the Breakdown of Immune System Free Essays

The Breakdown of Immune System Andy 1131400011 English? Liver Pool 2012. 10. 19 Diseases in every case out of nowhere burst into people’s lives and leave long haul scars for these patients. We will compose a custom paper test on the Breakdown of Immune System or on the other hand any comparative theme just for you Request Now There are numerous infections are not kidding to the point that have worldwide impact in mankind's history. As the article The Evolution and Breakdown of Immune System composed, â€Å"The breakdown of safe framework is one of the most continuous and hazardous ailments everywhere throughout the world. (Jonsson, Brokstad, Hansen, Davies Ulevestad, 2002)† It impacts the patients, yet impacts their families, and much more dreadful, they may turn into the weight of the entire society. Each patient truly endures bunches of agony when they battle with these sorts of ailments. They will basically impact your invulnerable framework, the watchman of your body, even decimate it. Patients may become ill and think that its difficult to recoup once there have some unsettling influence originate from the outside condition. Helps is one of the most powerful illnesses of them. As per the dates from UNAIDS, in2010, there are absolutely 33. 3 million individuals who languish bunches of torment over AIDS in the earth (UNAIDS, 2010). Individuals who get AIDS will turn out to be staggeringly defenseless and can just protract their life under some clinical assistance. The impact of these sorts of infections will grow from individual to social. Patients’ families are the principal who will bear the torment of stresses and pity. Resistant framework is difficult to remake after separate so the patients’ families need to pay cash for their treatment unendingly. When they need more cash, the patient can just sit tight for the finish of the life, which will bring families enormous agony. Just in Africa, 23 million individuals who kicked the bucket on account of AIDS in 2010 (UNAIDS, 2010). Also, there are a huge number of families endure the hurt brought about by AIDS. Not just the patients’ families will endure a great deal when they attempt to spare the patients, the general public likewise overloads by the use to treat patients. In 2009, US$ 15. 9 billion was utilized to get a wide range of accessible hotspots for HIV, however in 2010 there will have $ 26. 8 billion required for HIV administrations, and the researchers said there will have an extensive stretch ncrease in light of the development of patients who is contaminated by AIDS (UNAIDS, 2010). Since broad effects brought about by resistant framework breakdown, on the off chance that we can discover a few reasons for it, there may have some ideal change in our future. In view of its various causes, it is typically isolated into three fundamental parts: immunodeficiency, autoimmunity and touchiness. Im munodeficiency is first sort, which alludes to maladies that can make the capacity of resistant framework to battle irresistible sickness is undermined or totally missing. Most instances of this sort of ailments are obtained yet a few people are brought into the world with surrenders in their safe framework, or essential immunodeficiency. One model gave by Dr. Greenberg is the blend utilization of things which can contact our body, for example, syringe needles and toothbrush (Greenberg, 2009). So we ought to be mindful so as to our activities in our day by day lives. The second is autoimmunity, which contains illnesses are brought about by the disappointment of a life form in perceiving its own constituent parts as self, which permits an invulnerable reaction against its own cells and tissues. It is frequently brought about by an absence of germ advancement of an objective body. The insusceptible framework may battle with one another paying little heed to the organizations. A few researchers view overemphasize and exhaust as two principle reasons of these sorts of sicknesses (Clare, 2003). It implies the unpredictable living style may prompt the breakdown of the insusceptible framework. Finally is excessive touchiness. It alludes to bothersome responses created by the typical resistant framework, including hypersensitivities. A large number of them are brought about by undesirable living propensities in our every day lives (Allen, 1999). Perhaps a few people consistently eat a ton once they discover something is scrumptious, possibly they invest an excessive amount of energy in a specific situation, all these may cause the breakdown of our invulnerable framework. After we know about the awful impacts of resistant framework breakdown on patients, families and society; after we exploration and follow its causes and gap them into three primary sorts, immunodeficiency, autoimmunity and excessive touchiness, we truly trust that the breakdown of the insusceptible framework will leave less torment on people’s lives. Be that as it may, sadly, safe framework breakdown is as yet one of the most damaging sicknesses on the planet. Word tally: 718 words Reference 1) JONSSON, R. R. , BROKSTAD, K. , HANSEN, T. T. , DAVIES, T. T. , ULVESTAD, E. E. (2002). The Evolution and Breakdown of the Immune System: Implications for Development of Autoimmune Diseases*. Scandinavian Journal Of Immunology, 56(3), 323-326. doi:10. 1046/j. 1365-3083. 2002. 01158. x 2) Greenberg, S. (2009, 2). Immunodeficiency. Recovered from http://www. utoronto. a/kids/Immunodeficiency. htm 3) UNAIDS. (2010, 12 23). The reality sheet on HIV for worldwide report use. Recovered from http://www. unaids. organization/reports/20101123_FS_Global_em_en. pdf 4) Clare, A. (2003). The outsider inside. New Scientist, 180(2421), 34. Recovered from http://www. katewerk. com/delusion. html 5) Allen, C. (1999). Postponed type extreme touchiness: Current hypotheses with a memorable point of view. Dermatology Online Journal, 5(1), 7. Recovered from htt p://dermatology. cdlib. organization/DOJvol5num1/audits/dark. html The most effective method to refer to the Breakdown of Immune System, Papers

Ethels Chocolate Lounges

Customers settle on many buying choices consistently. Proficient advertisers need to comprehend what rouses buyers to make a buy. These components and impacts are various, from wide social and financial patterns to individual contemplations and individual impression of items, administrations, brands and companies’ publicizing strategies.Advertising We will compose a custom contextual investigation test on Ethel’s Chocolate Lounges explicitly for you for just $16.05 $11/page Learn More Routine buying choices don't take a lot of time; notwithstanding, with progressively costly items and administrations, shoppers should think about the relative advantages and expenses of each buying other option. If there should be an occurrence of Ethel’s Chocolate Lounges, broad dynamic is the principle kind of client purchasing choices, though customary materialistic qualities and socialization with individuals from the equivalent or higher societal position (upward versatility) are the most striking elements influencing purchaser ability to remain at Ethel’s. The narrative of chocolate houses goes back to the seventeenth century (Anonymous, n.d.). Around then, individuals from society’s world class would utilize them as a spot for get-together and associating in a rich climate with a cup of prevalent quality hot cocoa (Anonymous n.d.). Today, Ethel’s Chocolate is the organization which saves and loves old chocolate conventions; named out of appreciation for Ethel Mars whose spouse established a sweets organization in 1911, Ethel’s Chocolate Lounges embody an interesting spot, where chocolate is allowed to live new life (Anonymous, n.d.). All purchaser purchasing choices can be separated into three classifications: routine reaction practices, broad dynamic, and restricted dynamic (Lamb et al., 2010). Routine reaction conduct is an example of buyer dynamic most normally connected with minimal effort and oftentimes bought products (Lamb et al., 2010). Customers who settle on routine purchasing choices are not regularly mindful of their needs, until they are exposed to publicizing and showcasing impacts/battles (Lamb et al., 2010). Constrained dynamic infers that customers know about the item yet have practically zero information on the present brands and item alternatives accessible in the market (Lamb et al., 2010).Advertising Looking for contextual investigation on business financial aspects? We should check whether we can support you! Get your first paper with 15% OFF Learn More Neither of these purchasing choices depicts the decision to enjoy at Ethel’s. Or maybe, it is through broad dynamic that clients pick or don't decide to associate at Ethel’s. Broad dynamic becomes an integral factor when the item is pricey and customers purchase the item inconsistently (Lamb et al., 2010). Buyers are effectively associated with the way toward taking the purchasing choice. However, everything changes. Buyer purchasing choices are no special case. Most likely, with time, purchasers who enjoy at Ethel’s will begin to show routine reaction practices, however not until they acquaint themselves with Ethel’s items and benefits and become accustomed to the examples of the company’s promoting and publicizing procedures. Various variables influence shopper purchasing choices; these incorporate however are not constrained to social, social, individual, and mental impacts (Lamb et al., 2010). If there should be an occurrence of Ethel’s, social and social elements produce the most grounded impacts on customer decisions. Ethel’s Lounges give one of a kind chances to benefactors, who need to invest their energy in the lap of extravagance; this implies the social estimations of material achievement and individual flexibility, just as optimistic reference gatherings, inspire customers to pick Ethel’s (Lamb et al., 2010). The unimportant truth that costs at Ethel’s are not for everybody suggests, that determination and societal position assume a colossal job in how buyers settle on their decisions. Numerous shoppers decide to be at Ethel’s in light of the fact that they can become individuals or if nothing else feel like individuals from the reference bunches they might want to join (Lamb et al., 2010). It is conceivable to accept that most shoppers associating at Ethel’s have their salary needs fulfilled; consequently, they try to spend their cash on what best relates to their qualities (De Mooij Hofstede, 2002). Rich and expensive, Ethel’s expands on customary materialistic qualities. At the same time, singular components like sexual orientation ought not be dismissed: sex influences purchaser decisions at Ethel’s, and most shoppers going to Ethel’s Chocolate Lounges are women.Advertising We will compose a custom contextual analysis test on Ethel’s Chocolate Lounges explicitly for y ou for just $16.05 $11/page Learn More Based on the investigation of buyer elements and decisions, socialization with different individuals from the equivalent or higher societal position will, most presumably, become the most remarkable driver of inspiration among Ethel’s buyers. Most customers at Ethel’s show the most trademark highlights of renown looking for practices: they are hoping to have eminence brands which represent and reaffirm their social gathering participation (Vigneron Johnson, 1999). Since Ethel’s items are neither basic nor schedule/reasonable for most purchasers, glory, dependence on social headway, socialization, and acknowledgment will assist the organization with attracting more guests and hold them. Promoting administrators at Ethel’s state that appreciating chocolate in a rich setting for ladies is equivalent to taking a flame lit air pocket shower (Anonymous, n.d.). The principle needs Ethel’s offers to incorporate (1) pe ople’s taking a stab at upward social portability, and (2) Americans’ want to purchase the best for their cash (Anonymous, n.d.). Ethel’s likewise fulfills numerous other buyer needs, including renown chasing, social acknowledgment and participation, and socialization with individuals from a similar social gathering. Most likely, the worth got from going to Ethel’s isn't material yet social and enthusiastic. Most Ethel’s guests are ladies, who experience positive feelings basically from being a piece of Ethel’s sumptuous and renowned network. End Consumers settle on many buying choices consistently. As the rate and power of market rivalry increment, advertisers try to comprehend the fundamental drivers of buying practices and factors influencing them.Advertising Searching for contextual investigation on business financial aspects? We should check whether we can support you! Get your first paper with 15% OFF Find out More If there should be an occurrence of Ethel’s Chocolate Lounge, renown chasing, socialization, acknowledgment, and having a place with a higher social layer are the most notable drivers of customer purchasing choices. As a general rule, shoppers participate in broad dynamic, until they acquaint themselves with the range and nature of items offered by Ethel’s. For some purchasers, the worth got from visiting Ethel’s isn't material yet enthusiastic. Most Ethel’s guests are ladies, who experience positive feelings just from being a piece of Ethel’s rich and renowned network. References Anonymous. (n.d.). Ethel’s Chocolate Lounges. Contextual investigation. De Mooij, M. Hofstede, G. (2002). Union and difference in customer behavior: Implications for global retailing. Diary of Retailing, 78, 61-69. Sheep, C.W., Hair, J.F. McDaniel, C. (2010). Advertising. Client version. Bricklayer, OH: South-Western Cengage Learning. Vigneron, F. Johnson, L.W. (1999). A survey and an applied structure of notoriety looking for shopper conduct. Institute of Marketing Science Review, 1, 1-14. This contextual analysis on Ethel’s Chocolate Lounges was composed and presented by client Sara L. to help you with your own examinations. You are allowed to utilize it for research and reference purposes so as to compose your own paper; be that as it may, you should refer to it likewise. You can give your paper here.

Halleck, Henry Wager

Halleck, Henry Wager Halleck, Henry Wager, 1815â€"72, Union general in the American Civil War, b. Oneida co., N.Y., grad. West Point, 1839. He entered the Corps of Engineers and became an expert on fortifications; his Elements of Military Art and Science (1846) was influential in the Civil War. In the Mexican War he served in California, holding various positions in the military government there. Halleck resigned from the army in 1853 and entered the leading law firm of the state. In the Civil War he was made a major general in the regular army (Aug., 1861) and was sent to succeed John C. Frémont in command of the Dept. of the Missouri. In Mar., 1862, the departments of the Ohio and Kansas were added to his jurisdiction. Although he was an able organizer, the prestige that he gained was due to the successes of Ulysses S. Grant , Don Carlos Buell , Samuel R. Curtis , and John Pope â€"all under his command. After Shiloh (Apr., 1862) Halleck took the field himself and advanced on Corinth, which Gene ral Beauregard abandoned to him in May. In July, 1862, he was appointed general in chief with the understanding that he was to remain in Washington as military adviser to the President and the Secretary of War. His failure to act decisively made him ineffective as general in chief, however, and he was grateful when, upon Grant's being given supreme command in Mar., 1864, he was demoted to chief of staff. He remained in the army after the war and held command of the Division of the South at the time of his death. See study by S. E. Ambrose (1962). The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved. See more Encyclopedia articles on: U.S. History: Biographies

Nuclear Physics A Scientist - 989 Words

A scientist suspects that if he or she continues to research nuclear physics, his or her country will use the findings to produce a weapon capable of annihilating thousands or even millions of innocent civilians. The scientist, however, strongly believes that a weapon of this magnitude should remain nonexistent. Should he or she continue with this research even though it could be used to create a weapon of mass destruction? The scientist absolutely should. A scientist has no moral obligations in regards to the unintended applications of his or her research because termination of scientific development deprives society of beneficial technological progress; discontinuation of potentially harmful research has no actual effect on the project’s overall timeline as another scientist will likely be willing to finish the research; and the moral responsibilities concerning the destructive use of scientific developments fall on government officials, not scientists. If a scientist ethically disagrees with the unintended applications of his or her research, the scientist should continue the work in order to effectuate the advantageous applications of the research. Cessation of research eliminates society’s opportunity to benefit from scientific progress. For instance, although some scientists may have been morally uncomfortable with creating atomic bombs during World War II, copious valuable developments of nuclear technology have emerged since the bombs’ creation. Examples of theseShow MoreRelatedThe Atomic Bomb1094 Words   |  5 PagesScientists have always strived for knowledge. With knowledge comes more power and understanding. There are many scientists and nations that can be accredited to helping create the atomic bomb. The idea of the atomic bomb with atoms and fission was not conceived overnight. 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Scientific and military development in the early 20th Century had demonstrated the potential of atoms and other properties to create large-scale nuclear weapons. The developments of the arms race within the context of World War I and World War II further led to the emergence of nuclear weapons for combat. Countries such as the United States, USSR, and Britain also sought to create effective nuclear weapons. SubsequentlyRead MorePavel Alekseyevich Cherenkov and the Cherenkov Effect1078 Words   |  4 PagesThe 1958 Nobel Prize in Physics was awarded to Pavel Alekseyevich Cherenkov, Ilya Frank and Igor Tamm for the discovery and the interpretation of the Cherenkov Effect. Cherenkov radiation is the electromagnetic radiation emitted by particles moving through a medium faster than the speed of light in the same medium. It was fist a detected by Soviet scientist Pavel Alekseyevich Cherenkov, of who the effect is named after and a theory was later developed by Ilya Frank and Igor Tamm. Cherenkov’s contributions

Electronic Health Record And Emergency Room Unconscious Essay

A woman was brought into your Emergency Room unconscious. She was the driver of a vehicle and was alone in the car. She has no purse or identification with her. The police were able to identify her by her license plate number. You are unable to obtain a history of this patient because you know nothing about her. How do you know what her allergies are or what medications she is currently taking? Thank goodness you are able to access her Electronic Health Record and obtain a complete history. An Electronic Health Record (EHR) is a computerized digital chart as opposed to a paper chart. This electronic record will contain the patient’s allergies, medications, diagnosis, labs, radiology reports and treatment plans. The Electronic Health Record impacts the delivery of health care and specifically nursing. This is because often time’s patients are unable to be a good historian of their health history. Family members are often times not very helpful either. The E HR makes it possible for all disciplines regardless of location to see what the other disciplines are doing. There are two different types of Electronic records. The Electronic Health Record (EHR) and the Electronic Medical Record (EMR). 1. Electronic Health Record †¢ Health information recorded digitally †¢ Sharing of information in real time †¢ Medical information that moves with the patient †¢ Access to important information to be used by providers when making decisions 2. Electronic Medical Record †¢Show MoreRelatedConversion to Electronic Health Records Essay1039 Words   |  5 Pagesexciting time to become part of the health care industry! Medical research makes new discoveries to improve the quality of patient care and save lives on a daily basis. Health care reform is gaining momentum, revolutionizing the industry and requiring many administrative changes, such as the creation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Rules and standards evolved from this act provide a way to ensure your protected health information remains confidential. InRead MoreHcs 235 Interview Essay1079 Words   |  5 PagesHealth Care Interview HCS 235 March 4, 2013 Dr. Robert Clegg Health Care Interview There are many components to a hospital or medical facility. All of them are necessary to have a properly functioning environment. The emergency department of a hospital is a fast paced world. You have to be constantly on your toes and prepared for whatever may come through the doors. There are many people that work in an emergency room to make it run smoothly. Techs, nurses, CNA’s, LVN’s, and doctors allRead MoreNyu Langone Medical Center For New York University1169 Words   |  5 PagesIntroduction: NYU Langone Medical Center, located in the heart of New York City, is an academic health care facility affiliated with New York University. Considered one of the nation’s premier medical centers, NYU Langone is a 1,069- bed general medical and surgical facility with over 50,000 emergency room visits, 38,000 annual admissions, and performing over 14,800 inpatient surgeries and 42,000 outpatient surgeries, (NYU Langone Medical Center, 2014). NYU Langone consists of four hospitals:Read MoreSocial Media And Its Effects On The Emergency Room Essay1668 Words   |  7 Pagesstudents engaging in social media than ever before, the legal and ethical issues that could potentially arise need to be well understood and avoided. Chosen Scenario Conclusion I am a registered nurse that traditionally works night shifts in the emergency room (ER). During the majority of my night shifts, I encounter the same frequent combination of unhealthy frail patients that are in need of immediate relief or assistance. The most common cases I see throughout a great deal of my shifts contain patientsRead MoreThe Evolution of Anesthesia Essay example1638 Words   |  7 PagesThe scene is a 19th century home; a man knocks on the door for his appointment. The door opens and standing there is the doctor in a stiff, dry, blood-covered smock. The man is there for surgery and the doctor leads him to his designated operating room. As the doctor sets the man down in the chair, the man sees the dry blood and sharp instruments. He starts to have second thoughts on the surgery and struggles to get away. Two of the doctor’s assistants hold him down as the doctor gives him a blowRead MoreThe Effects Of Social Media On Health Care1373 Words   |  6 Pages The use of social media can be very beneficial to health care in different ways, including fostering professional connections, promoting timely communication with patients and family members, and educating and informing consumers and health care professionals. Social media is changing the way that health professionals and patients interact with each other. The use of social media and other electronic communication is expanding exponentially as the number of social media outlets, platforms and applicationsRead MoreUtilizing Qr Code Technology for Emr.4005 Words   |  17 PagesElmasri PhD College of Computer and Information Systems, King Saud University, Saudi Arabia Abstract: In situations like emergency, where the immediately gained, summarized and accurate information may radically make the difference between life and death, the need for a solution that fulfills this requirement arises. Number of solutions was previously proposed including emergency card and smart cards, but each has number of cons and pros. With the rapid adoption of smartphones, QR codes (Quick Response)Read MoreMeditech2510 Words   |  11 PagesMeditech Health Information Systems Kristy Trumble September 15, 2012 Table Of Contents Meditech†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.2 Meditech Product Uses†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦2 Meditech Integration†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.4 User Friendliness†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.5 Benefits†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..6 Implementation Process†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..7 Findings Analysis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.8 Conclusion†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.8 References†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.10 Meditech â€Å"IRead MoreAdvanced Technology Facility Design / Construction3623 Words   |  15 PagesIntroduction 4 Smart Hospitals 5 Need for SMART 6 Smart Technology 7 RFID 7 Patient Tracking 8 Pharmacy medical distribution: 9 RFID Instrument tracking 11 Sponge Tracking 11 Blood Tracking 12 Smart Operating Theatres 12 Design of the readers: 12 Tele health 13 Wireless Mobility 14 Technologies – Application Benefits 15 Technology Barriers 16 Conclusion 17 Introduction In this advancing world, healthcare has been one of the fast growing facilities with respect to the use of technologies forRead MoreHsm 542 Course Project6706 Words   |  27 PagesEffecting Change Information Technology: Why is the Healthcare Industry sluggish to upgrade their Hospital Information Technology Systems? John Iskarous Health Rights/ Responsibilities – HSM542 Prof. Gomillion DeVry University, Keller Graduate School of Management February 22, 2013 Table of Contents Abstract 3 Background 3 Define The Problems 5 Privacy and Security Concerns 11 High Level Solution amp; Suggestions 13 Problem Analysis

The Delphi Technique Making Sense of Consensus Free Essays

A peer-reviewed electronic journal. Copyright is retained by the first or sole author, who grants right of first publication to the Practical Assessment, Research Evaluation. Permission is granted to distribute this article for nonprofit, educational purposes if it is copied in its entirety and the journal is credited. We will write a custom essay sample on The Delphi Technique: Making Sense of Consensus or any similar topic only for you Order Now Volume 12, Number 10, August 2007 ISSN 1531-7714 The Delphi Technique: Making Sense Of Consensus Chia-Chien Hsu, The Ohio State University Brian A. Sandford, Oklahoma State University The Delphi technique is a widely used and accepted method for gathering data from respondents within their domain of expertise. The technique is designed as a group communication process which aims to achieve a convergence of opinion on a specific real-world issue. The Delphi process has been used in various fields of study such as program planning, needs assessment, policy determination, and resource utilization to develop a full range of alternatives, explore or expose underlying assumptions, as well as correlate judgments on a topic spanning a wide range of disciplines. The Delphi technique is well suited as a method for consensus-building by using a series of questionnaires delivered using multiple iterations to collect data from a panel of selected subjects. Subject selection, time frames for conducting and completing a study, the possibility of low response rates, and unintentionally guiding feedback from the respondent group are areas which should be considered when designing and implementing a Delphi study. The Delphi technique, mainly developed by Dalkey and Helmer (1963) at the Rand Corporation in the 1950s, is a widely used and accepted method for achieving convergence of opinion concerning real-world knowledge solicited from experts within certain topic areas. Predicated on the rationale that, â€Å"two heads are better than one, or†¦ n heads are better than one† (Dalkey, 1972, p. 15), the Delphi technique is designed as a group communication process that aims at conducting detailed examinations and discussions of a specific issue for the purpose of goal setting, policy investigation, or predicting the occurrence of future events (Ulschak, 1983; Turoff Hiltz, 1996; Ludwig, 1997). Common surveys try to identify â€Å"what is,† whereas the Delphi technique attempts to address â€Å"what could/should be† (Miller, 2006). In the literature, Delphi has been applied in various fields such as program planning, needs assessment, policy determination, and resource utilization. Delbecq, Van de Ven, and Gustafson (1975) specifically indicate that the Delphi technique can be used for achieving the following objectives: 1. To determine or develop a range of possible program alternatives; 2. To explore or expose underlying assumptions or information leading to different judgments; 3. To seek out information which may generate a consensus on the part of the respondent group; 4. To correlate informed judgments on a topic spanning a wide range of disciplines, and; 5. To educate the respondent group as to the diverse and interrelated aspects of the topic (p. 11). CHARACTERISTICS OF THE DELPHI TECHNIQUE The Delphi technique is well suited as a means and method for consensus-building by using a series of questionnaires to collect data from a panel of selected subjects (Dalkey Helmer, 1963; Dalkey, 1969; Linstone Turoff, 1975; Lindeman, 1981; Martino, 1983; Young Jamieson, 2001). Delphi, in contrast to other data gathering and analysis techniques, employs multiple iterations designed to Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique develop a consensus of opinion concerning a specific topic. Ludwig (1994) indicates: Iterations refer to the feedback process. The process was viewed as a series of rounds; in each round every participant worked through a questionnaire which was returned to the researcher who collected, edited, and returned to every participant a statement of the position of the whole group and the participant’s own position. A summation of comments made each participant aware of the range of opinions and the reasons underlying those opinions (p. 55). More specifically, the feedback process allows and encourages the selected Delphi participants to reassess their initial judgments about the information provided in previous iterations. Thus, in a Delphi study, the results of previous iterations regarding specific statements and/or items can change or be modified by individual panel members in later iterations based on their ability to review and assess the comments and feedback provided by the other Delphi panelists. Other notable characteristics inherent with using the Delphi technique are the ability to provide anonymity to respondents, a controlled feedback process, and the suitability of a variety of statistical analysis techniques to interpret the data (Dalkey, 1972; Ludlow, 1975; Douglas, 1983). These characteristics are designed to offset the shortcomings of conventional means of pooling opinions obtained from a group interaction (i. e. , influences of dominant individuals, noise, and group pressure for conformity) (Dalkey, 1972). One of the primary characteristics and advantages of the Delphi process is subject anonymity which can reduce the effects of dominant individuals which often is a concern when using group-based processes used to collect and synthesize information (Dalkey, 1972). Additionally, the issue of confidentiality is facilitated by geographic dispersion of the subjects as well as the use of electronic communication such as e-mail to solicit and exchange information. As such, certain downsides associated with group dynamics such as manipulation or coercion to conform or adopt a certain viewpoint can be minimized (Helmer Rescher, 1959; Oh, 1974; Adams, 2001). Controlled feedback in the Delphi process is designed to reduce the effect of noise. Based upon Dalkey (1972), noise is that communication which occurs in a group process which both distorts the data and deals with group and/or individual interests rather than focusing on problem solving. As a result, the information developed from this kind of communication generally consists of bias not related to the purposes of the study. Basically, the controlled feedback process consists of a well organized summary of the prior iteration intentionally distributed to the subjects which allows each participant an opportunity to generate additional insights and more thoroughly clarify 2 the information developed by previous iterations. Through the operation of multiple iterations, subjects are expected to become more problem-solving oriented, to offer their opinions more insightfully, and to minimize the effects of noise. Finally, the ability to use statistical analysis techniques is a practice which further reduces the potential of group pressure for conformity (Dalkey, 1972). More specifically, statistical analysis can ensure that opinions generated by each subject of a Delphi study are well represented in the final iteration because, â€Å"at the end of the exercise there may still be a significant spread in individual opinions† Dalkey, 1972, p. 21). That is, each subject would have no pressure, either real or perceived, to conform to another participant’s responses that may originate from obedience to social norms, customs, organizational culture, or standing within a profession. The tools of statistical analysis allow for an objective and impartial analysis and summarization of the collected data . THE DELPHI PROCESS Theoretically, the Delphi process can be continuously iterated until consensus is determined to have been achieved. However, Cyphert and Gant (1971), Brooks (1979), Ludwig (1994, 1997), and Custer, Scarcella, and Stewart (1999) point out that three iterations are often sufficient to collect the needed information and to reach a consensus in most cases. The following discussion, however, provides guidelines for up to four iterations in order to assist those who decide to use the Delphi process as a data collection technique when it is determined that additional iterations beyond three are needed or valuable. Round 1: In the first round, the Delphi process traditionally begins with an open-ended questionnaire. The open-ended questionnaire serves as the cornerstone of soliciting specific information about a content area from the Delphi subjects (Custer, Scarcella, Stewart, 1999). After receiving subjects’ responses, investigators need to convert the collected information into a well-structured questionnaire. This questionnaire is used as the survey instrument for the second round of data collection. It should be noted that it is both an acceptable and a common modification of the Delphi process format to use a structured questionnaire in Round 1 that is based upon an extensive review of the literature. Kerlinger (1973) noted that the use of a modified Delphi process is appropriate if basic information concerning the target issue is available and usable. Round 2: In the second round, each Delphi participant receives a second questionnaire and is asked to review the items summarized by the investigators based on the information provided in the first round. Accordingly, Delphi panelists may be required to rate or â€Å"rank-order Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique items to establish preliminary priorities among items. As a result of round two, areas of disagreement and agreement are identified† (Ludwig, 1994, p. 54-55). In some cases, Delphi panelists are asked to state the rationale concerning rating priorities among items (Jacobs, 1996). In this round, consensus begins forming and the actual outcomes can be presented among the participants’ responses (Jacobs, 1996). 3 Rescher (1959), Klee (1972), and Oh (1974) concur that choosing individuals who are simply knowledgeable concerning the target issue is not sufficient nor recommended. Considering the necessity of selecting the most qualified individuals, Delbecq, Van de Ven, and Gustafson (1975) specifically state that three groups of people are well qualified to be subjects of a Delphi study. The authors recommend: â€Å"(1) the top management decision makers who will utilize the outcomes of the Delphi study; (2) the professional staff members together with their support team; and (3) the respondents to the Delphi questionnaire whose judgments are being sought† (p. 85). Delphi subjects should be highly trained and competent within the specialized area of knowledge related to the target issue. Investigators need to closely examine and seriously consider the qualifications of Delphi subjects. Oh (1974) indicates that choosing appropriate subjects is generally based on the judgment and discretion of the principal investigators. Jones and Twiss (1978) state that the principal investigators of a Delphi study should identify and select the most appropriate individuals through a nomination process. Ludwig (1994) also states that, â€Å"solicitation of nominations of well-known and respected individuals from the members within the target groups of experts was recommended† (p. 2). Generally, the pool of selecting possible Delphi subjects is likely to use positional leaders (Kaplan, 1971; Ludwig, 1994), to follow a review of authors of publications in the literature (Meyer, 1992; Miller, 2001), and/or to make contacts with those who have firsthand relationships with a particular issue (Jones, 1975; Anderson Schneider, 1993). The latter basically consists of individuals who are primary stakeholders with various interests related to the target issue or research effort. Concerning the appropriate number of subjects to involve in a Delphi study, Delbecq, Van de Ven, and Gustafson (1975) recommend that researchers should use the minimally sufficient number of subjects and should seek to verify the results through follow-up explorations. Ludwig (1994) notes that the number of experts used in a Delphi study is â€Å"generally determined by the number required to constitute a representative pooling of judgments and the information processing capability of the research team† (p. 52). However, what constitutes an optimal number of subjects in a Delphi study never reaches a consensus in the literature. Delbecq, Van de Ven, and Gustafson (1975) suggest that ten to fifteen subjects could be sufficient if the background of the Delphi subjects is homogeneous. In contrast, if various reference groups are involved in a Delphi study, more subjects are anticipated to Round 3: In the third round, each Delphi panelist receives a questionnaire that includes the items and ratings summarized by the investigators in the previous round and are asked to revise his/her judgments or â€Å"to specify the reasons for remaining outside the consensus† (Pfeiffer, 1968, p. 52). This round gives Delphi panelists an opportunity to make further clarifications of both the information and their judgments of the relative importance of the items. However, compared to the previous round, only a slight increase in the degree of consensus can be expected (Weaver, 1971; Dalkey Rourke, 1972; Anglin, 1991; Jacobs, 1996). Round 4: In the fourth and often final round, the list of remaining items, their ratings, minority opinions, and items achieving consensus are distributed to the panelists. This round provides a final opportunity for participants to revise their judgments. It should be remembered that the number of Delphi iterations depends largely on the degree of consensus sought by the investigators and can vary from three to five (Delbecq, Van de Ven, Gustafson, 1975; Ludwig, 1994). Subject Selection Regarding the selection of subjects for a Delphi study, choosing the appropriate subjects is the most important step in the entire process because it directly relates to the quality of the results generated (Judd, 1972; Taylor Judd, 1989; Jacobs, 1996). Since the Delphi technique focuses on eliciting expert opinions over a short period of time, the selection of Delphi subjects is generally dependent upon the disciplinary areas of expertise required by the specific issue. Regarding any set standards of selecting Delphi subjects, there is, in fact, no exact criterion currently listed in the literature concerning the selection of Delphi participants. That is, â€Å"throughout the Delphi literature, the definition of [Delphi subjects] has remained ambiguous† (Kaplan, 1971, p. 24). Regarding the criteria used to guide the selection of Delphi subjects, individuals are considered eligible to be invited to participate in a Delphi study if they have somewhat related backgrounds and experiences concerning the target issue, are capable of contributing helpful inputs, and are willing to revise their initial or previous judgments for the purpose of reaching or attaining consensus (Pill, 1971; Oh, 1974). Helmer and Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique be needed. Witkin and Altschuld (1995) note that the approximate size of a Delphi panel is generally under 50, but more have been employed. Ludwig (1997) documents that, â€Å"the majority of Delphi studies have used between 15 and 20 respondents† (p. 2). In sum, the size of Delphi subjects is variable (Delbecq, Van de Ven, Gustafson, 1975). If the sample size of a Delphi study is too small, these subjects may not be considered as having provided a representative pooling of judgments regarding the target issue. If the sample size is too large, the drawbacks inherent within the Delphi technique such as potentially low response rates and the obligation of large blocks of time by the respondents and the researcher(s) can be the result. Time Requirements Conducting a Delphi study can be time-consuming. Specifically, when the instrument of a Delphi study consists of a large number of statements, subjects will need to dedicate large blocks of time to complete the questionnaires. Delbecq, Van de Ven, and Gustafson (1975), Ulschak (1983), and Ludwig, (1994) recommend that a minimum of 45 days for the administration of a Delphi study is necessary. With regard to the time management between iterations, Delbecq et al. (1975) note that giving two weeks for Delphi subjects to respond to each round is encouraged. Ludwig (1994) indicates, â€Å"a drawback to Delphi was that the questionnaire method may slow the process greatly as several days or weeks may pass between rounds† (p. 54). More specifically, since developing the instrument, collecting the data, and administering the questionnaire are interconnected between iterations, ensuring Delphi subjects respond to the investigators on time does in many ways either promote or prohibit the ability of the investigators in analyzing the data, developing a new instrument based upon the prior responses, and distributing subsequent questionnaires in a timely fashion. These are challenging aspects of conducting a Delphi study and do require proper planning and management. The use and prevalence of electronic technologies (i. e. e-mail, teleconferencing, etc. ) may facilitate those who are interested in using the Delphi technique. Witkin and Altschuld (1995) note that electronic technology provides an opportunity for individuals to more easily employ the Delphi process by taking advantages of, â€Å"(1) the storage, processing, and speed of transmission capabilities of computers; (2) the maintenance of respondent anonymi ty, and; (3) the potential for rapid feedback† (p. 204). Data Analysis Regarding data analysis, decision rules must be established to assemble and organize the judgments and insights provided by Delphi subjects. However, the kind and type 4 of criteria to use to both define and determine consensus in a Delphi study is subject to interpretation. Basically, consensus on a topic can be decided if a certain percentage of the votes falls within a prescribed range (Miller, 2006). One criterion recommends that consensus is achieved by having 80 percent of subjects’ votes fall within two categories on a seven-point scale (Ulschak, 1983). Green (1982) suggests that at least 70 percent of Delphi subjects need to rate three or higher on a four point Likert-type scale and the median has to be at 3. 5 or higher. Scheibe, Skutsch, and Schofer (1975) reveal that the use of percentage measures is inadequate. They suggest that a more reliable alternative is to measure the stability of subjects’ responses in successive iterations. In the Delphi process, data analysis can involve both qualitative and quantitative data. Investigators need to deal with qualitative data if classic Delphi studies, wh ich use open-ended questions to solicit subjects’ opinions, are conducted in the initial iteration. Subsequent iterations are to identify and hopefully achieve the desired level of consensus as well as any changes of judgments among panelists. The major statistics used in Delphi studies are measures of central tendency (means, median, and mode) and level of dispersion (standard deviation and inter-quartile range) in order to present information concerning the collective judgments of respondents (Hasson, Keeney, McKenna, 2000). Generally, the uses of median and mode are favored. However, in some cases, as manifested by Murray and Jarman (1987), the mean is also workable. Witkin (1984) questions the appropriateness of using the mean to measure the subjects’ responses if scales used in Delphi studies are not delineated at equal intervals. In the literature, the use of median score, based on Likert-type scale, is strongly favored (Hill Fowles, 1975; Eckman, 1983; Jacobs, 1996). As Jacobs (1996) states, â€Å"considering the anticipated consensus of opinion and the skewed expectation of responses as they were compiled, the median would inherently appear best suited to reflect the resultant convergence of opinion† (p. 57). The use of mode is also suitable when reporting data in the Delphi process. Ludwig (1994) specifically addressed that â€Å"the Delphi process has a tendency to create convergence, and though this was usually to a single point, there was the possibility of polarization or clustering of the results around two or more points. In these instances, the mean or median could be misleading† (p. 57). CONSIDERING DELPHI SHORTCOMINGS AND WEAKNESSES Potential of Low Response Rates Due to the multiple feedback processes inherent and integral to the concept and use of the Delphi process, the Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique potential exists for low response rates and striving to maintain robust feedback can be a challenge. â€Å"In the Delphi technique, [poor response rate] is magnified fourfold because a maximum of four surveys may be sent to the same panelists† (Witkin Altschuld, 1995, p. 196). If a certain portion of the subjects discontinue their responses during various stages of the Delphi process, the quality of information obtained could be discounted or at least critically scrutinized. As such, Ludwig (1994) specifically addresses subject motivation as the key to the successful implementation of a Delphi study and investigators need to play an active role in this area to help ensure as high a response rate as possible. Consumption of Large Blocks of Time The Delphi technique can also be time-consuming and laborious. Unlike other data collection techniques such as the telephone survey and the face-to-face administration, which can be simultaneously conducted by a group of people and can be completed in a short period of time if the sample size is small, the Delphi technique is terative and sequential. As a result, the necessity of taking large block of time to successively complete a Delphi process is inescapable. Ludwig (1994) indicates that, â€Å"a drawback to Delphi was that the questionnaire method may slow the process greatly as several days or weeks may pass between rounds† (p. 54). Optimally speaking, the iteration characteristics of the Delphi proces s provide the opportunities for investigators and subjects to improve the accuracy of the results. In contrast, the same characteristic also increases the workload of investigators and the amount of time needed to successfully complete the data collection process (Cunliffe, 2002). Potential of Molding Opinions The iteration characteristics of the Delphi technique can potentially enable investigators to mold opinions (Altschuld, 2003). An experiment, conducted by Scheibe, Skutsch, and Schofer (1975), indicated that Delphi subjects would rate their responses differently after receiving a distorted feedback. Dalkey and Helmer (1963) also noted that, â€Å"some ‘leading’ by the experimenters inevitably resulted from the selection of the information supplied† (p. 467). Moreover, Cyphert and Gant (1971) illustrated that a statement in their study was initially rated below average. However, Delphi subjects rated the statement above average after receiving false feedback. Therefore, Cyphert and Gant (1971) concluded that the Delphi technique could, â€Å"be used to mold opinion as well as to collect [data]† (p. 273). Indeed, â€Å"subtle pressure to conform with group ratings† was one of the major drawbacks in the Delphi technique (Witkin Altschuld, 1995, p. 188). Delphi investigators need to be cognizant, exercise caution, and implement the proper safeguards in dealing with this issue. 5 Potential of Identifying General Statements vs. Specific Topic Related Information An assumption concerning Delphi participants is that they are equivalent in knowledge and experience (Altschuld Thomas, 1991). However, this assumption might not be justified. More specifically, the expertise of Delphi panelists could be unevenly distributed, especially in the field of high technology (Marchant, 1988; Altschuld Thomas, 1991). â€Å"Some panelists may have much more in-depth knowledge of certain topics, whereas other panelists are more knowledgeable about different topics† (Altschuld Thomas, 1991, p. 187). Therefore, subjects who have less in-depth knowledge of certain topics are unable to specify the most important statements which have been identified by those subjects who possess in-depth knowledge concerning the target issue. The outcomes of a Delphi study could be the results of identifying a series of general statements rather than an in-depth exposition of the topic (Altschuld Thomas, 1991). SUMMARY The Delphi technique provides those involved or interested in engaging in research, evaluation, fact-finding, issue exploration, or discovering what is actually known or not known about a specific topic a flexible and adaptable tool to gather and analyze the needed data. Subject selection and the time frames for conducting and completing a Delphi study are two areas which should be considered carefully prior to initiating the study. The additional precautions concerning low response rates, unintentionally guiding feedback, and surveying panelists about their limited knowledge of the topic rather than soliciting their expert judgments should also be built into the design and implementation of the study. The Delphi technique has and will continue to be an important data collection methodology with a wide variety of applications and uses for people who want to gather information from those who are immersed and imbedded in the topic of interest and can provide real-time and real-world knowledge. REFERENCES Adams, S. J. (2001). Projecting the next decade in safety management: A Delphi technique study. Professional Safety, 46 (10), 26-29. Altschuld, J. W. (2003). Delphi technique. Lecture, Applied evaluation design. The Ohio State University. Altschuld, J. W. , Thomas, P. M. (1991). Considerations in the application of a modified scree test for Delphi survey data. Evaluation Review, 15 (2), 179-188. Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique Anderson, D. H. , Schneider, I. E. (1993). Using the Delphi process to identify significant recreation research-based innovations. Journal of Park and Recreation Administration, 11 (1), 25-36. Anglin, G. L. 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The Delphi method: Substance, context, a critique and an annotated bibliography. Socio-Economic Planning Science, 5, 57-71. 7 Scheibe, M. , Skutsch, M. , Schofer, J. (1975). Experiments in Delphi methodology. In H. A. Linstone, M. Turoff (Eds. ). The Delphi method: Techniques and applications (pp. 262-287). Reading, MA: Addison-Wesley Publishing Company. Taylor, R. E. , Judd, L. L. (1989). Delphi method applied to tourism. In S. Witt, L. Moutinho, (Eds. ). Tourism marketing and management handbook. New York: Prentice Hall. Turoff, M. , Hiltz, S. R. (1996). Computer based Delphi process. In M. Adler, E. Ziglio (Eds. ). Gazing into the oracle: The Delphi method and its application to social policy and public health (pp. 56-88). London, UK: Jessica Kingsley Publishers. Ulschak, F. L. (1983). Human resource development: The theory and practice of need assessment. Reston, VA: Reston Publishing Company, Inc. Weaver, W. T. (1971). The Delphi forecasting method. Phi Delta Kappan, 52 (5), 267-273. Witkin, B. R. (1984). Assessing needs in educational and social programs. San Francisco, CA: Jossey-Bass Publishers. Witkin, B. R. , Altschuld, J. W. (1995). Planning and conducting needs assessment: A practical guide. Thousand Oaks, CA: Sage Publications, Inc. Young, S. J. , Jamieson, L. M. (2001). Delivery methodology of the Delphi: A comparison of two approaches. Journal of Park and Recreation Administration, 19 (1), 42-58. Citation Hsu, Chia-Chien Sandford, Brian A. (2007). The Delphi Technique: Making Sense of Consensus. Practical Assessment Research Evaluation, 12(10). Available online: http://pareonline. net/getvn. asp? v=12n=10 Editors Note: Another paper on the Delphi Technique that appeared in Practical Assessment Research Evaluation is: Yousuf, Muhammad Imran (2007). Using Experts’ Opinions through Delphi Technique. Practical Assessment Research Evaluation, 12(4). Available online: http://pareonline. net/getvn. asp? v=12n=4 . Authors Chia-Chien Hsu Post-doctoral Studies The Ohio State University 393 Schrock Road Worthington, OH 43085 Practical Assessment, Research Evaluation, Vol 12, No 10 Hsu Sandford, Delphi Technique Tel: (614) 885-0763 E-mail: hsu. 127 [at] osu. edu Brian A. Sandford Assistant Professor 214 Willard Hall Occupational Education Oklahoma State University Stillwater, Oklahoma 74074 405-744-3461 brian. sandford [at] okstate. edu 8 How to cite The Delphi Technique: Making Sense of Consensus, Papers

Maxine Hong Kingston Essay Example For Students

Maxine Hong Kingston Essay For many of the writers discussed in class, family stories are a guide to live by. The family stories told, give an outline of morals as well as a way to stay close to their true family. Both Cofer and Stone show how family stories give them a very strong form of acceptance. Acceptance is key for each of the writers because they both face the challenge of living as multicultural people in a world that tends to shame diversity. These stories are extremely important to Cofer and Stone; questioning them would violate all they believe in. However, there is another side to this subject. Maxine Hong Kingston reveals to the reader a different side to family stories. A side that is not of love and acceptance, but more of hate, betrayal, and rejection. In some cultures family circles cannot always be of love and protection. In her case she reveals to the reader a family circle that would murder in order to keep the circle clean of sin, no matter what the cost. Kingston may not successfully gains the recognition from the family, but at least she is sure of herself now. I am worthy of eating the food. She reassures herself that she too is useful and respectful. Though she may not be the dutiful swordswoman in her mothers eyes, and her mother is certain that she will grow up as wives or slaves. Kingston chooses to be a warrior who will stand up and fight against all these traditional discrimination. She has successfully found another way to achieve what the woman warrior has achieved by using a pen. She is confident of herself despite lacking recognition from the villagers and her family. The story of Fa Mu Lan also helps Kingston understand herself better with Kingston own reinterpretation of the story. Reinterpreting the story is a process of self-revelation. Through the reinterpretation of the story, she actually learns that the only way that she will gain approval of the villagers or her family is to take her fathers place in fighting and behead the baron and evil emperor. The impossibility of doing this makes Kingston acknowledge the difference between her American life and the fantasy. She may not be like the swordswoman having all kinds of hard physical training, to copy tigers anger or stalking kill, etc. However, she does learn to stand up in her life to challenge the racist. When her boss called her Nigger Yellow, she pointed out that I dont like that word, unlike the no-name aunt who endured all humiliation silently, she expresses her dissatisfaction. She also challenged the boss when the boss was being unreasonable. I refuse to type these invitations. Though this is again not her mothers intention in telling her the folklore, Kingston displays courage in fighting against injustice by using a pen. She does not recede under the spite teasing of others. Kingston is not a timid woman who let this kind of inequality continue without people paying attention to them. She is a female avenger and she sees herself as a liberator from all these old attitudes of China. In conclusion, the intention of the mother telling Kingstons stories is somehow twisted. Kingston breaks from the restrain of tradition and work out a set of her own values. She librates from the patriarchal society. She is not submissive anymore,. She writes her desire and dissatisfaction and in turns opens the way for understanding herself better.