Acceptance and Commitment Therapy

Acknowledgment and Commitment Therapy An as of late embraced type of psychotherapy known as Acceptance and Commitment Therapy has gotten exceptionally well known. It was made during the 90s by Steven Hayes and is a type of social and psychological treatment. These treatment strategies have for some time been utilized to treat social issues like tension, worry because of awful circumstances, and sadness. Intellectual conduct treatment instructs patients to take a negative idea and assess all the reasons why it is bogus. In any case, Acceptance and Commitment Therapy (ACT) will permit the patient to acknowledge that idea immediately. Those musings may even be permitted to proceed or rehash until the power of them is normally decreased. These undesirable musings are not promptly discharged however rather are acknowledged. Proficient specialists who utilize the ACT procedure have contended that this technique increasingly fruitful in a shorter measure of time. It permits an individual to comprehend that they can in any case make a move with changing or special stepped area your emotions in any capacity. You can understand that you are having these unsettling sentiments yet at the same time can follow up on the inverse. ACT focuses on the possibility of Mindfulness, which is an act of being available in musings and day by day living. You will likewise be educated to distinguish your own arrangement of qualities and picked practices and activities that concur with your qualities. Information has demonstrated that from 1996 to the present, that there has been a high adequacy rate in an assortment of circumstances. Author and supporters of this treatment technique accept that a more elevated level of satisfaction is accomplished when we can conquer considerations and sentiments that are negative. Patients are instructed to decide to make positive move occasion when dangerous circumstances emerge. Indeed, even this therapys abbreviation suggests that at long last you have to act to make in any positive change. Acknowledgment and Commitment Therapy is an incredible instrument for individuals managing substance misuse, physical or psychological mistreatment, just as patients with OCD, fears, and bi-polar scatters. Couples and families have likewise had the option to profit by this technique and develop nearer and progressively personal with one another. Grown-up A.D.D. Grown-up A.D.D or Adult Attention Deficit Disorder is the place individuals experience issues centering for a specific measure of time or on each thing in turn. Numerous individuals with differing kinds of Attention Deficit Disorders feel that others effectively misconstrue them. They don't see the world similarly as others. Analysis of this issue is underrepresented in grown-ups and conceivably over analyzed in youngsters. Actually, grown-ups frequently dont acknowledge what the indications that they are A.D.D until their youngsters get determined to have it. Grown-ups who experience the ill effects of this condition have issues with proceeding with an errand, being sorted out, or completing things on schedule. Furthermore, those managing this have issues with having long haul connections and controlling emotional episodes. The test used to help analyze a grown-up is generally equivalent to youngsters, however rather than word like school, the grown-up will utilize work. So in the event that you score with the scope of having this condition, what do you do straightaway? You should have a specialist wipe out other potential explanations behind your manifestations like, OCD, bi-polar, melancholy, tension, or hormonal awkward nature. Early menopause and pre-menopause can likewise make ladies display comparable indications of consideration shortfall. From the start, your PCP may give you antidepressants since sorrow is basic in grown-ups with this issue. In the event that these dont work, at that point they may advance to an energizer sedate on the off chance that you dont have a background marked by tranquilize maltreatment as this medicine can be irresistible. Consequently, individuals with this issue feel that the treatment is more regrettable then the condition. There are approaches to adapt to Adult A.D.D normally. Changing your way of life with a legitimate eating regimen and exercise can assist you with managing the confusion without clinical reactions. Normal exercise causes you to soothe pressure and can even decrease sadness. Sustenance is significant when we have to center. Cerebrum boosting nourishments with amino and unsaturated fats are critical to helping you diminish consideration shortfall side effects. In conclusion, make records. Records can assist you with remaining focused. Spot obligations of the most elevated significance first and work on going all together. You will feel pleased with yourself every night when the entirety of your undertakings have been finished. Gloom Quiz Gloom is considerably more than negligible misery. It is characterized as enthusiastic downfall and withdrawal. We frequently state that we are discouraged on the grounds that something appalling occurred during our day or we couldnt get our direction. Nonetheless, genuine gloom is a clinically analyzed condition that regularly needs treatment and additionally prescription to calm. There is an approach to see whether you have a propensity toward this condition. It is known as a downturn test. This test encourages you decide if you are giving indications of being discouraged by the side effects you express. This test wont show consequences of how profoundly this condition is felt, yet it is useful toward getting an analysis and deciding your perspective. Indicating your primary care physician this test will support that person to learn the degree of your condition and what steps should be taken. This test is equipped towards making you mindful of the general signs and side effects of this condition yet giving significant and applicable realities. The test contains a lot of inquiries that will decide whether your condition is gentle to extreme, intense to incessant. You can adequately make a rundown of the indications that you are experiencing or encountering at whatever point you answer yes to any of the inquiries. At least three yes answers can be proof of an intense type of melancholy. An incidentally discouraged individual will see these manifestations decrease as the issues that caused them likewise blur. In any case, side effects that stay over a time of a month or more can be proof of an increasingly genuine condition. For this situation, you should contact a clinical expert. These side effects comprise of weariness, sleep deprivation, crabbiness, and considerations of self destruction. On the off chance that you feel any of these side effects or only an inclination that things arent right, at that point you should take a downturn test. It would be ideal if you know that his test isn't a replacement for a clinical determination. It ought to be utilized as an approach to decide your perspective and make you mindful of the manifestations one can look with this condition. Demonstrate your outcomes to your primary care physician to decide the following stage toward emotional well-being. Crystal gazing Matching Marriage these days is a mind boggling try. Finding your ideal perfect partner has become a bet that numerous couples are losing each year. Numerous single guys and lone rangeresses stress that they may always be unable to locate the correct individual to develop old with. Individuals everywhere throughout the world have looked for different assets in discover an accomplice. There are such huge numbers of match making sites and organizations that it is difficult to get rid of the counterfeit ones. In any case, there is one strategy that is an antiquated method of discover Mr. or on the other hand Mrs. Right; its soothsaying coordinating. This training utilizes a people star signs to figure out what kind of mate would be the best for them. Utilizing this kind of similarity scale you can discover somebody to impart your life to. Celestial prophets assemble data by utilizing stars, planets and the sun. They accept that these components frequently impact our conduct and increment the likelihood of finding an accomplice. In certain societies, guardians counsel celestial prophets to assist them with finding a reasonable spouse or wife for their youngsters. The data gave by the crystal gazer will impact the choice to concur with the marriage. These readings wont reveal to you the exact future, however it can tell you what trademark you have to search for in a mate. These qualities will be the most perfect to your own or parity out your shortcomings. For instance, in the event that you are modest, you might need to look for somebody somewhat more friendly. On the off chance that you have a temper, you should search for somebody progressively gentle tempered. These things can help keep your relationship fascinating and less difficult. Knowing how that specific sign acts, thinks, and feels will give you a favorable position while looking for a mate. In any event, when you do discover an individual with a good horoscope it isnt ensured that it will last. There are numerous factors to celestial coordinating that you need to consider. This strategy should just be utilized as an instrument to limit your pursuit. You might be good with a wide range of horoscopes, however on the off chance that you are not perfect with Virgos for instance, you could know about that. You will even now need to work at any relationship. You should bring the best pieces of your character out to show possible admirers. Leo Astrology Symbol Person who are brought into the world under the Leo crystal gazing image or sign are those conceived between July 23rd and August 22nd. Leo is administered by the Sun and their component is fire. This is viewed as an exceptionally autonomous sign. Leo is the fifth mysterious sign and is from the group of stars of Leo which speaks to the lions tail. Men brought into the world under this sign are warm and cheerful and inclined to activity. He wants to be the focal point of consideration. He is profoundly social and his eagerness spreads to every one of his companions. He isnt only a pleasant time companion, yet you can likewise rely upon him when times are hard. Leos are incredible, normal conceived pioneers with quality initiative aptitudes. They are straightforward, faithful and positive and like to lead out front. They can identify with individuals from various ways of life and are exceptionally strategic. Despite the fact that they are incredible at designating assignments to other people, they dont effectively acknowledge them. Leos are dont like to acknowledge disappointment and are resolved to succeed. Leos love sentiment with candlelit meals and neighborliness. They lean toward extravagance and living truly agreeable. You need to stroke the Leos sense of self as they love acclaim and adoration when they have accomplished something. They are normally touchy animals. Leos are solid willed and predominant, so two together can be a major issue. For the most part Leos are liberal, warm, lo

Vera Drake Movie Review Example | Topics and Well Written Essays - 1000 words

Vera Drake - Movie Review Example The truly stunning component with Vera is that she is acquainted as totally devoted with her family and her obligations as spouse and mother. Staying quiet from her family and being undisturbed for a long time, for her this was an ordinary visit to somebody's home and getting them out of the circumstance. At the time single ladies specifically would be socially and monetarily denounced in the event that they got an ill-conceived kid. So as to keep away from the cataclysmic circumstance, ladies would effectively spare their social appearance and picture. What the film attempts to suggest to the crowd is that the courageous woman follows up on the bases of her own standards and she is guided by her positive attitude to spare the ladies and enable them with the option to choose for themselves what is best for them. What we don't anticipate from the film is that such a sort and pleasing, spouse and mother could ever thought of performing unlawful premature births when social standards and limitations don't legitimize it. Vera has the inward quality and endurance to do these techniques and she is continually alleviating the setback ladies indicating profound comprehension and backing for their circumstance. The executive cautiously investigates and assumes with the jobs that Vera satisfies - spouse, mother and criminal. In spite of the fact that we are acquainted with Vera's family, companions and social encompassing we are never given the contention what made Vera into rehearsing the then illicit premature births. So we can just accept that she is doing it because of her cooperative attitude and conviction that she is making a difference. She is bolstered by her reaction when the monitor comes into her home. Truth be told, they never ask her what she is doing, she gives her in by conceding that she knows as of now why they are here. What's more, she answers: I help young ladies out. Using this code word persuades that her longing is to help the young ladies. Vera's activity can be best portrayed as getting young ladies in the clear. Another proof of her cooperative attitude is that she isn't taking cash. Rather she is brought food or milk or different fixings. At the point when gotten some information about that she is spurned. It appears that her clarification is unmistakably more entangled than just increasing additional money. Vera's watchful administrations and house to house visits part with that she is negligent about exploiting ladies' circumstances and rather chances everything - her family and her great name so as to help the ladies in their longing to make premature birth. The crowd is additionally given different viewpoints after Vera's capture. We have Reg's conclusion (Vera's little girl potential spouse) - It ain't reasonable. Me mum raised six of us in two rooms. On the off chance that you can't take care of them, you can't cherish them, presently can you His point shows understanding about the job that ladies play as moms, homemakers and care suppliers. Vera has extremely tender bond with her better half - Stan. His opinion of her capture is that Whatever she done, she done it because of the decency of her heart! Since the watchers need to depend on signs that different characters part with, Stan and Reg give us potential clarifications why Vera started her activities. The explanation behind Vera's capture is a perilous incident that transpired of her clients a little girl of a rich bourgeoisie family for whom Vera cleans. Susan's urgency is as serious as Vera's

Transformation of Gregor Samsa from Metamorphosis by Kafka

Transformation of Gregor Samsa from Metamorphosis by Kafka Diagnosing Gregor Samsa from Metamorphosis Oct 30, 2018 in Literature Characteristic of Metamorphosis by Franz Kafka The novella The Metamorphosis written by Franz Kafka narrates the case of the protagonists physical and mental transformation. At the beginning of the story, the author writers, As Gregor Samsa woke one morning from uneasy dreams, her found himself transformed into some kind of monstrous vermin (Kafka 29). The author describes in detail how this transformed creature attempts to survive. Its transformation can be of psychotic nature because of detached and dreamlike reality. Gregor delineates himself from the external social environment, family, and work. He has problems with speech and severe deviations in outlook on the real world. In general, psychosis has been related with the loss of identity, accompanied with a range of visual, hallucinations, auditory, and somatic disorders. In this respect, in Kafkas The Metamorphosis, the current interpretation of Gregors diagnosis is closely associated with psychosis followed by the loss of identity, and the recognition of fatal disease, whi ch could be compared with AIDS. Gregor Samsa and His Transformation in the Novella While comparing the main character with other people who have disorders and psychological problems, it can be stated that Gregor was treated like a strange sick person especially by family members and society. In order to understand Gregors psychological state, the attention should also be paid to his personal background. As a result of his metamorphosis, it has been evident that the heros adhesion of his physical state makes his further actions logical, concrete, and predictable. Therefore, his reminiscence of a person who has AIDS explains some of the actions described in the story. Kafka recognizes that Gregors family members and family background in general is really complicated and is full of conflicting and controversial situations, followed by hatred and fights. Therefore, the protagonists detachment and desire to stay in the room shows his reluctance to communicate with the outside world, including his family. Gregor is depicted as a social outcast who is rejected by society. The presence of illusions and hallucinations is also revealed through the description of Gregors psychological state because the novella is regarded as a fusion between realism and surrealism, an allegoric representation of psychotic protection. In order to understand whether Gregor Samsa really suffered from psychosis, the analysis of symptoms should be conducted.

How Does Nitrogen Oxide Pollution Affect the Environment

NOx pollution occurs when nitrogen oxides are released as a gas into the atmosphere during the high-temperature combustion of fossil fuels. These nitrogen oxides consist mainly of two molecules, nitric oxide (NO) and nitrogen dioxide (NO2); there are other nitrogen-based molecules considered to be NOx, but they occur in much lower concentrations. A closely related molecule, nitrous oxide (N2O), is a significant greenhouse gas that plays a role in global climate change. Where Does NOx Pollution Come From? Nitrogen oxides form when oxygen and nitrogen from the air interact during a high-temperature combustion event. These conditions occur in car engines and fossil fuel-powered electricity plants. Diesel engines, in particular, produce large amounts of nitrogen oxides. This is due to the combustion features characteristic of this type of engine, including their high operating pressures and temperatures, especially when compared to gasoline engines. In addition, diesel engines allow excess oxygen to exit the cylinders, diminishing the effectiveness of catalytic converters which prevent the release of most NOx gases in gasoline engines. What Are the Environmental Concerns Associated With NOx? NOx gases play an important role in the formation of smog, producing the brown haze often observed over cities, particularly during the summer. When exposed to the UV rays in sunlight, NOx molecules break apart and form ozone (O3). The problem is made worse by the presence of volatile organic compounds (VOC) in the atmosphere, which also interact with NOx to form dangerous molecules. Ozone at the ground level is a serious pollutant, unlike the protective ozone layer much higher up in the stratosphere. In the presence of rain, nitrogen oxides form nitric acid, contributing to the problem of acid rain. Additionally, NOx deposition in the oceans provides phytoplankton with nutrients, worsening the issue of red tides and other harmful algae blooms. What Are the Health Concerns Associated With NOx? Nitrogen oxides, nitric acid, and ozone can all readily enter the lungs, where they create serious damage to delicate lung tissue. Even short-term exposure can irritate the lungs of healthy people. For those with medical conditions like asthma, just a short time spent breathing these pollutants has been shown to increase the risks of an emergency room visit or hospital stay. Approximately 16% of houses and apartments in the United States are within 300 feet of a major road, increasing exposure to hazardous NOx and their derivatives. For these residents—especially the very young and elderly—this air pollution can lead to respiratory diseases such as emphysema and bronchitis. NOx pollution can also worsen asthma and heart disease and is tied to elevated risks of premature death. What Role Does NOx Pollution Play in the Volkswagen Diesel Scandal? For a long time, Volkswagen has marketed diesel engines for most vehicles in their fleet. These small diesel engines provide ample power and impressive fuel economy. There were concerns over the cars nitrogen oxide emissions, but those were appeased as the little Volkswagen diesel engines met the stringent requirements policed by the U.S. Environmental Protection Agency and the California Air Resources Board. Somehow, few other car companies seemed to be able to design and produce their own powerful but thrifty and clean diesel engines. It became clear why in September 2015, when the EPA revealed that VW had been cheating the emissions tests. The automaker had programmed its engines to recognize testing conditions and react by automatically operating under parameters that produce very low amounts of nitrogen oxides. When normally driven, however, these cars produce 10 to 40 times the maximum allowable limit. Sources EPA. Nitrogen Dioxide – HealthEPA. Nitrogen Dioxide (NOx) – Why and How They Are Controlled This article was written with assistance from Geoffrey Bowers, Professor of Chemistry at Alfred University, and author of the book Understanding Chemistry Through Cars (CRC Press).

Marketing Mix Example - 1838 Words

1. Read following paragraph and explain the process this firm might go through to reach this specific marketing strategy - how and why this company reach to use this decision. Also explain results this firm may get from using this specific marketing strategy. In addition, recommend any modification of strategy based on SWOT analysis. Bakery chain Tous Les Jours introduces two varieties of Kim Yu-na bread,à ¢Ã‚€Â  named after the popular Korean figure skater. The flavors, chosen by Kim herself, are the sweet potato and cream bread, and the kaya bun. The company said that the proceeds will go to various charities selected by Kim. The bread will be sold nationwide. à ¢Ã‚â€" how this company reach to use this decision they must go through this†¦show more content†¦tous les jours also can increase in sales and proceeds. moreover another sort of breads that they carry make sales more as a synergy effect because the customers who visited dont purchase just one bread.  à ¢Ã‚â€" recommend any modification of strategy based on SWOT analysis. in this case, the objective of marketing strategy is to build good image by SO strategy. I think it is good. but I want to recommend one thing with threat component of SWOT. nowadays most of food industry is forced to open food additives in order to reveal whether some food is good to eat or not. but bread is not mandatory to open their information. I think thats big problem in relation to trend. to remove risk about food problem, to notify this companys food is good and nice hygienically and also to prevent some problems, tous les jours had better choose things which deprive of threat, food-polluted problem. 2. Today we live in an environment of global warming and high oil prices, which demands energy efficiency. Choose any firm which is currently operating in a market, and develop marketing strategy which is applicable to that specific firm in relation with above statement. a. first step : market situation evaluation the customers need is changing into environment-friendly product. that means the customer forces the producer produce cost(energy)-efficient items because the globe grow warmer and warmer and the people are threatened by green houseShow MoreRelatedExamples Of Decisions ( Marketing Mix )870 Words   |  4 PagesExamples of Decisions (Marketing Mix) The main component of the marketing mix is the product. It consists of the services, along with the physical product itself. The company imaging, packaging, and the brand name are all included in this concept. An example of product decision in this particular case study is the variety of cookies that are provided: The Girl Scouts will also be asking certain troops to reduce their cookie lineups to six varieties. The top six selling cookies--Thin Mints, Do-si-dosRead MoreMarketing Mix Essay examples1043 Words   |  5 PagesMarketing Mix MKT 421 Tyson Foods promotes several different types of food in the food chain industry. They are ranked 96 in the Fortune 500 in America’s largest corporations. Tyson’s produced poultry, beef, and pork, as well as providing the previous to several chain stores to use products. From McDonald nuggets to the Subway sandwich, Tyson is one of the largest poultry processing plants in the country. Tyson also distributes bag in bag products to stores which include Sam’s and Wal-Mart storesRead MoreMarketing Mix Essay example1473 Words   |  6 PagesMy Marketing Mix I am now going to create a marketing mix for my chosen product using the 4 Ps, Product, Place, Price and Promotion. Product The product I will be re-launching is the Cadburys Double Decker bar with less calories than a traditional bar. This new re-launch of a chocolate bar will be a limited edition chocolate bar. The idea being limited edition is to make a substantial profit in a short period of time. Although the product will say limited edition I aim to keep theseRead MoreMarketing Mix – Literature Review and Company Example5234 Words   |  21 PagesDiploma in Sales Marketing - 66th Intake Module DSM 101-Marketing Principals Marketing Mix – Literature Review and Company Example Lecturer: Thomas Lim Team Members:Christopher Mark Charlton (team leader) Gary Chow Hock Meng Andrew Peter O Lai Wohlstand Cheah Rong Jin We declare this report is XXXXX words in length 1 Table of contents Introduction to the Marketing Mix 4Ps ~ page number 3 Marketing Mix 4Ps Place Literary Review Company Example of Marketing Mix 4Ps Place – Ritchie Bros.Read MoreMarketing Mix1491 Words   |  6 PagesMarketing Mix MKT 421 Marketing Introduction Companies today try their best to continue to keep up with the changes of services, products and technology. Companies rely on their abilities in marketing to keep consumers interested in their products and services. The success of a company may rely on the company’s marketing performance. Marketing planning starts by thinking of the targeted audience needs, strategies, and the development of the products and or service needed. DevelopingRead MoreMajor Pricing Strategies1486 Words   |  6 Pageselements  that  determines a firms market share and profitability, although in recent decades non-price factors have gained increasing importance.   --Price is  the only element in the marketing mix that produces revenue and the most flexible marketing mix elements. --Price is  the number-one problem  facing many marketing executives. Smart managers treat pricing as a key strategic tool for creating and capturing customer value. --As a part of company s overall value proposition, price  plays a key roleRead MoreEssay about Marketing Mix of the Berocca1345 Words   |  6 Pages1.0 Abstract In this report, the aim was to analyze the marketing mix of Berocca according to our group’s survey and questionnaires. Marketing mix includes product, price, place and promotion. In terms of the survey and questionnaires, some results were givens and analyzed. In addition, some personal suggestion will be presented. 2.0 Introduction Berocca is a brand of effervescent drink and vitamin tables, the tables contain comprehensive vitamin B group and vitamin C. At first, Berocca wasRead MoreFlight Centre1695 Words   |  7 Pagesfindings: 1. Wide gap in the revenue growth of high and low performing stores. Difference in revenue growth of highest to lowest performing stores in last six months showed a huge variance. 2. Inconsistent customer experience across stores. The marketing metrics provided in the case study reveals that customers are treated differently in various Flight Centre stores. The company does not have organization level guidelines for their staff for customer handling. 3. Lack of commitment towards the visionRead MoreMkt421 Marketing Mix1094 Words   |  5 Pagesof Phoenix MKT421 - Marketing Mix The marketing mix is comprised of four basic marketing strategies. The four strategies, which include product, place, price, and promotion, involve the decisions that a business must make to succeed. The marketing mix is reliant on how clear and defined the business’ target market is and how well the company directs the strategies towards its targeted market (Glenco McGraw-Hill, 3rd Edition). This paper will further define marketing mix, the four strategiesRead MoreIncreasing Competition Between Low Cost Carriers1679 Words   |  7 PagesSingapore Airlines. Is has been a raising star in the LCC industry, thus makes me interested in analyzing their marketing strategies, find out that whether only the marketing mix contributes to their success, or there are some other factors effecting. The following paragraphs will analyze Scoots’ marketing mix in advance, and then move forward to some other success factors. Marketing Mix The core value customers get from taking an airplane is the service of traveling or transportation. As a traditional

The contribution of the Upper tribunal to the first-tier tribunal’s work Free Essays

string(127) " feature of the new system and, as demonstrated above, shares features with the judicial review available in the courts\[24\]\." Introduction The reform of the haphazard system of tribunals in the UK has often provided a neat symmetry with the chaos the system has been vehemently criticised for. It has taken half a century for the Tribunals, Courts and Enforcement Act 2007 to be given royal assent, which Bradley Ewing rightly suggest to be the fulfilment of the conclusions of the influential Franks Committee of 1957, constituted to provide a once-in-a-generation review of tribunals and inquiries in the UK[1]. The Franks Committee concluded that tribunals are â€Å"machinery provided by Parliament for adjudication,† the operation of which should be fair, open and impartial[2]. We will write a custom essay sample on The contribution of the Upper tribunal to the first-tier tribunal’s work or any similar topic only for you Order Now Thus at one legislative stroke the proliferation of tribunals in the last century, which moved the then Lord Justice Woolf to author a paper entitled â€Å"a hotchpotch of appeals – the need for a blender†[3], has now been significantly curtailed by the 2007 Act which established two tiers of tribunals to simplify what was becoming unaccountable, undemocratic and in violation of ECHR treaty convention rights[4]. A review in 2001, formed under the auspices of the then Labour Government and the main catalyst for the 2007 Act, found that there were 70 different tribunals across England and Wales and that a number of them were obsolete[5]. The Government’s response in the White Paper Transforming Public Services: Complaints, Redress and Tribunals[6] laid the foundations for the unified system which now prevails. The problems of the past which plagued tribunals are of â€Å"historical interest† in the words of Bradley Ewing[7]. In the context of mental health the relevant first-tier tribunal chamber is the Health, Education and Social Care Chamber and in the Upper tribunal the relevant chamber is the Administrative Appeals Chamber which can hear appeals, with leave from the first-tier tribunal, on points of law only and exercises a judicial review function[8]. The two tiers of tribunals opened for business in November of 2008[9] and the first case in the context of mental health heard by the Administrative Appeals Chamber was heard in 2009[10]. Thus there have been almost three years of cases to evaluate the effectiveness of the Upper Tribunal’s contribution towards enhancing the safeguarding role of the first-tier tribunal in mental health cases[11]. In total there have been 28 cases hearing appeals from the Health, Education and Social Care Chamber within this time[12]. It is very early in the life of the unified system to conclusively say whether it is enhancing the system[13] but Bradley Ewing m ake some general observations on the advantages the two-tier system is bringing which are relevant to the mental health sphere: â€Å"One valuable result of the two-tier structure is to rationalise the diverging procedures that separate tribunals had used. This task has been carried out by the Tribunal Procedure Committee, Chaired by a Court of Appeal judge. The aims of the procedure rules include that of ensuring that in tribunal proceedings ‘justice is done’; that the tribunal system is ‘accessible and fair’; that proceedings are handled ‘quickly and efficiently’; and that the rules are ‘both simple and clearly expressed’†[14] The administrative advantages of a unified system[15] are perhaps obvious but the case law has revealed some potential weaknesses with the Supreme Court recently holding that the Upper Tribunal is amenable to judicial review itself[16]. This essay will critically analyse the contribution of the Upper tribunal to the first-tier tribunal’s work over the past three years by analysing the statutory basis of the tribunal in part 1 as well as the decided case law in the context of mental health. The essay will then, in part 2, discuss the strengths and weaknesses of the current system and conclude that the new Upper Tribunal is indeed enhancing the work of the first-tier tribunal as demonstrated by the high number of successful appeals, the innovative judicial review function and ECHR compliance under article 6. Part 1: The Upper Tribunal in mental health 1.1 The Administrative Appeals Chamber and the 2007 Act S.3(5) of the 2007 Act confers on the Upper Tribunal the status of a â€Å"superior court of record†[17]. As noted above in the introduction the Upper Tribunal is split into three Chambers with the Administrative Appeals Chamber dealing with, inter alia mental health cases, with its functions split neatly into three categories: appellate, judicial review and referral[18]. The ordinary appellate procedure on a point of law derives from article 7(a) of the First tier Tribunal and Upper Tribunal (Chambers) Order 2008 and, in the context of mental health, is able to hear an appeal â€Å"against a decision made by the first-tier tribunal†[19] but only in respect of a point of law which is not an â€Å"excluded decision† under s.11(5)(a) – (f). With respect to the novel judicial review function, what Lady Hale of Richmond called â€Å"a major innovation in the 2007 Act†[20], under article 7(b) of the 2008 Order this function has been transplanted from the High Court with the Administrative Appeals Chamber able to grant the following kinds of relief: a mandatory order, a prohibiting order, a quashing order, a declaration and an injunction[21]. This function has been qualified by the Lord Chief Justice in England and Wales who issued a practice direction to the effect that the relief of judicial review will be available where there is no power of appeal to the Upper Tribunal and where the decision is not an excluded one[22]. Finally the Administrative Appeals Chamber also has a referral function where cases may be transferred from the First-Tier Tribunal to the Upper Tribunal under s.9(5) of the 2007 Act where the First-Tier Tribunal has set aside a decision. Lady Hale noted in the Supreme Court that the appellate procedure is the most important function of the Administrative Appeal Chamber[23] although her Ladyship pointed out that this right can only be exercised with the permission of either the First-tier or Upper tribunal under ss11(3) and 11(4). The judicial review function of the Upper tribunal is indeed a novel feature of the new system and, as demonstrated above, shares features with the judicial review available in the courts[24]. You read "The contribution of the Upper tribunal to the first-tier tribunal’s work" in category "Essay examples" A curiosity of the system arose in 2011 in the Supreme Court where it was decided that decisions of the Upper Tribunal are amenable to judicial review in the High Court, a decision which Phillip Murray suggests undermines the advances the unified system represents[25] and which will be discussed in part 2 of this essay[26]. 1.2 Case law in mental health As noted in the introduction there have been 28 cases in the three years of the 2007 Act’s life which relate specifically to mental health law[27]. In order to determine whether or not the Upper Tribunal is enhancing the safeguarding role of the First-Tier Tribunal, the Health, Education and Social Care chamber, it is important to analyse the case law both qualitatively and quantitatively. In quantitative terms the appellate procedure is being used in the Upper Tribunal in the majority of cases with judicial review used very sparingly. In all cases heard in 2011, 13 in total, four were successful appeals with the decision of the First-Tier tribunal set aside[28] while in just one case the decision was taken not to set aside the decision despite the successful appeal[29]. In two cases no error on a point of law was discovered by the Upper Tribunal[30] and in only one case was the appeal dismissed entirely[31]. In another case permission to appeal was refused[32] and, to emphasi se the young nature of the tribunal two cases were dedicated to in-depth discussions of tribunal procedure about the open justice principle[33] and the revocation of Community Treatment Orders (CTO’s)[34]. The final decision[35] deserves closer attention in light of the fact that it is the only judicial review decision of 2011[36] and but the second judicial review in all three years[37]. The facts in this case were that while P was serving a five months’ sentence for various criminal offences he was sentenced to a further nine months’ in relation to an assault. On 21st October 2008 the Secretary of State used his powers under s.47 of the Mental Health Act 1983 to have P transferred to a psychiatric hospital. P then appealed against this decision to detain him to the First Tier tribunal on 19th February 2010 which ordered his discharge. A further appeal was made within the power of the First-Tier tribunal to review and set aside its own decisions and thus Judge Foster agreed to set aside the decision under Rule 45 of the Tribunal owing to a discussed Community Treatment Order which Judge Foster felt invalidated the original decision. A further appeal was then heard by Jud ge Foster against her own decision which led to the present judicial review proceedings. In essence, Judge David Pearl reinstated the original First-tier tribunal decision of 19th February 2010 and observed: â€Å"In this case, given the findings made by the First-tier Tribunal in its decision dated 19th February 2010, the tribunal was under a positive duty to direct a discharge, albeit deferred for a period of six weeks to enable after-care arrangements to be put in place. It follows therefore that Judge Foster’s two decisions must be quashed. Both of those decisions are unlawful, in that they are predicated on a reading of the First-tier Tribunal’s decision which can in no way be justified.†[38] Part 2:Discussion of the Administrative Appeals Chamber 2.1 Enhancing the first tier tribunal? (a) Weaknesses Despite the fact that the Administrative Appeals Chamber has only been in operation for a short time there are some evident weaknesses in the way case law has developed which arguably undermine rather than enhance the First-Tier tribunal’s role[39]. The most obvious weakness is the fact that the decisions of the Upper Tribunal are amenable to judicial review[40]. Perhaps it was wishful thinking that unappealable decisions of the Upper Tribunal would not be subject to judicial review and that the two-tier system would continue to be â€Å"authoritative, efficient and self-contained† as Phillip Murray points out[41]. There was a clear intention by Parliament in the drafting of the 2007 Act that the Upper Tribunal would have the final say as to whether any appeal from the First Tier Tribunal on a point of law should be allowed and, since there is little difference between an appeal on a point of law and a judicial review[42], a judicial leak has appeared in what was, until the Supreme Court’s decision[43], a very tight and secure system. The implications of allowing review of the Upper Tribunal’s decisions are, in Murray’s opinion, grave: â€Å"Judicial review is not, like appeal, concerned with settling important points of principle or practice. Rather, its concern is with vires – that is, ensuring that decision-makers act within the four corners of their power – as well as questions of procedural fairness. This is the primary focus of the Sivasubramaniam model, and it would have been preferable as a result. Such an approach would have maintained the orthodox constitutional basis for review, avoided flouting Parliament’s express will, and ensured proportionate protection of the rule of law.†[44] (b) Strengths The strengths of the administrative appeals chamber certainly outweigh the main weakness identified above in enhancing the First-Tier Tribunal. The high number of successful appeals which have, in the context of mental health and explored earlier, set aside decisions of the first-tier tribunal are obvious indicators of the Upper Tribunal enhancing the First-Tier Tribunal’s safeguarding role by ensuring justice is done[45]. Thus in the 28 cases it is apparent that erroneous decisions are being caught and corrected with appropriate procedures whether that is having the decision set aside or remitted back to a reconstituted First-Tier Tribunal. The use of the judicial review function is both innovative and flexible and has, in two key decisions, proved to be invaluable in reversing procedural decisions taken at first instance[46]. In the Mersey case the internal review procedure of the First Tier Tribunal was simply ineffective and it took the Upper Tribunal to step in and rectify matters under judicial review in an impartial and independent manner. The Administrative Appeals Chamber enables the First-Tier Tribunal to be compatible with article 6 of the European Convention on Human Rights both in terms of independence and also in terms of procedural fairness. Conclusion In conclusion the Administrative Appeals Chamber has, in its short lifespan, enhanced the safeguarding role of the First-Tier tribunal within the new unitary system ushered in by the Leggatt Review of 2001[47]. In the context of mental health cases there have been 28 in total in the 3 years of the 2007 Act’s operation which serve to validate the work of the Upper Tribunal. As can be expected the number of appeals is relatively modest but clearly the Upper Tribunal is performing a vital function in holding the First-Tier tribunal to account and, where appropriate, setting aside its decisions. In terms of the novel judicial review function this has been used only twice in the context of mental health but has demonstrated a willingness by the tribunal system to deploy it when natural justice demands it. The fact that the First-Tier Tribunal can review its own decisions is not in itself an adequate safeguard and the case of MP v Mersey Care NHS Trust[48] is a useful reminder that the first instance tribunals, just like courts, need to be supervised independently. The Upper Tribunal also ensures vital article 6 compliance. This aspect enhances the whole system which can now survive scrutiny from Strasbourg. The one main weakness, that the Upper Tribunal is susceptible to judicial review itself, is in reality a technical one and something that is unlikely to become a crippling problem. Overwhelmingly the Upper Tribunal has enhanced the First-Tier Tribunal in its short life. Bibliography 1.0 Books Bradley, AW Ewing, KD (2011) Constitutional Administrative Law Pearson: Worldwide Creyke, Robin (2008) Tribunals in the Common Law World Federation Press: Sydney Jacobs, Edward (2010) Tribunal Practice and Procedure: Tribunals under the Tribunals, Courts and Enforcement Act 2007 Legal Action Group: UK Thompson, Brian (2010) ‘Current Developments in the UK: System Building – From Tribunals to Administrative Justice’ in Adler, Michael (ed) Administrative Justice in Context Hart Publishing: Oregon and Portland at p.484 2.0Journals Case Comment (2011) ‘Tribunal Merger may â€Å"dilute rather than enhance† expertise, Lady Hale warns’ Solicitors Journal 155(25), 3 Gledhill, Kris (2009) ‘The First Flight of the Fledgling: The Upper Tribunal’s Substantive Debut’ Journal of Mental Health Law Spring 81-93 Mitchell, Gareth (2010) ‘Judicial Review, but not as we know it: Judicial Review in the Upper Tribunal’ Judicial Review 15(2), pp112-117 Murray, Phillip (2011) ‘Judicial Review of the Upper Tribunal: Appeal, Review, and the Will of Parliament’ in Cambridge Law Journal 70(3), pp487-489 Rutledge, Desmond (2011) ‘Practice and Procedure: Jurisdiction – Scope for Judicial Review of Upper Tribunal Decisions by High Court’ Journal of Social Security Law 18(4) pp135-137 3.0 Reports Leggatt, Andrew (2001) Tribunals for Users, One System, One Service accessed on 20/12/2011 and available from: http://webarchive.nationalarchives.gov.uk/+/http://www.tribunals-review.org.uk/leggatthtm/leg-00.htm Report of the Franks Committee, Cmnd 218, 1957, parts II and III Transforming Public Services: Complaints, Redress and Tribunals CM 6243, 2004 4.0 Statutes Tribunals, Courts and Enforcement Act 2007 European Convention on Human Rights article 6 First tier Tribunal and Upper Tribunal (Chambers) Order 2008 5.0 Cases AH v West London Mental Health Trust and another [2011] AACR 15 CM v DHNHSFT and Secretary of State (Justice) [2011] UKUT 129 (AAC) Dorset Healthcare NHS Foundation Trust v MH [2009] UKUT 4 (AAC) (UT) DN v Northumberland Tyne Wear NHS Foundation Trust [2011] UKUT 327 (AAC) JLG v Managers of Llanarth Court SOS for Justice [2011] UKUT 62 (AAC); DP v Hywel DDA Health Board [2011] UKUT 381 (AAC) KL v Somerset Partnership NHS Foundation Trust [2011] UKUT 233 (AAC) MB v BEH MH NHST SoSJ [2011] UKUT 328 (AAC) PS v Camden and Islington NHS Foundation Trust [2011] AACR 42 (on the application of Cart) v Upper Tribunal [2011] UKSC 28 (SC) R (On the application of Cart) (Appellant) v The Upper Tribunal [2011] UKSC 28 RN v Curo Care/ OE [2011] UKUT 263 (AAC) RB v Nottinghamshire Healthcare NHS Trust [2011] UKUT 73 (AAC) TR v Ludlow Street Healthcare Ltd and TR [2011] UKUT 152 (AAC) Appendix A: Decided cases of the Administrative Appeals Chamber in Mental Health From research conducted for this essay from the Government’s tribunal judiciary homepage accessed on 19/12/2011 and available from: http://www.administrativeappeals.tribunals.gov.uk/Decisions/decisions.htm Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 28/05/2010JR 3066 20092010 UKUT 160 AACTribunal procedure and practice (including UT)other29/06/2010 23/04/2010M 837 20102010 UKUT 119 AACMental healthAll05/05/2010 08/04/2010M 1653 20092010 UKUT 102 AACMental healthAll05/05/2010 25/02/2010M 2704 20092010 UKUT 59 AACMental healthAll15/03/2010 01/10/2009M 827 20092009 UKUT 195 AACTribunal procedure and practice (including UT)tribunal jurisdiction13/10/2009 07/08/2009M 708 20092009 UKUT 157 AACMental healthAll02/09/2009 08/01/2009M 3592 20082009 4Mental healthAll14/01/2009 Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 15/03/2011JR 2381 20102011 UKUT 107 AACMental healthAll30/03/2011 17/02/2011HM 84 20102011 UKUT 74 AACMental healthAll07/03/2011 11/02/2011HM 840 20102011 UKUT 73 AACMental healthAll07/03/2011 09/02/2011HMW 2881 20102011 UKUT 62 AACMental healthAll07/03/2011 20/12/2010HM 1533 20102010 UKUT 454 AACMental healthAll12/01/2011 17/12/2010HM 525 20102010 UKUT 455 AACMental healthAll12/01/2011 12/11/2010M 695 20092010 UKUT 32 AACTribunal procedure and practice (including UT)statements of reasons17/02/2010 03/09/2010HMW 134 20102010 UKUT 319 AACMental healthAll06/10/2010 29/07/2010M 84 20102010 UKUT 264 AACMental healthAll17/08/2010 02/06/2010M 1089 20092010 UKUT 185 AACMental healthAll17/06/2010 Bottom of Form Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 21/09/2011HMW 1339 20112011 UKUT 381 AACMental healthAll06/12/2011 16/08/2011HM 226 20112011 UKUT 327 AACMental healthAll13/09/2011 12/08/2011HM 803 20112011 UKUT 328 AACMental healthAll13/09/2011 10/06/2011HM 2479 20102011 UKUT 233 AACMental healthAll29/06/2011 11/04/2011HM 2201 20102011 UKUT 263 AACMental healthAll04/07/2011 07/04/2011HMW 509 20112011 UKUT 152 AACMental healthAll27/04/2011 30/03/2011HM 487 20112011 UKUT 143 AACMental healthAll19/04/2011 29/03/2011HM 840 20102011 UKUT 135 AACMental healthAll19/04/2011 23/03/2011HM 2915 20102011 UKUT 129 AACMental healthAll19/04/2011 15/03/2011JR 2381 20102011 UKUT 107 AACMental healthAll30/03/2011 How to cite The contribution of the Upper tribunal to the first-tier tribunal’s work, Essay examples

Cardiomyopathy A Disease Of The Heat Muscle Essay Example For Students

Cardiomyopathy : A Disease Of The Heat Muscle Essay Cardiomyopathy is a disease of the heat muscle and has many different types. Dilated, Hypertrophic, and Restrictive are the three main types of cardiomyopathy. Each of these types have different causes, signs and symptoms, and treatments. In cardiomyopathy, the heart muscle can become enlarge, thick, or rigid, and in some rare incidents the muscle tissue can become replaced with scar tissue. As the condition worsens, the heart becomes weaker and less able to pump blood throughout the body. The heart will also become unable to maintain a normal electrical rhythm. Results from cardiomyopathy can lead to heart failure or irregular heartbeats called arrthymias (American Heart Association, 2016). Dilated cardiomyopathy is the most common type of cardiomyopathy, occurring in adults between the ages of 20-60. It affects more of the male population then the female population. Dilated cardiomyopathy affects the heart’s lower (ventricles) and upper (atria) chambers of the heart. The disease starts in the left ventricle (heart’s main pumping chamber). As the chamber dilates, the heart muscle doesn’t contract normally and can’t pump blood very well. The inside of the chamber enlarges and the problem often spreads to the right ventricle and then to the atria (Elliot. 2000). Signs and symptoms of dilated cardiomyopathy †¢ Systemic embolism ( blood clot in arterial circulation) †¢ Pulmonary congestion (excess fluid in the lungs) †¢ Low cardiac output †¢ Fatigue for many months or years †¢ Intercurrent illness †¢ Development of arrhythmias †¢ Genetics †¢ Sudden death (Elliot, 2000) Myocarditis an inflammation of the heart muscle is known to be a cause of dilated cardiomyopathy. A carnitine and calcium deficiency can also lead to dilated cardiomyopathy. Excessive alcohol and drug use such as Anthracyclines have been linked to the cause of dilated cardiomyopathy. Anomalous coronary arteries, a malformation of coronary vessels and arteriovenous malformations, a congenial disorder of blood vessels in the brain are some other known causes. X linked diseases such as Becker’s and Duchene’s muscular dystrophies are linked to dilated cardiomyopathy as well as mitochondrial mutations. Becker’s muscular dystrophy is an x linked recessive inherited disorder in which the leg and pelvis muscle slowly weakens. Duchene’s muscular dystrophy is a severe form that is caused by an x linked genetic defect that prevents the production of dystrophin, a normal protein found in muscles. Most cases of dilated cardiomyopathy are idiopathic (Elliot, 2000). Diagnosis for dilated cardiomyopathy starts with an assessment of the patient’s family history, specially paying attention to a history of muscular dystrophy, mitochondrial diseases (epilepsy), and signs/symptoms of other inherited diseases. A complete drug history is also essential, both in the administration of drugs that are toxic to the heart and the use of illegal drugs such as cocaine. An ECG in patients with dilated cardiomyopathy could be remarkably normal, but abnormalities in an isolated T wave to septal changes to Q wave can show up with patients who have extensive left ventricular fibrosis, prolonged AV conductions, and bundle branch block may be seen. 20%-30% of patients have non-sustained ventricular tachycardia and a small percent present with sustained ventricular tachycardia. Metabolic exercise testing may be able to provide diagnostic information in patients with ventricular impairment by detecting a severe state of low blood pH (Elliot, 2000). There is no specific treatment for dilated cardiomyopathy. The primary aim of treatment is to control the symptoms, prevent disease progression, and prevent complications of progressive heart failure, sudden death, and obstruction of blood vessels by a blood clot. Warfin is used to treat patients with moderate ventricular dilation. Partial left ventriculectomy is performed to reduce the left ventricular size by removing a portion of its circumference to reduce stress on the wall and to improve ventricular blood flow (Elliot, 2000). .uc96d7413db3006f94bae5df3248cf11b , .uc96d7413db3006f94bae5df3248cf11b .postImageUrl , .uc96d7413db3006f94bae5df3248cf11b .centered-text-area { min-height: 80px; position: relative; } .uc96d7413db3006f94bae5df3248cf11b , .uc96d7413db3006f94bae5df3248cf11b:hover , .uc96d7413db3006f94bae5df3248cf11b:visited , .uc96d7413db3006f94bae5df3248cf11b:active { border:0!important; } .uc96d7413db3006f94bae5df3248cf11b .clearfix:after { content: ""; display: table; clear: both; } .uc96d7413db3006f94bae5df3248cf11b { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uc96d7413db3006f94bae5df3248cf11b:active , .uc96d7413db3006f94bae5df3248cf11b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uc96d7413db3006f94bae5df3248cf11b .centered-text-area { width: 100%; position: relative ; } .uc96d7413db3006f94bae5df3248cf11b .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uc96d7413db3006f94bae5df3248cf11b .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uc96d7413db3006f94bae5df3248cf11b .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uc96d7413db3006f94bae5df3248cf11b:hover .ctaButton { background-color: #34495E!important; } .uc96d7413db3006f94bae5df3248cf11b .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uc96d7413db3006f94bae5df3248cf11b .uc96d7413db3006f94bae5df3248cf11b-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uc96d7413db3006f94bae5df3248cf11b:after { content: ""; display: block; clear: both; } READ: General Studies and research of Cardiology EssayHypertrophic cardiomyopathy (HCM) is a primary disease of the muscle of the heart in which a portion of the heart muscle is thickened without any obvious cause. The thickening of the heart muscle creates functional impairment and can make it harder for the heart to pump blood. This type of cardiomyopathy is the leading cause of sudden death in young athletes. HCM can often go undiagnosed because most people have few, if any symptoms and can lead normal lives with no significant problems. However, a small number of people with a thickened heat muscle may experience shortness of breath, chest discomfort, fainting, dizziness, pa lpitations, and extreme fatigue. HCM is caused by a gene mutation and appears in 50% of people of any generation. The mutated gene influences certain proteins that are part of the heart muscle (Maron, 2002). Hypertrophic cardiomyopathy is usually identified by an echocardiogram that produces ultrasound images of the thickened wall of the heart muscle. HCM is most prominent in the wall separating the left and right ventricle (ventricular septum). Echocardiograms may also show partial obstruction of blood flow from the left ventricle into the aorta, caused by forward motion of the mitral valve and whether there is abnormal leakage through the mitral valve. Atrial fibrillation occurs frequently in HCM and accounts for the high numbers of unexpected hospitalizations. A-fib in older patients can cause heart failure and stroke, so anticoagulants may be recommended (Maron, 2002). Implantable cardioverter-defibrillator (ICD) is the most reliable and effective treatment for hypertrophic cardiomyopathy patients at high-risk. ICD has the potential to alter the course of the disease by automatically sensing and terminating lethal disturbances of heart rhythm, often in young people with little to no symptoms. If blood flow obstruction is detected, then a septal myectomy operation is recommended. A surgeon removes a small amount of muscle from the upper part of the septum. Treatment options are more limited to patients who have severe symptoms and these patients may become candidates for a heart transplant. Sudden death occurs in young patients who are athletes due to vigorous exertion (Maron, 2002). Restrictive cardiomyopathy (RCM) is a rare form of heart muscle disease that is characterized by restrictive filling of the hearts ventricles. The squeezing (contractile) function of the heart and wall thickness are usually normal, but the relaxation or filling phase of the heart is very abnormal. The lower walls of the heart become abnormally rigid and lack the flexibility to expand and to fill with blood. RCM is found mostly in children ages 5-6 years old and mostly in girls. There is no known cause (Goldstein, 2014). Signs and Symptoms of RCM †¢ Repeated lung infections †¢ Appearance of an enlarged heart †¢ Fluid in abdomen †¢ Enlarged liver †¢ Edema †¢ Abnormal heart sound †¢ Signs of heart failure †¢ Fainting †¢ Sudden death (Goldstein, 2014). Diagnosis for restrictive cardiomyopathy is very difficult to establish and is only made after certain symptoms become present such as decreased exercise tolerance, a gallop heart sound, syncope (fainting), or chest pain during exercise. Once suspected, certain test are performed to help confirm a diagnosis. An ECG can be most helpful by showing abnormalities of the atria. Cardiac catheterization is used to confirm a diagnosis of RCM, a catheter is slowly advanced through an artery or vein into the heart, while the doctor is watching it on a TV monitor, so the pressure in the hearts chambers can be measured. These measurements show significant elevated pressure during the relaxation period of the heart. In rare cases a cardiac biopsy may be performed to look for potential causes of RCM (Goldstein, 2014). Currently there is no â€Å"cure† for restrictive cardiomyopathy. Treatment is used to improve the symptoms of RCM. Diuretics, sometimes called water pills, can be taken to reduce excess fluid in the lungs and other organs by increasing urine production. Beta-blockers can be also given to slow the heartbeat and increase relaxation time of the heart. This can allow the heart to fill better with blood before each heart beat and decrease some of the symptoms created by stiff pumping chambers. Heart transplantation is the only effective surgery offered for patients with RCM, particularly those who already have symptoms at the time of diagnosis or have reactive pulmonary hypertension (Goldstein, 2014). .uc5e0655dea8a2376166e872a8102dca2 , .uc5e0655dea8a2376166e872a8102dca2 .postImageUrl , .uc5e0655dea8a2376166e872a8102dca2 .centered-text-area { min-height: 80px; position: relative; } .uc5e0655dea8a2376166e872a8102dca2 , .uc5e0655dea8a2376166e872a8102dca2:hover , .uc5e0655dea8a2376166e872a8102dca2:visited , .uc5e0655dea8a2376166e872a8102dca2:active { border:0!important; } .uc5e0655dea8a2376166e872a8102dca2 .clearfix:after { content: ""; display: table; clear: both; } .uc5e0655dea8a2376166e872a8102dca2 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uc5e0655dea8a2376166e872a8102dca2:active , .uc5e0655dea8a2376166e872a8102dca2:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uc5e0655dea8a2376166e872a8102dca2 .centered-text-area { width: 100%; position: relative ; } .uc5e0655dea8a2376166e872a8102dca2 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uc5e0655dea8a2376166e872a8102dca2 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uc5e0655dea8a2376166e872a8102dca2 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uc5e0655dea8a2376166e872a8102dca2:hover .ctaButton { background-color: #34495E!important; } .uc5e0655dea8a2376166e872a8102dca2 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uc5e0655dea8a2376166e872a8102dca2 .uc5e0655dea8a2376166e872a8102dca2-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uc5e0655dea8a2376166e872a8102dca2:after { content: ""; display: block; clear: both; } READ: Essay on Transcatheter Aortic Valve ReplacementPrognosis for cardiomyopathy is based on the different types. For dilated cardiomyopathy the prognosis is poor. 50% of patients die within 2 years of diagnosis and 25% survive longer than five years with treatment. The common cause of death for dilated cardiomyopathy is progressive heart failure and arrthymia. The overall annual mortality rate for hypertrophic cardiomyopathy is 3-5% in adult and at least 6% in children. Severity of disease and prognosis varies according to the genetic features associated with HCM. Restrictive cardiomyopathy has a very poor prognosis with patients dying within a year of the diagnosis even with treatment (Oakley, 1997).

A Small, Good Thing Essay free essay sample

A small, good thing by Raymond Carver brings a lot of vivid images to mind for me. Even though the writing is minimalist, the story came alive. The lack of description enabled me to read the story and project characters from my own life In the place of the ones the author had created. From the beginning of A small, good thing I put my nephew, my niece, and my own son In the place of the boy In the story. The emotional tie to the stories outcome Is what made me keep reading.For e, the meaning of the story Is forgiveness. There Is a family that has lost a beloved son, a baker who made a cake for someone who Is yelling at him and refusing to pick up the cake, and a family waiting for their son to get out of surgery. The story follows Scotty mother as she deals with her sons hospitalizing. We will write a custom essay sample on A Small, Good Thing Essay or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page In the beginning the mother Is very Judgmental and alone In her pain, but throughout the story she opens up; first to her husband, and then to the baker.The reason I think the story Is about rigidness Is that all the characters In the story must forgive to have the peace at the end. The mother and father must forgive the baker for his insensitive calls, and realize that he is a lonely man whose life revolves around the bakery. The baker must forgive the man and his wife for their anger and for not coming to pick up their cake. He has to let it go, and help the man and woman cope with the greatest loss of their lifetime. He gives them forgiveness and compassion, and they come to peace together.

The Effect of Brown V. the Board of Education essays

The Effect of Brown V. the Board of Education essays Martin Luther King Jr. stated in his famous I have a dream speech that, I have a dream my four little children will one day live in a nation where they will not be judged by the color of their skin but by the content of their character. I have a dream today! (3) Kings speech set the tone for a civil change in the society especially in the school system. The law during this time period was in favor of white society and felt the need to separate whites from blacks in every public place in society. The public school was another realm where white parents wanted separation between their children and blacks. Brown v. the Board of Education (1954) was a vital case that overturned the custom of separate but equal that was established by the Plessy verse Ferguson case. The Jim Crow laws were laws that enforced the separation of blacks and whites in society. Most all states in the south adopted the Jim Crow Laws. The issue of segregation was first brought up in the case of Plessy verse Ferguson. In 1890, Homer Plessy violated the Louisiana state law of The Separate Car Act by sitting in the white car of the train. Plessy thought since he was seven-eights white he was able to sit in the white only cars but police officials disagreed and regarded him as a black male.(Hartin 1) Plessys case was appealed all the way to the United States Supreme Court on the basis of the Thirteenth and Fourteenth Amendment (Hartin 1). The justices of the United States Supreme Court ruled against Plessy on the grounds of separate but equal. The justices stated that The Fourteenth Amendment could not have been intended to abolish distinctions based upon color, or to enforce social, as distinguished from political equality, or a commingling of the two races upon te rms unsatisfactory to either (Hartin 2). This code of separate but equal became the law of the land in the relationship between blacks and whites. Th...

Safety Tents and Other Non Permanant Buildings Essay

Safety Tents and Other Non Permanant Buildings - Essay Example These shelters take numerous forms, including a traditional tentlike structure. One of the main advantages of these protective structures is that they are incredibly strong in relation to the weight of their components. Therefore, they can be rapidly deployed by two to four people. Kevlar’s superiority stems from its minimal â€Å"vibration transfer† (Kayak Terapad). It can be molded and shaped, yet maintains its structural integrity. Therefore, it enhances the user’s safety in numerous stress and impact scenarios. One of the military uses for such shelters is the Chemical Biological Protected Shelter System (CBPSS) (Business Wire 1997). They are intended for battlefield use against biological or chemical weapons assault. A company called Chemfab has developed the Kevlar-based fabric. The shelter also reduces lingering air contamination following a chemical or ballistic explosion. Homeland Security is using such a device in dirty bomb control. This variation is called a Universal Containment System, and it was developed by Vanguard Response Sytems in Canada (Popular Mechanics 2004). The ballistic resistant tent contains a foam that suppresses the detonation blast. At present, the system can only suppress a bomb the size of a book bag. The technology will be developed to contain a truck bomb, like the one deployed at the World Trade Center in 1993. A similar application is called the Chemical Biological Explosives Containment System (CBECS). It consists of a seven foot inflatable tent that contains a water-based foam, which not only contains the explosion, but it also puts out any chemically-based fires that may ignite (Patent Storm 2007). The whole structure can cover an explosive device, which is then deployed relatively safely (DOD Tech Match). These tents are now being made for the general public by Zumro, Inc. The Chemical/Biological Counterterrorism

Sulfur recovery processes Essay Example | Topics and Well Written Essays - 750 words

Sulfur recovery processes - Essay Example gas treatment system, where the effluent gases that remain from the purification process are used to oxidize sulfur into sulfur dioxide, instead of being released to the atmosphere to cause pollution. Most significant is that this process yields high quality sulfur, making it a good source of this valuable chemical (Kohl & Nielsen, 1997). However, the air pollution controls that have been put in place have made the Claus process even more expensive, since some installations that prevent air pollution have to be made, despite the fact that they may not be economical at all. The problem of Claus Process is added to, by the fact that it is unable to fully convert hydrogen sulfide into elemental sulfur, due to some equilibrium limitations. Therefore, no matter how well the emission of sulfur compound is controlled, the process ends-up releasing relatively high quantities of the air pollutant than is actually acceptable (Kohl, 1997). Thus, most of the times, the process requires to be supplemented with specific processes meant to remove the sulfur residue, which ensures that any excess sulfur emission from the process is cleaned-up. Claus process occurs in two forms, referred to as the straight-through process and the split-flow process. The processes are differentiated by the fact that, while in the straight-through process gas is fed through the reaction furnace, it is fed directly into the major catalytic reactor through bypassing the furnace, in the split-flow process (Kohl & Nielsen, 1997). The choice of the process to be used between these two sulfur purification processes depends on the content of hydrogen sulfide in the gas to be purified, and whether the gas contains hydrocarbons. If the gas to be purified contains hydrocarbons, then, the straight-through process is opted for, while the split-flow process is applied where the gas does not contain large quantities of hydrocarbons (Kohl, 1997). There are some fundamental aspects of the Claus process that should

Conveyor Bases Sorting System Colour Sensor Signal

Conveyor Bases Sorting System Colour Sensor Signal CONVEYOR BASED SORTING SYSTEMÂ  COLOUR SENSOR SIGNAL CONDITIONING Abstract: This report analyses the best strategy for interfacing the colour sensor with the microprocessor by using either Comparators or Analogue to Digital Convertors (ADC) in the process. Focusing mainly on the advantages and disadvantages of these two components, we can conclude which one is more effective and responsive with cost, time taken to process the programme and reliability. Using C programming a microprocessor is programmed in order to detect the colour of the objects passed on the conveyor belt using LDR. Analogue to Digital Convertor (ADC): It is a system that converts the input analogue signals (from a light source or sound signal) to digital output signal by a process called quantization, which is also called as digital signal processing that is the process of mapping a large set of input values to a countable smaller set. Generally, the digital output signal is in binary number that is proportional to the input values. Component parts of ADC: There are seven different components within the ADC that make up the whole processing circuit which includes, Set-Reset latch has 2 inputs and outputs which used as storage element in ADC Clock a constant input signal that fluctuates between high and low and is used coordinate the actions of the circuit. AND gate a basic logic gate which has only high inputs (1) to start the conversion when prompted. Counter an electronic device which stores the number of times something occurred and used directly with the clock signal. DAC to convert the digital signals to analogue output signals when commanded (reverse function of an ADC) DATA latch takes the output of counter as its input and convert the analogue signals into digital outputs. Comparator that compares two voltages or currents and changes its output depending on which is larger. Advantages of ADC: Some benefits of using the ADC in this colour sensor interfacing system with the microprocessor are listed below, Cheap in cost and speed varies to different ADC for example flash ADC is the fastest of all its kind. ADC has higher resolution than using a comparator. Less steps and components when it comes to programming in a microprocessor Clock in ADC keeps the circuit in time and provides a square wave input. Set-reset function allows the circuit to be functioned and keeps it in control. It converts any input voltages, even from 1V to 5V into a digital output (flashing LED from less bright to very bright display) through its built in components whereas in a comparator it is either 0 from 0V to 2V and 1 from 2.5V to 5V. Disadvantages of ADC: Also the drawbacks of using the ADC are, Slow in speed compared to a comparator device as ADC has more component parts than comparator. Each and every parts have to be earthed appropriately. Have to have many inputs into the encoder (for 4 bit outputs 16 input signals and for 5 bit its double the inputs). ADC has several sources of errors like quantization error. These are measured in least significant bit (LSB) Comparator: Comparator is an electronic device that compares the input two voltages or currents and outputs the higher or larger (1) digital signal. It consists of a specialized high -gain differential amplifier which are commonly used in devices that measure and digitize analogue signals, such as Analogue to Digital Convertors (ADC). Comparators are also being installed within analogue to digital convertors (ADC). Advantages of comparator: Using the comparators in the microprocessors in the circuit can have some positive impact on the project. Some of them are, Cheaper in cost when comparing to other devices of amplifying. Comparators does not require an external power source such as additional current or voltage supply since the power comes from the processor. These are in ordinary working condition and very compact and robust model and are very easy to handle. Can be portable as well. Electrical comparators have very less moving parts and the pointer is very light and not sensitive to the vibrations. Disadvantages of comparator: Some of the disadvantages of using the comparators are, Heating of coils in the measuring unit may cause zero drift and can alter the calibration. If only a fixed scale is used with a moving pointer then with high magnifications a very small range is obtained, in this case itll be from 0V to 2V its low (0) and from 2V to 5V its high (1). Conclusion: Using an Analogue to Digital Convertor would be the possible solution in this colour sensor operating system as there are more benefits from ADC than Comparator. Since ADC has higher resolution and uses two registers to record the values from their 10 bits of inputs, it is more reliable and accurate with a few quantization and bubble errors. Comparator is one of the parts in ADC and it can only be used to differentiate two or less objects as it has a maximum of two outputs but ADC has plenty. Therefore, with ADC we can identify the three different coloured objects through this colour sensor.

The Transformation of Henry Fleming in The Red Badge of Courage Essay

The Transformation of Henry Fleming in The Red Badge of Courage        Ã‚  Ã‚  Ã‚   Stephen Crane's purpose in writing The Red Badge of Courage was to dictate the pressures faced by the prototypical American soldier in the Civil War.   His intent was accomplished by making known the horrors and atrocities seen by Unionist Henry Fleming during the Battle of Chancellorsville, and the conflicts within himself.    Among the death and repulsion of war, there exists a single refuge for the warrior--his brethren.   The success of combat is directly related to the morale of the soldiers, as it is the relationship with the neighboring soldier that demonstrates the motive for fighting.   This association between men creates an abundance of compulsion from one man to the next.   Similarly, as Henry Fleming developed a rapport with men throughout the 304th Regiment, he began to be subjected to the pressures of war and his companions, which greatly influenced his maturation during the Civil War.    Having read of marches, sieges, conflicts, and the exploits of Greek warriors, and, as well, longing to see such, Henry enlisted into the Union army, against the wishes of his mother.   Before his departure, Mrs. Fleming warned Henry, "...you must never do no shirking, child, on my account.   If so be a time comes when yeh have to be kilt or do a mean thing, why, Henry, don't think of anything `cept what's right..."   Henry carried with himself this counsel throughout his enlistment, resulting in his questioning himself on his bravery.   As a sign of Henry's maturation, he began to analyze his character whilst marching, while receiving comments from his brethren of courage in the face of all adversity, as well as their fears ... ...urth kept to himself, fearing for his safety, and ashamed of being captured.   Henry's final step in maturation was finally made through the sacrifice of his companions, and their pressuring him to lead the charge.      Ã‚  Ã‚   The reaction of one soldier to another is the basis of war, as camaraderie is the methodology by which wars are won.   Henry gave witness to the horrors of war, the atrocities of battle, the deaths of his friends, and later a life of victory.   The ultimate transformation in Henry's character leading to a mature temperament was found by finding himself in the confusion of war and companionship.    Works Cited and Consulted:    Crane, Stephen.   The Red Badge of Courage.   W.W. Norton & Company, Inc.   Canada; 1976.    Gibson, Donald B. The Red Badge of Courage:   Redefining the Hero.   Boston:   Twayne Publishers, 1988.

Education and Skills Bill Essay

The Education and Skills Bill introduces a new duty on young people in England to participate in education or training until the age of 18. The Bill follows the green paper Raising Expectations: staying in education and training, which described the perceived benefits to individuals, the economy and society of young people staying in education or training for longer. Responsibility for support services currently carried out by the Connexions service will be transferred to local education authorities (LEAs). The Bill makes changes relating to adult skills. The Bill also provides for the transfer of the regulatory regime for independent schools in England from the Secretary of State for Children, Schools and Families to the Chief Inspector of Education, Children’s Services and Skills (the new Ofsted) There are miscellaneous provisions in relation to pupil behaviour, external qualifications, inspection of teacher training, and Schools Forums. Also a framework power is provided for the National Assembly for Wales to legislate in relation to the inspection of pre-16 education and training. The territorial extent of the Bill varies according to the scope of the different provisions. The Bill contains provisions that trigger the Sewel Convention. Christine Gillie Social Policy Section Contributions: Ed Beale, Paul Bolton, Grahame Danby, Susan Hubble, Vincent Keter House of Commons Library. Recent Library Research Papers include: 07/72 07/73 The ‘Governance of Britain’ Green Paper Child Maintenance and Other Payments Bill Committee Stage Report 07/74 07/75 07/76 07/77 07/78 07/79 07/80 Economic Indicators, November 2007 Channel Tunnel Rail Link (Supplementary Provisions) Bill Unemployment by Constituency, October 2007 The European Communities (Finance) Bill [Bill 2 of 2007-08] Sale of Student Loans Bill Housing and Regeneration Bill [Bill 8 of 2007-08] The EU Reform. Treaty: amendments to the ‘Treaty on European Union’ 07/81 07/82 07/83 07/84 07/85 07/86 Health and Social Care Bill House of Lords – developments since January 2004 Economic Indicators, December 2007 Planning Bill [Bill 11 of 2007-08] Crossrail Bill: Committee Stage Report The Treaty of Lisbon: amendments to the Treaty establishing the European Community 22. 11. 07 03. 12. 07 04. 12. 07 06. 12. 07 06. 12. 07 06. 12. 07 06. 11. 07 09. 11. 07 14. 11. 07 15. 11. 07 15. 11. 07 22. 11. 07 22. 11. 07 26. 10. 07 02. 11. 07 Research Papers are available as PDF files: †¢ to members of the general public on the Parliamentary web site, URL: http://www. parliament. uk †¢ within Parliament to users of the Parliamentary Intranet, URL: http://hcl1. hclibrary. parliament. uk Library Research Papers are compiled for the benefit of Members of Parliament and their personal staff. Authors are available to discuss the contents of these papers with Members and their staff but cannot advise members of the general public. We welcome comments on our papers; these should be sent to the Research Publications Officer, Room 407, 1 Derby Gate, London, SW1A 2DG or e-mailed to PAPERS@parliament. uk ISSN 1368-8456 Summary The Education and Skills Bill was presented in the House of Commons on 28 November 2007. At the same time Explanatory Notes, an Impact Assessment and a Memorandum of Delegated Powers were also published. The Bill, as presented, is in five parts. Some of the provisions are linked to the Government’s policies for reforming 14 to 19 education and improving the learning and skills of young people and adults. Other parts of the Bill are on separate matters particularly relating to the regulation and inspection of independent schools and colleges. Part 1 introduces a new duty on young people in England to participate in education or training until the age of 18, and creates a statutory framework to support and enforce it with new duties on local education authorities (LEAs ), educational providers and employers. The raising of the participation age will be introduced in two stages: to 17 by 2013 and to 18 by 2015. Provision is made for LEAs to enforce the participation duty, if necessary. They may issue attendance notices to young people who refuse to participate. New attendance panels will be created to hear appeals and to monitor the enforcement process. LEAs may also issue parenting contracts or parenting orders to parents of young people who are failing to fulfil the duty to participate. The proposals follow the green paper Raising Expectations: staying in education and training (March 2007), which described the perceived benefits to individuals and society of young people staying in education and training for longer. While there has been wide acceptance of the principle that young people will benefit from participating until they are 18, concern has been expressed about making it compulsory. Part 2 makes provision for the transfer to LEAs of the information, advice and support services for young people currently provided by the Connexions service. This follows proposals in the Youth Matters green paper (July 2005). The funding for the Connexions service will be transferred to LEAs in April 2008. It is intended that LEAs will continue to maintain the Connexions database so as to help them provide the right support services to young people and promote the new duty on young people to participate in education or training. Part 2 also places a duty on LEAs to arrange for the assessment of the education and training needs of a person with a statement of special educational needs (SEN) during their last year of schooling. This takes account of the change in the Bill to raise the participation age. Other provisions in Part 2 include: a requirement for secondary schools to present careers information in an impartial way and to provide careers advice that is in the best interests of the child; an explicit duty on the Learning and Skills Council (LSC) to provide proper facilities for apprenticeships for 16 to 18 year olds, and to make reasonable provision for apprenticeships for those aged 19 and over; a requirement for LEAs to have regard to journey times in preparing their transport policies for students of sixth-form age attending educational establishments; and a requirement for LEAs to co-operate with partners who are responsible for 14 to 19 education and training. Part 3 contains provisions in relation to adult skills. The issue of maintaining a sufficiently skilled workforce to meet the economy’s needs in the face of growing global competition has become increasing prominent, particularly since the publication of the Leitch Review of Skills in 2006. In its response to the review, the Government set out a range of goals relating to workforce skills for 2020 and outlined how it intended to achieve them. This Bill places duties on the LSC to provide a free entitlement to training for all adults in England aged over 19 up to their first full Level 2 qualification, with a similar entitlement up to Level 3 for those aged 19-25. Provision is also made to enable the sharing of data between relevant departments and the devolved administrations in order to assist in the effective assessment and provision of education and training for those aged 19 and over. Part 4 creates a wider definition of an independent educational institution in England, which includes certain part-time educational provision, to which the regulatory regime for independent schools in England will apply. That regime, currently contained in the Education Act 2002, is restated in Chapter 1 of Part 4. The regulatory framework for ‘independent educational institutions’ is changed so that the Chief Inspector of Education, Children’s Services and Skills (the new Ofsted) and not the Secretary of State is the registration authority. The function of approving non-maintained special schools is also transferred from the Secretary of State to the Chief Inspector. Sixth-form pupils in nonmaintained special schools are given a right to opt out of religious worship. (Pupils in mainstream maintained schools already have this right under the Education and Inspections Act 2006. ) The Bill also seeks to amend section 347 of the Education Act 1996 to remove in England the category of approved independent school for the placement of a child with a statement of SEN, and to remove the requirement for LEAs in England to seek consent to place pupils with statements of SEN in non-approved independent schools. Other changes in Part 4 include the introduction of a new management standard for independent educational institutions, and changes relating to fees for registration and inspection. Part 5 includes miscellaneous provisions in relation to pupil behaviour, the Qualifications and Curriculum Authority (QCA) and the approval of external qualifications, the inspection of teacher training, and the constitution of Schools Forums. Also Part 5 creates a framework power for the National A ssembly for Wales to legislate in relation to the inspection of pre-16 education and training. The Bill extends to England and Wales. Many of the provisions apply to England only. A number of new or expanded powers are conferred on Welsh Ministers. (These are set out in table 1 of the Explanatory Notes to the Bill. ) Five clauses that relate to sharing information extend to Scotland and trigger the Sewel Convention. Two clauses relating to the remit of the QCA extend to Northern Ireland. This research paper outlines the key provisions of the Bill, and provides background on them. It is not intended to be a comprehensive account of the clauses. A detailed clause by clause account is given in the Explanatory Notes to the Bill. Library contacts: Christine Gillie : raising the participation age, Connexions service, special educational needs, post-16 transport, regulation and inspection of independent schools, pupil behaviour and attendance and Schools Forums Paul Bolton: statistics on the above Ed Beale : apprenticeships, training and adult skills Grahame Danby: data processing Susan Hubble: financial support for students and external qualifications Vincent Keter: employers and business CONTENTS I Part 1 of the Bill: duty to participate in education or training (England). A. B. Introduction Background 1. History 2. Participation of 16 and 17 year olds in education, employment and training 3. The green paper and the case for change 4. Responses to the green paper C. D. Overview of the proposed system for raising participation 7 7 8 8 8 12 15 20 Suitable provision and enabling young people to participate: the ‘four building blocks’ 23 The Bill 1. Key provisions 2. Comment 31 31 35 38 38 38 40 41 42 43 43 E. II Part 2 of the Bill: Support for participation in education or training: young adults with learning difficulties and young people in England A. Provision of support services (Connexions Service) 1. Background 2. The Bill B. C. D. E. F. Assessments relating to learning difficulties Careers education Apprenticeships Provision of transport for persons of sixth form age: journey times Co-operation as regards provision of 14 to 19 education and training 44 45 45 47 49 III Part 3 of the Bill: Adult Skills A. Background 1. The Leitch Review of Skills 2. Current measures to address adult skills 3. House of Commons Education and Skills Committee report: Post-16 Skills 51 B. The Bill 1. Reaction IV Part 4 of the Bill: regulation and inspection of independent educational provision in England A. Current arrangements for regulation and inspection of independent schools Consultation proposals Response The Bill 53 54 55 55 57 61 63 64 64 65 66 68 69 69 70 B. C. D. V Part 5 of the Bill: miscellaneous provisions A. B. C. D. E. F. Pre-16 education and training: Wales Maintained schools in England: behaviour and attendance External qualifications Inspections of teacher training in England Schools Forums General provisions VI VII Data processing Appendix I: Reaction from specific organisations to the green paper, Raising expectations: staying in education and training 73 Appendix II: relevant documents 85 VIII. RESEARCH PAPER 07/87 I A. Part 1 of the Bill: duty to participate in education or training (England) Introduction In March 2007 the Government’s green paper Raising Expectations: staying in education and training post-16, proposed that the minimum age at w hich young people should leave education or training should be raised to 18. 1 The participation age would be increased in two stages: to age 17 from September 2013, and to 18 from September 2015. The green paper set out a detailed package of measures for consultation. Alongside the green paper the Government published an Initial Regulatory Impact Assessment on the estimated cost of the proposals. 2 (These projections have been reviewed and revised and are now published in the Impact Assessment that accom panies the Education and Skills Bill – see below). In July 2007 the Government published a report of the consultation on the green paper’s proposals. While it noted that there had been wide acceptance of the principle that young people would benefit from continuing to develop their skills formally until they were 18, it also noted that there was concern about making participation compulsory. 3 Also in July 2007, the Government published World Class Skills: Implementing the Leitch Review of Skills in England. 4 This set out the Government’s plans to improve the skills of young people and adults. The Government’s Draft Legislative Programme, published on 11 July 2007, announced that a bill would be introduced to ensure that young people stay in education or training until age 18, and to provide new rights to skills training for adults. 5 In his Fabian Society lecture on 5 November 2007, Ed Balls, the Secretary of State for Children, Schools and Families, described the Government’s proposals, and published a further document – From policy to legislation. This explained how the Government intended to proceed, and what aspects of the policy required legislation. 6 Also on 5 November 2007, the Government published its strategy for reducing the proportion of young people not in education, employment or training. 7 1 2 3 4 5 6 7 Raising Expectations: staying in education and training post-16, Cm 7065, March 2007: http://www. dfes. gov. uk/consultations/downloadableDocs/6965-DfESRaising%20Expectations%20Green%20Paper. pdf Initial Regulatory Impact Assessment for Raising Expectations: staying in education and training post16, DfES, March 2007: http://www. dfes. gov. uk/consultations/downloadableDocs/RIA%20[FINAL]%20word%20version. pdf Raising Expectations: Consultation Report, DCSF, July 2007: http://www. dfes. gov. uk/consultations/downloadableDocs/Raising%20Expectations%20Consultation%20R eport. pdf http://www. dfes. gov. uk/skillsstrategy/uploads/documents/World%20Class%20Skills%20FINAL. pdf http://www. cabinetoffice. gov.uk/reports/governance. aspx Raising Expectations: Staying in education and training post 16: From policy to legislation, DCSF, November 2007: http://www. dfes. gov. uk/14-19/documents/Raising%20Expectations. pdf Reducing the number of young people not in education, employment or training (NEET) by 2013, DCSF, 5 November 2007: http://www. dfes. gov. uk/14-19/documents/NEET%20%20Strategy. pdf 7 RESEARCH PAPER 07/87 The Education and Skills Bill was presented in the House of Commons on 28 November 2007. 8 Explanatory Notes9, an Impact Assessment10, a Memorandum of Delegated Powers11 and a Short Guide 12 were also published. B. 1. Background History The Education Act 1918 raised the compulsory school leaving age from 12 to 14. It also made provision for all young people to participate in at least part-time education until they were 18 but this provision was not implemented. The end of the First World War was followed by a period of austerity; public expenditure cuts dubbed the ‘Geddes axe’ 13 meant that the aspiration of increasing participation was not achieved. The Education Act 1944 made provision to raise the school leaving age to 16 but this was not implemented until 1972. 14 The 1944 Act also re-enacted the 1918 provision to extend participation at least part-time until the age of 18 but again this was not implemented. The school leaving age has remained at 16 since 1972, although the leaving date was amended in 1997. 15 2. Participation of 16 and 17 year olds in education, employment and training At the end of 2006 around six out of every seven 16 and 17 year olds were provisionally estimated to be in some form of education or training. The large majority were in fulltime education, others were in Government supported Work Based Learning (WBL)16, Employer Funded Training 17 or other types of education and training including part-time courses. The latest data are summarised below: 8 9 10 11 12 13 14 15 16 17 Education and Skills Bill, Bill 12, Session 2007-08: http://www.publications. parliament. uk/pa/cm200708/cmbills/012/08012. i-v. html Education and Skills Bill Explanatory Notes: http://www. publications. parliament. uk/pa/cm200708/cmbills/012/en/index_012. htm Impact Assessment of the Education and Skills Bill, DCSF, 29 November 2009: http://www. dfes. gov. uk/publications/educationandskills/docs/impact_assessment. pdf Memorandum of Delegated Powers, DCSF, 28 November 2007 (an electronic copy was not available at time of writing but a hardcopy was available from the Vote Office) DCSF, Short Guide to the Education and Skills Bill: http://www. dfes. gov. uk/publications/educationandskills/docs/BillNarrative. doc after Sir Eric Geddes who chaired a committee set up to suggest economies SI 1972 No 444 The 1997 change introduced a single school leaving date – the last Friday in June in the school year in which a young person reaches age 16: DfES Circular 11/97, School Leaving Date for 16 Year Olds, September 1997 http://www. teachernet. gov. uk/management/atoz/S/schoolleavingdate/index. cfm? code=furt Includes Advanced Apprenticeships, Apprenticeships, Entry to Employment and NVQ Learning. Young people who received training in the previous four weeks, includes non-WBL apprenticeships. 8 RESEARCH PAPER 07/87 Education, employment and training status of 16 and 17 year olds in England, 2006 16 year olds  number % of population 17 year olds number % of population 16 and 17 year olds number % of population Full-time education Work Based Learning Of which also in full-time education Employer Funded Training Other education and training Total education and training Not in any education or training Of which also not in employment Source: 516,900 37,700 1,300 15,000 25,600 593,800 68,400 42,800 78. 1% 5. 7% 0. 2% 2. 3% 3. 9% 89. 7% 10. 4% 6. 5% 428,600 51,600 1,200 26,700 32,000 537,600 122,000 62,700 65. 0% 7. 8% 0. 2% 4. 0% 4. 9% 81. 5% 18. 5% 9. 5% 945,500 89,300 2,500 41,600 57,600 1,131,400 190,400 105,500 71. 5% 6. 8% 0. 2% 3. 1% 4. 4% 85. 6% 14. 4% 8. 0%. Participation in Education, Training and Employment by 16-18 Year Olds in England: 2005 and 2006 and Participation in Education and Training by 16 and 17 Year Olds in each Local Area in England: 2004 and 2005, DCSF Overall participation rates were higher for 16/17 year old females at 88% compared to 83% for males. The gap was nearly 10 percentage points for full-time education participation, but young men were more likely to be in one of the training categories. These figures are based on the academic year age of young people, i. e. their age at the start of the academic year. Therefore 16 year olds are in their first year after the end of compulsory education. The data are estimated as at the end of the calendar year, hence some of these young people will have had their 17th/18th birthdays. Among the one million 16 and 17 year olds in full or part time education in 2006, 426,000 were in further education/specialist colleges, 366,000 were in maintained schools, 130,000 in sixth form colleges and 82,000 in independent schools. The overall number in full-time education has increased by 14% over the last decade; the largest proportionate increases were at sixth form colleges (22%) and at maintained schools (19%). There was relatively little difference in the type of education attended by 16 and 17 year olds. A slightly higher proportion of 17 year olds attended further education colleges at the expense of maintained schools. 18 Trends in participation by broad status are summarised in the table at the end of this section. In the early 1950s (when the school leaving age was 15) fewer than one in five 16 year olds and fewer than one in ten 17 year olds were in full time education in England and Wales. Immediately before the leaving age was increased to 16 (1972) these figures had increased to around one in three 16 year olds and one in six 17 year olds. The 16 year olds’ participation rate reached 50% in the mid 1970s; the 17 year olds’ rate reached this level in the early 1990s. 19 At the end of 2006 78% of 16 year olds and 65% of 17 year olds were in full time education in England. 20 Both were record highs. 18 19 20. DCSF SFR 22/2007, Participation in Education, Training and Employment by 16-18 Year Olds in England: 2005 and 2006 and Participation in Education and Training by 16 and 17 Year Olds in each Local Area in England: 2004 and 2005 Statistics of Education 1962 part one, Ministry of Education; Education and training statistics for the United Kingdom 2006 and earlier, DfES DCSF SFR 22/2007F 9 RESEARCH PAPER 07/87. a. 16 and 17 year olds not in education or training The earlier table showed that there were an estimated 190,000 16 and 17 year olds not in any education or training (NET), 106,000 of whom were not in work and hence not in any education, employment or training (NEET). The NEET rate among 16 and 17 year old males was 9. 5% compared to 6. 4% for females. 16 year olds had a lower NEET rate than 17 year olds (6. 5% v 9. 5%). Around 60% of those in the NEET category were classed as unemployed21, the rest were economically inactive. 22 While there is a particular focus of attention on young people who are not in education, employment or training (the ‘NEETs’), the Bill proposes a duty on those in employment to participate in some training or education – hence it is also relevant for the ‘NETs’. The latest similar sub-national data collected is for the end of 2005. This only looked at education and Work Based Learning (WBL) and showed that the total proportion of 16 and 17 year olds not in either category was lowest in London (16%), the South East (18%) and the South West (18%) and highest in Yorkshire and the Humber (23%) and the East Midlands (21%). 23 More recent data from Connexions, which is not directly comparable, gives NEET rates at the end of 2006 which vary from 5. 6% in the South East and 6. 0% in the South West to 10. 5% in the North East and 9. 2% in Yorkshire and the Humber. 24 b. Trends The table at the end this section summarises trends in NET and NEET rates. These are also illustrated in the charts below. 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 1985 NET NEET 16 year olds 45% 40% 35% 30% 25% 20% 15% 10% 5% 0% 1985 17 year olds NET NEET 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 1987 1989 1991 1993 1995 1997 1999 2001 2003 2005 There was a break in the series in 1994 and there have been some recent more minor inconsistencies. However, some trends are clear. The NEET rate among 16 year olds fell in the early 1990s and increased steadily for much of the last decade to a high of 8. 1% in 2005. The provisional fall to 6. 5% in 2006 takes it to its lowest level for almost a decade. The NET rate for 16 year olds fell by a larger amount in the late 1980s and 21 22 23 24 ILO definition of unemployment DCSF SFR 22/2007 ibid. NEET Statistics – Quarterly Brief, DCSF 10 RESEARCH PAPER 07/87 early 1990s as there was a general shift from employment and WBL to full-time education. This rate increased from 9. 2% in 1994 to 14. 3% in 2001, but has since fallen to 10. 3% in 2006. The NEET rate among 17 year olds fell by around half between 1984 and 1994 to 7. 7%. This rate has increased more recently to 10. 9% in 2005 before dropping back to 9. 5% in 2006. The NET rate fell from 44% in 1984 to below 20% in 1993 as there was a major shift from employment to full-time education. The scale of this was even greater than that seen among 16 year olds. The level of this rate increased from the late 1990s onwards to almost 22% before falling back to below 18% in 2006. Trends in education, employment and training status of 16 and 17 year olds in England Percentages (a)(b) 1985 Full-time education Work Based Learning Employer Funded Training (c) Other Education and Training Total Education and training Total Not in any education or training Of which also not in employment Notes: 1990 51. 1 19. 1 7. 5 3. 5 79. 7 20. 3 8. 0 1995 65. 6 11. 6 4. 0 4. 3 84. 7 15. 3 6. 7 2000 65. 6 9. 5 3. 7 4. 9 83. 5 16. 5 7. 1 2001 64. 8 8. 4 3. 9 5. 2 82. 1 17. 9 8. 4 2002 65. 4 7. 9 4. 0 5. 2 82. 4 17. 6 8. 2 2003 66. 0 8. 1 4. 1 5. 2 83. 2 16. 8 7. 7 2004 67. 2 7. 9 3. 8 4. 9 83. 6 16. 4 8. 3 2005 2006p 69. 2 7. 4 3. 5 4. 5 84. 5 15. 5 9. 5 71. 5 6. 8 3. 1 4. 4 85. 6 14. 4 8. 0 39. 7 16. 1 9. 2 4. 5 68. 2 31. 8 11. 0 There was a break in the series in 1994 due to changes in the source of further and higher education data. (a) Participation estimates may be slightly underestimated for 16 year olds between 1999 and 2000 and 17 year olds between 2000 and 2001. (b) There is a discontinuity from 2002 onwards whereby participation in additional institutions are included for the first time. This increases the full-time education rate by around 0. 1 points and the any education or training rate by around 0. 4 points (c) Includes other part-time education not included elsewhere and full- or part-time education in independent further or higher education institutions. Source: Participation in Education, Training and Employment by 16-18 Year Olds in England: 2005 and 2006 and Participation in Education and Training by 16 and 17 Year Olds in each Local Area in England: 2004 and 2005, DCSF c. International comparison of enrolment in education 16 year old enrolment rate in secondary education, 2005  100% 90% 80% 70% 60% 50% 40% 30% 20% 10% FRA GRE AUS SWE NOR KOR OST LUX IRE BEL ICE SWI 0% US POL SLO JAP UK ITA POR OECD MEX ESP CZ FIN NED DEN NZ TUR OECD data on enrolment by age look at the actual age of pupils/students, the rates calculated are different from those given earlier. In 2005 94% of 16 year olds and 80% of 17 year olds were in ‘secondary’ 25 education in the UK. The 16 year olds’ rate was three percentage points above the OECD average, the 17 year olds’ rate three points below. The UK’s relative position is shown opposite. Source: Education at a Glance 2007, OECD. Table C2. 3 25 This is based on the assessed academic level using international classification which at their highest level split education into primary, secondary and tertiary. It does not mean these pupils are in secondary schools. 11 GER HUN RESEARCH PAPER 07/87 Although the UK’s participation rate for 16 year olds was above the OECD average it was still below that of most other countries as the average was skewed downwards by much lower levels in Turkey and Mexico. The UK ranked 18th out of 29 states included in the 16 year olds measure and 20th on the 17 year olds rate. 17 year old enrolment rate in secondary education, 2005 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% SLO 0% KOR HUN NOR CZ GER SWE BEL POL FIN JAP OST OECD POR GRE MEX DEN NED TUR AUS ICE SWI ESP FRA LUX IRE NZ US UK Some of the countries ranked Source: Education at a Glance 2007, OECD. Table C2. 3 below the UK have relatively high enrolment rates in non-secondary education, 26 but direct comparisons cannot be made due to a lack of comparable data on enrolment on these types of education in the UK. 27 3. The green paper and the case for change The green paper, Raising Expectations: staying in education and training post-16, described the perceived benefits to individuals and society of young people staying in education and training for longer. 28 It proposed a detailed package of measures for consultation. These were summarised in the DfES press notice launching the green paper: †¢ From 2013, young people should remain in education or training after 16 – this means the first pupils to be affected would be those entering secondary school in September next year. Young people would be required to work towards accredited qualifications at school, in a college, or in â€Å"on the job† training or day release; Apprenticeships will be significantly expanded so that they are available to any qualified young person who wants one; Participation should be full time for young people not in employment for a significant part of the week and part time for those working more than 20 hours a week; Better advice and guidance for young people to enable them to access the provision that’s right for them; A high quality, accurate registration system to keep track of the education options a young person has chosen and to make sure they don’t drop out; Building on the Education Maintenance Allowance we will consider new financial support measures to ensure young people from low income †¢ †¢ †¢ †¢ †¢ †¢ 26 27 28 Tertiary and post-secondary non-tertiary Education at a Glance 2007, OECD. Table C2. 3 Raising Expectations: staying in education and training post-16, Cm 7065, March 2007: http://www. dfes. gov. uk/consultations/downloadableDocs/6965-DfESRaising%20Expectations%20Green%20Paper. pdf 12 ITA RESEARCH PAPER 07/87 backgrounds get the support they need to overcome any barriers to participation. To make sure the right provision is in place the new requirement would not be implemented until 2013 by which time the new Diplomas will be a National Entitlement. This will give young people a choice of A levels, GCSEs, the International Baccalaureate, the new Diplomas, Apprenticeships, and accredited in work training. Young people would be supported to re-engage if they drop out through integrated Youth Support Services. Any enforcement process would be used only as a last resort if a young person refused to re-engage. 29 Chapter 2 of the green paper set out the evidential basis for raising the education and training participation age. This referred to research showing that young people who stay on in education and training after 16 are more likely to gain further qualifications by 18 than those who go into employment without training or drop out altogether. Individuals with qualifications earn more than those without. In addition to higher wages, betterqualified individuals have improved employment prospects and an increased likelihood of receiving workplace training. There are also wider benefits associated with higher qualification levels, such as improved health and better social skills. The green paper noted evidence on the relationship between higher levels of skills and qualifications and economic performance and productivity. It highlighted evidence suggesting that up to one fifth of the UK’s output per hour productivity gap with Germany and an eighth of the gap with France results from the UK’s relatively poor skills. The green paper also noted the wider benefits to society from increased participation. It stated that those who participate are less likely to experience teenage pregnancy, be involved in crime or behave anti-socially. The green paper refers to a study that looked at Offender Index data between 1984 and 2001 which showed that an additional year of compulsory schooling decreases conviction rates for property crime, and that it has also been estimated that compulsory schooling lowers the likelihood of committing crime or going to prison. 30 The green paper went on to outline t e combination of measures taken so far to h encourage increased participation. These include changes to the 14 to 19 curriculum and the introduction of new specialist diplomas with an emphasis on applied and practical learning; changes to the curriculum for 11 to 14 year olds to allow greater flexibility and personalisation of learning; an expansion of work-based learning; from September 2007 a ‘September Guarantee’ of an offer of an appropriate learning place for every young person leaving school at 16; improvements in information, advice and guidance for young people to help them make choices; and financial support through educational maintenance allowances.