Paper assignment 3# Essay Example | Topics and Well Written Essays - 500 words

Paper assignment 3# - Essay Example The setting of the novel is in New York which is a diverse community with people from different class division, races and nationalities. Corrigan is placed amidst all the types of people in New York and undertakes the role of helping and playing guardian for them even for those who are not part of his faith. As a young man, the readers are introduced to a child who would sneak out at night just to be able to help and spend time with the drugs addicts, homeless and the prostitutes. After the death of his mother, he is compelled to leave Ireland due to his devotion to help those who are suffering and moves to New York following the 9/11 attack. Both his physical and spiritual labor are directed towards helping those in different types of difficulties. Corrigan finds excellence in difficulty and suffering of people through despair and trauma, McCann says, ‘So you force yourself into a position of difficulty, because it seems to me that we have forgotten†¦ But there’s s omething really beautiful in the notion of difficulty.’ By being an Irish catholic, Corrigan has also been used a representation of the theme of religion. As a central personality in New York, his vocation has been used to show the act of redemption for the church even after going through many challenges and scandals. His religious role is used in the narrative to reconcile God and the reality of New York streets. As such, Corrigan is placed in a setting of the everyday life filled with tragedies and horrors in the streets of New York yet, he is expected to come out after defeating evil. As such, although he may go through darkness and end up bruised and damaged, the light at the end of the tunnel will make God more believable to the people he is interacting with. Religion and hope are themes which are intertwined in order to draw people closer to God. Corrigan gives hope to the people affected by different social evils

Type II Diabetes in African Americans Essay Example for Free

Type II Diabetes in African Americans Essay Introduction                                                    The 1986 report of the Secretarys Task Force on Black and Minority Health called notice to the upsetting excess morbidity as well as mortality from chronic illnesses for instance non-insulin-dependent diabetes mellitus (NIDDM), cancer, and heart disease that exists in minorities in the United States. Besides the added disease burden, restricted research in the area of minority health has exacerbated the problem in the African-American population by reducing the knowledge essential for understanding the contributing factors plus planning effective intervention strategies. Diabetes mellitus, one of the diseases targeted for augmented investigate focus among minorities, carries on to have overwhelming consequences on the African American population. It is anticipated that about 1.8 million African Americans are affected with the disease (Report of the Secretarys Task Force on Black and Minority Health, 1985). Furthermore, the occurrence and mortality from diabetes are almost double as high among African Americans as in the U.S. White population (CDC, 1990). Consequently, there remains a critical need for research intended to explain the aspects contributing to the augmented diabetes-related morbidity as well as mortality in this ethnic group. Biomedical definition and Epidemiology of Diabetes Mellitus Diabetes mellitus is a heterogenous group of disorders that are typified by an abnormal augment in the level of blood glucose. It is a chronic disorder of carbohydrate metabolism ensuing from inadequate production of insulin or from insufficient utilization of this hormone by the bodys cells (Professional Guide to Diseases 1998:849). Diabetes mellitus takes place in 4 forms classified by etiology: Type I (insulin-dependent), Type II (noninsulin-dependent), other special types (genetic disorder or exposure to certain drugs in chemicals), as well as gestational diabetes (occurs during pregnancy). http://etd.fcla.edu/SF/SFE0000527/AfricanAmericanWomen.pdf When studies are performed to evaluate the epidemiology and public health impact of diabetes mellitus on the African-American population, non-insulin-dependent diabetes mellitus (NIDDM) plus insulin-dependent diabetes mellitus (IDDM) are most frequently considered. Though, further forms of glucose intolerance have as well been studied, together with impaired glucose tolerance (IGT), gestational diabetes (GDM), and other atypical diabetes syndromes. Categorization of these diabetes subtypes is usually footed on standards published by the National Diabetes Data Group (NDDG) (1979) and the World Health Organization (WHO) (1980). The analysis of diabetes is recognized by a finding of fasting plasma glucose (FBS) value greater than 140 mg/dl or a value of 200 mg/dl 2 hours after a 75-gram glucose challenge on the oral glucose tolerance test (OGGT). Non-Insulin-Dependent Diabetes Mellitus The initial estimates, footed on national samples, of the incidence of diabetes in African Americans came from data collected on male World War II registrants age eighteen to forty-five, which recommended that the occurrence of diabetes was greater in White than Black males (Marble, 1949). Since these data were collected over age ranges with a prevalence of distribution toward younger age, where diabetes rates may mainly reveal insulin-dependent diabetes mellitus, they may not offer a factual picture of the occurrence of NIDDM in the races at that time. More current and dependable data from the National Center for Health Statistics point out that, in the United States, the occurrence of known diabetes is higher among African Americans than White Americans mainly among individuals age forty-five to sixty-four, when the rate for Blacks is 50.6 percent higher (Harris, 1990). The occurrence of diabetes augments with age for U.S. Black adults and is about 1.2 times higher for females (Harris, 1990). Among African Americans, the occurrence of diabetes is inversely associated to educational achievement and is highest among individuals in the low income group. Insulin-Dependent Diabetes Mellitus The occurrence of insulin-dependent diabetes mellitus pursues a different racial prototype from that of NIDDM: White children have approximately twice the rate of Black children. (Lipman, 1991). Across the United States, there is much greater inconsistency in the occurrence of IDDM for African-American children than White children. It is probable the variability in IDDM incidence among African-American children might consequence from variations in degree of White admixture in the different registry locations. There is proof that White admixture differs by geographic region in the United States with greater admixture in northern areas than in the south. This is reliable with the drift for more European-American genetic admixture in Allegheny County, Pennsylvania, where the occurrence of IDDM in African Americans is higher, than in Jefferson County, Alabama (Reitnauer et al., 1982) and the incidence of IDDM is lower. Atypical Diabetes Atypical diabetic syndromes, typified by normoglycemic reduction with ensuing periods of hyperglycemic deterioration, generally needing insulin for glycemic control, have been explained in African-American and further Black populations. Winter et al. (1987), accounted an atypical diabetes in young African Americans that shows with features typical of IDDM however lacks the HLA association’s trait of the disease. The insulin dependence in this syndrome was irregular or steadily declined all through the course of the illness. Diabetic syndromes presenting in adulthood with alike phasic insulin dependence have as well been reported. Whereas further forms of diabetes together with protein deficient pancreatic diabetes and fibrocalculus pancreatic diabetes take place in some Black African populations, so far they have not been revealed to be important for African Americans. Type I diabetes reports for three percent of all new cases of diabetes diagnosed every year in the United States. Type I can build up at any age, thus far the majority cases are diagnosed when the individual is under thirty. Type II, the more widespread form of the disease, normally has a steady start, generally appearing in adults over the age of forty (Managing Your Diabetes 1991). It has an effect on an estimated ninety percent of the six million Americans diagnosed with diabetes yearly. The probability of developing Type II is about the same by sex however is greater in African Americans, Hispanics, and Native Americans. Main risk factors comprise a family history of diabetes, obesity, being age forty or over, hypertension, gestational diabetes, or having one or more infants weighing more than 9 pounds at birth (Professional Guide to Diseases 1998). Diabetes mellitus is a main clinical as well as public health problem in the African American community. African American men have an occurrence of diabetes that is eighty percent higher than that for European American men, whereas African American women have occurrence ninety percent higher than that for European American women (Herman et al. 1998:147). These diabetes statistics point out that not merely are there characteristic differences between African Americans and European Americans in the occurrence and hospitalization rates related with diabetes however as well that research is required to find out if any other factors, for instance social and cultural, may be causative to the large difference of diabetes-related problems (Bailey 2000). Cultural Perceptions of Diabetes Mellitus In a study to find out differences in self-reported adherence to a dietary routine, Fitzgerald et al. (1997) analyzed one hundred and seventy-eight African American and European American patients at a Michigan suburban endocrinology clinic from 1993 to 1994. They establish that the 2 groups of patients with non insulin-dependent diabetes (NIDDM) reported similar adherence to dietary recommendations; similar on the whole adherence, beliefs, plus attitudes as calculated by their diabetes care profile scale; and a similar percentage of ideal body weight (Fitzgerald et al. 1997:46). Further analyses, though, exposed that African Americans and European Americans differed in the opinion of diabetes and the view of adherence to the dietary routine for diabetes. Fitzgerald et al. (1997) speculated that among African American women the inspiration to lose weight frequently is not for health reasons however for improved look. The significance of weight loss to ones diabetic condition is de-emphasized, and more significance is placed upon losing weight for better look. If weight loss does not take place, then unconstructive beliefs and attitudes may reduce the individuals inspiration and endorse a â€Å"why bother† attitude, in that way causing nonadherence to the dietary regimen for diabetes (Fitzgerald et al. 1997:46). To work against this â€Å"why bother† attitude as it affects weight loss and dietary adherence, Fitzgerald et al. (1997) recommended that health educators require to assist patients distinguish their feelings regarding diabetes, recognize the habits that their feelings influence their behaviors, and build up tactics for managing with their feelings. The cultural/social functions of food and what food â€Å"means† plus â€Å"represents† to the individual must be measured when developing meal plans and educational interventions for the African American diabetic patient. So as to study more of the fundamental cultural health beliefs related with diabetes mellitus, Maillet et al. (1996) carried out a focus group of African American women with NIDDM and those endangered for this disease. Six African American women susceptible for noninsulin-dependent diabetes mellitus contributed in the northeastern urban medical university in a tranquil and relaxed classroom. The main themes that appeared from the focus groups were the significance of family and social support, a tendency to binge or overindulge when food limitations were placed by family members, difficulties with dietary changes, incapability to build up an exercise program due to multiple barriers, lack of clarity regarding diabetes complications, value for however lack of knowledge regarding prevention of complications, as well as a need for future programs that are ethnically responsive to African American women (Maillet et al. 1996:44). Additionally, a constant theme of this focus group was that family support or a lack of support had an impact on ones stated capability to make dietary alterations. Particularly, Maillet et al. recommended that older African American women discover it hard to make dietary changes for the reason that altering their diet disturbs a lifetime of culture within the context of family. Culture may directly manipulate diabetes education and have to be understood and included into intervention programs to persuade success (Maillet et al. 1996:45). Consequently, when providing care to African American women of all ages, Maillet et al. recommended that the primary health care providers have to be sensitive to the role that culture plays in diet, weight loss, plus diabetes self-management. By means of qualitative and quantitative data collection techniques to examine health beliefs and health care-seeking outlines of African American and Euro-American diabetics, the fieldwork project was performed in 2 phases at the diabetes clinic in the Regenstrief Health Center at Indiana University, Indianapolis. The qualitative phase 1 occurred from June to August 1991, and the quantitative phase 2 from June to December 1992 (Bailey 2000:178). From 9 total site visits over the 5 months, the following noteworthy themes come into view regarding the African American diabetic patient: Appraise the source of the patients diabetes; Effort to dispel any delusions of diabetes; Make active the patient for self-care of diabetes; Carry on to reeducate the patient on blood glucose monitoring as well as insulin injection; and Hearten social and familial support for devotion to diabetic regimen.   Besides, other qualitative results pointed out that physicians required to (1) recognize the sociocultural restraints of a patients keeping appointments; (2) regulate the dietary alteration of the patient to his or her lifestyle and cultural dietary pattern; (3) build up more permanence of care; (4) find out new skills to build up understanding and trust with patients; and (5) give emphasis to the significance of the diabetic condition to the patient (Bailey 2000:182).   Phase 2 (Bailey 2000) consisted of performing qualitative and quantitative observations and interviews of African American and Euro-American diabetic patients. For instance, during the six-month period of phase 2, African American patients shared the following comments:   Patient Informant #1 (African American female): Im not sure what caused my diabetes. I know that there is a family connection to diabetes and my weight has something to do with it, but I dont take all of it too seriously. www.ecu.edu/cs-dhs/ah/upload/Bailey.ppt When asked to assess her capability to pursue the doctors set diabetic dietary regimen, patient informant #1 stated:   My sons and husband want their meals the way they normally have it. They dont want no unseasoned meals, so what am I supposed to do? www.ecu.edu/cs-dhs/ah/upload/Bailey.ppt Patient Informant #2 (African American female): I was on those diabetic pills, but I had to be placed on insulin injections. I hate taking these injections, but I have to do it. www.ecu.edu/cs-dhs/ah/upload/Bailey.ppt   Fascinatingly, patient informant #2 was placed on diabetic pills and told to watch her diet years ago. Though, she stopped taking the pills on a regular basis and did not stick to the diabetic diet routine. Now that she is on insulin injections and closely adhering to the diabetes dietary routine, her insulin injections have slowly been reduced.   Patient Informant #3 (African American male): I was really not shocked when I was diagnosed with diabetes simply because my father and aunt have diabetes and I knew it was a matter of time before I would develop it. www.ecu.edu/cs-dhs/ah/upload/Bailey.ppt   Diabetes is widespread among African Americans and this is because of dietary eating pattern—fried foods and not sufficient vegetables.   Even though patient informant #3 thought that it was a matter of time before he would build up diabetes, he is still unsure of the procedure and the reasons why he developed Type II diabetes. He came to the clinic merely to discover what was wrong with his stomach. To his shock, he was diagnosed with Type II diabetes. The qualitative findings that tend to be more related with the African American diabetic patients than with the Euro-American diabetic patients were as follows: The doubt of the real source of ones diabetes; The lack of perceived importance of ones diabetic condition; The perceived incapability to stick to the diabetic routine; The lower ranking of ones health as compared to other social and family obligations. These qualitative outcomes pointed out that numerous sociocultural issues still require to be further examined in the African American diabetic population (Bailey 2000:184).   Lastly, the former president of the National Medical Association, Yvonnecris Smith Veal (1996), utters that there are three fundamental causes why diabetes carries on to plague the African American community. First, there is the way of life and behavioral patterns related with African Americans for example poor eating habits, obesity, restricted access to enough medical care, and restricted funds. African Americans generally tend to eat foods high in calories and loaded with saturated fats and sugar and to have an inactive lifestyle—all of which are causative factors to being overweight. Second, African Americans have a history of making foods with lard and other heavy oils. This sort of food preparation, together with the incapability to get a balanced diet, contributes to the risk factors related with diabetes. Third, African Americans require more choices to decide dietary diabetic routines that fit the preferences for certain foods plus eating practices among all segments of the African American population (Bailey 2000).   Factors Influencing the Occurrence of Diabetes in African Americans Significant factors influencing the incidence of diabetes mellitus in African Americans comprise personal characteristics for instance genetics, age, sex, plus history of glucose intolerance (IGT, GDM). Further routine factors for instance physical activity plus obesity, which are related with altering socioeconomic as well as cultural climates within countries, to a great extent have an effect on the risk of developing the disease. Even though the exact etiological interactions remain arguable, it is definite that a mixture of most of these factors is accountable for precipitating the disease. Genetics An individuals risk of developing diabetes mellitus is significantly influenced by his/her hereditary background. Individuals who are first-degree relatives of diabetes patients are at noticeable augmented risk of developing the disease compared to unrelated individuals in the general population. (W.H.O. Multinational, 1991). Proof from studies of identical twins specifies a concordance rate of about ninety percent for NIDDM and fifty percent for IDDM, representing that the influence of genetics is greater in the former than in the latter (Barnett, Eff, Leslie Pyke, 1981). The investigation for the hereditary reasons that rates of diabetes fluctuate in different ethnic groups has caused hypotheses that try to report for the observed frequencies of NIDDM and IDDM in African Americans. (Tuomilehto, Tuomilehto- Wolf , Zimmet, Alberti Keen, 1992) Thrifty Gene Hypothesis Neel (1962) recommended that populations exposed to intermittent food shortage would through natural selection augment the incidence of genetic traits, thrifty genes, that incline to energy conservation. These genes would augment survival during times of famine by permitting for adept storage of fat in times of abundance. In the absence of feast and famine cycles, in times of continued profusion, these genes would turn out to be detrimental, predisposing to the growth of obesity and an augmented frequency of NIDDM. This hypothesis would be constant with the observation of much higher rates of diabetes and obesity among African Americans and urban Africans compared to Black Africans residing in conventional environments. Age and Sex In the majority populations the occurrence of diabetes differs with age and sex. For African Americans, the peak age range for diagnosis of IDDM is about fifteen to nineteen years of age, whereas NIDDM occurs more often after age fifty-six, when it is 3 times more common than in the White population (Roseman, 1985). African-American females are more probable to build up IDDM compared to Black men are more probable to develop NIDDM than Black men, White women, and White men, correspondingly (Harris, 1990). The sex discrepancy for IDDM may be because of differences in vulnerability or experience to etiologic agents (Dahlquist et al., 1985). Differences in NIDDM by gender may be because of differences in the levels of related risk factors such as obesity plus physical activity.   Socioeconomic Status (SES) Racial differences in disease rates may reveal socioeconomic differences. In the United States socioeconomic status and the frequency of NIDDM have a converse relationship. The impact of SES on NIDDM rates among African Americans may be particularly strong. Studies concerning socioeconomic status to the development of IDDM have been contradictory. Some studies establish a positive relationship. Others have found a negative (Colle et al., 1984) or no relationship at all. It appears improbable that socioeconomic status contributes considerably to racial differences in the frequency of IDDM in the United States. Obesity Obesity, usually measured as body-mass index (BMI)), is the most important risk factor for NIDDM. Overweight is a severe problem for the African-American female, with the level of obesity (that is BMI 27.3) being greater than fifty percent among women older than age forty-five (Van Itallie, 1985). Compared to White women, African-American women are more overweight. African-American men demonstrate a similar prototype of obesity when compared to White men (Van Italie, 1985).   The development of NIDDM is not merely influenced by the presence of obesity however as well by where the body fat is distributed. The danger of developing NIDDM is greater for individuals with central or android obesity. African Americans have been accounted to have a greater propensity to store more fat in the trunk than Whites, which could clarify part of the excess occurrence of NIDDM in the Black population (Kumanyika, 1988). Physical Activity There is proof that physical inactivity is an independent danger factor for developing NIDDM (Taylor et al., 1984). On the other hand, exercise perhaps a strong defensive factor against the development of the disease. On the whole there is a converse association between levels of obesity and physical activity. Consequently, higher levels of obesity among U.S. Blacks compared to Whites propose that reduced levels of physical activity among African Americans may donate to their higher rate of diabetes. Insulin Resistance The danger of developing NIDDM is absolutely related with fasting levels of circulating insulin. It has been revealed that insulin resistance, typified by hyperinsulinemia, can predate the development of NIDDM for years. besides diabetes, insulin resistance causes numerous interrelated disorders together with hypertension, body fat mass and distribution, as well as serum lipid abnormalities (Ferrannini , Haffner, Mitchell Stern, 1991). This has encouraged speculation that hyperinsulinemia and/or insulin resistance may be the phenotypic expression of the thrifty genotype anticipated by Neel (1962). Impaired Glucose Tolerance (IGT) and Gestational Diabetes Impaired glucose tolerance (IGT) and gestational diabetes mellitus (GDM) are 2 types of glucose intolerance that are strong risk factors for developing NIDDM and IDDM. Gestational diabetes denotes the development of diabetes during pregnancy and a subsequent return to normal tolerance following parturition, whereas IGT is the class of glucose tolerance where fasting glucose values are between normal and diabetic. (OSullivan Mahan, 1968). The risk of developing obvious diabetes among individuals with IGT is associated to the severity of impaired tolerance plus presence of further risk factors, together with a positive family history of diabetes and obesity (Harris, 1989). Numerous risk factors for GDM have been recognized among African-American women, including age, gravidity, hypertension, obesity, plus family history of diabetes (Roseman et al., 1991).   Diabetes Mortality At present, diabetes mellitus is the 3rd most recurrent cause of death from disease among African Americans. Higher rates of diabetes mortality in African Americans compared to the White population may partly be because of their higher occurrence of diabetes. When mortality among individuals who have developed diabetes is measured, though, it emerges that African Americans have a lower mortality rate than Whites with the disease (Harris, 1990). In recent years, there has been a leveling off in the rate of mortality from diabetes for both races.   Diabetic Complications Chronic diabetes mellitus is related with numerous overwhelming complications that reduce the quality of life and cause early mortality. These comprise hypertension, diabetic retinopathy, neuropathy, nephropathy, as well as macrovascular complications.   In the United States, African Americans with diabetes have higher rates of hypertension than Whites. The constancy of high rates of hypertension among African Americans and Afro-Caribbean populations (Grell, 1983) has caused the proposition that Western Hemisphere Blacks are offspring of a highly selected group of Africans who were efficient at retaining salt, which permitted them to uphold sodium homeostasis and survive the long sea voyages from Africa (Grim, 1988). Recent proof proposes that high rates of hypertension among African Americans might be associated to hyperinsulinemia plus abnormal renal sodium transport (Douglas, 1990). Information on the incidence and impact of other diabetes-associated complications are limited. Though, retinopathy, neuropathy, and stroke emerge to be more recurrent in African Americans than Whites with diabetes (Roseman, 1985). The rate of lower limit amputations ensuing from diabetes has been reported to be considerably greater among U.S. Blacks than Whites. Occurrence rates of diabetic end-stage renal disease (ESRD) have been revealed to be greater for African Americans than for Whites. After developing ESRD though, U.S. Blacks emerge to survive longer than Whites. There is as well some implication that certain cardiovascular complications including angina and heart attack may take place less often among African Americans than among Whites with diabetes (Harris, 1990).   It has been recommended that the on the whole higher rates of diabetes complications among African Americans might be associated to poorer metabolic control. Additionally, the high rate of hypertension among African Americans with diabetes may make worse or make haste the start of other complications for example retinopathy and nephropathy. Other significant risk factors for diabetes complications comprise age of onset, education, cigarette smoking, socioeconomic status, plus access to medical care (Roseman, 1985).   Prevention and Intervention Strategies The main metabolic defect of type 2 diabetes is insulin resistance in association with a relative and progressive deficiency in insulin secretion. This insulin resistance, present in many tissues, makes its primary contribution to hyperglycemia by reducing peripheral glucose uptake in muscle and failing to suppress hepatic glucose output. Additionally, resistance in adipose tissue to insulin-mediated suppression of lipolysis results in an elevation of free fatty acids (FFAs) and a further aggravation of hyper-glycemia. The degree of insulin resistance observed in diabetic subjects may vary according to a subjects ethnic background, body mass index (BMI), and physical activity. Pharmacologic intervention with either metformin, a biguanide, or a thiazolidinedione (TZD) has been successful in reducing insulin resistance in subjects with type 2 diabetes. In the management of the majority forms of diabetes, there is a need to be concerned concerning the acute complications of hypoglycemia and ketoacidosis and/or development of acute hyperosmolar crises. Hypoglycemia, a major treatment concern in type 1 diabetes, is much less frequent with type 2 diabetes and is discussed later in association with specific therapies. Although DKA and hyperosmolar crises have been reported in children with type 2 diabetes, they are uncommon, in our experience after initial presentation, but such crises have been reported. About 10-15% of children and adolescents with type 2 diabetes present at diagnosis with DKA, hyperosmolar crisis, or a combination of these states. The long-term goals in the management of type 2 diabetes are twofold: first, the prevention of microvascular complications, including retinopathy, nephropathy, and neuropathy; secondly, the prevention of macrovascular complications such as atherosclerosis of the coronary, cerebral, and large arteries of the lower extremities. These lead to myocardial infarction, stroke, and amputation, and are the major causes of morbidity and mortality with type 2 diabetes. The development of these complications is multifactorial, but is influenced by associated hypertension, dyslipidemia, and hyperinsulinemia in addition to the effects of hyperglycemia. The aim of therapy in type 2 diabetes is to specifically target the underlying metabolic defects of this disorder, which are obesity, abnormal insulin secretory function, and the insulin resistance present in the three primary insulin responsive tissues skeletal muscle, fat, and liver. The first approach is to reduce obesity through lifestyle interventions in diet and exercise. In addition, the introduction of an ÃŽ ±-glucosidase inhibitor may be considered to delay carbohydrate digestion and absorption, reducing peak postprandial hyperglycemia. A second therapeutic approach is to address insulin secretory dysfunction with insulin secretagogues such as sulfonylureas or meglitinides. Alternatively, or if these secretagogues are ineffective, exogenous insulin can be initiated. A third approach is to address tissue-specific insulin resistance. Metformin can decrease hepatic glucose output and improve peripheral insulin sensitivity. Thiazolidinediones have been successful in improving peripheral insulin resistance in type 2 diabetes in adults; however, experience with these therapeutic agents is limited in children. At present, diabetes mellitus remains a serious problem tackling the African Americans population. High diabetes mortality rates reflect merely part of the problem. The viewpoint of increasing diabetes occurrence rates casts a threatening shadow over the future for the African Americans community. The morbidity related with diabetic complications places a great financial burden on individuals and communities least able to bear the cost of such an illness. Evidently, the challenge of addressing the problem of diabetes mellitus in the African Americans population is great and will need a multidisciplinary approach involving government, researchers, educators, as well as members of the African Americans community. Health Promotion Of main importance is the requirement for distribution of information regarding diabetes and its consequences into the African-American community. An uneducated African-American community may be inclined to undervalue the diabetes problem or to pay less attention to the signs and symptoms of its commencement. This may outcome in late diagnosis or care, thus raising the probability of rapid start of complications. Consequently, ethnically sensitive strategies intended to get involved and educate African Americans on the subject of the behavioral and environmental risk factors for diabetes plus its complications are necessary. Undoubtedly, in order for African Americans to take steps to lessen the diabetes linked morbidity and mortality in their communities they have to have the capability to make informed decisions regarding the disease. Cooperative Efforts for Provision of Health Services Rates of diabetes mortality and complications may depend on the accessibility and permanence of care. There is some sign that African Americans with diabetes may be underserved regarding medical care (Harris, 1990). Cautious study of this problem is needed, and innovative solutions have to be developed. The African-American community must as well become empowered to expect and demand the essential care they deserve. To have an effect on such change, community based institutions, for instance the church, can build up programs for using the health professionals within their congregations to offer care or therapy to diabetics and their families. Organizations concerned with minorities, for instance the UrbanLeague, can comprise diabetes and further health problems in their national agendas to generate concern and act at the community and national levels.   Governmental agencies and institutions engaged in training health professionals, for example medical schools and schools of public health, must institute action to augment the pool of African Americans in the professions concerned with the care of individuals with diabetes. Federal agencies, for instance the National Institutes of Health, may as well offer special grant programs to hearten submission of research grants to study diabetes in African Americans and to improve the growth of minority researchers in the area.   Research The inadequate data presently accessible on diabetes among African Americans raise numerous questions however deliver few answers regarding the etiology and natural history of diabetes plus its complications in this racial group. Up to now, a small number of studies of diabetes in the United States have included representative samples of African Americans. This inadequacy has to be addressed if future studies are to give way valid conclusions concerning the factors accountable for the incidence of the disease in the African-American population. In the Report of the Secretarys Task Force on Black and Minority Health (1985), numerous research priority areas for addressing the health disparity between Black and White Americans were recognized. These areas are mainly pertinent to diabetes mellitus and comprise the following: (1) investigation into risk-factor recognition, (2) investigation into risk-factor occurrence, (3) investigate into health education intrusions, (4) investigation into prevention services interventions, (5) investigation into treatment services, as well as (6) investigation into sociocultural factors and health outcomes. The recognition of these target areas for investigation and other recent efforts by the Department of Health and Human Services to endorse the study of diabetes in the African-American population (Sullivan, 1990) are significant steps toward addressing the gap in awareness of how diabetes have an effect on African Americans. In the future we have to translate the knowledge achieved from new and continuing studies into efficient preventive action.    References:   Bailey, Eric (2000). Medical Anthropology and Africans American Health. Westport, CT: Bergin Garvey. Centers for Disease Control (CDC). (1990). Diabetes surveillance: Annual 1990 report. U.S. Department of Health and Human Services, Centers for Disease Control, Division of Diabetes Translation, Atlanta GA Colle E., Siemiatycki J., West R., Belmonte M. M., Crepeau M. P., Poirier R., Wilkins J. (1984). Incidence of juvenile onset diabetes in Montrealdemonstration of ethnic differences and socioeconomic class differences. Journal of Chronic Disease, 34, 611-616. Dahlquist G., Blom L., Holgren G., Hogglof B., Larsson Y., Sterky G., Wall S . (1985). The epidemiology of diabetes in Swedish children 0-14 years: A six year prospective study. Diabetologia, 28, 802-808. Douglas J. G. (1990). Hypertension and diabetes in blacks. 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Obesity in black women. Epidemiology Review, 9, 31-50. Lipman T. H. (1991). The epidemiology of Type I diabetes in children 0-14 years of age in Philadelphia. Doctoral dissertation, University of Pennsylvania, Pennsylvania. Report of the Secretarys Task Force on Black and Minority Health. ( 1985). Volume 1: Executive Summary. DHHS Publication No. 017-090-00078. Washington, DC: Government Printing Office. Maillet, Nancy, G. Melkus, and G. Spollett (1996). â€Å"Using Focus Groups to Characterize the Health Beliefs and Practices of Black Women with Non-Insulin Dependent Diabetes.† The Diabetes Educator 22: 39-46. Marble A. (1949). Diabetes mellitus in the U.S. Army in World War II. The Military Surgeon, 105, 357-363. National Diabetes Data Group (NDDG). (1979). Classification and diagnosis of diabetes mellitus and other categories of glucose intolerance. Diabetes, 26, 1039-1057. Neel J. V. (1962). Diabetes mellitusA thrifty genotype rendered detrimental by progress? American Journal of Human Genetics, 14, 353-362.   OSullivan J. B., Mahan C. M. (1968). Prospective study of 352 young patients with chemical diabetes. New England Journal of Medicine, 278, 1038-1041. Professional Guide to Diseases (1998). Springhouse, PA: Springhouse. Reitnauer P. J., Go R. C. P., Acton R. T., Murphy C. C., Budowle B., Barger B. O. , Roseman J. M. ( 1982). Evidence of genetic admixture as a determinant in the occurrence of insulin-dependent diabetes mellitus. Diabetes, 31, 532-537. Roseman J. M., Go R. C. P., Perkins L. L., Barger B. D., Beel D. A., Goldenberg R. L. , DuBard M. B., Huddlestone J. F., Sedacek C. M., Acton R. T. ( 1991). Gestational diabetes among Africans American women. Diabetes and Metabolism Review, 7, 93-104. Sullivan L. (1990). Opening remarks. Diabetes Care, 13 (Supp. 4), 1143. Taylor R., Ram P., Zimmet P., Raper R., Ringrose H. ( 1984). Physical activity and the prevalence of diabetes in Melanesian and Indian men in Fiji. Diabetologia, 27, 578-582. Tull E. S., LaPorte R. E., Vergona R. E., Gower I., Makame M. H. ( 1992). A two-fold excess mortality among Africans American IDDM cases compared withWhites: The Diabetes Epidemiology Research International experience Van T. B. Itallie (1985). Health implications of overweight and obesity in the United States. Annals of Internal Medicine, 103, 983-988. Veal, Yvonnecris (1996). â€Å"Africans Americans and Diabetes: Reasons, Rationale, and Research.† Journal of the National Medical Association 88: 203-204. WHO Multinational Project for Childhood Diabetes. (1991). Familial insulin-dependent diabetes mellitus (IDDM) epidemiology: Standardization of data for the DIAMOND Project. World Health Organization Bulletin OMS, 69, 767-777. Winter W. E., Maclaren N. K., Riley W. J., Clarke D. W., Kappy S., Spillar R. P . (1987). Maturity-onset diabetes of youth in black Americans. New England Journal of Medicine, 316, 285-291. World Health Organization. (1980). Report of expert committee on diabetes mellitus. Technical Report, Series no. 646. Geneva: World Health Organization. http://etd.fcla.edu/SF/SFE0000527/AfricanAmericanWomen.pdf www.ecu.edu/cs-dhs/ah/upload/Bailey.ppt

Leadership and time management skills.

Leadership and time management skills. Leadership is defined as the to make people understand to gain certain course, and also the leader must follow the same power of mind. Leader ship is not an authority of an organization but its a strange strength personality which attracts the ordinary person. Personal and professional skills for a successful Manager/Leader:- Time Management Running meetings Making presentation Stress Management Time management :- It is consider as one of the most important skill under the mangers requirement. A proverb has been said Once the time has gone it never comes again. In this fast moving world time is precious and its been consider as money so time should be utilize in a proper way. The main features of the time management are to organize the work in a proper way and in a proper time, handling the meeting in a specific time period, to utilize the free time. In this business world everyone is concerned about the time management to achieve their success. The time frame which is available in this world for each person is 24 hours. Thus it is not possible for every individual to achieve their goal in the specific time period if its not been managed properly. Components of Time Management are as follow:- The leader/manager should set their priorities as per the time frame and should try to achieve their goal in a specific time with proper monitoring and feedback. Prioritize goal according to their importance. An time log of daily/weekly basis should be made to utilize time effectively Leader/Manger should give motivate and should give guidance to their staff to develop and to achieve goals. Running meetings :- Meeting lead to achieve the goal effectively probably meeting can be successful one or unsuccessful one. While running the meeting all the features are been consider so that the meeting will not be unsuccessful one. The agenda of the meeting should be clear. In which the meeting timing, points to be discussed, last meeting discussion and also the concerned person to carry out meeting should be mentioned properly. The important factor for the meeting is the time .It is necessary to mention the ending and the starting time of the meeting. A proper planning may lead to success of the meeting. For a successful meeting environmental condition should be nice enough. Such as, location, room and the availability of the equipment to carry out the meeting. It is a duty of a manager to maintain a quorum .And to consider the points discussion for the meeting by the subordinates. At the end of the meeting the points discussed by the subordinate should be ensure to all the members and the summary of meeting should be circulated to all the members. Making Presentation_:- It is pattern to shown or present the data in front of audience .presentation should consist of appropriate information related data and should be provided in an under stable language . The manager should be actively take part in the meeting and should be confident enough to carry out the meeting. The meeting starting and ending time should be considered by the manager while running the meeting. The physical presentation by the manger should be good enough he/she should dress them self properly and should be confident to carry out the meeting. While carrying out the meeting manager should make an eye contact with the members and should ask the questions if necessary. To make the meeting interesting it should be more of visuals either than the lectures so the members will not get bored of the meeting. Stress management:- It plays a vital role in the life of the mangers. Its normally been distinguish in two types it is personal and professional. The personal is been related to money problem, sickness, family problems etc while the professional will be the completion, business problems, large workload. To get release with the stress manger should follow the following steps:- He should identify the problem is it a professional or personal stress. A proper solution should be made to reduce the stress. Normally the main reason of the stress is time .If the time is managed by anyone he/she can reduces stress in a proper way. Regular exercise ,yoga, and meditation also help to reduce the stress and increases energy and strength In managers time log there should be some time for his hobbies or for the favorite thing to carry out so that he will be fresh to perform his task. Proper planning should be there for the task which is not the simple. So by the study of it proper notes, remark should be made to reduce stress. Thus by achieving these steps manger can reduce the stress and can achieve its goal in a proper plan time which can leads to an organisation profit. Task 2 (1.1b) The leader /manager have to know himself first mostly in terms of his weakness and the strength to perform the work in the proper way. Following are the practical methods of skills for developing or improving are as follow. Proper time frame should be made to carry out work efficiently in a proper and organized way. By these it become easily t carry out or too run the meetings easily and effectively. With the help of logs like daily and weekly it become easy to identify the problems or the jobs which was carried out and with the help of logs it can be sorted out easily. Proper planning should be there to carry out work easily so that the stress will be get reduced .Normally work is been carried out as per the as per the indivivals satisfaction. Proper planning or using of phone calls or the internet should be specific so that there will be no delay for the work. Proper backup or the files should be saved in a computer data as if it becomes easy to sort out the problems. Outcome 2 Task 3 (1.2a) By personal development it makes us understand to know our strength and weakness. As most of the people are unaware about their sturdy and fragile areas. Due to which the work get spoiled and do not get completed properly. So thats why the term personal skill audit is been used in management studies so that the employee will able to know their weakness and strength so that he can able to overcome with it easily. Due to which it become easy for the organisation to complete its goal. After having a study Advanced Professional Development I came to know that I am pragmatist. My Strength is as follow:- I like to know about the recent things happening around me relates to books and technologies. Most of the times I try to make out some new ideas from the job to make it easy. I make my plan for each work and try to make most of it to complete it. I utilize the option available to me. Most of the time I like to work independently to complete any task. My weakness is prescribed below:- I am very eager to complete the task without considering caution. Most of the time the group task is not performed by me because I try to dominate others. Without involving other people I like to do my work. I try to keep control on other because of which it may underestimate others. With the help of my strength it becomes easy to do work in a proper way. Gathering the information may help to complete the task. With the help of these it become easy to perform or to run the meeting easily. Also proper arrangement of agenda which includes the figures and facts help to make meeting successful. And also some time working alone or to perform the work help me to complete it properly as I dont have to rely on other to complete my work or task. As without considering the caution may leads to crash the task. Because of these act normally it direct me to the way of failure. Due to independent working stress and the mental pressure get increase because of which leads to work failure. Because of underestimating other people by me lead to differences between family, subordinates with me. These differences may cause nervousness, stress to mental condition. Due to which it take directly to the way of failure. After knowing to my weakness and strengths, I will try to overcome with it with the help of four skills which can also reduce the individual and proficient efficiency. I will plan my work in a proper way to compete it. Also I will persistence to my work or task and will study it properly to overcome it. And also I will frame out the related caution which may arise so thats I can overcome it. By utilizing strength I can achieve the goals successfully to hike the company in the right direction Outcome 3 Task 4 (1.3a) Before to be linked with the Personal Development Plan, I have constructed SMART and SWORT analysis to identify my objectives in life and to know my strength and weakness which will help me out to achieve my MBA and to be a successful manager in future. SMART -: It stands for S-Specific, M- Measurable, A-Achievable, R-Relevant and T-Time. Considering these all things I have set my goals for future. Specific-: To gain and implement four skills they are Time Management, Running Meetings, and Making Presentation, Stress Management which will help me out to complete my MBA. Measurable-: To complete the assignment successfully in APD/MBA. Achievable-: To complete and submit the assignment successfully in a specific time period and to get passes through it. Relevant-: As I have gained a perfect group of teachers because of which I have 100% interest and commitment for my subject which aim to concentrate and to put my efforts to achieve my goal. Time-Bound-: To obtain MBA degree by the end of March 2011. SWOT ANALYSIS Strengths-: I try to find out more options To disclose the facts I use my detective skills I am eager to find and implement the ideas, techniques and theories. I perform the work well when I am independent. I set the goal and act to meet them I take my opportunities for experiment I am good to gather the information from the entire source available I am good in performing oral presentation which holds the attention of the audience. Weaknesses-: I proceed without caution I underestimate personal feelings I require full control I am impatient I dominate task which is given to others I like to do work/task alone I am not good in making logical disputes for the essay format I am not good in presenting the assignments professionally I am not good in evaluating the progress of any work. Opportunities-: Facilities which are available from our college -Live campus update, advanced technology for teaching like Smart Board, computers,projectors,library with all the books and facilities, the best teachers/staff. Special service for the student that is tutorial service in which we can interact our problems with the tutor. Performing practical workshops by our lecturer Mrs. Ginny Cox at our College. Through workshop it makes us easy to perform and practice our skills Threats-: Problems evaluating like login for live campus and collage computer systems Cannot take books outside the library Time consuming student services token system and limited time period for tutor service Because of newcomers and unprepared members in the group lecture cant able to concentrate on the workshops properly. Workshop cannot be get completed in time Professional Development Plan-: Learning and development need Weaknesses to be overcome and strengths to assist the outcome Learning actions to be taken including resources needed to achieve them Monitoring and feedback point Time frame for success Time management Weaknesses-: Have to wait for the last moment Always work alone To keep reminder or alarm for the deadline To do split up the small task and the large task first and then to do the important one. To decide and frame out the deadline and important dates. To record the summary at the end of the day To study and implement on daily action plan. To study and get on to the result time period of two months is needed. Strengths-: To perform the work on time Working hard for the work Proper planning and techniques can avoid wastage of time. It is hard to meet time constraint by working out daily. Approximately 1 month Running meetings Weaknesses-: Do not practice before performing Do not consider other people effectively Have to be prepare by own first before discussing the matter and implementing the decision assigned to him. To check the others works and allocate work to them. To take the survey in between and to ensure the progress of the work interval check is required. Up till the proper decision is implemented Strengths-: Able to make own decision Able to make control on others To set the goals and try to achieve them To stuck up with the decision and make a use of an employee to achieve the target. Through financial reports, sales reports and annual reports of an company In an interval of 3, 6, 9, 12 months. Making presentations Weaknesses-: Always in hurry Underestimate personal feelings To communicate properly To explain the topic rather than continuity of speech To take the survey in between and to ensure the progress of the work interval check is required. While presentation Strength-: Good speaker To find the facts by using detective skills Proper use of multimedia and PowerPoint in the presentation and getting the feedback from the subordinates/colleagues Through financial reports, sales reports and annual reports of an company After 1 month of presentation Stress management Weaknesses-: Always in hurry Wants the result instantly acts without caution Internal cure Taking break from work and assigning the work to subordinates/colleagues Mental stress progress continuously Strength-: Without depending on others for the work Utilizing essential and useful techniques to do task. Proper planning techniques make it easy to do work Mental stress programs continuously Task 5 (1.3b) Monitoring and feedback- As per the condition changes in the plan is been made to complete the work these skills is been effectively monitored and the feedback is been carried out to achieve the outcome. The confirmation of these monitoring and feedback is represented below. TIME MANAGEMENT-: In the starting weeks of the lecture I was asked to fill the daily/weekly time log table as during which we dint had any assignment to do so I used to utilize my time like with the friends, internet, gaming, watching TV, listening music (please see appendix 1).As after certain weeks I adjusted my time log table because of the assignments and exam were coming closure to submit and write it so using time log I planned my time properly. Also by comparing with the past time log table I come to know what mistakes I have made and how I can make a change in it.Therfore considering the sitivation I have made changes in my study hours which will be helpful for me to prepare for exam and assignment were as I have reduced my hours from the TV and music section to utilize them for studies. (Please see appendix 2).These time log I have done to do the things at time considering their priorities instead of leaving them at the end. Thus with the help of these I will be able to complete my work in ti me as if effective time management. MAKING PRESENTATION As in the lectures we had a presentation in which I had performed one presentation as a workshop in which I was making a mistakes continuously like less speech volume, repeating of the words or the mixture of the words which was not proper enough. After few days I had a presentation for the work shop for which I performed it quite well and I got a very positive results from my friends and teachers. For this presentation I had a very good preparation like to understand the subject pre-planned the matter and performed it at home and recorded it then I saw the mistakes and tried to overcome it. My main intention was to make a good presentation which should be liked by everyone. Thus after these I had many presentation and the results very quite well enough. Thus from these I have secured very good skill. Task 6 (1.3c) Conclusion Thus after completion of these task I came to know about my learning style due to which my strength and weakness is been easily identified though which it is possible for me to work out on any task easily. Also the four skills play a vital role with the help of which it may leads to a successful and good manger. As it is a part of Master of Business studies it shows the importance of time management, preparation of successful meetings which may be helpful as a part of life. Thus though these assignment I have learned also the thing that to respect the others ideas and views and use them effectively for the task which may reduce the stress.

Finding Deeper Meaning in Ode on the Death of a Favourite Cat :: Ode to the Death of a Favorite Cat Essays

Finding Deeper Meaning in Ode on the Death of a Favourite Cat      Ã‚  Ã‚  Ã‚   First impressions are important when meeting new people, applying for jobs, and even when reading literature. It provides us with an idea of what is going on, where things are taking place, and who the important characters are. This first impression can be described is the Pre-Critical Response; the average reader performs this type of analysis every time he or she reads. For some people, this simplistic perspective is satisfactory; others find the quest for deeper understanding intriguing and part of the ultimate experience gained through literature.    The Formalistic Approach is one way to analyze literature in order to gain fuller understanding. This approach examines a piece of literature by identifying its individual structures and form. It studies sentence structure in terms of verb placement, the multiple meanings and etymology of words, and the stanza and line breaks. The Formalistic Approach stresses sensitivity to words and their connotations, denotations, and implications they may have to surrounding words and phrases. Location, setting, place, and time are other aspects identified through this approach. Formalistic analysis is referred as "...close reading in practice" (HCAL 73).    The Dialogical Approach recognizes "...the essential indeterminacy of meaning outside of the dialogic - and hence open - relationship between voices" (HCAL 349). The voices of a novel or work create a dimension all their own. Dialogical's creator, Mikhail Mikhailovich Bakhtin, uses the key term of carnivalization to describe the "...diversities of speech and voice reflected in its structure" (HCAL 351). Mood and tone are derived from this and can be further amplified through the Formalistic Approach of analysis.    My Pre-Critical Response to Thomas Gray's "Ode on the Death of a Favourite Cat, Drowned in a Tub of Gold Fishes" is as follows: A cat was playing with a fish in the fish bowl. The cat fell in and then drowned because none cared enough to save her. When I take a second look, details of the setting and location; language usage and sentence patterns; tone and mood; deeper meanings to the poem can be found. The Formalistic and Dialogical Approaches can be used to find these deeper meanings.    Setting and location are essential when creating atmosphere.

Meaning of Education Essay

â€Å"Yep, that’s the last of it† my dad yelled as he slammed the trunk shut. Totes were piled up high and filled with clothes, shoes, and lots of old memories. After getting all settled in my new apartment my family and I said our goodbyes. This next chapter in my life was finally here. I was now a college student entering the real world. We all have our purposes for taking the next step in life and going to college. My purpose for attending college is to take a leap towards creating success and meaning in my life. My family has been a giant influence on attending college. The day my older brother went off to college it was no surprise. It seems that moving on to college was the natural thing to do. For instance, graduating kindergarten and moving to the 1st grade is similar to graduating from high school and moving on to college. It’s just a chapter in life that our parents brought us up expecting to reach and we’ve been taught that it would be the right choice since elementary school. It’s what we grew up knowing we were supposed to do when we got to that point in life. Ultimately, we were taught that this step would lead us to the success to building a more meaningful life. All in all, education is the key to success. Having an education opens many doors to amazing opportunities. Why waste time stuck in a slump when one can go out into the world and be someone, make a difference in this world, and have the pride to say that â€Å"I am successful†. With a college education, the amount of freedom is endless. There are many more careers to choose from and the ability to stand out from others increases your career success. An education helps one develop a more meaningful life, that’s what I want to achieve. I want to make a difference in this world by not only my art but my everyday life. My goals are to one day be very well off financially, enabling me to support my future family and enjoy all the accomplishments and great opportunities life has to offer. Just on a walk to school, I get a glance of the harsh reality by seeing all the unfortunate civilians struggling to survive each day. For instance, an old man and his dog, hungry as can be, asking for money on the corner of the street. This makes me realize that I am very grateful for what I have and that an education is what I must pursue to accomplish my goals and dreams. With all the love and support of my family and friends I have a great positive outlook on a college education. Having moved on to this next step in my life, I already feel as if I’m that much closer to reaching my goals. I can see how proud my family is as they watch me better my life and future. With all my past experiences, I now have a strong mentality to finish with pride and follow all my dreams. Overall, an education is the way to success and the key to many great opportunities.

Butler Lumber Essays

Butler Lumber Essays Butler Lumber Paper Butler Lumber Paper Why has Butler Lumber borrowed increasing amounts despite its consistent profitability? How has Mr.. Butler met the financing needs of the company during the period 1 988 through 1 990? (It would be helpful to develop a cash flow analysis (use vs.. Source) and the cash flow statement based upon the income statement and the balance sheet provided in the case for the period of 1988 to 1990. Through the period of 1988 to 1 990 Mark Butler has met the needs of financing through decreasing the amount of cash the company carries, by increasing bank loans, by increasing the size of accounts payable, and by carrying net income over into retained earnings. The needs of this cash was generated by the loan to Mr.. Stark as M. B. Needed this money to buy out Mr.. Starks share in the company, an increase in account receivable, an increase in inventories, and an increase in fixed assets. Working capital turned out to make up a use Of 68% during the years 1 988 to 1990. The buy out of Mr.. Stark made up 22% of the use of cash. Source bank note payable 49%, trading credit 28%, retained earnings 16%. All in all Mr.. Butler has been using the wrong sort of financing to raise funds. If you were to make a comparison as to how Mr.. Butler has been generating funds thus far it would be like financing a mortgage with a credit card. 2. Has the financial strength of Butler Lumber improved or deteriorated? The ratios show that the strength of Butler Lumber is slowly deteriorating. Their current ratio has been slowly going down from 1. To 1 2, if this continues it will only be a matter often until Butler Lumber will no longer be able to cover their current liabilities with their current assets. Along with this the company is growing more and more leveraged from 54. 5% in 1988 to 71. % in 1992. As their working capital decreased through the years and into the projection BAL average payment period is increasing from 35 days to 47 days. It will not be long until t heir vendors grow tired of the slow payments, not to mention the fact that BAL is not taking advantage of the vendors 2% discount by paying in ten days from the purchase. Bless times interest earned is growing smaller also. In 1988 Bless TIE figure was 3. 8 but now the estimated figure for 1992 is 1. 9. This means that Bless BIT is becoming increasingly lower relative to the interest that they must pay out on loans. . Does rapid sales growth always result in a need for substantial external finance? (Hints: exam asset management, does the efficiency of using assets at Butler align with its rapid sales growth? ) In this case MBA needed a loan to buy out Mr.. Starks interest so that in itself caused a need for external financing. Generally when companies experience rapid sales growth they do need substantial external financing. As sales increase accounts such as A/P, A/ R, and inventory always increase also, which creates a demand for more funds, for instance in net working capital. This is needed so that the business can operate smoothly, make their payments on time, absorb increases in accrued expenses, and meet the needs of countless other needs of cash that come along with increases in sales. The speed at which sales are growing is the reason why a company needs external financing, assuming that the company doesnt have a rich uncle with 4. How attractive is it to take the trade discounts? A 2% percent discount will result in a savings of $41000 in 1991 and $60,000 in 1 992, which will increase net income significantly to 58,000 in 1991 and $73,000 in 1992. The increased savings in net income will show up in retained earnings and will provide a source of cash for the coming year which will in turn reduce the amount of external financing that the company needs. The annual cost of not taking this discount works out to be 20% Once again this shows that Mr.. Butler is not using the best source of financing because he could take out a loan at a much lower rate of interest to pay his bills in 10 days and save quite a bit of money. 5. Do you agree with Mr.. Butlers estimate of the companys loan requirements? That is, will a credit line of $465,000 be sufficient to meet the Meanys needs beyond 1 991 if it takes the trade discounts? How much will Mr.. Butler need to finance the expected expansion in sales to $3. 6 million in 1991 and to take all trade discounts? (Develop projected income statement and balance sheet, and then estimate the financial needs. ) If MBA takes the 465,000 line of credit and does not take the trade discount he will be able to operate through the year of 1991 but he will need even more money to continue into 1992. By not taking the trade discount BAL will not be running very efficiently and their current ratio will continue to get worse. If Mr.. Butler does take the trade discount the projected external financing for 1991 is $666,000 so it seems that the 465 thousand line of credit will not be enough for BAL to continue experiencing the rapid growth. 6. Would you, as Mr.. Dodge, agree to lend Butler the money needed? This is a tough call based just upon these numbers. It seems a bit risky for the bank to extend this financing to BAL. I do not have industry figures or what the current home building growth is projected to be. It mentions in the book that MBA thinks that even if home building slows residential remodeling will continue to rive his sales. I think that Mr.. Dodge should recommend BAL to scale back sales growth to a more manageable rate. 33% sales growth per year is very high. History shows us growth at this rate never continues year after year. Additionally, growth at this rate generally causes financial problems and lower chances for the companys survival over the long run. As things are going right now Mr.. Dodge probably would not grant this loan. 7. What are the alternatives open to Mr.. Butler if Mr.. Dodge refuses his request for an increased credit line?