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Does this test have other names?
ESR, sed rate
What is this test?
Erythrocyte sedimentation rate (ESR) is a blood test. It measures how quickly erythrocytes, or red blood cells, separate from a blood sample that has been treated so the blood will not clot. During this test, a small amount of your blood will be put in an upright tube. A lab specialist will measure the rate that your red blood cells settle toward the bottom of the tube after 1 hour.
If you have a condition that causes inflammation or cell damage, your red blood cells tend to clump together. This makes them heavier, so they settle faster. The faster your red blood cells settle and fall, the higher your ESR. A high ESR tells your healthcare provider that you may have an active disease process in your body.
Why do I need this test?
You may need this test if you have symptoms of one of the diseases that may cause ESR to go up.
You may also need this test if you have already been diagnosed with a disease that causes a high ESR. The test can allow your healthcare provider to see how well you are responding to treatment.
The ESR blood test is most useful for diagnosing or monitoring diseases that cause pain and swelling from inflammation. Other symptoms may include fever and weight loss. These diseases include:


Temporal arteritis


Rheumatoid arthritis


Polymyalgia rheumatica


ESR is not used as a screening test in people who do not have symptoms or to diagnose disease because many conditions can cause it to increase. It might also go up in many normal cases. ESR doesn't tell your healthcare provider whether you have a specific disease. It only suggests that you may have an active disease process in your body.
What other tests might I have along with this test?
You may have other tests if your healthcare provider is doing this test to diagnose a disease. One of these tests is called a C-reactive protein test, or CRP. This test also measures active inflammation in the body.
Your healthcare provider may do an ESR alone if they are monitoring a disease you already have.
Because ESR tells your healthcare provider only what is happening right now, you may need to have the test repeated over time.
What do my test results mean?
Test results may vary depending on your age, gender, health history, and other things. Your test results may be different depending on the lab used. They may not mean you have a problem. Ask your healthcare provider what your test results mean for you.
ESR is measured in millimeters per hour (mm/hr). The normal values are:


0 to 15 mm/hr in men


0 to 20 mm/hr in women


ESR above 100 mm/h is most likely caused by an active disease. For instance, you may have:


A disease that causes inflammation in your body


An active infection


Cancer


Heart disease


Kidney disease


Blood disease


Diabetes


Collagen vascular disease


How is this test done?
The test is done with a blood sample. A needle is used to draw blood from a vein in your arm or hand.
Does this test pose any risks?
Having a blood test with a needle carries some risks. These include bleeding, infection, bruising, and feeling lightheaded. When the needle pricks your arm or hand, you may feel a slight sting or pain. Afterward, the site may be sore.
What might affect my test results?
Many things that are not active diseases can increase your ESR. These include:


Pregnancy


Old age


Being female


Having a menstrual period


Having recently eaten a fatty meal


Being obese


Taking certain medicines


How do I get ready for this test?
You don't need to prepare for this test. Be sure your healthcare provider knows about all medicines, herbs, vitamins, and supplements you are taking. This includes medicines that don't need a prescription and any illegal drugs you may use. Tell your healthcare provider if you ate a fatty meal recently, if you are having your period, or if you may be pregnant.

Medical Reviewers:

Chad Haldeman-Englert MD
Raymond Turley Jr PA-C
Tara Novick BSN MSN

The main principles of the Lean methodology include:

Eliminating Waste
Amplifying Learning
Deciding as Late as Possible
Delivering as Fast as Possible
Empowering the Team
Building Integrity In
Seeing the Whole

Lean development eliminates waste by asking users to select only the truly valuable features for a system, prioritize those features, and then work to deliver them in small batches. It relies on rapid and reliable feedback between programmers and customers, emphasizing the speed and efficiency of development workflows. Lean uses the idea of a work product being “pulled” via customer request. It gives decision-making authority to individuals and small teams since this has been proven to be a faster and more efficient method than a hierarchical flow of control. Lean also concentrates on the efficient use of team resources, trying to ensure that everyone is as productive as possible for the maximum amount of time. It strongly recommends that automated unit tests be written at the same time the code is written.

The main principles of the Lean methodology include:

Eliminating Waste
Amplifying Learning
Deciding as Late as Possible
Delivering as Fast as Possible
Empowering the Team
Building Integrity In
Seeing the Whole

Lean development eliminates waste by asking users to select only the truly valuable features for a system, prioritize those features, and then work to deliver them in small batches. It relies on rapid and reliable feedback between programmers and customers, emphasizing the speed and efficiency of development workflows. Lean uses the idea of a work product being “pulled” via customer request. It gives decision-making authority to individuals and small teams since this has been proven to be a faster and more efficient method than a hierarchical flow of control. Lean also concentrates on the efficient use of team resources, trying to ensure that everyone is as productive as possible for the maximum amount of time. It strongly recommends that automated unit tests be written at the same time the code is written.

Regardless of your version of true happiness, living a happier, more satisfied life is within reach. A few tweaks to your regular habits like getting more sleep and exercise can help you get there.
Daily habits
The following daily habits may help you achieve more happiness in your life.
1. Smile
You tend to smile when you’re happy. But it’s actually a two-way street.
We smile because we’re happy, and smiling causes the brain to release dopamine, which makes us happier.
While not completely foolproof, researchers have found that the link between smiling and happiness could be attributed to the “facial feedback hypothesis,” where facial expressions may have a modest influence on emotions.
That does not mean you have to go around with a fake smile plastered on your face all the time. But the next time you find yourself feeling low, crack a smile and see what happens. Or try starting each morning by smiling at yourself in the mirror.
2. Exercise
Exercise isn’t just for your body. Regular exercise can help reduce stress, feelings of anxiety, and symptoms of depression while boosting self-esteem and happiness.
Even a small amount of physical activity can make a difference. You don’t have to train for a triathlon or scale a cliff — unless that’s what makes you happy, of course.
The trick is to not overexert yourself. If you suddenly throw yourself into a strenuous routine, you may just end up frustrated (and sore).
Consider these exercise starters:

Take a walk around the block every night after dinner.
Sign up for a beginner’s class in yoga or tai chi.
Start your day with 5 minutes of stretching.

Remind yourself of any fun activities you once enjoyed but that have fallen by the wayside. Or you could consider starting activities you always wanted to try, such as golf, bowling, or dancing.
3. Get plenty of sleep
Most adults need at least 7 hoursTrusted Source of sleep every night. If you find yourself fighting the urge to nap during the day or just generally feel like you’re in a fog, your body may be telling you it needs more rest.
No matter how much our modern society steers us toward less sleep, we know that adequate sleep is vitalTrusted Source to good health, brain function, and emotional well-being. Getting enough sleep also reduces your riskTrusted Source of developing certain chronic illnesses, such as heart disease, depression, and diabetes.
Here are a few tips to help you build a better sleep routine:

Write down how many hours of sleep you get each night and how rested you feel. After a week, you should have a better idea how you’re doing. You can also try using an app to track your sleep.
Go to bed and wake up at the same time every day, including on weekends.
Reserve the hour before bed as quiet time. Take a bath, read, or do something relaxing. Avoid heavy eating and drinking.
Keep your bedroom dark, cool, and quiet.
Invest in some good bedding.
If you have to take a nap, try limiting it to 20 minutes.

If you consistently have problems sleeping, consider talking with a doctor. You may have a sleep disorder that requires treatment.
4. Eat with mood in mind
You may already know that your food choices have an impact on your overall physical health. But some foods can also affect your state of mind.Trusted Source
For example:

Carbohydrates release serotonin, a “feel good” hormone. Just keep simple carbs — foods high in sugar and starch — to a minimum because that energy surge is short and you’ll crash. Choosing complex carbs, such as vegetables, beans, and whole grains, can help you avoid a crash while still providing serotonin.
Lean meat, poultry, legumes, and dairy are high in protein. Protein-rich foods release dopamine and norepinephrine, which boost energy and concentration.
Omega-3 fatty acids, such as those found in fatty fish, have been found to have anti-inflammatory effectsTrusted Source that extend to your overall brain health. If you don’t eat fish, you might consider talking with a doctor about possible supplementation.
Highly processed or deep-fried foods tend to leave you feeling down and so will skipping meals.

If you want to eat with your mood in mind, consider starting with making one food choice for your mood each day.
For example, swap a big, sweet breakfast pastry for some Greek yogurt with fruit. You’ll still satisfy your sweet tooth, and the protein will help you avoid a midmorning energy crash. Consider adding in a new food swap each week.
5. Practice gratitude
Simply being grateful can give your mood a big boost, among other benefits. For example, a two-part study found that practicing gratitude can have a significant impact on feelings of hope and happiness.
You might try starting each day by acknowledging one thing you’re grateful for. You can do this while you’re brushing your teeth or just waiting for that snoozed alarm to go off.
As you go about your day, consider keeping an eye out for pleasant things in your life. They can be big things, such as knowing that someone loves you or getting a well-deserved promotion.
But they can also be little things, such as a co-worker who offered you a cup of coffee or the neighbor who waved to you. Maybe it could even just be the warmth of the sun on your skin.
With a little practice, you may even become more aware of all the positive things around you.
6. Give a compliment
Research shows that performing acts of kindness may also help promote your overall well-being.
Giving a sincere compliment is a quick, easy way to brighten someone’s day while giving your own happiness a boost.
Catch the person’s eye and say it with a smile so they know you mean it. You might be surprised by how good it makes you feel.
If you want to offer someone a compliment on their physical appearance, make sure to do it in a respectful way.
7. Breathe deeply
You’re tense, your shoulders are tight, and you feel as though you just might “lose it.” We all know that feeling.
Instinct may tell you to take a long, deep breath to calm yourself down.
Turns out, that instinct is a good one. ResearchTrusted Source supports the fact that slow breathing and deep breathing exercises can help reduce stress.
The next time you feel stressed or are at your wit’s end, work through these steps:

Close your eyes. Try to envision a happy memory or beautiful place.
Take a slow, deep breath in through your nose.
Slowly breathe out through your mouth or nose.
Repeat this process several times until you start to feel yourself calm down.

If you’re having a hard time taking slow, deliberate breaths, try counting to 5 in your head with each inhale and exhale.
8. Acknowledge the unhappy moments
A positive attitude is generally a good thing, but bad things happen to everyone. It’s just part of life.
If you get some bad news, make a mistake, or just feel like you’re in a funk, don’t try to pretend you’re happy.
Acknowledge the feeling of unhappiness, letting yourself experience it for a moment. Then shift your focus toward what made you feel this way and what it might take to recover.
Would a deep breathing exercise help? A long walk outside? Talking it over with someone?
Let the moment pass and take care of yourself. Remember, no one’s happy all the time.
9. Keep a journal
A journal is a good way to organize your thoughts, analyze your feelings, and make plans. And you don’t have to be a literary genius or write volumes to benefit.
It can be as simple as jotting down a few thoughts before you go to bed. If putting certain things in writing makes you nervous, you can always shred it when you’ve finished. It’s the process that counts.
Not sure what to do with all the feelings that end up on the page? Our guide to organizing your feelings may help.
10. Face stress head-on
Life is full of stressors, and it’s impossible to avoid all of them.
There’s no need to. Stress isn’t always harmful, and we can even change our attitudes about stress. Sometimes, there’s an upside to stress.
For those stressors you can’t avoid, remind yourself that everyone has stress — there’s no reason to think it’s all on you. And chances are, you’re stronger than you might think you are.
Instead of letting yourself get overwhelmed, try to address the stressor head-on. This might mean initiating an uncomfortable conversation or putting in some extra work, but the sooner you confront it, the sooner the pit in your stomach may start to shrink.
 
Testing.....

Many foods are both healthy and tasty. By filling your plate with fruits, vegetables, quality protein sources, and other whole foods, you’ll have meals that are colorful, versatile, and good for you.
 
Here are 50 healthy and delicious to include in your diet.



1–6: Fruits and berries

Fruits and berries are popular health foods.
They are sweet, nutritious, and easy to incorporate into your diet because they require little to no preparation.
1. Apples
Apples contain fiber, vitamin C, and numerous antioxidants. They are very filling and make the perfect snack if you’re hungry between meals.
2. Avocados
Avocados are different from most other fruits because they contain lots of healthy fat. They are not only creamy and tasty but also high in fiber, potassium, and vitamin C. Swap mayonnaise for avocado as a salad dressing, or spread it on toast for breakfast.
3. Bananas
Bananas are a good source of potassium. They’re also high in vitamin B6 and fiber and are convenient and portable.
4. Blueberries
Blueberries are both delicious and high in antioxidants.
5. Oranges
Oranges are well known for their vitamin C content. What’s more, they’re high in fiber and antioxidants.
6. Strawberries
Strawberries are highly nutritious and low in both carbs and calories.
They provide vitamin C, fiber, and manganese and make a delicious dessert.
Other healthy fruits
Other healthy fruits and berries include cherries, grapes, grapefruit, kiwi, lemons, mangoes, melons, olives, peaches, pears, pineapples, plums, and raspberries.

7. Eggs

Eggs are highly nutritious.
Once demonized for being high in cholesterol, expertsTrusted Source now see them as a useful source of protein that may have various benefits.






Testing...

Many foods are both healthy and tasty. By filling your plate with fruits, vegetables, quality protein sources, and other whole foods, you’ll have meals that are colorful, versatile, and good for you.
 
Here are 50 healthy and delicious to include in your diet.



1–6: Fruits and berries

Fruits and berries are popular health foods.
They are sweet, nutritious, and easy to incorporate into your diet because they require little to no preparation.
1. Apples
Apples contain fiber, vitamin C, and numerous antioxidants. They are very filling and make the perfect snack if you’re hungry between meals.
2. Avocados
Avocados are different from most other fruits because they contain lots of healthy fat. They are not only creamy and tasty but also high in fiber, potassium, and vitamin C. Swap mayonnaise for avocado as a salad dressing, or spread it on toast for breakfast.
3. Bananas
Bananas are a good source of potassium. They’re also high in vitamin B6 and fiber and are convenient and portable.
4. Blueberries
Blueberries are both delicious and high in antioxidants.
5. Oranges
Oranges are well known for their vitamin C content. What’s more, they’re high in fiber and antioxidants.
6. Strawberries
Strawberries are highly nutritious and low in both carbs and calories.
They provide vitamin C, fiber, and manganese and make a delicious dessert.
Other healthy fruits
Other healthy fruits and berries include cherries, grapes, grapefruit, kiwi, lemons, mangoes, melons, olives, peaches, pears, pineapples, plums, and raspberries.

7. Eggs

Eggs are highly nutritious.
Once demonized for being high in cholesterol, expertsTrusted Source now see them as a useful source of protein that may have various benefits.






Testing...

What if I told you about this magical teaching practice that, done even once, produces large improvements in student final exam scores[1], helps narrow the grade gap between poorly prepped and highly prepped first year college students[2], and might even result in more positive course reviews[3],[4]? What if I also told you this magical teaching practice is something you already know how to do? What if I told you, the secret to increasing your students’ success and  overall satisfaction is……more TESTS!?
Okay…well to be fair, it’s a little more nuanced than that. While adding just one test to a class does indeed improve final exam scores, it turns out that more frequent, graded exercises in general improve learning outcomes for students [2],[5]. Even better – if these exercises are low stakes, they can improve learning outcomes without increasing student anxiety [4],[6].
We often view testing as an unpleasant but necessary way to assess student performance. It may be time for us to instead view testing as a useful teaching tool and to implement an assessment system that maximizes the potential learning benefits. In this post I will discuss the important known benefits of frequent, low stakes assessments as well as some practical tips for how to maximize these benefits without adding undue stress to your life or the lives of your students.

Benefit #1: “Thinking about thinking”
Testing can improve a student’s metacognition, or their ability to “think about thinking.” A good metacognitive thinker understands how their thought processes work and can pay attention to and change these processes [7]. A student with strong metacognitive skills can therefore more successfully monitor, evaluate, and improve their learning compared to students lacking these skills. Unfortunately, many students struggle with metacognition and must contend with “illusions of mastery” (or thinking they understand a subject better than they actually do).  Self-testing is a good way to prevent illusions of mastery, but many students do not incorporate self-testing into their studying, instead electing more passive modes of exam preparation such as rereading texts[8]. Incorporating more testing into the curriculum forces students into the position of making mistakes and receiving feedback, allowing them to frequently measure their learning in relation to expectations and adjust accordingly. Again, note that providing feedback is an essential part of this process.

Benefit #2: Practice Remembering
Testing can improve a student’s long term memory of information presented in class by forcing students to recall what they’ve learned through a cognitive process called active retrieval. Active retrieval strengthens neural pathways important for retrieving memories, allowing these memories to be more easily accessed in the future.
While any sort of retrieval practice is useful, it is most beneficial when it is effortful, spaced, and interleaved.  An example of effortful retrieval practice includes testing which forces students to provide the answers (i.e. Short answer and fill in the blank questions as opposed to multiple choice). More effortful retrieval also occurs with spaced and interleaved practice.
Spaced practice is testing that occurs after enough time has elapsed for some (but not complete) forgetting to occur (i.e. Present the information and then wait a couple months, days, or even just until the end of class to test students on it). Interleaved practice incorporates different but related topics and problem types, as opposed to having students practice and master one type at a time (e.g. cumulative testing where you mix problems from different units together). Interleaved practice can help students learn to focus on the underlying principles of problems and to discriminate between problem types, leading to more complex mental models and a deeper understanding of the relationships between ideas[6].

How to Implement More Assessments (Without Losing Your Mind)
So, all you have to do now is come up with a ton of quiz and test questions and free up a bunch of class time for assessments! Don’t forget you also need to grade all of these! After all, feedback is an important part of the process, and frequent (even low stakes) grading has the added benefits of enhancing student motivation, attentiveness, and attendance.I know what you busy teachers (ie. all of you) out there are thinking….“Your ”magical” teaching practice is starting to sound like a hugely effective pain in my butt.”
Don’t give up on me now though! There are some fairly simple ways to add more assessments to your curriculum. Furthermore, you should be able to do this sans student rebellion because these assessments are low-stakes. Frequent, low-stake assessments as opposed to infrequent, high-stakes assessments actually decrease student anxiety overall because no single test is a make it or break it event. In fact, several teachers have reported a large increase in positive student evaluations after restructuring their classes in this way[3],[4],[6]!

Below I lay out some tips for getting the most out of shifting your assessment practices while maintaining both your own and your students’ sanity:

1) Know that “effortful” testing is not always necessary
While effortful testing is best for retrieval practice, even basic, easily graded recognition tests such multiple choice questions still offer benefits, such as helping students remember basic (but important!) information[6],[9].

2) Create different assessment questions
You can also make assessments more effortful by creating questions that engage higher cognitive processes. Now you can sit back, relax, and indulge in one of my personal favorite pastimes (watching student brains explode) without the stressful grading!

3) Make use of educational technologies to ease your grading
For instance, clicker tests are a quick way to test students and allow you to provide feedback for the class all at once.

4) Make assessments into games
If your students need a morale boost, make a quiz into a trivia game and give winning groups candy. Some good old competition and Pavlovian conditioning may make students reassess their view of testing.

5) Assess participation
Doing something as simple as a participation grade will still provide students with incentive without overburdening them or yourself. For instance, this type of grading would work in conjunction with #3.

6) Keep graded assessments predictable
Making assessments predictable as opposed to utilizing pop quizzes helps students feel at ease.6 Furthermore, if they students KNOW an assessment is coming, they are more likely to study and pay attention.

7) Find ways to revisit old material in your assessments
Making assessments cumulative is an effective way to space out your review of material and has the added benefit of making problems interleaved and effortful, all of which maximize retrieval practice[6].

8) Have students reflect on mistakes
You can help students develop metacognitive skills by giving them opportunities to reflect upon and correct their mistakes on assessments. For instance, have students take a quiz and then discuss their answers/thinking with their classmates before receiving feedback. You can also give students opportunities to create keys to short answer questions and grade their own and several (anonymous) classmates’ answers. This will allow them to think through what makes an answer complete and effective.

9) Break large assessments into small ones
Instead of creating new assessments, break up large ones into multiple, lower-stakes assessments. For example, consider replacing big tests with several quizzes. Consider scaffolding large projects such as independent research projects and term papers. Ask for outlines, lists of references, graphs, etc. along the course of the semester before the final project is due. This might cause more work for you in the short term but can help prevent complete disasters at the end of the semester, which can be time consuming.

10) Utilize short daily or weekly quizzes
If you don’t want to adjust a big project/test or lose class time by adding time-consuming assessments, consider adding short daily or weekly quizzes. These grades can add up to equal one test grade. One could consider dropping the lowest score(s) but allowing no make ups to reduce logistical issues.
These are only a few of the many strategies one can use to transition to a frequent, low-stakes assessment system. What are your experiences with low stakes assessments? Have you made use of any which seem particularly effective in enhancing student learning?

Related Reading:
Much of the information about the benefits of testing is from:
Brown, P.C., Roediger III, H.L., McDaniel, M.A. (2014). Make it Stick: The Science of Successful Learning. Cambridge, MA: The Belknap Press of Harvard University Press.

ADHD is a problem with attention, so adult ADHD can make it hard to succeed in today’s fast-paced, hustle-bustle world. Many people find that distractibility can lead to a history of career under-performance, especially in noisy or busy offices. If you have adult ADHD, you might find that phone calls or email derail your attention, making it hard for you to finish tasks.