Sunday, December 8, 2019
This study explores the data collection and management challenges in four Ghanaian hospitals using a survey study approach and proposes implementing an Electronic Health Record (EHR) system as a solution to these challenges. Some challenges that would impede the implementation of EHR in a Ghanaian hospital are the initial huge start up costs, poor computer skills of healthcare professionals, poor maintenance culture, and lack of policy to spearhead the implementation of the system. The weak state of information infrastructure at the hospitals is another challenge in an EHR implementation. EHR could potentially reduce waiting times for patients, reduce the cost of the hospitalÃ¢â¬Ës operations, improve interdepartmental communication and collaboration, provide opportunity for sharing best practices among physicians within Ghanaian hospitals, and enhance better resource allocation. The data an EHR could primarily capture would be patientsÃ¢â¬Ëdemographics, care plans, laboratory results, billing and NHIS claims information. Keywords: Electronic communication technology Introduction health record; Information and Appropriate information and Health Information Systems (HIS) are seen as crucial to strengthen the health system in developing countries  and in pursuing the Millennium Development Goals (MDGs) . On the ground, however, HIS and especially hospital information systems development in developing countries has proven difficult due to organisational complexity , fragmented and uncoordinated organisational structures all maintaining their own HIS , and unrealistic ambitions . The important role, influence, and impact of Information and Communication Technology (ICT) in all sectors of our society have long been recognized [6-12]. In the health sector, ICT-tools are being more and more developed, recommended, and used to improve the quality of work in administration, patient records, health services, and research [13-15]. During the nineteen-eighties, at the inception of the use of ICT-tools in most developed countries, the use of ICT-tools were not an issue or at best a matter of low priority in Less Developed Countries (LDC) . Given the complex nature of healthcare delivery and the numerous decisions that must be made, sometimes under very challenging circumstances, the need for accurate, reliable and timely information becomes very crucial. Paper-based records cannot provide the flexibility and leverage that Electronic Health Record (EHR) presents. The ministry of health (Ghana) clearly identifies the need for an efficient health information management system. Medical work is a highly complex, distributed, dynamic, regulated, knowledge-intensive and often time-critical activity. To make treatment of ill and/or injured patients possible in these time-critical, specialised and physically distributed work settings, medical staff constantly needs to cooperate with each other. Cooperation in these distributed medical work settings requires extensive coordination between the medical actors involved. To facilitate this coordination medical work is heavily regulated by procedures and conventions, as well as supported by a number of technologies like paper documents and analogue films that are used by a large number of medical actors for many different purposes. These technologies are not isolated artefacts but social and material parts of work. Over the years, the government being the principal health care ervice provider has implemented a number of policies to improve care delivery development, unfortunately these policies have not yield the necessary success expected due to lack of accurate and timely data. On the other hand, most developed countries are experiencing improvements in care delivery by implementing various kinds of health information systems such as electronic medical record, computerized provider order entry and clinical decision systems. It is therefore the focus of this study to examine the benefits of EHR and its contribution to care delivery, development in less developed countries. Materials and Methods Literature and report of on-going electronic health record system projects in Ghana, current health challenges and the quality of the local manpower were examined. Information was collected by reviewing documents on current practices at the various hospitals and by site visits. The following hospitals were used for the study: Effia Nkwanta Regional Hospital, Takoradi, Western Region, Komfo Anokye Teaching Hospital, Kumasi, Ashanti Region, Korle-Bu Teaching Hospital, Accra, Greater Accra Region and Tamale Teaching Hospital, Tamale, Northern Region. These four major hospitals in Ghana were studied and the type of records system being used at these facilities. National reports on health, and national health insurance scheme reports were reviewed. Only public hospitals were involved in this study. Korle-Bu Teaching Hospital (KBTH) The KBTH is a tertiary hospital in Ghana. It is one of the busiest hospitals in the sub-Sahara. It has the only Cardiothoracic Centre in the country. The hospital was founded in 1923 as the Gold Coast Hospital. The then Governor, Gordon Guggisberg laid the foundation for Korle-Bu *Corresponding author: Emmanuel Kusi Achampong, Department of Medical Education and IT, School of Medical Sciences, University of Cape Coast, Ghana, E-mail: [emailprotected] com Received May 16, 2012; Published July 30, 2012 Citation: Achampong EK (2012) Electronic Health Record System: A Survey in Ghanaian Hospitals. 1: 164. doi:10. 4172/scientificreports. 164 Copyright: Ã © 2012 Achampong EK. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Volume 1 Ã¢â¬ ¢ Issue 2 Ã¢â¬ ¢ 2012 Citation: Achampong EK (2012) Electronic Health Record System: A Survey in Ghanaian Hospitals. 1: 164. doi:10. 4172/scientificreports. 164 Page 2 of 4 Hospital in 1921, and it was finally opened on 9th October, 1923. The hospital has expanded in phases and now has 1600 beds. 1993 in three out of the ten administrative regions of Ghana, it focused on organized collection of data and reporting at the departmental level . Little is mentioned of the success of this intervention though, and whether it had been replicated in the remaining seven regions of Ghana. The District Health Information Management System (DHIMS) is one of GhanaÃ¢â¬Ës first attempts of modernizing health information capture using ICT. It was first piloted in twenty districts across the country and then deployed in all district/municipal health hospitals/administrations throughout the country in 2007. The software is used to capture data solely for management and policy development. The data captured is forwarded to regional Health Administrations for analysis and onward transmission to the National Health Administration (the Ghana Health Service [GHS] and/or the Ministry of Health). The Ministry of Health has however identified poor human resources, low levels of investment in ICT, and the uncoordinated nature of Health Information Systems (HIS) deployment as some of the start-up challenges of an effective HIS. Steps have been taken by the Ministry of Health to address the human resource challenge through the development of a curriculum to train health information officers at the Kintampo Rural Health Training School. Some public and private universities have also started running programmes in health informatics to augment what the ministry of health is doing. The University of Ghana and Kwame Nkrumah University of Science and Technology have started Master of Science programmes in health informatics whilst the Catholic University College is running a Bachelor of Science programme with specialisation in health informatics. These universities are helping to provide the human resource for the implementation and management of health/medical informatics projects in the country. Effia Nkwanta Regional Hospital (ENRH) ENRH was established in 1938 as a military hospital by the then British West African Royal Frontier Force (BWARFF) based in Takoradi, Western Region. The hospital is currently the third largest hospital in the country after Korle-bu and Komfo Anokye Teaching Hospitals. The administration, with the Medical Director as the head, has the oversight responsibility of the daily operations of the hospital. The hospital is organized into an Outpatient Department (OPD) and an Inpatient Department. The OPD is usually the first point of call for all visiting patients. At the OPD, patients are triaged and referred to the appropriate consulting rooms. Based on the outcome of the consulting, patients are either admitted as inpatients or outpatients. The hospital is also organized into several wards, namely the Maternity Clinic, Paediatric Ward, Surgical Ward (Male/female), Intensive Care Unit, Causality Ward, and the Gynaecology Ward. The hospital has a bed capacity of 416 and a total workforce of about 572. It offers practical training for health service administrators, student nurses and other medical house men and interns. Komfo Anokye Teaching Hospital (KATH) KATH is located in Kumasi, the Regional Capital of Ashanti Region with a total projected population of 3,204,609 (1998). The geographical location of the 1000-bed KATH, the road network of the country and commercial nature of Kumasi make the hospital accessible to all the areas that share boundaries with Ashanti Region and others that are further away. As such, referrals are received from all the northern regions (namely, Northern, Upper East and Upper West Regions), Brong Ahafo, Central, Western, Eastern and parts of the Volta Regions. The hospital became a Teaching hospital in 1975 for the training of Medical Students in collaboration with the School of Medical Sciences of the University of Science and Technology, Kumasi. Implementation of Electronic Health Record (EHR) The primary purpose of the EHR is to provide a documented record of care that supports present and future care by the same or other clinicians. This documentation provides a means of communication among clinicians contributing to the patients care. The primary beneficiaries are the patient and the clinician(s) . The demands for equitable and quality healthcare are far from been met in developing countries, especially in the face of limited resources, both human and financial. Ghana, a developing country is no exception and still grapples with the problem of providing equitable and quality healthcare to its citizens. With a population of around 23 million, access to healthcare, especially for those in the rural communities is very limited. Even in most rural communities where there are clinics, the healthcare professionals to run these facilities are usually inadequate in number or inadequately trained to carry out these duties. Implementing an EHR system could help to significantly address these gaps of inadequate access and poor healthcare quality currently delivered in rural Ghana. This could help create a national repository of health data, and will therefore make the deployment of telemedicine applications easier in the future. Far to reach communities presently referred to as Ã¢â¬Å"overseasÃ¢â¬ in Ghana could have access to specialistÃ¢â¬â¢s services with a functional telemedicine application in place. Implementing a new technology (such as EHR), especially in complex work environments such as in the health sector requires a careful thought out plan and strategy, not only to ensure a successful implementation but also to strike a balance between conflicting important goals. Important goals such as patient safety and privacy, healthcare quality, process efficiency, the organizationÃ¢â¬Ës business plans and goals and the EHR usability all need to be balanced . Tamale Teaching Hospital (TTH) TTH is located in the Northern part of Ghana, Tamale, the capital of the northern region. It serves the Tamale metropolis (with 300,000 inhabitants), it also serves as a referral facility for hospitals within the Northern region and others in two neighbouring regions, Upper East and West regions. Training and Development in Health Informatics There have been reforms in the health information management systems recently aimed at improving the quality of health information, and this has largely been in response to requests from donor agents like the UNDP and also as a commitment to meeting the Millennium Development Goals (MDGs) . The National Health Insurance Scheme (NHIS) of Ghana, which was passed by an act of parliament in 2003, promises to be a lead promoter for the introduction of ICT in the Ghanaian health service. NHIS has introduced electronic identification cards to help minimize fraudulent claims and also for easy identification of NHIS clients at health facilities throughout the country. Of the various interventions in Health Management Information Systems (HMIS), the UNDP supported Maternal and Child Health Information System is the most extensive and significant. Piloted between 1987 and Volume 1 Ã¢â¬ ¢ Issue 2 Ã¢â¬ ¢ 2012 Citation: Achampong EK (2012) Electronic Health Record System: A Survey in Ghanaian Hospitals. 1: 164. doi:10. 4172/scientificreports. 164 Page 3 of 4 Implementation of EHR should not be a mere automation of existing workflows, but rather it should be geared towards the development of new and efficient workflows. Electronic health record implementation could be problem or technology led; where in the former the existence of a problem necessitates the development of a technological solution to solve it, whereas for the latter an existing technology is used to facilitate or improve present workflows. The existence of data collection and management challenges in Ghanaian hospitals will necessitate the use of technology to solve these challenges. National policies on EHR There is a national policy on e-health now in Ghana which came into been in 2010. There is no legislation on personal and health-related data to ensure privacy of personally identifiable data and to protect personally identifiable data specifically in EHR. There is no legislation for sharing health-related data between health care staff through EHR within the same health care facility and its network of care providers and with different health care entities within the country and with health care entities in other countries. The country doesnÃ¢â¬â¢t have policy guidelines for the implementation of EHR and the sharing of data between hospitals and medical staff. This is very crucial for the implementation of EHR. Change management in EHR implementation It is important to recognize that an organization is like any other social system and change where everything and everybodyÃ¢â¬Ës actions are interrelated and is not limited to one entity . All departments in an organisation are integrated and interdependent. Implementation of change in one department affects the function of another. It is also likely that change, although embraced in one department, may be completely resisted by another. Additionally, there may be other changes occurring within the organization that affect or will be affected by the proposed system implementation. Managers must completely assess the effects of change on the entire organization and develop a plan to motivate each department to participate in the implementation and adapt to change . Classic work suggests that behaviour in an institutional setting is not a static habit or pattern but a dynamic balance of forces working in opposite directions within the social-psychological space of the institution . Lewin identified three stages for accomplishing changes in behaviour: unfreezing the existing equilibrium, moving toward a new equilibrium, and refreezing the new equilibrium. To initiate the unfreezing of the equilibrium, there are three strategies. Increase the number of driving forces Ã¢â¬ ¢ Decrease the number of resisting forces Ã¢â¬ ¢ A combination of the two preceding factors In an organisation experiencing change, these driving forces should be carefully managed so as to attain a suitable and sustainable balance. The key components that engineer the interplay of these driving forces are the people/organizational issues, the hardware and the software. In managing organizational change during the implementation of an EHR, the people/organizational issues s hould be prioritized. Usually managements and IT supporters first focus on hardware and software and then Ã¢â¬â if at all on people/organizational issues. This might be because of lack of the understanding for Ã¢â¬â or lack of knowledge about the importance of the people/organizational issues, when implementing new IT-systems. This aspect is however extremely important. As  have shown, the greatest problems when implementing EHR are those of organisational nature in the form of resistance from the employees towards the new system, and thus not of technical nature . It has also been found, that the resistance is focused on different aspects: Ã¢â¬ ¢ Against those responsible for the changes (political) Ã¢â¬ ¢ Against the frequency of changes Ã¢â¬ ¢ Against changes in the organization Ã¢â¬ ¢ Against the specific IT-system which is to be implemented. Implementation challenges of EHR The challenges encountered in the implementation of EHR projects have been more with commitments from staff and users of the system. Most of the time, users are ignored in the beginning of the projects but are expected to use it after its completion. There are no policy guidelines to promote the implementation EHR in the country. Although there is an e-health policy now, implementation is another issue since the commitment from top management which trickle down to users. Discussion With the emergence of the National Health Insurance Scheme (NHIS) almost every hospital in Ghana has one stand alone personal computer for the purposes of the scheme. The situations in these hospitals differ since each has reached a level of implementation. Some are implementing EHR by using the incremental approach whilst some have not even started with the implementation. KATH already has a system in place for their patient records and they have a strong Information Technology (IT) Unit that is in charge of supervising the system. KATH is using customised pro-medical software for the patient records alongside the paper records until the paper records phase out. This is just at the records section and thus using the incremental approach. ENRH has a personal computer in every office connected to the internet. In the wards, doctorsÃ¢â¬â¢ office and other units, there exists an intercom telephone to relay important information. In this hospital, there are only stand-alone computers in offices; they are not using any EHR software. The computers are only used for secretarial services. ENRH has been fully wired ready for the implementation of a new software program, in March, 2011. For now, their records system is mainly paper-based. The hospital has an IT Director who oversees all issues on ICT. Korle-Bu Teaching Hospital has some of their departments computerised, surgery and cardiothoracic departments have some of their record computerised and some are still kept on paper. Patients are allowed to take their records home and bring to the hospital whenever they visit the hospital. Although the hospital has an IT Unit, not much has been achieved with reference to EHR. The hospital is still struggling to fully implement the EHR system. Tamale Teaching Hospital has no EHR system in place. They only have computers at various departments for secretarial purposes. Volume 1 Ã¢â¬ ¢ Issue 2 Ã¢â¬ ¢ 2012 Citation: Achampong EK (2012) Electronic Health Record System: A Survey in Ghanaian Hospitals. 1: 164. doi:10. 4172/scientificreports. 164 Page 4 of 4 With the almost completion of the national fibre optic project, these teaching/regional hospitals will have no excuse as to why they have not implemented EHR system. Despite the known importance of EHR, some major hospitals in Ghana are yet to fully benefit from these. The challenges of implementing EHR in Ghanaian hospitals will be a daunting one. A lot of effort will have to be put in the restructuring and reorganisation of workflows to effectively implement a successful EHR. Information infrastructures in Ghanaian hospitals are still weak and data collection and management is a serious challenge yet to be surmounted. Some of the immediate challenges of successful EHR implementation in Ghanaian hospitals will be human resource and the funds to procure and maintain hardware; sustainability of such system will be another issue. 4. Chilundo B, Aanestad M (2004) Negotiating multiple rationalities in the process of integrating the information systems of disease-specific health programmes. 5. Heeks R (2002) Failure, success and improvisation of information systems projects in developing countries. Institute for Development Policy and Management, University of Manchester. 6. Viviane RR (2006) The role of ICT in innovation and growth. In Forum de la Nouvelle Economie. Madrid, Spain. 7. Chandrasekhar CP, Ghosh J (2001) Information and communication technologies and health in low income countries: the potential and the constraints. Bull World Health Organ 79: 850-855. 8. Pan-American-Health-Organization (1998) Information systems and information technology in health: challenges and solutions for Latin America and the Caribbean 119. 9. Haux R (2002) Health care in the information society: what should be the role of medical informatics? Methods Inf Med 41: 31-35. 10. Ojo T (2006) Communication networking: ICTs and health information in Africa. Information Development 22: 94-101. 11. WHO (1998) Health Telematics Policy 12. WHO (1987) Working Group on Application of Informatics in Health, Manila, Philippines. 13. Hersh WR (2002) Medical informatics: improving health care through information. JAMA 288: 1955-1958. 14. Alvarez RR (2005) Health care has to move into the hi-tech age. Bull World Health Organ 83: 323. 15. Lapointe L, Rivard S (2006) Getting physicians to accept new information technology: insights from case studies. CMAJ 174: 1573-1578. 16. Hull C (1994) Observations on health information in developing countries. Methods Inf Med 33: 304-305. 17. Ghana (2006) Health care. 18. ISO/TC 215 Technical Report (2003) Electronic Health Record Definition, Scope and Context. 19. Walker JM, Bieber EJ, Richards F (2005) Implementing an Electronic Health Record System. Health Infor 247. 20. Hunt EC, Sproat SB, Kitzmiller RR (2004) The Nursing Informatics Implementation Guide. New York: Springer. 21. Lewin K (1969) Quasi-stationary social equilibria and the problem of permanent change. In: Bennis WG, Benne KD, Chin R (eds. ) The Planning of Change New York: Holt, Reinhart: 235Ã¢â¬â238. 22. Lorenzi NM, Riley RT (1995) Organisational aspects of health informatics: Managing technological change. Springer-Verlag 312. Conclusion The potential of EHR system to transform medical care practice has been recognized over the past decades to enhance health care delivery and facilitates decision making process. Subsequently, EHR and other clinical decision support system tools are currently used in both primary and secondary health care facilities in most developed nations. However, implementing an EHR system or any HIS in a clinical practice is a daunting task. It requires good planning, strong management and physician leadership and supportive staff. The most immediate benefits of EHR system include accurate medication lists, legible notes and prescriptions, immediately available charts, decreased chart pulls, lower transcription costs, medical errors reduction and improve quality care and standard in patient safety. Unfortunately most countries in sub Saharan Africa and other poor nations lack the experts, fund and ICT infrastructure necessary for the implementation of such modern health care technology to ensure continuity of care.
Sunday, December 1, 2019
Space Essay, Research Paper Development, a procedure of alteration through clip, is what links together the tremendous diverseness of the life universe. A batch of grounds is present that indicates that the Earth has had a really long history and that all living things arose in the class of that history from earlier, more simpler signifiers. In other words, all species have descended from other species and all life things portion common ascendants in the yesteryear. Basically, beings are what they are because of their history. Today there are many theories and possibilities related to development which contribute to our apprehension of the procedure. Our planet was born 4.6 billion old ages ago as a great cloud of dust and gas condensed into a sphere. As gravitation pulled this great cloud tightly together, heat from great force per unit area and radiation melted the planet? s inside and most of its mass. We will write a custom essay sample on Space Essay Research Paper Evolution a process or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page For 1000000s of old ages after this, strong volcanic activity all over the planet shook the Earth? s crust. At the same clip, the Earth was showered by a really strong meteor shower. From analyzing vents, it is known that eruptions pour out C dioxide, N, and other gases. It is besides known that meteorites carry H2O, in the signifier of ice, and many C incorporating compounds. That might propose that the combination of volcanic activity and a changeless shower of meteorites released the gases that created the Earth? s atmosphere. Geologists believe that the Earth? s early ambiance contained H2O vapour, C monoxide, C dioxide, H, and N. It besides may hold contained ammonium hydroxide and methane. It did non incorporate O, which is the chief ground why the Earth could non hold supported life. As for oceans, they couldn? Ts have existed at foremost because the Earth? s surface was highly hot. But about 3.8 billion old ages ago, the Earth? s surface cooled plenty for H2O to stay a liqui d on the land. Thunderstorms wet the planet for many old ages and oceans began to make full. This is known because the earliest sedimentary stones have been dated to that clip period. Miller and Urey were two scientists who attempted to explicate the beginning of life on Earth without mentioning to any supernatural events. They performed an experiment that suggests how the Earth? s atmosphere might hold formed. Miller assorted # 8220 ; atmospheric # 8221 ; gases ( H, methane, ammonium hydroxide, and H2O vapour ) in a unfertile glass container and charged them with energy by adding electric flickers to them. The electric flickers resembled lightning at the clip of the Earth? s formation. After about a hebdomad, the mixture turned brown and was found to incorporate aminic acids. This organic compound produced in this experiment was efficient in cognizing how the Earth? s early atmosphere formed. That is because it was successful in bring forthing some of the edifice blocks of nuclei c acids under geologically relevant conditions. A inquiry that puzzled scientists was how could all this have started in the first topographic point. It is noted that aminic acids and nucleic acids stick to the constructions of clay crystals. By being held together in a regular form on clay crystals, these molecules combine to organize proteins and polynucleotides. Other research workers non that some sorts of RNA can fall in aminic acids into protein ironss without aid from protein enzymes. Some signifiers of RNA can copy themselves and can really redact other RNAs by adding and canceling bases. These experiments support another hypothesis that RNA, instead than DNA, functioned as life? s first information storage system. Harmonizing to this hypothesis, life based on RNA have started when RNA fragments began to copy and redact themselves and assemble proteins. As clip passed, these RNAs could hold evolved to the point where they produced protein enzymes that took over the work of c onveying about chemical reactions. Subsequently, hive awaying familial information could hold likewise been passed on to DNA. In this manner, over 1000s of old ages, RNA, DNA, and proteins could hold evolved into the complex system that characterizes life today. Detecting that RNA can move as a accelerator, makes it easier to conceive of how life began. Harmonizing to Bruce M. Alberts, # 8220 ; One suspects that a important early event was the development of an RNA molecule that could catalyse its ain reproduction # 8221 ; . That makes it really obvious why it is possible that RNA was the first molecule that could retroflex. These molecules so diversified into a group of accelerators that could piece ribonucleotides in RNA synthesis or roll up lipid-like molecules to organize the first cell membranes. This clearly suggest how the first membranes could hold formed. Fox and his colleagues attempted to happen an reply, to the beginning of membranes and procaryotes, in their research labs. They heated amino acids without H2O and formed long protein ironss. As H2O was added and the mixture cooled down, little microspheres were formed. These seemed to roll up certain compounds inside them. They besides attracted lipoids and formed a lipid-protein bed around them, as mentioned above. Assuming that the microspheres combined with self-replicating molecules, we are looking at a really ancient being. This is what might hold happened 3.8 billion old ages ago as the first membranes and procaryotes were organizing. As for eucaryotic cells, harmonizing to Lynn Margulis? s hypothesis, they arose from what is called a symbiont relationship. Lynn Margulis believed that mitochondra were originally independent procaryotic aerophilic persons, populating on a symbiont relationship with another procaryote. The aerophilic procaryote was enclosed by the bacteria? s cell surface membrane in the procedure of endocytosis, which is made easy by the absence of a cell wall in the bacteria . The aerophilic procaryote wasn? T digested but continued to work inside the other cell. The host cell received energy that the aerophilic procaryote released. The chondriosome that was organizing had everything it wanted, taking it from its host. A similar procedure occurred subsequently with the host cell and photosynthetic procaryotes. This grounds explains the symbiotic theory for the beginning of the four Eukaryotic lands, which are the Protista, Fungi, Animalia, and Plantae. Jean Baptiste de Lamarck had his ain proposal of development. It was non truly accepted because his grounds, which was non really convincing, was non really back uping. Harmonizing to his belief, development is supposed to bring forth # 8220 ; higher # 8221 ; beings, with human existences at its ultimate end. Lamarck? s theory included heritage of acquired features, intending that an being? s life style could convey about alterations that it passed on to its progeny. An illustration would be the fact th at Lamarck believes Giraffes have long cervixs because their ascendants stretched their cervixs because their ascendants stretched their cervixs to shop on the foliages ; and that this addition in length was passed on to wining coevalss. This seemed unreasonable because people had been cutting off dress suits of many Canis familiariss but they neer resulted in an progeny born without a tail for that same ground. Therefore, Lamarck? s thought can non be right, chiefly because these alterations do non impact the familial stuff. Change happens in familial stuff merely when games are involved. In 1858, Charles Darwin introduced a theory of development that is accepted by about all scientists today. His theory provinces that all species evolved from a few common ascendants by natural choice. Another British scientist, Alfred Wallace, introduced an indistinguishable theory at about the same clip. But Darwin? s theory was better developed and more celebrated. Darwin? s and Wallace? s const ruct was based on five premises: 1 ) there is stableness in the procedure of reproduction 2 ) in most species, the figure of beings that grow, survive, and reproduce is little compared to the figure ab initio produced 3 ) in any population, there are fluctuations that are non produced by the environment and some are inheritable 4 ) which single tungsten ill grow and reproduce and which will not are determined to a significant degree by the interaction between these chance variations and the environment 5) given enough time, natural selection leads to the accumulation of changes that differentiate groups of organism from another. Darwin?s theory of natural selection is really the process of nature that results in the most fit organisms producing offspring. There has been experimental evidence for this process, attempting to prove it correct. Darwin observed that wild animals and plants showed variations just as domesticated animals and plants did. He filled his notebooks with records of height, weight, color, claw size, tail length, and other characteristics among members of the same species. He also observed that high birthrates and a shortage of life?s necessities forced organisms into a constant Ã¢â¬Å"struggle for existence,Ã¢â¬ both against the environment and against each other. Plant stems grow tall in search of sunlight, plant roots grow deep into the soil in search of water and nutrients. All that evidence is what supported Darwin?s theory about natural selection. Peppered moths provide an example of natural selection in action. Peppered moths spend most of their time resting on the bark of oak trees. In the beginning of the nineteenth century, the trunk of most peppered moths in England were light brown speckled with green. There were always a few dark-colored moths around, but light colored moths were the most common. Then, the Industrial Revolution began in England and pollution stained the tree trunks dark brown. At the same time, biologists noticed that dark-colored moths were appearing. The evolutionary hypothesis suggested that birds were the main reason. Birds are the major predators of moths. It is a lot harder for birds to see, catch, and eat moths that blend in with the color of the tree bark than it is for them to spot moths whose color makes a strong contrast with the tree trunks. The moths that blend in with their background are said to be camouflaged. As the tree trunks darkened, the dark-colored moths were better camouflaged and harder to spot, having a better condition for survival. This hypothesis was not enough, and more experiments had to be made. A British ecologist, called Kettlewell, prepared another test for this hypothesis. He placed equal numbers of light and dark colored moths in two types of areas. In one area, trees were normally colored. In the other area, they were blackened by soot. Later on, he recaptured, sorted, and counted all the moths he could, which were marked earlier by him. Kettlewell found that in unpolluted areas, more of his light-colored moths had survived. Kettlewell showed by his experiments that the moths that were better camouflaged had the higher survival rate. In conclusion, when the soot darkened the tree trunks in an area, natural selection caused the dark-colored moths to become more common. Kettlewell?s work is consider ed to be a very good classic demonstration of natural selection in action. All organisms share biochemical details. All organisms used DNA and RNA to carry information from one generation to another and to control growth and development. The DNA of all Eukaryotic organisms always has the same basic structure and replicates in the same way. The RNAs of various species might act a little differently, but all RNAs are similar in structure from one species to the next. ATP is an energy carrier that is also found in all living systems. Also many proteins, such as cytochrome c, are also shared by many organisms. This molecular evidence has made it possible to make precise comparisons of the biochemical similarities between organisms. Scientists also noticed that embryos of many different animals looked so similar that it was hard to tell them apart. Embryos are organisms at early stages of development. These similarities show that similar genes are present. The fact that early development of fish, birds, and humans is similar shows that these animals share a common ancestor, who had a particular gene sequence that controlled its early development. That sequence has been passed on to the species that descended from it. In the embryos of many animals the limbs that develop look very similar. But as the embryos mature, the limbs grow into arms, legs, flippers that differ greatly in form and function. These different forelimbs evolved in a series of evolutionary changes that altered the structure and appearance of the arm and leg bones of different animals. Each type of limb is adapted in a different way to help the organism survive in its environment. Structures like these, which meet different needs but develop from the same body parts, are called homologous structures. This is all additional evidence of descent from a common ancestor. There are other theories for the origin of species including special creation and panspermia. Special creation involves humans. Many p eople believe that humans were created by God; so the theories of evolution go against their religions especially why they do not see God?s hands in the process. As for panspermia, it suggests that life could have originated somewhere else and came to us from space. This might be possible but there is actually no supporting evidence for it. Paleontology has also played a big role in the study of evolution. Over the years, paleontologists have collected millions of fossils to make up the fossil record. The fossil record represents the preserved history of the Earth?s organisms. Paleontologists have assembled great evolutionary histories for many animal groups. An example would be looking at probable relationships between ancient animals whose evolutionary line gave rise to today?s modern horse. The fossil record also tells us that change followed change on Earth. Scientists can use radioactivity to determine the actual age of rocks. In rocks, radioactive elements decay into non-radio active elements at a very steady rate. Scientists measure this rate of radioactive decay in a unit called a half-life. A half-life is the length of time required for half the radioactive atoms in a sample to decay. Each radioactive elements has a different half-life. Carbon-14 is particularly useful because it can be used to date material that was once alive. Because carbon-14 is present in the atmosphere, livings things take it into their bodies while they?re alive. So the relative amount of carbon-14 in organic material can tell us how long ago this material stopped taking in new carbon into its system. That was the time it died. Then, a graph is used to determine the time. This is the way scientists can deduce the approximate age of materials based on a simple decay curve for a radioisotope. In organisms, variations in specific molecules can indicate phylogeny; and biochemical variations can be used as an evolutionary clock. Phylogeny is the line of evolutionary descent. Biochemi stry can be used to support other evidence about revolutionary relationships, and it can be very simple. Scientists study similar molecules in different species and determine how much difference there is between the molecules. The more difference there is, the longer the time-span since the two species shared a common ancestor. The most commonly used substances in this technique are hemoglobin , cytochrome c, and nucleic acids. Hemoglobin is suited to studying closer related organisms that contain hemoglobin. Cytochrome c has been used to compare groups that are more different. The results from comparative biochemistry lone do not prove anything, but they confirm data found using other methods. Together, they become convincing. Today, the theory of evolution is generally considered to be the most important fundamental concept in the biological sciences. Nearly all scientists support it. However, large numbers of people opposed the theory when it was introduces. Still, some people do not accept it today.
Tuesday, November 26, 2019
Journey Through Life in a Carriage Emily DickinsonÃ¢â¬â¢s Ã¢â¬Å"Because I could not stop for DeathÃ¢â¬ is a remarkable masterpiece that exercises thought between the known and the unknown. In DickinsonÃ¢â¬â¢s poem, Ã¢â¬Å"Because I could not stop for Death,Ã¢â¬ there is much impression in the tone, in symbols, and in the use of imagery that create an eerie yet peaceful mood for the reader. One might undoubtedly agree to an eerie, haunting, if not frightening, tone in DickinsonÃ¢â¬â¢s poem. Dickinson uses controlling adjectives- Ã¢â¬Å"slowlyÃ¢â¬ and Ã¢â¬Å"passedÃ¢â¬ - to create a tone that seems rather placid. For example, Ã¢â¬Å"We slowly drove- He knew no haste / Ã¢â¬ ¦We passed the School Ã¢â¬ ¦ / We passed the Setting Sun- ,Ã¢â¬ sets a slow, quiet, and calm atmosphere. Although not necessarily depicted as a sadistic murderer of innocence, death is indeed personified by Dickinson to a certain extent, as an unavoidable conqueror one hanging over us and around us, inescapable. The tone in DickinsonÃ¢â¬â¢s poem will put its readersÃ¢â¬â¢ ideas on a unifying track heading towards a boggling atmosphere. DickinsonÃ¢â¬â¢s masterpiece lives on complex ideas that are evoked through images, which carry her readers through her poem. Besides the literal significance of - the Ã¢â¬Å"School,Ã¢â¬ Ã¢â¬Å"Gazing Grain,Ã¢â¬ Ã¢â¬Å"Setting Sun,Ã¢â¬ and the Ã¢â¬Å"RingÃ¢â¬ - much is gathered to complete the poemÃ¢â¬â¢s central idea. Emily brought to light the mysteriousness of lifeÃ¢â¬â¢s cycle. Ungraspable to many, the cycle of oneÃ¢â¬â¢s life, as symbolized by Dickinson, has three stages and then a final stage of eternity. Ã¢â¬Å"School, where children stroveÃ¢â¬ (9) may represent childhood; Ã¢â¬Å"Fields of Gazing GrainÃ¢â¬ (11), maturi ty; and Ã¢â¬Å"Setting SunÃ¢â¬ (12) old ageÃ¢â¬ (21). In addition to these three stages, the final stage of eternity was symbolized in the last two lines of the poem, the Ã¢â¬Å"Horses HeadsÃ¢â¬ (23), leading Ã¢â¬Å"towards EternityÃ¢â¬ (24). Dickinson fathomed the incomprehensible progression of life by... Free Essays on E Dickenson Free Essays on E Dickenson Journey Through Life in a Carriage Emily DickinsonÃ¢â¬â¢s Ã¢â¬Å"Because I could not stop for DeathÃ¢â¬ is a remarkable masterpiece that exercises thought between the known and the unknown. In DickinsonÃ¢â¬â¢s poem, Ã¢â¬Å"Because I could not stop for Death,Ã¢â¬ there is much impression in the tone, in symbols, and in the use of imagery that create an eerie yet peaceful mood for the reader. One might undoubtedly agree to an eerie, haunting, if not frightening, tone in DickinsonÃ¢â¬â¢s poem. Dickinson uses controlling adjectives- Ã¢â¬Å"slowlyÃ¢â¬ and Ã¢â¬Å"passedÃ¢â¬ - to create a tone that seems rather placid. For example, Ã¢â¬Å"We slowly drove- He knew no haste / Ã¢â¬ ¦We passed the School Ã¢â¬ ¦ / We passed the Setting Sun- ,Ã¢â¬ sets a slow, quiet, and calm atmosphere. Although not necessarily depicted as a sadistic murderer of innocence, death is indeed personified by Dickinson to a certain extent, as an unavoidable conqueror one hanging over us and around us, inescapable. The tone in DickinsonÃ¢â¬â¢s poem will put its readersÃ¢â¬â¢ ideas on a unifying track heading towards a boggling atmosphere. DickinsonÃ¢â¬â¢s masterpiece lives on complex ideas that are evoked through images, which carry her readers through her poem. Besides the literal significance of - the Ã¢â¬Å"School,Ã¢â¬ Ã¢â¬Å"Gazing Grain,Ã¢â¬ Ã¢â¬Å"Setting Sun,Ã¢â¬ and the Ã¢â¬Å"RingÃ¢â¬ - much is gathered to complete the poemÃ¢â¬â¢s central idea. Emily brought to light the mysteriousness of lifeÃ¢â¬â¢s cycle. Ungraspable to many, the cycle of oneÃ¢â¬â¢s life, as symbolized by Dickinson, has three stages and then a final stage of eternity. Ã¢â¬Å"School, where children stroveÃ¢â¬ (9) may represent childhood; Ã¢â¬Å"Fields of Gazing GrainÃ¢â¬ (11), maturi ty; and Ã¢â¬Å"Setting SunÃ¢â¬ (12) old ageÃ¢â¬ (21). In addition to these three stages, the final stage of eternity was symbolized in the last two lines of the poem, the Ã¢â¬Å"Horses HeadsÃ¢â¬ (23), leading Ã¢â¬Å"towards EternityÃ¢â¬ (24). Dickinson fathomed the incomprehensible progression of life by...
Friday, November 22, 2019
Thomas Jefferson Quotations Thomas Jefferson was the third president of the United States. He was very important as one of the founding fathers of the United States. He wrote the Declaration of Independence. As president, his greatest achievement was the Louisiana Purchase which more than doubled the size of the US. He created numerous writings including his famous letters to political rival John Adams in his later years. Following are some quotes that shed light on Jeffersons beliefs. Thomas Jefferson Quotes But every difference of opinion is not a difference of principle. We have been called by different names brethren of the same principle. We are all Republicans, we are all Federalists. Nature intended me for the tranquil pursuits of science, by rendering them my supreme delight. But the enormities of the times in which I have lived have forced me to take a part in resisting them, and to commit myself on the boisterous ocean of political passions. The tree of liberty must be refreshed from time to time with the blood of patriots and tyrants. When a man assumes a public trust, he should consider himself as public property. A bill of rights is what the people are entitled to against every government on earth, general or particular; and what no just government should refuse, or rest on inference. I view great cities as pestilential to the morals, the health, and the liberties of man. I know that the acquisition of Louisiana has been disapproved by some ... that the enlargement of our territory would endanger its union... The larger our association the less will it be shaken by local passions; and in any view is it not better that the opposite bank of the Mississippi should be settled by our own brethren and children than by strangers of another family? A little rebellion now and then is a good thing... The natural progress of things is for liberty to yield and government to gain ground. Its soul, its climate, its equality, liberty, laws, people, and manners. My god! how little do my countrymen know what precious blessings they are in possession of, and which no other people on earth enjoy!
Thursday, November 21, 2019
Marketing Campaign for a Successful Product Launch - Essay Example In particular, this report focuses on the four promotional tools that were used that are public relation, direct marketing, promotions and advertising. The report seeks to inform the team about the appropriateness of the selected promotional tools in bringing about a successful marketing campaign. It also demonstrates how the selected promotional tools will be fully utilized in devising a creative mix of marketing activities suitable for a successful marketing campaign. 2.0 Introduction The marketing department of Nokia Company was tasked with devising the marketing campaign plan that would be used in ensuring that the two new Nokia brands sell well in South Africa and they proposed that the company utilize advertisements, sales promotion, direct marketing, and public relation as promotional tools (Awad 2004). Promotion is one of the elements in the marketing mix, and just like all the other elements, it deserves a lot of evaluation before being approved by the senior management team of a company (Armstrong & Kotler, 2012). ... The research aimed at establishing and identifying the characteristics of the target audience. This was done through observation and interviews. 4.0 Main Findings The team found out that i. Both Nokia Luminia 920 and 820 will appeal most to young customers who are particularly tech-savvy. ii. The company needs to come out with strategies that will make the prospective customers aware of the new Nokia phone models on the market: Nokia Luminia920 and 820. iii. The company needs to come up with promotional tools that can create interest in prospective customers. iv. The company needs to have promotional tools that will sustain clientÃ¢â¬â¢s satisfaction during and after sales. It is out of this finding that the team settled on public relation, advertising, direct marketing, and sales promotion as appropriate promotional tool to be used. Armstrong and Kotler (2012) describe advertisement as a promotion technique whereby words, signs, or songs are used to create awareness among the audi ences about the product, service, or an upcoming event. In this case the two Nokia models would be advertised via popular South African radio and television stations, billboard and posters, internet, via popular sites such as face book and twitter. This is guide necessary because the target audience is the youth who are tech survy. Advertisement in this case, would also be appropriate because it will be able to create awareness amongst the mass audience by positioning a product in the mind of the audience and inform them about the advantages of Nokia Lumia 920 and 820 (ibid) . Wood (2010) support the use of advertisement as a promotional tool when he states that advertisements help in boosting consumerÃ¢â¬â¢s confidence
Tuesday, November 19, 2019
Economic Indicators Paper - Essay Example forms at a level below full employment then monetary and fiscal policy renders a positive impact by increasing employment rather than simply causing inflation or directing the resources towards inefficient use in order to create jobs. Th paper studies the automobile industry with the help of the six economic indicators Ã¢â¬â real GDP, Unemployment rate, Inflation rate measured by the Consumer Price Index (CPI), Auto Sales, Foreign Exchange Rate and Oil and Fuel Prices. The study focusses essentially on the inflation rate which in turn affects the other indicators as well as the industry and a whole. Real GDP: This is the measure of the total output produced during a specific time period within a certain territory. This is measured at constant prices in order to adjust for the inflation rate. This helps in estimaitng the size of the economy with ajdustment in prices and inflation rates. Unemployment rate: We consider the status of unemployment for a particular individual when he or she is eager to work but is without work. The percentage of the potential labor force who are unemployment is estimated as the unemployment rate. Unemployment is often related to the recessionary phase of an economy or a business cycle. As production falls during recession, in order to cut he cost, labour is retrenched and a sudden unemployment might arise. Inflation rate: This refers to the rate of increase in a certain price index. Usually Consumer Price Index is used to reflect inflation. This is defined as the percentage change in price. level over a certain time period. Conversely, inflation rate is also the decrease in purchasing power of money. With increase in prices purchasing power falls, money supply in the economy rises while the supply or production falls. The automobile industry played an important role in the 1920s when the US economy grew at an accelerated rate creating more and more jobs and income. In the late 1980s, with the increase in competition with the foreign
Saturday, November 16, 2019
Loneliness of Curleys wife Essay The author never tells us the name of Curleys wife in the novel, which could be for many reasons. E. g. she wasnt important enough or even because she was a woman. But I think it was because she was regarded as one of Curleys possessions, and because of this everyone approached her with haste. They were all afraid of Curley and didnt want any bother from him so they left her alone. They didnt speak to her and ignored her most of the time which could after a while make a person very lonely and feel unwanted. She didnt like this so she tried to do something about it. She put on attractive clothes, and was heavily made up with full rouged lips and widely spaced eyes. Fingernails painted red and hair in little clusters like sausages. Obviously she wanted to attract some attention from the workers on the ranch, she just wanted somebody to notice her. But as in doing this she is labelled a tart and jailbait. George doesnt see past the outer cover when she comes back and sees a woman trying to get someone arrested or killed, so he strictly warns Lenny to keep away from her. Another reason for Curleys wifes loneliness could have been that she was the only woman on the ranch so she has no other female to gossip to, and all the men are ignoring her so she has absolutely nobody on the ranch to chat with except Curley. Curley isnt a good husband as he regards her mainly as a possession and not his wife, and therefore doesnt treat her all that well. He is one of the main reasons that she feels so unhappy. He forces his wife to stay at home alone every day as he forbids her to leave the house in fear that she might go and stray off with one of the ranch workers. He himself is not all that loyal either as he visits brothels with the other men at the end of the month even though he is married. She admits to us when chatting with Lenny that she doesnt love Curley. She only married him because of her mother. She had met a film producer that had said he was going to put her in the movies, and when the letter didnt come from him she thought her mother had stolen it. So she moved of and married Curley maybe as a way to get revenge on her mother. Whereas it is more likely that the man wasnt a film producer and probably wanted just to get her to sleep with him. When talking with Lenny she also tells him all the things she wanted in her life. She wanted to wear nice clothes, stay in big hotels, have pictures taken of her and to be an actress. She even hinted that she was going to leave Curley someday by saying maybe I will someday when talking about an acting career. Curleys wife seems awfully lonely and gets great pleasure out of talking with Lenny in the barn. She even lets him stroke her hair causing a great ruckus and eventually leading to her violent death. But it was instantaneous and when Candy looked at her body he saw that her face was sweet and young. She hadnt a care in the world. All the ache for attention and discontent were gone from her face and she was finally at peace. I personally dont think she is the cause of all the trouble because she was only seeking a bit of company. She hardly talked to anyone on the ranch for ages and when she finally gets the chance, you cant blame her for wanting to take it. It maybe is a bit her fault as she let Lenny stroke her hair, but she didnt know what he was going to do when he wouldnt let go and started to panic. She did initially get Lenny killed but I dont think she did it intentionally as she speaks no desire to get herself killed. It is a bit of everybodys fault, if the men had spoken to her she may not have wanted to go into the barn with Lenny and therefore not have been killed. Lenny and Georges dream may have came true if Curleys wife had not been killed so in a way this major event changed all of their lives forever. 30/04/2007 Simon Gurney Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE John Steinbeck section.