Chlamydia Essay -- essays research papers

Chlamydia trachomatis is the most widespread and infamous bacterial infection affecting the genital tract. Not only is it quite common in developed countries but an increase in cases has sprung up in developing countries as well. In the United States, there is a 4 million per year case rate of chlamydia which costs the US approximately $2 billion dollars in consequences and treatments. Persons who suffer from chlamydia in underdeveloped countries and have no means of seeking treatment may become blind because chlamydia has the potential of causing trachoma. It is becoming a global interest to control and restrain this budding disease. In order to do so it is essential to recognize the symptoms of chlamydia, diagnose the victim, and provide treatment immediately.   Ã‚  Ã‚  Ã‚  Ã‚  Observing symptoms of chlamydia is often a difficult process considering that 75% of females and 50% of males are asymptomatic; for those who are infected and do show symptoms, there are obvious signs directly connected to the chlamydia bacterium. In infected females, purulent discharge and a burning sensation while urinating are common indicators. The irregular discharge can be mistaken for normal vaginal discharge making this indicator slightly less conspicuous. These signs are caused by the bacterium’s concentration on the cervix and urethra and is classified as an acute endocervical infection. Other signs in the female are spotting between menstrual periods, fever, and severe back and abdominal pain. In males, burning sensation and discharge from the penis also occur. In addition, pain around the opening of the penis as well as soreness of the testicles can be observed. These symptoms occur from epididymitis. The contraction of chlamydia through anal pe netration can lead to rectal discharge, bleeding, and pain. If symptoms appear the next stage is to verify that the symptoms are directly related to the chlamydia bacterium. There are a number of methods in the process of diagnosing a potential case of the chlamydia trachomatis bacteria. Classic methods of diagnosis have been centered on cell culture; the â€Å"culture era† began in the 1970s and proceeded into the late 1980s. Cell culture â€Å"was the inoculation of clinical material into animals, embryonated hens eggs or tissue culture cells and the demonstration of characteristic chlamydial inclusions.† Minor complication... ...s were tested for chlamydia through IgG antibodies and the PCR process. The study concluded that IgG antibodies in males were associated with lower pregnancy rates and a higher IgG antibodies count in the woman. There is a higher occurrence of IgG antibodies in the infertile couples than in fertile couples. After some treatment, the odds ratio of not successfully completing pregnancy with the male being chlamydia trachomatis positive is 2.6. In those couples that were not treated, the odds ratio is much higher at about 3.9. The study deems it â€Å"cost-beneficial† to screen infertile couples by means of the PCR tests because it is been deemed â€Å"cost-effective† in places where the chlamydia bacteria was very common. The chlamydia trachomatis disease is on the rise so further studies and research is quite necessary to maintain a tight grip on this epidemic. Innovative diagnosis will assist persons infected with chlamydia to identify the disease in early stages to help reduce further complications and cost concerns. Advancement in treatments will evidently be beneficial for those with acute and chronic stages of chlamydia which will also reduce costs as well as grief to those infected.

Analysis If Homeward Bound :: essays research papers

Homeward Bound Homeward Bound is a satiric play, which attacks the socially accepted standards of today’s society. This play is known as a comedy of manners; defined as light social satire. Homeward Bound also consists of amusing characters that the audience can relate to. This type of play appeals to mostly sophisticated audiences and actors because the play consists of clever use of language and brilliant conversation.   Ã‚  Ã‚  Ã‚  Ã‚  Elliot Hayes’ use of satire in Homeward Bound plays an important part in the telling of the story. His use of satire expresses how the characters feel about each other and their situations. There were many parts of the play that had satire in them. The scene where the mother is talking about her gay son and his partner is an example because it was a mockery of how “normal people'; handled the touchy subject of homosexuality. Another satiric scene is where Norris told her family about her affair, but the circumstances were that she had the affair with Nick’s gay partner and she was bearing his child. This is a very unusual example of satire because this sort of thing usually does not happen to a middle class society (or at least not that I have heard of). The family’s reaction to this newfound information is very humorous because they act almost opposite as to what is expected. Hayes is almost ridiculing the middle class’ mentality and their views on life. Hayes also satirizes when Bonnie reveals Donna’s little secret of her indecent behavior when she was a little child. This was totally unexpected and it revealed Donna’s character as being loose. Even though the characters did the opposite of what was expected and were quite amusing, the audience could relate to them because, before all the surprises were revealed the audience saw the characters as ordinary people. Once the “skeletons'; came out of the closet, the audience realized that euthanasia, homosexuality, alcoholism and affairs are problems that all levels of class face. This realization brings the audience closer to the characters and the circumstances presented on stage. This play appeals more to a sophisticated and mature audience because of the clever use of language and brilliant conversation. There was a lot of slang and colloquialism used. Usage of swears was interesting; it is a normal assumption to make that middle class families are not so crass. This was effective because it provided more realism by showing how people would talk in these serious and yet humorous situations.

Florida Should Legalize Euthanasia :: Free Essay Writer

Florida Should Legalize Euthanasia Florida should legalize euthanasia and I offer the following plan. The way Florida would legalize euthanasia should be by setting up a set of professional doctors who could examine all cases in which a person or an ill patients family request euthanasia due to extreme pain or an incurable disease. The doctors could examine these people and if they find there is no way other than the use of machines 24-hours a day to keep these people alive they will allow the doctor of the patient to assist in suicide or in better terms freeing an immense pain and agony. The benefits from legalizing euthanasia in Florida would be the health care spent to keep many of the people who live on machines from terminally or incurable diseases would be saved, many families would not have to watch there family member die slowly, and many stories like Sue Rodriguez's would never be. In the first place, health care on people with incurable or deadly diseases cannot be paid by many people because of no medical insurance according to Euthanasia questions by the IAETF. The government jumps in and pays for the treatment and care. This could be replaced in incurable or agonizing pain situations with the better and cheaper treatment of death. Next, not all family life is harmonious, and underlying pathology can often be exacerbated by the stresses of a family member's terminal illness bring says an article in Law Medicine & Health Care of 1992. If euthanasia is legalized the family members of a patient could sleep peacefully knowing that they have been "mercied" and died easily and with little pain instead of being kept alive by a machine or dying slowly and painfully from an incurable disease. Finally, let me tell you a true story from Vess Fast Access TO Information On Euthanasia, about a 31-year old mother named Sue Rodriguez. Sue Rodriguez was dying slowly of the incurable Lou Gehrig's disease. She lived several years with the knowledge that the disease would one by one waste away her muscles until the point while still conscious the lack of muscles would choke her to death. She begged the courts to allow her and her doctor to choose the moment of her death instead of the inspicable pain of being choked to death. The court refused to mercy her and she lived in terror every day. Every morning she would wake up wondering if this is the day she would be choked to death maybe while her children watch. In February 1994, Sue Rodriguez died. Florida Should Legalize Euthanasia :: Free Essay Writer Florida Should Legalize Euthanasia Florida should legalize euthanasia and I offer the following plan. The way Florida would legalize euthanasia should be by setting up a set of professional doctors who could examine all cases in which a person or an ill patients family request euthanasia due to extreme pain or an incurable disease. The doctors could examine these people and if they find there is no way other than the use of machines 24-hours a day to keep these people alive they will allow the doctor of the patient to assist in suicide or in better terms freeing an immense pain and agony. The benefits from legalizing euthanasia in Florida would be the health care spent to keep many of the people who live on machines from terminally or incurable diseases would be saved, many families would not have to watch there family member die slowly, and many stories like Sue Rodriguez's would never be. In the first place, health care on people with incurable or deadly diseases cannot be paid by many people because of no medical insurance according to Euthanasia questions by the IAETF. The government jumps in and pays for the treatment and care. This could be replaced in incurable or agonizing pain situations with the better and cheaper treatment of death. Next, not all family life is harmonious, and underlying pathology can often be exacerbated by the stresses of a family member's terminal illness bring says an article in Law Medicine & Health Care of 1992. If euthanasia is legalized the family members of a patient could sleep peacefully knowing that they have been "mercied" and died easily and with little pain instead of being kept alive by a machine or dying slowly and painfully from an incurable disease. Finally, let me tell you a true story from Vess Fast Access TO Information On Euthanasia, about a 31-year old mother named Sue Rodriguez. Sue Rodriguez was dying slowly of the incurable Lou Gehrig's disease. She lived several years with the knowledge that the disease would one by one waste away her muscles until the point while still conscious the lack of muscles would choke her to death. She begged the courts to allow her and her doctor to choose the moment of her death instead of the inspicable pain of being choked to death. The court refused to mercy her and she lived in terror every day. Every morning she would wake up wondering if this is the day she would be choked to death maybe while her children watch. In February 1994, Sue Rodriguez died.

Boon or Bane

Advantages and Disadvantages of Internet Research Surveys: Evidence from the Literature Ronald D. Fricker, Jr. and Matthias Schonlau RAND E-mail and Web surveys have been the subject of much hyperbole about their capabilities as well as some criticism about their limitations. In this report we examine what is and is not known about the use of the Internet for surveying. Specifically, we consider evidence found in the literature regarding response rates, timeliness, data quality and cost.In light of this evidence, we evaluate popular claims that Internet-based surveys can be conducted faster, better, cheaper, and/or easier than surveys conducted via conventional modes. We find that the reality of cost and speed often does not live up to the hype. Nonetheless, it is possible to implement Internet-based surveys in ways that are effective and cost-efficient. We conclude that the Internet will continue to grow in importance for conducting certain types of research surveys.INTRODUCTION Wit h the advent of the World Wide Web (Web or WWW) and electronic mail (email), the Internet has opened up new vistas in surveying. Rather than mailing a paper survey, a respondent can now be given a hyperlink to a Web site containing the survey. Or, in an e-mail survey, a questionnaire is sent to a respondent via e-mail, possibly as an attachment. As either an alternative or an adjunct to conventional survey modes (e. g. , the telephone, mail, and face-to-face interviewing) Internet-based surveys offer unique new capabilities.For example, a Web survey can relatively simply incorporate multi-media graphics and sound into the survey instrument. Similarly, other features that were once restricted to more expensive interviewer-assisted modes, such as automatic branching and real-time randomization of survey questions and/or answers, can be incorporated into self-administered Web (and some e-mail) surveys. However, not unlike when phone and mail surveys were first introduced, concerns exis t about whether these Internet-based surveys are scientifically valid and how they are best conducted.In the late 1980s and early 1990s, prior to the widespread availability of the Web, e-mail was first explored as a survey mode. As with the Web, e-mail offers the possibility of nearly instantaneous transmission of surveys to recipients while avoiding any postal costs. Early e-mail were primarily ASCII text-based, with rudimentary formatting at best, which tended to limit their length and scope. The only significant advantage they offered over paper was a potential decrease in delivery and response Field Methods, Vol. 14 No. 4, 2002 347-367. 1 imes, though some also hypothesized that the novelty of the new medium might enhance response rates (Parker, 1992; Zhang, 2000). The Web started to become widely available in the early to mid-1990s and quickly supplanted e-mail as the Internet survey medium of choice because it was easy to implement, it provided an improved interface with the respondent, and it offered the possibility of multimedia and interactive surveys containing audio and video. For convenience samples, the Web also offered a way around the necessity of having to know respondents’ e-mail addresses.As a result, â€Å"quick polls† and other types of entertainment surveys have become increasingly popular and widespread on the Web. Internet-based surveys are now in vogue—those conducted via the Web in particular—because of three assumptions: (a) Internet-based surveys are much cheaper to conduct; (b) Internet-based surveys are faster; and, (c) when combined with other survey modes, Internet-based surveys yield higher response rates than conventional survey modes by themselves. Yet, does the evidence in the literature confirm these assumptions?Are Internet-based surveys faster, better, cheaper, and/or easier than surveys conducted via conventional modes? What can we conclude about the strengths and current limitations of Intern et-based surveying from the facts in the literature? In this report we synthesize the literature about the use of the Internet (e-mail and the Web) in the survey process. Other accounts of the literature include Schonlau, Fricker and Elliott (2002), Couper (2000), Dillman (2000), and Tuten et al. (2002). In addition, an extensive source of Web survey literature can be found on the Web at www. ebsm. org. LITERATURE SUMMARY FOR INTERNET-BASED SURVEYS In this section we summarize key characteristics of Internet-based surveys—that is, surveys using the Web and e-mail as a response mode—as documented in the literature. We employed a professional librarian to conduct a thorough literature search in the Social Science Database and the Conference Paper Index database. The Social Science Database indexes more than 1,500 of the most important worldwide social sciences journals since 1972.Additional articles relevant to the social sciences are also incorporated from over 2,400 jo urnals in the natural, physical, and biomedical sciences. The Conference Paper Index provides access to records of the more than 100,000 scientific and technical papers (since 1973) presented at over 1,000 major regional, national, and international meetings each year. Field Methods, Vol. 14 No. 4, 2002 347-367. 2 The literature search yielded 57 papers that were substantively interesting and informative.Here we report on a subset of those articles of direct relevance to this discussion. (Appendix B of Schonlau et al. , 2002, lists 52 papers and we have augmented the list here with an additional five that have appeared since Schonlau et al. was published. ) We consider the following key characteristics of surveys: (1) response rate, (2) timeliness, (3) data quality, and (4) cost. We compare what has been published in the literature about Internet-based surveys to a natural conventional survey alternative: mail.While no survey mode is going to be optimal in all of these areas, we cho se mail because both mail and Internet-based surveys are self-administered, mail surveys tend to be the least expensive of the conventional modes, and virtually all of the comparisons made in the literature are to mail surveys. Response Rates A standard way to summarize survey performance is by comparing response rates among various survey modes. By â€Å"survey mode† (sometimes called response mode) we mean the mode by which the survey itself is conducted: Web, e-mail, mail, etc.In this section, we compare response rates for studies classified into one of three categories: (1) Surveys employing probability sampling or conducting a census that used the Web as the only response mode; (2) Surveys in which respondents were allowed to choose one of several response modes, including at least one Internet-based response mode; and, (3) Surveys in which respondents were assigned one of several response modes, including at least one Internet-based response mode. We begin with results for studies that used the Web as the primary or only response mode with either censuses or robability samples (Table 1). The table is ordered by year and it shows that Web-only research surveys have currently only achieved fairly modest response rates, at least as documented in the literature. Field Methods, Vol. 14 No. 4, 2002 347-367. 3 Table 1. Response Rates for Web-only Surveys Using Probability Samples or Censuses Sample Size 1,602 14,150 Response Rate 42%d 8% Population University of Michigan Students College-bound high school and college students Everingham (2001) 1,298 44% RAND employees Jones and Pitt (1999) 200 19% University staff b 9,522 41% Purchasers of Dillman et al. 1998) computer products c 2,466 38% Purchasers of Dillman et al. (1998) computer products a Most respondents were contacted via their parents, which reduced the response rate. A mail response mode was added late in the survey protocol. b A relatively plain Web survey design was used in this experimental arm. c A relatively fancy Web survey design was used in this experimental arm. d Another 5. 6 percent of partially completed surveys were also received. Survey Couper et al. (2001) a Asch (2001)In fact, the results in Table 1 may overstate response rate performance for research surveys of broader populations because Dillman’s results are based on participants who were initially contacted by phone and had agreed to participate in a Web survey and Everingham’s sample was of a closed population of employees at one company. Jones and Pitt (1999) sampled staff at â€Å"10 universities whose staff directories were available on the WWW† and Couper et al. (2001) surveyed 1,602 University of Michigan students.In all of these cases, the potential survey participants were likely to be more homogeneous and more disposed to respond compared to a random sample of the general population. In addition, because university populations often tend to have greater access to the Inter net, and today’s college students can be expected to be more computer- and Internet-savvy. In Table 2 we summarize the studies published in the literature that allowed the respondent to choose to respond either via the Web or through the mail, ordered in terms of the fraction that responded via the Web.Since for many populations the fraction of respondents that can or will answer via the Web may not be sufficiently large, and mail emerges as the most relevant second mode for a dual mode survey, these studies are important. Field Methods, Vol. 14 No. 4, 2002 347-367. 4 Table 2. Studies Allowing Respondents to Choose a Web or Mail Response Mode Total Sample Size a Study % Chose to Respond by †¦ Mail Web Overall Response Rate Population U. S. military and spouses Quigley et al. (2000) (DoD study) 7,209 83% 27% 37% Civilians c b 45% 58% U.S. Geriatric Chiefs 57 52% Raziano et al. (2001) Zhang (2000) 201 20% 80% 78% Researchers d Schleyer and Forrest (2000) 84% 74% Dentists 4 05 16% NOTE: The multiple Quigley et al. and Raziano et al. entries represent multiple arms of the same study. a This arm of the study used mail as the contact mode. b Includes e-mail. The authors do not distinguish between e-mail and Web as a response mode. c This arm of the study used e-mail as the contact mode. d The response mode in this case was either e-mail or fax. 21,805 Raziano et al. 2001) Sedivi Gaul (2001) and Griffin et al. (2001) (American Community Survey [2000]) Sedivi Gaul (2001) and Griffin et al. (2001) (Library Media Center Survey [1998]) Sedivi Gaul (2001) and Griffin et al. (2001) (Library Media Center Survey [1999]) Quigley et al. (2000) (DoD study) 57 9,596 924 13,440 96% 95% 95% 81% 77% 4% 5% 5% b 77% 38% 38% 63% 42% U. S. Geriatric Chiefs U. S. households Librarians Librarians 19% 23% In Table 2 we see that for most of the studies respondents currently tend to choose mail when given a choice between Web and mail.In fact, even when respondents are contracted electronically it is not axiomatic that they will prefer to respond electronically, as in Raziano et al. (2001) that did not find a statistically significant difference in response rates. Zhang (2000) and Schleyer and Forrest (2000) are the only studies that contradict this conclusion and they tend to represent groups of respondents that are largely or entirely computer literate and comfortable with electronic communication. In comparison, Quigley et al. (2000) and the American Community Survey (2000) study tend to represent general cross-sections of the U. S. ublic in terms of computer literacy and availability and for these studies the fraction that chose Web as the response mode was quite small. In Table 3 we present studies that compared response rates between groups assigned to one of either two or three response modes. Here we see that Internet-based mode response rates generally do not achieve response rates equal to mail surveys. (The table is first ordered from lowest to h ighest e-mail response rate and then by Web response rate. ) Further, Sheehan (2001) concludes that e-mail response rates are declining over time (though the reason for the decline is unknown).Field Methods, Vol. 14 No. 4, 2002 347-367. 5 Table 3. Studies With Multiple Study Arms: Comparing Response Rates for E-mail, Web and Mail Response Modes Total Sample Size 400 500 418 153 262 8,000 904 140 200 1,800 Response Rate E-mail Mail 6% 27% 7% 52% 19% 57% 28% 78% 40% 45% 43% 71% a 58% 53% 68% 38% 34% 72% -54% -62% Population University staff University staff MIS and marketing faculty Health educators BBS newsgroup users Federal employees WSU faculty AT&T employees University staff Businesses in Slovenia Undergraduates at the University 600 of Florida McCabe et al. 2002) 5,000 63% -40% University of Michigan Students — Indicates not applicable; the indicated response mode was not evaluated in the study. a An additional 5 percent that were returned by mail are not included in this number. b In the 2nd follow-up of both study arms respondents were contacted by both mail and e-mail. c An additional phone study arm achieved a response rate of 63%, an additional contact mail / response fax study arm achieved a response rate of 43%. Study Tse et al. (1995) Tse (1998) Schuldt and Totten (1994) Kittleson (1995) Mehta and Sivadas (1995) Couper et al. 1999) Schaefer and Dillman (1998) Parker (1992) Jones and Pitt (1999) c Vehovar et al. (2001) b Pealer et al. (2001) Web ——–19% 32% 58% Parker (1992) is the only study of which we are aware in which e-mail achieved equal or higher response rates when compared to postal mail. Parker conducted a survey of 140 expatriate AT&T employees on matters related corporate policies for expatriation and repatriation, reporting a 63 percent response rate via e-mail (63 returned out of 100 sent by e-mail) compared to a 38 percent response rate for postal mail (14 returned out of 40 sent by mail).Interestingly, Par ker (1992) also attributed the difference in response rates to the fact that, at the time, AT&T employees received a lot of corporate paper junk mail yet, over the internal e-mail system, they received little to no electronic junk mail. Hence, recipients of the paper survey were more likely to discount its importance compared to e-mail survey recipients. With the spread of e-mail â€Å"spam,† this situation is likely to be reversed today.In an example more typical of the current state of affairs, and in one of the few studies to randomize respondents to mode, Couper et al. (1999) obtained an average email response rate of about 43 percent compared to almost 71 percent with mail in a survey of employees in five federal statistical agencies. Couper et al. chose e-mail as the Field Methods, Vol. 14 No. 4, 2002 347-367. 6 mode for the survey over the Web because e-mail was almost universally available in the five agencies while the Web was often not available. Turning to the Web, McCabe et al. 2002) conducted an experiment in which 5,000 University of Michigan students were randomized to receive a survey about drug and alcohol use; 2,500 potential respondents received a mail survey and 2,500 were notified of an equivalent Web-based survey. Respondents in both groups received a $10 gift certificate incentive. In this study, McCabe et al. achieved a 63 percent Web response rate compared to 40% for mail. In contrast, however, Pealer et al. did not find a statistically significant difference between Web and mail response rates for a survey of undergraduates at the University of Florida.The only other published study that achieved exceptional response rates with an Internet-based survey is Walsh et al. (1992) in which potential respondents were solicited by e-mail and offered the option to respond by e-mail or request a paper survey by postal mail. While they did not conduct an equivalent postal mail only survey for comparison (and thus are not listed in Table 3 ), Walsh et al. achieved a 76 percent overall response rate of a randomly sample of subscribers (300 out of a total population of 1,100) to a scientific computer network for an e-mail survey.In addition to providing nonrespondents with two follow-up reminders, a lottery prize of $250 was employed as an incentive. Walsh et al. found that 76 percent of the respondents replied by e-mail and the other 24 percent responded by postal mail. They also received requests from an additional 104 subscribers (who were not chosen in the sample of 300) to participate in the survey. For the self-selected 104, 96 percent responded by e-mail. Not surprisingly, they also found a positive correlation between propensity to respond electronically and amount of network usage.In conclusion, there is little evidence in the literature that Internet-based surveys achieve higher response rates, as a general rule, than conventional surveys. The few Internet-based surveys that have achieved higher response rates have tended to be either of university-based populations or small, specialized populations. The majority of results reported in the literature show Internet-based surveys at best currently achieve response rates equal to conventional modes and often do worse. The reasons for this difference are not yet clear and require more study.Yet, as we have seen, there are also a few examples of Web surveys outperforming mail for some specific populations. Whether this was idiosyncratic of these few surveys, Field Methods, Vol. 14 No. 4, 2002 347-367. 7 or it is an indication that methodology is developing to achieve higher response rates in the new medium is yet to be shown. It is important to note that, contrary to intuition, there is no evidence in the literature that concurrent fielding of a survey via a conventional mode and via an Internet-based mode results in any significant improvement in response rates.This may be because, as Table 2 shows, except in specialized populations, when gi ven a choice between mail and Web surveys, most individuals tend to respond to the mail survey. In addition, there is no evidence that those who would normally refuse to complete a mail survey would choose to respond if the survey was Internet-based. Of course, these results are specific to the current state of the art of Internet-based surveying, existing technology, and the current state of respondent attitudes toward surveys, both Internetbased and conventional.Future developments may significantly alter these findings and more research is certainly warranted in an attempt to improve the response rate performance of Internet-based surveys. Finally, we note that while research surveys based on probabilistic survey sampling methods are generally recognized as being necessary to conduct statistical inference to any population outside of the sample, convenience sampling can also be useful to some researchers for other purposes. For example, early in the course of research, responses from a convenience sample might be useful in developing research hypotheses.Responses from convenience samples might also be useful for identifying issues, defining ranges of alternatives, or collecting other sorts of non-inferential data. In fact, in certain types of qualitative research, convenience samples on the Web may be just as valid as other methods that use convenience samples. There are a number of studies in the literature that used convenience samples, for which response rate comparisons do not apply (and hence precluded their inclusion in Tables 1-3), often with respondents recruited through advertising of some form.While response rates for these studies are meaningless, we present a few of the more interesting studies here to illustrate alternative ways that Web surveys can be used. In a social science study of geographic mobility and other topics Witte et al. (2000) recruit a large number of respondents: 32,688. Similarly, Vehovar et al. (1999) conducted a large-scale survey targeted at the Internet population of Slovenia, which corresponds to about 13 percent of the total population of Slovenia.In both cases, similarly sized traditional mail surveys would likely have been more complicated and very expensive to field. Coomber (1997) conducted a survey about drug dealer practices, where his target population was illicit drug-dealers throughout the world. Coomber solicited responses by e-mail and Field Methods, Vol. 14 No. 4, 2002 347-367. 8 through advertising, and collected responses on the Web hoping his respondents would be encouraged to respond more honestly because of a perceived anonymity.Timeliness In today’s fast-paced world, survey timeliness is increasingly stressed. The length of time it takes to field a survey is a function of the contact, response, and follow-up modes. Decreasing the time in one or more of these parts of the survey process will tend to decrease the overall time in the field. However, it is important to keep in mind that the relevant measure is not average response time but maximum response time (or perhaps some large percentile of the response time distribution) since survey analysis generally does not begin until all of the responses are in.Most studies tend to conclude, often with little or no empirical evidence, that Internet-based surveys are faster than surveys sent by postal mail. This conclusion is usually based on the recognition that electronic mail and other forms of electronic communication can be instantaneously transmitted while postal mail takes more time. However, simply concluding that Internet-based surveys are faster than mail surveys naively ignores the reality that the total amount of time for survey fielding time is more than just the survey response time.A complete comparison must take into account the mode of contact and how long that process will take and the mode of follow-up allowing for multiple follow-up contact periods. For example, if e-mail addresses of res pondents are unavailable and a probability sample is desired then respondents may have to be contacted by mail. In this case a Web survey only saves time for the return delivery of the completed questionnaire, and not for the contact and follow-up, so that the resulting time savings may only be a fraction of the total survey fielding time.In the case of e-mail surveys, where the presumption is that the potential respondents e-mail addresses are known and can therefore be used not just for delivering the survey but also for pre-notification and non-response follow-up, the time savings can be substantial. For example, one is often forced to allow for a week of delivery time in the postal mail. With an advance letter and a single mail follow-up, this one week delay telescopes into over a month in survey fielding when two weeks must be budgeted for initial survey delivery and return time, plus an additional two weeks for a single followup reminder delivery and response time.By compariso n, in an all-electronic process the same operation has the potential to be completed in a few days or less. Yet, even in an all-electronic environment it is not necessarily true that the Internet-based survey will be timelier. For example, in a comparison of response speed Field Methods, Vol. 14 No. 4, 2002 347-367. 9 between e-mail and mail, Tse et al. (1995) did not find a statistically significant difference in the time between sending and receipt of an e-mail survey to university faculty and staff and an equivalent survey sent by mail.Furthermore, to achieve sufficiently high response rates, it may be necessary to leave an Internet-based survey in the field for an extended period of time. For example, a prominent commercial Internet survey company, Knowledge Networks, has indicated that to achieve 70-80 percent response rates they must leave a survey in the field for about 10 days. This period comprises one workweek with two weekends, because they find that most respondents comp lete their surveys on the weekend. However, there are cases in the literature that did show more timely response.Tse (1998) found a statistically significant difference in the average initial response time for those that received an e-mail survey compared to those that received a paper survey in the campus mail (one day versus 2-1/2). Further, in Tse’s experiment, most e-mail survey recipients either responded almost immediately (within one day) or they did not respond at all, which raises the question of the effectiveness of non-response follow-up in the electronic forum. Schaefer and Dillman (1998) also document faster e-mail response rates: 76 percent of all responses were received in 4 days or less. Pealer et al. 2001) found a statistically significant difference in the average return time between their e-mail study arm (7. 3 days) and their mail study arm (9. 8 days). However, the final e-mail survey was received after 24 days and the final mail survey after 25 days†”a negligible difference in overall fielding time. In conclusion, while it is certainly reasonable to conclude prima facie that the delivery time of an Internet-based survey is faster than the delivery of a survey by mail, it does not necessarily follow that the increased delivery speed will translate into a significantly shorter survey fielding period.Two points are relevant: (1) dramatic improvements are only possible with an all-electronic process, which is currently only possible for specialized populations; and, (2) even for populations in which all-electronic surveys are possible, the literature is not very informative as there is no information available about the length of fielding time required to achieve particular response rates. Quality When the primary purpose of a survey is to gather information about a population, the information is useless unless it is accurate and representative of the population.While survey error is commonly characterized in terms of the precisi on of statistical estimates, a good survey design seeks to reduce all types of errors, including coverage, Field Methods, Vol. 14 No. 4, 2002 347-367. 10 sampling, non-response, and measurement errors. (See Groves, 1989, for a detailed discussion of the â€Å"Total Survey Error† approach. ) Indeed, even when a survey is conducted as a census, the results still may be affected by many of these sources of error. Coverage error is the most widely recognized shortcoming of Internet-based surveys.Today the general population coverage for Internet-based surveys still significantly lags behind the coverage achievable using conventional survey modes. However, there are some important caveats to keep in mind. First, the coverage differential is rapidly closing and may become immaterial in the relatively near future (though this is far from a preordained conclusion). Second, even though conventional modes have the ability to reach most of the population, it is becoming increasingly dif ficult to get people to respond (e. g. answering machines are routinely used to screen calls these days and, hence, screen out telephone surveyors and solicitors). Third, while conventional modes have near universal coverage, there will always be special subpopulations that have little or no coverage for any mode. Fourth, in the case of Internetbased surveys, access is only one consideration. Even if the respondent in principle has Internet access (e. g. through a library), there are large portions of the population that are still computer illiterate and would have difficulty correctly responding to such a survey.Finally, access and computer literacy are necessary but not sufficient conditions for success: Respondents must also have compatible hardware and software. However, less than universal access to the Internet can be immaterial for some studies, such as studies that focus on closed populations with equal access or Internet users, for example. In order to improve coverage, Dil lman (2000) recommends a mixedmode strategy for contact, using both e-mail and postal mail for pre-notification. Similarly, using mixed response modes, such as Web and e-mail can be used to increase coverage.However, as we previously mentioned, there is little evidence in the literature that concurrent mixed mode fielding increases response rates over what would have been achieved using a single, conventional mode. In addition to coverage, data quality is a function of a number of other dimensions, including: (1) unit and item nonresponse; (2) honesty of responses, particularly for questions of a sensitive nature; (3) completeness of responses, particularly for openended questions; and, (4) quality of data transcription into an electronic format for analysis if required by the survey mode.All other things held constant (such as pre-notification and non-response followup), unit and item non-response are generally smaller using interviewer-assisted modes (de Leeuw, 1992) compared to s elf-administered survey modes. Face-to-face interviews Field Methods, Vol. 14 No. 4, 2002 347-367. 11 have long been considered the gold standard of surveys and tend to result in the lowest unit and item non-response as well as minimizing respondent misinterpretation of questions and skip patterns.However, it has been shown that interviewer-administered survey modes, particularly face-to-face, yield more socially desirable answers than selfadministered modes (de Leeuw, 1992, Kiesler et al. , 1986, p. 409). This is particularly relevant for surveys of sensitive topics or for surveys that contain sensitive questions, such as questions about income or sexual practices, for example. Mail and other selfadministered modes tend to be the least expensive but often have higher unit and item non-response rates. On the other hand, they tend to elicit the most accurate responses to sensitive questions.Data quality is usually measured by the number of respondents with missing items or the percen tage of missing items. For open-ended questions, longer answers are usually considered more informative and of higher quality. In those studies that compared e-mail versus mail, for closed-ended questions, it appears that e-mail surveys may incur a higher percentage of items missing than mail surveys. As Table 4 shows, for studies in the literature that reported the percentage of missed items, the percentage for mail respondents was less than or equal to the percent for e-mail respondents.Table 4. Average Percentage of Missed Items for E-mail and Postal Mail Surveys Postal Mail Population 14. 2 Undergraduates, University of Florida 0. 7 Business school deans and chairpersons 0. 4 Names and addresses purchased from Internet magazine in the U. K. 0. 5 Fourth-year medical students 0. 8 Employees of five U. S. federal agencies < 0. 3 Active U. S. users of bulletin board system (BBS) news group Study Peale et al (2001) Bachman at al. (1996) Comley (1996)a Paolo et al. (2000) Couper et al . (1999)b Mehta and Sivadas (1995)c a E-mail 14. 2 3. 7 1. 2 1. 2 0. 8 < 0. 3Based on three questions. Based on 81 attitude questions. c Across five different study arms, one of which allowed for both mail and e-mail responses. b At the respondent level, Paolo et al. (2000) also found that 27 percent of e-mail respondents did not respond to at least one question versus 9 percent for mail respondents. Kiesler and Sproull (1986) found the opposite: in the e-mail (contact and response) study arm only 10 percent of respondents failed to complete or spoiled one Field Methods, Vol. 14 No. 4, 2002 347-367. 12 item compared to 22 percent in the mail (contact and response) study arm.Tse (1995, 1998) found no difference in quality of responses. For open-ended questions, studies found that e-mail responses are either longer or of the same length as mail responses. Comley (1996) found that in the two open-ended questions e-mail respondents gave longer answers. One respondent even wrote a minies say. Mehta and Sivadas (1995) found that there was â€Å"hardly any difference between the average completed responses for both the open and close-ended questions† (Mehta and Sivadas, 1995, p. 436). Kiesler and Sproull (1986) found that the total number of words did not significantly differ for e-mail and mail respondents.If one also takes into consideration that open-ended items for mail respondents are not always encoded for cost reasons, it appears that Internet-based survey modes may be better suited to open-ended questions. Other quality issues for Internet-based surveys resulting from some sort of sampling error are generally the same as for conventional surveys. However, as the Internet becomes more ubiquitous, collecting much larger samples becomes more feasible. Indeed, we have talked to some organizations recently that have electronic access to their entire population and are considering eliminating sampling and simply conducting censuses.Often these census efforts result in much larger numbers of respondents than otherwise could have been gathered using traditional survey sampling techniques and those larger numbers give the appearance of greater statistical accuracy. However, such accuracy may be misleading if non-response biases are not accounted for and researchers need to carefully consider the trade-offs between smaller samples that allow for careful non-response follow-up and larger samples with less or no follow-up.The former may have larger standard errors but less bias while the latter may have much smaller standard errors but an unknown, and potentially very large, amount of bias. Finally, we note that Web surveys offer the ability to clearly improve on other forms of self-administered surveys in terms of data validation, skip pattern automation, and the elimination of transcription errors, all of which help to minimize measurement error. Web surveys can be programmed to conduct input validation as a logical check of the respondentà ¢â‚¬â„¢s answers.These types of checks improve data quality and subsequently save time in the preparation of the analysis file. As with logic checks, Web surveys can also be programmed to manage the process of skipping questions. This will eliminate errors and, from the respondent’s point of view, simplify the process of taking the survey. And, while all conventional surveys required some form of conversion into an electronic Field Methods, Vol. 14 No. 4, 2002 347-367. 13 format for analysis, for Web surveys respondents’ answers are directly downloaded into a database, avoiding transcription errors.Cost Designing a survey fundamentally involves making trade-offs between the quality and quantity of data and cost. For smaller research surveys that are not subsidized in any way, a major component of total survey cost is frequently the researchers’ time for survey design and subsequent data analysis. However, these costs vary little by survey mode. A major expense t hat does vary by mode is the labor cost of the personnel who actually execute the survey.Depending on the size of the survey and the complexity of the design, either researcher labor costs, survey personnel labor costs, or a combination of the two will likely dominate the survey budget. Comparing the costs of doing a Web survey versus a mail survey or other some other mode in the literature is difficult because different authors define costs different ways. Academics frequently only consider postage and reproduction costs and often fail to account for the cost of one or more of various types of labor, including: survey design and/or programming, coding, analysis, and other such items.Estimates also vary depending on whether they are given on a per mail-out or per complete survey response basis and, unfortunately, most studies in the literature omit any discussion about costs altogether. However, the question often reduces to how to price the time spent programming a Web survey and w hether and how to price the time of the investigator or a survey coordinator. While lower costs are often touted as one of the benefits of Internet-based surveys, Couper et al. (1999) found no cost benefit in e-mail compared to postal mail surveys in their work.In a large and comprehensive survey effort of different government agencies Couper et al. compared an all e-mail survey (contact, response, and follow-up) versus an all mail survey. They found that evaluating and testing the e-mail software took over 150 hours – almost 4 times as much as they budgeted. For the mail survey, costs for printing and postage were $1. 60 per reply; and data editing and entry cost about $1. 81. For the email survey, managing the e-mail cost $1. 74 per completed case. In addition, they handled over 900 toll-free calls of a mostly technical nature.While the printing and mailing costs were eliminated for the e-mail survey, Couper et al. found that the costs of evaluating and testing the e-mail s oftware, additional post-collection processing, and the costs of maintaining a toll-free phone line which was largely dedicated to responding to technical questions related to the e-mail surveys offset any savings. (For example, while Field Methods, Vol. 14 No. 4, 2002 347-367. 14 the e-mail survey was designed so that respondents would use the reply function of their e-mail program so the resulting replies could be automatically read into a database upon receipt. Further, almost 47 percent of the e-mail surveys required some type of clerical action to prepare them for automatic reading. On the other hand, Raziano et al. (2001) in a small study of 110 Geriatric Chiefs across the U. S. , compute the cost per respondent for their mail study arm to be $7. 70 and for their e-mail study arm $10. 50. The programming time to construct the e-mail survey is factored into this calculation. However, the total programming time accounted for, two hours, may be unrealistic for a large or complica ted survey operation.Also, these estimates fail to reflect the fact that their postal arm response rate from the first mail-out exceeded the e-mail arm response rate after four contact attempts. Hence, for a given desired response rate, the difference in costs would be less as fewer mailings would be required. Similarly, Schleyer and Forrest (2000) in their study received responses over the Web, by mail, and by fax and found the total costs for the Web survey turned out to be 38 percent lower than for the equivalent mail survey. Asch (as reported in Schonlau et al. 2002) found that adding a Web response option to a mail survey to be economical when about 620 responses are obtained over the Web when the Web is first used as the primary survey mode and surveys are only mailed out to non-respondents. Their calculations were based on the trade-off of the expected savings in postage, printing, and labor costs to prepare survey mailing packages and code the subsequent survey returns again st the expected extra costs of programming, additional management effort, and maintaining a telephone help-line for the Web survey.This study did achieve a cost savings since it garnered over 1,000 Web responses. In two studies that essentially ignore personnel costs, Mehta and Sivadas (1995) and Jones and Pitt (1999) conclude, not surprisingly, that Internet-based surveys are less costly than mail surveys. These conclusions simply stem from the fact that Internetbased surveys do not incur postage and printing costs while mail surveys do. In conclusion, when only considering postage and printing costs, e-mail and Web surveys almost by definition are cheaper than mail surveys.However, when the total costs of a survey are considered, including labor and other costs, Web surveys may or may not be cheaper depending on whether the additional expenses incurred with that mode, such as programmer costs, are offset by savings, such as postage and data entry costs. When planning for and subse quently executing a Web survey, care must be taken that unanticipated technical problems are minimized or these problems can easily eliminate all potential cost benefits. Field Methods, Vol. 14 No. 4, 2002 347-367. 15SUMMARIZING THE CURRENT PERFORMANCE OF INTERNET SURVEYS In the Introduction we said that Internet-based surveys are in vogue – those conducted via the Web in particular – primarily because of three assumptions: (a) Web surveys are much cheaper to conduct; (b) Web surveys are faster; and, (c) combined with other survey modes, Web surveys yield a higher response rate than the other survey modes by themselves. That is, the usual naive generalization about Internet-based surveys is that they can be conducted faster, better, cheaper, and easier than surveys conducted via conventional methods.How do these claims stand up when compared to what has been published in the literature? Faster? Web surveys are thought to be much faster than conventional survey modes. W hile there is no question that the delivery time of an Internet-based survey is faster than a survey sent via the mail, there is little to no evidence in the literature to substantiate whether this increase subsequently results in a shorter overall fielding period.We are aware of a couple of organizations that have implemented all-electronic survey processes by communicating with respondents via e-mail, but this is only currently possible for prerecruited panels or specialized subsets of the population. If respondents must be contacted through mail or phone, which generally is the case if a probability sample is required by the research, then there may only be a marginal improvement in overall response times. Better? Response rates for Web surveys where no other survey mode is iven have tended to range from moderate to poor. The reasons for this are not clear. It is possible that potential respondents simply do not respond as well to electronic solicitation or response. If true, thi s may improve as Internet-based communication methods continue to spread and become routine with all segments of the general population. It is also possible that the execution of the Internet-based survey experiments have been less than optimal – something that will improve with surveyor experience.There are a few examples of Web surveys outperforming mail in some of the more recent comparisons between these two media. Whether this was a unique result for these few surveys, or whether it is a leading indicator that the field is maturing and learning how to achieve higher response rates in the new medium is not known. In either case, it Field Methods, Vol. 14 No. 4, 2002 347-367. 16 is of concern that any improvements in these areas may be offset by over-saturation of the population with other forms of commercial surveys.Setting the question of response rate aside, Web surveys offer some advantages over conventional modes. For example, if multi-media and/or interactive graphic s are required then there are few conventional alternatives (and those alternatives, such as face-to-face interviewing, would likely be significantly more costly). If a convenience sample will suffice for the research, then Web can be an excellent medium to use, particularly if the desired respondents are geographically diverse or hard to find/identify.A major issue for Web surveys is their ease of implementation facilitates naive misuse. The particular concern for this medium is the easy collection of large numbers of surveys can result in surveyors and survey data consumers confusing quantity with quality. There is on-going research about the effects of surveying via the Internet, the Web in particular, on unit and item non-response and on the affect the medium has on survey responses. Preliminary results have been reported at some conferences and symposia, but little has appeared in the literature as yet. Cheaper?The usual claim that Web surveys are much cheaper than mail surveys is not necessarily true. Web and e-mail surveys can save on some or all mailing costs, but except for very large surveys these may be small costs in the overall survey effort. Web surveys can also eliminate data entry costs; e-mail survey results may not because they often require additional manipulation before they can be downloaded into an analytical database. However, savings in data entry may be partially or completely offset against higher programming costs and additional help desk staffing requirements.The literature mostly neglects labor costs, which form the highest cost component for Web surveys. Nonetheless, adding a Web survey to a mail survey can be cost efficient if done carefully and properly. Easier? The implementation of Web surveys is technically more involved than mail or phone surveys. Survey designers need to specify many issues related to the technical control of Web surveys (e. g. how to move back and forward between questions, input validation, passwords, for what questions answers are not optional) that are simpler or not required with conventional survey modes.Web surveys also require more extensive Field Methods, Vol. 14 No. 4, 2002 347-367. 17 pretesting to ensure both that the questions elicit the desired information and that the program works properly across numerous hardware and software configurations. The fielding process may or may not be made easier. Internet-based surveys have the potential to eliminate some of the more labor-intensive fielding tasks, such as survey package preparation and mailing and the subsequent data entry.Yet, if mixed modes are required to obtain sufficient population coverage and/or response rates, then these tasks cannot be completely eliminated and the fielding process may actually then become more complex since support for two or modes must be maintained and managed. What is the Future of Internet-based Surveying? The first Internet browser was introduced only about a decade ago and early use of th e World Wide Web as a survey medium only started about five years ago. The result is that significant research results about the use of this new survey medium have only recently begun to become available in the literature.Hence, there is a great deal that is still not well known about Internet-based surveys. While some predict that Web surveys will replace other survey modes, we expect Web surveys to develop into a distinct survey mode with advantages and disadvantages that will have to be weighed against the conventional alternatives. Little is known about Web instrument design and the effects of instrument design on how survey participants respond to a survey or a particular survey question, and what enhances response rates and response accuracy.For example, at the 2001 American Association of Public Opinion Researchers conference, some anecdotal evidence was presented that respondents taking surveys on the Web had shorter attention spans, tending to browse the survey like they br owse other Web sites. If true, this would suggest that long surveys and/or surveys with complex questions may not perform as well on the Web as by mail. While many of the design principles from paper-based surveys may translate to Internet-based surveys, much more research is required.To date, most Web surveys have been conducted on convenience samples or in organizations where a list of target populations readily exists. However, Internet-based surveys with probability samples can be fielded by using the mail or telephone for respondent contact and the Web for response. There is currently no equivalent to random digit dialing for e-mail. Even though the fraction of the population having access to email will continue to grow, it is unlikely that one will ever be able to construct a random e-mail address in the same way a random telephone number is constructed.However, Field Methods, Vol. 14 No. 4, 2002 347-367. 18 large commercial e-mail lists may yet emerge that are of high enough quality to be useful in survey research. A major challenge for researchers will be to distinguish themselves and their survey from the plethora of commercial and entertainment surveys that exist and continue to multiply on the Web. These other surveys will continue to proliferate because the financial and technical barriers are so low for Web surveys. Thus, just as telephone survey response rates have continued to decline because of telemarketers, it s likely to become increasingly difficult to achieve superior response rates in the new medium. Nonetheless, Internet-based surveys are here to stay. The challenge for researchers is to learn to use the new medium to their best advantage. REFERENCES Asch, B. , (2001). RAND, Santa Monica, California. Personal communication. Bachman, E. , J. Elfrink, and G. Vazzana (1996). Tracking the Progress of E-Mail vs. Snail-Mail, Marketing Research, 8, 31-35. Bradley, N. (1999). Sampling for Internet Surveys. An Examination of Respondent Selection for Internet Research, Journal of the Market Research Society, 41, 387395.Cochran, W. G. (1977). Sampling Techniques, 3rd edition, John Wiley & Sons, New York, NY. Comley, P. (1996). Internet Surveys. The Use of the Internet as a Data Collection Method, ESOMAR/EMAC: Research Methodologies for â€Å"The New Marketing,† Symposium ESOMAR Publication Services, vol. 204, 335-346. Coomber, R. (1997). Using the Internet for Survey Research, Sociological Research Online, 2, 14-23. Couper, M. (2000). Web Surveys, A Review of Issues and Approaches, Public Opinion Quarterly, 64, 464-494. Couper, M. P. , J. Blair and T. Triplett (1999). A Comparison of Mail and E-mail for a Survey of Employees in U.S. Statistical Agencies. Journal of Official Statistics, 15, 39-56. Couper, M. P. , M. W. Traugott, M. J. Lamias (2001). Web Survey Design and Administration. Public Opinion Quarterly, 65, 230-253. Field Methods, Vol. 14 No. 4, 2002 347-367. 19 de Leeuw, E. D. (1992). Data Quality in Mail, Tel ephone, and face to Face Surveys, Ph. D. dissertation, University of Amsterdam, ISBN 90-801073-1-X. Dillman, D. A. (2000). Mail and Internet Surveys, The Tailored Design Method, 2nd ed. , John Wiley & Sons, New York, NY. Dillman, D. A. , R. D. Tortora, J. Conradt and D. Bowerk (1998). Influence of Plain vs.Fancy Design on Response Rates for Web Surveys. Unpublished paper presented at the Annual Meeting of the American Statistical Association, Dallas, TX. Dillman, D. A. (1978). Mail and Telephone Surveys, The Total Design Method, John Wiley & Sons, New York, NY. Everingham, S. (2001). RAND, Santa Monica, California. Personal communication. Fowler, Jr. , F. J. (1993). Survey Research Methods, 2nd ed. , Applied Social Science Research Methods Series, volume 1, SAGE Publications, Newbury Park, CA. Griffin, D. H. , D. P. Fischer, and M. T. Morgan (2001). Testing an Internet Response Option for the American Community Survey.Paper presented at the American Association for Public Opinion Re search, Montreal, Quebec, Canada. Groves, R. (1989). Survey Errors and Survey Costs, John Wiley & Sons, New York, NY. Hamilton, C. H. (2001). Air Force Personnel Center, Randolph Air Force Base, personal communication. Henry, G. T. (1990). Practical Sampling, Applied Social Research Methods Series, Volume 21, SAGE Publications, Newbury Park, CA. Jones, R. and N. Pitt (1999). Health Surveys in the Workplace: Comparison of Postal, Email and World Wide Web Methods, Occupational Medicine, 49, 556-558. Kiesler, S. and L. S. Sproull (1986).Response Effects in the Electronic Survey, Public Opinion Quarterly, 50, 402-413. Kish, L. (1965). Survey Sampling, John Wiley and Sons, New York, NY. Kittleson, M. J. (1995). An Assessment of the Response Rate Via the Postal Service and E-Mail, Health Values, 18, 27-29. McCabe, S. E. , Boyd, C. , Couper, M. P. , Crawford, S. , and H. d'Arcy (2002). Mode Effects for Collecting Health Data from College Students: Internet and US Mail. Paper under review. Mehta, R. and E. Sivadas (1995). Comparing Response Rates and Response Content in Mail versus Electronic Mail Surveys, Journal of the Market Research Society, 37, 429-439.Field Methods, Vol. 14 No. 4, 2002 347-367. 20 Nichols, E. , and B. Sedivi (1998). Economic Data Collection via the Web: A Census Bureau Case Study Proceedings of the Section On Survey research Methods, American Statistical Association,366-371. Paolo, A. M. , Bonaminio, G. A. , Gibson, C. , Partridge, T. and K. Kallail (2000). Response Rate Comparisons of e-mail and mail distributed student evaluations, Teaching and Learning in Medicine, 12, 81-84. Parker, L. (1992). Collecting Data the E-Mail Way, Training and Development, July, 5254. Pealer, L. , R. M. Weiler, R. M. Pigg, D.Miller, and S. M. Dorman (2001). The Feasibility of a Web-Based Surveillance System to Collect Health Risk Behavior Data From College Students. Health Education & Behavior, 28, 547-559. Quigley, B. , Riemer, R. A. , Cruzen, D. E. , and S. Rose n (2000). Internet Versus Paper Survey Administration: Preliminary Finding on Response Rates, 42nd Annual Conference of the International Military Testing Association, Edinburgh Scotland. Raziano, D. B. , R. Jayadevappa, D. Valenzula, M. Weiner, and R. Lavizzo-Mourey (2001). E-mail Versus Conventional Postal Mail Survey of Geriatric Chiefs.The Gerontologist, 41, 799-804. Schaefer, D. R. and D. A. Dillman (1998). Development of a Standard E-mail Methodology: Results of an Experiment. Public Opinion Quarterly, 62, 378-397. Schleyer, T. K. L. and J. L. Forrest (2000). Methods for the Design and Administration Web-Based Surveys, Journal of the American Medical Informatics Association, 7, 416-425 Schillewaert, N. , F. Langerak and T. Duhamel (1998). Non-probability Sampling for WWW Surveys: A Comparison of Methods, Journal of the Market Research Society, 40, 307-322. Schonlau, M. , Fricker, R. D. , Jr. , and M.Elliott. (2002). Conducting Research Surveys via E-Mail and the Web, RAND: San ta Monica, MR-1480-RC. Schuldt, B. A. and J. W. Totten (1994). Electronic Mail vs. Mail Survey Response Rates, Marketing Research, 6, 36-44. Sedivi Gaul, B. (2001a). Web Computerized Self-administered Questionnaires (CSAQ). Presentation to the 2001 Federal CASIC Workshops. U. S. Census Bureau, Computer Assisted Survey Research Office. Sedivi Gaul, B. (2001b). United States Census Bureau, Washington, D. C. Personal Communication. Field Methods, Vol. 14 No. 4, 2002 347-367. 21 Sheehan, K. B. (2001).E-mail survey response rates: A review. Journal of ComputerMediated Communication, 6(2). Retrieved March 9, 2002, from http://www. ascusc. org/jcmc/vol6/issue2/sheehan. html. Tse, A. C. B. , Tse, K. C. , Yin, C. H. , Ting, C. B. , Yi, K. W. , Yee, K. P. , and W. C. Hong (1995). Comparing Two Methods of Sending Out Questionnaires: E-mail versus Mail, Journal of the Market Research Society, 37, 441-446. Tse, A. C. B. (1998). Comparing the Response Rate, Response Speed and Response Quality of Two Methods of Sending Questionnaires: E-mail versus Mail, Journal of the Market Research Society, 40, 353-361.Tuten, T. L. , D. J. Urban, and M. Bosnjak (in press, 2002). â€Å"Internet Surveys and Data Quality: A Review† in: B. Batinic, U. Reips, M. Bosnjak, A. Werner, eds. , Online Social Sciences, Hogrefe & Huber, Seattle, 7-27. Vehovar, V. , K. Lozar Manfreda, and Z. Batagelj (1999). Web Surveys: Can the Weighting Solve the Problem? Proceedings of the Section on Survey Research Methods, American Statistical Association, Alexandria, VA, 962-967. Vehovar, V. , K. Lozar Manfreda, and Z. Batagelj (2001). Sensitivity of e-commerce Measurement to the Survey Instrument.International Journal of Electronic Commerce, 6, 31-51. Walsh, J. P. , S. Kiesler, L. S. Sproull, and B. W. Hesse (1992). Self-Selected and Randomly Selected Respondents in a Computer Network Survey, Public Opinion Quarterly, 56, 241-244. Witte, J. C. , L. M. Amoroso, and P. E. N. Howard (2000). Research Methodol ogy – Method and Representation in Internet-based Survey Tools, Social Science Computer Review, 18, 179-195. Zhang, Y. (2000). Using the Internet for Survey Research: A Case Study, Journal of Education for Library and Information Science, 5, 57-68. Ron Fricker is a statistician at RAND.He has designed, managed, and analyzed many large surveys of national importance, including a survey of Persian Gulf War veterans about Gulf War Illnesses and, most recently, a survey on domestic terrorism preparedness in the United States. Dr. Fricker holds Ph. D. in Statistics from Yale University. In addition to his position at RAND, Dr. Fricker is the vice-chairman of the Committee on Statisticians in Defense and National Security of the American Statistical Association, an associate editor of Naval Research Logistics, and an adjunct assistant professor at University of Southern California.Field Methods, Vol. 14 No. 4, 2002 347-367. 22 Matthias Schonlau, Ph. D. , is an associate statisticia n with RAND and heads its statistical consulting service. Dr. Schonlau has extensive experience with the design and analysis of surveys in areas such as health care, military manpower and terrorism. Prior to joining RAND, he held positions with the National Institute of Statistical Sciences and with AT Labs Research. Dr. Schonlau has co-authored numerous articles as well as a recentRAND book â€Å"Conducting Internet Surveys via E-mail and the Web. † In 2001, he and his team won second place in the data mining competition at the world's largest conference on data mining â€Å"KDD. † Acknowledgements. The helpful and substantive comments of three anonymous reviewers and the editor significantly improved this work. Our research was supported by RAND as part of its continuing program of independent research. Field Methods, Vol. 14 No. 4, 2002 347-367. 23

Local Care Home Essay

At this care home, equality, diversity and rights is very important as residents come from a wide cross-section of society. This chapter is set for the new staff members to deliver good quality and compassionate care for our services users. This handbook contains the policies, rules and procedures referred in your contract of employment and the ones you are expected to abide by as a member of the Local Care Home team Wishing all of you a pleasant and worthwhile time with your career at this organisation – your line manager Know your key terms Here is an explanation, with examples of what equality, diversity and rights mean: Equality is being equal and having a fair society, especially in rights, status or opportunities. Some people may experience discrimination because of gender, race, sexuality, age, disability and few others. For example; A blind person is at a disadvantage because they can’t look at a presentation or won’t be able to know what it is about. A diverse action towards this situation is if you read what the power point said they would be getting all equal chances to their education. Diversity means accepting differences; everyone’s differences are equal and accepted/respected. An example of this is; professionals in a health and social care setting should have an understanding that each and every one of their patients is unique and be able to recognise and accept these differences. Rights is a legal entitlement to carry out or have something. When we talk about this, it means mostly to give all the equal opportunities whether small or big. In a health and social care setting such as a nursing home,  every one of the service users should have the right to live, freedom and education. No one should be treated in any different way because of the way they are. Vulnerability (the state of being exposed to emotional or physical danger/harm from others) – in health and social care settings, many people are vulnerable due to the nature of their support needs Non-discriminatory practice is a term used to describe appropriate professional practise. This refers to a number of things: Not treating individuals or groups less favourably than others, whether the treatment is on purpose or not Being treated equally and getting the right non-discriminated care and procedure in a health and social care setting is very important and this will also be expected and assumed from the patients that they are being treated the same as others Valuing diversity All staff and patients must appreciate diversity and respect each other diversely as everyone is unique in their own ways. Meeting individuals’ diverse needs For example if your patient has speech and learning difficulties or their sight is impaired, it is your duty to enable communication any way possible. This could be through body language and tone of voice Discriminatory practice is when someone is discriminated against with a number of forms of discrimination. There are four types of discrimination. Discriminating is treating someone less favourably because of their certain features as mentioned above. This is known as direct discrimination. Discrimination can occurs where there is a policy, practice that disadvantages people. This is a form of indirect discrimination. Harassment, unwanted conduct violating an individual’s dignity or creating an intimidating, hostile, degrading, humiliating or offensive act. And lastly, victimisation, example of this is; unfair treatment of an employee who made or supported a complaint Discrimination can have many negative impacts on someone’s life and cause  problems and result in low self-esteem and stress. The equality act 2010 mentioned below protects the rights of certain individuals and makes sure that all are being treated equally in all aspects and provides opportunities. You should also bear in mind that patients with certain disabilities may be affected by your or other people’s reactions to their condition. This will also have an impact on their ability to communicate. The Equality Act 2010 This is a legislation which replaced many anti-discrimination laws with a single act. It simplified the laws on things such as sex and religious discrimination. This made it much easier for people to understand and comply with the law. This act promotes the protection for certain people and tackles discrimination and inequality. Here is an example; You suffer from depression, so it’s very hard for you to make decisions or even to get up in the morning. You’re forgetful and you can’t plan ahead. Together, these factors make it difficult for you to carry out day-to-day activities. You’ve had several linked periods of depression over the last two years and the effects of the depression are long-term. So, for the purposes of the Equality Act, you’re defined as a ‘disabled person’. Before the Equality Act, you might not have been able to get disability discrimination protection. Different discriminatory practises Covert abuse of power – this is a hidden use of power to discriminate. This can is when someone is being treated in a different way compared to others and not getting the same level of treatment. This can lead to jeopardising one’s health and well being Overt abuse of power – openly using power to discriminate. This will have similar results as with covert abuse of power but if the discriminated person realises their situation, they will be greatly affected and this will have a negative impact on their recovery and may even trigger mental health issues. Prejudice – this is an opinion or idea based on no real knowledge or experience of the truth. Will lead to suspecting and even hatred of another group of people. As a result of discriminatory actions of others individuals may develop physical or mental health problems. Stereotyping – a common, fixed and oversimplified view of a person/group of people. A generalisation and to describe or classify someone. For example, a racial or religious stereotype. (All Muslims are terrorist, as a minority of the followers did something silly, now all Muslims are judged bad due to what the minority has done). Bullying – is using power to intimidate another person. This comes in many forms such as cyber, physical, verbal etc. which all lead to distress and maybe even mental health. Depending on the age of the person that gets bullied it can really affect them. For example; several teenagers have committed suicide because of being bullied. Whereas, some adults may have had to leave their job as they were being bullied or abused. Infringement of rights is when we are not respecting an individual’s rights and not letting them practice their religion or culture. This may then lead an individual feeling devalued and unhappy, which can then affect their health. Scenarios 1. A health care visitor could be discriminative to someone due to them being a different religion and they may think that they will raise their children in a strange or a different way. This could lead them being discriminated and end up being reported, neglected and abused which in turn can cause depression and end in having low self esteem 2. A care profession is making the judgment that Mark is on drugs and doesn’t care about his health and his family so the doctor does not give him a fair  treatment. Now Mark might become reluctant to seek support and his condition worsen and affect his physical health even more as he did not receive the promised support from the health care center. In the worst case, Mark might end up dying. 3. Julia is a Gypsie traveler and she wants to register to a GP surgery service. As everyone is required to provide proof of address for first time registering, Julia is at a disadvantage because she’ll find it difficult to register (no constant address). This is an indirect discrimination against her group of race. Because of their characteristics of race, she and her group will be affected. This can lead to Julia not receiving the help and surgery care that she needed and now Julia can end up distressed as not knowing what to do and her condition may deteriorate. http://www.windowonwoking.org.uk/sites/wavs/wavs_services/hradvisoryservice/HRToolkit/ConInd/ConInd07 class worksheets (A.1 understand the importance of non-discriminatory practice in health and social care – discriminatory and non-discriminatory practice in health and social care) http://www.chaucer.ac.uk/ctsshared/HealthandSocial/Text%20Book%20Chapters/Unit%202/u2%20p34.pdf http://www.faculty.londondeanery.ac.uk/e-learning/diversity-equal-opportunities-and-human-rights/Diversity,%20equal%20opportunities%20and%20human%20rights.pdf http://www.google.co.uk/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&cad=rja&uact=8&ved=0CCQQFjAA&url=http%3A%2F%2Fwww.adviceguide.org.uk%2Findex%2Fequlity_act_2010_overview.pdf&ei=GaZ0VLDINcuqPNKwgYgH&usg=AFQjCNEpr1b2Fqj1-fOJf1Qql26xswNOlA www.nhs.uk

Case: Patients like me Essay

Patients like me(PLM) is a social network which covers different diseases. Members get access to a large database of information about other people who has the same illness as them selves. They also have access to forums, which lets them communicate with other patients as well. This enables patients to get information about their disease and gain new insight, the possibility to ask for practical advice, which doctors do not know about. Other reasons for becoming a member can be to contribute to research about their disease, to help other people with the same medical problems, sharing experiences and having someone to relate to and who knows what they are going through. The site thus covers human needs for both information and emotional support when handeling complex problems in pressing situations. Does the platform work for any diseases? In the short term the platform is most useful on diseases that have a lot of daily practical aspects to it. This is because this is where other patients can best contributing with advice. In the longer term medical companies can use the information to research new drugs. 2. What are the reactions of physicians to sites like PLM? Do you agree with them? Reactions for physicians are mainly issues of misinformation and for what purpose the information is used. When it comes to misinformation this is related to people self reporting on their illness and people without a medical degree voicing their unqualified opinion about drugs, other peoples symptoms ect. The statements on these pages can have consequences that unqualified person did not intend. When it comes to misinformation I have agree with the physicians. There are limitations to the data posted by the unqualified members of sites like PLM. On the other hand I am also of the opinion that even though the information is self-reported, it can be a valuable lead and provide information that is good enough for a particular use. This large amount of self reported information could also be a way to gain new insights that were previously unknown. 3. Should PLM launch the General Platform? If yes, how does it ensure that it is as successful in engaging patients as its current platform? If no, how does PLM grow? From a business standpoint, PLM should launch the General Platform. This creates a business opportunity to start the first communities for a lot of different illnesses that does not yet have a social network. The first mover advantage is very significant in social media and should be taken advantage of. There are a number of factors that make up a digital social network with engaged users. One of them is functionality and ease of use. This is very important so that the user experience is as enjoyable as possible and thereby barriers to usage are as low. Secondly, the content that is on the site needs to be of use for the members using it. This means that there should be some sort of moderation on the site. This is important since bad/abusive/misinforming users tend to crowd out the good/contributing users. If abusive users are allowed to still be active on the site can make potential members shy away from the site. This will seriously damage the PLM brand and profitability in the long run. By being aware of this and having prepared systems to handle this kind of problem the risk of this happening is limited. 4. So far, PLM has generated revenues by providing market research to pharmaceutical companies. Should it expand its business model to insurance companies and research institutions? Does it have the potential of becoming the â€Å"Bloomberg of medical data’? PLM has opened a large amount of data about different patients that would otherwise not be avaliable to third party institutions. This makes it possible for them to become a †Bloomberg of medical data†. It is without doubt that this can be a large business opportunity for PLM and the firms in need of medical information. If insurance companies could get better insight into how the populations health is, they could write more precise policies which better descibes the risk that patients are exposed to. If the risk is overstated, this means more expensive insurrance. This can lead to a loss of marketshare for the insurrance company and higher prices for consumers. Research institutions can get access to data that they might not have been able to get or would have cost a lot of money to gather. This would be a win-win situation for both PLM, the research institutions, insurance companies and patients.

Effect Of Inflation, Pro and Cons Of Inflation

This graph above show the inflation rate and gdp rate in Malaysia for the year 2005 until 2012. http://zaidzainuddin. wordpress. com/2012/12/14/the-effect-of-inflation-on-malaysias-economic-growth/ The effect of inflation on economic growth is debatable and can act as either a positive or a negative influence. Local and international researchers have conducted studies on the relationship of Malaysia’s inflation rate and economic growth. It can be concluded that over the past decades, there has been a general non-linear relationship between inflation rate and economic growth in Malaysia. However, in the long run inflation has a positive effect on Malaysia’s economic growth. This correlates with econometric study as they too reported a positive impact of inflation in the long run. Pro & Cons Of Inflation Inflation may have a positive effect in Malaysian economy. This is because deflation is very harmful, inflation enables adjustment of prices and wages and boost economy growth. The first advantage is deflation is very harmful. Deflation is a negative effect of inflation. For example, the Japanese economy has suffered lower growth because of deflation. When prices are falling people are reluctant to spend money because they are concerned that prices will be cheaper in the future, therefore, they keep delaying purchases. Second advantage is moderate inflation enables adjustment of prices and wages. It is argued a moderate rate of inflation makes it easier to adjust relative wages and prices. For example, it may be difficult to cut nominal wages (workers resent wage cut). But, if average prices are rising, it is easier to increase good workers’ wages more than unproductive workers. Third advantage is inflation can boost growth. At times of very low inflation the economy may be stuck in a recession. Arguably targeting a higher rate of inflation can enable a boost to growth. This view is controversial. Not all economists would support targeting a higher inflation rate. However, some would target higher inflation, if the economy was stuck in a prolonged recession. Inflation is considered to be a problem when the inflation rate rises above 2%. The higher the inflation, the more serious the problem it is. The first problem is inflation tends to discourage