I Am America, Too

The poem I, Too is a reflection of the nature of American society during the time it was written by Langston Hughes. It does not only speak for the feelings and insights of the writer himself but also to all people subjected to discrimination, especially the â€Å"black† people, who were the I in the poem. â€Å"They send me to eat in the kitchen, when company comes†¦Ã¢â‚¬  speaks of the inconsiderate treatment to black people being sent away every time they got near or in close contact with them. â€Å"But I laugh, and eat well, and grow strong†¦Ã¢â‚¬  shows the writer’s positive thought on being discriminated – getting enough courage and resources to be stronger, and finally be recognized as part of America. The visions of Hughes on a bright future for the black people in America and be at the table when company comes came true with the emergence of Condoleeza Rice, Oprah Winfrey, Michael Jordan, Denzel Washington, Beyoncà © Knowles, Williams sisters, among others. They already made themselves big in every aspect of American life. The Americans have finally recognized how beautiful the black people are and nobody could just tell them to â€Å"eat in the kitchen† because they, too, are Americans. Reference: Hughes, L. 2006. I, Too. In Concise Anthology of American Literature. G McMichael & JS Leonard. 6th ed. New Jersey: Pearson Prentice Hall. 1086.      

Gap Model in Services Marketing

The GAP MODEL in SERVICES MARKETING GAP 1 The gap between the customer expected service and company perception of customer expectation. |Inadequate market research. |Design, conduct and implement appropriate market research. | |Poor communication between customers and management and between|Design and implement an upward communications programme. | |front line employees and managers. | | |Lack of, or poor marker segmentation. Build customer relationships through market segmentation | | |techniques and customer retention strategies | |Focus on transactions rather than relationships. | | | | | |Focus on new customers rather than existing customers. | | GAP 2 The gap between company perception of customer expectations and development of customer driven service designs and standards. |Lack of standardization of Service behavior &|Reengineering | |actions. | | | | | |Lack of formal process for setting service |Establish the Service Encounter sequence | |quality goals. | | | | |Lack of customer defined standards. |Identify existing or desired service encounter sequence. | | | | | |Translate customer expectations into behaviors and actions. | | | | |Select behavior and actions for standards | | | | | |Select appropriate ‘Hard’ and ‘Soft’ standards | | | | | |Enable feedback mechanisms for measurement to standards | | | | | |Establish measures and target levels | | | | | |Track measures vs. tandards | | | | | |Give performance to employees | | | | |Inadequate service Leadership |Synthesizing, articulating, promoting commitment and implementing the service | | |vision. (The leadership model). | | | |Lack o f understanding that that quality |PIMS research. | |service is indeed a profit strategy | | | | | |Incomplete performance appraisal system |In addition to financial measures include, the customer perspective, the | | |operational perspective and the innovative perspective to performance appraisal. | GAP 3 The Gap between Customer driven service designs and standards and service delivery. The Employees’ roles in service delivery |Human Resources Strategies | | | | |Ineffective recruitment |Hire the right people | |Role ambiguity and role conflict | | |Poor employee-technology-job fit |Develop people to deliver service quality | |Inappropriate evaluation and compensation systems| | |Lack of empowerment and teamwork |Provide needed support systems | | | | | |Retain the best people | | | | | |(Details in the human resource strategies wheel pg 312 Zeithaml) | |Key factors related to Intermediaries |Strategies for effective service delivery through intermediaries | | | |Channe l conflict over objectives and performance |Develop and implement: | |Channel conflict over costs and rewards |Control strategies | |Difficulty controlling quality and consistency |Empowerment strategies | |across outlets |Partnering Strategies | |Tension between empowerment and control | | |Channel ambiguity | | |Key factors related to Customers |Strategies for enhancing customer participation | | | | |Customers lack understanding of their roles |Define customers job | |Customers unwilling or unable to perform their |Recruit, Educate and reward customers | |roles |Manage the customer mix | |Customers are not rewarded for good performance | | |Other customers interfere | | |Market segments are incomplete | | |Key factors related to demand and capacity |Strategies for matching supply and demand | | | | |Failure to smooth peaks and valleys of demand |Match supply and demand through (i) shifting demand to match capacity or | |Overuse of capacity |(ii) flexing capacity to meet demand | |Attracting inappropriate customer segments to |Demonstrate the benefits and risks of yield management strategies in | |build demand |establishing balances mong the service variables | |Relying too much on price to smooth demand |Manage waiting lines for time when capacity and demand cannot be aligned | |Legal and Cultural barriers in International |Opportunities in International services | |marketing |Adapting the service | | |Adapting promotion and distribution | | |Adapting entry modes | | |Adapting communications | | |Adapting workforce management | | |Adapting service employees incentives | | |Adapting service standards | | |Adapting market research internationally | GAP 4 The Gap between Service Delivery and External communications to Customers Factors relating to communications |Strategies to match service promise with delivery | | | | |Inadequate management of service promises |Manage service promises | |Over promising in advertising and personal selling|Reset custom er expectations | |Insufficient customer education |Improve customer education | |Inadequate horizontal communication |Manage horizontal communications | |Differences in policies and procedures across | | departments | | |Key factors relating to pricing |Pricing Strategies | | | | |Assuming customers have reference price for | | |services |Match customer perception of value with appropriate pricing strategy that | |Narrowly defining price as monetary cost |match each customer definition | |Signaling wrong quality level with inappropriate |Cost based | |price |Demand based | |Not understanding customer value definitions |Competition based | |Not matching price strategy to customer value |Value based | |definitions | | |Key factors related to Physical Evidence |Physical evidence strategy | | | | |Incompatible or inconsistent physical evidence | | |Over promising through physical evidence |Recognize the strategic impact of physical evidence | |Lack of physical evidence strate gy |Map the physical evidence of services | | |Clarify roles of the services cape | | |Assess and identify physical evidence opportunities | | |Be ready to update and modernize the evidence | | |Work cross-functionally |

Data Communication Reviewer

Reviewer DataCom: Chapter 1-5 Chapter 1: Intranet- Restricted group on a company and only allows internal employee access. Extranet- Type of network that allows outside vendors special access to limited info in a company. Protocols- Rules of communication. * An identified sender and receiver * An agreed-upon method of communicating * Common language and grammar * Confirmation or acknowledgement requirements Elements of a Network: * Rules or agreements: protocols or how the message is semt, directed, received and interpreted. * Massages: units of info that travels Medium: means of interconnecting these devices, can transport the messages* Devices: devices on the network exchange messages Messages- a generic term that encompasses forms of communication enabled by the Internet. Devices- several devices work to see that the message is properly directed to the source to the destination device. Icons- symbols that graphically presents network devices and media. * Desktop Computer * Laptop * Server – a computer dedicated to providing app services * IP Phone – a digital phone* LAN media * Wireless media LAN switch – most common device for interconnect LANs * Firewall – provides security to networks * Router – helps direct messages between networks * Wireless router * Cloud – summarize a group of networking devices * WAN media IP (Internet Protocal) & TCP (Transmission Control Protocol) – most common protocols * WWW – HTTP * E-mail – SMTP * Instant messae – XMPP * IP telephony – SIP Convergence – coming together of technologies onto a digital platform. It occurs when computer communications all use the same rules to transport their messages. Network Architecture – the conceptual plans on which a physical network is built. Fault tolerance- needs to function even if some components fail * Scalability- network’s ability to grow & react to future changes * Quality of service- p erformance level of services. Prioritize traffic and its characteristics to manage data. * and Security Packets-single message is broken into small blocks of data. Bandwidth- measure of the data-carrying capacity of the network. Chapter 2: Elements of communication: * Message source, or sender * Destination, or receiver *Channel- media that provides pathway Network- refers to data networks carrying massages. Segmentation- all messages are broken into smaller pieces Multiplexing- occurs when segments of two messages can shuffle into each other and share the medium. * Increased efficiency of network communication End device- a piece of equipment that is either the source or the destination of a message on a network. Host- an end device that sends or receives messages. Clients- other hosts that set up to store and share info by the host servers *The host address is a unique physical address used by hosts inside a LAN. Intermediary device- connects the individual host to the network and connect multiple individual network to form an internetwork. Network access devices* Internetwork devices * Communication severs * Modems * Security devices Network media: Copper, Fiber-optic cable, Wireless Encoding- refers to the way data is converted to patterns of electrical, light, or electromagnetic energy. LAN- a group of end devices and users under the control of a common administrator. WAN- a network that is used to connect LANs that are geographically far apart. Internetwork- is a collection of two or more LANs connected by WANs. Proprietary – A limited-use protocol owned by a company. Network Representations: Network interface card (NIC)- provides the physical connection to the network at the PC or other host device. * Physical port- is a connector or outlet on a networking device where the media is connected to a host.* Interface- refers to how the device can allow 2 different networks to communicate. The organizations that standardize networking protocols are: * IEEE – Institute of Electrical and Electronics Engineers * IETF – Internet Engineering Task Force Interaction of Protocols: * Hypertext Transfer Protocol (HTTP) – common protocol that governs the way that a web server and a web client interact. Transport protocol – Transmission Control Protocol (TCP) is the transport protocol that manages the individual conversations between web servers and web clients. * Internetwork protocol * Network access protocols – describes 2 primary functions: Data-Link Management & the physical transmission of data on the media. Layered Models – describe the complex process of network communication. Open Systems Interconnection (OSI) – is the most widely known internetwork reference model.Provides an abstract description of the network communication process. Developed by International Organization for Standardization (ISO). Application, Representation, Session, Transport, Network, Data Link, Physical TCP/IP Model – defines the 4 communication functions that protocols perform. * Application, Transport, Internet, Network Access Encapsulation- Process of adding control info as it passes through the layered model Decapsulation- process of removing extra information Protocol Data Unit (PDU) – generic term for data at each level. Chapter 3: Presentation Layer has 3 primary functions: * Coding and conversion of application layer data * Compression of the data * Encryption of the data TCP/IP protocols: Domain Name System (DNS) – used to resolve internet names to IP address. * HTTP – used to transfer files that make up the web pages of the WWW. * Simple Mail Transfer Protocol (SMTP) – used for the transfer of mail messages and attachments. * Telnet – a terminal emulation protocol used to provide remote access to servers and networking devices. * File Transfer Protocol (FTP) – used for interactive file transfer between systems. Process – e ach executing program loaded on a device. Client/server model Deamon – are describes as â€Å"listening† for a request from a client. Application layer services and protocolsPeer-to-peer networking and applications * 2 or more computers are connected through a network and can share resources such as printers and files without having a dedicated server. nslookup – a utility that allows the user to manually query the name servers to resolve a given host name. ipconfig/displaydns – displays all the cached DNS entries 3 common message types are: * GET- is a client request for data. * POST and PUT- are used to send messages to that upload data to the web browser. E-Mail Server Processes: * Mail Transfer Agent (MTA) – process used to forward e-mail. * Mail Delivery Agent (MDA)Server Message Block (SMB) – a client/server file-sharing protocol. Chapter 4: Transport Layer – provides transparent transfer of data between end users, providing rel iable data transfer services to the upper layers. It enables applications on devices to communicate. * Tracking the individual communications * Segmenting data and managing each piece * Reassembling the segments * Identifying the different applications * Performing flow control between end users * Enabling error recovery * Initiating a session Flow Control – can prevent the loss of segments on the network and avoid the need for retransmission.Used to avoid buffer overflows. Two most common transport layer: TCP (Transmission Control Protocol) – incurs additional overhead to gain functions. * Web browsers, E-mail, File transfers UDP (User Datagram Protocol) – provide the basic functions for efficiently delivering the data pieces. Has the advantage of providing low-overhead data delivery. * DNS, Video streaming, Voice over IP (VoIP) 3 basic operations of reliability: * Tracking transmitted data * Acknowledging received data * Retransmitting any unacknowledged data Socket – refers only to the unique combination of IP address and port number.Internet Assigned Numbers Authority (IANA) – assigns port number. Different types of ports: * Well-known ports (0 to 1023) – reserved for services and applications. * Registered ports (1024 to 49151) – are assigned to user processes or applications. * Dynamic or private ports (49152 to 65535) – also known as ephemeral ports, are usually assigned dynamically to client applications. netstat – a command that is an important network utility that you can use to verify TCP connections. It lists the protocol in use, the local address and port number†¦ Datagram – is a UDP segment (piece).Flags – are six 1-bit fields contain control information used to manage the TCP processes: * URG: Urgent pointer field significant * ACK: Acknowledgement field significant * PSH: Push function * RST: Reset the connection * SYN: Synchronize sequence numbers * FIN: No more data from sender *flags have fields that the only value is 1 bit and, therefore, has only two values: 1 or 0. 3 way handshake: Step 1 – SYN, Step 2 – SYN and ACK, Step 3 – ACK. Expectational acknowledgement – occurs when TCP uses the acknowledgement number in segments sent back to the source to indicate the next byte in this session that the receiver expects to receive.Window size – is the amount of data that a source can transmit before an acknowledgement must be received. Chapter 5: OSI Layer 3 – provides services to exchange the individual pieces of data over the network between identified end devices. The network layer describes four tasks to be performed: * Addressing packets with an IP address * Encapsulation – is the process of adding that information. * Routing – is the process router perform when receiving packets†¦ * Decapsulation – is the process of removing encapsulation data at different layers. Source IP address – is the IP address of the sending hostDestination IP address – is the IP address of the receiving host. IP header – contains the address information and some other bits that identify the PDU as a network layer PDU. Packet – is referred when an OSI layer 4 PDU has been encapsulated at the network layer. Hop – is each route that a packet takes to reach the next device. Common network protocol: * IPv4 – most widely used network protocol. * IPv6 – currently in use in some area. * Novell IPX – a widely popular internetworking protocol in the 1980s and 19990s. * AppleTalk – Apple Computer’s propriety networking protocol. Connectionless Network Service (CLNS) – a protocol used in telecommunication network. IPv4 basic characteristics: * Connectionless * Best effort (unreliable) * Media independent *Some networks have media restrictions and must enforce a Maximum Transmission Unit (MTU). Fragmentation â €“ is the process when the network layer builds the packets according to specification. Key fields: * IP source addressing * IP destination addressing * Time to Live (TTL) * Type of Service (ToS) * Protocol * Flag and Fragment Offset Other Key Fields: * Version * Internet Header Length (IHL) * Packet Length * Identification Header Checksum * Options * Padding *Because broadcast do not travel beyond the network boundary, the network is known as a broadcast domain. Gateway router – is the router a network uses to send and receive messages beyond the network. Hierarchical addressing – is read from the most general information to the most specific. Subnetting – the process when a large network needs to be divided into smaller subnets, additional network codes can be created using some of the bits designated for the host. *The default route is used when the destination network is not represented by any other route in the routing table.Next hop – is the add ress of the device that will process the packet next. *The route info can be manually configured on the router, creating what is known as a static route. Dynamic routing – when routers learn about routes automatically from other routers in the same internetwork. Routing Protocols – are the set of rules by which routers dynamically share their routing information. * Routing Information Protocol (RIP) * Enhanced Interior Gateway Protocol (EIGRP) * Open Shortest Path First (OSPF) 3 key factors to consider when grouping hosts into a common network: * Purpose * Ownership * Geographic location

Mercedes Benz Company Case Study Example | Topics and Well Written Essays - 1000 words

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Export Final Project - Malaysian fashion retailer wishing to expand Term Paper

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Problems Stemming from the Economic Crisis and Potential Recovery Research Paper

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Hume's analysis of the process by which we make causal judgments Essay - 1

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A report on application of technology in Operations Management - Essay Example This forms the revenue-generating function of any business and thus based on five critical strategies such as speed, flexibility, dependability, quality and cost. All operations activities are carried out based on these strategies. In order to continuously enhance effectiveness of these strategies, various technology services are employed in operations management through advanced information technology and information service (IT/IS) systems. This report evaluates application of IT/IS in various operations activities and their impact on its core strategies. 2. Operations management and strategic objectives: The entire operations/production process is accomplished using resources such as money, raw material, equipment, manpower and finance. These inputs are processed in specific manner through a sequence of preplanned activities in order to produce desired outputs, which can be in the form of completed parts, products, chemicals, service to customers, completed paperwork etc. Operatio ns strategy controls the strategic position of the firm, and is aligned to the overall corporate strategy. This alignment is to ensure all policies and plans reinforce organizational effectiveness and aid in optimum production of goods and services. For example, Toyota’s operations strategy includes designing, assembling and marketing the finished products, but procures the rest from other suppliers (Feist et al, 1999). This strategy is aligned to its corporate strategy of producing defect-free products, in less time and occupy largest market share. In general, operations strategy involves decisions related to design of the process of production or service providing as well as facilities and/or infrastructure needed to support the process. To achieve such tough and complicated objectives, organizations make optimum usage of advanced information and technological services. The IT services form a part of their tactical planning approaches, which also include capital, human reso urces, technology, facilities; staffing and scheduling methodologies to achieve target productions; sales and service operations; inventory management of supplies and delivered goods etc. In addition, short-term operations planning activities such as capacity, quality control, inventory, manpower etc also require IT services for effective operations. 3. Practical applications of IT for objective achievement: The three major components of corporate strategy in any business include operations effectiveness, customer management and production process and innovation (Chase 2006). Information Technology (IT) provides strong platform to convert, store, protect, process, transfer and recover information related to operations, customer and production processes. IT and its systems are used in all operations management processes such as capacity planning, inventory control and management, quality control, human resources management, etc. All business processes such as taking orders from custo mers, handling returns, manufacturing, marketing, delivery of end products also require IT systems. IT finds effective application in all customer management activities such as evaluation of customer feedback, customer satisfaction, customer expectations etc. Application of IT for innovation in operations and production management is mainly through research and development activities. According to Slack et al. (2004) the main objectives of operations manage

Ethics Essay Example | Topics and Well Written Essays - 750 words - 11

Ethics - Essay Example It also entails the study of common values, for example, natural or human rights, the significant equality of all human beings, obeying the laws of the land, and concern for safety and health (Singer 14). Ethics can help me live a better life. The role of ethics in the society is extremely significant because it is the basic standards and beliefs that make everything function properly. Ethics is included in all institutions and organizations around us whether social, political, religious, lawful, or medical. Ethics may help in improving my life by giving me comfort in knowing that I have the capacity to choose between the right and wrong. For instance, I am able to live a better life because I believe doctors are ethical and can trust their diagnosis. If ethics did not apply in various areas of life, for example, medicine, a number of health professionals may deliberately misdiagnose their patients for the purpose of getting money instead of improving the wellbeing and health of the patient. In addition, ethics can help me live a better life through business. Ethics gives me comfort that a business exchange will not fall through. In today’s world, contracts and laws are put into effect to ensure that the business exchanges are favorable to both parties and that these parties will keep up their side of the deal. Therefore, without ethics, my life will not improve as the society will be one of uncertainty and dishonesty. Even though there is no perfect society, ethics plays a significant part in improving the lives of individuals. There are several ethical parameters that I utilize to determine my actions, thoughts, and the kind of life I live. I reflect and think about the worldview and values of individuals. Everyone has specific worldviews that structure and inform the way they interact and relate with others and the world. Nevertheless, the values system and worldview is not something that I am completely aware of. My values system and worldview is par tly shaped by influences and experiences that I have minimal influence over, for example, teachers and parents. In taking time to reflect and think about the way I perceive the world I am able to determine my actions, thoughts, and way of life. I assess my value system. This helps in adopting an objective or impartial view. It entails recognizing the qualities that I think signify my pleasant points, faults, and components that need enhancement (Singer 18). I attempt to see myself the way other people see me. I also determine my actions, thoughts, and way of life through reading and other cultural activities. I read novelists whose works contain ethical dilemmas and moral issues, which is acts as a beneficial way of extending my moral and ethical horizons. In addition, reading ethical work of significant philosophers, for example, John Dewey and Plato provides me with a profusion of ideas for thoughts, actions, and life in general. I also write down a moral standard for myself to de termine my actions, thoughts, and the kind of life I live. This includes both the type of individual that I want to be and the type of world I want to exist in. A moral code refers to an individual statement that forms a manual for personal preferences and choices. Taking the time to extend my ethical parameters indicates that ethical systems come in varying sizes and shapes. It also entails writing down a series of queries that are significant to me and find out how to

Excel based problems Essay Example for Free

Excel based problems Essay The fund-basis financial statements of Jefferson county have completed for the year 2012 and appear in the first tab of the excel spreadsheet provided with this exercise. The following information is also available: a. Capital Assets †¢ Capital assets purchased in previous years in governmental type funds totaled $752,000 (net of accumulated depreciation) as of January 1, 2012. †¢ Depreciation on capital assets used in governmental- type activities amounted to $79,500 for 2012 †¢ No capital assets were sold or disposed of in 2012 and all purchases are properly reflected in the fund-basis statements as capital expenditures. b. Long-term Debt †¢ There was no outstanding long-term debt associated with governmental- type funds as of January 1, 2012. †¢ April 1, 2012, 6 percent bonds with a face value of $ 700,000 were issued in the amount of $ 720, 000. Bond payments are made on October 1 and April 1 of each year. Interest is based on an annual rate of 6 percent and principal payments are $ 17, 500 each. The first payment (Interest and principal) was made in October 1. †¢ Amortization of the bond premium for the current year is $1,000. c. Deferred Revenues †¢ Deferred revenues (comprised solely of property taxes) are expected to be collected more than 60 days after year-ed. The balance of deferred taxes at the end of 2011 was $18,200 d. Transfers †¢ Transfers were between governmental-type funds. e. Internal Service Fund †¢ The (motor pool) internal service fund’s revenue is predominantly derived from departments classified as governmental-type activities †¢ There were no amounts due to the internal service fund from the General fund. The outstanding balance of â€Å"due to other funds† was with the Enterprise Fund and is not capital related. †¢ The enterprise fund provided a long-term advance to the internal service fund (not capital related). Required Use the excel template provided to complete the following requirement; a  separate tab is provided in Excel for each of these steps. 1. Prepare the journal entries necessary to convert the governmental fund financial statements to the accrual basis of accounting 2. Post the journal entries to the conversion worksheet provided 3. Prepare a governmental-wide Statement of Activities and statement of Net Assets for the year 2012. All of the governmental fund revenues are â€Å"general revenues.† This is an involved problem, requiring many steps. Here are some hints. a. Tab 1 is information to be used in the problem. you do not enter anything here b. After you make the journal entries (Tab2), post these to the worksheet to convert to the accrual basis. This worksheet is set up so that you enter Debit as positive numbers and credits as negative. After enter you post your entries, look at the numbers below the total credit Colum to see that debits equal credits. If not, you probably entered a credit as a positive number. c. Make sure that total debits equal total credits in the last column (balances for Government-wide statements ) d. When calculating Restricted Net Assets, recall that permanent fund principal is added to restricted fund balances.

DeLone McLean IS success models

DeLone McLean IS success models DeLone McLean IS success models According to Grover(1996), there is no definition of IS success. Each group of stakeholders who assess IS success in an organization has a different definition. From a software developer’s perspective, a successful information system is completed on time and under budget, has a set of features consistent with specifications, and functions correctly. Users may find an information system successful if it improves their work satisfaction or work performance. From an organizational perspective, a successful information system contributes to the company’s profits or creates a competitive advantage. Furthermore, IS success also depends on the type of system that is evaluated (Seddon et al. 1999, p. 21). IS success had seen different definitions given by many authors. According to Bailey and Pearson (1983) IS success is defined as â€Å"Measuring and analyzing computer user satisfaction is motivated by management’s desire to improve the productivity of information systems.† Authors Goodhue and Thompson (1995, p. 213) had given definition to IS success as â€Å"†¦MIS success ultimately corresponds to what DeLone and McLean (1992) label individual impact or organizational impact. DM reviewed the literature published in 1981-1987 in seven publications to develop a taxonomy of IS success. This taxonomy was based upon Mason’s modification of the Shannon and Weaver model (C.E. Shannon Weaver 1949)ofcommunications which had identified three levels of information: the technical level (accuracy and efficiency of the system that produces it), the semantic level (its ability to transfer the intended message), and the effectiveness level (its impact on the receiver). M ason adapted this theory for IS and expanded the effectiveness level into three categories: receipt of information, influence on the recipient, and influence on the system (R.O. Mason 1978). DM identified categories for system success by mapping an aspect of IS success to each of Mason’s effectiveness levels. This analysis yielded six variables of IS success: System Quality, Information Quality, Use, User Satisfaction, Individual Impact, and Organizational Impact. System Quality was equivalent to the technical level of communication, while Information Quality was equivalent to the semantic level of communication. The other four variables mapped to Mason’s subcategories of the effectiveness level. Use related to Mason’s ‘‘receipt of information.’’ User Satisfaction and Individual Impact were associated with the ‘‘information’s influence on the recipient.’’ Organizational Impact was the ‘‘influ ence of the information on the system.’’ DM developed their initial taxonomy using established theories of communication adapted to IS. These theories suggested that the flow of information was linear; however, they suggested that for IS, these different measures of success were independent, but that there was interdependency among them. Fig. 1 shows the original model. DM suggested that researchers should use this model in a predictive manner, yet they cautioned that one must measure and/ or control each of the variables in the model to ensure a complete understanding of IS success. DM called upon others to validate their model .† In order to provide a more general and comprehensive definition of IS success that covers these different points of view, DeLone and McLean (1992) reviewed the existing definitions of IS success and their corresponding measures, classifying them into six major categories. They created a multidimensional measuring model with interdependencies between the different success categories. The original DM IS success model According to DeLone and McLean (1992), measurement of IS success is critical for understanding the value and efficacy of IS management actions and IS investments. One of the most important and popular works on IS success model is the DeLone and McLean model (DM IS success model). DeLone and McLean proposed in 1992 a taxonomy and an interactive model as the frameworks for conceptualizing IS success. Driven by the need of a process to understand IS and its impacts, they developed a multi-dimension integrated view of IS success model. DeLone and McLean (1992) comprehensively reviewed IS success measures and concluded with a model of interrelationships between six IS success variable categories: (1) system quality, (2) information quality, (3) IS use, (4) user satisfaction, (5) individual impact, and (6) organization impact (see Fig. 1). This model makes two important contributions to the understanding of IS success. First, it provides a scheme for categorizing the multitude of IS success measures which have been used in the research literature. Second, it suggests a model of temporal and causainterdependencies between the categories (McGill, Hobbs, Klobas, 2003; Seddon, 1997). Since 1992, a number of studies have undertaken empirical investigations of the multidimensional relationships among the measures of IS success. Seddon and Kiew (1994) tested part of the DeLone and McLean (1992) model using a structural equation model. They replaced â€Å"use† with â€Å"usefulness† and added a new variable called â€Å"user involvement,† and their results partially supported the DeLone and McLean (1992) model. The description and examples of measures for these six dimensions are: First, system quality denotes system performance like data accuracy, system efficiency, response time, etc. Second, information quality refers to the quality of the IS product, such as currency, relevance, reliability, and completeness. Third, use refers to the frequency an information system is used, examining items like the number of functions used, frequency of access, and amount of connect time. Fourth, user satisfaction records the satisfaction level as reported by system users, including overall satisfaction and satisfaction of interface, etc. Fifth, individual impact refers to measuring the impacts brough t about by the information system on individual users, such as changes in productivity, decision model, and decision making. Sixth, organizational impact requires the evaluation of the changes caused by the information system to the organization, such as decrease in operating cost, savings in labor costs, and growth in profits. This original model identified six interrelated dimensions of IS success. It suggested that the success can be represented by the system quality, the output information quality, consumption (use) of the output, the user’s response (user satisfaction), the effect of the IS on the behavior of the user (individual impact), and the effect of the IS on organizational performance organizational impact). This model provided a scheme for classifying the multitude of IS success measures and suggested the temporal and causal interdependencies between the six dimensions. Motivated by DeLone and McLean’s call for further development and validation of their model, many researchers have attempted to extend or respecify the original model. A number of researchers claim that the DM IS success model is incomplete. They suggest that more dimensions should be included in the model, or present alternative success. Other researchers focus on the application and validation of the model (Rai et al. 2002). Following the Seddon’s extension of Delone McLean IS success model in 1997 into partial behavioural model of IS use and IS process model for IS success, Garrity and Sanders (1998) further adapted the model taking into account the organisational and sociotechnical systems. The model was further extended by Molla and Licker (2001) to measure e-Commerce success. The New DM IS model Information systems (IS) success is one of the most researched topics in IS literature. De Loneand McLean (1992) become aware of the complex reality that surrounds the identification and definition of the IS success concept. They organize the large number of studies on IS success and present a comprehensive and integrative model. DeLone and McLean, in their study, identify six main dimensions for categorizing the different measures of IS success: system quality, information quality, use, user satisfaction, individual impact, and organizational impact. They develop an IS success model in which these categories are interrelated, shaping a process construct. Their model proposes that â€Å"system quality and information quality singularly and jointly affect both use and user satisfaction. Additionally, the amount of use can affect the degreeof user satisfaction as well as the reverse being true. Use and user satisfaction are direct antecedents of individual impact; and, lastly, this impact on individual performance should eventually have some organizational impact† (DeLone McLean, 1992) (Figure 2). DeLone and McLean (1992) state that their model is â€Å"an attempt to reflect the interdependent, process nature of IS success†, undertaking to describe the IS success concept and the causes for the success. According to Ballantin other researchers (1996) and Seddon (1997), DeLone and McLean’s work makes several important contributions to the understanding of IS success. First, it consolidates previous research. Second, it provides a scheme for classifying the different measures of IS success that have been proposed in the literature into six dimensions. Third, it suggests a model of temporal and causal interdependencies between the identified categories. Fourth, it makes the first moves to identify different stakeholder groups in the process. Fifth, it has been considered an appropriate base for further empirical and theoretical research. Sixth, it has met general acceptance in the IS community. In the years that followed, several researchers altered or extended the model, while others adapted it for specific applications, such as knowledge management or e-commerce (W.H. DeLone, E.R. McLean 2004) systems. Recognizing these potential improvements over their original model, DM acknowledged these modifications and revised their model accordingly (W.H. DeLone, E.R. McLean 2003). The updated model is shown in Fig. 2. DM also modified their model to address some limitations of the original model. A key addition in the updated model was the inclusion of Service Quality as an additional aspect of IS success (L.F. Pitt, R.T. Watson, C.B. Kavan 1995); it was added because the changing nature of IS required the need to assess service quality when evaluating IS success. DM also recommended assigning different weights to System Quality, Information Quality, and Service Quality depending on the context and application of the model. There has been an intense debate about whether system use is a good measure of IS success. Although some authors (P.B. Seddon 1997) have suggested that it is better to remove system use as an IS success variable, DeLone andMcLean argued that systemusewas an appropriate measure. They asserted that the source of the problem was a too simplistic definition of system use, and that researchers must consider the extent, nature, quality, and appropriateness of it. Simply measuring the amount of time a system is in use is not enough: informed and effective use is an important indication of IS success. The DeLone and McLean Information System Success model, published in 1992, supplies a general framework to measure information systems success through the analysis of six different but interdependent factors: â€Å"system quality† on a technical level, â€Å"information quality† on a semantic level and â€Å"use†, â€Å"user satisfaction†, â€Å"individual impacts† and â€Å"organization impacts† on an effectiveness level. All these factors relate each other both on a temporal and a causal model; in the temporal model we first find system quality and information quality, which characterize an information system when it is just created; in a second stage of this process come use and user satisfaction, which feed or restrain each other and that are strongly influenced by the first two factors; finally, both in a temporal and in a causal way, comes first the individual impact and then the organizational impact, which is not seen as a simple sum of individual impacts but as a complex network of consequences. The generic nature of each of these entities makes the framework suitable for a variety of different information systems and contexts. During the last decade hundreds of articles have been written to confirm or challenge the validity of DeLone and McLean conclusions; in 2003 a new article was written by the same two authors to refine the whole model by taking into account all the suggestions/critiques made to the original article. The primary purpose of the original 1992 DM IS success model was to synthesize previous researches on IS success into a more coherent body of knowledge and to provide guidance to future researchers (DeLone and McLean, 2003). The role of IS has changed and progressed during the last decade. Similarly, academic inquiry into the measurement of IS Although it may be more desirable to measure system benefits in terms of numeric costs (e.g cost savings, expanded markets, incremental additional sales, and time savings), such measures are often not possible because of intangible system impacts and intervening environmental variables that may influence the numbers (T. McGill, V. Hobbs 2003).Therefore, there has been little consensus on how net benefits should be measured objectively and thus they are usually measured by the perceptions of those who use the IS. Therefore, ‘‘perceived system benefits’’ or ‘‘perceived usefulness’’ has been adopted as an important surrogate of IS success (B.H. Wixom, H.J. Watson 2001) The right-hand side of the DeLone and McLean’s model, which assumed linear causality between system use, user satisfaction, individual impact, and organizational impact, has not been authenticated. Seddon contended that the model was too encompassing and introduced some confusion because it mixed process and causal explanation of IS success. He further argued that system use must precede impacts and benefits, but that it did not cause them. Accordingly, system use would be a behavior that reflects an expectation of system benefits from using an IS and thus would be a consequence of IS success, rather than a determinant of system net benefits. Some empirical surveys (M. Gelderman 1998) also found that the association between system use and system benefit was not statistically significant. System use is necessary but not sufficient to create system benefits. User satisfaction results from the feelings and attitudes from aggregating all the benefits that a person hopes to receive from interaction with the IS (B. Ives, M.H. Olson, J.J. Baroudi 1983). In fact, attitude cannot influence system benefits—on the contrary, perceived system benefits can influence user satisfaction. Therefore, individual impact and net benefits can cause user satisfaction (rather than vice versa). There has been an intense debate about whether system use is a good measure of IS success. Although some authors (P.B. Seddon 1997) have suggested that it is better to remove system use as an IS success variable, DeLone andMcLean argued that systemusewas an appropriate measure. They asserted that the source of the problem was a too simplistic definition of system use, and that researchers must consider the extent, nature, quality, and appropriateness of it. Simply measuring the amount of time a system is in use is not enough: informed and effective use is an important indication of IS success. Although it may be more desirable to measure system benefits in terms of numeric costs (e.g. cost savings, expanded markets, incremental additional sales, and time savings), such measures are often not possible because of intangible system impacts and intervening environmental variables that may influence the numbers (T. McGill, V. Hobbs 2003).Therefore, there has been little consensus on how net benefits should be measured objectively and thus they are usually measured by the perceptions of those who use the IS. Therefore, ‘‘perceived system benefits’’ or ‘‘perceived usefulness’’ has been adopted as an important surrogate of IS success (B.H. Wixom, H.J. Watson 2001) The right-hand side of the DeLone and McLean’s model, which assumed linear causality between system use, user satisfaction, individual impact, and organizational impact, has not been authenticated. Seddon contended that the model was too encompassing and introduced some confusion because it mixed process and causal explanation of IS success. He further argued that system use must precede impacts and benefits, but that it did not cause them. Accordingly, system use would be a behavior that reflects an expectation of system benefits from using an IS and thus would be a consequence of IS success, rather than a determinant of system net benefits. Some empirical surveys (M. Gelderman 1998) also found that the association between system use and system benefit was not statistically significant. System use is necessary but not sufficient to create system benefits. User satisfaction results from the feelings and attitudes from aggregating all the benefits that a person hopes to receive from interaction with the IS (B. Ives, M.H. Olson, J.J. Baroudi 1983). In fact, attitude cannot influence system benefits—on the contrary, perceived system benefits can influence user satisfaction. Therefore, individual impact and net benefits can cause user satisfaction (rather than vice versa). The measurement of IS success or effectiveness is critical to our understanding of the value and efficacy of IS management and investments (DeLone and McLean, 2003). They have striven to bring both awareness and structure to the â€Å"dependent variable†- IS success in IS research, and the result is the so-called updated DM IS success model (Figure 2). Their major contribution is proposing a taxonomy and an interactive model as frameworks for conceptualizing and operationalizing IS success for future researchers. In response to the progresses in IS applications, DeLone and McLean refined their original model and proposed an updated version in 2003. Service quality was added into the success model, and the individual impact and organizational impact were combined into a single variable named â€Å"net benefits† as shown in Figure 4. To catch up with the advancements of its applications, IS needs not only to provide users information products but also to meet users’. In addition, some researchers (J.J. Baroudi, M.H. Olson, B. Ives 1986) have suggested that user satisfaction causes system use rather than vice versa. Thus, the Delone and McLean’s assertion that system use causes user satisfaction seems to be merely a temporal rather than causal relationship. Many models based on that of DeLone and McLean have been presented. However, they often confuse the independent variable and dependent variables of IS success. ‘‘Technological support’’, ‘‘knowledge strategy or process’’, and ‘‘support and service’’ are three examples of suggested additions but these clearly cause success (rather than being part of it). The variables should be dependent; i.e. surrogate measures for success. DeLone and McLean suggested that the IS success model should include service quality for electronic commerce systems. DeLone McLean (2003) argue that Seddon’s (1997) reformulation of the DeLone McLean (1992) model into two partial variance models (i.e. IS success model and partial behavioural model of IS Use) unduly complicates the success model, and thus assert that System Use or Intention to Use is still an important measure of IS success. Given that Systems Use/Intention to Use is included in their updated IS success model, DeLone McLean (2003; 2004), however, did not attempt to reconcile their model with Seddon’s (1997) Perceived Usefulness measure and Davis’s (1989) Technology Acceptance Model (TAM) that explains system use behaviour. Thus, there is a need for research to combine the updated DM model with Seddon’s (1997) Perceived Usefulness construct and the IS acceptance/adoption literature to give it the richness in theoretical perspective that it presently lacks. While the updated DM model is a generic, comprehensive e-commerce systems success model, it suffer s from certain difficulties. First, the Net Benefit measure in the model is conceptually too broad to define. As DeLone McLean (2004) suggest, ‘The new net benefits construct immediately raises three issues that must be addressed: what qualifies as a benefit? for whom? and at what level of analysis’ Thus, when using the updated DM model, researchers need to clearly and carefully define the stakeholders and the context in which Net Benefits are to be measured (DeLone McLean, 2004). DeLone and McLean (2003) propose an updated IS success model (Fig. 2) and evaluate its usefulness in light of the dramatic changes in IS practice, especially the advent and explosive growth of ecommerce. They agree with Seddons premise that the combination of variance and process explanations of IS success in one model can be confusing, but argue that Seddons reformulation of the DeLone and McLean (1992) model into two partial variance models unduly complicates the success model, and defeats the intent of the original model. Based on prior studies, DeLone and McLean (2003) propose an updated model of IS success by adding a â€Å"service quality† measure as a new dimension of the IS success model, and by grouping all the â€Å"impact† measures into a single impact or benefit category called â€Å"net benefit.† DeLone McLean (2004) propose several e-commerce systems success measures identified in the management information systems (MIS) and marketing literature, t he nomological structure of the updated DM model is not fully consistent with the quality- value-satisfaction-loyalty chain in the marketing and consumer behavior. Thus, continued research is also required to reconcile the updated DM model with the marketing research literature. Although some researchers claim that service quality is merely a subset of the models systems quality, the changes in the role of IS over the last decade argue for a separate variable called the â€Å"service quality† dimension (DeLone McLean, 2003). On the other hand, while researchers have suggested several IS impact measures, such as individual, work group impacts, organizational impacts (DeLone McLean, 1992), interorganizational impacts, consumerimpacts, and societal impacts (Seddon, 1997), DeLone and McLean (2003) move in the opposite direction and group all of the impact measures into a single net benefits variable, to avoid complicating the model with more success measures. Given that system usage continues to be used as a dependent variable in a number of empirical studies, and takes on a new importance in Internet-based system success measurements, where system use is Voluntary, â€Å"system usage† and the alternative â€Å"intention to use† are still considered as Important measures of IS success in the updated DeLone and McLean model. References Seddon PB, Staples S, Patnayakuni R, Bowtell M (1999) Dimensions of information systems success. Communications of the AIS Grover V, Jeong SR, Segars AH (1996) Information systems effectiveness: the construct space and patters of application. Information Management 31(4):177-191 Goodhue DL, Thompson RL (1995) Task-technology fit and individual performance. MIS Quarterly 19(2):213 DeLone WH, McLean ER (1992) Information systems success: the quest for the dependent variable. Information Systems Research DeLone WH, McLean ER (2003) The DeLone and McLean model of information systems success: a ten-year update. Journal of Management Information Systems McGill, T., Hobbs, V., Klobas, J. (2003). User-developed applications and information systems success: A test of DeLone and McLeans model. Information resources Management Journal, R.O. Mason, Measuring information output: a communication systems approach, Information Management Seddon, P. B. Kiew, M.-Y. (1994). A partial test and development of the DeLone and McLean model of IS success. In J. I. De Gross, S. L. Huff, M. C. Munro (Eds.), Proceedings of the international conference on information systems Atlanta, GA: Association for Information Systems Rai, A., Lang, S.S. Welker, R.B. (2002) Assessing the validity of IS success models: an empirical test and theoretical analysis. Information Systems Research, Molla, A. Licker, P.S. (2001) E-commerce systems success: an attempt to extend and respecify the DeLone and McLean model of IS success. Journal of Electronic Commerce Research Taylor, S. and Todd, P. â€Å"Understanding information technology usage: a test of competing models,† Information Systems Research

Bland-Altman Agreement Analysis in Laboratory Research

Bland-Altman Agreement Analysis in Laboratory Research Use of Bland-Altman agreement analysis in laboratory research: A survey of current reporting standards. Introduction- Advances in technology have led to development of new instruments and measurement devices in field of medicine. The clinicians and researchers often need to compare a newer method of measurement with an established one, to check for interchangeability. While assessing for interchangeability the emphasis should be on testing how well two methods agree with each other. Earlier Pearson’s product-moment correlation coefficient was used as a measure of agreement[R]. However the approach was inappropriate as this coefficient merely indicated association rather than agreement [R]. Hence Bland and Altman in their series of publications[R] stressed on quantification of bias. They provided a simpler and visually attractive plot for agreement analysis of continuous variables measured on the same scale.[R] After its introduction to medical literature in 1983, the Bland-Altman’s (B-A) method [R] is one of most commonly used statistical method for agreement analysis. The method is extensively used in evaluating the agreement of laboratory analytes, physiological variables, newer instruments and other devices. B-A method[R] advocates the construction of a scatter plot, where the absolute difference between the paired measurements is plotted on y-axis against the mean of two methods on x-axis. The SD of differences between paired measurements is then used to construct 95% limits of agreement (as  ± 1.96 SD). The 95% of differences between paired measurements are expected to lie between these upper and lower LOA. The conclusions on agreement and interchangeability of two methods are then made based upon the width of these LOA in comparison to a priori defined clinical criteria[R]. The plot also enables the researcher to visually assess the bias, data scatter and the relationship between magnitude of difference and size of measurement. Often in biologic systems data scatter and the magnitude of differences increases proportionally to the size of the measurement (hetero-scedastic distribution). Bland and Altman recommended the logarithmic or percentage transformation of data in case of heter o-scedastic distribution and then constructing B-A plot with transformed data[R] instead of classical absolute difference plot. Contrary to conventional statistical hypothesis testing, the output of B-A analysis consists of bias and LOA, both of which are estimates[R]. The estimates have inherent risk of sampling error and hence the authors suggested calculation of confidence interval (CI) of bias and LOA. The method also advocated the collection of data in replicates. Replicates are defined as two or more measurements on the same individual by the same method, taken in identical conditions. Replicates enable the comparison of the agreement between the two methods with the agreement each method has to itself (repeatability) [R] B-A also advocated for sample size calculations on in method comparison studies[R]. Despite its simplicity and frequent use in clinical laboratory research, the B-A method is not properly interpreted and reported in medical literature. Studies [R]conducted a decade ago highlighted poor reporting standards of B-A method, however there is paucity of current information on the same. Furthermore, uniform statistical reporting of results not only increases the generalizability of results, but also facilitates the inclusion of studies in systemic reviews and meta-analysis. Hence the aim of study was to review the current reporting standards of B-A method in laboratory research in medical literature. Material and methods- Three researchers (VC, RB, and SK) participated in this study. All researchers were qualified health professionals. VC and SK had previous experience of publishing laboratory research [R] with use of B- A agreement analysis. Eligibility criteria- Studies which tested agreement of laboratory analytes with continuous measurements, as per B-A methodology were included. Literature search- A thorough search of PUBMED, MEDLINE and GOOGLE SCHOLAR was conducted for studies published in years 2012 and 2013. The search strings used to search potential studies were â€Å"Agreement analysis† AND/OR â€Å"Bland Altman analysis† (MeSH) and â€Å"Laboratory analytes† and â€Å"clinical biochemistry† (MeSH). Included studies were evaluated according to Bland and Altman methodology on a predesigned checklist. The studies were evaluated for following 8 items: (1.) Measures of repeatability (2.) Representation and correct definition of LOA (3.) Correct representation of x-axis on BA plot (4.) Reporting of CI of LOA (5.) Comparison of limits of agreement with a priori defined clinical criteria (6.) Evaluation of pattern of relationship between difference (y-axis) and average (x-axis) (7.) Use of logarithmic or percentage conversion of data in case of heteroscedastic relationship between the difference and average (8.) Sample size calcula tions. Each item on the checklist was rated as ‘Yes’or ‘No’. We also recorded the data on use of other statistical methods for testing of agreement. However, we did not perform detailed evaluation of included studies for other statistical methods of agreement. To ensure accurate data retrieval, each included study was evaluated twice by one author (VC) and data recorded on predesigned checklist. Opinion was taken from second author (SKK) in case of confusion arising during data extraction. We compared the results of our study with 3 similar surveys done earlier. Results- A total of 156 studies were screened for potential inclusion in the study. A total of 50 studies, were retrieved and included in the final study. The 38% of included studies were published in journals of various streams of internal medicine, while 30%, 26% and 6% were published in journals of laboratory medicine, emergency medicine, anaesthesia respectively. Results of survey and its comparison to three previous studies are as shown in Table-1.The other statistical methods used in addition to B-A plot in included studies were correlation coefficient (70%), Deming Regression(14%), Passing Bablok regression (14%), linear regression (24%), Lin’s Concordance (8%), Sensitivity specificity analysis (16%), Interclass correlation coefficient (6%), Grid error plot (10%), Critchley polar plots (2%). Discussion- Use of B-A for method comparison has increased in recent years with most of authors using it for analysing agreement. The original paper on agreement analysis by B-A[R] is among one of most cited statistical publication, with more than 34000 citations. Although claimed as a method which is simpler to perform and interpret, the method is often used and interpreted without proper understanding. Review by Berthelsen et al[R] in 2006 and earlier studies[R] demonstrated unsatisfactory reporting of B-A analyses, in anaesthesiology literature. Williamson et al[R] proposed a method of meta-analysis of method comparison studies, however authors also highlighted the problem of non-uniform reporting of studies. [R] Twomey et al [R] suggested use of method hierarchy for selection of x-axis and advocated use of gold standard method as x-axis in B-A plot. However Bland and Altman statistically proved that use of any single method instead of average of two methods as x-axis is misguided and leads to misinterpretation[R]. Results of our study suggest that 94% of studies reported x-axis correctly, which is almost similar to results of earlier studies conducted by Mantha et al (94%) [R] and Dewitt et al (87%) [R]. although most method comparison computer softwares (analyse it, Graphpad Prism, EP evaluator) automatically select x-axis as mean of two methods, errors in selection of x-axis are still noticed. The 95% LOA were correctly defined and drawn in 94 %( 47) of included studies. Further among 47 studies with correct definition of LOA, the 3 studies interpreted LOA wrongly concluding good agreement because 95 % of differences were present in-between upper and lower LOA. The 95 % LOA are in-fact drawn so as to contain 95% of differences between them. It is not LOA per se, but width of these LOA in comparison to a priori defined clinical criteria that conclusions regarding agreements can be made. The decision on acceptable differences between two methods is primarily clinical rather than statistical. Earlier studies by Dewitte et al [R]and Mantha et al[R] had shown that comparison with pre-defined clinical criteria was missing in >90% of studies. Total 74 % of authors in our study commented on agreement on basis of predefined clinical criteria which represents a significant improvement in reporting standards. The specifications for clinical acceptance criteria of laboratory analytes have been provided as by Ricos et al[R], CLSI[R], and West guard QC[R]. Alternatively a Delphi survey (expert opinion) can be done to determine acceptable limits before instituting study. The CI limits of LOA were reported in only 6% of included studies in our study. The LOA are estimates and reporting LOA without CI is equivalent to reporting a sample mean without its CI. The CI limits [Ludbrook et al] represent the range within which a single, new, observation taken from the same population would be expected to lie. Although strongly recommended by B-A[R], and subsequently proved by a simulation study conducted by Hamilton et al[R], the statistical reporting of CI of LOA has remained poor (Mantha et al-2.6%) [R]. Although recommended by B-A method, the pattern of relationship between difference and wider concentration range is rarely evaluated[R]. Drawing difference plot with parallel LOA in datasets with heteroscedastic scatter makes LOA wider in lower concentration range and narrower in higher concentration range thus affecting validity of interpretation. [R] Bland and Altman [R]proposed logarithmic transformation of data with heteroscedasticy and then constructing difference plot against average of two methods using log transformed data. For meaningful understanding of LOA, they suggested back-transformation (antilog) of the log transformed data. Alternatively[R] plot of ratios of two methods or percent difference can be plotted against average of two methods for simpler interpretation. Transformation of data usually renders the scatter of differences as uniform (Homoscedastic). Twomey et al[R] recommended the drawing up of funnel shaped or V shaped LOA instead of classical parallel LOA in data sets with heteroscedastic scatter. Another option is breaking the data into smaller subsets and then analysing these subsets with absolute difference plot to make conclusions. [Twomey et al] We observed that only 28 % of studies made an attempt at evaluation of pattern of scatter. Rest of authors did not comment on pattern thus affecting the validity of results. Another important problem noticed was lack of assessment of repeatability (38%), a practice that has not shown any substantial improvement Table-1. Conclusions drawn from studies without repeatability assessment are likely to be uncertain. Assessment of errors of the two methods (repeatability) enables the construction of the worst-case acceptable LOA. [R] With poor repeatability of one or both methods, the agreement between the two methods is bound to be unacceptable. [R] Sample size calculations were done in only 15 studies. Lack of power and sample size analysis reduces validity of results. Different researchers have proposed sample size calculation for method comparison studies using Bayesian[R], regression[R], or concordance [R] approach. However Stockl et al[R] proposed an approach incorporating CI of LOA and predefined error limits in B-A plot. The approach is simple and allows for visual interpretation of appropriate sample size, as the classical B-A plot provides for agreement. Despite a lot of research on B-A method in field of statistics, the uptake of the method in medical research has been slow. While efforts are on in statistical community for use of modifications of B-A plot in special situations like repeated measure studies[R] or using bar charts in B-A plots with limited value ranges[R], unfortunately reporting standards of classical B-A method among medical community are unacceptable. Guidelines â€Å"Reporting reliability and Agreement Studies (GRRAS)† were published as a guide to appropriate reporting of reliability and agreement studies. We found unsatisfactory reporting of B-A analysis in our study.

Essay --

The Power of Conformity There are many type of social concepts; however, there is one that I personally experienced through: social conformity. Conformity is a type of social influence involving a change in belief or behavior in order to fit in a group. Growing up as an immigrant is a perfect example for changing me in order to adapt to a new environment. Conformity can also be simply defined as â€Å"yielding to group pressures† (Crutchfield, 1955). Group pressure may vary in many forms such as bullying, persuasion, teasing, or criticism. Conformity is also known as group pressure. The term conformity is often used to describe one side arguing with the other side by a desire to ‘fit in’ or be liked, or because of a desire to be correct, or simply to conform to a social role. The desire to be accepted and belong to a group is every human’s need. However, how does this need affect an individual? There are many researches that include groups can change their members’ thoughts, feelings and behaviors. There are several types of conformity include compliance, internalization and identific...

Replacement Advertising on the Web - Is it Legally and Ethically Essay

Replacement Advertising on the Web - Is it Legally and Ethically Acceptable? Summary ======= This report discusses the legality and ethics of a new piece of software launched in February 2001, which allows ISP's to overlay advertising banners on any web page on the net with adverts sold by, and controlled by them. Investigations led to discussions about Copyright infringement and European Competition Law. Many examples of Case Law were also investigated for their possible links with issues arising from the use of this software. Introduction ============ This report is being written to try to understand the issues raised, both legally and ethically, by the release of a new piece of software (Fotino) onto the Internet market. In an attempt to answer whether this software is an acceptable addition to the world of the web, only replacement advertising as facilitated by Fotino software will be considered. This is due to the fact that since my investigations into this subject began other software packages have come to light, which may be able to perform this function in a slightly different way. The problem posed by this software has required investigations from both a practical and theoretical standpoint, in that in practice the software has not yet been adopted by any of the Internet Service Providers (ISP's) and so cannot be fully investigated along this route, yet from investigation I have been able to see the software in action from it's marketing campaign. From a theoretical point of view I have investigated existing laws and cases that I think may be used in the future, either for or against the use of this software, should any of the legal and ethical issues raised be fought in a court of law. This report is being written for anyone who may have an interest in developing technologies and how they affect both the technological world and society as a whole, ethically and legally. This report will raise issues about the catch-up situation of the legal system and the fast developing world of the internet. Due to the speed at which the world of computers develops I do not feel that this report will provide answers to the problem, but will merely provoke discussion and thought about many issues. The Managing Director of Meltingpoint Technologies - the company who developed the Fotino software, has requested a c... ...opean Community Law. London: Blackstone Press Ltd. pp 250-267. Web Sites --------- Hunt, J, 2001. Guardian Unlimited [online]. UK: Guardian. Available at: URL:http://wwwguardian.co.uk/archive/article/0,4273,4136232,00.html [Accessed 18th February 2001]. Lambert, J, 2001. Electronic Telegraph City News Headlines [online]. UK: Electronic Telegraph. Available at: [Accessed 24th February 2001]. (Author unknown), 1997. Lawtel Case Law [online]. UK: Lawtel. Available at: [Accessed 4th March 2001] (Author and year unknown), Analysis - Agency-client Contracts [online]. UK: Marketing Law. Available at: [Accessed 20th February 2001]. Case Law -------- Cooper v Stephens [1895] 1 Ch 567 Shetland Times Ltd v Dr Jonathan Wills [1997] FSR 604 Sinanide v La Maison Kosmeo [1928] 139 LT 365 Spectravest Inc v Aperknit Ltd [1988] FSR 161 United Brands Co. v Commission (Case 27/76) [1978] ECR 207 Volk v Etablissements Vervaecke Sprl (Case 5/69) [1969] ECR 295 Statutes -------- The Copyright Act 1956 The Copyright, Designs and Patent Act 1988 s 16(1), s 17(2), s 20 European Competition Law Article 85(1) European Competition Law Article 86

Dothea Orem Self-Care Theory

Dorothea Orem's Self-Care Theory This page was last updated on February 4, 2012 INTRODUCTION †¢Theorist : Dorothea Orem (1914-2007) †¢Born 1914 in Baltimore, US †¢Earned her diploma at Providence Hospital – Washington, DC †¢1939 – BSN Ed. , Catholic University of America †¢1945 – MSN Ed. , Catholic University of America †¢She worked as a staff nurse, private duty nurse, nurse educator and administrator and nurse consultant. †¢Received honorary Doctor of Science degree in 1976. †¢Theory was first published in Nursing: Concepts of Practice in 1971, second in 1980, in 1995, and 2001.MAJOR ASSUMPTIONS †¢People should be self-reliant and responsible for their own care and others in their family needing care †¢People are distinct individuals †¢Nursing is a form of action – interaction between two or more persons †¢Successfully meeting universal and development self-care requisites is an important compon ent of primary care prevention and ill health †¢A person’s knowledge of potential health problems is necessary for promoting self-care behaviors †¢Self care and dependent care are behaviors learned within a socio-cultural context DEFINITIONS OF DOMAIN CONCEPTSNursing – is art, a helping service, and a technology †¢Actions deliberately selected and performed by nurses to help individuals or groups under their care to maintain or change conditions in themselves or their environments †¢Encompasses the patient’s perspective of health condition ,the physician’s perspective , and the nursing perspective †¢Goal of nursing – to render the patient or members of his family capable of meeting the patient’s self care needs †¢To maintain a state of health To regain normal or near normal state of health in the event of disease or injury †¢To stabilize ,control ,or minimize the effects of chronic poor health or disability Health – health and healthy are terms used to describe living things †¦ †¢It is when they are structurally and functionally whole or sound †¦ wholeness or integrity. .includes that which makes a person human,†¦operating in conjunction with physiological and psychophysiological mechanisms and a material structure and in relation to and interacting with other human beings Environment environment components are enthronement factors, enthronement elements, conditions, and developed environment Human being – has the capacity to reflect, symbolize and use symbols †¢Conceptualized as a total being with universal, developmental needs and capable of continuous self care †¢A unity that can function biologically, symbolically and socially Nursing client †¢A human being who has â€Å"health related /health derived limitations that render him incapable of continuous self care or dependent care or limitations that result in ineffective / incomple te care. A human being is the focus of nursing only when a self –care requisites exceeds self care capabilities Nursing problem †¢deficits in universal, developmental, and health derived or health related conditions Nursing process †¢a system to determine (1)why a person is under care (2)a plan for care ,(3)the implementation of care Nursing therapeutics †¢deliberate, systematic and purposeful action, OREM’S GENERAL THEORY OF NURSING Orem’s general theory of nursing in three related parts:- †¢Theory of self care Theory of self care deficit †¢Theory of nursing system A. Theory of Self Care This theory Includes: †¢Self care – practice of activities that individual initiates and perform on their own behalf in maintaining life ,health and well being †¢Self care agency – is a human ability which is â€Å"the ability for engaging in self care† -conditioned by age developmental state, life experience sociocultural orientation health and available resources †¢Therapeutic self care demand – â€Å"totality of self care actions to be performed for some uration in order to meet self care requisites by using valid methods and related sets of operations and actions† †¢Self care requisites – action directed towards provision of self care. 3 categories of self care requisites are- oUniversal self care requisites oDevelopmental self care requisites oHealth deviation self care requisites 1. Universal self care requisites †¢Associated with life processes and the maintenance of the integrity of human structure and functioning †¢Common to all , ADL †¢Identifies these requisites as: oMaintenance of sufficient intake of air ,water, food Provision of care assoc with elimination process oBalance between activity and rest, between solitude and social interaction oPrevention of hazards to human life well being and oPromotion of human functioning 2. Developmental sel f care requisites †¢Associated with developmental processes/ derived from a condition†¦. Or associated with an event oE. g. adjusting to a new job oadjusting to body changes 3. Health deviation self care †¢Required in conditions of illness, injury, or disease . these include:– †¢Seeking and securing appropriate medical assistance Being aware of and attending to the effects and results of pathologic conditions †¢Effectively carrying out medically prescribed measures †¢Modifying self concepts in accepting oneself as being in a particular state of health and in specific forms of health care †¢Learning to live with effects of pathologic conditions B. Theory of self care deficit †¢Specifies when nursing is needed †¢Nursing is required when an adult (or in the case of a dependent, the parent) is incapable or limited in the provision of continuous effective self care.Orem identifies 5 methods of helping: oActing for and doing for others o Guiding others oSupporting another oProviding an environment promoting personal development in relation to meet future demands oTeaching another C. Theory of Nursing Systems †¢Describes how the patient’s self care needs will be met by the nurse , the patient, or both †¢Identifies 3 classifications of nursing system to meet the self care requisites of the patient:- †¢Wholly compensatory system †¢Partly compensatory system †¢Supportive – educative system †¢Design and elements of nursing system define Scope of nursing responsibility in health care situations †¢General and specific roles of nurses and patients †¢Reasons for nurses’ relationship with patients and †¢Orem recognized that specialized technologies are usually developed by members of the health profession †¢A technology is systematized information about a process or a method for affecting some desired result through deliberate practical endeavor, with or w ithout use of materials or instruments. Categories of technologies 1. Social or interpersonal †¢Communication adjusted to age, health status Maintaining interpersonal, intra group or inter group relations for coordination of efforts †¢Maintaining therapeutic relationship in light of psychosocial modes of functioning in health and disease †¢Giving human assistance adapted to human needs ,action abilities and limitations 2. Regulatory technologies †¢Maintaining and promoting life processes †¢Regulating psycho physiological modes of functioning in health and disease †¢Promoting human growth and development †¢Regulating position and movement in space OREM’S THEORY AND NURSING PROCESS †¢Nursing process presents a method to determine the self care deficits and hen to define the roles of person or nurse to meet the self care demands. †¢The steps within the approach are considered to be the technical component of the nursing process. †¢Orem emphasizes that the technological component â€Å"must be coordinated with interpersonal and social processes within nursing situations. Nursing Process Orem’s Nursing Process †¢Assessment †¢Diagnosis and prescription; determine why nursing is needed. analyze and interpret –make judgment regarding care †¢Design of a nursing system and plan for delivery of care †¢Production and management of nursing systemsStep 1-collect data in six areas:- †¢The person’s health status †¢The physician’s perspective of the person’s health status †¢The person’s perspective of his or her health †¢The health goals within the context of life history ,life style, and health status †¢The person’s requirements for self care †¢The person’s capacity to perform self care †¢Nursing diagnosis †¢Plans with scientific rationaleStep 2 †¢Nurse designs a system that is wholly or partly compe nsatory or supportive-educative. †¢The 2 actions are:- Bringing out a good organization of the components of patients’ therapeutic self care demands †¢Selection of combination of ways of helping that will be effective and efficient in compensating for/ overcoming patient’s self care deficits †¢Implementation †¢evaluationStep 3 †¢Nurse assists the patient or family in self care matters to achieve identified and described health and health related results. collecting evidence in evaluating results achieved against results specified in the nursing system design †¢Actions are directed by etiology component of nursing diagnosis †¢evaluationApplication of Orem’s theory to nursing process Therapeutic self care demandAdequacy of self care agencyNursing diagnosisMethods of helping Air Maintain effective respiration Water No problem Food maintain sufficient intakeInadequate Adequate InadequatePotential for impaired respiratory status P F fluid imbalance Actual nutritional deficit r/t nauseaGuiding & directing Teaching Providing physical support Hazards Prevent spouse abuse Promotion of normalcyInadequate InadequateP/F injury A/d in environment Shared housingPersonal development Guiding & directing Guiding & directingMaintain developmental environment Support  ¬ed normalcy in environment Prevent /manage dev threatInadequate InadequateActual delay in normal dev. R/T early parenthood Level of education Dev deficit r/t loss of reproductive organsGuiding & directing Providing psy support Providing physical, psy support Maintenance of health status Management of disease process Inadequate InadequateP/F contd. alterations in health status P/F UTIGuiding & directing, teaching Guiding & directing, teaching Adherence to med regimen Awareness of potential problemsInadequate InadequateP/F ? dherence in self catheterization & OPD RT Actual deficit in awareness of advisability of HRT & RT effectsteaching teaching Adjust to los s of reproductive ability & dev healthy view of illness Adjust life style to cope with change Inadequate InadequateActual threat to self image Actual self deficit in planning for future needs Providing psy support Guiding & directing OREM’S WORK AND THE CHARACTERISTICS OF A THEORY †¢Orem's theory ointerrelate concepts in such a way as to create a different way of looking at a particular phenomenon ois logical in nature. ois relatively simple yet generalizable ois basis for hypothesis that can be tested contribute to and assist in increasing the general body of knowledge within the discipline through the research implemented to validate them ocan be used by the practitioners to guide and improve their practice omust be consistent with other validated theories ,laws and principles Strengths †¢Provides a comprehensive base to nursing practice †¢It has utility for professional nursing in the areas of nursing practice nursing curricula ,nursing education administrat ion ,and nursing research †¢Specifies when nursing is needed †¢Her self-care approach is contemporary with the concepts of health promotion and health maintenance Limitations In general system theory a system is viewed as a single whole thing while Orem defines a system as a single whole, thing. †¢Health is often viewed as dynamic and ever changing. †¢The theory is illness oriented. RESEARCH ON OREM'S THEORY 1. Self-care requirements for activity and rest: an Orem nursing focus 2. Nursing diagnoses in patients after heart catheterization–contribution of Orem 3. Self-care–the contribution of nursing sciences to health care 4. Self-care: a foundational science 5. Orem's self-care deficit nursing theory: its philosophic foundation and the state of the science 6. Dorothea E. Orem: thoughts on her theory . Orem's theory in practice. Hospice nursing care 8. Solving the Orem mystery: an educational strategy 9. Orem's family evaluation REFERENCES †¢Ore m, D. E. (1991). Nursing: Concepts of practice (4th ed. ). St. Louis, MO: Mosby-Year Book Inc. †¢Taylor, S. G. (2006). Dorthea E. Orem: Self-care deficit theory of nursing. In A. M. †¢Tomey, A. & Alligood, M. (2002). Significance of theory for nursing as a discipline and profession. Nursing Theorists and their work. Mosby, St. Louis, Missouri, United States of America. †¢Whelan, E. G. (1984). Analysis and application of Dorothea Orem’s Self-care Practuce Model.Retrieved October 31, 2006. †¢George B. Julia , Nursing Theories- The base for professional Nursing Practice, 3rd ed. Norwalk, Appleton & Lange. †¢Wills M. Evelyn, McEwen Melanie (2002). Theoretical Basis for Nursing Philadelphia. Lippincott Williams& wilkins. †¢Meleis Ibrahim Afaf (1997) , Theoretical Nursing : Development & Progress 3rd ed. Philadelphia, Lippincott. †¢Taylor Carol,Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Philadelphia, Lippincott. †¢Potter A P atricia, Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. London Mosby Year Book.