Friday, August 21, 2020
Essay Topics For Your AP English Course
Essay Topics For Your AP English CourseFinding good essay topics for the next year's AP English course has a number of benefits for students and for teachers. It is far more convenient to find essay topics and know what students need. Additionally, essay topics are important for classroom practice.Once the essay topic is decided, the student can begin writing the essay from start to finish without any deviation. The teacher, however, may allow for a few lines of independent research for each chapter or lesson.There are several different kinds of essay topics, such as political, scientific, or technical in nature. Many of the same essay topics, though, are used for different subject areas. Students will be able to write about general principles of literature, political theory, and grammar for example.If possible, students should give a great attention to their own research, and any other details. Before writing, they should carefully think through every topic. After they have a solid topic, they can plan how they will present it.Some students will take great lengths to be specific about what they intend to write. Others will want to write like an encyclopedia, simply defining all the details without any explanations.Once essay topics are determined, the writer can move on to the important step of writing the essay. As mentioned above, this process is easier for a teacher than it is for a student.Teachers are able to use some basic writing techniques, such as rephrasing, in order to provide the structure and clarity that students will need. On the other hand, a student cannot do this and will probably find themselves torn between two or three different essay topics, all of which he or she really wants to write.Student research and independent research are often required. In addition, the student should ensure that he or she writes the best that he or she can, using his or her own ideas and thoughts, and not simply a compilation of ideas. It is also important to m ake sure that there is no copycat essay to detract from the original.
Monday, May 25, 2020
What Is the Difference Between Climate and Weather
Weather is not the same as climate, although the two are related.à The sayingà Climate is what we expect, and weather is what we getà is aà popular saying that describes their relationship.à Weather is what we get because its how theà atmosphere is behaving now or will behave in the short-term (in the hours and days ahead). On the other hand, climate tells us how the atmosphere tends to behave over long periods of time (months, seasons, and years). It does this based on weathers day-to-day behavior over a standard period of 30 years. This is why climate is described as what we expect in the above quote. So in a nutshell, the main difference between weather and climate is time. Weather Is Day-to-Day Conditions Weather includes sunshine, cloudiness, rain, snow, temperature, atmospheric pressure, humidity, winds, severe weather, the approach of a cold or warm front, heat waves, lightning strikes, and a whole lot more. Weather is communicated to us through weather forecasts. Climate Is Weather Trends Over Long Periods of Timeà Climate also includes many of the above-mentioned weather conditions--but rather than looking at these daily or weekly,à their measurements are averaged over months andà years. So, instead of telling us how many days this week Orlando, Florida had sunny skies, climate data will tell us on average how many sunny days Orlando experiences per year, how many inches of snow it generally gets during the winter season, or when the first frost occurs so farmers will know when to seed their orange orchards. Climate is communicated to us through weather patterns (El Nià ±o/La Nià ±a, etc.) and seasonal outlooks. Weather vs. Climate Quiz To help make the distinction between weather and climateà even more clear, consider the below statements and whether each deals with weather or climate.à Weather Climate Todays high was 10 degrees hotter than normal. x Today feels so much hotter than yesterday. x Heavy thunderstorms are expected to move through the area this evening. x New York sees a White Christmas 75 percent of the time. x Ive lived here for 15 years and Ive never seen flooding like this. x Forecasting Weather vs.à Predicting Climate Weve explored how weather differs from climate, but what about differences in predicting the two? Meteorologists actually use similar tools, known as models, for both.à The models used to forecast weather incorporate air pressure, temperature, humidity, and wind observations to produce the best estimate of the atmospheres future conditions. A weather forecaster then looks at this model output data andà adds in his personal forecasting know-howà is able to figureà out the most likelyà scenario. Unlike weather forecast models, climate models cannot use observations because future conditions arent known yet.à Instead, climate predictions are made using globalà climate models that simulate how our atmosphere, oceans, and land surfaces might interact.
Friday, May 15, 2020
The Future Of China Is A Subject Of Great Interest And...
The future of China is a subject of great interest and debate. While some scholars, economists, politicians, and political scientists claim to know the future, the only certainty is that no one really knows what is going to happen. There are prevailing forecasts that predict that China will either become the foremost economy in the world, or will fail spectacularly in that mission. Another prominent forecast is that China will democratize on their way to the top. This democratization will occur in the form of economic reform, greater social freedom, and political action. These reforms and steps toward democratization would bolster all facets of Chinese life and would assist their rise to the top. Unfortunately, it does not seem like even the smallest forms of democratization are on the horizon for China. The Chinese government is far too attached to their current ruling practices and has no plans to change. Couple that with the continued repression of dissent and the desire to do any thing to stay in power, and China is on no path toward democratization. While democratic reform is one of the future forecasts for the nation, and ruling it out entirely would be naà ¯ve, it would be equally foolhardy to consider it as a likely path for the nation to take. Recent behavior and long term strategies point to much different forecasts. Governments are put in place to help run the country and make it the best place for the citizens. There is a problem, however when the leaders begin toShow MoreRelatedTourism Business Environment Of The Inbound Chinese Market1548 Words à |à 7 PagesThe subject of this report is to analyse the tourism business environment of the inbound Chinese market and evaluate this country in the perspective of Visit Britain. On this report, it will be provided an introduction of the Pest (Political, Economic, Social and Technological) analysis, where it will be explained the nature of this study and it will be described what each sector means. A briefly overview of the country selected, China and how it is the situation of the country in terms of businessRead MoreWar Is An Inevitable Feature Of International Politics1560 Words à |à 7 Pagesthe real power of the state. Power arises from ââ¬Ëgreat military powersââ¬â¢ and ââ¬Ëgreat economic powersââ¬â¢. Indeed, the greatest powers obtained permanent seats on the Security Council of the United Nations. Can such security organisations including, non-governmental organizations really prevent conflicts? We have seen the inevitability of wars through the history, from which has arisen decades of theoretical debates (First ideologist-realist great debate took place between 1930ââ¬â¢s and 1940ââ¬â¢s, which focusRead MoreChina s Engagement In to Multilateral Participation Essay1209 Words à |à 5 Pages2 Literature Review In spite of the fact that China s engagement into multilateral participation in the South China Sea dispute comes up with compositions on conflict management in this area by various researchers, so far not very many endeavours have been made to clarify the explanations behind China s changing state of mind towards multilateralism (Desjardins 2014). The current level headed discussions essentially take after three lines of contentions. The three systemic theories incorporatedRead MoreThe Fight Of The Fugitive Slave Law1442 Words à |à 6 Pagescongressional debates that raged on over the issue of slavery during Millard Fillmore s term in office, the President had a foreign policy agenda that emphasized expanding trade while limiting American commitments outside the Western Hemisphere. Asia Pacific: Japan and Hawaii - For nearly three centuries, Japan had been a completely isolated nation. American shipping interests, however, identified the nation as a prime location to stop and resupply their ships on the way into China and SoutheastRead MoreWorld War II Was The Deadliest Conflict Of Japanese Americans On The West Coast Of The United States1625 Words à |à 7 Pagesxenophobia. The events leading up to the internment of Japanese-Americans on the west coast of the United States lie in the beginnings of World War II. Imperial Japan hoped to expand its area of control, starting with Manchuria, a territory belonging to China. Japanââ¬â¢s Kwantung Army, a force that had resided in Manchuria since 1905, attacked the province and completely took it over. It was soon turned into a puppet state, renamed Manchukuo. Although the U.S. gave moral disapproval, the overall response wasRead Moreââ¬ËTodayââ¬â¢s China Is Both a ââ¬Å"Status-Quo Powerâ⬠and a ââ¬Å"Revisionist Powerâ⬠ââ¬â¢2430 Words à |à 10 Pagesââ¬ËTodayââ¬â¢s China is both a ââ¬Å"status-quo powerâ⬠and a ââ¬Å"revisionist powerâ⬠ââ¬â¢ The Peopleââ¬â¢s Republic of China (PRC) has become more integrated and willing to cooperate within the global political and economic systems than ever in its history. However, there is growing apprehension in the Asia-Pacific region and the U.S. in regards to the consequences of rising in economic and military power in China. Descriptions about Chinese diplomacy in the policy and scholarly are less positive lately concerning Chinaââ¬â¢sRead More Clash Of Civilizations Essay examples1587 Words à |à 7 Pagesaffairs publication, Foreign Policy. In 1993 Samuel P. Huntington wrote an article for the respected journal Foreign Affairs titled ââ¬Å"The Clash of Civilizations?â⬠. This article was very controversial and stirred up much debate among scholars, politicians, and anyone interested in the future of international affairs. His book, The Clash of Civilizations and the Remaking of World Order, is a more detailed exploration of the ideas and predictions put forth in his article. Huntington believes that with theRead MoreThe Outdoor Leisure Areas Of China1622 Words à |à 7 PagesIn China, it is not rare to register an organization as a business, but then run it as independent social club. In fact, none of the outdoor leisure communities I joined was an official minjian organization: zhuifeng outdoor under the social network ââ¬Å"WeChartâ⬠, Chunqiu ââ¬Å"Spring-Autumnâ⬠outdoor under the umbrella of Reading Association under a local real estate companyââ¬â¢s sponsor , and a few more operated under the auspices of an outdoor gear franchise. Attached to a website, cafà © or store, the runningRead MoreGenetically Modified Organisms ( Gmo ) Essay1737 Words à |à 7 Pagesaltered. They are also known as transgenic, genetically manipulated, or engineered organisms. The intentional incorporation or deletion of their genes is intended to introduce or modify some of its characteristics. Although this has been seen as a great advantage by many scien tists and supporters of this technology, transgenic organisms suppose a danger that has not been conceived at all and that may affect the world in an unrepairable and decontrolled way. There has been always the need to improveRead MoreThe Theory Of The International System1741 Words à |à 7 Pagespower over others. This is due to the fact that states must constantly be prepared to use force, as other states may use violence at any time. Great powers have greater offensive military capability than small states, creating a potential dangers to the weaker actors in the international system. Due to the ultimate goal of hegemony that anarchy creates, great powers have aggressive intentions as they always try to one up each other (Mearsheimer, Anarchy and the Struggle for Power). This mentality creates
Wednesday, May 6, 2020
James Joyces Dubliners Essay - 1422 Words
Dubliners In the story Dubliners by James Joyce, he writes about a few different themes, some of these being autonomy, responsibility, light, and dark. The most important of the themes though must be the individual character in the story against the community and the way they see it. I have chosen to take a closer look at ââ¬Å"Araby,â⬠ââ¬Å"Eveline,â⬠and ââ¬Å"The Deadâ⬠because the great display of these themes I feel is fascinating. Many things affect the way the individual characters see the community, for example their family, friends, fellow citizens, or even new places. In Dubliners, the way the characters see the community affects them and other people around them. In the story ââ¬Å"Araby,â⬠the boy has a negativeâ⬠¦show more contentâ⬠¦It all starts with his neighbor, Mrs. Mercer. Mrs. Mercer is a garrulous lady, who is a widow to pawnbroker. She is the kind of lady that loves gossip and will go on about it for ages. As the boy made his way back to equilibrium he found himself at the dinner table with Mrs. Mercer. Mrs. Mercer adds to the boysââ¬â¢ frustration by prolonging her visit for more than an hour. All the boy wanted to do is get money so he could make his way to the bazaar. The second case of a woman inflicting frustration to the boy is the young lady at the porcelain vase stand at the bazaar. As the boy glances at the vases the lady asks him if he wants to buy anything and he responds, ââ¬Å"No, thank you.â⬠At this stand the boy realizes the reality of his whole entire situation. First of all, the boysââ¬â¢ chance to get the girl is very slim for a few reasons, one being that sh e is older and two she is most likely going to become a nun when she is older; the girl is away on a retreat this weekend and that is why she canââ¬â¢t go to the bazaar herself. The second thing he realized and questions, can you really buy love? These two things combined hit him all at once and came to him at as a shock. In ââ¬Å"Araby,â⬠there are some positive aspects of the way the boy sees the world around him. The boy idolizes the girl and canShow MoreRelatedJames Joyceââ¬â¢s Dubliners Essay1493 Words à |à 6 PagesJames Joyceââ¬â¢s Dubliners is a collection of short stories that aims to portray middle class life in Dublin, Ireland in the early twentieth century. Most of the stories are written with themes such as entrapment, paralysis, and epiphany, which are central to the flow of the collection of stories as a whole. Characters are usually limited financially, socially, and/or by their environment; they realize near the end of each story that they cannot escape their unfortunate situation in Dublin. These storiesRead MoreParalysis In James Joyces Dubliners1086 Words à |à 5 PagesHopefully this Essay is Slightly More Intelligible than Finneganââ¬â¢s Wake: Dubliners Essay ââ¬Å"To be or not to be, that is the question.â⬠Hamletââ¬â¢s famous quotation implies only two solutions: to be, or to not be. However, there is another option that Shakespeare never explored: to remain paralyzed between the two states, unable to commit to either. James Joyceââ¬â¢s Dubliners is a collection of short stories first published in 1914, that follows the inhabitants of Ireland. Published nearly a half a centuryRead MoreEssay on James Joyces Dubliners1145 Words à |à 5 PagesJames Joyces Dubliners Throughout James Joyceââ¬â¢s ââ¬Å"Dublinersâ⬠there are four major themes that are all very connected these are regret, realization, self hatred and Moral paralysis, witch is represented with the actual physical paralysis of Father Flynn in ââ¬Å"The Sistersâ⬠. In this paper I intend to explore the different paths and contours of these themes in the four stories where I think they are most prevalent ,and which I most enjoyed ââ¬Å"Arabyâ⬠, ââ¬Å"Evelineâ⬠, ââ¬Å"The Boarding Houseâ⬠, and ââ¬Å"A LittleRead MoreJames Joyces Dubliners Essay1430 Words à |à 6 PagesA Literary Analysis of Dubliners James Joyce created a collection of short stories in Dubliners describing the time and place he grew up in. At the time it was written, Joyce intends to portray to the people of Dublin the problems with the Irish lifestyles. Many of these stories share a reoccurring theme of a characterââ¬â¢s desire to escape his or her responsibilities in regards to his relationship with his, job, money situation, and social status; this theme is most prevalent in AfterRead More Triangular Structure in James Joyces Dubliners1970 Words à |à 8 PagesTriangular Structure in James Joyces Dubliners Within the body of literary criticism that surrounds James Joyces Dubliners is a tendency to preclude analysis beyond an Irish level, beyond Joyces own intent to create the uncreated conscience of [his] race. However, in order to place the text within an appropriately expansive context, it seems necessary to examine the implications of the volumes predominant thematic elements within the broader scope of human nature. The psychic dramaRead MoreReligion in James Joyces Dubliners Essay1452 Words à |à 6 PagesReligion in James Joyces Dubliners Religion was an integral part of Ireland during the modernist period, tightly woven into the social fabric of its citizens. The Catholic Church wa s a longstandingRead MoreJames Joyces Dubliners Essay1450 Words à |à 6 PagesDubliners James Joyce wrote Dubliners during the 20th century. As Joyce wrote Dubliners, he probably intended on telling what Ireland was like at the time that he wrote it. He uses many different themes in this book. He specifically uses the themes of light and dark and autonomy and responsibility to illustrate what life in Ireland is like. The stories that use these themes are ââ¬Å"An Encounterâ⬠, ââ¬Å"The Boarding Houseâ⬠, and ââ¬Å"The Deadâ⬠. Each story contains the themes of light/autonomyRead MoreSymbolism Used in James Joyces Dubliners2126 Words à |à 9 Pagesothers. James Joyce, a well-known Irish author, uses symbolism repeatedly throughout his collection of short stories published in 1916. In these stories, titled Dubliners, Joyce uses symbolism not only to enhance the stories, but to also show the hidden, underlying message of each story without coming out and saying it directly. Joyceââ¬â¢s stories are centered on the problems of Dublin and through his use of symbolism Joyce is able to focus attention on what problem each story is addressing. James JoyceRead MoreEssay on James Joyces Dubliners1404 Words à |à 6 PagesDubliners James Joyce wrote the book Dubliners; Joyce expresses many different types of emotions throughout the book. The emotions portray individuals in society, and light and dark. The emotions of individuals are examined throughout the stories by other members in society. The stories that express the ideas are: ââ¬Å"The Encounter,â⬠ââ¬Å"Evelineâ⬠, and ââ¬Å"The Dead.â⬠The symbolism of individuals in society expresses many different situations that are happening in the characters lives. TheRead MoreEssay on Evelines Decision in James Joyces Dubliners790 Words à |à 4 PagesEvelines Decision in James Joyces Dubliners à à à à à à à à In the short story, Eveline, James Joyce introduces us to the life of a young woman named Eveline. She has the opportunity to escape with Frank, the man she thinks she loves, to a faraway country in search of a new life.à Instead, she decides to stay in the dreary and gloomy life she already knows.à To understand Evelines final decision to stay we have to analyze the reasons that prevent Eveline from pursuing a better
Tuesday, May 5, 2020
Business Strategy and Trendy Word
Question: Discuss about the Business Strategy and Trendy Word. Answer: The strategy is not like tactics, goals, or threads. In recent years, Strategy might have become a trendy word. The strategy is a Greek word. And its like an art of war. In the Art of War- winning is just the best. Like generals dictate to the team to make them win like in wars- General strategize and coordinate all the pieces and resources to make sure everything is achieved. Executive nowadays need to make a strategy by making clear and concise answers to- where we compete and how, our unique value, our resources, and capabilities we can use and sustainability. Organizations should know what they have to do and they should not. Intended, Emergent and Realized Strategy should be taken into account. A well-orchestrated staff will do the wonders. The four questions we need to answer is something which will give us the best strategies. (Kryscynski, 2015) Paragraph 2: Organization where Ideas can be put: IKEA has a great offering which has been using strategies by using economies of scale and their USP is their stores which are fun. They also have an inexpensive manufacturing as they have economies of scale. Their shipping costs are very low. Also, they can easily ship and send in mass volumes as they can produce a lot. IKEA doesnt compete in a high level of products and services. They design their products but not manufacture. Thus their strategies are very clear. Also if we talk about Suzlon- energy giant, should actually see to it where they need to apply their resources. That company having tons of resources and capabilities should actually know where their expertise lies. They have a great base of customers and more but if they strategies well they can actually do a lot of wonders in terms of cost cutting. (Engardio, Keenan, 2002) Business Model Innovation: Answer: Paragraph 1: Ideas Extracted: Todays success is the enemy of tomorrows success. Innovation creates a high customer perception value. Innovation doesnt stems from ideas and we dont need high-level technology to make something innovative. Leaders combine many ideas from the old ideas which make innovation. Business model innovation is something that who is your target, what your product is and how you change perception. There are so many companies that have changed business models like Tom and tom that has changed navigation. Flat rate, supermarket, razor and blade pattern etc. have changed the models. The ink- jets printers like have innovation. Initiation, ideation, integration and implementation are something which you need to do to develop and change your business model to have innovation. You need to return to deign your to make sure that you can have innovation. (Burt, 1987) Change initiatives do fail. Only implement one model and communicate nicely. Dont emphasize, get top level trust, and overcome the not h ere syndrome. Innovation is the key factor to make sure you are in the market. You should learn from other and reinvent so that you can do wonders by following the main 4 steps. Apply innovation patters and start implantation. Make sure you innovate and learn from your leaders. Think big, think different. (HSGUniStGallen, 2013) Paragraph 2: Organization where Ideas can be put: Dell uses this model by made to order. E-bay has changed the trade way. The one company should use it is non-other than Corus. They should actually go for a turnaround strategy as overall industry is also falling. (Kenny, 2009) Because with the current organization structure and strategy they cant compete in the international market with steel companies as this is now known as the Tata Europe steel company as the joint venture with Tata has broken down almost. (Raustiala Sprigman, 2012) They should go for trunk around and divestiture strategy in some of the offerings as they have to focus on the core competing for business with a business model innovation is the main key here. As Tata Corus was one of the main employers in the steel industry in Europe, after the inconvenience and end of this merger. They should go for something which no body has thought of and should combine many ideas to gain their position again. (Shenkar, 2012) Pankaj Ghemawat: CAGE framework to evaluate international trade opportunities- Paragraph 1: Ideas Extracted: This has been researched on international economics. How to countries Culture, Administrative/ Political, Geographical and Economic (CAGE) as a framework, can be used in two companies who are in similarly sized countries. Two companies can have trade and not just trade but other exchanges as well are usually dampened because of differences in countries like in GDP etc. and it can flourish if they have legal administration same and similar languages- then they flourish. (Bowen, et. al, 2015) If we see economically, this framework for the countries to trade like between in Canada and Mexico. (Carlson School of Management, 2015) Organization where Ideas can be put: Paragraph 2: Like the example of China and India, trade in toys and this is only because of the demographics being same in this segment. Here we talk about the same size of the countries, the similar kind of population numbers and loads more. This helps the companies to trade nicely and in abundance. Also due to the similarity in countries, the companies trade more and more. (Scott, 2014) References Engardio, P. Keenan, F. 2002 The Copycat Economy, Bloomberg Businessweek. Last viewed on 23rd August, 2016 https://www.businessweek.com/stories/2002-08-25/7-the-copycat-economy Raustiala K. Sprigman, C. 2012 The Knockoff Economy: How Imitation Sparks Innovation, Oxford University Press: New York. Shenkar, O. 2012, Just Imitate It! A Copycat Path to Strategic Agility, Ivey Business Journal Scott, M. 2014, Copycat Business Model Generates Genuine Global Success for Start-Up Incubator, The New York Times. Last viewed on 31st March, 2016 https://www.nytimes.com/2014/02/28/technology/copycat-business-model-generates-genuine-global-success-for-start-up-incubator.html?_r=0 Kryscynski, D. 2015, what is Strategy? https://www.youtube.com/watch?v=TD7WSLeQtVw. Last viewed on 23rd August, 2016 Carlson School of Management, 2015, Pankaj Ghemawat: CAGE framework to evaluate international trade opportunities, https://www.youtube.com/watch?v=7FpUJaG7uMk, Last viewed on 23rd August, 2016 HSGUniStGallen, 2013, Business Model Innovation, https://www.youtube.com/watch?v=B4ZSGQW0UMI, Last viewed on 23rd August, 2016 Burt R.S. 1987, Social Contagion and Innovation: Cohesion versus Structural Equivalence. The American Journal of Sociology, 92 (6), 1987, 1287-1335. Gibbons, P., 2015, Science of Successful Organizational Change, The: How Leaders Set Strategy, Change Behavior, and Create an Agile Culture, Pearson, USA Bowen, Harry P. ; Bake , H. Kent Powel , Gary E. , 2015, Globalization and diversification strategy: A managerial perspective, Scandinavian Journal of Management, vol.31, Issue no. 1, pp. 2539 Kenny, G., 2009, Diversification Strategy: How to Grow a Business by Diversifying Successfully, Kogan Page
Saturday, April 11, 2020
Canterbury Tales - Wife Of Bath Essays (425 words) -
Canterbury Tales - Wife of Bath Chaucer portrays the Wife of Bath as if she is a hypocrite, although, beneath the words, there is a great deal of wisdom involved. The approach that I take, is the view that this tale is advice for women to take. This tale teaches women that there are times one should be a feminist and times you should not. If a women would be a feminist all her life, she probably wouldn't get anywhere in her life or with any man. If a woman were not to have a feministic character anytime of her life, she would be overwhelmed by most men, of work or whatever the case may be. Early in The Wife of Bath, there is a quotation said by the wife of bath supporting the idea that she is feministic. "I don't deny that I will have my husband both my debtor and my slave; and as long as I am his wife he shall suffer in the flesh. I will have command over his body during all his life, not he." In other words, she is saying that she will have total control over herself, her husband, and their household and very specifically, "...not he". This can be interpretated that her husband will not have the same privileges as her in the sense that he is like a 'slave' and she will 'command' over him.. This quotation seems as if the Wife of Bath is leaning toward the feministic opinion. "Nevertheless, since I know your pleasure I'll satisfy your physical pleasure." This was said by the Wife of Bath and supports the non-feministic view. The reason this is considered non-feministic is because the woman is giving in to the man's desire which goes against feministic beliefs. The Wife of Bath has a choice of not giving in to the man, but she decides to let the man have pleasure for his desire not hers, because she has experienced sex before and she knows how much men enjoy it. This quotation obviously goes against feministic beliefs, leaving an unanswered contradiction about the Wife of Bath. My view on The Wife of Bath is negative. I feel that this tale is very vulgar and contains too much involvement of sex. Besides the fact of the tales vulgarness the Wife of Bath was a well told story and the message was well received. This story might seem hypocritical at first, but between the lines there is some helpful advice for many women in the world today.
Tuesday, March 10, 2020
A Comprehensive PET-CT Database for Tracking Patient Variables
A Comprehensive PET-CT Database for Tracking Patient Variables Free Online Research Papers Abstract: A relational database was developed tracking demographic and examination information for patients undergoing PET/CT studies. Methods: A worksheet was first developed to capture patient and study information which was then entered into a relational database. Reports were designed to provide administrative and clinical information. Results: Approximately 2000 patients and three years of data have been recorded in the database. Reports have been used for administrative and research purposes. Conclusion: The database provided reports used to justify staffing, expenditures, and growth. It has also provided research data as well as clinical feedback used to improve the care and management of our patients. Introduction: In July 2003, the Medical College of Georgia installed a PET/CT scanner in its Radiation Therapy Outpatient Center. The scanner is used to perform a variety of diagnostic and oncology-related procedures. In order to be able to retroactively derive research data, a means of tracking patients as well as their individual studies was needed. Although a previously existing diagnostic PET scanner was in use, only radiopharmaceutical records were kept. In the radiation therapy PET/CT environment we felt it important to record additional information obtained from the in-depth patient history and physical. Materials and Methods: A worksheet was developed which allows the technologist to record a current medical history. It was designed by the nuclear medicine physician, the on-site radio pharmacist, and the lead PET technologist. Worksheet entries directly correspond to the database fields to simplify data input for the technologist. If funding becomes available for a computer in the incubation area, the technologist will be able to enter the history directly into the database. Worksheets are filled out by the nuclear medicine technical staff but in order to reduce errors, only the certified PET technologists perform data entry. Data has been collected since the inception of the PET/CT unit in August, 2003. The database currently holds approximately 2000 patients each of whom has had from 1 to 6 PET/CT examinations. Because of the complexity of the information to be recorded, it was determined that a relational database rather than a spreadsheet would be the most effective tool. A relational database promotes accuracy and flexibility and also simplifies data input. Rather than the free text fields used in spreadsheets, extensive use was made of drop boxes and radio buttons as shown in figure 1 which provide selection from fixed, pre-established choices. Because a patient can and often does have multiple examinations, one table was established for the patient and a related table for procedures. There is also a table of examination types. Using the relational capability of the database, every procedure is linked to a specific patient and exam type, both of which are selected from drop boxes. Tables were also developed for referring physicians and exam indications. Because information is linked rather than entered as free text, accuracy is improved and consistency is ensured. Current departmental research interests focus on several patient populations including pediatric lymphoma, cervical and gynecological cancer, and patients requiring treatment planning. Specific database fields were selected to allow future correlations of disease and risk factors. In addition, fields were provided related to patient demographics in order to provide regional coverage documentation for the Certificate of Need. As shown in figure 2, pre administrative reports include monthly procedure counts (figure 3), Veteranââ¬â¢s Administration patient volume, patient demographics for the Certificate of Need, and patient referral volume by physician (figure 4). For research purposes, study data in reports can be filtered by examination indications, type of exam, or patient sex, race, age, or risk factors. Results: The database is useful in providing financial reports. These reports are used to correlate contract billing and to monitor coding accuracy. Reports are also useful in looking at volumes in order to monitor productivity and develop future budgets. Database reports organize research data on patients and their studies including demographics, history, and risk factors. The tools associated with a relational database provide statistics useful in the publication of case studies, preparation of lectures, and tracking of research data. Discussion: The database was designed and structured to provide flexibility in the use and presentation of information. One of the advantages of a properly designed database is that the presentation of information can be readily customized. Those entering information into the database as well as the individuals who will be using the results and reports should be involved in the design process. After obtaining all potentially useful information in the proper format, reports can be customized to fit the needs of administrators and researchers. The approach used in the development and use of this database is adaptable to other types of institutions. The focus should be predicting the information required by the specific users as well as simplifying data entry. Well-designed database structure and screens can save time and reduce or eliminate many input errors, thus enhancing productivity and accuracy. Once accurate information is collected in a well-designed format, it is relatively simple for someone proficient with databases to produce customized reports. This is especially important because users often have changing needs and interests over time. Below are examples of reports which administrators and clinicians at our institution have found useful: Veteran Patient Volume The reimbursement department uses this data to track billing cycles. Physician Referral Base This information is useful in focusing marketing efforts by identifying areas for development. Pediatric Lymphomas Following pediatric patients over a period of years will help determine improved clinical pathways for disease management. Gynecological Cancers The gynecological clinic is one of our largest referral bases. This information will be used to differentiate needs for customized scanning such as ââ¬Å"dual pointâ⬠scanning post surgery. Patient Logs and Volumes Reports provide monthly and yearly patient volume data in both textual and graphical format. Accurate volume information allows us to project staffing needs and schedule system maintenance. The printout also provides a hardcopy back-up of invaluable data. Radiation Treatment Planning By tracking the protocol used for each patient, outcomes are improved by retrospectively analyzing clinical patient management. Conclusion: This database has provided hospital administration with accurate and timely reports to justify staffing, expenditures, and growth. It has provided our physicians with a plethora of research data and has provided our technologists with a method of correlative thinking in the care and management of our patients. As volume increases, the need for accurate, easily accessible information becomes more important. The database is being continually modified and new reports are being developed to enhance management and research functions. Use of a PET/CT tracking database should prove helpful to other facilities to exploit the potential of this technology. References: 1. Gardner WD. Breast Cancer Database Provides Faster Access To Patient Records. InformationWeek Web site. 2005. Available at: informationweek.com/story/showArticle.jhtml;jsessionid=NBXENMVY3EP5AQSNDBGCKHSCJUMEKJVN?articleID=174400322. Accessed April 28, 2007. 2. Johnson S, Paul T, Khenia A. Generic Database Design for Patient Management Information. American Medical Informatics Association Web site. Available at: amia.org/pubs/symposia/D004062.PDF. Accessed April 28, 2007. 3. Friedman C, Hripcsak G, Johnson SB, Cimino JJ, Clayton PD. A Generalized Relational Scheme for an Integrated Clinical Patient Database. Proceedings of the Fourteenth Annual Symposium on Computer Applications in Medical Care. Washington, D.C. 1990. 4. Essin DJ, Lincoln TL. Implementing a Low-cost Computer-based Patient Record: A controlled vocabulary reduces database design complexity. In: Gardner R, ed. Nineteenth Symposium on Computer Applications in Medical Care. Philadelphia: Hanley and Belfus, 1995:431-5. Research Papers on A Comprehensive PET-CT Database for Tracking Patient VariablesArguments for Physician-Assisted Suicide (PAS)The Project Managment Office SystemRiordan Manufacturing Production PlanResearch Process Part OneThe Fifth HorsemanInfluences of Socio-Economic Status of Married MalesIncorporating Risk and Uncertainty Factor in CapitalBionic Assembly System: A New Concept of SelfThree Concepts of PsychodynamicOpen Architechture a white paper
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