Results are something which you have no control over.So focusing on something which you have no control over is just waste of your time and energy.Although you can influence your results through your decisions and hard work

What happens when you focus on results 

Focus on achieveing small goals Eg: if you are a youtuber then publishing a video every day may be a goal for you which you have complete control over.

What should you focus on

You will not feel disappointed when you don't meet your results like reaching 100K+ views on YouTube. You will be much more happy when you finally achieve your goals

Benefits of this practice 

Learn more about it on my blog<a href="https://selfdevelopmentfreak.blogspot.com/2022/04/why-you-shouldnt-focus-on-results.html">Click here to learn more</a>

A little learning is a dangerous thing 

Learn why you shouldn't focus on the results and instead focus on the process

personaldevelopment

Personal Development

health

Health

Why shouldn't you focus on the results 

Bacteria, also called germs, are microscopic organisms not visible with the naked eye. Bacteria are single-celled, or simple organisms. Though small bacteria are powerful and complex, and they can survive in extreme conditions. Bacteria are when it comes to straight numbers, the biggest population of organisms that exist on Earth. Bacteria can be found almost anywhere on the planet, deep underground, below the deepest points in the oceans, and even 40 miles high up in the atmosphere. There are many bacteria in the human body also.

How Much Bacteria Is On Earth? 

How Much Bacteria is On Earth?
What Are the Types of Bacteria?
How Are Bacteria Good for us?  And, 
How Are Bacteria Harmful?

#bacteria #sciencenews #generalknowledge Bacteria, also called germs, are microscopic organisms not visible with the naked eye. Bacteria are single-celled, or simple organisms. Though small bacteria are powerful and complex, and they can survive in extreme conditions. Bacteria are when it comes to straight numbers, the biggest population of organisms that exist on Earth. Bacteria can be found almost anywhere on the planet, deep underground, below the deepest points in the oceans, and even 40 miles high up in the atmosphere. There are many bacteria in the human body, especially in the stomach and mouth. Bacteria are found on surfaces and in substances such as water, soil, and food. So, The questions are… How Much Bacteria is On Earth? What Are the Types of Bacteria? How Are Bacteria Good for us? And, How Are Bacteria Harmful? Let's find out with me… ..................................... Know more about other topics…  Space : https://youtube.com/playlist?list=PLO6kTsDI4xfnAISJIMWKxkPoL9qoU9Hwv General knowledge : https://youtube.com/playlist?list=PLO6kTsDI4xfn6hHfyZBGiw-atw0its-7Q Science & Technology : https://youtube.com/playlist?list=PLO6kTsDI4xfmONVgfMhMbstBLpZuyJCP2 Health : https://youtube.com/playlist?list=PLO6kTsDI4xflrlYCGE0EIyWXoBoNG81-r You also follow me on: -  Facebook: www.facebook.com/thetechers You can visit my Website : www.knowledgevaccination.blogspot.com This video is under Fair Use: Copyright Disclaimer Under Section 107 of the Copyright Act in 1976;  Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research.  Fair use is a use permitted by copyright statute that might otherwise be infringing.  Non - profit, educational or personal use tips the balance in favor of fair use.  All rights and credit go directly to its rightful owners.  No copyright infringement intended. Sound credit : YouTube Audio Library Footages/Images Credit : Storyblocks/pixabay/wikipedia Narration : Joy Mukherji References : https://www.healthline.com/health/bacteria https://www.worldatlas.com/how-much-bacteria-is-on-earth.html http://kidshealth.org/kid/word/b/word_bacteria.html https://go.skimresources.com/?id=41977X1601025&isjs=1&jv=15.2.4-stackpath&sref=https%3A%2F%2Fwww.healthline.com%2Fhealth%2Fbacteria&url=http%3A%2F%2Fwww.microbeworld.org%2Ftypes-of-microbes%2Fbacteria&xs=1&xtz=-330&xuuid=1a14207add2c591543d0ef7c1f336f58&xjsf=other_click__contextmenu%20%5B-1%5D http://www.ucmp.berkeley.edu/bacteria/bacterialh.html http://www.nlm.nih.gov/medlineplus/bacterialinfections.html http://www.ucmp.berkeley.edu/bacteria/bacteria.html http://www.childrensuniversity.manchester.ac.uk/interactives/science/microorganisms/whatarebacteria/ 🙏Requests🙏  I requested to you (My viewers) please subscribe to my channel and if you like video then please press like button.All youtubers are doing hard work in video making and your like, Share, Subscribes are fruits for our hard works. Thank you all of you...🙏

#bacteria #sciencenews #generalknowledge 
Bacteria, also called germs, are microscopic organisms not visible with the naked eye. Bacteria are single-celled, or simple organisms. Though small bacteria are powerful and complex, and they can survive in extreme conditions. Bacteria are when it comes to straight numbers, the biggest population of organisms that exist on Earth. 
Bacteria can be found almost anywhere on the planet, deep underground, below the deepest points in the oceans, and even 40 miles high up in the atmosphere. 
There are many bacteria in the human body, especially in the stomach and mouth. Bacteria are found on surfaces and in substances such as water, soil, and food.

So, The questions are… 
How Much Bacteria is On Earth?
What Are the Types of Bacteria?
How Are Bacteria Good for us?  And, 
How Are Bacteria Harmful?

Let's find out with me…
..................................... 
Know more about other topics… 

Space : https://youtube.com/playlist?list=PLO6kTsDI4xfnAISJIMWKxkPoL9qoU9Hwv

General knowledge : https://youtube.com/playlist?list=PLO6kTsDI4xfn6hHfyZBGiw-atw0its-7Q

Science & Technology : https://youtube.com/playlist?list=PLO6kTsDI4xfmONVgfMhMbstBLpZuyJCP2

Health : https://youtube.com/playlist?list=PLO6kTsDI4xflrlYCGE0EIyWXoBoNG81-r

You also follow me on: - 

Facebook: www.facebook.com/thetechers

You can visit my Website : www.knowledgevaccination.blogspot.com

This video is under Fair Use: Copyright Disclaimer Under Section 107 of the Copyright Act in 1976;  Allowance is made for "Fair Use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research.  Fair use is a use permitted by copyright statute that might otherwise be infringing.  Non - profit, educational or personal use tips the balance in favor of fair use.  All rights and credit go directly to its rightful owners.  No copyright infringement intended.

Sound credit : YouTube Audio Library
Footages/Images Credit : Storyblocks/pixabay/wikipedia
Narration : Joy Mukherji
References :
https://www.healthline.com/health/bacteria
https://www.worldatlas.com/how-much-bacteria-is-on-earth.html
http://kidshealth.org/kid/word/b/word_bacteria.html
https://go.skimresources.com/?id=41977X1601025&isjs=1&jv=15.2.4-stackpath&sref=https%3A%2F%2Fwww.healthline.com%2Fhealth%2Fbacteria&url=http%3A%2F%2Fwww.microbeworld.org%2Ftypes-of-microbes%2Fbacteria&xs=1&xtz=-330&xuuid=1a14207add2c591543d0ef7c1f336f58&xjsf=other_click__contextmenu%20%5B-1%5D
http://www.ucmp.berkeley.edu/bacteria/bacterialh.html
http://www.nlm.nih.gov/medlineplus/bacterialinfections.html
http://www.ucmp.berkeley.edu/bacteria/bacteria.html
http://www.childrensuniversity.manchester.ac.uk/interactives/science/microorganisms/whatarebacteria/

🙏Requests🙏 

I requested to you (My viewers) please subscribe to my channel and if you like video then please press like button.All youtubers are doing hard work in video making and your like, Share, Subscribes are fruits for our hard works.

Thank you all of you...🙏

Hi Friends,
In this channel, We provide you with Facts about Latest Space, Science & Technology research and information, Research based Health-related facts, General Knowledge facts, and many more. Your Information, Our Responsibility. 
Here I research a lot to make one video and Compress it in only 1-10 minutes video to gives you an instant knowledge boost. 
So friends Subscribe to my channel and watch my videos. Also, press the Bell icon to get new video notifications. And if you like videos, don't hesitate to tell your friends to subscribe to my channel. 
Because The Knowledge is Infinite.
Thank you in advance.

Sudhir Talati

How Much Bacteria is On Earth? #sudhirtalati

The history of cannabis cultivation by humans goes back as far as 12,000 years ago. As legalization spreads around the world, it is important to know how to grow your own medicine. These skills may also help in growing many other plants including vegetables and herbs.

A Simple Guide to Germinating Cannabis & Hemp Seeds

You can grow your cannabis from either a seed or a clone. In commercial marijuana production, producers will often sow many seeds of a single strain and select the best plant. During the cannabis growth stages, producers will take clones of that particular plant, allowing for uniform genetics in large production.Depending on cannabis legality in your state, you can purchase seeds or clones from the local dispensary or several seed banks online.

Where to start?

The beginning of spring is the optimal time to germinate cannabis seeds for outdoor growing. Cannabis plants are annuals, meaning they will grow throughout the spring and summer before flowering in the Autumn as the days become shorter. If you're growing your seeds inside, you can germinate them whenever you want as long as you provide them with the necessary atmosphere.

When is the Ideal Time of Year to Start Growing Marijuana Seeds?

Sprouting can take anything from a few days to a week for your seeds to begin to sprout and grow into plants.

Duration Taken in Cannabis Seeds Germination

Yes, to put it briefly, a seed will often sprout with a bit of moisture, warmth, and darkness.A substance called phytochrome is the key to this. In light, phytochrome exists in one form, and after a time of darkness, it exists in a different form. After a few HOURS, the light form decreases to a dark state; after several MINUTES in the light, it is converted back. As a result, a seed on the soil's surface receives enough light to maintain the dark state of phytochrome low for long enough to prevent germination.

Will Seeds Germinate in a Paper Towel When Placed in The Dark?

The dark version of phytochrome is only active long enough to cause germination when the seed is in complete darkness.The tissue will help keep your sprouts moist, but it will not provide additional nutrients. They'll have enough food to get started from seed, but they'll require soil or food for happy roots and light to create strong green leaves.Remember to distinguish between what a seed requires and what your seedlings require; thus, examining the plant's requirements after germination is an intelligent idea.

Will Seeds Germinate in a Paper Towel When Placed in The Dark? #2

Seeds require appropriate warmth, humidity, and air to sprout efficiently. Cannabis seed sprouts like a temperature range of 70°F to 90°F for sprouting. It's why cannabis grow tents are dark on the outside to increase temperatures. Seeds do not require light to germinate, but seedlings need good lighting to grow.

What are the Optimum Temperature and Light Settings in Germination of Cannabis Seeds?

When growing cannabis from seeds, seeds may fail to sprout because of various causes, including age or dryness, improper storage, incorrect cannabis germination methods, and difficulties at the seed bank.I do not recommend disturbing or attempting to shatter the seeds at this time because they are very fragile and could be damaged. To "activate" your seed, use the "glass of water" procedure. It's best to wait for now and be patient, ensuring they have the best sprouting conditions.

Why Won't My Cannabis Seeds Sprout?

Direct planting is even more natural than soaking in water. Sow your seeds 1/2 inch to one inch deep in damp soil or a similar medium. Not subjecting your seedlings to transplant shock is a significant advantage of this method. They will have adjusted to their surroundings because they have grown up in them.

How Deep Should I Plant My Cannabis Seeds?

When you want to germinate cannabis seeds, patience is essential, and this step is no exception. Taking notes is a great way to keep track of your progress and figure out what's working and what isn't. Refrigerate your seeds until you're ready to start. It takes a little research and experimentation to grow cannabis, but it's not rocket science, and it's a VERY satisfying experience. <a href="https://upperlimitsinc.com/cultivation-harvest">Learn more about grow and cultivation accessories. </a>

Bottom Line

The history of human cannabis cultivation goes back as far as 12,000 years ago. As legalization spreads around the world, it is important to know how to grow your own medicine. These skills may also help in growing many other plants including vegetables and herbs. I hope you find this to be informative.

The first steps in growing cannabis are often the most daunting.  We're here to ensure you that anyone can grow quality cannabis inside their own home with successful cannabis germination.  Growing cannabis from seed is easy! 

scienceandnature

Science & Nature

A Simple Guide To Germinating Cannabis Seeds - Content That Matters - The Upper Limits Blog

Bruce Willis has recently been diagnosed with aphasia, a disorder that stems from damage to parts of the brain responsible for speaking, writing and understanding language. About 180,000 people in the United States are diagnosed with aphasia every year. It can occur after a sudden emergency, like a stroke or a head injury, or come on more slowly over time. It can affect people of any age but is more common in middle-aged or older individuals.

Aphasia affects communication

Some people with aphasia may speak in short or incomplete sentences or longer sentences that are non-sensical. They also use unrecognisable words. According to the Mayo Clinic, people with aphasia fall into one of three patterns.<ul><li>Expressive aphasia: They can understand others but struggle to respond in complete sentences. They may say things like: "Walk park today."</li><li>Comprehensive aphasia: People speak in long, complex sentences that are non-sensical. They don't always know that people don't understand them.</li><li>Global aphasia. People have poor comprehension and a poor ability to form words.</li></ul>

Communication challenges

Aphasia is caused by damage to one or more brain areas responsible for language, such as a stroke. When the blood supply to part of the brain is stopped or greatly reduced, it can prevent the brain tissue from getting oxygen and nutrients. The impact can be immediate and lasting. Other causes of aphasia are severe head injuries, brain infections, brain tumours or a progressive neurological condition, such as Alzheimer’s.

Aphasia doesn't happen on its own

Symptoms of aphasia are:<ul><li>Difficulty speaking</li><li>Trouble understanding speech</li><li>Difficulty with word recall</li><li>Problems with reading or writing</li></ul> Treatment depends on the root cause. Some people can recover from a brain injury such as a stroke, depending on which parts of the brain were affected. Rehabilitation programs, including a speech pathologist, can help with recovery. Aphasia therapy helps people with aphasia to use their remaining language abilities, restore language abilities, and learn other ways of communicating, such as gestures, pictures, or the use of electronic devices.

Aphasia symptoms and treatment

Bruce Willis is "stepping away from acting" because of the health condition. Here's what causes it and how it affects people.

What You Need To Know About Aphasia

It could be said, I'm a psychonaut. After 35 years of learning about methods of exploring the universe, why, how and when it occurs, I believe it's a title I've earned. It's not all sitting around taking acid and frying your brain. It actually involves very little use of mind altering substances and the kind of indepth learning you would undertake in a top university. It was 30 years of learning and introspection, self evaluation adjustment of values and hard work before I was fully ready to partake of what's known as "the spirit molecule".

You can't buy facetime with God.

Why go to all the effort? Instead tread the path cut by colonialists. With the mighty dollar, trample through the remote Amazonian rain forest, where 80% of the world's biodiversity precariously exists, introducing the countless dangers to a people, ecosystem and culture totally unprepared for it? Without all the years of learning, the possibility of completely losing ones mind, taking powerful halluciogens in an unprepared situation, is entirely understandable.Those isolated tribes that survived rubber tappers, colonialists and loggers face a new threat.

The short cut

Wealthy westerners seek a short cut to enlightenment, flocking to retreats that make a mockery of the complex spirituality being culturally appropriated. Increasing reports of disappearances and deaths emerge. No mention of the loss of life, from disease, the distancing of a people with their identity and the damage to the delicate balance within the region that is to the Earth, what a heart is to a human.Profiteers allege that it affords the tribes luxuries. Perhaps like giving a starving child a Fabergé egg.Eco tourism of this kind must end.

There's no winners in war.

The right to enlightenment must be earned.

Ayahuasca was a sacred medicine. Now it's a global 'it' drug, and the trendiness is threatening the source.

religionandspirituality

Religion & Spirituality

artsandculture

Society, Arts & Culture

Millennials on Spirit Quests Are Ruining Everything About Ayahuasca

On to the list of books that make you smarter.

Begi

This 2011 bestseller by Nobel Laureate Kahneman is an intriguing account of the way the human brain works, with its two main manners of thinking and coming to decisions: namely, fast and slow. How do they differ? Is one of them better? Kahneman seeks to explore this, and more.

1. Thinking, Fast and Slow  by Daniel Kahneman

A deeply compelling exploration of human history, Harari’s work delves into the evolution of the human species, from the time that Homo Sapiens shared the earth with others, to the contemporary human, and beyond. It tracks the three great revolutions that altered the course of humankind, and the way our brains and cultures developed and expanded.

2. Sapiens: A     Brief History of Humankind    by Yuval Noah Harari.

This short book undertakes to stimulate your brain in order to prevent its aging and loss of capabilities. It consists in a series of spreadsheets with daily exercises to boost your brainpower. A bestseller in Japan, it’s a practical and engaging way to stimulate your mind.

3. Train Your Brain: 60 Days to a Better Brain

This wildly popular book can boast of divulging complex scientific topics in an intelligible, accessible manner. Bryson wrote it in order to make science interesting for himself as well as the everyday reader. With a rating of 4.2 stars on Goodreads, it’s fair to say that he succeeded.

4. A Short History of Nearly Everything    by Bill Bryson

It is a heart-wrenching yet inspiring account of the power of learning and reading, as well as an exploration of the ways in which slavery was denigrating for slaves and slaveowners alike (this doesn’t negate the responsibility or evil of the latter).

5. Narrative of the Life of Frederick Douglass    by Frederick Douglass

It contains the most important document(s) of both Judaism and Christianity, and has been wielded as a weapon throughout most of its history. Depending on whose hands it has fallen in, it has been both a blessing and curse. Whether you’re a believer or not, it’s an interesting account of two of the most prominent religions in the world.

6. The Holy Bible

If reading the Bible is important, the Quran is equally so. Islam has been subjected to incredibly gross attacks for years, and its cornerstone text provides a deeper understanding of another of the most followed – and persecuted – religions of our time.

Quran

Morin’s book offers practical, actionable advice to stimulate emotional intelligence. She draws from her experience as a licensed clinical social worker, and her own journey through devastating loss, to sketch a map of qualities that help build emotional resilience.

8. 13 Things Mentally Strong People Don’t Do  by Amy Morin

Hawking wrote this definitive account of cosmology for the non-scientist who wished to know more about this fascinating science. Updated throughout the years, A Brief History of Time remains unsurpassed as an introduction to the topic.

9. A Brief History of Time    by Stephen Hawking

A list of books that make you smarter, in order to boost your intelligence and general knowledge of the world and the human brain.

Understand yourself and those around you.

psychology

Psychology

problemsolving

Problem Solving

10 Books That Make You Smarter | Book Riot

EBM is the integration of evidence, clinical expertise, and patient values and preferences. Factors influencing clinical expertise include judgement, clinical skills and personal experience. EBM requires life-long self-monitored learning to stay up-to-date with the most recent clinical interventions and techniques, as this information is constantly changing.

So you Want to Know About EBM... (Evidence-Based Medicine)

EBM aims to improve patient care quality and produce optimal patient outcomes. It is identifying and promoting clinical practices that work, and eliminating those that don't. Additionally, the precision, accuracy and power of the intervention must be critically assessed. This process furthers the development of critical thinking.

Why use EBM?

According to AK Akobeng, there are five main steps to properly practise EBM. The next few blocks will explore this concept.

The 5-Step Model

Formulate Answerable Clinical Questions (CQs)The key is to translate the clinical problem into an answerable clinical question (CQ) – e.g. “Is treatment A effective in irradicating disease B?”. CQs should be clear, focus directly on the presenting complaint, and be answerable in terms of clinical evidence available.Form clinical questions using the PICO method.“P” - the Patient themself and the Problem i.e. their medical history and presenting complaint.“I” - Intervention i.e. the treatment / test used.“C” - Comparison of various interventions.“O” - Outcome i.e. the predicted result.

STEP 1

Find the Evidence : SourceLook for evidence that will answer your CQ. Clinical databases (e.g. Archimedes) are relatively reliable and timesaving sources, compared to traditional textbooks and oral sources. The Cochrane Database - a collection of system reviews - is also widely used in the medical field.

STEP 2A

Find the Evidence : SearchBeing able to search these databases is another skill in and of itself. Firstly, extract keywords from your PICO framework e.g. Problem is Thrombosis and Intervention is Aspirin, therefore the search will include the words “Thrombosis Aspirin”. When conducting the search, use the operating word “AND” for search results including all keywords and “OR” for either/some of the keywords.

STEP 2B

Appraise the EvidenceNot all research evidence is made the same – some is high-quality and thorough, some isn’t. It is thus paramount that research evidence is appraised in terms of validity, importance, and applicability. The CASP (Critical Appraisal Skills Programme) tools developed by Oxford Univ. incorporate all of these factors and provide a framework for your appraisal.

STEP 3

Apply the EvidenceEstablish the efficacy, risks, availability, and cost of the proposed treatment/test/intervention, and discuss with the patient before proceeding. This establishes trust between the health care practitioner and the patient - a "therapeutic alliance" as Akobeng says.

STEP 4

Evaluate PerformanceSelf-monitoring and -auditing are fundamental in EBM practice. Ask yourself, "Am I following all 5 steps to the best of my ability?". This ensures that you are always providing the best possible patient care, and that favourable patient outcomes are strived for and ultimately, achieved.

STEP 5

A comprehensive summary of AK Akobeng's article on the Principles of Evidence Based Medicine.

moneyandinvestments

Money & Investments

Principles of Evidence Based Medicine - A K Akobeng (as summarised by S Carstens)

Dr Herluf Lund, a board-certified plastic surgeon in Chesterfield, Mo., started performing aesthetic enhancements 30 years ago. Then, most of his patients wanted their surgeries kept a secret. Now, his patients expect their pictures to be taken, and they want to post them. Procedures used to be done discretely, but in the post-Kardashian world, transparency is just part of the process. Social sharing, particularly among celebrities and influencers, has reduced the stigma about plastic surgery and medical aesthetics.

Plastic surgery is becoming more transparent

Dr Devgan, age 42, uses her social media to extend her medical practice by educating viewers and managing their expectations around what is possible.  @celebface on Instagram shows the amount of work that goes into making famous people look the way they do. Though social media has been part of removing the stigma of aesthetic work, keeping up with the Kardashians is ushering in a new transparency around undergoing procedures.

Education and expectations

Part of the new display of aesthetic enhancements is about status: You're saying you can keep up with the Kardashians if you can get procedures like them. Part of self-care has been stretched to such an extent that it might include getting injections in your face every six months so you don't look "tired". Yet, no one can achieve the ever-escalating beauty ideal without training, diets, and cosmetic interventions, which is becoming a part of a normalised beauty routine.

Status and aesthetic enhancements

Justine Bateman, 55, a filmmaker and former actress, writes in her new book, "Face: One Square Foot of Skin," that women's faces are not broken and don't need to be fixed. The book reflects on women's faces and the cultural pressure to be ashamed that their faces aged naturally. Ms Bateman says she can either look in the mirror and think she looks horrible, or she can think it's a super cool face. But Dr Devgan points out that plastic surgery allows people to look like the best version of themselves.

Pushing back

Procedures used to be done in secret, but in the post-Kardashian world, transparency is just part of the process.

fashion

Fashion & Beauty

The Mesmerizing Pull of Plastic Surgery Videos

Health care professionals are increasingly required to base clinical decisions on the best available evidence. Evidence-based medicine (EBM) is a systematic approach to clinical problem solving which allows the integration of the best available research evidence with clinical expertise and patient values.To get there, the 5 step EBM model needs to be introduced.<ol><li>Creating an answerable clinical questions.</li><li>Search for evidence.</li><li>Critical Appraisal of evidence.</li><li>Applying the evidence.</li><li>Evaluating the performance.</li></ol>

1] Principles of evidence based medicine

The concept of evidence-based medicine (EBM), defined as the ‘‘integration of best research evidence with clinical expertise and patient values’’The practice of it requires life long, self-directed learning where patient care creates the need for important information about clinical and other healthcare issues.Healthcare and science is ever-changing, so staying current is imperative.This is made easier by utilising the tools of EBM; such as finding the relevant evidence, critically appraising it and using it in daily clinical practice.

2] What is evidence-based medicine?

To Improve quality care through the identification and promotion of practices that work, and the elimination of those that are ineffective or harmful.EBM demands that the effectiveness of clinical interventions, the accuracy of diagnostic tests, and the power of prognostic markers should be scrutinised and their usefulness proven.Clinicians should be open to try new scientifically proven methods and discard those that aren't. It's important that clinicians develop key EBM skills including the ability to find, critically appraise, and incorporate sound scientific evidence in their own practice.

3] Why evidence-based medicine

The practice of EBM should start with a well formulated clinical question.A good question should be clear, directly focused on the problem and answerable by medical literature research. A good clinical question has 3-4 components:<ul><li>Patient or problem</li><li>Intervention, test or exposure of interest</li><li>Comparison interventions (if applicable)</li><li>Outcome(s)</li></ul>Question should then be made using the PICO (Patient, Intervention, Comparison, Outcome) or PIO (Patient, Intervention, Outcome) format .

4] EMB model 1: Creating answerable clinical questions.

A 4 month old baby is admitted with viral bronchiolitis. The baby's symptoms worsen and you wonder if corticosteroids might help the child improve and reduce the length of hospital stay.The key components of your clinical question would be:Patient: 4 month old baby with viral bronchiolitis.Intervention: corticosteroids.Comparison: no corticosteroids.Outcomes: clinical score, length of stay.Clinical question may be formulated as follows:In a 4 month old baby with viral bronchiolitis, does the administration of corticosteroids improve clinical score and reduce length of hospital stay, or not?

5] PICO/PIO Example:

The next step is to seek relevant evidence that will help you answer the question.Sources are:<ol><li>Traditional methods (textbooks, journals).</li><li>Ask an expert. (answer quality will vary)</li><li>Summarised clinical evidence (<a href="www.bestbets.org">BestBets</a>).</li><li>Electronic bibliographic databases(<a href="https://www.cochranelibrary.com/">Cochrane</a> Library databases, <a href="https://pubmed.ncbi.nlm.nih.gov/">PUBMED</a>, <a href="https://www.nlm.nih.gov/">MEDLINE</a>, <a href="https://www.embase.com/landing?status=grey">EMBASE</a>, and <a href="https://www.ebsco.com/products/research-databases/cinahl-complete">CINAHL</a>).</li></ol> To find relevant articles fast:<ul><li>Use Boolean operators "AND" and "OR"</li><li>Example:</li></ul><ol><li>Viral bronchiolitis</li><li>Corticosteroids OR steroids OR glucocorticoids OR prednisolone OR dexamethasone</li><li>Clinical score OR hospital stay</li><li>(1) AND (2) AND (3).</li></ol>

6] EBM model 2: Finding the evidence.

After obtaining relevant articles on a subject, the next step is to appraise the evidence for its validity and clinical usefulness.Research evidence may be appraised with regard to three main areas: <ol><li>Validity</li><li>Importance</li><li>Applicability to the patient or patients of interest.</li></ol>Critical appraisal provides simple, structured methods for assessing research evidence in all three areas. Appraisal skills may be learnt within small tutorials, workshops, interactive lectures, and at the bedside.Tools for appraising research articles are available. Like the Critical Appraisal Skills Programme (<a href="https://casp-uk.net/">CASP</a>).

7] EBM model 3: Critical appraisal.

After critically appraising the evidence, we then decide whether that evidence can be applied to our individual patient or population, taking into account the patient’s own personal values and circumstances.Both efficacy and risks should be fully discussed with the patient or parents, or both, to allow them to make an informed decision.This approach is consistent with the EBM principle: the integration of good evidence with clinical expertise and patient values.This decision should also take into account the feasibility and availability of the treatment.

8] EBM model 4: Applying the evidence.

As we incorporate EBM into routine clinical practice, we need to evaluate our approach at frequent intervals and to decide whether we need to improve on any of the four steps discussed above.We need to ask whether we are formulating answerable questions, finding good evidence quickly, effectively appraising the evidence, and integrating clinical expertise and patient’s values with the evidence in a way that leads to a rational, acceptable management strategy.Formal auditing of performance may be needed to show whether the EBM approach is improving patient care.

9] EBM model 5: Evaluating the performance

Principles of evidence based medicine: Summary

<ul><li>In 1775, Benjamin Franklin raised the idea of getting up earlier to make better use of daylight and avoid nighttime burning of candles</li><li>Around the turn of the 20th century, George Hudson of New Zealand and William Willett of England separately pitched summertime clock changes, each seeking an extra hour of sunlight for personal hobbies</li><li>Daylight saving time wasn’t implemented until World War I, when countries on both sides of the conflict adopted it as a way of saving energy</li></ul>

When and why did daylight saving time begin?

<ul><li>Most of the United States spends 34 weeks, or about seven months, from mid-March to mid-November, on standard time.</li><li>Around the world, most of North America, Europe, and New Zealand as well as some parts of the Middle East, South Africa, and Australia practice a biannual switch, but the dates of the time change vary. Much of Africa and Asia do not switch.</li></ul>

Where is daylight saving time observed?

Twice-yearly switching- Changing the clocks twice a year has become widely viewed by the public, lawmakers and sleep experts as not only an inconvenience, but also as a serious health and public safety concern.Daylight saving time - While the original purpose of daylight saving time was to save energy by extending daylight into the evening, research has cast doubts on that idea. Advocates of daylight saving time also argue that it promotes public safety, with evidence linking the extra daylight in the evenings to a decrease in crime

What are the arguments regarding each time system?

<ul><li>Most Americans had to go to work and school in the dark, with sunrise arriving around 8:30 a.m. in cities including Washington, D.C., New York, and Detroit.</li><li>Disapproval of the switch grew when multiple children were fatally struck by cars while headed to school in dark.</li><li>By late January, the governor of Florida had called for a repeal, and some members of Congress questioned the wisdom of the decision.</li><li>On Oct. 6, not long after Nixon’s resignation, President Gerald Ford signed a bill ending the Daylight Saving Time experiment.</li></ul>

The last time the U.S. tried permanent daylight saving time was in 1974

<ul><li>More than 60 percent of Americans are in favor of stopping the biannual switch</li><li>Of the people who want to eliminate the shift, nearly twice as many prefer permanent daylight saving time over standard time</li><li>The poll found that older adults expressed a clear preference for year-round daylight time while adults under 30 were "closely divided" on whether they wanted more daylight in the morning or later in the evening</li></ul>

What does the public want?

timemanagement

Time Management

Daylight saving time: Explaining the century-old debate

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