The Constitution And The Bill Of Rights - 1767 Words

American Government Exam #1 Bill Cox The Constitution and the Bill of Rights Ratified in 1788 and 1791 respectively, the Constitution of the United States and the Accompanying Bill of Rights have set the stage for the political culture and society which has, and continues to exist in the United States of America. The system of laws, regulations, liberties, and rights created by these documents has set the stage for many of the dynamic qualities inherent in the American culture. Because of the dynamic and intentionally vague nature of the documents, championed by the Non-Originalist view interpretation of the Constitution and the Bill of Rights the American legal system possesses the ability to adapt and evolve along with the continuously evolving American society and culture. The United States Constitution and its accompanying Bill of Rights are intended to provide the legal framework for the structure of a central Federal Government, and the rights and protections afforded to citizens under the Federal Government and its subservient states. The U.S. Constitution arose out of the Constitutional Convention of 1787, a secretive convention held in Philadelphia Pennsylvania intended to establish minor structural changes to the standing Articles of Confederation. However the convention soon transitioned away from altering the Articles of Confederation to drafting an entirely new constitution. The Resulting document established a strong Central Federal Government presidingShow MoreRelatedThe Bill Of Rights And The Constitution1530 Words   |  7 PagesBefore dealing with individual amendments I would like to deal with the entire Bill of Rights and the constitution itself. The framers of the Constitution were wary of ceding too much power to the federal government. They rightly believed many local citizens would never make it to the capital but would interact with local government, so the power should be kept at the most local level possible. It was impossible to foresee in 1791 a world with video conferencing, 24-hr news an d the ability to flyRead MoreThe Constitution And Bill Of Rights877 Words   |  4 PagesAmericans,† (Ginsbery, 2015 29). The constitution and Bill of Rights American citizens of the 21st century have grown up with was not the original idea our founding father created. As the Constitution developed in the late 18th century, debated started to emerge questions about where power should be concentrated within the government. The Article of Confederation was in power before. The constitution and bill of rights one sees today is not the original constitution of America. After the RevolutionaryRead MoreThe Constitution And The Bill Of Rights1294 Words   |  6 PagesReasonably measure of individuals can contend that numerous dialects are talked in the Unified States, however English is without no question is the national dialect. Our establishing fathers fabricated this nation by composing the Constitution and the Bill of Rights in English. Be that as it may, I do trust that the instructive framework here in the Unified States needs to educate the understudies a moment dialect, particularly Spanish since it is the second most talked dialect. As per WikipediaRead MoreThe Bill Of Rights And The Amendment Of The Constitution962 Words   |  4 Pagesincluded the Bill of rights that provided us with Freedom (Schweikart, 2004). The bill of rights was established so each citizen is equally treated and allowed to share their idea and not be disgraced for it (Bodenhamer, 1993). The first ten amendments to the constitution of the United States established basic American civil liberties (Schweikart, 2004). The Bill of rights and the amendments of the constitution were written about the same time by the same people. The Bill of Rights and amendmentsRead MoreThe American Constitution And The Bill Of Rights1463 Words   |  6 Pagesrepercussions all through Europe and America. Addressing conventional teachings and qualities denoted the Enlightenment; there was a prominent propensity towards independence and accentuation on the thoughts of human advance. The American Constitution and the Bill of Rights are both results of the Enl ightenment and thoughts of the philosophes, specifically John Locke. Thomas Hobbes and John Locke were both English philosophers,influential thinkers of the seventeenth century, both had confidence in a SocialRead MoreThe Bill Of Rights Of The United States Constitution914 Words   |  4 PagesWhat is a bill of rights? What is an amendment? How are the different? A bill of rights is a formality such as the Declaration of Independence and it is the outline of what the citizens feel their born rights are as people of a union. An amendment is the changing or altering of a legal or civil document. Specifically amendments in the United States Constitution include the changing or detailing of what the people need. These two phrases differ in what their purposes are. The bill of rights was setRead MoreBill Of Rights, The Center Of The American Constitution984 Words   |  4 Pages Bill of Rights Bill of rights, the center of the American constitution. The reason that why Bill of rights can be established is the anti federalist thought the constitution only stipulated that power from government, and the citizen can not get any power from it. In 1788, at the beginning of the United States, all the citizens want the freedom and democracy, then The â€Å"Bill of Rights† is here. The birth of the Bill of Rights, is the most basic principles of personalRead MoreEssay On The Us Constitution And The Bill Of Rights943 Words   |  4 PagesThe U.S Constitution and the Bill of Rights are iconic pieces of American History. These two documents are very important for every American to know and to read critically because it can highly affect them. However, there are many people in the country that do not know what is exactly in these documents. I have read through these pieces, and I will be discussing what I found to be most surprising to find in the piece. Also, the items that I expected to find in the documents that is not there. FirstlyRead MoreThe Bill Of Rights Of The United States Constitution Essay1359 Words   |  6 PagesThe Bill of Rights contains the first ten amendments to the United States Constitution. These first ten amendments were ratified on December 15, 1791. The Bill of Rights define and interpret constitutional rights and protections that are guaranteed under the US Constitution. The following text is a transcription of the first ten amendments to the Constitution in their original form. â€Å"Amendment I Congress shall make no law respecting an establishment of religion, or prohibiting the free exerciseRead MoreRatifying the Constitution to the Bill of Rights Essay618 Words   |  3 PagesIn 1787, the Constitution was written and submitted for ratification by the 13 states, but not everyone agreed with it. There were two groups of though. One was the Anti-federalists, who opposed the Constitution and the other group were the Federalists, who supported it. The Anti-federalists were people who supported the Articles of Confederation because they were doing well under them. They were mostly poor people from rural areas and were supported by the big states. They believed that the Constitution

Biography of Jim Morrison - 618 Words

Jim Morrison remains one of the most popular and influential singers and writers in rock history; they became famous on the classic rock radio stations. To this day, he is widely regarded as the prototypical rock star: sexy, scandalous, and mysterious. Morrisons performances have influenced many, including Richard Ashcroft, Nick Cave, Patti Smith, Glenn Danzig, Ian Curtis, David Gahan, Henry Rollins, Ian Astbury, Perry Farrell, Scott Weiland, Trent Reznor, Eddie Vedder, Jude Rawlins, Ville Valo, Sully Erna, The Blood, Siouxsie Sioux, and Jeff Martin. There were many great rock and roll artists out their like Jimi Hendrix, Led Zeppelin, Janice Joplin, Keith Richards. But there was something different about Jim Morrison; his poetry was astonishing along with his music lyrics. Morrison was that guy that would push things to the limit, just to see what would happen. Some people saw their behavior as the defiant, even revolutionary acts of a brilliant artist. Other people saw them to be r ude, drunken and obnoxious behavior.â€Å"Ladies and Gentlemen; The Doors!!!!† Jim Morrison was born in Melbourne, Florida on December 8th 1943. His father George Stephen Morrison was in the United States Navy and his mother’s name was Clara Clark Morrison. They met in Hawaii in 1941. He had a sister named Anne Robin (born on 1947 in Albuquerque, New Mexico) and a brother named Andrew Lee (born in 1948 in Los Altos, California). His brother Andy said that their parents would never use abusiveShow MoreRelatedJim Morrison1446 Words   |  6 Pages2014 James Douglas Morrison The most legendary man to live mainly people know him as Jim Morrison or Lizard King, known for his unique music and writings. Considered as a sex icon in the 60’s due to his charismatic character and giving birth to rock in roll. James Douglas Morrison, an American Poet, filmmaker lead singer for The Doors, was influenced by philosophers and poet’s views on aesthetics and morality mainly portrayed in Fredriech Nietzsche’s work. Jim Morrison was born on DecemberRead More The Doors Biography Essays1025 Words   |  5 Pages The Doors Biography nbsp;nbsp;nbsp;nbsp;nbsp; nbsp;nbsp;nbsp;nbsp;nbsp;From their beginnings during the summer of 1965 at Venice Beach, California, The Doors were a band of creative energy, with most of the focus on Jim Morrison. His looks and talents clearly tell why. Jim was well aware that the magic of The Doors could never have happened without the fortunate talents of John Densmore, Robby Krieger, Ray Manzarek and Jim Morrison. Robby Krieger, for example, wrote lyrics and music thatRead MorePsychedelic Rock : The Defining Music Genre Of The 1960 S1717 Words   |  7 Pagespsychedelic history, another group of excited students were ready to start their own band, albeit on the other side of the Atlantic. The Doors, one of the most influential and controversial rock bands of the 60s, were formed in 1965 by UCLA film students Jim Morrison, vocals, Ray Manzarek, keyboards, John Densmore, drums, and guitarist Robby Krieger. The group’s sound was dominated by Manzarek’s electric organ work and Morrison’s dee p, sonorous voice. The band released their first LP, The Doors, in 1967, featuringRead MorePhil Collen And The Left Of The Band Members Essay2049 Words   |  9 Pagesand depression, which led to his inevitable death on January 8th, 1990. An autopsy revealed the Clark died from an unintentional overdose of alcohol, Valium and Codeine. â€Å"He had been drinking and he cracked a rib earlier on,† Collen wrote in his biography Adrenalized. â€Å"The doctor told him not to drink while taking his pain medication. He drank anyway. The coroner’s report, I believe, read that it was due to a swelling of the brain. (Jon Wiederhorn Loudwire) Ultimately, Clark’s death was a tragic turnRead More Kurt Donald Cobain Essay examples1076 Words   |  5 PagesKurt Donald Cobain The subject of this writing, is on a man who changed music; a man on the level of Jimi Hendrix, Janis Joplin, and Jim Morrison. This individual is Kurt Donald Cobain from the revolutionary grunge/rock band, Nirvana. While some people would never consider Cobain to hold a major role in the shaping of our music and culture today, they haven’t taken the time to look around. Many people overlook the fact that music played a huge role in the lives of Americans during the 90’sRead MoreThe Harlem Renaissance1154 Words   |  5 Pagesculture, and revealed to the world what life was like as a black person in America. The Harlem Renaissance began with the Great Migration, when black men and women from the southern United States began moving to Northern cities. They were escaping Jim Crow laws and searching for better jobs (The Harlem Renaissance). Many people moved into Harlem, a neighborhood in Manhattan, New York City. It was relatively empty and apartments were cheap, though small. The sudden influx of African Americans, allRead MoreWilliam Blake was born in London on November 28, 1757 to James and Catherine Blake. His father,1600 Words   |  7 PagesAugustine and St. Thomas Aquinas in that the world is â€Å"the handiwork of God† (â€Å"Biography†). He also agreed with the views of Hegelianism as well as John Locke’s theory that the world is perceived through the senses (Clarke 1). Blake uses these philosophical ideas constantly in his poems, as well as his own view of Christianity. â€Å"The Book of Thel† and â€Å"The Marriage of Heaven and Hell† arenâ⠂¬â„¢t poems, just his philosophic ideas (â€Å"biography†). Blake drew his artistic inspiration from the classical molds of RaphaelRead MoreAnxiety And Other Mood Disorders1460 Words   |  6 Pagesdepression and other mood disorders (Verhaeghen, 2005, p.226). 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For example, in a study mentioned in â€Å"Why We Sing the Blues: The Relation Between Self-Reflective Rumination, Mood, and Creativity†, the following was reported: In his survey of the biographies of 1,004 eminent individuals living in the 20th century, Ludwig (1995) found a lifetime prevalence of depression of 50% for people working in the creative arts, compared with 20% of those in the field of enterprise, 24% of scientists, and 27% ofRead MoreFun with Literature10373 Words   |  42 Pagesresearch (both large small) projects that can be used to collaborate with other departments (such as physical education/health and history/social studies) †¢ Answer Key to handouts Thank you for your purchase! If you view Stephen King’s AE Biography, I have a Video Guide with Quiz: http://www.teacherspayteachers.com/Product/Stephen-King-BiographyVideo-Worksheet-Quiz More lessons can be found in my store: www.teacherspayteachers.com/Store/Tracee-Orman Quitters Inc. by Stephen King (published

Bowel cancer is the third most common cancer in the United Kingdom Free Essays

string(69) " and a high specificity \(to reduce the number of false positives\)\." 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. We will write a custom essay sample on Bowel cancer is the third most common cancer in the United Kingdom or any similar topic only for you Order Now 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). You read "Bowel cancer is the third most common cancer in the United Kingdom" in category "Essay examples" 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.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.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. Duke’s 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). â€Å"A comparison of faecal occult-blood test for colorectal cancer screening.† NEJM 334: 155-9. Donabedian, A. (1990), â€Å"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). â€Å"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. http://www.statistics.gov.uk/sdataset.asp?9091 Price et al. 2010) BMC Health Services Research 2010, 10:103 http://www.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). â€Å"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. J Med Screen 15: 130–136 Salkeld, G., Solomon, M., Short, L., Ward, J. (2003). Measuring the impact of attributes that influence consumer attitudes to colorectal cancer screening. ANZ Journal of Surgery, 73, 128–132. Szczepura A, Price C, Gumber A (2008) Breast and bowel cancer screening uptake patterns over 15 years for UK south Asian ethnic minority populations, corrected for differences in socio-demographic characteristics. BMC Public Health 8: 346 The NHS Cancer Plan Department of Health, 2000. Towler BP, Irwig L, Glasziou P, Weller D, Kewenter J. Screening for colorectal cancer using the faecal occult blood test, Hemoccult (Cochrane Review). The Cochrane Library, Chichester, UK: John Wiley Sons, Ltd. Issue 3, 2004. Scottish Executive Health Department (2006). Cancer Scenarios: An aid to planning cancer services in Scotland in the next decade. Edinburgh: The Scottish Executive. 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. British Medical Journal, doi:10.1136/bmj.38153.491887.7C ( published 5 July 2004) Von Wagner C, Semmler C, Good A, Wardle J (2009b) Health literacy and self-efficacy for participating in colorectal cancer screening: the role of information processing. Patient Education. 75: 352–357 Weller D, Coleman D, Robertson R, Butler P, Melia J, Campbell C, Parker R, Patnick J, Moss S (2007) The UK bowel cancer screening pilot: results of the second round of screening in England. Br J Cancer 97: 1601–1605 Weller, D., Alexander, F., Orbell, S. et al. (2003) Evaluation of the UK colorectal cancer screening pilot: final report. NHS Cancer Screening Programmes Worthley, D., Cole, S., Esterman, A., Mehaffey, S., Roosa, N., Smith, A., et al. (2006). Screening for colorectal cancer by faecal occult blood test: Why people choose to refuse. Internal Medicine Journal, 36, 607–610. Young GP, St John JB, Winawer SJ, Rozen P. Choice of Faecal Occult Blood Tests for Colorectal cancer Screening: Recommendations Based on Performance Characteristics in population Studies. A WHO (World Health Organisation) and OMED (World Organisation for Digestive Endoscopy) Report. The American Journal of Gastroenterology 2002:97(10) 2499-2507. How to cite Bowel cancer is the third most common cancer in the United Kingdom, Essay examples

FreeRTOS and Implementation of Context Switch

Question: Write a report on the FreeRTOS and how the context switch isimplemented. Answer: Introduction FreeRTOS is a real time operating system for the embedded devices. It is designed to be small as well as simple. It provides methods for various threads, tasks as well as software timers. FreeRTOS is the market leading real time operating system as well as a standard solution for both microcontrollers as well as small microprocessors (Chen and Wang 2015). It is most trusted real time operating system as it is professionally developed, robust, free to use for the commercial products, quality controlled, supported. Without the requirement it can exposed to the source code as well as it has no IP infringement risks. The report is based on the concept of FreeRTOS with reflection on the context switch that is being implemented. It also reflects on the real time kernel context switching source code commencing the bottom up. As FreeRTOS is a real time kernel, therefore it is ported to number of variety of architectures of the microcontroller. The report discusses about the implementation of the context switch between two of the tasks. Implementation of context switch FreeRTOS abstracts the details of peripheral interface such as implementation of the interrupt service routines that are required. Various data transfer modes are catered using various techniques to read as well as write the data makes the FreeRTOS applicable to wide range of applications (Strnadel and Rajnoha 2012). The task within the context switch is a sequential piece of code that it does not recognize if it is going to suspend such as swap out or switch out and resume such as swap in or switch in by the kernel. As the task is executed, it utilizes the processor as well as microcontroller registers with accessing the RAM as well as ROM to another program. The resources such as processor, stack as well as registers comprise the execution of task context. When the task is suspended before execution of the instruction, then it sums up the value that contains in two processor registers. When the task is balanced as well as other tasks are executed, then it may modify the processor r egister values (Cheng, Woodcock and DSouza 2014). Upon resumption of the task, it will not distinguish if the processor registers, then it modifies if it used the customized values the outline results into incorrect value. In order to prevent the error within the task, it is required that the resumption of the task has some context identical prior to the suspension (Stangaciu, Micea and Cretu 2015). The operating system kernel is used to make sure that it does by saving the context of the task as the task is suspended. When the task is resumed, then it saves the context that is restored by the operating system kernel prior to the execution. Th process to save the task context being suspended as well as restored the task context being resumed is defined as the context switching. In order to switch two established context, it is required to save all the registers on current and switch slacks. It restores all the registers of the new stack (Ferreira et al. 2014). This operation is called as thread_switch. The following are the implementation steps that are followed: Pushing all the callee-save registers onto the current stack. Saving the current stack pointer (%rsp) into the old thread control block. Loading of the stack pointer from new thread control block into %rsp. Pop all the callee-save registers from the new stack. Then Return. The FreeRTOS real time kernel events the time using the tick count variable. The timer interrupt increases the tick count with strictly temporal accuracy (Simonovic and Saranovac 2013). It allows the real time kernel in order to calculate time to resolution of selected timer interrupt frequency. A the time the tick count is incremented, the real time kernel ensures to observe if it is the time to unlock the tasks (Mistry, Naylor and Woodcock 2013). If it is probable that the task is unblocked throughout the tick ISR, then it has the priority higher than that to interrupt the tasks. In the case when the tick ISR returns, then it unblocks the tasks while interrupting one task but recurring to another (Freertos.org 2015). The context switch occurs in such a way that it is called Preemptive as the interrupted task preempts with no delaying itself. The context switching refers to the control of the flow jump, which occurs when one of the threads gives up the central processing unit as well as another thread that takes over (Okas, Krzak and Worek 2015). Like a function of call, the context switching involves with a push values onto the system stack. It also manipulates the registers of the CPU. Apart from this, unlike a call function, the context switches explicit entry as well as exit points. The context switching can happen at any time without any of the warning (Guan et al. 2016). If both the stack as well as the set of the registers represent as the user need to know about the flow of control, then the result is that the entire context must be saved before it is switched to another one. Context switches between two of the tasks The following are the steps to implement the FreeRTOS context switch implementation between two tasks as follows: It is assumed that the task A is running currently. Figure 1: Context of the Task A that is running (Source: Mistry, Naylor and Woodcock 2013, pp-1132) The RTOS tick occurs which also generates hardware interrupt. The hardware interrupt saves the register of the program counter automatically which points to the next instruction of the task A within the program stick of Task A. Figure 2: Program counter saved by the hardware within the slack of Task A at the time of interruption (Source: Mistry, Naylor and Woodcock 2013, pp-1132) The next step is that it has to imagine that the timer code saves the context that is beig executed. The stack pointer of the task A is stored by Kernel. Figure 3: Context of the task A that is saved within the program stack of the task A (Source: Mistry, Naylor and Woodcock 2013, pp-1133) The stored stack pointer of the task B is to be copied onto the stack pointer register of the Multi-point Control Unit (MCU). Figure 4: MCU stack pointer that points to top of the context of task B (Source: Mistry, Naylor and Woodcock 2013, pp-1134) It has imagined that the timer code restores the context of the task B that is already being executed. Figure 5: Context of the task B that is restored (Source: Mistry, Naylor and Woodcock 2013, pp-1135) The program counter register restores by the hardware automatically and then the task B s being resumed for executing. Figure 6: Execution of the task B (Source: Mistry, Naylor and Woodcock 2013, pp-1135) Conclusion It is concluded that the FreeRTOS is a real time operating system that leads in the marketplace due to some of its functions, as it is a standard solution for both microcontrollers as well as small microprocessors. The main functions of the FreeRTOS are that it is developed professionally, and use for the commercial products. It has good quality controlled, supported. Without the requirement it can exposed to the source code as well as it has no IP infringement risks. FreeRTOS also measures the time using the tick count variable. The interruption of the timer increases the tick count with accuracy of the time. References Chen, W. and Wang, J., 2015. Design of RFID Card Reading System Based on LWIP and FreeRTOS.AMM, 734, pp.916-920. Cheng, S., Woodcock, J. and DSouza, D., 2014. Using formal reasoning on a model of tasks for FreeRTOS.Formal Aspects of Computing, 27(1), pp.167-192. Ferreira, J., Gherghina, C., He, G., Qin, S. and Chin, W., 2014. Automated verification of the FreeRTOS scheduler in Hip/Sleek.International Journal on Software Tools for Technology Transfer, 16(4), pp.381-397. Guan, F., Peng, L., Perneel, L. and Timmerman, M., 2016. Open source FreeRTOS as a case study in real-time operating system evolution.Journal of Systems and Software, 118, pp.19-35. Mistry, J., Naylor, M. and Woodcock, J. (2013). Adapting FreeRTOS for multicores: an experience report.Softw. Pract. Exper., 44(9), pp.1129-1154. Okas, P., Krzak, Ã…Â . and Worek, C., 2015. C++14 concurrency on ARM Cortex-M using FreeRTOS and GCC.IFAC-PapersOnLine, 48(4), pp.262-267. Simonovic, M. and Saranovac, L., 2013. Power management implementation in FreeRTOS on LM3S3748.Serb J Electr Eng, 10(1), pp.199-208. Stangaciu, C., Micea, M. and Cretu, V., 2015. An Analysis of a Hard Real-Time Execution Environment Extension for FreeRTOS.Advances in Electrical and Computer Engineering, 15(3), pp.79-86. Strnadel, J. and Rajnoha, P., 2012. Reflecting RTOS Model During WCET Timing Analysis: MSP430/Freertos Case Study.Acta Electrotechnica et Informatica, 12(4).