Comparative & International HRM Essay Example | Topics and Well Written Essays - 1500 words

Comparative & International HRM - Essay Example This deal is the one that really worked out for the BMW in turning around the company fortunes. The company saw the strategic decision of involving workers in the factory as the key in improving the performance of the company. The workers were encouraged to come up with ideas of improving the company performance. This saw the group, who work mainly on roofs for the new version of the iconic car being rewarded for coming up with the best money-saving idea. The workers suggested a change in the design of the Mini that saw BMW saving up to 6M. The BMW Company utilised the Industrial relation approach which involved establishing healthy relationship between the employees and the management. BMW used trade union to strike ground breaking deals that resulted in improved performance on the side of the organisation. It is my sincerely advice to BMW company to use the principle of industrial relation as it prepare to consolidate its production and cost reduction stage this would facilitate smooth implementation of its future plans. Strategic human resource management (SHRM) involves linking the human resource functions with the strategic goals of the organisation. Human resource managers need to maintain good relationships within the organisation so as to improve performance and maintain talented employees. BMW used what is known as Continuous Improvement (CI) strategy to enhance organisational performance. CI emphasise the importance of customer focus, internal customer-supplier relationships, process management and control, empowered work teams and visionary leadership. BMW used all of these strategies in establishing processes for strategic or business planning, organisational and job re-design, cultural change and performance management (Hammond, 2001). BMW is an icon of a company that can use staff-company relations to improve firm production.BMW was determining to give the Mini firm a new face lift. This involved among other things involving the workforce whom the BMW absorbed from the old Mini firm. According to Werner Rothfuss, director of corporate communications at the plant, BMW is committed to the staff engagement in the running of the company. The BMW developed good staff- management relations. This is seen where the company engage the union in the dialogue so as to strike the new deals. Many Companies would shy away from this kind of engagement. However BMW believe that in order to succeed it has to pay whatever the price so as to improve the relationship with its employees. As the report exemplify, "...Union acquiescence was bought by promising a minimum bonus of 130, even if targets are missed, and one of the largest wage rises in the industry." (BMW Report). The organisational skills in communicating these changes the best way possible was mandatory in order to avoid workers unrest or resentment. This seems to be the area of expertise for MBW. The BMW was able to convince the workforce to strike a new working deal with workers union. The BMW hammered a new pay deal that reduced the evening entertainment hours for workers and make them more involved and creative in revamping the company. This way the company was able to cut cost and harness creativity on the part of the employees. BMW believe that 'Employees can make a difference' (BMW Report) Another

The James Bond Franchise Movies Essay Example | Topics and Well Written Essays - 2250 words - 17

The James Bond Franchise Movies - Essay Example The movies produced in the James Bond franchise strongly reflect the changing American identity and experience. The start of James Bond Films began with the purchase of rights from Ian Fleming by the American CBS television network, to turn the novel, Casino Royale, into a television adventure that would last for one hour (Rubin 23). The television adventure was adapted for screen by Anthony Ellis and Charles Bennett. It starred the American actor, Barry Nelson, as Bond. The movie franchise then developed over time under the auspices of Eon Productions, expanding in terms of business revenues and performance. It currently takes pride as the world’s one of the most experienced and lasting film organization in the world. Most of its movies espouse the events that mark the American experience and identity (Rubin 27). A number of these movies are highlighted below to show how they show and strongly reflect the identity and experience of America. From Russia with Love (1964) was the second movie done by the James Bond Film franchise. It was produced by the Eon Productions. The producers of the film were Albert Broccoli and Harry Saltzman while the director of the movie was Terence Young. The movie was premised and informed by a novel that had the same title done by Ian Fleming. The movie’s story centers on the mission that James Bond is sent to accomplish, which is to help in the defection of Soviet consulate clerk in Turkey. SPECTRE has arrangements for revenging the killing of Dr. No by Bond (Dodd 125). Red tells Bond â€Å"The first one wont kill you; not the second, not even the third... not till you crawl over here and you KISS MY FOOT!† (Young). The film is quite informative about the experience and identity of America. An analysis of the film presents a picture of how America was during the days and the transformation that had taken effect in the movie industry by then.

Classroom Instructional Strategy Essay Example | Topics and Well Written Essays - 1250 words

Classroom Instructional Strategy - Essay Example Student uses his thinking, learning, and practical skills to follow a course of study or a lesson plan that is being implemented by the teacher. The term teacher's pedagogy is used to refer to the different teaching methods that a teacher will use. When a teacher determines the method of instructions there are a number of factors he or she has to consider these are: Another important aspect is the teacher's ability to deal with the different abilities of the students and the disabilities of the students. Sometimes the teacher has to do more than just teaching in the classroom that is going with students to field trips, supervise study halls, help in organizing school functions, and act as a supervisor in extra curricular activities. There is a possibility that a teacher while teaching might use a combination of some of these 13 ways. Though a combination might not necessary be more effective but in most of the cases it is. Another way a teacher can teach is by implementing every method not in the same class but in different sessions, meaning that in one session the teacher uses Lecture accompanied by a discussion and in his next session in the same class he can use Case Studies. As said before a combination would be more effective I will use a combination of method 2, 8 and 13. ... Another way a teacher can teach is by implementing every method not in the same class but in different sessions, meaning that in one session the teacher uses Lecture accompanied by a discussion and in his next session in the same class he can use Case Studies. As said before a combination would be more effective I will use a combination of method 2, 8 and 13. That is using Lectures accompanied by a discussion including feed back sessions and Presentation to explain things in a much a better way. Selected Teaching Method I choose these three methods due to a couple of reason. The first being that a lecture might be boring but in fact an effective listener can understand a concept much better when things are explained to him with examples during a lecture. Apart from this he can make notes while a lecture is being delivered, this helps a student in revising the matter he studied in the classroom. A discussion after the lecture makes sure in telling the teacher that how much the students learnt and what part was difficult for them. Feed back sessions not only tell the teacher how much the student has learnt but also help a student in realizing how well he or she is doing in a subject and what amount of effort he needs to put in the future. Presentations help a student in noting down important concepts of the course. Apart from this presentations help in teaching as it is said computer aided teaching has always been handy for a teacher as well as the student. Now I will discuss the advantages of these teaching methods and how must a teacher prepare for these methods. Lecture with Discussion This method makes sure that the students are involved in what is going on in the class, students can also raise questions and queries on things that they don't

Description of Personal and Professional Goals Essay Example for Free

Description of Personal and Professional Goals Essay At present, I am enrolled as a student in the mental health counseling master program. I live in Miami, Florida and I am also employed as an Administrative Clerk III in Dade County Corrections Rehabilitation within Miami Dade County. I have been working there for the past six years. One of the reasons I want to have a license in counseling is so I can continue helping these individuals that are in desperate need of professional help; I want to direct them towards the right path. I take such interest in mental health counseling, because I want to be able to work closely with each inmate that needs special help. I enjoy helping others; most importantly, I want to make a difference in other people’s lives. There is also a great need for mental health counseling in Florida. I feel that the craziness of our world today has produced more people in need of mental care. The pressure of living in a highly-industrialized country, with ever widening gaps between family members greatly contribute to this. The commercialized society we live in forces us to aim for instant gratification instead of dealing with our problems head on. While working in a jail facility, I have seen so many men with substance abuse problems and others types of difficulties. I personally think that these inmates are not getting proper help from the system. It is as if they are the dregs of society, ignored and not given proper care and attention. They are misunderstood, and viewed as if they have contagious diseases, and are by nature, violent. A lot of people are afraid to work in jail, due to the fact some of these men can be dangerous at times. I am aware that for me to help these men and women, I need to have a professional license. With the right training at Walden University, I know I will be ready to take care and help these individuals with their needs. I want to be able to work with all type of clients, since I have been around inmates for the past six years. I would like to help them in getting their lives together. First, I want to be able to listen to what they have to say, or at least have some idea of where they want to go once they get released from jail. Second, I want to make sure that they are capable of making decisions for themselves, especially the ones who have mental disorders. Lastly, I want to be able to locate and provide them with different types of help and sources. I will supplement the knowledge I have gained from Walden University with additional information, such as where they can go to get further assistance. I have observed so many men and women that have lost their sense of life and mind; they have no idea where to start a new life or even have any kind of moral compass to know to what’s right or wrong. Some of them used a lot of drugs; some allowed themselves to be used sexually for money, just so they will be able to sustain their everyday expenses. The system thinks the best thing to do is lock them in a cell with others criminals. I believe that this should not be done. Their problems need special attention and different solutions. I believe that these people should be understood; their problems should be put within a context. These kinds of problems crop up because of the situations that push these people over the edge and engage in anti-social behavior. Once I graduate from Walden University, I will be better equipped to deal with such cases, and give the appropriate remedy. I want to be able to solve problem without hesitation. Again, once I get the degree from Walden University, I will be able to share my information with others as soon as possible. Part two: Description of Educational background and research proficiency I received my undergraduate degree from Union Institute University in Florida 2007. I graduated with a Bachelor of Science degree in Social Work. I like helping people, which is why social work was and still something I want to do. I feel that in my own way, I help make the world a better place to live in. I may not be able to engage in bigger ways of changing the world, but I am doing it through baby steps. This is my approach to my education: taking baby steps. I have not yet worked for a degree, due to the recessions that we going through right now. I have applied to so many places; no one has called me yet. I am still hoping I get a job soon, so I can have some experience by the time I graduate from Walden University with the graduate degree. I enjoy working in the field that I am in right now, because so many men and women are in desperate need of help. I am also inspired to change repeating offenders through guiding them to the right path. I am willing to take as much Walden has to offer. When I was doing my undergraduate degree in Florida, I was introduced to so many positive mentors throughout my stay in school. I was overwhelmed with the inspiring stories they told, such as how they started and the struggle they encountered in the course of their studies. But they have no regrets. They encourage us to go all the way. Don’t be discouraged when things turn out not according to one’s plan, be persistent, disciplined, and most of all know what one wants in life and go for it: these are the most valuable lessons I have learned from my professors. One important point one of my professors told me was to not be around people who did not have the same work ethic as mine, especially in school. This is due to the fact that it is easy to get lazy or discouraged from succeeding what I want to do with my life. My greatest fear right now is not being able to finish my graduate study, which will greatly disappoint me. I am going to try my best to stay with the program. About a month or so, I decided I want to go back to school, but I had no idea which school I wanted to attend. I knew I wanted to be a counselor. I sought online for the school that offers the best program in Mental Health Counseling; I discovered Walden University. I filled out the form they have online for more information. The next day I received a call from a certain person; he told me exactly what I needed to get accepted to Walden. After a couple of days, I was accepted by Walden University. Since school was starting the following week, I was happy, yet nervous, because I just made the decision, not to long ago. I kept asking myself I am ready for this. After a week or so, I made myself ready. I am still asking myself that question, especially when am stuck with an assignment. I refuse to be a quit, once I started something. I always finish the task. Part Three: Program of Study My goal is to get that degree and use it as much as I can to even go further with a Ph.D. degree. I want to be able to produce as much as I can with my education and knowledge through Walden University. In order to do so, I have to be equipped with as much information as I can take out to the field of my profession. I don’t have much experience with field work in social work environment, besides the six years experience I have with Dade County Corrections Rehabilitation Department. Though this is the case, I have learned a lot, such as motivation and team work. I am not satisfied with this, of course. I am looking forward to more experience while I am at Walden University, and beyond. My academic skill is to be able to discipline my self as much as I can, so I won’t fall behind in the program and my coursework. Secondly, I am still indeed working on organizing my priorities, to what needs to be done and when it has to be done; I plan on having a scheduled plan with each semester. I want to put things in perspective, so that I am able to become one of the students at Walden who will be used as example for the new students. Fortunately, my scheduled is very flexible at the present. My weakness, however is having a writer’s block when I have to write a paper. To resolve this, I usually walk away from that assignment or coursework for at least an hour. Once I am ready to write my paper, I use Microsoft Word for my spelling and grammar check. Since English is my third language, I make sure I have access to an editor and to not forget the writing center at Walden, which has and continue to be of great help with my writing. Throughout my undergraduate years, I did most of my papers from the books that the professor wants us to use, not so much journals nor independent research. I am hoping Walden will prepare me for the unexpected in my graduate study. Additionally, I have attached my residencies page, and I have also done my research to where I will obtain my license through Tallahassee, Florida. Also, I have attached my course work and course work definition of each course. Conclusion: Walden and my development Given my academic background, I know that I am capable of accomplishing a lot. I know that I can develop into a better social worker. I have a lot to offer, and not just my skills. Skills, I feel can only get one so far. Passion, I feel, is much more important. It determines how much you will achieve, and how far you will go. It also puts humanity in whatever work one is doing. This I feel is the true essence of service: not only getting things done, but getting things done because people are dependent on you to achieve these things. With my passion for serving people, and the training Walden is giving me, I will transcend success; I will put the warmth and correction back in social work.

The Dental Induced Bacteraemia

The Dental Induced Bacteraemia Your Uncle not the same as last time who has been taking clopidogrel for a number of years approaches you, a dental student, to explain something to him. After two weeks of weariness and fever, his doctor recently diagnosed Infective Endocarditus by blood cultures. An echocardiogram indicated a bicuspid aortic valve, and listening to the chest using a stethoscope the doctor could also detect a slight murmur. His doctor had asked him whether he had had any dental treatment recently. He admitted that he had not seen a dentist for a number of years and a cursory investigation revealed dental caries and inflammation of the gums. His reason for avoiding the dentist was because of bleeding in the mouth following visits. Your Uncle was quizzical about a number of things and has asked for your advice. He wants to know what information the echocardiogram and stethoscope can reveal. Further, he wants to understand the connection between oral health and an individuals general medical condition. Specifically, what oral bacteria are present, what roles do they play in oral biology, how they could cause systemic problems, and what sort of strategies could be employed to prevent infection. à ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦Ãƒ ¢Ã¢â€š ¬Ã‚ ¦. Working in your groups, generate a list of leaning outcomes for this topic and return an individual copy by 23rd November by email to [emailprotected] These learning outcomes will be assessed, and intended learning outcomes returned to assist you with your report. Individually write a 2000 word manuscript in a scientific manner addressing the learning outcomes by 7th January (2013) and upload via QMplus. Please note that with QMplus the time cut-off is 23:55. Learning Outcomes 1. To identify the connection between clopidogrel and excessive bleeding gums. 2. To describe normal and abnormal heart valve formations. 3. To understand and describe the information that echocardiograms and stethoscope can provide regarding heart function. 4. To explain how oral derived bacterial flora can colonise heart valves. 5. To explain why the heart valves are susceptible to bacterial colonisation. 6. To describe when prophylactic antibiotics should be prescribed prior to oral treatments. Introduction Bacteraemia is a condition that is caused when bacteria enters the blood stream. When large amount of bacteria are present in the blood it can cause infections such as meningitis, pericarditis and endocarditus. Individuals with heart valve disorders, prosthetic joints, chronic diseases or weakened immune system are at increased risk of developing infections during Bacteraemia. Dental induced Bacteraemia is caused by minor injury from tooth brushing or from dental procedures. In the above problem based learning scenario we have been presented with our uncle who has been taking Clopidogrel for a number of years and has now been diagnosed with Infective Endocarditis by blood cultures. Below I will expand on the proposed learning outcomes. [2] FIG.1Identify the connection between Clopidogrel and excessive bleeding gums. Clopidogrel is an oral antiplatelet drug which reduces the risk of blood clots forming. It works by preventing Adenosine diphosphate (ADP), which causes platelets aggregation, from binding to its P2Y12 receptors on platelets and stops activation of the glycoprotein GPIIb/IIIa complex. This prevention reduces the likelihood of clots forming. [1] [3]Source:Harvey, R; Champe, P Lippincott illustrated reviews: Pharmacology, 4th edition. LWW: 2009. Blood clots can be very dangerous as they can cause blockages of blood vessels reducing the blood supply to an organ. A reduction in blood flow to the brain or heart can cause a stroke or heart attack. This explains Clopidogrels biggest use in patients who have had a recent heart attack or stroke; it helps to stop a reoccurrence. [1] Taking Clopidogrel therefore can cause excessive bleeding gums. If a blood vessel ruptures when brushing the teeth, through dental treatment or even by eating the gums will carry on bleeding for longer than usual because of the lack of platelet aggregation. http://birthnow.com/wp-content/uploads/2012/05/Clopidogrel.gif Describe normal and abnormal heart valve formations. A healthy human heart consists of four chambers; two upper atria and two lower ventricles and four valves; two semilunar and two atrioventricular valves. The aortic and pulmonic valves are both semilunar valves and found in the arteries leaving the heart. The tricuspid and mitral valves are the atrioventricular valves and are found between the atria and ventricles. [5] Valves are made up of cusps which basically act as flaps or leaflets that are responsible for the one way flow of blood going into and out of a ventricle. Each valve has three leaflets, except the mitral valve, which only has two. [4] FIG.3Strong fibrous cords called chordae tendineae also known as heart strings are attached to the papillary muscles found on the floor of the ventricles and they act as anchors to stop the valves from inverting back into the atria. When the valve closes the papillary muscles contract and tenses the chordae tendineae to ensure the one way flow of blood. The valves are also supported and surrounded by a fibrous skeleton called annuli that also acts as another anchor. http://www.tokresource.org/tok_classes/biobiobio/biomenu/transport_system/heart-valves.jpg [6] FIG.4Blood flows from the right and left atria into the ventricles through the open tricuspid and mitral valves respectively. When the ventricles are full, the tricuspid and mitral valves shut. The ventricles now begin to contract and the pulmonic and aortic valves are forced open and blood is pumped out. Blood from the right ventricle passes through the open pulmonic valve into the pulmonary artery and carries deoxygenated blood to the lungs while blood from the left ventricle is oxygenated and travels through the open aortic valve into the aorta and goes to the rest of the body. This happens in a cycle, between heartbeats the ventricles will then relax, the semilunar valves will close and the atrioventricular valves will open and allow blood from the body and lungs to enter the heart. [7]http://mitral-valve-repair.com/wp-content/uploads/2011/01/heart-valves_heart-chambers.jpg Heart valves can however malfunction in several ways. Abnormal heart valve formations fall into two main groups; Regurgitation and Stenosis. Regurgitation of the valves is when they fail to close properly which causes the backward leakage of blood, this is often happens as a result of coronary heart disease, rheumatic heart disease or because or bacterial and viral infections including infective endocarditus. [8] Mitral regurgitation is the most common heart valve disorder being found in 20% of adults over the age of 55. [9] The backward leakage of blood causes an increase in atrial pressure and the wall of the left atrium will thicken by hypertrophy and possibly dilate. The pulmonary venous pressure will also rise which produces pulmonary oedema (fluid accumulation in the air spaces).It also reduces the blood supply to the rest of the so the left ventricle will also become thicker and the heart rate will increase to try and maintain normal cardiac output. Symptoms include shortness of breath, chest pains, dizziness and the pulse becomes faster. [10] [11] Stenosis of the heart valves occurs when the valve is narrowed and obstructs the forward flow of blood, it is usually a result of a congenital defect which has caused the valve to become inflamed or calcified. [12] FIG.5 Aortic Stenosis Aortic valve Stenosis is one of the most common valve disorders, when the valve doesnt open correctly there is reduced blood flow from the left ventricle into the aorta. In severe cases the walls of the left ventricle will become thicker as it has to work harder to maintain cardiac output into the aorta. Symptoms include dizziness, chest pain and an irregular heart beat. If the condition worsens it can lead to heart failure and more uncommonly to endocarditus.http://www.heart-valve-surgery.com/Images/aortic-stenosispicture-275.jpg Aortic Stenosis develops over time because or turbulent blood flow through a usually bicuspid aortic valve. Calcific valvular disease is an inflammatory process and the biggest cause of the disorder, calcification of the valve makes it very stiff and makes it difficult for the valve to open easily. Again as with regurgitation rheumatic fever and endocarditis are also causes of Stenosis. [11] [12] Valve deformations are more common in the left side of the heart but they do also occur in the right hand side. Stenosis and regurgitation can affect all four valves and not only the two mentioned above. [13] Other abnormal valve formations are congenital heart valve diseases which are those present at birth when the aortic or pulmonary valves dont form properly. Understand and describe the information that echocardiograms and stethoscope can provide regarding heart function. Echocardiography is a non-invasive technique used to assess cardiac structure and function by the use of ultrasound. Echoes are used to listen for congestion in the lungs, irregular heartbeats and murmurs. [11] There are several types of echocardiograms; transthoracic (TTE) are the most common. A device called a probe or transducer is placed on the chest and high frequency sound waves are used to produce sounds and images of the heart. It picks up echoes of sound waves and transmits them as electrical impulses which are then converted to 2D or 3D moving pictures on the screen. A Doppler echocardiogram shows the movement of blood. If a clear picture cannot be formed a small amount of liquid can be injected via IV to give a better picture. [14] Echocardiograms show details of the chambers including size, volume and thickness of the walls which helps to identify certain disorders including hypertension, the pumping function can also be reviewed and this can show conditions such as cardiomyopathy. Echoes also help with diagnosis of heart valve disorders including those mentioned above. It identifies the basic structures of the valve including thickness and movement and shows any abnormalities such as calcification and scaring. The Doppler will show any leakage through the heart valves and if there is a restriction in blood flow. Echoes of mitral regurgitation will show a dilated left atrium and left ventricle and echoes of aortic Stenosis will show the thickened calcified leaflets. In cases of suspected endocarditis a transesophageal echo can be used instead to show high-quality images of the heart and its valves. It is slightly more invasive and a long tube is passed down the oesophagus. [15] A stethoscope is a non invasive diagnostic instrument used to listen to or auscultate a patients heart, lungs, pulse and abdomen. It can also be used to help check blood pressure by listening to blood flow restoration when the sphygmomanometer cuff is removed. The diaphragm is placed on the patients chest where it picks up vibrations and amplifies them as sounds to the earpieces going via a hollow tube. [16]http://upload.wikimedia.org/wikipedia/commons/3/3c/Stethoscope_(PSF).png A healthy heart produces a double beat or lub dub with little other sound when the semi lunar valves open and close. A stethoscope helps detect a heart murmur which makes a whooshing sound after the heart beat, this can indicate serious other problems such as infective endocarditis. [17] [18] FIG.6 S Mutans adhering to surface of mitral valve Explain how oral derived bacterial flora can colonise heart valves Explain why the heart valves are susceptible to bacterial colonisation. Streptococcus mutans are a type of bacteria found in dental plaque of the oral cavity that is largely responsible for causing tooth decay and cavities via the process of demineralisation. However on occasion after dental treatment or from brushing the teeth if blood is exposed it can enter the blood stream and cause bacteraemia. Diseased Aortic Valve Endocarditis typically develops on surfaces of the heart, which have become rough and sticky after sustaining endothelial damage after being subject to turbulent blood flow. (In bicuspid valves blood flow is more turbulent and this creates a high pressure which makes the surface of the valve rough and more susceptible to bacterial colonisation). [19] Platelets and fibrin attach to the endochardium surface and form a platform which the bacteria can attach to; vegetation is now formed. This vegetation can damage the heart valves and affect how they open and close, or breakaway and cause complications in other areas of the body. The aortic and mitral valves of the left side of the heart are the most common to be affected. S mutants are thought to be responsible for 50% of all bacterial endocarditus cases. Staphylococci found on the skin can also cause it. [11] The risk of developing endocarditis is increased in a person who has already got artificial heart valves, general heart valve conditions, congenital birth defects, rheumatic fever and those with a lowered immune system. The problem with when bacteria colonises heart valves is that the valves dont have a designated blood supply to them so white blood cells are unable to fight the infection that is forming there. [20] [21]Full-size image (41 K) [22] FIG.7 Transthoracic echocardiogram (a) and apical four-chamber view (b) demonstrating a well circumscribed vegetation measuring 2 ÃÆ'- 1 cm, confined to the posterior mitral valve leaflet and impinging on the left atrium. Describe when prophylactic antibiotics should be prescribed prior to oral treatments. The term prophylactic antibiotics refer to when antibiotics are given prior to an event as a preventative measure to infection. Where rheumatic fever is still common, control and prevention will prevent rheumatic heart disease and associated endocarditis. [11]Previously people with heart valve conditions and artificial valves were thought to be at high risk of developing endocarditus when receiving dental treatment and other surgical operations so a treatment of antibiotics, usually penicillin were given prior to the procedure in question. Today however this practice is questioned as there were no placebo trials conducted. The large scale use of penicillin as a preventative measure comes with risks such as anaphylactic shock so now as recommended by the National Institute for Health and Clinical Excellence (NICE) it is mainly only offered to those patients who have an infection beforehand and those with artificial valves. Conclusion In conclusion to this PBL I now understand that the presence of bacteria in the blood can have serious consequences all over the body and not just at the site of entry. In answer to my uncles question about preventing infection it would be worth noting that meticulous oral and skin hygiene is significant in preventing such infections like endocarditis. With regards to oral hygiene a dentist should be seen at least every 6 months so any issues that may be present can be resolved before they develop further. Brushing twice a day, flossing and keeping ones toothbrush clean are always that can prevent bacteraemia.

Vonneguts Simple Style in Vonneguts Cats Cradle Essay -- Cats Crad

Vonnegut's Simple Style in Cat's Cradle The simple style with which Kurt Vonnegut, Jr. writes his novels belies the complexity hidden behind his sentences. Vonnegut's novels, as a result, are amazingly easy and, to many, enjoyable to read, yet they contain messages that go to the very root of humanity, messages that are not hidden underneath flowery prose. The success of Cat's Cradle, like all of his novels, relies on this simplicity to reveal its messages about religion, death, and apocalypse to the reader. Cat's Cradle is composed of a series of short, very direct, and seemingly simple sentences, that, when combined, form a surprisingly complex novel. Cat's Cradle, like most of Vonnegut's novels, is not very wordy. Vonnegut will almost always say things directly; for example, when discussing the history of San Lorenzo, he writes, "Subsequent expeditions came for gold...found none, burned a few natives for entertainment and heresy, and sailed on" (89). Vonnegut uses a very direct and flippant manner when he writes of things that others might not confront, such as the cruelty of the conquistadors. He does not try to hide his messages subtly, so his readers get the full meaning out of his novel, even if they are reading the book merely for entertainment. One does not have to search through his novel word-for-word to find Vonnegut's themes. Instead, Vonnegut sends his themes via simplicity and exaggeration. For Vonnegut to convey his ideas successfully to the reader, he must use a simple style to do s o; his point of view is so contrary to the norm that simplicity is the only way for him to get hi... ...continue trying, because it is human nature to risk destroying the world to further one's own ends. Cat's Cradle depends on Vonnegut's simplicity and other literary techniques, like exaggeration, to make its point. Man's destructive nature is made quite clear in this excellent novel, and unnecessary words and sentences would have destroyed the clarity of Vonnegut's message. The message, and the readability of the novel, are more important than if the novel is of the same literary caliber as the likes of Shakespeare and Hemingway. Vonnegut's simple sentences, combined with exaggeration, irony, and elements of science fiction, make his novels, and the messages contained within them, very powerful, and very enjoyable to read. In this way, Kurt Vonnegut, Jr. has established himself as a literary master. Vonnegut's Simple Style in Vonnegut's Cat's Cradle Essay -- Cat's Crad Vonnegut's Simple Style in Cat's Cradle The simple style with which Kurt Vonnegut, Jr. writes his novels belies the complexity hidden behind his sentences. Vonnegut's novels, as a result, are amazingly easy and, to many, enjoyable to read, yet they contain messages that go to the very root of humanity, messages that are not hidden underneath flowery prose. The success of Cat's Cradle, like all of his novels, relies on this simplicity to reveal its messages about religion, death, and apocalypse to the reader. Cat's Cradle is composed of a series of short, very direct, and seemingly simple sentences, that, when combined, form a surprisingly complex novel. Cat's Cradle, like most of Vonnegut's novels, is not very wordy. Vonnegut will almost always say things directly; for example, when discussing the history of San Lorenzo, he writes, "Subsequent expeditions came for gold...found none, burned a few natives for entertainment and heresy, and sailed on" (89). Vonnegut uses a very direct and flippant manner when he writes of things that others might not confront, such as the cruelty of the conquistadors. He does not try to hide his messages subtly, so his readers get the full meaning out of his novel, even if they are reading the book merely for entertainment. One does not have to search through his novel word-for-word to find Vonnegut's themes. Instead, Vonnegut sends his themes via simplicity and exaggeration. For Vonnegut to convey his ideas successfully to the reader, he must use a simple style to do s o; his point of view is so contrary to the norm that simplicity is the only way for him to get hi... ...continue trying, because it is human nature to risk destroying the world to further one's own ends. Cat's Cradle depends on Vonnegut's simplicity and other literary techniques, like exaggeration, to make its point. Man's destructive nature is made quite clear in this excellent novel, and unnecessary words and sentences would have destroyed the clarity of Vonnegut's message. The message, and the readability of the novel, are more important than if the novel is of the same literary caliber as the likes of Shakespeare and Hemingway. Vonnegut's simple sentences, combined with exaggeration, irony, and elements of science fiction, make his novels, and the messages contained within them, very powerful, and very enjoyable to read. In this way, Kurt Vonnegut, Jr. has established himself as a literary master.

Marriott Corporation: The Cost of Capital

In April 1988, Dan Cohrs, vice president of project finance at the Marriott Corporation, was preparing his annual recommendations for the hurdle rates at each of the firm's three divisions. Investment projects at Marriott were selected by discounting the appropriate cash flows by the appropriate hurdle rate for each division. In 1987, Marriott's sales grew by 24% and its return on equity stood at 22%. Sales and earnings per share had doubled over the previous four years, and the operating strategy was aimed at continuing this trend. Marriott's 1987 annual report stated: We intend to remain a premier growth company. This means aggressively developing appropriate opportunities within our chosen lines of business—lodging, contract services, and related businesses. In each of these areas our goal is to be the preferred employer, the preferred provider, and the most profitable company. Mr. Cohrs recognized that the divisional hurdle rates at Marriott would have a significant effect on the firm's financial and operating strategies. As a rule of thumb, increasing the hurdle rate by 1% (for example, from 12% to 12. 12%), decreases the present value of project inflows by 1%. Because costs remained roughly fixed, these changes in the value of inflows translated into changes in the net present value of projects . Figure A shows the substantial effect of hurdle rates on the anticipated net present value of projects. If hurdle rates were to increase, Marriott's growth would be reduced as once profitable projects no longer met the hurdle rates. Alternatively, if hurdle rates decreased, Marriott's growth would accelerate. Marriott also considered using the hurdle rates to determine incentive compensation. Annual incentive compensation constituted a significant portion of total compensation, ranging from 30% to 50% of base pay. Criteria for bonus awards depended on specific job responsibilities but often included the earnings level, the ability of managers to meet budgets, and overall corporate performance. There was some interest, however, in basing the incentive compensation, in part, on a comparison of the divisional return on net assets and the market-based divisional hurdle rate. The compensation plan would then reflect hurdle rates, making managers more sensitive to Marriott's financial strategy and capital market conditions. Professor Richard Ruback prepared this case as the basis for class discussion rather than to illustrate either effective or ineffective handling of an administrative situation. Copyright  © 1998 by the President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-545-7685, write Harvard Business School Publishing, Boston, MA 02163, or go to http://www. hbsp. harvard. edu. No part of this publication may be reproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without the permi ssion of Harvard Business School. Marriott Corporation: the Cost of Capital 1. How does Marriott use its estimate of its cost of capital? Does this make sense? Marriott has defined a clear financial strategy containing four elements. To determine the cost of capital, which also acted as hurdle rate for investment decision, cost of capital estimates were generated from each of the three business divisions; lodging, contract services and restaurants. Each division estimates its cost of capital based on: Debt Capacity Cost of Debt Cost of EquityAll of the above are calculated individually for each of the three divisions, and this is a critical aspect due to the varying cost of debt in particular for each division. Marriott then calculate company wide cost of capital using weighted average of the individual divisions cost of capital. This is a very clever approach, particularly as we see that for example the lodging unit, has a 74% debt percentage in the capital structure, and the fact that Marriott use long term cost of debt for lodging (which in this case is c lose to Government debt 110 bps margin) demonstrates the low risk investors perceive this side of the business to haveWe believe this approach is sound due to the difference in the cost of capital between the divisions being a function of the risk associated with the investments considered so this approach incorporates the fact that risk between the divisions varies. Given this we believe the method chosen by Marriott is compliant with the â€Å"Marriott Financial Strategy† as the capital costing approach is due diligent and reflect the single entity risk (bottom-up) rather than an estimated top-down.We believe this approach enables Marriott to optimize the financial performance and in turn increase the shareholder value. 2. If Marriott used a single corporate hurdle rate for evaluating investment opportunities in each of its lines of business, what would happen to the company over time? Marriott's three divisions are very different in terms of business area, business risk an d capital structure (debt capacity). The result is varying capital costs between the divisions. For instance Lodging has a significant lower cost of capital (WACC) than the Restaurant and even than the company as a whole.Using a single company-wide hurdle rate would create an uneven process in assessing investment opportunities across the divisions. In practical terms the accept/reject decision would not reflect the inherent business risk of the division, which could lead to investments being accepted, while they should have been rejected. Given the WACC calculations in the following questions, we see there is a significant difference in the cost of capital between the different divisions varying from 8. 85% (Lodging) to 12. 11% (Restaurants)Therefore, if we were to use one single corporate hurdle rate, we would assume in this instance that we would use the Marriott WACC of 10. 01%, then we may reject an investment in ‘Lodging’ which would yield a positive NPV and vice versa, we may accept an investment opportunities in ‘Restaurants’ which potentially would yield a negative NPV. Going back to the brief, we know that typically an increase in hurdle rate of 1% will decrease present value of project inflows by 1%. If we were to then use one hurdle rate (10. 1%) and take the lodging hurdle rate (8. 85%) this would be an increase in WACC of 13. 10% (lodging) and would therefore decrease PV of project inflows by the same 13. 10% – so the effect of using a single rate is compounded, firstly it impacts the decision, and the PV due to the discount impact. Over time a single hurdle rate (if consistently higher than the existing approach) would significantly hurt the performance of company as the approach could lead Marriott to reject (or accept) investment opportunities which should have been accepted (or rejected).This would destroy shareholder value. 3. What is Marriott’s Weighted Average Cost of Capital? What types of investmen ts would you value using Marriott’s WACC? To calculate Marriott’s WACC, we need to assess three factors 1) Capital structure, 2) Cost of debt, 3) Cost of Equity. As the corporate tax rate is given we will not manually calculate it. If required we would have used the financial statement in appendix 1 to do so.After having calculated the three factors mentioned above we employ the following formula to find WACC: WACC = (1-t)*rD*(D/V) + rE*(E/V) where Re = After tax cost of equity, Rd = pre tax cost of debt, E = market value of the firm's equity, D = market value of the firm's debt, V = E + D = firm value, E/V = percentage of financing that is equity, D/V = percentage of financing that is debt and t = corporate tax rate. 1) Capital Structure We find the capital structure in Table A on page 4 in the case. As the â€Å"debt percentage in capital† – D/V in the WACC formula – is given we find the equity percentage in capital (E/V) as: E/V= 1 – D/V. Using this we see Marriott is funded using 60% debt and 40% equity. We do realize the data in Table A is the target-leverage ratio, but we are comfortable using the target capital structure for this purpose instead of the current capital structure. 2) Cost of Debt The cost of debt is mathematically defined as Cost of Debt = (1-t) rD, where rD is the rate for pretax cost of debt and (1-t) represents the tax shield via the corporate tax rate. In the following rD is calculated, while the tax shield is not included until the final WACC calculation.Marriott’s debt was divided into two different segments; floating rate and fixed rate. 40% of Marriott’s debt was floating rate where the interest rate payment changes with changes in the market interest rates, while 60% was fixed rate. The case gives a â€Å"debt rate premium above government†, but information about term structure or other features of the floating debt are limited. We believe the correct way to estimate t he cost of debt is to estimate the cost per debt type/segment and then in a second step weigh the costs using the debt structure.To do this we estimate that the floating debt rate is best estimated using the 1yr government rate in Table B – for the reason that we do not have any shorter term data or average, and this most closely would represent floating. While for the fixed debt portion we have selected the 10yr government rate. Again, this is due to a mix of long term and shorter term fixed debit. This is the best assumption we can take using the data provided. Given the above the cost of debt of Marriott is: [Average((1yr Gov. ate)*(Floating debt fraction) + (10yr Gov. rate)*(Fixed Debt Fraction)) + â€Å"Debt Rate Premium Above Government†] [Average((6. 90%)(40%) + (8. 72%)(60%)) +1. 30%] = 9. 29% 3) Cost of Equity Cost of Equity is found using the Capital Asset Pricing Model (CAPM) or rE = RF+ ? i(E[RM] – RF), Where rF is the risk free rate we estimated ear lier, ? is the systematic risk or the overall risk factor and (E[RM] – RF) is the ‘price of risk’ or ‘market risk premium’ (MRP) investors expect over and above what the risk free securities yield.To be consistent in selecting expected market return and the risk free rate, we have selected to use the same time period for both estimates. Using Exhibit 4 and 5 we find the appropriate data. We take the longest time period available as we believe this is the conservative method as outliers in the data is crowded out due to the law of large numbers, which increases the empirical probability of accuracy. Given this we have selected 1926-87 average returns of the long-term U. S government bond as the risk free rate (RF) thus RF is 4. 58%. (Exhibit 4).The MRP is estimated using Exhibit 5, where we use the S excess return over the long term U. S government bond over the same time period as the risk premium (E[RM] – RF) = MRP = 7. 43%. S is chosen as th e â€Å"market return† as the stock index represents a wide and diversified range of equity across different sectors and industries. Given this we believe it is fair to use the S excess return over the risk free rate as the market risk premium (MRP) To find the ? we need to adjust the equity ? given in Exhibit 3 as it reflects the current capital structure and not the target structure.To re-calculate in order for the ? to reflect the Marriott target capital structure, we first calculate the unleveraged ? and then re-leverage it with the target capital structure. The unleveraged ? is calculated using: Unlevered ? = Equity ? / (1 + (1 – t) x (Debt/Equity)). As all data is given in Exhibit 3, we find unleveraged ? = 0. 7610. (See detailed calculations in excel sheet under tab â€Å"Exhibit 3†). To re-leverage the data we re-write the formula: Equity ? = Unlevered ? * (1 + (1 – Tc) x (Debt/Equity)) = 0. 7610 *(1+(1-34%)*(60%/(1-60%)) = 1. 514.We now have all the data need to calculate the cost of equity: rE = RF + ? (E[RM] – RF ) 4. 58%+ 1. 514(7. 43) =15. 83%. Finally we find WACC by employing the formula: WACC = E/V ? rE + D/V ? rD ? (1 – t) 40%*15. 83% + 60% *(9. 29%(1-34%)) = 10. 01%. Please find all detailed calculations in the attracted excel sheet under tab â€Å"Table A†. We would value an investment of similar risk, which would offer us a return higher than the WACC of 10. 01%, as anything over and above this in terms of return would be adding value as the present value of the future cash flows in that case would be positive.In otherwords, we could use WACC as our discount rate and hurdle rate to calculate NPV of potential investment projects of physical asset, where it is expected the financing will be similar to the financing of the company conducting the investment. 4. What is the cost of capital for the lodging and restaurant divisions? The WACC calculation methodology is the same for the divisions as t he calculations under question 3. However the inputs are changed to mirror the attributes and characteristics of the divisions.Please also see excel spreadsheet included within this submission for breakdown of the calculations. Lodging: Cost of debt: For the calculations of the fixed rate debt, we are using the 30 year government bond rate instead of the 10 year. This is a reflection of the comments in the case about the longer durability of the asset and longer financing. For the floating leg of the debt, we continue to use the 1 year government bond rate. rD = Average((1year US (Table B)*Fraction of Floating Debt + 30 Year US*Fraction of Fixed Debt) + 1. 10% rD = Average((6. 90%*50% + 8. 5%*50%) + 1. 10% = 9. 03% Cost of equity: To be consistent we opt for the long-term securities and long-dated data just as we did when calculation the cost of equity in question 3. As for the ? we use the peer group as presented in Exhibit 3. Hence to find the unleveraged beta, we take the average of the equity ? s of the peer group the average debt/equity ratio. After having calculated the unleveraged ? , we re-leverage using the target capital structure of the lodging division. We realize the limitations of using comparable companies to estimate the ? nd understand the criticality of defining the right peer group of comparable companies. We could most likely have increased the accuracy of our calculations by being more due diligent in the selection to find companies that were a closer match to the Lodging (and restaurant) division. However, for the purpose of the calculations in this case, we use the peer group defined in the exhibit. Restaurants: Cost of debt: For the calculations of the fixed rate debt the 10 year government bond is used. rD = Average((1year US (Table B)*Fraction of Floating Debt + 10 Year US*Fraction of Fixed Debt) + 1. 10% D = Average((6. 90%*25% + 8. 72%*75%) + 1. 10% = 10. 07% Cost of equity: To reflect the shorter nature of the assets in the restaur ant business division, we use short-term securities to estimate the risk free rate and the risk premium. We use the same method for estimating ? as we did for the Lodging calculations. Using the data described above, we find WACCLodging to be 8. 85% and WACCRestaurants to be 12. 11%. These findings support the notion that incorporating debt will lower the cost of capital due to the tax shield. Lodging has a debt/equity ratio of 74/26 against the 42/58 in the restaurant division. See detailed calculations in the attached excel sheet) We would also like to point out that of the restaurants given in the brief, many of these would in essence not necessarily be our peer group per se and we would be more selective over the restaurants we would selected to more closely mirror Marriott’s restaurants. With our aim to ensure we have the closest peer group possible for comparison. 5. What is the cost of capital for Marriott’s contract services division? How can you estimate its e quity cost without publicly traded comparable companies?We use the same framework as for the WACC calculations under Q3 and Q4. However, as we do not have a defined ? for the Contract Service division or an adequate peer group, we will estimate the ? using the existing data for Marriott and the two divisions. We know from the literature that a (holding) company’s ? is the weighted ? ’s of the individual business divisions. We use the revenue as the catalyst for the weighing of the ?. For the purpose of the calculations we use the unleveraged ? ’s. Mathematical this can be expressed as: ?(Marriott) = Revenue Weight (Lodging)* ? Lodging) + Revenue Weight (Contract Division)* ? (Contract Division) + Revenue Weight (Restaurants)*? (Restaurants). To find the ? (Contract Division) we re-write the formula to: ?(Contract Division) = [? (Marriott) – Revenue Weight (Lodging)* ? (Lodging) – Revenue Weight (Restaurants)*? (Restaurants)]/ Revenue Weight (Contra ct Division) ?(Contract Division) = [0. 7610 – 40. 99%*0. 5841 – 13. 49%*1. 0014]/45. 52% = 0. 8490 Adjusting for the target capital structure we find ? (Contract Division) equals 1. 223 Using this data, we find WACC for the Contract Service division to be 10. 82%.