Hello. I’m Tom Hathaway. I’m wearing my BA hat, so let’s talk business analysis. In this nugget I’d like to discuss how to write good user stories. We’re going to talk about what the components of a user story are and how to make your user stories more effective. These techniques will help you when you are the one wearing the BA hat.

What Are User Stories?

User stories have rapidly become one of the most popular forms for expressing stakeholder requirements management software on projects whether your project follows an Agile approach or a more traditional methodology. Many feel that the mold, “As a role the author represents. I/we can do or have something with these qualities to achieve my goal or objective” by itself is sufficient to explain how to write user stories.

I believe there are still a few dimensions missing. For instance, examine two implementations of this mold. “As a website visitor, the role, I can view all training, do something, which I need, quality requirement, to qualify for the CBAP exam, goal.” Second example: “As a human being, role, I can differentiate sounds, do something, in my native tongue, quality requirement, to comprehend what others are saying, goal.”

Note that both statements follow the mold, and, by that definition, are user stories. Whereas the first gives the developers great guidance, I question the value of the second. As a result, I have developed a set of guidelines or rules for writing an effective user story that go beyond the mold and might help you.

Keep The Story Simple

The first rule in writing an effective user story is simple: keep the user story simple. A simple sentence states only one thing. However, it does a good job at that. If you try to express too much in a single sentence, you add confusion. For instance, the user story, “As an applicant I can navigate to the coverage screen, enter personal and vehicle data, and submit the application online to request automobile insurance coverage,” contains three distinct thoughts. It would be clearer if you expressed each thought as a single user story, i.e., “As an applicant I can navigate to the coverage screen to select the insurance coverage I need. As an applicant I can enter personal and vehicle data to compare premiums. As an applicant I can submit an application online to request automobile insurance coverage.”

Avoid Compound Sentences

Compound sentences are by definition never simple. That means you should not have ifs, ands, or buts in the user story. Well, you actually have to take that with a grain of salt. The word and is a phenomenally versatile word in the English language, and in my experience in any language. It can be a sign of a compound sentence if the sentence contains two phrases, each of which contains an action, a verb, and a subject or object, nouns.

The other use of the word and is to create a list of items based on common characteristics. For example, let’s look again at our previous example. The original user story, “As an applicant I can navigate to the coverage screen, enter personal and vehicle data, and submit the application online to request automobile insurance coverage,” uses the word and in the phrase, “and submit the application,” to create a compound sentence. The use of and in the user story, “As an applicant I can enter personal and vehicle data to compare premiums,” simply connects common types of data.

Be Careful When Using Delimiting Phrases

I also recommend against using delimiting phrases, starting with words like unless, or except, in the user story. For instance, the user story, “As an underwriter I can override a coverage denial for an applicant to increase our customer base unless the denial was due to bad credit, in which case I can confirm the denial to protect our customer base.” That user story is confusing and would be much clearer if I expressed it as two user stories.

“As an underwriter I can override a coverage denial for an applicant with good credit to increase our customer base. As an underwriter I can confirm the coverage denial for an applicant with bad credit to protect our customer base.” Delimiting phrases commonly create a user story with two different goals. By expressing each goal in a separate user story, the intent and purpose of each becomes much clearer.

To sum up my first rule, an effective user story is a simple sentence that does not contain conjunctions, and, or, but, etc.; or limiting phrases, unless, without, except, etc. Following this rule facilitates user story elaboration, the process whereby developers ensure that they understand the story and can implement it.

Making the decision to get Lap Band Surgery can be one of the best choices you may ever make. When years of countless diets and will power have failed, sometimes weight loss surgery is the best option.

Lap Band Surgery is the least invasive gastric procedure that simply involves placing an adjustable band around the the top section of the stomach. However, unlike other procedures that permanently change the structure of the digestive organs, the Lap Band will eventually be removed once the ideal weight has been reached. This means that the patient must put forth more effort to maintain the weight loss.

Before Getting The Surgery

Your eating habits prior to the Lap Band Surgery will have a large effect on your results post-operation. It is advised to lose as much weight as possible and make an attempt to reduce your portion consumption beforehand. You must be in the right mindset to change your lifestyle before and after surgery, as once the gastric band is removed, you may gain the weight back.

Calories Will Always Count

Gastric surgery is not a “free ticket” to eat as you please. Although the lap band pouch will only hold about a tablespoon of food at first, this pouch can gradually become larger if too much food is consumed.

High calorie liquids, such as bottled juices or fattening soups can easily move through the pouch into the stomach. If these are consumed on a regular basis, you may experience weight gain or abnormally slow weight loss.

Your practitioner will provide you with a diet that will yield you the best results.

Ensuring You Are Getting Enough Nutrients

Since you are not able to eat a wide variety of food in large portions, it is crucial to eat the most nutrient dense food. This includes focusing on protein, fruits, vegetables and whole grains.

Protein is especially important to preserve muscle and tissue, as your body is prone to break these down during your weight loss. Low-fat protein options include lean chicken breast, turkey breast, fish (such as tilapia), egg whites, beans or fat free cottage cheese.

You must eat these foods in very small bites and chew them until they are almost liquidfied in your mouth. Swallowing solid food may create blockages inside the band.

Your doctor may also recommend supplements such as a multi-vitamin, calcium and iron.

The Bottom Line

Getting Lap Band Surgery will undoubtedly change your life forever. To keep your weight off, you must always strive to practice a healthy lifestyle of proper food choices and exercise. Always use your better judgement to take care of your body.

There are thousands, if not millions, of different weight loss supplements available on the market today. These supplements are formulated with a wide range of ingredients that work in different ways to help shed off unwanted pounds. You can browse through different types of products and purchase online supplements Canada from many different online retailers.

Fat Burners
Fat burners can include stimulants, such as caffeine or ephedra. These chemicals work by directly raising your metabolism and effecting your nervous system to reduce your appetite.

There has been a new recent study on a chemical called “p-synephrine” (found in bitter orange extract) that has found definite effects on fat loss during exercise. This chemical can be found in many popular diet products available on the market.

Due to widespread health concerns, Canadian consumers are opting for stimulant-free fat burners that are more gentle on the body. Raspberry ketones and green coffee bean extract are two of the most popular ingredients available in Canada today. Both of these can be purchased in pure form. They are touted as “all natural” and “stimulant free”. They have been clinically proven to boost metabolism and regulate blood sugar levels.

Coconut oil is another highly popular stimulant free fat burner. This oil contains Medium Chain Triglycerides, which are metabolized by the body, leading to an increase in thermogenesis (aka metabolism).

Fiber Supplements
When strolling through the “Diet and Weight Loss” section of a store, you more than likely will find a variety of fiber products, in powder and pill form.

Fiber does not directly burn fat, but helps the body to feel full without added calories. Consuming fiber prior to a meal helps slow down the absorption of calories and helps maintain blood sugar levels.

Konjac root powder and psyllium husks are two forms of soluble fiber frequently used to compliment weight loss.

Meal Replacements
Many Canadians often lead busy lifestyles and making proper food choices may become difficult, leading to sabotaged weight loss efforts.

Meal Replacements offer convenience and do not require much preparation. These can include meal bars, liquid drinks or powders.

They can provide all the necessary macronutrients, such as fats, carbs and protein within a reasonable caloric range.
Most meal replacements are formulated with added vitamins and minerals as well.

These can be consumed in place of breakfast, or any other meal of the day.

In Conclusion
Determining which weight loss product is best for you depends on your lifestyle and personal body type. Please keep in mind that weight loss aids will not cause weight loss alone. They must be used in conjunction with a healthy diet and exercise plan.

Knowing a little about retirement homes or nursing homes is a necessity, especially if you have a family member who needs either short term assisted living or long term care. Many of the elderly citizens are no longer able to perform some of the essential functions and activities on their own, in which case it becomes necessary to find the best way to assist them in getting the most suitable type of long term care and assistance. Although sometimes families have time to look for the best retirement homes for the care of their elderly relatives, at times the decisions regarding where to get such care for a family member have to be made quickly. For instance, a sudden injury will certainly require a new care plan.

What is a Nursing Home?
Nursing homes, also known as a skilled nursing facilities are the places that provide assisted living, which is the care given to people who do not have to be hospitalized but can no longer get sufficient care from home. These residences care for people suffering from serious illnesses, critical injuries, those in need of attention after surgery, and the elderly citizens who can no longer get adequate care while at home.

Most of the retirement homes comprise of skilled nurses and aides who are available 24 hours a day. However, before you can find out whether or not assisted living is the best option for your relative, it is important to consult with your healthcare provider.

Nursing homes can be:
Household-like: Such facilities are structurally and functionally designed to be more like our homes. They also rarely entail a fixed day-to-day routine. In the household-like facilities, the teams, comprised of a combination of residents and staff, all try their best to create a more relaxed feeling. Kitchens areas are usually open to residents, the décor intentionally designed to provide a sense of home for the patients, and the entire staff is encouraged to develop and maintain friendly relationships with all residents.

Hospital-like: This particular type of facility is usually set up in the same manner as a hospital. Only members of staff provide medical care here, which includes speech, physical, and occupational therapies. As a rule, only one or two people can live in a single room while there is usually a nurses’ station on each and every floor. However, a number of the hospital-like nursing homes allow couples to live together while most of the items that can make a room appear more relaxing such as family photos are also welcome.

Combination: Some assisted living facilities such as retirement homes comprise of a combination of household-like and hospital-like units, with most of them featuring visiting doctors who serve their patients on site. However, some of these facilities also have their patients visit the doctors’ offices. At times, you might find that these facilities consist of separate areas known as special care units. These areas are for the care of people suffering from severe memory issues such as dementia. Visit Sienna Living if you would like to learn more.

The use of information and telecommunication technology (ICT) is transforming the healthcare industry:

IT allows telemedicine, digital-related services to support clinical health care and even telehealth, care at-a-distance. Computing technology is enabling doctors to connect and communicate through the Web or mobile tools with colleagues and other clinics and reach out to relevant medical specialists, from virtually anywhere, at any time, to assist in diagnosis and treatment of patients. Even examinations through a live IP video conference feed are now possible through real-time telehealth consultation for faster medical care.

In essence, telehealth and telemedicine are promising technologies for improving the overall quality of healthcare in providing a value-added system of care delivery. However, even though digital health may be positively changing the medical industry, there are concerns about the safety of confidential patient information processed digitally. This is true, especially, when handling electronic health records (EHRs) and when managing health-related information across computerized systems.

According to a year-long examination of cybersecurity by The Washington Post, IT security researchers revealed that the healthcare industry is vulnerable to hacking threats and cyber-attacks. The security professionals say that health information privacy (HIP) is at risk and the framework for sharing between doctors and health care providers is a big concern. Cybercriminal are potentially able to exploit patient information and steal their identity to commit identity fraud. Impersonators could even gain medical care services and coverage, see a doctor, get prescription drugs, and file claims under the victim’s health insurance plan.

With digital transformation of healthcare already in full swing, EHRs becoming more used at hospitals and clinics, the Health Information Technology for Economic and Clinical Health (HITECH) Act incentive payments going ahead and the launch of the Obamacare insurance website, some people question the integrity of the digital health system where hackers are able to possibly break into and steal information through security data breach flaws.

Encryption and authentication are apt security measures to assure patients that their information and identity will be protected, IT security experts say. Those simple measures are a front line of defense when it comes to security of health and medical data that is transmitted over a network. This is something HIPAA (the Health Insurance Portability and Accountability Act) mandates; encryption must be utilized when medical information is going to be passed over an open network such as the Internet, and it comes optional when dealing with a closed network.

It is important to know that health care providers are responsible for safeguarding protected health information under HITECH and HIPAA regulations.

“Some hospitals and clinics take proactive measures to reduce the risks regarding data privacy; they have strengthened information privacy by implementing a shred-all policy and safeguarded patient information by means of encryption and authentication; yet, not all health-care organizations are doing enough to provide effectiveness of their data protection efforts”, conveys security experts from Shred-it

At a minimum, the following information security tips should be followed by healthcare professionals:

• Healthcare organizations have to take security very seriously. Data security awareness training in a healthcare environment is paramount to teach people about threats and attacks.

• Health care facilities may want to consider carrying out risk assessments in identifying loopholes in their health delivery systems and have safeguards in place, as needed.

• Health care providers collecting, sharing and/or storing patient information on PCs or mobile devices ought to protect it according to established security policies and compliance.

• Patients, physicians and insurers need to be wary of online scammers who may solicit information from patients through digital means to commit identity theft.

Digital health futurists, like Fard Johnmarare, are optimistic that telehealth and telemedicine will change health-care delivery for the better; the goal is to expand and improve upon the services already offered at medical facilities to care for patients even when they cannot be seen face to face, and to serve those residing in rural and medically underserved areas and populations.

As for security defense measures, essential servces like document shredding Toronto are needed to protect sensitive data from being compromised. They’ll be beneficial for the safety and efficiency of these new health delivery systems, which are so vital for the future of Healthcare IT.

As Canadian medical colleges continue turning away applicants in the thousands, and a growing number of Caribbean Medical Schools open their doors to international students, inefficiencies of supply-and-demand in the medical provider marketplace continue to spark public debate. Both Canada and the United States project severe physician shortages in just a few years. Yet in these developed nations, thousands of well-trained medical students cannot obtain career advancement. Five trends bear watching:

1. The Law Controls

In the Canadian legal system, laws and not academic standards ultimately control the right to practice medicine. If the public voted to admit high school graduates with one year of training as licensed physicians, for instance, Canadian medical societies could do little about the situation except protest. Today, some Caribbean medical institutions find their medical board-passing graduates unable to obtain residencies in Canada or the USA, a practical necessity for employment in many jurisdictions. As the physician shortage increases, will public demand for qualified medical assistance ultimately produce a change in the laws governing licensing of Canadian physicians? Economists might answer in the affirmative. For example, perhaps legislators will eventually permit anyone passing medical boards to qualify for automatic volunteer residencies?

2. Flourishing Caribbean Medical Schools

Academic institutions in the Caribbean have benefited in recent decades from an influx of fee-paying students from Canada and other developed nations. The global physician shortage suggests this trend will continue, especially as more teaching hospitals arise in the region. Some established allopathic physicians in Canada could soon face competition from Canadian Caribbean-trained MDs.

3. Holistic Medicine

Holistic medical concepts have gained ground in North America since the 1980s. As Canadian physicians face greater competition from Caribbean-trained allopaths, licensing bodies in other under-served medically-related fields in Canada, such as Clinical Psychiatry and Veterinary Medicine, will face pressure to reduce barriers to entry into these professions.

4. Revamping Medical Training

As the University of the People has demonstrated, technology exists today to train remotely in a growing number of subjects. In the past, physical attendance at a University remained a prerequisite. Yet that situation no longer pertains. While considerable evidence supports the importance of clinical education in medicine, perhaps the arrival of more teaching hospitals in third world nations will offer opportunities for distance medical learners. Educators in North America might want to ponder that issue as tuition spirals upwards.

5. Inefficient Medical Markets

Ultimately, in a capitalist system, market forces of supply and demand will determine the allocation of physician resources. A sufficiently large contingent of qualified, unemployed Canadian Caribbean-trained School of Medicine graduates who have demonstrated the ability to pass medical boards will produce changes of some kind in the North American medical school system. Unfortunately, unless they begin implementing reforms soon, experienced medical educators might find that the momentum for making changes has passed from their professional organizations to legislatures.

Supply-and-demand will ultimately control the future of medical admissions policies in Canada. Inefficient markets eventually correct themselves.

Please note, CCS pocket guides are no longer available for order online. All orders received prior to March 25th will be fulfilled.

Please see our online versions or check out our smartphone apps.

On February 14^th. Drs. Derek Exner and Ratika Parkash, Co-Chairs of the Primary Panel for the CCS Guidelines on Cardiac Resynchronization Therapy: Evidence and Patient Selection, along with Drs François Philippon and David Birnie, presented the new CRT Guidelines during a one-hour webinar.

We are pleased with the outcome of this on-line session which included 40 participants from across Canada, many questions that contributed to good discussion and the positive and constructive feedback we continue to receive.

During the session, our presenters completed the following:

• Reviewed the appropriate selection of patients for CRT
• Discussed the role of CRT pacing
• Described the risks and benefits related to patients with AF, RBBB and chronic RV pacing
• Explained the technical issues related to CRT including vascular access and lead placement
• Discussed the role of imaging in assessment of CRT

For the first time, the CCS is making this on-line session available with audio and video recording. You will be prompted to enter your email address  and then your first and last name to download/stream the file.

  CRT Webinar Recording Available
Thank you to the presenters and participants for contributing to a successful CRT knowledge translation activity.

If you attended this session, please take a few minutes to complete the CRT Webinar survey.