Evaluate Postmodernist Explanations of the Role and Functions of Religion in Contemporary Society Essay

Evaluate postmodernist explanations of the role and functions of religion in contemporary society. Postmodernist religion can be defined as any type of religion that is influenced, interpreted or shaped by postmodernism and postmodern philosophies. Postmodern religion is not an attempt to banish religion from society; rather, it is a philosophical approach to religion that considers orthodox assumptions that may reflect power differences in society rather than universal truths. A postmodern interpretation of religion emphasises the key point that religious truth is highly individualistic, subjective and resides within the individual. Science technology and efficiency would overcome many social problems. The collapse of the ‘grand-narrative’ is part of post-modernism as it is a belief system that claims universal authority, religion; science and philosophies are examples of these. They have a superior status over other belief systems and also claimed they could explain the causes of society’s problems and could therefore provide solutions. According to Jean-Francois Lyotard, the grand-narratives powerful attraction has been lost during the 20th century. So, science hasn’t delivered solutions, wars have devastated nations, and the world is still full of evils that the grand-narratives can’t explain or resolve. Examples of this are world wars; nuclear warfare; AIDS and global poverty. The common perspective of post-modernist religion is ‘there is a god who can’t do anything, there is a god who won’t do anything, or there isn’t a god. ’ Zygmunt Bauman said post-modernity is the irretrievable loss of trust in the project of modernity and its ability to manage, enhance and fulfil human potential. Symbols, signs and meanings are also another theory to post-modernism. Mass media like television and the internet have exposed us all to different cultures and ideas from across the globe, also known as globalisation. The ‘meanings’ of things have now become more individualised, we consume the products, symbols and signs of a globalised economy, but we provide our own meanings to these. Jean Baudrillard said â€Å"we are what we consume†¦ and our identities are formed and changed through acts of consumption. † Signs and symbols have become detached from their original meanings; original purposes and meanings have become lost. Religious signs and symbols are losing their meaning, these signs and symbols have been adopted by mass consumer culture, usually used for decorative and playful purposes such as jewellery. Joseph Natoli said â€Å"post-modernity has questioned the authority and legitimizing of both faith and reason, opting for the view that both offer stories of reality†¦ both do so on the shifting sands of a post-modernist outlook. † Signs and symbols have become insecure from the things they were linked to originally. Individuals no longer identify with a single religion and so they blend different beliefs with practices to create an identity for themselves. This can be known as being utilitarian, so there is no substance to our identity and actions, we are no longer just shaped by the moulding force of socialisation. Zygmunt Bauman said the consumption of goods and services becomes more important in our lives as a way of constructing and changing identity. This consumption is addictive and advertising drags us in. â€Å"I don’t know what’s right and what’s real anymore, and I don’t know how I’m meant to feel anymore, and when do you think it will all become clear? † from ‘The Fear’ by Lily Allen (2009). Many different religions now exist and people tend to mix the styles and genres with one another. Baudrillard said it is hard to find guidance in our lives as sources of authority and moral leadership are often undermined, they seem almost irrelevant. In the past we believed anything that religious leaders told us, simply because they were a religious leader, but this is no longer the case as we are now sceptical. We live in a world of images, and so it is hard to distinguish between image and reality as we live in a world where media simulations are more ‘real’ than the reality that we live in. Anthony Giddens said we live in a new form of modernity where we have lost faith in the ‘project of modernity’. We are now able to try out many different cultures in a globalised world. Life is now more uncertain than before. So to sum up, we live in a society characterised the coexistence of many different subgroups and cultures; the erosion of traditional social classes; the growth of movements such as environmentalism, feminism and ethnic politics; the absence of agreed standards for evaluating what is true/false and right/wrong; the blurring of what is real and not; and experimentation with self-identity. Stewart Clegg said that organisations are different in the post-modern age. For example, in the modern age there is rigid authoritarian control; mass consumption; it is dominated by technology and is demarcated and deskilled. Whereas, in the post-modern age there is flexible and democratic control; niche markets; it is enabled by technology and is undemarcated and multi-skilled jobs. Postmodernists believe that the advent of postmodernity has led to significant changes in religion. In particular, they see it as leading to the decline of traditional church-based religions in which believers follow rules laid down by their religion, and the growth of new age beliefs where people can pick and choose their own belief systems. Marxist religion is all about the ruling class owning the means of production, and through wealth they derive power which allows control over the superstructure of society. Ruling class ideology of religion keeps the ruling class in power by discouraging the working classes from realising they are being exploited and in turn trying to rebel against the ruling class power. Karl Marx famously described religion as the ‘opium of the masses’, by this he meant that religion was seen as being like a drug that helps people deal with pain, much like ‘opium’. Religion promises eternal life in heaven for people who accept religion. As the biblical quote says ‘it is easier for a camel to pass through the eye if a needle, than for s rich man to enter the kingdom of heaven’. It offers hope of supernatural intervention to end suffering, for example, Jehovah’s witnesses believe that judgement day will arrive and those who are not religious will be judged and punished. Marx saw religion as a mechanism of social control. It creates false class consciousness, mistaken beliefs about the true nature of social life, which justify the position of the ruling class. This prevents the working class developing class consciousness, in which they become aware that they are exploited, and unite to overthrow the capitalist system that exploits them. Marx believed the only escape of this exploitation was communism, this way religion would no longer be necessary. Without social classes there would be no need for religion as its sole purpose was to legitimate ruling class power. Religion would therefore disappear. For example, in the Soviet Union under communist leadership from 1917 to 1990 the state consistently opposed the existence of religious beliefs and destroyed many Russian orthodox churches, as well as mosques and synagogues. The Marxist view of religion has been proven in many societies across the world; some examples of these are the Hindu caste system and evangelical Christianity in Latin America. In the Hindu caste system in India, people were divided into 5 castes based upon their supposed degree of religious purity. The Brahmins (priests) were at the top and the untouchables (unskilled labourers) at the bottom. This supports the Marxist view since no movement was permitted between castes, this system ensured the ruling class maintained their power and control and justified the lowly position of those at the bottom in terms of their religious impurity. The new Christian right have encouraged the spread of protestant religious beliefs in predominantly catholic Latin America countries particularly amongst the poor in shantytowns. This supports the Marxist view of religion as protestant religious beliefs provide religious discipline and hope of salvation in afterlife to some of the poorest in Latin American societies, discouraging them from supporting radical catholic liberation theology and encouraging support for US-style capitalist values. However Marxist view can also be criticised, just a few criticisms would be that Marxist only focus on one possible role of religion in society and it ignores the much broader range of effects religion might have. Another criticism would be that attempts to destroy religion in communist countries were not successful. Religion survived in the USSR and Catholicism thrived in communist Poland. Much like Marxists, feminists believe that religion does not serve the interests of society as a whole, and only serves the interests of a particular social group. They see religion as being patriarchal, male-dominated, and serving the interests of men. Karen Armstrong argued that religion has not always been patriarchal and that in early history women were considered central to spirituality and archaeologists have found numerous symbols of the great mother goddess, in comparison there were few portrayals of male gods. With the advent of Judaism, Christianity and Islam, monotheistic religions largely replaced polytheistic religions. In all these cases god was portrayed as a male. Jean Holm argues that in the public sphere of religion when important positions are held, men almost always dominate. However, in the private sphere, women are dominant and do most of the religious work. Holm has identified inequality between men and women in all major world religion. Some examples of these inequalities are shown in Christianity/roman Catholicism; Islam; Hinduism; Chinese folk religions; Orthodox Judaism and Sikhism.

Post-CABG Nursing

Coronary heart disease is a major physical illness and one of the main causes of death in Western society People who do not die an early and sudden death may have to consider a major surgical treatment, the most prevalent being coronary artery bypass graft surgery (CABG). More than 350,000 such operations are performed annually in the United States alone. This operation prolongs the life of patients in cases of triple-vessel disease It also improves patients' quality of life), thus providing them with the opportunity for successful rehabilitation (Ben-Zur, 2000).The postoperative complications of CABG include the following: high anxiety or depression, central nervous system damage (CNS), and atrial fibrillation. In this paper, we will discuss the postoperative complications of CABG and how they impact nursing practice. . During the first several weeks after CABG surgery, states of high anxiety or depression are usually observed (see, for example, Pick, Molloy, Hinds, Pearce, & Salmon , 1994; Trzcieniecka-Green & Steptoe, 1994).In long-term research (that is, approximately one year after the operation), the results present a more positive trend in terms of elevation in positive moods (King, Porter, Norsen, & Reis, 1992; King, Reis, Porter, & Norsen, 1993), as well as an increase in quality of life (Kulik & Mahler, 1993). Such outcomes can be accounted for by illness severity factors. In addition, in recent years, the individual's personality and coping characteristics have been investigated as important determinants of post-CABG patients' emotional reactions and rehabilitation (Ben-Zur et al., 2000). Research studies indicate that depression is prevalent in approximately 20% of CAD patients, and has a significant effect on post-surgery morbidity and mortality. (Remedio, 2003). One major type of morbidity following CABG is central nervous system (CNS) dysfunction (. Barbut D, Hinton et al. 1985)]. Of all the adverse neurological outcomes that may be incurred posto peratively, stroke is one of the most serious.However, due to technological and surgical improvements the incidence of stroke is now reported to be as low as between 0. 8 and 5. 8% [McCann GM, et al. 1997) Duke University Medical Center study published in 2001 indicated that fully half of people undergoing bypass surgery developed memory or thinking problems in the days following it, and that these problems were usually still evident five years later. (Bypass surgery and memory, 2005) Consequently, the rate of post-CABG stroke is no longer a sufficient index of CNS dysfunction.Neuropsychological research suggests, however, that a considerable proportion of all patients who undergo CABG sustain some degree of cerebral damage and that this manifests as mild cognitive impairment. Although these cognitive deficits rarely disturb activities of daily living, they are still considered cause for concern. Therefore, it is these less severe forms of neurological injury, which are now targeted for reduction in what has been described as an age of quality improvement (Stump D. A. 1995; Stump D. A. , Rogers A. T. , and Hammon , J. W. 1996;].Cognitive impairment following coronary artery bypass grafting, Neuropsychological tests are valuable tools in the assessment of brain dysfunction as they provide a method of systematically and quantitatively studying the behavioral expressions of this dysfunction (Lezak, 1995) .As there is now only a low risk of stroke following CABG, milder forms of cerebral damage have become a greater focus of concern. Consequently, neuropsychological assessment has become more important within the domain of cardiac surgery. The advantage of neuropsychological tests is that they are capable of detecting subtle changes in cognitive function.In comparison, conventional neurological assessment techniques, such as the Mini-Mental State Examination, are less sensitive and therefore less able to detect subtle CNS changes In addition, neurological assessme nt techniques do not lend themselves as readily to quantitative analysis [Heyer E. J, et al. 1995) Cognitive decline has been observed by many researchers using batteries of neuropsychological tests, usually administered to patients before and after surgery. A patient’s pre- and postoperative scores are then compared. In this way, intersubject variability is minimized as the subjects act as their own controls.While cognitive deficits have been consistently reported in the immediate postoperative period, some researchers have readministered test batteries in the immediate postoperative period, typically within 5–10 days of surgery (Aris A, et al, 1986; Clark et al. , 1995; . Newman MF, Croughwell ND, Blumenthal JA et al. 1994; Pugsley et al, 1994; Shaw PJ et al. 1986; Townes B. D. , Bashein G. , Hornbein T. F. et al. 1989; Symes et al, 2000).. Atrial fibrillation (AF), although t not life threatening, is one of the most common complications after CABG.Hospital stays oft en are prolonged due to intermittent hemodynamic instability of thomboembolic complications. During AF, loss of synchronous atrial mechanical activity response, and inappropriately high heart rates may have adverse effects o n hemodynamic functions and cause hypotension and hear failure. Of all the complications associated with postoperative AF< the most serious are throboemboic complications, which cause permanent morbidity in many patients. Risk of postoperative stroke has been found to be significantly increased with postoperative atrial tacharrhymias.Earlier studies shows that the incidence of AF can be as high as 50% in patients after the incidence of AF can be as high as 50% in patient after coronary artery bypass grafting (CABG), with a peak incidence on postoperative day 2 to 3. Atrial effective refractory periods (ERP) has been used a parameter to evaluate atrial repolarization and ERP and its dispersion are known parameters of atrial vulnerability that indicate enhanced at rial arrhythmogenesis, include a history spontaneous paroxysmal AF and easy inductility of atrial arrhthmias.( Solyu et al). Pleural effusion occurs in up to 80% of patients during the first week after CABG. Most of these effusions are small, self-limiting and do not require interventions. However, chronic, persistent post-CABG effusions have been reported. The etiology of these persistent effusions remains unknown. ( Lee et al, 2001) Sleep disturbances is another big postoperative complication The purpose of a 1996 Schafer et al study was to describe the nature and frequency of sleep pattern disturbances in patients post coronary artery bypass (CABG) surgery.An exploratory design using telephone interviews at one week, one month, three months and six months was used to describe the incidence and nature of sleep disturbances post CABG surgery. Forty-nine patients completed all four measurement times. More than half of the patients reported sleep disturbances at each measurement time . Sleep disturbances during the first month post CABG were reported to be the result of incisional pain, difficulty finding a comfortable position and nocturia. Although less frequent over time, these problems persisted for six months. . Miller et al (2004) discusses post CABG postoperative symptoms.At 1 week post-CABG, symptoms were incisional pain, wound drainage, chest congestion, shortness of breath, dizziness, sweating, swollen feet, and loss of appetite; incisional pain and swollen feet were reported by a few patients at 6 weeks after CABG. The incidence and frequency of postoperative symptoms declined over time. There were several age-related differences in symptom reports prior to and at 1 and 6 weeks after the procedure (Miller et al, 2004. ). Nursing interventions A wide variety of interventions have been tested for recovery of CABG patients. These 19 studies tested 20 interventions.Most of the interventions were educational in nature and dealt with preoperative or dischar ge instructions or counseling provided to patients. Preoperative interventions to affect in-hospital recovery included preparatory information about cognitive dysfunction following surgery, preparatory information and counseling about physical and psychologic recovery, and psychiatric counseling. Two of the studies[Rice VH, Mullin MH, Jarosz P.. 1992. ] compared the effectiveness of preadmission versus postadmission preparatory instructions, and one study [Barnason S, Zimmerman L, Nieveen J. 1995; Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.1988); . compared the effects of music, relaxation, and structured rest on hospital recovery outcomes. One study tested the effect of in-hospital range-of-motion (ROM) exercises on arm ROM at discharge. Interventions for home recovery were delivered close to the time of discharge or within the first couple of weeks following discharge. Most of the studies involved tests of structured discharge preparatory information about home recovery using slide and tape programs,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al. 1988; Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993;.] telephone follow-up and counseling,[ Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al.. 1988;13:649-661. , Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Beckie T. 1989; Barnason S, Zimmerman L. 1995;] outpatient group teaching,[ Dracup; 1982. Dissertation. ,32] and homegoing audiotapes Interventions to promote risk factor modification behaviors included four studies[Dracup KA. 1982. ] that assessed the effect of structured versus unstructured teaching programs designed to increase knowledge of risk factors and enhance compliance with risk factor modification behaviors.Another study tested an education program that included a behavioral component as well Various outcome variables have been used to evaluate CABG recovery. The most frequently used outcome was mood states; 10 of the 19 studies used mood states as an outcome measure. The most frequently used measurement point for hospital recovery outcomes was the first day following surgery and discharge. Home recovery outcomes were usually measured at 1, 3, and 6 months following discharge. Outcomes associated with risk factor modification most often were measured at 6 weeks and 3, 6, and 12 months following surgery.What is the effectiveness of the interventions? Preparatory information was the intervention most frequently tested. In the two studies[Rice VH, Mullin MH, Jarosz P. 1992;, Anderson EA. 1987;] assessing its effectiveness to reduce analgesia use during hospital recovery, preoperative preparatory information was not found to be effective. Preoperative preparatory information was found to be effective in increasing patients' comfort and control when experiencing postoperative delirium.There was no support for the ability of preoperative preparatory information to reduce anxiety during in-hospital reco very] Discharge preparatory information also was found not to be effective in three of the four studies evaluating mood states during home recovery; this finding was noted even when individual counseling and telephone follow-up were added to the initial information provided Preadmission preparatory information about activity resumption during hospital recovery was found to be effective in one study (Cupples 1991. ] but not in another. [ Rice VH, Mullin MH, Jarosz P. 1992).Activity resumption at home was found to be significantly increased by the provision of discharge preparatory information in two[Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. 1993; Moore SM. 1996] 33 of three studies. Discharge preparatory information aimed at families was not found to be effective in improving family functioning (family cohesion and family communication) during the home recovery periodGiven the small number of studies addressing the effect of preparatory information on phys iologic outcomes (blood pressure, heart rate, angina), no conclusions were made about its effectiveness on these variables.Similarly, no conclusions were drawn about the effectiveness of ROM exercises, music, and visual imaging to enhance CABG recovery because of the small single studies testing each of these interventions. There was clear evidence that information interventions designed to increase individuals' knowledge about managing recovery experiences during the first home recovery month and about coronary artery disease risk factor modification was effective; three of the four studies evaluating this intervention found significant effects.Similarly, tests of the effectiveness of structured versus unstructured instruction indicated that structured information was more effective in increasing knowledge. Education to enhance compliance with medical regimens and risk factor modifications was found to be effective for some risk modification behaviors but not for others. It appears that information alone does not change behaviors. Allen's[Allen. 1996;. ] study of an intervention to increase self-efficacy using both counseling and behavior modification techniques represented an important departure from previous interventions that were based solely on education and counseling.Although Allen found a positive effect for only one of the risk modification behaviors studied (dietary intake), the addition of a behavioral component is an important change in cardiovascular health behavior modification interventions. Gender differences have been widely explored by nurses. Investigators have identified that gender can constitute a form a biculturalism (that is, women view surgery as a minor inconvenience, whereas men view it as a major life event). Postoperative symptoms vary, with males experiencing more fatigue, incisional chest pain, and atrial dysrythmias.Conversely, women have more numbness and breast discomfort, heart failure, and functional impairment. The 2 areas wherein the most work has been done are pain and sleep. A number of descriptive studies have been done on patients' self-report of pain, their satisfaction with treatment, and underuse of analgesics. Limited research on interventions to relieve pain has been reported. Despite these studies on pain outcomes, more exploratory work is required for pain associated with minimally invasive cardiac surgery, pain, and discomfort at discharge, and subsequently identification and trialing of interventions to provide pain relief.The relationships between exercise behavior and functional status of men and women 5 to 6 years after CABG have not been examined in a representative patient sample. This study (Treat-Jacobson & Lindquist, 2004). compared the 5- to 6-year recovery in a cohort of 184 patients at the Minnesota site of the Post CABG Biobehavioral Study. Data were collected by telephone interview and self-administered questionnaires. Results showed that women had lower physical (p ? .004) and social (p = . 001) functioning scores; men were more likely to participate in regular exercise (p = .01). Exercisers had higher functional status scores. ANCOVA demonstrated that differences in measures of functional status by exercise category were maintained even after controlling for age, sex, and symptom severity (p ? .01). In conclusion, individuals who exercised had more positive functional outcomes 5 to 6 years In general, nurse investigators have conducted sufficient studies within each of the generic outcome categories to allow for identification of cardiac surgery-specific outcomes that can be considered nurse sensitive.Artinian (1993) demonstrated that in the early recovery phase, only 62% of women spouses felt they were prepared for discharge, with key concerns being the availability of social support, use of coping strategies, personal resources, and knowing what to expect. At 6 weeks after discharge, women's concerns were most often regarding their husband's self- care activities, uncertainty, and husband's physical and mental symptoms. At 1 year after surgery, women reported less social support and greater role strain than they did at earlier time periods.48 Other investigators have shown that positive psychosocial adjustment to illness is influenced both by the quality of the patient's marriage and level of dysphoria. 49 Nursing interventions to improve family functioning have been reported by a number of investigators. Family members of ICU patients, who were recipients of care from nurses who attended educational sessions and who used checklists to assure provision of information and support, reported lower anxiety and higher satisfaction levels than did families not provided with this level of care.50 Other reports of a controlled trial with a nurse-led psychoeducational intervention51 and follow-up phone calls33 demonstrated no differences in improving patients' recovery or family functioning. Further research in this field should focus on determining if these findings persist across different demographic and economic groups Studies of functional status outcomes have focused on general activity and activities of daily living (ADLs). Specific findings have included that high levels of self-efficacy and decreased tension and anxiety at 4 weeks after surgery are predictive of greater activity at 8 weeks.Women report greater disruption of ADLs at 1 than at 3 months, while disruption of their recreational activities is similar at both times. Need during home health visits include maximum assistance with meals and laundry but only partial assistance with bathing and dressing. One randomized controlled trial comparing usual care with supplemental hospital education and weekly telephone follow-up to improve self-efficacy demonstrated that patients in the experimental group developed higher expectations for walking, lifting, climbing stairs, and working than did patients in the control group.(Whitman, 2004). Conclusion Cor onary artery bypass graft (CABG) surgery is regularly performed in most major hospitals, reflecting the high prevalence of coronary artery disease in western countries. A number of studies have identified cohorts of patients undergoing CABG and other cardiac procedures who experience a higher than expected rate of mortality and morbidity. Increasing age, poor left ventricular function, urgent/emergency procedures, complex operations and reoperation procedures have all been identified as risk factors resulting in prolonged hospital stays and increased morbidity.Subsequently, with current emphasis on both better clinical management and more cost-efficient practice, it is becoming increasingly beneficial to identify low-risk patients who can be safely ‘fast tracked’ to reduce postoperative management costs. The current, eclectic mix of topics studied reflects early resolution of specific issues. However, surgical procedures, recovery times, hospital length of stay, transit ional care facility length of stay, use of home healthcare, and patient characteristics have changed dramatically during the last decade, suggesting that new functional outcome recovery trajectories evolved.These new patterns for functional recovery and interventions merit new inquiry and reporting. The nursing studies have been well designed and have allowed the investigators to move, in many categories, through logical iterations of discovery (this is, from exploratory and descriptive work to predictive and correlational work and, finally, into interventional work). Future work in all categories needs to focus on moving through these stages and enhancing the current directions being taken so that patients achieve positive, optimal outcomes.Such information can be used to plan the care of patients undergoing CABG, to prepare them for normal recovery, and to determine the need for symptom management by health care providers References Allen J. A. . (2000) Coronary risk factor modifi cation in women after coronary artery bypass surgery. Nurs Res;45:260-265. Aris, A, et al.. Arterial line filtration during cardiopulmonary bypass. Journal of Thoracic and Cardiovascular Surgery1986; 91:526–533. Artinian N. (1993) Spouses' perception of readiness for discharge after cardiac surgery. Appl Nurs Res. ;6(2):80-88 Barbarowicz P, Nelson M, DeBusk RF, Haskell WL.A comparison of in-hospital education approaches for coronary bypass patients. Heart Lung. 1980;9:127-133. Barbut D. , Hinton R. B. , Szatrowski T. P. et al. Cerebral emboli detected during bypass surgery are associated with clamp removal. Stroke 1994; 25:2398–2402. Barnason S, Zimmerman L. (2000) A comparison of patient teaching outcomes among postoperative coronary artery bypass graft (CABG) patients. Prog Cardiovasc Nurs. ;10:11-20. Barnason S. , Zimmerman L. , Nieveen J.. Psychosocial aspects of cardiac care: The effects of music interventions on anxiety in the patient after coronary artery bypass grafting.Heart Lung 1995;24:124-132. Beckie T. A supportive-educative telephone program: Impact on knowledge and anxiety after coronary artery bypass graft surgery. Heart Lung. 1989;18:46-55. Ben-Zur, Hasida, Rappaport, Batya, Ammar, Ronny, Uretzky, Gideon. Life Style Changes, And Pessimism After Open-Heart Surgery Health & Social Work, 03607283, Aug2000, Vol. 25, Issue 3 Bypass surgery and memory. (cover story) Harvard Heart Letter, Aug2005, Vol. 15 Issue 12, p1-2 Clark R E. et al. (1995).. Microemboli during coronary artery bypass grafting. Journal of Thoracic and Cardiovascular Surgery; 109:249–258.Cupples S. A. Effects of timing and reinforcement of preoperative education on knowledge and recovery of patients having coronary artery bypass graft surgery. Heart Lung. 1991;20:654-660. Dracup K. A.. The Effect of a Role Supplementation Program for Cardiac Patients and Spouses on Mastery of the At-Risk Role. Ann Arbor, Ml: University Microfilms International; 1982. Dissertati on. Gilliss CL, Gortner SR, Hauck WW, Shinn JA, Sparacino PA, Tompkins C. A randomized clinical trial of nursing care for recovery from cardiac surgery. Heart Lung. 1993;22:125-133.Gortner SR, Gilliss CL, Shinn JA, Sparacino PA, et al (2000). Improving recovery following cardiac surgery: A randomized clinical trial. J Adv Nurs. 13:649-661. Heyer E. J. , Delphin E. , Adams D. C . et al. Cerebral dysfunction after cardiac operations in elderly patients. Annals ofThoracic Surgery 1995; 60:1716–1722. King, K. B. , Porter, L. A. , Norsen, L. H. , & Reis, H. T. (1992). Patient perceptions of quality of life after coronary artery surgery: Was it worth it? Research in Nursing and Health, 15, 327-334. King, K. B. , Reis, H. T. , Porter, L. A. , & Norsen, L.H. (1993). Social support and long-term recovery from coronary artery surgery: Effects on patients and spouses. Health Psychology, 12, 56-63. Kulik, J. A. , & Mahler, H. I. M. (1993). Emotional support as a moderator of adjustment a nd compliance after coronary artery bypass surgery: A longitudinal study. Journal of Behavioral Medicine, 16, 45-63. Lee, Y. C. et al. (2001). Symptomatic Persistent Post-Coronary Artery Bypass Graft Pleural Effusions Requiring Operative Treatment. CHEST, Vol. 119 Issue 3, p795-801. Lezak M. D. Neuropsychological Assessment. 3rd edn.New York: Oxford University Press, 1995. Lyon, William J. ; Baker, Robert A. ; Andrew, Marie J. ; Tirimacco, Rosy; White, Graham H. ; Knight, John L. (2003). Relationship between elevated preoperative troponin T and adverse outcomes following cardiac surgery.. ANZ Journal of Surgery 1/2, p40-44. Marshall J, Penckofer S, Llewellyn J. Structured postoperative teaching and knowledge and compliance of patients who had coronary artery bypass surgery. HeartLung. 1986;15:76-82. McKhann GM, Goldsborough MA, Borowicz LM et al. Cognitive outcome after coronary artery bypass: a one year prospective study.Annals of Thoracic Surgery 1997; 63:510–515. Miller, K . H. ; Grindel, C. G, (2004). Comparison of Symptoms of Younger and Older Patients Undergoing Coronary Artery Bypass Surgery.. Clinical Nursing Research, 3, p179-193 Moore SM. (2002) The effects of a discharge information intervention on recovery outcomes following coronary artery bypass surgery. Int J Nurs Stud. 33:181-189. Munro I. Two-year follow up study of coronary artery bypass surgery. Psychologic status, employment status and quality of life. Journal of Thoracic and CardiovascularSurgery 1998; 97:78–85.Newman M. F. , Croughwell N. D. , (1994). Blumenthal JA et al. Effect of aging on cerebral auto regulation during cardiopulmonary bypass – association with postoperative cognitive dysfunction. Circulation 90:243–249. Penckofer S, Llewellyn J. Adherence to risk-factor instructions one year following coronary artery bypass surgery. J Cardiovasc Nurs. 1989;3:10-24. Pick, B. , Molloy, A. , Hinds, C. , Pearce, S. , & Salmon, P. (1994). Post-operative fatigue fo llowing coronary artery bypass surgery: Relationship to emotional state and to the cathecholamine response to surgery.Journal of Psychosomatic Research, 38, 599-607. Pugsley W, et al. (1994).. The impact of microemboli during cardiopulmonary bypass on neuropsychological functioning. Stroke; 25:1393–1409. Remedios, C. (2003). The role of medical, demographic and psychosocial factors in the incidence of depression among coronary artery bypass patients. Australian Journal of Psychology, Supplement, Vol. 55, p8-13 Rice V. H. , Mullin M. H. , Jarosz P. (2001) Preadmission self-instruction effects on postadmission and postoperative indicators in CABG patients: Partial replication and extension.Res Nurs Health. 2; 15:253-259. Schaefer K. M. Swavely D, Rothenberger C, Hess S, Williston D. Sleep disturbances post coronary artery bypass surgery.. Prog Cardiovasc Nurs. 1996 Winter;11(1):5-14. Shaw P. J. , Bates D. , Cartlidge N. E. F. et al. Early intellectual dysfunction following coro nary bypass surgery. Quarterly Journal of Medicine, New Series 1986; 58:59–68. Soylu, M. et al. (2003). . Increased Dispersion of Refractoriness in Patients with Atrial Fibrillation in the Early Postoperative Period after Coronary Artery Bypass Grafting.Journal of Cardiovascular Electrophysiology, Vol. 14 Issue 1, p28-31 Stump D. A. Selection and clinical significance of neuropsychologic tests. Annals of Thoracic Surgery 1995; 59:1340–1344. Stump D. A. , Rogers A. T. , Hammon J. W. Neurobehavioural tests are monitoring tools used to improve cardiac surgeryoutcome. Annals of Thoracic Surgery 1996; 61:1295–1296. Stump DA, Rogers A. T. , Hammon JW, Newman SP. Cerebralemboli and cognitive outcome after cardiac surgery. Journal of Cardiothoracic and Vascular Anaesthesia 1996; 10:113–119. Symes, Emma; Maruff, Paul; Ajani, Andrew; Currie, Jon. (2000)Issues associated with the identification of cognitive change following coronary artery bypass grafting: Australia n & New Zealand Journal of Psychiatry, 5, p770-784, Taylor, S. E. , & Aspinwall, L. G. (1993). Coping with chronic illness. In L. Goldberger & S. Breznitz (Eds. ), Handbook of stress: Theoretical and clinical aspects_(pp. 511-531) (2nd ed. ). New York: Free Press. Townes BD, Bashein G, Hornbein T. yF. et al. Neurobehavioural outcomes in cardiac operations – a prospective controlled study. Journal of Thoracic and Cardiovascular Surgery 1989; 98:774–782. Treat-Jacobson, Diane; Lindquist, Ruth A. (2004).Functional Recovery and Exercise Behavior in Men and Women 5 to 6 Years Following Coronary Artery Bypass Graft (CABG) Surgery. Western Journal of Nursing Research 5, p479-498, Vanninen R, Aikia M, Kononen M. et al. (1998). Subclinical cerebral complications after coronary artery bypass grafting: prospective analysis with magnetic resonance imaging, qualitative electroencephalography and neuropsychological assessment. Archives of Neurology; 55:618–627. Whitman, G. R. Nursing-Sensitive Outcomes in Cardiac Surgery Patients, The Journal of Cardiovascular Nursing: Volume 19(5) September/October 2004 p 293-298

Nietzsche’s Ubermensch Essay

Nietzsche’s Ubermensch stands for homo superior, overman or super man. Nietzsche philosophy of Ubermensch is based on ‘Will to Power’. All doctrines are dependent on ‘power to will’. Many of his philosophies are misinterpreted before but there still a lot of disagreement exists in his philosophy of power to overcome everything by willpower. He describes man to be Ubermensch when he gains such power and then he can do anything. This power can be destructive or constructive or by self-improvement. Though there is some truth in the fact that whatever we do or whatever we want to do we can attain it by willpower, but our willpower is limited. It is not a self-created giant that will overcome all obstacles in life. God has granted us will to choose between right and wrong and will to perform and overcome difficult situations. But our willpower is limited as we experience in day-to-day life. Because in whatever environment we live we’re surrounded by a number of situations and it is not always possible to tackle all the situations simultaneously. A number of examples can be cited for this. A person goes out of his house to perform a particular task. He’s determined that he has five jobs to complete during the day. But he’s not aware of an unknown incident that might occur in his way and block him to do his jobs. Similarly a sports man who is very well prepared for the competition and full determined that he’ll win the competition may loose because of any sports injury or simply bad luck! His philosophical ideas about truth that our minds have faith in the beliefs because they’re very convincing not because they are truth is again controversial. Nietzsche’s philosophical claim cannot be agreed upon. The fact that we do believe in things that are true. And only those beliefs are convincing that have universal truth in it. For example, we do believe in some kind of ancient saying that â€Å"Green tea has power to cure†. It is due to the fact that green tea has been used for several years and it has proved to be good in maintaining health. Now scientific research has also proved that it possess certain good polyphenoids that are required by the body in maintaining health and combating disease. Truth forms the basis of several facts that we believe. Hence, Nietzsche’s notion cannot be said as valid. He has extraordinarily overstressed the on the use of ‘power’. His statement is baseless when he says in philosophy we only have power and no higher truth. On the contrary, in science we have facts based on truth. Though our willpower does affect our inner strength and determination, but our power is limited as there is a divine unlimited power of one God ruling and final decisions rests on His willingness and permission. Men do strive hard to attain a goal but it is in the hands of God to grant us that or not. Man’s power is always limited and controlled. Nietzsche stresses on personal character and inner strong determination for power. However, it is not reasonable to solely judge the occurrence of events on the basis of strong determination. Under many circumstances in daily life we come across things that are not wanted by our own self. And our determination breaks when the outcomes of our thinking and our willpower are just the opposite. References Thus Spake Bart by Mark T. Conrad, Thus Spoke Zarathushra the Three Metamorphoses

El Derecho Essay Example | Topics and Well Written Essays - 750 words

El Derecho - Essay Example A crane is a bird. Then consider: The crane is used to lift heavy things. The meaning gets twisted depending on the usage. The same is true for El Derecho. In Spanish, as an adverb, the term when translated to English means straight, upright, or directly. Or if used in a sentence, Derechos could mean a straight path, as in â€Å"The children walked straightly to the room† But as a noun, the term is no longer used to describe a direction, but rather it refers to the â€Å"right† of a person. Erichsen, Gerald, a Spanish Language Guide (n.d.), explains that the word, when used as a noun would mean another thing and not specific to direction, but more on the rights of a person such as morals, customs, principles, or according to law. The word can also come in a plural form such as â€Å"derechos†, or derechas. So if one would refer to human rights, it is correct to call it â€Å"derechos humanos† for human rights’. When â€Å"derecha† is used, Er ichsen said it connotes political affinity, such as opposite of the â€Å"left† political party, or ‘right wing’. Vernor Munoz Villalobos, UN Special Rapporteur on the right to education (2010) used the term â€Å"derecho humano† on her paper to describe a human right to have an education.(UN General Assembly, New York, 2010) . The word has a clearer meaning when used as an adjective because it is specific such as right, opposite of left, straight or upward or in brief, it gives a specific direction, like â€Å"linea derecha†, that means straight line. In news reporting, El Derecho is used as a super storm prediction and a criterion for severe wind gusts. It is a word coined by the NOAA-NWS-N CEP Storm Prediction Center that describes â€Å"derecho† as a long-lived wind storm that is associated with a band of rapidly moving showers or thunderstorms. This could be related to my above description of the word because of the straight damage direc ted in one direction. Thus the Storm Prediction Center calls it a ‘a straight-line wind damage’ or Derecho (John, Roberts, et. al. 2012). The word Derecho was created by a physics professor in Iowa University in 1888. Reportedly, it was said he chose this term to describe a thunderstorm-induced straight line winds as an analog to tornado. The Center so far has used the word to classify storm according to its behavior and damaging winds. It has also become an important word used in meteorological forecasting. As such, â€Å"derecho’ has been an adapted term for storm news reporting, like D.C. Derecho, Maryland Derecho, Derecho Storm, etc.(Debonis, Mike. 29 June 2012); the Intense storms called Derecho as reported by Accuweather.com, July 2, 2012 (author not mentioned) and a rare Derecho storm reported by Aron Harris of ABC news, July 2, 2012 As to usage to signify a â€Å"right†, the United Nations used the word â€Å"Derecho al Desarollo† to mark t he 25th Anniversary of Declaration to the Right to Development (Naciones Unidas) The usage of the word is limitless and some even used the word to name organizations, title, etc. Take for example, the international partners of Catholic for Choice in Latin America, a Catholic Organization that has named their organization as â€Å"Catolicas por El Derecho a Decidir (CCD) in Latin America†( Catholics for Choice n.d.). I will not discuss here the purpose of the organization since it is beyond the scope of my topic. A Spanish newspaper for European press has adapted the name El Derecho for its publication because it is mainly concerned on the legality and rights of people (El

Generally Accepted Accounting Principles Paper Essay

Generally Accepted Accounting Principles Paper - Essay Example The accounting Principles are accounting standards that should be implemented, without exception. The United States Generally Accepted Accounting Principles indicate how to record the entity’s assets, liabilities, capital, revenues, expenses, costs, and profits in the financial reports. The entity includes the healthcare facilities. There are organizations that are tasked with implementing the United States generally accepted accounting principles (Kieso, 2011). The United States Securities and Exchange Commission (SEC) contributes to more understandable United States Generally Accepted Accounting Principles (GAAP). The American Institute of Certified Public Accountants (AICPA) plays a major role in the successful implementation of the same principles. United States Financial Accounting Standard Board (FASB) contributes a vital part in the propagation and discussion of the complex United States Generally Accepted Accounting Principles. In terms of assets, the United States hea lth care facilities must implement all rules in terms of recording the fair amount of assets during the related accounting period (Glencoe, 2008). The assets include what the United States health care facilities own. ... The United States health care facilities’ own buildings and lots form part of the company’s assets. Next, United States generally accepted accounting principles includes recording all United States health care facilities’ liabilities. The liabilities include short term and long term liabilities. The short term liabilities are the accounts payable and the notes payable amounts. The long term liabilities include the bank loans and other loans where the final payment occurs after the company’s accounting period expires. Furthermore, United States health care facilities’ United States generally accepted accounting principles include recording all stockholder equity or capital accounts (Horngren, 2009). The stockholders equity accounts include the cash and noncash contributions of the current and future investors. The stockholders equity total is reduced by the company’s net losses. The stockholders’ equity amount is increased by the compan y’s net profits that are generated within one accounting period. The United States health care facilities’ United States generally accepted accounting principles includes recording the fair amount of revenues within the related accounting period (Glencoe, 2008). The United States health care facilities must record the amounts equal to the United States health care facilities’ patient services. The healthcare services include the medical operations, medical examinations such as stool exam, vital statistics exams, medical operations, and medical doctors’ medical consultation services. The United States health care facilities’ United States generally accepted accounting principles include recording all the

Rising Oil Prices and the Scottish business Essay - 7

Rising Oil Prices and the Scottish business - Essay Example Scotland has a very rich history, and it has played a significant role in bringing in enlightenment to the United Kingdom as modern economics was born from the lush green meadows of Scotland. Over the period of time, Scottish businesses have developed their core competencies and reached to a point where they are significantly contributing towards the economy of the country. An analysis of the Scottish business industry would suggest that it is dominated by heavy industry such as shipbuilding, coal mining and steel industries. This stratification of the industry within the Scottish economy suggest that it is heavily reliant on much larger industries involved mostly into Business 2 Business kind of business transactions therefore key economic variables such as rising prices hardly have the impact on them.  A recent history of oil prices suggests that they are on increasing constantly due to various factors. Many analysts believed that rising demand from China and other emerging marke ts such as Brazil, Russia, and India created a strong increase in prices of oil all over the world. Besides, there are different seasonal patterns in production as well as consumption of oil, therefore, the oil prices tend to increase due to these seasonal patterns as well as strong demand from emerging markets. (IMF).  Further, there is a growing increase into the production of alternative energy sources such as ethanol which is selling at high prices, therefore, the oil prices in the market are also going to replicate that process because alternative products are selling at higher prices. Further, the depreciation of the dollar against major currencies such as the Euro is also considered as one of the major factors behind the increase in oil prices.  These rising oil prices, however, are being considered as a good omen for the Scottish business due to different reasons. The following section will discuss whether rising oil prices are good for Scottish businesses.

Quality management in the education sector Assignment

Quality management in the education sector - Assignment Example It is a methodology of complete quality control that relies on developed metrics and organisational techniques to achieve better quality in a variety of organisational dimensions and departmental divisions (Assadej and Igel 2009). Quality management is the achievement of mutual cooperation of all members of the organisation and the connected processes and procedures needed to produce quality outputs and services which exceed expectations of customers or other related stakeholders (Evans and Lindsay 2005; Dale 1999). It is a holistic organisational philosophy that manages to combine organisation teamwork with a quality management system, using a variety of qualitative and quantitative measurement instruments to improve processes (Creswell 2003), leadership, control costs, increase the organisation’s competitive position, motivate employees, and increase organisational responsiveness in a variety of activities. Having defined quality management and total quality management procedures and ideologies, quality management strategies can be applied to the educational sector in order to improve areas such as team-working, organisational behaviour, leadership and maintain a customer orientation to achieve competitive advantage. In the educational sector, academics are a form of learning that includes improvement of individual student knowledge, skills and competencies that are able to be transferred generationally through a variety of tactics that include training, teaching and even research (Hanushek and Woessmann 2008). Outside of merely teaching quality and the provision of life-long learning, in the university sector, the goal of universities are to improve revenues, enhance the competitive positioning amongst other higher education centres in a market, and ensure top quality professionalism throughout all aspects of the teaching process. In order to accomplish the aforementioned objectives, it is necessary to implement a

Where does government spending go Essay Example | Topics and Well Written Essays - 1000 words

Where does government spending go - Essay Example It is also important to note that often the overall expenditure made by the government on its purchase of goods and services exceeds the revenue generated by the government through taxes. As such government tend to borrow either from the international or domestic market in order to fill short fall or deficit arising in its budget. US government spent its revenues on major goods and services which it renders including the defense services, infrastructure development, salaries of the government employees as well as other heads under which the overall revenue or budget of the country is spent. Almost 54% of the revenue earned by the government is spent on the military related activities whereas 46% of the revenue is spent on the non-military related expenditure. The recent surge in the military related expenditure has mostly been associated with the new military activities conducted by US government in Afghanistan and Iraq. The current budget proposed by the Obama administration show a complete breakdown of how the overall budget will be spent on different activities of the government. The government has also proposed different budget cuts in order to improve the situation of its finances. (Harris). The overall public debt in US still more than $14.2trillion dollars suggesting that the government may be borrowing heavily in order to finance its activities. This paper will trace as to where the government money is spent and why US faces such huge debt of $14.2 trillions. How government money is spent? The recent budget proposed by the Obama administration shows how the government money will be spent under different heads1. A critical analysis of the data would suggest following: National Defense 2011 proposed budget is $3.69 trillions out of which $738 billions will be spent on the national defense which is mostly related with the military related expenditure. The money spent on the national defense however, is further broke down into different sub-headings such as operations and maintenance, military personnel, procurement, research and development, military construction, energy as well as family housing and other benefits to the military personnel. This composition of the spending suggests that most of the spending on the national defense is made in terms of operations and maintenance. Social Security The second largest chunk on which government money is spent is social security services provided by the government. Under social security, most of the money is spent on the old age and survivors insurance whereas the rest of the money is spent on the disability insurance. Income Security Another important source where most of the money is spent by the government is providing income security to the citizens. Under this head, money is spent on the unemployment insurance, food stamps, child tax credit, supplemental security income, military retirement, unemployment insurance, rental income support, child nutrition and various other heads. Income security therefore serves as an income stabilizing factor for the citizens with the help of government. Health and Education Another important source on which the government spends money is health and education sector under which State offer both these basic services. Under the health and education, government offers grants to the States for health facilities as well as the health services are offered to the retired employees, funding to National Institute of Health, children health insurance program as well as other expenditure is made. Under the head of education, government offers assistance in terms of student scholarships, support for the disadvantaged, elementary and vocational training, training and employment services as well as other services which are offered by the governmen

Topic 2 Eco Essay Example | Topics and Well Written Essays - 500 words

Topic 2 Eco - Essay Example This notwithstanding, another concern that continues to be raised by experts in the field has to do with the cost associated with the use of these tools, where there continues to be debate as to whether or not these state-of-the-art screening and diagnostic tools would not lead to an increase in the rate of growth of healthcare expenditure. Taking a stand on the issue, it would be said that there are two broad financial impacts of the current situation on the rate of growth of healthcare expenditure. These are short term impact and long term impact. Short term impact of the use of state-of-the-art screening and diagnostic tools refers to the financial outcomes of using these tools from the time the spending is made to the next financial seasons when financial season when budgets are prepared. What is noted is that most health facilities purchase these tools not as part of their daily consumables but as lifetime purchases. This means that when they buy them once, they hardly buy them again in a very long time. The prices of these tools are however very high. In the short term when the health facilities would have to made huge financial allocations to make purchases, it can be said that the impact on expenditure will be massive in terms of growth. This is because the current healthcare budget is already plagued with very high demand from the need to achieving quality healthcare delivery (Henderson, 2012). Greater parts of the budgets of health facilities have tried to focus on human resource development in the past and even thoug h this form of spending has not ceased, there has been this new form of spending. The other form of impact is the long term effect of this form of spending, which looks at the results that the screening and diagnostic tools will have on healthcare delivery after about a year of their usage. From this context, it can be said that the usage of these tools promotes quality healthcare delivery, greater part of which focuses on

Collision of the right to privacy and the right to freedom of Essay

Collision of the right to privacy and the right to freedom of expression - Essay Example The verdict of the cases, whether they were in compliance with the Human Rights Act, has been made. A discussion of the European Convention and the acts adopted by the Convention has also been made. An evaluation of the prior laws that helped to mould the Human Rights in Europe is also analyzed in the paper. Human Rights are the set of guidelines laid down by legal bodies and organizations that safeguards the rights and freedoms of human beings. The elementary rights and freedoms, which every human being irrespective of cast creed social stature; are entitled to can be collectively termed as Human Rights. Human Rights include civil rights, freedom of expression, political rights, and also equality before a court of law for uniform generation of justice. Civil, economic, cultural, social and political are the various classification of Human Rights. However, Human Rights, although are made for social benefits are not social rights. Social rights are more like objectives which need to be attained, while Human Rights are objectives or norms which are to be followed. Human Rights are laws which need to be obeyed to maintain the social, cultural and legal balance. The different classification of Human Rights is a contribution to it, as it covers all necessary aspects, which needs to be covered for the well being of the civilians. . The history of human rights can be traced back to thousands of years covering cultural, political, legal and religious aspects. Emperor Ashoka of India issued the 'Edicts of Ashoka' back in 250-270 BC, which is a collection of thirty three inscriptions on pillars, made by the emperor. The edicts, being the first form of Buddhist preaching, were moral in nature and were based on doing basic good deeds. The Magna Carta, formerly known as the English Legal Charter was written in Latin and was issued in 1215. It is one of the important historical examples that developed the English law, to protect the rights of the people against monarchial rule. It influenced the development of constitutional laws and common laws. The British Bill of Rights, 1689 was an act that protected the interest of the people against government actions in the United Kingdom. The Geneva Conventions, and the Lieber Code, 1864 can be described as the initiations that laid the basic foundations of International Humani tarian laws. International Humanitarian laws The Geneva Convention adopted by the International Committee of Red Cross was one of the first attempts to safeguard the interest of individuals fighting in wars. It was revised after the World War II and adopted by the Red Cross Community in 1949. Presently the Geneva Conventions are referred to as the Humanitarian law, under the governance of International Committee of Red Cross. The Universal Declaration of Human Rights (UDHR) was adopted by the United Nations General Assembly in 1948. This is a non binding declaration that was adopted after the World War II. The UDHR may be referred to in any national and international cases, and is considered to be a central component of international humanitarian law. (United Nations, 2008) Human Rights Treaties The International Covenant on Economic, Social and Cultural Rights (ICESCR) and The International Covenant on Civil and Political Rights (ICCPR) were the two most important treaties that were

Opinions on Stereotypes Essay Example for Free

Opinions on Stereotypes Essay Webster’s Dictionary defines the word â€Å"stereotype† as a simplified and standardized conception or image of a person, group, etc. , held in common by members of a group. (1265) Many people create stereotypes of an entire group of people based off a single person. There are several different stereotypes that exist amongst society today in many different forms. Most churches and religious affiliated organizations condemn homosexuality which causes less gays to be open about their faith. This brings upon the stereotype that the gay community is not religious at all. This, however, has been proven false. According to Dan Giloff’s article, â€Å"While 72 percent of straight American adults describe their faith as ‘very important’ in their lives, so do 60 percent of gays and lesbians. †(par. 3), the gay community has plenty of religious affiliates now; The United Church of Christ now ordains ministers. Other religious groups are following in their footsteps, making moves to open their doors to the gay community. The people of the gay community are stereotyped heavily in society. Gay men are said to be obsessed with fashion, have great style, have a caddy attitude with very strong opinions, a love for dogs and are destined to be hairdressers, stylists, Broadway dancers, or fashion designers. Lesbians have plenty as well, such as: they move fast in relationships, dress manly, work in some kind of construction field, wear flannel, and hate men. These are all huge generalizations. Although gay men and lesbians may fall under some of these categories, not all do. People have too many factors that make up their identity, so it is unfair to set a certain list of characteristics to them. One of the most common stereotypes is gender stereotyping, which can be limiting to men and women in the world today. Throughout the years there have been plenty of stereotypes placed on women. One being that the woman should always be in the house cooking, cleaning, and tending to their spouses with no complaints. The culture of today has cultivated an image of women, saying that they are outspoken and have strong opinions about anything, that they spend all your money, that they are extremely demanding, and do nothing but gossip and shop endlessly. Women have worked towards breaking this stereotype by taking a stand over many decades and actually making many breakthroughs. Although that is a big stereotype involving women, there is research that shows women are â€Å"typically categorized in 3 primary clusters: traditional (e. g. homemaker), nontraditional (e. g. career woman) and sexy. † (Psychology of women quarterly). In an article from Psychology of Women Quarterly, scientists did research showing that career women held jobs in higher status while the sexier women held more appeal for the lower status, more feminine occupations. A sexier dressed woman showed to invoke negative emotion while also making people think incompetence was inevitable. Where as a more career based woman showed to be looked at as more of a leader figure that was prepared to take care of business at any cost. While Women are stereotyped to be a homemaker or a career woman, men too have sterotypes. Men have been stereotyped as being stupid and sex-obsessed people only worried about the next sports game; or weathly businessmen who cheat on their wives constantly with the closest woman in his office. Contrary to most women’s belief, there are plenty of men who are hardworking businessmen who have happy and loving home lives. Men live above this stereotype all the time. The blonde has two sides, the positive side where blondes are considered to be alluring and desirable. Then there is the negative side, where they are perceived as not being too intelligent and don’t use their common sense to figure out things; they rather rely on their looks than their intelligence. The hair color is often associated with â€Å"floosies†, â€Å"airheads†, or â€Å"ditzy† women. This is a very broad stereotype because there are many smart and successful blond women in society amongst the governments, school systems, and many other places. According to Harriet Brown, â€Å"In landmark 2003 research from the University of Pennsylvania, more than half of the 620 primary-care doctors surveyed characterized their obese patients as ‘awkward,’ ‘unattractive,’ ‘ugly,’ and ‘noncompliant‘ the latter meaning that they wouldnt follow recommendations. More than one-third of the physicians regarded obese individuals as ‘weak willed,’ ‘sloppy,’ and ‘lazy. ’† (par. 3). The stereotypes placed upon obese people usually falls under the words the doctors stated in the study from the article. Most people over look that it could be a medical condition causing such weight gain in obese people. They see the weight and automatically assume that it was a choice based upon laziness and lack of drive. People do not look beyond what they see, which creates plenty of false accusations. While there are many lifestyles that are stereotyped, such as, people assume if your gay; you must have aids, if your atheist; you must hate the world, if you have no religion; you must not have any morals, etc. One in particular is if you’re a biker you like to party hard, have tattoos and are a criminal. However, as much as people who ride motorcycles love the smell of fresh air and the open road, different riding styles are associated with different lifestyles and are completely diverse Racial stereotypes are in abundance in today’s world as well as throughout history. Most associate themselves with racist thoughts. Asians must be smart, Arabs must be terrorists, Irish must have drinking problems, Italians must be in the Mafia, Germans must be Nazi’s, African Americans must be in gangs, whites must be nerds, etc. These stereotypes can be wrong and hurtful in many situations. One public incident from any person of any race can create a stereotype. Society places people they don’t know much about or they don’t understand into classifications, thinking that people who look like them will act the same. Media plays a role in creating all of these stereotypes although people play the biggest role in creating them. It is human nature to notice the difference between themselves and others before the similarities. Media is still held responsible for a lot of the creation because not only does it use pictures of a generalized group to show how a person may look, but media also uses stereotypes as comedic entertainment on popular shows and movies. The romantic movies of today ,as well as in the past, depict very heavily the gender stereotypes placed upon men and women. They always show the â€Å"knight in shining armor who saves the damsel in distress† story, the men always sticking to their â€Å"typical† man stereotype and the women always to theirs. Media does influence our views and thoughts about people and does encourage generalizations about certain classifications of people. People to this day still fight with being held under heavy stereotyping. Society places an immense amount of merit on these loose generalizations. This sadly makes it hard for a lot of the people who do not fall under them and do break free from these stereotypes. While there is some truth to a lot of stereotypes, people need to understand one person cannot define an entire group of people. Whether a stereotype is negative or positive, they both exist and are limiting and leave no room for individuality. Works Cited Brown, Harriet. Does Your Doctor Make You Feel FAT? Prevention 63. 7 (2011): 26-33. Academic Search Premier. Web. 11 Nov. 2011. Gilgoff, Dan. Fighting the Gay-As-Godless Stereotype. U. S. News Digital Weekly 1. 23 (2009): 12. Academic Search Premier. Web. 10 Nov. 2011. Heather Branstiter, et al. Evaluations of Sexy Women in Low- And High-Status Jobs. Psychology of Women Quarterly 29. 4 (2005): 389-395. Academic Search Premier. Web. 11 Nov. 2011.

David M’Naughten Essay Example for Free

David M’Naughten Essay David M’Naughten hails from Scotland. He earn his living by being a wood cutter. He hardly can make both ends meet and develop hatred to the Prime Minister of Great Britain in the year 1843. To M’Naughten, the Prime Minister was the cause of his personal and financial sufferings due to the failure of the former to run the British government well. In an attempt to get even with the Prime Minister, M’Naughten attempted to kill the leader. M’Naughten was not successful because his ploy was thwarted by the secretary of the Prime Minister and instead killed the secretary and afterwards attempted to murder the Prime Minister. During the trial, nine witnesses testified that M’Naughten was an insane and the jury acquitted him, finding him â€Å" not guilty by reason of insanity † ( pbs. org. n. d. The Right/Wrong M’Naughten Test†. Paragraph 1) Reporter Bill Mears of CNN Washington in 2006 reported â€Å"There was little doubt that Eric Clark, then 17, shot and killed a police officer six years ago in Flagstaff, Arizona. And prosecutors and defense attorneys agreed that the killer had some degree of mental illness he was a diagnosed paranoid schizophrenic who believed he was being constantly watched by aliens from outer space†. â€Å"Teen shot and killed police officer he thought was an alien†, 1st paragraph). Eric Clark believe that the police who accosted him was an alien from outer space who came here to get him, and so, Eric shot and killed him. Eric was found guilty of first degree murder three years after the fatal shooting. Eric defense lawyers entered a plea of not guilty due to insanity. It took three years of deliberation by Arizona court whether Erick will be jailed or sent to mental rehabilitation center while serving the sentence. The court Arizona court ruled Eric to languish in jail for life. Based from the two court decisions just mentioned, it appears that there is sort of disagreement among the different U. S. legal courts as to the legal definition of insanity and its acceptance as legal defense in court. This essay will trace the development of insanity as legal defense from its origin up to what it is in today’s legal battle. Evolution of insanity defense As early as 1581, insanity defense has been well considered in Anglo-American law and a legal treatise was enacted saying that â€Å"If a madman or a natural fool, or a lunatic in the time of his unacy do [kill a man], this is no felonious act for they cannot be said to have any understanding will â€Å" ( pbs. org. n. d. â€Å"A Brief History of Insanity Defense†, paragraph 3 ). There was no available record of court proceeding from the date of treatise enactment up to 17th century. Three hundred years later, the British court elaborated the treatise and gave rise to the â€Å"wild beast test† ( 4th paragraph ) which emphasized that â€Å"If a defendant was so bereft of sanity that he understood the ramifications of his behavior no more than in an infant, a brute, or a wild beast, he would not be eld responsible for his crimes ( 4th paragraph). In other words, if the defendant lacks sanity and cannot comprehend the outcome of what he did, as his ( defendant) mind is that of infant or a wild animal, then the defendant is not liable for the crime committed. The codification of this British â€Å" wild beast test† was put at stake in 1843, in the case of David M’Naughten as outlined in our introduction. Queen Victoria was not impressed with the decision of the court and requested a review of the case with a panel of judges. The resulting decision was â€Å"that a defendant should not be eld responsible for his actions if he could not tell that his actions were wrong at the time he committed them â€Å" (The Right/Wrong M’Naughten Test†. Paragraph 3). This was also mentioned in the research of Chiacchia ( 2001) and law. jrank org. n. d. ) This became the basis of the insanity defense in England and adopted by American courts and legislatures for more than 100 years without any modification. Up to 1998, 25 states including the District of Columbia adopted this Right/Wrong M’Naughten Test†. According to legal critics, the M’Naughten test has one major rawback. While the rule focus on the ability to distinguish right from wrong (which is cognitive in nature), it failed to consider the unstoppable desire that was the dominant feeling before and during the consummation of the crime. This resulted to modification of the M’Naughten rule by adding a provision called irresistible impulse ( â€Å"Irresistible impulse†, 1st paragraph). The added provision in effect will absolve a defendant who can distinguish between right and wrong but unable to stop the crime due to his uncontrollable desire to consummate it to get even with the victim. A number of tates adopted the M’Naughten modification and coined another name as â€Å" policemen in the elbow test† (1st paragraph). The name clearly highlight the intense desire to consummate the crime as even if there is police authority around to witness, the defendant will do it. In 1950, advances in psychiatry and psychology as a science was very noticeable. In the light of the advances, legal critics saw the M’Naughten rule as too rigid and antiquated. In 1954, an appellate court discarded the M’Naughten and â€Å" irresistible impulse â€Å" test in favor of a more scientific and medically based insanity test. This became the basis of the Durnham â€Å" Mental Defect† rule. In Durnham v. United States, The U. S. Court of Appeals of the District of Columbia ruled that a defendant is not guilty † if his unlawful act was the product of mental disease or mental defect. (â€Å" The rise and fall of the Durnham â€Å"Mental Defect† rule, 1st paragraph). The decision was considered as within the demand of the times and a major breakthrough in American legal system as it exemplify the replacement of moral considerations with a more neutral and scientific evidences reflective of the advances of psychiatry and psychology ( â€Å" The rise and fall of the Durnham Mental Defect† rule). Legal experts claim that the Durnham rule is vague and difficult to apply. According to the experts, the term â€Å"mental defect† is very broad and they were concerned that due to its vagueness, more and more defendants will be acquitted than before. The confusion arises over the interpretation of â€Å" mental disease or defect† clause. Will mental defect mean only psychosis or any of the minor mental disorder found in Diagnostic and Statistical Manual of Mental Disorder (DSM). Critics were concerned of the possibility that defendants will use alcoholism and other ental disorder with antisocial behavioral symptoms as defense of their crimes. Also, it is not clear where the burden of proof is; that is whether it’s up for the court to determine the mental defect or the burden lies with the defendant and the psychiatrist as professional witness. Another disagreement is that the Durham test inadvertently grant too much influence to the psychiatrist and psychologist as to the result of the court trial. Twenty two states rejected the Durham test in 1972 and a panel of judges considered the Model Penal Code Test of the American Law Institute ( A. L. I. as eplacement (pbs. org. n. d. ). The A. L. I. standard is intended to soften the M’Naughten with the â€Å"irresistible impulse† by introduction of medical and psychiatric evidence requirement. The A. L. I. standard, rule â€Å"that a defendant will not be held criminally responsible if at the time of the behavior in question as a result of a mental disease or defect, he lacks substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law. (pbs. org. n. d.  A Brief History of Insanity Defense, â€Å"The A. L. I. Standard†, 1st paragraph). In ddition to requiring the defendant to show proof that at the time of the consummation of the crime, there is absolutely no understanding as to the nature of the act ( as in M’Naughten test), a certification from a psychiatrist or psychologist is needed to attest to the fact that the defendant lack â€Å" substantial capacity† ( paragraph 2, line 4 ) to understand the right f rom wrong together with the irresistible impulse consideration. Under the A. L. I. tandard, the act of serial killers whose mental defect manifests only during the act of killing and shows normal mental behavior before and after he consummation of the act can lead to his/her conviction. In 1998, 22 states used the A. L. I. rule while 26 used the M’Naughten version regardless of the irresistible impulse clause. It is also provided in the A. L. I. standard, the provision for due process and equal protection concerns for those who were acquitted by reason of insanity for automatic and indefinite confinement to assess and treat their mental disorder and check their dangerousness potential to society periodically. If found during the evaluation that further confinement is no longer needed, then the defendant can be eleased. By early 1980’s all state legislatures except for 10 has reformed their laws incorporating the provision for periodic review. In 1981, a test for stability of the A. L. I. standard ensued. John Hinckley, Jr. , a Washington police officer and secret service agent shot then U. S. President Ronald Reagan and his press secretary James Brady. Hinckley claimed during the trial the following: that he was trying to impress the actress Jodie Foster, with whom he was infatuated. He later described the incident in a letter to The New York Times as the greatest love offering in the history of the world. At one time Miss Foster was a star and I was the insignificant fan. Now everything is changed. I am Napoleon and she is Josephine. I am Romeo and she is Juliet (pbs. org. n. d. A Brief History of Insanity Defense, â€Å"After Hinckley† , 1st paragraph). Hinckley was acquitted by the jury of 13 assault, murder and weapon counts and moreover, ruling him not guilty by reason of insanity. This resulted to a great American public uproar that call for thorough review of the insanity defense strategy and plugging loopholes in the justice system that allows an obviously guilty man to escape punishment. Senator Dan Quayle claimed that the insanity efense allowed pampering of criminals by allowing them to kill without conscience. The psychiatric and legal professional group called for the modification instead of total abolition of the insanity defense resulting to legislation called â€Å" The Insanity Defense Reform Act of 1984† ( 3rd paragraph). The act is a stricter version of the M’Naughten rule. The Cornell University Law School in 2006 released the following information related to a more stricter version ( article 17, Insanity defense, U. S. Code Collection, 1st paragraph) (a) Affirmative Defense. — It is an affirmative defense to a prosecution under any Federal statute that, at the time of the commission of the acts constituting the offense, the defendant, as a result of a severe mental disease or defect, was unable to appreciate the nature and quality or the wrongfulness of his acts. Mental disease or defect does not otherwise constitute a defense. (b) Burden of Proof. — The defendant has the burden of proving the defense of insanity by clear and convincing evidence The burden of proof now is with the defendant and not with the prosecution. The defendant in order to qualify for the insanity defense must show proof that the disorder is severe. The volitional test that excused a defendant who lacked the capacity to fight the â€Å" irresistible impulse† was eliminated, in effect going back to the M’Naughten â€Å" right/wrong â€Å" standard of the 19th century. The influence of psychiatric testimony was effectively limited and more stricter procedure on hospitalization and release of those acquitted was put into effect. Thirty states adopted â€Å"The Insanity Defense Reform Act of 1984 † while the three states of Montana, Utah and Idaho abolished completely the insanity defense strategy. In the year 2000, a provision to â€Å"The Insanity Defense Reform Act of 1984 † was enacted nd 20 states instituted it. The provision is called â€Å" Guilty But Mentally Ill â€Å" or GBRI ( Chiacchia. 2006. Insanity defense, â€Å" Guilty but mentally ill†, 1st paragraph, line 2. ). Under the GBRI, the defendant can be sentenced guilty although he is legally insane. The convicted will be jailed and his mental illness will be checked by the government periodically. The criticism of GBRI lies on the fact that very few jail institution can actually look at the mental state of the convicted insane. Examining the success of using the insanity defense in this modern time, Chiacchia ( 2001 ) eported ( â€Å" Insanity defense statistics, 2nd paragraph) that: Successful NGRI defenses are rare. While rates vary from state to state, on average less than one defendant in 100-0. 85 percent-actually raises the insanity defense nationwide. Interestingly, states with higher rates of NGRI defenses tend to have lower success rates for NGRI defenses; the percentage of all defendants found NGRI is fairly constant, at around 0. 26 percent It shows from the statistics that the chances of acquittal using the insanity defense is very slim, considering that practically every loop hole in the American jurisprudence has been effectively ealed with the adoption of â€Å"Guilty But Mentally Ill† provision. Summary and Conclusion It is now a known fact that the insanity defense dates back in 17th century in Great Britain with the acquittal of David M’Naughten. The M’Naughten Right/Wrong Test underwent five modifications from 17th century up to the present time. A number of celebrated cases involving rich families and big political figures as victims in the past three centuries resulted to acquittal of the defendants in the light of the different legal interpretation of insanity defense among states. The acquittal of John Hinckley, Jr. who shot then U.  S. President Reagan and killed his press secretary in 1981 was the strong force that caused widespread public clamor for reviewing and unification of interpretation of the insanity defense strategy. At present, all states except for three ( Montana, Utah and Idaho which scrapped the insanity defense in its entirety) enacted the M’Naughten rule with modifications centered on the burden of insanity proof on the defendant. Twenty states enacted â€Å"The Insanity Defense Reform Act of 1984 † with provision for Guilty But Mentally Ill, shutting the loopholes.

Corporate Financial Analysis Of Pfizer Finance Essay

Corporate Financial Analysis Of Pfizer Finance Essay Pfizer, is the worlds largest research-based pharmaceutical company, founded in 1849. The company is headquartered in Midtown Manhattan, New York, with its research headquarters in Groton, Connecticut. Ian Read is the president and CEO of Pfizer. And other important officers are these following people. (Table 1) The Company manages its operations through five segments: Primary Care; Specialty Care and Oncology; Established Products and Emerging Markets; Animal Health and Consumer Healthcare, and Nutrition. The Companys diversified global healthcare portfolio includes human and animal biologic, small molecule medicines and vaccines, as well as nutritional and consumer healthcare products. Pfizer produces many house hold famous medicine like Lipitor, Viagra and Celebrex. Pfizer has 103,700 employees and in No. 81 of Carbon Disclosure Rating. And here are some important data. (Table 2)In the highly competitive pharmaceutical industry, Pfizer has these main competitors: Ankur Drugs and Pharma Ltd. and Bayer. 1.2 Analyst Coverage 1.2.1 Analyst Opinion This table (1.1) shows the analyst opinion to recommendation trends. We can see strong buy and buy both have a high score while the other three have a very low score. It suggests that investors to buy this stock but do not suggest long-term hold. 1.2. 2 Analyst Estimate Here these two tables show the analyst estimate on Pfizer. They are just a part of the analyst estimate. Earnings history (1.2) shows that the difference between EPS Estimate and EPS actual is very small. So the estimate was quite accurate. 1.2.3 Price Target Summary The recent stock price of PFE is about $22.56. This price is a little lower than the price target in table (1.3). It does not mean it is not good. At least this price is higher than its low target. Pfizers stock is not bad and still have chance to perform better. 1.3 Analysis of Pfizers financial statements 1.3.1 Balance Sheet Analysis In general, the total amount of the assets of Pfizer decreased from 212.949 million (in 2009) to 188.002 million (in 2011). This may because Pfizer wanted to give up unattractive investments and focused on its innovation core. Total liabilities decreased continuously. It indicates Pfizers ability of repayment of debt was not bad. Current liabilities decreased 1.98% from 2010 to 2011 and 23.1% from 2009 to 2010. Changes of total liabilities were similar. On stockholders equity, its total number also decreased as the result of its decrease of total assets. Due to the decrease in total assets, the stockholders equity decreased 6.4% from 2011 to 2010 and 2.4% from 2010 to 2009. (Graph 1) We can calculate Debt-Equity Ratio, Current Ratio, and Quick Ratio in 3 years. (Table 3) As we can see from the table 1, Pfizers financial situation in 2011 was not bad. 1.3.2 Income Statement Analysis In 2011, total revenue was 67.425 million, a 0.54% increase over 2010 and a 36.85% increase over 2009. Operating income in 2011 was 12.762 million and net income was 10.009 million, both of them increased. Gross profit was not very obvious but we can find a sharp increase from 2009 to 2010. (Graph 2) In 2011, ratio of gross profit and total revenue was 77.63%. Operating expenses of total revenue proportion in three years were around 60%. It shows Pfizers ability of controlling in operating expenses was better in 2010 and 2009. (Table 4) Graph 3 shows that changes in gross margin, operating margin, net profit margin, ROA and ROE. The companys operating conditions were very stable. (Graph 3) 1.3.3 Cash Flow Analysis Here is a table shows that three years cash flows of three kinds of activities. (Table 3) In 2009, cash flows from operating activities were 16.587 million and in 2010. If investing activities cant bring enough money to make up cash outflows, cash flows from investing activities would be negative. In 2011, Pfizers cash flows from investing activities were 2.2 million. Pfizers investments were effective and they created a positive cash flow and can create profit. (Table 4) Generally speaking, the larger the cash flows from financing activities the more pressure of debt the company will be faced with. We can see in 2010 and 2011, Pfizers was under huge pressure. All in all, Pfizer has a good financial situation. 1.4 Summary of Pfizers Challenges 2011 was generally a good year for Pfizer, Inc. Revenues increased 1%, Net income also had significant gains. However, the company still faces diverse challenges from many aspects, which can have a long term impact on Pfizers performance. U.S. Healthcare Legislation Enacted Since 2010 It brought two negative influences: 1. A $648 million reduction to Revenues, related to higher, extended and expanded rebate provisions and the Medicare coverage gap discount provision. 2. An extra $248 million expense in informational, sales and administrative, related to the fee payable charged by the federal government. Loss of Expiration of Intellectual Property Rights It can be an adverse factor and decline total revenues. When the patent protection has expired, Pfizer loses exclusivity on these products and generic pharmaceutical manufacturers can produce similar products and sell them for a lower price. Problems in Productivity and Regulatory Environment Pfizer devoted significant resources to research and development; these activities involve a high risk and may take many years to transfer research achievements into products. Besides, there is no assurance that the development of any particular product will achieve desired clinical success, be approved by regulators and commercially. If Pfizer failed, sunk costs lost, which can be a huge loss. 1.4.4 Pfizer is Under Pressures of Pricing and Access Governments, healthcare organizations and other payer groups implement price controls and require price cuts in order to pay less in purchasing Pfizers products. There were government regulated price reductions for certain products beginning in 2011. Whats more, health insurance and social welfare plans continue to limit access to some of Pfizers medicines by setting restrictions in the increased use of generics. 1.4.5 Challenges from Poor Macroeconomic Environment We believe that with high unemployment rate and increases in co-pays, patients tend to buy generics, delay treatments, skip doses or use less effective treatments to reduce costs. During 2011, portions of the revenues are exposed to fluctuations in foreign exchange rate. Pfizer need to seek appropriate management in foreign exchange rate risk as it operates in multiple foreign currencies 2. Stock Price Analysis 2.1 Track Pfizers Stock Price in the Last 3 Years 2.1.1 2009(Graph 4) We can find that the stock price continued going down from Jan. to Mar. However, it went up until the end of the year. Stock price in Mar is the lowest all the year and the stock price at the beginning of the year and the end of the year are almost the highest. The highest is nearly $19, and the lowest is less than $12. 2.1.2 2010(Graph 5) The chart show us that the stock price in 2010. Generally speaking, the stock price went down from Jan to Jul. We can see the stock price in Jul is the lowest number throughout the year, and it was 14.14 dollars per unit. After Jul, the stock price gradually rose. But between Aug and Sep, the stock price experienced a decline within a narrow range. This circumstance also happened between Nov and Dec. The highest price occurred in Jan, and it was 20.00 dollars per unit. 2.1.3 2011(Graph 6) It seems that the chart of 2011 was a little complex. From Jan to Jun the general momentum of the stock price was up though a few small declines. From Jun to Aug, the number experienced a decline by a large margin after Aug, the statistics generally rose up though some declines. The highest price was 21.83 dollar per unit in Dec, and the lowest price was in Aug, and the number was 16.66 dollar per unit. 2.2 Calculate Stock Price of the Company To calculate the stock price of the company, I will use the formula EPSÃÆ'-P/E=P. EPS=NI/ SO. I will calculate the stock price of the company in 2012. (Graph 7) 1. Highest and lowest PE Ratio in 2009 are 14.79 and 11.45, so the average ratio is 13.12. 2. The 2 ratios in 2010 are 23.52 and 13.58, so the average is 18.55. 3. The 2 ratios in 2011 are 19.34 and 12.28, so the average ratio is 15.81. (Graph 8) The EPS in 2009, 2010 and 2011 are 1.235, 1.205, 1.255. According to P=EPSÃÆ'-P/E, stock price in 2009, 2010, 2011 are 16.20 ¼Ã…’22.35 ¼Ã…’19.84. 2.3 Assessment of the Current Stock Price According to the Income statement, PFE has earnings per share of 1.27, the average P/E is $17.81, estimate a value of PFE using P/E as a valuation multiple. Thus, P=$1.27*17.80=$22.6060B It assumes that PFE will have similar future risk. Assuming NVS is comparable to PFE in term of its underlying business NVS has earnings per share of $3.55, the average P/E is $15.39, under the same assumption, P=$3.55*15.39=$54.6345B. Compare to the two major competitors, PFE share price is relatively low. According to Income Statement, PFE has EBITDA of $27.56B and has an enterprise value to EBITDA multiple of $6.71, shares outstanding of 7.54B and debt of $38.96B Enterprise value would be V=$27.56B*6.71=$184.9276, estimate PFEs share price: P=(184.9276-38.96)/7.54=$19.2361. As this estimation is based on enterprise value, it is more reliable than the first one. It is overvalued obviously when its stock price being $22.66 per share. Similarly, NVS has EBITDA of $17.05, enterprise value to EBITDA multiple of 8.81, shares outstanding of $2.42 and debt of $24.59. NVS share price would be: P=(17.05*8.81-24.59)/2.42=$51.9093 As Comparables only provide information regarding the value of a firm relative to other firms in the comparison set, using multiples will not help us determine if an entire industry is overvalued. According to the research, PFE share price is much less than NVS, I would suggest that PFE is relatively less deserving investment. According to the Balance Sheet, dividend paid is $6.234. , it is easy to get the dividend paid annually: Div=$6.234/7.54=$0.8268 The share price is $22.66, suppose investors hope the constant dividend growth model would based on a 4% growth rate, we would estimate a stock price of P=0.8268/(0.4811-0.04)=$1.8744 We can calculate the growth rate: g=r-Div/P=0.4811-o.8268/22.66=1.16%. Investors would feel disappointed if invest in PFE as the growth rate is relative lower than he/her expectations. 2.4 Value of Pfizers Stock Price Compared with Competitors From statistics online, we can know that the 52week range of Pfizer is 16.63-23.3, Roches is 115.1-169.2, and Eli Lilys is 33.75-42.03. Obviously, the stock price of Roche changes the most, the changed absolute amount of 54.1. A risk lover may prefer this kind of stock because it can change by a larger scale, and if we can seek this opportunity well, huge profits can be achieved. Compared with Roche, Pfizer stock has a large advantage. The change scope of Pfizer stock is not big, which indicates that it is relatively stable, and a risk-averse may prefer this kind stock. The perceived benefit of any gain is outweighed by the perceived cost of an equivalent loss. Most people are risk-averse, so Pfizer stock has an excellent competitive advantage and suitable to hold for a long time. Besides, to compare the value of the stock price, analyzing the P/E ratio is the most traditional method. Pfizer earned $1.24 per share last year and the stock is trading at 22.38, so the stock has a P/E ratio of approximately 18.05-to-1.Similarly, the P/E ratio of Roche is 15.04, the P/E ratio of Eli Lily and Company is 10.7. Generally, the lower the P/E ratio, the better value the stock represents. Thus, in this case Pfizer is less competitive than his competitor, Roche and Eli Lily and Company. 2.5 Beta of Pfizer and Comparison with Its Competitors The beta of Pfizer is 0.64, the beta of Roche is 0.66, and the beta of Eli Lily and Company is 0.37. Beta is a risk index, can be used to measure fluctuation of one stock price relative to the whole stock market. The bigger the absolute amount, the larger the change of profit .The stock of Pfizer and its competitors, Roche and Eli Lily and Company, all can be regarded as low risk stocks. 3. Summary 3.1 Major Developments of Pfizer during 1Q of 2012 During the 1st quarter of 2012, Pfizers revenues were $15.4 billion, a decline of 7% compared with $16.5 billion in the year-ago quarter and the unfavorable impact of foreign exchange of $57 million, or less than 1%. Established products unit revenues increased 17% in comparison with prior year period, obviously driven by recent launches of generic versions of some products. Revenues of Lipitor were $383 million, which made a great contribution to the company. In addition, revenues were positively influenced by the entry of multi-source generic competition in the U.S. Emerging markets unit revenues grew 9% due to continued demand growth in China, Russia and Mexico. In animal health unit, revenues increased 6%, primarily due to the purchase of King Pharmaceuticals. Nutrition unit revenues gained 8%, created by making benefits from the launch of successful new products, increased marketing activities and overall strength in emerging markets, especially China. Pfizers first-quarter 2012 financial performance is pleased; however, it still faces fierce competition from other companies. Pfizer need to focus its problems in exclusivity and financial management. 3.2 Summary of All We Have Learnt About Pfizer Pfizer is better than others. It could be name recognition, innovation, market share or any other attributes that makes a company stand out from the herd. From what has been discussed, we may draw the conclusion that there are three ideas to contribute the success of Pfizer. Innovation creates success and being innovative in your business is one of the keys to being successful. Innovation is the introduction of new processes, new ways of doing things and revolutionizing how things have been accomplished previously. The most surprising thing is Pfizer cannot research an influential drug independently in the past 10 years of 20 century. Although it invested huge amount of money in R D, it seems more like a marketing company. Throughout Pfizers development in recent years, its success can be summed up that use the advantage of large-scale and well-capitalized to strengthen the ability in value chain in marketing. Through buying mature technology, products and combination new companies, building alliance with competitors to consolidate its market share. Giving full play to the enthusiasm of its medical representatives, integrating the advantages of its marketing network, and enhancing core competitiveness, thus achieve a leading position in the industry. In conclusion, Pfizer is a rare example of successful combination of R D and marketing strategies in international pharmaceutical companies. 3.3 Should We Buy Pfizers Stock or Not Pfizer has a good ability in finance, improved control in operation. For big investors, I would recommend Pfizer, which requires low risk, stable growing dividends, and long term return. Despite Pfizer stock price is relative lower than its competitors, big investors can gain large amount of cash by purchasing large amount of shares. However, I will not recommend Pfizer to retail investors. It would not be wise to invest in a company which may take years to transfer research investments into product profits. Higher return indicates higher risk; it would be too risky for retail investors to take the gamble. Quick money never stays too long. Appendices Table 1: Table 2: Table 3: 2011 2010 2009 Debt-Equity Ratio 0.563 0.550 0.577 Current Ratio 2.057 2.131 1.657 Quick Ratio 1.780 1.842 1.323 Table 4: 2011 2010 2009 Operating activities 20,240,000 11,454,000 16,587,000 Investing activities 2,200,000 (492,000) (31,272,000) Financing activities (20,607,000) (11,174,000) 14,481,000 Graph 1: Graph 2: Graph 3: Graph 4: Graph 5: Graph 6: Graph 7: Graph 8: Tables: (1.1) (1.2) (1.3)