According to sociologists, there are several different ways in which a person may become recognized as the leader of a social group in the United States. In the family traditional cultural patterns place leadership on one or both of the parents. In other cases, such as friendship groups, one or more persons may gradually emerge as leaders, although there is no formal process of selection. In larger groups, leaders are usually chosen formally through election or recruitment.
Although leaders are often thought to be people with unusual personal ability, decades of research have failed to produce consistent evidence that there is any category of “natural leaders.” It seems that there is no set of personal qualities that all leaders have in common; rather, virtually any person may be recognized as a leader if the person has qualities that meet the needs of that particular group.
Furthermore, although it is commonly supposed that social groups have a single leader, research suggests that there are typically two different leadership roles that are held by different individuals. Instrumental leadership is leadership that emphasizes the completion of tasks by a social group. Group members look to instrumental leaders to “get things done.” Expressive leadership, on the other hand, is leadership that emphasizes the collective well-beings of a social group’s members. Expressive leaders are less concerned with the overall goals of the group than with providing emotional support to group members and attempting to minimize tension and conflict among them. Group members expect expressive leaders to maintain stable relationships within the group and provide support to individual members.
Instrumental leaders are likely to have a rather secondary relationship to other group members. They give others and may discipline group members who inhibit attainment of the group’s goals. Expressive leaders cultivate a more personal or primary relationship to others in the group. They offer sympathy when someone experiences difficulties or is subjected to discipline, are quick to lighten a serious moment with humor, and try to resolve issues that threaten to divide the group. As the difference in these two roles suggest, expressive leaders generally receive more personal affection from group members; instrumental leaders, if they are successful in promoting group goals, may enjoy a more distant respect.
Wednesday, January 4, 2012
Dental education in the new century
As the twentieth century began, the importance of formal education in the United States increased. The frontier had mostly disappeared and by 1910 most Americans lived in towns and cities. Industrialization and the diversification of economic life combined with a new emphasis upon qualifications and expertise to make schooling increasingly important for economic and social mobility. Increasingly, too, schools were viewed as the most important means of integrating immigrants into American society.
The arrival of a great wave of southern and eastern European immigrants at the turn of the century coincided with and contributed to an enormous expansion of formal schooling. By 1920 schooling to age fourteen or beyond was compulsory in most states, and the school year was greatly lengthened. Kindergartens, vacation schools, extracurricular activities, and vocational education and counseling extended the influence of public schools over the lives of students, many of whom in the larger industrial cities were the children of immigrants. Classes for adult immigrants were sponsored by public schools, corporations, unions, churches, settlement houses, and other agencies.
Reformers early in the twentieth century suggested that education programs should suit the needs of specific populations. Immigrant women were one such population. Schools tried to educate young women so they could occupy productive places in the urban industrial economy, and one place many educators considered appropriate for women was the home. Although looking after the house and family was familiar to immigrant women, American education gave homemaking a new definition. In pre-industrial economies, homemaking had meant the production as well as the consumption of goods, and it commonly included income-producing activities both inside and outside the home, in the highly industrialized early-twentieth-century United States, however, overproduction rather than shortage was becoming a problem. Thus, the ideal American homemaker was viewed as a consumer rather than a producer. Schools trained women to be consumer homemakers cooking, shopping, decorating, and caring for children "efficiently" in their own homes, or if economic necessity demanded, as employees in the homes of others.
The arrival of a great wave of southern and eastern European immigrants at the turn of the century coincided with and contributed to an enormous expansion of formal schooling. By 1920 schooling to age fourteen or beyond was compulsory in most states, and the school year was greatly lengthened. Kindergartens, vacation schools, extracurricular activities, and vocational education and counseling extended the influence of public schools over the lives of students, many of whom in the larger industrial cities were the children of immigrants. Classes for adult immigrants were sponsored by public schools, corporations, unions, churches, settlement houses, and other agencies.
Reformers early in the twentieth century suggested that education programs should suit the needs of specific populations. Immigrant women were one such population. Schools tried to educate young women so they could occupy productive places in the urban industrial economy, and one place many educators considered appropriate for women was the home. Although looking after the house and family was familiar to immigrant women, American education gave homemaking a new definition. In pre-industrial economies, homemaking had meant the production as well as the consumption of goods, and it commonly included income-producing activities both inside and outside the home, in the highly industrialized early-twentieth-century United States, however, overproduction rather than shortage was becoming a problem. Thus, the ideal American homemaker was viewed as a consumer rather than a producer. Schools trained women to be consumer homemakers cooking, shopping, decorating, and caring for children "efficiently" in their own homes, or if economic necessity demanded, as employees in the homes of others.
highways
A goverment study recommended a national highway systerm of33,920 miles,and congress passed the Federcal-Aid Highway Act of 1944,which called for strict,centrakky controlled desert criterra.
The interstate highway system was finally launched in 1956 and has been hailed as one of the greatest public works projects of the century .To bulid its 44,000-mile web of highways,bridge.and tunnels hundreds of unique engineering designs and solutions had to be worked out.Consider the many geographic ,features of the country:mountains,steep grades,wetlands,rivers,desorts and plains.Variables included the slope of the land,the ability of the pavement to support the load.Innovative, designs of roadways,tunnels,bridges,overpasses,and interchanges that could run through or bypass urban areas soon began to weave their way across the country ,forever altering the face of American .
Long-span,segmented-concrete,cable-stayed bridges such as Hale Boggs in Louisiana and the Sunshine Skyway in Florida,and remarkable tunnels like Fort Mchenry in Maryland and Mr.bakerin Washington developed under the nation's physical challenges,Traffic control systems and methods of construction developed uder the interstate program soon influenced highway construction around the world,ang were invaluable in improving the condition of urban streets and traffic patterns.
Today .the interstate system links every major city in the U.S,and the U.S with Canada and Mexico,Built with safety in mind the highways have wide lanes and shoulders,dividing medians,or barriers,long entry and exit lanes,ourves engineered for safe turns,and limited access,The death rate on highways is half that of all other U.S roads (0.86 deaths per 100 million passenger miles compared to 1.99 deaths per 100 million on all other roads)
By opening the North American continent,highways have enabled consumer goods and services to reach people in remote and rural areas of jobs,access to the growth options in terms of jobs access to cutural progreams health care ,and other benefits.Above all,the interstate system provides individuals with what they enerish most:personal freedom of mobility.
The interstate system has been an essential element of the nation's economic growth in terms of shipping and job creation:more than 75 percent of the nation's freight deliveries arrive by truck.and most products that arrive by rail or air use interstates for the last leg of the journey by vehiole.
Not only has the highway system affected the American economy by providing shipping routes,it has led to the growth of spin-off industries like service stations ,motels,restaurants,and shopping centres.It has allower the rwlocation of manufacturing plants and other industries from urban areas to rural.
By the end of the century there was an immense network of paved roads ,residential streets,expressways,and freeways built to support millions of vehicles,The high way system was officially renamed for Eisenhower to honor his vison and leadership.The year construction began he said:"Together,the united forces of our communication and transportation systems are dynamic elements in the very name we bear -United States.Without them ,we would be a mere alliance of many sepaeate parts."
The interstate highway system was finally launched in 1956 and has been hailed as one of the greatest public works projects of the century .To bulid its 44,000-mile web of highways,bridge.and tunnels hundreds of unique engineering designs and solutions had to be worked out.Consider the many geographic ,features of the country:mountains,steep grades,wetlands,rivers,desorts and plains.Variables included the slope of the land,the ability of the pavement to support the load.Innovative, designs of roadways,tunnels,bridges,overpasses,and interchanges that could run through or bypass urban areas soon began to weave their way across the country ,forever altering the face of American .
Long-span,segmented-concrete,cable-stayed bridges such as Hale Boggs in Louisiana and the Sunshine Skyway in Florida,and remarkable tunnels like Fort Mchenry in Maryland and Mr.bakerin Washington developed under the nation's physical challenges,Traffic control systems and methods of construction developed uder the interstate program soon influenced highway construction around the world,ang were invaluable in improving the condition of urban streets and traffic patterns.
Today .the interstate system links every major city in the U.S,and the U.S with Canada and Mexico,Built with safety in mind the highways have wide lanes and shoulders,dividing medians,or barriers,long entry and exit lanes,ourves engineered for safe turns,and limited access,The death rate on highways is half that of all other U.S roads (0.86 deaths per 100 million passenger miles compared to 1.99 deaths per 100 million on all other roads)
By opening the North American continent,highways have enabled consumer goods and services to reach people in remote and rural areas of jobs,access to the growth options in terms of jobs access to cutural progreams health care ,and other benefits.Above all,the interstate system provides individuals with what they enerish most:personal freedom of mobility.
The interstate system has been an essential element of the nation's economic growth in terms of shipping and job creation:more than 75 percent of the nation's freight deliveries arrive by truck.and most products that arrive by rail or air use interstates for the last leg of the journey by vehiole.
Not only has the highway system affected the American economy by providing shipping routes,it has led to the growth of spin-off industries like service stations ,motels,restaurants,and shopping centres.It has allower the rwlocation of manufacturing plants and other industries from urban areas to rural.
By the end of the century there was an immense network of paved roads ,residential streets,expressways,and freeways built to support millions of vehicles,The high way system was officially renamed for Eisenhower to honor his vison and leadership.The year construction began he said:"Together,the united forces of our communication and transportation systems are dynamic elements in the very name we bear -United States.Without them ,we would be a mere alliance of many sepaeate parts."
A meeting
O.K., everybody. Can we start the meeting now? I’m Jeff Milton, the chairperson of the Graduation Committee for this year. You’ve all been selected as representatives to plan the graduation ceremonies. I’m sending around the sheet of paper for you to fill in your name and telephone number. Also, please write down what part of the ceremonies you would like to work on. Remember, as a representative, you will have a lot of responsibilities. So only sign up if you feel you have the time to participate. When everyone has finished writing down the information, please return the paper to me. At our next meeting one week from today, we’ll start to discuss the details of the ceremonies.
People dreams four to six times a night
People dream four to six times a night. They dream while they are in the REM stage of sleep, which means rapid eye movement stage in one’s sleep. Sleepers go into the REM stage about every 90 minutes. The first dream of the night may last about ten minutes. Each dream gets a little longer. The last dream of the night may be an hour long.
People need their dreams. Younger children spend more time dreaming. Babies spend almost half of their sleep in the REM stage.
One experiment showed that everyone needs to dream. Doctors gave some people sleeping pills. These sleeping pills didn’t let them go to REM sleep. After a few nights without dreams, they began to feel bad. They became angry easily, they worried a lot, and they wanted to fight with everyone. Then they stopped taking the sleeping pills. They all began to dream all night for a few nights to catch up.
Why do people dream? Dreams give them time to find the answers to some of their problems. If they think they will have difficult problems the next day, they may spend more time on REM sleep the night before. In their dreams, they may find an answer to their problems.
People need their dreams. Younger children spend more time dreaming. Babies spend almost half of their sleep in the REM stage.
One experiment showed that everyone needs to dream. Doctors gave some people sleeping pills. These sleeping pills didn’t let them go to REM sleep. After a few nights without dreams, they began to feel bad. They became angry easily, they worried a lot, and they wanted to fight with everyone. Then they stopped taking the sleeping pills. They all began to dream all night for a few nights to catch up.
Why do people dream? Dreams give them time to find the answers to some of their problems. If they think they will have difficult problems the next day, they may spend more time on REM sleep the night before. In their dreams, they may find an answer to their problems.
I have a guide dog in China dental lab
A guide dog is a dog especially trained to guide a blind person. Dogs chosen for such training must show good intelligence, physical fitness, and responsibility.
At the age of about fourteen months, a guide dog begins an intensive course that lasts from three to five months. It becomes accustomed to the leather harness and stiff leather handle it will wear when guiding its blind owner. The dog learns to watch traffic and to cross streets safely. It also learns to obey any command that might lead its owner into danger.
The most important part of the training course is a four-week program in which the guide dog and its future owner learn to work together. However, many blind people are unsuited by personality to work dogs. Only about a tenth of the blind find a guide dog useful.
At the age of about fourteen months, a guide dog begins an intensive course that lasts from three to five months. It becomes accustomed to the leather harness and stiff leather handle it will wear when guiding its blind owner. The dog learns to watch traffic and to cross streets safely. It also learns to obey any command that might lead its owner into danger.
The most important part of the training course is a four-week program in which the guide dog and its future owner learn to work together. However, many blind people are unsuited by personality to work dogs. Only about a tenth of the blind find a guide dog useful.
Sunday, January 1, 2012
Prestige of China dental lab dgroup determined by our qualities
A person’s social prestige seems to be determined mainly by his or her job. Occupations are valued in terms of the incomes associated with them, although other factors can also be relevant—particular the amount of education a given occupation requires and the degree of control over others it provides. The holders of political power also tend to have high prestige.
Unlike power and wealth, which do not seem to be becoming more equally shared,the symbols of prestige have become available to an increasing number of Americans.The main reason is the radical change in the nature of jobs over the course of this century.In 1900, nearly 40 percent of the labor force were farm workers and less than 20 percent held white-collar jobs. At the beginning of the 1980s, however, less than 5 percent of the labor force worked on farms and white-collar workers were the largest single occupational category. Blue-collar workers, the largest category in the mid-fifties, now constitute less than a-third of all workers.The increase in the proportion of high prestige jobs has allowed a much greater number of Americans to enjoy these statuses and the lifestyles that go with them.
Unlike power and wealth, which do not seem to be becoming more equally shared,the symbols of prestige have become available to an increasing number of Americans.The main reason is the radical change in the nature of jobs over the course of this century.In 1900, nearly 40 percent of the labor force were farm workers and less than 20 percent held white-collar jobs. At the beginning of the 1980s, however, less than 5 percent of the labor force worked on farms and white-collar workers were the largest single occupational category. Blue-collar workers, the largest category in the mid-fifties, now constitute less than a-third of all workers.The increase in the proportion of high prestige jobs has allowed a much greater number of Americans to enjoy these statuses and the lifestyles that go with them.
Strikes in Britain
Strikes are very common in Britain. They are extremely harmful to its industries. In fact, there are other countries in Western Europe that lose more working days through strikes every year than Britain.The trouble with the strikes in Britain is that they occur in essential industries. There are over 495 unions in Britain. Some unions are very small. Over 20 have more than 100,000 members. Unions do not exist only to demand higher wages. They also educate their members. They provide benefits for the sick and try to improve working conditions. Trade unionists say that we must thank the unions for the great improvement in working conditions in the last hundred years. It is now against the law for union members to go on strike without the support of their union. This kind of strike is called unofficial strike and was common until recently. Employers feel that unofficial strikes were most harmful because they would not be predicted. However, these unofficial strikes still occur from time to time and some unions have also refused to cooperate with the law. As a result, the general picture of the relations between workers and employers in Britain has gone from bad to worse.
Where’s the beef?
Every person uses its own special words to describe things and express ideas. Some of these expressions are commonly used for many years. Others are popular for just a short time. One such American expression is "Where's the beef?" It is used when something is not as good as it is said to be. In the early 1980s, "Where’s the beef?" was one of the most popular expressions in the United States. It seemed as if everyone was using it all the time.
Beef, of course, is the meat from a cow, and probably no food is more popular in America than the hamburger made from beef.In the 1960s a businessman named Ray Kroc began building small restaurants that sold hamburgers at a low price. Kroc called his restaurant "McDonald’s".Kroc cooked hamburgers quickly so people in a hurry could buy and eat them without waiting. By the end of the 1960s the McDonald’s Company was selling hamburgers in hundreds of restaurants from California to Maine.Not surprisingly, Ray Kroc became one of the richest businessmen in America.
Other business people watched his success. Some of them opened their own hamburger restaurants. One company, called "Wendy’s", began to compete with McDonald’s. Wendy’s said its hamburgers were bigger than those sold by McDonald’s or anyone else. The Wendy’s Company created the expression "Where’s the beef?" to make people believe that Wendy’s hamburgers were the biggest. It produced a television advertisement to sell this idea. The Wendy’s television advertisement showed three old women eating hamburgers. The bread that covered the meat was very big, but inside there was only a tiny bit of meat. "Where’s the beef?" She shouted in a funny voice. These advertisements for Wendy’s hamburger restaurants were a success from the first day they appeared on television. As we said, it seemed everyone began using the expression "Where’s the beef?"
Beef, of course, is the meat from a cow, and probably no food is more popular in America than the hamburger made from beef.In the 1960s a businessman named Ray Kroc began building small restaurants that sold hamburgers at a low price. Kroc called his restaurant "McDonald’s".Kroc cooked hamburgers quickly so people in a hurry could buy and eat them without waiting. By the end of the 1960s the McDonald’s Company was selling hamburgers in hundreds of restaurants from California to Maine.Not surprisingly, Ray Kroc became one of the richest businessmen in America.
Other business people watched his success. Some of them opened their own hamburger restaurants. One company, called "Wendy’s", began to compete with McDonald’s. Wendy’s said its hamburgers were bigger than those sold by McDonald’s or anyone else. The Wendy’s Company created the expression "Where’s the beef?" to make people believe that Wendy’s hamburgers were the biggest. It produced a television advertisement to sell this idea. The Wendy’s television advertisement showed three old women eating hamburgers. The bread that covered the meat was very big, but inside there was only a tiny bit of meat. "Where’s the beef?" She shouted in a funny voice. These advertisements for Wendy’s hamburger restaurants were a success from the first day they appeared on television. As we said, it seemed everyone began using the expression "Where’s the beef?"
Notice the health of Children
Many parties are occupying important positions in the growth of the young. Some people think that the parents are the most essential in this process, arguing that the young have been together with their parents since birth and that they are influenced without their notice.
Other people hold the opinion that the peers of the young play a major role in their growing up. The young prefer to hang out with their friends, like to learn from one another, and are more likely to follow the so-called "fashion".
Of course, both views have an element of reason. In the first few years of life, the young see whatever their parents are doing and learn from them, which lays a basic foundation for their later development as well as their value on life, their outlook. When they grow older, they have a sense of independence and identity. They want to be recognized as members of certain groups. Thus, both parents and friends greatly affect the young, but in different stages.
Other people hold the opinion that the peers of the young play a major role in their growing up. The young prefer to hang out with their friends, like to learn from one another, and are more likely to follow the so-called "fashion".
Of course, both views have an element of reason. In the first few years of life, the young see whatever their parents are doing and learn from them, which lays a basic foundation for their later development as well as their value on life, their outlook. When they grow older, they have a sense of independence and identity. They want to be recognized as members of certain groups. Thus, both parents and friends greatly affect the young, but in different stages.
Childhood amnesia
Memory is a special thing in our life. What’s your earliest childhood memory? Can you remember learning to walk? Or talk? The first time you 62 thunder or watched a television program? Adults seldom 63 events much earlier than the year or so before entering school, just as children younger than three or four 64 retain any specific, personal experiences. A variety of explanations have been 65 by psychologists for this "". One argues that the hippocampus, the region of the brain which is responsible for forming memories, does not mature 66 about the age of two. But the most popular theory 67 that, since adults do not think like children, they can not 68 childhood memories. Adults think in words, and their life memories, are like stories or 69 —one event follows 70 as in a novel or film. But when they search through their mental 71 for early childhood memories to add to this verbal life story, they don’t find any that fits the 72 . It’s like trying to find a Chinese word in an English dictionary.
Now psychologist Annette Simms of the New York State University offers a new 73 for childhood amnesia. She argues that there simply 74 any early childhood memories to recall. According to Dr. Simms, children need to learn to use 75 spoken description of their personal experiences in order to turn their own short-term, quickly 76 impressions of them into long-term memories. In other 77 , children have to talk about their experiences and hear others talk about 78 —Mother talking about the afternoon 79 looking for seashells at the beach or Dad asking them about their day at Ocean Park. Without this 80 reinforcement, says Dr. Simms, children cannot form 81 memories of their personal experiences.
Now psychologist Annette Simms of the New York State University offers a new 73 for childhood amnesia. She argues that there simply 74 any early childhood memories to recall. According to Dr. Simms, children need to learn to use 75 spoken description of their personal experiences in order to turn their own short-term, quickly 76 impressions of them into long-term memories. In other 77 , children have to talk about their experiences and hear others talk about 78 —Mother talking about the afternoon 79 looking for seashells at the beach or Dad asking them about their day at Ocean Park. Without this 80 reinforcement, says Dr. Simms, children cannot form 81 memories of their personal experiences.
Animals developed different strategies to survive
Large animals that inhabit the desert have evolved a number of adaptations for reducing the effects of extreme heat. One adaptation is to be light in color, and to reflect rather than absorb the sun’s rays. Desert mammals also depart from the normal mammalian practice of maintaining a constant body temperature. Instead of trying to keep down the body temperature deep inside the body, which would involve the expenditure of water and energy, desert mammals allow their temperatures to rise to what would normally be fever height, and temperatures as high as 46 degrees Celsius have been measured in Grant’s gazelles. The overheated body then cools down during the cold desert night, and indeed the temperature may fall unusually low by dawn, as low as 34 degrees Celsius in the camel. This is an advantage since the heat of the first few hours of daylight is absorbed in warming up the body, and an excessive buildup of heat does not begin until well into the day.
Another strategy of large desert animals is to tolerate the loss of body water to a point that would be fatal for non-adapted animals. The camel can lose up to 30 percent of its body weight as water without harm to itself, whereas human beings die after losing only 12 to 13 percent of their body weight. An equally important adaptation is the ability to replenish this water loss at one drink. Desert animals can drink huge volumes in a short time, and camels have been known to imbibe over 100 liters in a few minutes. A very dehydrated person, on the other hand, cannot drink enough water to rehydrate at one session, because the human stomach is not sufficiently big and because a too rapid dilution of the body fluids causes death from water intoxication. The tolerance of water loss is of obvious advantage in the desert, as animals do not have to remain near a water hole but can obtain food from grazing sparse pastures. Desert-adapted mammals have the further ability to feed normally when extremely dehydrated. It is a common experience in people that appetite is lost even under conditions of moderate thirst.
Another strategy of large desert animals is to tolerate the loss of body water to a point that would be fatal for non-adapted animals. The camel can lose up to 30 percent of its body weight as water without harm to itself, whereas human beings die after losing only 12 to 13 percent of their body weight. An equally important adaptation is the ability to replenish this water loss at one drink. Desert animals can drink huge volumes in a short time, and camels have been known to imbibe over 100 liters in a few minutes. A very dehydrated person, on the other hand, cannot drink enough water to rehydrate at one session, because the human stomach is not sufficiently big and because a too rapid dilution of the body fluids causes death from water intoxication. The tolerance of water loss is of obvious advantage in the desert, as animals do not have to remain near a water hole but can obtain food from grazing sparse pastures. Desert-adapted mammals have the further ability to feed normally when extremely dehydrated. It is a common experience in people that appetite is lost even under conditions of moderate thirst.
The job of computers
Computers are now employed in an increasing number of fields in our daily life. Computers have been taught to play not only checkers, but also championship chess, which is a fairly accurate yardstick for measuring the computer’s progress in the ability to learn from experience.
Because the game requires logical reasoning, chess would seem to be perfectly suited to the computer. All a programmer has to do is to give the computer a program evaluating the consequences of every possible response to every possible move, and the computer will win every time. In theory this is a sensible approach; in practice it is impossible. Today, a powerful computer can analyze 40,000 moves a second. That is an impressive speed. But there are an astronomical number of possible moves in chess—literally trillions. Even if such a program were written (and in theory it could be, given enough people and enough time), there is no computer capable of holding that much data.
Therefore, if the computer is to compete at championship levels, it must be programmed to function with less than complete data. It must be able to learn from experience, to modify its own program, to deal with a relatively unstructured situation—in a word, to "think" for itself. In fact, this can be done. Chess-playing computers have yet to defeat world champion chess players, but several have beaten human players of only slightly lower ranks. The computers have had programs to carry them through the early, mechanical stages of their chess games. But they have gone on from there to reason and learn, and sometimes to win the game.
There are other proofs that computers can be programmed to learn, but this example is sufficient to demonstrate the point. Granted, winning a game of chess is not an earthshaking event even when a computer does it. But there are many serious human problems, which can be fruitfully approached as games. The Defense Department uses computers to play war games and work out strategies for dealing with international tensions. Other problems—international and interpersonal relations, ecology and economics, and the ever-increasing threat of world famine can perhaps be solved by the joint efforts of human beings and truly intelligent computers.
Because the game requires logical reasoning, chess would seem to be perfectly suited to the computer. All a programmer has to do is to give the computer a program evaluating the consequences of every possible response to every possible move, and the computer will win every time. In theory this is a sensible approach; in practice it is impossible. Today, a powerful computer can analyze 40,000 moves a second. That is an impressive speed. But there are an astronomical number of possible moves in chess—literally trillions. Even if such a program were written (and in theory it could be, given enough people and enough time), there is no computer capable of holding that much data.
Therefore, if the computer is to compete at championship levels, it must be programmed to function with less than complete data. It must be able to learn from experience, to modify its own program, to deal with a relatively unstructured situation—in a word, to "think" for itself. In fact, this can be done. Chess-playing computers have yet to defeat world champion chess players, but several have beaten human players of only slightly lower ranks. The computers have had programs to carry them through the early, mechanical stages of their chess games. But they have gone on from there to reason and learn, and sometimes to win the game.
There are other proofs that computers can be programmed to learn, but this example is sufficient to demonstrate the point. Granted, winning a game of chess is not an earthshaking event even when a computer does it. But there are many serious human problems, which can be fruitfully approached as games. The Defense Department uses computers to play war games and work out strategies for dealing with international tensions. Other problems—international and interpersonal relations, ecology and economics, and the ever-increasing threat of world famine can perhaps be solved by the joint efforts of human beings and truly intelligent computers.
new types ad of dental lab in China
Currently, there are an increasing number of new types of small advertisement becoming increasingly common in newspaper classified columns. It is sometimes placed among "situations vacant", although it does not offer anyone a job, and sometimes it appears among "situations wanted", although it is not placed by someone looking for a job, either. What it does is to offer help in applying for a job.
"Contact us before writing your application", or "Make use of our long experience in preparing your curriculum vitae or job history", is how it is usually expressed. The growth and apparent success of such a specialized service is, of course, a reflection on the current high levels of unemployment. It is also an indication of the growing importance of the curriculum vitae (or job history), with the suggestion that it may now qualify as an art form in its own right.
There was a time when job seekers simply wrote letters of application. "Just put down your name, address, age and whether you have passed any exams", was about the average level of advice offered to young people applying for their first jobs when I left school. The letter was really just for openers, it was explained, everything else could and should be saved for the interview. And in those days of full employment the technique worked. The letter proved that you could write and were available for work. Your eager face and intelligent replies did the rest.
Later, as you moved up the ladder, something slightly more sophisticated was called for. The advice then was to put something in the letter which would distinguish you from the rest. It might be the aggressive approach. "Your search is over. I am the person you are looking for", was a widely used trick that occasionally succeeded. Or it might be some special feature specially designed for the job interview.
There is no doubt, however, that it is the increasing number of applicants with university education at all points in the process of engaging staff that has led to the greater importance of the curriculum vitae.
"Contact us before writing your application", or "Make use of our long experience in preparing your curriculum vitae or job history", is how it is usually expressed. The growth and apparent success of such a specialized service is, of course, a reflection on the current high levels of unemployment. It is also an indication of the growing importance of the curriculum vitae (or job history), with the suggestion that it may now qualify as an art form in its own right.
There was a time when job seekers simply wrote letters of application. "Just put down your name, address, age and whether you have passed any exams", was about the average level of advice offered to young people applying for their first jobs when I left school. The letter was really just for openers, it was explained, everything else could and should be saved for the interview. And in those days of full employment the technique worked. The letter proved that you could write and were available for work. Your eager face and intelligent replies did the rest.
Later, as you moved up the ladder, something slightly more sophisticated was called for. The advice then was to put something in the letter which would distinguish you from the rest. It might be the aggressive approach. "Your search is over. I am the person you are looking for", was a widely used trick that occasionally succeeded. Or it might be some special feature specially designed for the job interview.
There is no doubt, however, that it is the increasing number of applicants with university education at all points in the process of engaging staff that has led to the greater importance of the curriculum vitae.
Will Electronic Medical Records Improve Health Care?
Electronic health records (EHRs) have received a lot of attention since the Obama administration committed $19 billion in stimulus funds earlier this year to encourage hospitals and health care facilities to digitize patient data and make better use of information technology. The healthcare industry as a whole, however, has been slow to adopt information technology and integrate computer systems, raising the question of whether the push to digitize will result in information that empowers doctors to make better-informed decisions or a morass of disconnected data.
The University of Pittsburgh Medical Center (UPMC) knows firsthand how difficult it is to achieve the former, and how easily an EHR plan can fall into the latter. UPMC has spent five years and more than $1 billion on information technology systems to get ahead of the EHR issue. While that is more than five times as much as recent estimates say it should cost a hospital system, UPMC is a mammoth network consisting of 20 hospitals as well as 400 doctors’ offices, outpatient sites and long-term care facilities employing about 50,000 people.
UPMC’s early attempts to create a universal EHR system, such as its ambulatory electronic medical records rolled out between 2000 and 2005, were met with resistance as doctors, staff and other users either avoided using the new technology altogether or clung to individual, disconnected software and systems that UPMC’s IT department had implemented over the years.
On the mend
Although UPMC began digitizing some of its records in 1996, the turning point in its efforts came in 2004 with the rollout of its eRecord system across the entire health care network. eRecord now contains more than 3.6 million electronic patient records, including images and CT scans, clinical laboratory information, radiology data, and a picture archival and communication system that digitizes images and makes them available on PCs. The EHR system has 29,000 users, including more than 5,000 physicians employed by or affiliated with UPMC.
If UPMC makes EHR systems look easy, don’t be fooled, cautions UPMC chief medical information officer Dan Martich, who says the health care network’s IT systems require a "huge, ongoing effort" to ensure that those systems can communicate with one another. One of the main reasons is that UPMC, like many other health care organizations, uses a number of different vendors for its medical and IT systems, leaving the integration largely up to the IT staff.
Since doctors typically do not want to change the way they work for the sake of a computer system, the success of an EHR program is dictated not only by the presence of the technology but also by how well the doctors are trained on, and use, the technology. Physicians need to see the benefits of using EHR systems both persistently and consistently, says Louis Baverso, chief information officer at UPMC’s Magee-Women’s Hospital. But these benefits might not be obvious at first, he says, adding, "What doctors see in the beginning is that they’re losing their ability to work with paper documents, which has been so valuable to them up until now."
Opportunities and costs
Given the lack of EHR adoption throughout the health care world, there are a lot of opportunities to get this right (or wrong). Less than 10 percent of U.S. hospitals have adopted electronic medical records even in the most basic way, according to a study authored by Ashish Jha, associate professor of health policy and management at Harvard School of Public Health. Only 1.5 percent have adopted a comprehensive system of electronic records that includes physicians’ notes and orders and decision support systems that alert doctors of potential drug interactions or other problems that might result from their intended orders.
Cost is the primary factor stalling EHR systems, followed by resistance from physicians unwilling to adopt new technologies and a lack of staff with adequate IT expertise, according to Jha. He indicated that a hospital could spend from $20 million to $200 million to implement an electronic record system over several years, depending on the size of the hospital. A typical doctor’s office would cost an estimated $50,000 to outfit with an EHR system.
The upside of EHR systems is more difficult to quantify. Although some estimates say that hospitals and doctor’s offices could save as much as $100 million annually by moving to EHRs, the mere act of implementing the technology guarantees neither cost savings nor improvements in care, Jha said during a Harvard School of Public Health community forum on September 17. Another Harvard study of hospital computerization likewise determined that cutting costs and improving care through health IT as it exists today is "wishful thinking". This study was led by David Himmelstein, associate professor at Harvard Medical School.
The cost of getting it wrong
The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D’Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients’ conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.
This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D’Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can’t measure something, you can’t improve it, and without access to this data, you can’t measure it."
To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use
Aggregating info to create knowledge
Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D’Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D’Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.
The University of Pittsburgh Medical Center (UPMC) knows firsthand how difficult it is to achieve the former, and how easily an EHR plan can fall into the latter. UPMC has spent five years and more than $1 billion on information technology systems to get ahead of the EHR issue. While that is more than five times as much as recent estimates say it should cost a hospital system, UPMC is a mammoth network consisting of 20 hospitals as well as 400 doctors’ offices, outpatient sites and long-term care facilities employing about 50,000 people.
UPMC’s early attempts to create a universal EHR system, such as its ambulatory electronic medical records rolled out between 2000 and 2005, were met with resistance as doctors, staff and other users either avoided using the new technology altogether or clung to individual, disconnected software and systems that UPMC’s IT department had implemented over the years.
On the mend
Although UPMC began digitizing some of its records in 1996, the turning point in its efforts came in 2004 with the rollout of its eRecord system across the entire health care network. eRecord now contains more than 3.6 million electronic patient records, including images and CT scans, clinical laboratory information, radiology data, and a picture archival and communication system that digitizes images and makes them available on PCs. The EHR system has 29,000 users, including more than 5,000 physicians employed by or affiliated with UPMC.
If UPMC makes EHR systems look easy, don’t be fooled, cautions UPMC chief medical information officer Dan Martich, who says the health care network’s IT systems require a "huge, ongoing effort" to ensure that those systems can communicate with one another. One of the main reasons is that UPMC, like many other health care organizations, uses a number of different vendors for its medical and IT systems, leaving the integration largely up to the IT staff.
Since doctors typically do not want to change the way they work for the sake of a computer system, the success of an EHR program is dictated not only by the presence of the technology but also by how well the doctors are trained on, and use, the technology. Physicians need to see the benefits of using EHR systems both persistently and consistently, says Louis Baverso, chief information officer at UPMC’s Magee-Women’s Hospital. But these benefits might not be obvious at first, he says, adding, "What doctors see in the beginning is that they’re losing their ability to work with paper documents, which has been so valuable to them up until now."
Opportunities and costs
Given the lack of EHR adoption throughout the health care world, there are a lot of opportunities to get this right (or wrong). Less than 10 percent of U.S. hospitals have adopted electronic medical records even in the most basic way, according to a study authored by Ashish Jha, associate professor of health policy and management at Harvard School of Public Health. Only 1.5 percent have adopted a comprehensive system of electronic records that includes physicians’ notes and orders and decision support systems that alert doctors of potential drug interactions or other problems that might result from their intended orders.
Cost is the primary factor stalling EHR systems, followed by resistance from physicians unwilling to adopt new technologies and a lack of staff with adequate IT expertise, according to Jha. He indicated that a hospital could spend from $20 million to $200 million to implement an electronic record system over several years, depending on the size of the hospital. A typical doctor’s office would cost an estimated $50,000 to outfit with an EHR system.
The upside of EHR systems is more difficult to quantify. Although some estimates say that hospitals and doctor’s offices could save as much as $100 million annually by moving to EHRs, the mere act of implementing the technology guarantees neither cost savings nor improvements in care, Jha said during a Harvard School of Public Health community forum on September 17. Another Harvard study of hospital computerization likewise determined that cutting costs and improving care through health IT as it exists today is "wishful thinking". This study was led by David Himmelstein, associate professor at Harvard Medical School.
The cost of getting it wrong
The difference between the projected cost savings and the reality of the situation stems from the fact that the EHR technologies implemented to date have not been designed to save money or improve patient care, says Leonard D’Avolio, associate center director of Biomedical Informatics at the Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC). Instead, EHRs are used to document individual patients’ conditions, pass this information among clinicians treating those patients, justify financial reimbursement and serve as the legal records of events.
This is because, if a health care facility has $1 million to spend, its managers are more likely to spend it on an expensive piece of lab equipment than on information technology, D’Avolio says, adding that the investment on lab equipment can be made up by charging patients access to it as a billable service. This is not the case for IT. Also, computers and networks used throughout hospitals and health care facilities are disconnected and often manufactured by different vendors without a standardized way of communicating. "Medical data is difficult to standardize because caring for patients is a complex process," he says. "We need to find some way of reaching across not just departments but entire hospitals. If you can’t measure something, you can’t improve it, and without access to this data, you can’t measure it."
To qualify for a piece of the $19 billion being offered through the American Recovery and Reinvestment Act (ARRA), healthcare facilities will have to justify the significance of their IT investments to ensure they are "meaningful users" of EHRs. The Department of Health and Human Services has yet to define what it considers meaningful use
Aggregating info to create knowledge
Ideally, in addition to providing doctors with basic information about their patients, databases of vital signs, images, laboratory values, medications, diseases, interventions, and patient demographic information could be mined for new knowledge, D’Avolio says. "With just a few of these databases networked together, the power to improve health care increases exponentially," D’Avolio suggested. "All that is missing is the collective realization that better health care requires access to better information—not automation of the status quo." Down the road, the addition of genomic information, environmental factors and family history to these databases will enable clinicians to begin to realize the potential of personalized medicine, he added.
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