The Saga Of Oedipus By Sophocles - 1082 Words

The saga of Oedipus begins long before the setting of the play takes place. It begins with a prophet, who tells Jocasta and Laius—the king and queen of Thebes at the time—that their son is destined to slay his father and bear children with his mother. To keep this sinful event from happening, they sent the baby away to be abandoned and killed. However, the messenger took pity on the baby and gave it to a shepherd of King Polybus, and the boy was adopted into royalty. When the boy came of age he was told the same fate that had been told to his birth parents. Fearing his adoptive father’s life, he exiled himself from the land. On his journey, he met King Laius, though not knowing it him, at a symbolic location: a crossroad. This emphasizes that it was Oedipus’ decision to kill Laius and travel to Thebes, but was that decision out of free will? Throughout Oedipus Rex, Sophocles employs several examples of a theme of predestined fate determined by the gods suc h as Oedipus inevitably killing his father, marrying his mother, and then having children with her. On Oedipus’ journey after leaving his home in Corinth, he came to a point where three roads met. Crossroads are a symbol for a crucial decision or choice. Does he go left or right? â€Å"As I drew near the triple-branching roads, A herald met me and a man who sat In a car drawn by colts—as in thy tale—The man in front and the old man himself Threatened to thrust me rudely from the path†¦Ã¢â‚¬  (Sophocles) At this point Oedipus isShow MoreRelatedSophocles Use of Social Commentary in Antigone1334 Words   |  6 Pagestheir origin. In Antigone, Sophocles does this by creating a fictionalized Thebes in which he reflects upon the politics, religion, and societal norms of his own world. He creates a ruler, Creon, whose tyrannical actions serve to promote the merits of democracy and criticize the contemporary government. He also creates a protagonist, Antigone, w ho challenges the validity of the social structure while upholding ancient traditions. This social commentary allows Sophocles to connect with his both theRead MoreAncient Greek Theatre and Drama1648 Words   |  7 PagesGreece was the development of choral songs. These songs were performed at festivals all over the country. Myths resulted from the songs, and soon became stories. According to Peter Arnott, author of An Introduction to the Greek Theatre, the Hercules saga is an example of one of these stories. Most tragedies began with a prologue that gives the audience an introduction. Then the chorus introduced the paradox, which is where characters are made. The paradox is also where the mood of the play is establishedRead More Pathetic vs Ethical1997 Words   |  8 PagesRecognition; the Pathetic (where the motive is passion); the Ethical (where the motives are ethical). The fourth kind is the Simple. Antigone is Sophocles Greek tragedy where we see a woman as the main character. Antigone is part of the â€Å"saga of Thebes† that deals with Oedipus Rex and Oedipus at Colonus. Produced around 442 B.C., we see the children of Oedipus deal with what fate has brought them. Antigone deals with the conflict of her burying her brother which would be in defiance of an order givenRead MoreHAMLET AND ORESTES10421 Words   |  42 Pagesthe Greek stage; and he ^eight if we occurs in no less than seven of our extant tragedies count the Iphigenia in Aulis, where he is an infant whereas Oedipus, for instance, only comes in three and Agamemnon in — — four. I shall use all these seven plays as material : viz. Aeschylus, Choephori and Eumenides; Sophocles, Electra; and Euripides, And Electra, Orestes, Iphigenia in Tauris, and Andromache. before any of these plays was written Orestes was firmly fixed both

Effects of Deinstitutionalisation

Question: Discuss about the Effects of Deinstitutionalisation. Answer: Introduction: The healthcare system of Australia has changed explicitly since deinstitutionalisation. This has led to targeting a larger number of individuals suffering from mental maladies and illness with the help of switching to community based settings than the common settings such as hospitals, asylums and others. Furthermore, a well established recovery framework has also led to effective systematization of the proceedings required to be followed for optimal treatment (Willis, Reynolds, Keleher, 2016). The essay undertakes critical analysis and evaluation of mental healthcare practices and services implemented prior to deinstitutionalisation and after it in Australia. This essay outlines the importance of optimal mental health services and the different scenarios prevailed before and after deinstitutionalization in Australia. Furthermore, detailed analysis has been undertaken on the recovery framework implemented by the Australian government to tackle the issue. Mental health services are determined as the pharmacological and non-pharmacological interventions provided to the patient suffering from any sort of mental malady or illness (Jennings, 2016). Such services are needed to be specifically patient-oriented in order to impart required optimal remedial treatment in terms of medication and palliative care. There has been a tremendous improvement and changes in healthcare system of Australia. Different public sector specialists are now working together in multidisciplinary and multiagency teams for the effective treatment of larger number of mental patients (Leutwyler, et al., 2014). Deinstitutionalisation is a process of converting and substituting the lengthy remedial procedures of the hospitals or asylums into the community settings especially for the treatment of the patients suffering from the mental conditions. This process was initiated in Australia way back in 1800s when a large number of people were suffering and dying due to inefficient remedial treatment towards various mental diseases or illness (McDermott, 2017) . In order to provide effective treatment at a larger scale, concept of community settings was established to reach every nook and corner of the country. Prior to deinstitutionalisation, awareness and treatment were not subjective and directed patient knowledge and comfort. Only those people could access resources and treatment that were aware of it. Furthermore, certain other prevalent issues that led to the disquiet and unease in the patient were inaccessible resources, expensive treatment, poor quality of treatment, disinterest among the h ealthcare professionals towards the work, over-crowded hospitals, asylums and other places of treatment. All these issues required interventions from the legislation of the Australia for safeguarding the patients under vulnerable groups. This has led to the formulation and implementation of conducts that led to optimal deinstitutionalisation in Australia (Wiesel Bigby, 2015). The Victorian Mental health standards provided legal rights and undertakings that worked to prevent any harm to the mental patients in terms of treatment, social and cultural wellbeing. The year 1888 undertook the establishment of the commission on Zox Royal that ensured effective implementation of the policies and protocols of Victorian mental health standards. Year, 1914 undertook the privatisation of the health services in places other than hospitals and asylums. Furthermore, the year 1933 determined the formulation, implementation and regulation of The Mental Act that ensured the practicing of updated tech nology in terms of tools, equipment and treatment methodologies in order to abandon the old fashioned methodologies undertaken for the treatment at that time. In addition to this, with many upcoming years, amendments have been made in this act ensuring the protection of the rights of patients, better implementation and regulation of the practices by healthcare professionals and undertaking of voluntary and involuntary measures as a part of decision-making during palliative care under critical condition. The protection of mental patients rights and updated treatment has been registered under the Charter of Rights and Responsibilities act of 2006 under the section 10 and section 21 (Scheid, 2016). Majorly, three different studies have been conducted on the deinstitutionalization of Australia. The first study was conducted determining the relocation of patients from a small and underdeveloped institution to St. Nicholas Hospital. It was found out that there was no substantial improvement in the condition of the patients after shifting to the hospital. Another study conducted in the New South Wales on the people with disability shifted to the community settings determined that the new adaptation was positive for them in terms of better responding to the implemented treatment and acquisition of new skills for the enhancement in the quality of life (Kidd, Kenny, McKinstry, 2015). Another study was conducted to compare the patients residing in the St. Nicholas Hospital and in the community settings of New South Wales. The resultant determined that better response to the imparted treatment and desire for a quality life was determined in the community setting of New South Wales pati ents than the patients of St. Nicholas Hospital (Kritsotaki, Long, Smith, 2016). A lot has changed after the deinstitutionalisation in Australia and this had led to the formulation of National Mental Health Strategy that covers every aspect of the optimal treatment and protection of the vulnerable people suffering from mental disabilities (Bradbury, Hutchinson, Hurley, Stasa, 2016). This strategy was first formulated in the year 1992 by the government of the Australia and has been reported and amended many times according to the changes required. Besides this, the Australian government has undertaken a recovery framework called as The Mental Health Service System that undertakes different services, programs and legislation required for the early recovery of the mental patients. This framework provides optimal national guidelines for both the practitioners and patients for the effective delivery of the care and treatment and optimal responding to the treatment by patients. Furthermore, this framework provides recovery and patient oriented theories, policies and p rotocols based on existing research for the effective regulation of the treatment. The policies, procedures and strategies are extremely important as they set efficacious guidelines for the systematic conduction and regulation of the safeguard interventions (Slade, et al., 2014). Conclusively, deinstitutionalisation has played a significant role in formulating, assessing and regulating the optimal treatment and palliative care to the mental patients residing in Australia. Prior to deinstitutionalisation, the treatment and care provided to such patients were not effective enough due to which high mortality rate prevailed. Furthermore, overcrowded asylums, hospitals, rehabilitation centres were also one big issue faced by healthcare professionals and legislation. National mental health strategy provides a recovery-oriented systematic framework for the optimal regulation and conduction of the treatment. Furthermore, mental health service system is another framework based on similar guidelines providing effective treatment, legislation involvement and enhanced response to treatment by the patients. Bibliography Bradbury, J., Hutchinson, M., Hurley, J., Stasa, H. (2016). Lived experience of involuntary transport under mental health legislation. International journal of mental health nursing. Jennings, A. (2016). On being invisible in the mental health system. Sexual Abuse in the Lives of Women Diagnosed WithSerious Mental Illness. Kidd, S., Kenny, A., McKinstry, C. (2015). The meaning of recovery in a regional mental health service: an action research study. Journal of advanced nursing, 181-192. Kritsotaki, D., Long, V., Smith, M. (. (2016). Deinstitutionalisation and After: Post-War Psychiatry in the Western World. Springer. Leutwyler, H., Hubbard, E. M., Slater, M., Jeste, D. V., Taylor, A. C., Bond, G. R. (2014). Transforming the mental health system into a recovery oriented, integrated system of care requires a psychiatric work force that understands the relationship between recovery processes and community living. Fellowship programs in public and community psyc. Community Mental Health Journal, 120-125. McDermott, S. ((2017).). Housing for Australians with Serious Mental Illness. Housing, Citizenship, and Communities for People with Serious Mental Illness: Theory, Research, Practice, and Policy Perspectives,. McDermott, S. (2017). Housing for Australians with Serious Mental Illness. Housing, Citizenship, and Communities for People with Serious Mental Illness: Theory, Research, Practice, and Policy Perspectives,. Scheid, T. L. (2016). An Institutional Analysis of Public Sector Mental Health in the Post-Deinstitutionalization Era. Emerald Group Publishing Limited., (pp. 63-87). Slade, M., Amering, M., Farkas, M., Hamilton, B., O'Hagan, M., Panther, G. .., Whitley, R. (2014). Uses and abuses of recovery: implementing recovery?oriented practices in mental health systems. World Psychiatry, 12-20. Wiesel, I., Bigby, C. (2015). Movement on shifting sands: Deinstitutionalisation and people with intellectual disability in Australia. Urban Policy and Research, , 178-194. Willis, E., Reynolds, L., Keleher, H. (. (2016). Understanding the Australian health care system. Elsevier Health Sciences.

Crittically Examine The Use Of The Term Community Essays

Crittically Examine The Use Of The Term Community Critically examine the use of the term ?community' in the 1990's. The essay should be structured in such a way that it incorporates reference to Social Policy, Legislation and practice issues. Students will be required to make use of theoretical studies, particularly from relevant academic and other sources such as books, journals and relevant publications. The meaning of community is a tricky one. It is used in many different contexts and is a concept that means very different things to different people. A useful starting point is in the book Keywords by Raymond Williams. His research on the word community indicates that it has been part of English language since the 14th century, originally used to refer to the common people as opposed to those of rank, or to state or organised society. By the 16th century it was used to refer to ?the quality of having something in common' and ? to a sense of common identity and characteristics.' In time Community also came to refer to a particular quality of relationship, as well as a distinction between community and civil society on one hand and the state on the other. There are many different types of community and the word is very ambiguous, but it is possible to distinguish between several types according to their contrasting features and characteristics, such as density of their social networks, the degree of their openness and their duration. Sociologically it is usually taken to mean people who live in a common geographical area or it can be defined in terms of common interest. It implies some kind of association, perhaps even sharing, and participation in common relationships. It is in these shared characteristics which bind people together where we start to understand the term and its implications, although even within sociology community takes many different forms. In 1995 researcher Hillery found 94 sociological definitions and the only common thread was that they all dealt with people. The classic form of community which many think of when they here the word is the traditional working class communities found throughout industrial Britain during the earlier part of the 20th century. These were tightly knit settlements of workers and their families who grew up around the mines, factories, ports and other workplaces. However with an increasingly efficient transport network many British industries came under threat from cheaper and better quality products from abroad, and within those industries that Britain still held, the workers were replaced with machines. This loss of industry had a crippling effect on local areas, many of which had grown up around the industry. Research into such areas revealed that such communities are very conservative. They are also seeped in tradition related to these ideologies. Such traditions include a moral obligation to maintain a respectable standard of living and a strong commitment to the work ethic. Howe's research on a working class district of Eastlough in Protestant East Belfast showed despite a high unemployment rate the dole was still seen as an interruption of work, and it was legitimate employment which was sought and desired. This was strongly supported by long standing attitudes and values. Being on the dole induced strong feelings of private shame, which, in turn often led people to withdraw from the community. As a result Howe found their lives to become further impoverished by ?social isolation, fragmentation and distrust' (Howe 1990). With the decline of these so-called ?occupational communities' comes the notion that the concept of community is not relevant in the 21st century. The Elderly who once belonged to such so called ?occupational' communities reminisce about the good old days, when everyone knew and looked out for each other. They talk about a strong community consciousness generated by common residence and common necessity - a social support network that they feel is lacking in modern day society. Not just among the elderly but in general, there is a widely held belief that modern times have witnessed a decline of community. In my opinion this comes about because selective, romanticised views of the past are often adopted and the less sentimental memories of characteristics and events from the past are often forgotten. The conflicts and internal tensions

Gold Alloys in Colored Gold Jewelry

Gold Alloys in Colored Gold Jewelry When you buy gold jewelry, it isnt pure gold. Your gold is really an alloy, or mixture of metals. The purity or fineness of gold in the jewelry is indicated by its karat number 24 karat (24K or 24 kt) gold is as pure as gold for jewelry gets. Gold that is 24K is also called fine gold and it is greater than 99.7% pure gold. Proof gold is even finer, with over 99.95% purity, but it is only used for standardization purposes and is not available for jewelry. So, what are the metals that are alloyed with gold? Gold will form alloys with most metals, but for jewelry, the most common alloying metals are silver, copper, and zinc. However, other metals may be added, especially to make colored gold. Heres a table of the compositions of some common gold alloys: Gold Alloys Color of Gold Alloy Composition Yellow Gold (22K) Gold 91.67%Silver 5%Copper 2%Zinc 1.33% Red Gold (18K) Gold 75%Copper 25% Rose Gold (18K) Gold 75%Copper 22.25%Silver 2.75% Pink Gold (18K) Gold 75%Copper 20%Silver 5% White Gold (18K) Gold 75%Platinum or Palladium 25% White Gold (18K) Gold 75%Palladium 10%Nickel 10%Zinc 5% Gray-White Gold (18K) Gold 75%Iron 17%Copper 8% Soft Green Gold (18K) Gold 75%Silver 25% Light Green Gold (18K) Gold 75%Copper 23%Cadmium 2% Green Gold (18K) Gold 75%Silver 20%Copper 5% Deep Green Gold (18K) Gold 75%Silver 15%Copper 6%Cadmium 4% Blue-White or Blue Gold (18K) Gold 75%Iron 25% Purple Gold Gold 80%Aluminum 20%

Life Cycle Analysis Case Study Example | Topics and Well Written Essays - 1250 words

Life Cycle Analysis - Case Study Example In the end I have concluded this paper with my final words. The conclusion consisted of possible strategies or plans of action that the company could take to come out of the position it is in at the moment. In the end, I would like to state that the purpose of this paper was only academic and it was not intended to take any unlawful gain from the data used in this paper. Coyote Logistics are industry leader in logistics industry. It was founded in 2006 in Chicago, Illinois. They provide a wide range of services to their clients. These services include: Supply Chain Management, Transportation and Technological Solutions. In terms of revenue the company is going from strength to strength Coyote Logistics' revenue grew 587.5 percent from 2006 to 2008 according to the company. They also increased the number of the employees from 82 in 2006 to about 350 at the end of 2008. In order to qualify, the company had to be privately owned, based in the 20-county metro Atlanta area and not be a subsidiary of another company. It has to have been established in the first quarter of 2006 or earlier, and to have had 2008 revenue between $1 million and $300 million. Coyote logistics is the industry leader in logistics industry. ... If we look at the company from the lens of life-cycle assessment we will determine the company's true worth in the social environment. The Life Cycle Analysis or Assessment is the investigation and it is a means by which we evaluate the true worth of the company for society. It helps us in determining environmental costs and benefits that the company is rendering. These costs are known as social costs. The first thing that used in the life cycle analysis is determining the goal and scope of this analysis. In our case we want to determine the social costs of Coyote Logistics. Coyote Logistics is using modern technology in its operations. So, our scope will deeper in determining how this technology is developed. If Coyote Logistics technology has result in destruction of any natural resources while experimenting then the cost of that natural resources will be apportion to the product in which this technology is used. Similarly, as a result of development of this new technology, some costs would have been reduced and the society would have been benefitted from this cost reduction and these will be considered as possible benefits for the society or social benefits. So, we want to assess the technological aspect of Coyote Logistics and that is where we will set our boundaries. If we do not set these boundaries we will have assess every single detail and that would be impossible to compu te and will be too time consuming. The next step is called Life Cycle Inventory Analysis. In this stage we will collected the data from Coyote Logistic about their products and based on our findings created a model. According to their Coyotelogistics.com, they have been able out perform other companies worth

Organization value's Paper Research Example | Topics and Well Written Essays - 1500 words

Organization value's - Research Paper Example Perhaps, the conflict weakened the foundation of the university’s mission and vision. A large number of people in the university, such as senior administrators, discovered that severe problems continue unresolved. Demands to the administration led to the formation of a committee tasked to identify the issues that the university’s important constituents had. What followed is a comprehensive assessment of senior administrators. The general findings showed that most British and Irish students and employees had little or even no knowledge of the decisions and actions of the administrators due to poor information sharing. In contrast, the American employees stated they were aware of what should be performed and how it should be realized. In order to concretely ascertain the dissatisfaction with the process of information sharing in the university, I conducted small interviews with some of the administrators, faculty staff, and students. Some of the students and employees bel ieved that the administration could work by itself and should be doubted to work for their best interests. Only the administrative personnel expressed high satisfaction with the process and outcome of information sharing in the university. The responses of the students express a considerable degree of ‘uninformed’ stances. ... and I know that these are not reliable sources of information.† The opinion of the faculty staff on the poor system of information sharing is expressed in the statement, â€Å"Honestly, I am not informed of the steps that are being taken to build the assets of the university. Our administrators do not show genuine commitment to the people at the university, especially with regard to sharing of information and values. Apparently, the dissatisfaction among the employees and students at the university is rooted in the lack of information, but with the Irish people this lack of information is a defense mechanism against accountability. The Americans and British demand information for the purpose of learning. The Irish are more contented with the lack of information for the purpose of blaming. This is a major issue for the university. The responses of the faculty staff, mainly British and American, express discontentment with the administration of Americans and British, whereas the most positive opinions of top administrators originate from the Irish employees. This phenomenon is conceivably brought about by differences in cultures and values within the organization. The Effect of Cultural Diversity and Poor Information Sharing Practices on the University’s Organizational Values The Irish groups demonstrate greater power distance over the British and American personnel. The latter groups demand that they have the right to question or challenge those in authority. My interview reveals that a number of American and British faculty members believe that it is their duty to oppose those in the top echelons. This opposition occurs in person, in the form of debate. On the other hand, Irish personnel dislike opposing those in power. The more relevant the concern is to them, the

Primary Health Care And Improving Polypharmacy Nursing Essay

Primary Health Care And Improving Polypharmacy Nursing Essay Polypharmacy is common in older people around 20% of people over 70 take five or more drugs (Milton, J et al. Prescribing for older people. BMJ 2008; 336: 606-9) With reference to both literature and your CBM experience discuss how the Primary Health Care team can work together to improve both compliance and concordance in relation to medication in patients. Polypharmacy is defined as: the use of a number of different drugs possibly prescribed by different doctors and filled in different pharmacies, by a patient who may have one or several health problems [1]. The World Health Organisation estimates that only 50% of patients who suffer chronic diseases comply with treatment recommendations [2]. During day four entitled A Pill for Every Ill? at our GP practise we discussed and learnt about the issue of polypharmacy and how it effects compliance (The extent to which the patients behaviour matches the prescribers recommendations [3] ) and concordance (a concept in which doctor and patient agree therapeutic decisions that incorporate their respective views [3] ) in patients. I also got the opportunity to interview patients about their medication use. From interviewing two patients I found that they all took a number of different drugs for several health problems not simply for one. All of the patients were over the age of sixty and had initially presented with one health problem. Later, further health complications arose that led to more health conditions/problems and consequently increased polypharmacy. The first patient I interviewed took eleven different tablets and had two inhalers. He had had asthma since his childhood and carried an inhaler with him. He initially presented with type two diabetes mellitus twenty years ago and was prescribed medication to help control his diabetes. However, he had a heart attack ten years ago but was unfortunately not prescribed certain preventative heart medications for nine years and consequently only began to take his full course of heart medications a year ago. He has now been prescribed with GTN spray and eight tablets including beta blockers, statins, aspirin and GTN spray. He takes five of these tablets in the morning and three at night. He is on repeat prescription for all his medications and he picks up a blister pack/ dosette box from the pharmacy every month with his medication in, so that he can remember what to take and when to take it. When asked he said he was very happy with how clearly the tablets, inhalers and the side effects o f both had been explained to him. He does not pay for his medications because he is an old age pensioner. He does not feel he suffers any side effects from the medications. He has regular appointments to have blood taken so that he can be monitored so that if necessary, changes in his medication can be made. The second patient I interviewed took nineteen different tablets. She had presented with angina and was prescribed heart medications (beta blockers, statins, aspirin and GTN spray). She later became hospitalised due to an infection in her leg for which she was prescribed antibiotics which she was still taking at the time. Two years ago she began to suffer from severe pain up her back, at the side of her face and at the back of her head. She consulted because of this pain and after a number of follow ups with a specialist at hospital; it was found that the pain on the side of her face and back of her head, was being caused by a large vein lying on a nerve in her face causing painful muscle spasms. Due to the pain in her back, she found it hard to climb the stairs. She was prescribed codeine for the pain by sticking patches on to her skin (to change every day) to give her a continuous dose over a longer period of time than tablets would. The codeine tablets were prescribed for instance s when the pain became too severe that the dose being administered by the patches wasnt enough. The lady explained that she did not suffer any side effects from the medications she took. She is on repeat prescription for all her medications which she takes daily at different dosages for each medication, apart from the antibiotics for which she is on the last course. She does not have to pay due to her being an old age pensioner. To remember to take her medications, she keeps them all in a box by her bed. She has never been in a situation where she completely ran out of medicine because she has the help of her family who go to the pharmacy to pick up her medicines for her. I found the interviews I conducted very interesting and helpful in understanding the important issues of compliance and concordance with patients that arose from polypharmacy. In relation to compliance and concordance, both patients gave a lot of importance to the fact that every time they were prescribed a medicine, the GP would take time to explain why they were prescribing the drug, explaining the way the drug worked, the dosage required and answering any questions they had about the medicine. Whilst studying literature on the topic, I came across an article about a randomised control trial in patients with heart failure and how the intervention of a pharmacist may possibly increase compliance with the patients [4]. It is a fact that patients with heart failure have several prescriptions and for that reason sometimes have problems being compliant and taking full courses of their medication at prescribed times. The trials objective was specifically to see if pharmacist intervention improves medication adherence and health outcomes compared with usual care for low-income patients with heart failure [4]. 39% of the 314 patients with low income were assigned intervention while the remaining 61% remained with usual care. Both groups were followed for 12 months. The group subject to intervention underwent 9 months of multilevel intervention by the pharmacist with a 3 month follow up period. The intervention was designed by an interdisciplinary healthcare team who helped patients with low health understanding and inadequate resources to manage their medication. The results of this trial showed that during the 9 months of intervention, compliance to take medication in the group with normal care was 67.9% whilst in the intervention group it was 78.8%. This difference of 10.9% was found to be statistically significant; therefore these results prove that intervention by a pharmacist does increase compliance in patients. However, in the 3 month follow up these results dissipated. The rate of compliance reduced to 66.7% in the group with normal care and 70.6% in the group with intervention. The difference of 3.9% between the two groups was found not to be statistically significant meaning there was no lasting effect on compliance. Medication was taken at the correct time 47.2% of the time by the normal care group and 53.1% of the time by the intervention group. This soon lowered to 48.9% and 48.6% in the normal care and intervention group respectively in the 3 mo nth follow up [4]. For there to be a lasting effect on increasing compliance and as a subset, taking the medication at the correct times, it was necessary to continue intervention. This study was useful in helping find a method of increasing compliance; however, it was not clear exactly how this intervention worked. I understood it involved helping patients manage their medication better but not how exactly and also involved educating them better about the drugs. In relation to this essay, this study has these limitations but at the same time it reveals useful methods to increase compliance which I can not ignore. There are proven reasons other than the ones explained above, for non-compliance. These include being male, being a new patient, having a shorter disease period and work and travel pressures [5]. Non-compliance entails the disadvantage of patients not following a strict routine of taking medication which consequently causes further ill health and possible bacterial resistance in the long term. Once these issues have been recognised through discussion between a patient and a practitioner; there are two interventions proven to significantly increase compliance. These methods were proven useful in a study conducted to look at ways in which compliance could be increased in patients with ulcerative colitis [5]. In both instances it is necessary for there to be a good relationship between the patient and practitioner where the patient feels comfortable to talk openly about their problems. Educational intervention can be provided [5]. This is comprised of verbal explanation of the dosage re gime and how the drug itself works. Written information on the drug is also provided to educate the patient further. Once the patient feels they are sufficiently equipped with knowledge on the drug and have agreed to take it, the practitioner and patient draw up a self-management programme collaboratively. However, this method of intervention has its drawbacks due to time constraints many doctors are under. They can not find the time to go through this lengthy process with every patient. This problem could be overcome by having another member of the primary healthcare team take care of this process such as a pharmacist who is qualified to answer questions on medications. The second intervention is based on the patients behaviour [5]. It involves making it easier and more memorable to take their medication. This is done with the use of calendar/blister packs which are made/provided at the pharmacy. The blister packs serve as reminders or cues. They have the day and time at which each tablet should be taken on the back so it becomes harder to get confused and to miss tablets, therefore improving compliance. This is a cheap and cost-effective method which has been proven to improve compliance. The interventions together optimised compliance when they were adapted to individual patient needs in the study involving ulcerative colitis patients. To investigate methods to improve compliance I first need to make clear some of the reasons for poor compliance. For this I will use a study based on the causes of non-compliance to statin therapy as a major challenge in cardiology, as my evidence [6]. This study found that there were a variety of factors that caused non-compliance. These include patient, practitioner and system factors [6]. Patient factors include comorbidities (two or more coexisting medical conditions or disease processes that are additional to an initial diagnosis [7]) which increase polypharmacy which decreases compliance and also financial constraints in being unable to buy prescribed medication. Practitioner factors include poor communication skills, time constraints and poor doctor-patient collaboration. System factors include medication costs, lack of clinical monitoring and drug side effects [6]. These valid points presented by the study highlight where the changes need to be made in the Primary Healthcare team to improve compliance in patients. Some of the causes of decreased compliance above have apparent solutions. Financial constraints on patients could lead to a means tested system where patients that earn less than a certain amount receive medications free. This would eliminate the problem of patients not being able to obtain their medications. Practitioners could be sent on courses to improve their communication skills so that patients feel they are being listened to more and so they feel they understand the drugs and side effects so they feel comfortable being compliant. The idea of communication courses for doctors will also have a good impact on doctor-patient collaboration thereby increasing compliance. Medication costs could only be decreased when patents on specific drugs run out and other drugs companies compete for business thereby decreasing costs. Drug side effects are simply a limitation of the technology companies have at the moment, to formulate drugs. When technology advances, so will mans ability to dec rease the number and severity of side effects. However, doctors can also regularly review medication to reduce side effects by switching a patients medication to another drug with similar effects but fewer side effects. This will increase compliance because drugs will increasingly only have the desired effects and little or no side effects. Many of the system factors that lead to decreased compliance are in fact not in the control of the primary healthcare team, such as controlling the medication costs which are set by the drugs companies and drug side effects. The patient factors leading to decreased compliance are very personal and individual to the patient. However, the primary healthcare team can be useful in helping these problems to be overcome by, for example, sorting medicines into a dosette box for a patient who is very forgetful. The practitioner factors that lead to decreased compliance are indeed the same reasons that cause decreased concordance as well as other reasons. Improving concordance is linked to improving compliance. In fact improved compliance in certain cases is a direct consequence of improving concordance. For this reason tackling the problem of decreased concordance is a key issue in the primary healthcare team. Decreased concordance is a result of intentional non-compliance by patients [8] due to time constraints a doctor is under, poor doctor-patient relationship, poor communication skills of the doctor including poor explanation of the patients conditions [9] and the drugs they are taking and poor appearance/professionalism. Time constraints are a problem because GPs feel pressured to rush everything necessary leaving the patient feeling ill prepared. Government initiatives to set a minimum time limit on how long any consultation should last, could be a possible answer to this problem. This would give doctors more of an opportunity to ask more open questions and more probing questions into how the patients life is affecting their health/compliance. Patients are given the choice of asking to have appointments with doctors they believe they have better relationships with, however, if it is noticed that a pattern is emerging when a certain doctor is consistently not asked for, then a review can take place to investigate why the care given by a particular doctor is not good enough. The doctor can be sent on courses in improving care and be sanctioned if deemed necessary by the General Medical Council through fitness to practise measures. If the NHS makes sure that the doctors are provided with more than enough information to educate them on the drugs they prescribe, the likelihood of poor explanations by doctors to patients on their medications is more unlikely. Doctors should also avoid the use of medical jargon and use simpler language that the patient is likely to understand to improve concordance [9]. If this is the reason for poor communication of doctors then poor concordance is also solved. However, poor communication on the part of the doctor can be due to number of different non-intentional problems including family problems. If this is the case then support services can be made available to the doctor to improve his condition/practise. This has the wider effect of improving appearance/professionalism if this is also suffering. Compliance and concordance are of great importance because a decline in either can lead to an exacerbation of the underlying illness or in many cases of polypharmacy, an exacerbation of comorbidities. In conclusion, there are many simple methods in improving compliance, in certain cases as a result of improving concordance. The doctor-patient relationship is key in improving compliance as it involves a mutual understanding and importantly lends help in listening to complaints of patients and finding methods for them to remain compliant. The simplest methods such as the use of dosette boxes, having doctors that are knowledgeable about the drugs they prescribe and taking the time to explain them to patients, are the most useful methods of improving compliance and concordance.