Risk and profitability analysis Coursework Example | Topics and Well Written Essays - 1000 words

Risk and profitability analysis - Coursework Example Commercial banking is another kind of service offered by the bank which includes Credit and lending, International trade and receivables finance, Payments and cash management, Insurance and investment, GB&M. Global banking and markets is another verticals of services provided by the banks which comprises of Global markets and Global banking. The bank provides another domain of services like Global private banking which involves Private banking, Investment management and Private trust solutions (HSBC, 2012, pp. 60-61). Lloyds provides a range of products and services financial services which involves Debt capital markets, structured finance, Working capital finance, Private equity, Trade and supply chain finance, Terms loans and overdraft. Risk management service is another vertical of the bank which comprises of Inflation linked solutions, Interest rate risk management solutions, Commodities market related solutions, Foreign exchange related solutions, and Additional risk related ser vices. ... Other verticals of services of the bank are Private banking and Business banking and corporate banking (RBS, 2012). B. Profitability and Risk Analysis of Four Banks HSBC:-It is a British multinational bank and also a financial service company which has it’s headquarter in London, UK. It is one of the largest bank is the world. It has earned $20.64 billion in 2012 and profit of $14.02 billion. HSBC Profitability Ratios 2009 2010 2011 2012 Return on equity capital 0.04 0.08 0.10 0.08 return on assets 0.00 0.01 0.01 0.01 net interest margin 0.02 0.02 0.02 0.02 net non interest margin 0.01 0.02 0.02 0.02 net bank operating margin 0.00 0.00 0.01 0.00 earning per share 0.04 0.09 0.11 0.08 From the above table we can see that return on equity capital has increased over the period of time from 2009 to 2010 to 2011.But in 2012 it has decreased slightly. Overall position of ROE was quite high. Return on assets was low continuously which means net income over total assets was quite low. Net interest margin remained stable during the period. Net non interest margin increased in 2010 from 2009 and then remain stable. Net bank operating margin was low. Earnings per share have improved during the period with exception in 2012. Overall profitability ratios for HSBC were remaining stable for the period of four years. credit risk measure 2009 2010 2011 2012 total loans/total deposits 0.97 0.92 1.18 1.24 provision for loan losses/total loan 0.11 0.06 0.03 0.02 liquidity risk measure 2009 2010 2011 2012 net loans/total assets 0.10 0.11 0.15 0.15 purchased funds/total assets 0.94 0.94 0.94 0.93 cash assets and govt. securities/total assets 0.39 0.38 0.40 0.40 interest rate risk

A Brief History of Economics Essay Example for Free

A Brief History of Economics Essay Through his use of dialectical materialism, Marx not only changed the history of economic thought, but found great illumination for himself regarding the bonds of human society. The concept that seems relatively simple in today’s complex economic world was utterly revolutionary in the time of Marx: people develop their ideas about the world (and thereby, their ideas for how society should be organized and stratified) based on the material aspects of their lives. It was an elegant extension of basic Marxist theory: capitalism, according to Marx, is interested in offering naked materialism as a kind of booby prize to make up for the means of production being taken away from the people. If the people can no longer work for themselves and no longer work at perfecting their own craft as individuals, then, as Marx correctly deduced, people would require something to validate their work. This became the center of capitalism, as Marx understood it: materialism exists as a kind of justification for capitalism, and since materialism has permeated our culture to such an extreme degree, eventually social orders began to revolve around it. Hence, what capitalism serves as the cause of what Marx saw as nothing less than ongoing class warfare. It is interesting to note that Marx believed a violent revolution on the part of the proletariat was not simply a possible method of changing things, but actually served as the only method of changing things. This is because materialism was so embedded into class structures (which, in turn, was so embedded in power structures), and the only way for society to functionally survive was for it to become overturned completely. It is also interesting to note the ongoing effect that Marx has had on philosophic thought: materialism had previously been dislodged by Descartes and the famous declaration â€Å"I think, therefore I am;† as far as most people who pondered these things could conclude, thought preceded matter. However, Marx not only brought materialism to the philosophic forefront—the then-controversial idea that material preceded thought—but illustrated the notion that the abstractions of materialism had been concretized by capitalism into purchasable goods. 2: Marx and the Secret Source of Profit Perhaps the most enduring notion of Marx’s is the so-called secret of the source of profit under a capitalistic society†¦though such is Marx’s legacy of intellectual thought, a great many people simply accept this notion as reality: the source of profit is the surplus value that an employer gains from laborers. After all, the means of production have been taken from the people: skilled artisan cobblers have been replaced by factory line workers churning out shoe after shoe after shoe. The money saved by employing this assembly-line method of industrial production becomes pure profit for the employer. Interestingly, Marx tethered this to his own theories on circulating capital—that is, something that does not last, and is used up in the production of other goods and services, in direct opposition to fixed capital, which is traditionally held for over a year by a business or institution. Marx astutely deduced that the distinction between these concepts is not only relative, but arbitrary: the idea that capital held for 365 days is circulating and that capital held for 366 days is fixed is absurd. However, it allows the proletariat to essentially gloss over their own necessity to the entire institution of capitalism: they are led to believe that society is held up by the fixed capital of major investors and their long-term investments. In reality, society is held aloft by the ongoing purchases of the common man (and woman): their disposable income is burned off to provide them a sense that capitalism is worth it†¦it turn, their disposable income is used to make the rich richer, as the cliche goes, all the way up the capitalist pyramid. In Marx’s view, this is one of many ways that those in power forestall the seemingly unavoidable class war that he advocates: those with power—the purchasing power of the common man—are convinced they have none, and are bought off with trinkets. It is interesting to note that this echoes the master/slave morality inversion of Nietzsche. 3: Marginalists and the Economy In the evolution of economic theory, the impact of marginalism cannot be overstated. Once one had accepted the blunt realities of Marx—specifically, that society was organized based on the perceived value of items—the logical question remained: how does one quantify the value of an item? Marginalism illustrated the diminishing returns on the marginal utility of resold products, which dramatically impacted analysis of capitalist economy, the focus of economic analysis, and theories of value and distribution. Regarding the analysis of capitalist economy, marginalism helped solidify the supply and demand notion of economics as that of mainstream economic thought, as opposed to the labor theory of value espoused by Karl Marx. To put it mildly, this has had ongoing economic effects for the last century and a half. The focus of economic analysis shifted accordingly, as marginalism interacted with price theory: this allowed economics to project demand curves utilizing marginal rates of substitution as a means of determining not only when, but why a seller is willing to relinquish a product for a particular price. Perhaps one of the most lasting effects of marginalism on economic thought has been its effect on theories of value and distribution. With the previous measures in place, economists (as well as common people) now had a more-or-less accurate measure of determining the value of any given product in any given social context. Of course, this also effects the ongoing distribution of certain products to certain demographics in order to maximize profitability. Interestingly, this is one of the chief criticisms of marginalism as well: that it is a vague pseudoscience whose intent is to maintain not only the economic status quo, but the appearance of the status quo. It is no surprise, then, that Marxists continue to grapple with marginalist theory: they see it as a means of keeping the proletariat in check, and preventing any uprisings from them. 4: Thorstein Veblen: Survival of the Fattest Thorstein Veblen, for better or worse, specialized in bringing the human element into economic theory. Specifically, he theorized that the institution of the leisure class was a parasite feeding upon America: upon the backs of workers who are actually productive are a class who seek only profit and produce nothing but waste. He essentially created and popularized the notion of conspicuous consumption as the epitome of this theory: that wealthy individuals spend large amounts of money on ostentatious goods whose sole benefit is to publicly display their wealth to the world. Unfortunately, this has become an integral part of the economy: although an engineer might weep at the man spending over a hundred thousand dollars for a car, the American economy would be crippled if conspicuous consumption vanished overnight. Hence, the parasite metaphor: conspicuous consumption and naked profit helps the wealthy to bloat themselves on the backs of the poor until the entire enterprise inevitably crumbles under its own weight. Veblen perceived quite clearly that human notions about the world are social constructs created by individuals, and as time went on, those notions would change, necessitating a change in economic thought as well. He makes frequent comparisons to evolution to further this end: idle curiosity spurs innovation, innovation spurs conflict between the old guard and the innovators, and an economic Darwinism is born. The advent of industry and technological revolutions merely expanded his original point: the parasitic relationship continued unabated, as the innovations of the productive engineer class were inevitably utilized as means of conspicuous consumption and waste on the part of the leisure class. Planes are developed as a result of idle curiosity, for instance, but it is the leisure class that necessitates the invention of first class as a way of displaying their own status in the social hierarchy.

Comparing Oxygen Levels to Heart Rate Recovery and Peak Time

Comparing Oxygen Levels to Heart Rate Recovery and Peak Time Research Question How do different concentrations of oxygen provided to the respiratory system affect the heart rate and thus a subjects  athletic capabilities? Introduction Firstly, it is important to investigate how the bodys respiratory system functions. The lungs have two primary functions, releasing carbon dioxide from the body and integrating oxygen into the bloodstream 3. The lungs never reach peak capacity and are not responsible for the limitation in oxygen delivered to the muscles 1. This is important because, in the case of this experiment the limitations may be reached. There is always approximately the same amount of oxygen in the air in relation to everything else: 21%. However  as altitude increases there is less air pressure and thus less oxygen available to the lungs per diaphragm contraction cycle. Instead of changing the barometric pressure, there will simply be less or more oxygen in the air, in this experiment. This may cause an abnormal result as the body responds differently to drastically altered conditions. When the oxygen content of the air is drastically reduced, the blood will most likely be significantly less saturated and when the oxygen content of the air is drastically increased the blood should be more saturated with oxygen 2. It is then necessary to investigate how this might affect the cardiac system. The amount of oxygen that is available to the cells while they are producing ATP  to drive the body is important, because if there is not enough oxygen available for aerobic respiration, than  anaerobic respiration will take place. Anaerobic respiration will produce lactate and carbon dioxide. The lactate (lactic acid), triggers a response from the sympathetic nervous system1, 2. The noradrenergic sympathetic nervous system produces norepinephrine. The SA node (sinoatrial node), stimulated by the norepinephrine hormone increases both the rate that the heart beats and the degree to which the heart completes a systolic contraction 1,2. In addition to the sympathetic nervous system, the medulla senses the increase of carbon dioxide in the blood due to anaerobic respiration. The medulla then sends an electrical signal through the cardiac nerve to the SA node2. A live O2 machine will be used in order to carry out this experiment. It produces and stores 15% oxygen and 95% oxygen separately. These will be the two concentrations of oxygen that will be used to compare the times it takes for heart rates to peak and then recover. The independant  variable is the concentration of Oxygen. The dependant  variable is the time it takes for the subject to peak and the time it takes for the subject to recover. The experiment will be controlled by regulating the speed at which the treadmill is set to. Since the point of this experiment is to compare differences  the difference in the individuals athletic ability should not make a difference in the data. Materials Live O2 Machine Oxygen mask Treadmill Heart rate/oxygen saturation monitor Clorox and paper towels Timer Experimental Overview The Live O2 machine which will be used to create, store and deliver the two different concentrations of oxygen is comprised of an oxygen machine, storage bag with two compartments, a delivery system with a mask and a switch to change which concentration of oxygen is being delivered. The picture above, depicting the live  O2 system is the one that was used, except a treadmill was used  instead of a stationary bike as is depicted. The test subjects heart rate peak times and recovery times were first tested with the increased level of oxygen, they were then given a period of rest while another subject ran on the treadmill. Then, after the period of rest the subject would run on the treadmill again and their peak and recovery times would be measured with the restricted levels of oxygen. The threshold for the heart rate peaking was 140 bpm. The threshold for recovered was when the heart rate of the subject was within 10 of their original resting heart rate. For example, if the test subjects resting heart rate was 65 bpm, they would be considered recovered when their heart rate dropped back below 75. Procedure Step 1 First 8  willing people were found, who were athletically fit enough that there would not be any damage to their body through the testing. Then the 8  people were instructed not to drink any sort of caffeine or any other stimulant before the experiment. The mask of the live  O2 machine was cleaned with clorox  and the oxygen machine was turned on to fill up the two individual bags. Step 2 Then the resting heart rate of the subject was taken with the heart rate monitor. Ten was added to the resting number to determine the threshold that the heart rate must reach during recovery to determine whether or not the subject has recovered. The heart rate monitor was left on the subjects  finger to monitor their heart rate, Then  the oxygen was set to the 95% setting and the treadmill was set to 5 miles per hour. Then, once the subject was at 5 miles per hour the timer was started and the subject was instructed  to hold the mask to their face. The timer was stopped once the subjects heart rate reached 140 bpm. Then the treadmill was stopped and the subject was instructed to keep the mask on. Then the time it took for their heart rate to return to the predetermined resting rate was measured. Step 3 The first subject was then given rest while subject 2 performed step 2. Once subject 2 was done with step 2, subject 1 repeated step 2 with 15% oxygen instead of 95% oxygen followed again by subject 2. The mask was cleaned with clorox  between each subject. Step 4 Steps 1-3 were repeated with the remained of the test subjects and the data was recorded in a table within the lab book. Safety considerations Since this lab works with the human body and measuring its responses to what could be considered  strenuous situations, there must be precautions taken. Firstly, all of the subjects that were tested, were either in good or exceptional physical condition and had no preexisting health complications that would endanger them during the experiment. To further ensure that there was no physical harm done to the subjects, the subjects saturation was constantly monitored with the heart rate/oxygen saturation monitor. If at any point during the 15% oxygen test the saturation dipped too low (below 85% saturation) and remained there for more than a couple seconds then the 95% oxygen would immediately been switched on and that round of testing would be terminated and the subject time to rest. The mask that was being used was also constantly cleaned with clorox  to prevent the spreading of germs. Analysis Qualitative variables The two main variables that may have affected the data were: the heart rate monitor and the oxygen mask. The fact that the subject had to hold the monitor on their finger and the mask while running made the heart rate monitor slightly inaccurate and sometimes would simply not take readings. It only worked when the subject was holding onto it and this disrupted their normal running patterns. Some subjects also had trouble holding the mask to their face with enough force to hold a seal while running. This may have let some of the natural air into the mask. Holding the mask also inhibited the subjects natural running pattern. The fact that the subjects natural running pattern was inhibited made it harder for them to keep a normal running pace even with the treadmill set at a constant 5 miles per hour. Having to control all of these things at once may have also added to the strain on the subjects body, which could have affected the results. Then finally, there is also the fact that every one that was being tested was different in their biological makeup and therefore will respond slightly differently to the two concentrations of oxygen. Data Complete Peak and Recovery times (in seconds) run: 95% Oxygen Peak times (s) 95% Oxygen Recovery time (s) 15% Oxygen Peak times (s) 15% Oxygen Recovery time (s) 1 187 45 62 185 2 180 56 52 102 3 200 64 40 188 4 181 69 39 73 5 153 71 36 123 6 108 52 60 201 7 181 21 56 133 8 144 61 27 177 This table displays each run and the times in seconds associated with it. The runs where the higher concentration of oxygen (95%) was used are displayed first, on the left. The runs where the lower concentration of oxygen (15%) was used are displayed second, on the right. The peak times (the time it takes for the subjects heart rate to reach 140 bpm from resting) are displayed in the 2nd and 4th column and the recovery times (the time it takes for a subjects heart rate to go from 140 bpm back to within 10 of resting) are displayed in the 3rd and 5th column. This bar graph displays the average recovery times and peak times for the two different levels of oxygen concentration. The recovery times are listed at the top and the peak times are listed at the bottom. Average Difference in Peak and Recovery time in seconds Peak time (s) Recovery time (s) Difference 120.25 92.875 This table displays the difference between the average peak time of the 95% and 15% oxygen concentration. As well as the difference between the average recovery time of the 95% oxygen and the 15% oxygen concentrations. Evaluation Conclusion of results There is a clear difference between the times for the two different concentration of oxygen. When the subject was administered 95% oxygen their peak times took an average of 166.75 seconds, while when the average peak time when only 15% oxygen concentration was administered was 46.5 seconds. This is a difference of 120.25 seconds, so clearly when a subject is administered more oxygen it provides more oxygen for the system, this allows the body to stay out of anaerobic respiration longer and thus allows the heart to beat slower for a greater amount of time. The difference seen in recovery times was also significant. On average, with the higher 95% oxygen concentration the subjects recovered around 54.875 seconds. However when the subjects were administered the lower concentration of oxygen the recovery times took much longer, averaging out at 147.75 seconds. The difference was 92.875 seconds. This occurred because when the body was already deprived of oxygen and the saturation was low there was a large amount of carbon dioxide and lactic acid build up from anaerobic respiration. Then, after the subject stopped running, the low oxygen concentration most likely caused the subjects to stay in anaerobic respiration as the body tried to oxygenate the tissue. With the higher concentration of oxygen, the subjects body was able to quickly oxygenate the tissue and return the body to complete or near complete aerobic respiration. This would have stopped the build up of lactic acid and carbon dioxide and allowed the body to flush the two out of it s system. Once the lactic acid and carbon dioxide has either been absorbed or in the case of carbon dioxide, exited the lungs, the heart rate would return to resting. Therefore, the results matched what should have happened according to previous scientific research, outlined in the introduction. How the lab could be improved and extended The first thing that would be helpful would be to use a more accurate heart rate monitor. Most likely the best solution would be a heart rate monitor that could be taped to the finger being used in unison with a chest heart rate monitor. Using both of these simultaneously would ensure the best and most consistent results. In addition it would remove the responsibility from the subject of holding onto the heart rate monitor. Another issues that could be easily solved is the oxygen mask. The straps that were provided with the mask fell off very easily during running. As a result   the subjects had to hold the mask to their face as they ran. This hindered their ability to run smoothly and did not guarantee a complete seal around the face. Next time a full head cap could be used to ensure that a seal was maintained and would allow the subject to run normally. To further extend this experiment saturation rates could also be compared to heart rate and oxygen concentration. When the subjects were performing the test their saturation rates were monitored for safety reasons but not recorded. If the saturation rates could be recorded throughout the test at specific points along with the heart rate it would be interesting to look into how the saturation rates are correlated with the heart when very low and very high concentrations of oxygen are being administered to the subject. Works Cited Burton, Deborah Anne, FRCA, Keith Stokes, BSc PhD, and George M. Hall, MBBS PhD DSc FRCA. Physiological Effects of Exercise. Continuing Education in Anesthesia, Critical Care and Pain. Oxford Journals, n.d. Web. 10 May 2016. Damon, Alan, Randy McGonegal, Patricia Tosto, and William Ward. Higher Level Biology. N.p.: n.p., n.d. Print. How Your Lungs Work. How Your Lungs Work. Cleveland Clinic, 13 Oct. 2010. Web. 13 May 2016. Appendix Release forms: I, Jonas Kaare-Rasmussen understand that the experiment I am involved in and the tasks that I am performing, could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Jonas Kaare-Rasmussen I, Jack Larsen understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Jack Larsen I, Danielle Zimber understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Danielle Zimber I, Hailey Zimber understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health complications. Electronically signed by: Hailey Zimber I, Alex Kellam understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Alex Kellam I, Taso Warsa understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Taso Warsa I, Ben Voter understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Ben Voter I, Alex Alsop understand that the experiment I am involved in and the tasks that I am performing could be dangerous for my health. I assume all liability for my actions and understand that slight Oxygen deprivation may cause health problems. Electronically signed by: Alex Alsop

Private Hospitals for Undergraduate Medical Training

Private Hospitals for Undergraduate Medical Training Private Hospitals for undergraduate medical training an untapped resource in Ireland. Introduction Undergraduate medical education and training is a subject of considerable importance in relation to the quality of learning and teaching opportunities for students, and the ability of the learning environments to support the development of clinical skills and knowledge, professional practice and patient-focused high quality care delivery. The Irish context presents a particular challenge due to changes in the organisation and delivery of medical care into two distinct sectors, private or public, which alters the opportunities offered for medical student experience and focuses services in different ways. While the acute care sector (public) is the one in which most medical students train, it is apparent that there are opportunities to be gained from utilising private hospital and medical locations as well, in order to expose medical students to the widest possible and available medical expertise. However, the quality of the experience in such locations may be questionable, and the ran ge of experiences available may be severely limited A review of the literature pertaining to the title will demonstrate some of the key issues around this topic, drawing on literature from the UK and internationally, due to the commonalities in medical education structure, form and pedagogy that are found globally, and in particular, referring to the UK model as being the one which dominates still even in the Irish medical education sector. Discussion Due to changes in the healthcare structure in Ireland private, there has been a split in the way that doctors provide acute medical and surgical care services. Within Ireland in the healthcare model which has evolved, there are now public only or private only contracts for consultants, meaning that consultants cannot work across both sectors. Prior to this change, a doctor could work across both sectors, meaning that while they could engage in the public sector work that is the meat and drink of medicine and surgery, most consultants made their money in private hospitals, leaving their NCHD team to do their public work. However, the challenges this change poses for the way in which medical education is delivered in Ireland have not really been picked up on in the literature, and so an exploration of pertinent literature, in the light of the author’s contextual knowledge, is important, to explore this impact and to appreciate the scope and opportunities inherent within the new structure. There is some evidence that the changes to medical education, whilst global, are very real in the Irish context. The issues affecting medical education include â€Å"increasing service demands on clinical teachers, the need for shared teaching among different health-related disciplines, the need to incorporate modern educational principles and technologies, adapting to changing societal views of health and disease and the demand for health professionals to be more accountable.†[1] Issues such as professionalism and widening understanding of diversity are inherent in these issues. What this suggests, among other things, is that in order to make best use of the existing resources, areas still untapped need to be accessed, and at the same time, the way that medical ‘education’ is delivered needs to evolve.[2] Up until the present day, the private hospitals have not really been involved in med education. However, now they are currently making associations with universities who are eager to tap this resource, in order to make use of the private hospital setting for clinical experiences for medical students (and other healthcare students). It could be posited that these hospital present a hitherto untapped resource, full of opportunities, but also as a point of great scope for development of new ways of thinking about and providing more appropriate forms of education. As a public private system becomes more defined we need to start using the private sector to teach medical students. This is particularly important as there have been, recently, significant increases in the numbers of medical students[3], with public sector hospitals overwhelmed by medical student numbers, exacerbated by graduate entry into medicine adding to the larger and more diverse pool.[4] This may be affecting the qualit y of their learning, and also the quality of care provision.[5] There are, however, challenges, because as an unused resource, and an untested learning environemtn, there are not the internal resources, skills, systems and the like already in existence to support the influx of medical students. Similarly, there are lots of new private hospitals opening that are not used for teaching, and these hospitals are not equipped for teaching. This is something to bear in mind, and there is a need to identify the requirements of a hospital being equipped for medical student teaching and learning. Basic needs would be structural, such as the provision of a student centre, student accessible IT services, student support, changing rooms, training laboratories, and the like. Some of the major concerns are that private hospitals not equipped and did not make considerations for medical student education at the design phase, meaning that making them primary locations for medical student clinical experience could be very challenging and costly. There is also the issue private patients may not welcome students, particularly as they have paid for their care and so want complete control over it. This may mean students being excluded from key experiences. However, all patients in public sector healthcare have the option to not have students present, so this may not be insurmountable, but it would require rewriting protocols, mission statements, and the like to include an educational component. Another concern is the fact that private hospitals have not yet got to the same level of provision or range of clinical disciplines as public ones. For example, very few have intensive care departments, full time 24/7 consultant cover, emergency departments or major trauma units. Therefore the casemix of patients is elective, and limited, and students if only placed in private hospitals, will not be exposed to emergency. However, the contrary is also true as public teaching hospitals are now getting less elective patients for routine surgeries such as cholecystectomies and hernias. There is evidence to suggest that the relevance of the training medical students receive is of some importance to the quality of their experience and their future skills.[6] There could, therefore, be an argument for cross-sector placements, on rotation, with students doing different placements in different hospitals. This may have the advantage of exposing students to a wider socio-cultural mix of patient s as well as a wider pool of medical expertise, both of which may be of significance in the requirements of medical staff in the current climate.[7] Certainly, there is an emergence of a need to develop more creative approaches to clinical medical education which address the social and societal issues affecting health and illness as well as the medical knowledge itself.[8] This is evident in the emergence of debate around professionalism and professionalisation/socialisation of medical students into their profession, but also into the wider healthcare workforce. While traditionally, medicine has enjoyed a hegemonic position with near godlike autonomy[9], things have changed and new ways of viewing the medical profession have emerged. This has included a demand for more transparent, ethical practice, for doctors to view patients as individuals within their personal, social context, and the need for doctors to demonstrate respect for others, teamworking skills, and more self-awareness and increased awareness of social responsibility.[10] It also includes the reflexivity and awareness required to underpin the development of clinical decision making and problem solving skills, in general, and in application to particular disciplines and cases.[11] These notions of professionalism and reducing the divide between physician and patient are deemed important fo r the profession, as long as professional standards are also maintained.[12] This is where the challenge seems to reside, in providing medical students in Ireland with the scope to develop their professional knowledge and skills, along with the development of themselves, and their professional role, across two radically different healthcare provision domains.[13] Yet the research shows that it is the quality of the clinical or practical experience that medical students have which affects both aspects of their development, their clinical skills and their professionalism.[14] Medical education has moved away from the didactic forms that have characterised it for centuries towards a more interactive, student-centred type of training, although not as far as the other healthcare professions have.[15] Therefore, developing the private sector provision could serve a number of purposes, not just providing a useful place for the runoff of extra students currently flooding the public sector h ospitals. It could provide the opportunities for students to be assessed in skills and attributes relevant to each sector, as well as each individual case they are addressing. This would represent a more individualised approach to medical education.[16] There is a high likelihood of a considerable amount of resistance to such a reorientation, however, because the traditional, hierarchical and hegemonic structures of the medical profession will not be easily overcome.[17] What changes there are may not be fully bedded down within the Irish healthcare sector.[18] There is also the challenge of ensuring that there are adequate clinical educators available or even employed within this sector.[19] However, it would also be important to consider the impact of a large amount of private sector clinical experience on the professional development and socialisation of medical students, because much of this occurs within the institutional setting and is affecting by that setting, by the organisational culture, and by the behaviours of others within that setting.[20] Therefore, if students are modelling themselves primarily on what they are seeing within the private sector, this exposure could be detrimental, in the long run, to their professionalism, their awareness, and the ways that the work with others.[21] The nature of medical education itself is one which may need to change, to reorient itself to a different model of teaching and learning which is more appropriate to modern day medicine[22]. â€Å"Continued efforts are needed to reduce the factual load of the curriculum.†[23] It is apparent that in the current climate, with rapid developments in science and technology applied to medicine, and the increasing speed of these developments, that delivering a didactic curriculum is not practical, and instead, medical schools need to be able to â€Å"equip students with the skills and attitudes needed to cope with rapid change and lifelong learning.†[24] This includes students learning how to learn in a self-directed, more autonomous way,[25] which would then help to overcome the differences between the sectors and support students in cross-sector working and identifying the learning and development opportunities specific to each. However, the literature shows that in Ireland (as in many other places), the nature of medical education remains quite didactic and offers only limited opportunities for students to work in alternative ways. Yet the requirement for personal and professional development has already begun to be realised in the UK and Ireland, and as such the groundwork has already been laid.[26] Similarly, literature shows that medical student learning differs depending on the clinical environment,[27] which may be related to the culture of the environment and the purpose of the medical provision,[28] and if this is the case, then a great deal of research will be needed, along with ongoing evaluation, in order to assess the impact of the use of private sector hospitals within Ireland. The literature demonstrates that new ways of learning can be developed and implemented, based on more social, interactive, collaborative models[29], such as the development of communities of practice.[30] In this case, such communities would need to span the different sectors effectively, and overcome the differences between them, but these could expand to make better use of and collaborate more effectively with the training of interprofessional colleages[31]. This raises the question of whether there are the skills, capacity and even inclination to develop medical education along such lines, a lthough the ongoing benefits of communities of practice would be exponential.[32],[33]. The need for medical students to emerge as knowledgeable professionalss with the requisite understanding and skills must not be overlooked.[34],[35] Conclusion It would appear that there is a great untapped potential in the use of private sector hospitals in the Republic of Ireland to supplement medical student education by providing clinical locations for practice-based learning. However, this learning may need to be located in a different paradigm to the traditional medical apprenticeship model that has dominated this sector to date. The private sector hospitals would need to be come part of the partnership teams with universities and public sector hospitals. They would need to develop the facilities and infrastructure to support medical students. Medical students would gain a lot from such placements, but it would appear to be best that these form part of a cross-sector rotation of placements, rather than a private setting constituting their dominant clinical learning setting. The ways in which medical students are ‘taught’ would also need to change, to become more focused on personal and professional development, self-directed learning, and on all the elements of being professional in relation to current definitions of the word, and the social expectations placed upon healthcare professionals. Research is required into how private sector hospitals can be used, how medical education is changed by this and will change the nature of these locations, and how different approaches to new pedagogies will benefit medical students overall. The impact of these changes on professionalism, and the resistance from the profession, will also need to be considered. Ultimately, private hospitals can support the current provision, but the nature of the healthcare provision in Ireland would have to be considered also in the light of international models and how it intersects with these. Anything which improves student development and the skills and capabilities of newly qualified doctors must be a positive move, but research is needed to demonstrate that this would be so. References Arnold, L. (2002) Assessing professional behaviour: yesterday, today and tomorrow. Acad Med 77 (6) 58-70. Bligh, J. (2004) More medical students, more stress in the medical education system. Medical Education 38 460-462. Chastonay, P., Brenner, F., Peel, S. and Guilbert, J-J. (1996) The need for more efficiency and relevance in medical education. Medical Education 30 235-248. Cruess, R., Cruess, S. and Johnston, S.E. (1999) Renewing professionalism: an opportunity for medicine. Acad Med 74. (8) 878-884. Currie, G. and Suhomlinova, O. (2006) The impact of institutional forces upon knowledge sharing in the UK NHS: the triumph of professional power and the inconsistency of policy. Public Administration 84 (1) 1-30. Department of Health (2004) Medical Schools: Delivering the Doctors of the Future London: Department of Health. Dogra, N., Conning, S., and Gill, P. (2005) Teaching of cultural diversity in medical schools in the United Kingdom and Republic of Ireland: cross sectional questionnaire survey. BMJ 330 403-404. Dowton, S.B., Stokes, M-L., Rawstrong, E.J. et al (2005) Postgraduate medical education: rethinking and integrating a complex landscape. MJA 182 177-180. Dornan, T., Hadfield, J., Brown, M. et al (2005) How can medical students learn in a self-directed way in the clinical environment? Design-based research. Medical Education 39 356-364. Epstein, R.M. and Hundert, E.M. (2002) 287 (2) 226-235. Defining and assessing professional competence. JAMA 287 (2) 226-235. Finucane, P. and Kellet, J. (2007) A new direction for medical education in Ireland? European Journal of Internal Medicine 18 101-103. General Medical Council (2002) Tomorrow’s doctors: recommendations on undergraduate medical education. London: GMC. Gordon, J. (2003) Fostering students’ personal and professional development in medicine: a new framework for PPD. Medical Education 37 (4) 341-349. Hilton, S.R. and Slotnick, H.B. (2005) Proto-professionalism: how professionalisation occurs across the continuum of medical education. Medical Education 29 58-65. Howe, A., Campion, P., Searle, J. and Smith, H. (2004) New perspectives approaches to medical education at four new UK medical schools. BMJ 329 327-331. Irvine, D. (1999) The performance of doctors: new professionalism. Lancet 353 1174-1177. Littlewood, S., Ypinazar, V., Margolis, S.A. et al (2005) Early practical experience and the social responsiveness of clinical education: systematic review. BMJ331 387-391. Lloyd Jones, M. (2005) Role development and effective practice in specialist and advanced practice roles in acute hospital settings: systematic review and meta-synthesis. Journal of Advanced Nursing 49 (2) 191-209. McMahon, T. (2005) Teaching medicine and allied disciplines in the 21st century lessons for Ireland on the continuing need for reform. Radiography 11 61-65. Medical Council (2001) Review of medical schools in Ireland Dublin: Medical Council. Moercje, A.M. and Elika, B. (2002) What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process. Medical Education 36 472-478. Norman, G. (2002) Research in medical education: three decades of progress. BMJ 324 1560-1562. Nuffield Trust (2000) University Clinical Partnership: Harnessing Clinical and Academic Resources London: Nuffield Trust Working Group on NHS/University Relations. Ostler, D.T., (2005) Flexner, apprenticeship and ‘the new medical education.’ Journal of the Royal Society of Medicine 98 91-95. Perkins, G.D., Barrett, H., Bullock, I. et al (2005) The Acute Care Undergraduate Teaching (ACUTE) Initiative: consensus development of core competencies in acute care for undergraduates in the United Kingdom. Intensive Care Medicine 31 1627-1633. Rogers, J.C., Swee, D.E. and Ullian, J.A. (1991) Teaching medical decision making and students’ clinical problem solving skills. Medical Teacher 13 157-164. Satran, L., Harris, I.B., Allen, S. et al (1993) Hospital-based versus community-based clinical education: comparing performances and course evaluations by students in their second-year pediatrics rotation. Acad Med 68 380-382. Sinclair, S. (1997) Making doctors: an institutional apprenticeship Oxford: Berg. Smith, T. and Sime, P. (2001) A survey of clinical academic staffing levels in UK medical and dental schools: a report to the Council for Heads of Medical Schools London: Council for Heads of Medical Schools. Stewart, J., O’Halloran, C., Harrigan, P. et al (1999) Identifying appropriate tasks for the preregistration year: modified Delphi technique. BMJ 224-229. Swick, H. (2000) towards a normative definition of medical professionalism. Acad Med. 75 (6) 77-81. Thakore, H. and McMahon, T. (2006) Sink or swim: the future of medical education in Ireland. The Clinical Teacher 3 129-132. Wenger, E.C. and Snyder, W.M. (2000) Communities of practice: the organisational frontier. Harvard Business Review 78 (1) 139-147. Williams, G. and Lau, A. (2004) Reform of undergraduate medical teaching in the United Kingdom: a triumph of evangelism over common sense. BMJ 329 92-94. Worley, P., Esterman, A. and Prideaux, D. (2004) Cohort study of examination performance of undergraduate medical students learning in community settings. BMJ 328 207-209. Footnotes [1] Finucane, P. and Kellet, J. (2007) [2] Thakore, H. and McMahon, T. (2006) [3] Bligh, J. (2004) [4] Thakore, H. and McMahon, T. (2006) [5] Bligh, J. (2004) [6] Chastonay, P., Brenner, F., Peel, S. and Guilbert, J-J. (1996) [7] Dogra, N., Conning, S., and Gill, P. (2005) [8] Department of Health (2004) [9] Hilton, S.R. and Slotnick, H.B. (2005) [10] Hilton, S.R. and Slotnick, H.B. (2005) [11] Rogers, J.C., Swee, D.E. and Ullian, J.A. (1991) [12] General Medical Council (2002) [13] Arnold, L. (2002) [14] Littlewood, S., Ypinazar, V., Margolis, S.A. et al (2005 [15] Norman, G. (2002) [16] Ostler, D.T., (2005 [17] Williams, G. and Lau, A. (2004) [18] Currie, G. and Suhomlinova, O. (2006) [19] Smith, T. and Sime, P. (2001) [20] Sinclair, S. (1997) [21] Swick, H. (2000) [22] Howe, A., Campion, P., Searle, J. and Smith, H. (2004) [23] Medical Council (2001) [24] Medical Council (ibid) [25] Dornan, T., Hadfield, J., Brown, M. et al (2005) [26] Gordon, J. (2003) [27] Worley, P., Esterman, A. and Prideaux, D. (2004) [28] Satran, L., Harris, I.B., Allen, S. et al (1993) [29] Perkins, G.D., Barrett, H., Bullock, I. et al (2005) [30] Wenger, E.C. and Snyder, W.M. (2000) [31] Lloyd Jones, M. (2005) [32] Wenger, E.C. and Snyder, W.M. (2000) [33] Nuffield Trust (2000) [34] Moercje, A.M. and Elika, B. (2002) [35] Irvine, D. (1999)

Trauma and Adult Learning Essay -- Adult Education Learning Essays

Trauma and Adult Learning Effects of Trauma on Learning Adults experiencing the effects of past or current trauma may display such symptoms as difficulty beginning new tasks, blame, guilt, concern for safety, depression, inability to trust (especially those in power), fear of risk taking, disturbed sleep, eroded self-esteem/confidence, inability to concentrate, or panic attacks (Mojab and McDonald 2001). Some people may manifest no symptoms; at the other end of the spectrum is Posttraumatic Stress Disorder, characterized by flashbacks, avoidance, numbing of responsiveness (including substance abuse), persistent expectation of danger, constriction (dissociation, zoning out), and memory impairment (Isserlis 2001). It may not be readily apparent that a learner is experiencing the effects of trauma. Instead, such manifestations as missing class, avoiding tests, spacing out, and having what may be interpreted as inappropriate or extreme reactions to class discussions or activities may actually be responses to trauma. It is true that learning may be impeded by fear, anxiety, poor concentration, and the enormous energy involved in hiding abuse or struggling with immediate survival needs. However, interpretations of trauma and its effects on learning are shaped by education discourses (Horsman 1997, 2000b; Isserlis 2001). A deficit perspective suggests that the learner, not the social system, must change. A medicalizing discourse emphasizes that healing, "getting over it," must take place before learning is possible. Discourses of educational practice may view dropping out, stopping out, or spacing out/dissociating as lack of motivation or persistence rather than survival mechanisms. Discourses focu sed on outcomes and account... ...all/fob/2002/morrish.html Pearce, C. E. "Informal Learning of Homeless Women: A Feminist Study of Surviving the Everyday." In 40th Annual Adult Education Research Conference Proceedings, compiled by Amy Rose. De Kalb: Northern Illinois University, 1999. (ED 431 901) http://www.edst.educ.ubc.ca/aerc/1999/99pearce.htm Rosenwasser, P. "Tool for Transformation: Cooperative Inquiry as a Process for Healing from Internalized Oppression." In AERC 2000: An International Conference, edited by T. Sork, V.-L. Chapman, and R. St. Clair, pp. 392-396. Vancouver: University of British Columbia, 2000. (ED 452 417) http://www.edst.educ.ubc.ca/aerc/2000/rosenwasserp1-web.htm Williamson, B. "Learning in Extremis." In Lifelong Learning inside and outside Schools. Collected Papers, vol. 2, edited by P. Alheit et al., pp. 676-697. Roskilde, Denmark: Roskilde University, 2000.

evilmac Variety of Evils in Macbeth Essay -- Macbeth essays

Variety of Evils in Macbeth      Ã‚  Ã‚   The tragedy Macbeth by William Shakespeare manifests a rich variety of evils, not only by the main characters of Macbeth and Lady Macbeth, but also by the witches.    Clark and Wright in their Introduction to The Complete Works of William Shakespeare interpret the main theme of the play as intertwining with evil:    While in Hamlet and others of Shakespeare's plays we feel that Shakespeare refined upon and brooded over his thoughts, Macbeth seems as if struck out at a heat and imagined from first to last with rapidity and power, and a subtlety of workmanship which has become instructive. The theme of the drama is the gradual ruin through yielding to evil within and evil without, of a man, who, though from the first tainted by base and ambitious thoughts, yet possessed elements in his nature of possible honor and loyalty. (792)    Roger Warren states in Shakespeare Survey 30 , regarding Trervor Nunn's direction of Macbeth at Stratford-upon-Avon in 1974-75, how the witches represented the evil force of   black magic:    Much of the approach and detail was carried over, particularly the clash between religious purity and black magic. Purity was embodied by Duncan, very infirm (in 1974 he was blind), dressed in white and accompanied by church organ music, set against the black magic of the witches, who even chanted 'Double, double to the Dies Irae. (283)    Fanny Kemble in "Lady Macbeth" asserts that Lady Macbeth died as a result of her evil acts:    Lady Macbeth, even in her sleep, has no qualms of conscience; her remorse takes none of the tenderer forms akin to repentance, nor the weaker ones allied to fear, from the pursuit of which the tortured soul, ... ...nk. "Macbeth." The Riverside Shakespeare. Ed. G. Blakemore Evans. Boston: Houghton Mifflin Company, 1972.    Knights, L.C. "Macbeth." Shakespeare: The Tragedies. A Collectiion of Critical Essays. Alfred Harbage, ed. Englewwod Cliffs, NJ: Prentice-Hall, Inc., 1964.    Lamb, Charles. On the Tragedies of Shakespeare. N.p.: n.p.. 1811. Rpt in Shakespearean Tragedy. Bratchell, D. F. New York, NY: Routledge, 1990.    Mack, Maynard. Everybody's Shakespeare: Reflections Chiefly on the Tragedies. Lincoln, NB: University of Nebraska Press, 1993.    Warren, Roger. Shakespeare Survey 30.   N.p.: n.p., 1977. Pp. 177-78. Rpt. in Shakespeare in the Theatre: An Anthology of Criticism. Stanley Wells, ed. England: Oxford University Press, 2000.    Wilson, H. S. On the Design of Shakespearean Tragedy. Toronto, Canada: University of Toronto Press, 1957.

Impact of Technology on Music Essay -- Term Papers Research Essays

Impact of Technology on Music The introduction to the internet in the early nineties and the creation of broadband, MP3, and the file sharing network known as â€Å"peer to peer† has completely revolutionised the music industry. A large percentage of music is today downloaded over the internet, and not bought over the counter in a record store. This essay will address the impact of new technology on music, and how music is distributed. To do this, the paper will first briefly explain the history of the digital revolution. Then it will contrast the problems and the possibilities this technology has created. Over the years, the development of new technology has caused significant changes to the world we are living in. These technological advancements affect us to different degrees and in different ways. In recent years, the development of new technology has caused significant changes to the music industry. For three quarters of a century, records were made by a process now known as analogue recording. This process was replaced by digital recording in 1976. The initial advantage of digital recording was that it offered a more accurate way to reproduce sound. A few years later, in 1983, the compact disc was invented and it was now possible to store digital sound on a digital medium. This was widely thought of as the completion of the digital revolution (Teachout, 2002). The birth of the CD wasn’t the end of the digital revolution. There were bigger and more important innovations in the horizon. The evolution of the internet was on its way, and the possibilities of this medium were almost unlimited (Sutherland, 2004). The development of the internet, broadband, MP3, and then the different ways to share music with each other create... .... (2004). The RIAA is behind the times. Retrieved 14.9, 2004, from http://www.yale.edu/yfp/archives/feb04/feb04_riaa.html Green, H. (2004). Downloads: The Next Generation; Music merchants are trying new ways to make an honest buck off the Internet. Business Week, 1(3870), 64. Musicunintended.org. (2004). more than 2.6 billion files are downloaded illigaly per month. Retrieved 16.9, 2004, from http://www.musicunited.org/ RIAA. (2004). What the RIAA is Doing About Piracy. Retrieved 14.9, 2004, from http://www.riaa.com/issues/piracy/riaa.asp Sherman, C. (2000). Napster: Copyright killer or distribution hero? Online, 24(6), 8. Sutherland, J. (2004). Business Objects and the Evolution of the Internet. Retrieved 16.9, 2004, from http://jeffsutherland.com/papers/crcweb.html Teachout, T. (2002). Why listening will never be the same. Commentary, 1 14(2), 4.