Sepsis Related to Aspiration Pneumonia , With Current Condition of Cerebral Palsy and Developmental Delay - Free Essay Example

Sample details Pages: 5 Words: 1621 Downloads: 4 Date added: 2019/10/10 Did you like this example? Patient description The patient was admitted to the hospital from home as result of suffering from Sepsis-related to aspiration pneumonia. According to Balady et al. (2007), pneumonia is one of the leading infections, which causes the death of most adult within the different population, and it affects majorly the lungs which are made up of alveoli when an individual is breathing. Don’t waste time! Our writers will create an original "Sepsis Related to Aspiration Pneumonia , With Current Condition of Cerebral Palsy and Developmental Delay" essay for you Create order The patient was diagnosed and found to be suffering from pneumonia which caused mainly by bacteria which is transferred through the air while he was traveling together with infected persons in the environment where he lives. One of the symptoms of the infection as observed from the patient is inflation of the air sacs found in the patient lungs after which the alveoli are filled with fluids as well as pus thus interferes with the natural gases exchange taking place within the lungs. Other symptoms that the patient possesses include a cough, fever, chills, and breathing difficulties. Current medical condition of the patient The client has been examining to have cerebral palsy as he is also alert and nonverbal. Most of the symptoms shown by the patient currently are characteristics of a person who has been affected by the bacteria causing pneumonia. As the patient continues to go through treatment, his condition continues to get better day by day. There are various attempts made by the doctor for ensuring the patient get better as fast as possible. For example, restricting or putting on holds the fluid that the patient take is a step taken to ensure the Patient PIVV line is reinserted back to normal (Watson, 2007). The priority system assessment This indicates various findings and rationale for the findings regarding the conditions of the patient. The first assessment done to the patient is a respiratory assessment. This is associated with the ineffective airway clearance that is accompanied by excessive secretion along the respiratory track. For the patient suffering from pneumonia, a productive cough is experienced as one of the client symptoms. Interventions for pain management includes administration of medications such as Hydromorphone IV, teaching the patient how to manage pain such as deep breathing exercise and proper positioning if he can. Retained secretions can obstruct airways, leading to an impaired gas exchange that causes pain during inspiratory and expiratory. Rationale: The bacterial pneumonia found in most adults contains risks, which cause the adverse cardiac activities for example heart failure, and heart attacks this contributes significantly to mortality. The pain experienced by the patient is evidenced by the changes that occur in heart rate. Inventions required in the clinical treatment process. Various adjustments need to be made in the medical sector as clinicians make the effort of ensuring patients get required medical attention and drugs. Some of which are listed below. There is need to come up with ways of encouraging patients to get rest as well as avoiding over relaxation which can cause an increase in the number of symptoms they experience while they are they are under medication (Kuiper Pesut, 2004). Since the patient is examining to suffer from pneumonia, improving on the smoothness level of the patient airway patency is necessary. Secretion is one of the symptoms that the infection is characterized with and to fasten the recovery rate, there is need to ensure the secretion interfere retained in its initial conditions (Kuiper Pesut, 2004). This way breathing efficiency of the patients has increased hence the secretion clearance as well as volume expansion is promoted. Laboratory concerns based on the diagnosis values The patient is likely to have anemia based on the lab values obtained (iron deficiency). That is the patient has not been taking balance diet, which does not contain iron (Hgb- 95g/L-Low). Therefore, to ensure that the patient has a strong immune system the oxygen carrying capacity needs to improve for efficient breathing system (Winters, 2013). Medical history of the patient is a necessary clarification that all qualified physicians or doctors must inquire before recommending any further treatment for patients. Similar, carrying out physical exams are important which include auscultating the lungs to check for the abnormal bubbling as well as crackling sounds, which are symptoms of pneumonia. The physician or nurses started to ask about the medical history as well as doing a physical exam, including auscultating of the lungs for checking the abnormal bubbling experienced by the patient and the crackling sounds which are symptoms of pneumonia. Upon suspecting pneumonia, the doctor will recommend the tests listed below: Blood Tests: These are used for the purpose of confirming an infection as well as identifying specific organisms/pathogens, which causes the infection. They found client has low hemoglobin and high PT. Chest X-ray: A chest x-ray is the best tool for diagnosing pneumonia. It is used to determine the extent as well as location of the disease. The patient was examine through chest X-RAY to confirm whether he had lung abscess, fluids or air in his lungs. The X-RAY showed fluid in his right lower lobe. They inserted chest tube on his right chest to drain off fluids. Sputum Test: is a sample of fluid taken from the patient lungs after a deep cough by the patient and carry out its analysis to identify the pathogen causing the disease. Revealed my patient had bacterial pneumonia. CT scan: when the infection is not clearing faster as projected, the doctor will recommend an alternative testing which is a chest CT scan to be able to obtain an image of the lungs, which is more detailed. Pleural fluid culture:Â   is the liquid sample, which is taken through putting a needle in between the ribs of an individual starting from the pleural region as well as carrying out an analysis to assist in identifying the infection type. Incorporation of theory into the nursing practice Application of knowing via inquiry, which is termed to be empirical, personal as well as aesthetic, is used. The application of the science of knowing assist in identifying the patients normal and most sensitive signs making it easier to predict the possible result of diagnosis thus faster medical recommendations. Similarly, science knowing allows the clinicians to have a proper understanding of the side effects that the drugs they prescribed to the patients are likely to pose on their health (Winters, 2013). An effective introduction to patients needs the clinicians to have the ethical way of knowing. Ethical way of knowing provide the medical specialist with the opportunity to acquire knowledge in their field of study and master all procedures which are involved in treating patients in the clinics. Demonstration of safe patient care and the unsafe situations observed in the medical environment Ensuring safety in the medical facilities or health care clinics is essential, as most of the operations need to be carried out faster based on different conditions that are experienced by patients. One of the safe patient cares I employed to ensure their safety is keen monitoring and checking of the equipment used for their protection like oxygen and Foley cater (Landers, 2000). Removing obstacles in the clinic environment is another safe patient care practice that I employed in ensuring the patient is well-taken care off/safe. Other safety measures are put in place during treatment of the patient is cleaning of the equipment used during diagnosis after each procedure. Safe nursing practices is a step in ensuring that one gains personal nursing progression, that is the progress of competencies as well as being able to learn the plan goals (Zwarenstein, et al. 2009). This involved demonstrating a professional presence and model behavior while handling patients. This is possible through pear introduction and learning how to interact effectively with the patients in every medical environment (Zwarenstein, et al. 2009). Application of relevant assessment tools as well as techniques while consulting different patients and different health care providers is a safe nursing practice recommended for good patient protection. The BP machine and telescope were used effectively in assessing the bow sound produced by the patient suffering from pneumonia, and this ensures the feelings of the patient are recorded appropriately. After diagnosis and treatment of the patient, there are various factors, which act as barriers to the discharge of the patient. Some of which are listed below. Development of nosocomial infections such as C-difficult or MRSA, associated with hospitalization. Persistence of pneumonia symptoms despite a course of antibiotics. Fortunately, the patient had a good response to treatment within 48 hours of antibiotic administration. The Doctor even removed the chest tube, meaning the fluid in the lungs were not visible anymore (Kolanowski, et al., 2011). Development of complications indicated by an increase in temperature with growing cough, fremitus, and adventitious breath echoes on auscultation of the lungs, confusion and variations in cognitive status. Misperception might be related to hypoxemia, fever, dryness sleep deficiency or emerging sepsis (Kolanowski, et al., 2011). Development of complications is evidenced by the increase in temperatures as well as cough increased as well as well cognitive status. Some of the confusions experienced are related to hypoxemia, fever, dehydration and developing sepsis Areas of improvement One of the challenges I faced during my early days of my clinical was mixed emotions of nervous as well as existence. Because this was my first medical unit association with others after several years of study (Watson, 2007). For one to be able to learn new things in the medical field, for example, checking the IV for preventing complication like filtration, there is need to put more commitments. Working in a various hospital environment with modernized technology is an important factor that an individual practicing nursing needs to put into consideration. Being ready to assist others is another character that needs adjustment for one to cope up with the nursing assistance needs in health care centers.

There is No Perfect Government, No Utopia Essay - 2077 Words

From the early stages of civilization men created a form of government to help bring order to society. One of the greatest philosophers Thomas Hobbes believed that men left in their natural state is solitary, poor, nasty, brutish, and short; however, for men to obtain peace they must renounce their freedom to a form of government to gain freedom. (Hobbes, 1865 ) The government has shaped many civilizations, and brought many changes to each new civilization. Throughout history one can observe many forms of government, some government systems brought peace and prosperity to the states while others brought destruction, war, and famine which can be seen in Ancient Greek and Rome. The question then arises, what there a perfect†¦show more content†¦Athens was a civilization which prospered and exerted influence to other city-states, they focused on philosophy and education rather than military. Nevertheless, despite Athens Golden Age, there were many flaws in the government syst em, women, children, slaves and resident aliens were not considered citizens, and since everyone had a say in democracy, the Athens lacked professional civil service. The Politics and the judiciary in Athens remained under the influence of people of wealth and venal judges presided at courts of law marked by corruption and perjury. (Frank, 2009) Eventually, the Athenian government system failed to overpower their enemy in the Peloponnesian War against Sparta, and Athens was defeated. Sparta however was the fearsome polis in Ancient Greek. Unlike Athens, Sparta was a mixed constitution of democracy, monarchy and oligarchy. As unlikely as it seems, Sparta had one of the best functional government in the Ancient World. The Spartan government consisted of two kings, the Ephors, the council of Elders, and Demos which was an assembly of men over the age of thirty. (Mathisen, 2012) This form of government made sure that there was no corruption in the government, and during the time of warfare one king was on the battlefield while the other ruled the people. Sparta however was a military based civilization with two social groups, Spartan citizens and Helots (slaves); unlike Athens, SpartanShow MoreRelatedUtopia is defined as a place of ideal perfection especially in laws, government, and social1000 Words   |  4 PagesUtopia is defined as a place of ideal perfection especially in laws, government, and social conditions, (merriam-webster.com). Utopia is a mindset that p eople are conditioned to believe is achievable, when in actuality it isn’t. In a utopian society when people believe that they have reached idealized perfection, there will still be things or people that make the society imperfect. â€Å"Every utopia faces the same problem: What do you do with the people who dont fit in?† (Margaret Atwood, a novelistRead More Comparing Margaret Cavendish’s The Description of a New World, Called the Blazing World and Sir Tho1706 Words   |  7 PagesThe Description of a New World, Called the Blazing World and Sir Thomas More’s Utopia The so-called Utopia – the quasi-perfect society – flourishes in Margaret Cavendish’s â€Å"The Description of a New World, Called a Blazing World† and Sir Thomas More’s Utopia. While the former is a dreamlike account of fantasy rule and the latter a pseudo-realistic travelogue, both works paint a picture of worlds that are not so perfect after all. 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A Report On LVMH HR Policies Education Essay Free Essays

Lvmh HR policies are in surplus of required and implement on the concern groups and companies. Through flexible regulation, it besides provides organisation. The map of corporate HR is to normalise certain ways, to exemplify program and to give force to companies ‘ HR squads. We will write a custom essay sample on A Report On LVMH HR Policies Education Essay or any similar topic only for you Order Now In connexion with scheme, HR offers other than hardly of all time oblige. An employee work reciprocally with the concern group which study to corporate central office. Approximately 55 to 60 % of advancements are controlled by companies, the else managed by the concern groups or corporate. There are four types of HR directors at Lvmh. Subsequent the group ‘s construction, they operate on four degrees: corporate, regional, concern group and company degree. The subordinate HR Director or the individual moving as such, studies to the subordinate ‘s President. The subordinate ‘s HR Director gets recommendation and shore up from his company. The concern group ‘s HR Director organizes his companies ‘ HR Directors through monthly meetings. The intent of these meetings is to place vacant places throughout the universe and to analyze the list of possible campaigners for these places, between which are the Ready to Move. Lvmh has ready internal mobility – both geographic and functional – a footing of their human resources policy. This cross-fertilisation of experience within their ecosystem under the consolidative umbrella of the group creates matchless cause of proficient and personal fulfillment. International mobility is indispensable portion of every prospective calling way. It targets to make planetary directors many of them have far above the land cardinal practical move. As an illustration the caput of HR development remember the instance of a Gallic insurance specializer in the manner concern unit who was sent to Romania to head a shoe mill. LVMH be on familiar footings with they could make with hazards to develop likely impending. It needs to set them in new fortunes to assist them develop new accomplishments and set up their bravery. Lvmh actively supports the professional development of its employees. The decentralised organisation of the Lvmh group encourages single enterprise. Half of Lvmh ‘s senior executives and over 40 per cent of managerial staff are Gallic, whereas the Gallic history for 37 per cent of the group ‘s planetary work force. HR needs to develop more planetary concern directors so they can be a portion of globalized top direction. Lvmh mobility procedure works on the web of HR squads who largely staffed with locals. Lvmh did non direct out any experts because non hold local gift. Generally their experts fit two profiles: those sent out by the corporate HQ to command its subordinates and protect its involvements and sent out to develop their accomplishments. To back up the international concern growing relocate is lifting. Though, it non means that increasing figure of Gallic exiles will coerce this disposition. Lvmh lake of planetary directors creates their order adverse in footings of deploying adept director to company ‘s desire program or task given to that director. Lvmh did non pull experts by giving them higher fringe benefits in footings of their degree. The group is motivated for cost effectivity. They know that a good bundle is indispensable, but that it non the chief encouragement to travel abroad. The primary balance-sheet move in the way of bundle is based on the benchmark that proficient should neither lost nor turn from their reallocate. Lvmh ‘s C A ; B section has connected this draw near as a direct for it does remunerate bundle policy. Specific state based salary is evident for international mission. Salary will acquire hire during the period of mission. That is used as a vital for work out of societal security and pension payments. The mobility rewards are mean comparison to local labor market. Lvmh distinguishable two types of high potencies, HP1 and HP2 is an single likely to accomplish a top direction place such as member of Board commissions, Regional president or Subsidiary president. An HP2 is an employee probably to travel up one or two stairss in the hierarchy. For corporate HR this word picture of high potency is excessively wide and is more relevant for level constructions. It is now sing contracting it. It would retain the definition of HP1 and include those who are considered to be experts in their field. Lvmh is giving specific undertaking or mission to the planetary director in their working content for specific period and give him or her full authorization to take determination for the company, besides they want to larn from this sort of freedom to make new or dare things. Undertaking 2 To fit the planetary demand of concern working form Lvmh has to deploy local people instead than experts from the Gallic, because they do non hold know the local civilization or local market how they react in new or old section for their merchandises or what is the tendency among them for Lvmh ‘s merchandises. If they select local director with relevant expertness for their desire undertaking or purpose to accomplish. In this status they can acquire director with accomplishment which they want and besides acquire betterment from his cognition about their merchandise fiting the local public positions and if possible implement them for acquiring better consequences. For LVMH operates in all over universe so, they have to believe globally and move locally for their operations. For illustration they have decided same regulations and ordinances for the all employee universe broad like their rewards and benefits. In France they have decided to give 6500 ˆ per month wage to the planetary director for giving his or her services to the company as per same wage may non be pay in other continent like Asiatic states China or India. Populating criterion in all continents is different so, their policies should be different than headquarter and subordinate in footings of rewards. Lvmh has to take attention for the different civilization base for their scheme in HRM for illustration in Japan they can non deploy younger director on the employee who is senior in footings of age so him or her, because Nipponese have cultural usage that they respect elder individual and do non traverse their words of all time so, in that manner Lvmh has to be specific about cultural differences. Like in South East Asia India is a populated state and have more knowledge base potency campaigners are available to fit their standards but they have to maintain in head that Indian civilization is a versatile and full of festivals. If they want to establish the new merchandise there they have to look frontward for the appropriate gay season for their merchandises and the director who familiar with the usage of this festival and achieve company ‘s end. Before directing the planetary trough on his or her assignment they has to be given developing about linguistic communication which is locally spoken over at that place and have good bid over at least 3 linguistic communications other so French. Looking frontward the HRM policies of Lvmh is to follow divergency in footings of local environment like in UK people like to imbibe Beer while in USA and France prefer to imbibe Wine. Such things keep in head and develop their program for act in a planetary market through their planetary directors who really implement their policies to their concern. Undertaking 3 Lvmh has created his name in the planetary universe so they have to choose planetary linguistic communication like Good English talking individual because in the yesteryear they select staff from the France merely, they ca n’t talk English fluently for that they have to larn English as a preparation and development undertaking which is programmed by HR section and educate them to cover in English at planetary degree. How to cite A Report On LVMH HR Policies Education Essay, Essay examples

Business Development of Commonwealth Bank-Free-Samples for Students

Question: Discuss about the Sustainable Business Development of Commonwealth Bank. Answer: Introduction: The aim of this paper is to harp on the concepts of business model and disruption of the business model. The paper also discusses the threats and opportunities ushered in by the smart-connected devices by delving into its impact on Commonwealth Bank, Australia. There are discussions on the Osterwalder and Pigneurs business model in contextualizing the disruptive business model of Commonwealth Bank and further discussions on the two perspectives of business model. Business model: Business model comprises of three elements that define the structure and goals of the business (Tidd, Bessant Pavitt, 2005). These three elements are profit formula, value proposition and the key processes and resources. Customer value propositions deals with the notion of fulfilling the task are meant for the better experience of the customers (Chesbrough, 2010). The notion of profit formula is concerned with the strategies that the company has employed in generating a lucrative deal. Third notion of the key processes and key resources indicates the processes imperative for the delivery of the proposition. Disruption in business: Disruption in business has become the trend in contemporary phase of business. The term disruption refers to the drastic alteration in the landscape of the traditional business model of the company. Companies have adopted the disruptive model to bring innovation in their business. Some of the illustrations are that companies have disrupted the business model by converting the necessities into shipping products and subscriptions (Commonwelath Bank of Australia, 2018). Companies have tapped the advantage posed by the revolution in internet speed the mushrooming of the mobile device that would stream high-quality content in exchange of monthly subscription. Another illustration of innovation would be Netflix. The company has ensconced a strong position by continuously innovating its business model. This is done through renting the DVDs and therefore changing the fate of blockbusters. In 2007, the company incorporated the streaming service and has over the years built a reputation. It ha s also branched out into the sector of original content. Currently, Netflix has become the contributor in cord-cutting phenomenon that has posed a threat to the cable companies. Another illustration of disruptive business model is Amazon. The retail giant has been consistently focussed in elevating the experience of shopping for the consumers. It has placed 500 products in the market that would be available at the fingertip of the customers. Recently, it has launched that app that has led to a sweeping increase in its sales. To stay ahead in the business, the company innovated convenience that includes the facility of Amazon Prime for its customers. Along with that it has granted access to the customers membership to two-day shipping and has allowed them to access millions of products including the benefit of music libraries and video. Disruptive business model has incorporated drop box for the purpose of communication. This had led to the enhancement in participation, accessibility and productivity. Another feature of disruptive model is that it has led to the building in of gamification that has led to the enhancement in engagement with the customers Business model of Commonwealth bank: Opportunities and threats The eruption in technology has led to the radical automation in the service of the Commonwealth Bank (Porter Heppelmann, 2014). The company has introduced a range of smart machines that interact with humans and has led to the generation of GDP. Smart-connected devices and service has altered the business model of Common Wealth Bank as envisaged by Dilan Rajasingaham, the Head of the CommonBanks Emerging Technology team (Welcome to the Machine-to-Machine economy, 2018). The company has introduced machine-to-machine economy the feature of which is that machines can eliminate the tasks that are otherwise boring, tiring or onerous. The company is planning to introduce automated machines that can look after it, in other words it can do self-monitoring and are capable of taking orders and making decisions on insurance. Machines will perform these functions and will open a new door in terms of providing smooth service to the customers and ease their pain. The technology partner of Commbank Emerging Technology has collaborated with public and private tech partners and the academic community who would be able to experiment with technology. The focus areas of Commonwealth Bank are big data analysis, blackchain, smart machines and cyber security (Reinventing Your Business Model, 2018). The team of CommBank is committed in preparing a future based on experimentation, education, adoption of new technologies and learning. Whilst, these were the opportunities, the threats are also quite prominent. According to a survey conducted by the Mobile Ecosystem Forum, 60 per cent of the population were worried about the proliferation of the connecting devices, and 62 per cent of the population was of the opinion that privacy was a real concern that was being hampered by the smart-connecting devices (Commonwelath Bank of Australia ,2018). It was reported that 21 per cent of the sample population conceded that internet of Things (IoTs) poses a real threat (How Smart, Connected Products Are Transforming Competition, 2018). The advantage lies in gaining or securing the trust of the customers in the management of transactional data. CommBank is committed to innovating in the space of payment technology. The company has constructed a network that would enable in the innovation of the business through a decentralized structure and distribution. The broader aim of the company is to work its privacy protocols that would underpin the transaction banking of CommBank. Business model framework of Osterwalder and Pigneur to analyze the business model of Commonwealth Bank: An analysis of Commonwealth Banks disruptive model with the framework of Osterwalder and Pigneur is imperative. It has been found that the bank is committed towards building on its customer relationships and the value proposition. In terms of value proposition, the company believes in making transaction smoother for the customers, in terms of customer relationships, the company believes that smart-connected device would cater to the growing needs of the millenials for whom everything is just a click away and finally in terms of channels, the company is planning to reach to the potential customers via notification through mobile phones (Osterwalder Pigneur, 2010). Key Partners Partner with private and public service providers Key Activities Providing smooth bank experience to the customers Machine-to-machine transaction economy Big data analysis Cyber security Value Proposition The company delivers the value of easy money transaction Customer Relationships Building trust Customer service Cordial and long-term relationship. Customer Segments Millenials who service to be quick and efficient Key Resources Smart connected technology Automated banking Self-monitoring machines Channels Decentralized structure and distribution Cost Structure Technology Customs Employee wages Taxes to government and intercity and interstate taxes Production costs Installation of the machines throughout the country Revenue Streams Easing the burden on payment technology Two business model perspectives Business model as a set of capabilities- This refers to the ability of an organization to recognize and build on the right kinds of capabilities. This capability provides the opportunity to translate the strategy into actionable tasks and ensured that it is executed in the business areas (Zott Massa, 2011). Business model as profit formula- Business model as a profit formula refers to the four aspects of business. These are cost structure, target unit margin, revenue model and the velocity of the resources. Conclusion Therefore, it can be stated that smart-connected products in the form of machine-to-machine economy will make it easier for the customers to make transactions. It will also transform the landscape of the banking sector. This is an illustration of disruptive business model for CommonWealth Bank. References Chesbrough, H. (2010). Business model innovation: opportunities and barriers.Long range planning,43(2-3), 354-363. Commonwelath Bank of Australia (2018). Disrupting beliefs: A new approach to business-model innovation.McKinsey Quarterly,3, 66-75. How Smart, Connected Products Are Transforming Competition. (2018).Harvard Business Review. Retrieved 19 April 2018, from https://hbr.org/2014/11/how-smart-connected-products-are-transforming-competition Osterwalder, A., Pigneur, Y. (2010).Business model generation: a handbook for visionaries, game changers, and challengers. John Wiley Sons. Porter, M. E., Heppelmann, J. E. (2014). How smart, connected products are transforming competition.Harvard Business Review,92(11), 64-88. Reinventing Your Business Model. (2018).Harvard Business Review. Retrieved 19 April 2018, from https://hbr.org/2008/12/reinventing-your-business-model Tidd, J., Bessant, J., Pavitt, K. (2005).Managing innovation integrating technological, market and organizational change. John Wiley and Sons Ltd. Welcome to the Machine-to-Machine economy. (2018).Commbank.com.au. Retrieved 21 April 2018, from https://www.commbank.com.au/guidance/newsroom/corporate-travel1-201711.html Zott, C., Amit, R., Massa, L. (2011). The business model: recent developments and future research.Journal of management,37(4), 1019-1042

Virgin Group free essay sample

Which future for Virgin? Diversification is often seen as the last evolution for a company. However, there are ways and options to adapt your strategy after you diversify in order to make it more efficient to this new change. Virgin is, as we’ve seen in the previous parts, a well-diversified company. There are usually 4 paths a diversified company could use after it diversified, and we can use them to analyse the potential future of Virgin. 1 Broaden the diversification base Virgin’s essence since its creation is to explore new businesses and try to be a part of them. The company has a real thirst and desire to diversify and no one doubts that the Virgin Group will enlarge his portfolio. On its website, the Virgin Group says that in order to find new business, they just â€Å"put their selves in the customers shoes to see what could make it better. We will write a custom essay sample on Virgin Group or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page † In order to diversify more, the company is trying to find or create some businesses that will: * Reinforce its market position. For instance, Airlines are clearly a business that Virgin wants to strengthen. The â€Å"Media Mobile† division also seems to be a business where Virgin wants to invest, as evidenced by the recurrent creations of mobile companies in recent years. * Build positions in new industries. The company’s new â€Å"Green Vision† is clearly showing that Virgin’s new favourite Industry is the â€Å"clean energy† industry. More concretely, the company is investing the profits and dividends from its transport businesses into the development of alternative fuels for instance. Moreover, the â€Å"Virgin Green Fund† focuses on â€Å"middle market growth and expansion investment opportunities in the renewable energy and resource efficiency sectors including water† with the objective of helping companies realize their full growth potential, says the company. 2 Divest some businesses and retrench to a narrower diversification base * The company has no intention to narrow its diversification base and reduce its portfolio to some few core-industries. The goal is clearly to find some new businesses and needs, as this paragraph on their website shows. â€Å"We ask fundamental questions: is this an opportunity for restructuring a market and creating competitive advantage? What are the competitors doing? Is the customer confused or badly served? Is this an opportunity for building the Virgin brand? Can we add value? Will it interact with our other businesses? Is there an appropriate trade-off between risk and reward? † (Company’s website) 3 Restructure the company business line-up â€Å"Sell off noncore businesses†: There is no proper â€Å"core† or â€Å"non core† businesses at Virgin, even if there is some sectors more developed than others. Therefore, selling noncore businesses doesn’t seem to be in Virgin’s strategy for the years to come, as they try to develop new core businesses, like â€Å"clean energy†. * â€Å"Sell off competitively weak businesses†. The case und erlines that Branson wants to focus on long-term investment. He doesn’t have the pressure of Financial Markets, so he can wait few years after an investment, even if it means losing money. Thus, the company can either decide that some investments are not profitable and will never be, and sell off the business (as they did in the past), or decide that this is a long term investment and wait for the investment to become profitable. 4 Pursue multinational diversification * Multinational diversification seems to be the next step for the brand. The company is located in 30 countries, which is not much when compared to the 11,5 Billion $ revenues in 2009. The company has a very small presence in Asia, and should extend in this part of the world where fast developing countries are located. International diversification is complex but could really increase the company revenues by opening new markets to the company’s existing subsidiaries. Moreover, Virgin could use its knowledge of creating new businesses from the scratch to develop in new countries. Furthermore, the expansion of one of the Virgin’s companies in a country could really help the other companies to settle in this country, by transferring knowledge of this new market. * Virgin in China: this is difficult to find some recent articles and info about Virgin’s presence and goal in China. However, Virgin Atlantic has an office in China and Virgin Megastore is implanted in regions like Middle East and Europe, and will soon open stores China. Moreover, Branson plans to set up a Clean-Energy company in China. â€Å"We plan to invest quite heavily in it† he said in a recent article. He thinks China is currently making some research and trying to develop the â€Å"clean energy† business and he wants to be a part of it. Chinese government wants 15% of the energy production to come from wind or solar power by 2020, so it seems to be an interesting new business for Virgin.

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Ratio Analysis Sainsburys Vs Morrisons Finance Essay When considered as a whole, the grocery market in the UK has  steadily growing  in size, being about 4  bigger  today than it has been  a year ago;   August 2012 update: 12 weeks ending July 8, 2012 growth rate slows from 4.2% to 2.1% due mostly to a drop in price inflation: 6.2% to 3.8%.  Morrisons is growing more slowly then Sainsburys; the company is on track to add approx. 20 new stores  in 2012  with most of those locations featuring a  larger selection of produce. The UK grocery market was worth  £163.2 billion in 2012, an increase of 3.8% on 2011, IGD forecast that the UK grocery market value will be worth  £192.6bn in 2017, an 18.0% increase on 2012. The grocery markets share accounts for 54.3p in every  £1 of UK retail spending. What is the size of the UK grocery market Source: IGD UK channel forecasts 2012 1.2 The Companies 1.2.1 Sainsburys J Sainsbury plc. is the parent company of Sainsburys Supermarkets Ltd, commonly known as Sainsburys, the third largest chain of supermarkets in the United Kingdom with a share of the UK supermarket sector of 16.5%. The group also has interests in property and banking. It was founded in 1869 and today operates over 1,000 supermarkets and convenience stores and employs around 150,000 colleagues. It is listed on the London Stock Exchange and is a constituent of the FTSE 100 Index. 1.2.2 Morrisons The supermarket, which generated sales of  £18.1 billion in the year, said it had not done enough to communicate its promotions and suffered because it still lacked a meaningful presence in the two fastest growing sectors of the market. Morrisons is the UKs fourth largest food retailer with over 400 stores. The super market is mainly food and grocery weekly shop. Morrisons employs 129,000 staff at 498 stores. Their reports show that like-for-like sales dropped 2.1% in the year, while the average of 11.4 million customers in its stores each week was down on the prior year. 2. Gearing Ratio Analysis 2.1 Gearing Ratios Gearing Ratios (%) Company/Year 2012 2011 Sainsbury 31.73 30.13 Morrison 22.86 16.25 Source : Appendix 1 Sainsburys A gearing between 25% 50% is generally considered nominal for an established business. It implies that Sainsbury is happy to finance its activities using borrowing. Sainsbury focuses more on investment in revenue growth rather than profit as the company increased sales revenue and non-current assets but suffered a loss in 2012. Morrisons The business is considered low gearing as its gearing is less than 25%. The business is growing through reinvestment of profits and minimizing risk. However, in 2012, there is an increase in gearing from 16.25% in 2011 to 22.86% and this is mainly because the business increased long-term borrowings by  £548m and reduced retained earnings and shared capital. 2.2 Interest Cover Ratio Interest Cover Ratio Company/Year 2012 2011 Sainsbury 6.04 7.40 Morrsion 20.59 20.62 Source : Appendix 2 Sainsburys The ratio indicates that the borrowing capital is used effectively to generate profits and that the business is able to meet its short-term interest obligations from its earnings. Sainsbury is growing, making worthwhile investments to continue to expand. Morrisons The ratio suggests that Morrison is generating enough income to cover its interest obligations and is thus financially stable. However, such a high ratio also suggests that Morrison is neglecting opportunities to magnify profits through leverage. 3. LIQUIDITY RATIO ANALYSIS 3.1 CURRENT RATIO COMPANY/YEAR 2011 2012 SAINSBURY .580 .647 MORRISON .545 .574 Source : Appendix 3 Sainsburys Sainsburys current assets are considerably less than the current liabilities in both the years as Sainsbury has invested a lot in fixed assets as well as in subsidiaries and joint ventures. Sainsbury is obliged to pay a lot of money as a part of tax and also in generating its assets so the liability is therefore more than the assets. For every 1pound liability they have only 64.7 pence worth of asset to cover it. Morrisons Morrison current ratio is smaller than the current ratio of Sainsbury which indicates that Sainsbury is doing slightly better than Morrison in the market. Morrison current liabilities is more than the current assets due to more of borrowing that involves short term loans, investment in fixed assets and payment of tax. For every 1pound liability they have only 57.4 worth of asset to cover it. 3.2 ACID TEST RATIO COMPANY/YEAR 2011 2012 SAINSBURY .304 .348 MORRISON .239 .247 Source : Appendix 4 Sainsburys The acid test ratio is very less as Sainsbury, being a retail store, is highly dependent on sale of inventory. As acid test ratio of Sainsbury is .348 that is less than 1 it means that Sainsbury cannot pay their current liabilities. Morrisons Like Sainsburys, Morrison also being highly dependent on inventories, acid ratio is expected to be less. Morrisons acid ratio is .247, which is less than 1, meaning Morrison cannot pay their current liabilities. It would be only able to generate 24.7 % cash of its current liabilities. Both the companies fails in extinguishing its current liabilities but this is not due to their market position or growth but just due to the nature of the business (retail). 4. PROFITABILITY RATIO ANALYSIS 4.1 Return on Capital Employed (ROCE) Return on Capital Employed Co./Year 2012 2011 Sainsburys 10.11 % 11.06 % Morrisons 13.83 % 13.70 % (Source : Appendix 5 ) Sainsburys ROCE growth in 2012 was lower than last year partly due to the cumulative effect of Sainsburys accelerated investment in space growth since 2009 (Sainsburys, 2011). This initially shrank profits whilst increasing the value of capital employed. Morrisons Morrisons delivered improved returns to its shareholders. For every  £1 capital invested in the business, the annual return is 13.83 pence in 2012 and was 13.70 pence in 2011. This profitability ratio of Morrison is moderately higher than Sainsburys, hence Morrisons is able to gain more profit on average capital employed. 4.2 Return on Equity (ROE) Return on Equity Co./Year 2012 2011 Sainsburys 10.62 % 11.79 % Morrisons 12.78 % 11.66 % (Source : Appendix 6) Sainsburys Sainsburys Return on Equity in 2012 has decreased by 1.17 % compared to 2011 due to decline in shareholder funds. In 2011, they performed slightly better than Morrisons as they had better reserves and share capital and the Profit after Tax (PAT) was significantly lower than Morrisons. Morrisons Morrisons ROE has significantly improved over d last few years and continue to reach high values. In 2012, they showed a 1.12% increase in ROE compared to 2011 and had a 12.78 % shareholder equity. The shareholders invested a lot which resulted in higher returns. 4.3 Gross Profit Margin Gross Profit Margin Co./Year 2012 2011 Sainsburys 5.43 % 5.49 % Morrisons 6.89 % 6.96 % (Source : Appendix 7) Sainsburys A moderate decline in the ratio between 2011 and 2012 explains the fact that the gross profit was lower in relation to sales revenue. This means that cost of sales was higher relative to sales revenue within the period. Morrisons Morrisons Gross Profit Margin is higher than Sainsburys as they had a lower sales revenue and moderate gross profit compared to the latter. In 2012, 6.89 % of the net sales are available to pay off all the operating expenses. 4.4 Net/Operating Profit Margin Net/Operating Profit Margin Co./Year 2012 2011 Sainsburys 3.74 % 4.07 % Morrisons 5.48 % 5.38 % (Source : Appendix 8) Sainsburys Sainsbury accounted to lower Net Profit Margin than Morrisons because of falling sales and rising costs. The market has a lot of competition where small groceries and convenience stores capture quite a bit of total UK food retail. Morrisons Morrisons performed fairly well and showed significant increase in the operating profits from Sainsburys over the past year. It accounted 5.48 % Net Profit Margin in the current financial year (Sales Revenue:  £17663m). It is a result of superior execution and induction of higher margin products in their sales mix. Morrisons seems to be more profitable than Sainsburys across all available profitability measures. 5.0 Efficiency Ratios (Source of Data, Apendix 9, Financial Reports of Sainsburys and Morrisons) 5.1 Fixed Assets Turnover This ratio shows how efficiently the company is using fixed assets to generate sales. Low ratios indicate the company is capital intensive or that company requires a lot of fixed assets to generate a given amount of sales. (Gildersleeve, R. (1999) p.136). Efficiency Ratios Year/Comp. Sainsburys Morrisons 2011 2.40 times 2.18 times 2012 2.39 times 2.22 times Sainsburys In 2012 Sainsburys shows an increase in Sales Revenue for approx 1,100  £m, which made its ratio slightly lower comparing to 2011. The ratio remained fairly similar because the value of fixed assets at net book value increased as well. The reason for the increase in fixed assets could be explained by Sainsburys tendency for opening new stores. The financial report states that they opened 19 new supermarkets, 28 extensions, and 73 convenience stores, which are only to begin operating and contributing to sales. Morrisons On the other hand Morrisons managed to improve their ratio by obtaining similar value of their fixed assets from 2011 to 2012, and using them more efficiently to score an increase in sales revenue of 1,100 £m. Generally looking at the industry the Average ratios for Retail Food companies are between 4-5 (Wal-Mart Stores USA 5.00), (Gildersleeve, R. (1999) p.136), so Sainsburys should aim to increase the use of their fixed assets in order to increase the sales. 5.2 Average Inventories Turnover Shows how many days company had to stock goods for sale before they were sold. In the retail-food industry this period should be kept fairly low because of the nature of the business. Lower ratio indicates that company will spend less funds towards stocking items before putting it on sale and getting profit from it. Average Inventories Turnover Year /Comp. Sainsbury Morrison 2011 14.86 Days 15.19 Days 2012 15.85 Days 16.85 Days Sainsburys Sainsburys shows growth in the average of inventories held over the course of year by almost 100  £m. As costs of sales have increased from 2011-2012, this ratio shows a slight growth in number of days goods are kept in stock. The increase of inventory in stock could be explained by Sainsburys growth of sales in 2012. Higher demand forces company to have more items in stock in order to satisfy the needs of the customers. Morrisons Morrisons shows even higher growth in average days the goods are stocked. Morrisons also note the increase in cost of sales, even more than Sainsburys. The financial reports of Morrisons state a few reasons, among which increasingly higher prices of fuel on the market. 5.3 Profit Per Employee Profit Per Employee Year/ Comp. Sainsbury Morrison 2011 5,572.78  £ per emp. 6,617.50  £ per emp. 2012 5,256.58  £ per emp. 7,217.60  £ per emp. Sainsburys It is notable that companys profit has been reduced from 2011-2012 for 2.8 m £, which is 3.4%, even though its sales have risen for 6.8%. This could be explained by the number of reasons, but one of them that is important for this ratio is that they have also increased the number of employees. This has negatively influenced their Profit per Employee ratio, leaving it behind the industry average and Morrisons. Morrisons Unlike Sainsburys, Morrisons notes the increase in profit and reduction of number of employees. This is the most desirable situation for a company. Their profit was higher for 8 % in 2012 than in 2011. 5.4 Average Trade Debtor Collection Period It indicates the period of time which is needed for company to collect trade debts. This ratio reveals a great deal about a companys credit policy and the efficiency which it can collect money from its customers. (Fight, A. (2006) p. 57)). Average Trade Debtor Collection Period Year/Comp. Sainsbury Morrison 2011 1.61Days 4.79 Days 2012 1.90 Days 4.34 Days Sainsburys Sainsburys shows an increase in the average time that they needed to collect the trade dept. Even though their costs of sales remained fairly similar, there was a substantial increase in the amount of trade debt. Even though this negatively influenced the ratio, Sainsburys has made trades from which they expect to receive money in near future. Furthermore their ratio shows efficiency at collecting debts, comparing both to the industry and Morrisons. Morrisons Morrisons have significantly higher average debt collection period. Even though they have managed to slightly decrease their Trade receivables from 2011-2012, their costs of sales increased by approx 1,000 £m which has not made it possible for this ratio to improve further. 6. INVESTMENT RATIO ANALYSIS FORMULAS * Eearning Per Shares = profit available to shareholders/ no. of shares ranked for dividend * Dividend Yield= dividend per share/ market price * 100% *Dividend cover = Preference Dividend/Ordinary Dividend SAINSBURYS MORRISONS 2011 2012 2011 2012 (%) (%) EARNING PER SHARE 33.8 31.5 23.43 26.03 DIVIDEND YIELD 15.10 16.1 9.60 10.70 DIVIDEND COVER 1.75 1.75 2.40 2.39 6.1 EARNING PER SHARE YEAR Sainsburys In 2011 Sainsburys experienced a sharp increase in earnings per share going up by 33.8%. And in 2012 the Sainsbury went down with 31.5% having a loss of 2.3%. It is important that assets are revaluated in order to keep the real value of assets on balance sheet. Earnings per share in 2011 increased by 2.3% to 33.8 p, reflecting the improvement in the operating profit and the effect of the additional shares, more importantly due to the property profits. Morrisons Morrisons earnings per share compared to Sainsburys are lower. This is driven by smaller profit and the fact that Morrisons is a smaller sized supermarket chain. The earning per share has 23.43% at 2011 mainly caused by the higher profits on business disposals that the company went through last year, so the return to shareholders was a lower rate per share. 6.2 DIVIDEND YIELD YEAR Sainsburys The dividend yield had a slightly decreased since the dividend per share only increased by 15.10% from 2011 year. This was a decision from the company and it reflects the reduction in the earning per share already mentioned and the fall in the dividend cover by 1.75% in 2011. Morrisons Morrison dividend yield is much less in 2011 it was 9.6% and in 2012 the dividend went up to 10.70%. 6.3 DIVIDEND COVER YEAR Sainsburys Dividend cover of Sainsburys says that earnings available for dividend cover is 1.75% in 2011 and also in 2012 so there was not change in the divided cover over the past two years. In terms of dividend cover, Sainsburys has its policy based on their calculations to maintain the dividend cover between 1.50 1.75 times. The reason behind it is that if the dividend cover is too low, there is a possibility that the company will not be able to pay out the investors. Morrisons In Morrisons divided cover, it showers that in 2011 it has 2.40% whereas in 2012 it has 2.39%, which is still more than Sainsbury. For the year 2011 Morrisons dividend cover is 2.4 times, claim that it is in line with the European food retail sector average (Morrisons, 2011). 7. Future Perspectives and Strategies Both Sainsburys and Morrisons have their business strategies for future outlined in their financial statements. Morrisons financial strategy continues to deliver improved margins whilst positioning long term growth. They wish to increase their customer appeal and growth of sales, which is meant to be converted into profitable growth. They have realized the potential in online retail, so they will finally enter the online groceries market to challenge Tesco, Asda and Sainsburys, making it the last of the major supermarket groups to have an internet presence, but only after reporting its first fall in profits for six years.C:UsersUSERDesktopfinancial management1.JPG Sainsburys based their business strategy on meeting consumer needs, taking into the account the on-going inflation over the past four years. The economic downturn has changed how and what consumers buy, and these changes appear to be lasting. In 2012 they have launched their Live Well for Less campaign based on awarding loyalty and providing the best quality possible for optimal price. Through Nectar loyalty scheme they have a wealth of data about their customers behaviour. C:UsersUSERDesktopfinancial management2.JPG Source of the table: Morrisons financial statement 2012. Source: Sainsburys Financial Statement 2012 8 Conclusions Financial statements suggest that Morrisons financial performance was very good. They had a profitable year (profit of  £58m) while Sainsburys performance was not good compared to 2011 (loss of  £42m). Morrisons financial performance was strong, and they continued to invest in long term growth of the business, and to deliver increasing returns to shareholders. Even after having steady increase in sales revenue and gross profit, Sainsbury suffered loss compared to previous year mainly because their interest and tax expenses increased while profit from joint ventures reduced. Though Sainsburys acquisition of non-current assets was underfinanced with long term sources of finance, they still managed to generate more sales and cover the debt payable easily. Alternatively, Morrisons financial management was excellent as they covered all their non-current assets with long term sources of finance. High interest cover ratio indicates that there is no sort of pressure on the company and is very profitable. References Fight, A (2006) Flow Forecasting, UK: CFrion Tec. Pvt. Stickney C.P (2010) Financial Accounting : an introduction to concepts methods and uses USA: South Western Cengage Learning Smart B.S Megginson W.L (2009) Introduction to Corporate Finance USA: South Western Cengage Learning Alberth S.W (2011) Accounting, Concepts Applications, What, Why, How of Accounting USA: South Western Cengage Learning Gildersleeve R. (1999) Winning Business: How to use Financial Analysis and Benchmarks to outscore your competition Houston: Tex Gult Pub. Co. Unknown (2010) An evaluation of the business and financial performance of morrisons. Available at: http://www.ukessays.com/dissertations/business/financial-performance-of-morrisons.php#ixzz2NhjC0HdW (Accessed: 15/03/2013) London Stock Exchange (2013) London Stock Exchange Available at: www.londonstockexchange.com (Accessed: 20/03/2013) Morrison Group (2013) Financial Reports Available at: http://www.morrisons.co.uk/Corporate/Investor-centre/Financial-reports/ (Accessed: 18/03/2013) Sainsburys Group (2013) Annual Report and Financial Statements 2011 Available At: http://www.j-sainsbury.co.uk/ar11/ (Accessed: 10/03/2013) Unknown (2013) Forces analyses of Sainsbury Available at: http://www.oxbridgewriters.com/essays/management/forces-analyses-of-sainsbury.php (Accessed at: 18/03/2013) Appendix 1 Gearing Ratio = Long Term Loans + Value of Preference Shares Share Capital + Reserves + Long term Loans + Minority Interest Sainsburys 2012 2011 2617 + 0 538 + 5091 + 2617 + 0 2339 + 0 535 + 4889 + 2339 + 0 = 31.73 % = 30.13 % Morrisons 2012 2011 1600 + 0 253 + 5144 + 1600 + 0 1052 + 0 266 + 5154 + 1052 + 0 = 22.86 % = 16.25 % Appendix 2 Interest Cover Ratio = Profit before interest and tax Interest payable Sainsbury 2012 2011 834 138 859 116 = 6.04 = 7.40 Morrison 2012 2011 968 47 887 43 = 20.59 = 20.62 Appendix 3 Current ratio = current assets / current liabilities Sainsburys 2011 2012 Current assets = 1708 Current liabilities = 2942 Current ratio = 1708/2942 = .580 Current assets = 2032 Current liabilities = 3136 Current ratio = 2032/3136 = .647 Morrisons 2011 2012 current assets = 1138 current liabilities = 2086 current ratio = 1138/2086 = .545 Current assets = 1322 current liabilities = 2303 current ratio = 1322/2303 = .574 Appendix 4 Acid test ratio = liquid asset / current liabilities Liquid asset = current asset inventories 2011 2012 Current assets = 1708 inventories = 812 liquid asset = 1708 812 = 896 current liabilities = 2942 acid test ratio = 896 / 2942 = .304 Current assets = 2032 inventories = 938 liquid asset = 2032 938 = 1094 current liabilities = 3136 acid test ratio = 1094 / 3136 = .348 Sainsburys Morrisons 2011 2012 current assets = 1138 inventories = 638 liquid asset = 1138 638 = 500 current liabilities = 2086 acid test ratio = 500 / 2086 = .239 current assets = 1322 inventories = 759 liquid asset = 1322 759 = 569 current liabilities = 2703 acid test ratio = 569 / 2703 = .247 Appendix 5 Return on Capital Employed (ROCE) ROCE = For Sainsburys 2012 2011 834 X 100 538 + 5091 + 2617 + 0 859 X 100 535 + 4889 + 2339 + 0 = 10.11 % = 11.06 % For Morrisons 2012 2011 968 X 100 253 + 5144 + 1600 + 0 887 X 100 266 + 5154 + 1643 + 0 = 13.83 % = 13.70 % Appendix 6 Return on Equity ( ROE ) = Profit after Tax X 100 Share Capital + Reserves For Sainsburys 2012 2011 598 X 100 538 + 5091 640 X 100 535 + 4889 = 10.62 % = 11.79 % For Morrisons 2012 2011 690 X 100 253 + 5144 632 X 100 266 + 5154 = 12.78 % = 11.66 % Appendix 7 Gross Profit Margin = Gross Profit X 100 Sales Revenue For Sainsburys 2012 2011 1211 X 100 22294 1160 X 100 21102 = 5.43 % = 5.49 % For Morrisons 2012 2011 1217 X 100 17663 1148 X 100 16479 = 6.89 % = 6.96 %

Essay on Robert Frosts The Road Not Taken - It Made All the Difference

The Road Not Taken: All the Difference Each person must make many decisions in their lifetime. Some decisions are easy while others are more difficult. The poem "The Road Not Taken" by Robert Frost is a first person narrative tale of a monumental moment in Frost’s life. Frost is faced between the choice of a moment and a lifetime. Walking down a rural road the narrator encounters a point on his travel that diverges into two separate similar paths. In Robert Frost's poem "The Road Not Taken", Frost presents the idea of man facing the difficult unalterable predilection of a moment and a lifetime. This idea in Frost's poem is embodied in the fork in the road, the decision between the two paths, and the speaker's decision. Man's life can be metaphorically related to a physical journey filled with many twists and turns. Through out this journey there are instants where choices between alternate paths have to be made- the route man decides to take is not always an easy one to determine. The fork in the road represents the speaker's encounter of having to choose from two paths a direction that will affect his the rest of his life ( ). Frost presents to the reader a moment in anyone's life where an arduous problematic choice has to be made. There are an abundance of options in life man faces; Frost symbolizes this into the diverging of the two paths in his poem. The decision for which path to choose from can be hard to accept, just as the revelation of the choices. The two paths represent the options man has to choose from. Faced with these decisions, man has to weigh his options carefu... ...e ways. Faced with very similar choices man tries to examine what they have to offer, but often is not able to for tell the consequences. Man can opt to go the common route, which is the more reliable, and have a common life or he can choose the less common route, which is unknown and often difficult, and have a unique life that stands out above everyone else's life. The choices a person makes in life are ultimately responsible for their future, yet at the same time a person can never go back to the past and experience other possibilities. It is unfeasible to predict the outcomes of capital decisions we make; often it is essential to make these decisions fixed on nothing more than questioning which selection will provide fulfillment. In the end, we reflect over the decisions we have made, and like Frost, sigh, discovering they have made "all the difference."

Notes on a Scandal Essay

The title of the book offers to us an understanding what as to may be to going happen in the story. The story is written with a first person narrator and so we know that the story will be just one person’s way of thinking. Also as a reader we must ask, is the whole story unreliable when written in this diary form because it is one person’s view point? Through the involvement of Barbara in this story we do get a participant and narrator in one person, so we are invited to believe everything that this person is going to tell us about everybody relating to her. But Barbara also uses the power of control, because she does not tell as what we would like to know about her relationship with Jennifer. Her comments hint that Barbara has been obsessed in the past. From Barbara’s viewpoint we can understand that she is been too intense in the relationship with Jennifer. Barbara wept in a train station after seeing Jennifer with her new friend. This suggests that Barbara’s feelings go beyond friendship. Barbara tells as that, â€Å"From time to time one of my colleagues will call me ‘Barb’ or, even less desirably, ‘Babs’ but I discourage it.† But who would call her ‘Babs’? Everyone is scared to talk to her; she seems an unpopular person. Heller also hints to us about the similarity in age between Polly (seventeen years old and still a girl without boyfriend) and Connolly (fifteen years old, Sheba’s lover). Sheba is a forty-two-year old pottery teacher at St George’s school. After Sheba fell in love with Connolly she feels much younger and her feelings seem adolescent to the reader. Sheba’s husband is nearly the same age as Barbara around sixty years old, and both of them feel younger by having a relationship with Sheba. Barbara thinks, after the loss of Jennifer, that she has got a kindred spirit in Sheba. Barbara and her diary are inseparable; even when visiting her sister she spends more time with her diary than with the family; suggesting the diary itself has become an obsession. There are also advantages of the first person narrator, because we get the best insight into Barbara’s character. She shows the reader aspects of her private life, like when she is standing on a chair and talking into the mirror. She also describes her relationships to other people in her diary, so that the reader of the diary has really got a view of her mind. This is a device Heller uses to good effect. Barbara is describing Sheba’s character â€Å"Sheba was so pitifully alone†, but she was really describing herself and her character, so here Zoà ¯Ã‚ ¿Ã‚ ½ Heller uses irony. Barbara also writes a lot about the sexual affair between Sheba and the Connolly boy and that the public do not accept relations like this one. It seems really she could be referring to her relationship to Jennifer and the fact that the public would not accept a lesbian sexual affair between two teachers. Barbara confuses the reader with writing such things like: â€Å"I am presumptuous enough to believe that I am the person best qualified to write this small history† and â€Å"I rely upon detailed accounts provided by Sheba herself†, because we have to question Barbara’s reliability as she herself is hearing Sheba’s story â€Å"second hand.† It may be that Sheba herself is not entirely honest with Barbara and some elements of truth are lost along the way. An example could be the first kiss between Sheba and the Connolly boy, because there being few aspects of the Connolly business that Sheba has not described to Barbara. In the imagination of the first kiss it has to be the peak of the affair, because this first kiss has got so much energy and satisfaction which can allow every possibility with our feelings in this particular moment. It is situation like this that makes the reader question Barbara’s reliability. She talks with authority about situations she has not witnessed. â€Å"Certainly, there is no other friend or relative of Sheba’s who has been so intimately involved in the day-to-day business of her affair with Connolly†. The use of the â€Å"intimately† suggests a relationship not a friendship and it’s not true – Sheba didn’t tell her until she has to. â€Å"With my second blow I took the top of the boy’s head off cleanly, like an egg†. This is an example of symbolism – by breaking the sculpture, Barbara destroys the relationship. She thinks this will bring Sheba to her – showing the depth of her obsession. The affair actually ends already before it was discovered through Barbara. Heller shows us this in following sentences: â€Å"They made love rather quickly and – at Connolly’s behest – on the floor†. Also is shown Connolly’s loss of feelings: â€Å"‘Nothing like one afterwards is there?’ he said. Sheba remembers having to suppress a smile at this studied, post-coital nonchalance†. Connolly did become interested in girls his age: â€Å"Sheba remarked that her daughter liked to do the same thing when she was smoking and Connolly seemed interested by this†. From this moment on Sheba was scared to lose Connolly: â€Å"Sheba interrupted his questioning to kiss him and tell him how handsome he was†. Heller also shows us that Connolly is still a boy, even after this affair: â€Å"Connolly grimaced†. Barbara, this old lady with an unstable psyche, bites the hook which Sheba readied for her and marks this event with two gold stars in her diary: â€Å"For a split second we both looked at the boy. Then she looked back at me. There was fear in her expression but also something else – a kind of glee or amusement†. It is at this point in the novel the two obsessions collide also it’s almost as if, Sheba wants to share her experience. As well as the main two obsessions, there are also minor ones: Jennifer acquires a restraining in order against Barbara; Marcia still sees Richard at family occasions after twenty years of divorce. Sheba is fixated with Polly’s wardrobe which links in to the latter’s obsession with boys. Finally Brian uncovers the affair to the public, because it was intolerable for him to imagine Sheba being intimate with Connolly. Sheba seems to want to â€Å"share† her affair with others. This is confirmed by Sheba coming back home, after intimate contact with Steven; Sheba wants to shout at Richard, because she was feeling younger also she was absolutely proud of this affair: â€Å"Guess what, you complacent old fart? I’ve been out on the heath, getting fucked by a sixteen-year-old! What do you think of that?† In spite of her immoral behaviour Sheba oddly wants others to know. At the end Steven Connolly was her target of obsession and Sheba did achieve her aim. She had an affair with a young boy and she was his first lady. â€Å"You’re my first old lady if that’s what you mean†. Sheba was infatuated by Connolly’s sex appeal and flattered by his attention. We are told by Heller that Barbara is the winner of this novel, but by closely contemplation; what did Barbara get at the end? The burned out wreck of Sheba! Barbara has to look after Sheba, like she is a child: â€Å"‘Oh?’ she said. Her tone was dreamily neutral† also â€Å"Then I sat her down and I made us some lunch†. So in my opinion Sheba is the winner of this novel, because of her affair with Connolly and after that she got, Barbara as a replacement for Richard: someone to look after her burned-out body without spirit or life. Sheba has fooled everyone, but she didn’t expect to end up with broken heart and weaker mind. In appealing to the public for understanding of this non-orthodox relationship, Barbara and Sheba are really appealing to a society who would find a close relationship between them laughable.

An Analysis of the Social Gradient of Health Essay

â€Å"The demonstration of a social gradient of health predicts that reducing inequality itself has health benefits for all, not simply for the impoverished or deprived minorities within populations. † (Devitt, Hall & Tsey 2001) The above quote from Devitt, Hall and Tsey’s paper is a relatively well grounded and well researched statement which draws on contemporary theoretical sociological concepts to support the assertion that reducing inequality is the key to improving health for all. However the assertion that the demonstration of a social gradient of health predicts that a reduction in inequality will lead to health benefits for all is a rather broad statement and requires closer examination. The intention of this essay is to examine the social gradient of health, whose existence has been well established by the Whitehall Studies (Marmot 1991), and, by focusing on those groups at the lower end of the social gradient, determine whether initiatives to address inequalities between social classes will lead to health benefits for those classes at the lower end of the social scale. The effectiveness of past initiatives to address these social and health inequalities will be examined and recommendations made as to how these initiatives might be more effective. The social gradient described by Marmot and others is interrelated with a variety of environmental, sociopolitical and socioeconomic factors which have been identified as key determinants of health. These determinants interact with each other at a very complex level to impact directly and indirectly on the health status of individuals and groups at all levels of society; â€Å"Poor social and economic circumstances affect health throughout life. People further down the social ladder usually run at least twice the risk of serious illness and premature death of those near the top. Between the top and bottom health standards show a continual social gradient. † (Wilkinson & Marmot 1998) In Australian society it is readily apparent that the lower social classes are at greater disadvantage than those in the upper echelons of society; this has been discussed at length in several separate papers on the social gradient of health and its effects on disadvantaged Australian groups (Devitt, Hall & Tsey 2001, Robinson 2002, Caldwell & Caldwell 1995). Within the context of the social gradient of health it can be inferred that Indigenous groups, for example, are particularly susceptible to ill health and poor health outcomes as they suffer inordinately from the negative effects of the key determinants of health. A simple example of this is the inequality in distribution of economic resources: â€Å"Average Indigenous household income is 38% less than that of non-Indigenous households. † (AHREOC 2004). The stress and anxiety caused by insufficient economic resources leads to increased risk of depression, hypertension and heart disease (Brunner 1997 cited in Henry 2001). Higher social status and greater access to economic resources is concomitant with a reduction in stress and anxiety levels, as individuals in these groups have more control over economic pressures which create this stress. This simple comparison proves that the social gradient of health accurately reflects how socioeconomic determinants affect the health of specific social classes at the physiological level. An extension of the research into the social gradient and the determinants of health is the examination of the pathways through which specific social groups experience and respond to these determinants. These ‘psychosocial pathways’ incorporate psychological, behavioural and environmental constraints and are closely linked to the determinants of health; â€Å"Many of the socio-economic determinants of health have their effects through psychosocial pathways. † (Wilkinson 2001 cited in Robinson 2002). These pathways have been demonstrated by Henry (2001) in the conceptual model of resource influences (Appendix A), a model which illustrates the interaction between the constraints mentioned above and their impact on health outcomes. Henry states that a central differentiator between classes is the amount of control an individual feels they have over their environment. Whereas an individual from a lower class group holds a limited sense of control over their well being and consequently adopts a fatalistic approach to health, those in higher classes with a stronger sense of control over their health are more likely to take proactive steps in ensuring their future wellbeing. This means that both individuals will cope differently with the same health problem. This is partly as a result of socioeconomic or environmental determinants relative to their situation, but it is also a result of behavioural/physical constraints and, most importantly, the modes of thought employed in rationalising their situation and actions. In essence these psychosocial pathways occupy an intermediate role between the social determinants of health and class related health behaviours. This suggests that, while the social gradient of health is a good predictor of predisposition to ill health among specific classes, it cannot predict how reducing inequality in itself will affect health outcomes or how a specific social class will respond to these changes. An examination of some initiatives aimed at reducing inequality in the indicators of health outcomes reveals this problem; â€Å"In 1996 only between 5% and 6% of NT Aboriginal adults had any kind of post secondary school qualification compared with 40% of non-Aboriginal Territorians. † (ABS 1998). Within the context of the social gradient of health, education is an important indicator of health outcomes. It is evident from the quote above that there exists huge inequality within the Northern Territory education system; this suggests an increased likelihood of ill health for Aboriginal people in later life. Even though there have been initiatives to address this inequality in one of the indicators of health outcomes (Colman 1997, Lawnham 2001, Colman & Colman 2003), they have had only a minimal impact on Indigenous second level education rates (ABS 2003). This is partly due to the inappropriateness of these initiatives (Valadian 1999), but it is also due to the disempowerment and psychosocial malaise (Flick & Nelson 1994 cited in Devitt, Hall & Tsey 2001) which are a feature of Indigenous interaction and responses to the social determinants of health. Research has also been carried out into how effecting change in the inequalities in other indicators of health might affect health outcomes. Mayer (1997) cited in Henry (2001) examined the effects of doubling the income of low income families and concluded it would produce only modest effects. Henry believes that this points to the strong influence of the psychological domain in influencing health behaviours. This suggests that the key to better health for all lies not just in reducing inequality between the classes but also in changing those elements of the psychological domain which influence health behaviour. Another example of the gap between initiatives to reduce inequality and their impact on those inequalities is evident in an examination of economic constraints experienced by Indigenous Australians on social welfare. Price and McComb (1998) found that those in Indigenous communities would spend 35% of their weekly income on a basket of food, compared to just 23% of weekly income for those living in a capital city for the same basket of food. To combat this inequality it would seem logical to reduce the price of food in Indigenous communities or else increase the amount of money available to those living in remote communities, i. e. a socioeconomic approach. It has already been established that increasing income has only modest effects and in combination with the fact that smoking, gambling and alcohol account for up to 25% of expenditure in remote communities (Robinson 2002), how can it be guaranteed that the extra funds made available through either of the two suggestions above would be employed in achieving a desirable level of health? One possible suggestion is that a socioeconomic approach must be complemented by a psychosocial approach which addresses those abstract modes of thought, cultural norms and habits and health related behavioural intentions which dictate healthful behaviours. â€Å"Culture and culture conflict are factors in Aboriginal health. But instead of the emphasis being placed on Aboriginal failure to assimilate to our norms, it should rather be put on our failure to devise strategies that accommodate to their folkways. † (Tatz 1972 cited in Humphrey & Japanangka 1998) Any initiative which hopes to resolve inequality in health must incorporate a sound understanding of the influence of the psychosocial pathways relative to the class level and cultural orientation of that group, otherwise its success will be modest at best. Using Henry’s model of resource influences provides a framework for understanding how addressing these psychosocial pathways can lead to greater uptake of initiatives designed to address these inequalities. An analysis of the National Tobacco Campaign (NTC 1999) reveals how this initiative failed to impact significantly on Indigenous smoking rates. This was a purely educational initiative which aimed to raise awareness of the effects of smoking on health. One of the primary flaws of its design was its failure to even acknowledge those Indigenous groups at the lower end of the social scale; it also failed to communicate the relevance of its message to Indigenous people; â€Å"The only thing is that when it comes to Aboriginal people, they will not relate to Quit television advertisements because they don’t see a black face†¦. I’ve heard the kids say ‘Oh yeah, but that’s only white fellas’. They do. † (NTC 1999) Not only did this initiative fail to connect with Indigenous people, it also failed to influence the elements of the psychological domain which legitimate such high rates of smoking. Within Indigenous culture smoking has become somewhat of a social practice, with the emphasis on sharing and borrowing of cigarettes (Gilchrist 1998). It is ineffectual to put across messages about the ill effects of smoking if the underlying motivation of relating to others is not addressed. In a report conducted on Indigenous smoking (AMA & APMA 2000 cited in Ivers 2001), it was suggested that one of the key themes of an initiative aimed at reducing indigenous smoking rates should be that smoking is not a part of Indigenous culture. The ‘Jabby Don’t Smoke’ (Dale 1999) is an example of an initiative whose design attempted to influence accepted social norms. Its focus was primarily on children, thereby acknowledging the importance of socialization and the instillation of cultural norms at an early age. Unfortunately no data is available detailing its impact on smoking rates. As mentioned earlier in this essay, another feature of the psychological domain which has an effect through the psychosocial pathways is the modes of thought employed in rationalising actions and responses to various determinants and constraints. Self efficacy or the amount of perceived control over one’s situation is an important contributor to health status; â€Å"Empowered individuals are more likely to take proactive steps in terms of personal health, whilst disempowered individuals are more likely to take a fatalistic approach† (Henry 2001) Examples of initiatives which have strived to empower Indigenous people in being responsible for their own health include ‘The Lung Story’ (Gill 1999) and various health promotion messages conveyed through song in traditional language ( Castro 2000 cited in Ivers 2001, Nganampa Health Council 2005). By encouraging Indigenous people to address these issues in their own way, the amount of perceived control over their own health is increased thereby facilitating a greater degree of self efficacy. The intention of this essay has not been to deny that the social gradient of health does not exist or that it is not an effective tool in creating understanding of where social and health inequalities lie. Unfortunately programs and initiatives which have been guided by the social gradient of health and have been purely socioeconomic in their approach have failed to have a significant, sustainable effect on health inequalities. In the US, despite socioeconomic initiatives to resolve inequality, the gap between upper and lower class groups has actually widened in recent times (Pamuk et al 1998 cited in Henry 2001). The scale of the intervention required to ensure a sustained impact on health inequalities has been discussed by Henry (2001), he also highlights the need to garner substantial political will in order for these changes to happen and makes the point that those in the upper classes are relatively content with the present status quo. This essay has attempted to demonstrate that in an environment where well grounded, evidence based socioeconomic initiatives are failing to have the desired out comes, it is perhaps time to focus more on altering those strongly held health beliefs which not only dictate responses to social determinants of health but also dictate responses to initiatives designed to address these inequalities; â€Å"Healthful behaviours are due to more than just an inability to pay. A mix of psychological characteristics combines to form distinctive behavioural intentions†. (Henry 2001) In the current environment of insufficient political will and finite resources it would be prudent to use every tool available to ensure initiatives aimed at reducing inequality between the classes will have the maximum amount of benefit. This approach is not a long term solution, but until it is possible to achieve the large scale social remodelling necessary to truly remove social inequality, and consequently health inequality, it is the most viable solution available. REFERENCES. ABS, 2003. ‘Indigenous Education and Training’, Version 1301. 0, A Statistical Overview, Australian Bureau of Statistics, Canberra, viewed 22nd August 2005, http://www. abs. gov. au/Ausstats/abs@. nsf/Lookup/FC7C3062F9C55495CA256CAE000FF0D6 A statistical overview of Aboriginal and Torres Strait Islander peoples in Australia 2004, Australian Human Rights and Equal Opportunities Commission (AHREOC), Sydney, viewed 20th August 2005, http://www. hreoc. gov. au/social_justice/statistics/. Brunner, E. 1997. ‘Stress and the Biology of Inequality’. British Medical Journal. No. 314, pp 1472-1476. Castro, A. 2000. ‘Personal Communication’. No other details available. Caldwell, J. & Caldwell, P. 1995. ‘The cultural, social and behavioural component of health improvement: the evidence from health transition studies’, Aboriginal Health: Social and Cultural transitions: Proceedings of a Conference at the Northern Territory University, Darwin 28-30th September. Colman, A. 1997. ‘Anti-racism Course’, Youth Studies Australia, Vol. 16, Issue 3, p. 9, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 12878155. Colman, A. & Colman, R. 2003. ‘Education Agreement’, Youth Studies Australia, Vol. 22, Issue 1, p. 9, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 9398334. Dale, G. 1999. ‘Jabby Don’t Smoke, Developing Resources to Address Tobacco Consumption in Remote Aboriginal Communities’, Paper presented to the Eleventh National Health Promotion Conference, Perth. 23-26th May. Devitt, J. , Hall, G. , Tsey, K. 2001. ‘An Introduction to the Social Determinants of Health in Relation to the Northern Territory Indigenous Population’, Occasional Paper. Co-operative Research Centre for Aboriginal and Tropical Health. Darwin. Flick, B. , Nelson, B. 1994. ‘Land and Indigenous Health’, Paper No. 3, Native Titles Research Unit, Australian Institute of Aboriginal and Torres Strait Islander Studies, Canberra. Gilchrist, D. 1998. ‘Smoking Prevalence among Aboriginal Women’, Aboriginal and Islander Health Worker Journal, Vol. 22, No. 4, pp. 4-6. Henry, P. 2001. ‘An Examination of the Pathways through Which Social Class Impacts Health Outcomes’. Academy of Marketing Science Review, vol. 3, pp 1-26. Humphery, K. , Japanangka, M. D. , Marrawal, J. 1998. â€Å"From the Bush to the Store: Diabetes, Everyday Life and the Critique of Health Service in Two Remote Northern Territory Aboriginal Communities. † Diabetes Australia Research Trust and Territory Health Services, Darwin. Ivers, R. 2001. ‘Indigenous Australians and Tobacco; A Literature Review’, Menzies School of Health Research and the Cooperative Research Centre for Aboriginal and Tropical Health, Darwin. pp. 67-80, 93-107. Lawnham, P. 2001. ‘Indigenous Push at UWS’, The Australian, 27th June, 2001. p. 34, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 200106061025662941. Marmot, M. G. , Davey Smith, G. , Stansfield, S. , Patel, C. , North, F. , Head, J. , White, I. , Brunner, E. and Feeney, A. 1991. ‘Health Inequalities among British Civil Servants: the Whitehall II Study’, Lancet, 337, 1387. reading 1. 5. Mayer, S. 2001. What Money Can’t Buy: Family Income and Children’s Life Chances. Harvard University Press, Cambridge, Massachusetts. National Tobacco Campaign. 1999. ‘Australia’s National Tobacco Campaign: Evaluation report Volume 1’. Commonwealth Department of Health and Aged Care, Canberra. Nganampa Health Council. 2005. Nganampa Health Council, Alice Springs. Viewed 23rd August 2005, http://www. nganampahealth. com. au/products. php Pamuk, E. , Makuc, D. , Heck, K. , Reubin, C. , Lochner, K. 1998. ‘Socioeconomic Status and Health Chartbook’. Health, United States. National Centre for Health Statistics, Maryland. Price, R. , & McComb, J. 1998. ‘NT and Australian Capital Cities Market Basket Survey 1998’. Food and Nutrition Update, THS, Vol. 6, pp. 4-5. Robinson, G. 2002. ‘Social Determinants of Indigenous Health’, Seminar Series, Menzies School of Health Research. Co-operative Centre for Aboriginal Health. Valadian, M. 1999. ‘Distance Education for Indigenous Minorities in Developing Communities’, Higher Education in Europe, Vol. 24, Issue 2, p. 233, viewed 22nd August 2005, EBSCOhost Database Academic Search Premier, item: AN 6693114. APPENDIX A. CCONCEPTUAL MODEL OF RESOURCE INFLUENCES. [pic] Henry, 2001. .