Baroque Period And Opera

Baroque Period And Opera Early baroque composers favoured homophonic texture over the polyphonic texture typical of Renaissance music. They felt that words could be projected more clearly by using just one main melody with a chordal accompaniment. Homophonic textures only characterise early baroque, by the late baroque period, polyphonic texture returned to favour. To depict extreme emotions, early baroque composers used dissonance with a new freedom. Never before were unstable chords so prominent and emphatic. Contrasts of sound were stressed, one or more solo singers against a chorus, or voices against instruments. A baroque piece usually expresses one basic mood: what begins joyfully will remain joyful throughout. Emotional states like joy, grief, and agitation were represented-at the time, these moods were called affections. Specific rhythms or melodic patters were associated with specific moods. The prime exception to this baroque principle of unity of mood occurs in vocal music. Drastic changes of emotion in a text may inspire corresponding changes in the music. Rhythmic patterns head at the beginning of a piece are repeated throughout it. This rhythmic continuity provides a compelling drive and energy the forward motion is rarely interrupted. Baroque melody also creates a feeling of continuity. An opening melody will be heard again and again in the course of a baroque piece. And even when a melody is presented in varied form, its character tends to remain constant. There is a continuous expanding, unfolding, and unwinding of melody. This sense of directed motion is frequently the result of a melodic sequence, that is, successive repetition of a musical idea at higher or lower pitch levels. Many baroque melodies sound elaborate and ornamental, and they are not easy to sing or remember. A short opening phrase is often followed by a longer phrase with an unbroken flow of rapid notes. Volume tends to stay constant for a stretch of time. When the dynamics do shift, the shift is usually sudden, like physically stepping from one level to another. This alternation between loud and soft is called terraced dynamics. The organ and harpsichord were both well suited for continuity of dynamic level. Imitation between various lines, or voices, of the texture is very common. A melodic idea heard in one voice is likely to make an appearance in the other voices as well. In the baroque period chords became significant. As composers wrote a melodic line, they thought of chords to mesh with it. Indeed, sometimes they composed a melody to fit a specific chord progression. This interest in chords gave new prominence to the bass part. Basso continuo or figured bass is made up of a bass part together with numbers which specify the chords to be played above it. Usually the bass part is played by the left hand of an organist or harpsichordist and a cellist or bassoonist. The right hand, the keyboard player improvises chords or even a melodic line, following the indications of the numbers. Word painting was used. Heaven might be set to a high tone and hell to a low tone. Rising scales represented upward motion; descending scales depicted the reverse. Descending chromatic scales were associated with pain and grief. Composers emphasised words by writing many rapid notes for a single syllable of text. Opera is the fusion of music, acting, poetry, dance, scenery and costumes. Began in Italy around 1600. Voice types: Coloratura soprano very high range; can execute rapid scales and trills lyric soprano rather light voice; sings roles calling for grace and charm dramatic soprano full, powerful voice; is capable of passionate intensity lyric tenor relatively light, bright voice dramatic tenor powerful voice; is capable of heroic expression basso buffo takes comic roles; can sing very rapidly basso profondo very low range, powerful voice; takes roles calling for great dignity Aria A song for solo voice with orchestral accompaniment. Its an outpouring of melody that expresses an emotional state. In an aria, I love you, might be sung ten times to accommodate the expansion of the idea. Often the action stops while the characters feelings are revealed through music. An aria usually lasts several minutes. It is a complete piece with a definite beginning, high point, and end. Recitative A vocal line that imitates the rhythms and pitch fluctuations of speech. In a recitative, words are sung quickly and clearly, often on repeated tones. There is usually only one note to each syllable in a recitative. Recitative is used for monologues and dialogues that connect the more melodic sections of the opera. In opera multiple characters can express contrasting feelings at the same time when different melodies are combined. This is only possible in opera and cannot be duplicated in spoken drama. An opera chorus generates atmosphere and makes comments on the action. Their sound creates a kind of tonal background for the soloists. Most operas open with a purely orchestral composition called an overture or a prelude. Since the eighteenth century, the music for an overture has been drawn from material heard later in the opera. The overture is thus a short musical statement that involves the audience in the overall dramatic mood. Orchestral introductions to acts in the opera other than the first are always called preludes. Opera was born in Italy. During the late baroque, operas consisted largely of arias linked by recitatives. These recitatives were usually accompanied only by a basso continuo, in which case they are called secco recitatives. At emotional high points and moments of tension, however, they might be supported by the orchestra, they are then called accompanied recitatives. Late baroque arias followed the structure of ABA called da capa aria. Monteverdis Orfeo is considered to be the first great opera. Orfeo is about Orpheus, the gifted musician of Greek mythology. Orpheus, son of the god Apollo, is ecstatically happy after his marriage to Eurydice. But his joy is shattered when his bride is killed by a poisonous snake. Orpheus goes down to hades hoping to bring her back to life. Because of his musical talent, he is granted this privilege, as long as he does not look back at Eurydice while leading her out of hades. Orpheus looks back in a moment of anxiety and Eurydice vanishes. Apollo pities Orpheus and brings him up to heaven, where he can gaze eternally at Eurydices radiance. Orfeo includes recitatives, arias, duets, choruses, and instrumental interludes. Tu se morta in Act II of Orfeo is an example of a secco recitative. Orpheus sings solo in a recitative style with accompaniment by a basso continuo played by an organ and bass lute. The texture of this piece is homophonic, as was popular in early Baroque music. There is no time signature which gives the performer the freedom to portray emotion in their singing. Word painting is also found in this piece. Words such as stelle (stars) and solo (sun) are sung high in the performers register while abissi (abysses) and morte (death) are sung low. Roman opera was based more on religious subjects than on Greek mythology, and it made more use of the choruses. Distinction between recitative and aria began to emerge. The prototype of comic opera were intermezzi, comic interludes between the acts. The principal characteristics of Venetian opera were: more emphasis on formal arias, the beginning of bel canto style and more attention to vocal elegance than to dramatic expression, less use of chorus and orchestral music, complex and improbable plots, elaborate stage machinery, and short fanfare-like instrumental introductions. As compared to Italian opera, the outstanding traits of French opera were: use of ballet, greater importance of the drama, more use of the orchestra and instrumental music, shorter and simpler dance-like airs, careful attention to accentuation of the text, more expressive and melodic recitative, less emphasis on virtuosity, the French overture. In Baroque music, ritornello was the word for a recurring passage for orchestra in the first or final movement of a solo concerto or aria (also in works for chorus). In ritornello form, the tutti opens with a theme called the ritornello (refrain). This theme, always played by the tutti, returns in different keys throughout the movement. However, it usually returns in incomplete fragments In the Prologue of Orfeo there is a recitation by La Musica, there are five verses, each introduced by a ritornello. The same ritornello appears at the end of Act II and at the beginning of Act V. La serva padrona was originally an intermezzo to Pergolesis opera seria Il prigioniero superbo (The Proud Prisoner). The two were premiered on 5 September 1733, the first performance after an earthquake in Naples had caused all theatres to be closed, and celebrated the birthday of the Empress of Habsburg. Il prigioniero was unsuccessful in its day[1] and is not a recognized title in todayà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒ ¢Ã¢â‚¬Å¾Ã‚ ¢s operatic repertoire. Eventually the two pieces were separated, and La serva padrona went on to enjoy fame throughout Europe for years after its premiere. The importance of this intermezzo can hardly be overlooked in the history of opera. With a new finale, the French version played a large part in the Querelle des Bouffons. It was appealing because of its presentation of characters that were relatable to any audience, namely the cunning maid and her aging master. La serva padrona is often seen as the quintessential piece that bridges the gap from the Baroque to the Classical period. Owing to its importance, over time it came to be known as more than just an intermezzo and was performed as a stand-alone work. Intermezzo I Dressing room. Uberto, an elderly bachelor, is angry and impatient with his maidservant, Serpina, because she has not brought him his chocolate today. Serpina has become so arrogant that she thinks she is the mistress of the household. Indeed, when Uberto calls for his hat, wig and coat, Serpina forbids him from leaving the house, adding that from then on he will have to obey her orders. Uberto thereupon orders Vespone to find him a woman to marry so that he can rid himself of Serpina. Intermezzo II Same dressing room. Serpina convinces Vespone to trick Uberto into marrying her. She informs Uberto that she is to marry a military man named Tempesta. She will be leaving his home and apologizes for her behavior. Vespone, disguised as Tempesta, arrives and, without saying a word, demands 4,000 crowns for a dowry. Uberto refuses to pay such a sum. Tempesta threatens him to either pay the dowry or marry the girl himself. Uberto agrees to marry Serpina. Serpina and Vespone reveal their trick; but Uberto realizes that he has loved the girl all along. They will marry after all; and Serpina will now be the true mistress of the household. The piece is for bass, soprano, and a mute actor. Opera is the fusion of music, acting, poetry, dance, scenery and costumes. At the end of the sixteenth century a small group of aristocratic intelligentsia, known as the Camerata, met frequently in Florence. The Camerata had the intention of reproducing the combination of words and music which made up Greek theatre. The text was the main focus of this music with all the words being sung naturally, in the same manner as normal speech, and the music must interpret the spirit of the text. This resulted in a new style of music which was mostly homophonic, in contrast to polyphonic music that was popular at the time. The first surviving opera, Peris Euridice in 1600, was a flop, Monteverdis Orfeo seven years later, however, was not. Orfeo managed to fulfil the requirements posed by the Camerata and while also being dramatic and portraying extreme emotion. Over the baroque period opera evolved and developed into different types and varied in different areas. Orfeo was characteristic of a Florentine opera and an opera seria. All forms of opera shared similar musical components such as: solo song, in opera called aria; pieces for two or more solo voices, duet, trio etc; recitative, a singing style that replicated the rhythms and pitch fluctuation of speech; chorus; the orchestra; and the overture, the instrumental introduction to an opera. The various cities of Italy each had variants on the opera. Florentine opera, such as Orfeo, was based off Greek mythology. While Roman opera was based on religious subjects and made more use of choruses. Venetian opera had an emphasis on formal arias, less use of chorus and orchestral music, complex and improbably plots and short fanfare-like introductions. Choruses were nearly non-existent in Neopolitan opera and there was a new style of operatic song, arioso, which was a mix between recitative and aria. Castrati were popular and drew great interest from audiences. Opera spread to France and included the use of ballet, more extreme drama, more use of the orchestra and instrumental music, more expressive and melodic recitative and less emphasis on virtuosity. Towards the end of the Baroque period a new style of opera appeared known as opera buffa. These comic operas originated as intermezzi between the acts of opera serias. Opera buffa differed from opera seria due to its light and humorous subjects, commonplace characters rather than heroic figures, popular tunes replaced the dramatic and formal aria; and characters, subjects and melodies of opera serias were parodied. Pergolesis opera buffa La serva padrona was an intermezzo to Pergolesis opera seria Il prigioniero superbo. Monteverdis Orfeo and Pergolesis La serva padrona show the development and similarities between early baroque and late baroque opera. Whilst the pieces are of differing style and were written over 100 years apart many characteristics of baroque music and opera appear in both. The plots of Orfeo and La serva padrona differ greatly as one is a opera seria and the other an opera buffa. Orfeo tells the tale of Orpheus, the gifted musician of Greek mythology. Orpheus, son of the god Apollo, has just married Eurydice but his joy is soon crushed after she is killed by a poisonous snake. Orpheus goes down to hades hoping to bring her back to life and further drama and tragedy ensues. La serva padrona features the old bachelor Uberto and his maidservant Serpina. Uberto and Serpina are contantly fighting but Serpina manages to trick Uberto into marrying her and becomes the homes mistress. Verspone, a servant of Ubertos, is a mute character but is important to the plot. The opera is light hearted and made up of common people. Over the baroque period the plots of operas changed dramatically in style as can be seen in Orfeo and La serva padrona. All operas were mostly homophonic, this way words could be projected more clearly with only one main melodic line. Both Orfeo and La serva padrona are mostly homophonic. In fact, whilst polyphony came back into fashion as the baroque period progressed, La serva padrona is less adventurous in terms of harmony in comparison to Orfeo. Orfeo makes use of polyphony in choruses, duets and trios. This can be seen in Act I: lo non diro qual sia nel tuo gioir with Euridice, Chorus, Nymph and the Sheperds singing two different melodies in a round-style which eventually join together in a homophonic ending. Excerpt from Orfeo Act I: lo non diro qual sia nel tuo gioir La serva padrona is rather simple, only written for a string quartet and a soprano and bass. The second violins generally double the first violins and the viola generally doubles the bass part one octave higher. The instrumentation of Orfeo is more expansive than that of La serva padrona. Orfeo utilises: 2 clavicembalos, 1 double harp, 2 chitarrones, 2 bass cithers, 3 bass gambas, 2 organs with wood pipes, 1 organ with reed pipes, 2 small violins, 4 violins, 4 violas, 2 violoncellos, 2 contrabass viols, 4 trombones, 2 cornetts, 1 fautino, 1 high trumpet, 3 soft trumpets. Orfeo makes use of this range of instruments through its varying pieces. Orfeo has arias, recitatives, choruses, dances, sinfonias and duets. La serva padrona on the other hand is made up of only arias and recitatives and a duet to end each act. The range of instruments in Orfeo also results in contrast of dynamics between pieces. The use of more and less instruments changes the volume from loud to soft, suddenly, rather than gradually. This is known as terraced dynamics and is characteristic of the baroque period. La serva padrona remains a similar dynamic for most of the opera. Dynamics are altered through the doubling of string parts and the removal of string parts. Two different types of recitative were used in baroque opera. The first being secco recitatives, which were usually accompanied by only a basso continuo. The second being accompanied recitatives which were accompanied by the orchestra. Tu se morta in Act II of Orfeo is an example of a secco recitative. Per altro io penserei in Act II of La serva padrona is an example of an accompanied recitative. This style of recitative is used for an emotional high point in the opera. Arias are also found in both pieces. La serva padrona being a piece of the late baroque period, the arias follow the structure of ABA known as de capa aria. Excerpt from La serva padrona Act II: Per altro io penserei The ascending violin patterns in the excerpt above are an example of the musics use in supporting the text. The fast, ascending, scalic pattern is representative of the excitement and confusion in this piece of the opera. This is a technique known as word painting. Words may be set to higher and lower tones according to the emotion or type of word. This is seen in Te se morta in Act II of Orfeo in which the words stelle (stars) and solo (sun) are sung high in the performers register while abissi (abysses) and morte (death) are sung low. Word painting was used throughout the whole baroque period in opera. Excerpt from Orfeo Act II: Te se morta Beyond the standard soprano, alto, tenor, bass, there were different types of opera voices. These included: coloratura soprano, lyrics soprano, soprano castrato, dramatic soprano, lyric tenor, dramatic tenor, basso buffo, basso profondo. Orfeo makes use of a variety of voice types. Orfeo is performed by a dramatic tenor, due to their powerful voices, while Eurydice and La Musica were performed by soprano castrato. In La serva padrona Uberto is performed by a basso buffo as they could sing very fast and were perfect for comic roles. Serpina is performed by a coloratura soprano which is evident due to her rapid scales and trills and high range. The contrast in voice types in the two operas is due to their different style with one being an opera seria and the other an opera buffa. Reoccurring passages for the orchestra in baroque music are called ritornellos. Ritornellos are found throughout Orfeo. The ritornello is introduced in Act I and it appears at the end of Act II and at the beginning of Act V. Excerpt from Orfeo Act I: Prologo Ritornellos do not appear in La serva padrona as there is only a string quartet and voices. Imitation however does appear. The imitation of various voices of texture was common of the baroque period. Melodic ideas that are shown in one voice appear in other voices as well. Excerpt from La serva padrona Act I: Sempre in contrasti Due to the increased use of homophony in the baroque period chords became much more significant than they were in the past. Basso continuo or figured bass is a bass part that is used together with numbers which specify the chords to be played above it. Usually the bass part is played by the left hand of an organist or harpsichordist and a cellist or bassoonist. In Orfeo the basso continuo is played by many instruments but mainly by organs. In La serva padrona the basso continuo is played by the cello or double bass and is doubled by the viola an octave higher. Basso continuo is a primary characteristic of the baroque period and lasted over all 150 years. Monteverdis Orfeo and Pergolesis La serva padrona both share many characteristics that are common of the baroque period. They also have a few significant differences that are due to the differing style of opera. French and German operas would offer further contrasts to these two Italian operas. On first glance it appears that Orfeo is more evolved and later opera than La serva padroma, this, however, is not true. While Orfeo does offer more instruments and a greater contrast of pieces La serva padroma takes a small part of the first operas and expands on them so that it stands as a genre of opera on its own. The evolution of opera through the baroque period wasnt through the invention of new techniques or massive stylistic changes but rather through refinement of the original techniques and slight tweaks to the musical and lyrics content.

Checkpoint: Financial Management Goals Essay

It is sometimes suggested that the most important goal for financial management is to earn the highest possible profit for the company. However, the key is to use that in setting a goal for the firm. The main measure of performance is how the earnings are valued by the investor. It is important to an investor how the firm’s earnings have increased or decrease, the quality, reliability and risk of it. The financial manager must take all of these into considerations when making each decision on the firm’s overall valuation. The financial manager may attempt to maximize the wealth of the firm’s shareholders by getting the highest value for the firm. Stock prices are not directly controlled by the financial manager since it is generally affected by the expectations of the firm’s future as well as the current economic environment. In some instances, management may be more interested in maintaining its own tenure than in maximizing stockholder wealth. The goal of shareholder wealth maximization is consistent with a concern for social responsibility for the firm. By adopting policies that would maximize values in the market, the firm can attract capital, provide employment, and offer benefits to its community. Another importance is the ethical behavior of a company because it creates an invaluable reputation. Companies can become more visible than others in their pursuit of these goals. The companies that do a good job at practicing ethical behaviors are profitable, save money, and are good citizens in their communities.

Health Promotion - 2274 Words

Health Promotion: Giving up Smoking in Pregnancy Introduction The object of this assignment is to critically appraise a health promotion initiative related to midwifery practice. The initiative chosen is a NHS Health Scotland leaflet entitled Smoking: giving up during pregnancy: a guide for pregnant women who want to stop smoking (NHS Health Scotland 2003). It will be referred to as the initiative or the leaflet throughout this assignment. The World Health Organisation (WHO) identified that health promotion was a way of equipping people to have more power enabling them to make choices in regard to improving their well-being (WHO 1986). Ewles and Simnett (2003) determine from this, that the fundamental elements of health promotion†¦show more content†¦The leaflet may still be issued as having the information readily at hand may prompt the individual to think about stopping smoking. The advantages of leaflets mean they allow individuals to read through them at their own pace (Ewles and Simnett 2003). The second stage is the contemplation stage where the individual is motivated to consider changing their behaviour, maybe she reads the leaflet and attempts to seek information (Naidoo and Wills 2000). The role of the midwife at this stage would be to determine why the woman smokes and what barriers she may face in stopping smoking (Dunkley 2000). The leaflet facilitates this by allowing the woman to question why she smokes and how she feels about it. It also seeks to establish what the woman feels is good and bad about smoking and how she anticipates changing her behaviour towards smoking. It has been suggested (McLeod et al 2003) that some midwives find it difficult to broach the subject of smoking particularly with women who have no desire to stop and those who are still considering stopping. 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“ThereS A Fine Line Between Genius And Insanity. I Have

â€Å"There s a fine line between genius and insanity. I have erased this line† - Oscar Levant. William Shakespeare s tragic play, Hamlet, is centered around the idea of Revenge. Hamlet’s father was murdered by his uncle, who then married his widowed mother, leaving him absolutely traumatized. And to add to this trauma, his father’s ghost returned to tell him he was murdered and that revenge must be sought, or he must remain in purgatory. Hamlet then vowed to fulfill his father’s wish while also feigning madness so that no other could determine his intentions to kill the man that was then king. On his path to take revenge on the king, Ophelia was driven into true insanity which greatly contrasts his own feign of madness. Many have believed†¦show more content†¦. . this not to do, // So grace and mercy at your most need help you, // Swear!†(I,v,173-175,180-182). Knowing that the apparition could have been the devil’s doing, as Hamlet h ad no absolute way of knowing that it had been his father and that he had told the truth, he waited until he himself could prove Claudius’ guilt. This is a pivotal moment in discerning Hamlet’s sanity. An insane person would have taken action immediately without thought, but he knew to think through the possibility of a lie while still intending to follow through with the request. Insanity causes unclear thinking and excessive anger, both of which were countered in that single moment. Shakespeare himself intentionally put in an example of what true insanity is to contrast Hamlet’s act; Ophelia achieved such status after the murder of her father by the one she loved. Prince Hamlet was only ever perceived as insane when he wanted to be, but Ophelia unwillingly lost all control of her mind. 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The Ethical Ambiguity Concerning the Death Penalty Essay

The question of ethical behavior is an age-old conundrum. The prevailing issue with ethics is that it is extremely difficult to measure. A person’s moral fabric is largely based on their particular personality traits, as well as, their psychological state and environmental influences. Many believe that ethics are tied to a person’s conscience, and that good morals are often facilitated by a strong religious background. Furthermore, a person’s moral development can be linked to their economic situation and cultural differences. Interestingly, even while examining the status of one’s moral code is challenging; everyone seems to have their own unique array of ethics. While this is an ambiguous subject, wracked with speculation and†¦show more content†¦No one should have to endure such needless suffering. Capital punishment used to be a routine universal practice. The torrid history surrounding executions dates back thousands of years and includes the majority of civilizations around the world. Throughout history, the death penalty has been utilized as a tool to manage society. Hammurabi, a successful Babylonian king, established what many scholars thought to be the first code of laws. Charles F. Horne, author of â€Å"The Code of Hammurabi,† explains: â€Å"The code . . . regulates in clear and definite strokes the organization of society† and these â€Å"grim retaliatory punishments take no note of excuses or explanations, but only of the fact† (Horne Online). Obviously, Hammurabi was aware of the advantages of capital punishment and eagerly supports it! Furthermore, according to the Death Penalty Information Center, â€Å"In 1612, Virginia Governor Sir Thomas Dale enacted the Divine, Moral and Martial Laws, which provided the death penalty for even minor offenses such as stealing grapes, killing chickens, and trading with Indians† (DPIC Online). While capital punishment is clearly unnecessary for s uch trivial delinquencies, it is evident that this practice has been widely employed and passed down through the ages. If someone were to survey the ethical issues associated with capital punishment, the sheerShow MoreRelatedbusiness law chap 92036 Words   |  9 Pagesdown to the present Uniform Commercial Code, including ethical considerations and social responsibilities fundamental principles of law pertaining to business and persons, contracts and principal-agent relationship. (Prerequisite: Sophomore Standing). Offered every term. Textbook: Smith and Roberson s Business Law, 15th Edition Course Design and Objectives 1. 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Outline Alcohol and Pharmaceutical Treatment Free Essays

utliResearch Paper Outline I. Introduction Alcoholism is an ongoing problem, it’s dangerous, ___ people in the United States are affected by it. (Source 1 #1) Thesis: While the symptoms and damaging effects of alcoholism can be physically and mentally dangerous, there are many different treatment options and precautions available to prevent against this harmful disease. We will write a custom essay sample on Outline: Alcohol and Pharmaceutical Treatment or any similar topic only for you Order Now II. A. Symptoms of alcoholism Topic sentence: The symptoms of alcoholism are quite noticeable in those who are effected by the disease. 1. Excessive use 2. Neglecting of normal activities (social, occupational, recreational)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   3. Ongoing unsuccessful efforts to cut down use 4. Persistence of use (can’t stop though you have reoccurring problems or medical conditions)   Ã‚  Ã‚  Ã‚   5. Withdrawal B. Effects of alcoholism Topic sentence: Effects of alcoholism can be detrimental to one’s lifestyle, and can cause both life threatening and non-life threating cancers and disease essay writers for hire. 6. Disease (NC 10) 1. Family Problems (NC 5,6, 7)  (Our room) 4. Unintentional and intentional injury  ( NC 9) . Cancer  (NC 8) 3. Imprisonment, fines, tickets, etc (source 1 #2) 2. Problems in the workplace (NC 3 4) C. Treatments available Topic sentence: Treatments for alcoholism are available such as rehabilitation care, pharmaceutical treatment, and various support group meetings. 1. Rehab centers 2. Pharmaceutical treatment 3. Support groups D. Prevention against alcoholism Topic sentence: Drin king in moderation and taking into account alcohol laws and regulations can act as prevention against alcoholism. . Employee health promotions (NC 1) 2. Alcohol laws 3. Alcohol taxes 4. Alcohol Education (NC 2) III. Conclusion Revisit main points and tie it all together. â€Å". . . the detrimental impact of alcohol consumption on the global burden of disease and injury was surpassed only by unsafe sex and childhood underweight status but exceeded that o many classic risk factors, such as unsafe water and sanitation, hypertension, high cholesterol, or tobacco use† (Rehm). How to cite Outline: Alcohol and Pharmaceutical Treatment, Papers

Medication Adherence and Community Pharmacy

Question: Explain about the Medication Adherence and Community Pharmacy? Answer: The role of community pharmacy in the face of funding cuts of the magnitude of 170M this year to improve patient services According to Clifford et al. (2010), Community pharmacy plays a vital role in dispensing medicines, providing advice on medicines use, promotion of good health as well as providing support the prevention agenda. The community pharmacy also supports people to take care of themselves, who went through major operations. However, considering the present condition, it can be said that the community pharmacy needs to play a greater role as part of the "integral local care models." These greater roles may include optimizing usage of medicines, provide support to the people with long-term conditions, treat minor injuries and illness, prevent ill-health and promote good health (2). The vision of the community pharmacy is to integrate with the wider social and healthcare system, which in turn will be helpful to relieve pressure on emergency departments, accident department as well as GPs. However, it is found that the reducing of funding for the community pharmacy is inhibiting them to provide their best care service for the patients. According to the NHS, in 2015/16, the NHS provided 2.8 bn on remuneration funding for the community pharmacy. From this 2.8, 2 is used for allowances and fees and 800m is used for drug reimbursement (3). However, the NHS declared to save 22 billion by 2020/2021, in this context it is important to know the role played by the community pharmacy. The numbers of pharmacies had increased by 20% since 2003. Although the government is cutting the fund for the community pharmacy, they are not ready to accept the decrease of efficiencies of community pharmacy. However, there are several reasons to believe that the efficiency of the community pharmacies will not decrease. Such as there are huge too many pharmacies to maintain "good patient access." On the other hand, most of the pharmacies under NHS funding are qualified for a high range of fees regardless of the quality service they provide. However, it is also found that most of the community pharmacies do not have efficient as well as effec tive dispensing arrangements, which have a deep impact on the quality care they supposed to provide. Apart from the fact that the community pharmacy has a good infrastructure to cope up with the new circumstances with less fund, it is also true that providing same efficient and effective quality service is not very easy task. The Chief Executive of NHS, Sir David Nicholsons aim to cut down the fund for the community pharmacy but expect same efficient work from the community pharmacy. According to the Chief Executive of NHS, Sir David Nicholson this was his new "challenge." On the other hand, when he retired Simon Stevens took his position and took similar venture, which is to reduce the funding for community pharmacy but expecting the same quality care (7). Therefore, the question remains same, is it possible to run same quality services in less funding? The answer is very complicated since the cut of money is not very little. According to the NHS, the Chief Executive decided to cut 170M in this year. When the Chief Executive of NHS, Sir David Nicholson announced to cut down about 170m the reaction from the press and common people were immense. According to mailOnline, 170m cuts could kill off a QUARTER of our chemists - prompting a warning of even more pressure on AEs (4). In the PHARMACEUTICAL JOURNAL, it is also stated: "Up to 3,000 pharmacies could close after government cuts, MPs warn. Therefore, it can be said that the pharmaceutical community is going to face a tough time (5). To fight back in this situation, the community pharmacy is already asking for public support through different social media. They also took the initiative to visit MPs and other local decision makers as well as to the local press and the patient groups to seek their support. According to the PSNC and NHS, the funding would be reduced from 2.8 bn to 2.63 bn, which is a reduction of more than 6% in cash terms (6). To help the community pharmacy in this situation, the PSNC agreed to provide discussion with the community pharmacy under NHS and DH as NHS and DH failed to provide specific proposals. To cope up with the situation, the community pharmacy took different steps, such as optimizing the se of medicines, provide support to the people with long-term conditions, treating m inor injuries and illness, preventing ill-health and promoting good health. Besides, the pharmacies are also taking initiatives to change their pharmacy care package to reduce their budget, which can be considered as effective to maintain the sustainability of the community pharmacy. To provide better care facilities, the community pharmacy took many initiatives, which were appreciated by the common people. Such as providing medicines optimization support, implementation of the MUR-type conversation and NMS-type intervention. To reduce the wastage of medicine, the pharmacies also started to synchronize patients medicines. To indicate the impact of pharmacy interventions, the pharmacy is using adherence scores and PAM (Patient Activation Measure) as well as educating the patients to use correct dosage or amount of medicines (8). The community pharmacy is also trying to implement enhanced community pharmacy care package for the patients. The patients, as well as their caregivers hugel y, appreciated this initiative step. The community pharmacy always tries their best to provide best services to the patients. On the other hand, based on the current news, the government is cutting of the funding of the community pharmacy, which is more than 6%. This announcement made the position of the community pharmacy very complicated. According to the new announcement, the government is going to cut 170M from the community pharmacy funding, which will certainly effect on the care services of the pharmacies. However, according to NHS, they are not going to accept any decrease in the care service quality. In this situation, the communist pharmacy accepted help from the PSNC and took several initiative steps to help the patients without decreasing their quality care. On the other hand, it was also found that the common people, as well is the newspapers, are raising their voice against the reduction of the fund for the community pharmacy, which is a positive sign. References Clifford S, Garfield S, Eliasson L, Barber N. Medication Adherence And Community Pharmacy: a review of education, policy and research in England. Pharm Pract (Internet). 2010 Apr 1;8(2):77-88. George K, Lovelady C, Connolly D, Parmar S, Davies MJ. Community pharmacy contribution to weight management: identifying opportunities. International Journal of Pharmacy Practice. 2010 Feb 1;18(1):7-12. co.uk. Government plans 6% cut to pharmacy funding : Independent Pharmacist [Internet]. 2016 [cited 25 February 2016]. Available from: https://www.independentpharmacist.co.uk/government-plans-6-cut-to-pharmacy-funding Mail Online. Home | Daily Mail Online [Internet]. 2016 [cited 25 February 2016]. Available from: https://www.dailymail.co.uk/home/index.html Pharmaceutical-journal.com. The Pharmaceutical Journal news, information and learning resources on pharmacy and pharmaceutical sciences [Internet]. 2016 [cited 25 February 2016]. Available from: https://www.pharmaceutical-journal.com/ PSNC Main site. PSNC Main site [Internet]. 2016 [cited 25 February 2016]. Available from: https://psnc.org.uk/ co.uk. Loading... [Internet]. 2016 [cited 25 February 2016]. Available from: https://www.pulsetoday.co.uk/news/clinical-news/gp-practices-to-face-greater-demand-as-community-pharmacy-budget-is-cut/20030754.fullarticle Sunderland LPC. Christmas blow of 6% cuts to community pharmacy [Internet]. 2016 [cited 25 February 2016]. Available from: https://psnc.org.uk/sunderland-lpc/our-news/christmas-blow-of-6-cuts-to-community-pharmacy/