource be allocated in a different way to achieve the desired results. The issue of whether the programme could be delivered more cost effectively has been reviewed in a number of publications (Allison et al. 2006.   Rozen et al. 2000.   Levin et al 1997).   These comparisons have, in particular, considered the merits of; FOBT alone, flexible sigmoidoscopy and FOBT combined, and one-off colonoscopy with cost-effectiveness more often defined as the cost per cancer death prevented.   Of all the screening tests, FOBT alone prevents fewer cancer deaths than the other interventions, but the addition of a flexible sigmoidoscopy to the FOBT increases the rate of cancer prevention. One-off colonoscopy has the greatest impact on colorectal cancer mortality.   Although purported to be the most cost effective the outcomes are all based on clinical outcome alone but when considering cost FOBT returns better broader population results (in terms of patient acceptability and absolute cost to deliver) than any other of the interventions outlined. One of the most popular measures of cost effectiveness is considered through estimating the lifetime NHS costs and potential health benefits (defined as cost per QALY quality-adjusted life-years).   For bowel screening this equates to comparing the population not offered screening but treated according to current practice compared with a sample of the population who are offered screening as per the protocol used in the pilot study.   The cost per QALY is the additional costs of screening, after allowing for treatment cost savings, and the gain in survival and quality of life. The problem with QALYs has always been the question of what is the upper limit on what society is prepared to pay for health gains.   Ã‚  The National Institute for Clinical Excellence (NICE) provides some limited information about upper limits in this context.   It has been suggested that  £30,000 per QALY might represent an acceptable threshold (NICE, 2008).   Studies (Young et al, 2005. Lieberman, 2005. Khandker RZ, 2000) have returned a cost per QALY for bowel screening of between  £2,000 to  £3,000 which is well within the acceptable cost guidance offered through NICE but this does not mean that it is the more cost effective or efficient way of delivering the service. Raffle Gray (2007) touch on the issue of broader public health view and the influence of single issue groups, they outlined that; ‘If information for policy making is to serve the health needs of the public to best effect, then it must enable policy makers to keep a sense of perspective and context.   Doing this requires policy questions that are concerned with whole programmes of care, not just the single issue being considered.’ If we consider this in the context of a UK bowel screening programme costing  £50 million per year can we justify its delivery on the associated reduction in mortality of up to 16%? On face value, it seems we can (e.g. economic analysis and QALY returns etc) but that is assuming 60% uptake.   PCTs in the West Midlands are currently delivering the programme at between 28% and 42% uptake. As public health policy makers at what point do we consider the low uptake at sustained high cost as a reasonable return on investment?   There may be a greater return on investment if the  £50 million was invested in broader public health programmes targeted at reducing the population risks by changing behaviour (e.g. smoking cessation, diet, exercise). Taking this even further, could we reinvest the total  £50 million in another, unrelated, public health issue such as falls prevention programmes and tackle the risk factors associated with bowel cancer through legislation and regulation (e.g. increased taxation of tobacco or introducing a more challenging approach to price per unit for alcohol)?   In the long term, this may have more effect on a population effect on bowel cancer mortality at a lower cost. Description and analysis of the ethical issues associated with implementing this screening programme including accessibility, equity, the balance of harm and good and informed choice (15 marks) The benefits of bowel screening include a modest reduction in colorectal cancer mortality and a possible reduction in cancer incidence through the detection and removal of colorectal adenomas.   These benefits need to balanced against the potential harm of the programme.   One of these identified harms is the psycho-social consequences of receiving a false-positive result or a false-negative result, the possibility of over diagnosis (leading to unnecessary investigations or treatment) and the complications associated with treatment. Another key possible harm relates to the possibility of bowel perforation for those patients who have with a positive FOBT and require further investigation.   The UK National Bowel Cancer Screening evaluation (2003) suggested a perforation rate of 1 in 1500 colonoscopies.   This compares well with other bowel screening programmes in Australia and France which have returned a rate of 0.96 per 1000 procedures .   Following a diagnosis of perforation, most patients (over 90%) require surgery, and a significant number (30%) require colostomy or ileostomy. From a health inequalities viewpoint there are a number of issues relating to accessibility and equity that are cause for concern.   The first of these is the issues of uptake in the context of deprivation. Data for 2004-2008 shows us that there is a 11% of higher incidence rate of colon cancer for males in the most deprived population compared with the least deprived population (ONS 2008). This can be compared with uptake of screening which has demonstrated that males and younger age groups have lower uptake rates (Weller et al, 2007).   In the long term this pattern has the potential to further increase inequalities in health. There is also strong evidence that suggests certain ethnic sub-groups have lower participation rates of bowel screening than the general population (Robb et al, 2008; Szczepura et al, 2008). The reasons for these differences are complex ranging from health beliefs, misunderstanding and cultural attitudes. This defined lack of uptake by ethnic group is not evident in all screening programmes, for example, South Asian women are significantly less likely to undertake bowel screening compared to breast screening   (29% compared to 49%)   (Price et al. 2010).   This suggests more research needs to be undertaken to try and understand the key factors involved. Literacy can also be linked to deprivation and ethnicity and is a critical factor in participation in colorectal cancer screening.   As with many screening programmes a great deal of resource has been allocated to producing information and materials for the bowel cancer screening programmes – but we know that health literacy varies a great deal in the population (Von Wagner et al, 2009), and many patients will have limited comprehension of the material provided. Equity of access to diagnostic services is also a possible issue to manage. For two of the hospitals participating in the UK bowel screening pilot, there were significant differences between waiting times for colonoscopy for screened and symptomatic patients. For example, in Scotland the average waiting times for pilot patients was between 2 and 7 weeks, whereas for symptomatic patients they rose from around 10 weeks to between 16 and 20 weeks within the first year of the Pilot (Scottish Executive Health department 2006). Description of how to implement programme quality assurance and an assessment of the practical issues with implementation (15 marks) There are a number of frameworks for assessing and assuring the quality of healthcare service.   Examples include Deming’s 14 principles of management and Donabedian’s seven components of quality.   Raffle and Gray build in these two models and advocate six key points in applying quality assurance to screening. These are; Defining the objectives of the programme in a way that encapsulates what a ‘good’ screening programme will look like. Devise ways of measuring quality that will ensure these objectives are met. Set standards for each measurement; this is a subjectively chosen level that you will want the programme to achieve. Give responsibility to the local programmes for monitoring, how well they are doing in meeting the standards, and for working to improve quality in meeting those standards. Collate information about performance against standards and publications nationally for all the local programmes Provide support mechanisms for overseeing quality and for assisting local programmes with training and quality improvement. One way of doing this is by creating regional quality assurance teams. From personal experience, working with breast screening a cervical screening programmes, the need for clear standards and an overarching review process (the support mechanism) is essential.   A ‘deep dive’ approach to some of the key performance indicators is also very useful.   For example, if the target for local uptake is 60% a PCT, with the help of public health team, should approach this in terms of ensuring this uptake is achieved within the hardest to reach populations. In terms of the practical issues of implementation issues such as ease of completing the kit can be an important factor in determining uptake (The UK CRC Screening Pilot Evaluation Team, 2003).   Uptake can also be greatly affected by simple mistakes in postal address –so intended recipients do not receive the testing kit. This is one of the biggest factors associated with the uptake of an Australian trail where 20% of respondents in an Australian study claimed that they had not completed a FOB test because it had never been received in the post (Worthley at el., 2006). The Australian study also identified a preference by patients for increased GP involvement or promotion in the bowel cancer screening procedure (Salkeld et al., 2003; Worthley et al., 2006).   Many patient may prefer to have been offered screening through their GP, while almost half of those patients suggesting an alternative method of invitation wanted greater GP involvement (Worthley et al., 2006).   Similar evidence findings have emerged in the US, where a physician’s recommendation has been cited as the ‘strongest predictor’ of compliance with screening among men and women (Rabeneck, p. 1736, 2007). Overall discussion and conclusions about whether to implement the screening programme in light of the considerations already discussed and the UK NSC criteria (20 marks) Evidence suggests there is a reduction in colorectal cancer mortality as a result of introducing the UK bowel screening programme.   Following the national evaluation, it is also indicated that there was a beneficial shift towards identifying colorectal cancer at an earlier stage (e.g. Dukes Stage A).   Other benefits of screening that were not explored in this essay include the reduction in colorectal cancer incidence through detection and removal of colorectal adenomas, and potentially, less invasive treatment of identified early-stage colorectal cancers. These outcomes alone may be justification enough to continue to implement the programme in the UK. Several important additional areas require further research when deciding whether to continue with the programme or not. First, there is limited information currently available concerning the information needs and psychosocial consequences of screening for colorectal cancer.   Secondly, there is limited research on patient acceptance of colorectal cancer screening or on how best to involve particular socio-economic or ethnic groups who, as outlined previously, are often under-represented in uptake. Thirdly, the accuracy of other methods of the faecal occult blood test (e.g. RHNA) for colorectal cancer screening also requires further investigation. Maybe conclusions could be drawn through assessing the programme against the The UK NSC criteria which are considered below. NSC criteria states that all the cost-effective primary prevention interventions should have been implemented as far as practicable before consideration is given to proceed with the screening programme. This has not been the case in the UK. As outlined in this essay, greater effort could have been made to tackle the population risk factors before decision on implementing a  £50 million programme.   The screening programme could also be seen to negate the need for individuals to take responsibility for lifestyle behaviour and the risks associated with colorectal cancer. In terms of ‘The test’, it is simple, safe, precise and validated as per NSC guidance, and is generally acceptable in the population. Although, the essay has outlined the differences in uptake by socio-economic group and ethnicity. When considering ‘The Treatment’, there are effective treatments for patients identified through early detection, and this evidence has shown to lead to better outcomes than late treatment. The Screening Programme is based on good evidence from high quality Randomised Controlled Trials that the screening programme is effective in reducing mortality or morbidity and there is evidence that it is   clinically, socially and ethically acceptable to health professionals and the public. The benefits from the screening programme also outweigh the physical and psychological harm (caused by the test, diagnostic procedures and treatment).   The opportunity cost of the screening programme resource has been touched upon in this essay. The view is that all other options for managing the condition have not been fully considered, particularly primary prevention. Overall, the national bowel screening programme does provide a population drop in mortality.   The programme follows NSC guidance which is a benchmark for acceptability and although this essay supports the programme there still needs to be some further research undertaken in relation to uptake for specific population groups and the opportunity cost of the investment. References Allison, J., M. Tekawa, et al. (1996). A comparison of faecal occult-blood test for colorectal cancer screening. NEJM 334: 155-9. Donabedian, A. (1990), The seven pillars of quality’’, Archives of Pathology and Laboratory Medicine, Vol. 114, pp. 1115-18. Hardcastle JD, Chamberlain JO, Robinson MHE, Moss SM, Amar SS, Balfour TW et al. Randomised controlled trial of faecal occult blood screening for colorectal cancer. Lancet 1996, 348; 1472-1477 Hoff G, Bretthauer M (2008) Appointments timed in proximity to annual milestones and compliance with screening: randomised controlled trial. Br Med J 337: 2794 Khandker RZ, Dulski JD, Kilpatrick JB, Ellis RP, Mitchell JB, Baine WB: A decision model and cost-effectiveness analysis of colorectal cancer screening and surveillance guildelines for average-risk adults. Int J Tech Assess in Health Care 2000, 16;3:799-810. Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal occult blood test. Lancet 1996; 348; 1467-1471 Levin, B., K. Hess, et al. (1997). Screening for colorectal cancer: a comparison of 3 faecal occult blood tests. Archives of Internal Medicine 157(9): 970-7. Lieberman DA: Cost-effectiveness model for colon cancer screening. Gastroenterology 1995, 109:1781-90. Mandel JS, Bond JH, Church JR, Snover DC, Bradley GM, Schuman LM et al. Reducing mortality from colorectal cancer by screening for faecal occult blood. N Engl J Med 1993; 328; 1365-1371 National Institute for Health and Clinical Excellence. 2007/042a updated.   NICE responds to judicial review outcome. NCIN, Cancer Incidence by Deprivation England, 1995-2004. 2008. NHS MEL(1998)62. Screening for Colorectal Cancer Office for National Statistics. 2010. statistics.gov.uk/sdataset.asp?9091 Price et al. 2010) BMC Health Services Research 2010, 10:103 biomedcentral.com/1472-6963/10/103 Rachet, B., et al., Population-based cancer survival trends in England and Wales up to 2007:an assessment of the NHS cancer plan for England The Lancet Oncology (2009). Raffle A, Gray M. Screening; Evidence and Practice, Oxford University Press, 2007. Rozen, P., J. Knaani, et al. (2000). Comparative screening with a sensitive guaiac and specific immunochemical occult blood test in an endoscopic study. Cancer 89: 45-52. Robb KA, Power E, Atkin W, Wardle J (2008) Ethnic differences in participation in flexible sigmoidoscopy screening in the UK. 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Steele RJC, Gnauck R, Hrcka R, Kronborg O, Kuntz C, Moayyedi P, et al (2004) Methods and economic considerations, Report from the ESGE/UEGF workshop on colorectal cancer screening. Endoscopy; 36, 349-53. Steele RJC, McClements PL, Libby G et al. (2008) Results from the first three rounds of the Scottish demonstration pilot of FOBT screening for colorectal cancer. Gut 2009 58: 530-535 originally published online November 26, 2008 doi: 10.1136/gut.2008.162883 Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC et al (1995) Five hundred life-saving interventions and their cost-effectiveness. Risk Analysis; 15, 369-90. UK CRC Screening Pilot Evaluation Team (2003) Evaluation of UK Colorectal Cancer Screening Pilot – Final Report UK Colorectal Cancer Screening Pilot Group (2004) Results of the first cycle of a demonstration pilot of screening for colorectal cancer in the United Kingdom. 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TED talk Movie Review Example | Topics and Well Written Essays - 250 words

TED talk - Movie Review Example presentation content is of much significance; nonetheless, I hold the opinion that the style of presentation is more important, as it goes a long way in guaranteeing the concentration of the audience. There is no doubt that body language can enhance the delivery of a given content. This is because even the utmost dazzling arguments can send the listeners to slumber if the speaker is uninteresting and downbeat in tone (Knapp et al, 2014). On the other hand, a vibrant one with affirmative body language and changing tone often comes across as well versed, even when their subject of discussion is not attractive. It is indeed true that a polished presentation can compensate for weak content. That notwithstanding, I hold the opinion that both Allan Pease and Amy Cuddy were well informed on their topics of discussion, and their outstanding presentation skills supplemented the entire productions. Over and above, both the presentations have encouraged me to pay significant attention to nonverbal aspects of presentations, as the way in which an individual paces, stands, waves the hands and even moves the head drive countless