Market reforms and privatisation in the English National Health Service

The article examines developments in the marketisation and privatisation of the English National Health Service, primarily since 1997. It explores the use of competition and contracting out in ancillary services and the levering into public services of private finance for capital developments through the Private Finance Initiative. A substantial part of the article examines the repeated restructuring of the health service as a market in clinical services, initially as an internal market but subsequently as a market increasing opened up to private sector involvement. Some of the implications of market processes for NHS staff and for increased privatisation are discussed. The article examines one episode of popular resistance to these developments, namely the movement of opposition to the 2011 health and social care legislative proposals. The article concludes with a discussion of the implications of these system reforms for the founding principles of the NHS and the sustainability of the service.

El estereotipo de género como nuevo valor noticia en los periódicos digitales en Europa

El objetivo principal de la investigación es el análisis de los estereotipos de género como nuevo valor noticia en los diarios digitales The Times, El País, Le Monde, Diario de Noticias y Corriere della Sera. La metodología utilizada fue el análisis de contenido de 1688 noticias publicadas entre el 1 de mayo del 2013 y el 1 de mayo del 2014. Los resultados indican que perviven los estereotipos tradicionales de las mujeres especialmente en el caso de El País, El Corriere della Sera y el Jornal de Noticias. Sin embargo, al mismo tiempo aparecen los que denominamos “contraestereotipos” como un nuevo valor noticia caracterizados por presentar a la mujer con valores positivos opuestos a los estereotipos tradicionales especialmente en The Times y Le Monde.

Acceptance of relapse fears in breast cancer patients: effects of an act-based abridged intervention

Objective: Relapse fear is a common psychological scar in cancer survivors. The aim of this study is to assess the effects of an abridged version of Acceptance and Commitment Therapy (ACT) in breast cancer patients.Method: An open trial was developed with 12 non-metastatic breast cancer patients assigned to 2 conditions, ACT and waiting list. Interventions were applied in just one session and focused on the acceptance of relapse fears through a ‘defusion’ exercise. Interference and intensity of fear measured through subjective scales were collected after each intervention and again 3 months later. Distress, hypochondria and ‘anxious preocupation’ were also evaluated through standardized questionnaires.Results: The analysis revealed that ‘defusion’ contributed to decrease the interference of the fear of recurrence, and these changes were maintained three months after intervention in most subjects. 87% of participants showed clinically significant decreases in interference at follow-up sessions whereas no patient in the waiting list showed such changes. Statistical analysis revealed that the changes in interference were significant when comparing pre, post and follow-up treatment, and also when comparing ACT and waiting list groups. Changes in intensity of fear, distress, anxious preoccupation and hypochondria were also observed.Conclusions: Exposure through ‘defusion’ techniques might be considered a useful option for treatment of persistent fears in cancer patients. This study provides evidence for therapies focusing on psychological acceptance in cancer patients through short, simple and feasible therapeutic methods.

Why marine phytoplankton calcify

Calcifying marine phytoplankton - coccolithophores - are some of the most successful yet enigmatic organisms in the ocean, and are at risk from global change. In order to better understand how they will be affected we need to know 'why' coccolithophores calcify. Here we review coccolithophorid evolutionary history, cell biology, and insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands, and that coccolithophores might have calcified initially to reduce grazing pressure, but that additional benefits such as protection from photo-damage and viral-bacterial attack further explain their high diversity and broad spectrum ecology. The cost-versus-benefit of these traits is illustrated by novel ecosystem modeling, although conclusive observations are still limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming.

Why marine phytoplankton calcify

Calcifying marine phytoplankton - coccolithophores - are some of the most successful yet enigmatic organisms in the ocean, and are at risk from global change. In order to better understand how they will be affected we need to know 'why' coccolithophores calcify. Here we review coccolithophorid evolutionary history, cell biology, and insights from recent experiments to provide a critical assessment of the costs and benefits of calcification. We conclude that calcification has high energy demands, and that coccolithophores might have calcified initially to reduce grazing pressure, but that additional benefits such as protection from photo-damage and viral-bacterial attack further explain their high diversity and broad spectrum ecology. The cost-versus-benefit of these traits is illustrated by novel ecosystem modeling, although conclusive observations are still limited. In the future ocean, the trade-off between changing ecological and physiological costs of calcification and their benefits will ultimately decide how this important group is affected by ocean acidification and global warming.

Processing of hierarchical syntactic strusture in music

Hierarchical structure with nested nonlocal dependencies is a key feature of human language and can be identified theoretically in most pieces of tonal music. However, previous studies have argued against the perception of such structures in music. Here, we show processing of nonlocal dependencies in music. We presented chorales by J. S. Bach and modified versions inwhich the hierarchical structure was rendered irregular whereas the local structure was kept intact. Brain electric responses differed between regular and irregular hierarchical structures, in both musicians and nonmusicians. This finding indicates that, when listening to music, humans apply cognitive processes that are capable of dealing with longdistance dependencies resulting from hierarchically organized syntactic structures. Our results reveal that a brain mechanism fundamental for syntactic processing is engaged during the perception of music, indicating that processing of hierarchical structure with nested nonlocal dependencies is not just a key component of human language, but a multidomain capacity of human cognition.

The Importance of Work-Life Balance Opportunities and Support from the Perspective of Nursing Stu-dents in Dalarna, Sweden

There is a shortage of nurses leading to challenges in recruitment in Sweden and many other countries. Especially for less populated regions recruitment can be chal-lenging. Nurses often face difficulties with work-life balance (WLB). This study aims to identify the importance of WLB opportunities and support that make a work-place attractive from the perspective of nursing students studying in Dalarna. A questionnaire was distributed via email to 525 students enrolled in the nursing bach-elor program at Dalarna University. They were asked to rate the importance of 15 sub questions regarding WLB opportunities and support. These sub questions were asked in order to analyze the importance of 15 components regarding WLB oppor-tunities and support. 196 students (37 percent) answered the questionnaire. Three WLB components, working from home, childcare and rooms for breastfeeding, were found to be not important to nursing students studying in Dalarna. This was reason-able due to the profession of nursing and the WLB support provided by the Swedish government. Cultural factors, such as the organization being positive towards using WLB opportunities and support, were more important than structural factors, such as the possibility to work part-time. Moreover, to have a manager that is supportive towards using WLB opportunities and support was found to be the most important factor and having workplace practical support such as childcare was found least im-portant. Furthermore, contrary to the expected results, no statistical significance was found on the influence on the importance of all combined relevant WLB opportuni-ties and support by the sociodemographic variables; gender, semester of studies, age, having children, months of work experience and work experience in the healthcare sector. However, nine individual components were found to be influ-enced by one or more sociodemographic variables. Therefore, some recommenda-tions on how to target specific groups of individuals were made. However, the con-clusion of the study is that, regardless of the sociodemographic variables and gov-ernmental support, organizations should offer new nurses opportunities and support to gain a balance between work and life, especially in terms of cultural factors.

Modern Horn Playing in Beethoven: An Exploration of Period Appropriate Techniques for the Orchestral Music of Beethoven for the Modern Horn Player

Thesis (D.M.A.)--University of Washington, 2016-06

Performance interpretativa das sonatas nº1 em Sí emol maior e nº2 em ré maior de Felix Mendelssohn

Este texto, define o trabalho final do Mestrado em Música da Universidade de Aveiro, e é um documento de apoio ao projeto artístico. Tem por objetivo perceber a importância dos compositores, Bach, Mozart e Beethoven, sobre Felix Mendelssohn “Bartholdy”, analisando o impacto que eles tiveram sobre o curso de vida desta compositor e até a que ponto influenciaram as suas obras. Centro-me na análise das sonatas em Sí bemol Maior, e Ré Maior para violoncelo e piano, que também é apresentada neste projeto, e cuja performance constitui o repertório do recital na defesa do trabalho. Inclui ainda uma reflexão sobre a liberdade criativa no quadro da composição e da interpretação musical, articulando este conceito com os nossos limites enquanto artistas “originais”.

Ewald Kiel (Hrsg.): Unterricht sehen, analysieren, gestalten, 2., überarbeitete Auflage. Stuttgart/Bad Heilbrunn: UTB/Klinkhardt 2012 [Rezension]

Rezension von: Ewald Kiel (Hrsg.): Unterricht sehen, analysieren, gestalten, 2., überarbeitete Auflage, Stuttgart/Bad Heilbrunn: UTB/Klinkhardt 2012 (176 S.; ISBN 978-3-8252-3702-8)

Teaching Sight-Reading to Undergraduate Choral Ensemble Singers: Lessons from Successful Learners

This study was designed to investigate professional choral singers’ training, perceptions on the importance of sight-reading skill in their work, and thoughts on effective pedagogy for teaching sight-reading to undergraduate choral ensemble singers. Participants in this study (N=48) included self-selected professional singers and choral conductors from the Summer 2015 Oregon Bach Festival’s Berwick Chorus and conducting Master Class. Data were gathered from questionnaire responses and audio recorded focus group sessions. Focus group data showed that the majority of participants developed proficiency in their sight-reading skills from instrumental study, aural skills classes, and through on-the-job training at a church job or other professional choral singing employment. While participants brought up a number of important job skills, sightreading was listed as perhaps the single most important skill that a professional choral singer could develop. When reading music during the rehearsal process, the data revealed two main strategies that professional singers used to interpret the pitches in their musical line: an intervallic approach and a harmonic approach. Participants marked their scores systematically to identify problem spots and leave reminders to aid with future readings, such as marking intervals, solfege syllables, or rhythmic counts. Participants reported using a variety of skills other than score marking to try to accurately find their pitches, such as looking at other vocal or instrumental lines, looking ahead, and using knowledge about a musical style or time period to make more intuitive “guesses” when sight-reading. Participants described using additional approaches when sight-reading in an audition situation, including scanning for anchors or anomalies and positive self-talk. Singers learned these sight-reading techniques from a variety of sources. Participants had many different ideas about how best to teach sight-reading in the undergraduate choral ensemble rehearsal. The top response was that sight-reading needed to be practiced consistently in order for students to improve. Other responses included developing personal accountability, empowering students, combining different teaching methods, and discussing real-life applications of becoming strong sight-readers. There was discussion about the ultimate purpose of choir at the university level and whether it is to teach musicianship skills or produce excellent performances.

Dilemas éticos en niños con enfermedades neuromusculares y dependencias tecnológicas: Ethical dilemmas in children with neuromuscular diseases and technological dependencies

En los últimos años, los cuidados respiratorios especializados, y en particular los cuidados respiratorios no invasivos y otros avances tecnológicos han contribuido a una mejor calidad de vida y sobrevida de los pacientes con enfermedades neuromusculares. La naturaleza de las opciones terapéuticas (como ser la ventilación invasiva versus ventilación no invasiva, las cargas psicológicas, sociales y financieras) tienen ramificaciones éticas. Por lo tanto resulta esencial que los médicos comprendan todas las opciones terapéuticas y los factores psicosociales al informar a sus pacientes, en lo que tiene que ver con sus ventajas y desventajas y sus costos asociados, de modo que los padres puedan tomar decisiones informadas. Los nuevos desarrollos incluyen exámenes prenatales y neonatales más precisos, nuevas terapias genéticas y soporte respiratorio no invasivo para evitar episodios de fallas respiratorias y vías aéreas invasivas. Al empoderar a los pacientes y sus familias para educar y capacitar servicios personales de cuidados para que no deban depender de las instituciones y servicios de enfermería constante, y los recientes avances tecnológicos facilitan su permanencia en el hogar y dejan de estar atados a una vida dependiendo de la institución y los servicios de enfermería. Estos últimos infantilizan a los pacientes en lugar de promover su autonomía. Las consideraciones financieras, las terapias genéticas, el screening prenatal y las distintas opciones terapéuticas que promueven la autonomía, todos tienen implicancias éticas. Algunos de los avances discutidos en este artículo requieren un cambio de paradigma en la forma en que los médicos ven y tratan a estos individuos.

Obrazy muzyki w twórczości Janiny Kraupe-Świderskiej

Filologii Polskiej i Klasycznej: Zakład Dydaktyki Literatury i Języka Polskiego

Processing of hierarchical syntactic strusture in music

Hierarchical structure with nested nonlocal dependencies is a key feature of human language and can be identified theoretically in most pieces of tonal music. However, previous studies have argued against the perception of such structures in music. Here, we show processing of nonlocal dependencies in music. We presented chorales by J. S. Bach and modified versions inwhich the hierarchical structure was rendered irregular whereas the local structure was kept intact. Brain electric responses differed between regular and irregular hierarchical structures, in both musicians and nonmusicians. This finding indicates that, when listening to music, humans apply cognitive processes that are capable of dealing with longdistance dependencies resulting from hierarchically organized syntactic structures. Our results reveal that a brain mechanism fundamental for syntactic processing is engaged during the perception of music, indicating that processing of hierarchical structure with nested nonlocal dependencies is not just a key component of human language, but a multidomain capacity of human cognition.

Mikrofaunistisch-lithologische Untersuchungen der Hilssandstein-Region (Apt/Alb) im Raum Salzgitter-Goslar

So gut sich im nördlichen Harzvorland die Sandstein- Fazies des Hilssandsteins als morphologisch herausragende Schichtrippe kartieren ließ, so problematisch ist bis heute ihre genaue stratigraphische Position geblieben. Die von STROMBECK (1856, Tab.S.493) aufgestellten Schichtgruppen Hilssandstein und Minimuston verwendete noch STOLLEY (1937, S.1,54) in stratigraphischem Sinn, obgleich es sich um Fazieseinheiten handelt, deren Grenzen durchaus schräg zu den biostratigraphischen Zonen verlaufen können. Beispiele für die Richtigkeit dieses Prinzips lieferten die Beobachtungen am Flammenmergel des Hils und der Sackmulde (JORDAN & SCHMIDT 1968): Die Bildungszeit der Flammenmergel-Fazies beginnt nach neuer Zonengliederung (COLLIGNON 1965) nicht zugleich mit dem Ober-Alb, sindern erst im unteren Ober-Alb und reicht bis zum Cenoman, kann aber auch schon im Ober-Alb beendet sein. Ein ähnliches Verhalten wurde daher auch von der Quarzsandstein-Fazies des Hilssandsteins im Raum Salzgitter-Goslar vermutet. Seltene Vorkommen von Acanthohoplites milletianus D'ORB. in den Steinbrüchen von Ostlutter und in der Sandgrube bei Goslar waren für BODE & SCHROEDER (1912 - 1926) bei ihrer geologischen Kartenaufnahme der Beweis für Unter-Gault (= Unter-Alb) -Alter des Sandsteins. Bei der Auswertung der Bohrungen im Gebiet von Hornburg grenzte SEITZ (1943, S.355,398) die Quarzsandstein Fazies mit dem Gaultkonglomerat nach unten gegen tonige Apt-Serien ab und stellte die obere Faziesgrenze des Hilssandsteins gegen Minimuston nach einem Leymeriellen Fund etwa in die Mitte des oberen Unter-Albs. Weiter östlich durchgeführte mikropaläontologische Beobach- tungsn in der Unterkreide am Kleinen Fallstein (BACH 1965) bestätigten, daß hier die Quarzsandschüttung bereits im Unter-Alb beendet war. Im Westen des Untersuchungsgebietes soll die Quarzsandschüttung im Hils nach BRINKMANN (1937, S.15) im Ober-Apt, örtlich sogar im Ober-Hauterive (FRATSCHNER 1950, S.31) begonnen und nach einem Hoplites-Fund (BRINKMANN 1937, S.15) bis ins oberste Mittel-Alb angedauert haben. Den Hilssandstein der Sackmulde stell- tein JORDAN & SCHMIDT (1968, S.428) ins Unter-Alb, vermuteten aber dessen Sedimentationsbeginn im Ober-Apt. Im Untersuchungsgebiet dieser Arbeit wurde das Unter- Alb-Alter des Hilssandsteins von DEWIEL (1951, S.39) unter anderem in der Finkeikuhle (bei Salzgitter-Bad) angezweifeit: Seines Erachtens ist dort die gesamte, ungefähr 50 m mächtige, tonig-sandige Folge mit Sandsteinbänken in ihrem oberen Teil dem Ober-Apt zuzuordnen. Er unterstrich damit WEIGELTs (1923, S.44/45) Auffassung von einer zumindest partiellen Zugehörigkeit des Sandsteins zum hohen Neokom. Abgesehen von der guten Übereinstimmung in der Datierung der Hilssandstein-Region des Kleinen Fallsteins nach Makro- wie Mikrofauna, gaben die zum Teil widersprüchlichen Altersangaben für dieselbe Schichtregion in den anderen Gebieten Südniedersachsens Anlaß zur Skepsis. Das hiesige Institut machte es sich daher zur Aufgabe, die stratigraphische Stellung des Hilssandsteins zunächst im Hils (SEILER 1973) und im Raum Salzgitter-Goslar erneut zu untersuchen. Die hier bearbeiteten Aufschlüsse (Abb.l) (Bl. Ringelheim, Salzgitter, Lutter a.B., Goslar) liegen im wesentlichen im Ausstrich der Unterkreide an den Flanken der Innerste-Mulde (gelegentlich auch Ringelheimer Mulde genannt). Bekanntlich entstand diese asymmetrische, mit Kreide-Sedimenten gefüllte Mulde durch halokinetisch modifizierte junge (?subherzynische) tektonische Bewegungen (s. KÖLBEL 1944). An ihrer Westflanke und in der Harzrandzone westlich Goslar bildet der Hilssandstein eine Schichtrippe und überlagert transgressiv Trias- und Jura-Schichten. - An seiner Basis treten örtlich (z.B. SO Ortshausen, SW Neuwallmoden) geringmächtige Brauneisenstein-Phosphorit- Lagen auf, deren Zugehörigkeit zum Neokom- oder Gaultkonglomerat bisher nicht sicher war. An der östlichen Muldenflanke ist der Hilssandstein in Tagesaufschlüssen aus zwei Gebieten bekannt: a) im Kreuzungsbereich der rheinisch streichenden Ringel- heimer Störungszone (KÖLBEL 1944, S.82) mit dem eggisch bis steil-herzynisch streichenden Salzgitterer Sattel in der Umgebung von Gitter und Grube "Finkeikuhle", b) am Südende des Salzgitterer Sattels. - Hier, wie auch am Südteil der östlichen Sattelflanke bei Groß-Döhren und Weddingen (Aufschluß 5: "Morgenstern"), liegt der Hilssandstein samt Gaultkonglomerat transgressiv auf den erzführenden Serien der tieferen Unterkreide.