Management Accounting Change Essay Example for Free

Management Accounting Change Essay Describe the ‘Challenge of Management Accounting Change’ in light of recent research findings and discuss, how can this change help an organisation, in getting its strategic, tactical and operating objectives? Management accounting change and the continuously changing roles of management accountants have dominated accounting literature for the past few decades and the theme of management accounting change procedures has been a topical issue of many studies such as Baines and Langfield-Smith, 2003; Kapla, 1985 and Granlund and Lukka, 1998, just to name a few. In order to understand the relationship between a firms strategy and objectives with its management accounting systems, it is necessary to first define the latter. The Chartered Institute of Management Accountants (CIMA) define Management Accounting as the process of identification, measurement, accumulation, analysis, preparation, interpretation and communication of information used by management to plan, evaluate and control within an entity and to assure appropriate use of and accountability for its resources. Management accounting also comprises the preparation of financial reports for non-management groups such as shareholders, creditors, regulatory agencies and tax authorities. It is important to explore the extent to which management and strategic concerns are driven by accounting practices, and also how accounting practices are mediated by the views that managers have of the role of accounting (Burns et. al, 1999). Changes in Management Accounting can be viewed as an inevitable process, and they are also intrinsically interlinked to not only changes in a firms strategy, but also with environmental changes. Both internal and external changes in our economic and business environment are the dominating factors in the change of management accounting practices within organisations. This view that change is inevitable has been supported by Kaplan (1985), where he details the change as a cause-effect relationship. In short, management accounting systems have to change whenever there is any sort of change in an organisations business or economic environment. Organizational change is frequently a response to environmental change; such as changes in competition, or changes in laws and legislation. So if Management Accounting change occurs due to organizational change, it is important to note the indirect link between environmental change and management accounting change (Burns et. al, 1999). Wijewardena and De Zoysa (1999) support this idea by detailing that the success of an organisations strategy can be determined by how quickly and effectively management accountants can adapt to their systems to ever changing environmental and economic conditions, thereby supporting the link between management accounting practices and the business environment. It is fair to state that there are a number of factors that can influence change in management accounting and these factors are both internal and external. A research project on management accounting change in the UK, that was funded by CIMA and the Economic and Social Research Council was conducted between 1995 and 1998 by Burns et. al (1999). The study aimed to investigate changes in management accounting systems, the changing role of management accountants and the adoption of modern accounting techniques. The study initially sought to settle the claim that management accounting had not changed in more than 60 years (Johnson and Kaplan, 1987). The initial stages of the research found that management accounting practices use traditional accounting systems and modern techniques such as Activity-Based Costing and Strategic Management Accounting were not being used as much as expected. One reason for management accounting changes is the general economic factors such as the globalisation of markets. Changes in technology are another key factor, especially changes in information systems and methods of production. It is in this context that changes in management accounting have taken place. Changes in information technology have allowed for accounts and information to be dispersed around the organisation and managers have a more profound and hands on role within a firm. This in turn indefinitely has an impact on how objectives are met and how strategies and tactics are implemented to achieve, said objectives. This has led to a decentring of accounting knowledge, meaning that it is not only specified accountants who have knowledge of a company’s accounts, but also managers and their subordinates. This gives managers a greater ownership of information and it also means that they have to have an increased knowledge of accounting systems. Ezzamel (1997) states that a lack of change in accounting practices is presented as being not only detrimental to business interests but also threatening to corporate survival. However we must also look at external environmental factors and how they affect management accounting systems. A definition stated by Macy and Arunachalam (1995) define an external environment as a phenomenon that is external and have either potential or actual influence on organisations. However we must reiterate the fact that organisations of no control whatsoever over external factors. It is in an organisations best interest to take any external factors that could affect their operations, into consideration and to recognise them for their long term survival. External factors create a lot of uncertainty for firms. This uncertainty means that companies have to learn to adapt to sudden changes in external environmental business factors. Research by Mia and Patiar (2001) show that organisations must have more refined management accounting practices in order to operates successfully in uncertain business environments. There are also a number of views that contradict the idea that management accounting systems are directly influenced by external environmental factors. The idea of uncertainty, according to Chapman (1997), can be linked to internal factors as well as external factors. More research shows that external factors affecting management accounting can be dealt with in the way internal managers and accountants actually perceive the external variables. Despite the vast amount of advantages to management accounting and organizational change, there are also downsides to such changes. Burns, Scapens and Ezzamel (1999), show that accounting change can challenge existing routines and institutions within an organisation. This can then lead to conflict and resistance within employees, managers and perhaps even board members. Goal congruence may disappear, and an organisations strategy to achieve objectives may be hindered with the lack of an aligning view from all the members who have succumbed to the initial accounting change. Burns et al. (1999) also state that it can be a difficult process for previous systems to be unlearned. A major role for management accounting systems is to motivate behaviours of employees and managers in line with the desires of the organisation as a whole. A great problem is that many managers try to implement new accounting systems without taking into consideration the behavioural implications and consequences of employees with regards to these systems. The lack of goal congruence and effective communication can lead to low motivation and dysfunctional behaviour of employees. A change in an existing system will reduce employees’ knowledge and skill thereby affecting the effectiveness to achieve company objectives. Implementation of new techniques has to be orchestrated with great care and communicated thoroughly throughout the organisation. Accounting practices and emerging routines can be said to be institutionalised when they become widely accepted in the organisation such that they become the unquestionable form of management control. In which case, they are an inherent feature of the management control process, and represent expected forms of behaviour and define the relations between the various organisational groups (Burns and Scapens, 2000). Burns et. al study of CHEM, a small chemicals manufacturer showed that a change in the accounting and organisational systems had little impact on the company as a whole and it did not change their previous ways of thinking. This led to conflict between individual members of the chemical manufacturing company. Later, the new accounting systems were scrapped as they offered little benefits to the company; there had been very little change in the routines, institutions and systems of the firm. There are also claims that management accounting does not always change or respond to environmental or business changes. For example Kaplan (1984) suggests that despite significant changes to the business environment, such as increased competition and continuous changes in technologies and production processes, there has been no signicant changes in management accounting to match since 1925. Research conducted by Horngren (1995) and Burns et. al (1999) show that firms still tend to use traditional management accounting methods instead of adopting new techniques such as ABC. It is also important to note that their has also been a lack of implementation of non-financial measures such as Total Quality Management, Strategic Management Advice or Internal Financial Presentation and Communication. The absences of modern accounting methods support the claim that there is indeed in some cases little change within organisations from traditional accounting systems to new techniques. It is a difficult process to draw a set conclusion on the effectiveness of management accounting change. It is evident that there are vast pools of research both supporting the idea that management accounting hange is beneficial in aiding an organisations strategy but there is an equal amount of research to support the idea that change in accounting systems is derogatory to the success and progress of a business. It is fair to say that further external factors can determine how successful accounting change can be for a firm. For example we must take into account cultural and political factors of the country a particular organisation resides in to fully understand the implications of strategic, and management accounting change. It is impossible to apply findings from research to every company, because in short, every company is different; be it its strategy, its structure, its ethics or its objectives. We must be liberal in what we determine is successful implementation of management accounting change. The change that has taken place in organisations cannot be pinpointed to solely a change in management accounting systems and techniques but it is in fact the change in how these new systems are used and implemented (Burns et. al 2000) and these changes are more often than not part of wider changes of the organisation as a whole.

Effect Of Maitland Mobilisation Health And Social Care Essay

Effect Of Maitland Mobilisation Health And Social Care Essay Patient is a 35 years old golf coach. Patient had a history of going over his ankle on both sides. General health status of the patient is good. Patients activity ranges from a round of18holes of golf and driving range for 60mins a day. Patients activity includes more walking. The main problem of the patient is pain and stiffness in right ankle. Patient had a history of slowly developed pain and stiffness over the last 4months during his full time coaching job. The aggravating factors of his problem were powerful driving range shots for 30mins and walking for 40mins. The easing factors of his problem are rest and heat for 40mins. In the 24hours pattern of pain, patient has stiffness on rising and which gets easier with gentle activity. On palpation there is puffiness to anterior and lateral aspect of right ankle. On examination the resisted dorsiflexion is weak and painful. There is a decreased range of motion of active plantar flexion. In passive plantar flexion pain is produced after resistance. The resisted plantar flexion is weak and painful. Active range of motion of inversion is reduced and painful. During passive inversion pain is felt after resistance. Resisted inversion is weak and painful. Resisted eversion is weak. In accessory movement of talocrural joint, postero-anterior glide is stiff and the pain is produced at the end of range. In the distal tibio-fibular joint, longitudinal cephalad glide is painful before resistance and during postero-anterior glide the patient feels easier. The muscles are weak on both sides of ankle. The right ankle is weaker compared to left ankle. Anterior talo-fibular ligament and calcaneo-fibular ligaments show bilateral laxity. On palpation there is puffiness around the lateral malleolus. Heel raise of the patient is poor, which is 5 on right and 10 on right side. SEVERITY, IRRITABILITY, AND THE NATURE OF PAIN According to Petty (2006) severity and intensity of pain are related together. Severity can be determined by the ability of the patient to maintain the position or movement. Severity is a main factor to determine whether the patient may be able to tolerate overpressure and perform movements up to the first point of pain. According to Hartley (1994) the perception of pain differs from person to person depending on the individuals emotional status and his previous pain experiences. The intensity of pain depends on the number of nociceptors in the site of injury and the surrounding tissues. Intensity of pain can be more in the areas of high innervation than the area of poor innervations. According to Hengeveld Banks (2003) the intensity of pain is subjective and it varies from person to person. In this case the intensity of pain of the patient is 4/10 of visual analogue scale. The patient can play a round of18holes of golf a day and practices on the driving range for 60mins a day. He also walks for a long distance. In spite of pain the patient was able to perform his activity. So the patients severity of pain may be low to moderate. Hengeveld Banks (2003) says that irritability depends on activity causing the pain, the intensity of the activity and the time taken for the pain to subside after the activity is stopped by the patient. According to Petty (2006) irritability can be determined by the time taken for pain symptoms to ease. The symptom is said to be irritable, when the symptom persist after the activity producing pain is stopped. If the symptoms are irritable the patient will not be able to tolerate movements for longer durations. The symptoms may even get worse with activity. So the testing movements should be done with caution. In this case the aggravating factors are powerful driving rage shots for 30mins and walking for 90mins. Similarly the easing factors are rest and heat for 40mins. So the irritability of patient may be moderate to high. However according to Hartley (1995) aching pain is related to the structures like deep ligament, deep muscles, tendon sheath, chronic bursa, compact fascia. Further Magee (2008) argues that, when pain is caused by an activity and eases with rest indicates that there is a mechanical problem which is related to movements. Occasional pain may indicate that there is a mechanical involvement and it is related to movement and mechanical stress. In this case the pain is intermittent and deep in nature. The patient has pain after activity and the pain resolves with rest. So the pain may be mechanical, intermittent and deep in nature MANUAL THERAPY TREATMENT In this case, the main problem of the patient is stiffness rather than pain, in the right ankle. Maitlands grade4 mobilisation with postero-anterior glide of talus on ankle mortise can be given to improve range of motion of plantar flexion. The glide can be given in grade 4, because it is stable and controlled compared to grade3 (Hengeveid Banks, 2003). Here the ankle mortise is a concave surface and the dome of talus is convex. When ankle mortise is fixed and talus is moved, plantar flexion occurs by concave-convex rule. (http://www.pt.ntu.edu.tw/hmchai/Kinesiology/KINmotion/JointStructionAndFunciton.htm, Date accessed: 13/12/2009) However before treatment the important factors that should be taken into account are patients objective marker of pain, loss of range of motion and movements causing pain and these factors should be evaluated after treatment sessions. In Maitlands technique, there is no standard duration for the treatment, but the duration of the treatment should not be more than 2minutes. The duration of the treatment can be altered based on the severity, irritability and nature of the symptoms of the patient. Since the irritability of the patient is moderate to high, the initial treatment can be given for the duration of 30 seconds, with one or two repetitions to avoid exacerbation of the symptoms. After observing the objective marker, duration of the treatment can be progressed to 1 to 2mins and the repetitions can be progressed gradually. The patient can be positioned in prone lying with knee in 90 degree flexion. The starting position of the therapist can be standing by the side of patients righ t knee to have close contact with the treatment area. To give proper support to the shin, the left knee is placed on the couch. The therapist can perform the postero-anterior glide by holding the posterior surface of the calcaneus in his right hand with his thumb, fingers fanning around the calcaneus and his left hand held in supination, with his heel placed against the tibial anterior surface and the therapists fingers are proximally pointed. These positions can be followed to stabilise the part. The force can be applied by movement of the forearms opposing each other. The movement of the therapists forearms produce postero-anterior glide (Hengeveld Banks, 2003). Even though, there are literatures supporting the effectiveness of joint mobilisations, there is not enough controlled studies to prove that joint mobilisation can restore the normal range of motion and functions of hypomobile joint effectively (Farrel, J.P Jenson, G.A. 1992) EFFECT OF MAITLAND MOBILISATION Maitlands technique, are based on restoring arthrokinematic movements. Generally arthrokinematic motion of the joint can be restricted by the ligaments, capsules of the joint and periarticular fascia. The elastic properties of these connective tissues are based on the arrangement of the collagen bundles. In ligaments and tendons, the collagen bundles are arranged parallel to each other with elastic bundles in between them. When the connective tissue structures are unloaded, the collagen bundles show a crimp formation in their structure. This crimp results in production of slag in the connective tissue structure. During the phase of loading, slag is stretched first, followed by the stretching of main bundles. In contrast the fascia and aponeurosis have multilayer collagen bundles but have less crimping and slack compared to ligaments. Initially when the load is applied, structures with less slack are first subjected to stress, followed by the other bundles. The bundles of the fascia w hich have least slag will first resist the tensile stress. If the stress is increased then the ligaments which have more slag will resist the tensile load. After further deformation, the other bundles will act to resist the stress. To obtain elongation of the connective tissue on the whole, all the bundles should be subjected to required stress. This principle can be explained with the help of stress strain curve. In this graph, x-axis represents the stress and y-axis represents the corresponding strain produced by the load. The curve shows a slope, which indicates the connective tissue resistance to a load. The collagen bundles which are still slag, represent the toe region. The curve also represents the physiological loading range, which is then followed by the stage of microscopic failure. If the stress still increases the curve will proceed to the stage of macroscopic failure and may even result in the rupture of the connective tissue. Based on this concept Maitlands grade 4 technique aims to produce permanent elongation (plastic deformation) of the tissue by inducing low level of micro-failure in the connective tissues, there by increases the range of motion (Therkeld, 1992). There is no enough evidence to prove that Maitlands mobilisation can be done in full weight bearing and functional position. Its reliability is based on the clinicians treatment experience and patients reaction to the treatment (Farrel, J.P Jenson, G.A. 1992) SECONDARY TREATMENT The other problems of the patient are poor heel raising due to the weakness in the muscles of ankle joint and pain. In this case Maitlands grade1 mobilisation can be given to reduce pain by pain gate mechanism. As the patient is a golf coach, he needs good heel rising and strong ankle muscles for good performance in the game and to prevent further injury to ankle joint. Strengthening exercises to the muscles of plantarflexion, dorsiflexion, inversion and eversion can be taught to the patient to correct the muscular imbalance of the patient. Then the heel raising should be encouraged gradually and can be progressed if there is no pain. Balance training with the help of wobble board can be taught to the patient. The final phase of treatment is functional training. The patient can be trained to gradually increase the intensity and the duration of drive shots in the game. Walking can be encouraged in a stable surface. CONCLUSION Additional to manual therapy the effective means of rehabilitation of sports injuries should consist of soft tissue massage, electrotherapeutic modalities, proprioceptive neuromuscular facilitation, strengthening exercises, co-ordination training, endurance, flexibility, improving stability and educating the patient about the injury mechanism and methods of prevention (Farrel, J.P Jenson, G.A. 1992). Sports therapist should mainly concentrate on prevention of the injury rather treating when the injury has occurred.

Similes in The Big Sleep Essay -- sleep

Similes in The Big Sleep      Ã‚   In response to Raymond Chandler's The Big Sleep, I have just one question. Why all the similes? There isn't a single page in the novel that doesn't display this annoying literary device. Everything is "like this" or "like that." It never ends! Similar to decoding a secret message that isn't difficult to understand, but nevertheless tiring due to the overwhelming amount of messages, the novel is frustrating to read. The following analysis acknowledges Chandler's creativity in developing his main character, Philip Marlowe, with his usage of simile. However, the excessive style of the novel creates a dominating force that ultimately leaves the reader unfulfilled at the end.    Chandler goes into great detail describing the different characters--most notably, the women. There are many sections where the shrewd detective is quick to notice (and make analogous) certain physical features of the Sternwood daughters; not that I blame him. Early in the novel he observes Mrs. Regen's legs in the following manner. "They were visible to the knee and one of them well beyond...The calves were beautiful, the ankles long and slim and with enough melodic line for a tone poem" (17). I think that every guy reading this book perked up when reading of Vivian's legs. In this sexual sense, the similes work. Those long sentences would be much easier to read if there were more comparisons of Vivian's legs to a "melodic line for a tone poem".    Carmen Sternwood is described with profoundness but in a different (less sexual) sense than her sister is. Marlowe encounters her on many occasions and is thorough in describing her--from her first flirtations to her continuous irritations. In t... ...be something similar to, "It was raining again the next morning, a slanting gray rain like a swung curtain of crystal beads...I was as empty of life as a scarecrow's pockets" (159). There is only so much of that a human being can actually absorb.    And that is precisely why The Big Sleep is a novel that has a hard time coming off as a pleasant reading experience. If the reader has to sift through all the repetition of Marlowe's observations, then it subtracts from the novels overall themes, which I believe are the most captivating parts. Perhaps if it were a short story or if Chandler displayed mercy on our souls by using similes lightly, then the novel would produce a stronger effect.    Works Cited Chandler, Raymond. The Big Sleep. New York: Vintage Books, 1996. Kemp, William. The Writing Process: Chandler 202. January 14, 1999   

Industrial France And England :: essays research papers

Andrew Battaini   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   2/16/00 Industrial France and England   Ã‚  Ã‚  Ã‚  Ã‚  The impact Industrial Revolution was immense on the countries of France and England, which caused large changes in the social classes. Another class of peoples emerged in England and France; they were the middle classes. The middle class was made up of intelligent people who made their money through their smarts and not how they were born. This was clearly proven in France when it's middle class emerged and being influenced by the philosophies filtered ideas of natural rights (life, liberty, and property). This in turn created ideas of revolution in France which eventually overthrew the monarch and set up there own government. Both of these countries however used the Industrial Revolution to there advantage in terms of new inventions and bettering the economy. This essay will show the impact of the Industrial Revolution on France and England.   Ã‚  Ã‚  Ã‚  Ã‚  England started its Industrial Revolution at its peak by first having the proper tools available at the right time. One of the reasons England did so well before the Industrial Revolution was that it had a strong merchant marine which got the materials that didn't occur naturally on there island. This also allowed them to gain news of technological advances and soon machines replaced the gape where workers couldn't be because of the limited work force. And due to England's supremacy of the sea anything they couldn't make now they could trade for it. This led to a better economy, which fell into the time slot of the industrial revolution. Through out all of this the classes remained the same except the small percent of peasants that moved up to the middle class. Family life was very similar through out Europe and there was no exception in England , the father was the head of the family and worked while the women stayed home and took care of the children an did most of the household chores. Rural life did not change much but urban life did with people moving to the cities to work in factories so population in cities grew gradually, but this sudden flood of people made many of them homeless because there was not enough room for them ,so they ether walked many miles to work or if lucky enough a person could find a room to live in. This view of the industrial revolution in England shows that it was beneficial for the economy and upper class but it was horrid for

Helping Beyond Our Borders Essay -- International Crime

There are currently 14 names on the International Criminal Court’s (ICC) â€Å"Most Wanted† list (USA for the International Criminal Court). This is the list of the individuals that are responsible for the most heinous crimes happening around the world. It is the goal of the ICC to find these criminals and bring them to justice. American Involvement in the International Criminal Court, designed to provide enforcement and prosecution for crimes against humanity, is critical to its success in fighting those who are responsible for the world’s worst crimes. The International Criminal Court was first established in 1998 when 120 countries voted to adopt the treaty outlining its structure. This treaty went into effect on July 1, 2002, and 108 countries have ratified it as of 2008. The goal of the ICC is to bring the most serious international war criminals to justice and stop crimes such as genocide, crimes against humanity, and war crimes (USA for the International Criminal Court). The involvement of the United States in the ICC has changed with each president in office. During the Clinton Administration, President Clinton participated in negotiations with the ICC and signed its statute in 2000. However, he did not ratify the treaty because he believed it to be flawed. Then, in 2002, the Bush Administration announced that it would no longer participate in any ICC activity and would not support the court when it was established (AMICC). Since then, the Obama Administration has changed the United States’ relationship with the ICC f rom that of hostility to positive support. Under Obama, the U.S. has supported international criminal justice and principled engagement with international institutions. The U.S., however, does not wish to become... ...fference. Aggressive prosecution aided by the strength the U.S. would add to the process, would help deter future events. There are many people behind all of these horrific crimes, and American involvement in the ICC is crucial to its success in bringing those individuals to justice. Works Cited American Non-Governmental Organization Coalition for the ICC. AMICC, 2012. Web. 12 Mar 2012. MacPhee, Briony. "The United States Should Be a Part of the International Criminal Court." American Non-Governmental Organizations Coalition for the International Criminal Court (AMICC), 2008. Gale Opposing Viewpoints. Web. 9 Mar 2012. "U.S. Influence Being Felt at International Criminal Court." America.gov Press Release. 16 Jun 2010. SIRS Government Reporter. Web. 09 Mar 2012. USA for the International Criminal Court. Citizens for Global Solutions. Web. 12 Mar 2012.

Margaret Laurence’s The Stone Angel Essay

Margaret Laurence’s The Stone Angel is a novel, which depicts the last days of life of the protagonist – Hagar Currie-Shipley. Pride, loneliness and final journey to death are the main themes of the novel.   The character of Hagar is transformed through the novel and the readers can see different stages this old woman comes in her perception of other people, life and death. Multiple flashbacks give us idea about the life of the main character and people who surround her. Margaret Laurence goes further than mere description of events. Deep investigation of Hagar’s beliefs, thoughts and ideas present not only a valuable investigation of old lady’s inner world, but also make the readers to reflect on such important themes as love, friendship, pride, acceptance of death and coming in terms with one’s reality. Margaret Laurence wrote in one of her interviews that she was not sure if the last days of ninety-year old woman could be an interesting reading for the wide audience. But she dared and fulfilled her idea and the novel became popular among the readers. It was included into several study courses soon after it was published. The subject touched in the novel echoed in the hearts of the readers and they were ready to share an experience of dying woman and reflect on the themes of pride and loneliness. Pride is the best characteristic of the main character. All Hagar’s life is dedicated to one ultimate purpose – she wants to make a good appearance by any means. Any manifestations of emotions she regards as weakness, which should be avoided by any means. The name of the novel becomes a symbol for this pride, which makes the main purpose of Hagar’s life. From early age she feels superior to other children. An accident on the Manawak dump is very characteristics for better understanding of Hagar’s character. When Hagar’s friend Lottie killes small chicks in the Manawak dump Hagar becomes greatly impressed by this accident. This accident made such a great impression on Hagar that she was not able to forget about it during all her life. Many years later she retold this accident to Lottie after the death of their children. This accident had such an impression on Hagar not only because of her extra sensitiveness. For her killing birds became manifestation of strength. This strength was manifested by her shy friend. As Hagar herself describes her: â€Å"Lottie was light as an eggshell herself, and I felt surly toward her littleness and pale fine hair, for I was tall and sturdy and dark and would have liked to be the opposite† (Laurence,. 27). Comparing herself to Lottie Hagar suddenly came to realization that she was weaker than slim and shy girl she disdained. This accident became one of the turning points in the becoming of Hagar’s personality and shaped out all her further life. An accident in the Manawak dump made Hagar obsessed with pride and desire to keep a good appearance in front of people by any mean. Pride became sense of life and she was ready to sacrifice everything to this ideal. She did not make any exceptions, even for her dearest people. Being afraid to become weak, she even refuses to pretend being her mother when her dying brother asks her about this. She refuses to do so because she believes her mother was a weak person and Hagar is afraid even to pretend being weak. Pride does not let Hagar to accept the choice of her son to marry Lottie’s daughter. She sees their relations â€Å"as a joke of God – if people had told me forty years ago my son would fall for No-Name Lottie Drieser’s daughter, I’d have laughed in their faces† (Laurence, 204). She boldly takes God’s â€Å"challenges† and decides to destroy their relationships. For this purposes she even turns to Lottie’s help. Hagar is stubborn and self-assured enough to make the decisions for other people and their future. She does not take feelings of other people seriously and even happiness of her own son does not count in comparison to her own ambitions. She does not hesitate even for a minute when making a decision to destroy John’s and Arlene’s relationship. Hagar forgets her own youth when she did not listen to anybody and married the man she had fallen in love with. â€Å"I saw them with a covey of young, like Jess’s had been, clustered like fish spawn, children with running noses and drooping, handed-down pants four sizes too large. I couldn’t face the thought.† (Laurence, 211) She is absolutely sure in her right and power to decide the destinies of other people and such attitude finally results in a tragedy. Pride and aesthetic feeling become main reasons, which define all Hagar’s behavior. Obsession with the importance of appearance becomes a reason, which destructs Hagar’s life. This concern about appearance prevented her from enjoying physical love with the husband. Inner rules and restrictions did not let her to forget about morals and appearance even for a minute. Doing her best to keep a good appearance she does not even cry on the funerals of her beloved son. Death is another important theme of the novel. All Hagar’s life becomes a constant battle with death. Since early years she denies death and destructions and since these very early times they follow her step by step. Feeling an approach of death, Hagar tries to escape this reality and looks for the mean to deceive death. In the beginning she turns to memories and recollects the pictures from her past. Childhood memories, marriage and children, all these memories help Hagar to create her own reality where there is no place for death. She can not even tolerate thoughts about death. In her reflections she states: â€Å"Hard to imagine a world and I not in it. Will everything stop when I do? Stupid old baggage, who do you think you are? Hagar. There’s no one else like me in this world† (Laurence, 255). Such a position reflects selfish attitude and pride. Hagar can not believe that the world can exist without her.   When Hagar realizes that she can not escape from reality any more aggression and desire to change something replaces all other feelings. Hagar rejects help of other people and tries to fight death. She can hardly control her feelings and anger becomes a mean to express her protest against the existing order of the world. The realization become difficult because death is that phenomenon, which Hagar tried to escape by any means since early childhood. From the very moment when Lottie killed chicks Hagar did not want to confess even to herself that death was a natural part of the world. She rejects any kind of help and perceives Marvin’s attempt to put her in the nursing home as a humiliation. Only after long period of inner fight Hagar finally comes in terms with the reality. Acceptance of the world around her becomes new experience for Hagar. She finally comes to hard realizations that her will and proud can not control everything in the world and there are things she has to perceive as they are, not attempting to improve them. Ability to see different sides of the problem also becomes new experience for Hagar. As she states, â€Å"how you see a thing – it depends which side of the fence you’re on† (Laurence, p. 224) May be for the first time in her life Hagar realizes that there are other people around her and these people also have feelings, thoughts and emotions. Such simple conclusion becomes a very serious breakthrough for this strong and proud woman who used to control everything and everybody during all her life. Hagar finally starts counting with the will of other people. She does several mercy deeds, which are done not because of some aesthetic value or in the attempt to make a good appearance. Hagar helps ill girl who can not get up. Later she talks to her son and tells him she loves him more than John, who died in the car accident. These actions require enormous amount of Hagar’s inner force. Simple acts of mercy are so new to her that she can not perceive them as something normal, like most of the people do. This transformation becomes the greatest accomplishment for Hagar. She lies to Marvin in the name of love. This lie is very vividly apposed to her proud refusal to lie for the sake of her dying brother many years ago. All these changes become a vivid indicator of big transformation, which happens to Hagar during the last days of her life. She finally realizes that there are things, which are more important than pride and good appearance, which have determined all her previous life. Such things as compassion, friendship and love for the first time uncover their true meaning for Hagar. The author uses the death to show the change in the perspective of the main character and to let the reader follow the person who leaves this world. From the other side new realization does not change her proud and independent nature. Hagar is still afraid and feels lonely, but she does not fight her destiny and the whole world any more. She makes her final decision to leave the world being proud and independent, like she has spent her whole life. In the last scene Hagar, dying, rejects the help of the nurse to help her drink some water. She does it herself and this usual action which we do several times a day becomes an exploit for dying woman and proves her independence and power of her spirit. Margaret Laurence has chosen a difficult topic for her novel. She depicted the last days of the old woman left alone in her world, surrounded by the memories of the past and lonely in her voluntary isolation. The author describes different stages Hagar passed before her death and analyses her emotional conditions during these stages. But we meet death several times during the novel. We see in the memories of Hagar who lost almost all her dear people but didn’t think about the death like about something which could happen to her. The death is described without embellishments and exaggerations. But ordinary and routine descriptions help to get better understanding of the death and, finally, of life. Works Cited: 1. Margaret Laurence, The Stone Angel, New Canadian Library, Toronto, 1968.

Explaining patterns and trends in health Essay

There are many ways to measure patterns of ill health; these include mortality, morbidity, health events, disease incidence, disease prevalence and health surveillance. These are; Morbidity Rates is how many individuals suffer from the disease at a given time. Mortality Rates is how many individuals die from suffering from the disease and health events individuals being aware of health issues such as the NHS providing information about the main concern. Disease incidence is the chance of the individual being diagnosed. Disease Prevalence is how the proportion of the population is suffering from the disease. Health Surveillance identifies early signs of ill health and way to prevent and protect. There are many social groups which can influence an individual’s health and lifestyle both positively and negatively. These are; Gender which is just whether you are male or female. Age which is how old an individual is when the data is recorded. Social Class which is not meant to still be around as we are supposed to live in a classless society were the class of people does not matter. Risk Behaviour which is certain forms of behaviour which are shown to be associated with increased susceptibility to a certain disease of ill-health. Ethnicity which is the state of belonging to a certain social group that has a common national or cultural tradition. Locality which is the position or site of something. The classifications of social classes are the five class scheme Register Generals Social Class (RGSC) WHICH IS: I – Professional Occupational, II – Managerial and Technical Occupational, III – Skilled Occupational, Manual (M) and Non-Manual (N). IV – Partly –skilled Occupational and V – Unskilled Occupational. NS-SEC stands for the National Statistics Socio-Economic Classification which is: 1 – senior professionals/senior managers, 2 – Associate professionals/Junior managers, 3 – Other administrative and clerical workers, 4- Own account non-professional and 5- Supervisors, technicians and related workers. 6 – Intermediate workers, 7- other workers and 8 – never worked/other inactive. In 1980 the black report was then published. It had been commissioned  approximately 30 years after the founding of the NHS and provided a commentary about how the UK had done in providing for the health of its population. The report concluded that there was a poorer health experience for the lower occupational groups at all stages in life. These were; Gender -Men and women in occupation class V had two and a half times higher chance of dying before reaching the retirement age than those in occupational class I. – At birth and during the first month of life the risk of death in families of unskilled workers was double that of professional families. – Boys in class V had a ten times greater chance of dying from fire, falls or frowning than those in class I – The difference between the health of men and woman indicated that the risk of death for men in each social class was almost twice that for women. – Difference in the health experiences of different ra cial ethnic groups are also identified. Age Health inequality exists in our society and even though they affect different areas they are interlinked. Acheson (1998) said ‘health inequalities affects the whole society and can be identified from foetus to old age’ Locality From the black report I can see that were you live can affect your chances for getting an illness or disease. We find that death rates for CHD for those born I the Indian sub-continent were 38% higher for men and 45% higher for women than rates within the UK. Social Groups The health gap between rich and poor in the UK has widened since 1980 and class is the main core of inequalities wherever they are identified. They found that the scientific evidence supports a socio-economic explanation of health inequalities which are caused by factors such as income, education, employment, environment and lifestyle. The report made three key recommendations to the government. These are; – All policies are likely to have an impact on health should be evaluated in terms of their impact on health inequalities. – A high priority should be given to the health of families with children. – Further steps should be taken to reduce income inequalities and improve the living standards of poor households. Risks of Behaviour Consistent death rates in Europe have reached their lowest point in the entire history of human society. The twentieth century has witnessed a dramatic drop in the rate of infectious disease, as well as the introduction of therapies fo r its treatment. Common causes of death which have greatly weakened, such as TB and diphtheria were often linked to poverty and material deprivation.  Ethnicity One of the most important dimensions of inequality in contemporary Britain is race. Immigrants to this country from the so-called new Commonwealth, whose ethnic identity is clearly visible in the colour of their skin, are known to experience greater difficulty in finding work and adequate housing. The different patterns and trends that I have found within my own research about alcohol related deaths links with ageing, Ethnicity, Risks of behaviour, Locality, Gender and social groups. Gender and Ageing Males aged 30 and over are significantly more likely than females to die of alcohol related causes over 66% of all alcohol related deaths in the UK (in 2011 were among males). Males aged 30 and over were significantly more likely than females o die from alcohol-related causes. For both sexes, the number of alcohol0related deaths increased sharply from the 25-29 year old age group, increasing to 838 for males and 411 for females aged 55 to 59. After this age, the number of alcohol-related deaths began to reduce steadily for males across each age group reducing to 92 for those ages 85 and over. The decline across age groups was more gradual in females, dropping to 81 in the 85 and over age group. 45-49year old men have died from alcohol related death by 32,000 but from females it goes to 14,000. Locality Data for Scotland and Northern Ireland are published separately. Between 2007 and 2010 male alcohol-related death rates were significantly higher in wales than in England. A three year decline in male death rates in wales means this difference is no longer significant. The table shows drinking habits by region in 2012 show people above the age of 16 who consumes alcohol weekly such as in the north east people who drink up to 3-4 units are 46% compared to North West who drink up to 3-4 units are 42%. Social Groups The table shows drinking habits in pregnancy in 2012. Women who are pregnant have consumed alcohol in the last week is 10% compared to women who are not pregnant and unsure are 53%. Ethnicity This table shows drinking habits by ethnicity in 2012 for people who have drank alcohol within the last week is 58% and the people who have drank alcohol five or more occasions last week is 11%.