How Artists Represent the World Essay

Abstract artists have been greatly criticized and underestimated for their lack of culture and sophistication produced in their artwork. Interpreting, reading and deriving meaningful, useful information from abstract art requires the highest level of creative skills, and the most developed and trained imaginations. Learning how to perceive messages from art takes just as many years of conscious effort as the traditional forms of education. As a result, art perception is not a significant part of formal education, dismissing art’s literacy’s importance as requiring a special â€Å"gift. † The Beginning, painted by Barnett Newman, appears to be very simple, basic, nothing more than colorful lines pasted against a blue background. â€Å"His (Newman’s) paintings can seem to be barely doing anything at all, and yet, given time and attention, they reveal depths and subtleties of immense power. â€Å"(Denny, 2002) The Beginning clarifies the underlying patterns and natural order of life sciences, shows the invisible connections from the sky to the ocean, and forever creates new life’s beginnings. The Beginnings is an image of a crystal ball used as a window for scrying into the ocean, and eventually seeing a mirroring effect of reality. All artwork, including abstract and surrealism, created only from imagination is a window to look into reality. â€Å"Alberti, in his De pittura (1435), harnessed the technique of perspective to the theory that painting is an imitation of reality. He viewed the picture plane as a window through which one looks at the visible world. † (â€Å"Perspective,† 2007) Realism art is a mirror image reflecting tangible existing objects. Realism art is definite, showing what the artist actually sees as he or she is making up the painting. Abstract art is a lot more complexed, but is still realistic. One of abstract art’s significant contributions is clarifying the underlying patterns, and the natural order of universal life, forcing deeper parts of the imagination that normally go unused to be activated. Using imagination to interpret art helps us to understand the facts that are hidden from us. Abstract paintings are nothing more than a mixture of colors. â€Å"Whitehead systematically elaborates in his imposing Process and Reality (1929), going so far as to suggest that process, rather than substance, should be taken as the fundamental metaphysical constituent of the world. † (Irvine, 2003) Barnett Newman’s abstract, The Beginning, background color is apparently early morning sky blue or a blue sea. Metaphysically, the sea and the daybreak sky symbolizes new beginnings. The sky represents a new day, everything pertaining to the sea or water symbolizes a new life, translating into life as having constant new beginnings, reflecting a reality we can never touch. Reality is constantly moving and changing. The sky and the sea also symbolizes movement. Using the alleged symbology of the colors and the name of the art as windows, we understand Newman’s interpretation of realism, or actual visual images of the reality of life occurring in nature. The structure or underlying pattern of the atmosphere’s progressions can be viewed in The Beginning. â€Å"Chaos theory reveals an underlying pattern and order that is hidden in natural phenomena that before were considered to be merely random. † Peirce, 1996 Assuming the light blue dominating most of the abstract represents the sky or the sea, and the alleged symbols represent the beginning of a new eternity, Newman is implying that this is the hidden underlying basis of what everyone thought had no beginning, such as lightning falling from the sky. Looking at the painting right side up, lightning bolts are coming from the sky in unusual colors. To the center left at the very bottom is a splash of darker blue upon impact of the lightning bolts hitting the sea. The lightning bolts are in red, yellow and white offset colors. Between the red and white lightning bolts, a blue lighting bolt is coming down, but does not have enough power or force to complete the journey. The lightning bolt blending in with the background spatial point stops before reaching its destination. â€Å"It would be a mistake to think of a spatial point as being anything more than an abstraction; instead, real positions involve the entire series of extended volumes. † (Irvine, 2003) The lightning bolt unable to reach its destination can also be the beginning of a pattern of sequential events. The white lightning bolt is the most powerful or forceful object in the painting. A light red line runs down the center of the white lightning bolt, making the loudest splash into the sea. Then the pattern starts over. To the left is the weakest lightning bolt. Angling from the upper left corner is a vivid red appearing to ending up in front of the splash where the white bolt hit. To the far right is the yellow lightning bolt, perhaps starting its own pattern of sequential events of connecting life between the sea and skies. â€Å"Studying the process of art can provoke the beast and initiate the journey within. † (Lodato-Suppa, 1996) Barnett Newman was famous for painting colorful bands calling them zips on sky blue canvases. It appears like there was nothing to it. (Ned Denny). Visualizing art is the same thing as listening to or composing music. The impact of art speaking directly to the subconscious is so powerful the mind is completely overtaken by its presence. Music and painting selections incorporated into everyday life should be taken with great caution because of it’s powerful effect on the mind. Interpreting art is a tool guiding us individually on life’s journey. References Hall, D. , Mills. , H (1996) The Society for the Advancement of Creative Scientific Thinking Society Charter Retrieved March 15, 2008 http://ibiblio. org/scst/charter. html Irvine A. D. (2003) Alfred North Whitehead Stanford Encyclopedia of Philosophy Retrieved Retrieved March 15, 2008 Newman, Barnett. (2007). In The Columbia Encyclopedia (6th ed. ). New York: Columbia University Press. Retrieved March 15, 2008, from Questia database: http://www. questia. com/PM. qst? a=o&d=112876047 Contemporary Art. (2007). In The Columbia Encyclopedia (6th ed. ). New York: Columbia University Press. Retrieved March 15, 2008, from Questia database: http://www. questia. com/PM. qst? a=o&d=112853364 Perspective. (2007). In The Columbia Encyclopedia (6th ed. ). New York: Columbia University Press. Retrieved March 15, 2008, from Questia database: http://www. questia. com/PM. qst? a=o&d=112879220 Denny, N. (2002, October 7). Nothing to It: Ned Denny Discovers Great Depths and Subtleties in Emptiness. New Statesman, 131, 40+. Retrieved March 15, 2008, from Questia database: http://www. questia. com/PM. qst? a=o&d=5000662917 Lodato-Suppa, P. (1996). Awakening Picasso Learner/teacher as Artist. Education, 117(1), 106+. Retrieved March 15, 2008, from Questia database: http://www. questia. com/PM. qst? a=o&d=5000436049

Problem and its Background Essay

Man’s progress is measured through the advancement of Science and Technology in different fields especially in business arena. Through the years, many business establishments were built and organized to boost their business operation. Almost all types of business may it be small, medium or large scale are trying to take advantage of this technology. This means less paper works for office employees and even fewer employees for some organization seems to depend on its ability to utilize computer technology at its fullest. Presently, automation is one of the leading industry in the country today. Since technology changes rapidly and demands for machines are rising. There is a need for a basic understanding of computer technology , this understanding enables us to be comfortable in an increasing computer oriented environment by removing the fear with the unknown that many people have about the computer. One of the benefits of the system is it provides a prompt computation and accurate enough within a certain design space, especially for time-consuming manual process. New users often fret over the potential for lost data due to system malfunctions with a well designed and tested backup scheme and disaster recovery system, a computer-based record is much more reliable and less prone to data loss than conventional paper-based records. Record access can be restricted and monitored automatically. Provided that data are structured and coded in an unambiguous fashion, programs can continuously check and filter the data for errors, summarize and interpret data, and issue alerts and/or reminders. Once in electronic form a data can be linked to reference information stored and maintained locally or, via the internet. If the electronic record is integrated, then all data is immediately available to all practitioners regardless of their physical location as soon as the data is entered into the computer. The health care environment is currently undergoing a revolution. A rapidly growing cost of providing medical care are forcing hospital to merge at an increasing rate in order to consolidate the types of services offered. The cost of the new technology is also requiring a hospital to reevaluate their mission to the communities they serve. Originally no specialized users were contented with common tasks such as paper, ball pen, typewriter and file cabinet to perform their jobs. These people could satisfactorily accomplish their tasks without computer technology, but these situations have change dramatically. With the new technology, hospitals provide faster more accurate and more convenient services to their patients. Background of the study San Juan District Hospital is the only government hospital in this part of Batangas. It is a 25 bed capacity secondary government hospital that was established by virtue of Republic Act 3956. A Puericulture Center has been offered by concerned citizen of the town headed by Mrs. Marietta O. De Villa as the first hospital building. It is a two story building with a floor area of roughly 200 square meters which was . approved by the Department of Health. The National Aid Budget was first released under TW# 804-039288 dated June 11, 1975 and received on June 20, 1975 in the amount of P 105,645. 00. With this financial source, organization of the hospital was immediately approved of about 13 hospital items/positions. The hospital was opened to the public on July 1, 1975 for consultation services only, headed by Dr. Marciano Marcellana as Chief of Hospital. The catchment areas of this hospital are San Juan Rural Health Unit I & II, Rosario and Taysan. In the year 1982, the Trivino family donated one hectare of farm lot for the construction of new hospital building at Barangay Talahiban 2nd, San Juan, Batangas. The hospital then transferred to the new site year 1988. In April, 1993 with the implementation of Republic Act No. 7180, otherwise known as Local Government Code of 1991, San Juan District Hospital was devolved to the Provincial Government of Batangas under the immediate supervision of the Provincial Health Officer. In 1999 as part of the government’s computerization program the San Juan District Hospital received computers from the local government. The hospital had a payroll system on 2001. MISSION: Development of health conscious and healthy families and communities thru partnership with the people by the provision of the four ACES: availability, accessibility, affordability, acceptability and omnipotently guided health care services. VISION: A socialized medicine for the Batanguenos especially the underpriviledge. GENERAL OBJECTIVE: Further uplift the health of the people particularly Batangenyos through curative, promotive and preventive aspect of health care delivery. Conceptual Framework Feedback Fig 1. Conceptual Paradigm Examination of Conceptual Paradigm The system is â€Å"San Juan District Hospital Management System†. It is intended for the operations inside the hospital which caters Billing and Record Keeping of patients. The users include the administrator who has full access of the system. The cashier, one who receives the payment of the patients. The Billing Clerk computes for the bill of patients, Chief of Billing verifies and updates records in case invalid data was inputted and also verifies the eligibility for discount of the patients. The encoder, one who adds record concerning billing. The nurse gathers the information from the patient including the patient’s picture then it is turned over to the record officer for storage and safekeeping. The encoder is the one to add patient records. The record officer verifies and update the records of the patient. The nurse in each station could only view the information regarding the patient. In Patient’s Information the users gather the patient’s record such as the patients name, disposition, diagnosis and etc. On the other hand in Billing, the user entails the medical Transactions as well as the medical supplies consumed by the patient. All of the medical transactions as well as medical supplies consumed by the patient are submitted to the billing section. The adoptability of San Juan District Hospital Management System: Reliability-refers to the dependability and precautionary measures of the system. -The system provides accupate information on the billing of patients – The system provides useful information regarding the patient’s record – The system provides accuracy and consistency in the patient record – The system provides an accurate computerized print out of records – The system minimizes the work load of the users Security-refers to the accessibility of the users to the system. – The system provides log in and log out forms for an improved security – The system provides the ability of the admin to access all the functions of the system – The system provides user level like the administrator, record officer, cashier, etc. – The system provides restrictions appropriate for the type of user – The system provides system management the user account by using add, edit and delete functions. User Friendliness-refers to the simplicity and understandability of the system. – The system provides an easy to understand visual user interface – The system provides an interactive help system for easy usage – The system makes use of shortcut buttons for easy system navigation – The system makes use of proper colors and fonts suitable interface environment – The system provides a confirmation message for the confirmation of the action. Efficiency-refers to the competence of the system. – The system Provides a search engine for fast retrieval of informatio – The system Makes use of the add, edit, delete functions for easy information updates. – The system Speeds up the work of the users – The system Simplifies the record keeping and record handling of the hospital. – The system Speeds up the patient and hospital transactions The data gathered from the devices is then processed by the system. The devices include printer which is use to produce hard copy of receipts as well as reports. Since it is an integrated system it needs a LAN Card for networking. WebCam to input pictures of the patients. This leads to gathering of Timely reports for Billing. It also generates Patient’s Record by request. The system is insignificant if it has no benefit. The system Accelerates work in generating Bill Reports as we all know that waste of time effort in every business means a lost in their assets. It could easily keep track of information regarding the patients bills since it is presented timely and it also enhances the quality of work since the production of inaccurate reports would be lessened. It also lessens time and effort in looking for the patient’s record in a logbook and filling cabinet. The users could easily manipulate the system because it is presented in a user friendly environment. Statement of the Problem 1. What are the profile of the respondents? a) Position b) Computer Literacy 2. How do the respondents perceived the current way of retrieving information? a) Filling Cabinet b) Index Card 3. How do the respondents perceive the current way of generating bill reports? a) Manually generated receipts 4. How do the respondents perceived the idea of having â€Å"San Juan District Hospital Management System† based on the ff: a) Reliability b) Security c) User Friendliness d) Efficiency 5. How do the respondents perceive the applicability of San Juan District Hospital Management System? Scope and Limitation of the study The system consists of computerized billing and record keeping system. Only authorized persons is able to access these processes through the use of passwords. The nurse of each workstation has limitation in using a system due to the hierarchy of authority. Each of these has data storage, data entry and report generation. It is in LAN Based. Billing System consists of the invoices of the patient. It generates timely reports as well as printing of receipts. This incorporates the laboratory charges and medical supplies used. Provided that the medicines are bought inside the hospital. It also computes for the discounts such as PhilHealh, insurance and etc. This does not include monitoring of the profit earned by the hospital. It does not include payments with the use of credit cards. Record Keeping System encloses only the In-patient and out-patient’s personal information that would be needed for the diagnosis such as the name, ailment, gender,picture and etc. It also encompasses the laboratory results of the In-patient which is attached to nurse records through the availability of computer in the laboratory. Importance of the Study Giving latest innovation with the use of computer integration, the proponents have arrived in the best possible computer integration assets by the creative minds in achieving optimum success. The system provided a design model for the better, effective and efficient processing of the system. This system intends to help the San Juan District Hospital in the processing of the needed data and documents. This system can perform tasks of an individual in an accelerated manner so it could increase job performance. It reduces manual process and so it could minimize human errors. This system is made easily for the user, so they can easily adopt. It minimizes the paper works of the person in charge in monitoring. It enhances the quality of work, since the production of inaccurate reports would be lessened if not eliminated. The processing can change the way the user operates. In addition, the system solves time and labor, the processing can lead to benefits such as improve services and control flow. The system can improve the processing of the hospital. The data can be access easily and the reports could be made available anytime the clients need it. The importance of the system primary focuses to meet and satisfy the given objectives of the system. This system is undertaken by proponents in order to adopt in a more advance techniques that are currently use in some offices and institutions. The finding of the system should be able to be of great help to the billing section as well as to other departments to take a direction towards modern computerization. Therefore, a lot of effort and time would be saved. It is a great advantage for San Juan District Hospital for the reason that the client could avail a good service and marks for the reason to help more organize and punctual to their tasks so they could do their responsible well. Definition of Terms Administrative Department- responsible for the operation of the entire institution. Anesthesiologist- a doctor who supervises the use of drugs for the relief of pain during surgery. Charge Nurse – A registered or licensed practical or vocational nurse assigned to be in charge of a nursing unit. Custodial Care – Basic care provided on a 24 hour basis that meets an individual’s basic physical needs; simple assistance or total care may be needed. District or Community Hospital- serves larger population centers such as towns and large cities. Geriatric Hospital- hospital that accommodates the older population segment. Hospital – A health care facility that has a governing body, an organized medical and professional staff, and inpatient facilities and provides medical, nursing, and related services for injured patients. Inpatient – A person who has been admitted at least overnight to a hospital or other health facility. Intensive Care Unit- unit where an intensive monitoring and nursing is provided for seriously-ill patients. Laboratory- hospital unit where tests are conducted to help doctors in the diagnosis and treatment of illnesses. Level of Security Password Access-the persons who can only access one computer. Maternity Units- hospital unit that help protect mothers and infants from infection. Medical Units- units for patients who are required treatment by drugs. Medication-treatment of an illness using drugs. Medicine card-patient medication with corresponding time. Medical Prescription-covers the doctors medical prescription to his patient. Medical Records Department- keeps records on every patient. Networked-A state of being physically connecting 2 or more computers to create a communication and data exchange system. Nurse-somebody trained to look after sick and inured people,especially somebody who works in a hospital or clinic,administering the care and treatment that a doctor prescribes. Nurse note -a form a sheet which nurses ask to record their observation and report. Nursing staff- form the largest group on the patient care system. Outpatient – a patient who is receiving ambulatory care at a hospital or other facility without being admitted to the facility. Patient Record System-covers the processing of the information pertaining to the patient. This system stores all the details about her patient. Radiologist- directs a hospital X-ray and other imaging services. Surgical Unit- hospital unit for patients necessitating surgery. Ward- a room where a patient stays while receiving treatment. Acronyms CVD- Cardiovascular Disease CBC- Complete Blood Count DR- Delivery Room FBS- Fasting Blood Sugar ICD- International Code of Diseases ID- Once Daily LAN-Local Area Network MGH- May Go Home OPD- Out-Patient Department OR- Operating Room ORT- Oral Rehydration Therapy PC- Platelet Count QID- Four times a day RBC- Red Blood Cells RHU- Rural Health Unit RX- Prescription SE- Stool Exam UE- Urinalysis SWO-Social Welfare Office CHAPTER II Review of Related Literature and Study Local Study A study states that â€Å"It generates multiple reports for every department of Kolin Plant†. (Comia, 2005) The system concentrates and focused on the development of computer-based system. The system also includes generating of reports. In relation to this study, the researchers provide a computerized Monitoring System for J07 construction supply and services. The system includes the monitoring of the incoming ; outgoing raw materials ; updating of raw materials. The system also features the capability to print out file information like the available and consumed stocks. It monitors the total number of product that are sold ; unsold ,; update sales ; record of accurately . It also serves as a feature of assigning of prices to a particular item ; automatically detecting the required products for recording . It also has features of monitoring the daily sale of market. In relation to this study, the researchers developed a computerized Monitoring System for J07 construction supply ; services. The system includes the monitoring of the incoming and outgoing raw materials and updating of raw materials. A study (Edralin, 2003) states that small company as we can see majority of the business uses computers with also included the use of computerized system in order to achieve their goal and to lessen in the manual process in the business. As they believe using computer makes the business flow smooth and faster and we can’t regret for what they believe because as far as we know it has been proven for many times in many aspects of business. It provides the data needed for automation and computerization of its sales monitoring system. It also supplies the company a better system that benefits each and everyone on the company as a whole. According to Lee (2004) In this hospital Admitting and Centralized Billing System aims to develop a system that would monitor the room availability, speed up the processing of readmittance and would decentralized the exchange of patient’s record. Included in the system is a work area that provides a faster and easier method of adding, viewing, modifying and deleting of reports. This study focuses in admitting and billing system of patient. It has own data entry and report generations. Reports include the following. In-patient bills, in-patient information and last of patient. LAN setup is notr tackled in this study. According to Rogelio D. Rivera (2006) I usually design a system design requested when there is some dissatisfaction present in the system. In the system in this book Analysis of Data Management stated that â€Å"No system can be devised which is full proof against personnel which do not know or make property in developing a system, a process is set to meet the dissatisfaction of the present system, on the part of the beneficiaries such as the personnel and applicant, the new system should at least give them the ease of maintaining a fast and better procedure on handling records. A study (Augusto ,2003) wrote in this national press academic entitled â€Å"Reduce medical error requires Computerized Patient Information System† stated that to significally reduce the tens of thousands of deaths and injuries caused by medical errors every year, health care organizations must adopt information technology system that are capable of collecting and sharing essential health information on patients and their care, says a new report by the institute of medicine of the national academics. These systems should operate seamlessly. As part of the national network of health information that is accessible by all health care organization and that includes electronic records of patient’s care and secure platforms for the exchange of information among providers and patients and data standards that makes health information uniform and understandable to all. Foreign study A study (Monlb, 2002) states that the reality of today’s medical world is that cost effective, efficient management of receivables is a major challenge. Successful relationship with their client have Medical Data Systems an industry leader in revenue management Services. Specializing in secondary collection of hospital allow end professional fee billing, medical net-System has the solutions to today and tomorrows challenges. It has maintained an excellent reputation through out its 14 year history currently employing over 150 staff members at 6 locations throughout the Southeast and Southwest. We pride ourselves on or seminar-oriented, peer cooperative working relationship with a clients. The ultimate goal is to design a unique management services package to match the needs of our practice of facility. They work closely with you to assess your intimations, analyze and evaluate your specific requirements and faster solution to your need. Through over 14-year history of medical billing they have observed that professional fee-components billing is time-consuming laborious process that detracts the hospital billing staff that detracts the hospital billing staff from their more comprehensive compliance issues required for the much lower value professional claims is often not a cost effective undertaking for a medical facilitating they have developed an intermediate information system, which is utilized as a holding database between the hospital and their billing system, which screens information for discrepancies and incomplete data prior to exportation into their billing system. This yield information into their staff to concentrate on the aged receivables. The Resident Care System is a computerized medical record system designed to reduce the amount of hand written paper works required to maintain resident and nursing center records. (Moshida, 2004). It is a computerized medical record that prevents lost of productivity, improve clinical accuracy and charge captures. Experts are taking its institution’s paperless and tell the benefits of the next level of efficiency that are being delivered to the HIPAA V. DRUG Info today. All stakeholders in healthcare organization and caregivers, consumers, purchasers, payers and policy making are focused in the orientation of medical errors and weighing the health care providers involve. Thousands of people did it every year as a result of Adverse Drug Event (ADE). The result is efficient, high-quality care. In relation to this study, the system reduced paper works and avoids loss of files or manipulation of medical information/records. A study (Peters,2004) wrote the System Analysis and Design refers to the process of examining a situation and deciding whether improvements is deserved or feasible. The intent of the system investigation is to study a business process and evaluating it. Manage should be a result, not an â€Å"intent†. In developing a system, a process is set to meet are the dissatisfaction of the present systems on the part of the beneficiaries, such as the personnel and the applicant, the new system should at least give then the ease of maintaining a fast and better procedure on handling records. According to William, (2002) A system is combined with a function or purpose and each person thinks in terms of the job he or she is trying to accomplish. It is necessary to explore alternative ways of some changes to be made. Manage should be a result, not an intent. † It is impossible to set standard for handling applicant and employees records. The only matter to be considered is simply developing the best system which is set to meet the requirements of file handling and management. In this book the way of doing something to see if the method should continue as is modified slightly completely revised. A study Henry F. Korths (2003) states that: â€Å"The system should produce meaningful results quickly. This usually means action reports an a basic on immediate responses to inquiries. It does not eliminate entirely the traditional historical aspect, but it does not mean, that such reports most supplement with current oriented reports† Local Literature According to the article â€Å"Asian Hospital uses new info system for faster, efficient transactions â€Å"(Veroy Robert,2006) states that the system, called Hospital 2000, is highly-specialized software that integrates the hospital’s various systems into a single platform and one database. Hospital 2000 takes account on specially-designed programs that will facilitate the hospital’s internal transactions to better serve the inpatient and outpatient populations. â€Å"Running a modern hospital requires proper data facilitation and accurate system management to deliver efficient and real time transactions particularly between doctors and patients. That’s why with this new system, we are now at par, if not better, than any other hospital in the Asia-Pacific region,† said Pamela Robinson, Asian Hospital CEO and President. The system, according to Asian Hospital Director for General Services Joel Garcia, has three major components covering administrative, clinical and imaging activities. Furthermore, the system takes care of the hospital’s financial records, purchasing, recording functions, and on-line ordering system for the nurse’s station. Hospital 2000 was specifically made for Bumrungrad Hospital, a Bangkok-based healthcare facility, in 1998. Asian Hospital recently sealed a partnership with Bumrungrad International in an effort to upgrade its existing facilities including the hospital’s information and communications technology system. The need for efficient records management and information service in the administration of justice in the Philippines, may be addressed through IT. It is interwoven into almost every hand of the country’s social fabric and the judiciary is not exempted Chief Justice Andres Narvasce said that â€Å"the benefits of using an Information Technology in judicial system is readily apparent†. An article in Metropolitan times, Volume No. 27, states that the high court created the computerization committee tasked with the automation of the Supreme Court. The committee’s first task include the installation of a Case Administration System (CAS). The CAS links the different offices with are primary concerned with the supreme counts judicial work through a Local Area Network. According to Sacobel (2004) the progress is significant because it is capable of decongesting the back loss of cases in the courts. The chief justice believes that if the case is available and the system prepared to use it, then it becomes simply a matter of you providing the necessary logistical support. The high tribunal is currently proposing revisions in the laws in production with the objective of simplifying procedure. Though there will be substantial changes. They are intended to harmonize the rules in this area of the law and simplify the work of lawyer and judges. This would translate into faster more efficient case disposition and overall improvement of justice system. A popular author of Accounting Parsin (2005), states in his book that business organization are using computers to improve their efficiency and reduce their cost of operation. Reports are more timely and accelerate computer have manipulate and recall data to the form , all users wishes to use with the introduction of microcomputers computation of business is more affordable. He also stated that computers are beneficial to the improvement of the company. Reduce time, effort and money. Computers play a major role in every company for their improvement and giving quality service to their respective customers. According to Chua (2003) it pervades every aspect of our lives. Ti has become ubiquitous and essential for developments. The information technology embarks the passage of our time. It is necessary to adapt to response our changing needs. It corresponds to the unfolding body of knowledge which is now being sensible anywhere. Information Technology nowadays becomes a necessity, OLE to the beneficial aspect it brings in human life. It tends to keep daily routines efficient, accurate and timely to the needs depending to the needs of people. According to Simons (2006) as Information Technology continues to burst, it gives attention to different aspect of the needs of the user. â€Å"In this tech-driven age, scientific break through made practically everyday as a science and technology march forwards to the proverbial leads and bonds†¦Ã¢â‚¬ . The prolongation of this breakthrough gives convenience life to the users, which signifies the progress of computerization. It comes in different aspects in offices, hospital, establishments, even at home. Thus, computerized information system is a phenomenon to handle, for it adapts to relevant needs to different people. Foreign Literature An article entitled China’s Computer-aided Hospital Management System( Chih-Ho Yu & Ning Huang Washington,2004) states that China – Computer Hospital Management System 11/30/94 BEIJING, CHINA, 1994 NOV 30 — A computer-aided hospital management system has been developed by Xinyuan Electronic Corporation, a subsidiary of the First Research Institute of the Electronic Industry Ministry of China. The company claims that, with its user-friendly interface and flexible networking the system is suitable for almost for all kinds of hospitals. The developed system is being used by several civil and military hospitals in Beijing, China. Currently, a complete system consists of nine subsystems, including clinic management, medical record management, in-patient department management, statistic department management, price management, dispensary management, preparation manufacturing management, and general manager information system. An application system for a specific hospital can be constructed by using some or all of these subsystems. The overall system software is developed in the C programming language on Novell networks. Its database files are claimed to be compatible with Xbase’s. All departments in the hospital can input their information at workstations and share information with other members on the network. The system offers menus and help information in Chinese. The system also uses advanced multimedia techniques. For example, the system gives voice output for price information and touch-screen- operation at pharmacy departments. An article entitled â€Å"With a Sharp focus on Pharmacy Medicine Shoppe posts double –digit gains† (Earl Smith, 2001) states that medical shoppe posts double digit gains narrates that part of its success is due to the number of Pharmacy specific innovations implemented over the past year. According to Ronald Hofmeister, R. Ph executive vice president of pharmacy operations. These innovations includes automation and work flow efficiencies, a program and an enhanced prescription compounding program. Looking at the retail pharmacy today and the challenges to making a profit, Hofmeister stated â€Å"Retail Pharmacy has a tremendous opportunity to properly position and fulfill our role as the provider of true, efficient, effective and accessible health care in any government prescription drug program for seniors, if we fail to do it correctly, retail will be challenged to remain profitable with only dispensing fees related to such programs. With this, the study should put into consideration the role of the Pharmaceutics Company in rendering services to the people fulfilling its commitments to give quality services by providing the right prescription drug will also result into a true and efficient health care to its customers. According to Flamholtz (2003) still defined that records would prove continuing records for system. These records reflect the result of the â€Å"cycle play sick record†. The computerization of record means agreement is beyond reducing operating cost mean agreement is beyond reducing operating cost of bill. It cannot make a decision for the user. It only shows what is happening. It is a management system that provides records usability throughout bound, receiving, order processing, storage and shipping. This system generates loading instruction and view release orders. Almost 500 companies information a series of standard software pack as compatible software packages from the company are designed to interface automated and manual materials storage system. Millar(2003) stated in his article entitled â€Å"New Technology will enhance patient care† the Calgary health region has entered into an agreement to purchase an innovative new health information system to better manage patient information support the delivery of high-quality care and enhance patient safety in its hospital. He said that patient care information system would provide timely access to information critical for clinical decision making, help reduce the potential for clinical decision making, help reduce potential for medical errors and speed up the flow of information that can be critical to saving lives. Having access to a complete and consiste

Week 5 Psy/322

Case Study Analysis Psy/322 March 11, 2011 Japan to Apple’s iPhone The Apple iPhone did not make as big of a splash in Japan as Apple’s had hoped it would. The projection to sell a million iPhones in Japan unraveled and sales were very low. People of Japan were already aware of cell phones with a 3G network, which the faster network had been around for several years, much longer than the United States. A few problems that Japan had with the Apple iPhone were the touch screens, the iPhone were not as advanced as what they could already get in Japan, and the iPhone could not purchase train passes as the other phones did. Emoji†, clip art that is used to create a more interesting and creative e-mail was also an application that Apple could not offer. Citizens of Japan have high complex standards and when it comes to technology Japan is known for being well head of its time. The iPhone just did not stand up to what Japan already had in their back pocket. Cell phone us ers in Japan are infatuated with photos, video games, and high light features. Apple iPhone could not compete with what a market already established in Japan from other cell phone makers. The competitors had already offered Japan everything they needed.Japan made a mistake in trying to market the Apple iPhone in Japan at the time they did. In research they should have seen that they didn’t have everything that the Japanese wanted in a cell phone. Knowing Japan already had a 3G network that should have told Apple it would not be a new technology for the country. The people of this culture wanted everything at their fingertips and Apple didn’t have all they wanted. The Apple computers did well in Japan due to the technology is in the running with the other computers and they are similar.IPod also did well in Japan markets and that was due to the product being affordable, slim, and available to the people of Japan. Pricing and the cells phone plans in Japan are very compe titive and equates to low monthly expense for cell phones. The iPhones average monthly start around $60 dollars, which is much higher than competitors. The United States pays on average around $80 to $100 dollars for an iPhone plan. Many people of Japan also purchase their phones to use and the iPhone does not come cheap hen purchased. A large number of Japanese live with only a cell phone, so that cell phone needs to be everything in one. People of Japan do not want to use their cell phone as a personal computer and the problem with the iPhone is Apple relies on computers for syncing media and involving updates of software from the computer. ITunes is an example of an application that would require updates from a computer over time. Cell phones in Japan are about fashion as well and who has the most state of the art phone.Japan is so advanced with their technology that something new is coming out every day, so carrying around a cell phone that has been out for a year is unacceptabl e. The technology is consistently getting better and better, which the United States fall further behind. Apple did not grasp the cross-cultural concept and get an international perspective prior to marketing the iPhone. Apple also should have researched the marketing mix for the country. Price would be to high for the iPhone due to what Japan already had in service.The product did not have everything the consumer wanted on the product that would entice the consumer to purchase it. The place Apple wanted to move the product, which was Japan, already had the 3G network in place. Apple really did not have anything to promote that was different in the markets of Japan. The sheer functionality of the iPhone just did not make sense out of Japan. Mickey and Shark Fin Soup Shark fin soup is a popular soup item of Chinese culture that is usually served at big events such as weddings and banquets.This soup is considered a luxury item and the soup may cost up to $150 dollars a bowl. The soup originally came from the Ming Dynasty many years ago and is an important part of the celebrations. When Disney wanted to serve the soup to the guests that were going to have their wedding at Disney Hong Kong, advocates came out to protest serving the soup. There is an international concern over the sustainability and welfare of the sharks that will be used to make the delicacy. There is also concern that because the cost for the soup is so high there will be a higher demand for the soup.If the soup is in such high demand them the environmentalist have concern the sharks will become endangered. The Disney Company was trying to reach out to the people of Hong Kong and show an appreciation for the culture of their country. Disney wanted to offer the same items that other companies could offer to the people of Hong Kong. If Disney does not offer the Shark Fin Soup then the customers approaching Disney for their wedding will go somewhere else to receive the goods and service they want fo r the celebration.With the guidelines that Disney would have strict guidelines being such a large corporation, they would not be smuggling in sharks to create the soup. Disney chose not to serve the shark fin soup due to the pressure of the environmentalists. Much of the pressure came from the hits to Disney’s corporate image. Disney did careful research and determined that the environmentalists had a valid point that linking shark declines in the largest shark species.Disney felt the company needed to have the right balance with the cultural of Hong Kong and the conservation of the sharks. If I were a member of the Disney management team at the Walt Disney Company, I would not have the Shark fin soup on the menu for wedding in Hong Kong. Disney would lose more money by people boycotting the company then they would if Disney did not serve the soup. It is important for companies to research and know what they are dealing with before they make decisions that will affect a large group of people or animals as in this case.There is so much more money to be made through ticket sales and all the other foods that are offered by Disney. The damage that might have been done by making the decision to keep the shark fin soup on the menu would truly out way the damage if they took the soup off the menu. References: Keith Bradsher, â€Å"Chinese Delicacy Has Disney in Turbulent Waters, †New York Times, June 17, 2009, C1, C7 Yukari Iwatani Kane, â€Å"Apple’s Latest iPhone Sees Slow Japan Sales, â€Å"Wall Street Journal, September 15, 2008, B3

Real Life Research Action Assignment Example | Topics and Well Written Essays - 1500 words

Real Life Research Action - Assignment Example PART 1 With respect to the first scholar, i.e. Dr Briseno one of the vital topic that the leader has discussed is the importance of facts. In this regard, the importance of qualitative data has been mentioned. Additionally, the leader has also mentioned the ways technology has been accepted in data recording as well as interpretation and also for the results to be shared with major schools in the district from a futuristic point of view to conduct research studies. He also suggested that division of the best child within the campus can also help in motivating others’ child. One of the vital suggestions that the leader has described thereafter emphasises the need of studying more and more on the research topic as it would help in understanding the importance and the different aspects that would make the research more effective. The leader here tries to explain how maintaining a proper set of data can help in analysing the present situation with the past. It is also worth mentio ning that an effective research can only be conducted when elaborated and rigorous studies are conducted before finalizing the outcome. With respect to the details provided by the second scholar, Dr. Lewis, one of the vital aspects that he discussed concentrated on the importance of recording data. The leader has tried to explain how data stored helps in ensuring the performance of any individual. Additionally, Dr. Lewis has also stated the importance of detailed, formal procedure to be followed while conducting a research. One of the vital suggestions given by Dr. Lewis in this context advocated that although formal and detailed procedure is needed to be followed while conducting a research, the final result should be published in such a way, which will permit easy and appropriate interpretation of the purpose of the research to the reader. The leader also stressed on the fact that evaluating the findings obtained through past researched when conducting a new study shall be quite b eneficial in deriving a generalised understanding regarding the issue in concern. PART 2 1. Staff development: With the advent of modern techniques and theories in a working environment, it is not only businesses that are involving their employees while making vital decisions but academic centres are also adapting new techniques to develop the qualities of their staff members with a vision to gain efficiency in making effective decisions for the overall benefit of the campus. It has been viewed that today’s schools are more focused on Career and Technical Education (CTE). CTE mainly focuses on developing the technical skills of an individual. In this context, it can be stated that teachers and their qualifications are considered to be a vital element in the success of a school to deliver effective knowledge on CTE to the students. Therefore, developing their skills would help in establishing a coordinated relation amid their pupils resulting in better achievements of the stud ents (Dana 32-34). 2. Curriculum development: Curriculum is considered to be an organized planning of the facets to be taught in a school within a calendar year or a specific tenure. Curriculum development is considered to be a vital step of any academic centre as it guides the teachers in assisting the students to learn in the most convenient way, so that the process yields a guaranteed positive return. In this context, the academic centre can design, develop, implement, monitor and evaluate the various factors that can help in

Creativity in different forms of everyday writing, factors account for Assignment

Creativity in different forms of everyday writing, factors account for the emergence of creativity in written forms - Assignment Example No matter the kind of definition provided to explain writing, it is appreciable that the essence of creative writing is to convey the human imagination to the people in the most convenient, effective and understandable manner. Effective writing can be evaluated by the creativity features that can be identified in any piece of literary work and the clarity of the message alluded in the work. In general, a creative writing will provide information in the most conspicuous manner possible and the recipients of a message should be gratified. The essence of this essay is to identify features of creative writing and to identify the factors that have culminated in the emergence of creativity in linguistic writing. Various scholars have presented different definitions and dimensions of creative writing as applied in linguistics today. Harper (2010) expresses the complexity of defining creative writing in the field of linguistics and is of the opinion that scholarly definitions of these terms as mere attempt. However, he pays a keen attention to the reference of creative writing as a by-product of a mind that is acquiring a new image of operation. The concept of this definition is rather unique and sees creative writing as an expression of the human mind in a planned and orderly manner. From the words of this author, creative writing is not only an art of the mind but also an art of the hands that must be coordinated to achieve creativity and the originality implied in this definition. However, Harper (2010) disregards this definition and he feels that this kind of definition lacks the concept of planning that must be accounted in any definition of creative writing. Schlepphege (2010), another scholar, has provided a different dimension of creativity in the modern creativity research as the process of producing a whole new concept in the society. The author makes a direct connection to the concept of creation in its literal meaning as the process making something new, an d presenting it to the community. From this point of view, creative writing is an art of bringing up new acts, thoughts and idea in the society. The implication of this definition is that to evaluate whether writing is creative or not, one would require evaluating if a piece of work presents a new concept. Schlepphege (2010) states that all forms of literary works such as poetry, drama, fiction, speeches or even song lyrics must express a new form of expression, communication or even self-awareness in human beings. In addition, creative writing is not a product of writing expertise but a natural urge of human beings to communicate or express themselves. Maybin and Swann, (2007) have analysed the language in two different dimensions in the attempt of explaining the practical application of creativity in contemporary writing. The two authors evaluate feel that language use takes either a textual or a contextual sense and creativity will revolve around these two dimensions of language use. The textual sense of language use refers to the linguistic forms and structures that are used to express an intended brain perception by a writer. Example of this kind of use of language use is expression of irony in voice intonation, use of word play in comic writing and the use of images to express an emotional feeling is

WAN Technology Research Paper Example | Topics and Well Written Essays - 250 words

WAN Technology - Research Paper Example Moreover, like any business ABC Inc cannot afford problems with the network connectivity due to low reliability since it would affect the customers and the business directly. Given the constraints on security and reliability there is little doubt that the solution for ABC Inc is a private WAN connection. A dedicated private WAN would cost ABC Inc far more than using packet switched connectivity. It is common for multiple businesses to be using the same private WAN with packed switched connectivity since it affords the amount of reliability and security needed by businesses without entailing the extra cost of a dedicated private WAN (O’Brien & Marakas, 2009). Moreover, it is highly likely that the private WAN used by ABC Inc would utilize the frame relay protocol since it is more widely implemented than the X2.5 protocol (Cisco, 2012). Using frame relay protocol would provide ABC Inc the required amount of reliability and security for its private WAN

Dance by Design Essay Example | Topics and Well Written Essays - 2250 words

Dance by Design - Essay Example However, despite this, it is important to explore the effect that hip-hop has on youth sexuality as well as the cultural impact that it has on youth culture in general precisely because of this importance. The purpose of this essay is to explore the links between the use of the body in hip-hop culture and this much explored and maligned sexuality that is associated with hip-hop dance. In doing this exploration, it will become clear that there are many positive forces associated with hip-hop, although there are definitely negative aspects of the strong link between hip-hop and sexuality, particularly female sexuality. Hip-Hop Culture Hip-hop culture is one that is usually described by scholars as being ‘misunderstood’ (Rose, 2010, p59), despite the fact that it generates millions or billions of US dollars in its industries and many people believe that it ‘ascends to the level of art and cultural heritage’ (Rose, 2010, p59). There are many reasons for the misu nderstanding associated with hip-hop culture. ... e itself is at its most influential and important in the United States (Dimitriadis, 2009), where it is commonly associated with African Americans or Latinos, and therefore many of the elements of hip-hop culture are direct derivatives of these two influences (Rabaka, 2011). It is important to note that hip-hop culture itself is not just limited to the music (which is commonly seen to include rap), but includes a whole variety of different dance styles (including breaking, locking and popping) as well as art forms such as graffiti and cinematography (Rabaka, 2011). In this way, hip-hop can be seen to be associated with a greater scheme of design, rather than just being limited to a music genre. It is perhaps from this perspective that it becomes obvious how such a wide-ranging culture has come to be associated with sexuality, because it permeates all aspects of life for those immersed in it (Dimitriadis, 2009). Traditionally, hip-hop is associated with youth (or seen as a youth movem ent) precisely because of the age of the culture (having started as a movement in the 1970s) and the people that partake in hip-hop dance (Schloss, 2009). The Relationship between Hip-Hop and Sexuality One important factor involved in the fact that hip-hop is perceived as a youth movement is that it will probably always be involved in some discourse on sexuality, predominantly because of the obvious link between young people and emerging sexualities. There are a number of reasons why hip-hop (dance in particular) and sexuality have often been highlighted as having such a strong link. One is that there is a hugely sexual range of motions involved in hip-hop dance, particularly with the phenomenon of grinding (Schloss, 2009). This type of dance is so sexually explicit that many towns in the

Religious Values in War and Peace Essay Example | Topics and Well Written Essays - 1250 words

Religious Values in War and Peace - Essay Example Most often, a war that is based upon religious ideology will not end until one faction subjugates the other. Religious ideologies that are in conflict more than likely will never find true resolution and peace. Two very different places in the world where this is in evidence is in Northern Ireland and Israel. These two places have been host to factions who are in constant conflict with each other. Generations pass and yet the conflict continues because it is not the individuals that are in conflict, but belief systems. According to Brinkley, â€Å"Staunch belief in something greater than ourselves is an essential building block in the construction of a personal reality† (83). When a personal reality is violated, a reactionary violence can be the result. In believing so strongly in the right of one doctrine, the acceptance of others who don’t share that doctrine can threaten the reality that has been created through a system of beliefs. The very existence of other avenues of thought can be perceived as a threat to a way of life. The rise of the modern secularized state has helped to minimize the number of conflicts that arise because of religious belief. Up until the rise of the ideologically founded political system of the United States that firmly situated the acceptance of faith as a personal choice, rather than a state dictated set of national beliefs, most nations were built on a foundation of religious, political and warfare structures in which exclusionary policies promoted conflict. The needs that a civilization had for religious sacrifices were one of the first causes for war in history. The Aztecs based much of their warring on the need for human sacrifices and the Maring based their cyclical warring on the need for pigs to sacrifice to their gods (Wade 128). There is an innate conflict within the Christian religion between the promotion of war for its cause and the desire for peace as is interpreted through the teachings of

Affect of Specific Language Impairment Essay Example | Topics and Well Written Essays - 2500 words

Affect of Specific Language Impairment - Essay Example A child whose major problem is with receptive language (comprehension) faces difficulties in language which inhibit appropriate communication exchanges and their comprehension may act as a barrier to the development of social interactions and socially-skilled behaviours as compared to children with expressive language difficulties, Also they are more likely to experience social and behavioural problems and to be the target for bullying. Their measures of cognitive and language performance tend to be consistent over time, but ratings or measures of behavioural difficulties are more variable they show higher level of behavioural, emotional, and social adjustment difficulties.  A child with expressive language impairment has difficulty with the production of language that adequately represents the child intended message and may include problems with word retrieval, word use, sentence formulation, and/or conversational skills. The following characteristics may indicate difficulties in producing language. The child speaks in words, phrases, incomplete or inaccurate sentences, relies upon gesture to supplement or substitute for oral language, uses pronouns, plurals, and possessives incorrectly, has difficulty with the agreement of subjects and verbs, , has difficulty telling a story or describing an event or procedure in a logical sequence, uses run-on sentences, has limited expressive vocabulary, has difficulty finding the appropriate word (s) to express meaning, overuses filler words such as â€Å"ah† or â€Å"um†.

Aims of Academic Study Essay Example for Free

Aims of Academic Study Essay To accomplish it, there are obviously needed excessive practices and comfortable surrounding environments including class-size. This essay will deal with the aims of the academic study and various ways of how to accomplish the aims. Firstly, the aims of the academic study are to help students to discover and form future goals or careers and show the whole view of different kinds of jobs, aims and tasks that suits the desires and determine specific goals for the future. It is a tough fight for people who do not have a clear future goal or career and it also can be a burden in the future by making it hard for them to find a suitable job. Therefore, it is highly important to have higher knowledge and a clear plan, to compete for a chance to obtain a position. Secondly, the aims of the academic study also assist the university and college students. It is highly important for college students to have high academic skills due to its complexity. This will also help them to understand a wide range of academically important subjects and deal with a particular task. University is the greatest challenge place for adults and the most crucial part of all is to pass the tests and to finish the final exam in university. Another advantage is that the aims of academic study also enhance knowledge in critical-thinking, problem-solving and general information. Improving abilities in thinking more deeply and organizing ideas in order to solve things in a higher level requires extra knowledge of general information. This idea means that the academic performer appears to have a stronger sense of solving and thinking in a greater way than normal person does. Additionally, it enriches several kinds of knowledge and self-reflection in real life including social skills. On the other hand, in order to accomplish or reach these aim, pupils should try undertaking excessive researches and focus on the course as much as possible. They also expand their knowledge of general information by reading numerous articles and news. Nonetheless, they require support from their surrounding include parents, peers, teachers and class-sized. Different type’s class sized is also a notice problem for pupils to decide to choose. Finn calculated that â€Å"Students in small classes outperformed their counterparts in normal-sized classes by a fifth of standard deviation† – by Ehrenberg et al. (2001) Does class size matter?. To sum up, academic studies have an important role in the educational societies as its aims help the academic performers in various ways to reach and succeed their future goal.

Comparison of Electroconvulsive Therapy and Antidepressants

Comparison of Electroconvulsive Therapy and Antidepressants Brief 101151 INTRODUCTION Depression is one of the more common forms of mental illness. It has been estimated that approximately 9.5% of the population will suffer with depression at any one time (Robins and Regier 1990) and that 17% of people will suffer with depression at some point in their life (Blazer et al 1994). Defining depression is not a straight forward task. This is due to the fact that it can range from normal unhappiness through persistent and pervasive ways of feeling and thinking to psychosis (Hale 1997). Having said this, a number of different features which can be associated with depression have been identified by Hale (1997): Persistent low mood Loss of interest and enjoyment Reduced energy and diminished activity Poor concentration and attention Low self esteem and low confidence Ideas of guilt and unworthiness Bleak pessimistic views of the future Ideas or acts of self harm or suicide Disturbed sleep Diminished appetite It is also possible to distinguish between three major types of depression. The first form of depression is Dysthymia which involves long-term chronic depressive symptoms which do not necessarily disable the individual. The second form is Bipolar Disorder which involves the patient experiencing periods of mania and depression through cycles of mood change. The third and final category concerns Major Depression. The symptoms involved with this mental illness combine to ensure that it is difficult for the patient to work, study or to enjoy activities as well as them having difficulties regarding eating and sleeping patterns. It is this third and most serious form of depression which will be the focus of the following discussion. TREATMENT OF SEVERE DEPRESSION A number of different approaches to the treatment of depression have been taken which are based on a range of theoretical perspectives. These include approaches such as Cognitive Behavioural Therapy, Psychoanalysis and those based on increasing exercise levels. However, perhaps the most common treatment for depression involves the use of antidepressant drugs (American Psychiatric Association 1993) These include medications such as Tricyclic (which is cheap and effective but does have side effects which limit compliance), Selective Serotonin Up-Take Inhibitors (which has fewer side effects but less effective for disturbed sleep) and Monoamine (which, in rare cases, can be fatal when mixed with certain foods) Although antidepressants can be effective, research has indicated that they may not be the optimal solution. For example, Thomas et al (1982) conducted a study involving 115 participants who were randomly allocated to receive either a combination of antidepressants or a placebo. T he medication was found to have a significant effect but non-compliance was identified as a significant problem. It has been estimated that non-compliance regarding antidepressant drugs is between 20 and 59% (Johnson 1973 and Thomas et al 1982). Further research has also reported that patients who are suffering with depression are still at a significant risk of relapse or recurring symptoms even when they have been adhering to their medication programme for a long period of time (Grunhaus et al 1990). It may also be the case that medication is not suitable for all forms of depression. For example, Hale (1997) suggested that antidepressants may not be effective for psychotic depression. Therefore, as a result of the potential drawbacks of non-compliance, relapse and not being effective for all forms of depression, efforts have been made to identify other approaches for the treatment of severe depression. One of the most controversial treatment approaches is Electroconvulsive Therapy (ECT). It was first used in 1938 by Cerletti and Bini (Linington and Harris 1988). It involves sending an electrical current through the patient’s brain with the aim of stimulating the release of neurotransmitters which will ultimately improve the patient’s mood. ECT has obtained a somewhat negative reputation due to stories of bitten tongues and fractured bones and it is often seen as a form of punishment rather than treatment. However, reviews of its application have demonstrated that ECT does have significant benefits compared to simulated ECT, when all procedures are followed without an electrical current actually being given (The UK ECT Review Group 2003). Whenever one is making decisions regarding the use of any given treatments, one must consider the body of scientific evidence which has assessed the treatment’s efficacy and effectiveness. The following review will aim to consi der the research which has assessed the efficacy and effectiveness of ECT as a treatment for severe depression in order to determine its effectiveness with reference to the use of antidepressants. RESEARCH QUESTION Thus, the following review will aim to answer the question ‘Is ECT an effective treatment compared with antidepressants in cases of severe depression’. The methodology which was employed within this research will now be outlined. LITERATURE SEARCH A systematic review aims to integrate existing information from a comprehensive range of sources, utilising a scientific replicable approach, which gives a balanced view, hence minimising bias. It can also be stated that systematic reviews provide a means of integrating valid information from the research literature to provide a basis for rational decision making concerning the provision of healthcare. 2.1 SOURCES OF DATA The methodology employed within the research involved obtaining data from three key sources: Computerised searches, Manual searches, and the Internet. Each of these data sources will now be considered in more detail. 2.11 COMPUTERISED SEARCHES The methods used in this research will include a detailed computerised literature search. Multiple databases, both online and CD–Rom will be accessed to retrieve literature because they cite the majority of relevant texts. The computerised bibliographic databases are:- MEDLINE EMBASE CINAHL PSYCHINFO Biological Abstracts Cochrane SIGLE However because articles may not be correctly indexed within the computerised databases, other strategies will be applied in order to achieve a comprehensive search. 2.1.2 MANUAL SEARCHES A manual search will be performed to ensure that all relevant literature is accessed. The manual searches will include:- Books relevant to the topics from university libraries and web sites Inverse searching- by locating index terms of relevant journal articles and texts Systematically searching reference lists and bibliographies of relevant journal articles and texts 2.1.3 THE INTERNET The internet will provide a global perspective of the research topic and a searchable database of Internet files collected by a computer. Sites accessed will include:- Department of Health National Institute of Clinical Excellence English National Board of Nursing, Midwifery and Health Visiting Google British Medical Journal 2.2 IDENTIFICATION OF KEY WORDS A set of key words will be used within the literature search. Elements of the research question will be used to provide the search terms. Therefore, the words Electroconvulsive Therapy, Antidepressants, Depression, Effectiveness and Evaluation will all be used. 2.3 INCLUSION AND EXCLUSION CRITERIA To ensure that the more relevant research studies are identified, a set of inclusion and exclusion criteria will be utilised. In order to be included in this research the studies will need to relate to the evaluation of Electroconvulsive Therapy and relate to the treatment of depression. Furthermore, studies will be excluded if they are published before 1975 or if they are not available in English. DISCUSSION This review has identified literature which has focussed on assessing the effectiveness of ECT in comparison to antidepressants regarding the treatment of severe depression. In order to structure the discussion, the research will be analysed with reference to the benefits of ECT regarding relapse, patients who are drug-resistant and those with severe depression in particular. The potential drawbacks of ECT will then be briefly considered before overall conclusions are drawn regarding the research question. 3.1 RELAPSE Studies were located which highlighted the benefits of ECT regarding the reduction of relapse. For instance, Petrides et al (1994) reviewed the case histories of 33 patients who had been diagnosed with long term depression. A set of 21 patients were included in the study as a one year follow up report was available for analysis. Each of the participating patients had been taking antidepressants for a significant length of time but were still experiencing relapses of depression. After the delivery of ECT it was reported that the number of patients with depression who suffered relapses fell from a normal rate of 50% to 33% at the one year follow up. For the patients with delusional depression in particular, the relapse figure fell from a normal rate of 95% to 42%. Based on this research it would appear that ECT can be more effective than antidepressants in terms of reducing relapse rates. A more recent and relevant study was conducted by Gagne et al (2000) which also involved the retrospective reviewing of patients’ notes. Two groups of 29 matched participants were identified. The first group had only been taking antidepressants were as the second group had antidepressants along with ECT. At the two year follow up stage the relapse rates for those who had ECT was 52% compared to the 93% associated with those who only had medication. At the five year follow up stage, the relapse rate for the drug-only group had fallen slightly to 73% where as the ECT group had fallen dramatically to just 18%. The average survival rate of the ECT group was 6.9 years which was significantly longer than the 2.7 years for the drug-only group. Therefore the research considered in this section would lead one to conclude that ECT can be more effective than antidepressants alone in terms of reducing relapse rates. Having said this, it should be noted that these research projects involve d combining ECT with antidepressants rather than replacing them entirely. 3.2 MEDICATION RESISTANT PATIENTS Although antidepressants are effective for many patients with depression, there are some groups for whom it is less effective. Rabheru and Persad (1997) reviewed the literature which focused on assessing the effectiveness of ECT for patients who were found to be resistant to antidepressant medication. They found that the research evidence indicated that ECT could have significant benefits for medication resistant patients. These benefits were particularly relevant for elderly patients with depression. An important point to make here, however, was demonstrated by research conducted by Prudic et al (1996). They reported that the effectiveness of ECT may decline as the time for which the patient has suffered with severe depression increases. Therefore, the approach of using ECT when the patient has been found to be resistant to antidepressants may not be the optimal approach as the possible benefits of ECT may have been reduced. Therefore, this section has demonstrated that ECT could be beneficial for patients who have severe depression and have not been significantly helped by the use of antidepressants. However, it is important to note that the use of ECT may decline over time. 3.3 PATIENTS WITH SEVERE DEPRESSION Further research has indicated that ECT may well have particular benefits over antidepressants with regards to patients who have severe depression. Sobin et al (1996) conducted research to evaluate the effectiveness of ECT for patients with a range of levels of depression. They reported that 70% of the participants responded significantly as a result of the ECT and that significant improvements were made by those who had severe depression. Other research has also leant support for the assertion that ECT is particularly beneficial for patients with severe depressive symptoms, mood congruent delusions and those who are at prominent risk of committing suicide (Martin 1989, Schatzberg 1992, Persad 1990, Philibert et al 1995 and Fink et al 1996). It appears that the attributes of ECT are particularly suited to the treatment of people with severe depression. It may be that the more severe a person’s depressive symptoms are, the more drastic and severe the treatment approaches need t o be for them to be effective. CONCLUSIONS This review has considered research which has investigated whether ECT is effective in treating severe depression when compared to antidepressant drugs. Based on this research it can be concluded that ECT, when combined with antidepressants, does appear to significantly reduce patients’ relapse rates. It can also be said that the evidence supports the view that ECT can be effective for patients who have been found to be resistant to antidepressants. The third and final conclusion is that ECT appears to be particularly suited to patients with the more severe forms of depression. Having said this, some criticisms need to be acknowledged regarding this body of research. For instance, Rose et al (2003) highlighted three major drawbacks. Firstly 1 in 3 patients who are given ECT report persistent memory loss. Secondly, the research studies conducted by clinicians in this area report more positive results than those conducted by consumer agencies. This may be due to the selection of participants or the focus of the research questions. The third and final drawback outlined by Rose et al (2003) is that the studies which support ECT rarely assess the long term effects or cognitive functioning and the majority of them were conducted many years ago using small samples. The research is also limited because it mainly uses case studies (Thienhaus et al 1990), naturalistic studies (Aronson et al 1987) or retrospective reviews of patient notes (Stiebel 1995). Few randomly controlled trials were highlighted by this literature search. Such criticisms must be kept in mind when considering the effectiveness of ECT in comparison to antidepressants for treating severe depression. 5.0 IMPLICATIONS FOR PRACTICE Guidelines produced by the National Institute of Clinical Excellence, based on a review of Department of Health and Cochrane database research, recommends that ECT be used for rapid and short term improvements for patients with severe depression or who are at significant risk of suicide (Tharyan and Adams 2003). However, as highlighted by the Royal College of Psychiatrists (2003) in their response to these guidelines, the use of ECT may have a wider scope than this approach would suggest and the guidelines may ensure that patients who may benefit from ECT are not given the treatment. Further research in this area will provide a basis upon which to test the appropriateness of these guidelines and the current use of ECT. It would appear that ECT can have significant benefits for patients with severe depression but that more efforts need to be made to tackle the negative impressions which may be associated with this treatment such that it can become a more accepted approach. The main im plication of this review for practice is that ECT appears to have a significant role to play in the treatment of severe depression but that it is likely to be alongside the use of antidepressants rather than instead of them. This strategy will enable the most comprehensive treatment programme to be delivered to the patients and ensure that their chances of a full recovery are maximised. REFERENCES American Psychiatric Association (1993). Practice guidelines for major depressive disorder in adults. American Journal of Psychiatry; 150(suppl): 4. Aronson TA, Shukla S, and Hoff A: (1987) Continuation therapy after ECT for delusional depression: a naturalistic study of prophylactic treatments and relapse. Convulsive Therapy; 3:251–259[Medline] Blazer DG, Kessler RC, McGonagle KA, and (1994) Swartz MS. The prevalence and distribution of major depression in a national community sample: the national comorbidity survey. American Journal of Psychiatry;151:979-6. Gagne, G. G., Furman, M. J., Carpenter, L. L. and Price, L. H. (2000) Efficacy of continuation ECT and antidepressant drugs compared to antidepressants alone in depressed patients. American Journal of Psychiatry, 157, 1960-1963 Grunhaus L, Pande AC, and Haskett RF (1990) Full and abbreviated courses of maintenance electroconvulsive therapy. Convulsive Therapy; 6:130–138 Johnson DAW. (1973) Treatment of depression in general practice. British Medical Journal; ii: 18-20. Linington, A. and Harris, B. (1988) Fifty years of electro-convulsive therapy. British Medical Journal, 297, 1354-1355 Martin BA (1989) Electroconvulsive therapy for depression in general psychiatric practice. 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