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?"
Sunday, January 1, 2012
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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