Preventing Healthcare Associated Infections (HAI)

Preventing Healthcare Associated Infections (HAI) Introduction Clinical governance is important for providing safe care to patients and is essential to continuous improvement in patient safety.(vicgov) One of the key components in relation to this safety and quality issue in health care is preventing and controlling healthcare associated infections(HAI) which plays a significant role in poor outcomes of patients.(sahealth) To prevent transmission of HAI, Hand Hygiene should be done which is one of the most effective ways. Clinical professionals, especially nurses who have high risk of HAI transmission to patients, need to review the effects and great importance of Hand Hygiene to minimize the risk of HAI. Also, study tells that a number of infections can be prevented by adherence to established infection control practices.(sahealth) However, when accessing articles, they need to know the review methods such as a systematic review and randomized control trial, to satisfy evidence based practice with having analysing skills for quality resources. Five articles were reviewed to practice this. Critique Larson et al did research to examine the impact of the new practice Guideline on HAI and this compared the infection rates of pre- and post-Guideline implementation in a sample of US hospitals in different time. The problem is the result can be affected by time. Some components, such as how surveillance is conducted, how infections are defined and other concurrent infection prevention activities over time, might play a significant role in the result. Also, there were no control groups in this research so that the outcome of this research cannot be compared with the control group’s infection rates in the same time of post-Guideline implementation. And there was only 2 days observation which is unlikely to be an accurate reflection of practice. Monistrol et al used no control group as well. And Hand Hygiene compliance, the consumption of alcohol-based hand rub (AHR), HAIs and MRSA hospital acquisition incidence were measured. Hand Hygiene compliance was measured by direct observation of health care workers during daily work routine. Observations covered all the 8 hour shifts on weekdays, which is more acceptable than Larson et al’s only 2 days observation. However, infection control nurses undertook the observers and also part of the educator. This could explain the high Hand Hygiene compliance in all periods due to the presence of observers. Meanwhile, Allegranzi et al assessed the effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country, evaluating hand hygiene infrastructure, compliance, healthcare workers’ knowledge and perceptions, and handrub consumption. The ideal design for these researches would be Randomized Clinical Trial (RCT), because the research outcomes can be compared by control groups for more exact data in a same time. However, those cannot be done properly with RCT and this is the reason why they did not choose RCT for the research strategy. Once the new practice Guideline is published, the control groups will be informed as well. And this might withhold best practices from patients, raising ethical concerns. The most rigorous study among those three articles was Allegranzi et al’s research. To examine the effectiveness of WHO’s hand hygiene improvement strategy, they prepared well with training the observers for a long time according to the WHO observation method. And for the baseline evaluation and follow-up evaluation WHO knowledge questionnaire was administered. Also, more scientific and specific categories such as hand hygiene infrastructure and healthcare workers’ level of knowledge were shown in this research than others. Stout et al and Melissa et al reviewed articles by using a systematic review. In regards to the search strategy, Stout et al searched only PubMed for relevant articles. While Melissa et al searched MEDLINE, EMBASE, CINAHL, HMIC, the Web of Science and the Cochrane Library databases. There is evidence that single electronic database searches lack sensitivity and relevant articles may be missed if only one database is searched(Akobeng 2005). Meanwhile, Stout et al evaluated and reviewed 3,463 articles published between January 1, 2000 and March 31 2013. Forty two articles were selected and grouped into 1 of 4 categories after quality assessment of articles. Also, the earliest year of 2000 was selected because alcohol-based hand rub was not widely in use in prior years. This is a quite scientific strategy. While, there was no specific reason for Melissa et al to pick the articles between May and November 2004, as well as there was no mention about quality assessment of studies. A systematic review was selected for these articles to examine primary studies on focused clinical questions so that specific answers from narrowly defined review questions were given. Findings Conclusion The result of Larson et al indicates that hand hygiene guideline was disseminated and hospitals responded by modifying procedures and policies, compliance with hand hygiene recommendations remained low. Similarly, Monistrol et al suggested that no changes in incidences of HAI were shown after the multimodal campaign. However, Allegranzi et al found that hand hygiene improvement is affordable and effective in a healthcare setting with limited resources. The difference between Summary Number Author/s, year country Aims Sample/setting Design/methods Main Findings Strength/limitations of the study 1 Stout, Ritchie Macpherson 2007 UK To improve compliance with hand hygiene guidelines, resulting in low incidence of HAI. Search strategy with combined terms of ‘handwashing’, ‘alcohol cleanser’, ‘infection’, or ‘compliance’ Date or language limitation were applied. A systematic review: MEDLINE, EMBASE, CINAHL, HMIC, the Web of Science and the Cochrane Library databases between May and November 2004 2 Melissa et al 2014 US To assess the existing evidence surrounding the adoption and accuracy of automated systems or electronically enhanced direct observations and also reviews the effectiveness of such systems in health care settings. 3 Allegranzi et al 2010 US To assess the feasibility and effectiveness of the World Health Organization hand hygiene improvement strategy in a low-income African country. University Hospital, Bamako, Mali Introducing a locally produced, alcohol-based handrub; monitoring hand hygiene compliance; providing performance feedback; educating staff; posting reminders in the workplace; and promoting an institutional safety climate according to the World Health Organization multimodal hand hygiene improvement strategy. Compliance increased from 8.0% at baseline to 21.8% at follow-up 4 Larson, Quiros Lin 2007 US To evaluate implementation and compliance with clinical practices recommended in the new Centers for Disease Control and Prevention(CDC) Hand Hygiene Guideline To compare rates of HAI before and after implementation of the guideline recommendations To examine the patterns and correlates of changes in rates of HAI Survey for 89.8% of 1359 staff members Hospitals that were members of The National Nosocomial Infections Surveillance System Quantitative study during 2001 – 2004, Hand Hygiene Guideline implementation and compliance measures: the introduction of the guideline within the hospital; the presence of the recommended products on clinical units; institutional policies and procedures regarding hand hygiene, includeing the presence of a formalized plan to monitor compliance. Measure of HAI pre- and post-Guideline: collecting data regarding HAI rates in the ICUs of study hospitals for 12 months before and 12 months following publication of the Hand Hygiene Guideline. Hand hygiene compliance: ranged from 24% to 89% per ICU None of the pre to post-rates of change were associated with hospital characteristics. Assessment of hand hygiene compliance was based on just 2 days of observation 5 Monistrol et al 2011 Spain To evaluate the effectiveness of a multimodal intervention in medical wards in relation to hand hygiene compliance, alcohol-based hand rub consumption and incidence of HAI and MRSA. 825 patients and 868 patients totally in the pre and post period respectively. Conducted at three internal medical wards(113 beds) in Hospital Universitari Mutua Terrassa, Spain Quantitative: Prospective study during 2007 2009. Carried out in four phases: a baseline phase(10 weeks from February 2007), an intervention period(5 months from June 2007), a post intervention(10 weeks from November 2007) and follow-up evaluation(November 2009) Hand hygiene compliance improved from 54.3% in the pre period to 75.8% in the post period. Alcohol-based hand rub consumption increased from 10.5 to 27.2L per 1000 patient-days. The incidence density of HAI ranged from 6.93 to 6.96 per 1000 hospital days and new Healthcare Associated MRSA went down from 0.92 to 0.25 per 1000 hospital-days. Strengths: conducted in general medical wards with the long-term follow-up Limitations: no control group was used; no group session, compliance observation or surveillance of HAIs was carried out outside the studied area Vic gov http://health.vic.gov.au/clinrisk/publications/clinical_gov_policy.htm sahealth http://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/clinical+resources/safety+and+quality/preventing+and+controlling+healthcare+associated+infections

Mixed Handedness In Schizophrenia Health And Social Care Essay

In the present survey I conducted a meta-analytical reappraisal of the literature of an association between laterality and schizophrenic disorder in an effort to ; ( 1 ) clear up the strength of the grounds for the prevalence of assorted laterality in schizophrenic disorder, ( 2 ) measure the effects of two of the chief manus penchant appraisals in the prevalence of mixed-handedness in schizophrenic disorder patients. The premise is that the methodological difference between specifying laterality within a class ( such as the Edinburgh Inventory ) or by grades ( as does the Annett Hand Preference Questionnaire ) will impact on the prevalence of assorted laterality observed. Background Schizophrenia is a disease characterized by profound break in knowledge and emotion, impacting the most cardinal human properties: linguistic communication, thought, perceptual experience, affect, and sense of ego ( American Psychiatric Association [ DSM-IV-TR ] , 2000 ) . Even though the neuropathology of schizophrenic disorder remains vague, there have been several hypotheses proposed for the aetiology of the disease, one of which is unnatural intellectual anatomical lateralization ensuing from pre-natal neurological abuse ( Cannon et al. , 1995 ) . In fact, a break in the dissymmetry of the human encephalon is considered a cardinal characteristic in many psychiatric conditions ( Francks et al. , 2007 ) . One feature which is considered to associate to differences in encephalon construction is lateralised behavior, for illustration manus penchant ( White, Lucas, Richards & A ; Purves, 1994 ) . In schizophrenic disorder, the unnatural development of intellectual lateralization is co nsidered to ensue in a displacement off from manual laterality ( Cannon et al, 1995 ) . Indeed, one of the chief markers of schizophrenic disorder is the prevalence of untypical laterality in schizophrenics compared with the healthy population. In add-on to this, it has been suggested that the way of sidelong dissymmetry in schizophrenic disorder has been associated with the chronicity of the upset, Cannon et Al ( 1995 ) reported a strong association between chronicity and assorted laterality in schizophrenic disorder. Although there have been several surveies purporting to demo the association of laterality in schizophrenic disorder, consequences have been conflicting sing the strength and way of untypical laterality in schizophrenic disorder with some surveies describing an addition in left-handednesss ( Gur, 1977 ; Manoach et al. , 1988 ) and others describing an addition in mixed-handedness ( Cannon et al, 1995, Dane et Al, 2009 ) . This raises the inquiry of whether a differentiation between assorted laterality can be made at all. Method Study choice Included were surveies that reported a tripartite categorization of manus penchants ( right, left and assorted laterality ) for both grownup ( aged 18 or over ) schizophrenic disorder patients and healthy controls. Surveies were included which had assessed manus penchants utilizing the Edinburgh Handedness Inventory ( EHI ; Oldfield, 1971 ) or the Annett Hand Preference Questionnaire ( AHPQ ; Annett, 1970 ) . Datas from non-clinical samples were excluded. Schizophrenia diagnosings should be made utilizing Research Diagnostic Criteria, DSM-III, DSM-IIIR and DSM-IV. All other surveies utilizing different diagnostic standards were excluded. In add-on, merely surveies utilizing grownup ( aged 18 or over ) as schizophrenic disorder typically presents itself in early grownup life, and may show itself really otherwise in childhood. The result step was the frequence of a given manus penchant ( right, assorted or left ) grouped by population group ( schizophrenia patients, healthy controls ) . Search Procedure Searchs were performed in two databases: Web of Knowledge and Psychinfo. These databases were searched up to September 2010. The hunt footings used were ; ‘schizophrenia ‘ , ‘handedness ‘ , ‘lateralisation ‘ . Surveies were besides attained by analyzing the mention lists of two reappraisal articles ( Somers, Sommer, Boks, & A ; Kahn, 2009 ; Dragovic & A ; Hammond, 2005 ) . Lone diaries in English were searched. Abstractions of surveies were so examined by one writer with mention to the exclusion and inclusion standards. The programmer was familiar with the literature being reviewed. Data extraction For each survey the following informations were extracted: Writer ( s ) and twelvemonth of publication ; methods: participants and control sample used, where they were recruited from, the diagnostic standards used, the laterality appraisal used, age of oncoming and chronicity of the patients ; whether the consequences from the surveies were important and extra notes. Data Analysiss Calculations were based on the frequence informations described in the primary studies. To gauge the prevalence of assorted laterality within schizophrenia patients we calculated single odds ratios for each survey to analyze consequence sizes. Overall odds ratios were calculated by uniting the single surveies ‘ frequence informations within each subtype ( right, assorted and left laterality ) and subgroup ( schizophrenia patients and wellness controls ) . The cogency of ciphering an overall odds ratio is questionable as the consequence can frequently be misdirecting, however it was chosen because it provides an approximative computation of overall consequence sizes for assorted laterality. An estimation of the significance degree for each survey was used by ciphering the z-scores for each odds ratio in order to happen the alpha value. Consequences Features of included surveies Ninety-five diary articles were identified by the hunt scheme, of which 5 surveies conducted between 1995 and 2008 met all standards for inclusion. Three of the surveies used in the analyses used the EHI ( Cannon et al. , 1995 ; Dane et al. , 2009 ; Reilly et al. , 2001 ) , and two surveies used the AHPQ ( DeLisi et al. , 2002 ; Malesu et al. , 1996 ) for laterality appraisals. In relation to the different laterality appraisal methods used, the surveies differed markedly in the standards they used to specify the three different categorizations of laterality ( right, assorted and left ) . Within the model of the EHI, two surveies defined right-handedness as ‘+100 ‘ , left- as ‘-100 ‘ and mixed- , every bit assorted as everything between these two extremes ( Cannon et al, 1995 and Reilly et al. , 2001 ) while the other defined mixed-handedness as values between -75 and +75. Within the model of the AHPQ, one survey used a wide definition of assorted laterality as between 2 and 7 ( Malesu et al, 1996 ) while the other used a somewhat narrower definition for assorted laterality as between 3 and 6 ) . Oddss ratios for assorted laterality Table 1 displays the single odds ratios ( OR ) for assorted laterality compared with the lateralised group ( right and left handers combined ) in schizophrenic disorder patients compared with controls. The single odds ratios ranged from 1.21 to 4.59. The overall odds ratio was based on 5 surveies with a sum of 749 schizophrenic disorder patients and 572 control topics and indicates that schizophrenic disorder patients were about 1.5 times more likely to be mixed-handed than healthy controls ( OR = 1.64 ; 95 % CI = 1.22-2.20 ) . As shown in Table 1, three of the five surveies ( Cannon et al, 1995 ; Dane et Al, 2009, and DeLisi et al. , 2002 ) found stronger odds ratios for the prevalence of assorted laterality in schizophrenic disorder patients compared with controls.Need to add estimation of significance degree for each surveyTable 1 Odds ratios for prevalence of assorted laterality in schizophrenic disorder patients compared with controls.AAAAAAAAAAAASchizophrenia PatientsAControlsA AASurvey N Assorted LateralisedAN Assorted LateralisedAOddss Ratios 1995 Cannon et Al. 93 35 58A43 5 38A4.59 2009 Dane et Al. 88 33 55A118 23 95A2.48 2002 DeLisi et Al. 418 43 375A288 25 263A1.21 2001 Reilly 30 11 19A37 6 31A2.99 1996 Malesu et Al. 120 36 84A86 21 65A1.33AEntire 749 158 591A572 80 492A1.64 Oddss ratio for EHI and Annett laterality appraisals To look into the hypothesis that the stronger prevalence of assorted laterality in schizophrenic disorder patients is attributed to the type of laterality appraisal used we calculated an overall odds ratio for the prevalence of mixed-handedness in surveies utilizing the Edinburgh Handedness Inventory compared with the Annett questionnaire ( see Table 2 ) . As shown in Table 2, patients assessed for laterality utilizing the EHI were about 3.5 times more likely to be categorised as assorted handed every bit opposed to lateralised. We converted this odds ratio into a pearson correlativity coefficient and found a reasonably positive correlativity between the type of appraisal used and the prevalence of assorted laterality in schizophrenic disorder patients ( r =0.4573 ) Table 2 Overall odds ratio for prevalence of assorted laterality in schizophrenic disorder patients when assessed with the EHI compared with the APHQ.AAAAMixed vs. lateralised OR 95 % CI Handedness Assessment EHI ( N ) 79 vs. 132 Annett ( N ) 79 vs. 460 3.4848 2.4142 – 5.0301AAAADiscussion One of the chief findings in the present meta-analyses on laterality from five selected surveies is that schizophrenic disorder patients are significantly more likely to be mixed-handed than normal controls, a determination which is paradoxically compatible with one major reappraisal of the literature ( Somers et al. , 2009 ) and incompatible with an averment from another major reappraisal ( Dragovic & A ; Hammond, 2005 ) . We found grounds of a positive moderate correlativity between the types of manus penchant appraisal used ( EHI or AHPQ ) and the prevalence of assorted laterality reported in schizophrenic disorder patients. One possible account for this association is the differences in the scope of parametric quantities used to specify assorted laterality within the EHI and AHPQ. Furthermore, the EHI and AHPQ use two different methods to measure laterality ; one uses discrete ( EHI ) values and the other ( AHPQ ) uses uninterrupted appraisals. For illustration within the EHI, di fferent scopes were used to sort assorted laterality ; some surveies used between -75 and +75 to exemplify assorted laterality whilst others have used a broader step to measure assorted laterality ( between the two extremes of -100 and +100 ) . Studies which used the EHI to analyze the rate of mixed-handedness in schizophrenic disorder patients were about 3.5 times more likely to sort patients as assorted handed. This in portion is due to the wider definitions of assorted laterality used with the model of the EHI questionnaire, what remains unchallenged is the rates of non-right laterality. The inquiries raised by this is whether it is right to specify an intermediate parametric quantity for assorted laterality given that manual laterality can merely be a displacement towards Thursday. If we are to find a leftward displacement towards sole left laterality or an intermediate categorization of assorted laterality so the manner we assess this should be planetary for all surveies. At pr esent, the surveies are n't truly comparable within themselves because of this mutual exclusiveness between which definitions of assorted laterality have been used and which appraisal questionnaire is to be used. Restrictions A major restriction to this survey was the modest sum of surveies used. This issue may be related to the pick of choice standards we devised. We chose to measure surveies which reported laterality in three-ways ( right, assorted and left handed ) . Although this enabled usage to describe the single per centums of the different types of laterality for each survey, it narrowed the surveies we were able to include. Besides it is of import to turn to the issue of our utilizing merely published surveies for this meta-analysis which may belie the true nature of any association between schizophrenic disorder and laterality as negative findings tend to be under-reported. Decision

How does Edgar Allan Poe misguide the reader in his story ‘The Black Cat’? Essay

When I first read the title of the story by Poe, My immediate assumption was that it was a mysterious story about a black cat that may contain superstition and witchcraft, because in literature, black cats are associated with superstition, darkness and evil but as the essay title questions how it misguides the reader, I thought that the story may have nothing to do with the supernatural. This story, ‘The Black Cat’ is by Edgar Allan Poe. We do not know of what the story is about but we make assumptions from the title and we do not know whether the narrator is male or female because the story is fictional but Poe writes as if it is a personal account and it had really happened to him. His intent of the story is to unburden his soul and I think he wants to confess to everyone and anyone who will listen to him as he says he wants to ‘place before the world what has happened’ and claims he is going to die tomorrow. The opening is unusual because of his proposal when he says ‘tomorrow, I will die’. Also he gives the storyline but without detail, is this to misguide us? We never usually see this in a story. I think the story is about someone who has been involved in a series of unfortunate household events that ‘have terrified, have tortured and have destroyed’ him. The general tone is a frightened and worried one because he says how it has affected him and used powerful language, such as ‘tortured’. Also the writer seems desperate for someone to explain these happenings. In this story this writer has wrote the story in first person. This means that being a reader I can emphasise with the narrator. In most stories the narrator is the hero, he is known as being courageous and have the characteristics of a hero although in this story this is not the case. Poe was the first writer to use this style and make the narrator an ‘anti-hero’ he is also called this because it doesn’t seem right to label him a villain, but he also is not a hero. At the beginning of the story the narrator tries to make you feel sympathetic towards them by telling you that ‘tomorrow, I will die’ and tells of how recent events have ‘tortured’, ‘terrified’ and ‘destroyed’ him. He then continues to tell us how he was a animal lover by saying ‘never was I so happy as when feeding and caressing them’. He also says how he was married early and his wife has ‘a disposition not uncongenial with my own’, he and his wife were very alike and quite obviously happy. We are perceived into thinking he is a nice a nice and well natured gentleman. However we have been misguided as he is far from this stereotype is reality. We are fooled into thinking that he was an animal lover who would never hurt a soul. He tries to get our sympathy because he is consumed with guilt at the fact he sickly mistreated and killed a cat and ill-treated and went on to try and kill his second cat with an axe, but instead he savagely and ‘accidentally’ killed his wife, he says how he ‘buried the axe in her brain’. We have been betrayed completely by the narrator. Another way that the reader is misguided is by the unusual structure. In most stories these usually contains only one major climax but in ‘The Black Cat’ there is a number of major climax’s but the events that happen in the climax’s gets worse as the story goes on, making us forget the last climax that happened and we become ‘immune’. The first major climax is when the narrator ‘gouges the cats’ eye out’. We think this is the major climax but as the story progresses the events become worse and go from the cat being hanged and then finally resulting in his wife being murdered by him. He does this because he wants to tell us the evil things he has done one-by-one because he hopes we will forget about the previous atrocities and still feel sympathy for him. I also feel that, Pluto was used to misguide the reader in this story. First off, we find out that the cat is named Pluto, this could be associated with a mysteriousness and possibly magic and witchcraft. Poe then continues to say how at first the cat was an affectionate, loving pet, none the less he reveals his wife’s belief cats are witches in disguise. This automatically makes us think that supernatural happenings will later come into the story. The fact that he says about the cats white patch changing into a collar like a noose and that the second cat is a reincarnation of the first seems pretty surreal and unbelievable. The reason for this is so that we also believe that the cat is evil. The main role of the cat in this story is to divert the blame from the narrator to the cat for the terrible things he had done and the murder of his wife. The story would be incomplete without the cat, as it would just be about a man who has killed his wife; the cat is the main character. Another way Poe attempts to misguide the reader is by using doubles, a common factor used in gothic horror stories to show the story contains split personallities. In this story, it is two cats that are used as doubles to highlight the fact of the narrators split personality. Also another thing that suggests the narrator has a split personallity is the gouging of his cats eye. In english litrature, the gouging of an a eye is interpretted as the person who done it, wanting to be self-castrated. As this story was wrote in the pre 20th century when homosexuallity was illegal, one theory is that the narrator may have in denile of being homosexual,. This relates back to the self-castration, is it possible he wanted to become a woman? So that it was legal to have relationships with males. And by killing his wife with an axe demonstrates his inability to be with a woman. In conclusion I felt the purpose in the narrator writing his account of what had happaned was to divert the blame of all the horrible things he had done, off of himself. My personal reaction tp this story was rather excited and anxious as to what would happen next, after each climax, but I also felt quite disturbed as the story made me be in the mind of a murderer.

Christopher Morleys Classic Essay on Laziness

Critically and commercially popular during his lifetime while unfairly neglected today, Christopher Morley is best remembered as a novelist and essayist, though he was also a publisher, editor, and prolific writer of poems, reviews, plays, criticism, and childrens stories. Clearly, he was not afflicted by laziness. As you read Morleys short essay (originally published in 1920, shortly after the end of World War I), consider whether your definition of laziness is the same as the authors. You may also find it worthwhile to compare On Laziness with three other essays in our collection: An Apology for Idlers, by Robert Louis Stevenson; In Praise of Idleness, by Bertrand Russell; and Why Are Beggars Despised? by George Orwell. On Laziness* by Christopher Morley 1 Today we rather intended to write an essay on Laziness, but were too indolent to do so. 2 The sort of thing we had in mind to write would have been exceedingly persuasive. We intended to discourse a little in favour of a greater appreciation of Indolence as a benign factor in human affairs. 3 It is our observation that every time we get into trouble it is due to not having been lazy enough. Unhappily, we were born with a certain fund of energy. We have been hustling about for a number of years now, and it doesnt seem to get us anything but tribulation. Henceforward we are going to make a determined effort to be more languid and demure. It is the bustling man who always gets put on committees, who is asked to solve the problems of other people and neglect his own. 4 The man who is really, thoroughly, and philosophically slothful is the only thoroughly happy man. It is the happy man who benefits the world. The conclusion is inescapable. 5 We remember a saying about the meek inheriting the earth. The truly meek man is the lazy man. He is too modest to believe that any ferment and hubbub of his can ameliorate the earth or assuage the perplexities of humanity. 6 O. Henry said once that one should be careful to distinguish laziness from dignified repose. Alas, that was a mere quibble. Laziness is always dignified, it is always reposeful. Philosophical laziness, we mean. The kind of laziness that is based upon a carefully reasoned analysis of experience. Acquired laziness. We have no respect for those who were born lazy; it is like being born a millionaire: they cannot appreciate their bliss. It is the man who has hammered his laziness out of the stubborn material of life for whom we chant praise and alleluia. 7 The laziest man we know—we do not like to mention his name, as the brutal world does not yet recognize sloth at its community value—is one of the greatest poets in this country; one of the keenest satirists; one of the most rectilinear thinkers. He began life in the customary hustling way. He was always too busy to enjoy himself. He became surrounded by eager people who came to him to solve their problems. Its a queer thing, he said sadly; no one ever comes to me asking for help in solving my problems. Finally, the light broke upon him. He stopped answering letters, buying lunches for casual friends and visitors from out of town, he stopped lending money to old college pals and frittering his time away on all the useless minor matters that pester the good-natured. He sat down in a secluded cafe with his cheek against a seidel of dark beer and began to caress the universe with his intellect. 8 The most damning argument against the Germans is that they were not lazy enough. In the middle of Europe, a thoroughly disillusioned, indolent and delightful old continent, the Germans were a dangerous mass of energy and bumptious push. If the Germans had been as lazy, as indifferent, and as righteously laissez-fairish as their neighbours the world would have been spared a great deal. 9 People respect laziness. If you once get a reputation for complete, immovable, and reckless indolence the world will leave you to your own thoughts, which are generally rather interesting. 10 Doctor Johnson, who was one of the worlds great philosophers, was lazy. Only yesterday our friend the Caliph showed us an extraordinarily interesting thing. It was a little leather-bound notebook in which Boswell jotted down memoranda of his talks with the old doctor. These notes he afterward worked up into the immortal Biography. And lo and behold, what was the very first entry in this treasured little relic? Doctor Johnson told me in going to Ilam from Ashbourne, 22 September, 1777, that the way the plan of his Dictionary came to be addressed to Lord Chesterfield was this: He had neglected to write it by the time appointed. Dodsley suggested a desire to have it addressed to Lord C. Mr. J. laid hold of this as an excuse for delay, that it might be better done perhaps, and let Dodsley have his desire. Mr. Johnson said to his friend, Doctor Bathurst: Now if any good comes of my addressing to Lord Chesterfield it will be ascribed to deep policy and address, when, in fact, it was only a casual excuse for laziness. 11 Thus we see that it was sheer laziness that led to the greatest triumph of Doctor Johnsons life, the noble and memorable letter to Chesterfield in 1775. 12 Mind your business is a good counsel; but mind your idleness also. Its a tragic thing to make a business of your mind. Save your mind to amuse yourself with. 13 The lazy man does not stand in the way of progress. When he sees progress roaring down upon him he steps nimbly out of the way. The lazy man doesnt (in the vulgar phrase) pass the buck. He lets the buck pass him. We have always secretly envied our lazy friends. Now we are going to join them. We have burned our boats or our bridges or whatever it is that one burns on the eve of a momentous decision. 14 Writing on this congenial topic has roused us up to quite a pitch of enthusiasm and energy. *On Laziness by Christopher Morley was originally published in Pipefuls (Doubleday, Page and Company, 1920)