Inter-professional Working and the Needs of the Patients

Inter-professional Working and the Needs of the Patients QUESTION I Not sharing information is detrimental to inter-professional working Indeed, the needs of patients are best met by the inter-professional team, the evidence indicates that collaboration can promote coordination, cooperation between carers and significantly improve patient outcome and resource management (DoH, 2000, 2001a, 2001b). ‘Inter-professional’ working has thus become popular following pivotal policies drafted to structurally re-shape the National Health System (NHS) and influence how professional groups work together (DoH 2000, 1998, 1997). The literature has thus seen an upsurge in studies investigating patient oriented inter-professional collaborations with evidence for the positive impact of good, innovative inter-professional practice (Freeman et al, 2000), some of which have been seen in the areas of acquisition of clinical skills via inter-professional approach (Freeth, 2001, Freeth and Nicol 1998), management of acutely ill patients (Smith et al, 2002), palliative care (Vickridge, 1998) and in the sphere of care of older peo ple (Tierney and Vallis, 1999). Collaboration between professionals and their teams, mutual respect, the sharing of knowledge, skills, decisions and the recognition of the contribution of participating professional/teams highlight the integrated nature of inter-professional work (Molyneux 2001; Ovretveit (1997). Nevertheless, several factor militates against inter-professional working; these include information unshared, poor communications skills/methods and language differences (Caldwell and Atwal 2003; Pietroni, 1992; DOH, 1991), role overlap and confusion (Caldwell and Atwal 2003), conflicting and unequal power relationships (Caldwell and Atwal 2003; Blane,1991), different ideologies (Caldwell and Atwal 2003), differing perception of patients needs and treatment goals (Stevenson 1985) role confusion (Opuko, 1992) and a persisting tendency to promote professionalism in work settings. Areskog (1988) and Carpenter (1995) suggested that if collaboration ideologies is included in the qualification programmes of professionals and exemplified at that early stage, it will lead to better inter-professional working as issues of differing perceptions of treatment goals and patients’ needs will be tackled along with professional ‘stereotype’ that become impediments of meaningful inter-professional work. In view of this, the work of Freeth and Nicol (1998, attached) is an important study that sheds light on the barrier, opportunities, benefits and perhaps the way forward for inter-professional education and practice. The study was described as innovative programme of shared learning in acute care, involving final year medical students and newly qualified staff nurses and was developed in response to the indistinct professional role of junior doctors and the expanded roles of nurses. The programme utilized patient scenario which was pertinent to the partic ipants area of practice for the training purpose. The authors defined inter-professional education as â€Å"learning with and from each other† and reports from a supportive climate, the description and analysis of an inter-professional clinical skill course for newly registered nurses and senior medical students. While the benefits of inter-professional working was a strong motivation for the training/study, the authors deemed inter-professional learning as difficult and fraught with practical problems; the non-resolution of which may lend further support to critics of the initiative. The Clinical Skills Initiative was a collaborative venture between a School of Nursing Midwifery and a Medical School (Studdy et al 1994). The importance of information sharing was underscored by the fact that the entire programme had communication skills taught, and role played using realistic patient scenarios. This was thought to have made for a balanced diet of clinical and communication skills that is vital for high quality patient care. A background to this was the development of the Inter-professional Skills Centre that ensured that the channels of communication between the two Schools were strengthened and inter-professional relationships was well established. This in the opinion of the authors provided the inter-professional initiatives with an infrastructure, and a supportive climate underpinned by common understandings, thus, enhancing the chances of success (Freeth and Nicol 1998). The course provided an inter-professional arrangement that allowed for an inter-change of information thus enabling members of the nursing and medical professions to learn from each other. Such sharing of information was shown from the analysis of field notes, interviews, flip chart and questionnaires to have promoted mutual appreciation of expertise and the roles of both profession in contributing to overall patient care. In a case scenario where the participants were told that conservative management of a patient’s leg ulcer has failed and surgery was needed, it was interesting to note that both professionals, in small inter-professional groups, explored issues surrounding informed consent, focusing on the information needed to make an informed decision and the way in which this should be communicated to patients and relatives (Freeth and Nicol 1998). Undoubtedly the sharing of information here improved the outcome of the deliberation. The result suggests that the study was a positive experience for the participants; they were able to contribute something to the overall patient problem solving, drawing upon each other’s practical experience, and specialized knowledge. They shared information even during social interactions, as much of any waiting time was employed to enquire about each others ward-based experiences (Freeth and Nicol 1998). The registered nurses saw the inter-professional training as a great chance to learn new clinical skills and commented that the education made obvious what should have been done in their past experiences. Additionally, some participants from the medical profession had technical questions relating to ward procedures and their rationale. These were addressed to the staff nurses and information exchange was again beneficial to both team members, thus confirming the authors’ assumption that nurses ward experience is an asset for inter-professional training. A member of the medical team considered the inter-professional education to have ‘un-smudged’ some of the boundaries in roles and highlighted the need to work together and communicate. Overall, this article is relevant to the understanding of the vital ingredients needed for an inter-professional education that will promote current health policies and maximize patients’ benefits. The article indicates the im portance of ‘information sharing amongst professionals’ for the success of inter-professional collaborations. Caldwell and Atwal (2003) highlighted a number of problems of hospital inter-professional practice, a significant number of which can be attributed to ‘not sharing information’. A case involving a staff nurse, a consultant, an occupational therapist, social services, the patient and a hoist was described. The staff nurse considered the hoist as important for the authorised discharge of the patient and was concerned that one has not been issued; this was expressed at a multidisciplinary team meeting. However, underlying the ill-feelings of the professionals is the fact that information about varying perception of what should be the optimum care strategy for the patient has not been shared or negotiated. According to Caldwell and Atwal (2003), uknown to the occupational therapist the staff nurse had received pressure from the consultant to discharge this patient, and unknown to the staff nurse the occupational therapist is contending with social services who are suggesting that this patient could benefit from further rehabilitation and therefore should not be issued a hoist. It is thus reasonable to suppose at this point that team members’ innate un-willingness or the inability to share information or communicate is detrimental to inter-professional working. Professionals in such teams or settings should necessarily share information to promote an understanding of each others role and care plan thus fostering the approach of a team working toward optimum patient oriented goals in a well orchestrated manner (Cooper et al, 2001). The issue of role boundaries was also highlighted in the Freeth and Nicol (1998) study; sometimes however, it is a case of role overlap and confusion amongst professionals, for example, nurses and junior doctors. This has become apparent especially since Government policies now favour expansion of nurses’ role and reduction in the hours worked by junior doctors (DoH (1994). Clarity of these professional functions is important for practitioners in the ever changing inter-professional interface (Taylor 1996). It may be argued for instance, that why should a physiotherapist wait to have a wheelchair prescribed only after patient assessment by an occupational therapist when the former also have the requisite assessment skills. Clear definition of roles and optimum utilisation of professional resource capacities will make for an enhanced inter-professional practice and patients benefit. Other issues of importance to inter-professional working identified in the article included stereotypes, inter-professional barriers, and a tendency for some professionals to minimize the importance or value of the work of other professionals owing probably to excessive emphasis on professionalism during training. These issues are constraints to effective patient care and need be properly addressed for the optimum functioning of an inter-professional initiative. While works, such as those of Freeth and Nicol (1998) clearly demonstrate the benefits of inter-professional education, background schooling for the majority of professionals still take place in mono-disciplinary settings that fosters professionalism and stereotyped image/ expectations of other professionals (Leiba 1996). This trend cannot achieve the policy aims of effective collaborative working (DoH, 2000; 2001a; 2001b; 1998; 1997). A key solution will be the provision of support for inter-profession education/training as exemplified by Freeth and Nicol (1998); it is an integrated approach with potential for preparing professionals to encourage inter-professional practice. QUESTION II Part A: Points learnt include: The benefits of inter-profession working A positive outlook on multi-disciplinary teams that inter-relate for better patient outcome The need for interest in other professions and an understanding of their roles. The importance of ‘sharing information’ effectively with other healthcare professionals, patients and relatives while maintaining patient’s autonomy and confidentiality Professional need for effective communicate skills The need to be involved in therapeutic decision making and care plan formulation that earns patients’ concordance. An important practical message in the considering of inter-professional education/work is the need for attitudinal changes; the immediate effect of which in clinical practice, includes the readiness to share relevant information with clinicians to promote effective delivery of care, the perception of other professional as equally making valuable indispensable contributions to patient care as well as a positive outlook on inter-professional working. These attitudinal changes are necessary for the efficient local practice of inter-professional working. McGrath (1991) showed that the benefits of inter-professional working includes but is not limited to (1) efficiency in human resource allocation and the optimum utilization of capacity within the team, i.e. specialist staff focus on specialist skills/cases (2) efficient delivery of health care with improved patient outcome and (3) increase in job satisfaction for members of the inter-professional team arising from the support of willing team members and an enabling work environment. Inter-professional working could thus have improved the clinical outcomes in a number of the hospital cases that in my experience has led to grave loss or patient suffering. The recent experience was in the care of hospital in-patients with a clinical diagnosis of osteoporosis without any history of fracture and on a frailer group of patients with advance bone changes usually having sustained fracture/s (CSP 2002) and for which NICE (2005) has provided a guideline for the secondary prevention of fragility fractures. The patients were managed at any of the 11 wards representing medicine, surgery, orthopaedic and elderly care wards of a tertiary care facility in London during an 8-week placement period. Gross observation revealed treatment gaps in meeting guideline recommendations for the management of these patients in the areas of risk of fall assessment and referral to multi-factorial fall risk assessment and intervention clinic. There did not seem to be a unified format or standard for the assessment of fall risk within the 11 wards and risk of fall was not assessed in more than 50% of the cases in which this was a guideline requirement, perhaps, due to confusion in role identity and the location of this responsibility amongst the professional concerned. The clinical records of these patients showed that both nurses and physiotherapist assessed fall risk criteria and reported this in different formats. Proper integration of the services and communications between these professionals as prescribed within the frame work of inter-professional working will avoid needless duplication of effort, the waste of resources and clinicians time. Saved time could then be expended by either of the professionals in improving quality of care and quality time spent with patient; this is in addition to improved consistency in patients’ records and the ease of continued care should there be a need for patients to moved between wards of the unit. Part B: While Government policy has reflected a cultural shift by way of imposition of radical changes to the way in which health services are organized and delivered, there are distressing problems that make inter-professional working an arduous task. The issue of power and its distribution within the health institution is here of prime importance. There exist unequal power distributions between health care professionals, often leading to organizational and working structures that are impediments to inter-professional working. (Carrier and Kendall, 1995; Kgppeli’ 1995; Blane, 1991). Power is often in the domain of the older, more established medical profession; and there has been a pattern of domination over other professionalized disciplines, such as nursing, social work and other allied health professions (Kgppeli’ 1995; Hugman, 1991). The study of Manias and Street (2001) revealed that nurses faced many difficulties that practically precluded them from participating in therapeutic decision making for patients to whom they maintain permanent physical, emotional and sensitory closeness (Kgppeli’ 1995). Manias and Street (2001) found that nurses on medical ward rounds answered ‘doctors’ questions only, were not encouraged to give unsolicited information about the patient and hence found it very difficult to present relevant patient issues during a medical ward round. An enormous amount of literature has been written on the nurse-doctor relation; a significant portion of these appear to imply that the powers and influences of medical profession are hindrances to development of nursing. From a historical standpoint, it is logical to think of health professions as complementary to each other, however, the fact that they are organised ‘around’ a patient, that they ought to cooperate for his benefit seems secondary if not trivial (Kgppeli’ 1995). There is a lingering tendency to maintain professionalism and to expect ‘predetermined behavior’ of other health care professionals. The domination of one professional over the others within a health team is a major factor that can strengthen the boundaries between the professional groups engaged in inter-professional working and constrain effective teamwork (Beattie, 1995). Power in-balance within the inter-professional team will also encourage the making of many ‘rules’ and regulations that are capable of controlling major aspects of professional practice (Kgppeli’ 1995), thus making un-necessary any substantial discussion intended to individualise care and improve clinical and social patient outcome. The care and management of a hospitalised patient cannot be achieved by one person, neither is one professional group capable of the task. It is always a complex multidisciplinary phenomenon (Kgppeli’ 1995) in which the integrated knowledge and skill of people with different professional backgrounds makes for better clinical and social patient outcome. Hence, leadership within inter-professional team should not be ‘zoned’ to one profession as such will be detrimental to the optimal functioning of the initiative. The leadership need be more inspirational and stimulating, enabling other team members to respond positively to opportunities presented by developing improved knowledge and skills in managing professional practice and inter-professional relationships. According to Colyer (1999), non medical professional members of the team who are willing to assume the demanding responsibilities of full membership of the inter-professional teams should also be made to feel a sense of belonging and responsibility to the integrated patient oriented goal of the team. References: Areskog N-H (1988) The need for multiprofessional health education in undergraduate studies. Medical Education 22:251-252 Beattie A (1995) War and peace among the health tribes. In: Soothill K, Mackay L, Webb C, eds. Interprofessional Relations in Health Care. Edward Arnold, London: 11–26 Blane D (1991) Health Professionals. In: Scambler G ed. Sociology as Applied to Medicine. Bailliere Tindall, London Caldwell K and Atwal A (2003) The problems of interprofessional healthcare practice in hospitals British Journal of Nursing 12 (20)1212 1218 Carpenter J (1995) Doctors and nurses: stereotypes and stereotype change in interprofessional education. Journal of Interprofessional Care 9 (2): 151-161 Carrier J, Kendall I (1995) Professionalism and interprofessionalism in health and community care: some theoretical issues. In: Owens P, Carrier J, Horder J, eds. Interprofessional Issues in Community and Primary Health Care. Macmillan, London: 9–36 Colyer, Hazel (1999) Interprofessional teams in cancer care. Radiography 5: 187-189 Cooper, H., Carlisle, C., Gibbs, T. and Watkins, C. (2001) Developing an evidence base for interdisciplinary learning: a systematic review, Journal of Advanced Nursing 35(2): 228–37. CSP: Chartered Society of Physiotherapy (CSP, 2002) www.csp.org.uk. DoH (1991) Working Together: A Guide to Arrangements for Inter-agency Cooperation for the Protection of Children from Abuse. DoH, London DoH (1994) Implementing Caring for People: Training and Development. HMSO, London DoH (1997) The New NHS: Modern, Dependable. The Stationery Office, London DoH (1998) A First Class Service: Quality in the New NHS. DoH, London DoH (2000) The NHS Plan: A Plan for Investment, A Plan for Reform. The Stationery Office, London DoH (2001a) National Service Framework for Older People. The Stationery Office, London DoH (2001b) Working Together, Learning Together: A Framework for Lifelong Learning in the NHS. The Stationery Office, London Freeman M, Miller C, Ross N (2000) The impact of individual philosophies of teamwork on multiprofessional practice and the implications for education. J Interpr of Care 14(3): 237–47 Freeth G (2001) Sustaining interprofessional collaboration. J Interprof Care 15: 37–46 Freeth D and Nicol M (1998). Learning clinical skills: an interprofessional approach. Nurse education Today 18, 455-461 Hugman R (1991) Power in the Caring Professions. Macmillan, London Kgppeli’ Silvia (1995) Interprofessional cooperation: why is partnership so difficult? Patient Education and Counseling 26: 251-256 Leiba Tony (1996) Interprofessional and multi-agency training and working British Journal of Community Nursing 1 (1): 8 12 Manias E and Street A (2001) Nurse–doctor interactions during critical care ward rounds. J Clin Nurs 10:442–50 McGrath M (1991) Multi-disciplinary teamwork. Avebury, Aldershot Molyneux J (2001) Interprofessional teamworking: what makes teams work well? J Interprof Care 15: 29–35 National Institute for Health and Clinical Excellence (NICE 2005) Bisphosphonates (alendronate, etidronate, risedronate), selective oestrogen receptor modulators (raloxifene) and parathyroid hormone (teriparatide) for the secondary prevention of osteoporotic fragility fractures in postmenopausal women. Technology Appraisal Document No 87. Opuko D K (1992) Does Interprofessional cooperation matter in the Care of Birthing Women? Journal of Interprofessional Care 6(2): 119-25 Ovretveit J (1997) Evaluating Health Interventions: An Introduction to Evaluation of Health Treatments, Services, Policies and Organizational Interventions. Open University Press, Buckingham Pietroni P C (1992) Towards Reflective Practice The Languages of Health and Social Care. Journal of Interprofessional Care 6(1): 7-16 Smith G, Osgood V, Crane S (2002) ALERT: a multiprofessional training course in the care of the acutely ill adult patient. Resuscitation 52(3): 281–6 Stevenson O (1985) The community care of frail elderly people: co-operation in health and social care. Br J Occup Ther 48: 332–4 Studdy S J, Nicol M J, Fox-Hiley A (I994) Teaching and learning clirdcal skills, Part 1: Development of a mullidisciplinary skills centre. Nurse Education Today14:177-185 Taylor J (1996) Systems thinking, boundaries and role clarity. Clin Perform Qual Health Care 4(4): 198–9 Tierney A, Vallis J (1999) Multidisciplinary teamworking in the care of elderly patients with hip fracture. J Interprof Care 13: 41–52 Vickridge R (1998) Collaborative working for good practice in palliative care. J Interpr of Care 12: 63–7

Dow Pbb

Dow Chemical By Kai Draaisma Laurens de Blij Diedrik Oost Eva Sloff Lesley Flohil 13-11-2012 Duisenberg School of Finance Executive summary 1. Summary of Facts. With an annual revenue of $20. 2 billion Dow held the leading market position worldwide in ethylene and polyethylene (exhibit 1b). To consolidate all of Bahia Blanca’s polyethylene activity under Dow’s control a three-stage plan was developed. The first stage involved taking control of PBB, the second stage involved acquiring Polisur’s two polyethylene plants, and the third stage involved building a new ethylene cracker.To determine a proper risk premium Dow had to consider possible country risks. Currency and government policy risk may have had an impact because of possible future crises and changing government policies relevant to foreign investments. Furthermore, because of the ending of the convertibility law Dow also had to consider a possible exchange-rate risk. Dow created a holding company, Dow In vestment Argentina, to invest in the project, then they had to decide whether they will use general corporate funds or raise debt for the PBB bid. 2. Statement of problem . 1General analysis Rational for Acquisition of PBB Dow Chemical’s corporate strategy is to look for horizontal- and vertical integration, achieve technological leadership and gain international presence. Dow will benefit from a more integrated production process by lowering their cost of production. PBB will also create stable supplies of ethane for Dow allowing them to achieve operating rates near 100%. Cracking ethane in the region will result in lower operating risk for Dow meaning the supply/input risk for the production of Polyethylene.An increase in the production output of Dow will allow them to benefit from economies of scale. Overall Dow will gain technology leadership and operational excellence from adding PBB to their company and enhance them with a costleader position in the market required to c ompete with the government-subsidized chemical complexes. Risk measurement In this section we provide a brief risk analysis. Table 1 is designed to give a compact overview of the different risks, possible mitigating actions and whether the risks are integrated in the cash flow or discount rate.Not every risk was applicable in the acquisition of PBB. The risk that influenced our cash flows the most is the currency risk caused by a possible liquidity crisis in Argentina. Argentina has experienced eight major currency crises (tijd/reference)and there is a risk of a new currency crisis in the future. When this happens, Dow will not be able to sell its output to the home country and will have to increase its export. Revenue de We have also taken into account that the convertibility law that now provides stability could eventually stop. This will also have a significant impact on inflation.Operating risk is the second risk with a large impact on projected cash flows. This is mostly the ri sk of not meeting the full operating capacity. For the first 3 years we keep the operating rate of the plant at 65% and from 1995 we increase the operating rate by 5% each year. Other risks had less of an impact on our cash flows. Information risk was less of an issue because Dow was already present in Argentina and PBB was important to the government of Argentina. Corporate Governance risk in Argentina is not expected to have a significant additional impact on cash flows.This risk is already included in the discount rate for similar projects in the US. Table 1: Risk overview| Risk| Mitigating actions| Cash Flow (CF) or Discount rate (DR)| Corruption risk| 1. Have a large bank loan from a national bank. 2. Government stake of 49% here is a mitigating factor | DR| Expropriation risk| Same actions as for corruption risk| CF (tax wil increase 5%)| Operating risk (only post/ completion risks )| n/a| CF| Sovereign risk| Through the convertibility law, the peso has been anchored to the US D to prevent hyperinflation. | DR| Currency/ Foreign exchange risk| 1.Dow is a well diversified investor, therefore this should be mitigated. 2. Buy put options on the Arg peso. | CF| Corporate Governance risk| Give shares to management to align incentives. | DR| Repatriation risk| Current political climate is stable, not likely that Arg will impose limits on fund outflows. | DR| Information Risk| Dow Chemical already has presence in Argentina, therefore are more likely to receive high quality information. | n/a| Adjusted discount rate All risks that are not used for adjusting cash flows are integrated in the adjusted discount rate.These risks include but are not limited to corruption risk, information risk, hyperinflation, sovereign risk, repatriation risk and other residual risks. These risks are partly mitigated, however all the different risks combined constitute a premium which we will add on to the the given discount rate for similar projects in the US of 8%-10%. A reasonable assumption for the combined premium will be [ ]. The auumed premium results in a discount rate of [ ] which we will use in our further valuation. 4. Recommendation Bidding decisionCompeting bidders need to comply with certain covenants (exhibit 6). Competitors Perez Companc S. A. and Copesul do not comply with the requirements of having a statement of net worth of at least 5 billion. Even if the two companies would merge they do not meet the the requirements. This makes Dow the sole bidder for PBB. This has a profound impact on the internal valuation. Appendix 1 Risk Information risk. When you are doing a cross-border valuation you have to take into account that there may be information risk.This includes the risk of outside investors getting the wrong information because of poor disclosure in the financial statements. However since Dow entered Argentina in 1957 we assume they are familiar with the market and accounting rules, therefore information risk for this project is low as Do w chemical has already collected country experience in Argentina via Dow Quimica. Because this is difficult to quantify we have taken this into account in our discount rate. Corruptionrisk. The risk of corruption includes the illegal payments and favors outside the rule of law.Corruption exists to some extent in all countries, but there are large differences across countries. According to the Global Corruption Index by Transparancy international, the level of corruption for Argentina in 1995 was given a 5. 24 out of a possible score of 10. This gave them a ranking of 24 out of 42 countries surveyed. All of which were assumed to be developed countries. However, Dow somehow secured itself thanks to PBB’s importance and the Argentine government’s intention to keeps 49% which is an advantage and not a disadvantage.The Argentine government will also appreciate the jobs being created in the later project stages, if successful, and a good relationship with the government will likely also be beneficial when discussing with YPF about long-term ethane supply. Mitigation: Part of this risk can be mitigated by taking a loan in Argentina to finance the project as the government will not want Dow to default on their debt resulting in an overall bad outcome for Argentina’s economic situation. Furthermore part of this risk is mitigated as the government has a stake in the company so it is also in their interest to keep the company strong.Currency risk: As Argentina has experienced 8 major currency crises in the past there is the risk of a new currency crisis occuring in the future. Even though the convertibility law took away some of the risk, Dow will still have to bear in mind that when a crises happen, they will not be able to sell their output to the home country and will have to increase its export. This risk is taken into account in the cashflows. Expropriation risk. Political instability or expropriation is small as they company has had a stable dem ocratic government past 12 years.However, changes in the policy of the government will cause a risk for Dow and their foreign investments. At that moment there were no restrictions on borrowing abroad and there were no limits imposed on payments of foreign loan principal and interest. If something changes in this regulations it may have an effect on the acquisition of Dow. For this reason we will also include this risk in our discount rate. Furthermore the government has no limits on cash flows going out of their country but can eventually decide to do so.We consider the risk of the government taking over the company to be low as the production of polyethylene and deriving ethylene from hydrocarbon crackers is complex. This is a process for skilled people and not just anyone can therefore run the company properly. The risk of expropriation is therefore low. As the production of ethylene and derivatives such as polythylene is a highly complicated process, requiring large captial inve stment and a high operating leverage, not many companies will be able and willing to take over the business.Furthermore as Polythylene is a commodity product that trades globally with a narrow price range. Mitigation:Dow can decrease the risk exposure by taking on a loan in Argentina to finance their project. This will decrease the risk exposure as Dow can only default on their debt when the government decides to raise taxes, which will not lead to a company default. Foreign Exchange Rate Risk. Foreign Exhange rate risk will be low because of Dow Chemical’s international presence and the assumption that shareholders are sufficiently diversified. The convertibility law which ensured a fixed Argentine peso and U.S. dollar at exactly one already decrease the foreign exchange rate risk. However we need to take into account the risk that the convertibility law might come to an end. Mitigation: The risk can be decreased by setting up binding financial contracts with the governmetn to make sure the deal will happen. Furthermore Dow could decide to place a put option on the peso to protect themselves when the peso collapses. Operating risk Pre-completion: as the project is already completed there is no risk concerning the technology risks or other completion risk.Post-completion: we have included the post-completion risk in our cashflows as we run the risk of not meeting the full operating capacity. For the first 3 years we keep the operating rate of the plant at 65% and from 1995 we increase the operating rate by 5% each year. As the company provides their own input this risk does not need to be taken into account. Operating risk would likely matter but we handled that risk by adjsuting down our casfhlows in stage 1 so we do not take it into account for adjusting our cost of capitalSovereign risk Politcal events suchs as wars, labor strikes, terrorism and changes in laws can happen in any country you work with and therefore needs to be taken into account. Sinc e it is hard to quantify this risk we have handled it through the discount rate. Appendix 2 | | Source: Erb, Harvey Viskanta, ‘Poltical risk,Economic risk and Financial risk’, Fuqua School of Business Working Paper No. 9606, 1996. | ——————————————– [ 1 ]. For broader explanation of the different risks see Appendix 1 [ 2 ].According to the Global Corruption Index by Transparancy international the level of corruption for Argentina in 1995 was given a 5. 24 out of a possible score of 10. This gave them a ranking of 24 out of 42 countries surveyed. All of which were developed countries more or less. Source: http://archive. transparency. org/policy_research/surveys_indices/cpi/previous_cpi [ 3 ]. See Appendix 1 for an explanation of the mitigating factors of the before mentioned risks [ 4 ]. This conclusion was reached byTaking the ‘total assets’ as net worth on the financial statements of Perez on Copesul (exhibit 8a &8b).

The Positive Aspects Of Happiness - 901 Words

Happiness could be described as the perception that the positive aspects of life outweigh the negative. With this definition, people could often attain ephemeral moments of happiness. When, for example, a man discovers that his favorite baseball team has won the championship, a woman is complimented on her dress, or a child discovers that school has been cancelled for the day, they feel happiness because at that moment some occurrence has caused them to feel that the good in the world exceeds the bad. Long-term, sustainable happiness, however, is more elusive. Given time to ponder the ratio of positive to negative in their lives and the world, many people find that happiness is not so easily achievable. The man soon remembers that he has to work a twelve-hour day in a factory; the woman returns home to an abusive husband; the child is bullied at school. Whenever possible, people compensate for these adversities with beneficial experiences and insights, so they can achieve happiness m ost often. Therefore, they tend to ignore the suffering and atrocities in the world that they perceive as not directly affecting themselves. They choose a happiness that is easily obtained and immediate, yet short-term and individual rather than one that is more difficult and time-consuming, yet enduring and widespread. Both the collective happiness of society and a person’s individual happiness are hindered in the long-term by selfish attitudes and conformity to unchallenged traditions, whichShow MoreRelatedThe Search for Happiness Essay1026 Words   |  5 Pages The search for happiness has been one of the greatest driving forces over the ages. Defined as an active or passive sense of pleasure or satisfaction, happiness drives individuals to accomplish a number of fulfilling activities in their lives. 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Hedonic happiness focus more on activities that bring individuals’ pleasure whereas, eudemonic happiness focus on the circumstances that influence people emotions and life’s expectations. Fisher (2010) defines hedonic happiness as the pursuit of pleasure. These pleasures mayRead MoreThe Happiness Advantage By Shawn Achor983 Words   |  4 Pagescommon is the pursuit of happiness or â€Å"creation or construction of happiness† (Achor, 78). To be able to fulfill this wish of becoming happy, people often think the key to achieving happiness is success. In the book, The Happiness Advantage by Shawn Achor, he debunks this theory of success leading to happiness by illustrating the reverse theory of success. Through dozens of studies and experiments as forms of evidence, the author argues that an individual needs to achieve happiness in order to be trulyRead MoreWhat Makes You Happy?896 Words   |  4 Pageswhat makes you happy? Is it family, friends, music, food, money? The list just keep on going. The happiness in our lives is endless. There are many factors that contribute to a happy and fulfilling life. Some psychologists are beginning to understand a variety of aspects that contribute to living a successful life. Such as life events, personal factors, goals and happiness. When studying happiness psychologists have focused more on a term called subjective well-being. Subjective well-being is aRead MoreThe Happiness Advantage By Shawn Achor986 Words   |  4 PagesThe Happiness Advantage Final The most universal goal every human has in common is the pursuit of happiness or â€Å"creation or construction of happiness† (Achor, 78). To be able to fulfill this wish of becoming happy, people often think the key to achieving happiness is success. In the book, The Happiness Advantage by Shawn Achor, he debunks this theory of success leading to happiness by illustrating the reverse theory of success. Through dozens of studies and experiments as forms of evidence, the

Genetically Modified Organisms Or Gmos - 1231 Words

The world is an ever changing place, full of people with constantly evolving ideas and innovations. Humans have been designed to create and innovate; to explore the world around them and to solve problems. One of these innovation scientists have been working with are genetically modified organisms, or GMOs for short. The topic of GMOs is extremely controversial. There are those who back it one hundred percent, and those who seek to see it destroyed. While much of GMOs’ fame comes from the field of genetically modified foods, it is most certainly not limited to it. A quieter, and perhaps more imaginary field of GMOs has to do with genetically modified pigs. Scientists have been reworking the genes of some swine in order to make their tissue and organs usable for humans. In other words, scientists have been trying develop a breed of pigs who can be used as tissue and organ donors for people. While many people have expressed concerns for GMOs, genetically modified pigs, as tissue donors for humans, may prove beneficial in the near future. Before being able to understand genetically modified pigs and their benefits, it is vital to understand what GMOs are and how they work. According to the Encyclopaedia Britannica, genetically modified organisms are â€Å"organism[s] whose genome[s] ha[ve] been engineered in the laboratory† with the propose of bringing about â€Å"physiological traits or the production of desired biological products (Encyclopaedia Britannica).† The process ofShow MoreRelatedGenetically Modified Organisms ( Gmo )1665 Words   |  7 PagesA genetically modified organism (GMO) is a chemical organism processed in a laboratory where genes from the DNA of the crops are extracted and then artificially forced into an unrelated product that, when put into the crops the farmers raise, can chemically change the makeup of the crop. The chemical makeup can be from the change in the skin color of the crop to the actual organic chemistry co mpound. Genetic engineering is the process of splicing the genes in the crop and taking out a certain chemicalRead MoreGenetically Modified Organisms, Or Gmos, Are Genetically966 Words   |  4 Pages Genetically Modified Organisms, or GMOs, are genetically modified plants, animals, or microorganisms whose genetic information has been modified by DNA-editing methods such as DNA splicing or gene modification. This modification creates unstable combinations of plant, animal, or bacterial genes that are not found in nature (GMO Facts). It is the right of the consumer to know exactly what they are consuming. However, in the United States, it is not required that food containing GMOs has to be labeledRead MoreGenetically Modified Organisms ( Gmo )1236 Words   |  5 PagesLayla Sugawara 4/12/15 9/Fe Genetically Modified Organisms (GMO) A genetically modified organism (GMO) is any organism whose genetics has been altered by some form of technology. GMOs were first developed from the idea of selective breeding or artificial selection. Selective breeding or artificial selection is when humans purposely breed two selected organisms to reproduce a offspring with a desired trait. The beginning of genetic engineering is unclear. Before the 1900s, some farmers and naturalistsRead MoreGenetically Modified Organisms ( Gmos )2083 Words   |  9 PagesABSTRACT Genetically modified organisms (GMOs) are organisms whose genetic make-ups have been changed, inserted or deleted into another organisms. While the safety, disadvantages, and public concerns of genetically modified foods has grown significantly with the productivity of the genetic engineered foods. The problem can be solved with stricter regulations for manufacturer from the Food and Drug Administration and U.S Department of Agriculture. Some of many possible solutions to the genetically modifiedRead MoreGenetically Modified Organisms ( Gmos )996 Words   |  4 PagesGenetically modified organisms (GMOs) are seeds that are genetically altered in a laboratory before being planted. Later on, they grow into genetically modified (GM) foods. Genetically Modified Organism (GMO) A GMO is a plant-based organism, such as seed. However, it has: Genes that are altered to act in a certain way that does not naturally happen OR Contains genes from another plant-based organism History Since 1994, about 85 GM foods have been approved for sale in Canada. This includes GM foodsRead MoreGenetically Modified Organisms ( Gmo )1194 Words   |  5 Pagesof? If you are eating anything that was processed more likely than not you’re eating genetically modified organisms (GMO) in some way. This is because â€Å"in the U.S. GMO are in as much as 80% of conventional processed food (Non-GMO project).† A GMO is a â€Å"genetically modified organisms† which can be a plant or animal. What makes them a GMO is that they have been genetically engineered with DNA of another organisms that has a desired trait of some kind. The DNA used can come from other animals and plantsRead MoreGmo : Genetically Modified Organisms876 Words   |  4 Pagespeople that try to speak up against GMO products are â€Å"breaking the law† and are being sued for showing people the truth that they have the right to know? This is because GMO’s are bad. GMO’s (Genetica lly Modified Organisms) are being created in order to help make these companies do that exact, along with a few other things. GMO’s are plants or animals that have undergone a process wherein scientists alter their genes with DNA from different species of living organisms, bacteria, or viruses to get desiredRead MoreGenetically Modified Organisms : Gmos980 Words   |  4 PagesGenetically modified organisms, GMOs for short, is a plant or animal that is created through gene slicing techniques of biotechnology which mean merging different DNA from different species to make the plant and animal stronger and faster at growing them. It introduces to the public that GMOs crop are answer to keep up the food production rate to feed the growing global population by the Monsanto Companies which is one of the company that introduce the GMOs crops. GMOs Company suggests that GMOsRead MoreGenetically Modified Organisms ( Gmo )1383 Words   |  6 PagesGenetically Modified Organisms (GMO ) is one of the most important issues around the world. Genetic engineering is a process where scientists take genes from one species and force it into the DNA of other species. GMO has long been in practice to breed select individuals of a species to produce offspring of the desirable behaviors. It is used in conventional livestock production, crop farming and even pet breeding. It involves combining elements of DNA from different sources to create a new DNA moleculeRead MoreGenetically Modified Organisms ( Gmos )912 Words   |  4 PagesPeople need to try to be GMO free For many years, genetically modified organisms (GMOs) have been thought to be good for you and bad for you. There is no actual answer to which is true. GM foods are a popular topic that brought along debate and controversy that still continues in the present day (Newton). A number of organizations with varying degrees state that GM foods do or may present a threat to human health (Newton). What also needs to be kept in mind is that industry funded studies find ways