Compare three stories of suspense Essay

It tells the story of a man on a steam liner who unintentionally falls overboard whilst he is alone on the deck of the ship. This story, unlike the others, is written in the third person. This doesn’t greatly impinge on the whole impact of the story although it might be easier to envision yourself in the man’s position if it was written in the first person; it would cause the reader to be more familiar with the story. However, reading a story in the third person can occasionally help you look upon the event more visibly because you are looking at the story happening in your mind when you are reading. The technique of writing in the third person in this story has worked to its advantage since it has done just that. When reading â€Å"Man Overboard†, I detected that Churchill supplied a lot of information about the locale of the story so I was able to create a very vivid image in my mind of the story. I felt I could see the story happening. This story is written in prose but contains elements of verse, like â€Å"Frankenstein†. Verse in â€Å"Man Overboard† is used to show that there are parts of a song being sung during the story and that everybody else on the ship is occupied with singing the song whilst the man is in the water. This isolates the man from the rest of the people making it seem that there is little chance that he will be rescued. It shows he is alone and that no one has noticed what has happened to him, which creates a strong feeling of fear and death. If this story were to be made into a film, I can imagine the song haunting the background of the scene where he is shouting for help. The song plays a very important part in the story: it is what causes the death of the man because it is the barrier between him and the rest of the people on board. The characters in each story are men and in â€Å"The Raven† and â€Å"Man Overboard† they remain nameless. I think this is either to create a mysterious atmosphere where the reader is wondering their name or because they haven’t lived to tell their story to anyone human. I think that if the men were both named in â€Å"The Raven† and â€Å"Man Overboard†, the stories may have been more memorable because there would have been a name people could talk about to go with the story. It makes the men look more unfortunate if they don’t have names because it showed that maybe they didn’t use them because they didn’t come into contact with many people. Both of the men didn’t encounter another human in the stories so they weren’t able to use their names either, for example, in conversation. Frankenstein and the man in â€Å"The Raven† are quite similar in the fact that they are both mentally affected by what they have been through in the story. The only character with an evident history is Frankenstein. This is because the story of â€Å"Frankenstein† is a novel and novels supply many details concerning the history of events, plots and characters. Frankenstein had a stable childhood. He was loved and admired by his parents. He was their â€Å"plaything and idol†. From the quality of his childhood, it seemed there would be a fortunate and successful life in store for Frankenstein but things change as he is ‘punished for offending naturei. We are first introduced to Frankenstein in Walton’s letters in the prologue. Walton is very curious about this â€Å"man in so wretched a condition† whom he has taken on board his vessel. This makes the reader wonder what this man has been through and why he is ill because it is evident he has experienced a lot. Small hints of Frankenstein’s story are given away by his actions described by Walton in the letters. â€Å"He is continually on deck, apparently watching for the sledge that preceded his† and he â€Å"seeks one who fled from him†. Walton and his men on board are very curious about Frankenstein and the reader would be building up the same feelings here too, especially as Frankenstein wants to tell his story. He has the urge to tell someone what he has been through. The reader would believe that if he has the urge to tell the story, it must be good. This is the same with Poe’s characters. The man in â€Å"The Raven† wants to tell his story. He includes every detail of how he felt, what happened and what he were thinking about. This helps the reader to fully understand what is happening in the story so they can begin to imagine exactly what the character experienced. Poe wrote every verse containing as much detail as possible to make sure the reader would perceive a very vivid image of the story. For example, in verse two, the last two full lines say â€Å"From my books surcease of sorrow – sorrow for the lost Lenore, For the rare and radiant maiden whom the angels name Lenore†. We learn three things from these two lines that are important in the plot. The man feels sorrowful because he has lost someone named Lenore whom he must love because he describes her as â€Å"rare and radiant† and he is trying to distract himself from his melancholy feelings by reading his book. In â€Å"Man Overboard† the first thing we are told is about the man is that â€Å"It was little after half-past nine when he fell overboard†. This removes most suspense from the story because you know what happens in the middle and you could start to think about the ending from the very first sentence. However, it could make a reader curious as to why he fell over board and so they would be eager to read on. We don’t learn much about the man during the story because things happen so fast. We know he was liked by the other passengers because â€Å"he had been listening to the music and joining in the songs† before he went out on deck and he is heading to India on the mail steamer. From the way he is written about I think the man enjoyed being alone. He is very nostalgic and reflective and maybe this is why he was so vulnerable in the event that followed and gave up easily. The settings of â€Å"Man Overboard† and the prologue of â€Å"Frankensteini ‘ are very similar. They are set in the ocean. This part of â€Å"Frankenstein† is set in the Arctic, which is a place many people had no knowledge of or had explored in the nineteenth century. â€Å"Man Overboard† is set in the Red Sea. This creates a completely different mood to â€Å"Frankenstein† but still contains a feeling of danger in that there is no one near-by. Setting a story in a desolate location creates a feeling of uncertainty and adventure and the feeling that anything could happen because the place is unfamiliar. If a place were far from populated land, it would make it harder to survive if anything went wrong and it is known that in the sea things can sink and people can drown very easily. Phrases used to describe a sense of place in the Arctic such as â€Å"stiff gales†, â€Å"floating sheets of ice indicating the dangers of the region†, and â€Å"many hundred miles from any land† make it sound a very dangerous place. Many people hadn’t experienced the environment of such a place during the time Shelley wrote â€Å"Frankenstein† which made it harder to imagine and therefore more frightening. It would be more frightening to someone reading this one hundred years ago because they would have less knowledge of the world surrounding them. The way the setting in â€Å"Man Overboard† is described is a contrast to this image of the Arctic. The Red Sea is said to be â€Å"warm† and the surfaces of the water are â€Å"still† but there is one sentence that makes me think of the ocean as a more horrific thing. When it says, â€Å"The mail steamer was hurrying through the Red Sea in the hope of making up the time which the currents of the Indian Ocean had stolen† it made me think that if the ocean could steal time, then it could be capable of stealing life. That sentence contains a very powerful metaphor that adds a slight amount of suspense to the otherwise calm settings being described. The moon adds a lot of atmosphere to the setting. Where the moon is hidden behind the clouds in the beginning, it suggests that it will be harder to notice the man falling overboard because there is less light. The moon and clear sky reflect the man’s emotions in the beginning. The man is calm when the atmosphere is calm. When the moon comes out from behind the clouds at the end when the shark is moving towards the man, it reinforces that God had heard his appeal and sheds light on the man’s last moments. Churchill probably created a calm atmosphere to make the event of the man falling overboard more dramatic because most elements of suspense were removed from the plot in the first line. A contrasting event to the setting it happens in is different to what happens in â€Å"Frankenstein† and â€Å"The Raven† where the horrific parts of those stories are set in bleak, dark, mysterious locations. For example, when Frankenstein creates his being and gives it life for the first time â€Å"it was on a dreary night in November†. This tells us that it was in winter when it was cold, there are no leaves on trees and there is less life to witness this terrible crime that Frankenstein was about to commit. Phrases such as â€Å"the rain pattered dismally against the panes† and â€Å"the candle was nearly burnt out† make the waking of the monster more terrifying because it is dark and stormy. The monster would have been able to attack Frankenstein in the dark without anyone knowing and it would have been harder for him to escape. As a result of the monster’s appearance, Frankenstein fears his own creation even though he doesn’t know him. â€Å"A mummy again endued with animation could not be so hideous as that wretch. † This prejudice adds to the suspense and the reader would start to wonder about the destiny of the monster and how people will react to him. The monster would definitely be more terrifying to someone reading the story in the nineteenth century because horror was just being introduced for the first time and people would have been shocked at the sound of the appearance of such a creature. Each time Frankenstein meets his creation, the weather is gloomy or stormy. After the monster has murdered Frankenstein’s brother, William, he reveals himself to Frankenstein on the horizon when â€Å"A flash of lightening illuminated the object†. Stormy weather has always been linked with horror stories because many people fear storms. Storms would have been more frightening in the nineteenth century because again, people wouldn’t have known as much about them as scientists do today. The one time when the weather is calm when Frankenstein meets his monster is when the monster tells of his travels. The atmosphere is happier when the monster tells Frankenstein of how he was kind hearted and how he learnt to speak all by himself. It creates a feeling of new life in the setting although it is still set in winter. In â€Å"The Raven†, Poe uses the same ideas of a stereotypical horror setting to match the image of the Raven and how it signified an omen of death in the nineteenth century. Phrases such as â€Å"the air grew denser† make me think of suffocation, which leads to death. This story is set at night and in â€Å"the bleak December† similar to the creation of the monster in Frankenstein. Being alone at night is like being alone in the sea where there are no people to help if you are in trouble. Each story contains lifeless settings to inspire horror in the story by making the characters appear alone and vulnerable. The three stories open very differently because of the different forms they are written in: novel, short story and poem. When Frankenstein begins his story, he starts with his history and talks about his childhood. As his childhood was happy and healthy, the mood of the first three chapters are happy as he talks about the highlights of his childhood, such as Elizabeth, his â€Å"companion†. The opening of this story contradicts the rest of it where normally if someone has a good childhood they go on to lead a successful life. Shelley probably did this to make the events of the story less expected and more upsetting, as Churchill did in â€Å"Man Overboard†. â€Å"Man Overboard†, the short story, opens with the main plot being revealed. I think that making an opening quite short can leave a lot of space for detail in the middle, especially in a short story, which may make the story more effective in the end. The opening of â€Å"The Raven† provides a little history of the character and actually lasts for six verses until the Raven enters in the seventh verse. This builds up a lot of suspense because the entry of the Raven keeps getting delayed because the man is continually trying to guess what is tapping at his door. In verse five there is a lot of suspense built up when it says â€Å"But the silence was unbroken, and the stillness gave no token,† because there is something at the man’s door but it is not clear what it is. The atmosphere in the opening of â€Å"The Raven† is similar to the atmosphere all the way through the story, unlike â€Å"Man Overboard† and â€Å"Frankenstein†, where the mood of the stories changes more frequently. The characters in the three stories each get disturbed by a being that is not human. This definitely adds a deeper sense of horror to the stories because we have less knowledge of other creatures compared to ourselves so they appear more powerful to us. How frightening a person finds the creature in each story depends on how society perceives the creature at that time, which would directly affect the reader’s opinion. For example, in the nineteenth century when â€Å"The Raven† was written, ravens were considered as a very significant omen of death. The public feared the dark and sinister presence of ravens because they were thought to be present only at times of death. I remember watching a film set in the late nineteenth century in which there was a funeral and burial scene. In the corner of the screen sat perched in a tree there was a raven looking down on the event. It was almost as if the raven were watching the consequences of his presence. The man in â€Å"The Raven† believes that the raven that has visited him is an omen of death because it calls it a â€Å"prophet, thing of evil, devil† and enquires to whether the â€Å"Tempter† sent it, which means he thinks either God or the Devil has sent it. He also enquires about his destiny and if he will meet Lenore again. He believes the raven has the power to know all. In â€Å"Frankenstein†, Shelley also talks of the Devil and compares Frankenstein’s creation to â€Å"a thing such as even Dante could not have conceived†.

Biography Informative Speech

As we all know, grandmas are known for making delicious food. I discovered a long time ago that have a big problem breaking eggs; so I was very excited when I discovered the gaggles recipe for Cocoa Kiss Cookies. I was given the recipe for these cookies by my mom, Rena Williams. My mom got the recipe from her mother; Lucy Long, who got the recipe from the chocolate factory in Hershey, PA. II. If you ever are In a situation where you need to Impress your grandma then, cook her a chocolate cookie with a kiss In the center. Ill.Cookies are easier to make than you think so I'm going to show you the three steps in making cocoa kiss cookies: the ingredients, the mixing process, and baking. ‘V. First: Ingredients needed A. The wet mixture 1. You will need 1 cup melted butter. 2. 2/2 cup sugar combined with melted butter. 3. 1 teaspoon vanilla extract to form wet mixture. B. The dry mixture 1. You will need 1 and % cups all purpose flour. 2. To finalize dry mixture you need 1/4 cup coc oa. C. Re-last the Ingredients: 1. 1 cup melted butter 2. 2/2 cup sugar 3. 1 TTS. Vanilla extract 4. /2 cup all-purpose flour 5. H cup cocoa 6. Hershey Kisses to put In center later V. Secondly: Mixing ingredients 1 . First the contents of the wet mixture (the butter, sugar and vanilla) are mixed within a larger bowl until all the ingredients are well blended. 2. A good tip from my grandma, Lucy, is to never pour the vanilla over the mixing bowl in case the vanilla spills. This way if a spill occurs, the dough Is not ruined. B. The dry mixture 1 . The Ingredients of the dry mixture (flour and cocoa) are mixed together In a smaller bowl until evenly distributed.Mixing the flour and cocoa evenly will only take a few stirs with a spoon. 2. After mixing the dry ingredients together, pour them into the wet mixture and start stirring. C. The dough 1 . A hint from Hershey. Com says, â€Å"Do not over-mix the dough because it may cause the cookies to spread too much. † 2. To help che ck your mixing, the dough should be place in the refrigerator to chill for an hour, or until firm enough to handle. VI. Baking A. Forming the dough 1. To form the dough into balls, scoop out a spoonful of dough and place in the palm f your hand. . Take one Hershey kiss and place in the center of the dough ball. 3. Use both hands to form the dough around the Hershey kiss. B. Baking the dough 1. Heat the oven to 375 degrees. 2. Place the dough balls onto an engrossed cookie sheet. 3. Bake 10-12 minutes or until they are set. 4. Cool the cookies completely after baking before removing them from cookie sheet. VI'. Conclusion So, to summarize lets go over the three parts: A. First, we have the butter, sugar, and vanilla which make up the wet mixture. The lour and cocoa make up the dry mixture.B. Second, we blend the wet and dry mixtures together until we have playgroup like dough. C. Lastly, after rolling the dough and Hershey Kisses together, they are baked in the oven for about 10 minu tes. So if you ever are in a situation where you need to impress your grandma, cook her a chocolate cookie with a kiss in the center. Works Cited â€Å"Baking Hints. † Heresy's website. Hershey, PA. 2014. Http://www. Heartsickness. Com Long, Lucy. Personal Interview. Septet. 2014. Williams, Rena. Personal Interview. Septet. 2014.

Phillip Morris

Philip Morris promotion of Marlborough cigarettes. Instituted in the sass's. The brand moved to and assured that the flavor would be unchanged by the decision of adding a filter. â€Å"Come to where the flavor Is: Come to Marlboro man,† Marlboro man was a rugged cowboy smoking Marlboro cigarettes while rolling his horse In the outdoors. The ad helped propel Marlboro to the top of the world market Threefold 1 ) Significant economic advantages. Standardized advertising lowers the cost of value creation by spreading the fixed costs of developing the advertisements over many Mounties. Ex.Coca Cola saved $90 million over 20 yr by using certain elements of Its campaign globally 2)Creative talent is scarce and one large effort to develop a campaign is much more successful than numerous amounts of smaller efforts 3)many brands are global brands Against standardizing advertising 1) cultural differences between nations- a message that works In one nation could potentially fall In anothe r nation. Cultural diversity makes It difficult to develop a single theme that Is effective on a global level 2)advertising regulations may block implementation of standardized advertising.Ex. Kellogg could not use a commercial it produced in great Britain to promote its product in other European countries. A reference to iron and vitamins in its cereal was not allowed in the Netherlands because health and medical benefits were outlawed. In France children are not allowed to endorse products. In Germany a key line was disallowed because of competitive claims. Another example would be American express offering bonus points every time the card was used. And the points could be used towards air ravels and hotel accommodations.Germany competition law was broken as it is suppose to prevent the offer of free gifts In connection with the sales of goods. Dealing with country differences Experimenting with capturing benefits of global standardization while recognizing differences in countrie s cultural and legal environments. Some features to include in all of its advertising, which can result in saving on costs while building international brand recognition. Monika in the sass's launched a global advertising campaign † 1001 reasons to have a Monika imaging phone.Did this to reduce costs and capture economies of scale. Value in trying to establish a global brand image. Used actors from regions where the advertising covered. And used local settings as well. Doves global real beauty campaign 1) Milliner, who marketed dove a storied consumer multinational with global reach, a strong positioned In fast growing developing nations, and a reputation for customizing products to condition prevailing In local markets. ( ex. Indian women OLL hair before washing , so western shampoos that TLD remove the OLL didn't sell well.However, milliner reformulated shampoos for India. Company exaggerated because it has shifted towards a global emphasis. Dove. Brand should stand for the real beauty of all women. Mission was to make women feel more beautiful everyday by widening the stereotypical definition of beauty and inspiring them to take care of themselves. 3) Following workshops held around the globe that brand managers and agencies communicate beauty. Asked 67 photographers to submit portraits of women of all shapes, sizes and ages. Dove photo tour. ) German office of Milliner advertising agency, Googol and Matter worldwide, came up with a concept for communicating real beauty based on photographs showing ordinary women in their underwear. Advertisement made its way to the I-J where they perceived it as politics and not advertising. 5) 2% of women worldwide considered themselves as beautiful and the half thought their weight was too high 6) 2004 campaign was launched globally. Radical shift form Milliner . Tweaked to take local sensibilities. 7) Milliner extended the dove product line to include skin creams, shampoos, and shower gels.Made a video on youth 8) Dove created â€Å"Evolution, depicting the transformation of a real woman into a model and promoting awareness of how unrealistic perceptions of beauty are created. † 9) â€Å"he Dove global study, Beauty Comes of Age, revealed that 91% of women ages 50-64 believe it is time for society to change its views about women and aging. The campaign celebrated the essence of women 50+ ?wrinkles, age spots, grey hair and all. It was brought to life through a communications campaign created with internationally renowned photographer Annie Leibniz. 0) â€Å"The [email  protected] Movement for Self-Esteem provides women everywhere with opportunities to mentor the next generation and celebrate real beauty. â€Å"11)†[email  protected] has created self-esteem- building, educational programs and activities that encourage, inspire and motivate girls around the world. Dove has reached over 7 million girls so far with these programs, and set a global goal of reaching 15 million girls by 2015. † -supply chains looks like -How Is it going to come in? -How you will market? Brand is the logo, 100, and connotations â€Å"Bat† night, up late.

Art and fashion Essay Example | Topics and Well Written Essays - 2000 words

Art and fashion - Essay Example Mannequins such as the Siegel-Vigneau had very seductive with undeniably lifelike bodies significantly contributed to the success of social as well as cultural reconstruction. Surrealists perceived women as in an erotic and decadent disguises who were actually predators in life of men due to their passive sex as well as accessibility which prompts men to be attracted to the female bodies. Female bodies were turned into elements amongst the surrealists because a body could also attract attention and communicating information. A body could reveal some of the most hidden meanings behind its restructuring. Most images were therefore belonged to the repertoire of surrealists although some of them lost their origin in favor of sex appeal. Sexual appeal of a woman’s body was crucial since a woman was considered a sexual object whose life is engrossed exclusively with sexuality (Emanuel 2006). Initially, mannequins were so heavy and were more unrealistic creations which were made of w ax and could melt in the summer heat. However the understanding of women psychology led to great imperfections that made mannequins look like real women bodies. It should be noted that surrealism became very prevalent in 1930s particularly to the public where their artwork became the model for international exhibitions. Visual style artwork became dominated the period between 1930 and 1935 by Dali and Magritte. During this period art served a significant purpose as a way of expression that included hallucinatory imagery (Beck 2007). Surrealism came up with visual techniques that incorporated giving ordinary objects their usual meaning so that they could compel to the public. Audience’s empathy would therefore be aroused because of the image characteristics which were more than just ordinary formal organization. 1930s was characterized with stylistic evolution that included a mixture of depictive and the emotional elements which were very necessary in influencing an audience. Mannequins actually reflected fashion models but some of the headless mannequins represented would make someone think that it had been sliced thus representing scene of a brutal war (Stewart 2008). Mannequins were made to fit dress maker’s form thus reverting them to look like shop mannequins. Shop mannequins were however not made to represent any form of personality or lifestyle but simply to show the outline of the garment. This was really amazing because the objects simply drew attention to how they were created rather than the dress they were wearing (Emanuel 2006). Someone would not think much about the garments on the display despite close imitation of the tailor or designer’s dummy. Representation of the mannequin to the clients became very important hence prompting the introduction of heads and limbs to the headless and limbless mannequins. The most appealing mannequins were the ones which were introduced in the 1930s which had movable limbs making them seem as if they were engaging in some activities. Movements of the limbs proved useful in representation of the lifestyle (Thesander 1997). Surrealists greatly incorporated art into life by relating subject and object in their work. The mannequins were greatly designed by artists who made them look like body objects. Mannequins were nicely used to define surrealism since it

Sexism in Popular Culture Dissertation Example | Topics and Well Written Essays - 3000 words

Sexism in Popular Culture - Dissertation Example Important here to note is there is a significant portion of the movies in Hollywood and instances in the popular culture, where one can easily find female characters, whether lead or supporting, with similar traits, whether it be film, television, theatre, drama, advertising, comic books, literature, video games, cartoons and others (Stephanie & Brabon, 2009, p. 225). The rise of feminism and the debate about the identity of women has forced many filmmakers directors and producers in the media to move away from the traditional emotionally unstable and weak concept of women and portray women in a more realistic and empowering way. This created a demand of â€Å"strong female characters† and over the past couple of decades, many strong female characters have emerged to fill this gap. However, many feminist critics and even other experts have challenged and criticised the idea and depiction of strong female characters. This paper is an attempt to explore and analyse the depiction of women in film and video games, while simultaneously exploring the concept of â€Å"strong female characters†, its ideological grounding and the criticism. ... Towards the end, the Hero would come and save them to live a life happily ever after. However, towards the mid 20th century, the rise of feminism created discontent amongst female viewers and stakeholders of Hollywood that this portrayal of women as â€Å"needy† and â€Å"weak† creatures in sexist. In order to address the same, writers came up with female characters that would be trapped by the villain only after putting up a strong fight (Hollows & Moseley, 2006, p. 58). These women, to a certain degree, had skills normally possessed by men. They could drive sport cars, use guns, had physical strength, was comfortable with her body and could outdrink any man. Even when she could put a fight, these â€Å"strong female characters†, in the end of the movie, would get themselves into trouble and that also in the sexiest way possible. Surprisingly enough, even when she could put a fight to resist the pressures of villain, she would never get a black eye or get physic ally injured probably because they same would decrease her appeal. The point here is that all the â€Å"strength† added to the female character was just an attempt to make her a better and more attractive prize for the hero at the end. (Meyers, 2008, p. 172 (Gillis, et al., 2007, p. 413). The problem with the commonly used phrase â€Å"strong female characters† or â€Å"strong females or women† is that it is ironic, paradoxical and contradictory within itself. Female characters are viewed as strong only when they are able to exhibit dominance, assertiveness, tendency for violence, boldness, rudeness and impudence that is characterised with male characters (Haase, 2004, p. 340). The point here is that in order to become â€Å"strong female characters†, women have to give up the

Personal Development Plan Essay Example | Topics and Well Written Essays - 1000 words - 2

Personal Development Plan - Essay Example As a result of the way and manner in which I approach my work with much confidence, my clients have always had trust in my ability to delivery, which is a very important tool for ensuring that I deliver up to expected standards for my clients. Equally so is the confidence and trust that my co-workers and superiors have in me. Finally, I have showed great strength in my knowledge in general x-ray procedures, which has affected the output of my work very positively. In the delivery of my works, there are very specific procedures such as fluoroscopy that I have not effectively mastered. My communication with some line of people is also affected with my difficulty in understanding their accent. Very often also, I have overworked myself, causing me to be stressed. Lastly, I do not have an in-depth knowledge in the area of pathology. These weaknesses are actually guidelines for me as to how I need to develop my action plan into the future to function more effectively. This is because I realise that if I am able to overcome these weaknesses and turn them into strengths, I shall become more useful at work. As important as it is for me work on all my identified weaknesses, I believe that taking this one at a time will be much helpful for me. For this reason, I have a focusing area which I want to start with. This focus area has to do with developing my knowledge in pathology. I have selected this as my focusing area due to the direct influence and linkage it has on my professional practice. With my work in x-ray procedures and radiography in general, I find the development of my knowledge in pathology as a crucial requirement that will ensure that I have a total understanding for my patients and their health situations. Clearly having a better understanding of the overall health structure of a patient helps in giving quality healthcare to the patient. As pathology deals with â€Å"the examination of organs,

Holywood Studio System Between 1940s and 1960s Essay

Holywood Studio System Between 1940s and 1960s - Essay Example This was because there was discovery of the telescope, a cure for arthritis and even new advancements in astronomy. 2 With all these factors going so well for America; Hollywood home, one would presume that there would be greater opportunities for the studio system. However, this did not happen. 3 The main reasons were that there was a shift from cinema to television4, there was also politics involved and also other managerial and technological reasons came into play. 5 Details of these factors shall be examined below. In the wake of the country's economic boom, many people could now afford to purchase their own television sets. 6This meant that there was no need for any of them to go to the movies. By the year 1946, cinema attendance had diminished by a whooping 20 million consumers. 7 The studio that felt the highest pinch was the leader at that time; MGM. Before the decline in the Hollywood studio system, most studios were producing about eighteen billion dollars in revenue. However, after the popularisation of television, most studios were now making a mere four billion dollars. 8 There were also other political reasons that affected the Hollywood Studio system in the late forties. Prior to the decline, most studio owners or movie producers had exclusive rights to movie theatres. The five major studios in Hollywood (Fox, Warner's, Paramount, RKO and Lowe's) 9 had the ability to control distribution of their movies through these vested interests in movie theatres. However, The US Justice Department felt that that monopoly was going against the rules of free market and fair competition. 10Therefore, the Attorney General serving at that time gave a notice to the five major studios to appear in court. They were charged with conspiracy in the theatre industry. They were not supposed to control distribution as stated by the government and they were expected to let go of their vested interests in theatres During their appearances in court, top studio executives agreed to surrender their vested interests in the distribution sector and just after a short while all the big five studios gave up their rights to the movie theatres. 11Most of theses theatres were then sold to other vested interests. Consequently, studio producers had very little revenue to give their actors. Before selling away their theatres, most studios would contract actors for a period of seven years. But after the decline of theatres and studios, it was difficult to make such contracts anymore. Most studios started getting into deficits and they started closing down. 12These results came into play during the sixties. Eventually, the legacy of the Hollywood Studio system came to an end during those fateful years. Rise of independent movie producers During the 1960s more and more movie producers would choose locations that were outside Hollywood. They would prefer other countries such as England, Rome and Pinewood. Consequently, most of the equipments needed in studios were exported to the outdoors. This seriously affected the studio system as movie producers no longer considered the studio system as the norm. 13 The situation was made worse by increased competition from some independent movie producers. These movie producers were affiliated to their own movie producing companies and made the Hollywood studio system seem traditional. The

International Trade Unions 2 Assignment Example | Topics and Well Written Essays - 750 words

International Trade Unions 2 - Assignment Example Trade Union executive realized that they were legally responsible to imprisonment and prosecution for bona fide union actions, and it felt that some legislation for the safeguard of trade union was essential. The Indian government found it necessary for the protection and registration of trade unions. The act (Indian trade union 1926) sets rules for both the industrialists and the workers. The Act deals with the registration of trade unions, their liabilities, responsibilities and their rights to ensure that their funds managed properly. This is done through annual submission of the report on their expenditure, income, and membership to the ministry of labor and employment. Impacts of trade unions on export Trade unions negotiated for implementation of taxes policies to all tariffs where they argued that, the workforce was behind all the economical benefit realized and increased exports, in the manufacturing industries. The objective of any baseline was to work out the sectoral techn ological development fitting with the working people and GDP projections, which will then be kept unaffected for all simulations. Harmonization of employee’s salaries and working conditions lead, to improvement of the productivity of the goods and services produced in these sectors. The industrial sector, wholly measured similar significance for the two economies (India, & India2007). The Production moved towards manufacturing sectors wearing apparel sector, the textile, and leather. As a result, efficiency increased in exports rates in china does market linearization? Indian exports represent $ 77 billion spreading mainly on Industry and Textile goods (20%), manufactures (48%). Where the biggest share comes from manufacturers, and the major export market for Indian exports? EU are intense mainly on the manufacturing sector is worth noticing that in general evolutions of welfare are to a certain extent small in this situation, as it is common with this kind of models. This is mainly due to the choice to ignore the outcome of liberalization on efficiency and good organization. Countries sharing of trade union policies and markets, export efficiency would increase as a consequence of a bilateral agreement. This because there will be minimal sabotages and strikes on the sector. Impacts of trade union on employee’s grievances Trade unions not only act as a system to give voice to employee problems and grievances before management, but they also are fairly concerned in welfare trial for workers, and in improving the value for their life work; all such procedures may be placed under ancillary functions of unions.( Carr,2010). They actively take part in negotiations with management at different levels concerning safety, working conditions, and various other worker-related issues. Through these unions, the workers were able to get annual seminars related to their job to enhance their productivity. The issues of educating their families they got reorganiz ed fee structures for their children education in the schools of their township. Salary / wages decisions, considerations concerning dual pension on the ratio they will receive and the duration it will take after their retirement period. Improvement of information conveying to

Martin Luther King Essay Example | Topics and Well Written Essays - 500 words - 9

Martin Luther King - Essay Example One which will not leave more sufferings through people being arrested and even killed in riots and police retaliation. His followers were conditioned to only involve themselves in mass protests that were peaceful an example being the bus riot protest seeking an end to segregation in the buses and other transportation systems. His leadership as a civil rights activist compared to that of other leaders was marked with less bloodshed. Even though the masses and their perseverance to their just cause always caused a headache to the white people and the justice system, as well as other security branches of the government, in the end, they got what they were looking for and that is justice (Kirk 38). Other than seeking justice which was what he is famously remembered for, Martin Luther King Jr. was also deemed important because of his seeking equality for all as long as people lived in the same country. His young and old adulthood was marked with him seeking equality for people he did not even know about but did that because he believed in the human rights and in people being created equally and hence should be accorded equal treatment at all times. This did not mean that he did not respect the authority because he did but he wanted the same authority to use their power for just causes. He went to hotels and other public areas â€Å"preaching† the importance to equality among mankind and this is how he gained his popularity as a civil rights activist and started seeking justice later on in his life. Martin Luther King’s speech of â€Å"I have a dream† shot him to the highest of the popularity ranks and is still sensational up to date decades later after his death. He was elite and a very smooth-spoken and talented orator and public leader with excellent public speaking skills. This made him an autocratic leader moving people with just his words and paralyzing people with his speech.

Mail Essay Example | Topics and Well Written Essays - 500 words

Mail - Essay Example However, it might also be possible for the seller to deliver their products to retail stores that are near the customer where it is possible for the customer to receive and retrieve their product (Kotler & Keller, 2012). This form of mail order service, which appears to be a catalog, is very popular and, in this case, it contains the product, prices of the product inventory, and descriptions of the product. Usually, these publications are sent to consumers who are most likely to purchase the decoder being sold. The format used for this publication is not unusual as such, although it is quite innovative. This can be seen from the way in which the seller uses fanciful paper, as well as the colorful nature of the fancy paper. There are several eye-catching graphics, including the words ‘The Cable Crusher’ placed in a vice, in which some of the letters have cable connection jack pins at their ends. There is also a graphic that shows animated airplanes, most likely indicating that the cable company carries cartoon packages, while there are several remote controls shown for only one decoder, which could represent the numerous choices available on the cable network. As noted, the paper used is fanciful, while the printing is colorful and clear with the most important points being written in color. Possibly the thing that most held my interest was the image of a vice next to a graphic showing package offer reductions. Printed make a mail order sales will always be fashionable because of their ability to focus on direct messages (Kotler & Keller, 2012). The fact that this publication is targeted and brief makes it believable because the message is directed current and prospective customers, meaning that the company seeks to build a relationship with those who choose to buy their cable services. However, there are questions regarding its limited time offer that provides for a return of $150 after mail redemption, specifically because the highest price for

How to Choose Your Topic Essay Essay Example for Free

How to Choose Your Topic Essay Essay Good evening Ladies and Gentleman , my name is Adam Maljan. Before we proceed , I would like to ask all of you a simple question . Have any of you had any difficulties on choosing a topic when you are asked to present to an audience ? If your answer is yes , then Do Not Worry . Because you see i. Choosing a topic for a speech is no easy thing to do . Especially if you are a student preparing a speech for your subject . ii. I myself had a hard time in choosing a topic for a public speaking event when I was in my 2nd semester as a diploma student . It took me days just to find the right topic which everyone can understand and relate to easily. Today , I would like to talk to you about how to choose or at least narrow down your choices of topic using the simple criteria of Knowing your theme , Listing and narrowing Down and researching and gaining confidence. The first criteria in order to choose your topic is that you should know your theme. For example , the seminar you were invited to talk to is about Health . But Health, as we all know, is a general topic , there are multiple subtopics that you can relate to with health ,some are maintaining a healthy lifestyle , how to reduce the risk of heart disease, effects of obesity and many more . So if this situation happens to you . Please do not panic , because once you identify your theme or topic using the general topic given to you, you can now look at your audience and use them to determine your decision on which topic to present . For example, if your audience is mostly teenagers , then you can choose the topic on maintaining a healthy lifestyle topic , but if it is mostly senior citizens , then it is better for you to choose the topic on how to reduce the risk of heart disease. The same goes with women or children .

Supporting people with long term health conditions

Supporting people with long term health conditions This report reflects on the care needs of 67 year old Kingsley, at 55 he was diagnosed with Type 2 Diabetes then at 65 Kingsley suffered a stroke. After a lengthy stay in hospital he was moved to a nursing home where he currently lives, he is not happy in the nursing home and wishes to be discharged and return home to the care of his wife. He displays his unhappiness to care staff with bouts of anger and frustration. He has a social worker assigned to his case who is currently undecided if Kingsley should return home to his wife, he questions the layout of the home and his wifes ability to cope with Kingsleys care needs. Kingsley and his wife have some difficult decisions to make and should be able to discuss these with the social worker as these will have a fundamental impact on where he lives as this will be instrumental to his wellbeing. Living with a long term health condition can have its challenges when receiving health care, its paramount that a care user receives the correct level of support and information available. A psycho sociological perspective offers a holistic approach which addresses an individuals needs and an anthropological perspective which offers a biological study of the human being. A psycho sociological perspective addresses an individuals psychological health and wellbeing needs which are individual to functioning within human society. This perspective highlights that factors such as age, gender, environmental living conditions and the individual differences that people face are to be considered in health needs and care issues. A psycho-social approach to public health aims to incorporate the environment which will address the health of groups of people by social context, social class, location and how accessible they are to local resources. In the past this has been referred to as the social model of health (K217, Learning Guide 2, p43). The structure of the social model of health aims to make health services more affective, accessible and acceptable to individuals. The components are as follows (K217, Learning Guide 2, p43). To acknowledge the influence that health has on political, economic, social, psychological, cultural and environmental factors and also biological factors. To improve health a focus must be placed on the socio-economic environment. To achieve community participation with shared decision making between lay people and practitioners. Health services to collaborate with other government agencies and sectors. Commitment to equity and accountability in health. The use of evidence which is qualitative and quantitative. The concept of this perspective is that the focus of social causes are linked to illness rather genetics. If the social causes which are causing a detrimental effect on health are addressed then a better quality of life and sense of wellbeing are to be achieved. In Kingsley case he is not socially active because of the environment he is currently living in, which is restricting him from participating in any social networks, which gives the practitioners power over him so he is then not part of the decision making regarding his wellbeing. Holism perspective The practice of holism is to recognise that each persons needs are unique to ones own identity. It acknowledges that focus is to be given to lifestyles and choices which have an impact on health and illness. The approach links all aspects of a persons physical, mental and emotional state to create a composition of a state of health and illness. The approach of a biomedical perspective will address medical conditions with a biological, anatomy, and a physiology view but ignores an individuals needs, as a holism approach would address the individuals needs which would have an effect on lifestyles and choices. So a Biomedical perspective has a place in some health conditions such as Diabetes which will address the medical needs such as insulin. But a holistic approach will identify the whole person combining their mind, body and spirit. This can be helpful for practitioners to understand how a Diabetic may be feeling with effects of injecting insulin, are they coping with self management of the condition. The whole person approach to care is to give service users the ability to move on from the professional dominance in the doctor centred model and to achieve the self care model which is to encourage independence. (K217, Learning Guide 2, p42). Discussion. The contribution of theory. Do theories have a place in health and social care services and how can they help people like Kingsley who is suffering from a long term health condition. Theories in health and social care are developed from two perspectives Good research and medical engagements which results in theories from evidence. Generalised practice and an understanding of experience within a profession, these theorises are developed from practical experiences. Theories in understanding long term health conditions can be found in two perspectives bio medical and the social model of health. The bio medical approach is that the body functions normally but when things go wrong a specialist can repair the body; its focus is that biological problems can be addressed with medicine. The social model of health recognises biological factors but also includes the recognition of the influence of health being a matter of psychological and social addressing the wellbeing of an individual. If just a bio medical approach to theory was taken of Kingsleys situation he would have been diagnosed with two long term health conditions a stroke and type two diabetes by a practitioner then undergone biological treatment in hospital, were tests were taken and symptoms were controlled with medication. He is now living with two conditions controlled by medication. Bio medical may adapt mechanical metaphors which presume that a practitioners approach is to be an engineer and to fix what is malfunctioning with medication (K219, leaning guide 1, p36). The N.H.S. point out that a stroke is a medical emergency and should be diagnosed as soon as possible this would be in a bio medical environment. A bio medical view would be taken to determine the emergency treatment needed and also for after care with medication, therapists, physiotherapist and G.Ps. The N.H.S also highlight that the social model of health should be incorporated into a patients social care needs social workers would ass ess a patient and their carers needs and offer services such as meals on wheels and home care services (N.H.S. 2011). A purely social view of theory to long term health conditions would offer Kingsley and his with sociological support in dealing with his conditions addressing needs for his wellbeing. Kingsley has experienced a change to his identity, because of his illness he feels he can no longer contribute in society. Kingsleys illness has made it impossible for him to work so he now relies on the welfare benefit system so his identity has changed from a working man providing for his family to the sick role. The sick role can be identified when an ill person becomes exempt from a social role of responsibilities examples are because of illness, a sick person will not get better without being taken care of and the sick person will want to overcome illness and should be obligated to seek the correct professional help to deal with an illness (Parsons, 1951, p.294). This theory of the sick role has an element of social care and bio medical, society will address an ill persons needs with benefits and c are issues and a biological factor will be present with medication. What can be learnt from research and practice guidelines? Research show that suffers from a long term health condition such as a stroke may face physical disabilities and suffer from social exclusion which can lead to spoiled identities. The Stroke Association commits approximately two and a half million pounds per year in to research of stroke prevention and treatment .Two key achievements are (The Stroke Association 2011). Staying physically fit after 40 cuts risk of a stroke. People who are physically fit after the age of 40 can lower their risk of stroke by as much as 50 percent, compared to people who arent as physically fit (The Stroke Association 2011). The benefit of occupational therapy for stroke care home residents. A recent study funded by the Stroke Association has shown how beneficial even a small amount of occupational therapy can be to residents in care homes who have had a stroke. The study, carried out is extremely significant as the care home population is an understudied and extremely vulnerable group (The stroke Association 2011). The research suggests that prevention can reduce the risk of a stroke and that life style changes and rehabilitation will help with the recovery process, learning to deal with the effects that the stroke has had on them and learning to adapt to the limitations caused by stroke. Rehabilitation would also address the need for any support in dealing with social, emotional and practical issues. A government report on long term health conditions and self care (Your health, your way, 2009) is aimed at promoting discussion between health and social care professionals and people with long term health conditions, it addresses what options, support and information are available for health care users who wish to self care. The N.H.S. and social services want to encourage people with long term health conditions to self care, its shared aims and values for the transformation are to ensure that service users and their carers are not discriminated because of illness or disability and are supported to be able to: Live independently and be able to sustain a family unit, which will avoid children taken on inappropriate caring roles. To stay healthy and to be able to recover quickly from illness. The ability to exercise control over their own life and if appropriate the lives of family members. To participate economically and socially as active and equal citizens. Have the best quality of life, irrespective of illness or disability and retaining respect and dignity. (Your health, your way, 2009, p.4) Self care is build around a holistic process that places the service user at the centre of their own care but also recognising that different issues can impact on an individuals health and wellbeing so the process is supportive, individual, flexible and non-judgemental, the focus is solely on enabling the individual to achieve the outcomes that they want for themselves. People who use services completed a survey prior the transition to self care and after the changes had occurred the findings are. (Your health, your way, 2009) (Your health, your way, 2009) The results show how being empowered to take a more active role in health and well-being can improve quality of life. People who are living with a long term condition can benefit enormously from being supported to self care. They can live longer, have less pain, anxiety, depression and fatigue, have a better quality of life and be more active and independent (Your health, your way, 2009, p.6). Theory and practice. The social model of disability (K217, Learning Guide 6, p43) plays a significant part in a care service users life, such as Kingsley. This theory accepts that people will experience differences in life because of health issues such as stroke and diabetes, but questions that the difference is the problem when society does not adapt to such differences. The theory was introduced in the 1970s when disabled activists debated that society is the problem that faced disabled people not the individuals disability. This approach has a commitment to improving the lives of disabled people, by promoting social inclusion and removing the barriers which oppress disabled people (Tom Shakespeare, 2006, p 9). The biomedical paradigm ignores the differences between individuals and is criticised for overlooking social influences which have an effect to health care (K217, Learning Guide 2, p40). This is clear in the case of Kingsley; he has received biomedical treatment in the past for type 2 diabetes and now for a stroke from medical practitioners. Kingsley is now experiencing differences in life to an able bodied person as well as a change to his identity to being disabled because he cannot walk or use his right hand without being aided. The nursing home were Kingsley now lives accepts his disabilities and provides care for him such as assistance to walk and use his right hand. Two people assist Kingsley to get out of bed, shower and dress him. The environment is restricting his independence and making him disabled relying on assistance and there are no aids he can use himself which would give him control of his care. Empowering people who use services (K217, Learning Guide 10, pp28-34) is a theory which would allow Kingsley to become involved in his health care needs. The focus of the theory is the concern regarding the need for people to participate in their health care needs, and that empowerment will encourage them to use services and empower them to participate within them. People need to be encouraged to use health care services but also need to empower themselves to participate within a service. Health and social care services encourage users to become empowered; this can be with support groups with people who share similar experiences (Diabetes NHS, 2011). Key factors of the theory are that power and control should be equally divided between service provider and user, several options will be available to the user which there will have knowledge on, information supplied to assist in making decisions and if the user is dissatisfied with the system has the option to decline any further use of the system and make a complaint. Involving people who use health and social care services with empowerment gives them achievement by (K217, Learning Guide 10, p30). Having control and being engaged with services. Equal share of power with practitioners. The contribution of planning individual services and the development of good practice. Including all members of society. Empowerments goal is to involve participation at all levels in care services allowing users to have a say and to be engaged in their care needs working with practitioners to satisfy care needs. Empowerment is a way of equalising the distribution of power between users of services and practitioners (Tuner, MacKian, Woodthorpe, 2010, quoted in Learning guide 10, p.30). Kingsleys care needs are being dictated to him by the care home and his social worker if he was to be empowered to use care services and was to empower to participate in services he may be more actively contented with his care needs. Conclusions and recommendations Who cares for Kingsley and where he receives care are now important decisions to make. The decisions will influence his care needs and his future wellbeing. This report highlights the concerns that people who have long term health conditions face with care needs and the services that provide care. Clearly when a person suffers from an illness such as a stroke or diabetes an emergency response for care is received from a medical practitioner who will offer a biomedical diagnoses and if needed medical treatment and medication. As was the treatment Kingsley received, the next phase in the care process is how after care support and treatment is provided for people with a long term health condition. Kingsleys individual care needs have not been addressed; he may be adequately receiving biomedical care in the nursing home and his basic fundamental needs for living such as shelter, food and warmth are being provided his individual needs are not being considered. Kingsley wishes to return home to the care of his wife, a psycho sociological perspective will identify that his individual psychological health and wellbeing in society is not being fulfilled. The care home environment is restricting him from participating in main stream society; he cannot be active within society because he has no access to social networks. This will be a fundamental reason for his bouts of anger and frustration as before his illness he was social active and provided for his family. Kingsleys care needs are unique to his new identity as a disabled person with a long term health condition, along with a psycho sociological perspective a holistic approach will help to identify the impact this is having on his health, lifestyle and wellbeing. The social worker assigned to Kingsley is concerned that his wife would not be able to cope with his care needs, one option is to recognise what difficulties in society will be restricting Kingsley because of his disability (The social model of disability). The care home is disabling Kingsley because of its lack of practices and environment. If the social worker was to work with Kingsley and his wife to identify the support needed to provide a self care package such as direct payments (K217, Learning Guide 10, p29) this would allow them to be independently in control over which services they use. Allowing them to live independently as a family and able to participate economically within society.

The Revolutionary War :: essays research papers

The Revolutionary War was an enormous part of American history. The revolution in Russia, that sparked the overthrow of communism, was a huge part of Russian history. The revolution of Christianity from the concepts of Greek gods was also a large part of religious history. Christianity and Greek gods have many comparisons, contrasts, and these contrasts resulted in Christianity being revolutionary. The concepts of Christianity and the religious concepts of the Greek gods are comparatively alike. To begin, in both religions, humans believe that there are speakers for their God/gods. Gods do not speak to mere mortals. These people are the priests who teach of the gods ¹ ways and wants. Some are fortune tellers or prophets, as they were called in Greek times, that foretell the future. For example, Tiriesias, in the plays Oedipus the King and Antigone, was a blind prophet who could see the future and foretell it to people. In Greek times the prophets were of high social status. Also, the people believe that their God or gods are above all human ranks. They believe a god is above all and listens to people when they need help. This is why humans pray to the God/gods for forgiveness. The two religious views also believe that the God/gods are watching over their followers. The God/gods decide either before or after a person ¹s life on earth where the person will live in the afterlife, depending on the person ¹s values. Both believe one would either go to a bad place, called Hell or Hades, or a good place, called heaven or the Elysian Fields. Likewise both believe in an afterlife that is eternally chosen. The ideas of the followers of Christianity and Greek religions are also very different. To begin, Christians believe in one almighty God. This is also known as monotheism. Christians believe this God gave the world his only son. When that son was put to death by a human, He told the people He would die to forgive their sins. This shows that God and His son were both caring and forgiving beings. They are respected by the followers of Christianity. God helps humans. Humans pray to this God for help and forgiveness. People also go to church to learn about their religion and to pay their respects to God. The church is thought to be God ¹s house. This is why people get dressed up and try to look nice when they are guests in God ¹s house. God and Jesus are thought to live in heaven. Greeks, however, are very different from Christians. They believe in many gods. This is also known as polytheism. These gods are mean and torture the

beethoven :: essays research papers

As someone who suffers from extreme hearing loss, I am amazed at the great Talent of Ludwig vans Beethoven, who as one of the greatest composers of all time wrote most of his music while he was deaf! It seems impossible, but what a genius he was. Ludwig van Beethoven was born in Bonn, Germany on December 16, 1770. His mother died while he was a teenager and his father was very abusive and a crazy alcoholic. Beethoven came from a very musical family. His grandfather became a conductor and his father played and taught piano and violin. From a very young age, Beethoven was a perfectionist and became emotional and moody when things didn’t go well with his music. Beethoven saw his world as â€Å"all or nothing,† If something he was working on wasn’t absolutely perfect, he would feel he was a total failure. In Beethoven’s life, there wasn’t room for any compromise. He began to realize that he was losing his hearing when he was 28 and he couldn’t hear the church bells ringing. Some people have said that his terrible temper was really his frustration with his music as he became more and more deaf. Beethoven became so sad about his deafness that he considered suicide. He even wrote a suicide letter to his brother to tell him that he planned to kill himself. When he was 50, he was completely deaf. As time went on, Beethoven learned how to cope with his disability. One way Beethoven coped was in order to hear the sounds; he would cut off the legs of the piano and put it on the floor , so that he could feel the sounds in the floor as he played. Once he learned how to handle this, Beethoven began to write his greatest works. Beethoven was such a perfectionist that he would rework his musical compositions for years until they were perfect. It is incredible that during his life, Beethoven wrote nine symphonies and thirty-two piano sonatas. Because of these problems, Beethoven never had many close friends or happy relationships. The music he created showed this and was almost sad and heavy, it wasn’t full of life and fun. Beethoven loved to take walks in the country and enjoy the beauty of nature. It was nature that gave him the inspiration to write â€Å"Symphony No. 6.† One of Beethoven’s earliest and most successful works was a religious composition, named â€Å"Opus 85†, in 1803, known as the â€Å"Hallelujah† choir that we all sing on Easter Sunday.

1968 :: American America History

1968 "An Indignant Generation." With all its disruptions and rage, the idea of black revolution was something many white Americans could at least comprehend, if not agree with. When rebellion seized their own children, however they were almost completely at a loss. A product of the posts war "Baby Boom," nurtured in affluence and concentrated in increasing numbers on college and university campuses. It was a generation marked by an unusual degree of political awareness and cultural alienation. Some shared with the beat writers and poets of the late fifties, a deep disillusionment with this status quo, a restless yearning for something more than a "realistic" conformity. Others had been aroused by the southern sit-in movement, "The first hint," wore a contemporary, "That there was a world beyond the campus that demanded some kind of personal response. "Not so much ideological as moral, in Jessica Mitford's words, "An Indignant Generation." Although an image of arrogance, even ruthlessness, had followed him from his early days as counsel to a Senate committee investigating labor racketeering, Robert Kennedy had shown a remarkable capacity to understand the suffering of others. More than this, he had demonstrated an untiring commitment to the welfare of those who had gotten little more than the crumbs of the Great American Banquet. In fact, Kennedy Appealed most strongly to precisely those groups most disaffected with American society in nineteen sixty-eight, they believed in him with a passion unmatched for any other national political figure, in part for what he had done, but also for the kind of man he was. The collapse of communications made it impossible to determine the fate of the pacification program, but most assessments were pessimistic. When the communists launched their attacks, the government pulled nearly half of the five hundred and fifty revolutionary development teams out of the hamlets to help defend the cities, along with eighteen of the fifty-one army battalions assigned to protect the pacification teams. In so doing, Saigon abandoned the countryside and dealt the pacification program what many felt was a considerable setback. "There always was a semi vacuum in the countryside," said one United States pacification worker. "Now there's a complete vacuum." By the end of the February, orders have gone out for pacification teams and some troops to return to the hamlets, but progress was slow. Although ninety-five percent of the five thousand RD workers in the Saigon

Romeo and Juliet Dramatic Effects

Analyse the dramatic importance of Act 3 Scene 5. Act 3 scene 5 is of huge dramatic importance as it is pivotal to the plot of the play. Act 3 scene 5 takes place the morning after Romeo and Juliet have spent their first night together following their marriage. In the first part of the scene, they are very happy and also very romantic as Romeo says â€Å"How are you, my love? † This shows that Romeo cares for Juliet and it also shows how much love, Romeo has just been banished from Verona for killing Tybalt and is preparing to leave.This makes Juliet very upset as they haven’t even spent a day together. The nurse comes to warn them that Juliet’s mother is coming to see her to discuss her marriage to Paris. After Romeo has left, Juliet bursts into tears. When Lady Capulet arrives, Juliet cries even more but Lady Capulet thinks she is crying because of her cousin’s death. Lord Capulet explodes with anger when he hears that Juliet disagrees with the marriage. The nurse unexpectedly advises her to marry Paris. The key themes highlighted in this scene are: happiness, love, parental conflict, anger and sadness.In this scene we learn a great deal about the characters of: Romeo, Juliet, Capulet, Lady Capulet and the nurse. In the previous scene Romeo and Juliet get married and the Montagues and the Capulets have a fight which leads to the deaths of Mercutio and Tybalt. Romeo is banished from Verona for murdering Tybalt because Tybalt has murdered Mercutio. Lady Capulet seems to support and comfort her daughter, but when Juliet argues and shouts she simply hands it over to Lord Capulet who will control Juliet. In the time of Shakespeare the men were in charge of the house and the children so the audience would have agreed to the play.Lady Capulet thinks that she can control Juliet, so she informs her of the marriage that has already been arranged. She seems very concerned about Juliet but she cannot control her herself and threatens Juliet â €Å"here comes your father. Tell him so yourself, and see how he will take it at your hands†. She means I will not say anything so see what your father has to say. In the previous scenes she was very quiet and innocent but in this scene she changes from being quiet into a very loud character which reveals her true nature.The Nurse is a very caring character and understands Juliet’s problems but in this scene she disagrees with Juliet as she advises her to marry Paris when she is aware that she has already been married to Romeo. This disheartens Juliet so much as she is the only person who she trusted. The Nurse says â€Å"I think the best thing to do is to marry the count† as if she is speaking to someone she doesn’t know. Juliet relies on her so much that she is shocked when she hears such a thing come out of the Nurse’s mouth. Juliet declares â€Å"from now on I will never tell what I feel in my heart†.She also doesn’t say this stra ight to her face as the Nurse would start avoiding her which would please her parents and lead to Juliet getting into more trouble. The Nurse tries to persuade Juliet of Paris’ superiority and believes â€Å"Romeo’s a dishclout to him†. The image of the dishcloth indicates that Romeo is not worthy of Juliet. This makes Juliet furious because it was originally the Nurse who reported positively about Romeo. In this scene the Nurse is ambivalent because she supports Juliet when Lord Capulet explodes with anger as Juliet refuses to marry Paris.In previous scenes the Nurse is very supportive and thinks of Juliet as her own daughter when she says â€Å"What, lamb! What, ladybird! †, but in this scene she changes from supporting Juliet to letting her down when she asks for her advice. Lord Capulet is a very strong character throughout the play but he does care about Juliet as he claims that he will not do anything against his daughter’s will but in this s cene he orders her to â€Å"go to church on Thursday or never look me in the face again.Don’t say anything. Don’t reply. Don’t talk back to me†. This quote would be very aggressive when said in the play as he is saying it with aggression and anger. Which shows that the old Capulet has gone. In this scene, generally, everyone shows their bad side as it is now getting serious about Juliet’s wedding. In this scene Capulet uses metaphors such as â€Å"when the sun sets, the air drizzles dew. But at the death of my brother’s son, it rains a down pour. What are you, girl? Some kind of fountain? he is comparing the downpour and the amount of tears that Juliet is producing and he is also trying to express that Juliet is not crying for her cousins death but crying for her husband Romeo. He also slams her on the floor while she begs on her knees and as he is not aware that Juliet is already married he repeatedly tells her to marry but the audience kn ows that if she marries she will go to hell as there is a sin if she marries again. This scene would have been very dramatic and sad as the audience would have felt sorry for her.By Capulet doing this creates a feeling of tension and pressure for Juliet as she is begging him. From the audience’s point of view, Juliet is very innocent but Capulet refers to her as a â€Å"disobedient wretch†. This shows the amount he cares he takes for his daughter. If this were to happen in today’s society maybe he would be prosecuted for child abuse. Later in the play Juliet pretends to agree to the marriage but nobody is aware of that. Friar Lawrence gives her a potion that she will have before the night of the wedding so that she will fall into a deep sleep and wake up after 12 hours.Act 3 scene 5 is one of the most dramatic scenes in the play. This scene leads to many misconceptions as the Friar Lawrence was supposed to inform Romeo of the plans but Romeo didn’t get th e message. But he got the news that Juliet had died. Act 3 scene 5 reveals most of the characters’ true natures. This scene is important as this is the scene that leads to the death of Romeo and Juliet and also it reveals the Nurses’ real character as she didn’t really understand the true love of Romeo and Juliet. All of the characters undergo a dramatic change in how they behave in this scene.

The Man to send Rain Clouds

â€Å"The Man to Send Rain Clouds† Leslie Mormon Silks wrote â€Å"The Man to Send Rain Clouds† in 1969. The story details the death of an old Indian named Teflon. During one point of the story Leon prepares Topsoil's body for burial. Leon proceeds to paint Topsoil's face yellow. In the Native American Culture the color yellow stands for mourning or death. Teflon may be dead, but Silks presents him as a transitional character going through the three stage process. Silks uses the three stage process to demonstrate the importance of vying a full life and leaving a lasting impression upon the world.The first stage of the process is Separation. Separation is the character moving away into the unfamiliar. Teflon is literally, physically separated from his tribe. In the beginning of the story Teflon is found dead in the sheep pasture under a tree. Teflon was an old shepherd who tended the sheep alone at night. Silks presents Teflon as a lonely, neglected, poor man. â€Å"The y found him under a big cottonwood tree. His Levi Jacket and pants were faded light blue so that he had been easy to find. The big cottonwood tree stood apart from a small grove of winter bare cotton woods which grew in the wide, sandy arroyo.He had been dead for a day or more, and the sheep had wandered and scattered up and down the arroyo. † Silks illustrates the tree as being isolated from the other trees because it parallels Topsoil's separation from the others. â€Å"The people stood close to each other with little clouds of steam puffing from their faces. † The next stage of the process is transition. Transition is the character going through trials and tribulations that stimulates personal growth ND knowledge. Topsoil's burial process is his Journey of change.Teflon went from being a weathered lively old man to being a fragile decomposing corpse. Topsoil's fragility and age is illustrated when the young people dress him in his burial clothes. â€Å"He looked sma ll and shriveled, and after they dressed him in the new shirt and pants he seemed more shrunken. † â€Å"They laid the bundle in the back of the pickup and covered it with a heavy tarp before they started back to the pueblo' The other characters do not even look at Teflon as a human anymore. Topsoil's death transitioned other characters as well. But there he was, facing into a cold dry wind and squinting at the last sunlight; ready to bury a red wool blanket while the faces of his parishioners were in the shadow with the last warmth of the sun on their backs. † Throughout the story the priest transitioned from religious to spiritual. Teflon taught the Father Paul the importance of having a spiritual life. Teflon transition was physical and spiritual. The last stage of the process is reintegration. Reintegration is the character turning to the place where he started or a better place than where he started.Teflon returned to the earth from which he came from. â€Å"They lowered the bundle into the ground, and they didn't bother to untie the stiff pieces of new rope that were tied around the ends of the blanket. † In the King James Version of the bible it is stated in Genesis chapter thirteen verse nine, â€Å"By the sweat of your brow you will eat your food until you return to the ground, since from it you were taken; for dust you are and to dust you will return. † Teflon is returning from what he was made from. I believe that Silks wrote this story to show her readers that she believes life is short.I know life is short. I have seen many people die in my twenty years of life. After I read this short story I went to visit my mom's grave. It seems that after you die no one remembers you. I wandered through the older part of the cemetery fixing headstones. So many were turned over, broken and abandoned. I wondered where the decease's loved one was. The optimism in me wants to believe that I will leave a lasting impression on the world ar ound me. In reality I will probably die and be ergot as soon as my casket hit the bottom of my grave Just like Teflon.I think that Silks is trying to inspire her readers to live fully because one day it will all be over. I want to leave this world a better place. Also another question is, â€Å"Can someone give a greater gift from the beyond then from life itself? † I'm sure the rain did come and replenish the crops so that the Indians had plenty of food and agriculture to sell. Teflon gave a greater gift to his tribe then what he would have been able to give them during life. Teflon also gave Father Paul the gift of Spiritual learning.After watching the burial Father Paul realized that religion isn't the only thing in life. Father Paul expanded his view on death and life after death because of Teflon. Teflon gave everyone a greater gift then what was expected. â€Å"The Man to Send Rain Clouds† shows readers how life after death really is. At one point or another ever yone ponders how the world is going to react in response their death. I think everyone should read this story because it really changes ones perspective about death after life. â€Å"The Man to Send Rain Clouds† will motivate and fresh you outlook on life.After reading this a reader will respond to life in a more conscientious way. This story could improve the quality of our world if it was well- known. â€Å"The Man to Send Rain Clouds† is an inspiring tale of death.

Explain the Rationale for the Existence of Supplier Induced Demand in Health Care

EXPLAIN THE RATIONALE FOR THE EXISTENCE OF SUPPLIER INDUCED DEMAND IN HEALTH CARE AND EXPLORE THE EXTENT TO WHICH EMPIRICAL WORK HAS BEEN ABLE TO ESTABLISH ITS EXISTENCE Introduction: In the traditional market, consumers decide how much to consume and suppliers decide how much to supply and prices coordinate the decisions. For perfect competition it is assumed inter alia that there is: perfect information so that individuals are fully informed about prices, qualities etc; a lot of buyers and sellers; no single buyer or seller that has influence on the price. But health care market falls short of the perfect market paradigm as it is dogged by many phenomena that cause it to fail (Arrow 1963). One such phenomenon is supplier-induced demand (SID), whereby health care providers, usually physicians, exploit their information advantage over patients in order to induce patients to utilize more healthcare services than they would if they were accurately informed. The phenomenon of SID tends to take an important place within social debates because it has an impact on health care expenditures, health status and the allocation of income between patients and physicians (Labelle et al 1994). Therefore, it has attracted considerable attention in the health economics literature since Roemer (1961), who observed a positive correlation between the number of hospital beds available and their use leading to the observation, ‘a bed built is a bed filled’, sometimes referred to as Roemer’s Law. Although a variety of empirical tests of SID have been reported in literature, researchers disagree on the definition of and tests for SID. The validity of the results from the tests is controversial. Therefore there is no consensus on the development and implementation of public policy based on these results (Labelle et al 1994, p349). Indeed, Doessel (1995, p. 58) observed that this area of research can be described as a theoretical and empirical quagmire. After defining the terms, this essay is going to explore and explain the theoretical rationale, the empirical evidence and policy implications for the existence of SID. The argument will be summed up in the conclusion. Health Care Market and SID A market is a shorthand expression for the process by which households’ decisions about consumption of alternative goods, firms’ decisions about what and how to produce, and workers’ decisions about how much and for whom to work are all reconciled by adjustment of prices. Health care comprises services of health care professionals, which are addressed at health promotion, prevention of illnesses and injury, monitoring of health, maintenance of health, and treatment of disease, disorders, and injuries in order to obtain cure or, failing that, optimum comfort and function (quality of life) (Worldbank website). In health care market there is: a few buyers and sellers; asymmetry of information therefore violation of consumer sovereignty; allocation of resources by physicians and not price mechanism etc. Therefore patients face a dilemma in translating their desire for good health into a demand for medical care. This requires both information and medical knowledge, which they usually do not have. There is no definitive and widely accepted definition of SID. In literature, the definitions range from positive and value free (Fuchs 1978) to normative with negative connotations (Folland et al 2001, p. 04). McGuire (2000, p504) says that SID ‘exists when the physician influences a patient’s demand for care against the physician’s interpretation of the best interest of the patient’. Labelle et al (1994, p. 363) point out the need to incorporate in the definition of SID both the effectiveness of the agency relationship and the effectiveness of the induced services. This me ans that inducement can give rise to ‘good’ or ‘bad’ outcomes for patients depending on its clinical effectiveness, e. g. f a doctor persuades a patient to undertake more treatment where the patient would otherwise have opted for a less than clinically effective package of care. Rationale for the existence of SID: The theoretical analysis of SID is based upon the assumption that doctors maximise their utility subject to income and inducement. Dranove (1988, p 281) argues that under certain conditions the physician will have an incentive to recommend treatments whose costs outweigh their medical benefits. SID involves a shift of the demand curve, such that as supply ncreases, demand also increases (Fig. 1). In practice the exact demand curves themselves cannot be measured. Only the equilibrium points (A, B, C and D) of the overall market can be observed. If the supply of doctors increases from Q1 to Q2 (Fig. 1a), then the fee payable decreases from P1 to P2. But if SID exists (Fig. 1b), as the number of doctors increases from Q1 to Q2 the doctor would keep shifting the demand curve from D through to D3 in order to maintain or increase income. Fig. 1: Graphical representation of competing hypotheses The potential for SID to arise is shaped but not guaranteed by a number of characteristics of the health care market including: information gaps and asymmetries which encourage patients to seek medical advice and delegate decision-making to doctors; potential weaknesses in the agency relationship and the impact of clinical uncertainty on the decision making processes of doctors. Systems for financing, organising and paying for medical services also influence doctor and patient behaviour. The asymmetry of information between user and provider is the most fundamental peculiarity of health care, and the source of the most serious failures of market processes during resource allocation. Informational asymmetries may also invalidate the assumption of â€Å"consumer sovereignty† which underlies evaluative policy assessment in much of economics. Patients will often be relatively poorly informed compared with their doctor about their condition, treatment options, expected outcomes and likely costs. Unlike other professional services, information asymmetry is most pronounced in health care markets. Many researchers have tested the hypothesis that more knowledgeable patients should be resistant to SID and that they should therefore make less use of medical care. Surprisingly these studies have consistently found that knowledgeable patients frequently use more care [Bunker and Brown (1974); Hay and Leahy (1982) and Kenkel (1990)]. The institutional responses to information asymmetry are professionalisation, self-regulation, and the development of an agency relation between individual transactors and between the professions and society collectively. Agency relationship is formed whenever a principal (patient) delegates decision-making authority to another party, the agent (doctor). Ill-informed consumers are protected, by provider advice, from consumption of unnecessary or harmful services (inappropriate or poor quality) and also from failure to consume needed services. If this agency relationship were perfect, doctor would take on entirely the patient’s point of view and act as if he/she were the patient. All consumption choices made for the patient by the provider would be made so as to maximize the patient’s (and ultimately society’s) utility function. Health care providers do not always act as perfect agents for their patients. Their recommendations are sometimes influenced by self-interest, or the interest of the organization for which they work. This imperfect agency arises because the doctor (agent) performs a dual role — the same person who provides advice about a treatment usually provides and receives payment for that treatment. Hence, demand is no longer independent of supply; the agent can shift the demand curve to any position (Fig. 1b). The demand curve (Figure 1a), assumes that independent consumers of care are not directly influenced by suppliers in their decisions to use care, or alternatively that if such direct influence exists, its level is determined external to the market process itself. On the other hand, it has been shown that in spite of the presumed physician influence over the patient, the physician cannot predict the level of patient compliance (Goldberg et al 1998). Therefore it is doubtful how much influence the physician wields over the patient when it comes to SID. Traditionally doctors’ behaviour is controlled by a professional code- â€Å"Hippocratic oath†. Financial self-interest on the part of the physicians is only one of the causes of imperfect agency. Another very important cause is the failure of physicians to understand or accept patients’ preferences regarding the impact of health status on utility and provide this information to the patient (Labelle et al 1994). The target income theory posits that as the number of physicians has increased, they have induced additional demand to get a particular income, e. g. y increasing the volume and variety of tests and procedures. This is in contrast with conventional economics where increasing supply lowers the price for the consumer. The target income is determined by the local income distribution (Rizzo and Blumenthal, 1996). A professional service like Health care is inherently heterogeneous and nonretradable. A monopolistic competitor selling a nonretradable service set s a quantity to maximize profit and unless there is some cost to inducement, a physician or dental practitioner pursuing net income would induce demand to an infinite extent (Gaynor 1994). However, physicians prefer not to induce demand and only do so if they are compensated by adequate gains in income. The utility maximisation of physicians is limited by disutility of discretion, i. e. either the physician’s internal conscience (Evans 1974; Mcguire and Pauly 1991) or as a result of a reputation process by which doctors who excessively induce demand are punished through future reductions in true patient demand (Dranove 1988). SID can arise when clinical uncertainty causes provision of ‘unnecessary’ or ‘wasteful’ medical services even if doctors act in the perceived interests of their patients. If a doctor inadvertently underestimates a patient’s ability to pay for the cost of medical procedures, the level of care recommended might exceed that which the patient would have nominated. However, some analysts maintain that doctors’ responses to clinical uncertainty can give rise to SID fully consistent with the patient’s interests rather than self-interest (Richardson and Peacock 1999, p. 9) e. g. use of diagnostics in excess of ‘standard’ levels in the event of diagnostic uncertainty. Institutional and regulatory arrangements influence how medical markets work. They create incentives or disincentives for doctors (and patients) to behave in ways that could engender SID. For example, the cost-bearing and financing aspects of the doctor’s service are largely borne by third parties (i. e. governments and private insurers). As a consequence, typically neither the consumer nor the provider carefully considers the price or cost of the service supplied. This can influence the extent and form of SID. Other arrangements that can promote SID include: the system of payment for doctors (i. e. ee-for-service, capitation or salaried); the effect of medical indemnity arrangements on the adoption of ‘defensive medical practices’ by doctors; and the form of monitoring of doctor treatment practices. The link between physicians and pharmaceutical companies can also promote SID. Big pharmaceutical companies approach physicians and â€Å"ask† them to prescribe specific drugs to patients in exchange for a reward, such as free holidays. For example, in 2002 drug firms spent nearly $9. 4 billion on marketing to American doctors (The Economist 15th Feb. 2003). As a result, physicians are illing to prescribe extra medicines that are unnecessary and provide no benefit to the patient. Moreover, these drugs favoured by the physicians and produced by big companies might be more expensive than others with equivalent effectiveness However, one major criticism of the SID model is that it focuses on only one price– the nominal fee level–while ignoring access costs. If increased supply reduces travel time and office waits, the total cost of care has fallen even if fees remain constant. Secondly, the SID theory carries an implicit assumption that the extra services are unnecessary. An alternative view is that few situations in medicine are clear-cut and a broad range of indications is consistent with generally acceptable practice. Empirical evidence of SID Several indirect hypotheses and empirical tests have been carried out but due to the lack of a rigorous theoretical model and the presence of econometric and measurement problems, results concerning the existence of SID still remain controversial and inconclusive. SID is not easy to measure and interpret because of the difficulty of separating out induced from un-induced demand, supply changes from demand changes and SID from other factors influencing demand (e. . income, insurance coverage, health status). However, there is clear evidence that physicians who are paid on fee-for-service basis can adjust the number of services in response to limitations on the levels of fees (Rice, 1983), but such responses are not automatic and health economists don't have a good understanding of what contextual factors are i mportant in predicting such responses. Nevertheless, the potential for such responses means that inducement is an important factor to consider in policy development. To test for SID early studies looked at changes in utilisation compared to increases in physician/population ratio. The hypothesis underlying the tests is that, in response to an increase in the doctor/population ratio (i. e. competition), doctors will seek to induce demand or raise their fees so as to maintain their incomes. Cromwell and Mitchell (1986) demonstrated a significant demand inducement for surgical procedures with overall rates of surgery increase by about 0. 08% for each 1% increase in surgeon supply. Rice’s (1984) found that 10% decline in physician reimbursement led to a 6. 1% increase in intensity of medical services and a 2. 7% increase in intensity in surgical services. However, a similar study found mixed responses to fee changes across procedures (Labelle et al 1990). Another technique used for testing SID is to examine the effect of changes in doctor supply on doctor compared with patient initiated visits. Assumption here is that if SID exists, increases in doctor numbers would lead to an increase in doctor-initiated visits (that is, an income maintenance response test). Tussing and Wojtowycz (1986), using this technique, found that areas with more GPs were associated with much larger proportion of return visits arranged by doctor, i. e. a strong relationship to support SID. On the other hand, doing a similar experiment, Rossiter and Wilensky (1983) found only very small inducement effect. This approach to investigating the presence of SID effects (increasing physicians and increasing utilisation) fell somewhat out of favour when Dranove and Wehner (1994) found that, according to the standard methodology among SID theorists, an increase in the number of physicians resulted in an increase in childbirths. Recent studies have looked at physician behaviour in response to fee reduction, e. g. Yip (1998) found that physicians compensate for income losses due to public price reduction by increasing volume. Medicare fee cuts lead to increased amounts of heart surgery enabling physicians to recoup 70% of lost revenue. Gruber and Owings (1996) found that a 13% reduction in fertility rate in the US in 1970-1982 led to an increase in caesarean sections and reduction in the less profitable vaginal births. Between 1971-1981, the number of GPs per capita in Winnipeg, Canada increased by 56%. Remarkably, however, real gross income per physician remained virtually unchanged during the period. GPs simply increased the number of contacts with existing patients – so much so that their average revenue actually increased (Roch et al 1985). On the other hand, in Norway, Grytten and Sorensen (2001) compared a salaried group of physicians with another one that was compensated by fee for service. Neither of the two groups of physicians increased their output as a response to an increase in physician density. In UK, dentists are paid on a fixed fee-for-service basis. Supplier income can only be increased by increasing utilisation. Therefore, testing for the existence of SID in dentistry has involved looking for a positive correlation between dentist density and utilisation of dental care. Birch (1988) concluded that a positive correlation between the number of dentists per capita and the treatment content per visit provides sufficient (but not necessary) evidence for the existence of SID, in a fee-regulated market environment. Other researchers [Manning and Phelps (1979); Grytten et al (1990)]  found similar correlations. Sintonen and Maljanen (1995) found that individual and general inducement appeared to have considerable effect on utilisation, but no systematic connection with supply conditions (dentist/population ratio). This was interpreted to indicate that some dentists, regardless of the market situation, have adopted individual inducement. However, there are alternative explanations for a positive correlation between dentist density and the utilisation of medical services: permanent access demand on the market for medical services due to price regulation; demand decisions by rational patients (the opening of new practices, particularly in rural areas, reduces the average time and transport costs, and the average time spent in the waiting room also falls); reversed causality where physicians set up shop in high demand regions (Zweifel 1981 p216). Policy Implications of SID: SID is of great importance to the policy maker because it threatens the basic market paradigm and severely undermines economic recommendations about market policy. There are differing interpretations of policy significance of SID. According to Carlsen and Grytten (2000), policy makers can compute the socially optimal density of physicians without knowledge of SID. Yet most analysts look at SID from the perspective of manpower and reimbursement policy for purposes of cost containment. They do not consider its contribution to the health status of patients. The impact of SID on equity, distributional issues and the net social benefits is usually ignored (Labelle et al 1994). The issue of SID raises another major controversy of whether adequate control over resource allocation to and within healthcare is best achieved through the demand side or through regulatory controls on the supply side (Reinhardt 1989, p. 339). Indeed, due to problems with moral hazard and SID, insurers use demand-side incentives (e. g. co-insurance and deductibles), as well as supply-side incentives aimed at providers (e. g. aying physicians through salary or capitation). An example of policy implications of SID to manpower planning is when a government wishes to attract physicians to rural areas, and it does so by paying rural doctors more than those in urban areas. This could precipitate SID within urban practices, hence nullifying the government’s intention. Direct regulation of the supply of physicians—by mandating that all new graduates spend a c ertain number of years in rural communities, for example —might have some advantages, although this may well affect the number and quality of medical students. For facility planning purposes, Roemer’s Law has the fundamental implication that there is no external â€Å"demand† standard, based on observed utilisation, from which â€Å"needed† levels can be inferred. Providers will themselves determine use on the basis of available capacity inter alia. SID means increased demand by patients, which raises costs of care. If it exists, then the policy maker may wish to provide for control of supplier behaviour by mandating evidence-based medicine: cost-effectiveness evaluation of new interventions, medical audits etc, all of which encroach on clinical freedom. Use of provider payment mechanisms like salaries for doctors, global budgets, and case payments could help. However, Ferguson (2002) argues that overall, demand curve for medical care slopes downward, and that supplier-induced demand is overrated as a policy concern. Conclusion: This essay has explained the rationale for the existence of SID and has explored its policy implications and empirical evidence of its existence. There is arguably sufficient evidence to accept that SID can occur. Even Hippocrates himself realised that as in all things mercenary (in health care it is â€Å"fee-for-service†) there is no such thing as pure altruism. Indeed, the Hippocratic oath is an admission to the potential for pecuniary self-interest and abuse of sacred trust. Imperfect agency and clinical uncertainty are the main causes of SID. If SID is pervasive, there could be a variety of economy-wide impacts, e. g. it could increase health expenditure without a commensurate improvement in health outcomes. Therefore, it has important implications for the health policy process. Strong support for SID hypothesis was found in the UK dentistry. Otherwise, there is no robust evidence on the likely magnitude of SID. Although inconclusive, most studies suggest that where SID arises, it is small both in absolute terms and relative to other influences. However, it is still worth considering SID-attenuating arrangements say in the case of physician reimbursement policy. As there are a number of fundamental and seemingly irresolvable methodological and data problems associated with trying to assess SID, definitive evidence of its existence most likely will remain illusive. References: 1. Arrow, K. J. (1963). Uncertainty and the Welfare Economics of Medical Care. American Economic Review 53: 941-973. 2. Birch, S. (1988). The identification of supplier-inducement in a fixed price system of health care provision: The case of dentistry in the United Kingdom. Journal of Health Economics. 7:129–150. 3. Bunker, J. P. and Brown, B. W. (1974). The physician patient as an informed consumer of surgical services. New England Journal of Medicine 290: 1051-1055 4. Carlsen, F. and Grytten, J. (2000). Consumer satisfaction and supplier induced demand. Journal of Health Economics 19:731-753 5. Cromwell, J. and Mitchell J. (1986). Physician-Induced Demand for Surgery. Journal of Health Economics 5: 293-313. 6. Doessel, D. P. (1995). Commentary. In Harris, A. (ed), Economics and Health: 1994, Proceedings of the Sixteenth Australian Conference of Health Economists, School of Health Services Management, University of New South Wales, NSW. 7. Dranove, D. (1988). Demand inducement and the physician/patient relationship. Economic Inquiry 26:281-298 8. Dranove, D. and P. Wehner (1994): Physician-induced demand for childbirths Journal of Health Economics 13:61-73 9. Evans, R. G. (1974). Supplier induced demand; some empirical evidence & implications. In Perlman, M. (ed). The economics of health & medical care. London: Macmillan 10. Ferguson, B. S. (2002). Issues in the demand for medical care: can consumers and doctors be trusted to make the right choices? AIMS Health Care Reform Background Paper #5. Halifax: AIMS http://www. aims. ca/Publications/Demand/demand. pdf (accessed: 26th April 2004). 11. Folland, S. , Goodman, A. and Stano, M. (2001). The Economics of Health and Health Care. 3rd ed, Upper Saddle River, New Jersey. Prentice Hall 12. Fuchs, V. (1978). The supply of surgeons and the demand for operations. Journal of Human Resources, 13(supplement): 35–56. 13. Gaynor, M. (1994). Issues in the Industrial Organization of the Market for Physician Services. The Journal of Economics and Management Strategy 3(1): 211-255. 14. Goldberg, A. I. 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Amsterdam: North-Holland ———————– P- fees for ServiceQ- supply of doctors S- supply curve of servicesD- demand curve for services P2 P1 Q1 Q2 D C A S1 S P3 P1 P2 Q1 Q2 Q3 Q4 D D2 D1 D3 S1 S B (a) No SID(b) With SID D