Discuss factors and attitudes influencing eating behaviour Essay

There are many factors and attitudes, which can have a major influence over an individual’s eating behaviour, such as mood, cultural factors or even their parents. Mood can have a major influence over an individual’s eating behaviour. It has been suggested that someone who over eats or under eats, may be suffering from Depression, and they use their eating behaviour as a way of masking their negative mood. It has also been shown that being in a low mood state can result in the desire to eat sweet or starchy foods. This is said to be because carbohydrates help the manufacture of serotonin (neurotransmitter associated with mood). Consuming high carb foods can also be used as a way of self-medicating an individual’s low mood. Verplanken et al (2005) conducted a correlational analysis on mood, impulse buying and the consumption of snacks. In this study, it was found that those with low self-esteem were more likely to impulse buy and consume snacks. It could be said that this is their way of coping with the emotional distress caused by low-self esteem. Therefore supporting the idea that an individual’s mood can influence their eating behaviour. However, as this was a correlational study, cause and effect can not be established. It may be that impulse buying causes a lowered mood. Social Learning Theory places emphasis on the impact that observing other people (i. e. our peers) has on our personal attitudes and behaviour. Our eating behaviours and attitudes to food, can be down to observing the behaviour of our parents. Parental attitudes towards food inevitably affect children because they control the food bought and served in the household. However, research has also shown an association between parents’ and children’s attitudes towards food generally. For example, Brown and Ogden (2004), reported consistent correlations between parents and their children, in terms of snack food intake, eating motivations and also body dissatisfaction. Our attitudes and eating behaviour can also be effected by influences from our peers. A study supporting this theory was conducted by Meyer and Gast (2008) who surveyed 10-12 year old girls and boys, and found a significant positive correlation between peer influence an disordered eating. The ‘likeability’ of peers was considered the most important factor in this relationship. One criticism of the Social Learning Theory is that it focuses solely on learning eating behaviours through observation of others. It fails to take into account biological and evolutionary factors which can also have a major influence over our attitudes towards food and our eating behaviours. Another factor which can have an influence over an individuals eating behaviour, is cultural influences. Research carried out by Bally and Kenardy, examined the eating habits of women in Australia, they specifically focussed on a group aged between 18 to 23. From this study, they found that the longer the women spent in Australia, the more likely they were to alter their attitudes towards eating in a similar way to women born in Australia. This is known as ‘acculturation’. This research strongly suggests that eating behaviour is learnt and is therefore linked to the behavioural model. However, similar to the Social Learning Theory, this fails to take into account biological reasons for eating habits or why some disorders such as Anorexia, can be heredity. As well as this, the research can also be said to be reductionist as it was only set in Australia therefore, the results can not be generalised to the wider population. Also, another criticism of this study, is that it is gender biased, as it only looked at women, rather than looking at the eating behaviours of both sexes. Further studies linked to this imply that, body dissatisfaction is a characteristic of white women rather than black/asian women. However, evidence from Mumford et al goes against this. Mumford et al found that bulimia was more common amongst Asian school girls than their white counterparts. This therefore questions whether the ethnicity of an individual plays a role in our eating behaviour.

Bacterial Transformation Lab Report Essay

Backround: The plasmid pGLO contains an antibiotic-resistance gene, ampR, and the GFP gene is regulated by the control region of the ara operon. Ampicillin is an antibiotic that kills E. coli, so if E. coli, so if E. coli cells contain the ampicillin-resistance gene, the cells can survive exposure to ampicillin since the ampicillin-resistance gene encodes an enzyme that inactivates the antibiotic. Thus, transformed E. coli cells containing ampicillin-resistance plasmids can easily be selected simply growing the bacteria in the presence of ampicillin-only the transformed cells survive. The ara control region regulates GFP expression by the addition of arabinose, so the GFP gene can be turned on and off by including or omitting arabinose from the culture medium. Purpose: The purpose of this lab was to understand bacterial transformation, how it occurs, and to make DNA glow. Hypothesis: If the transformed E. coli is mixed with the ampicillin resistance gene, it will be able to grow in the ampicillin plates, but the non-transformed E.coli will not. Materials: Two microcentrifuge tubes 500 uL of ice cold 0.05 CaCl2 E. coli bacteria A sterile plastic loop A sterile P-20 micropipette 10 uL of pAMP solution A timer Ice A water bath 500 uL of Luria broth A spreading rod Four plates Incubator Procedure: Day before lab 1. Streak E. coli host cells for isolation. 2. Prepare six source plates. Day of lab 1. Get two microcentrifuge tubes, which should each contain 200 uL of cold CaCl2 solution. Label one tube with your initials and a (+) and the other tube with your initials and a (-). 2. Transfer 2-4 large colonies using a sterile plastic loop to each microcentrifuge tube and completely resuspend. Do not transfer any agar. Put the tip of the loop into the CaCl2 solution and spin until there is not any cells on the loop. 3. Close each of the tubes and put them in ice. 4. Ask your teacher to use a P-20 micropipette to add pGLO DNA to your transformation mix. 5. Add pGLO DNA to the (+) labeled microcentrifuge tube. 6. Incubate both microcentrifuge tubes on ice for fifteen minutes. 7. Take both tubes out of ice and immediately place in incubator at 42Ù ¥C for 90 seconds. 8. After place both tubes back in the ice for two minutes. 9. Add 200uL Luria Recovery Broth to both microcentrifuge tubes. 10. Let both the tubes rest at room temperature for 10 minutes. 11. During the 10 minutes, get the LB agar and LB+AMP agar plates ready. Mark your plates with the transformation tube mixture to use (+ or -), the lab group names, and the date on the top of the dishes. 12. Add 100ul of the pGLO transformation cell mixture to the center of the agar surface of the corresponding LB agar and LB+AMP plates. 13. Use a sterile plastic loop to distribute the cell suspension evenly on the plate by â€Å"skating† the loop back and forth across the LB agar plate several times. 14. Use the same loop and technique to spread the same cell suspension (+) on the LB+AMP agar plates. Dispose of the sterile loop in a beaker of germicide. 15. Repeat the procedure by spreading the (-) transformation cell mixture to each of the (-) labeled LB and LB+AMP plates. Be sure to use a fresh plastic loop for the ‘None’ transformation mix. 16. Stack your group’s set of plates on top of one another and tape them together. The plates should be left upright position to allow the cell suspension to be absorbed by the agar. 17. Place the plates in an inverted position (agar side on top) in a 37Ù ¥C bacterial incubation oven for overnight incubation (15-20 hrs.). Day after lab 1. Lower the lighting in the room and use a long wave U.V. light to visualize the transformed cells that will glow due to the expression of the green or blue fluorescent proteins. Data: LB+ (Positive Control) LB- (Positive Control) LB/AMP+ (Experimental) LB/AMP- (Experimental) Bacterial Growth lawn lawn 3 colonies No growth Conclusions: The bacteria treated with the pAMP solution developed a resistance to ampicillin and were able to grow on the ampicillin plate. Those that were not treated with the pAMP were not able to grow on this medium. The plates with no ampicillin served as a control to show how the bacteria would look  in normal conditions. Transformation is never fully effective, Only cells that are competent enough are able to take up the foreign DNA. Therefore, the ampicillin+ plates showed less growth that the control plate. Questions: 1. Record your observations about the color and growth (number of colonies) of bacteria on the Petri plates. If you have so much bacterial growth that you can’t count individual colonies, this is referred to as â€Å"lawn.† LB+ (Positive Control) LB- (Positive Control) LB/AMP+ (Experimental) LB/AMP- (Experimental) Bacterial Growth lawn lawn 3 colonies no growth 2. Calculate the transformation efficiency of your transformation experiments. Transformation efficiency refers to the number of cells transformed per microgram (ug) of DNA. The transformation efficiency of my transformation experiments is 0.0125 cells transformed per microgram (ug) of DNA.

Punk music paper Research Example | Topics and Well Written Essays - 2250 words

Punk music - Research Paper Example Background of Punk music The word â€Å"Punk† was first realized in the 1970’s. Punk music was majorly related to Punk rock which also developed during the same period. In addition to that, Punk rock music was more of a â€Å"garage† kind of music since most of the artists who indulged in punk music sang from their garages. The 70’s punk rock music had a number of previous influences. First, due to the fact that most of the punk rock artists incorporated garage rock characteristics; punk music was highly influenced by garage rock. As a result, garage rock became one of the influencers of punk music. Secondly, genres such as proto punk, pub rock, glam rock, surf rock and ska had a very huge influence to the origins of punk rock. For example, proto punk was very much common in the 1960’s. Some of the bands which propagated this style of music were the Velvet Underground, MC5 and the Stooges. Whereas single artists included Lou Reed, David Bowie, Captain Beefheart and Iggy Pop. It is important to note that the mentioned bands as well as the individual artists promoted and encouraged the emergence of punk rock bands such as the New York Dolls, the Dictators (â€Å"Proto punk†, 2013), the Ramones and the Sex Pistols (â€Å"History of Punk Rock†, n.d). Garage rock was also a major influencer to punk music. This style of music was prevalent in the 1960‘s; however, at that time it was closely related to rock and roll. Additionally, it was characterised by garage performances – that is, the artists used to practice and perform in their garages. Some of the notable garage rock bands then included the likes of the Aardvarks, the Actioneers, the Angry, the Bad Boys, the Cobras only to mention a few. The culture that developed out of punk music was the â€Å"Punk culture†. The Punk culture had a variety of distinctive characteristics that were mostly based on their ideologies, looks and clothing. It is without doubt that the individuals who were already down for the Punk culture could be determined very easily without any hustles. To start with, this style was music was unique in its own way. It was characterised by fast musical beats, the use of instruments especially bass drums and electric guitars, the songs were in themselves shorter and the y were advocating and/ or portraying a message – that is, the lyrics were quite direct. For example, the Clash was a punk rock band from the UK and they had hit songs such as: â€Å"Career Opportunities† and â€Å"Right to Work†. Both of these songs were portraying messages of work opportunities for the youth. Due to the fact that the lyrics related to this music genre had a meaning behind them, a lot of people were attracted to it especially the youth. Through that appreciation, the punk culture evolved to greater heights in the 70’s. There were a number of intriguing and distinctive attributes related to the punk culture and their followers and/ or fans. The first feature was in their looks; secondly, their clothing was also quite distinctive as it included the likes of t-shirts, fitting pants, leather jackets, leather boots and other accessories; thirdly, a large number of the fans were anti – authoritarian – that is, they had their own i deologies with regard to a number of society issues. Apparently, United Kingdom had the highest prevalence of the punk culture followed by United States and Australia. Punk music goes way back into the 1960’s were the existing music genres were the likes of garage rock, proto punk, pub rock, glam rock, surf rock and ska. As a result, some of the performers of punk rock included the likes of the Ramones from USA, specifically New York City, the Sex Pistols and the Clash who were from UK, specifically London. The composers of punk rock were mostly the artists. This is because they were the ones who were projecting the message to the public. However, the works of Marty Munsch were also remarkable as he worked with a variety of punk rock artists. One of the bands that he

Business change Management Essay Example | Topics and Well Written Essays - 3000 words

Business change Management - Essay Example Organizational change is a term generally used for an extensive change within the organization where companies try to change, implement or also reengineer their processes. In most cases, organizational change tends to be radical and can lead to reorientation of the business. Any change within an organization is generally based on external factors that impact them and form the driving force. Since organizational changes are very deep-seated stakeholders of the company also tend to be impacted. This paper aims at discussing the changes management strategies that can be adopted by Huanghe Technology to overcome the issues that are being faced within the organization. The paper will provide an overview of the current issues, followed by a detailed discussion of the proposed solution and the possible challenges. Current Issues: The rapid expansion of the business has led the company to develop and work as three different and independent units. Although Huanghe Technology has very effectiv ely implemented latest technologies and has also seen intense growth, the lack of clear support for the customers. Since each of the three business units have grown independently and behave as separate entities with different cultures, there has been a lot of information loss. Huanghe Technology is currently being faced with issues like lack of proper customer support, lacking technical support and also numerous call drops between the customer care and sales teams. Hence it is crucial that the company implements a change plan to help develop an organized and effective approach to resolve this issue. The main focus of the change plan is on the customers and their needs. Huanghe Technology currently has its customer service office in UK and the company currently plans to reorganize this by keeping all of the Customer Service Department activities for the Huanghe UK office under the supervision of a new head. This can cause two main issues, i) resistance from the employees, ii) another independent unit to deal with customer service. Hence these are the main issues that the company currently needs to focus on while developing the change management program. Also, in the case of the SOHO customers, the company has set down two different channels to meet the needs of these customers. The first is where the company caters to the need directly and second where the products is sold by retailers like Tesco. In the retail channel, the technical aspects are dealt with by the company directly. However there is a major gap that has been found here and it is clear that the SOHO customers are not getting adequate technical support from the company. Proposal for New Customer Service Department Customer Relationship Management (CRM) plays an essential role in every business and holds an enormous importance in today’s competitive world. CRM is a business strategy that has been built around the notion of being customer-centric (Evans, O’Maley, & Patterson, 2004). The main aims are to have optimum revenue by better customer satisfaction through improved

Organization and Management of a Health Care Facility Research Paper

Organization and Management of a Health Care Facility - Research Paper Example Under the chief of operating officer and the chief of financial officer is their various administrative staff that is considered the subordinates in the health care facility and the lowest in the organizational structure. Under the chief of medical staff is various departmental heads in charge of the different health related departments. They include the head of surgery, head of trauma, head of palliative care and head of pediatrics. Under each of these departmental heads are the staffs which include the nurses and physicians (Daniels and Ramey, 2005). The Chief Executive Officer is the hospital head in charge of all the staff in the hospital. He is also the administrative head who liaises with various chief heads to find the way forward for the health care facility. He receives advice from the rest of the chiefs and heads of departments and then makes the final decisions. He also gives authorization of budgets, people to hire and fire as well as other types of authorizations. He is the chair of the disciplinary committee which is composed of all chiefs and heads of departments (Garber, Gross and Slonim, 2010). The chief information management officer is in charge of the staffing issues in the hospital. His role is similar to that of a human resource manager and legal officer all combined in one concerned with all staffing affairs from hiring to firing and other staffing issues that may arise in the health care facility. He is also in charge of tracking of the professional certificates, tracking and handling any legal issue in the facility as well as provides monthly reports to the chief executive officer on the general functioning of the hospital (Dewan, Luo and Lorenzi, 2010). The chief financial officer is in charge of all the financial details and records in the health care facility starting from budgets, preparing and disbursing salaries and wages, handling payments from patients and purchase of

An examination of employee perception of womens adoption of Essay - 1

An examination of employee perception of womens adoption of stereotypically male leadership styles in traditionally male dominated organisational positions in the 21st century - Essay Example Other studies have been done, but the root cause of the problem in Arabian countries is yet to be identified. This research proposal thus will examine a myriad of factors that hinder the progress of women towards CEO positions in traditionally male dominated organizational positions even in the 21st Century. Womens unequal status has been contributed by various factors such as their absence from managerial and leadership positions. A lack of cultural consensus probably plays the most basic role in determining the lengths at which women can stretch their ambition and this vacuum is itself part of the problem and as it is, as a social concern to development in the 21st century. Corporate management and organizational leadership has been a domain of men. Statics in various organizations have shown that the number of men in leadership and management is far much above that of women (Stephan 145). However, the difference in number of women and men in leadership varies from country to country depending on a countries culture, religion, and population demographics among other factors (Kottke, Janet and Mark 191). A conglomeration of committees, consultancies, commissions, conferences etc have been assembled over the last few decades in an attempt to address womens underrepresentation in positions of power. However, it is still remains a dispiriting distance in the quest for providing solutions to this problem (Gary and Laura, 25). Case in point, Arabian countries have fewer women in corporate management and organizational leadership. This has been caused by a variety of factors that will be investigated by this research. Previous studies have been done, but the root cause of the problem in Arabian countries is yet to be identified. This research will employ different methodologies such as questionnaires and interviews in order to come up with the relevant data to answer the research questions. From a theoretical perspective, this research paper criticizes

MHE503 Survey of Emergency and Disaster Mgt Module 4 Case Essay

MHE503 Survey of Emergency and Disaster Mgt Module 4 Case - Essay Example The evacuation of such huge population would have been a task nearest to impossible, but it was the availability of aircrafts in the U.S military base which escorted the locals safely. The Clark Air Force Base offered its services to the response team of Volcano Disaster Assistance Program; the team was fully engaged towards the monitoring of the volcano. The team was able to install certain instrumentation for the purpose of seismic monitoring; the intent of this exercise was to determine the occurrence of earthquakes and conduct the mapping of the volcanic deposits. The monitoring equipments assisted the team to realise that "large eruption was imminent". Soon after this confirmation, the evacuation scheme was pursued. It was the monitoring equipments which assisted the geologists in determination of the actual threat. From the incident of Mount Pinatubo eruption, it has been confirmed that the importance of monitoring equipments is immense, and the timely application of these moni toring equipments can assist in the estimation of challenge, and its extent (Goodwin, 2002). The technological advancement is the key to safe and secure future (Murphy, 1989). The presence of the American military base offered U.S. Geological Department to conduct its activities without further diplomatic intervention, and the timely intervention with application of the latest gadgets secured the future of hundreds of thousands. The American military was able to mobilize its hardware to secure locations, and damage worth millions of dollars was prevented. From geological aspect, any geological catastrophic is never spontaneous. The geological upset occurs when certain activities between the layers of the Earth take momentum; these activities are steady, and accelerate when porosity on the earth layer exists. The installation of the monitoring equipments - which in actual determines the nature and momentum of activities occurring inside the earth layer, assists the government and non-governmental organizations to develop evacuation plan to prevent major loss to humanity (Blair, 2001). At international forum of USGS Cascades Volcano Observatory, it was confirmed that economically it is not possible to install the monitoring system near all the volcanoes. The focus was towards the development of portable monitoring instruments that "could be quickly deployed to a reawakening volcano"; through installation of such system the critical parameters including "earthquakes, ground deformation, mudflows, and volcanic gas emissions" can be traced and recorded (Blair, 2001). The Volcano Disaster Assistance Program - VDAP was established to offer assistance to all the countries where volcanic eruption was a challenge, under this program the mobile team of VDAP will offer services for monitoring, will assist in the determination of actual challenge, and will "provide timely information and analysis to emergency managers and public officials". This institution is also committed towards training, and conduct exercises and workshops for evacuation team squad etc. Perry has identified three important activities which shall be practiced and executed internationally to avert humanitarian crisis due to volcanic eruptions. The identification areas for improvement include, 1. public education 2. access controls 3. evacuation systems (Perry, 2005) These three measures are important under social management technique to avoid

Budgeting in Health Care Organizations Essay Example | Topics and Well Written Essays - 750 words

Budgeting in Health Care Organizations - Essay Example There are numerous other types of budgets such as annual statistics budget and revenue budget and they vary according to their purposes (Gapenski). These budgets can vary across different health care institutions. The reason for this is the diversity of the financial structures, organizational culture and reporting systems of organizations (Finkler and McHugh, 2008, p.171). The process by which health care organizations design and implement budget based on such organizational structure, culture and reporting system determines whether they will achieve budgeted operating margin targets. This is demonstrated in the experience of University of Utah Hospitals and Clinics (UUHC). It was found that the institution's personnel are not knowledgeable on budgeting and finance and that there is no organizational mechanism or aspect of the organizational culture that encourage the education of the staff. As a result, expenses always exceed the budget and what is worse, the extra expenditures are found to be unnecessary (Clark, 2005, p.79). Budgeting, or correct budgeting, is important because it supports the operation of the health care organization. ... lth care institutions and it needs budgeting in order to maintain positive performance and deal with problems, such as "shrinking revenues and rising expenses" (Schwieters and Harper, p.76). The benefit of budgeting is aligned with the importance of cost information. As managers and hospital personnel are informed about budgeting and cost, a sound operating budgeting process can finally be implemented in order to achieve financial health. This point was explained by the intervention introduced at UUHC in 2004 to improve budgeting results. The organization pursued an aggressive education drive for its staff about budget and finance, "offering incentives to stay within budgets, holding budget variance meetings with managers, and requesting corrective action plans from managers". The result was improved budgeting performance. The intervention model highlighted by the case of UUHC included an important tool in budgeting: variance analysis. It is a method that focuses on comparisons of ac tual results and budgeted expectations for each line in the budget of each cost center in the health care organization (Finkler, Ward and Baker, 2007, p.200). The flexible budgeting variance analysis is one of its types that is widely used in health care organizations. The methodology follows a framework of gathering information the comprehensively cover the composition of departmental expenses. This could lead UUHC, for instance, to subdivide total variance (the difference between standard prices and quantities and actual prices and quantities) into three: price, quantity and volume (Baker, 1998, p.128). Baker explained these three in detail: Price variance pertains to the proportion of the overall variance caused by the differences between actual and expected price input; Quantity

Do you have to believe in Reason to believe in Democracy Essay

Do you have to believe in Reason to believe in Democracy - Essay Example 42). Therefore, an individual is able to make logic, justify his or her actions and have personal beliefs. This is based on the information that is existent. Philosophy considers reason as rational (Swanson 35). Therefore, cognition, intellect and thinking are part of the reason. Arguably, reason leads to actions or habits that are a person’s thinking. Consequently, one can judge a situation just or unjust, good or bad (Copp et al. 48). In summary, reason and democracy are two different aspects but with a connection yet cannot be said to be tightly linked. Democracy has its connection to rights and freedom to do what one desires. However, freedom and rights come with responsibilities according to democracy (Swanson 55). Consequently, people in democratic nations have the freedom to speech, live, assemble and do other things in accordance with the highest rule of law. Additionally, democracy is also a human right because it gives citizens the free will to carry on their mandate s. Moreover, democracy also protects the basic rights of people. Therefore, democracy is a principle mandate that most governments try to uphold. In summary, democracy is all about the rights and freedom of people. A government that is democratic has power but is accountable to the public. However, this accountability raises concerns because the government should respond to the voice of the citizens (Swanson 63). Consequently, forms of democracy that exist are direct and representative democracy (Held 80). Direct democracy means citizens can actively and directly participate the making of decisions within the government. On the other hand, there is a representative democracy where a set body has sovereignty of power (Held 80). These forms are to help in the representation of the people. Interestingly, this form of modern democracy is common today. In summary, democracy can be either direct or representative but still represents the will of the people. The sole principle in democracy is the equity and freedom of the people. This means that every citizen is equal before the law and the legislative process (Copp et al. 52). Therefore, every person is equal to the other. However, upward control, social norms and political equity are the fundamental principles (Copp et al. 54). As a result, the government reflects equality through these principles. Therefore, democracy allows citizens to be fully part in the life of the society. Democracy often characterizes the majority rule. As a result, the minorities within the government have the tyranny of the majority (Held 197). This is when the protection of a group or individual rights protection. On the other hand, democracy entails elections, which mainly are competitive. Additionally, democratic elections allow people their freedom of speech, political expression and press (Held 201). The citizens are eligible since they serve the interest of the people. In summary, democracy in the modern world entails the majority ru le and their tyranny as they enhance the freedom of the people. Reason is a substance that makes a judgment of a person’s behavior. It helps in arguments since it creates the sense of logic (Manktelow 15). Therefore, attitudes, institutions and traditions play a role in the creation of reason. Moreover, reason is associates with freedom and determinism. According to scientists, the cognition enhances reason in the

Human history Essay Example for Free

Human history Essay Human history has witnessed numerous examples of wars. Our history has taught us that wars are unique by nature. Different philosophers at different times were trying to generate solid philosophical understandings of what war and strategy were. As a result, we possess sufficient theoretical basis for discussing the philosophical foundations of war, yet we have not been able to predict our military failures. After the end of WWII the world has finally taken a deep breath, and people were confident that violence would never enter their lives again. However, we are still surrounded by constant risks of war, and continue witnessing the acts of violence, and murders. Certainly, contemporary wars are completely different from those at the beginning of the 20th century: the development of the new weaponry types and communication technologies, have turned the simplest military actions into highly sophisticated acts. The war in Iraq has critically impacted the military balance in the world, and it is interesting to see, how Iraqi war would be explained through the prism of various philosophic works. Clausewitz: On War Carl von Clausewitz has written a well grounded research on the philosophy of war. His theoretical assumptions make it possible to distinguish philosophic implications of military actions. Having evaluated what war is, Clausewitz was able to create a general structure of war, and I think that his ideas are easily applied to the issues of the war in Iraq. â€Å"War is nothing but a duel on an extreme scale. If we would conceive as a unit the countless number of duels which make up a war, we shall do so best by supposing to ourselves two wrestlers. Each strives by physical force to compel the other to submit his will to his will: each endeavours to throw his adversary, and thus render him incapable of further resistance† (Clausewitz 1989, p. 4). Although, this Clausewitz’ definition is very objective, grounded, and universally applicable (any war implies the fight of several opponents for power), there are some amendments which should be made in terms of war in Iraq. It is difficult to admit, but it is true, that the war in Iraq is nothing more than the fight for power: Clausewitz does not distinguish whether this might be economic, social, or military power, or some other different aspect of political superiority. Clausewitz risks applying limited perspectives to discussing what war is. In the fight between the two wrestlers, only one of them initially seeks superiority. As a result, at the initial stage of war, only one of the opponents fights for power and superiority. Clausewitz supports this line stating that â€Å"two motives lead men to war: instinctive hostility and hostile intention. In our definition of war, we have chosen as its characteristic the latter of these elements, because it is the most general†. Has the U. S. started the war in Iraq with hostile intentions? Probably, it has. Many of us argue the fact that the U. S. military actions in Iraq were primarily aimed at promoting democracy in the country. To be objective, hardly any democracy can survive in the whirl of blood, murders, terrorist acts and violence caused by military actions. However, in the fight between Iraq and the U. S. Clausewitz seems to have neglected one essential stage of developing military actions: the first stage is the military intervention, and it hardly looks as the fight of the two wrestlers. On the contrary, its image is similar to unexpected blow on the side of the opponent to which another wrestler cannot stand and falls. The situation described by Clausewitz is actually the next stage of war. Iraq required certain period of time to gather it strength and to enter the war as an equal. At the stage when we started to receive the reports on murders and terrorist acts against American soldiers, one could suggest that the war has turned into the discussed fight. However, in this fight one of the opponents was trying to prove his superiority, while the other tried his best to defend the integrity of his physical territory and peace in the country. We cannot but agree with Clausewitz that war is never an isolated act, and it is never a separated single military blow. â€Å"War does not spring up suddenly, it does not spread to the full in a moment; each of the two opponents can, therefore, form an opinion of the other, in a great measure, from what he is and what he does, instead of judging of him according to what he, strictly speaking, should be or should do† (Clausewitz 1989, 5) The war in Iraq had long prehistory. The United States were continuously trying to defend their position in this military conflict. It was evident that the war was inevitable. As a result it is difficult to argue the position of Clausewitz. Actually, the work of Clausewitz seems to be very close to what we currently witness in Iraq. Of course, we do not know much as none of us has fortunately participated in this campaign. All we have at our disposal are news reports and other secondary information, but this secondary information allows analyzing the events in Iraq from the viewpoints of several philosophers. Clausewitz creates a philosophic picture of war. He implies that war does not change its face, and the structure of military actions and interactions remains unchanged, no matter at what historical period of our development a war may occur. This does not really matter, whether we use nuclear weapons or fight in the open sea – the war is always the utmost use of force, which does not break out of sudden, and which is the means of proving one’s superiority. Jablonski: Roots of Strategy In his work, David Jablonski has evaluated the works of the four theorists, as applied to military actions and military strategies. It is surprising, that Jablonski was able to avoid bias in his discussion. It is even more surprising, that the works of philosophers written at the beginning of the 20th century seem to have predicted the exact course of events during the war in Iraq. This, on the one hand, continues the line found in the work of Clausewitz: the essence of military actions remains unchanged through the centuries. On the other hand, Jablonski’s selection helps us understand WHY the U. S. was involved into the war in Iraq, and has actually initiated it. â€Å"In the United States our people have been slow to realize the changed conditions. Isolated as we have been from possible enemies, the people could see little chance for aggression by others. Separated as we are from Europe by the Atlantic, and from Asia by the Pacific which form most certain and tremendously strong defensive barriers, we seemed to be protected by the design of the Almighty. [†¦] The vulnerability of the whole country to aircraft as distinguished from the old conditions that obtained when the frontiers or the coast had to be penetrated before an invasion of the country could be made, has greatly interested the people of the nation† (Jablonski 1999, 452) What facts do we have in the war against Iraq? First, the U. S. has for long been isolated from others’ aggression. Even during WWII the U. S. was not directly involved into military actions. The terrorist acts of 2001 have been a tremendous shocking therapy to the whole American nation. The continuous isolation from the direct aggression has made the U. S. senseless towards possible military and terrorist threats. The image of the almighty nation was rather exaggerated, and the events of 9/11 have proved this assumption. The terrorist attacks had to attract the attention of the U. S. to its vulnerability and to eliminate the discussed senselessness, but the country has misinterpreted these events. The senselessness has turned into aggression against the states which were suspected in promoting terrorism (Iraq is in the top list of such ‘promoters’). As far as the United States has not experienced any acts of continuous aggression, which it could not stand, it has not fully realized the continuous effects of military actions brought into Iraqi land. In the introduction to his book, David Jablonski puts emphases on the most critical elements of war. â€Å"Modern military forces normally work in an environment in which the major dilemma is that of properly matching continuity and change. [†¦] the core attribute to such thinking is to imagine the future as it may be when it becomes the past – a thing of complex continuity. † Thus, planning continuity and looking at military actions through the prism of the past is the crucial element in making this strategy reasonable and justified. What are continuous impacts that the U. S. has caused onto the Iraqi population? These are economic defeat, and the need to restore all social and political structures of the country. It is still unclear whether the U. S. was able to promote democratic ideals in Iraq, but it is evident that it has failed to apply the principles of â€Å"continuity through the past† to planning the Iraqi military strategy. Jablonski states that the significance of the theoretical works he discussed in his book is in that they are presented in a structured manner, and can be easily understood and applied in practice. It seems that both the U. S. in its war in Iraq, and the terrorists in their 9/11 attacks have applied the principles discussed by Jablonski: â€Å"sometimes implicitly, more often explicitly, they created images of how aerial destruction of ‘vital centers’, could bring a nation to its knees. After all, there were the examples of mass panic on the home fronts and mutiny in the trenches during the recent war. † Similar to Clausewitz, who creates parallels between military actions and wrestling, Jablonski also underlines the importance of the sudden effect. Consequentially, we come to understanding an interesting military controversy: military campaigns cannot be sudden, but the â€Å"sudden effect† of aerial or other destruction often determines the success of the planned military campaign. These two elements are integral to the U. S. intervention to Iraq, too. Liddell-Hart: Strategy There are the two crucial elements which make Liddell-Hart’s view applicable to the war in Iraq: first, the author extensively researches the historical implications of specific military actions, and second, he does not expand his research to broader notions, but is rather concentrated on the ‘cause-effect’ research. His book is in many instances similar to that of Clausewitz. This is why the author is initially biased. In both works the reader meets identical philosophical parallels: â€Å"To move along the line of natural expectation consolidates the opponent’s balance and thus increases his resisting power. In war, as in wrestling, the attempt to throw the opponent without loosening his foothold and upsetting the balance results in self-exhaustion, increasing in disproportionate ration to the effective strain upon him. Success by such method only becomes possible through an immense margin of superior strength in some form – and, even so, tends to lose decisiveness. † (Liddell-Hart 1991, 5) In this citation, we find many elements which have already been found in other philosophical works: loosening foothold may be paralleled to the sudden aerial attacks, while moving along the line of natural expectation is similar to complying with the principles of continuity and thorough planning. Simultaneously, it is difficult to apply this statement to the military actions in Iraq. If the U. S. used Liddell-Hart’s philosophical implications in developing its strategy in Iraq, it would never apply the means of sudden attack against the Iraqi nation. People in Iraq would not know what means being bombed. As a result, the U. S. would risk losing its powerful positions. The philosophic perspective created by Liddell-Hart is hardly applicable to the war in Iraq or to any other military campaign in contemporary world. In addition, when Liddell-Hart speaks about morale in war, he represents its too idealistic image: the violence of American soldiers against Iraqi people eliminates any possibility to link morale to the war in Iraq. Niccolo Machiavelli: The Prince â€Å"A prince ought to have no other aim or thought, nor select anything else for his study, than war and its rules and discipline; for this is the sole art that belongs to him who rules, and it is of such force that it not only upholds those who are born princes, but it often enables men to rise from a private station to that rank. † This is another aspect of the war in Iraq, described in the terms of Niccolo Machiavelli’s â€Å"The Prince†. As Hitler used the war to prove his superiority and to create the nation of Aryans, the U. S. seems to be in constant need to prove its superiority to other nations. Several recent decades have turned into the years of constant fight, in which the U. S. always positioned itself as the leading and powerful nation: Vietnam, Afghanistan, Kuwait, Yugoslavia, and finally, Iraq; who is going to be the next? Machiavelli makes special emphasis on the importance for the prince to understand and to possess the art of war: â€Å"a prince who does not understand the art of war, over and above other misfortunes already mentioned, cannot be respected by his soldiers, nor can he rely on them. † (Machiavelli, 2006) The best information and intelligence resources have been employed to develop a sound military strategy towards Iraq, yet the U. S. was not able to display a skilful approach towards Iraqi intervention. Numerous deaths of the American soldiers and their inability to find common language with the native population, whom they had to protect, suggest that the United States did not possess any sound military skills. Expectation of easy victory usually leads to easy failure. The war in Iraq has displayed the U. S. inability to analyze the world military history, about which Machiavelli speaks. The author refers to the importance for the prince to study the actions of illustrious men and to see how they behaved themselves during war. Being powerful does not mean being non-educated; being powerful means being skillful, reasonable, and objective. Military failures in Vietnam and Yugoslavia have not taught the U. S. any meaningful lessons. In distinction from Clausewitz, Liddell-Hart, and Jablonski, Machiavelli did not apply any historical perspectives to evaluating military strategies, but he was wise enough to emphasize the importance of historical lessons, and of the ability to properly evaluate these lessons. Peter Paret: Makers of Modern Strategy While Clausewitz applied the painting parallels to researching war, Paret has performed a profound research of several philosophic writings related to the topic of war. All authors he discussed in his book sought to answer several crucial questions: whether it was possible to evaluate war, whether it was a viable tool of foreign policy, and how ethical war was. Paret’s views are directly connected with the understanding of nuclear threats as applied to military strategies. Paret’s book is actually the selection of the major philosophic works and their evaluation. It seems that modern philosophers try to distance themselves from creating their own ideas about war, but prefer analyzing the ideas of others as applied to contemporary political and military environment. In the introduction to his book, Paret writes that â€Å"strategy is the use of armed force to achieve the military objectives and, by extension, the political purpose of the war. To those engaged in the direction and conduct of war, strategy has often appeared more simply, in Moltke’s phrase, as a system of expedients† Thus, war is initially the conjunction of political and military ideas. The war in Iraq is also the combination of political and military aims, but which of them prevails? In his book, Paret often cannot make a case. He states that Machiavelli lived during the time when warfare was unregulated and thus the relevance of his assumptions could decrease. However, who says that our warfare is regulated? Paret suggests that while Clausewitz supported the idea of war to be limited in time, goals, and strategies, there was no place to global military campaigns. Does this mean that local military conflicts similar to those in Iraq cannot expand beyond the geographical borders of the Iraqi nation? They can, and the conflict in Iraq has already stretched itself across the world. The war in Iraq has already turned into the political fight between the two opposing political camps, and the perspective of the global war has never been so close since the end of WWII. This is why it is difficult to understand the aim of Paret’s analysis. For the aims of objective military research, one should rather read the original works of philosophers, than their subjective interpretations made by contemporary authors. Sun Tzu: The Art of War â€Å"Whoever is first in the field and awaits the coming of the enemy, will be fresh for the fight; whoever is second in the field and has to hasten to battle will arrive exhausted. Therefore the clever combatant imposes his will on the enemy, but does not allow the enemy’s will to be imposed on him. [†¦] If we do not wish to fight, we can prevent the enemy from engaging us even though the lines of our encampment be merely traced out on the ground. All we need do is to throw something odd and unaccountable in his way† (Sun Tzu 1971, 24) The ideas of war produced by Sun Tzu, partially seem as odd as the instruments he offers to use if one does not want to fight. On the one hand, being first to the field also implies using ‘sudden’ tactics. On the other hand, what odd instruments could Iraqi people use to openly claim their desire not to start war with the U. S.? One should not repeat its tactics which had been successful earlier, but it should be regulated according to the constantly changing military environments. Moreover, using the tactics which has already proved to be a failure is a guaranteed double failure. The U. S. has not taken into account numerous important elements of an effective military strategy: being sudden does not always mean being successful. Aerial attacks make people fall to their knees, but do not break them completely. The U. S. develops a sound strategy of removing its military from the Iraqi territory. The aim is to turn retreat into a victory, which is virtually impossible. Until the U. S. is able to re-evaluate its defeats and tactics in previous military campaigns, it will have to be prepared to new military failures. Conclusion I think that each of the analyzed philosophers has something to say about the war in Iraq. Each of them discussed interesting elements of military strategy which could be applied to Iraqi military campaigns. Although certain views are limited, some risk being biased, and some cannot make the case at all, all of them deserve attention at least for having researched the question which we will hardly ever answer: What is War? It is never stable, it is always changeable, it always has a different face, and sometimes we even fail to recognize it from the start. One thing is evident: no matter how difficult a war can be, no excuses can justify our inability to fight well. BIBLIOGRAPHY Clausewitz, C. On War. Princeton: Princeton University Press, 1989. Jablonski, D. Roots of Strategy. Book 4. Merchanicsburg: Stackpole Books, 1999. Liddel-Hart, Basil H. Strategy: Second Revised Edition. New York: Meridian Books, 1991. Machiavelli, N. The Prince. The Project Gutenberg, 2006. Available from http://www. gutenberg. org/files/1232/1232-h/1232-h. htm Paret, P. , G. A. Craig F. Gilbert. Makers of Modern Strategy: From Machiavelli to the Nuclear Age. Princeton: Princeton University Press, 1986. Sun Tzu. The Art of War. Translated by Samueal B. Griffith. Oxford: Oxford University Press, 1971.

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.

A Brief History of Aesthetics Essay -- essays papers

A Brief History of Aesthetics Aesthetics is the theoretical study of the arts and related types of behavior and experience. It is traditionally regarded as a branch of philosophy, concerned with the understanding of beauty and its manifestations in art and nature. However, in the latter 20th century there developed a tendency to treat it as an independent science, concerned with investigating the phenomena of art and its place in human life. Yet, what in a field with a hazy line in between being classified as a science or study of beliefs is considered data for determining what can be studied? It can simply be drawn to the only three things involved in the process of art : The creator, the person experiencing, and the art itself. Now this leads us to understand what exactly, is art. studies all the typical â€Å"arts†. This includes music, literature, theatre, dance, film, as well as painting, sculpture, and architecture. This directs the student towards a very broad field. For example, architecture may involve the Sistine Chapel, considered one of the world’s most loved works of art. However, it may also include the landscaping in a small town square. So then, art is defined as something that deals with both the â€Å"useful† and â€Å"fine† arts, insofar as they appeal to aesthetic taste, or as long as they are created with the specific intent to cause a reaction, whether it be positive or negative. Some disagreement about the proper definition of survives from the conflict of rival schools of thought in philosophy and art criticism during the 18th ad 19th centuries, when first achieved recognition as a distinct field of knowledge and examination. The turning point which influenced most scholars to believe that leaned toward the sciences, rather than towards philosophy began with Immanuel Kant’s Critique of Aesthetic Judgment. The approach to beauty and art became more metaphysical and transcendental. A leader in the renewed attempt of art as science was Hippolyte Taine, who proposed that styles of art should be studied in the same way as plants are studied by botanists, and are subject to the same evolutionary development. At the same time in Germany, the name Kunstwissenschaft was applied to the historical writings of Semper, Fiedler, Burckhardt, and Riegl. In their writings, they strove for neutrality in comparative analysis i... ...took place. Through , an area of its own had been set aside for man’s artistic creativity. Now independence turned into domination, and the tendency towards differentiation gave way to desire for total inclusiveness. Art, after liberating itself from service under alien powers, (namely the repression of artists and their art, or the lack of education in the arts) aspired in its turn to embrace life in its entirety. In everything, there is art, and in art, there is everything. Or so it was in German romantic thought. Throughout the history of , which is arguably the length of time held within the universe, not much has been distorted. Art, along with is an incredibly difficult subject to comprehend, due to the varying nature of themes, opinions, and judgments. Not to cite all the societies, time periods, ethnicities, age and gender biased opinions. It is neither a science, nor a philosophy. It is both. within itself is a beauty, which will forever perplex the minds of the world. Art, placed in the neighborhood of philosophy and science reveals its innate inclination, (although undefined) to forever intrigue and perplex both the scientific and philosophical minds.

Essay --

The wedding Industry in the United States is massive, with an expenditure of over 80 billion dollars in the 2 million plus wedding ceremonies that take place across the nation annually. Some of the amount is spent on one-off payments like location, dà ©cor and costumes, but a large portion is directed towards increasing the wealth of wedding planners. While the wedding planner salary is considerable, the job demands grit and determination, since these professionals have to learn to cope with the wild expectations of people who want them to deliver the greatest day of their life. The work pays off, but what most people don’t know is that a top wedding planner salary in NYC can reach well over $120,000 per year. Considering that most people hope to be married only once, they are willing to spend as much as it takes to ensure that they realize their dream wedding. This translates to a high demand for wedding planners, which gives them the luxury to quote their own price. Wedding Planner Job description salary A wedding planner job description requires tact, creativity, organizational skills and communications skills, which enable them to inspire, support and advice the couple while planning for a seamless series of events that culminate in an extraordinary day for both family and friends. So, what factors affect the wedding planner salary range? 1. Experience in the wedding industry According to the United States Bureau of Labor Statistics (BLS), the average wedding planner salary is about $50,000 per annum, though the figure tends to increase with experience in the industry. For instance, wedding planners or professional event planners that have been in the wedding industry for more than five years have obvious... ...the coordinator will make more money. Boston wedding planners are claimed to make the highest salaries, usually in excess of $100,000. 6. Size of the business Another factor that influences wedding planner earnings is the size of the business. Your ability to comprehend the economic aspects and save money on expenses, budgeting and accounting will increase your demand and earnings. If there are multiple events on a weekend and you can only cater for one, then it means that your earning potential is inhibited. Top earners supplement their income by keeping a large inventory of wedding merchandize to hire to their clients. The type of services that you offer, between full-service planning and design and partial services, impacts your earnings. For a higher wedding planner salary package, strive to grow your business and provide all inclusive planning services.

The Role of Women in Literature Essay -- Thousand and One Nights, The

The Role of Women in The Thousand and One Nights, The Ramayana of Valmiki and The Medea Throughout most of the assigned readings in this class, women are portrayed as clever, ruthless, and deceitful individuals that are willing to do whatever it takes in order to get what they desire. With careful calculation and timing they are able to manipulate others into doing things their way and have favor in their eyes. Sometimes they use their craftiness for good and other times for evil, whatever reason they have for such action usually impacting the story and its characters immensely. In The Thousand and One Nights tale, the deceitfulness of women impacts the story from the beginning to the end. Every good and bad thing that occurred in the tale did because of the act of women. It was the deceitfulness of women that caused King Shahrayar to lose all his trust for women, and vowed to have nothing to do with them for more than a night. However, it was that same deceitfulness that changed his viewed of women and has him see that all hope is not lost; there are some that are still loyal and honest. This quote is an important piece in the story because it changed the way King Shahrayar and his brother viewed women. It was the moment that they both realize that all women are disloyal, crafty, and deceitful and therefore can never be trusted. In addition, it also exemplifies the treacheries and craftiness of women and how they can greatly influence others, especially men. After King Shahrayar discovered that his wife and his concubines have been deceiving him, by having him think that they are honest and loyal to him, he loses all his trust and respect for women. He was so heartbroken and confused; he could not understand how such ... ...t the same time it is fair to say that there are few that try to be deceitful in a good way, meaning their intension are good and will use it for a good cause. For example, Shahrazad, deceive the king by telling him a new tale just before dawn each day because she was trying to save her life and that of many more women that would have been killed had she not been successful. Her cunningness was for a good deed, a deed that not only changed the king himself but his brother as well. He, Shahzaman, hearing about the good act that had happen to his brother, king Shahrayar, decided to stop his practice too and try to have a relationship again, in hopes that it would be different. One could say that it is sometimes a good thing that women have the ability to deceive others, especially in times of trouble and at other time they are better off without their deceitfulness.

Professional Development Opportunities Essay

NAYCE (National Association for the Education of Young Children) – http://www.naeyc.org NAYCE is a vast among the Early Childhood Education. The programs feed knowledgeable information to Early Childhood teachers. Teachers can become a member and go to many Expos and Conference to meet other teachers and program directors. NAYCE also have educational books online for teachers to develop more learning into their classroom and curriculum. CAT (Creative Art Team)- http://www.creativeartsteam.org/professional-development/professional-development/early-childhood-professional-development-initiativ The CAT website provides an Early Childhood Professional Development Initiative workshop for mentoring teachers. The schools who wish to participate for the workshop will have five days of in-services for students, in class mentoring and coaching with four teachers, on site staff development and second-five hour’s professional development with CAT. The workshop is free for all teachers who are interested to join. Collaborative for Children- www.collabforchildren.org/training-child-care-providers The Collaborative for Children is a learning development for teachers in the surrounding Houston area and online for all Early Childhood teachers. The professional development programs offer Early Childhood Training Courses with the cost of $12.00. The Collaborative is part of Texas Agrilife Extension Service, an educational agency of the Texas A&M System. New York Early Childhood Professional Development Institute- http://www.earlychildhoodnyc.org/ New York Early Childhood Professional Development Institute offers many programs to benefit new awareness in New York City. The Institute offers on site coaching, professional development, and technical assistance also CDA programs for aspiring childcare workers. These programs are working with parents and teachers to develop healthy and learning children. Early Learning Leaders- http://www.earlylearningleaders.org/?page=Professional The website contains Early Care Professional Training and Education for child care administrators. The program enriches childcare directors into learning and developing new programs into their childcare program home base. There are weekly webinars and sessions for each learning development.

Impact of Social Network on the Language Essay

The impact of social network in language English to teenagers Nowadays, social network is very popular especially to teenagers. It makes communication faster and more convenient. Examples for social networks are facebook, twitter, MSN, Xanga and so on. People communicate through languages, and there are good and bad impacts on language English that caused by social networks. I will explain my views in my presentation later on. First of all I would like to talk about the good impacts first. Teenagers tend to have more chance to communicate in English through using social networks. It is because typing or texting in English is much more easier and faster than in Chinese. Therefore, teenagers prefer to type in English. And that will definitely improve their writing and reading skill when they get more chance to communicate in English. Moreover, due to the problem that some teenagers are not confident enough to talk in English, so that communicate more in English through social media will not only develop teenager’s writing and reading skill it will also make teenagers have more confident to talk to people face to face in English when they have developed skills. However, there are still some bad impacts. Some people might claim that chatting through social networks or online might reduce teenager’s ability to write. It is because teenagers might develop some short forms when communicating through social network. For example, they prefer using letter c, u and tmr to represents see you tomorrow, or use letter b and number 4 to represents the word before. I agree that the use of those short forms is really convenient and can communicate faster, but if teenagers used to communicate by those short forms, and they might accidentally use it in their school works or other formal writings, which is not acceptable. In addition, some teenagers think that using those short forms to communicate are a symbol of â€Å"young generation† and its cool which makes them prefer to use those short forms to communicate rather than the old and formal one. Lastly, after talking about both good and bad impacts of social networks to language English of teenagers, we can see that, to have bad or good impact is depend on the teenagers. It is because there are both good and bad consequences, when teenagers communicate through social networks it will improve their ability of writing and reading. However, if they rely or used to communicate in the way they communicate through social networks it will then reduce the ability of writing formal works. Therefore, teenagers should learn to balance the use of social network and try not to cause bad consequences.

Music, Race, and Nation

Peter Wade’s Music, Race, and Nation is a book that takes a long look at something that the author clearly has a passion for. Not only does Wade have a clear and honest passion for the cultures of South America, but it is clear through his writing that Wade has spent plenty of time researching the things that he writes about. In the book, Wade’s primary goal is to shed a fun and interesting light on the cultural dances which are such a part of the culture in places like Colombia. After reading the work, it would seem foolish for anyone to argue that Wade did not achieve his stated objectives, as he clearly hits the mark with both his message and the overall presentation of that message to the reader. The basic themes presented in this book are a bit heavier than one might expect when they pick it up, but after reading, one can clearly understand why they were included. In Colombia, the music is a huge part of the cultural fabric there. In a nation that has long been dominated by white people and their overbearing culture, a mostly African dance takes hold and becomes a staple of the country. In order to truly understand the social dynamic that exists in Colombia, one has to understand the interesting dynamic presented with the relationship between the music and the people who enjoy it. Wade seems to understand the importance of this theme and because of his understanding; he does everything within his power to impart that knowledge to those who read the book. The presentation of this theme is somewhat different when compared to other works, but in the context of his objectives, the presentation certainly works. Before Wade gets started with the deeper and more complicated themes in his book, he makes sure that the reader has a strong grasp on the history of the subject at hand. Because the majority of people reading his book do not have a firm understanding of the basic pretenses on which it was written, Wade had to give those readers a crash course, or else they would be lost. In this regard, he succeeds beautifully. The organizational tactics used in this work give the reader a chance, while other books with similar themes might preclude those people who do not already have a basic understanding of Colombian culture. From that history, Wade does not just jump to his next theme. As any good author would, he builds upon the history that he has established in order to show how the music and dancing is interwoven into the country’s history. This is a very interesting way to present a thesis to readers and in this case, it is an effective means to the stated end. In this work, Peter Wade sticks to the point and never deviates from that. This is a fine line to walk when it comes to presenting a book with some history involved. Authors want to include enough information so that their readers can understand, but they do not want to include so much information that the readers feel like they are taking another history class. Wade walks this fine line and never falls over into the dreaded scholastic feel with this work. He gives the reader exactly what he or she needs and he does not do it with much fluff. The styling of the writing is simplistic enough to stay on point, yet it flows with enough grace to be easily readable. In short, Wade hit a home run with his diction and style. His writing is almost like the dance that it is describing. When one considers this book’s overall contribution to the topic that it addresses, it is easy to see why the book has been so successful. Though a few books have been written about South American music and South American culture, few have done it with this much passion. When the author cares about the subject matter contained in the book, that comes out through the writing. After flipping only a few pages, readers can tell that they are reading a work by an author that has a deep, profound understanding of Colombian culture. In addition, this book speaks to the importance of the Colombian music in the development of the culture of that country. This is an important theme that absolutely must be captured if individuals want to fully grasp the culture of Colombia. In regards to impact, it sheds a positive light on something that people did not know very much about. It brings to the forefront a brand of music that helped create a nation and helped create a culture that is often misunderstood. The work is a good one for a number of reasons. No book can be considered perfect, but this one is perfect in that it achieves its set objectives. When writers like Wade pour their heart and soul into the research of a subject, the resulting work bares that out. Music, Race, and Nation is one of those works. Â  

Helping Teachers Become Leaders Essay

In â€Å"Helping Teachers Become Leaders,† Patricia Phelps (2008) presents a model that teachers, administrators and teacher educators can internalize in order to cultivate effective teacher leadership in our nation’s schools. Phelps begins her discussion of teacher leadership first by defining the concept. She cites Barth’s definition: â€Å"Making happen what you believe in† (p. 19). Phelps then goes on to argue that the development of teacher leadership has often been overlooked by both teacher education programs and by school administrators themselves: â€Å"The importance of cultivating leadership among teachers should not be underestimated as a powerful way to improve schools† (p. 122). The risk then of not empowering teachers to become leaders results in a significant threat to healthy school communities and effective and empowering teaching: â€Å"Those teachers who do not become leaders are typically satisfied with the status quo, easily discouraged, sometimes cynical, perhaps burned out, and may engage minimally in professional development activities† (p. 123). In the school that I have been working at, it is very evident that the handful of teachers who do believe in their ability to become leaders, are indeed the teachers who complain the most without doing anything about it, and seem to be most dissatisfied with their job. After having developed an argument for the rationale behind cultivating teacher leadership, Phelps outlines several key components about what skills, dispositions and competencies teachers need in order to take on leaderships roles within their schools. To begin with teachers must know what they believe about education. Phelps argues that teachers should be presented with opportunities throughout their teacher education program and throughout their careers that ask them to define what they believe about best teaching practices and the purpose of education. Furthermore, Phelps argues, teachers must understand and appreciate the value of becoming a leader in the schools. Teacher education programs and staff development must show examples of how teachers can and should become agents of positive change within their schools. Phelps also reminds teachers that a critical disposition for becoming a teacher leader is resiliency. Inevitably teachers will encounter obstacles along the way either internally from colleague or administrators or externally as a result of federal policy that sometimes fails to take into account the best interests of students. The next step in Phelps’ model is the development of the knowledge base that will help teachers assume a proactive and effective role within the school: â€Å"The knowledge base of teacher leadership consists primarily of the concepts of educational change and school culture† (p. 121). Phelps suggests that there are various types of roles that a teacher leader might assume: advocate, innovator and steward. After explaining how the teacher can best prepare to assume leadership roles, Phelps goes on to suggest that school administrators also play a significant role in determining whether or not teachers will feel comfortable taking on leadership roles: â€Å"By making clear the unique challenges that a school faces, the principal opens opportunities for leadership† (p. 120). I believe that Phelps’ emphasis on administrator’s role in this process is important. Administrators very much set the tone at a school, and when teachers feel that their ideas are valued and appreciated, they will be much more likely to step up to leadership roles. My principal frequently asks for staff input during meetings and asks for volunteers to become members of a committee. For example, when the school was considering whether to implement a dress code, our principal formed a committee and took all of their recommendations when it came time to adopt new policy. This makes staff members at our school feel valued and much more likely to take on leadership roles when they see other ways to improve the school. The process of preparing teachers to become leaders requires the commitment of many, not just teachers themselves. Teachers must be able to articulate what they believe and identify the roles that they can assume within the school to effect change. Administrators must create a positive tone and actively seek input from their staff. Teacher educators have the responsibility of cultivating an attitude and a belief in pre-service teachers that teacher leadership is both possible and necessary. If administrators, teachers and teacher educators take to heart these core components outlined by â€Å"Helping Teachers Become Leaders,† then we will make a big step toward sculpting out positive work environments that welcome and promote innovation. I believe that readings and discussions in this course about why becoming a leader is so important to schools and to individual teachers will help me to seek out and assume leadership roles throughout my career. Especially in the early stages of my career, I see myself most able to assume the role of steward, by exemplifying effective and innovative teaching practices and displaying a strong work ethic and a positive attitude about my profession. Once I begin to establish more of a professional identity, I hope then to be able to assume leadership roles in my school that will result in positive change on an even larger level.

Making Movies Essay Example | Topics and Well Written Essays - 500 words

Making Movies - Essay Example His critical analysis and great knowledge makes his book a must read for all amateurs who are learning the art of filmmaking. His book almost covers all aspects required to make a creditable film. He gives detailed knowledge about music, production, direction, props, cameras, editing, cinematography, scripts, actors etc. Â  This book provides a vision and a guiding pathway for all those who are entering this field and all those young filmmakers intending to make this vast field as their ongoing profession. In the movie The Verdict director Sidney Lumet according to me does not come up to my level of expectation as a lot more could have been done. After reading the novel I personally think direction was not as strong as it should have been for a person with so much in depth knowledge of the field. The level and the bar raised by Sidney are quite high which he didn’t sustain in this book. This clearly explains that despite the great effort and techniques involved far more could be done to make the movie a success. Apparently this movie for me was a very entertaining and a top notch courtroom based drama which had elements of tragedy, suspense, fraud, emotions and romance making it a complete story. Sidney holds this view that the script should disturb the conventional balance. Astonish the reader, entertains, intrigues and then when it is about to conclude the reader must develop a feeling that this was meant to happen. This precisely means that the script is the skeleton for any film and a good script keeps the audience awe struck. Likewise in the movie the script is one of the most complex elements, when Frank goes to meet his mom he is immensely affected by her present state which brilliantly unveiled another side of Frank. Â  Sidney believes that usually he is not thinking about the viewer might react; there are basically two perspectives when it comes to life that have a great impact, that is precisely life and death. These aspects are so intense

The problems regarding lack of leadership skills and inadequate job Essay

The problems regarding lack of leadership skills and inadequate job designning for the new employees - Essay Example The paper tells that job design is refered to as the contents of the job. It facilitates to analyse the various duties and tasks of the job and the methods required to perform the job in an efficient and effective way from the perspective of human process intervention as well as from the HRM intervention. Thus, job design includes the descriptions and the provision of the job which helps in evaluation of the performance as well as enhancement of profitability of the firm. Similarly, in case of ‘Lentil as Anything’, after recruiting the new migrated employees, Shanaka Fernando, the owner of ‘Lentil as Anything’ should offer them specific job related trainings in order to describe the various specifications, rules, responsibilities and requirements. This would assist in enhancing the motivation as well as the eficiency of the employees. Senior & Flemming, stated that it is through job design that the roles and responsibilities are clearly described according t o the past skills and knowledge of the employees. Moreover, it can be identified that the induction training programs are utilized to present the actual procedure of the particular jobs so as to acquire competency and accuracy in the performance. Parker & Wall highlighted that the job design intervention is essential to assess the specific skills and knowledge of the new entrants and helps to evaluate the proficiency level and the expertise gaps as well. Therefore, in order to reduce the skill gaps, various induction tranning programs are offered to the employees to increase their aptitudes and capabilities. Thus, it is essential for ‘Lentil as Anything’ to motivate the employees towards the job by communicating an appropriate design of the jobs. Proper job design helps to accomplish the task responsibilities in a specific time frame and in an skilled manner which ultimately proves beneficial for the employee as well as for the company. Hence, it is obligatory to develo p a particular job design statement for ‘Lentil as Anything’ which might be beneficial for the new employees and the restaurant as well (Accel-Team, 2011; Parker & Wall, 1998). The paragraph mainly highlights the facts about the techno-structural intervention required for the restructuring of the organization. While taking decisions for ‘Lentil as Anything’, Mr. Shanaka Fernando should involve all the employees so as to evaluate the varied viewpoints regarding a particular decision. It also offers proper contribution of the employees regarding a specific circumstance which is clearly observed in the documentary of ‘Lentil as Anything’. In order to sustain in the crisis situation, Mr. Shanaka Fernando decided to expand Lentil in Sydney in order to serve high quality of foods and services to the customers which can enhance the cash inflow and thus, assist in lessening the burden of heavy debt. Notably, this is a strategic decision on his part but without the involvement of the other employees (Cummings & Worley, 2008). Moreover, it can be determined that the involvement of all the employees in the decisison making process leads to increase in the confidence level and the morale of the employees which in turn enhances the employee performance and productivity of the organization. It can be depicted in terms of four elements such as power, skill, information, knowledge and rewards. Power helps to offer enough ability to make job related decisions where timely access to any pertinent information is essential to make any