Annunciation vs. Enunciation

Annunciation vs. Enunciation Annunciation vs. Enunciation Annunciation vs. Enunciation By Maeve Maddox I read the following in an NPR (National Public Radio) transcript: Im articulate, which means that when it comes to annunciation and diction, I dont even think of it cause Im articulate.   My first reaction was to smile at what I assumed was an amusing typo, perhaps the result of a mechanical voice transcription error. But then I decided to see if I could discover other examples of annunciation used in contexts calling for enunciation. I found quite a few. Not surprisingly, many of the errors occur on amateur sites and forums where correct spelling is not an issue: He had a pretty heavy lisp, and the thing that was most pronounced was his over-annunciation of words so that his speech was very slow and drawn out. Almost 5 [years old and] has annunciation issues. just started speech therapy 2x week 30 minutes each. It’s just an overall annunciation issue, rather than a particular sound. More surprising is finding the error in a professional context, on sites offering speech therapy and in documents posted on government sites: [Our] speech therapists help adults who have problems understanding written or spoken words, feeding and swallowing, or speaking clearly with appropriate annunciation and tone. Our daughter is six years old and is being teased at school for her annunciation. (A parental testimonial featured on a professional site’s landing page.) While he has come a long way, he is still very behind in his pronunciation and annunciation. (Petition requesting insurance coverage for speech therapy) The word annunciation means announcement. The word is closely associated with a particular announcement: the one made to Mary regarding the impending birth of Jesus: And the angel said unto her, Fear not, Mary: for thou hast found favour with God. And, behold, thou shalt conceive in thy womb, and bring forth a son, and shalt call his name  Jesus.–Luke 1:30-31, KJV. This use of Annunciation is always capitalized: One of the most famous paintings of the Annunciation is one attributed to Leonardo da Vinci and Andrea del Verrocchio. Enunciation, on the other hand, refers to the clear utterance of speech sounds: If youre looking to improve your childs  enunciation, its best to begin with an evaluation by a speech-language pathologist.   No vocal warm-up is complete without reciting a few  enunciation  exercises. One way to keep the words apart is to pronounce the a in annunciation as a schwa sound and the e in enunciation as a long e sound, as in he. Note: The schwa sounds like â€Å"uh.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Misused Words category, check our popular posts, or choose a related post below:Program vs. ProgrammeYay, Hooray, Woo-hoo and Other Acclamations50 Synonyms for "Song"

My Life Essays - Fiction, Narratology, Writing Style, Health, Sleep

My Life Essays - Fiction, Narratology, Writing Style, Health, Sleep My Life HEA 285 Professor KK Introduction Many people take their health for granted and underestimate the fact that at any given moment their life could be turned upside down. Good health is essential for everyday life and functions. Making sure we eat properly, sleep enough and exercise are just a few ways of improving and maintaining good health. Having good health not only affects ourselves but those around us too; family and friends. A lot of people find their life too busy for healthy food, sleep or exercise, but making the time is key to living longer and better lives. (Why health is important to my life, 1 paragraph) (Define the 6 dimensions of health, 1-3 paragraphs, then explain why these 6 are important to strive by, 2 sentences) (Give examples of how the health of America affects our country socially, economically and politically, (1-3 paragraphs) (State what behavior I changed and how it related to your own lifestyle, (1 paragraph) (Discuss how your new behavior could improve each of the 6 dimensions of health, 1-2 paragraphs) (Reasons why I wanted to change this behavior, include warning signs or events that may have prompted your decision, 1-2 paragraphs) (describe my overall goal, (1 paragraph) Plan of Action Brief Review of Literature

Adult development Essay Example | Topics and Well Written Essays - 250 words - 1

Adult development - Essay Example This is for the reason that the adult learners are able to relate to those experiences. The adult learners are, in this case, presented with numerous learning preferences that support learning for varying needs. Motivating adult learners is possible through advocating for teamwork among the adult learners. Learners are challenged to the achievement of various tasks through sharing ideas. The proposed ideas can, hence, be learnt with a lot of ease; thus self actualization of an individual’s needs. Additionally, since the adult learners are best taught using problem-solving approaches, learn experientially, and have reasons for learning, then discussion is of great value to the adult learner. Since adult learning is androgogical- focuses less on the content and more on learning processes- the educator has no alternative but to apply strategies that would boost motivation for learning, for instance, role playing, individual evaluation and simulations. Adult learners must always be kept curious and motivated to learn (Wlodkowski,

Cuban Missile Crisis Movie Review Example | Topics and Well Written Essays - 1000 words

Cuban Missile Crisis - Movie Review Example The missile placement was being done as a means of deterring future invasion from enemies like United States. The result of Soviet Union’s decision was what became known as the Cuban Missile Crisis, which was influenced by different points of views held by leaders of the three countries involved. In this paper, the perspectives of the three countries are reviewed, as well as the result of the agreement reached between the countries. The review is done exclusively by using BBC’s documentary on the Cuban Missile Crisis of 1962. From the video, there are strategic and psychological analyses that the EX COMM makes to President JFK that come to represent the larger U.S perspective or view point of the Cuban Missile Crisis. From a strategic analysis point of view, the United States perceived that the Soviet Union had a motive of balancing forces to their favor so that the country would be freer to challenge the interests of the United States. But to make this possible, the Soviet Union had to have a capacitated force behind its remaining 50 ballistic missiles, which could range only to hit European countries. By placing the missiles in Cuba, the Soviet could have a closer range to target and attack the U.S. Indeed another strategic analysis that is perceived from the United States point of view was that the Soviet Union wanted to put the credibility of the United States into doubt by placing missiles at a position that can best be referred to as the backyard of the United States without the United States knowi ng of it. Then from a psychological analysis, there was a U.S held point of view that the Soviet leader Khrushchev perceived JFK as a weak leader from his inability to have firm positions against the Soviet leader in their 1961 summit. But seeing herself as the superpower of world, the US would not allow its voted leader to be taken for a weak leader who could not react to the missile laying in Cuba. The Soviet Union also had a perspective of the Cuban

Link Layer Protocol Services to the Network Layer Assignment

Link Layer Protocol Services to the Network Layer - Assignment Example (Keith 2008) The services offered by the link layer to the network layer are usually hidden from the network layer which only sees the services as a reliable communication channel which can send and receive data packets as frames. Framing, addressing, error detection, error correction, flow control, link management and acknowledgement of frames are some of the services provided by the link protocols. The link layer groups bits of the physical layer into frames enabling transmission of data in a form that can be understood by the network layer. Since various network stations have different speed of operation, the link layer protocol provides flow control service that ensures no station in the network is swamped with data from fast devices within the network. In addition the link layer provides a link management services through collision handling and avoidance. (Nancy 1988) One major services offered by the link layer protocol is error detection and correction. It has error check incl uded in the frame header which provides a more sophisticated error detection and correction since it can detect single bit and a wide range of common multiple -bit errors. Error detection in link layer uses checksum which is the same as those used in IP in the network layer as well as TCP in the transport layer. ... The frames are organized in seven fields: PREAMBLE which is 7 bits long used to warm the receiver that data is coming, SOF indicates that the next bit of data will be the destination address, DA the destination address which identifies the receiver of the data, SA identifies the source address, Length which indicate the length of the payload data, DATA contains the data transmitted its length varies with the size of data and FCS which is used for error checking. In 10BASE-T the PRE field is used for receiver synchronization while 100BASE-T does not require the PRE field for transmission since it has an electrical encoding that is different from 10BASE-T. The signal of 10BASE-T frame is zero when it is not transmitting while 100BASE-T transmits and idle signal between frames. Collision detection Figure 5.14 According to the figure node D detects collision first before the other node B detects since its transmission start time is greater than the transmission start time of node D. Node D detects the collision before node B since it started transmission later after D had already started. Furthermore node D has a shorter round trip time as compared to node B. Node A does not realize that detection has occurred between node B and D since it is not involved in transmission. Node A only waits for the signal from B in case of a collision since after the collision Node B will try to retransmit the signal after random times until it reaches its destination. Jamming signal is a signal sent by the data station, informing the other stations not to transmit. In this case the jamming signal is sent by node D since it is the node that detects a collision

Clinical Decision Support Systems in Healthcare

Clinical Decision Support Systems in Healthcare Melchor Abejon One pressing public health problem and a threat to patient safety are medical errors. Written articles about such incidents have highlighted cases and the amount of money spent. According to the United States (US) News and World Report (2013), medical error is the third leading cause of death in the US after heart disease and cancer with an estimate number of 250,000 deaths annually. Clinical decision making in healthcare is a very crucial process. Though this process will always be flawed, for sure there are ways to make it better. With the advent of the Electronic Health Record (EHR) meaningful use incentive program and the development of Clinical Decision Support (CDS) tools, healthcare organizations along with clinicians are mandated to integrate CDS into their federally certified EHR systems. As the director of clinical decision support at a healthcare delivery system, the purpose of this paper is to: Describe the different approaches to be used that will ensure all aspects of patient care are considered in the development of a CDS system. Identify how the efforts of the CDS team would be prioritized in the development of CDS in the organizations focus areas. Approaches to Developing a CDS System Like in the implementation of any other health information systems, the development and implementation of a CDS system entails an equivalent complexity and hard work. It is an endeavor that requires significant planning and preparation.ÂÂ   Once implemented, it is essential to evaluate and measure its value as an additional asset of the organization. According to Nelson and Staggers (2014), the CDS as a valuable tool can prevent many clinical errors especially when coupled with a computerized information system that enables process improvement measures. Though it is mentioned in the given scenario that the organization has existing CDS, my plan is to re-evaluate the existing systems and processes, and I want to make sure that I would not be missing a single essential step in my project, and have everything taken into consideration as I create a new plan.ÂÂ   Health IT provides a systematic strategic plan for the implementation of CDS which I will adopt for the organization. The strategic plan is composed of five steps as listed and described below: Commence the project with a strong foundation. This initial step includes assessing the readiness of the organization to adopt a CDS intervention; assessing the interest of stakeholders in using CDS to improve outcomes, and as well as assessing the overall capacity of the organization to adapt to the change. My key steps to establishing a strong project foundation are: To identify the essential stakeholders who can contribute to a discussion about using CDS to improve the quality and safety goals of the organization. To establish goals for the CDS by collaborating with the stakeholders to highlight the benefits and barriers to implementation. To determine the readiness of the organization for a CDS initiative. This is a critical process. A key aspect of readiness is understanding how well the organization can adapt to the change. To develop a plan on how to proceed with the implementation. It includes identifying the core members of the implementation team, outlining and refining achievable quality goals, identifying strategic next steps toward achieving the goals, building a shared vision among the stakeholders, and identifying champions of the project. Assemble a CDS implementation team.ÂÂ   My key steps to assembling the implementation team are: To stress the roles of the stakeholders that are required for the success of the project. To seek a clinical champion who possesses the desired characteristics for the role. To collaborate with an outside source who may be able to assist and fill the gaps in expertise in the implementation of CDS. To call for the implementation team to start planning by holding a kick-off meeting. Plan for successful development of CDS, design and deployment. The following are my key steps to assist the organization achieve the capacity for CDS interventions: To select a clinical goal that suits best to the goals and needs of the organization. The end users should agree with the chosen goal. To consult Electronic Medical Record (EMR) vendors and designers about ways on how CDS can help improve the clinical goals and objectives of the organization. It is important to discuss with them and determine the ability of a given CDS intervention to be customized to support the needs of the end-users. To select a CDS intervention that can help achieve the clinical goals and objectives of the organization. Considerations are ease of implementation, effect on clinical quality reporting, implementation of financial incentives, and workflow. To develop clinical objectives and baseline measures for the goals to help measure improvements. Example of this is through the utilization of metrics to measure baseline performance and assess the effect of the intervention. To map out existing workflows and clinical processes affected by the interventions. To develop a system for keeping interventions and CDS clinical knowledge current. This includes identifying people and processes that are involved in the interventions update. To ensure the usability of the CDS intervention by understanding its limits of functionality and possibly request for customization if needed. To test for the CDS interventions usability and effect on workflows. Roll out effective CDS interventions. My key steps are: To create a roll out plan. This includes defining the clinical goals and having the selected interventions assessed and tested. Also, to determine how to implement the interventions in the best way. To communicate the roll out plan to the end-users and stakeholders. This can be accomplished by describing and disseminating to the stakeholders the expected changes to the organizations workflow and processes. To develop a training plan to train users with the new intervention. To ensure that support structures such as people and other resources are in place to provide support during and after deployment of the intervention. Measure the effects of the intervention. This pertains to measuring the impact of the intervention post-implementation and to ensure it is improving the organizations processes and outcomes, and that clinical goals and objectives are being met. My key steps are: To conduct an ongoing assessment of the CDS systems usability. This includes capturing feedback and assessing how well is the intervention being received by the end-users. To collect and report the performance of the intervention against the clinical goals and objectives. To use feedback and measurement results to continually improve the performance of the intervention. To have the end-users get involved in the refinement of the intervention by communicating back to them the changes and by showing them continued support. Bates et al. (2003) published the Ten Commandments for effective Clinical Decision Support Systems (CDSS). This is another important collective approach and consideration in developing and implementing a CDSS for the organization. Listed below are the ten commandments for CDSS: Speed is everything. Speed is what end-users value most and is a top priority. Anticipate needs and deliver in real time. Information should be delivered when needed. Fit into the users workflow. Suggestions are integrated with clinical practice. Little things can make a big difference. In order to do the right things, usability of the intervention should be improved. Recognize that physicians will strongly resist stopping. Rather than insist on stopping, alternatives should be offered. Changing direction is easier than stopping. Example is changing dose defaults; route or medication frequency can change behavior. Simple interventions work best. Guidelines can be simplified by reducing to a single computer screen. Additional information can be asked when you really need it. A guideline will less likely be implemented when more data elements are requested. Monitor impact, get feedback and respond. If some reminders are not followed, either readjust or completely remove the reminder. Maintain and manage the knowledge -bases system. Information and currency of information should be monitored. CDSS Team Efforts and Areas of Focus Payment rates tied to quality measures. A primary consideration when developing and implementing a CDSS is the cost savings for the total system. With the existing reimbursement scheme, the financial commitment to implement a CDSS has become one major consideration to many health care organizations. Insufficient documentation of patients diagnosis has always been the difficulty in maximizing and meeting compliance with reimbursement and external quality agencies. As the director of the clinical decision support, I will summon and coordinate with the team to create a CDS intervention that can improve compliance with billing directives by ensuring systems work harmoniously to capture the correct diagnosis. Having such efficient CDSS in harmonious work with the organizations information systems can ensure delivered care, coded care, and documented care to become the same, thus meeting the meaningful use criteria and aligning with the nations health outcome policy priorities. CDS interventions that meet meaningful use. The stage 2 of the EHR meaningful use requires hospitals and healthcare professionals to implement five CDS interventions that are directly linked to four or more of the Center for Medicare and Medicaid Services (CMS) quality measures. As the leader of the team, I will suggest and work with the team on the implementation of support measures that will monitor health conditions that are of high priority such as stroke, hypertension, cancer and diabetes. Also, the team will aim to develop a CDS intervention that will alert clinicians when a patient is a candidate for colorectal screening. This intervention directly corresponds with the NQF-0034 colorectal cancer screening clinical quality measure. Also, the team will ensure that the CDSS will meet meaningful use by considering the five rights of CDS which are (a) the right information, (b) to the right person, (c) in the right format of intervention, (d) through the right channel, (e) at the r ight time in workflow (Campbell, R., 2016). CDSS in appropriate care services such as congestive heart failure. The team will consider developing a CDS intervention that will assist providers adhere to medical care, practice guidelines and prescribing guidelines. The administration of B-blockers has been demonstrated effective in improving the chance of survival for heart failure patients. The deployment of electronic reminder interventions for the prescription of drugs and appropriate dosing can additionally improve the care and survival for congestive heart failure patients and also in the management of chronic diseases. Other areas for clinical improvement. CDSS has also been proven effective in preventive service processes. As the leader of the team, I will work with the team to implement computer-generated reminders for providers to improve the standard of care in preventive services such as hypertension and smoking cessation counseling, eye and diabetic foot examinations, measurement of lipid levels, and glycosylated hemoglobin and proteinuria testing for diabetic patients. Conclusion The CDSS when coupled with the organizations existing systems such as the EHR and Computerized Provider Order Entry (CPOE) can work harmoniously to provide an effective clinical decision support to improve the quality of care in a healthcare organization. Though challenges may seem formidable, coming up with an effective approach in the development and implementation of such systems can assure positive return in investment overtime. References Bates, D. W. et. al (2003). Ten commandments for effective clinical decision support: Making the practice of evidence-based medicine a reality. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC264429/ Campbell, R. (2016). The five rights of clinical decision support. CDS tools helpful for meaningful use. Retrieved January 29, 2017 from http://bok.ahima.org/doc?oid=300027#.WJC59_krLIV Gross, P.A., Bates, D.W. (2007). A pragmatic approach to implementing best practices for clinical decision support systems in computerized provider order entry systems. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2215068/#bib13 HealthIT.gov (n.d.). How-to guides for clinical decision support implementation. Retrieved January 29, 2017 from https://www.healthit.gov/policy-researchers-implementers/cds-implementation Murphy, E.V. (2014). Clinical decision support: Effectiveness in improving quality processes and clinical outcomes and factors that may influence success. Retrieved January 29, 2017 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031792/ Nelson, R., Staggers, N. (2014). Health informatics: An interprofessional approach. (1st Ed.). St. Louis, MO; Elsevier Mosby United States News and World Report (2016). Medical errors are third leading cause of death in the U.S. Retrieved January 29, 2017 from http://www.usnews.com/news/articles/2016-05-03/medical-errors-are-third-leading-cause-of-death-in-the-us

A Work of Artifice and You Should Have Been a Boy Essay -- Marge Pierc

A Work of Artifice and You Should Have Been a Boy The word potential can be defined as the sum of abilities and capabilities that are possessed by, and specific to an individual being. In regards to humans we could say that it is all that a person can be and accomplish if encouraged and allowed the freedom to do so. Fulfillment of potential is curtailed in both the females in â€Å"A Work of Artifice,† by Marge Piercy and the female in â€Å"You Should Have Been a Boy,† by Elizabeth Cady Stanton; however, the manner and degree of such curtailing is quite different. In â€Å"A Work of Artifice† the growth and fulfillment of females is stunted physically, mentally, and sexually. The first evidence of this curtailment of potential we see is when the author says that the bonsai tree, which symbolically represents females, â€Å"could’ve grown to be eighty feet tall†¦but a gardener carefully pruned it.† Males, which are symbolically represented by the gardener, whittle away anything they find undesirable, thus curtailing the female’s growth and fulfillment. Example of the curtailing of the physical growth is â€Å"bound feet† by which females are unable to move around as they wish, limiting them to precisely where the males want them to be. In the words â€Å"croon[ed]† day after day by the gardener â€Å"it is your nature to be small and cozy, domestic and weak,† we see how males use these words to shape the mind of females, and they tell the females repeatedly also that they are so lucky to have men to tend to them as to inflict guilt as a safety net just in case the shaping was unsuccessful. All this careful attention works together to curtail females mentally. Lastly, the words â€Å"the hands you love to touch† imply that females... ...hese works signify the male dominance in society, and how male uses different venues and approaches to protect his dominant status, whether it is by conscious or unconscious acts. Also both works show how female acceptance of this hierarchy gives males the power and approval to continue to rule the roost, whether such acceptance comes through willing obedience or defeat. The females portrayed in â€Å"A Work of Artifice† and â€Å"You Should Have Been a Boy† developed deep and lonely voids inside their hearts because they had been conformed to the male’s wishes. They learned to ignore the pain created by the turning away from their own desires and aspirations and directed their lives on the path of living to please others. This empty existence denied what was rightfully theirs—a life full of happiness and satisfaction that occurs through the freedom of expression of self.