“Maintaining biodiversity at its present level is...

â€Å"Maintaining biodiversity at its present level is impossible if people are going to achieve a reasonable standard of living in the near future† - Discuss this with reference to a tropical biome you have studied (40 marks) Biodiversity means the variety of life forms/organisms in an ecosystem, biome or entire planet. Globally, biodiversity is not evenly distributed. It generally increases from the poles towards the equator as around 50% of the world’s plants and animals live in tropical rainforests. This is because of the proximity to the equator causing a warmer, more moist, stable climate which means plants grow better and can support more species higher up in the food chain. Standard of living is the level of wealth, goods and†¦show more content†¦However, due to more people searching for plots there is greater pressure on the amount of available land. The logging industry is responsible for a relatively small level of deforestation, accounting for 3% in Brazil. Consequently, all these activity contribute together to the rapid loss of what is left of the rainforest and a large proportion of the world’s biodiversity. All of the resources that the rainforest provides could be lo st in the next 40 years. The Grande Carajas mining project, Brazil as well as other individual projects have created a series of problems for the rainforests. The Grande Carajas project in particular is a large complex of open pit mines, which takes up more than 6miles of rainforest. Along with many other schemes of this nature, the Grande Carajas is contributing to the continued deforestation of the Amazon. In addition large areas were deforested to make way for the construction of The Trans-Amazonian Highway, which was meant to allow access in and out of several project schemes. After the highway was built evidence of soil erosion could be seen as the ground was left exposed due to the lack of vegetation. Access roads like this have been known to encourage settlements for the transport links they offer, and people will often settle close to the road, which leads to deforestation in order to create space. The HEP Project; the Tucurui dam also had similarShow MoreRelatedEssay on Sil ent Spring - Rachel Carson30092 Words   |  121 Pageswhen it came out. As workof social criticism, Silent Spring represented a considerable departure from the natural history with which she had made a name for herself. Whether this would have been a turning point in her career or merely a detour is impossible to know because Carson succumbed to breast cancer only a year and a half after Silent Spring appeared. What is clear, however, is that her public image was irrevocably transformed. Average Americans came to see her as a noble crusader while theRead MoreArticle: Performance Appraisal and Performance Management35812 Words   |  144 PagesI. INTRODUCTION Organizations are run and steered by people. It is through people that goals are set and objectives are realized. The performance of an organization is thus dependent upon the sum total of performance of its members. The success of an organization will therefore depend on its ability to measure accurately the performance of i ts members and use it objectively to optimize them as a vital resource (Biswajeet 2009). In the present highly competitive environment, organizations have toRead MoreSexually Transmitted Diseases35655 Words   |  143 PagesScience For Living Notes (Compiled) Table of Contents Unit 1 Measurement 5-10 Unit 2 Matter 11-48 Unit 3 Basic materials for maintaining life Air 49-54 Water 55-68 Food 69-71 Other biomolecules of life 72-76 Unit 4 Energy in the Community Electricity 77-78 Heat 78-81 Light 82-91 Sound 92 Simple Machines 93-99 Unit 5 The Physical Environment Weather and Climate 100-113 Soils 114-128 Read MoreContemporary Issues in Management Accounting211377 Words   |  846 Pages Indeed it is possible to argue that the British academic accounting professoriate has played an extremely important role in mediating between the profession and the state, both bringing knowledge to bear on policy issues and providing a cadre of people who can operate effectively in this policy sphere. Michael Bromwich has certainly contributed in this way, advising accounting and competition regulators on complex issues and providing his own intellectual authority to the office of President of

Lung Cancer A Common Malignant Disease - 794 Words

Introduction Lung cancer is a very common malignant disease around the world, which is mainly caused by long-term exposure to tobacco smoke (85% of all cases). [1] It is reported by WHO that, globally in 2012, 1.8 million people suffered from lung cancer, and 1.6 million patients died of lung cancer. [2] In cancer-related death all around the world, lung cancer ranks the top in men and second in women, only after breast cancer. [3] Statistically, 17.4% of lung cancer patients in the United States only have five-year survival after the diagnosis, and the average survival rate is even worse in the developing countries. [4] There are three main types of lung cancer, knowing as non-small cell lung cancer, small cell lung cancer, and lung carcinoid tumor. Among them, non-small cell lung cancer (NSCLC) is the most common one, which covers about 85% to 90% of lung cancer cases. [5] There are several common therapies for NSCLC, including surgery, chemotherapy, and radiation therapy. And the choice of therapy or therapies is based on lung cancer staging, which represents the degree of metastasis of tumor cells. [6] Usually, the TNM classification is used to evaluate NSCLC staging. This classification is based on the size of the primary tumor, whether lymph node is involved, and how about the degree of metastasis. [7] Generally, for early-stage NSCLC, the combination of surgery, chemotherapy, and radiation therapy is the most common and efficient treatment. However, for advancedShow MoreRelatedCancer : The Leading Cancer Killer1159 Words   |  5 PagesEveryone in the world today has been impacted by cancer i n some way. Lung cancer is the leading cancer killer in both men and women in the United States. In 1987, it surpassed breast cancer to become the leading cause of cancer deaths in women. Lung cancer causes more deaths than the next three most common cancers combined (colon, breast and pancreatic). 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Consumer Behavior Study Notes Free Essays

MKTG 4150 STUDY NOTES Chapter 1: An Introduction to Consumer Behaviour What is Consumer Behaviour? Consumer Behaviour: the study of the processes involved when individuals or groups select, purchase, use, or dispose of products, services, ideas, or experiences to satisfy needs and desires. Consumer behaviour is a process Buyer behaviour: the interaction between consumers and producers at the time of purchase. * Exchange (two or more organizations or people give and receive something of value) is an integral part of marketing Consumer behaviour involves many different actors Purchaser and the user of a product may not necessarily be the same person * Another person can also act as an influencer when providing recommendations for or against certain products without actually buying or using them Segmenting Consumers Market Segmentation: process of identifying groups of consumers who are similar to one another in one or more ways and devising marketing strategies that appeal to one or mo re groups Demographics: statistics that measure observable aspects of a population (i. We will write a custom essay sample on Consumer Behavior Study Notes or any similar topic only for you Order Now e. birth rate, age distribution, income, etc. * Changes and trends revealed in demographic studies are of great interest to marketers since it can be used to locate and predict the sizes of markets * Markets can usually be segmented by age, gender, family structure, social class and income, ethnicity, geography, and lifestyles Chapter 2: Perception Exposure Exposure: the degree to which people notice a stimulus that is within range of their sensory receptors Sensory Thresholds Psychophysics: the science that focuses on how the physical environment is integrated into our personal, subjective world The absolute threshold Absolute threshold: the minimum amount of stimulation that can be detected on a sensory channel The differential threshold Differential threshold: the ability of a sensory system to detect changes in a stimulus or differences between the two stimuli Just noticeable difference (JND): the minimum change in a stimulus that can be detected * The ability to detect a difference between two stimuli is the relative difference between the decibel level of the message and its surroundings Weber’s Law The stronger the initial stimulus, the greater its change must be for it to be noticed K= ? II where: K = the constant increase or decrease necessary for the stimulus to be noticed (this varies across the senses) ?I = the minimal change in intensity of the stimulus required to be just noticeable to the person (JND) I = the intensity of the stimulus before the change occurs * Retailers generally use a markdown rule of at least 20% to make an impact on shoppers Subliminal Perception * Another word for â€Å"threshold† is limen and stimuli that fall below the limen are called subliminal Subliminal perception: occurs when the stimulus is below the level of the consumer’s awareness Subliminal techniques Embeds: tiny figures that are inserted into magazine advertising by using high speed photography or airbrushing (supposedly exert strong but unconscious influences on innocent readers) Does subliminal perception work? Evaluating the evidence Factors why subliminal messages do not work: 1. There are wide individual differences in threshold levels. For a subliminal message to affect all individuals, it must be able to target ALL thresholds (which is impossible) 2. Advertisers cannot control the consumer’s position and distance from the screen (not everyone will have the same amount of exposure) 3. Consumers must pay absolute attention to the stimulus (not everyone does, most people are distracted) 4. Even if there is an effect, it only operates on a general level (can’t get a specific message out) Attention Attention: the extent in which the brain’s processing activity is devoted to a particular stimulus Multitask: the ability to process information from more than one medium at a time Perceptual sensitivity: process in which people attend to only a small portion of the stimuli to which they are exposed Personal selection factors Perceptual vigilance: consumers are more likely to be aware of stimuli that relate to their current needs (i. e. if you are hungry†¦ you will notice more food signs) Perceptual defence: people see what they want to see – and don’t see what they don’t want to see. If a stimulus is threatening to us in some way, we may not process it or we may distort its meaning so that it is more acceptable (i. e. smokers ignoring the warning on the cigarette package) Adaptation: the degree to which consumers continue to notice a stimulus over time (the more exposed to are, the less sensitive you are to it) Factors leading to adaptation: * Intensity (less intense stimuli habituate because they have less of a sensory impact) * Duration (stimuli that require lengthy exposure to be processed tend to habituate because they require a long attention span) * Discrimination (simple stimuli tend to habituate because they do not require attention to detail) * Exposure (frequently encountered stimuli tend to habituate as the rate of exposure increases) * Relevance (stimuli that are irrelevant or unimportant will habituate because they fail to attract attention) Stimulus selection factors Factors that allow stimuli to be noticed: * Size * Colour * Position * Novelty (stimuli that appear in unexpected ways or places tend to grab attention) Chapter 3: Learning Memory Learning: relatively permanent change in behavior that is caused by experience. Incidental learning: unintentional acquisition of knowledge. Behavioural Learning Theories Behavioral Learning Theories: assume learning takes place because of responses to external events. Classical Conditioning Classical conditioning: when a stimulus that elicits a response is paired with another stimulus that initially does not elicit a response on its own. Over time this 2nd stimulus (UCS) causes a similar response because it is associated with the first stimulus (CS). Unconditional stimulus (UCS): a stimulus naturally capable of causing a response (i. e. flavouring) Conditioned stimulus (CS): a stimulus that causes a response because of a learned association (i. e. bell) Conditioned response (CR): a new or modified response elicited by a stimulus after conditioning (i. . drool) Repetition * Repeated exposures increase the strength of stimulus-response associations and prevent the decay of these associations in memory * Most effective repetition strategy seems to be a combination of spaced exposures that alternate in terms of media that are more or less involving * Lack of association can be due to extinction (when the effects of a prior conditioning are reduced and finally disappear) Adv ertising wearout: repeated similar advertisements will lead to consumers tuning out Stimulus generalization Stimulus Generalization: tendency of stimuli similar to CS to evoke similar conditioned responses Masked branding: strategy used to deliberately hide a product’s true origin Applications: * Family branding (capitalize on the repetition of a company name) * Product line extensions (related products are added to an established brand) * Licensing (well-known names are rented by others) * Look-alike packaging (distinctive packaging designs create strong associations with a particular brand) Stimulus discrimination Stimulus Discrimination: stimulus similar to CS is not followed by a UCS - causes weakened reactions Instrumental Conditioning Instrumental Conditioning: known as operant conditioning, individual learns to perform behaviors that produce positive outcomes and avoids negative ones. There are 4 types: positive/negative reinforcement, punishment, extinction Shaping: process of rewarding intermediate actions (i. e. customers are rewarded with discounts in hopes of them coming for a second visit) 1. Positive Reinforcement: rewarding, response is strengthened and appropriate behavior learned. RECEIVES A REACTION AFTER DOING SOMETHING, SIMILAR TO PUNISHMENT. (i. e. getting a cookie for every A+) 2. Negative Reinforcement: the avoidance of a negative outcome by doing said behavior, NOTHING IS RECEIVED AFTER DOING SOMETHING. This is different from punishment, which doesn’t use avoidance to learn. (i. e. getting compliments from wearing nice perfume) 3. Punishment: a response is followed by unpleasant events. RECEIVES AN UNPLEASANT REACTION. (i. e. lap on the hand for eating without utensils) 4. Extinction: removal of positive event weakens responses, which are no longer followed by positive outcome. Consumers learn that responses no longer produce positive outcome. (i. e. woman no longer receives compliments on her perfume) Key for marketers is determining the most effective reinforcement schedule (amount of effort and resources they must devote to rewarding consumers to cond ition desired behaviours): * Fixed-Interval Reinforcement: A reward is made after a specified time period has elapsed. i. e. mouse hitting a button for food that will only come in intervals of 2 minutes, they’ll realize that and only begin to hit the button as every 2 min. mark looms but will not do anything right after that mark has passed. textbook uses an example of holiday sales season * Variable-Interval Reinforcement: Time before reinforcement varies around some average but not specified. i. e. mystery store check ups by management, induces staff to always maintain a high-level of service as opposed to only when â€Å"check up† periods loom * Fixed-ratio Reinforcement: Reinforcement occurs after a fixed # of responses. . e. royalty programs, getting a prize for hitting a button 10x * Variable-ratio Reinforcement: Reinforcement occurs after a certain number of responses, but he/she does not know how many are required. Produces very high and steady rates, behavior is very difficult to distinguish. i. e. slot machines, you know you’ll win eventually, just don’t know exactly how many tries Frequency Marketing: reinforces behavior of regular purchasers by giving prizes in line with amount purchased. i. e. royalty programs, frequent flyer programs. is building a database for refining product mixes, marketing strategies, tailoring communications – makes retention programs more effective, product launches/redesigns more successful, blunders prevented. Cognitive Learning Theory Cognitive Learning Theory: contrasting behavioral theories of learning, this focuses more on internal mental processes, i. e. creativity and insight. Views people as problem solvers and we actively use info to master the environment. Is Learning Conscious or Not? Mindlessness: the ability to process information in an automatic/passive manner * Argument as to whether or not learning is conscious. There are arguments that some people do things mindlessly and rely on their â€Å"adaptive unconsciousness† Observational Learning Observational Learning: occurs when people watch the actions of others and note the reinforcements they receive for their behaviors; learning vicariously rather than directly; AKA Modeling Lesson: marketers can show consumer a model + reinforcement without having to directly reward/punish the consumer to influence behavior The Role of Memory in Learning Memory: process of acquiring information and storing it over time for future availability The way info is encoded is important, if data can be associated with other info in memory already, better chance of new data being retained Sensory Meaning: a stimulus may be interpreted in terms of the senses it evokes, such as colour or shape Semantic Meaning: symbolic associations, i. e. rich people drink champagne Episodic memories: memories that relate to events that are personally relevant. + motivation t o retain these memories Flashbulb Memories: memories that are triggered by a stimulus, i. e. (wedding) song that reminds them of their wedding Memory Systems 3 Types of Memory Systems: 1. Sensory Memory: permits storage of info received from our senses – very temporary, i. e. the smell of a bakery when we walk by. If info warrants further investigation, it passes through the attentional gate and xferred to STM. a. Capacity: High b. Duration: 1 second (vision), few seconds (hearing) 2. Short-Term Memory/working memory: stores info for limited time, capacity is limited. Holds info that we are currently processing c. Capacity: Limited d. Duration: 20 seconds e. Chunking: combining small pieces into larger pieces to store info 3. Long-Term Memory: a system that allows for long-term retaining of info f. Requires elaborative rehearsal: thinking about meaning of stimulus and relating to other information in memory Storing Information in Memory Activation Models of Memory: depending on nature of processing task, different levels of processing occur that activate some aspects of memory rather than others, +effort, +likely of LTM storage Associative networks Associative Network/Knowledge Structures: a spiderweb of links containing info for a set of concepts (brands, stores, manufacturers), a storage unit * Info are placed into nodes, connected by associative links. Pieces of info seen similarly are chunked in some abstract form Hierarchical Processing Model: info is processed bottom-up, begins basic then increases to complex processing, if it fails to evoke further processing, info is terminated and capacity allocated elsewhere Evoked Set: a list of recallable information pertaining to a questioned category (i. . perfume). Implication: position itself in the right categories by providing cues (luxury for ex. ) Spreading activation Spreading Activation: as one node is activated, associated nodes are as well through links. = recalling competition/relevant attributes of brand, such as * brand-specific – claims of brand * ad-specific – claims of ad * brand identification * product category – how product works, where to b e used, experiences with it * evaluative reactions – â€Å"that looks like fun† Levels of knowledge Levels of Knowledge: Meaning Concepts Proposition Schema Script (schema): sequence of procedures expected from an individual Factors influencing forgetting Interference: stimulus-response associations will be forgotten if Retroactive: learning new responses to same/similar stimuli Proactive: prevent new learning as a result of past learning Chapter 4: Motivation and Values The Motivational Process Motivation: processes that cause behavior, occurs when need is aroused and consumer wants to satisfy it Utilitarian: desire to achieve some functional/practical benefit. i. e. cquiring a pair of durable running shoes Hedonic: experiential need involving emotional responses/fantasies. i. e. a special pair of running shoes for triathlon Goal: the desired end state Drive: the difference between a consumer’s present and desired state creates tension. The magnitude of this tension determines the urgency of the consumer to reduce this tension. That degree of arousal is drive Want: a mani festation of a need (basic needs such as hunger); particular form of consumption to satisfy a need (such as eating hamburgers or hotdogs or chicken wings or caviar to satisfy hunger) Motivational Strength degree to which a person is willing to expend energy to reach a goal as opposed to another reflects his/her underlying motivation to attain that goal Drive Theory Drive Theory: biological needs that produce unpleasant states of arousal (stomach growling). We are motivated to reduce tension * marketing: tension = unpleasant state – desired state :. achieve balance = homeostasis Expectancy Theory Expectancy Theory: behavior is largely pulled by expectations of achieving desirable outcomes, positive incentives. It is a cognitive theory rather than biological Types of Needs think Maslow’s hierarchy of needs Biogenic: elements necessary to maintain life (water, air, shelter) Psychogenic: culturally related, as belonging to groups, having status, power, affiliation Motivati onal Conflicts Valence: a goal can be either positive or negative Approach-approach conflict * choice between two desirable alternatives i. e. go home for holidays to see family or ski with friends Theory of Cognitive Dissonance: when picking between two products and one is selected, inherently you’ll lose on the benefits of the other and gain the negatives of the one chosen. People will start to rationalize their purchase, as a marketer, you can aid this conflict by bundling several benefits in your communications to help Approach-avoidance conflict * desire a goal but wish to avoid it as well i. e. want a goose to look cool, don’t want to be labeled Canada douche, bag of chips * marketing implication: overcome guilt by convincing luxury is worth it, remove the negative aspects (fake fur) Avoidance-avoidance conflict * choice between two undesirable alternatives i. e. throw + money at old car vs. buying a new one marketing implication: help them realize the unforeseen options of one option Maslow’s Hierarchy of Needs Consumer Involvement Involvement: a person’s perceived relevance of the object based on their inherent needs, values and interests. object = brand, product, advertisement or purchase situation Level of Involvement: * can range from simple processing to elaboration (info is related to pre-existing knowledge systems) * a c ontinuum * low end = inertia (decisions = habit because consumer lacks motivation to consider alt) * high end will find passionate intensity for people objects that carry great meaning Flow state: when consumers are truly involved with a product, ad, or website Characterized by: * sense of playfulness * feeling of control * concentration/highly focused attention * mental enjoyment of activity for its own sake * distorted sense of time * match between challenge at hand and one’s skills * Another view is the type of involvement: cognitive or affective (rational/emotional) Cult products Cult Products: commands fierce loyalty, devotion and worship by consumers who are highly involved with brand i. e. Apple fanboys The Many Faces of Involvement Product involvement Product Involvement: a consumer’s level of interest in a particular product. It can increase by having consumers involved in designing/personalizing. Mass customization: customization on mass production prices i. e. t-shirts, Dell computers Message-response involvement Message-Response Involvement: level of interest within a medium of communication i. e. tv = low, print ad = higher (can pause and reflect) Tactic: spectacles or performances, where message is also entertainment Marketing performances: turn public places into advertising stages, such as flash mobs. x. Sony BMG hired a group of passengers to burst into Thriller dance to promote MJ’s 25th anniversary of Thriller album Interactive mobile marketing: participation in real-time promotional campaigns through cell phones Purchase situation involvement Purchase Situation Involvement: differences that may occur when buying the same object in different contexts i. e. when trying to impress someone you may buy a nice brand to reflect good taste, but if buying for your hated cousin, you may buy something shit because you don’t care Values Values: a belief that some condition is preferable to its opposite. a function of individual, social and cultural forces Core Values Value System: a culture’s ranking of universal values, such as health, wisdom, or world peace Socialization Agents: institutions/people that teach us beliefs, like parents, teachers or friends Enculturation: process of learning beliefs and behaviors endorsed by one’s own culture Acculturation: learning of another’s culture How Values Link to Consumer Behaviour * Cultural values (i. e. security or happiness) * Consumption-specific values (i. . convenient shopping or prompt service) * Product-specfic values (i. e. ease of use or durability) Hofstede’s cultural dimensions Hofstede’s Cultural Dimensions: scores a country based on its standing of 5 dimensions so users can compare/contrast values * Power distance – extent of expectations and acceptance of unequal power distribution by less powerful members of organiza tions/institutions (like a family) * individualism – degree to which an individuals are integrated into groups * masculinity – distribution of roles between genders uncertainty avoidance – society’s tolerance with uncertainty ambiguity * long-term orientation – values of; long term = thrift/perseverance; short term = tradition, fulfilling social obligations, protecting one’s â€Å"face† The Rokeach value survey Rokeach Value Suvery: set of terminal values (end states) and instrumental values (actions required to achieve terminal values) i. e. American’s love for freedom (freedom to bear arms, expression, etc. due in large to history of wars for freedom, Canadians love equality The list of values (LOV) scale List of Values (LOV) Scale: developed to isolate values w/ more direct-marketing applications. Identifies nine consumer segments based on values The means-end chain model Means-End Chain Model: products are valued as a mean s to an end (they have abstract value beyond its bare product state) Laddering: consumers â€Å"climb† a ladder of abstraction that connects functional product attributes to desired end states i. . diamond ring for wedding = size of paycheque = size of love = size of self-worth Means-End Conceptualization of the Components of Advertising Strategy (MECCAS): 1st map relationship of product to terminal values, then employ: * message elements – specific attributes/features to be depicted * consumer benefits – + consequences of usage of product * executional framework – overall style/tone of ad leverage point – the way message will link terminal value with features * driving force – end value upon which advertising focuses on Syndicated Surveys Syndicated Surveys: large-scale, syndicated surveys to track changes in values Voluntary Simplifiers: believe once basic material needs are met, + income adds no value Conscientious consumerism: a new core value? Conscientious Consumerism: a value related directly to consumerism (ex. green) LOHAS: lifestyles of health and sustainability The carbon footprint and offsets Carbon footprint: measures (in units of carbon dioxide) the impact human activities have on the environment in terms of the amount of greenhouse gases they produce Primary footprint: measure of our direct emissions of CO2 from the burning of fossil fuels Secondary footprint: measure of the indirect emissions of CO2 from the whole life cycle of products we use Materialism: importance of which people attach to worldly possessions Chapter 5: The Self Perspectives on the Self Self-Concept Self-Concept: beliefs a person holds about his attributes and they evaluate these qualities Self-esteem Self-esteem: the positivity of your attitude toward yourself Social Comparison: a process where person evaluates themselves by comparing to others/media images; a basic human motive * High Self Esteem = takes more risks, expect success, *accepted socially, center of attention * Low = avoids risks, embarrassment, failures, or rejection Real Ideal Selves Ideal Self: conception of how they’d want themselves to be Actual Self: more realistic appraisal of qualities we do/don’t have * Purchase products in line with our qualities and others to help us attain our ideal self Impression Management: a process of managing how others think of us Multiple Selves Role Identities: different roles, such as husband, father, boss, student, etc. Virtual identity Virtual Identity: fictional depictions in a real-time, interactive virtual world (WOW) Computer-Mediated Environments (CME): virtual role-playing worlds Symbolic interactionism Symbolic Interactionism: relations with others play large part in forming â€Å"the self† * Who am I in this situation? And what do others think I am? * Pattern behavior on the perceived expectations, self-fulfilling prophecy * By acting the way we assume others expect us to act, we conform to those perceptions^ The looking glass self Looking-Glass Self: imagining the reactions of others towards us * Reflexive evaluation occurs when someone attempts to define the self; â€Å"bouncing† signals off others and trying to project the impression they have of us Self-Consciousness High Self-Monitors are more likely to evaluate products in terms of public impressions Consumption and Self-Concept Products that Shape the Self: You are What You Consume Symbolic Self-Completion Theory: predicts that people with incomplete self-definition tend to complete this identity by acquiring and displaying symbols associated with it (i. e. adolescent boys purchase macho products to complete t heir masculinity) * Prisons remove personal objects to reduce personal identity and create group identity * Burglary victims feel alienation, depression, or feeling â€Å"violated† Self/Product Congruence Self-Image Congruence Models: predicts that products will be chosen if their attributes match some aspect of the self * Ideal self more relevant for highly expressive social products like perfume * Actual self more relevant for everyday, functional products The Extended Self The Extended Self: Props or settings (external objects) considered to be a part of us i. e. my computer is an extension of myself, it represents me 4 levels of the extended self: Individual Level: Personal possessions, such as jewelry, cars, clothing * Family Level: A consumer’s residence and furnishings. House = symbolic body of family * Community Level: Neighbourhood or town of origin * Group Level: Attachment to social groups, such as landmarks, monuments, sports teams Gender Roles Gender Differences in Socialization Agentic Goals: stresses self-assertion and mastery; pertains mostly to males Communal Goals: affiliation and fostering of harmonious relationships; females * Every s ociety creates a set of expectations of behaviour for men/women. Starts early with stories * Biological gender =/= sex typed traits, characteristics stereotypically associated with a gender * Masculinity and femininity are NOT biological characteristics; culturally determined Sex-Typed Products: products that take on mascu/feminine attributes Androgyny: mascu/femininity are not opposites (duality); can possess both at the same time * like Korean doods * *guys typically influenced by overall theme of message, girls = specific pieces of info Chapter 6: Personality and Lifestyles Personality Personality: person’s unique psychological makeup + how it consistently influences responses to environment Freudian Systems Freudian Systems: consists of 3 â€Å"systems† Id: entirely oriented toward immediate gratification – â€Å"party animal† * Pleasure Principle: behaviour = desire to max pleasure and avoid pain Superego: counterweight to id. The â€Å"conscience†, internalizes societal norms and prevents id from seeking selfish gratification Ego: system that mediates id and superego * Finds ways to gratify id that is socially acceptable (reality principle); unconscious * Marketing Implication: consumers cannot tell us motivation as it may be unconscious * Product represents socially unacceptable, true id goal. By purchasing, live vicariously through it Trait Theory Trait Theory: identifiable characteristics that define a person * consumption differences between idiocentrics (individualist) vs. allocentrics (collective) * Contentment: idios are more satisfied with the way their life is * Health Consciousness: Allos avoid poor food choices * Food Preparation: Allo’s spend more time preparing meals * Workacholics: Idios more likely to say they work harder and stay later for work * Travel and Entertainment: idios interested in other cultures, travelling, movies, libraries Problems with trait theory in consumer research Scales for measurement are not valid/reliable * Tests are developed for specific populations then adopted to general population ultimately how individual decisions add up to society’s well-being * Consumer Confidence: optimism/pessimism of economic future Social Class: * Standing in society * Pecking Order: social hierarchy determines in ranking, the access to reso urces such as, education, housing, and consumer goods * People belonging in the same class share roughly the same occupations, lead similar lifestyles by virtue of income, tend to socialize and share many ideas and values regarding lifestyle. Homogamy: tendency to marry someone of same social standing * Social Stratification: process in which social system distributes scarce resources unequally amongst social classes in a relatively permanent manner * Reputation Economy: â€Å"currency† people earn when they post comments online and others recommend their comments * Ascribed Status vs Achieved Status: those who were born with it vs. those who earned it Blurring Social Classes * increasingly harder to link brands/stores to specific class, i. e. affordable luxuries†, university kids who splurge on clothing (Burberry, etc. ) but eat KD * Mass Class: those with purchasing power that allows for high quality goods, except for big ticket items such as cars, American colleges, luxury homes (Zara, HM) Components of Social Class * Occupational Prestige: worth derived from what they do for a living (i. e. white vs blue collar) * Income * Social Class better predictor of purchases with symbolic aspects and low-moderate price * Income better predictor of major expenditures with no symbolic meaning (major appliances) How Social Class affects purchase decisions * Attitudes towards luxury (consumers): * Functional: buys things that will last/enduring value. Conducts extensive research logical decision making * Reward: typically younger than first group and older than 3rd group. A way of saying â€Å"I’ve made it† * Indulgence: smallest group. owning luxury items is to be lavish and self-indulgent – to express individuality and make others take notice. ery emotional approach * Old Money: old money families distinguish themselves NOT ON WEALTH, but on history of public service, philanthropy, and tangible markers (Ivey Business School) * Taste Cultures: differentiates in terms of aesthetic and intellectual preferences * it’s like saying upper/upper-middle likely to go to museums, middle like camping and fishing. It’s like saying that you’re less sophisticated * Codes: ways consumers interpret and express meanings restricted codes: focus on content of objects, not relationships amongst objects * elaborated: more complex and depend on a more sophisticated worldview (p. 417) * Pierre Bourdieu concluded that taste is a status-marking force, or habitus * social capital: organizational affiliations and networks (connections) * cultural capital: set of distinctive and socially rare tastes and practices. basically the culture of the rich that allows them to stay within the upper echelon of society because they keep passing it down Status Symbols * we purchase products not to enjoy them, but to let others know that we can afford them * isn’t the same across all cultures. Bulky phones are more â€Å"luxurious† than slim sleek phones compared with the Western world. * invidious distinction: to inspire envy in others through display of wealth/power (reason for consumption) * conspicuous consumption: people’s desire to provide prominent, visible evidence of their ability to afford luxury goods * parody consumption: to seek status by mocking it and avoiding status symbols. i. e. frayed edges of denim clothing, wins with irreverent labels Chapter 14: Age Subcultures Subculture: group whose members share beliefs and common experiences that set them apart from others Microculture: a subset of subculture, which is based on lifestyle or aesthetic preference Age and Consumer Identity * era in which we grow up bonds us will millions of others from the same age * identity may become stronger when the be liefs/goals of one age group conflict with another * Age cohort: group of consumers of same/approximate age who have gone through similar exp. Marketers often target products to specific age cohort b/c possessions play key role in identity with others of a certain age and express priorities/needs of each life stage * Multigenerational Marketing Strategy: use imagery that appeals ;1 generation Chapter 15: Canadian Identity and Ethnic Subcultures Ethnic Subculture: self-perpetuating group of consumers who share common cultural/genetic ties recognized by both its members and others as a distinct category High-Context Culture: group members tend to be tightly knit, infer meanings that go beyond spoken word. x. symbols, gestures carry much more weight than spoken word (Koreans respecting elders) Low-Context culture: more literal. like Caucasians as opposed to minorities De-ethnicitization: occurs when detaches from roots (original ethnicity) and appeals to other subcultures Ethnicity as a moving target * becoming harder to target distinct ethnic groups: greater immigration and interracial marriage and cultural blending * Ethnic Stereotypes: you know what it is. Negative feedback in recent use Level of Acculturation: Acculturation: process of movement and adaptation to a cultural environment from another * Movement: factors that motivate people to uproot themselves physically from one to another place * Translation: to master a set of rules for operating in a new environment (fashion, social meaning) * Adaptation: process of forming new consumption patterns * assimilation: adopting new products, habits, and values identified with mainsteam culture * maintenance: retaining practices associated with culture of origin * resistance: resent pressure to submerge their cultural identities and take on new roles * Raymond Ng’s five phases of adjustment * Honeymoon: immigrant marvels at wonders of new environment * Culture Shock: reality of situation sets in * Superfic ial Adjustment: immigrant forays into new culture/manages day2day life * Stress and Depression: immigrant disparages aspects of new life: lack of high paying job opportunities, taxes, cold and wet weather. Intergenerational conflicts arise, often over career choices of kids * Integration: immigrant moves through society with degree of ase comparable to that of native born * Progressive Learning Model: assumes that people gradually learn new culture as they increasingly come in contact with it. Therefore, mix original culture with host culture Chapter 16: Cultural Influences on Consumer Behaviour UNDERSTANDING CULTURE: * culture – abstract ideas and material objects/services making up a society’s personality – determines the overall priorities s/he attaches to different activities and products – mandates the success/failure of specific products/services – a product that provides benefits consistent with those desired by members of a culture at a par ticular time has a much better chance of attaining acceptance in the marketplace * aspects of culture: ecology – the way in which a system is adapted to its habitat; this area is shaped by the technology used to obtain and distribute resources * social structure – the way in which orderly social life is maintained; includes dominant domestic and political groups * ideology – mental characteristics of a people and the way in which they relate to their environment and social groups; revolves around the belief that members of a society possess a common worldview and share ethos (a set of moral principles and aesthetic principles) Culture: is a concept to understand consumer behavior as society’s personality. It includes: Abstract ideas, Material objects and service. * Culture is the lens through which people view product. The relationship between consumer behavior and culture is two way street. Products relates to priorities of a culture being accepted more by consumer * Product, successfully produced by culture, provide a window onto the dominant cultural ideal of that period Culture system contains 3 functional areas 1. Ecology: which a system adapted to its habitat. 2. Social structure: the way which orderly social life is maintained. 3. Ideology: the mental characters of a people relate to their environment and social groups. Different dimensions on culture 1. Power distance – how much power 2. Uncertainly avoidance – degree people feel threatened 3. Masculinity and femininity – gender roles 4. Individualism – individual vs group Norms – rules dictating what is right or wrong, acceptable or unacceptable * Enacted norms – explicitly decided upon * Crescive norms – imbedded in a culture and discovered through interaction with other members of that culture * Custom – norm handed down from the past that controls basic behavior, such as division of labour in a household, or practice of particular ceremonies * When to eat * More – custom with strong moral overtone, often involves a taboo, or forbidden behavior, such as incest or cannibalism * What kind of food is permissible to eat * Convention – norms regarding the conduct of everyday life, correct way to furnish house, wear clothes, host a dinner party * how to eat the food Myth and rituals Myth: is a story containing symbolic elements that express the shared emotions and ideals of a culture * Often features some kind of conflict between two opposing forces, outcome serves as a moral guide for people * Provides guidelines about their world Functions of myths * Metaphysical – explain origin of existence * Cosmological – emphasize all components of the universe are part of a single picture * Sociological – maintain social order by authorizing a social code to be followed by members of a culture * Psychological – provides models for personal conduct Monomyth – common to many cultures Ritual: is a set of multiple, symbolic behaviors that occur in a fixed sequence and tend to be repeated periodically Ritual Artifacts: items used n the performance of rituals – to consumers, ex. birthday candles, diamond rings Types of ritual * Grooming rituals – purpose ranging from inspiring confidence before confronting the world to cleansing the body of dirt and other profane materials * Gift giving rituals – promotion of appropriate gifts for every conceivable holiday and occasion, three stages * 1. During gestation, giver is motivated by an event to procure a gift * 2. Presentation or process of gift exchange * 3. Reformulation, bonds between the giver and receiver are adjust to reflect the new relationship that emerges * Re-gifting is unwanted * Holiday rituals Rites of passage: a special times marked by a change in social status, three phases * Separation – detaches from original group or status, ex. leave home for school * Liminality – person literally in between status, ex. arrival on campus tries to figure out what is happing in O week * Aggregation – when person re-enters society after the rite of passage is complete, ex. returns home for summer vacation as university â€Å"veteran† Sacred and Profane Consumption Sacred Consumption – involves objects and events that are set apart from normal activities and are treated with degree of respect awe Profane Consumption – Involves consumer objects are ordinary, everyday things we do Domains of Sacred Consumption Scared places – set apart by society because they have religious or mystical significant, or because commemorate some aspect of a country’s heritage * Home can be sacred place, represents a crucial distinction between the harsh, external world and consumers â€Å"inner space† * People – idolized and set apart from the masses, ex. celebrities * Event – world sports is sacred and almost assumes the status of religion, ex. Olympics * Souvenirs are big industry Desacralization: occurs when a scared item or symbol is removed from its special place becoming profane as a result * Can be religion itself, the crosses are in mainstream fashion, Christmas is more materialistic Sacralisation: When events, people take on scared meaning to a culture or a group within a culture, ex. Stanley cup, or collections Chapter 17: The Creation and Diffusion of Culture Cultural Selection – how the culture in which we live creates the meanings for everyday products and how these meanings move through a society to consumers * Linking back to Chapter 1, people buy things for what they mean, not what they do * Though it seems like we have so many choices, our options only represent a small portion * Selection of certain alternatives is the culmination of a complex filtration process resembling a funnel * Cultural selection – many possibilities initially compete for adoption slowly winnowed down to make their way along the path from conception to consumption * Our tastes and product preferences not formed in a vacuum, * Choices are driven by images presented in mass media, observations of those around us, our desire to live in a fantasy world created by marketers * Constantly evolving and changing – what is hot one year may be out the next * Characteristics of fashion and popular culture include: * Styles often rooted in and reflect deeper societal trends, ex. olitics and social conditions * Styles usually originate as an interplay between deliberate inventions of designers and businesspeople and the spontaneous actions of ordinary people, help fuel fire by encouraging mass distribution (those anticipate what consumers want succeed) * Trends can travel widely, often between countries and continents * Influential people in the media play a large role in deciding which trends succeed * Style begins as a risky or unique statement by a relatively small group of people spread to others increase aware of the style feel confident about trying it * Most styles eventually wear out, as people continually search for new ways to express themselves and markers try to keep up * Cultural selection process never stops, when styles become obsolete others wait to replace them in popular culture Culture Production Systems – set of individuals and organizations responsible for creating and marketing a cultural product * No single designer, company or ad agency is totally responsible for creating popular culture, may different factors * Important factors include the number and diversity of competing systems and the among of innovation vs. conformity that is encouraged Components of a CPS – has three major subsystems: 1. Creative subsystem – responsible for generating new symbols or products ex. singer 2. Managerial subsystem – responsible for selecting, making tangible , mass producing, and managing the distribution of new symbols or products, ex. producer/distributor of CD 3. Communication subsystem – responsible for giving meaning to new products and providing them with symbolic sets of attributes that are communicated to consumers, ex. advertising agencies hired to promote music Cultural Gatekeepers – judges or â€Å"testmakers† influence the product that are eventually offered to consumers * Filter the overflow of information and material intended for consumers, ex. movie, restaurant, car reviewers * Collectively called – throughput sector Changed from top-down to bottom up, companies listen to everyday consumers; due to factors such as social networking * We now live in consumerspace – where customers act as partners with companies to decide what the marketplace will offer * Xerox uses voice of the consumer data in its RD – feedba ck from end customers well before it put new product on the market * First make prototype, then gets feed back â€Å"customer-led innovation† High Culture and Popular Culture * Culture production systems create many diverse kinds of products, basic distinctions through characteristics * Art Product – viewed primarily as an object of aesthetic contemplation without an functional value * Original, subtle, and valuable elite of society * Craft Product – admired because of beauty with which it performs some function, ex. ceramic ashtray * Permits rapid production High Art vs. Low Art (high and low culture) * We assume rich have culture and poor do not * Blended together in interesting ways, ex. fine art at Costco * We appreciate advertising as an art form The arts are big business, marketers often incorporate high art to promote products Cultural Formulae * Mass culture churns out products specifically for a mass market * Aiming to please average tastes of undiffere ntiated audience * Predictable because they follow certain patterns * Usually a formula followed because roles and props occur consistently * This means that we â€Å"recycle† images * Creative subsystem members reach back through time and remix the past, ex. Gilligan’s Island Brandy Bunch Reality Engineering – elements of popular culture are used and converted to promotional strategies * Many consumer environments have images/characters spawned by marketing campaigns or are retreads, ex. Real like Kwik-E-Mart * Hard to tell what is real – â€Å"new vintage† (used jeans) * Cultivation hypothesis – media’s ability to distort consumers’ perception of reality * Media tend to exaggerate or distort the frequency of behaviours such as drinking and smoking Product Placement – inserting real products in movies, ex. E. T and Reese’s pieces Advergaming – online games merge with interactive advertisements that let companies target specific type of customers Plinking – embedding a product or service link in video (you-tube) The Diffusion of Innovations – process whereby a new product, service, or idea spreads through a population * New products and styles constantly enter the market * Occur both consumer and industrial setting Form of clothing, new manufacturing technique or novel way to deliver a service * If innovation is successful it spreads through the population * First bought or used by few people more a nd more consumers decided until everyone has bought or tried innovation Adopting Innovations * Resembles decision-making sequence, moves stages of: Awareness, information search, evaluation, trial, and adoption * Importance depends on how much is already known about product as a well as cultural factors that affect people’s willingness to try new things * Not al people adopt an innovation at the same rate (some never do) * Consumers can be placed into categories based on likelihood of adopting to innovation can be related to product-life-cycle) * 1/6th of population very quick to adopt new products (innovators and early adopters), 1/6th are very slow (laggards) * 2/3rds are somewhere in the middle majority represent mainstream public * interested in new things, but do not want them to be too new, wait for technology to improve, or price to fall * Innovators – brave souls, first to try new offering (maybe innovator on one thing, laggard in another) ex. fashion, vs. reco rding technology, highly educated, and high income levels, and socially active * Early Adopters – share similar characteristics, but difference is – degree of concern for social acceptance (20% of pop. ), use magazines to learn about new trends Types of Innovations – can be categorized in terms of degree to which they demand change in behavior from adopters, three categories: * Continuous innovation – modification of existing product, set one brand apart from competitors, most products this type, evolutionary * Small changes made to position, to add line extensions, or merely alleviate consumer boredom * Dynamically continuous innovation – more pronounced change in an existing product, ex. touch-tone telephones, creating some behavior change * Discontinuous innovation – major change in the way we live, ex. airplane, car, TV Prerequisites for Successful Adoption – several factors required for new product to succeed * Compatibility – compatible with consumers’ lifestyle * Trialability – more likely to adopt of they can experiment with it prior to commitment, reduce risk, ex. ree â€Å"trial-size† samples * Complexity – should be low in complexity, easier to understand chosen over competitor * Observability – innovation easily observable, more likely to spread, ex. visible fanny packs * Relative Advantage – most important, should offer relative advantage over alternatives The Fashion System – consist of all those people and organization involved in creating symbolic meaning and transferring those meanings to cultural goods * Fashion affects all type of cultural phenomena, including music, art, architecture, and even science * Fashion as code/language for meanings * Terms * Fashion – process of social diffusion by which a new style is adopted by some group(s) of consumers * A fashion(style) – particular ombination of attributes * In fashion – this combination is currently positively evaluated by some reference group Cultural Categories – How we characterize the world reflects the meaning we impart to products * Culture makes distinctions between different times, leisure and work, and gend er * Dominant aspects/themes of culture are reflected in design/marketing of items * Costumes of politicians, rock/movie stars * 1950s/60s: â€Å"space-age† mastery * Fashion colours for each season * Creative subsystems attempt to anticipate the tastes of the buying public * Collective selection – process in which certain symbolic alternatives are chosen over others, ex. New Wave, Danish Modern, The Western Look, Nouvelle Cuisine Behavioural Science Perspectives on Fashion – major approaches to fashion * Psychological Models of Fashion – explain why people are motivated to be in fashion * Includes conformity, variety seeking, personal creativity, and sexual attention, ex. consumers seek need for uniqueness, want to be different, but not too different (conform to basic guidelines but improvise and make personal statements) * Also early theory of fashion â€Å"shifting erogenous zones accounted for fashion change, different zones become the object of interest because they reflect societal trends (pg. 536) * Economic models of Fashion – terms of supply and demand * Items limited supply have high value, while readily available are less desired (rare items command respect and prestige) * Ex. wear expensive clothing to show prosperity Though in contrast – parody display 0 which they deliberately adopt low-status or inexpensive products * Prestige-exclusivity effect – high prices create high demand * Snob effect – lower prices actually reduce demand (if its cheap it isn’t good) * Sociological Models of Fashion – focuses on initial adoption of fashion by subculture and is diffusion into society as a whole * Ex. Goth culture into mainstream or hip – hop * * Trickle-down theory – important! * States that there are two conflicting forces that drive fashion change 1. Subordinate groups try to adopt the status symbols of groups above them – try to climb the later of social mobility (thus dominant styles originate with upper classes and trickle down) 2. Those superordinate groups are constantly looking below them on the ladder to ensure they are not imitated, they adopt newer fashions * Self-perpetuating cycle of change of fashion Harder in modern times because of new developments in mass culture * Advance in technology to make people instantly aware of latest styles and trends * Each social group has own fashion innovator, trickle-across effect – fashion diffused horizontally among members of same social group * Current fashions often originate with lower classes, trickle up- less concern with maintaining status quo, more free time to innovate, take risks A â€Å"Medical† Model of Fashion – why do style diffuse through the population so quickly? * Meme theory explains the idea, meme – idea/product that enters the consciousness of people over time – includes tunes, catchphrases, or styles like Hush Puppies * Memes spread among consumers in a geometric progression, like a virus, starts off small and steadily infects increasing number of people until it becomes epidemic * Leap from brain to brain via processes of imitation To survive must be distinctive and memorable * Tipping point – when process reaches the moment of critical mass Cycles of Fashion Adoption * Fashion cycle – much similar to product life cycle, progresses through birth to death * Fashion acceptance cycle * Introduction stage – a song is listened to by smaller number of music innovators * Acceptance stage – song enjoys increased social visibility and accepted by large segments of population, wide airplay on Top 40 Stations * Regression stage – item reaches a state of social saturation, becomes overused, sinks into decline and new songs take its place * Different classes of fashions can be identified by considering relative ength of the fashion acceptance cycle * Classic – fashion with extremely long acceptance cycle, low risk * Fad – very short-lived fashion, usually adopted by relatively few people, trickles across common subculture, rarely breaks out of specific group, ex. hula hoops, snap bracelets, and pet rocks, or streaking in mid -1970s * Non-utilitarian – not performed any meaningful function * Adopted on impulse * Diffused rapidly, gains quick acceptance, and is short-lived Fad or Trend * Guidelines for long-term tr ends: * Fits with basic lifestyle changes * A real benefit should be evident * Can be personalized * Not a side effect or a carryover effect * Important market segments adopt change How to cite Consumer Behavior Study Notes, Essay examples

Human Resource Practice Management

Questions: 1. Produce an outline of a half-day training programme (off-the-job) focusing on customer care first and employee values at the heart of excellent customer service? The half-day programme should include relevance to training needs analysis, your key targeted aims, learning objectives, outcomes, timings, activities, assessment and a training feedback evaluation form. 2. Explore and produce at least three on-the-job training initiatives, and show how they ensure transfer of learning takes place and help improve the business?3. Explain and provide reasons on your chosen method and type of learning and development programme by focus on the following points? I. Explain why learning theory and styles are an important part of this process?II. What are the key advantages and disadvantages of the training and development methods you have proposed?III. Provide the process in how you will evaluate the training programme and who needs to be involved? Answers: A. Objective of the Half Day Training Program Outcomes of the Half Day training program Timings Activities Assessment The company has been planning to do a training program focusing on customer care first and the employee values at the heart of excellent customer service (Armstrong 2009) The employees must focus on the customer care at first and thus the employees are required to enhance their provided service to them. The feedback from the customers after conduction of the half day training program will evaluate the outcome of the training program (Beardwell and Claydon 2010) The company must arrange the training program at a convenient place as well as time. As the company has 30 stores nationally, it is important to arrange the meeting in a convincing way (Boxall and Purcell 2011) Proper demonstration of the training objective, power point presentation and a small question-answer round must be included in the training process The provided service to the customers and their feedback will assess the success of the training program. The customers would be requested to give feedback on perceived service from any of the One Pound Opium stores and based on the feedback, the assessment would be done Bradford (2012) has said that a systematic approach to a training program is comprised of some of the systematic steps that come one after another. Bradford (2012) has described this as a rational approach that tends to start from identifying the goal and the aim of the association and after some definite stages, it concludes at the implementation of the exercise programs (Baxter et al. 2013). Therefore, in this case, it is important to plan a training event for One Pound Emporium Company. First Stage: Aim of the Company The aim of the One Pound Emporium Company is to have a dominating market position in the marketplace with the help of the innovative and the capable advertising and the price minimization process. To attain the aim of the company, the organization wants to create a wide-ranging manufactured goods line as well as the successful cost manufacture (Callahan 2012). Second Stage: Setting up the Training Requirements In this particular phase, the Corporation, One Pound Emporium has identified that the production worker, as well as the marketing agent, must be more efficient. If they are not efficient enough, it is hard for the company to achieve the organizational goal (BPP Learning Media 2010). Therefore, the top management of One Pound Emporium has decided to conduct completely two dissimilar tuition actions for the two subdivisions individually (Callahan 2012). Third phase: conniving the Training Strategy The Corporation One Pound Emporium has intended a well affectionate tuition scheme for the production department workforce and the workers. The major aim of this program is how the production can easily run in a proper as well as cost effective manner so that the company can easily witness the fast growth (BPP Learning Media 2010). Apart from the production department, the company has designed an effective lecture method and there the adopted plans of marketing will be demonstrated to the employees, marketing staffs and the agents with the help of a power point projection. Dodge et al. (2012) have said that in designing the training strategy of the One Pound Emporium, the company is required to consider the budget as well as the effectiveness of the training events. Fourth Stage: Implementation of the Training Program At last, the group One Pound Emporium would implement both the training programs in due date and the due time for the betterment of the employees of the company. B. On job training methods takes into account different three types of approaches like Coaching, mentoring and job rotation. These three are highly important and this makes sure the transfer of proper learning takes place. Moreover, these help to improve the business in several aspects (Carberry and Cross 2015). Faulkner et al. (2012) have said that coaching is a one to one training session and mentoring focuses on the development of the attitude among the employees. Job rotation is the procedure of education the employees of the organization by rotating them through a variety of the related jobs (Foot And Hook 2008). It can be said that rotation not only makes a human being well familiar with different types of job. Therefore, these three are highly important for any of the organizations to focus on the on job training approach to enhance the business growth. One Pound Opium has nationally 30 stores and the it is expected that the half day training program as well as the on job training methods would enhance the performance of the employees in case of providing services to the customers. The motto of the company is to concentrate on customer care first and thus training methods are expected to motivate and develop the employee presentation (Taylor 2010). If the customers get good service from the employees who face customers, the growth of business will be high and the company will have more number of new customers (Torrington,Taylor And Hall 2011). C. I. Galinha and Pais-Ribeiro (2012) have opined that learning is solely associated with the wide concepts of knowledge, skills behaviors along with the principles and several predilections. Therefore, learning can be defined as acquiring these above-mentioned things or adjusting as well as reinforcing the preceding attainment of these things. On the other hand, Mathews (2012) has described learning as an important process of 3Ws, i.e. What, How and Why. Therefore, it can be easily said that the entire process of learning is not a sudden happening incident; rather this is the result of the consistent as well as a gradual process (Wilton 2011). It can be said that the human being has an all-purpose propensity for knowledge, and this can be prompted. However, it is important to mention that the mind and the prior knowledge here play one of the significant roles in the entire learning (Fulgosi-Masnjak, Masnjak and Lakovnik 2012). From several ways, a person acquires new knowledge along with different skills, etiquette, preferences and values through different ways and styles. Therefore, it can be easily said that the subject that deals with the particular ways of learning is called leaning theories, and there are several theories of learning. In this part, some controversies are observed, as some have said that the learning is a result of the active engagement and some other have argued that learning is not a personal matter, rather this might be considered as one of the social phenomenon and people learn from the social exposure. Therefore, it can be said that the learning theories are the conceptual framework that demonstrates how a new information or skill are required (Galinha and Pais-Ribeiro 2012). In this regards, many people have stated that many experts have shared their views about learning. Among the pioneers of the learning theories, David Kolb is one of the prominent persons who have advocated a particular type of the learning style. Apart from Kolb, Peter Honey and Alan Mumford have described some other different leaning styles. In this part, it is important to discuss the comparison between two famous learning styles (MacDonald, Kreutz and Mitchell 2012). Kolbs Learning Style: As per the viewpoint shared by David Kolb is that every person tends to follow the four learning styles in the entire learning process that is depended on the learning-cycle, and this series is composed of 4 important phases. Kolb has said that every person learn throughout this cyclic procedure, and the knowledge process can be one of these subsequent stages (Marchington and Wilkinson 2012). 1. Diverging Learning Style These individual who falls under this category can look at the things from several viewpoints, and they are comparatively sensitive. Kolb has called this particular method as deviating, as these people carry out improved in the circumstances. This category can be defined as feeling and watching, i.e. CE/RO (Marchington and Wilkinson 2012). 2. Assimilating Learning Style In this style, it is believed that ideas and concepts are more significant than the people and this learning style prefer a concise and logical approach. Kolb has stated that the people of this knowledge style are comparatively less purposeful on the people and more focused in ideas and the nonfigurative notions. This is explained as watching and thinking, i.e. AC/RO. 3. Converging Learning Style Kolb has stated that the people with congregating learning style can resolve the problems and utilize their learning to find out the solutions to the sensible questions. This approach is expressed as doing and thinking, i.e. AC/AE. 4. ccommodating Learning Style The people under this category are hands on and rely on instinct rather than reason. These people use the examination of other persons and favor to take a sensible and experimental advance. This style is expressed as doing and feeling, i.e. CE/AE (Mathews 2012). Honey and Mumfords Style: On the contrary to Kolb, Honey and Mumford have opined four completely different style of learning. 1. Activists Learning Style These people like to be familiar new things, and they are not concerned concerning the result and like to face new subjects on the sensible grounds (Marchington and Wilkinson 2012). 2. Reflectors Learning Style These people are highly careful persons and owing to the presence of their carefulness, they tend to gather most important and derivative data from several likely basis and after this stage, they analyze them and arrive at to a conclusion (Nansen et al. 2012). 3. Theorist Learning Style The persons who go to this specific education style like to devise several new theories through new experimentation and annotations. These people think that commonsensical derivation is a good method to resolve a problem (Ridge 2011.). 4. Pragmatics Learning Style Rose (2012) has opined that pragmatics like to try-out several new ideas as well as theories that were never before been in the actual world implementations. These people believe the trouble along with the differences as new confront that have to be faced and overcome. Therefore, it can be stated that in the realistic world, dissimilar people follow different learning styles, all these learning styles have their possess explanation, and as per justification, they are applied in the specified field to obtain good results. Practical knowledge related to different learning style is highly critical to any event designing. As a learning event designer, it is highly important to think about the reality first and based on the situation, the learning style is determined (Rose 2012). II. Based on the budget and the requirement, the company One Pound Emporium needs to choose the training methods. It is assumed that the company needs to talk about the compensation and shortcomings of the several different training methods used by the company. In this part, the pros and cons of the training and development method along with the on job trainings have been mentioned here. The company One Pound Emporium has arranged a half-day training program for the employees as well as the on job trainings for them. The advantages and disadvantages of these training and development program have been stated here. Pros Cons Trainers have the first hand experience Employers can select mentor-trainee pairs that is a good fit Trainees learn the job and at the same time earn wages Training program can teach skills as requested by the employers Incumbent workers can learn several latest technologies as per the requirement (Torrington,Taylor And Hall 2011) This can often slow down the productivity of the company The training program requires investment, if the company do not have proper training infrastructure The training providers often lack in the practical experience (Wilton 2011) The employers are required to pay union wages and this might hamper the company geowth 1. The classroom or Lecture: This is one of the common training methods where the trainees are placed in a classroom, and the instructors provide lectures through white board or power point presentation. The major advantage of this method is that a company can arrange this method for a huge number of workers at a time and price effectual manner. On the contrary, the disadvantage of this method is that this method can be applied for a tuition of the sensible manufacture work, as there is no span for the laboratory demonstration and sometimes this might be repetitive. 2. Demonstration or Practical Training Method: Rose (2012) has mentioned that the training method demands a practical field where the knowledge are demonstrated to the trainee. The advantage of this approach is that it is suitable for the production department of the selected company. Rose (2012) has said that this specific training method cannot be applied where the decision making is based on practical reality such as management level, and this is one of the disadvantages of this approach (Truss, Mankin and Kelliher 2012). 3. Case Study Method: It had been found that this training method is applicable to those places where a situation is given to the trainees, and then they are asked to solve the problem based on some assumptions. Therefore, the advantage of this approach is that this approach can be applied to the management level to enhance the decision-making potentiality of the managers. On the other hand, the prime disadvantage of this approach is that this method has no effect in the subordinate level and most importantly; this cannot be applied to the employee stage of the corporation as well (Truss, Mankin and Kelliher 2012). 4. Mixed Training Method: Rose (2012) has opined that mixed training method is one of the attractive training methods that accumulate all probable training means under one umbrella. This tends to train as well as expand the workers. This process can be applied at different levels, and this is one of the advantages of this approach. This method is costly and time-consuming, and these are the disadvantages of this approach. III. Rose (2012) has said that evaluation of the training program is important, as it measure the effectiveness of the training program. The HR team of the company takes this practical step. It is important to analyze the following steps, and these are as follows: 1. Satisfaction and the reaction of the participants This is the immediate assessment of the trainer, and it has been found that the One Pound Emporium has found the good reaction from both the training sessions. 2. Acquisition of Knowledge Most of the employees in the organization have participated, and their gesture was good. 3. Behavioural Application This is considered as the aftermath of the training program, and the behavior of the trainees have changed, and the improvement is eye-catching enough. 4. Measurable Business Improvement After 3 weeks of the conduction of the training program, the company has achieved a notable business growth (Rose 2012). At the completion of the entire study, it can be said that the decision taken by the Human Resource Managers of the company using several dissimilar means was helpful, and this helped to get an absolute image of tuition impact on the One Pound Emporium. References Armstrong, M. (2009), A Handbook of Human Resource Practice Management, 11th ed. Kogan Page Baxter, J., Gray, M., Hand, K. and Hayes, A., 2013. Parental joblessness, financial disadvantage and the wellbeing of parents and children. Canberra: Dept. of Families, Housing, Community Services and Indigenous Affairs. Beardwell, J and Claydon, T (2010), Human Resource Management A Contemporary Approach, 6th ed. Prentice Hall Boxall. P and Purcell, J. (2011), Strategy and Human Resource Management, 3rd ed. Palgrave Macmillan BPP Learning Media (2010), Human Resource Management, BPP BPP Learning Media (2013), Human Resources Development and Employee Relations, BPP Bradford, H., 2012. The Well-being of Children under Three. Hoboken: Taylor and Francis. Callahan, J., 2012. Journal Journey Update: Working Towards Digitizing and Diversifying. Human Resource Development Review, 11(3), pp.267-268. Callahan, J., 2012. Occupy . . . HRD? Expanding Our Vision of the Field Into Nontraditional Spaces. Human Resource Development Review, 11(2), pp.135-137. Carberry, R and Cross, C, (2015), Human Resources Development: A Concise Introduction, Palgrave Macmillan Dodge, R., Daly, A., Huyton, J. and Sanders, L., 2012. The challenge of defining wellbeing. International Journal of Wellbeing, 2(3), pp.222-235. Faulkner, S., Wood, L., Ivery, P. and Donovan, R., 2012. It Is Not Just Music and Rhythm ... Evaluation of a Drumming-Based Intervention to Improve the Social Wellbeing of Alienated Youth. Children Australia, 37(01), pp.31-39. Faulkner, S., Wood, L., Ivery, P. and Donovan, R., 2012. It Is Not Just Music and Rhythm ... Evaluation of a Drumming-Based Intervention to Improve the Social Wellbeing of Alienated Youth. Children Australia, 37(01), pp.31-39. Foot, M. And Hook, C. (2008), Introducing Human Resource Management, 5th ed. FT/Prentice Hall Fulgosi-Masnjak, R., Masnjak, M. and Lakovnik, V., 2012. Perceived Subjective Wellbeing of Parents of Children with Special Needs. Journal of Special Education and Rehabilitation, 13(1-2). Galinha, I. and Pais-Ribeiro, J., 2012. Cognitive, affective and contextual predictors of subjective wellbeing. International Journal of Wellbeing, 2(1), pp.34-53. MacDonald, R., Kreutz, G. and Mitchell, L., 2012. Music, health, and wellbeing. Oxford: Oxford University Press. Marchington, M. and Wilkinson, A., 2012. Human resource management at work. London: Chartered Institute of Personnel and Development. Mathews, G., 2012. Happiness, culture, and context. International Journal of Wellbeing, pp.299-312. Nansen, B., Chakraborty, K., Gibbs, L., MacDougall, C. and Vetere, F., 2012. Children and Digital Wellbeing in Australia: Online regulation, conduct and competence. Journal of Children and Media, 6(2), pp.237-254. RIDGE, T., 2011. Supporting Children? The Impact of Child Support Policies on Children's Wellbeing in the UK and Australia. J. Soc. Pol., 34(1), pp.121-142. Rose, R., 2012. Life story therapy with traumatized children. London: Jessica Kingsley Publishers. Sanfilippo, M., Neubourg, C. and Martorano, B., 2011 The impact of social protection on children. Solley, H. and Lyttle, C., 2012. Health-related behaviours and wellbeing in children aged 1013 years. Br J School Nurs, 7(7), pp.333-338. Taylor, S. (2010), Resourcing and Talent Management, 5th ed. CIPD Torrington, D., Taylor, S. And Hall, L. (2011), Human Resource Management, 8th ed. FT/Prentice Hall Truss, C., Mankin, D. and Kelliher, C., 2012. Strategic human resource management. Oxford: Oxford University Press. Walker, P. and John, M., 2012. From public health to wellbeing. Basingstoke: Palgrave Macmillan. Wilton, N. (2011), An Introduction to Human Resource Management, Sage Publications

One Dimensional man Essay Example

One Dimensional man Paper Considering false needs as being socially developed and superimposed upon people at the base, Marcuse argues that these needs are products of society in order to repress and dominate people as a whole (pp. 4-6). For example, we truly need food and shelter (in order to survive), but do we truly need cars or computers? His theory is similar to Webers theory of bureaucracy in that it explains how the power elite represented by the superstructure make the base think that people need to buy the goods (because they need to sell them in order to maintain power! ). This also relates to the dehumanizing dominance of means over values, which brought about Webers Iron Cage of Reason, which characterizes modern society as an iron cage where people are held hostage in a repressively well-organized, inevitable social order that threatens freedom and the self. In fact, people do not even recognize that there is an iron cage and, likely, they often do not recognize the presence of false needs. The dominant society does something even more shocking: It makes it seem like people have freedom of choice by giving them a realm of given possibilities. We will write a custom essay sample on One Dimensional man specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on One Dimensional man specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on One Dimensional man specifically for you FOR ONLY $16.38 $13.9/page Hire Writer For instance, people have the choice of buying a pair of shoes among these stores: Nike, Adidas, Reebok, And-One, Timberlands, etc. However, these alternatives do not determine freedom. Marcuse reveals that difference and variety are two completely different things. People have the option to choose among varieties-variations between similar forms-of goods and services because those are what they have been given. Oftentimes, they do not notice that these are not a sign of freedom if these goods and services sustain social controls over a life of toil and fear (p. 8). Marcuse brings up an interesting idea that the advanced industrial culture is more ideological than its predecessor, in that the process of the advanced industrial society he describes is not limited to the realm of ideas and rationalization-the ideas and rationalization of the social system have become part of the productive device itself (p. 11). The needs related to production turn out to be the needs of the members of society, and the two are tied together in a way that is one-dimensional and militates against qualitative change (p. 12). Freuds concept of the balance between the id and the superego is similar to Marcuses concept in that there are two realms: the private realm (id) and the public realm (superego). However, in Freuds case there is a dialectical interaction between the two realms, whereas in Marcuses case the public imprints itself on the private, leading to the removal of the bond between the private and the public realms and, therefore, the two almost being identified as one (one-dimensional). Marcuses analysis of advanced industrial societies is consistent and helpful. However, he does not provide pragmatic solutions to the problems he points out. He corroborates Marxs arguments concerning organized society and its effects on individuals and society as a whole. Using this source, he recognizes overpowering and technological rationality as the source of power toward homogeny, creation of false needs, continuation of this rationality, and ultimately leading to a one-dimensional form of society that is irrational. I agree with his argument that if societies can learn to use modern technologies in ways that benefit people instead of repressing them, the problems that they face will be solved. Works Cited Freud, Sigmund. Civilization and its Discontents. New York: W. W. Norton Company, 1961. pp. 36-46. Marcuse, Herbert. The New Forms of Control. in One Dimensional Man: Studies in the Ideology of Advanced Industrial Society. Boston: Beacon Press, 1964. pp. 1-18. Marx, Karl. The Fetishism of Commodities and the Secret Thereof. in The Marx-Engels Reader, second ed. New York: W. W. Norton Company, 1978. pp. 319-329. Weber, Max. Legal Authority with a Bureaucratic Administrative Staff. in The Theory of Social and Economic Organization. New York: The Free Press, 1947. pp. 329-341.

Pushkins essays

Pushkin's essays Pushkins short story, The Shot, has an emphasis on the duel as it was in the late 18th and early 19th centuries, and on the delicate balance of life and death that is brought into existence when a duel is begun. The narrator is not the protagonist, but rather a sort-of nondescript soldier; and while the story is written from his point of view, he does not play a very large role. The central figure of the plot is a grizzled retired hussar named Silvio. The narrator takes a singular interest in this mysterious figure that resides near his companys base of operations, but his interest disappears when Silvio is insulted by a drunken aggressor but fails to punish the insult with death. Shortly thereafter, Silvio receives a letter and announces to the officers that he has to leave immediately, but heinvites them all to dinner at his house one last time. After the rest of the officers have returned home, Silvio takes the narrator aside. Apparently disturbed by the narrators distant behavior, he tells the story of his past. As a hussar, Silvio was a great duelist and a favorite among his peers. When his popularity fell as a result of the arrival of a new soldier who is more handsome and witty than Silvio, he insulted him with the goal of inciting a duel. When it is Silvios turn to shoot, he is disheartened by his enemys casual behavior and nonchalance in the face of death. He calls the duel off until later. The letter Silvio received had told him that his enemy was being married to a beautiful young woman, and Silvio decides that now is the time to finish his duel, and travels off to find the newlyweds. Five years later, A rich count and his beautiful young wife move into the narrators neighborhood. It turns out that this is Silvios mortal enemy, and that he found them and made as if to finish the duel, but seeing the wifes fear and the husbands terror, he left satisfie...

Everything You Know About Leadership Is Wrong Assignment

Everything You Know About Leadership Is Wrong - Assignment Example The author also argues that the trainings are inefficient because they fail to include employees in the sessions yet she considers this to be essential for leadership to be successful. Ryan argues that the elimination of the fear of the leader in a group, the use of technology, and the improvement of human relations in organizations leads to successful teamwork and leadership (3). The topic that Ryan discusses is related to leadership styles that include authoritative, free rein, and participative (Lewin Slide 16). The author discourages the authoritative leadership style that is the one where the leader dictates what members of a team are supposed to do or not do. This is because this style of leadership is bureaucratic and it creates fear among workers. When workers fear the leader, this leads to the inefficiency of a team because it consequently leads to lack of trust between the leader and the followers. The author, however, does not point out anything about free rein, which is the style where the leader delegates all functions to the team members. In this style, the leader endorses decisions that are made by the followers without objections (Shriberg et al 70). The author encourages the participative leadership style that is the one where the leader involves members in making all decisions. When there is training, leaders and followers are involved so that they can discuss issues as a group. This helps to reduce fear and create trust among the members of a team (Ryan 3). This topic is also related to the human relations style of management that is the one where managers cater for the needs of employees before any other needs. The consideration of employee’s wants before others leads to efficiency in the performance of work, which consequently improves the performance of companies. This topic is also related to the subject about the stages of teams and their dysfunctions. Ryan argues

Writing for Media Assignment Example | Topics and Well Written Essays - 1250 words

Writing for Media - Assignment Example ually might have lived a little bit nicer, because gas was so much cheaper.† His comments were mirrored by his girlfriend, Marla, who laughed when asked about savings and interest rates, saying â€Å"I haven’t made enough to put any money away for years, what do you think? If the interest rate were 0 or 10% it couldn’t make a difference to me.† Though state budgets have been viciously slashed by the recession, neither of these two people seemed to notice the difference: they made too much money to be eligible for Medicaid already, and so did not face rollbacks there, and relied on very few other modes of social support. Certainly other people who made less or who were more reliant on social welfare may have had a very different experience, but for some, it is clear that being poor meant that the recession did not take a huge bight out of standard of living. The economic situation seemed much more dire to those in the lower middle and middle classes. Younghee Jan, 62, for instance, had worked as a welder and a post office clerk respectively for 35 years before attempting planning to retire around 2010. Planning to retire to a smaller but distinctly nicer house in a nicer neighborhood than he had lived for most of his life, Mr. Jang decided to buy a house in 2006, having moved here from northern California. His divorced wife tells a similar story. They sank a great deal of their nest-egg into a down payment, negotiating what seemed then like a low fixed interest rate and feeling certain that they could make their payments based on their pensions, especially given how much of the house they had already managed to pay off in a large down payment. As the recession worsened, however, they suddenly found themselves holding the bag on an unsustainable mortgage. The low interest rate they locked in at was almost twice as high as what one could get for a home loan now, and they find themselves, like many people, with a house that could not clear the mortgage

Economics of Race and Gender Article Example | Topics and Well Written Essays - 750 words

Economics of Race and Gender - Article Example It is because this discriminatory attitude is deeply rooted in one’s subconscious and it will take years of relentless struggle to wipe out this unethical approach from the society. It is emphasized by the movie’s director that even in the present competitive age, countless people still view, treat, and assess others on the basis of their cultural, ethnic, and racial backgrounds. The distinguished feature of this riveting movie is that it shows a mixed pot while taking care that the element of interest lasts till the end of the story. One finds the lives of various characters from entirely different racial backgrounds intertwined in such a way in this movie that everyone crashes or bumps into each other. Basically, every character in this movie has a different racial background and the individual interactions among them are portrayed in such a manner that the viewers cannot help but appreciate the reality and significance of the pervading discriminatory notions in the society. Each furious and provoking incident is tried to be presented as realistically as possible and that is an effort which is too conspicuous to ignore if this movie is scrutinized deeply. The movie starts with a car accident involving a female detective and an Asian woman, who start fighting each other and exchange racial insults straight-off. The way this incident is portrayed is too heart-touching and a sudden idea dawns on the viewers that the world is no yet free of unjustified biases despite many tedious efforts. This incident is then followed by a row reflecting racial biases between a Persian man and a gun shop owner, who refuses to hold any transaction with the Persian man owing to his religious background . Finally, the Persian man had to leave the gun shop seriously infuriated, while his daughter Dorri endured verbal sexual insults from the shop owner. After that, the scene between the district attorney, his wife and two black car hijackers also plainly shows paranoia, suspicion,

Patient Healthcare Using SMS Technology Application

Patient Healthcare Using SMS Technology Application Chapter 1 Introduction to Patient Care Using SMS Application Patients travel longer distances for the opinion of consultant which is not possible either due to patient situation or due to distances. Enhancement of health care in different locations and other remote areas can be achieved using mobile phone applications [1]. 1.1 Problem Statement Development of mobile communication networks playing an important part in the enhancement of a mobile medicine. Patient Care Using SMS Application represents a feasible solution of patient care such as text messaging and booking appointments using mobile phones, which are best aspects of mobile medicine. The main idea is improve patient access to healthcare; encouraging patients to use mobile health application and supporting people with long term conditions [5]. 1.2 Objectives Incredible growth of mobile communication and recognition of new generation Wireless protocols has initiated the advance SMS based medical applications. Following that facts Patient care using SMS based application for mobile application for patient is good solution [5 6]. * To design and develop a WAP enabled wireless applications that will enhance the feature of mobile device by incorporating the features of a digital diary. The application should be able to get integrated with the existing application vis-à  -vis Exchange Server etc * Main aim of this application is to achieve â€Å"greater quality communication between GPs and consultants using mobile medicine, which will results in enhancement of patients care â€Å"[5 6]. 1.3 Scope The goal of Patient Care Using SMS Application is based on two major conditions. First, is to achieve proficient means to exchange message between General Practitioners and consultants care have to be provided. The second is sufficient exchange of patients information have to be provided. Additionally, privacy of communication and stored information has to be guaranteed. Both ethical and technical aspects are equally important [7]. 1.4 Existing Systems The existing system of treatment consists of two different systems. They are as follows: * Traditional or manual system * Online application 1.4.1 Traditional or Manual system The present system of treatment consists of manually consulting a doctor by taking prior appointment or else registering at that instant of time, waiting to get register themselves and then consulting the doctor which is a time consuming process. 1.4.1.1 Drawbacks * Time consuming * Patient need to stand in long queues to make appointments * Patients not follow prescription directions once they leave the surgery or hospital. Research has showed that more than 50 percent of patients not follow the management advised by their doctors may be due to lack of time and interest. 1.4.2 Online System Online application is also available where the user is provided a login and password through which he can access the website, make appointments, clarify their queries etc. The problem with online application is we cannot access from remote areas, compulsory web connection should be there and we cannot get alerts [4, 5]. The online systems are discussed below are: * EMIS * VISION System 1.4.2.1 EMIS System EMIS ® stands for Egton Medical Information Systems Limited. EMIS provides a service that enables you access to your healthcare online [9]. After registering with the surgery, patients are able to book or cancel their appointments with the doctor. Patient can also request repeat prescription, send messages to their practice and update personal information if practice has set up these features online [10]. This example has been explained in detailed in chapter 2. 1.5.2 Example 2: Vision System Vision [14] is the most famous system in use UK, within the GPs sector today, due to its market leading features, functionalities and first class support from INPS. There are currently more than 1,800 GP practices which are using Vision system across the UK each day. â€Å"Vision system version 3 is fully RFA 99 acquiescent, includes, support for the encryptedEDIFACT pathology v1.1 message, MIQUEST and DTS. The Vision application is stable, proven and reliable. The strong product-base has allowed other features such as advanced-scanning, PDAs support and incorporated voice dictations as well as extension to core functionality such as XML based clinical-messaging, allowing integrations with third party systems† [14]. In this project we are more concentrating on EMIS rather than Vision system. Key Features Messaging Incorporated External system Appointments Consultation Manager Problem Orientated Views Community Caseload Search and Reporting 7. Clinical Audit Vision and the National Applications [14] Few of the above features are explain below [14]: 1. Messaging This system offers unparallel flexibility with the wider health community via its highly supple and adaptable in-built messaging and web-services. These allow patients data from number of external sources including the NHS Spine or local CPRs to be easily accessed and used within Vision, supporting the requirements of the NHS IT-strategy. Vision also manages a range of clinical messages from third party systems to support the patient care as follows: * Choose and Book Referrals (electronic booking) * E- Discharge Summaries * Radiology reports and Encrypted pathology reports * OOH Summaries With a powerful XML event and messaging engine, Vision is designed to ensure the performance of new messages require no changes to the core Vision product. In a single, clear and simple interface, all message types are managed. 2. Incorporated External System In the Vision tabbed views, external web enabled application can now be well-established, allow access patient information from number of sources to be seamlessly from the Vision desktop. The patient is automatically recognised in the target system, when the required data is passed to the third-party application. For integration into the patient record when required, important data may also be written back to Vision 3. Patients Appointments This Vision system allows user full access to the appointment screen. â€Å"Using session templates developed by the practice† the appointment books are defined in advance. The view of appointment book can be defined by user: all significant doctors and other Healthcare professionals can be added or deleted as requirements. To denote, each slots can be assigned in different colours. As the patients arrives at reception, enters the doctors room or leave the surgery, their status is recorded. Our evaluations are based on EMIS system, its features and limitation which have been explained in later chapters. 1.5 Thesis Organisation In chapter 1 we have explained Patient care using SMS application and its aim, objectives and scope. The existing systems such as manual and online systems are briefly explained in this chapter along with it features and disadvantages. The chapter 2 explains EMIS system and its features. Features of EMIS explained in this chapter with examples, their functionality and requirements. This chapter 3 gives brief overview of problems associated with online medical systems with examples. Problems of online medical system such as internet connection, email, prescription, Electronic Patient records and read codes are explained. In the chapter 4 we have focussed on Patient Records and how they are managed at General Practices and hospitals. The traditional paper based practices and its limitations have been explained with examples. The paper less practices and its pros have been explained and the reasons why practice should follow this have explained with examples. The advantages and disadvantages of Electronic patient records with s and examples are discussed in this chapter. The chapter 5 focuses on Read codes and its structures. In this chapter 3 versions of read codes are explain with examples. Maintenance of read codes i.e. internal process and external interaction and hierarchy has been explained with s. The example case study represents the limitations associated with 3 versions, its results and solutions. The chapter 6 is about EMIS database, i.e. patient database and focuses on its usability and security. It explains structure of database and its solutions. Secure Patient data transfer within the PCT has been explained. Storage Area Network is used by EMIS to store patient records. How the GPs and other Healthcare Professional access patient records has been explained. Advance system and its features are discussed in this chapter 7. Waterfall Models activities have been explained. The structure of advance system with s is discussed in this chapter. The conceptual and technical design of this project has been briefly explained. UML language is used in this project to represent user and admin operations. The chapter 8 explains the SMS system requirements such as Specification requirements, Functional requirements, Performance requirements, and hardware and software requirements. About operating system and languages used in this projects are discussed in this chapter. Wireless application protocol architecture and WAP server are explained using diagrams. Database requirements and its uses are explained using diagrams. Open wave SDK and its functions are discussed in this chapter. Chapter 2 Egton Medical Information Systems EMIS ® and EMIS intellectual technology are trading names of â€Å"Egton Medical Information Systems Limited†. EMIS had begun 18 years ago in a rural area dispensing practice in Egton near Whitby in North Yorkshire [11]. EMIS ® head-offices are based in Leeds, including Development and Support departments. Training for general practices is localised and headed by Provincial Operations Directors [11]. 2.1 Practice Care System Enterprise Due to the growing number of EPRs held in both GP and Secondary Care, the requirement for a whole EHR has never been greater. The EMISs Primary Care System Enterprise edition for PCTs has been designed to meet all the challenges. EMIS PCS will maintain the patient information at many levels and ease safe access 24/7 by the wider health care-community [11]. PCS Enterprise for PCTs has been designed with capability of future technological and keeping development in mind, such as sharing data between General Practices. This includes GP to GP records transfer and inter-operability between in- and OOH PCSs. Using a HL7 Version 3 the patient data is transferred between dedicated health care systems directly [11]. 2.2 An overview of PCS Enterprise This edition has been designed to develop EMIS provision of an absolute system solution for primary care. The system is scalable, multi-practice, and multi disciplinary with shared EPRs and seamless data exchange. This system is based on three-tier architecture, while utilising MS Dot Net technologies, this system has the flexibility to increase numerous clients with its ability to scale to thousands of instantaneous user connections [11]. EMIS Primary Care System Enterprise edition is designed to meet GP needs as closely as possible, while supporting specialties related to medicine. See in 2.1 below gives the overview of PCS Enterprise system: 2.3 EMIS Primary Care System Practice edition Health information system plays an important role in how practice operates. The good and right clinical system can help to save practice valuable time, assist in practice management and ultimately lead to improved patient care. The EMIS PCS Practice edition has been designed to meet GP needs, combining functionality with simplicity of use [11]. Key features of EMIS PCS * Complete patient record management * Quick and good prescribing * Formulary managements * Incorporated consultation mode * Incorporated appointments * Mentor Library * Integrated with MS Word support * User defined templates * Drug Explorer 2.4 EMIS LV Version 5.2 In the PCS market, EMIS Live Version [11] is the main text based medical system. Approximately 5000 GPs currently using EMIS LV system (which is shown below) in the UK. The system offers GPs consultation mode option, medical record, search and reports option, prescription and booking appointments. 2.5 Population Manager This system enables General Practices to effortlessly meet the requirement of the new GMS Contract. Population Manager [11] has a set of more than 160 searches that extract the data require for the new Contracts and present it in an understandable format. It also contains a set of specially designed templates to help speedy and standardised information entry. Population manager is an incorporated part of EMIS LV system. 2.6 Version 5.2 features This is the most recent release of EMIS LV. This LV offers users the following key features [11]: 2.6.1 MS Word incorporation Patient data is easily transferred between EMIS system and MS Word enabling the clinician or staff to create patient related letters in MS Word easily. To create consultation references for simple retrieval, documents are created in MS Word which is saved back into EMIS. 2.6.2 Referral template for Cancer patients If cancer is suspected GPs requires produce and fax or e-mail suspected cancer referrals within 24 hours of seeing the patient (this is according to the NHS Plan). These patients have to be seen by the Hospital Trust within 2 weeks; hence these referrals are named as â€Å"two week rule referrals†. EMIS has included a suite of MS Word templates for each cancer type into EMIS LV5.2. 2.6.3 Electronic Insurance reports One of the most common and time taking medical information requests for GPs is the PMA form for the claim companies. A familiar format for General Practitioner Report has been decided and computer-based reports (eGPR) are accepted by insurers. The electronic GPR can be generating within the EMIS system, integrating all related patient information. The eGPR template is installed by default in this system. 2.6.4 Scanning and attachments This module enables to scan corresponding or images and attaches them directly to a patients record in consultation mode. These documents are instantly available during consultation. 2.7 EMIS Clinical Communication Modules The following Clinical Communication Modules are available with EMIS LV5.2, providing links with Secondary Care [11]. 1 Online Referrals with Booked Admissions 2 Electronic Referrals 3 Incoming Reports including Electronic Discharges 4 Online Results Ordering With an approved list of suppliers this Clinical Communication Modules work. Using the common set of messaging standards currently being developed by the National Design Authority, links to other suppliers will become available, an arm of the National Programme for IT in the NHS. For this reason that EMIS are not progressing, with the further testing of links with other suppliers using proprietary messaging standards. The Clinical Communication Modules are explained below [11]: 2.7.1 Online Referrals and booked admissions Traditionally referring patients from doctors at general practices to hospital or Secondary Care consultants has been a paper based with its problems of delays (slowness) and occasional loss. The EMIS Online Referrals with Booked Admissions module enable us to create a referral on a Secondary Care website using protocols created by Secondary Care consultants, adding patient demographics and clinical information and in some cases booking an appointment. Requirements: Each EMIS practice must have: * EMIS LV 5.2 * NHS Net connectivity * Router access for EMIS * Version 2 clinical terms (5 byte Read Codes) The Secondary Care Provider will need: * An EMIS approved website 2.7.2 Electronic Referrals This module enables us to create a referral letter within EMIS LV and transmit it electronically to a secondary care consultant [11]. The way electronic referrals work You can use MS-Word Integration in EMIS LV to create a referral letter. When you save the referral letter, you are prompted to link with EDI for an electronic transmission: answer ‘Yes and the referral letter is placed in the Communications outbox (CO, OD). From here, you can check the letter before authorising the transmission. When you have authorised the transmission, you can either send the referral letter immediately or wait until the next scheduled transmission. Upon receiving the referral letter, the secondary care software system will transmit an acknowledgement that you can view within the EMIS Communications screen. Requirements Each EMIS practice must have: * EMIS LV 5.2 * NHSnet connectivity * Router access for EMIS Support * SMTP or DTS mailbox * MS-Word Integration The secondary care provider will need: * SMTP or DTS mailbox * Suitable software capable of sending and receiving XML messages and acknowledgements * SMTP/DTS and EDI code addresses of the practices involved the trust should obtain these from the health authority or national tracking database 2.7.3 Incoming Reports including electronic discharges Use this information sheet to give you an overview of the Incoming Reports module and the requirements to get you started. The communication of patient information from out of hours services and secondary care used to be paper system, which has been unmanageable and untrustworthy with discharge notes being illegible, incomplete and often late in delivery. The paper-based system replaced by Incoming Reports module which receives electronic discharge notes or other patient related reports from an OOH service or a secondary care provider [11]. How does the Incoming Reports module work? Incoming Reports is a one-way process whereby the out of hours service or secondary care provider sends a message containing the incoming report to EMIS LV. However, EMIS LV will send an acknowledgement of receipt back to the provider. When EMIS LV receives a report, it is matched to the correct patient and placed on a list ready for viewing, and then filing. If EMIS LV cannot match a report to a patient automatically, you can match a patient manually. When viewing a report, you can match the clinical information in the report to clinical terms before you file it. You can link a report to a past consultation (for example, the consultation during which the original referral was made) or create a new consultation specifically for the report. You can view filed incoming reports using the *RL function in Consultation Mode. Requirements To use Incoming Reports, an EMIS practice must have: * EMIS LV 5.2 * NHSnet connectivity * Router access for EMIS * A DTS address To use Incoming Reports, a secondary care provider must have: * A DTS address. * The DTS addresses and EDIâ‚ ¬Ã‚   codes for all required practices this information is available from the health authority or from the national tracking database. * Software to create and send XML messages and receive acknowledgements 2.7.4 Online Test Ordering Requesting and processing pathology samples were traditionally paper-based systems, with their inherent problems of slowness and occasional loss of information. Pathology labs can now provide web-enabled IT systems to produce a far more efficient and streamlined service. The EMIS Online Test Ordering module, available for EMIS PCS and EMIS LV systems, enables GPs, via a secure NHSnet connection, to access the pathology lab and exchange information regarding requests, samples and results [11]. Online Test Ordering can be access from Consultation Mode or Medical Record, and then access the website of a compatible laboratory. The current patients demographic and GP details are transferred to the laboratory system when you request the required tests. After you have ordered the tests, the test information is transferred to your EMIS system and filed in the patients record. At this point, you can continue with other work or take the test sample(s). When you take a sample, you can print a bar-coded label to attach to the sample, ready to send to the lab. Use the Online Test Ordering menu options to monitor the progress of the sample and view the results as soon as they are available, although you will still receive the results through the Clinical EDI or Pathology Links modules, as before [11]. Requirements Each EMIS practice must have: * EMIS LV 5.2 or EMIS PCS * NHSnet connectivity * Router access for EMIS * Version 2 clinical terms (5-byte Read codes) Support issues The overall Online Test Ordering process relies on different services and software all working in conjunction with each other: the EMIS software, the laboratory website and the NHSnet network. Unless a problem occurs with the EMIS software, EMIS is improbable to be able to resolve issues with the two areas; therefore, the secondary care trust and/or the practice should ensure that support facilities are in place for these eventualities. 2.8 Storage area network (SAN) Using the highest industry standard storage area network (SAN) configuration EMIS data centres are run [11], on which EMIS stores data [Detail explanation in later chapter]. Chapter Summary The chapter 2 explains EMIS system and its features. Features of EMIS explained in this chapter with examples, their functionality and requirements. Chapter 3 Drawbacks of Online systems Although online application provides many services the challenges associated with are given below. All the drawbacks are explained taking EMIS as an example. 3.1 Patient Record  ¨ Time required to put all relevant information onto system  ¨ Possible security issues  ¨ Doctor can focus too much on patient information onscreen which could intimidate the patient  ¨ Scanning and entry of data is more time consuming. Important information lost can when overlooking the record.  ¨ Medical record print-outs are frequently of poor quality and difficult to understand necessary information  ¨ In spite of using EPR, Paper records need to be kept back or scanned material become unmanageable.  ¨ Often using computer and paper records together will make patient data look very difficult.  ¨ Currently between GPs there is no electronic transfer as it is due to having a risk of data lost and duplication of data[16] 3.2 Appointments  ¨ Patients have to be checked into appointment system by receptionist  ¨ Problematic if patients cant read, or unable to view sign (e.g. blind people) 3.3 Prescriptions  ¨ Relies on drug information being up to date  ¨ Aptitude of doctor in using computer effectively  ¨ Some times doctors issue hand written prescription; they may not be available on computer. The acute and repeat prescribing registers can make it more confused. Printouts of Pharmacy still required [16]. 3.4 Email  ¨ Relies on doctor checking their mail daily  ¨ Troublesome patients abusing the system  ¨ Hospital letters not emailed (would be preferred) 3.5 Security issues  ¨ Doctors have to go to bother of signing on and off EMIS  ¨ Forgetting passwords  ¨ Passwords can be troublesome, staff or anyone can abused or swapped it, if they are lost the system can be absolutely in-operable  ¨ Leaving computer on  ¨ Locum doctors  ¨ Experts are need to show computer frauds and misuse [16] 3.6 Internet connection  ¨ Continuous internet connection required  ¨ The problem with online application is we cannot access from remote areas, compulsory web connection should be there and we cannot get alerts [4, 5]. 3.7 Backup  ¨ System backed up every night onto tape  ¨ Two copies:- Fireproof safe Remote location 3.8 Read codes Maintenance of enormous clinical expressions or codes is very complex, and the Read Codes present many challenges. In addition, structure of controlled terminologies has been learned about the principle because of the structure of the earlier versions. Version 3, the existing read code systems have been design keeping in mind the previous, simple versions, and to achieve forward compatibility [17]. The problems associated in steps in read coding the medical problems are explain below in s step 1 and step2 The Read Codes are used for many purposes such as clinical audit, searches, source allocation, and for the making of central government statistical returns. Problems arise from different uses and from the different views of Healthcare professional. [17]. Statistical classifications like ICD and OPCS4 may cause inconvenience so they are cross map. Version 2 with its diagonal section closely mirrors ICD9, even though this doesnt always reflect a clinicians view, and correct hierarchy placement of a concept according to ICD9 rules may appear anomalous to a clinician. Besides this Version 2 initial aim is for a code, with its preferred term and it offers a single cross-map to these classifications, and its and all its synonyms, to map correctly to ICD9 [17]. Version 3 came with its directed acyclic graph structure, greater synonym purity, and much easy cross-mapping design, incorporating default maps and alternative maps, avoids the previous version limitations. However this came with other possible problems. Therefore, the two processes, authoring and mapping are closely incorporated [17]. Read/SNOMED Codes Read/SNOMED codes are used by the doctors at hospitals because medical records in future can be transferred through GP2GP links. â€Å"Unlike the principal of Linnaean classification of species in the 19th Century, James Read brings in an international categorization of medical activity to contain disease names, operations and procedures. The main aim of this classification was to allow easy transfer of data between GPs, hospital and PCTs and easy to use by clinical staff, administrators and planners† [24]. Read codes has been explained more clearly in chapter 4. 3.9 GP2GP Record transfer The experience of the GP2GP record transfer and the clinical involvement are explained this section. 3.9.1 The underlying principle for electronic GP-GP record transfer The vast majority of UK GPs (greater than 96 percent) are computerised in some way or other. A sizeable proportion of these practices use their computer systems for recording patient record information in whole or in part [33]. This results from a variety of causes whose main headings are: * Patient records that are an unpredictable mix between paper and electronic. * The net effect of the above is to place difficulties on new practices in identifying salient information in transferred records and in incorporating that information within the new record. This is to known to have significant (but un-quantified) resource implications for practices. There is also widespread anecdotal evidence of resulting adverse effects on patient care. The rationale for the electronic transfer of records is therefore: * As a support for electronic records in general practice and their general benefits in terms of decision support and audit/governance abilities. * To obviate the need, as far as possible, for re-keying of paper-based information for new patients and thus reduce resource implications * To reduce the risks to patients arising from the transfer of confusing records. 3.9.2 The nature of electronic GP-GP record transfer Electronic patient record systems in general practice in England are provided by the commercial sector. At the time of writing this annex to the Good Practice Guidelines, eleven different commercial suppliers are known to be involved in this provision. In simple terms is that it is a common convention for the representation of [33]: * Record encounters; what constitutes a single transaction with the record like a doctors consultation, a letter received from hospital or outside, an examination result etc * Names for these encounters; e.g. home visit, * Headings within these encounters * Complex clinical constructs * Read code mappings; such medication codes sets * Codes and associated text * Major modifiers of clinical meaning 3.9.3 The Problems of electronic GP-GP record transfer There are four particular aspects of current GP-GP records where the transfer process of that record information needs to be supported by additional rules or processes if fully safe and usable records are to be reconstituted on receiving systems and are explain below [33]. Medication information There are currently three different coding schemes for the representation of medication information on GP systems. The principal reasons for failure to reach 100% reliability are: * The multiple coding schemes used and * Failure of previous code mapping exercises (see chapter 5 on data transfer). 3.10 The Problem Oriented Medical Record (PMOR) Electronic health records (EHR) are more used in UK General Practice despite continuing improbability about its legality and admissibility. The transfer of electronic record is currently in demand by the practices when the patient moves i.e. GP2GP transfer. The EHR implementations differ from a simple sequential list of medical concepts in an out of date coding system to sophisticated Problem Oriented Medical Records (POMR) [31]. 3.10.1 Limitations of the PO Medical Record The limitations of POMR are explain below [31] * It is very easy to pick up but very difficult to maintain. * In the strict way of the word not all headings are problems. For example, the heading of Immunisation is used usually to indicate where all the entries related to a immunization history may be found. * Many different problems may be discussed within a single consultation * To check scanned documents is very difficult especially when patient record is too big * Problems are frequently linked in a fundamental way. * The PO Medical Record only gives a basic measure of the state of a problem. * Different clinicians, view the clinical record, required different information from the medical record as well as with different views. * Some of problems are complex and they are difficult to read. Those records which have few entries are conversely are easy to read, hence POMR is meant to avoid comes to the fore again. Though POMR have above limitation but it is a popular medium for data entry and viewing, there is indeed room for enhancement and progress [31]. 3.11 Other Disadvantages * Typing skills required for doctors and other clinicians. They are using ever more abbreviations and acronyms. * Many screen need to be changes to find results and mouse activity * Information can be hidden as only the informati Patient Healthcare Using SMS Technology Application Patient Healthcare Using SMS Technology Application Chapter 1 Introduction to Patient Care Using SMS Application Patients travel longer distances for the opinion of consultant which is not possible either due to patient situation or due to distances. Enhancement of health care in different locations and other remote areas can be achieved using mobile phone applications [1]. 1.1 Problem Statement Development of mobile communication networks playing an important part in the enhancement of a mobile medicine. Patient Care Using SMS Application represents a feasible solution of patient care such as text messaging and booking appointments using mobile phones, which are best aspects of mobile medicine. The main idea is improve patient access to healthcare; encouraging patients to use mobile health application and supporting people with long term conditions [5]. 1.2 Objectives Incredible growth of mobile communication and recognition of new generation Wireless protocols has initiated the advance SMS based medical applications. Following that facts Patient care using SMS based application for mobile application for patient is good solution [5 6]. * To design and develop a WAP enabled wireless applications that will enhance the feature of mobile device by incorporating the features of a digital diary. The application should be able to get integrated with the existing application vis-à  -vis Exchange Server etc * Main aim of this application is to achieve â€Å"greater quality communication between GPs and consultants using mobile medicine, which will results in enhancement of patients care â€Å"[5 6]. 1.3 Scope The goal of Patient Care Using SMS Application is based on two major conditions. First, is to achieve proficient means to exchange message between General Practitioners and consultants care have to be provided. The second is sufficient exchange of patients information have to be provided. Additionally, privacy of communication and stored information has to be guaranteed. Both ethical and technical aspects are equally important [7]. 1.4 Existing Systems The existing system of treatment consists of two different systems. They are as follows: * Traditional or manual system * Online application 1.4.1 Traditional or Manual system The present system of treatment consists of manually consulting a doctor by taking prior appointment or else registering at that instant of time, waiting to get register themselves and then consulting the doctor which is a time consuming process. 1.4.1.1 Drawbacks * Time consuming * Patient need to stand in long queues to make appointments * Patients not follow prescription directions once they leave the surgery or hospital. Research has showed that more than 50 percent of patients not follow the management advised by their doctors may be due to lack of time and interest. 1.4.2 Online System Online application is also available where the user is provided a login and password through which he can access the website, make appointments, clarify their queries etc. The problem with online application is we cannot access from remote areas, compulsory web connection should be there and we cannot get alerts [4, 5]. The online systems are discussed below are: * EMIS * VISION System 1.4.2.1 EMIS System EMIS ® stands for Egton Medical Information Systems Limited. EMIS provides a service that enables you access to your healthcare online [9]. After registering with the surgery, patients are able to book or cancel their appointments with the doctor. Patient can also request repeat prescription, send messages to their practice and update personal information if practice has set up these features online [10]. This example has been explained in detailed in chapter 2. 1.5.2 Example 2: Vision System Vision [14] is the most famous system in use UK, within the GPs sector today, due to its market leading features, functionalities and first class support from INPS. There are currently more than 1,800 GP practices which are using Vision system across the UK each day. â€Å"Vision system version 3 is fully RFA 99 acquiescent, includes, support for the encryptedEDIFACT pathology v1.1 message, MIQUEST and DTS. The Vision application is stable, proven and reliable. The strong product-base has allowed other features such as advanced-scanning, PDAs support and incorporated voice dictations as well as extension to core functionality such as XML based clinical-messaging, allowing integrations with third party systems† [14]. In this project we are more concentrating on EMIS rather than Vision system. Key Features Messaging Incorporated External system Appointments Consultation Manager Problem Orientated Views Community Caseload Search and Reporting 7. Clinical Audit Vision and the National Applications [14] Few of the above features are explain below [14]: 1. Messaging This system offers unparallel flexibility with the wider health community via its highly supple and adaptable in-built messaging and web-services. These allow patients data from number of external sources including the NHS Spine or local CPRs to be easily accessed and used within Vision, supporting the requirements of the NHS IT-strategy. Vision also manages a range of clinical messages from third party systems to support the patient care as follows: * Choose and Book Referrals (electronic booking) * E- Discharge Summaries * Radiology reports and Encrypted pathology reports * OOH Summaries With a powerful XML event and messaging engine, Vision is designed to ensure the performance of new messages require no changes to the core Vision product. In a single, clear and simple interface, all message types are managed. 2. Incorporated External System In the Vision tabbed views, external web enabled application can now be well-established, allow access patient information from number of sources to be seamlessly from the Vision desktop. The patient is automatically recognised in the target system, when the required data is passed to the third-party application. For integration into the patient record when required, important data may also be written back to Vision 3. Patients Appointments This Vision system allows user full access to the appointment screen. â€Å"Using session templates developed by the practice† the appointment books are defined in advance. The view of appointment book can be defined by user: all significant doctors and other Healthcare professionals can be added or deleted as requirements. To denote, each slots can be assigned in different colours. As the patients arrives at reception, enters the doctors room or leave the surgery, their status is recorded. Our evaluations are based on EMIS system, its features and limitation which have been explained in later chapters. 1.5 Thesis Organisation In chapter 1 we have explained Patient care using SMS application and its aim, objectives and scope. The existing systems such as manual and online systems are briefly explained in this chapter along with it features and disadvantages. The chapter 2 explains EMIS system and its features. Features of EMIS explained in this chapter with examples, their functionality and requirements. This chapter 3 gives brief overview of problems associated with online medical systems with examples. Problems of online medical system such as internet connection, email, prescription, Electronic Patient records and read codes are explained. In the chapter 4 we have focussed on Patient Records and how they are managed at General Practices and hospitals. The traditional paper based practices and its limitations have been explained with examples. The paper less practices and its pros have been explained and the reasons why practice should follow this have explained with examples. The advantages and disadvantages of Electronic patient records with s and examples are discussed in this chapter. The chapter 5 focuses on Read codes and its structures. In this chapter 3 versions of read codes are explain with examples. Maintenance of read codes i.e. internal process and external interaction and hierarchy has been explained with s. The example case study represents the limitations associated with 3 versions, its results and solutions. The chapter 6 is about EMIS database, i.e. patient database and focuses on its usability and security. It explains structure of database and its solutions. Secure Patient data transfer within the PCT has been explained. Storage Area Network is used by EMIS to store patient records. How the GPs and other Healthcare Professional access patient records has been explained. Advance system and its features are discussed in this chapter 7. Waterfall Models activities have been explained. The structure of advance system with s is discussed in this chapter. The conceptual and technical design of this project has been briefly explained. UML language is used in this project to represent user and admin operations. The chapter 8 explains the SMS system requirements such as Specification requirements, Functional requirements, Performance requirements, and hardware and software requirements. About operating system and languages used in this projects are discussed in this chapter. Wireless application protocol architecture and WAP server are explained using diagrams. Database requirements and its uses are explained using diagrams. Open wave SDK and its functions are discussed in this chapter. Chapter 2 Egton Medical Information Systems EMIS ® and EMIS intellectual technology are trading names of â€Å"Egton Medical Information Systems Limited†. EMIS had begun 18 years ago in a rural area dispensing practice in Egton near Whitby in North Yorkshire [11]. EMIS ® head-offices are based in Leeds, including Development and Support departments. Training for general practices is localised and headed by Provincial Operations Directors [11]. 2.1 Practice Care System Enterprise Due to the growing number of EPRs held in both GP and Secondary Care, the requirement for a whole EHR has never been greater. The EMISs Primary Care System Enterprise edition for PCTs has been designed to meet all the challenges. EMIS PCS will maintain the patient information at many levels and ease safe access 24/7 by the wider health care-community [11]. PCS Enterprise for PCTs has been designed with capability of future technological and keeping development in mind, such as sharing data between General Practices. This includes GP to GP records transfer and inter-operability between in- and OOH PCSs. Using a HL7 Version 3 the patient data is transferred between dedicated health care systems directly [11]. 2.2 An overview of PCS Enterprise This edition has been designed to develop EMIS provision of an absolute system solution for primary care. The system is scalable, multi-practice, and multi disciplinary with shared EPRs and seamless data exchange. This system is based on three-tier architecture, while utilising MS Dot Net technologies, this system has the flexibility to increase numerous clients with its ability to scale to thousands of instantaneous user connections [11]. EMIS Primary Care System Enterprise edition is designed to meet GP needs as closely as possible, while supporting specialties related to medicine. See in 2.1 below gives the overview of PCS Enterprise system: 2.3 EMIS Primary Care System Practice edition Health information system plays an important role in how practice operates. The good and right clinical system can help to save practice valuable time, assist in practice management and ultimately lead to improved patient care. The EMIS PCS Practice edition has been designed to meet GP needs, combining functionality with simplicity of use [11]. Key features of EMIS PCS * Complete patient record management * Quick and good prescribing * Formulary managements * Incorporated consultation mode * Incorporated appointments * Mentor Library * Integrated with MS Word support * User defined templates * Drug Explorer 2.4 EMIS LV Version 5.2 In the PCS market, EMIS Live Version [11] is the main text based medical system. Approximately 5000 GPs currently using EMIS LV system (which is shown below) in the UK. The system offers GPs consultation mode option, medical record, search and reports option, prescription and booking appointments. 2.5 Population Manager This system enables General Practices to effortlessly meet the requirement of the new GMS Contract. Population Manager [11] has a set of more than 160 searches that extract the data require for the new Contracts and present it in an understandable format. It also contains a set of specially designed templates to help speedy and standardised information entry. Population manager is an incorporated part of EMIS LV system. 2.6 Version 5.2 features This is the most recent release of EMIS LV. This LV offers users the following key features [11]: 2.6.1 MS Word incorporation Patient data is easily transferred between EMIS system and MS Word enabling the clinician or staff to create patient related letters in MS Word easily. To create consultation references for simple retrieval, documents are created in MS Word which is saved back into EMIS. 2.6.2 Referral template for Cancer patients If cancer is suspected GPs requires produce and fax or e-mail suspected cancer referrals within 24 hours of seeing the patient (this is according to the NHS Plan). These patients have to be seen by the Hospital Trust within 2 weeks; hence these referrals are named as â€Å"two week rule referrals†. EMIS has included a suite of MS Word templates for each cancer type into EMIS LV5.2. 2.6.3 Electronic Insurance reports One of the most common and time taking medical information requests for GPs is the PMA form for the claim companies. A familiar format for General Practitioner Report has been decided and computer-based reports (eGPR) are accepted by insurers. The electronic GPR can be generating within the EMIS system, integrating all related patient information. The eGPR template is installed by default in this system. 2.6.4 Scanning and attachments This module enables to scan corresponding or images and attaches them directly to a patients record in consultation mode. These documents are instantly available during consultation. 2.7 EMIS Clinical Communication Modules The following Clinical Communication Modules are available with EMIS LV5.2, providing links with Secondary Care [11]. 1 Online Referrals with Booked Admissions 2 Electronic Referrals 3 Incoming Reports including Electronic Discharges 4 Online Results Ordering With an approved list of suppliers this Clinical Communication Modules work. Using the common set of messaging standards currently being developed by the National Design Authority, links to other suppliers will become available, an arm of the National Programme for IT in the NHS. For this reason that EMIS are not progressing, with the further testing of links with other suppliers using proprietary messaging standards. The Clinical Communication Modules are explained below [11]: 2.7.1 Online Referrals and booked admissions Traditionally referring patients from doctors at general practices to hospital or Secondary Care consultants has been a paper based with its problems of delays (slowness) and occasional loss. The EMIS Online Referrals with Booked Admissions module enable us to create a referral on a Secondary Care website using protocols created by Secondary Care consultants, adding patient demographics and clinical information and in some cases booking an appointment. Requirements: Each EMIS practice must have: * EMIS LV 5.2 * NHS Net connectivity * Router access for EMIS * Version 2 clinical terms (5 byte Read Codes) The Secondary Care Provider will need: * An EMIS approved website 2.7.2 Electronic Referrals This module enables us to create a referral letter within EMIS LV and transmit it electronically to a secondary care consultant [11]. The way electronic referrals work You can use MS-Word Integration in EMIS LV to create a referral letter. When you save the referral letter, you are prompted to link with EDI for an electronic transmission: answer ‘Yes and the referral letter is placed in the Communications outbox (CO, OD). From here, you can check the letter before authorising the transmission. When you have authorised the transmission, you can either send the referral letter immediately or wait until the next scheduled transmission. Upon receiving the referral letter, the secondary care software system will transmit an acknowledgement that you can view within the EMIS Communications screen. Requirements Each EMIS practice must have: * EMIS LV 5.2 * NHSnet connectivity * Router access for EMIS Support * SMTP or DTS mailbox * MS-Word Integration The secondary care provider will need: * SMTP or DTS mailbox * Suitable software capable of sending and receiving XML messages and acknowledgements * SMTP/DTS and EDI code addresses of the practices involved the trust should obtain these from the health authority or national tracking database 2.7.3 Incoming Reports including electronic discharges Use this information sheet to give you an overview of the Incoming Reports module and the requirements to get you started. The communication of patient information from out of hours services and secondary care used to be paper system, which has been unmanageable and untrustworthy with discharge notes being illegible, incomplete and often late in delivery. The paper-based system replaced by Incoming Reports module which receives electronic discharge notes or other patient related reports from an OOH service or a secondary care provider [11]. How does the Incoming Reports module work? Incoming Reports is a one-way process whereby the out of hours service or secondary care provider sends a message containing the incoming report to EMIS LV. However, EMIS LV will send an acknowledgement of receipt back to the provider. When EMIS LV receives a report, it is matched to the correct patient and placed on a list ready for viewing, and then filing. If EMIS LV cannot match a report to a patient automatically, you can match a patient manually. When viewing a report, you can match the clinical information in the report to clinical terms before you file it. You can link a report to a past consultation (for example, the consultation during which the original referral was made) or create a new consultation specifically for the report. You can view filed incoming reports using the *RL function in Consultation Mode. Requirements To use Incoming Reports, an EMIS practice must have: * EMIS LV 5.2 * NHSnet connectivity * Router access for EMIS * A DTS address To use Incoming Reports, a secondary care provider must have: * A DTS address. * The DTS addresses and EDIâ‚ ¬Ã‚   codes for all required practices this information is available from the health authority or from the national tracking database. * Software to create and send XML messages and receive acknowledgements 2.7.4 Online Test Ordering Requesting and processing pathology samples were traditionally paper-based systems, with their inherent problems of slowness and occasional loss of information. Pathology labs can now provide web-enabled IT systems to produce a far more efficient and streamlined service. The EMIS Online Test Ordering module, available for EMIS PCS and EMIS LV systems, enables GPs, via a secure NHSnet connection, to access the pathology lab and exchange information regarding requests, samples and results [11]. Online Test Ordering can be access from Consultation Mode or Medical Record, and then access the website of a compatible laboratory. The current patients demographic and GP details are transferred to the laboratory system when you request the required tests. After you have ordered the tests, the test information is transferred to your EMIS system and filed in the patients record. At this point, you can continue with other work or take the test sample(s). When you take a sample, you can print a bar-coded label to attach to the sample, ready to send to the lab. Use the Online Test Ordering menu options to monitor the progress of the sample and view the results as soon as they are available, although you will still receive the results through the Clinical EDI or Pathology Links modules, as before [11]. Requirements Each EMIS practice must have: * EMIS LV 5.2 or EMIS PCS * NHSnet connectivity * Router access for EMIS * Version 2 clinical terms (5-byte Read codes) Support issues The overall Online Test Ordering process relies on different services and software all working in conjunction with each other: the EMIS software, the laboratory website and the NHSnet network. Unless a problem occurs with the EMIS software, EMIS is improbable to be able to resolve issues with the two areas; therefore, the secondary care trust and/or the practice should ensure that support facilities are in place for these eventualities. 2.8 Storage area network (SAN) Using the highest industry standard storage area network (SAN) configuration EMIS data centres are run [11], on which EMIS stores data [Detail explanation in later chapter]. Chapter Summary The chapter 2 explains EMIS system and its features. Features of EMIS explained in this chapter with examples, their functionality and requirements. Chapter 3 Drawbacks of Online systems Although online application provides many services the challenges associated with are given below. All the drawbacks are explained taking EMIS as an example. 3.1 Patient Record  ¨ Time required to put all relevant information onto system  ¨ Possible security issues  ¨ Doctor can focus too much on patient information onscreen which could intimidate the patient  ¨ Scanning and entry of data is more time consuming. Important information lost can when overlooking the record.  ¨ Medical record print-outs are frequently of poor quality and difficult to understand necessary information  ¨ In spite of using EPR, Paper records need to be kept back or scanned material become unmanageable.  ¨ Often using computer and paper records together will make patient data look very difficult.  ¨ Currently between GPs there is no electronic transfer as it is due to having a risk of data lost and duplication of data[16] 3.2 Appointments  ¨ Patients have to be checked into appointment system by receptionist  ¨ Problematic if patients cant read, or unable to view sign (e.g. blind people) 3.3 Prescriptions  ¨ Relies on drug information being up to date  ¨ Aptitude of doctor in using computer effectively  ¨ Some times doctors issue hand written prescription; they may not be available on computer. The acute and repeat prescribing registers can make it more confused. Printouts of Pharmacy still required [16]. 3.4 Email  ¨ Relies on doctor checking their mail daily  ¨ Troublesome patients abusing the system  ¨ Hospital letters not emailed (would be preferred) 3.5 Security issues  ¨ Doctors have to go to bother of signing on and off EMIS  ¨ Forgetting passwords  ¨ Passwords can be troublesome, staff or anyone can abused or swapped it, if they are lost the system can be absolutely in-operable  ¨ Leaving computer on  ¨ Locum doctors  ¨ Experts are need to show computer frauds and misuse [16] 3.6 Internet connection  ¨ Continuous internet connection required  ¨ The problem with online application is we cannot access from remote areas, compulsory web connection should be there and we cannot get alerts [4, 5]. 3.7 Backup  ¨ System backed up every night onto tape  ¨ Two copies:- Fireproof safe Remote location 3.8 Read codes Maintenance of enormous clinical expressions or codes is very complex, and the Read Codes present many challenges. In addition, structure of controlled terminologies has been learned about the principle because of the structure of the earlier versions. Version 3, the existing read code systems have been design keeping in mind the previous, simple versions, and to achieve forward compatibility [17]. The problems associated in steps in read coding the medical problems are explain below in s step 1 and step2 The Read Codes are used for many purposes such as clinical audit, searches, source allocation, and for the making of central government statistical returns. Problems arise from different uses and from the different views of Healthcare professional. [17]. Statistical classifications like ICD and OPCS4 may cause inconvenience so they are cross map. Version 2 with its diagonal section closely mirrors ICD9, even though this doesnt always reflect a clinicians view, and correct hierarchy placement of a concept according to ICD9 rules may appear anomalous to a clinician. Besides this Version 2 initial aim is for a code, with its preferred term and it offers a single cross-map to these classifications, and its and all its synonyms, to map correctly to ICD9 [17]. Version 3 came with its directed acyclic graph structure, greater synonym purity, and much easy cross-mapping design, incorporating default maps and alternative maps, avoids the previous version limitations. However this came with other possible problems. Therefore, the two processes, authoring and mapping are closely incorporated [17]. Read/SNOMED Codes Read/SNOMED codes are used by the doctors at hospitals because medical records in future can be transferred through GP2GP links. â€Å"Unlike the principal of Linnaean classification of species in the 19th Century, James Read brings in an international categorization of medical activity to contain disease names, operations and procedures. The main aim of this classification was to allow easy transfer of data between GPs, hospital and PCTs and easy to use by clinical staff, administrators and planners† [24]. Read codes has been explained more clearly in chapter 4. 3.9 GP2GP Record transfer The experience of the GP2GP record transfer and the clinical involvement are explained this section. 3.9.1 The underlying principle for electronic GP-GP record transfer The vast majority of UK GPs (greater than 96 percent) are computerised in some way or other. A sizeable proportion of these practices use their computer systems for recording patient record information in whole or in part [33]. This results from a variety of causes whose main headings are: * Patient records that are an unpredictable mix between paper and electronic. * The net effect of the above is to place difficulties on new practices in identifying salient information in transferred records and in incorporating that information within the new record. This is to known to have significant (but un-quantified) resource implications for practices. There is also widespread anecdotal evidence of resulting adverse effects on patient care. The rationale for the electronic transfer of records is therefore: * As a support for electronic records in general practice and their general benefits in terms of decision support and audit/governance abilities. * To obviate the need, as far as possible, for re-keying of paper-based information for new patients and thus reduce resource implications * To reduce the risks to patients arising from the transfer of confusing records. 3.9.2 The nature of electronic GP-GP record transfer Electronic patient record systems in general practice in England are provided by the commercial sector. At the time of writing this annex to the Good Practice Guidelines, eleven different commercial suppliers are known to be involved in this provision. In simple terms is that it is a common convention for the representation of [33]: * Record encounters; what constitutes a single transaction with the record like a doctors consultation, a letter received from hospital or outside, an examination result etc * Names for these encounters; e.g. home visit, * Headings within these encounters * Complex clinical constructs * Read code mappings; such medication codes sets * Codes and associated text * Major modifiers of clinical meaning 3.9.3 The Problems of electronic GP-GP record transfer There are four particular aspects of current GP-GP records where the transfer process of that record information needs to be supported by additional rules or processes if fully safe and usable records are to be reconstituted on receiving systems and are explain below [33]. Medication information There are currently three different coding schemes for the representation of medication information on GP systems. The principal reasons for failure to reach 100% reliability are: * The multiple coding schemes used and * Failure of previous code mapping exercises (see chapter 5 on data transfer). 3.10 The Problem Oriented Medical Record (PMOR) Electronic health records (EHR) are more used in UK General Practice despite continuing improbability about its legality and admissibility. The transfer of electronic record is currently in demand by the practices when the patient moves i.e. GP2GP transfer. The EHR implementations differ from a simple sequential list of medical concepts in an out of date coding system to sophisticated Problem Oriented Medical Records (POMR) [31]. 3.10.1 Limitations of the PO Medical Record The limitations of POMR are explain below [31] * It is very easy to pick up but very difficult to maintain. * In the strict way of the word not all headings are problems. For example, the heading of Immunisation is used usually to indicate where all the entries related to a immunization history may be found. * Many different problems may be discussed within a single consultation * To check scanned documents is very difficult especially when patient record is too big * Problems are frequently linked in a fundamental way. * The PO Medical Record only gives a basic measure of the state of a problem. * Different clinicians, view the clinical record, required different information from the medical record as well as with different views. * Some of problems are complex and they are difficult to read. Those records which have few entries are conversely are easy to read, hence POMR is meant to avoid comes to the fore again. Though POMR have above limitation but it is a popular medium for data entry and viewing, there is indeed room for enhancement and progress [31]. 3.11 Other Disadvantages * Typing skills required for doctors and other clinicians. They are using ever more abbreviations and acronyms. * Many screen need to be changes to find results and mouse activity * Information can be hidden as only the informati