What leadership means to me

What lead means to me1. IntroductionAlthough leading is cognised as being an important construct, it is not a concept that holds one exclusive definition. What leadinghip actually is, or how to define it correctly is still regarded as a mystery by numerous. attractership is something that may differ depending on the people involved, the situation at hand, and the goals being pursued, and is consequently open to subjective interpretation. Stogdill (1974 259) concluded that thither are almost as m any definitions of attractors as there are persons who befool attempted to define the concept. It could be argued that perpetuallyyone has their own understanding of what constitutes leadership, based on personal and learning experiences, and situations and people, which is precisely why it is difficult to capture in a succinct definition. Grint (2004) narrows down the key reasons as to why it is so difficult to find a single and concurd understanding of leadership process prob lems, position problems, philosophy problems, and purity problems. These problems refer to whether leadership is derived from traits or a social process, whether a leader is automatically in charge with formally allocated authority, and the questions as to whether a leader has intentional influence on the behaviour of following, and is leadership embodied in several(prenominal)s or groups and is it a purely human phenomenon. This essay seeks to explore what leadership means to me, drawing on personal experience of leadership as a social phenomenon, and discussing my views from the panorama of both a leader and follower. In ordain to make sense of my understanding of leadership, a critical review and commentary on leadership possible action is included in the discussion. 2. Personal Experience of Leadership Within the WorkplaceFor the past five years I hand had a part cadence job at Marks and Spencer, and thus list across many types of leaders and motorbuss. The question oft en asked is whether a manager can automatically be sour to in the likes of manner be a leader? Zalenznik (1977) was one of the first to contrast leadership and management as he argued that a leader uses creativeness and intuition, whereas a manager solves problems using rationality and control. Since then, many academics progress to agreed and argued that good management brings about a degree of order and consistency to organisational processes and goals, whilst leadership is required for dynamic spay (Kotter 1990 104 cited in Bolden 2004 6). In an organisation such as Marks and Spencer then, it is essential that they have both good management, who offer st cleverness, consistency, order and efficiency, and good leaders who produce important change by keeping employees focused and motivated to give the deal communicated. In my workplace, I would say we have good managers based on the above assumptions, however, I would not say that every manager is also a good leader. For thi s reason I agree with Kotter and Zalenznik, leadership and management differ from one another substantially. In the workplace context I am a follower, and so from this perspective I have seen what I would up tag to be good leadership, and poor leadership styles. The authors who have focused on followers suggest that they are active participants in the leadership relationship (Boccialetti, 1995 Chaleff, 1995 Kelley, 1992 Shamir, Pillai, Bligh, Uhl-Bien, 2007). The socially constructed view sees leadership as being in the eye of the beholder where it is the followers who have to agree on what constitutes leadership, and who they are prepared to follow. If the followers, and in my personal situation fellow employees, do not respect the leader, it is unlikely they will follow at all. Unless followers recognise and orient to grouchy behaviours, which they regard to be leadership, then the person trying to lead is not a leader whatever their intentions. There is thus no way for an in dividual to lead unless people are prepared to follow. There have been many instances at work when one particular manager has tried to lead change in the store, however because she is not well respected, and in my opinion does not come across as being a natural leader, often her vision gets ignored until another manager provides instructions for staff about the same vision. This manager is viewed by employees as having the role of simply instilling discipline, completing administrative tasks, and organising the tell on floor, rather than communicating visions for change. Furthermore, although I conceptualise that the roles of managers and leaders are very different, in my job there are no visible leaders who are not managers in my store. The management team automatically take on the role of leadership, regardless of whether they are a good leader or not. As it is whence management who attempt to provide the visions and plans for change, and employees like myself have no responsib ility or say in the directions they wish to take. Uhl-Bien and Pillai (2007) argue that followers who perceive the leader as responsible for making decisions are less likely to take an active role in the decision making process, and so, they shit up autonomy. Many of my fellow employees, who often do not enjoy the job, also expect the leader, in this instance our manager, to motivate them rather than motivating themselves. The managers recognise this and often offer incentives, such as a bottle of wine, if we achieve certain targets. This could therefore be considered to be transactional leadership. A typical way of describing leadership styles within the organisation is applying McGregors (1969) theory X and theory Y. McGregor assumes that an organisation and its leaders can have differing opinions on the motivation and abilities of their employees. My line manager presumes that her staff dislikes operative and takes a negative view of human nature, believing we will avoid doing work if possible. This is evident, as she will often split employees up on the shop floor to prevent them from chatting, and she constantly checks up on her staff to ensure they are doing what she has asked them to do. Her actions and leadership style concur with what McGregor describes as theory X leaders. My manager believes that coercion and control is necessary to ensure that people work, and she never gives employees like myself any extra responsibilities. This style is also referred to as the autocratic style. Although my manager is assumed to be the leader at work, I would argue that she is not a good leader, and there have been times when I have had better counseling from a fellow colleague. My manager has a coercive style according to Golemans six leadership styles. She expects immediate compliance, often provides negative and corrective feedback and controls tightly. This style does not motivate employees to see her visions or follow her lead, instead it has often turned employees against her and people have refused to do certain tasks because of her leadership style. 3. Myself as a Leader Badminton Coach and CaptainFrom a young age I have been told that I am a natural leader, possibly because I am autocratic and like to get things done Ever since I remember I have had certain personality traits, which I consider to be those of leaders I am confident, ambitious, dominant, and so naturally take the lead in most situations. Based on what I have learnt from leaders I have come across, when leading my badminton team I keep in mind what styles I believe will be most successful. I consider myself to be a transformational leader (Bass and Avolio 1994) when in the role of badminton captain. As a leader I believe it is important for me to have a clear vision, and most importantly, be adequate to(p) to communicate it effectively to the whole team. Unlike the traditional transactional theory of leadership, which emphasizes corrective action, centralised co ntrol and rewards tho when performance expectations are met, transformational leaders trust their subordinates and it is a more developmental and constructive form of leadership. In a sports team context it is also important for me to articulate our teams goals, which should be realistic and achievable. For example, before entering a tournament I will state where I expect us to finish, and that the vision is to win a gold medal. In order to achieve this goal I also have to motivate the team, and make sure they put the team and tournament at the top of their priority list, above any other self-interests at that time. Additionally I have to get the team members to understand how their style of play affects others, therefore encouraging them to view their game from others perspectives. And ultimately I have to develop the team in many ways, both physically to prepare them for a big tournament, and mentally so they reach their highest levels of ability. It could therefore be argued, that as a leader I follow what Bass and Avolio (1990) call the four Is Idealised Influence, Inspirational Motivation, Intellectual Stimulation, and Individualised Consideration. As a person I have previously been told that I am very charismatic. I recover this also shows in my leadership style and I think I am also a charismatic leader. Northouse (2004) described the major characteristics as dominant personally with the desire to influence others, strong role simulate behaviour and competence, articulation of ideological goals with moral overtones, and high expectation of followers and confidence that they will meet these expectations. Although I believe I have the personality traits required to plump a leader, I am aware that there have been occasions when my leadership styles have been unsuccessful, as I have become impatient or intolerant of the followers. From these experiences I believe I have learnt a lot and therefore also see the importance of situational leadership and h aving the ability to alter the leadership styles I adopt.4. Could Parents be considered to be Leaders?When considering leaders and leadership, and what it means to me, I thought about what my first experience of leadership ever was. Although leadership in an organisation is the key focus of the module and course, it cannot go ignored that my parents were the first prestigious leaders in my life. My parents have been very influential leaders in my life. As managing directors of their own company, they have always played the role of managers, however in our home their leadership style varied to that of in their work place, and to the styles of each other. My parents have led me in the right direction. Unlike the traditional theories of leadership such as The Great Man Theory I would argue that my mum is the strongest leader in our home. It has been argued that women are more likely to use transformational leadership (Rosener 1990), and as the follower, this is the style I find motiva tional, inspirational and therefore successful. She uses more interactive leadership styles in comparison to my dad as she encourages participation, power and information sharing and enhanced self worth. Although the leadership styles of parents are arguably very different to those of leaders within an organisation, my parents and their styles have had a massive influence on my understanding of leadership and on my whole life They have led me to where I am today. I have been extremely lucky to be able to experience their leadership styles whilst running their company, therefore within an organisation. In this situation they both use different methods of leading than they do at home, thus supporting Hersey and Blanchards (1969) theory that leaders could adapt their styles to suit the situation. Situational or point leadership models recognise this, and support the argument that what constitutes effective leadership will be influenced by the situational factors such as the people inv olved, the task to be carried out, and the organisational culture. It is therefore essential that leaders employ a variety of approaches across a range of situations. 5. ConclusionFrom taking the time to consider what leadership means to me, it has only become more apparent about how complex the concept of leadership actually is. I believe leadership is different to different people. Whom I consider to be an effective leader, others may not, and what I consider to be traits that create a successful leader, others may not. Leadership to me is something that comes naturally, however in different situations, there needs to be different forms of leadership in order for your followers to follow. Although there have been many studies on leadership, and many theories produced, I agree with burn down statement that leadership is one of the most observed and least understood phenomena on earth. (Burns, 1978 3)5.1 My theoretical understanding of leadershipI have found it difficult to truly u nderstand and specify my theoretical stance of leadership. Generally speaking, it is assumed that a person either believes that leadership is a consequence of a set of traits or characteristics possessed by leaders, or that leadership is a social process that emerges and is learned throughout life and from group relationships. I, on the other hand, believe there is truth in both approaches. I would argue that some people are simply born leaders due to their dispositions and personalities, however they also need to learn and understand how to use these traits to become a successful leader, hence leadership capability must also be partly learned. I have this opinion because of my experiences. I often become the leader in group task situations, at university for example, and although I know it often comes naturally to me, I have had to learn how to use my leadership trait effectively in order to succeed and lead the followers. I agree with Gallies statement that Leadership appears to b e, like power, an essentially contested concept (Gallie 1995 cited in Grint 2004 1). Furthermore, I have the same opinion of the situational leadership approach due to personal experiences with leaders, and as a leader myself. Zaccaro (2007), Sternberg (2007), and Vroom and Jago (2007) argue that neither trait nor situational attributes alone are sufficient to explain leader behaviour and effectiveness. It is the interaction between traits and situations that counts.

Adverse Drug Reaction Reporting: a Novel Approach

Adverse medicine Reaction Reporting a romance ApproachADVERSE DRUG REACTION REPORTING, A NOVEL APPROACHAuthor Abdul Latif Sheikh*, Ale Zehra*, Salwa Zubair*, Muhammad Zeeshan Khan*ABSTRACTGlobally unfavourable dose chemical reactions (ADRs) has study contri plainlyion in public health cost mortality ratio. Therefore its a crucial time for an ongoing ADR-monitoring and new faint progress describe program which provides benefits to the health care professionals unhurrieds. The aim of hosting a ADRs physical compositioning modern tactic by the section of Pharmacy Services,Aga Khan University Hospital ,Karachi,Pakistan(AKUH)(a ordinal care setup), is to perceive the outcome of spontaneous reporting of ADRs through call in name of Hot line of merchandise operate its awareness oppose. In increment to manual yellow form and online reporting trunk,AKUH has launched the program with ADRs awareness session, memorandum sent through berth small spot quiz with ADRs account to all Doctors, Nurses Pharmacists. The department has fixed its one telephone line for voluntarily reporting of ADRs. native 08 awareness session has been taken at different forum of AKUH including its associated secondary hospital from August to December with 274 participants while 396 professionals participated in spot quiz activity. On weekly basis ADRs awareness memo mail was sent to all hospital professionals and ADRs flyers distributed to the covers. Impact of 05 calendar month activity has assessed for its achievement or not. Reporting of ADRs was increase(09%) from 43 to 52 in count with region of 29 ADRs, describe via hot line return while the awareness campaign boosted the professionals to report ADRs as pharmacist participation appeared to be increased from 35% to 64%. However different countries and organizations have different technologies for reporting ADRs but by adoption of such a type of modern smart approach which is easy for professionals to report ADRs awareness compaign of ADRs enhance the professional to report ADRs for positive patient out comes safety.Key word Report ADR through call, Novel technology in ADR reporting, ADRs awareness compaignIntroductionAdverse medicate reactions (ADRs), occurs at normal doses (used for prophylaxis, diagnosis, or therapy of disease, or for the modification of physiologic function), have a considerable adverse intrusion on the health of the population lead to contribution in health care cost due to hospital admissions (approx.5-6%), suggested the enormous direct and indirect sociable and economic costs for a society.2, 3, 4, 5, 6,7,14, 15,16,17,18. Globally the burden of ADRs is senior high school, accounting for considerable morbidity, mortality and extra cost28Thalidomide is the first drug whose ADRs was reported in 196019, estimated that 5000-6000 new innate(p) infants were effected by drug with characteristic of thalidomide-induced phocomelia, limb defects, often accompanied by deformit ies of internal organs20,21. Due to reporting of its adverse reaction, it was withdrawn from the world food market in late 1961, remaining available only for strictly defined research purposes, 22diverted the attention of health care bringr to chore on reporting transcription of adverse drug reaction.ADR monitoring or a reduction in their frequency simply cannot happen until and unless they are reported in an efficient and by the way manner. Spontaneous reporting is most accessible and easiest regularity for ADR reporting. WHO has implemented two methods in its public health program, cohort event monitoring (CEM) and targeted spontaneous reporting (TSR). CEM encompasses all drug related issues including poor quality, drug interactions, storage and medication errors23 while in TSR health professionals in specific setting (e.g. patients on drug resistant infection) reports about drug related issues, safety.24Spontaneous reporting is helpful but is usually prone to under reporting and poor quality reports 25Other methods embroil intensive monitoring (resource and time consuming)26, chart review (prospective and retrospective), FDA MEDWATCH reporting. One of the most common method is yellow broadsheet system which was started 30 years forward but the main problem associated with it is under reporting (less than 10%)27Due to remarkable burden of ADRs globally, 28, 42measures are needed to reduce the frequency of ADRs, healthcare costs and readmissions34, 35and to improve the benefit harm ratio of drug. Fatal ADRs appear to be the 4th or 6th leading cause of death31 it can be cut by making changes in systems for preventing and detecting adverse drug event(ADEs)29. A study indicates that a computer alert system prevented ADRs which were otherwise not recognizeable29.WHO database contains over 2.5 million case report epitome of this data32 ( 70% were known ADRs ,17% symptoms requiring further evaluation)33 .Spontaneous reporting is the most common method u sed in pharmacovigilance and most good in generating signals on new or rear adverse drug reactions28.Reduction in ADRs will occur only if ADRs are properly reported and the patterns can be studied to identify the causes of ADRs, which will in the end, help to reduce their occurrence.36Pakistan has been plagued with many health related problems, including ADRs. In Lahore, on Jan- 2012, at to the lowest degree 125 patients died due to an adverse drug reaction(ADRs) due to one of the cardiac medicine, which was adulterated with an antimalarial agent, found on investigation.37, 38However laws for monitoring and forms for reporting ADRs exist in Pakistan but thither is no National ADR database.39In Pakistan, medicines are used on a large scale, but still ADRs reporting is a subaltern known concept. Ministry of health (MOH) has been involved in ontogenesis an ADR program, but requires major improvements widespread implementation cosmos a critical factor. Majority of the hospitals have no ADRs reporting system, others are reporting ADRs restricted to some drugs, and only few hospitals have a proper established ADRs reporting system40. The Aga Khan University Hospital (AKUH), being the premier hospital of Pakistan, also has an established ADRs program, which includes utilizing various technologies to report ADRs Yellow cards, online reporting, and a recently established ADR reporting hotline service (where reports can be make via telephones). Having multiple technologies available to healthcare professionals to report ADRs makes the task easy and ultimately results in improved patient care.41MethodologyTo enhance the ADRs reporting system in an easiest more efficient way, The Department of Pharmacy services-AKUH, in addition to yellow card online ADRs reporting, tune up to a new spontaneous service in name of ADRs hot line service in which pharmacy fix its one telephone extension for receiving ADRs reporting calls. Caller is the reporting person but the login of ADRs in system is the responsibility of pharmacy by asking the information of about patients Medical record number, time date of reaction, surmise drug nature of reaction.Program started from 5th August, 2013 with adoption of following strategies.Aware session at different forum of doctors, pharmacists nurses, distribution of ADRs flyers to different unit of ward ADRs cards inform them about the importance outcomes of ADRs reporting.By taking a small spot quiz of ADRs (policies, how to login, and its outcome e.t.c) to different staff randomly give small prizes for their appreciation encouragement.On weekly basis advertise through mail, sent to all hospitals professional with different theme of ADRs. declare with appreciation words to those user who report the ADRs through hot line service for future courage.Collect the monthly data of ADRs reporting count with contribution of hot line service.At end of month Calculate how much this service was affective?Initially the data of 05 month activity was collected to try impact of new services.Table01Table02Table03ResultADRs reporting trendPRE ADRs hot line servicesTotal voluntarily ADR reported = 43Graph01Post ADRs Hot line ServiceTotal voluntarily ADR reported including Hot line service= 52Total ADR via Hot line service = 29Graph02 of ADRs Reported Doctor, Nurses Pharmacists.Pre ADRs Hot line serviceGraph03Post ADRs Hot line serviceGraph04Discussion impertinently methodologies in any set up always helpful for its goal achievement. In a current scenario, along with yellow card online reporting system, The Department of Pharmacy Services-AKUH introduces a new spontaneous method of ADRs reporting in name of ADRs Hot Line Service. Program( hot line service its awareness compaign) was started on 5th August -2013 to all hospitals Doctors, Nurses Pharmacists. Program features includes awareness session,spot quiz, memo through mail. Pre post service comparison indicate the increased in quantity of voluntaril y reporting ADRs, from 43 to 52 ( as shown in graph 01 02).Increase in 09% ADRs reporting status indicate that service along with campaign was effective but still need continuous effort in field of ADR reporting technologies34,35. Reporting via manual yellow card has almost vigour ( pre post evaluation showed zero reporting)which whitethorn be due to presence of online reporting as it is easy convenient as compare to yellow card while globally yellow card reporting is also underreporting27. Globally the burden of ADR28, 42 alarm each health care setup to narrow its way of reporting methodology so as large amount of ADR would be reported.Total reporting trend through hot line service in around 05 month campaign was 29 including from its associated secondary hospitals (06 ADRs reported by Secondary hospitals doctors Pharmacist) while before campaign there was zero reporting from there. Awareness sessions spot quiz campaign (as shown in table 01 02) over there boost the profess ionals to report the ADRs for future patient safety.As the campaign also include weekly memo (importance of ADR reporting new service) mail sent to to all professionals, act as enhancement factor for reporting. Total 20 memos have been mailed in 140 days program assesment as shown in table 03.Highest number of total ADRs has been reported in month of kinfolktember, 2013 (shown in graph 02) i.e 19 its was 2nd month of campaign while least number has been reported in month of November i.e only 2 which may be due to non occurrence of ADRs. Reporting via hot line service was seem to be high in month of September also (as shown in graph 02) while moderate in month of October December (as shown in graph 02) but over all contribution of hot line service in ADRs reporting was good satisficatory certified program to continue in future for patient safety.Though the doctors, pharmacist nurses have an equal accountability to report ADRs but Pharmacist have an vital role in direct patient care through counseling on ADRs, identification and documentation in the patients medical record of high-risk patients43 thus in current adopted approach contribution ofPharmacist to report ADR appeared to be high as compare to the pre awareness campaign indicate the positive outcome of compain.Reporting of ADRs is high in high income incoutries as compare to low income countries. As per World Health Organization,Pakistan stand among low income countries so there is need of development of such a smart approach for reporting ADRs its awareness for patient safety.ConclusionADRs have a major contribution in death mortality so there is need to continue effort in developing an easy and smart technology like spontaneous reporting of ADRs through call( ADRs hot line service) its awareness comapign seems to be very effective boosting professionals .ReferencesBiswas, P., Pharmacovigilance in Asia. J Pharmacol Pharmacother. 4(Suppl1) p. S7-S19.Goettler, M., S. Schneeweiss, and J. Hasford, Adverse drug reaction monitoringcost and benefit considerations. Part II cost and preventability of adverse drug reactions leading to hospital admission. Pharmacoepidemiol Drug Saf, 1997. 6 Suppl 3 p. S79-90.Einarson, T.R., Drug-related hospital admissions. Ann Pharmacother, 1993. 27(7-8) p. 832-40.Muehlberger, N., S. Schneeweiss, and J. Hasford, Adverse drug reaction monitoringcost and benefit considerations. Part I frequency of adverse drug reactions causing hospital admissions. Pharmacoepidemiol Drug Saf, 1997. 6 Suppl 3 p. S71-7.Lazarou, J., B.H. Pomeranz, and P.N. Corey, relative incidence of adverse drug reactions in hospitalized patients a meta-analysis of prospective studies. JAMA, 1998. 279(15) p. 1200-5.S., O., The role of the WHO program on International Drug supervise in coordinating worldwide drug safety efforts. Drug Saf 19, 1998 p. 110.Rawlins, M.D., Clinical pharmacology. Adverse reactions to drugs. Br Med J (Clin Res Ed), 1981. 282 p. 974-6.Edwards, I.R. and J.K . Aronson, Adverse drug reactions definitions, diagnosis, and management. Lancet, 2000. 356 p. 1255-9.Bandekar, M.S., S.R. Anwikar, and N.A. Kshirsagar, Quality check of spontaneous adverse drug reaction reporting forms of different countries. Pharmacoepidemiol Drug Saf. 19(11) p. 1181-5.Munir Pirmohamed, S.J., Shaun Meakin, Chris Green, Andrew K Scott,Thomas J Walley,Keith Farrar,B Kevin Park,Alasdair M Breckenridge., Adverse drug reactions as cause of admission to hospital prospective analysis of 18 820 patients. BMJ 2004. 329 p. 15-19.Mellin GW, K.M., The saga of thalidomide (concluded). . N Engl J Med 1962. 24 p. 1238-44.V, G., Thalidomide in human immunodeficiency virus (HIV) patients. A review of safety considerations. Drug Saf, 1992. 7(2) p. 116-34.DArcy PF, G.J., Thalidomide revisited. . Adverse Drug React Toxicol rev up 1994. 13 p. 65-76.Stephanie Tseng, G.P., Kenneth Washenik, Miriam Keltz Pomeranz, Jerome L Shupack., Rediscovering thalidomide A review of its mechanism of action, side effects, and potential uses. Journal of the American Academy of Dermatology, 1996. 35(6) p. 969-979.Pal, S.N., et al., WHO Strategy for Collecting Safety Data in Public Health Programmes Complementing Spontaneous Reporting Systems. Drug Safety, 2013. 36(2) p. 75-81.WHO, A practical handbook on the pharmacovigilance of medicines used in the treatment of tuberculosis enhancing the safety of the TB patient. 2012, 20 Avenue Appia, 1211 Geneva 27, Switzerland WHO Library Cataloguing-in-Publication.Figueiras A, H.M., Polnia J, et al., An Educational Intervention to Improve Physician Reporting of Adverse Drug Reactions A Cluster-Randomized Controlled Trial. JAMA, 2006. 296(9) p. 10861093.Bates DW, C.D., Laird N, et al., Incidence of adverse drug events and potential adverse drug events implications for prevention. JAMA, 1995. 274 p. 307311.Rawlins, M.D., Pharmacovigilance paradise lost, regained or postponed? The William Withering Lecture 1994. J R Coll Physicians Lond, 1995 . 29(1) p. 41-9.Al., G.J.e., Why Learn about Adverse Drug Reactions (ADR)? Am J Med, 2000. 109(2) p. 87-94.Davies, D.E.C., Emergency re-admissions to hospital due to adverse drug reactions within 1 year of the index admission. British Journal of Clinical Pharmacology, 2010. slew 70(Issue 5).Kass, B.L. Reducing and Preventing Adverse Drug Events To Decrease Hospital Costs. cited Available from www.ahrq.gov/qual/aderia/aderia.htm.Bate, A., et al., A Bayesian neural network method for adverse drug reaction signal generation. Eur J Clin Pharmacol, 1998. 54(4) p. 315-21.AGENCIES, Drug regulation follows heart patient deaths., in Daily Dawn. 2012-03-12 Lahore, Pak.Saeed, A., Pakistan heart drugs Lahore death toll reaches 100, in BBC News. 26 January 2012 Lahore, Pak.Jooma, P.D.R., Pakistan. Pharmaceutical Country write 2010, Health Ministry of Pakistan Pakistan. P. 1-56.Al., G.e., adverse drug reaction reporting system at different hospitalsof lahore, pakistan an evaluation and patient outcome analysis. journal of applied pharmacy, 2013. 4(1) p. 713-719.AKUH Pharmacy newsletter, Sep 2013, Vol.23, 02.www.ahrq.gov/qual/aderia/aderia.htmwww.worstpills.org/public/page.cfm?Op_id=4Lazarou, Jason, Bruce H. Pomeranz, and Paul N. Corey. Incidence of adverse drug reactions in hospitalized patients.JAMA the journal of the American Medical Association279.15 (1998) 1200-1205.Bate, Andrew, et al. A Bayesian neural network method for adverse drug reaction signal generation.European journal of clinical pharmacology54.4 (1998) 315-321.Evans, S. J. W., P. C. Waller, and S. Davis. Use of proportional reporting ratios (prrs) for signal generation from spontaneous adverse drug reaction reports.Pharmacoepidemiology and drug safety10.6 (2001) 483-486.Muehlberger N,Schneeweiss S,Hasford J. Adverse drug reaction monitoringcost and benefit considerations. Part I frequency of adverse drug reactions causing hospital admissions. Pharmacoepidemiol Drug Saf.1997 Oct6 Suppl 3S71-7.Dr Emma C. Da vies et al. Emergency re-admissions to hospital due to adverse drug reactions within 1 year of the index admissionBritish Journal of Clinical pharmacology intensiveness 70, Issue 5, article first published online 14 JUL 2010Anthony R cox et al. Assessing, managing and reportingAdverse drug reactions may better equip us to minimize medicines-related harm, 2008 volume 18, issue-2/5 PIP Basic pharmacy skills Mar08www.dawn.com/news/702090/drug-regulation-follows-heart-patient-deathswww.bbc.co.uk/news/world-asia-16742832WHOs Pharmaceutical country profile Pakistan.Gulamet al., 2013, adverse drug reaction reporting system at different hospitalsof lahore, pakistan an evaluation and patient outcome analysis, journal of applied pharmacy04(01) 713-719 January, 2013AKUH Pharmacy newsletter, Sep 2013, Vol.23, 02www.fda.gov/Drugs/developmentapprovalprocess/developmentresources/druginteractionslabeling/ucm114848.htmASHP Guidelines on Adverse Drug Reaction Monitoring and Reporting, www.ashp.org.

Christmas Essay -- Narrative Essays, Descriptive Writing

A few days before Christmas, Oxford street is swarming with last minute shoppers, laden with parcels and bags. Christmas is the high dim for many people, curiously little childen, from as tall as your ankle to as tall as your knee. Small todlers were moaning and disappearing into the clothes racks like magicians disappearing in a puff of smoke entertaining the gullible audiences. Families and friends gradually emerge from clogged buses and congested trains, tired, exhausted and hungry even at this very early stage, as if they had spent the whole night awake, like a distressed parent waiting for their child to arrive home from a party but has quiesce not arrived, two hours past their curfew. Oxford street is the main high street of the whole of England. It flocks many tourists, as though it has a force or power, solely like opposite ends of a magnet attract one another. Oxford street is as long as I can possibly imagine it is 10 time longer than any l ocal high street and is as wide as six elephants put together. Oxford street contains a lot of confused shop which other high streets have, plus roughly extra. It is as if Oxford street encloses a immeasurable proportion of England as it has a great deal of stores some immense while some petite. Its not restricted - even Regents street is much more genteel like a magnificent pet and oblige street is tremendously aristocratic like a diamond engagement ring and only the posh shop there. Oxford street is one maze, with all sorts of inscrutable secrets to be uncovered and adventures to be explored and experienced. It is one colossal, huge, extensive, perpendicular road with a range of exits... ...ng for breath. As I walk through MK1, I can undoubtedly see that many shoppers were haggling over the price of purchases. Then someone barges into me and I very nearly fall over with the force of it. After I recover from my sudden fall, I widen my horizon and gaze upon particular groups of people. I get attracted to look at the people with loud voices. The brightness of the light decreases as the clouds begin to fasten together together structuring one massive cloud. It began to snow. The cold was beating on me. I felt the cold reaching my system even with wearing a thick layer of wool covered by a fur coat. It was as though I was wrapped with a sheep, which had never had its fur, trimmed. The bitter air smacks my face as I walk, without any energy and worn out, forwards towards the end of the road to relaxation.

Diomedes in Agamemnon :: essays research papers

Since Agamemnon refused to return the daughter of a priest of Apollo, Agamemnon agrees to release Helen solitary(prenominal) if Achilles gives him his bread of honor. This is when Achilles found it unfair and withdraws from the battle including all his soldiers. Achilles then asks the gods to grant him revenge. Agamemnon the had attacked because a dream had encouraged him to. Paris flees the battle with the help of a divinity and Menelaus rages on with his brother demanding the release of Helen.As the battle continues, Diomedes makes a heroic stand and kills many Trojans, bringing his Time, Kudos and Arete up high. The term Time means the study among the prince/gods, Kudos is glory and Arete excellence meaning, doing more than a man can do. It all started when Pamdaros had shot an arrow through Diomedes shoulder, except Diomedes tells Sthenelos to pull out the arrow and he did. After this happened, Diomedes had prayed to thena asking her for help, here is where Diomedes is gett ing Kudos. Athena had decided to help Diomede just like she helped his father and she also heals him. Now not just now did she heal him but she also gave Diomedes the power to see gods while he was in the battle only if he fights no other god but Aphrodite.Diomedes recieves Kudos when Aineias tells Pandaros that Diomedes may be a god. When Diomedes rejects Sthenelos advice to retreat, so instead he stands, he receives more Kudos. Diomedes now adds Time with the gods when he threw a pear at Pandarus with Athenas help and kills him, when Aineias comes by to help his friend, Diomedes picks up a large stone and kills him by smashing the large stone on Aineias hip. more Time was added when he followed Aphrodite and then wounded her on her wrist and then shouted out to her "Away from the battle, you daughter of Zeus Isnt it enough that you amuse weak women? But is you will visit the battle field, I think after this is a battle will make shiver if you hear only echoes in the distanc e"After this, Aphrodite tells Ares about Diomedes as she asked him for his horses to go home.

The Life and Work of George Orwell :: Biography Biographies Essays

The Life and Work of George OrwellGeorge Orwell is the name of the person behind burnished works of literature much(prenominal) as Animal Farm and 1984. After my closer study of his book Animal Farm, I decided to look more closely into the person who wrote that brilliant allegory. I also tried to understand why, and how it was possible for a man raised far from communist/totalitarian regime could describe it so incisively in such an amazing prophetic way.Born under the name of Eric Blair on June 25 1903, in India in the family of an Imperial Officer, after going to embarkment school and then to Eton, he decided to stop with his education and enlisted in the Indian Imperial Police at the age of 20. He served in Burma for 5 years and later described that period as the most miser adequate to(p) times and that he hated macrocosm the bully arresting people to be beaten. After he left Burma Eric wanted to experience the life of the oppressed, so he moved to Paris disguised as a homeles s poor. He started living the life of tramps and all kinds of poor homeless, but soon he found himself in their true situation, without a serious job, Eric was forced to live on the streets and to make only enough not to starve. At that time he wrote his first book Down and Out in Paris and London and was able to publish it under the pen name of George Orwell. The book was a success, and after that he wrote and published in three years three more books Burmese days, a Clergymans daughter and Keep the Aspidistra Flying.In 1937 Orwell went to Spain to report on the civil war and, according to Judy P. Sopronyis article George Orwell on the Road to Nineteen eighty-four, got really involved in the idea of Socialism, he was thrilled by the idea of everyone treating each other as equals and his log sense of guilt for being born in the upper-middle class, as he called it, had found its cure. It wasnt long before he found out that regardless of how flawless an ideology was, people could be nding it viciously in order to make it work for their own political ambitions. His personal experience was involved in that notion, because after being loyal to, and armed combat on the side of the Republicans, he was quickly turned into the enemy for no apparent reason, and was forced to return to England to avoid arrest.

Comparing Saint Augustine and Charles Taylors Ideas of Authenticity Es

Comparing Saint Augustine and Charles Taylors Ideas of AuthenticityThe notion of authenticity is one of self-fulfillment and Charles Taylor recognizes that there are dangers in accepting modernitys drive toward self-realization. However, he is not willing to give up on this idea of authenticity. In The Ethics of Authenticity, Taylor lays go forth a system of thought and honorables that connect our search for self-realization with our desire towards self- induction. He is attempting to keep a form of laissez faire while cool off operational under objectivism. He will point out the good and damaging aspects of the modern culture of an authentic self and mention the importance of some moral measurement system. Taylor claims that St. Augustine initiated a concept of inwardness, a turning towards the inner self to find truth and the idea of authenticity is simply a further development of Augustines inwardness. In this paper I will discuss in detail Taylors idea of authenticity t he pros and cons. I will lay out some of his arguments as to why he thinks this idea originated with Augustine. I will talk about Augustines view on the inner man and how this is attached with knowledge and memory. I will then talk about some of Augustines views. Freedom is also an important aspect to moral conduct so I will explore both Taylors and Augustines view of liberty. Finally, I will argue that the angel of authenticity (although it contains some truth) is not an ideal that Augustine would promote. Three Modern WorriesTaylor begins the book by discussing three worries of modern society. The first is individualism which is selfish and self-centered. The modern concept is bothersome because people see freedom as loosening the chains of traditional notions of hierarchy. We have become a society where we are breaking away from older moral horizons. Everything in creation is connected in some way and when there is a loose hierarchy there follows a loose meaning of life. The d ark situation of individualism the focuses on the self in such a way that it flattens and narrows the framework which give significance and meaning to human life. The second trouble is the dominant anxiety given to instrumental reason. Instrumental reason values efficiency above all other goods. Nothing else is considered sacred or has intrinsic value, only unessential value. The question is how usef... ...y for us humans. I think it is, but only to the extent that we open ourselves to God, which means in fact, overstepping the limits set in theory by exclusive humanisms. Taylors idea of authenticity does give way to many warnings. It is analogous to walking a tight rope. If one leans likewise much to one side (which in all reality may not be much at all) it can ensue to disaster. He adopts a lot from the Romantics and the focus is too much on the individual. Although he does try to get away from too much emphasis on the individual by mentioning the horizons of significance h e still does not give us an idea of what this hierarchy consists. People may look inside themselves to formulate this hierarchy but this again can lead to subjectivism. It seems to suggest that there could be a variety of heirachies and who is to say that one is better than the other. Also the ambiguity of his idea of freedom only leads to more ambiguity on his idea of authenticity. These are all problems that Taylor must address if one is to get a clearer concept of his project. If Saint Augustine were to read Taylor I think he would find these worries and suggest that Taylors central focus should be on God.

An Analysis of Ballad of the Harp-Weaver Essay -- Ballad Harp-Weaver E

An Analysis of Ballad of the Harp-Weaver Take retributive a second to read the branch eight lines very carefully. Picture yourself as a small child being with your m some other or father sitting on their lap as they hold you. It is a good feeling that brings warmth and security to any child or any adult needing to recapture the essence of their childhood. In the initial four lines we are to understand that the boys begin is trying to rub his skin to make him warm. That is what chafe means, to warm by rubbing. But how many times put on you found yourself not quite sleepy enough to go to sleep and you ask your mother or father to read you a bedtime story? In this section we find the relationship between mother and son the very epitome of maternal union. Their bonding takes place in a form that closely children can remember from the early part of their lives. The act of storytelling is a wonderful part of growing up. Before the invention of reading and writing, people str uggled to survive against nature, animals and other humans. This rime is a good example of this basic need to survive by using whatever resources you have to keep alive. To survive, people developed skills that grew into heathen and educational patterns. This idea is present when we read the part about the severity of that winter and the mother and son burning up their furniture to stay warm. The boys mother is teaching him that you can use the wood in the furniture to use in the fire. That is an important lesson that a parent can pass down in order to insure the survival of their offspring. It teaches a lesson that a child would not otherwise know and can be used again and again to help oneself future generations. For a culture to continue into the future, peop... ... into their path of agony by letting us know it is Christmas. The boy cannot be soothed by his mothers singing and cries himself to sleep. This is so heart wrenching for any mother to have to endure. I be lieve this is the climax of the poem. The mother knows she can no longer go on with just rhymes and singing. In fact even her love cannot soothe her sons torment anymore. But we are left to wonder what it is she can do. She uses the only thing left, the harp. The boy dialogue about a light that falls on her, yet its source is unknown. Is it the light of God or divine intervention that is helping her to understand what she essential do? Or is it just that light that appears in our heads out of nowhere when we have exhausted all our options? We begin to understand that the harp is her last resort. The poem makes no mention of her playing the harp before so why now?