Kurt Vonnegut, PTSD, and Slaughterhouse-Five Essay Example

Kurt Vonnegut, PTSD, and Slaughterhouse-Five Paper â€Å"Post-traumatic stress disorder (PTSD) is a mental health condition thats triggered by a terrifying event either experiencing it or witnessing it. Symptoms may include flashbacks, nightmares and severe anxiety, as well as uncontrollable thoughts about the event.† (Post-traumatic stress disorder (PTSD)). Kurt Vonnegut came home from WWII suffering from PTSD. He struggled to overcome the horrors that he saw and turned to a pastime of his writing in order to recover. Although it took him many years to write, Slaughterhouse 5 became an antiwar book that inspired people to protest to the Vietnam War. It is considered a literary masterpiece by some and the ramblings of a delusional man by others. However one looks at it, the fact remains that Vonnegut’s writing will continue to inspire new readers for years to come. Kurt Vonneguts experiences as a POW in Dresden and the horrible things he saw likely scared him for life, which is why his writing is incongruous and center ed around what he witnessed in WWII. Biography For Kurt Vonnegut reading and writing had always been a pleasure. Surprisingly, in college he majored in chemistry and biology, he believes this was good however, because there were no professors telling him what to write and what to read.The birth of Vonnegut’s writing style began to take shape when he entered WWII. Kurt was flunking many of his classes in Eastern University. Then the USA entered WWII and Kurt, a pacifist, saw an opportunity to get away: â€Å"I was flunking everything by the middle of my junior year,† he admitted. â€Å"I was delighted to join the army and go to war.† (Indiana Historical Society). At first he was rejected for health reasons, but was eventually accepted into the Specialized Training Program to study mechanical engineering. Shortly after Vonnegut was shipped overseas, he was captured, and sent to a POW camp in Dresden. We will write a custom essay sample on Kurt Vonnegut, PTSD, and Slaughterhouse-Five specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Kurt Vonnegut, PTSD, and Slaughterhouse-Five specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Kurt Vonnegut, PTSD, and Slaughterhouse-Five specifically for you FOR ONLY $16.38 $13.9/page Hire Writer

Use of Spanish Subjunctive With Impersonal Es Phrases

Use of Spanish Subjunctive With Impersonal Es Phrases Learning when to use the subjunctive mood in Spanish can be a challenge, so to help you get started, this lesson looks at a particular type of simple sentence, one that starts with Es adjective or noun que. The English equivalent is It is adjective or noun that, and the usage is common in both languages. These sentences provide a good introduction to the subjunctive for Spanish students because the verb mood depends on how the verb is used rather than requiring memorization of particular phrases. The general rule about the use of mood in Spanish requires that Es _____ que would be followed by a verb in the indicative mood if the initial phrase expresses certainty- but in the subjunctive, if it expresses doubt, uncertainty, desire, probability, or an emotional reaction. The phrase can be thought of as a trigger; some phrases trigger one mood, some phrases another. The following list is far from complete, but learning them should help give you a feel for which mood will be triggered by other phrases. In the examples below, the verbs triggered by the it is statement are in boldface. Note that the that in the English translations before the verb is optional, but the Spanish que is mandatory. Es ... Que Phrases Triggering the Subjunctive Examples of the subjunctive being used to express lack of certainty: Es probable que (It is likely that): Es probable que las temperaturas mà ­nimas se acerquen a los 20 grados bajo cero. (It is likely that the low temperatures will approach the minus 20s.)Es posible que (It is possible that): Es posible que un religioso sea deshonesto. (It is possible that a religious person be dishonest.)Es imposible que (Its impossible that): Es imposible que el mundo termine el 2021. (Its impossible that the world will end in 2021.)No es cierto que (It isnt certain that): No es cierto que la medicina inyectable cause cncer. (It is not certain that the injectable medicine causes cancer.)No es seguro que (It is not certain that): No es seguro que el cliente tenga capacidad para devolver el prà ©stamo. (It is not certain that the customer has the ability to pay off the loan.) Examples of the subjunctive being used in giving advice: Es importante que (It is important that): Es importante que comiences una dieta sana. (It is important that you begin a healthy diet.)Es aconsejable que (It is advisable that):  ¿A partir de quà © edad es aconsejable que un nià ±o tenga mà ³vil? (Beginning at what age is it advisable that a child has a cellphone?)Es necesario que (It is necessary that): Es necesario que todo cambie. It is necessary that everything change. (Note that in this instance and the following two, the English translation explicitly uses the subjunctive mood.)Es preciso que (It is necessary that): Es preciso que Amà ©rica Latina reduzca la pobreza. (It is necessary that Latin America reduce poverty.) Examples of the subjunctive being used in expressing personal reactions: Es (una) lstima que (Its a shame that):  ¡Es una lstima que no està ©s conmigo! (Its a shame that you arent with me!)Es bueno que (It is good that): Es bueno que tus clientes te sigan en Twitter. (It is good that your customers are following you on Twitter. Note that the statement following que is factually true; the subjunctive is used here because the sentence is an evaluation of that fact.) Es ... Que Phrases Triggering the Indicative The indicative is used in these examples because of the expression of certainty, even though that certainty may be an opinion rather than factual. Es cierto que (It is certain that): Es cierto que solo dos personas conocen la formula secreta. It is certain that only two people know the secret formula. Es obvio que (It is obvious that): Es obvio que Miley Cyrus es mà ºchisimo mejor que Selena Gà ³mez. It is obvious that Miley Cyrus is much better than Selena Gomez. Es seguro que (It is certain that): Es seguro que el cliente tiene capacidad para devolver el prà ©stamo. It is certain that the customer has the ability to pay off the loan. No es dudoso que (It is not doubtful that): No es dudoso que ests obligado a restituirla. It is not doubtful that you are obligated to pay her back. (In real-life speech, however, it is fairly common to use the subjunctive after no es dudoso, despite what the rules of grammar say, possibly because Es dudoso que is always followed by the subjunctive.) Es verdad que (it is true that):  ¿Es verdad que los elefantes temen a los ratones? Is it true that elephants are afraid of mice? Key Takeaways A Spanish sentence beginning with es ____ que (it is _____ that) can be followed by a verb in either the subjunctive or indicative mood.The indicative verb is triggered by es ____ que phrases that express certainty.Subjunctive verbs are triggered by es ____ que phrases that indicate uncertainty, give advice, or provide an emotional reaction.

INTERNATIONAL STUDIES IN BUSINESS Assignment Example | Topics and Well Written Essays - 500 words

INTERNATIONAL STUDIES IN BUSINESS - Assignment Example However, the industrialization is an imperative need for England if the government is interested into fulfilling the basics of the country’s population. Taylor guided the managers to promote sameness and integrative objective setting in the organizations. The idea needed the companies to get highly trodden in order to facilitate effective communication. The SMEs have a smaller setup as compared to other larger forms of the organizational structures and therefore, they can provide the perfect venue for the execution Taylor’s philosophy towards organizational culture and structure. The main idea behind International Labor Organization’s definition of child labor is to give children an opportunity to experience growth, nourishment and development before becoming an active part of the workforce. The areas upon which the definition emphasizes are age, safety of children who work and it is strictly against the work that is taken without making appropriate compensation to the less-aged workers. Child labor does not encompass everything that is done by the children and ILO allows organizations to hire youngsters to do the jobs which do not strain them significantly. The current business, entrepreneurial and corporate mindset is looking to minimize the cost of production and they look to save each and every penny at their disposable. The child labor is the cheapest workforce available and the companies always seek cheap labor and therefore, businesses in all parts of the world are hiring children to do their dirty work. However, the developing economies and emergent nations have gotten the worst condition in this regard because of their poor legal infrastructure and framework. Nevertheless, the organizations such as UNO and WTO have to play their due roles in terms of causing the companies to implement modern labor laws until than they remain a set of dream-words. Additionally, the humanistic values are required to

Private Companies and Correctional Institutions Essay

Private Companies and Correctional Institutions - Essay Example This is not the case if things are handled in a proper manner when there is an all-out understanding that the private companies would follow the state’s dictum. The correctional institutions if set up under the realms of a private company, should be closely watched over by the state because this could mean problems of a magnanimous nature if the private companies prison individuals with which they have their own respective enmities and rifts. Having such jails would be tantamount to bringing in anarchic situations within the private companies and indeed the society at large, as there are problems that need to be understood before drafting in the correctional institutions (Cecil, 2010). What is even more significant is the fact that these correctional institutions should always be monitored regularly because this is the need of the hour. As far as the role of the private companies is concerned, the correctional institutions would always have to be bringing in the value for the sake of the society because the governmental believes in the same philosophy and it is only natural to think of it as such within the private companies. The private companies must comprehend that having correctional institutions is indeed a sensitive issue, and one that demands a great deal of vigilance and responsibility. The consequences of any weaknesses on the part of these private companies could have far reaching ramifications and the role of the top management within such private companies is one of essence. Administering such sensitive functions should only be carried about if the private companies believe in their strengths, and then only undertake such efforts to have correctional institutions within their fore. ... If these private companies believe that they can set up such correctional institutions and take care of the administration affairs at a later stage, this is asking for trouble. The state must not allow such private companies to undertake measures of correcting individuals who have committed a crime or have been labeled as offenders. The need is to carry out all the actions and tasks in a very honest way because the greater good of the society is at stake, and thus the private companies should always be certain that they will be at their best under such situations. What is even more interesting is the fact that the dangerous functions are understood properly by the private companies before these think of venturing into such domains. If they do not have any idea of the gravity of the tasks that they are getting into, it is in their best interest to keep away from the same, and concentrate on their core business areas. Works Cited Cecil, Dawn. Televised Images of Jail: Lessons in Contro lling the Unruly. Sociology of Crime Law and Deviance, 14,

Finance Problem Solving Assignment Example | Topics and Well Written Essays - 1000 words

Finance Problem Solving - Assignment Example Therefore, Amber has a net working capital of $200 and a current ratio of 1.20. This indicates that the company will be able to pay any short term obligations that arise unexpectedly due to some investment in the working capital. On the other hand, Barbie has no current assets, but has $600 worth of current liabilities. Therefore, Amber has a net working capital of negative $600 and a weak current ratio. This indicates that the company will not be able to pay any short term obligations that arise unexpectedly due to no investments in the working capital. Amber Barbie Current Assets $1,200 $0 Current Liabilities $1,000 $600 Net Working Capital $200 ($600) Current Ratio 1.20 0.00 Therefore, it is important for a corporation to invest some of its funds in the financing of the working capital. A company must be able to pay its creditor when payment becomes dues, and possess ample inventory and cash to ensure the smooth functioning of the company. Question 4 A firm achieves optimal level of working capital only when the constituents of the working capital achieve optimal position. The company must have a favorable level of inventory determined by the economic order quantity. It must work upon optimal lead times that ensure no shortfall and no excess inventory at any point in time. This will ensure minimum costs association with the inventory handling. Likewise, the company must forecast future cash inflows and outflows, risk tolerance and borrowing capability to ensure an optimal cash level. An excess surplus must be invested in short term securities, whereas a shortage must be immediately handled with an overdraft with the bank. Similarly, the company could determine its advantageous day’s sales outstanding which will allow it to make an effective policy toward the management of its receivables. (Brigham and Gapenski 1988) Question 6 The matching principle of the working capital financing states that the non-current assets and permanent current assets must b e financed by long term debt; whereas fluctuating current assets must be financed by short term debt. (Brigham and Gapenski 1988) For instance: A retail store balance sheet shows inventory, cash, account receivable and fixed assets. At any point in time, this store has a minimum amount of all current assets which becomes a part of the permanent current assets. Therefore, according to this matching principle, these permanent current assets and fixed assets are to be financed by long term debt. There is low cost associated with this technique as most of the assets are finance low interest long term debt. Likewise, it results in a higher profitability as interest expense is low in this strategy. It also provides the company with more liquidity and a better current ratio. (Brigham and Gapenski 1988) Problem 17-3 Company A Company B Current Assets $1,400 $960 Current Liabilities $900 $600 Net Working Capital $500 $360 Current Ratio 1.56 1.60 Company A appears to be more liquid as compare d to company B. This is because it has a higher net working capital. Even though company A has slightly lower current ratio, it holds more of its assets in the liquid form. Problem 17-6 a. Working Capital = $160 b. Net Working Capital = Current Assets – Current Liabilities Net Working Capital = $160 - $170 Net Working Capital = ($10) c. The company is following a very aggressive approach to working capital financing. This is indicated by a low net working capital; which shows that all of the current assets –

A Case Study of Change: Obesity

A Case Study of Change: Obesity Obesity in primary care has become an increasingly common problem. Like any other medical condition overweight and obese patients should have access to appropriate treatment and care using a delicate, understanding and non-judgemental approach. Weight loss in primary care is of interest for the purposes of improving a persons quality of life. During the study the author will explore the prevalence of obesity using the geographical trust region with a population of 158,000 (Office of National Statistics (ONS) 2007) in comparison with the town centre based practice where the author works as a trainee nurse practitioner. The practice has a mixed socioeconomic, predominately (95.53%) White British population of 15, 186 (Annual Public Health Report 2008). Local authority with in which the author works has been ranked as 49th most deprived out of the 354 local authorities in England in 2007 in the Index of Multiple Deprivation 2007 (IMD 2007). Although obesity is increasing at the same rat e in all social classes, the prevalence of obesity is higher in lower socio-economic groups, particularly in women (Henderson and Gregory 2002). The National Institute for Health and Clinical Excellence (NICE) developed guidelines on identifying and treating obesity in 2006 following on from the Scottish Intercollegiate Guidelines Network (SIGN 1996), this in turn along with Primary care service Framework 2007 has lead to Health Care Professionals looking at ways to gain the background knowledge, provide and implement a service to deliver integrated obesity management enabling patients to change their eating and activity habits and motivate obese individuals to lose weight, maintain weight lose and increase fitness in accordance with the White paper (2004). It is also thought that additional training in behavioural counselling maybe vital when assessing a patients readiness to accept change (Drummond 2000). Individuals who are not emotionally ready to tackle the issue of lifestyle changes are more likely to fail. Dealing with obesity in the practice setting can be achieved by setting up specific lifestyle clinics dedicated to offering support and advice to patients who wish to lose weight or maintain a healthier lifestyle looking specifically at behaviour change. This clinic can run alongside or in conjunction with existing chronic disease and routine Health check clinics with self referral or healthcare professional referal. By helping the patient look at how unhealthy behaviours can be an element of their lifestyle and daily choices (see table 1) it is possible to suggest ways in which to change in a mutually agreed plan of care. Awareness and knowledge of what change is required and why, are fundamental first steps in enabling change to occur. Motivation is an essential part of nearly everything we do. Regular reviews can provide motivation and change behaviour through incentives and penalties. Personal factors, such as individuals self motivation, drive and desire to improve their appearance and health are also important. Target and objectives can influence how much people want to change but their priorities and commitments may also obstruct their ability to change. Change to clinical practice can only be successful if the reasons for introducing the change are clear, compatible with current practice and ideas and the process is planned carefully in advance (Davis1999). Change theories share common factors. To ascertain behavioural change, according to these theories, patients need the desire to make a change, have the ability to make the change, believe that they will have a better quality of life if they make the change, believe that the change is right for them, and discover how and when to make changes. Obesity management needs an integrated approach involving a multi-disciplinary team of Healthcare Professionals. General Practice is an ideal starting point to influence and initiate management strategies. Healthcare professionals need better training and access to management programmes that include dietary advice, physical activity and behavioural change if they are to initiate the policy effectively. For the programme to succeed the patient needs to be the central component. Obesity does not lend itself to the classical medical model where the condition is diagnosed, treatment prescribed and then the professional responsible for the outcome. It is ultimately the patient who is in control over their decision to proceed and succeed. Weight lose/maintenance is not easy for obese/overweight patients, many of whom have already tried and failed in controlling their weight. It is the role of the primary care team to support and encourage weight management and lifestyle change. In an attem pt to achieve these changes in behaviour management are vital. Eating and physical activity are human behaviours which can be modified even though they are predisposed by a complicated set of factors. If in practice the overweight/obese patient was identified and advised of the fact, they simply wouldnt care. Consultation with the patient and establishing if they recognise they have a weight problem using a sensitive and respectful manner is the first essential step to change. It is then possible to produce a plan of action involving providing information and eliciting the patients views about their weight as well as details about their weight history and any previous attempts at weight loss. The early stages of consultation are about building a rapport with the patient through active listening. Communications skills are essential to implement a behavioural approach effectively (NICE 2007). Professionals should also have the ability to express consideration, build self-belief and provide clear, structured and relevant information. Raising the issue of lifestyle changes can be extremely difficult to talk about as the patient may feel uncomfortable and they may feel responsible. This could have a negative effect on the patient-professional relationship (Drummond 2000). As a professional it can be maintained that we have a duty of care to discuss the importance of a behavioural approach in managing obesity and its practical application in helping overweight patients achieve and maintain behavioural changes. Pearson 2003 suggests that ‘linking weight to a current health concern is often an appropriate way to introduce weight management issues. Advice should be individualised to condition and patient. By providing the patient with the appropriate information to help them make informed decisions about their health behaviour is part of the professional role. By individualising programmes to assist/support patients in changing their lifestyle for good can give them the incentive to lose some weight or prevent further weight gain. There is always the risk at this point that the patient will abandon the change process altogether. Behaviour change theory examines the difference between models of behaviour and theories of change (Darnton 2008). Models of behaviour identify us with specific behaviours, by pointing out the underlying factors which influence them. By contrast, theories of change illustrate behaviour change over time. The theories are complementary to each other; understanding both is essential in order to improve successful advances in behaviour change. Numerous models can be incorporated together to assist in understanding the reasons for our behaviour and how they interrelate but also help us work out the relationships between the reasons to allow us to envisage the behavioural outcomes. Tim Jackson writes ‘models reveal factors where policy can work (Jackson 2005). Models essentially recommend a feature menu for policy makers to choose from making no one model the perfect model but giving the policy maker choice and flexibility to use several different models. Social-psychologist Kurt Lewins Change Theory (1951) involves group work to change habitual behaviours, using an unfreezing, restructure, refreezing guide in which habitual behaviours (attitudes, values and behaviours) are studied by the group and reorganised, before being reintegrated back into everyday routines (Coghlan and Brannick, 2003; Coghlan and Claus, 2005; Lewin, 1951). Lewins work on change has provided the basis for many later advances in change theories (Lewin 1951). Lewins change theory will be the basic model for the proposed change in practice. Lewins early research entailed changing the patterns of diet in America and is therefore particularly relevant to issues, such as obesity, that we face today. Lewin concluded ‘that we are likely to modify our own behaviour when we participate in problem analysis and solution and more likely to carry out decisions we helped to make (Lewin 1951). Unfreezing is a reflective process that involves unlearning without removing own uniqueness and difficult relearning and restructuring of thoughts, awareness, beliefs and way of thinking. In the planning process of change this critical starting point for change can be overlooked. Three pre-conditions simultaneously need to be satisfied for current patterns of behaviour to unfreeze. Firstly ‘disconfirming information which involves disproving a theory. Secondly Lewin (1951) suggested creating ‘guilt or survival anxiety, getting patients to accept behaviour is incorrect but this destructs self-esteem and identity. The third pre-condition was that disconfirming information could also create what he termed ‘learning anxiety. This creates a sense of weakness, a feeling that change cant be initiated due to being unable to learn quickly enough to enable a move into a new situation and adapting inadequately often looks more acceptable than risking failure in the learning pr ocess. Overcoming learning anxiety is probably the hardest and most critical element in unfreezing. Unfreezing is the most significant and complicated part of any change process, and also the most difficult to achieve as self-esteem and identity securely control people. Yet achieving this is not the end but a gateway to the next level Lewins (1951) next stage, ‘restructuring, also had three elements beginning with reorganising thinking. He called this ‘cognitive redefinition and it is at the heart of much of todays ‘systemic thinking (Senge 1990). Albert Einstein quoted ‘the significant problems we have cannot be solved at the same level of thinking with which we created them. It is therefore essential to meet and communicate with others to look at the same problem in different ways. Lewin (1951) then suggested ‘managed learning. ‘Imitation or identification is the simplest way of learning in this situation. Learning by copying those we respect and trust. This process is very evident today in standard setting and peer-based learning. Lewin (1951) suggested learning in this way to be shallow and superficial; seen as an easy alternative in a difficult situation as it is a case of doing what has been advised without really understanding the implications of why it is being done. Kurt Lewin (1951) therefore favoured a different means of learning that he called ‘scanning. This meant seeking alternative sources of information including reading, travel and conversation with people from different backgrounds in order to obtain an accurate understanding of your own situation and adapt accordingly. The problem he saw with peer approaches was that if nobody had research a subject in detail data was incomplete. And if the new behaviour isnt correct for the behaviour and understanding of the learner then it becomes ‘disconfirming. The final element of Lewins model (1951) is ‘refreezing: making things stick. What he found was that working with ‘gatekeepers, collectively, through ‘scanning rather than ‘identification creates change that sticks and becomes eventually refrozen into the new norm. Lewin offers a basis for change within an ever changing environment. Health Belief Model Janz and Becker 1984 was influenced by Kurt Lewins theories (1951) which state that perceptions of reality, rather than objective reality, influence behaviour. For an obese patient to perceive the effects their weight has on their lifestyle they need to be able to admit they have a weight problem. The stages of change model Prochaska and Diclemente 1984 describes change as a process, broken down into a series of stages through which individuals progress, dependent on the degree of interest in the desired outcome of the individual. The concept of change is that the patient considers the consequences of actions for changing behaviour, what their desired outcome is and which results in a contract to make change. Changing habits happens gradually and often people will need to go through stages of the cycle many times before they achieve lasting change. Gottlieb 2004 suggested that the stages of change model conceived that everyone is on a journey of change, beginning with limited knowledge and progressing through numerous stages to achieve change. ‘Societal models are also important to those developing policies and change as often it is necessary to work on the background factors limiting behavioural options directly. Enabling change is not just about changing a persons perception of these material factors (e.g. cost). The Main Determinants of Health model (Dahlgren and Whitehead 1991) needs to be incorporated into obesity management and is a good ‘Societal model. The model shows the individuals behaviour as one element, beneath four other ‘tiers of influencing factors including social and economic factors, cultural factors, environmental factors and also the services that are available locally. Since Lewins field theory (1951), theoretical approaches to change have recommended developing theory through practice. Piloting and evaluation, followed by figuring learning back in, are the final stages in a process of intervention development which can be characterised as learning through doing. Guidance on policy development needs to be clear; however, it must also be flexible to different frameworks. Evaluation of any policy is undoubtedly important. Obesity as we have seen is measured in many different ways. Evaluations should measure change in the intended behaviour among the consultation group, as well as the effect on the key influencing factors. Process evaluation concentrates on how a program is put into practice rather than the outcome. It asks how services are delivered, differences between the intended population and the population served, how programmes are accessed and managed. It aims to provide an explanation of how or why proposed outcomes of the project were (or were not) met. Information from process evaluations can be used to decide future action, looking at whether a program should be abandon and a new plan of action devised , revise the current program (or components of it) to improve delivery, or how best to deliver it. This type of evaluation may also provide understanding about a programmes cultural, socio-political, legal and economic contexts that affect i mplementation Impact evaluation measures overall achievements; it is interested with the direct result of a program when it is finished. It should include a way of measuring unintended effects of a program, as well as the individuals targeted by the programme. Outcome Evaluation measures program goals and is concerned with longer term benefits of the program among the targeted population, and by how much. Monitoring of outcome is useful and necessary to determine whether outcomes were achieved within a specified timescale (Health Promotion, 2002), whereas evaluation attributes the changes observed to the intervention tested The models and theories used to underpin the intervention may then be reassessed in the framework of the target behaviour, and understanding of the behaviour itself assist in progression to the closing phase of the cycle in which learning from the evaluation is fed back into the policy process. As part of the evaluation process, the appropriateness of the behavioural models used in the intervention should be assessed. Evaluation findings should update the development of the intervention itself and future interventions in similar policy areas. Audit is a technique that can be used to monitor then maintain or improve the quality of care and services provided. It is the method used ‘to assess, evaluate and improve the care of patients in a systematic way, to enhance their health and quality of life (Irvine 1991) Structural audits are undertaken in relation to what resources there are available, suitability and access to the clinics, access to continued support either 1:1, self-help, buddying up with others, web based support or group and also the staff available to run the clinic looking at skill mix. Process audits focus on what was done to a patient, where clinical protocols and guidelines followed and did they work in practice. The audit may look at how an individual or the team operate, looking at waiting times from referral, patient recall for review, management plans, record keeping, communication between the patient and staff. Outcome audits relate to the impact of the team or services provided on the patient. This could be achieved through patient satisfaction questionnaires provided at the start of the intervention, part way through and on reaching target. Has there been an impact on their lifestyle and if so was this a positive experience or has it had a negative effect on their lives. Clinical audit gives valuable insight into how effective a service is being provided by systematically collecting and analysing data on current practice. This allows the lifestyle team to become involved in assessing the effectiveness of their interventions. Clinical audit can help identify areas of behaviour and management which meet required standards, identify area which could be improved, promote changes in problem areas, improve quality of patient care, develop Healthcare Professional skills, give direction for the most effective use of resources and evaluating how successfully changes have been implemented. Audit is also an important part of clinical governance, there to encourage the continual monitoring and improvement of healthcare services. When designing an audit many factors need to be considered (see table 2) A fixed date of 6 months would be agreed from the start for the collection of data and interpretation of the results initially but then audit would continue as long as needed to provide information to continue improving the service. Cost effectiveness also needs to be evaluated. Cost-effective analysis compares the cost-benefit ratio for one intervention against an alternative intervention. Benefits maybe expressed as patient-orientated health outcomes such as quality of life. The economic impact of lifestyle change maybe assessed in terms of direct costs, indirect costs and intangible costs. Direct costs arise from the use of health care resources and if the direct cost of providing treatment is lower than the direct cost of illness, the treatment is cost-saving for the health care system. Indirect costs look at the cost of illness to the economy. The broader costs to society and the economy from weight problems already cost the wider economy in the region of  £16 billion, and is set to rise to  £50 billion per year by 2050 if left unchecked (Department of Health 2009). Intangible costs are monetary values attached to the physical or psychological effects of illness, such as joint and back pain, breathlessness, varicose veins and gallbladder problems. Obesity is estimated to cost the National Health Service approximately  £4.2 billion (Department of Health 2009). Simple activities like getting around can be problematic for an obese individual (Drummond 2000). Quality of life for an obese person is thought to be less than optimal and this can lead to psychological problems. Intangible costs of illness maybe compared with the intangible costs of treatment, such as surgery.

Intellectual Property, Copyright, Authorship, and Individuality in Music and Print Culture :: Intellectual Property Copyright Authorship

Intellectual Property, Copyright, Authorship, and Individuality in Music and Print Culture When the alphabet was invented, spoken epics could be converted into an abstract representation - writing. The experience of the spoken epic poem could be transformed into written format. Although books can be read aloud and therefore retain some similarity to the communal nature of the oral tradition, books can also be read silently in solitude, emphasizing the individual reader. Among the many functions that Roger Chartier has attributed to the figure of the author is not only the role of creator to the content, but also to appropriate ownership of that creation to whomever owns the property rights to that content (36). Copyright law protects the specific manifestations of ideas and facts, but not those ideas and facts themselves. When commemoration was no longer used to experience memory, individual authors came to be recognized as readers became less participatory in the process of getting meaning from the work. The author as creator became an individual who gave meanin g to an audience fragmented by the ability of the written word to separate its readers from one another. The author serves as a meeting point for individual readers to receive meaning, whereas in pre-literate times, this meaning would have been constructed by a the entire group in the immediacy of the performance. In terms of property ownership, one parallel in music was the development of an agreed upon system of notes, scales, and representations of musical sounds and timings. This musical alphabet was necessary to write down scores of music, whether the ancient Egyptian's "music of the spheres" or Beethoven's Ninth Symphony. It serves to organize noise into a format that is accepted as the creation of a musician. As Albert Borgmann writes, "The identity and integrity of a piece of music can be underwritten by a score only if there is a complete and authoritative score" (94). This means that a written account of a performed piece is only equal in validity to the performed piece if some amount of authority is granted the former. The composer/author of the piece serves as the source of this authority. However, if there is no score, the identity and integrity of the piece must lie in its performance. In this case, it is the performers of the actual song that constitute it's integrity, an d this has implications that undermine the functions of the author.