Study Case Essay

Study Case Essay Study Case Essay Child V. Kim, Study Case Anna Smith Guideline Kaplan University Arranged for Paul S. Franklin, EJP CPA August 12, 2014 This contextual investigation includes two people: Stephen Son and Jinsoo Kim, and the subject of the case to decide whether Kim, offended party, ought to be conceded repayment of misfortunes guaranteed by Son. Jinsoo Kim, financial specialist, put $170,000 into one of the Stephen Son’s organizations. Be that as it may, Son’s enterprises didn't continue rivalry and fizzled. Afterward, the two accidently met at the café. Feeling regretful, in the wake of devouring rich measure of liquor, Son vowed to reimburse the obligation. To help the words, Son gave Kim a guarantee written in blood. Kim acknowledged the archive in return for vow not to sue Son for got harms. In any case, later on, at that point the Son calmed down, he would not respect the guarantee. Kim documented a suit attempting to fortify the agreement (Beatty, Samuelson, Bredeson, 2013, p. 164). To attempt to make sense of who was directly in this circumstance, I need to distinguish a law that ought to be utilized to help the contention: Common Law or UCC. To have the option to settle on a decision, let’s give the laws definitions; and take a gander at the contrasts between them. Uniform Commercial Code (UCC) discovers application in deeds related with trade, and manages exchanges of individual property. It is utilized in deals and rents, bunking and exchanges with utilization of debatable instruments, bank stores and moves, mass exchanges, title moves, tasks with land (Application of the UCC p.5). Customary law is received by the greater part of the states, barring Louisiana, and manages land, administration, protection immaterial resources and business contracts. The laws are comparative, yet have contrasts. The distinctions are as followed: 1. In the Common Law, reflect impact and counter offer would be considered as a dismissal of the existed offer. It doesn't really occur in UCC. At the point when counter offer is made it doesn't prompt crossing out of the agreement; 2. In UCC the primary center is amount, though in Common Law, the fundamental terms are: amount, value, execution time, nature of work and personality of offer; 3. At the point when the Common Law doesn't permit denying of the alternative agreements, the offers made by a firm is irreversible if the arrangement is made recorded as a hard copy in UCC; 4. Diverse time period in Statute of Limitation: it is four to six years in Common Law; and only four years in UCC (Pabhat, 2010, p.9). In this way, subsequent to investigating the two laws, I would allude this case to properties of UCC. Notwithstanding, to tell precisely if Kim can seek after cure of the misfortunes, we likewise need to check whether the thought was made while speaking with the respondent. Thought implies that in the event that you need to get something you need to give something back. It must be something of significant worth, not really a similar worth, yet important to the individual right now; and an object of significant worth mentioned by promisor. For this situation the thought is legal, except if: It is illicit; It is fake; It includes or infers injury of someone else; It is unethical, or against open wellbeing (CSJune89, 2009). Agreement can likewise be voidable if on the snapshot of entering the agreement the individual was inebriated. For this situation the reality can be demonstrated. It doesn't occur regularly that the debate is settled for inebriated individual since it is difficult to demonstrate that on the snapshot of making the agreement the individual was as well

Role of Ecotourism in Sustainable Development

Job of Ecotourism in Sustainable Development These days in creating nations, ecotourism is utilized as a phenomenal instrument for advancing practical turn of events. It is helpful for neighborhood networks making natural, financial and social advantages. Ecotourism is done by numerous travel industry organizers and advertisers these days. The significant perspective associated with ecotourism is its appropriate arranging and execution. On account of inappropriate arranging it changes over all the monetary increases into social and natural calamities. Ecotourism has picked up prevalence formed into an overall marvel giving no indications of easing back down. Despite the fact that it's anything but an all inclusive solution for accomplishing practical turn of events, its potential towards advancing reasonable improvement merits extensive consideration. The motivation behind this paper is to investigate the effect of ecotourism in achieving maintainable advancement in Costa Rica. Ecotourism The idea of ecotourism was very much recognized in 1960s by Hetzer who added to this by distinguishing four standards of ecotourism. They are limiting ecological effects, regarding host societies, augmenting advantages to neighborhood networks amplifying visitor fulfillment. Ecotourism is a reconciliation of social, ecological and efficient advantages meeting both human and natural needs. One of the significant foundations for the advancement of ecotourism is the disappointment with mass the travel industry making over turn of events, contamination and remote speculation. As per International Ecotourism Society (2004) Ecotourism is a Responsible travel to regular zones that monitors the earth and continues the prosperity of neighborhood individuals. Manageable Development The term manageable advancement got universal acknowledgment in 1980s. In 1987, Bruntland commission characterized reasonable advancement as Development that addresses the issues of the present without bargaining the capacity of things to come ages to address their own issues. It is a blend of social, affordable and natural turn of events. Ecotourism Sustainable Development It is only manageable the travel industry. In 1995 World Trade Organization expressed in Agenda 21 that Sustainable the travel industry improvement addresses the issues of present visitors and host locales while securing and upgrading open door for what's to come. Manageable the travel industry includes various standards in it. Feasible improvement isn't the main objective of ecotourism, yet economical advancement is significant for accomplishing the objective of ecotourism. About Costa Rica Costa Rica which implies Rich Cost is a nation in South America flanked by Nicaragua in north, Panamma in south, Caribbean Sea in east and Pacific Ocean in west. The administration is unavoidably majority rule. It intrinsically abrogated its military for all time in 1949 getting military impartial. It was positioned first among the Americas for Environmental Performance Index in 2010. All out territory 19,653 sq.m Water rate 0.7 Populace 4,253,897 Gross domestic product (ostensible) $29.318 billion It contains 5% of the universes biodiversity. Around 25% of the countrys land territory is secured by ensured national stops and secured regions. Around 24 national parks are found in Costa Rica. The Monteverde cloud timberland save is a home for around 2000 plant species, more than 400 feathered creatures, more than 100 types of warm blooded creatures and various orchids. Development of ecotourism in Costa Rica Costa Rica earned notoriety as a chief ecotourism goal on the planet likewise considered as ecotourisms post youngster. A portion of the elements that affected ecotourism in Costa Rica are charming atmosphere, great national park, best general human services framework, best government funded instruction, most elevated education rate in Latin America and so on. It is additionally honored with plenteous characteristic assets, for example, sea shores, mangroves, mountains, caverns, cascades, volcanoes and tropical rainforests which is one of the most organically differing territories of the world containing 5% of whole planets biodiversity. In a brief period Costa Rica has arrived at significant level of development in ecotourism making both valuable impacts and hindering results on supportable turn of events. It is considered as a model in actualizing ecotourism in numerous different zones. Monetary effects Globalization assumes a significant job in worldwide monetary dynamic. As globalization and unbridled monetary rivalry keep on ruling the worldwide motivation, the trip specialists who thought of the possibility of ecotourism were currently searching for new markets and not the approaches to spare the world. In view of this issue, many ensured locales of Costa Rica are progressively incorporated into the worldwide economy. Park passage expenses and other type of incomes increment the estimation of ensured land as opposed to the income acquired from deforestation. Ecotourism additionally procures remote trade to creating nations by bringing sightseers from north ( from created nations). An overview expresses that in mid 1990s Costa Rica was the main abroad ecotourism goal for U.S explorers, yet just 20% of its income went to the neighborhood network and the remaining was paid to the visit administrators, tickets on remote possessed aircrafts, to import items that intrigue outside sightseers. A specific level of benefits can be reused to the neighborhood network advancement through enactment with the goal that income spillage is decreased. When all is said in done, the work chances of the individuals living close to ecotourism goals depends on the visitors. In Costa Rica, individuals living close to Monteverde cloud woods save is a magnificent model who have increased extraordinary monetary qualities with this. Complexity to the past point, Osa promontory an ecotourism spot in Costa Rica has made its occupants significantly more less fortunate than before over fascination by ecotourists which made benefit to pariahs. Advertising as a rule is utilized to expound a buisness scale. In Costa Rica in districts where outcasts command, advertising is utilized es an effective apparatus by the nearby network to expand their buisness. Counterfeit showcasing is likewise done in certain locales which is of no natural obligation. Since ecotourism is a regular movement, it can change after some time to time and the neighborhood network can't completely rely upon this for their profit which prompts financial uneasiness. Pariahs took over numerous locales in Costa Rica which have gotten mutilated and the costs have expanded radically with the goal that numerous Costa Ricans have been evaluated out of land and home proprietorship. Social effects Despite the fact that the nearby networks are not generally engaged with ecotourism arranging and execution, it gets fundamental for them to engage in various periods of it for their own advantages. Additionally the nearby networks are exceptionally acquainted with the neighborhood assets, it settles on them basic to include in dynamic. Partner support and network inclusion are significant in dynamic procedure since they have the best stake in the result of any ecotourism venture. The way of life of the nearby network assumes a significant job in ecotourism. For a practical ecotourism, social structures of the neighborhood network must be surely known so the breaking down of the nearby networks can likewise be dodged. In Costa Rica, individuals in numerous rustic regions didn't bolster ecotourism rather they felt it as a danger to their social elements. Ecotourism carries numerous favorable circumstances to the neighborhood network on the off chance that they incorporate themselves with it else it can prompt commofication bringing about disintegration of culture and network union. Ecotourism gives some work chances to the nearby network, for example, inn adjusting, making, government organization staff, visit administrators and so on. In Costa Rica nearby network individuals are prepared in the regions of park maintanance, living space rebuilding, the executives and so on so as to consolidate them in secured zone the board. Govrnment ought to give a few sponsorships and intensives to neighborhood needy individuals to claim a buisness. Numerous inventive and resposible privately possessed ecotourism ventures bomb because of lacking speculations and their opposition with enormous remote organizations. The objective of ecotourism is that the benefits from ecotourism must be reinvested into the neighborhood network to meet their fundamental needs. Extra incomes are diverted into programs which legitimately advantage the nearby individuals in their wellbeing and training. At the point when individuals get engaged to ecotourism getting support from their locale, they will give their time and vitality to it, understanting that the accomplishment of ecotourism is legitimately connected to their individual ability to accomplish more noteworthy guidelines of life. Natural effects National stops in Costa Rica are the foundation of its ecotourism industry contributing a lot to the countrys the travel industry all in all. In 1960s Costa Ricas first carefully ensured zone was built up, after that four national parks were offically made in 1970s to save its biodiversity. There are 30 or more national parks and in excess of 230 ensured regions in costa Rica. Cost Rica structures an assortment of biological system with 850 feathered creature species, 1260 tree species, 1200 orchid species, 270 warm blooded animal species, 361 types of reptiles and creatures of land and water and in excess of 35,000 types of creepy crawlies. The formation of parks and secured zones ensure characteristic species, however it brought about deforestation. National parks structure the vital piece of ecotourism in Costa Rica which was expanding since 1980s and accomplished development toward the finish of 1990s. Indeed, even ecotourism profit have contuined to build, the Costa Rican government isn't appropriately subsidizing to the parks and ensured zones prompting dependancy on outside gifts a lot. Other than national stops and ensured zones, private stores have risen as another significant method to secure Costa Ricas characteristic assets and biodiversity. Around 68 stores were found in Costa Rica in which more than 40 includes in ecotourism in which La Selva, Rara Avis, Monteverde cloud woodland

How Ballet Can Make You a Better Leader

How Ballet Can Make You a Better Leader Leading a company to business success is not an easy task. Therefore, it isn’t a surprise to encounter countless articles and studies examining the abilities and qualities successful leaders hold. The focus is often not only on accomplished business leaders, but also on auspicious individuals in other sectors. © Shutterstock.com | Eugene MynzulSurprisingly, a hobby that could hold the key to turning you into a better leader is ballet. It is time to explore 1) the origins of ballet and examine 2) the leadership qualities as well as 3) the abilities this 4) dance can teach a leader.THE ORIGINS OF BALLETBefore we examine the qualities and abilities ballet can provide to leaders, lets take a moment to understand the history of ballet. Indeed, once you look into the origins of this dance, you can see it has been attractive to many famous leaders of the past.The dance took its first steps during the Renaissance in Italy around 1500. The word ‘ballet’ has its origins in the Italian word ‘ballare’, which means ‘to dance’. The first dancers wore masks and restrictive and sumptuous clothing. The difficulties dancers had carrying these heavy and decorative clothes led to the dance developing as a form of small hops, slides and gentle turns.From Italy, ballet was brought to France when Ca therine de Medici married the King of France, Henry II. The dance developed greatly in the French ballrooms and it was especially favored under the reign of Louis XIV. According to historians, the king himself liked to dance around. This is indeed an early indication that leaders have found this form of dancing intriguing and helpful.It was under King Louis XIV, that the dance became a professional form of art. His thirst for talent meant ballet wasn’t simply a leisure activity, but a routine that required professional training.In 1661, the first dance academy dedicated to ballet opened in Paris and soon everyone, not just the noblemen, were able to experience a ballet show.The dance quickly spread, with two clear centers forming in Russia and France. These two countries have undoubtedly played a major role in developing the dance to its current form and glory.In the 19th Century, the Romantic Movement became reflected in ballet and the dancers began dancing on the tips of their t oes. It was also when wearing the tutu â€" calf-length, full skirt made of tulle â€" became the norm for ballerinas.In Russia, the popularity of ballet skyrocketed during the 19th century. Russian choreographers added a more classical technique to the dance and made the precision and elegance of the movement the key parts of a ballet display. Part of the quest for showing off the detailed footwork and movement meant the tutu was cut shorter, to its current form.The origins of ballet include a number of strong visionaries, such as Serge Diaghilev and Pierre Beauchamps. Under King Louis XIV, it was a way to highlight power and influence. In Russia, the dance was practiced as a guide to accomplished behavior and the dancers trained to perfection. It’s therefore no wonder the dance can enhance leadership qualities.Before you read about these leadership qualities and abilities that come with training ballet, you can watch this interesting introductory of the development of ballet over time. This YouTube video specifically looks at the pointe work: THE LEADERSHIP QUALITIES YOU CAN LEARN FROM BALLETSo, what are the leadership qualities you could take home from this wonderful dance?FocusBallet is an intense dancing style. If you’ve seen a ballet performance, you know that the dancers must be able to perform complex routines, often without moving away from their spot. This requires focus, as you can’t take your eye of the ball at any point.The same applies to leadership. You need to be present on the ‘here and now’ when making decisions. A good leader must have the ability to focus on the present, while remembering to look forward to the next part.Furthermore, ballet dancers need to focus on a number of details. The greatest dancers have to establish the right exercise routines, follow the right diet and live according to a correct lifestyle (no late-night parties for the professionals!). Creating the perfect performance requires focus on these little details .Similarly, a leader can’t focus on any single aspect of leadership. The focus must be on a selection of details, which help the team to strive forward.PatienceBecoming a world-class ballet dancer doesn’t happen overnight. Professionals often start young and craft their skills for years before reaching their full potential.The style of ballet is also subtle and gentle. The understanding of the movements takes patience and practice. Patience is a key to improve in both, ballet and leadership skills.Leadership skills are not achieved overnight either and ensuring success as a leader will require plenty of patience.PassionSince ballet requires hard work and attention to small details, you’ll need passion to stay on course to mastering it. Ballet is by no means an easy form of art, even though it can be relatively accessible. Ballet lovers and dancers tend to be increasingly passionate about their art and live and breathe it at all times.When you watch a breath-taking ballet perfo rmance, you can see the passion and emotion. You don’t simply stare at the performance; you feel it and live it together with the performer.The same passion is required as a leader. Since you are leading the team , you need to be able to excite others and maintain the same intensity even when things don’t work out as you planned.Leadership and ballet aren’t just about technical perfection. You can be an intelligent and skilful person, yet lack the passion to lead others. In fact, you might be perfectly capable of achieving financial targets, but business isn’t just about money. If you are passionate about the product and the service, you can reach these goals while genuinely improving the world around you.PerseveranceBallet performances require the team to work together. But occasionally, a dancer might miss his or her steps. But this doesn’t and it shouldn’t stop the performance. Other dancers need to persevere and keep going.Furthermore, ballet shows rely on dancers pe rformance â€" even when their mind might be somewhere else. The dancer must be able to set aside his or her emotions and provide the team with a stunning show. This is also what great leaders do â€" they persevere, even when the situation looks dark.As a leader, you’ll know your team is relying on your performance. You are the dancer that needs to show example and show up, even when you’d rather put your feet up and rest.DisciplineThe levels of physical endurance needed for ballet can take many by surprise. Ballerina Misty Copeland told in an interview that during the performance season rehearsals start at noon and last until almost six in the evening, after which you must prepare for the show. The exercise routine is rigorous and when you are preparing for a ballet show, you repeat the same movements over and over again.The same discipline to organize is crucial for leadership. You set the example and if you are lazy, your team will quickly follow suit. You are in charge of org anizing the routine, ensuring everyone in the team follows it and setting the example of hard work.Goal OrientationAs a dance style, ballet is goal oriented, whether or not you are aiming at the top level. Even beginners will set out goals, whether they are about learning a specific move or simply improving their physique. For professional dancers, the goals might be about joining a famous ballet group or learning the routine for the next show.Leaders must be goal-oriented as well. In fact, you’ll often need to work towards multiple different goals. These could be about launching a new product, increasing the revenue stream or reducing the operational costs. You should always aim for something, whether it is a big or a small target. It can help clarify the right path, and help you and the team to stay focused.CompetitivenessBallet is an elegant and romantic dance, yet the professional world of ballet can be brutal. The competition for the best positions within the industry is toug h. Without a competitive spirit, you are unlikely to dance at the Bolshoi Ballet group.Ballet also has to compete with other forms of entertainment. Ever since its invention in the courts of Italy, France and Russia, the dance style has tried to improve and reinvent itself in order to reach a new audience. Ballerina Tamara Rojo told the Guardian,“We’re constantly trying to expand our audiences and reach people that have never thought they would love ballet”.Ballet needs to fight for its audience, as well as to attract new dancers to join its ranks.A leader has to have competitive qualities as well. You need the hunger to reach the top and the appetite to maintain your position. Becoming a team leader in a company doesn’t guarantee you a place in the sun forever. In fact, as soon as you gain that position, there will be a long line behind you waiting for you to slip.THE LEADERSHIP ABILITIES YOU LEARN FROM BALLETAs well as helping with the above leadership qualities, you can a lso gain essential leadership abilities from ballet.The ability to multi-taskIf you’ve ever watched a ballet performance, you know that different things are happening at the same time. The dancers often need to be on top of what the other dancers are doing, while performing their own routine. But the dancer must also perform different choreographies with his or her hands and feet.This type of ability to multitask is essential for leaders. You’ll need to juggle different tasks at the same time. The focus must not be on just the big picture, but also the finer details. Furthermore, you aren’t simply just performing various tasks and scraping by, you are in fact, finishing it all with graze.The ability to deal with different peopleOne of the great aspects of ballet is its ability to bring together people from all walks of life. It’s a sport that attracts young dancers, but there are also groups for older enthusiast. Not to mention how ballet, as a form of art, has fans from dif ferent sections of society.For the dancers, aiming at the top of the profession, reaching the goal often requires them to travel to different parts of the world to train. Moving to a different culture and training with new people isn’t easy â€" good people skills are needed.In today’s interconnected world businesses are also gathering talent from different parts of the world. A leader has to be able to make everyone feel welcomed and find ways to use these differences as an advantage.The ability to let others shineBallet performance isn’t built around an individual performance. For the show to work and to impress the audience, everyone has to play their part. In ballet, you might be dancing at the centre of the stage in one minute and fall into the background the second.Whilst the performance has a lead dancer or two, every member of the group plays an important role in ensuring the performance is going to be a success. A dancer will need to know how to deal with their spot in the sunlight, but also how to support others with their time.The same ability to allow others to shine is crucial for a leader. You might be leading the pack, but you aren’t the only member of the team. In fact, the best leaders are often not the ones basking in glory, but who help bring out the best in other people.The ability to be presentIt’s hard to imagine anything more majestic than a ballet dancer striking a pose. Like we’ve mentioned above, the dancer can wholly captivate the audience and make them feel the passion the dancer has for his or her craft.The posture during the performance is all about the presence â€" the full stretch of the body, the expressiveness of the face ensures the dancer captivates the whole room with his or her presence.In a Huffington Post interview, Japanese ballerina Misa Kuranaga explained the importance of presence by talking about a performance that captivated her. She was watching a performance and felt radiating energy from a dancer, who wasn’t in a leading role.“The way she was performing on stage was so beautiful; she was giving everything she had for that moment, for those five minutes of demonstration,” Kuranaga said.A competent leader can stand out from the crowd in the same way. A leader must be able to capture the room’s attention, with authority, charm and passion. Leading isn’t just about saying and doing the right things; our communication is as much about the verbal cues as it is about the non-verbal cues.If you are looking to learn more about physical presence and its importance to leadership, ballet is a fantastic teacher.The ability to stay on your feetYou can understand the physical requirements of ballet, by simply getting on your toes for a few moments. If that seemed difficult, imagine maintaining the posture for hours, while also gliding around the room in an elegant manner.As well as requiring emotional perseverance, ballet dancers must be in shape. You need a strong body to withstand the physical stress, as well as the emotional drain long hours and disciplined routines can have.The same applies to leaders. The saying “a healthy mind in a healthy body” is a great rule to live by, especially as a leader. Leaders are required to work long hours, withstand the emotional stress and even jet across the country or the world. If you aren’t physically fit, all of this becomes harder.The ability to get things doneThe French King Louis XIV turned ballet into a professional art and the Russians transformed it into a military-like exercise. The dedication of the Russian choreographers and dancers added the effectiveness to this beautiful dance.In ballet, you need to follow your training to become excellent, you learn the routine to a performance, you go on stage, you dance your part, and you walk off the stage until you start the routine again.Leadership follows this same routine â€" the routine of getting things done. Leaders don’t have the luxury of analyzing ever y move for hours or discussing topics until dawn. Leaders must have the ability to know when to practice, when to perform and when to walk off the stage.DANCING TO BECOME A BETTER LEADERThe above qualities and abilities are essential to ballet and to business leadership. Ballet is such an eloquent display of what perseverance, discipline and hard work can accomplish. It highlights the essential aspects of leading, but also working as a part of a group. The ability of the dancers to focus and endure is something valuable every leader, who wishes to accomplish success, should study and learn from. So next time you go experience a ballet performance, remember to look at the show through a new lens.

The World Health Organization ( 2014 ) Defines Mental Health

Mental Health SYNOPSIS OF THE TOPIC The World Health Organisation (2014) defines Mental Health â€Å"as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community† (para. 1). Mental health refers to an individual’s psychological, emotional and social wellbeing; it has the ability affect people’s perceptions, thought, feelings, actions and capacity to respond to change, stresses and challenges within their lives (Headspace, 2013, para. 1). It influences how individuals perceive themselves, their resilience, life decisions and the people around them. Maintaining a stable, healthy and positive mental state is crucial for all individuals throughout their lives in order to avoid developing mental health problems and illnesses. 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Research Paper Therapeutic Services - 1619 Words

Capstone Research Paper: Therapeutic Services For many Americans, there comes a time when people are in need of therapeutic services and need help finding the right treatment for them and or loved one. Often times therapy is very beneficial to people, but is not always offered with their insurance. Therapeutic services should be provided to all patients as a non-evasive treatment option because these services provide nontraditional alternatives that enhance patient care and therefore, insurance companies should cover these services. Therapeutic services are non-evasive medical therapy. There are many different types of therapy that is out there for people, depending on what treatment they need and what it will be used for. One of the†¦show more content†¦He or she can also evaluate how a person does an activity and make suggestions for doing the activity in a way that is less likely to result in an injury. Another common type of therapy that is frequently needed is psycholog ical therapy that helps people with Psychotherapy, or talk therapy. Psychotherapy is (National Institute of Mental Health). Within this type of therapy, there are different types. Such as cognitive behavioral therapy, CBT for depression, anxiety and bipolar disorders and much more. For example, CBT helps people with depression restructure negative thought patterns. Doing so helps people interpret their environment and interactions with others in a positive and realistic way. It may also help a person recognize things that may be contributing to the depression and help him or her change behaviors that may be making the depression worse (National Institute of Mental Health). Another example of a type of psychotherapy is CBT for bipolar disorder. People with bipolar disorder usually need to take medication, such as a mood stabilizer. But CBT is often used as an added treatment. The medication can help stabilize a person s mood so that he or she is receptive to psychotherapy and can get the most out of it. CBT can help a person cope with bipolar symptoms and learn to recognize when a mood shift is about to occur (National Institute of Mental Health). Although physical and

Diabetes Mellitus Study Guide Free Essays

DIABETES MELLITUS * Chronic multisystem dz , abnormal insulin production / impaired utilization * Disorder of glucose metabolism related to absent/ insuff insulin supply or poor utilization of inslin that’s available * 7th leading cause of death * leading cause of blindness, ESRD, lower limb amputation * contributing factor for heart dz/ stroke risk 2-4 x higher than without DM * INSULIN – hormone produced by cells in islets of Langerhans of pancreas. Normal – continously into bloodstream ( basal rate), or increased w/ meals (bolus) * Normal glucose range 70-120 mg/dL, average insulin secreted daily 40-50 U 0. 6 U/kg * Glucagon, epinephrine, GH, cortisol oppose effects of insulin counterregulatory hormones they blood glucose lebels, stimulate glucose production by liver, movement of glucose into cells. We will write a custom essay sample on Diabetes Mellitus Study Guide or any similar topic only for you Order Now Insulin released from cells – as precursor / proinsulin thru liver enzymes form insulin C-peptide ( C-peptide in serum urine indicator of cell function) * in plasma insulin after meal storage of glucose as glycogen in liver/ muscle, inhibits gluconeogenesis, fat deposition, protein synthesis * Nl overnight fasting release of stored g;ucose from liver, protein from muscle, fat from adipose tissue * Skeletal muscle adipose tissue receptors for insulin insulin-dependent tissues Type I Diabetes Juvenile onset, insulin-dependent, s/s abrupt but dz process present for several yrs, 5-10%, absent or minimal insulin production, virus/toxins, under 40, 40% before 20 yr * s/s thirst( polydipsia), polyuria, polyphagia ( hunger), fatigue, wt loss, Kussmaul respirations * immune mediated dz; T-cells attack destroy cells * genetic predisposition exposure to virus * Idiopathic diabetes – not atoimmune, strongly inherited, in small # pt w/ type I DM , African/Asian * Predispositio n HLAs human leukocyte ntigens when exposed to viral infection cells destroyed * Long preclinical period, s/s develop when pancreas can no longer produce sufficient insulin to maintain nl glucose levels * Req. insulin from outside source exogenous insulin eg. injection * No insulin diabetic ketoacidosis (DKA) life threatening, results in metabolic acidosis * â€Å"honeymoon period† – newely diagnosed pts, tx initiated pt experience remissions req little insulin because cells produce suff amount of insulin lasts 3-12 mths then req permanent insulin Prediabetes * risk for developing diabetes glucose levels high but not high enough for diabetes diagnosis * impaired fasting glucose IGF 100-125 mg/dL * 2 hr oral glucose tolerance test OGTT 140-199 mg/dL * HgB A1C – 5. 7%-6. 4% risk for diabetes * Increased risk for developing DM type II – if no preventive measures develop DM in 10 yrs * Long term damage to body heart, blood vessels occur in prediabetes * Usual ly no symptoms * Maintain healthy weight, exercise regularly, healthy diet risk of developing diabetes Type II Diabetes * Adult onset, non-insulin dependent, 90% * 35, overweight, tendency to run n families * African Am, Asian, Hispanics, Amerian Indians Some insulin is produced but either insufficient for body needs / poorly utilized * Gradual onset, many yrs undetected hyperglycemia, 500-1000mg/dL * Early usu. asymptomatic; high risk pt screen annually * Fatigue, recurrent inf, vaginal yeast inf, candida inf, prolonged wound healing, visual changes * Risk factor obesity ( abdominal/ visceral ) * 4 major metabolic abnormalities * insulin resistance tissue no response to insulin / unresp receptors – receptors are located on skeletal muscles, fat liver * ability of pancreas to produce insulin – fatigued from compensatory prod of insulin, ell mass lost * inappropriate glucose by liver – too much glucose for body needs – type II * altered prod. of hormone s cytokines by adipose tissue ( adipokines) role in glucose fat metabolism – type II. Two adipokines ( adiponectin leptin ) affect insulin sensitivity altered mechanism in type I I * Metabolic syndrome risk for type II cardio dz, cluster of abnormalities, insulin resistance, insulin levels, triglycerides, HDLs, LDLs, HTN * Risk factors for metabolic syndrome central obesity, sedentary lifestyle, urbanization, westernization Gestational Diabetes During pregnancy, 7% of pregnancies * High risk – severe obesity, prior hx of gestational DM, glycosuria, polycystic ovary syndrome, family hx of DM II screened at 1st prenatal visit * Average risk OGTT at 24-28 wks of gestation * Higher risk of cesarean delivery, perinatal death, neonatal complications * Will have nl glucose levels within 6 wks postpartum but risk of DM II in 5-10 yrs * Nutritional therapy – 1st line , if doesn’t work insulin therapy Other specific types of diabetes * Due to other medical co ndition or treatment causes abn blood glucose levels * Damage , injury, destruction of cell function Cushing’s, hyperthyroidism, pancreatitis, cystic fibrosis, hemochromatosis, TPN * Meds corticosteroid (prednisone), thiazides, phenytoin(Dilantin), antipsychotics – clozapine * Tx underlying condition, stop meds Diagnostic studies * A1C 6. 5 % ; greater convenience, no fasting req, less day to day alterations during stress/ illness * FPG 126 – no caloric intake for 8 hrs prior testing ; confirmed by repeated testing another day; if has s/s and FPG126 further testing OGTT not req * 2 hr OGTT 200, glucose load 75g accuracy depends on pt preparation, and factors that influence results. False negative impaired GI absorption, falsely elevated severe restrictions of carbs, acute illness, meds corticosteroids, contraceptives, bed rest * IFG impaired fasting glucose IGT prediabetes, 100-125 mg/dL, IGT 2 hr 140-199 * Glycosylated HgB – HgB A1C amount of glucose attached to HgB molecules over lifespan ( RBC 90-120 days ) DM pts should check it regularly, done to monitor success of tx / make changes to tx 6. % – risk of retinopathy, nephropathy, neuropathy dz affecting RBCs – can affect A1C results Treatment * Goals s/s, promote well being, prevent acute complications, prevent/ delay onset/ progression; met when pt maintain glucose level as near to nl, daily decisions about food intake, blood glucose testing meds, exercise * Rapid acting insulin – lispro (Humalog), aspart (NovoLog) – onset 0-15 min, peak 60-90 min, dur. -4 hrs , clear, give 15 min before meals ; bolus * Short acting – Regular (Humulin R, Novolin R) onste ? -1 hr, peak 2-3hr, dur 3-6 hrs, injected 30-45 min before meals; bolus * Intermediate acting – NPH, basal insulin, onset 2-4hrs, peak 4-10hrs can result in hypoglycemia, dur. 10-16 hrs, can be mixed w/ short rapid, cloudy, must be agitated before adm. Long acting – glargine (Lantus), detemir ( Levemir) addition to mealtime insulin, type I, to control glucose between meals overnight, without it risk of developing DKA, no peak – risk of hypoglycemia , not diluted or mixed, clear; onset 1-2 hrs, dur. 24hrs +, basal * Combination pt don’t want 2 separate injections, 2 type of insulin mixed together, not same control of glucose levels as with basal-bolus; ahort/rapid mixed w/ ntermediate provide both mealtime basal coverage * Storage vials room temperature 4 wks, heat freezing alter insulin, between 32-86 F; avoid direct exp to sunlight, extra insulin in fridge/ traveling-thermos, Prefilled syringes – sight impaired, manual dexterity; syringes w/ c;udy solution in vertical position needle up to avoid clumping of suspension, rolled gently, warm before injection. * Injection abdomen fastest absorption arm, thigh, buttock, rotate within 1 particular site; never into site that’s about to be exercised (heat = absorption onset), vial 1ml=100U, SQ 90 degrees * Needles ? 5/16 inch (short – children, thin adults); gauges 28,29,30,31 – higher gauge = smaller diameter = more comfortable injection * Recapping done only by person using syringe, never recap syringe used by pt; alcohol swabs in health care facility before inj to HAI, at home soap water * Insulin pump – continuous subq insulin infusion 24 hr/d basal rate , loaded w/ rapid acting insulin via plastic tubing to catheter in subq tissue. At meal time – bolus . (+) tight glucose control, similar to nl physiologic pattern, nl lifestyle, more flexibility (-) infection at site, risk of DKA, cost Problems w/ insulin therapy * Hypoglycemia * Allergic rxn – itching, erythema, burning around inj. site, may improve w/ low dose antihistamine ; rxns to Zinc, protamine, latex , rubber stoppers on vials * Lipodystrophy – atrophy of subq tissue if same inj site used Somogyi effect – rebound effect, overdose of insulin induces undetected hypoglycemia in hrs of sleep, produces glucose decline in response to too much insulin s/s headaches, night sweats, nightmares ; if in morning glucose – adcised to check glucose levels at 2-4am if hypoglycemia present at that time. If it is insulin dosage in affecting morning blood glucose is reduced TX : less insulin * Dawn phenomenon – hyperglycemia on awakening in the morning due to release counterregulatory hormones in predawn hrs ( possibly GH/cortisol) adolescence/ young; TX: adjustment in timing of insulin adm. or in insulin. Predawn fasting glucose levels insulin production from pancreas , s. ff wt gain, hypoglycemia * Meglitinides repaglinide(Prandin) insulin prod, less likely cause hypoglycemia because more rapidly absorbed/eliminated, cause wt gain, take 30 min before meal, not if skipped * Biguanides – Metformin glucose lowering, first choice DM II/prediabetes, obese â€Å"starch blockers† slow down carbs absorption, taken with â€Å"first bite†, effectiveness check 2 hr postprandial glucose levels * Thiazolidinediones – Avandia â€Å"insulin sensitizers†, for pts w/ insulin resistance, don’t insulin Production, not cause hypoglycemia; risk of MI, stroke , not for pt w/ HF * DPP4 inhibitor – Januvia new class, slow inactivation of incretin hormones; DDP4 inh are glucose dependent = risk of hypoglycemia, no wt gain * Incretin mimetics – exenatide (Byetta) stimulate incretin horm which are in DM II, stim. of insulin, Suppress glucagon, satiety = caloric intake, slows gastric emptying; prefilled pen * Amylin analog Amylin hormone secreted by cells, co secreted w/ insulin Pramlintide (Symlin) is Synthetic , type I II when glucose level not achieved w/ insulin at mealtimes , subq thigh or abdomen NOT arm , not mixed w/ insulin – cause severe hypoglycemia ! * blockers — masks s/s of hypoglycemia, prolong hypoglycemic effects of insulin * Thiazide / loop diuretic — hyperglycemia, K Nutrition Type I meal planning, exercise, developed w/ pt’s eating habits activity pattern in mind, day to day consistency in timing amount of food eaten * Type II wt loss = improved insulin resistance, t otal fats simple sugars = calorie carbs intake; Spacing meals , wt loss 5-7% = glycemic control, regular exercise * Carbohydrates sugar, starches, fiber whole grains, fruits, veggies, low fat milk included min 130g/d * Glycemic index GI describe blood glucose levels 2 hrs after carb meal , GI of 100 = 50g glucose * Fiber intake 14g/1000 kcal * Fats 7% of total calories , 200mg/d cholesterol trans fats * Protein same for diabetes / normal renal function / gen. population, high proein diet not recommended * Alcohol inhibits gluconeogenesis ( breakdown of glycogenglucose) by liver; severe hypoglycemia in pt on insulin / oral hypoglycemic dx. Moderate alcohol consumption 2 drinks men, track carbs w/ each meal daily, set limit for max amount ( depends on age, wt, activity level) usu. 45-60g /meal ; also My Pyramid plate method ( ? nonstarchy veggies, ? starch, ? protein, nonfat milk fruit * Exercise 150 min/wk moderate intensity aerobic; DM II resistance training 3 x wk, most adults should 30 min moderate intensity activity 5 x most days * Exercise insulin resistance, blood glucose, wt loss which insulin resistance ( may need less meds), triglycerides, LDL, HDL, BP, circulation * Start slowly w/ progression. Insulin, sulfonylureas, meglitinides risk of hypoglycemia with increase physical activity esp if exercise at peak of dx or no food intake. Effect may last 48 hrs post exercise Exercise 1 hr after meal, have 10-15g carb snack every 30 min. during exercise (prevent hypoglycemia). Before exercise glucose immediate info about glucose levels – can make adjustments diet, activity, meds * Recomm. for all insulin-treated pts * Multiple insulin injections – 3 or more x day, done before meals, before after exercise esp in type I, whenever hypoglycemia suspected, when ill (stress), 2 hrs after start of meal – if effective Pancreas transplantation * For pt w/ ESRD, plan to have kidney transplant * Pancreas transplanted following kidney transplant, pancreas alone –rare * Pancreas alone only if hx of severe metabolic complications, emotional roblems w/ exogenous insulin, failure of insulin-based management * Improve quality of life, no exogenous insulin need, no dietary restrictions * Only partially able to reverse renal neurologic complications * Need lifelong immunosuppression to prevent rejection * Pa ncreatic islet cell transplantation in experimental stage, islets from deceased pancreas via catheter into abdomen portal vein Nursing management * Pt active participant in management of diabetes regimen * Few/no episodes of acute hyper/hypoglycemic episodes, maintain glucose level near nl * Prevent/ delay chronic complications * Adjust lifestyle to accommodate DM regimen w/ min. stress Nursing assessment Past hx mumps, rubella, viral inf, recent trauma, stress, pregnancy, infant9lbs, Cushing, acromegaly, family hx of DM * Meds compliance w/ insulin, OA; corticosteroids, phenytoin, diuretics * Eyes sunken eyeballs, vitreal hemorrhages, cataract * Skin dry, warm, inelastic, pigmented lesions on legs, ulcers(feet), loss of hair on toes * Respiratory Kussmaul – rapid, deep * Cardio hypotension, weak rapid pulse * GI dry mouth, vomiting, fruity breath * Neuro altered reflexes, restlessness, confusion, coma * MS muscle wasting * Also electrolyte abnormalities, fasting gluc ose level 126, tolerance test 200, leukocytosis, BUN, creatinine, triglycerides, cholesterol, LDL, HDL, A1C 45yrs without risk factors for diabetes Acute intervention * Hypoglycemia, DKA, HHS – hypersmolar hyperglycemic syndrome * Stress f acute illness/ surgery counterregulatory hormones hyperglycemia ( even minor upper resp infection or flu can cause this) * Continue regular diet, noncaloric fluids (broth, water, diet gelatin, decaffeinated), take OA/insulin as prescribed, monitor glucose Q4H * Acutely ill DM I , glucose240 test urine for ketones Q3-4H , medium/large report to MD * Ill eat than normal continue OA meds/ insulin as prescribed + carbohydrate containing fluids (soup, juices, decaffeinated) * Unable to keep fluids/ food down MD * Don’t stop insulin when ill counterregulatory mechanisms will glucose level * Food intake important body needs extra energy to deal w/ stress Extra insulin may be needed to meet this demand, prevent DKA in DM I * Intraoperati ve IV fluids insulin before, during, after sx when there’s no oral intake In DM II w/ OA – explain it’s temporary measure, doesn’t mean worsening of DM * If contrast medium (w/iodine) Metformin discontinued 1-2 days before sx, resumed 48 hrs after sx risk of acute renal failure. Resume after kidney function nl ( creatinine checked is nl) * Insulin adm teach proper administration, adjustments, side effects, assess response to insulin tx, if new to insulin assess ability to manage tx safely, cognitive status, ability to recognize/ tx hypoglycemia, if cognitive skill another responsible person must be assigned; diff to self inject/ afraid of needles * Follow ups inspect injection sites ( lipodystrophy ) * Short term memory deficit OA or short acting OA cuz doesn’t cause hypoglycemia * OA w/ diet activity, not take extra pill when overeating * Diligent skin care dental aily brushing/ flossing, inform dentist about DM * Foot care !!! scrapes, burns treated promptly monitored nonirritating antiseptic ointment dry sterile pad not start to heal in 24 hrs or infection MD * Regular eye exams * Travel – sedentary walk Q2H to prevent DVT prevent glucose , carry snacks, extra insulin COMPLICATIONS Diabetic Ketoacidosis DKA * Diabetic coma Profo und deficiency of insulin hyperglycemia, ketosis, acidosis, dehydration * Most likely in DM I pts, but sometimes in DM II ( severe illness/ stress) * Causes illness, infection, undiagnosed DM I, inadeq insulin dosage, poor self management, neglect * Insulin – glucose cant be properly used for energy fat broken for fuel ketones (by product) serious when excessive in blood alter pH, cause metabolic acidosis ketonuria (in urine) electrolyes depleted; impaired protein synthesis, nitrogen lost from tissues * Untreated depletion of Na, K, Cl, Mg, phosphate hypovolemiarenal failure/ retention of ketones glucose shockcoma (result of dehydration, lytes acidosis)death * s/s dehydration, poor turgor, dry mm, HR, orthostatic hypotension, Kussmaul , abdominal pain, sunken eyeballs, acetone fruity odor, early s/s lethargy,weakness * blood glucose 250, arterial blood pH IV access begin fluid/ electrolyte replacement NaCL 0. 45% or 0. 9% to restore urine output 30-60 ml/hr BP * gluco se level approach 250 5% dextrose added * Incorrect fluid repl sudden Na cerebral edema * Obtain K level before insulin started – insulin further K * Insulin withheld until fluid resuscitation K3. 5 * Too rapid IV fluids rapid lowering of glucose cerebral edema Hypersmolar hyperglycemic syndrome HHS * Life threatening, able to produce insulin to prevent DKA but not enough to prevent severe hyperglycemia, osmotic diuresis, ECF depletion * Less common than DKA * Often 60, in DM II Causes UTI, pneumonia, sepsis, acute illness, new DM II * Asymptomatic in early stages so glucose can rise very high 600mg/dL * The higher glucose in serum osm neurologic manifestations somnolence, coma, seizures, hemiparesis, aphasia * Resemble CVA (stroke) determine glucose level for correct dx * Ketones absent in urine * Tx similar to DKA * First IV 0. 45% or 0. 9% NS, regular insulin given after fluid replacement * Glucose fall to 250 – add glucose 5% dextrose * Hypokalemia not as significant as in DKA * HHs require greater fluid replacement * Assess VS, IO, turgor, labs, cardiac / renal monitoring related to hydration electrolyte levels, mental status, serum osm Hypoglycemia Low blood glucose glucagon epinephrine defense against hypoglycemia * s/s of epinephrine shaking, palpitations, nervousness, diaphoresis, anxiety, hunger, pallor * brain req constant supply of glucose when affect mental functioning LOC, diff speaking, visual disturbances, confusion, coma, death * Hypoglycemis unawareness no warning signs until glucose reach critical point incoherent, combative, LOC often elderly w/ beta blocker meds * When very high glucose level falls too rapidly, too vigorous management of hyperglycemia * Mismatch in timing of food intake peak of isulin/ OA * Can be quickly reversed Check glucose levels, if contain fat that glucose absorption; check glucose in 15 min * Still 70 eat regular meal/snack low peanut butter, bread, cheese, crackers, check glucose in 45 min * No significant imptovement after 2-3 doses of 15g carb MD * Pt not alert to swallow 1mg glucagon IM in deltoid muscle ( nausea, vomiting rebound hypoglycemia) * Hospital setting 20-50ml of 50% dextrose IV push * CHRONIC COMPLICATIONS OF DM Angiopathy * end organ dz from damage to blood vessels (angiopathy) 2nd to chronic hyperglycemia * leading cause of diabetes-related deaths, 68% deaths due to cardio, 16% strokes * causes: accumul. Of glucose metabolism by products (sorbitol) damage to nerve cells, abnormal glucose molecules in basement membrane of small blood vessels (eye,kidney), derangement in RBCs – oxygenation to tissues * DM I keep blood glucose levels near to normal – retinopathy nephropathy (complications of microvascular complications) Macrovascular complications * Dz of large, medium size blood vessels , earlier onset in pt w/ diabetes * W 4-6x risk of cardiovascular dz, M 2-3 x * risk factors obesity, smoking, HTN, fat intake sedentary lifestyle * Smoking injurious to pt w/DM, risk for blood vessel dz, CV dz, stroke, lower extremity amputations * Maintain BP control – prevention of CV / renal dz Microvascular complication * Thickening of vessel membranes in capillaries/ arterioles in response to chronic hyperglycemia * Are specific to diabetes Eyes ( retinopathy ), kidneys ( nephropathy ), skin (dermopathy ) * Some changes present w/DM II at time of dx, but s/s not appear u ntil 10-20 yrs after onset of DM * Diabetic retinopathy – microvascular damage to retina, most common cause of blindness 20-74 yrs old. Nonproliferative most common, partial occlusion of small blood vesselin retina microaneurysms, Proloferative most severe, involves retina vitreous neovasculization ( form new blood vessels to compensate) if macula involved vision is lost * DM II dilated eye exam at time of diagnosis annually, DM I within 5 yrs after DM onset * Laser photocoagulation * Virectomy * Glaucoma Nephropathy – microvascular complication, damage to small blood vessels that supply glomeruli / kidney. Leading cause of ESRD in US; same risk for DM I II HTN, smoking, genetic predisposition, chronic hyperglycemia * Screen for nephropathy annually w/ measurement albumin / creatinine ratio * If micro/macroalbuminuria ACE inh ( lisinopril ) or angiotensin II rec antagonist ( Cozaar ) tx HTN delay progression of nephropathy * Aggressive BP management tight glucose control Neuropathy Sensory neuropathy (PNS)– loss of protective sensation in lower extremities amputations * Hyperglycemia sorbitol fructose accumulate in nerves damage * Distal symmetric polyneuropathy hand/ feet bilaterally * Loss of sensation – to touch/ temperature * Pain burning, cramping, crushing, tearing , at night * Paresthesias tingling , burning, itching * At times skin too sensitive (hyperesthesia) * Foot injury ulcerations without having pain TX : blood glucose control, topical creams capsaicin ( Zostrix ) 3-4 X/d pain in 2-3 wks, selective serotonin, norepinephrine reuptake inh ( Cymbalta ), pregabali ( Lyrica ), gabapentin Autonomic neuropathy – can affect all body systems lead to hypoglycemic unawareness, bowel incontinence, diarrhea, urinary retention Complications : * Delayed gastric emptying ( gastroparesis ) anorexia, n/v, reflux, fullness, can trigger hypoglycemia by delaying food absorption * Cardiovascular abnormalities , postural hypotension assess change from lying, sitting, standing, painless MI, resting tachycardia HR * Risk for falls * Sexual dysfunction ED in diabetic men 1st s/s of autonomic failure * Neurogenic bladder urinary retention, diff. voiding, weak stream empty bladder Q3H in sitting position, Crede maneuver ( massage lower abdomen) * Cholinergic agonists benthanechol Feet lower extremities Risk for foot ulcerations lower extremity amputations * Sensory neuropathy major rosk for amputations due to loss of protective sensations LOPS * Unaware of foot injury, improper footwear, stepping on objects w/ bare feet * Screening using microfilament insensitivity to 10g Semmes-Weinstein risk for ulcers * Proper footwear, avoid injuries, diligent skin care, inspect feet daily * PAD risk for amputations due to blood flow to lower extremities * PAD s/s intermittent claudication, pain at rest, cold feet, loss of hair, cap refill, dependent rubor ( redness when extr in dependent position ) * DX : ankle brachial index ABI angiography * Casting to redistribute weight on plantar surface * Wound control debridement, dressings, vacuum, skin grafting etc. Charcot’s foot ankle foot changes joint deformity need fitted footwear * Acanthosis nigricans – dark, coarse, thickened skin in flexures neck * Necrobiosis lipoidica diabeticorum – DM I, red-yellow lesions w/ atrophic skin , shiny transparent revealing blood vessels under the surface – young women * Granuloma annulare – DM I, autoimmune, partial rings of papules, dorsal surface of hands/ feet Infection Candida albicans, boils, fur uncles, bladder infections (glycosuria) antibiotics Gerentologic * reduction in cells, insulin sensitivity, altered carbohydrate metabolism * 20 % 65 YO * # of conditions treated w/ meds that impair insulin action ( How to cite Diabetes Mellitus Study Guide, Essay examples

Toro Company

Introduction In the process of organizational management, several strategies are deployed to ensure that organizational goals and targets are met. Some of the strategies deployed include marketing, restructuring and new products launches. The situation presented in this case looks into a company by name of Toro involved in selling snowblowers and lawn products.Advertising We will write a custom case study sample on Toro Company specifically for you for only $16.05 $11/page Learn More The company had been facing problems related to the sale of snowblowers. However, a program launched by the company and an insurance company changed the company fortunes. As an analyst, it is imperative to analyze the changes conducted by the company on different perspectives to see if this program was successful. Program’s Perspective Toro has been conducting good business as a result of the Company’s S’No Risk program. This program made the company sel l more snowblowers through guarantees handed out to distributors. The company took up an insurance policy that cushioned the company from risks related to product recalls. Dick Pollick of Toro was against the continuation of the program given that consumers might not be enthusiastic of the deal in the second year. Toro’s perspective is based on the fact that the snowfall levels might drop slightly meaning customers will be partially funded for their snowblowers (Bell, 1994). As a result, the campaign might put off potential customers in the second year. The insurance in this case offered a good deal to Toro that ensured that the company could not suffer high financial losses as a result of customer product recall. The insurance raised its rates based on past statistics that showed the climate might change leading to decreased snowfall (Albright, 2010). As a result, the insurance had a reason to cushion itself from losses that might result from decreased snowfall in the future leading to massive product recall from customers. Based on the analysis of the sales figures for Toro and the past agreement they had with distributors, it is acceptable for the insurance company to charge 8% of sales as the insurance rate. This is because prior to the No Risk Program, Toro used to offer distributors of its snowblowers a 10% discount for every sale. As a result, if Toro incurred 2% on marketing fees and 8% as insurance rates then it would amount to the 10% rate that was there previously. The risk taken by the insurance company could also cover all regions where snowfall is going to be less than the anticipated levels.Advertising Looking for case study on business economics? Let's see if we can help you! Get your first paper with 15% OFF Learn More Toro customers are pleased with the S’No Risk program which allows them to be repaid for unused snowblowers bought from Toro. However, the paybacks are restructured in a manner that paybacks will be offered when the snowfall falls below 50% of the historical snowfall levels (Bell, 1994). Although, the customer could suffer if snowfall falls below the 70 and 50% levels since no refunds would be availed. The paybacks could be restructured so that customers are repaid through the selling distributor instead of the issue being handled at Toro’s headquarters. Program Analysis The S’No Risk program was successful since sales increased to unprecedented levels and the customers felt that value for money was respected. In the case of Dick Pollick, I think he should continue on the program to protect the sales of the company. The program was successful based on the fact that the company increased its sales at no additional making the company achieve healthy financial margins. In case, management of the S’No Risk program was handed over to me, several factors would have to be looked at. One of the factors that I would look into is the insurance agreement which should be concise to avoid fluctuation in the insurance rates (Albright, 2010). The analysis of the three stakeholders in the case of the S’No Risk program a matrix of common factors they regard highly should be drawn as shown in figure 1. For instance, the customer is susceptible to payback not being respected while Toro is losses resulting from high payback request as a result of poor snowfall. The insurance company would suffer the greatest loss if poor snowfall was to occur in a consecutive manner. The S’No Risk program affects the customer in that the customer might regret purchasing snowblowers from Toro if paybacks take a long time or they are not honored. From Toro’s perspective, the payback form lists that the customer should write his/her name on purchase of the snowblower and mail the form to the company (Grant, 2005). Toro might deny the receipt of the customer forms while the insurance company would want to deal with Toro directly as opposed to the custome rs since the agreement was between them and Toro.Advertising We will write a custom case study sample on Toro Company specifically for you for only $16.05 $11/page Learn More Main Stakeholders Meaning of Scores 9- Very satisfied 4-Somewhat satisfied 1- Dissatisfied Objectives Customer Toro Insurance Be Profitable 1 9 9 Reduce Risks 1 4 9 Guaranteed Payback 9 4 1 Figure 1 Conclusion Insurance companies play a vital role in business because of their risk management line of business. In the case of Toro, the American Home takes care of the risk of product recalls for Toro while the company concentrates on selling its products. The analysis of the S’No Risk program shows that if American Home maintains it insurance rates then Toro could continue to sell its snowblowers without hitches. However, the S’No Risk program has its downside based on poor climatic conditions which could force the insurance companies or Toro to suffer los ses related to paybacks. Customers could also duffer the loss of paybacks taking long to materialize. References Albright, S. Winston, W. (2010). Data Analysis and Decision Making. Chicago, IL: John Wiley and Sons. Bell, D. Schleifer, A. (1994). Decision making under uncertainty. Detroit, MI: Course Technology. Grant, R. (2005). Contemporary strategy analysis. Boston, MA: Greenwood Publishing Group. This case study on Toro Company was written and submitted by user Liberty Z. to help you with your own studies. You are free to use it for research and reference purposes in order to write your own paper; however, you must cite it accordingly. You can donate your paper here.

Learning How to Write an Exploratory Essay by BestEssay.Education

Learning How to Write an Exploratory Essay by Learning How to Write an Exploratory Essay If you are working on an exploratory essay, you are working on a task that is quite unusual. In fact, it is so unusual that as you learn how to write an exploratory essay you will need to momentarily discard much of what you know about writing essays. The reason for this that the approach to writing an exploratory essay is completely different. When writing these essays, your goal is not to prove your thesis or to argue a specific point. Instead, your job is to walk your readers through the things that you have experienced when attempting to solve a problem. What is an Exploratory Essay? It may seem strange to read this, but an exploratory essay is essentially an introspective retrospective. Essentially what you will be doing is examining your approach to defining and solving a problem. The purpose of this essay is to give yourself some good insight on the methods that you use to solve problems, the methods that you use to identify problems, and even your writing style. In many cases, you might write an exploratory essay after completing a research project. What can a Student Get from Writing an Exploratory Essay? In an ideal world, research is objective. People however, are not objective. Each one of us views the world with through the filter of our experiences. This impacts everything we do, including research. An exploratory essay is a way for a student to explore their processes, methodologies, and motivations. When a student completes this process, the goal is that they become a better student and better researcher because they are more aware of themselves. What Questions Should an Exploratory Essay Answer? Here are the questions that you should consider when you write your exploratory essay. Why did I identify this problem as one that I wanted to explore? Why did I select the sources that I did when researching the problem? What made me think that the solution that I applied was the best one? What factors impacted the methods I used to apply the solution? As I read my research notes, what stands out to me about my writing style? Did the solution I applied work? If the solution didn’t work, can I identify any biases or tendencies on my part that contributed to that? Getting Help with your Exploratory Essay Even though this is not a common essay to write, you can still count on to help you with these assignments. We will find the best writer to write an essay of this type or any other type, just for you. Our writers will help you go through your research notes and other information so that your approach and methodology can be identified and explored. When your exploratory essay is finished, you will have an excellent essay to turn in for a grade, and you will also have a great document to refer to when you are questioning the choices that you make when researching a problem or applying solutions.

The Sociology of Gender

The Sociology of Gender The sociology of gender is one of the largest subfields within sociology  and features theory and research that critically interrogates the social construction of gender, how gender interacts with other social forces in society, and how gender relates to social structure overall. Sociologists within this subfield study a wide range of topics with a variety of research methods, including things like identity, social interaction, power and oppression, and the interaction of gender with other things like race, class, culture, religion, and sexuality, among others. The Difference Between Sex and Gender To understand the sociology of gender one must first understand how sociologists define gender and sex. Though male/female and man/woman are often conflated in the English language, they actually refer to two very different things: sex and gender. The former, sex, is understood by sociologists to be a biological categorization based on reproductive organs. Most people fall into the categories of male and female, however, some people are born with sex organs that do not clearly fit either category, and they are known as intersex. Either way, sex is a biological classification based on body parts. Gender, on the other hand, is a  social  classification based on ones identity, presentation of self, behavior, and interaction with others. Sociologists view gender as learned behavior and a culturally produced identity, and as such, it is a social category. The Social Construction of Gender That gender is a social construct becomes especially apparent when one compares how men and women behave across different cultures, and how in some cultures and societies, other genders exist too. In Western industrialized nations like the U.S., people tend to think of masculinity and femininity in dichotomous terms, viewing men and women as distinctly different and opposites. Other cultures, however, challenge this assumption and have less distinct views of masculinity and femininity. For example, historically there was a category of people in the Navajo culture called berdaches, who were anatomically normal men but who were defined as a third gender considered to fall between male and female. Berdaches married other ordinary men (not Berdaches), although neither was considered homosexual, as they would be in today’s Western culture. What this suggests is that we learn gender through the process of socialization. For many people, this process begins before they are even born, with parents selecting gendered names on the basis of the sex of a fetus, and by decorating the incoming babys room and selecting its toys and clothes in color-coded and gendered ways that reflect cultural expectations and stereotypes. Then, from infancy on, we are socialized by family, educators, religious leaders, peer groups, and the wider community, who teach us what is expected from us in terms of appearance and behavior based on whether they code us as a boy or a girl. Media and popular culture play important roles in teaching us gender too. One result of gender socialization is the formation of gender identity, which is one’s definition of oneself as a man or woman. Gender identity shapes how we think about others and ourselves and also influences our behaviors. For example, gender differences exist in the likelihood of drug and alcohol abuse, violent behavior, depression, and aggressive driving. Gender identity also has an especially strong effect on how we dress and present ourselves, and what we want our bodies to look like, as measured by normative standards. Major Sociological Theories of Gender Each major sociological framework has its own views and theories regarding gender and how it relates to other aspects of society. During the mid-twentieth century, functionalist theorists argued that men filled instrumental roles in society while women filled  expressive roles, which worked to the benefit of society. They viewed a gendered division of labor as important and necessary for the smooth functioning of a modern society. Further, this perspective suggests that our socialization into prescribed roles drives gender inequality by encouraging men and women to make different choices about family and work. For example, these theorists see wage inequalities as the result of choices women make, assuming they choose family roles that compete with their work roles, which renders them less valuable employees from the managerial standpoint. However, most sociologists now view this functionalist approach as outdated and sexist, and there is now plenty of scientific evidence to suggest that the wage gap is influenced by deeply ingrained gender biases rather than by choices men and women make about family-work balance. A popular and contemporary approach within the sociology of gender is influenced by symbolic interactionist  theory, which focuses on the micro-level everyday interactions that produce and challenge gender as we know it. Sociologists West and Zimmerman popularized this approach with their 1987 article on doing gender, which illustrated how gender is something that is produced through interaction between people, and as such is an interactional accomplishment. This approach highlights the instability and fluidity of gender and recognizes that since it is produced by people through interaction, it is fundamentally changeable. Within the sociology of gender, those inspired by conflict theory focus on how gender and assumptions and biases about gender differences lead to the empowerment of men, oppression of women, and the structural inequality of women relative to men. These sociologists see gendered power dynamics as built into the social structure, and thus manifested throughout all aspects of a patriarchal society. For example, from this viewpoint, wage inequalities that exist between men and women result from men’s historic power to devalue women’s work and benefit as a group from the services that women’s labor provides. Feminist theorists,  building on aspects of the three areas of theory described above, focus on the structural forces, values, world views, norms, and everyday behaviors that create inequality and injustice on the basis of gender. Importantly, they also focus on how these social forces can be changed to create a just and equal society in which no one is penalized for their gender. Updated by Nicki Lisa Cole, Ph.D.

Without positive freedom, it is impossible to lead a valuable life. Do Essay

Without positive freedom, it is impossible to lead a valuable life. Do you agree - Essay Example Therefore, it is true that valuable life might not be achieved in absence of positive freedom, people need to choose the course of their life and destiny without restrictions, freedom is essential also where individual potential is harnessed for the benefit of the whole society although in the process of enjoying this freedom care should be taken to make sure that other peoples liberty is not violated. In the process of enjoying positive freedom equity in opportunity must be regulated or observed, state may intervene to enforce equity and root out other social evils due to positive freedom (Raz, 1988). In a nutshell, complete absence of positive freedom leads to bad and impossible valuable life because every individual wants to operate in an environment which they feel free not intimidating surroundings, this will increase their productivity that in return improve the living condition and life at large for the whole society. A society that feels able to function without interruption although certain aspects must be observed as mentioned above (MacCallum, 1967). Positive freedom acts as an inner driving force in individuals. This equates and augers well autonomy. At the same time, autonomy many a time equates with several aspects that include individuality, integrity, and freedom of the will, responsibility, and critical reflection. In the same way, factors like self-knowledge, independence, freedom from compulsion, lack of external causation and self assertion play vital roles in perpetuating positive freedom. Different people have got varied notions about the steps that others should take to shape their lives. This is because individuals get involved in activities that portray absence of good morals. It has forced researchers to attempt to identify standing reasons that lie behind dissimilar nature of crimes that individuals commit. Even for all their attempts, the researchers are not able to impose their findings about criminology and its associated

Relationship Marketing Essay Example | Topics and Well Written Essays - 2750 words

Relationship Marketing - Essay Example Relationship Marketing: Relationship marketing is more about making a customer relationship and encouraging consumers to have a broader purchase rate and more satisfaction with their products. Typically relationship marketing is pitched towards long-term growth. Since the newspaper has not thought about relationship marketing the visitors make one buy and are never seen or heard from again. The newspaper continues to spend huge amounts of money in order to attract customers and has very little repeat business. Relationship marketing is all about the repeat business. Relationship marketing is a cost-effective method that finds to retain visitors (Goldglantz, 2007). The advantage of relationship marketing is that it aids retain the successes the newspaper has already attained. For example, a huge amount of visitors can be converted to a huge amount of return visitors. These return visitors can be examined for characteristics and traits. The disadvantage is that relationship marketing that seems inward (to current customers) does not attract new customers on a large scale. The advantage of traditional marketing is that it draws its net wide like a fisherman hoping to attain as many customers as possible. The broader the net the more fish and more markets we can dab into. The disadvantage of traditional marketing is that most organizations (newspapers) cannot simply keep paying high advertising costs to assert an expedient customer flow. Relationship and traditional marketing can be best applied when in conjunction. One exploits new markets and draws in first-time visitors while the other retains the customers as long as possible. The best the relationship, the best the sales results of the newspapers (Hunter & Perreault, 2007). Thus newspapers should conceive developing their marketing program so that it attains sales on the front end and the back end. Here we are considering two organizations. One organization use relationship approach with their customers and the other organization use traditional approach with their customers and here we are considering organization as a newspaper. First, describe the different activities of that newspaper which is using relationship approach with their customers. Relationship marketing: Definition: Relationship marketing is defined as the building of long-term, loyal, committed and economic relationships with potential and existing customers through communication and the provision of quality products and services. Relationship marketingis a type ofmarketingdeveloped from direct response marketing campaigns carried out in the 1970s and 1980s which emphasizes customer retention and satisfaction, rather than a dominant focus on point-of-sale proceedings. Relationship marketing is different from other forms of marketing in that it recognizes the long term value to the business firm of keeping customers, as opposed todirector "Intrusion" marketing, which focuses upon accomplishment of new clients by targeting majority statistics based upon prospective client lists. Development: Relationship mark

Does Austerity Work?

Does Austerity Work? Critically evaluate claims that austerity is the most effective strategy to counter a recession. Austerity is one of the most controversial economic policies, not only because there is an ongoing debate between academics and policy makers about its effectiveness and consequences, but also because it effects the life of millions and have caused many political and social turmoil when implemented. The advocate of this policy argues that it is the most effective and even more; it is the solution regardless of the structure of the economy and the cause of the economic downturn or recession. I will argue that this is not true, and that there are other policy designs that proved effective and delivered good results with less social cost in term of unemployment, social disturbances and welfare reduction. Austerity measures were recommended by policy makers in advanced economies as well as international organizations such as the IMF and the Word Bank. They were prescribed as a remedy in many economics situations and contexts in the developing countries, for example: Latin America sovereign debt crisis and the Asian crisis, furthermore in the aftermath of the financial crisis of 2007 and the great rescission that followed austerity policies were implemented or advocated in developed economies like UK, USA and part of the debt troubled EU countries referred to as PIGS (Portugal, Ireland, Greece and Spain) (Blyth, 2013). But it is important to first define what is meant by austerity and what is the underlying economic theory behind it. Usually when economists or policy makers refer to austerity they generally mean the reduction in the structural deficit in the government budget regardless of its effect on the business cycle, and it is also refers to the policy of reducing the size of the public sector in general (Room, 2015). This can be done through lowering the government expenditure (like social and welfare benefits, spending on infrastructure and healthcare, lowering wages, etc.). The underlying economic reasoning behind austerity policy is that high level of public debt is a burden on the future generations because any debt should be paid in the future from budget surpluses raised form tax payers. It also cause higher level of interest rate (due to higher demand by government) which in turn discourage private investment. Accordingly austerity policy by reducing the government expenditure will re duce the public debt, consequently increase confidence in the economy, reduce interest rates and consequently stimulate private investment spending and the economy. A common theme in austerity policy is the believe that government intervention itself through fiscal policy is the source of economic imbalances and it associate crisis with bad public finance management and reckless spending behavior (Wren-Lewis, 2016). The advocate of austerity say that the national economy cannot grow out of debt. Some scholars argue that if the ratio of debt to gross domestic product (GDP) is reach 90% for advanced economies, or 60% for emerging economies, the debt will slow down economic growth (Reinhart and Rogoff, 2010). In this situation, the economy can easily experience financial crises because the investor confidence will fall, and this will make foreign direct investment become less (Konzelmann, 2014; Reinhart and Rogoff, 2010). Another connected idea is that high level of debt means that the government needs to take capital resources from the community to pay for it, and this will also slow the growth of the economy. The national economies with high debt therefore likely to raise interest rates to encourage demand for government bonds, and this will make it more expensive for the public to borrow money. The result of this expense is low consumption and growth, so the economy will steadily decline (Boccia , 2013). The high interest rates also make the currency become more valuable, which means that exports slow down because they become more expensive for international market, and this will also slow down the economy (Patillo et al., 2002). The advocate of austerity therefore argue that high levels of debt will cause the economy to slow down, and say that cutting debt, which austerity does, is the best way to help countries with high debt to achieve growth (Blyth, 2013). There are ample of evidence contradicting the argument that the austerity is always a solution to recession. An analysis of the performance and consequences of such policies suggest that austerity policy in practice led in many instances to worsening the recession and budget deficit mainly due to its blind application and its tendency to ignore the different economic structure for each country, in fact it worsen the symptoms that it designed to cure (Haltom and Lubik, 2013). Lets look at the experience of Spain with austerity. Before the 2007 financial crisis Spain had enjoyed robust economy with long period of growth led by the real estate sector, the budget was actually in surplus at around 2.5% of the GDP. When the crisis of 2007 hit Spain economic vulnerabilities; mainly uncompetitive private sector and the over reliance on real estate sector and excessive borrowing by the private sector. The crisis resulted in lower demand and hence lower tax collection and budget deficit. Furth ermore deterioration in bank assets quality and solvency problem surfaced (Dellepiane and Hardiman, 2012). In 2010 Spain like many other troubled EU countries implemented the austerity formula i.e. cut spending. This solution was based on misinterpretation of the crisis cause in Spain (and southern Europe in general) that the crisis is caused by the mismanaged public finances, so not surprisingly was the result, instead of the expansionary austerity Spain got stuck of a vicious circle of lower demand (driven by lower government spending), lower tax collection (revenues), higher unemployment and further deterioration of the financial sector health (Dellepiane and Hardiman, 2012). In fact this was the situation of all the EU countries that implemented austerities, as we can show from the economic performance of Portugal, Italy, Ireland, Greece and Spain (PIIGS) since 2008. For all these countries, austerity made their debt increase, not decline, and economic activity slowed down (Blyth, 2013). In Greece, the ration of debt to GDP grew from 106% to 170% from 2007 to 2012, even though there w as much austerity cuts. The same case happened on Portugal, Italy, Ireland and Spain. The economist Paul Krugman pointed out that the idea of austerity collapsed under the empirical results of the policy of austerity, and he refers to the academic and research body that supported austerity did not stand scrutiny and turned out to be based on dubious statistical methods and sometimes outright mistakes (Krugman, 2015). In similar way, Simon Wren-Lewis (2016) observed that the austerity in Europe was unnecessary outcome of the fiscal contraction. In other words, the European countries could have successfully run a gradual fiscal consolidation accompanied with expansionary monetary policy by the ECB to offset the contractionary effect of the fiscal policy. However in case of Europe in 2010 the interest rates was already at zero and there was no room for expansionary monetary policy (a situation also referred to as liquidity trap), so postponing fiscal consolidation would not just delay austerity but avoid it all together (Wren-Lewis, 2016). It is therefore very clear that austerity cannot be a solution for recessions, but the question is then what can be the cure. If we go back in the recent history of the economic theory and policy we can establish that there have been examples of an alternative economic policy to austerity that has successfully dealt with recessions and restored the economic activity to the growth path. This policy was the Keynesian economic that prevailed for a period of 30 years from the world war II till late 1970s. Keynes model of how the economy works are based on the idea that when there is economic downturn and since business expectation in the recession are low because of the uncertainty only the government has can restore confidence to the economy and the policy recommendation is to increase government spending (expansionary fiscal policy) to boost he general level of economic activity, increase demand and compensate for the lower private demand (Burton, 2016). This is the very opposite of th e idea of austerity, and many economists now argue the same thing. Paul Krugman (2012) is a famous example of this argument. Krugman rejects the idea of austerity, and argues that to help the economy come out of the recession it is necessary for the government to increase debt. The foundation of this argument is the nature of debt. Krugman (2012) says that the economist must consider public debt and private debt as two separate things, rather than just the same. His reason for this idea is that, first, private debt needs to be recompensed, but this is not the issue with government debt. For the governments, it is just necessary to make sure that there is enough tax to cover debts. Another difference is that in private debt the money is owed to someone else, but government debt is money that the government owes to itself and to the country, such as pensions and other requirements (Krugman 2012). If these differences are considered, it becomes clear that in a situation of high personal debt, a good solution is for the government to take on higher debt to help boost the economic activity (Krugman and Eggertsson, 2012). Krugman and Eggertsson (2012) argue that fiscal expenditure must be used to maintain employment, productivity and earnings at the time that private debt is decreased, because this will keep the tax earnings up and permit the government to decrease its own debt when the recession is over. Beside, increased financial expansion will work better in a situation where interest rates are lower, because there will be lower crowding out of private business (Krugman and Eggertsson, 2012: 1490). In such situations, financial stimulus will therefore boost economic activity and give good growth to GDP, while decreases in public spending will have the opposite effect, slowing growth and bringing GDP down (Holland and Portes, 2012). In this essay, I have shown the foundation of the idea of austerity and explained why the economists who believe it say that it is the solution for the situation of a recession. The advocate of austerity argues that high public debt makes it more expensive to obtain a loan, and this causes the economy to slow. Furthermore, it also causes currency inflation, which causes exports to become more expensive and slows economic activity. FDI also slows down, and all these factors together mean that the economy cannot achieve any development. The solution of austerity is therefore to cut public spending to bring down the public debt. However, the empirical evidence of the effects of austerity measures show that it is not a useful policy to achieve these ends. In countries such as Greece, Spain and others where austerity has been used, austerity has caused the opposite of these results: ratio of debt to GDP gets higher and higher, unemployment rises, economic growth slows, and the recession b ecomes worse. The reason for this fail of austerity to solve the problem is because the advocate of austerity does not differentiate between public debt and private debt, as Krugman (2012) argues. In the recession, if the government takes on more debt through implementing fiscal stimulus, it can stimulate economic activity by allowing people to spend and take loans. This will increase the circulation of capital, which will have many positive effects in bringing about growth. Then, when the private debt level is high and the economy is more active, the government can reduce its financial stimulus to bring down its debt. In both theoretically and empirically, it is clear that austerity cannot solve the problems that cause recession, and it therefore necessary to consider the alternatives. References Dauderstà ¤dt, M. ed., 2013. Alternatives to Austerity: Progressive Growth Strategies for Europe. Friedrich-Ebert-Stiftung. Krugman, P., 2015. The austerity delusion. The Guardian, 29. Room, G., 2015. Alternatives to Austerity. Institute for Policy Research, University of Bath. (IPR Spotlight) Haltom, R.C. and Lubik, T.A., 2013. Is Fiscal Austerity Good for the Economy?. Richmond Fed Economic Brief, (Sept), pp.1-5. http://www.ilo.org/wcmsp5/groups/public/@ed_dialogue/@actrav/documents/publication/wcms_158927.pdf Wren-Lewis, S., 2016. A general theory of austerity. BSG Working Paper Series, University of Oxford. Blyth, M., 2013. Austerity: The history of a dangerous idea. Oxford: Oxford University Press. Dellepiane Avellaneda, Sebastian and Hardiman, Niamh (2012) The New Politics of Austerity : Fiscal Responses to Crisis in Ireland and Spain. Working paper. UCD Geary Institute, Dublin. Burton, M., 2016. Is Austerity Necessary?. In The Politics of Austerity (pp. 189-204). Palgrave Macmillan UK. Reinhart, Carmen and Kenneth Rogoff. 2010. Growth in a time of debt. The American Economic Review100(2): 573-578. Konzelmann, Suzanne J. 2014. The Political Economics of Austerity. Cambridge Journal of Economics38(4): 701-741. Boccia, Romina. 2013. How the United States High Debt Will Weaken the Economy and Hurt Americans. Backgrounder 2768: 1-8. Pattillo, C.A., Poirson, H. and Ricci, L.A., 2002. External debt and growth (No. 2002-2069). International Monetary Fund. Krugman, Paul. 2012. Nobody Understands Debt. The New York Times: The Opinion Pages. Accessed 28 October 2014. Available at http://www.nytimes.com/2012/01/02/opinion/krugman-nobody-understands-debt.html?_r=1 Krugman, Paul and Gauti Eggertsson. 2012, Debt, Deleveraging, and the Liquidity Trap: a Fisher-Minsky-Koo approach. The Quarterly Journal of Economics 127(3): 1469-1518. Holland, Dawn and Jonathan Portes. 2012. Self-Defeating Austerity? National Institute Economic Review 222(222): 4-10.