Category: Writing

Online Travel Agency and Traditional Travel Agency

Online Travel Agency and Traditional Travel Agency
Online Travel Agency and Traditional Travel Agency

How Do Customers Choose Between Online Travel Agency and Traditional Travel Agency

Order Instructions:

You need to do a background research on your topic/ startup to start the project.

You must write 1000 to 1500 words excluding references and appendix.

Format:
use Times New Roman font,
size 12,
1.5 spacing /
use normal margins/

1. Abstract
– direct question to the search project
– and an answer = we found out that….
2. Introduction
– Summarise academic articles/books
3. Body
– Going into details (from everywhere (articles, books, twitter, facebook etc.))
4. Summary/Conclusions
– We need a Marketing Implementation ( How can Marketing benefit from…, My results can effect Marketing in which way..)

so can talk about the background of online travel agency, advantage, disadvantage, impact to travel world and the customer preference regard hotel, flight ticket, transport and why customers will choose online travel agency rather than traditional travel agency…etc

SAMPLE ANSWER

How Do Customers Choose Between Online Travel Agency And Traditional Travel Agency?

ABSTRACT

This search project aims at determining how customers choose between online and traditional travel agencies. It is established that consumer choice is determined various factors including the availability and ability to use technology, past experiences, product value, accessibility and incentives, as well as a comparison of the strengths and shortcomings of each type of agency. Online travelling agencies are preferred because of the convenience associated with them and the increased internet use witnessed across the globe. However, traditional travelling agencies remain relevant and are mostly used by people with no access to technology or technical know how required, those who prefer direct contact with customer service and those who are more concerned about the reliability of online agencies. This report establishes that the choice to use online traveling agencies is determined by the reliability of information and service and ease of website use. The information collected in this report would be particularly useful to businesses that want to target online users.

INTRODUCTION

E-commerce has grown tremendously with increased access to technology and internet connectivity, rendering online business a highly preferred transactional platform. Traditional travel agencies are gradually losing popularity, as customers’ preference shifts to online travel agencies; due to the convenience associated with online business. Online travel agencies are considered more convenient because customers can make their bookings from any location, and save time and money. This is unlike traditional travel agencies where one must be available physically to transact. However, it is notable that a considerable number of customers still prefer to use traditional travel agents as opposed to online ones due to various reasons including reliability, security and less complexity (Zhang et al, 2015; Cho & Agrusa, 2006). Research indicates that the decision to choose between an online and a traditional travel agency is influenced by various factors depending on the customer preferences. This paper is a discussion of how customers choose between online and traditional travel agencies.

BODY

A research by Henry Fund in 2016 showed that 53% of all travel in the richest economies is done online. These statistics indicate considerable growth in e-commerce across the world, a trend influenced by increased access to the internet (Patel, 2016). In China, Chinese Outbound Tourism Research Insitute (COTRI) established that online travel agencies are gaining popularity. In 2015, 20% of outbound travelers in China used online travel agencies to book for transport, a 7% increase from 2014 (Skift, 2016). However, it is notable that a considerable number of customers in China still prefer the traditional travel agencies. This is presented by the figure below.

A number of researchers have embarked on determining the factors influencing an individuals’ decision to choose either an online or traditional travel agency. A majority of these researches base their findings on the advantages and disadvantages of each type of agency.  Online travel agencies have the advantage of convenience, such that customers can make bookings from the convenience of their homes, offices or anywhere as long as they have internet connection. The client on the other hand must go out of his way to access services in a traditional agency. Online traveling agencies offer time and cost savings to users. In essence, customers do not need to travel to a physical office and this saves them time. In addition, consumers can transact from their convenient location and thus do not have to incur travelling expenses to traditional agents (Pantelidis, 2014). In traditional agencies, customers incur more in terms of costs and time because they need to travel to the agency location. Queues at traditional agencies are also time consuming. Besides transacting anywhere, customers using online travel agencies can make bookings at any time, including non-official hours. Traditional travel agents limit their services to working hours, such that individuals cannot access services when they are closed (Pantelidis, 2014). In online business, customers have a wider choice of vendors. Internet offers customers a variety to choose from by providing various packages from competitors, such that they can benefit from cheaper and more competitive services. The customer has no choice but to take what the agency is offering, unlike in online agencies where the customer can compare different packages.

Traditional travel agencies have their own advantages which also illuminate the disadvantages of online travel agencies. Customers have direct contact with customer service, such that they receive any services required directly, including having their queries addressed immediately. This is unlike online agencies, where some sites do not offer direct customer service and the user may face challenges in case of any mishap when making a booking. Users of traditional agencies do not face technological challenges such as website downtimes, poor internet connectivity and power issues may affect access to services. Technical errors may also bring forth misleading information. Furthermore, there is no need for technical knowledge such as the ability to operate gadgets and surf the internet. This is because they can access services directly from customer service. It is also argued that information accuracy and reliability is higher in traditional agents because it is free from technical errors and can be verified physically. Bookings made physically are also more accurate.

The purchase decision making process is a complex undertaking and customers’ choice of a product is determined by a variety of factors. Below is a discussion of some of the factors influencing the decision to use online compared to traditional travel agencies.

Availability of infrastructure and ability to use

The most important aspect in considering online booking lies in the availability of technology and internet connectivity. This insinuates that an individual is more likely to use online booking if they have easy access to an internet device and more likely to use the traditional booking if they do not have internet access. As the world advances in terms of information technology, there is a rapid increase in the number of online users, which directly impacts online business. This is more so with the development if internet gadgets such as smartphones and tablets, which enable users to access online services from any location. Despite the availability of technology, the customer can only operate the online systems if they have the technical knowhow.

Product value

The value derived from a product or service plays an important role in influencing a customer’s purchasing decision. Scholl-Grissemann & Schnurr (2016) discuss how consumers booking intentions are affected by travel agency choices and establish that the increased utilitarian value derived from convenience is adequate to influence decision to purchase. In the case of OTAs, conducting the business online ensures that is convenient for the customer, given that they can make bookings at their own comfort. Customers also derive time value from faster service and cost savings in terms of time and money needed to visit a traditional travel agency.

Experience

According to Scholl-Grissemann & Schnurr (2016), the value of a product is only felt when it is used. Accordingly, the experience derived from the use of online and traditional travel agencies will influence whether a customer would utilize the service in future. Such experience would mostly emanate from the value derived from the service.  Cho & Agrusa (2006) study user satisfaction in relation to online travel agencies note that customer satisfaction varies from traditional businesses because there is no opportunity for physical customer service to address customer needs. Accordingly, online travel agencies must appeal to customers through an attractive and easy to use website, adequate information and available and reliable services to ensure that online services are reliable. Scholl-Grissemann & Schnurr (2016) note that the consumer’s web experience may influence their choice of online booking in future.

Accessibility

Customers make decisions based on convenience, which implies that a customer is more likely to utilize what is easily available or convenient to them. A person who lives far from a traditional travel agency is likely to seek an online alternative because it would be more convenient. On the other hand, a person who does not have access to the internet or is not familiar with the online process or who has easy access to a traditional agency will most likely utilize it.

Incentives

Incentives to a great extent influence the customer’s choice between OTAs and traditional agencies. Guo, et al (2013) note that OTAs offer cash back incentives to travelers who book through their website, thus attracting new customers and retaining existing ones. This may be in the form of reduced room rates, which encourage customers to use online agencies. Zhang (2015) also note that incentives have led to increased growth in internet bookings, due to the low cost packages including accommodation, airline costs and car rentals, which customers can benefit from when they book online.

SUMMARY AND CONCLUSIONS

The discussion above establishes that a customer’s choice between an online and traditional travel agency is based on a variety of factors, which can be explained by the features of each business platform. Based on the advantages and disadvantages of each, it can be established that the increased availability of internet and the convenience of online business have led to increased use of online traveling agencies. On the other hand, lower affinity to technology and the desire for reliability has played a great role in maintaining the market share of traditional travel agencies. This report has implications on marketing in that it provides the determining factors of customer decisions when it comes to online and traditional travel agencies. Companies that desire to excel in online travel agency can rely on this report to determine how best to increase customer satisfaction and promote online sales.

References

Cho, YC & Agrusa, J 2006, Assessing Use Acceptance and Satisfaction toward Online Travel Agencies, Information Technology & Tourism, 179–195.

Guo, X, Zheng, X, Ling, L, & Yang, C 2014, Online coopetition between hotels and online travel agencies: From the perspective of cash back after stay, Tourism Management Perspectives, 12, 104-112.

Pantelidis, LS 2014, The Routledge Handbook of Hospitality Management Routledge, London, Routledge.

Patel, N 2016, Online Travel Agencies, The Henry Fund Research, https://www.biz.uiowa.edu/henry/download/research/Online_Travel.pdf

Scholl-Grissemann & Schnurr 2016, Room with a view: how hedonic and utilitarian choice options of online travel agencies affect consumers’ booking intentions, International Journal of Culture, Tourism and Hospitality Research, 10 (4), 361 – 376

Skift, DA 2016, Online Travel Booking Grows in China, But Traditional Agents Still Dominate, https://skift.com/2016/05/20/online-travel-booking-grows-in-china-but-traditional-agents-still-dominate/

Toh, RS, DeKay, CF & Raven, P 2011, Travel Planning: Searching for and Booking Hotels on the Internet, Cornell Hospitality Quarterly 52(4) 388–398.

Zhang, M et al 2015, Online Travel Agent Service and Customer Satisfaction Based on Correlation Analysis:A Marketing Perspective in China, Journal of Marketing and Consumer Research, 11, 99-107

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Multi Choice Questions Assignments

Multi Choice Questions
Multi Choice Questions

Multi Choice Questions

Order Instructions

I have 50 multiple choice  questions – that have a answer of 9 answers you must correctly answer them

EMC&W – ethics multicultural competence and wellness
A = attending behaviour
O = observation
OQ = open questions
CQ = closed question
E = encourage
P = paraphrasing
S = summarising
R OR F = reflection or feeling

SAMPLE ANSWER

Multi Choice Questions

  1. S (Summarizing)
  2. R or F (Reflection or feeling)
  3. P (Paraphrasing)
  4. R or F (Reflection or feeling)
  5. P (Paraphrasing)
  6. A (Attending behavior)
  7. EMC & W (Ethics multicultural competence and wellness)
  8. E (Encourage)
  9. P (Paraphrasing)
  10. P (Paraphrasing)
  11. P (Paraphrasing)
  12. EMC & W (Ethics multicultural competence and wellness)
  13. P (Paraphrasing)
  14. S (Summarizing)
  15. E (Encourage)
  16. S (Summarizing)

SESSION 2

  1. A (Attending behavior)
  2. P (Paraphrasing)
  3. S (Summarizing)
  4. E (Encourage)
  5. S (Summarizing)

SESSION 3

  1. O (Observation)
  2. P (Paraphrasing)
  3. S (Summarizing)
  4. P (Paraphrasing)
  5. O (Observation)
  6. O (Observation)

SESSION 5

  1. P (Paraphrasing)
  2. P (Paraphrasing)
  3. S (Summarizing)
  4. S (Summarizing)
  5. S (Summarizing)

SESSION 8

  1. R or F (Reflection or feeling)
  2. EMC & W (Ethics multicultural competence and wellness)
  3. P (Paraphrasing)
  4. P (Paraphrasing)
  5. O (Observation)
  6. P (Paraphrasing)

SESSION 9

  1. O (Observation)
  2. CQ (Closed Question)
  3. CQ (Closed Question)
  4. OQ (Open Question)
  5. E (Encourage)

SESSION 12

  1. R or F (Reflection or feeling)
  2. EMC & W (Ethics multicultural competence and wellness)

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Ethics in and through Technology Research Paper

Ethics in and through Technology
     Ethics in and through Technology

Ethics in and through Technology

Order Instructions:

Identify a current application for digital technology that you feel has social, moral, and ethical implications for teachers and/or students. Technology is broadly defined to include anything from a piece of hardware (laptop, gaming console, tablet) to software, apps, social media platforms, etc.

*Write a one paper framed to argue its point toward a particular audience. You must first decide who you are considering to be the audience of the paper.

After you write the one page paper, write an additional short policy brief that could be given to the school board, administration, or the legislature with practical recommendations.

SAMPLE ANSWER

Critical Assessment – Ethics in and through Technology

Technology plays a very vital role in the lives of students and the society who have multiple technological devices and use them frequently. Though technology could have negative effects on the students but overall it helps the students to make their schooling much easier. This can be greatly supported by several studies conducted.

A research that emphases on information technology adoption and use within the education sector has been conducted. They analyzed the impact on learning efficacy of technology-mediated learning environments such as characterized by the adoption of tablet based technologies as a radical complement to old-fashioned teaching/learning methods. The study also analyzes the effect or outcome of “Support Activities” on students’ grades. The “Support Activities” are well-defined as the set of concepts similar to “Classmates’ Encouragement”, “Technical Support Availability” and “Teachers’ Encouragement”. It is known that grades are used as a measure of learning efficacy. In this study, a sample of 370 students partook, being attendants of experimental classes by using tablets as a regular working device to obtain to digital resources. The conventional theory reference was established on the theoretical fundamentals of Technology Acceptance Model, by matching the perceived effect of those concepts between grade ranges. The experimental sample was correlated to classes where the same instructors practice traditional learning resources. This is to give a practical understanding of support factors that influence tablet-mediated learning effectiveness. So, the findings showed the dissimilarities between humanistic and scientific subjects. The study confirms that technology alone could not reform and revolutionalize learning and teaching; nevertheless, it contributes to a better-quality experience if there are a deployed support initiatives (Caporarello, Magni, & Pennarola, 2016).

On the other hand, another study was done which seeks to discover the degree to which technology interrupts and occupies the time of a university student and to determine the extent to which these disturbances contribute to superficial stress. The study is a 71-item survey to evaluate perceived stress, disruptions, technology use and social support was overseen to 299 undergraduate learners. The results indicated that 25% of participants have issues and problems with distractions from technology, and more disturbances from technology are associated with advanced levels of perceived stress. Experiencing disruptions from technology is a notable problem among college students and needs to be tackled by student affairs professionals (Gemmill, & Peterson, 2006).

Policy brief

Students of today are now very fond of using modern devices that somehow aid in their studies and the environment they live in.

The people live in a very fast-changing ‘runaway world’ where the economic, social, cultural and political fundamentals of society are being redefined on an incessant basis (Giddens 2000).

The utilization of technologies to improve educational outcomes and support social inclusion in education has two main forms.

The number one is the usage of technologies to endorse social inclusion in terms of educational outcomes and prospects. The Information and Communication Technology (ICT) have long been supported as a predominantly opposite means of permitting citizens to play active parts in improving educational prospects and crucially proposing ways in which the underprivileged individuals could participate in education (Schofield Clark, 2003). The decentralized, intrinsically equitable, and democratic systems of education could be expected by many critics, with individuals – particularly young people – technologically re-placed at its core instead of the periphery. And the number two could be the usage of education to guarantee social insertion in terms of technological outcomes and opportunities. So, in this sense, educational organizations such as colleges, schools, museums, and libraries are used to deliver access to ICTs which training in technology skills and proficiency are seen to offer the students with the info literacy mandated to make the most of the ICTs.

Perhaps the most dominant have been guidelines and policies pursuing to use education to make sure social inclusion in terms of technological outcomes and opportunities. This kind of policy campaign have been typically built around the augmented resourcing of municipal institutions and public like libraries, community centers, schools, subsidizing of IT equipment acquisitions by those students who belong to the low incomes families and the development of formal computer education and support programs.

Recommendations

Here are some recommendations which the school board may consider for the betterment of their students:

  • Use technology to enhance the knowledge and skills of all students including those who cannot afford to buy their own device or gadgets
  • Since technology could help close achievement gaps and improve learning, the students should be encouraged to use technology but in moderation in order not to disrupt their focus on their studies
  • Technology should be efficiently and effectively used in school and the social aspects of the students.
  • Efficiently use the advantage of technology especially to those students who are at risk of dropping out and failing courses. Use technology to search and build rather than to “drill and kill,” and the correct blend of technology and teachers.

References

Caporarello L., Magni M., Pennarola F. (2016). When Teachers Support Students in Technology Mediated Learning. In: Rossignoli C., Gatti M., Agrifoglio R. (eds) Organizational Innovation and Change. Lecture Notes in Information Systems and Organisation, vol 13. Springer, Cham

Gemmill, E., & Peterson, M. (2006). Technology Use Among College Students: Implications for Student Affairs Professionals. NASPA Journal, 43(2). http://dx.doi.org/10.2202/0027-6014.1640

Giddens, A.(2000). Runaway world: how globalisation is shaping our lives. London: Routledge, 2000.

Schofield Clark, L. (2003). Challenges of social good in the world of Grand Theft Auto and Barbie. New Media & Society, v. 5, n. 1.

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Critical Evaluation of Road Crew Social Marketing Programme

Critical Evaluation of Road Crew Social Marketing Programme
Critical Evaluation of Road Crew Social Marketing Programme

Critical Evaluation of Road Crew Social Marketing Programme

Order Instructions:

Assessment 1 is an individual assignment that requires a comprehensive and critical analysis of an existing social marketing programme. This requires students to describe an existing social marketing programme, compare it to best practice, and to critically analyse, interpret and identify and discuss important implications from their analysis.

A selection of case studies examples of existing social marketing programmes to choose from will be made available online. Students will choose one case study and use materials from their own research, and from the lecture, tutorials, the textbook, videos and unit readings to critically analyse the case study.

Individual Essays will be assessed against your critical analysis of the following in relation to your chosen existing social marketing programme:

– Analysis of formative research used to inform the existing social marketing programme

– Target group(s) segmentation strategy in the existing social marketing programme

– Establishment of objectives and goals in the existing social marketing programme

– Development and use of the social marketing mix in the existing social marketing programme

– Implementation of the existing social marketing programme

– Process, impact and outcome evaluation of the existing social marketing programme including consideration of ethical implications

– Critical analysis and reflection on the strengths, weaknesses of the existing programme (this should feature throughout your essay), and your own suggestions for future programmes on this topic

– Quality of written communication (structure, formatting, spelling, grammar, readability of the essay)

No extensions will be granted. There will be a deduction of 10% of the total available marks from the total awarded mark for each 24 hour period or part thereof that the submission is late (for example, 25 hours late in submission – 20% penalty). This penalty does not apply for cases in which an application for disruption of studies is made and approved. No submission will be accepted after solutions have been posted.

This Assessment Task relates to the following Learning Outcomes:
Differentiate between commercial and social marketing and outline the scope of social marketing, seeking out new ideas and opportunities.
Demonstrate awareness of social responsibility and become familiar with the range of issues where social marketing has an impact.
Appreciate the characteristics and needs of others in society and understand prospective challenges to social issues including environmental sustainability.
Critically analyse, discuss, and evaluate social marketing strategies and use secondary research skills to collect, collate and integrate examples with theory.
Demonstrate use of written and oral skills to integrate key social marketing theoretical concepts and to create a coherent and theoretically rigorous argument relating to sustainability concepts.

SAMPLE ANSWER

Critical Evaluation of Road Crew Social Marketing Programme

Introduction

Social marketing has gained immense popularity in the contemporary world, as a strategy for promoting behavior change. Social marketing programmes fundamentally involves the application of commercial techniques for marketing in advocating for social change (Spotswood et al, 2012). Road Crew, a Wisconsin-based social marketing programme was developed with the aim of drunk driving behavior change in order to reduce road crashes related to alcohol. This paper discusses the Programme to critically review its effectiveness, impact and the extent to which it is successfully implemented as a social marketing programme.

Description of Road Crew

Road Crew existence can be traced to the year 2000 when the initial research on social marketing to promote road safety, through discouraging drunk driving was initiated by Wisconsin Department of Transportation, Bureau of Transportation Safety (WisDOT).  The service was first funded by the National Highway Traffic Safety Administration following an application by WisDOT with research support by Professor Michael Rothchild, a social marketing expert from the School of Business at Wisconsin University. The one year funding for piloting the project was expected to lay a foundation for road safety by reducing drunk driving and thereafter be adopted by communities for continuity.

Road Crew is a service for party goers which allows individuals to drink without having to drive, hence reducing alcohol-related accidents. Party goers make arrangements with Road Crew before embarking on a night out: vehicles are allocated to pick them from home, drive them from bar to bar as they enjoy the night and return them home when they are done having fun. This way, Road Crew prevents drunk driving, allows for socialization and adds to the fun. Over 97,000 rides had been given by the Road Crew as of 2008, preventing an estimate of 140 crashes from drunk driving.

Road Crew’s main target audience is the single male, aged 21-34 years, working in the rural areas as blue-collar workers. The research initially relies on findings by the US National Commission Against Drunk Driving whose public hearings and national conferences in the 1990s revealed that drinking drivers aged 21-34 made up half of drunk drivers in fatal crashes related to alcohol, were more likely to have revoked or suspended licenses and showed the greatest resistance in behavior change as far as drinking is concerned.

Analysis of formative research

The basis for any marketing campaign is comprehensive research, aimed at understanding the market and customer expectations, conducting competitor analysis and identifying the potential target market. According to Kotabe & Helsen (2011), market research ensures that the organization can develop a marketing strategy that is effective in meeting the needs of the target audience. Road Crew has demonstrated high level research on the social marketing programme, which was executed by a research team from University of Wisconsin under the guidance of Professor Rothchild. The research was undertaken from the year 2000 and sought to establish ways in which a social marketing campaign would be used in reducing accidents resulting from drunk driving. The research which utilized existing literature as well as data collection from the target audience concluded that discouraging people from drinking would not be as effective as providing them with a solution to drunk driving. Three types of studies were conducted namely existing literature review, focus group discussions with target group’s expert observers and focus group discussions with the targeted audience. This was effective in determining the behavior patterns of the target group and consequently ensure that the right strategy for the social marketing programme as implemented. Ritcher (2012), notes that research that includes the target audience as part of the respondents is likely to yield more accurate results. The research concluded that young male individuals aged 21-34 years working in small farms in rural areas were more likely to drink and drive and therefore more prone to alcohol-related accidents; thus making this population the target audience for the programme.

Segmentation strategy

The strategy selected for segmenting the market depends on the objectives of the marketing plan and the product or service in question. In social marketing, the same concept is applied, where the targeted behavior change influences the segmentation strategy. Road Crew utilizes a combination of segmentation strategies namely: geographical segmentation, demographic segmentation and behavior segmentation (Ritcher, 2012). In reference to geographical segmentation, Road Crew targets individuals living in the rural areas and small towns in the countryside. Demographic segmentation is demonstrated in the selection of customers of a particular age group and also in targeting male beneficiaries. Behavior segmentation on the other hand is evidenced by the fact that the service targets individuals who are likely to drink and drive. Such a combination is advantageous because it ensures that the target market is defined as effectively as possible. However, it may have the weakness of narrowing the segment too much and thus leaving out other individuals who may be a relevant target.

Establishment of goals and objectives

An effective social marketing programme must have well established goals and objectives because these act as a guide for the marketers. Goals and objectives define what the marketing program aims at achieving, how it will be achieved and how long it will take to be achieved. Road Crew successfully achieves this important aspect of marketing, given that there is a clear indication of what the service aims to achieve. Road Crew’s main objective is to reduce the number of road crashes related to alcohol by offering a service that prevents drinkers from driving while drunk. The social marketing programme effectively shows that this objective will be met through providing transport for the drinkers to ensure that they do not drive after drinking. The programme is also clear on the target group and the period in which it will be conducted in order to achieve the desired outcomes. The achievements made by Road Crew can be attributed to the well-articulated goals and objectives, which ensure that the programme achieves its intended function. The existence of project impact data which confirms the achievement of goals and objectives further provides backup for ell established goals and objectives.

Social marketing development and use of social marketing mix

An important aspect of marketing is the marketing mix because it acts as a guide for the marketing plan by providing a scope. Road Crew achieved this objective effectively by defining their marketing mix based on the 4Ps of marketing. The product was the vehicle ride to the bar, from bar to bar and back home; price was $15-20 per evening and $5-10 per single ride; place was home to bars; and promotion was done through advertising on television, newspapers, bars, movie theatres and over urinals. This marketing mix is used across the three pilot counties, which to a great extent promotes their performance.

Programme Implementation

Having developed an operational plan, programme implementation becomes the most important undertaking to ensure the plan is turned into reality. Jean (2013) notes that unless marketers are capable of implementing the programme effectively, having a plan is inadequate no matter how well it is designed. Road Crew can be described as a well implemented programme with tangible results. By 2008, Road Crew had made savings of $31 million by preventing 140 crashes, an indication of the impact that the social marketing programme was having on the efforts towards reducing crashes related to drunk driving. This was Road Crew’s major objective and a demonstration of the achievements of the programme is an indication of its effectiveness.

Road Crew worked together with the community during the programme implementation and effective adoption of Road Crew in various counties. A unique feature in the implementation is that Road Crew allowed counties to use locally available resources to achieve the model and also be unique in their own way to prevent drunk driving. In Pork County for example, the use of second-hand limousines was considered more cost effective while in Dodgeville and Mineral Point, the use of an existing cab service was encouraged through offering more affordable prices after 5pm. A shortcoming of this however is that it could lead to different outcomes because the model is adopted differently, thus leading to difficulties in measurement of outcomes.

Process, impact and outcome evaluation

An assessment of the process, impact and outcome reveals that Road Crew is a highly effective social marketing programme that achieved its mandate and whose impact was felt by the targeted group. The process was not only innovative but also appealing to the revelers and the community. This programme meets a major requirement in social marketing, which is to ensure conscious and voluntary behavior change. Spotswood et al (2012) notes that many social marketing initiatives fail because of the use of implicit behavior change techniques and use of tactics that do not appeal to the target audience. Road Crew specifically aims at encouraging revelers to use their services as opposed to drunk driving and participants do so willingly. In order to attract the interest of the target group, Road Crew uses innovative approaches such as limousine rides, which to a great extent encouraged individuals to use the service instead of driving their own cars.

Measuring a social marketing programme’s impact provides the basis for establishing whether the project was successful. Road Crew’s approach to showing impact is highly effective because it provides an overview of the program’s success in terms of cost savings and lives saved as opposed to merely providing the number of rides made. Road Crew attempts to demonstrate its impact in terms of cost savings derived when road crashes are avoided. The cost of preventing a crash through implementing Road Crew was $6,400, compared to the estimated $231,000 cost to the community in recovering from a crash. Through its services, Road Crew was shown to have made savings of over $31 million, prevented 140 crashes and prevented six deaths. This presentation of impact is catchy and motivates any reader to develop interest in the programme.

An important aspect of this program is that the sustainability of the service is assured because the community was involved from the beginning. As a result, they are conversant with the service and its impact, which makes it easier for them to continue with it once the funding from the government comes to an end. In this respect, it is natural to query where the funding to sustain the programme will come from but the programme also demonstrates that this was put into consideration. Users pay a reasonable fee when they use the vehicles and this is sufficient to promote sustainability. $400,000 collected from riders would be used in addition to the government funding to set up the program under community management.

The implementation of Road Crew raises an ethical issue which is not well addressed in the case study. It is notable that the programme aims at reducing instances of drunk driving, yet it does not show consideration of the fact that the transport services could actually increase alcohol addiction among beneficiaries. Road Crew picks revelers and drops them at their place of convenience and is aimed at creating fun out of the experience. This would certainly attract individuals who may not go drinking in ordinary circumstances due to the availability of transport and the fun factor. In essence, Road Crew could be raising a generation of alcohol addicts in their efforts to reduce drunk driving.

Conclusion

Road Crew provides an exceptional example of how social marketing can harnessed to drive social change. In this programme, Road Crew aims at reducing drunk driving by providing transport service to revelers to ensure that they do not drive after drinking. It can be concluded that the Road Crew social marketing programme was effective in achieving its goals and objectives, the implementation process was well executed and that the programme had the desired impact on the society. This model can be utilized in other areas of the United States to reduce the number of crashes and deaths attributed to drunk driving.

References

Jean, B 2013, International Marketing in Rapidly Changing Environments, Somerville, MA: Emerald Group Publishing.

Kotabe, M., & Helsen, K 2011, Global Marketing Management, 5th edition, Wiley, Hoboken, N.J.

Ritcher, T. (2012). International Marketing Mix Management: Theoretical Framework,  Contingency Factors and Empirical Findings from World-Markets.  Logos Verlag Berlin GmbH.

Spotswood et al 2012, Some reasonable but uncomfortable questions about social marketing,

Journal of Social Marketing, Vol 2, Issue 3, pp. 163-175.

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MANAGED CARE ORGANISATIONS

Managed care organisations
Managed care organisations

MANAGED CARE ORGANISATIONS

Order Instructions:

As your third assignment toward completion of the Session Long Project you are asked to review the paper by A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics and answer the questions below.
1.Consider this idea from the paper: “Medicine is a moral enterprise. Because MCOs are involved in the delivery of medical care, they too, are moral entities. However, MCOs are also businesses.”
2.Explain the idea that the authors sought to convey.
3.Discuss the physician’s dual function under an MCO model of care.
4.What concerns do you have about the physician- patient relationship under MCOs?

Module Overview

Basically, managed care and managed care organizations (MCOs) was championed as a powerful force for containing healthcare costs. We will see that this is not necessarily the case. We will also see that managed care brings up a range of structural issues related to price fixing and market power.

In the United States after World War II, healthcare was based on an indemnity model or fee for service. In this case health insurers simply paid the bills for services ordered by physicians. These traditional plans provided few incentives for cost containment medical decisions.

Responding to the lack of cost containment measures in the indemnity model, private insurers began to “manage care” by exerting influence on the decisions made by physicians. Managed care is the process of structuring or restructuring the healthcare system in terms of financing, purchasing, delivering, measuring, and documenting a broad range of healthcare services and products.

Sometimes this process of restructuring took the form of bureaucratic rules, e.g. requiring physicians to seek administrative approval before proceeding with certain procedures. In other cases, financial incentives were used to shape physician behavior. By the mid 1990’s, “managed care” had become the dominant form of private sector health insurance.1

Today managed care organization (MCO) is a general term used to describe any number of health insurance arrangements that are intended to reduce unnecessary healthcare costs through a variety of mechanisms, including: economic incentives for physicians and patients to select less costly forms of care; programs for reviewing the medical necessity of specific services; increased beneficiary cost sharing; controls on inpatient admissions and lengths of stay; and the intensive management of high-cost healthcare cases.

Managed care organizations are structured with an imperative to consider both the impact on costs and also the impact on doctors’ decisions whether to join their networks.

These considerations by MCOs to both contain costs and attract physicians are influenced by the values and practices that physicians bring to healthcare. Physicians want to earn a living but not at the risk of endangering the lives they are meant to serve. These healthcare values held by physicians pose a strategic dilemma for managed care organizations needing to contain costs and attract physicians to assemble provider networks.

Low cost MCOs with contract restrictions on spending are seen as highly restrictive. On the other hand, MCOs with large physician networks write cost containment rules into contracts that are not overly burdensome.

It is interesting to think about how MCOs balance competing interests and ethical issues in cost containment, physician ideals, and quality of care.

There are a wide variety of managed care models that integrate financing and management with the delivery of healthcare services to an enrolled population.

Health Maintenance Organizations: HMOs are organized healthcare systems that are responsible for both the financing and the delivery of a broad range of comprehensive health services to an enrolled population. HMOs act both as insurer and provider of healthcare services. They charge employers a fixed premium for each subscriber. An independent practice association (IPA)-model HMO provides medical care to its subscribers through contracts it establishes with independent physicians. In a staff-model HMO, the physicians would normally be full-time employees of the HMO. Individuals who subscribe to an HMO are often limited to the panel of physicians who have contracted with the HMO to provide services to its subscribers.

Preferred provider organizations (PPOs) are entities through which employer health benefit plans and health insurance carriers contract to purchase healthcare services for covered beneficiaries from a selected group of participating providers. Most states have specific PPO laws that directly regulate such entities.

Exclusive provider organizations (EPOs) limit their beneficiaries to participating providers for any healthcare services. EPOs use a gatekeeper approach to authorize non–primary care services. The primary difference between an HMO and an EPO is that the former is regulated under HMO laws and regulations, whereas the latter is regulated under insurance laws and regulations.

These integrated health delivery organizations raise a variety of issues with the Department of Justice and the Federal Trade Commission. The issues include price fixing and antitrust problems based on market power.

Depending on how the groups are organized- horizontal versus vertical- and who is integrated- competing physician groups or a multi provider network a MCO may violate several antitrust laws.

Whenever an MCO possesses significant market power or deals with a group that has significant market power, antitrust implications should be considered. To determine market power, it is necessary first to identify the market in which the entity exercises power. For antitrust purposes, the relevant market has two components: (1) a product component and (2) a geographic component.

Price fixing is considered a per se violation of the antitrust laws. Per Se Violations conclusively violate antitrust laws and means there is no further investigation of its effects on the competitiveness of the market because its intentions are so obvious. A Per Se Violation would almost always limit competition and decrease productivity. Activities that fall under per se violations are acts such as horizontal price fixing and horizontal market division.

Price fixing occurs when two or more competitors come together to decide on a price that will be charged for services or goods. The per se rule applies to restraints in trade that are so inimical to competition and so unjustified that they are presumed to be unreasonable and, therefore, are illegal.

Aaron, Henry J. and Reischauer, Robert D., (1995) “The Medicare Reform Debate: What is the Next Step?” Health Affiars. 14:4. p.8-30

Required Reading

D.A. Mains, A. Coustasse, K. Lykens: Physician Incentives: Managed Care and Ethics. The Internet Journal of Law, Healthcare and Ethics. 2004 Volume 2 Number 1. DOI: 10.5580/24ae – See more at: http://ispub.com/IJLHE/2/1/12416

Managed Care and Physician Incentives: The Effects of Competition on the Cost and Quality of Care. David J. Cooper and James B. Rebitzer. March 2004. http://myweb.fsu.edu/djcooper/research/managedcare.pdf

Government Agencies Soften Stance on What Constitutes Price Fixing. David A. Ettinger and Mark L. Lasser (March, 2008) http://corporate.findlaw.com/litigation-disputes/government-agencies-soften-stance-on-what-constitutes-price.html

Diagnosing Physician-Hospital Organizations. Susan A. Creighton. Federal Trade Commission Remarks Before American Health Lawyers Association, Program on Legal Issues Affecting Academic Medical Centers and Other Teaching Institutions. January 22, 2004. Washington, DC. Retrieved from: http://www.ftc.gov/public-statements/2004/01/diagnosing-physician-hospital-organizations

Statement of department of justice and federal trade commission enforcement policy on multiprovider networks; Federal Trade Commission; Competition in The Healthcare Market place; Statements of Health Care Antitrust Enforcement Policy; Statement 9. (July 8, 2009). Retrieved from: http://www.law.uh.edu/faculty/jmantel/health-law/Statement9AntitrustEnforcementPolicy.pdf

The above policy has been updated (Statement 9 on Multi-provider Network), Read the updates below:

Revised Statements on Multi-provider networks: http://corporate.findlaw.com/law-library/revised-policy-statements-on-health-care-antitrust-enforcement.html

Optional Reading

Competition in the healthcare marketplace. http://www.ftc.gov/bc/healthcare/antitrust/index.htm

Improving Health Care: A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice (July 2004). http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

QuickCounsel Antitrust: U.S. Laws and Regulations. Elizabeth Killingsworth, Esq. http://www.acc.com/legalresources/quickcounsel/auslar.cfm

SAMPLE ANSWER

MANAGED CARE ORGANISATIONS

“Medicine is a moral enterprise. Because MCOs are involved in the delivery of medical care, they too are moral entities. However, MCOs are also businesses.”

MCOs are moral entities because they aim at deliver quality, safe and effective medical care. They are responsible of doing what is right and best for the service users while ensuring equitable distribution of the scarce health resources. However, the managed care control changes the patient physician relationship to a business-consumer relationship.  This implies that the main goal  of MCOs is to ensure that   physicians adopts  the principle of distributive ethic; which is basically  providing the most safe and best quality of care to the greatest number of patients as possible using the allotted budget or incurring losses (Mains, Coustasse, & Lykens, 2004).

Under this moral obligation, the MCOs are guided by the utilitarianism- which basically entails performing the best action that maximizes utility.  However, the MCOs are economic tenets that aim at reducing costs for service users and aims at generating profit simultaneously. Therefore, when making decisions regarding MCOs, providers should consider the economic effects when maintaining aggregating costs of care so as to avoid loses in either the MCOs or the physicians. This involves establishing control, incentives, bonuses, and withholds as well as other quality assurance initiatives that will ensure that physician practices are safe, quality and profit generating (Cooper and Rebitzer, 2004).

Physician dual function

In managed care, the physicians have dual functions namely a) patient fiduciary and b) Financial advocates. The physician play the unrestricted role of patient advocates by ensuring that the managed care model puts into consideration to patient’s autonomy, respects it, and exercise the ethical principle of beneficence. This implies that the physicians are patient’s advocates in voicing their concerns whenever the managed care model prioritizes its benefits over the patient’s interests, or any other good that is beyond establishing effective physician-patient relationship.  This is an important role because the MCOs require expects the physicians to choose the society wellbeing over individual patient’s interest (Mains, Coustasse, & Lykens, 2004).

Therefore, when enrolling in these organizations, it is important for the physicians to understand that their first role is to be patient advocates. Under patient fiduciary role, the physicians are legally responsible for advising patients about all possible alternative care or technological advancement that can be used to manage their illness. The physicians are expected to remain prudent steward when advising and deciding the limits of patient care. This entails balancing between medical merits and financial risks.  Trust, honesty and caring are foundation of establishing effective physician-patient fiduciary relationship (Cooper and Rebitzer, 2004).

Concerns about physician-patient relationship

Managed care is associated with moral and professional ethical dilemmas. For instance, MCOs focus on financial incentives and social optimal outcomes instead of single patient well-being. This brings forth the concept of “countervailing agency” which is basically the physician’s role to choose between individual patient’s interests and the society wellbeing.  If a patient does not receive care as by MCOs, the physicians can be sued for malpractice. This puts the physicians at dilemma of delivering care based on MCOs expectations and risk for liability (Mains, Coustasse, & Lykens, 2004).

In addition, the MCOs emphasize on utilitarianism approach when solving the healthcare expenditure.  Despite its advantages, this approach raises concerns of its validity and morality in physician- patient relationship. The professional sovereignty vs. physician financial incentives complex interaction results into a conflict of interest. It is important for the managers in healthcare system to choose a strategy that helps them identify how to favor the interests of the patients and the society.  This calls for reforms to re-define the moral mission for MCOs to fulfill their goals and to preserve efficient physician-patient relationship ( Improving Health Care, 2004).

References

Cooper, D.J., and Rebitzer, J.B. (2004). Managed Care and Physician Incentives The Effects of Competition on the Cost and Quality of Care. Retrieved from http://myweb.fsu.edu/djcooper/research/managedcare.pdf                                                                       

Mains, D.A., Coustasse, A., & Lykens, C.K. (2004). Physician Incentives: Managed Care and Ethics. The Internet Journal of Law, Healthcare and Ethics. Volume 2 Number 1. DOI: 10.5580/24ae – Retrieved from http://ispub.com/IJLHE/2/1/12416

Improving Health Care (2004). A Dose of Competition: A Report by the Federal Trade Commission and the Department of Justice. Retrieved from http://www.ftc.gov/reports/healthcare/healthcarerptexecsum.pdf

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Peritonitis Essay Paper Assignment Available

Peritonitis
Peritonitis

Peritonitis

Order Instructions:

Assignment Instructions
• You will each choose 3 different journal published research study articles that explain the patient’s behavioral and/or psychological responses to having the illness. Do not include articles discussing the physiology or pharmacology of the illness, treatment of the illness or behavioral/psychological responses, or the risk factors for first developing the illness.
• Locate relevant journal published research study articles (these articles need to have been written after 1997 and you must NOT use general literature review articles.
• Choose the 3 articles that best relate to your case study patient.
• Briefly summaries the main topic and focus of each study and include a very summary of the study’s methodology, results, and discussion (i.e. where the authors explain the reasons for their findings and research conclusions) for the articles;
• discuss how each article explicitly and specifically explains the behavioral and psychological responses that the patient in your case study is experiencing in response to their illness.
• Make sure you are using article databases such as PsycINFO, MEDLINE, and CINAHL to run your searches. PsycINFO is likely to find you the most relevant articles for this assignment and all assignments within the behavioral stream. Just using Google or Google Scholar will NOT find you the articles you need. Also, make sure that the search terms you are using will give the databases the best chance of returning the articles you want. If you get no results with one search term, then try another or try and think laterally (e.g. what might be another word for “aggression” that you might find in the literature… hint: what about “irritability”? Or another word for “anxiety” might be “fear” etc.).
• The articles you include must have been published in a journal. Do not include theses, magazines, books or book chapters, letter to the editor or news articles. Academic journals publish all sorts of articles including research studies, book reviews, general literature reviews, editorials/commentaries, letters) but for the articles you include in your Annotated Bibliography you need to use only research study articles. A research study article will describe in detail a qualitative or quantitative research study (e.g., an experiment) including information about the study’s methodology, results, discussion and conclusions. For example, the Module 1 reading Zeilani and Seymour (2012) qualifies as a research study article because the authors describe how they collected and analyzed their data. A Module 3 reading, Lusk and Lash (2005) is a general literature review and does not qualify as a research study as the author does not specify how they went about sourcing information for their article. Lusk and Lash’s article is still a credible and valid source of reference information but it is not a research study and so cannot be used in the Annotated Bibliography assignment.

SAMPLE ANSWER

Peritonitis is a health condition that involves the inflammation of peritoneum (thin protective tissue layer that underlie the abdomen).  This health condition is caused by infection which spreads around the body.  It requires immediate treatment to prevent fatal complications from arising. In patients who have undergone surgical treatment, autonomic responses, mood swings and psychological coping responses are common. This paper explores 3 different journal study articles that explain patient’s behavioral and psychological responses to this illness. This study focuses on behavioral and psychosocial responses following surgical responses.

Boer, K. R., Mahler, C. W., Unlu, C., Lamme, B., Vroom, M. B., Sprangers, M. A., … Boermeester, M. A. (2007). Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis. Critical Care, 11(1), R30.

Introduction/Literature review:  This study investigates the behavioral response following secondary peritonitis. This is because numerous hospital admissions and intensive care unit (ICU) can be physically, emotionally and financially exhaustive. Patients who survive critical illness report critical poor quality of live and symptomology (PTSD) such as numbing, anxiety, loss of avoidant and intrusive recollections. The study suggests that the behavioral interventions are vital in patients with secondary peritonitis.

Methodology:  This is a retrospective cohort   in patients diagnosed with secondary peritonitis. The study comprises of 278 patients who had undergone surgery for secondary peritonitis, where 131 of them were long term survivors. The patients were interviewed Post-traumatic Stress Syndrome 10-question inventory (PTSS-10).

Study/ Results:  The study indicates that in a cohort of 100 patients diagnosed with secondary peritonitis, 86% of them presented with post traumatic stress disorder. PTSD related symptoms were also present in 4.3 times higher in older male patients.

Discussion/explanation: The study indicates that   25% patients who have received surgical treatment for peritonitis are likely to be emotionally and physically upset due to   surgical-related trauma, which could exacerbate illness behavior. The study suggests that patterns of behavior are seen as a product of socio-cultural conditioning and coping strategies. The study suggests that healthcare providers should recognize patient’s responses to various health procedures associated with pain and anxiety.  Other symptoms such as impaired appetite, lack of energy and disturbed sleep can occur due to illness. In addition, some treatments can affect patient’s mood. These conditions can also be aggravated by other environmental factors such as financial strain of lack of physical and emotional support.

Application to the case study: The study findings contribute to the body of research that demonstrates that psychosocial responses in patients are associated with the socio-cultural factors.  The suggests that the healthcare providers should incorporate psychosocial interventions  in routine care so as to help patients such as Mr. Jacobs to manage  stress associated with their new lifestyles of dependency, helplessness and pain. It is important for the healthcare providers to identify and be aware of this hidden morbidity among the patients diagnosed with secondary peritonitis.

Jennifer Finnegan-John and Veronica J. Thomas, “The Psychosocial Experience of Patients with End-Stage Renal Disease and Its Impact on Quality of Life: Findings from a Needs Assessment to Shape a Service,” ISRN Nephrology, vol. 2013, Article ID 308986, 8 pages, 2013. doi:10.5402/2013/308986

Introduction/Literature review: This study investigates the psychosocial experiences in patients with end stage renal disease.  The study conducts needs assessment on renal patients to explore their psychological, spiritual and social needs.  The study objective was to investigate behavioral responses and to conduct needs assessment so as to develop a comprehensive health psychology that can run concurrently with renal counseling.

Methodology:   The study design is prospective qualitative. The study population consisted of 50 patients with end stage renal disease.  The mean age of the participants was 55 years and 40% of them were from black and minority ethnic group.  The study utilized series of semi- structured face to face interviews in renal patients and their carers in order to explore their behavioral and psychological responses and how the disease impacted their quality of life.

Study/ Results:  The study findings indicated that depressive symptoms and disruptive behaviors are common in renal patients.  This is associated with the psychological burden associated with the disease.  Most of the patients in the study had feelings associated with depression and anxiety.

Discussion/explanation: This retrospective study indicates that depression and anxiety is a common behavioral response in patient diagnosed with renal disease. The study suggests that about 25% of patients who are diagnosed with the disease suffer from psychological burden. This behavioral response is associated with emotional numbness, avoidance of social activities and events.  It is also associated difficulty in sleeping, disruptive and reckless behavior and is easily irritated. The study states that these are body responses to stress or perceived threat.

Application to the case study:  The study indicates that depression and anxiety is a behavioral response that goes beyond the mental health. Based on this study, Mr. Jacob’s behavioral responses (irritability, social isolation and binge drinking) could be associated with the emotional burden of the disease. This research is interesting because it suggests that healthcare providers should engage with psychiatrists to help them better manage their improved outcome health.

Mckercher, C.M., Venn, A.J., Blizzard, L., Nelson, M., Palmer, A., Sshby, M., Scott, J., and Jose. M.D. (2012). Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the Tasmanian Chronic Kidney Disease study. BMC Nephrology, 14:83DOI: 10.1186/1471-2369-14-83

Introduction/Literature review: This study investigates behavioral and psychosocial responses in patient diagnosed with chronic illness. The literature links health outcomes with   depression, anxiety and dispositional tendency described by aggression, cynicism attitudes and anger/irritability. The study also indicates that hostility, anger and depression are related with renal failure experiences. According to this study, these psychosocial responses are controlled by biomedical risk factors, and are associated with most aspects of immune function.

Methodology:  This study design is quantitative. The study consisted of 105  patients above 18 years diagnosed with stage 4 CKD and was not under dialysis. The measures used in this study include depression (9- item patient Health questionnaire) and Beck Anxiety Inventory to investigate behavioral responses with disease progression and patient’s quality of life.

Study/ Results:  The study findings indicated that hostility and patient’s behavioral responses to chronic disease are correlated with their plasma levels of CRP. The study findings indicated that the cycle of inflammation levels influence depressive behavior, indicating that depression is problematic indicator of  patients under chronic pain.

Discussion/explanation: The longitudinal study findings indicated that there is a relationship between the CRP levels and psychosocial factors. The study also states that hormonal changes also induce inflammatory processes which in turn influence psychosocial responses. For instance, pain initiates systemic stress which activates neuro-endocrinological pathways (hypothalamic-pituitary-adrenal axis) leading to the secretion of stress hormone.  Accumulation of stress hormone is associated with hostility and depressive symptoms. The study also suggests that genetic predispositions play a major role in both inflammation and hostility.

Application to the case study: The study findings contribute to the body of research that demonstrates that psychosocial responses in patients are associated with systemic inflammation. This indicates that the Mr. Jacob’s depressive behavior (irritability, social isolation and binge drinking) is associated with elevated levels of the systemic inflammation. This research is interesting because it suggests that healthcare providers should reduce systemic inflammation so as to improve patient’s ability to improve pain, and to help them cope with the illness-induced stress in their lives.

References

Boer, K. R., Mahler, C. W., Unlu, C., Lamme, B., Vroom, M. B., Sprangers, M. A., … Boermeester, M. A. (2007). Long-term prevalence of post-traumatic stress disorder symptoms in patients after secondary peritonitis. Critical Care, 11(1), R30. Retrieved from http://doi.org/10.1186/cc5710

Jennifer Finnegan-John and Veronica J. Thomas, “The Psychosocial Experience of Patients with End-Stage Renal Disease and Its Impact on Quality of Life: Findings from a Needs Assessment to Shape a Service,” ISRN Nephrology, vol. 2013, Article ID 308986, 8 pages, 2013. doi:10.5402/2013/308986

Mckercher, C.M., Venn, A.J., Blizzard, L., Nelson, M., Palmer, A., Sshby, M., Scott, J., and Jose. M.D. (2012). Psychosocial factors in adults with chronic kidney disease: characteristics of pilot participants in the Tasmanian Chronic Kidney Disease study. BMC Nephrology, 14:83DOI: 10.1186/1471-2369-14-83

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Changing Variables in String Data to Numerical

Changing Variables in String Data to Numerical Order Instructions: This is the direction of the assignment we talked about. Model 3 document mentioned in the direction is next

Kindly view the attached files.

Changing Variables in String Data to Numerical
Changing Variables in String Data to Numerical

Changing Variables in String Data to Numerical Sample Answer

First, five variables were in string data type and had to be changed to numerical.

The variables were ID_Num, Age_BP, Systolic_E, diastolic, and BMI. After changing their data type, the incorrectly inputted data will be automatically be deleted. First, in the ID_Num there was an incorrect entry of “1o0” which was corrected by inputting number 11. On the Age_BP there was a wrong data entry “25y” that was collected by deleting the “y.” Although it is not clarified on the coding of the sex, there should be only two categories, either {0 and 1, or 1, and 2}. Therefore, the third category should be collected using the original data set.

In the systolic variable, the first three entries are incorrectly entered with alphanumeric letters. The letters s, sy, and sys were removed to have the values 139, 170, and 151 respectively. A similar correction was made on the diastolic column where the letters “d,” “di” and “dia” were removed to have the values 81, 110, and 109. Also, the bask slash “/” was removed to have 85. On the BMI column, the value “.25” was changed to be 25, and “223lbs” was corrected using the original data since there is a close association between the values.

In the death age column, the blue “-81” was changed to 81, and in the diabetic column, the value “-1” was changed to 1. For the place column, the values of 1.5, and 3.5 was referred to the original data collected for correction purposes. The data was saved and are as illustrated in the screenshot below. Notably, the black data points are to be corrected using original data collected for accuracy.

Introduction to the Healthcare Facility

Introduction to the Healthcare Facility
Introduction to the Healthcare Facility

Introduction to the Healthcare Facility

Order Instructions:

The Session Long Project for this course is to evaluate and critique a health care facility you are familiar with and compare it to the general principles and standards for quality assurance presented in this course.

In the earlier modules, you identified a health care facility for the subject of the SLP and presented a description of the facility and its quality assurance program. You also critiqued the facility’s Continuous Quality Improvement program.

In this module, you will discuss and critique the subject facility’s Utilization Management program. The remaining modules for the Session Long Project the remaining tasks are as follows:

SLP Assignment Expectations

For this module, you are to complete the following tasks and to submit a 4- to 5-page paper. (This does not include the title or reference pages):
•Describe and discuss the facility’s Utilization Management program.
•Compare and critique the subject facility’s Utilization Management program to that of a model facility and whether the facility adheres to the recognized standard for utilization management, including utilization review and whether this review leads to improvement in the quality of care.
•Identify areas for improvement in the facility’s Utilization management program, if any, and any recommendations you think should be implemented to improve the quality of patient care.

Module Overview

Utilization Review (UR): A system designed to monitor the use of, or evaluate the medical appropriateness, efficacy or efficiency of health care services, procedures, providers or facilities. utilization review may include ambulatory review, case management, certification, concurrent review, discharge planning, prospective review, retrospective review or second opinions. NCGS 58-50-61(a)(17). (Refer to Glossary at http://www.nciom.org/hmoconguide/GLOSS31E.html)

Introduction

Utilization review is an important component of a quality assurance program. It is intended to monitor the care provided to patients and to detect patterns of over and underutilization. However, utilization review doesn’t stop at this point. It moves ahead by taking the utilization data and changing utilization practices among practitioners and providers to improve quality and promote effective utilization of medical resources.

In many medical facilities, utilization review extends to outpatient review services by reviewing requests for elective procedures and diagnostic testing. Utilization managers and staff will then work with the attending physicians to determine if clinical data support the benefits covered for the requests. In some medical facilities, this is called Demand Management.

Utilization review, or UR, as it is frequently called, was originally intended as a vehicle that addressed cost containment rather than the adequacy of patient care. Basically, UR is a cost containment technique.

UR can occur retrospectively or prospectively. When it is conducted retrospectively, it is primarily concerned with the review of services already rendered; however, when it is conducted prospectively it is used to authorize or refuse proposed treatments, referrals, and even hospital admissions. In the perspective mode, UR may have severe time restraints which if not met may cause harm to the patients. Medical conditions/diseases do not remain static during utilization review.

Another issue regarding UR is whether the employees or agents of a managed-care organization are practicing medicine when they make a determination whether a requested treatment is medically necessary.

Utilization review is an integral part of quality assurance. If managed properly it certainly can results in a higher quality of care while controlling costs. However, if and organizations’ utilization review program is inefficient and poorly managed it has the potential to harm patients and lower quality of care.

Required Reading

Anonymous. (2013). Does your organization have a utilization management committee? Medical Staff Briefing, 23(11), 1,3-5.

Frazier, K. (2014). Utilization Review Software: The Impact on Productivity and Structural Empowerment in Case Management Nurses in an Acute Care Setting. Gardner-Webb University.

Koike, A., Klap, R., & Unützer, J. (2014). Utilization management in a large managed behavioral health organization. Psychiatric Services.

Mullahy, C. M. (2014). The Case Manager’s Handbook, (5thed). Burlington, MA: Jones & Bartlett Learning. Retrieved from http://books.google.com/books?hl=en&lr=&id=iUPyAAAAQBAJ&oi=fnd&pg=PA12&dq=concurrent+utilization+review+programs+in+nursing+homes&ots=iorEmkFyuh&sig=4YnmC-9Hh6jCoi0rK2dH58NhoIM#v=onepage&q&f=false

NHS England provides funding for clinical utilization review programmes to improve patient flow. (2014). Professional Services Close – Up, Retrieved from http://search.proquest.com/docview/1518167158?accountid=28844

Olaniyan, O, Brown, I. L., & Williams, K. (2011). Concurrent utilization review; Getting it right. Physician Executive, 37(3), 50-54.

Plebani, M., Zaninotto, M., & Faggian, D. (2014). Utilization management: a European perspective. Clinica Chimica Acta, 427, 137-141.

Tubbs, S. L., Husby, B., & Jensen, L. (2011). Ten common misconceptions about continuous improvement efforts in healthcare organizations. The Business Review, Cambridge, 17(2), 21 – 28.

Sample Answer

Introduction to the healthcare facility

The healthcare facility identified is  Durham Veterans Affair healthcare (VA) in North Carolina. The healthcare facility provides services to military members, their families, and the retired veterans. The services provided in this healthcare facility include primary care, surgical services, audiology, ophthalmology, inpatient services, and outpatient services. It also has other ancillary departments such as laboratory and radiology departments The department has operating rooms for regular surgical procedures, cytography and angiography. All the healthcare departments in this facility must follow quality assurance procedures established by its department (Durham.va, 2015).

Utilization Management Program

The VA Durham utilization program is design in a manner that ensures delivery of quality and cost effective care to the service user. The utilization program is under the administrative and clinical direction  of the Medical advisory council and the Medical Advisory  vice president. The Medical advisory council is mandated to evaluate and approve the utilization management program every year.  In my place of work, the utilization program is manual. The overview of VA utilization management plan is a follows (Durham.va, 2015);

Referral system: All referrals are to be made by the Primary Care Physician (PCP) after consultation with a specialist at any time. However, no referrals are needed to treat emergency medical condition  unless it puts the patient’s health in jeopardy, potential impairment of body functions and dysfunction of a body organ.

Tertiary plan care: All tertiary care plans should be reviewed on an individual basis based on the patients immediate medical need and its availability. The specialist final decision of referrals will be evaluated by the  plan medical director.

Out-of-Plan Referrals: The requests  of healthcare provider outside  the health facility will be done on an individual basis based on the availability and patients needs  unless the patient’s  health status could be impacted negatively if out-of- plan referrals is denied.

Corporate Pre-service Review: Approval must be given before providing services. The main reason is to determine if the services is appropriate for the patient and the setting. Clinical information must be provided for all healthcare services that need clinical review. The Utilization Management staff should use plan documents to determine patient medical necessity coverage and  determining their benefits. Clinical information needed for clinical review  should be provided on the appropriate date and time. The clinical information must contain patient name, history of presenting disease, diagnostic results and the patient’s response to current treatment.

Inpatient  review: The staff assigned to follow member at  the acute care facility should collaborate with the facility healthcare providers so as to ensure ca continuum of care. The  facility staff and utilization management’s clinical staff will work in coordination to ensure that member’s discharge needs are met. All inpatient  should be reviewed before their admission to ensure that they have appropriate and adequate services according to pre-established medical necessity and benefits determinants. The admission will be approved accordingly of rescheduled  in appropriate timing and setting.

Concurrent review: The ongoing patient care will be reviewed and evaluated based on patients specific needs and  pre-established medical necessity. Discharge planning can begin at this time so as to plan for continuing quality care even after the patient is discharged.

Retrospective review: is performed after discharging the patient from a  healthcare facility. This should be implemented at when so as to monitor a patient’s progress after the patient was discharged when a physician was unavailable or when the healthcare facility fails to demonstrate that the patient condition meet criteria for a patient stay.

Discharge planning: the utilization manager coordinator will monitor the ongoing needs for the patient after discharge. Few days after discharge, follow up  phone calls should be done so as to identify members at high risk of becoming admitted. This is to ensure that the quality assurance is complied to and to assist in care coordination so as to  mitigate adverse outcomes.

Denials and Appeals: All denials will be given by the physician and must state the denial reason and contact information to discuss the denial. A written denial will be written and emailed to the Utilization management committee.

Critique of VA utilization management program

The main challenge of VA utilization program at my work place is that  it is an expensive manual resource that fails to engage the providers adequately, and often results into inefficient service for the service users (Anonymous, 2013).  For instance, 90% of pre-authorizations need  phone communications, which is time consuming and costs  up to $50-$80 costs per each authorization. In addition, it is estimated that about 15% of medical care procedures are unnecessary such as duplicative tests and hospitalizations.

Most of these  costs are attributable to inconsistencies observed during clinical decision making that occur when relying on the traditional manual utilization management processes and the incomplete coverage as necessary.  In addition, when healthcare providers have to wait until healthcare is delivered to deliberate on the event, it leads to missing of opportunities that will ensure cost effective quality care. In addition, the pre-authorization process that follows manual process  requires a great deal of investment as compared to an automated system that facilitates immediate approvals upon request, and to providers with appropriate guidance based on evidence based practice (Mullahy, 2014).

Areas for improvement in Utilization Management program

Some utilization management program changes will occur in the VA utilization program.  The driving force  for most of these changes includes advancement in organizational relationships and utilization management technologies. Effective utilization management is based on its ability to provide detailed yet coherent clinical information, and in providing clinical guidelines that define the most effective and appropriate care that will ensure positive patient outcomes (Mullahy, 2014).

As aforementioned, the VA programs are severely constrained due to inadequate  information to support informed and appropriate care  to a current diverse cohort of patients.  The VA Utilization Management program  should be transparent enough to ensure that the health providers and service users reach their decisions by eliminating contention and  improving optimized decision making processes that put into consideration patient’s preferences (Frazier, 2014).

The utilization management program should be designed to ensure that it s actionable. This implies that the plan recognizes its implication and automatically provides specific guidance  based on evidence based clinical guidelines. The plan should deliver relevant information  in real time so as to ensure that smooth quality workflow is sustained. This includes automating workflows so as to shorten the path to seek approval, providing rapid response and  lowering administrative burden in most of pthe atients, and simultaneously allowing the clinicians to focus on complex “exceptions” that truly needs their concentration and expertise (Koike, Klap, & Unatzer, 2014).

This implies that it is time to rely on  innovate technology that suit the VA health care facility missions and vision. It is important to work on these  decision support solutions so as to help the healthcare systems to provide value based care. This is process  requires  collaborative  efforts between the healthcare providers so as to make it a reality.

References

Durham.va (2015). Durham VA medical Center: Retrieved from http://www.durham.va.gov/

Anonymous. (2013). Does your organization have a utilization management committee? Medical Staff Briefing, 23(11), 1,3-5.

Frazier, K. (2014). Utilization Review Software: The Impact on Productivity and Structural Empowerment in Case Management Nurses in an Acute Care Setting. Gardner-Webb University.

Koike, A., Klap, R., & Unatzer, J. (2014). Utilization management in a large managed behavioral health organization. Psychiatric Services.

Mullahy, C. M. (2014). The Case Manager’s Handbook, (5thed). Burlington, MA: Jones & Bartlett Learning. Retrieved from http://books.google.com/books?hl=en&lr=&id=iUPyAAAAQBAJ&oi=fnd&pg=PA12&dq=concurrent+utilization+review+programs+in+nursing+homes&ots=iorEmkFyuh&sig=4YnmC-9Hh6jCoi0rK2dH58NhoIM#v=onepage&q&f=false

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Structure of Eukaryotic Cells and Importance of Membranes

Structure of Eukaryotic Cells and Importance of Membranes
Structure of Eukaryotic Cells and Importance of Membranes

Structure of Eukaryotic Cells and Importance of Membranes

Order Instructions:

Assignment requested deadline November 22; NLT 8pm. Please read below for information concerning assignment. Support responses with examples and use APA formatting in the paper. You may access the school’s website by logging into:
https://mycampus.southuniversity.edu/portal/server.pt

Please note that when you log into the website you must click launch class, and on the next screen click syllabus to view this week’s readings (week2) and Academic Resources to access the school’s library.

The minimum length for this assignment is 1,200 words.

Structure of Eukaryotic Cells and Importance of Membranes

Eukaryotic cells are the most structurally advanced of the major cell types. Describe the structure and function of each of the eukaryotic organelles. Distinguish between those that are and are not membranous. Most are membranous. Explain the importance of membrane structure and function in the organization of living processes within cells.

Please be as thorough and original as possible.

SAMPLE ANSWER

Structure of Eukaryotic Cells and Importance of Membranes

Introduction

Eukaryotic cells are present in plants, animals, protozoa, and fungi (Voet, 2012). This paper will explore the structure and function of the eukaryotic cell organelles. The paper will also discuss the structure and function of biological membranes including the cytoplasmic membrane. A special focus will be given to internal membranes that enclose cellular organelles such as the nucleus, the mitochondrion, the peroxisome, the lysosome, the chloroplast, and the endoplasmic reticulum.

Cell Structures and Functions

The Cell Wall and Glycocalyx

The cell wall is a rigid layer that surrounds some cells, is composed of one or more polysaccharides, and provides additional strength to the cell. Higher plants and algae have cell walls made up of cellulose, pectin, and hemicellulose. Chitin is the main polysaccharide of fungal cell walls, while yeast cells have cell walls composed of mannan and glucan. An external layer called glycocalyx that strengthens the cell and facilitates attachment to neighboring cells surrounds animal cells (Voet, 2012).

The Cytoplasm

The cytoplasm is bound by the plasma membrane and includes all the materials inside the cell with the exclusion of the nucleus. It comprises of a gel-like substance called cytosol and internal cell substructures called organelles. Most of the cell activities such as cell division and metabolism occur in the cytoplasm. It is approximately 80% water, has dissolved salts and biomolecules such as proteins and carbohydrates and suspended insoluble molecules such as lipids (Nelson & Cox, 2013; Voet, 2012).

The Cytoskeleton

The cytoskeleton is a lattice-like array of cell fibers and fine tubes. It has three components namely: microtubules, microfilaments, and intermediate filaments. Microtubules maintain the cell shape and play central roles in chromosome segregation during cell division, endocytosis, and cell differentiation. Other eukaryotic cell structures derived from microtubules include cilia, flagella, centrioles, and spindles. Microfilaments are involved in cell shape change, phagocytosis, cyclosis, and amoeboid movement while intermediate filaments anchor membrane-bound organelles in the cytoplasm (Berg, Tymoczko, & Stryer, 2012; Voet, 2012).

Membrane-Bound Organelles

The nucleus is arguably the largest cell organelle and is bound by a membrane called nuclear envelope, which is punctuated into pores. The nucleus contains the genetic material called DNA and controls all the activities of the cell. The Endoplasmic Reticulum (ER) is a network of tubules that act as the transport system of the cell. There are two types of ER: rough ER and smooth ER. The rough ER is coarse in appearance because it is lined with ribosomes and is involved in the transport of proteins, while the smooth ER has no ribosomes and is the lipid transport system.

The Ribosomes are small particles either scattered in the cytosol or lined on the surface of rough ER. They contain RNA and proteins in almost equal proportions. The ribosomes function as the sites of protein synthesis. The Golgi apparatus is a membrane-bound eukaryotic cell organelle made up of tubes called cisternae. The Golgi is supported by microtubules and is located in proximity to the nucleus and the ER. The Golgi performs post-translational modification of proteins, packages them into vesicles, and exports them into target cell compartments(Berg et al., 2012; Voet, 2012).

The lysosomes are roundish, vesicular structures of animal cells that have a lumen containing hydrolytic enzymes. The pH of the luminal contents is 4.5-5.0 which is optimal for lysosome enzymes. The lysosome digests unwanted materials from outside the cell as well as obsolete cell components. The centrosome is present in eukaryotic animal cells and is made up of two centrioles and surrounding pericentriolar materials. The centrioles are short cylinders arranged such that they are perpendicular to each other. The centrosomes are microtubule-organizing centres that contain gamma-tubulin. The microtubules grow out of this gamma-tubulin in the pericentriolar material. The Vacuole is the major acid-containing organelle of plant and fungal cells. It contains a fluid called cell sap and is surrounded by a membrane called tonoplast. The plant vacuole is the equivalent of the lysosome in animal cells as it has hydrolytic enzymes that digest waste materials. The vacuole is also involved in maintaining cell turgor pressure (Berg et al., 2012; Nelson & Cox, 2013).

The mitochondrion and the chloroplast are two organelles involved in energy production. The mitochondrion is sausage-shaped double membrane cell structure whose inner membrane is invaginated to form cristae. The mitochondrial matrix contains ribosomes and DNA and is therefore self-replicating and semi-autonomous. The main function of the mitochondrion is synthesis of ATP. The chloroplast also has a double membrane and is present in plant cells. It has internal structures such as thylakoids and stroma and its main function is to carry out the process of photosynthesis. The peroxisome is another self-replicating organelle that has enzymes for oxidative degradation of molecules such as uric acid, amino acids, purines, methanol, and fatty acids (Nelson & Cox, 2013).

Structure of Biological Membranes

A biological membrane is composed of a phospholipid bilayer. The membrane is amphipathic, meaning that the polar phosphate lipid heads are on the surface while the hydrophobic tails point inwards. The lipid molecules diffuse rapidly in the plane of the biomembrane but not across. Also, the phospholipid molecules can move laterally from one side of the bilayer to the other, a process called the flip-flop. Moreover, biological membranes are asymmetric, meaning that the two phases are different from each other. In addition to the lipids, membranes also have proteins that move freely within the membrane, and this makes the membrane fluidic and mosaic. The proteins are categorized into either integral or peripheral proteins depending on their degree of association with the membrane. Integral proteins penetrate deep into the bilayer while peripheral proteins are superficially located. Some lipids are linked to carbohydrates to form glycolipids. Cholesterol is present in animal cells and is involved in maintaining membrane fluidity (Berg et al., 2012; Nelson & Cox, 2013).

General Functions of Biological Membranes

The plasma membrane plays a role in establishing a physical barrier between the cell contents and extracellular environment. Biomembranes also facilitate the formation of membrane-enclosed organelles a process called intracellular compartmentalization. Compartmentalization establishes microenvironments and biological barriers between biochemical processes, which allow the cell to carry out different processes simultaneously. Biomembranes are selective permeability barriers as they confine certain molecules within a specific region while restricting the entry of others (Voet, 2012). They contain molecular pumps, sinks, and gates or channels that regulate the molecular and ionic composition of the intracellular or intra-organelle medium. Membranes are the sites of biochemical processes such as oxidative phosphorylation (inner mitochondrial membrane) and photosynthesis (thylakoid membrane). Membranes also have receptors that trigger signal transduction (Berg et al., 2012).

The Plasma and Organelles Biomembranes

The Plasma Membrane

This is the biological barrier between the cell and the external environment. It has biomolecules for intercellular communication and transport. Based on the external environment, the cell membrane can either be an apical, sinusoidal or basolateral membrane. Contact between cells is either through tight junctions, gap junctions or desmosomes (Voet, 2012).

The Nuclear Membrane

The nucleus has a double membrane that is often continuous with the ER membrane. It houses and protects the genetic material and keeps the confines the DNA processing molecules closer to the DNA itself. The nuclear membrane also creates a barrier between transcription and translation and ensures that the two occur as separate processes. Nuclear membrane has nuclear pores, which allow passage of mRNA-protein complexes from the nucleus to the cytoplasm and passage of regulatory proteins from the cytoplasm into the nucleoplasm (Berg et al., 2012).

The Mitochondrial Membrane

The mitochondrion has inner and out membranes. The outer membrane has integral channels called porins that allow proteins less than 5KDa to diffuse through. A translocase is involved in the shipping of larger proteins. The outer membrane forms structures with the ER called mitochondria associated-ER membrane that are useful in calcium signaling and transfer of lipids between the two organelles. The inner membrane is impermeable to all molecules, and they require a transporter to pass through. The inner membrane is convoluted to many cristae to increase surface area for ATP synthesis (Berg et al., 2012; Nelson & Cox, 2013).

The ER and the Golgi Membranes

The ER membrane is an extension of the plasma membrane and is attached to the nuclear membrane. The ER membrane can form vesicles containing proteins that then fuse with the Golgi membrane. The Golgi membrane also facilitates the secretion of processed proteins via exocytosis (Berg et al., 2012).

The Chloroplast Membrane

This is a double membrane enclosing a third internal membrane called thylakoid membrane, which is a system of interconnecting compartments. The thylakoid membrane is the site of energy synthesis and contains a series of proteins collectively referred to as electron transport chain. The outer chloroplast membrane is highly permeable to small organic molecules, while the inner membrane is less permeable and has transport proteins as well as light harvesting pigments (Berg et al., 2012; Voet, 2012).

Lysosome Membrane

This membrane separates the cytoplasm from the acidic milieu of the lysosome. The lysosome membrane has glycosylated membrane proteins called lysosome-associated membrane protein (LAMP) which mediates contact to cytosolic proteins and with other cell organelles. Thus, the lysosome membrane and its proteins facilitate lysosome motility, exocytosis, phagocytosis, macroautophagy among other lysosome functions (Voet, 2012).

Peroxisome Membrane

This biological barrier surrounds the peroxisome and provides a compartment for oxidation reactions. It has membrane proteins called peroxins (PEX) that shuttle proteins between the peroxisome membrane and the cytosol. The peroxisome shuttling process is dependent on ATP and ubiquitylation (Voet, 2012).

Conclusion

Eukaryotic cells have subcellular structures called organelles that have specific functions. Both the plasma membrane and the organelle membrane are composed of lipid bilayers, proteins, and glycans. The plasma membrane is the biological barrier to the extracellular environment. The organelle membranes create microenvironments suitable for specific biochemical reactions.

References

Berg, J. M., Tymoczko, J. L., & Stryer, L. (2012). Biochemistry (7 ed.): W. H. Freeman.

Nelson, D. L., & Cox, M. M. (2013). Lehninger Principles of Biochemistry (6 ed.): W.H.Freeman.

Voet, D. (2012). Fundamentals of Biochemistry: Life at the molecular level: Wiley.

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Importance of water and carbon to life

Importance of water and carbon to life
Importance of water and carbon to life

Importance of water and carbon to life

Order Instructions:

Assignment requested deadline November 18; NLT 10pm. Please read below for information concerning assignment. Support responses with examples and use APA formatting in the paper. You may access the school’s website by logging into:
https://mycampus.southuniversity.edu/portal/server.pt

Please note that when you log into the website you must click launch class, and on the next screen click syllabus to view this week’s readings (week2) and Academic Resources to access the school’s library.

Hints from the Doc

Here is a link to a video I put up on Youtube a few years ago comparing prokaryotic and eukaryotic cells.
http://youtu.be/4ASXK6RG_f0
As you prepare your post, think about the many kinds of prokaryotic and eukaryotic organisms alive today and how each is successful in its own way. If they were not successful they would no longer be alive but would have gone extinct long ago :).
Students run into problems on this one by one or both of two routes:
1. Not covering all the differences between the two kinds of cells. Posting just two or three is definitely not enough.
2. Not explaining how the special characteristics of each kind of cell has set the stage for very different but successful evolutionary paths of the organisms made of these cells. Many students don’t even cover this. You are not likely to find a pat answer somewhere on this. Instead think critically and creatively about the characteristics of the cells, the characteristics of modern organisms having those cells, and how they moved along evolutionarily to get where they are today.
And as always, avoid short answers. I hate to think how many students have not been successful over the years in this class by trying to get by with short answers lacking substance.

Please respond to both of the discussion questions listed.

Question 1: Importance of water and carbon

Water and carbon are major components of all life. Describe the characteristics of these materials which make them so important to living things. Be prepared to discuss how life as we know it might be affected by slight changes in the characteristics of water or carbon.

Question 2: Prokaryotic versus eukaryotic and success

Prokaryotic and eukaryotic are the two major categories of cells making up life on earth. Describe the differences in prokaryotic and eukaryotic cells. How have the characteristics of each kind of cell put limitations and provided opportunities for the survival and divergence of modern living things? Be prepared to discuss why both types of cells could be considered equally successful as life has evolved over time.

SAMPLE ANSWER

W2 Assignment 1 Discussion

Importance of water and carbon to life

Water and carbon have unique properties that make them essential for life. Specifically, water has a high heat capacity and high heat of vaporization, meaning that water absorbs more heat per unit rise in temperature. This allows water to regulate environmental and physiological temperatures. Biochemically, water is a reactant in many hydrolytic reactions in the cells. Water is also a universal solvent, dissolving biomolecules such as proteins, sugars, and minerals. However, water is a poor solvent for non-polar molecules such as lipids, which enables the formation of bilayer lipid membranes (Berg, Tymoczko, & Stryer, 2012; Nelson & Cox, 2013). Similarly, carbon is also important element to life. Biomolecules such as proteins, carbohydrates, lipids, and nucleic acids are composed of carbon bonded with hydrogen, oxygen, or nitrogen. Carbon is also light and small making it easier for enzyme manipulation (Berg et al., 2012).

Prokaryotes versus Eukaryotes and Success

Both prokaryotes and eukaryotes adopted different but successful evolutionary strategies. Prokaryotic cells are smaller than eukaryotic cells and lack most of the classical organelles such as endoplasmic reticulum, the Golgi, cytoskeleton, peroxisomes, and lysosomes. As result, prokaryotes cannot carry out some eukaryotic cell functions such as sexual reproduction, cytoplasmic movement, endocytosis, and phagocytosis (Nelson & Cox, 2013). In addition, a membrane does not surround prokaryotic cell organelles while in eukaryotes a single or a double membrane binds the organelles. Prokaryotic cells have a single chromosome made up of circular naked DNA while eukaryotic cells have many chromosomes made up of linear DNA and histone proteins. Finally, gene expression is a continuous process in prokaryotes and occurs in the cytoplasm. In eukaryotes, transcription occurs in the nucleus while translation occurs in the cytoplasm and the two are separate processes (Berg et al., 2012; Nelson & Cox, 2013).

References

Berg, J. M., Tymoczko, J. L., & Stryer, L. (2012). Biochemistry (7 ed.): W. H. Freeman.

Nelson, D. L., & Cox, M. M. (2013). Lehninger Principles of Biochemistry (6 ed.): W.H.Freeman.

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