Case Study Discuss the pathpyysiology of Myelofibrosis Essay

Case Study Discuss the pathpyysiology of Myelofibrosis - Essay Example This disease is characterized by fibrosis and sclerosis of bone marrow. To compensate for the hematopoietic cell population, extramedullary hematopoiesis takes place in the spleen, accounting for the massive enlargement of the spleen. This disease occurs predominantly in subjects over the age of 54 years. The bone marrow fibrosis is the hallmark of pathological findings in such cases, where extensive fibrosis with resultant peripheral blood leukoerythroblastosis is expected as a typical histopathologic picture on bone marrow biopsy (Tefferi, 2000, p. 1255-1265). This clinically heterogeneous group of diseases stems from clonal proliferation of stem cell origin and is characterized at least initially by marrow hypercellularity with varying degrees of marrow fibrosis and an increase in the production of one or more terminally differentiated cell types. These differentiated elements may accumulate in the bone marrow, in the peripheral blood, and in other organs, such as, spleen. All these diseases demonstrate a variable tendency to undergo disease progression that may terminate in bone marrow failure or in transformation to an acute phase malignant disease. The evaluation of bone marrow histology holds an important role in defining the pathology of this disease, by mainly ruling out unsuspected pathology. The pathologic changes are subtle until the disease has progressed, and therefore, classification of these disorders benefits from the integration of the morphologic features with clinical, hematologic, and cytogenetic findings. Of major impo rtance is the presence or absence of Philadelphia chromosomes (BCR/ABL or translocation9;22). This group of diseases constitutes the classical group of BCR/ABL-negative chronic myeloproliferative disorders. The disease is regarded as one of the chronic myeloproliferative disorders. Recently considerable progress has been made in understanding its pathogenesis, although this has yet to result in significant therapeutic advances. Indeed, its prognosis remains poor when compared to other BCR-ABL-negative chronic myeloproliferative disorders with death resulting from cardiac failure, infection, hemorrhage, and leukemic transformation (Barosi, 2003, p. 1211-1226). Hemapoetic Components It has been appreciated for many years that MF is a clonal disorder and that the disease arises from the proliferation of malignant pluripotential stem cells. Recently, using fluorescent in situ hybridization (FISH), there is evidence that both B and T cells can be involved, while karyotypic analysis has shown that the stromal proliferation is polyclonal, or reactive, and not part of the underlying clonal hematopoiesis. An increased number of circulating hematopoietic precursors, including pluripotent and lineage restricted progenitor cells is a feature of MF and is likely to result from the proteolytic release of stem cells from the marrow. It is also possible that the spleen and liver contribute to the circulating progenitor pool as splenectomy temporarily normalizes levels. The high level of circulating progenitor cells is reflected in the significantly increased peripheral

Reducing College Tuition Essay Example for Free

Reducing College Tuition Essay Abstact There is a need to reduce the cost of college tuition in America. The rising costs threaten the ability and desire of students to attend college, but there are ways for both parents and students to make going to college more affordable. The Need to Reduce College Tuition With the cost of education on the rise, students are asking that time aged question, will they be able to attend college? The answer is yes, and without taking on the burden of overpriced tuition fees and loans. Attending community college has become a trend across the country and offer continuing education with little to no direct cost to students. Dual enrollment options, where a student can take a class that counts towards both high school and college credits are becoming increasingly popular with a large proportion of these students enrolling through two-year colleges and universities. Economic downturns are also believed to attract many students to community colleges, acting as a more affordable route to higher education at a time when money is tight and jobs are scarce. In 2007, 6.3 million students enrolled in community colleges in the United States, representing 34 percent of all undergraduates, and 46 percent of all undergraduates at public institutions. (25 Ways to Reduce the Cost of College Tuition, 2006) Community college enrollments have grown considerably over the last half-century, reflecting a general increase in demand for postsecondary degrees seen in this period. However, little attention is given to the fact that community colleges have quietly gained not only in enrollments, but in public institution market share as well (25 Ways to Reduce the Cost of College Tuition, 2006). Colleges and universities are not in a position to give you a discount on the cost of tuition. What they can do, however, is offer you gift aid in the form of scholarships, grants and work-study programs to reduce your out-of-pocket cost of attendance. Even if you’ve been awarded some gift aid from the school in your financial aid award letter, there may be additional aid available that the school can use to attract desirable candidates (Negotiating Your College Tuition, 2012). Once you’ve been accepted to a colleges or university, look at their published tuition rates and your financial situation. While public colleges will generally have a lower tuition, keep in mind that private, non-profit colleges are more dependent on tuition money, so they may be especially willing to make a deal with you – receiving less tuition money from a student is better than receiving no money at all, and you should always ask about other monies that may be available through programs and scholarships. If you do not ask, the school will not divulge this information willingly (Negotiating Your College Tuition, 2012). President Obama offered a plan Friday to reduce the costs of higher education by increasing the amount of federal grant money available for low-interest loans and tying it directly to colleges’ ability to reduce tuition (WP Politics, 2012). In an impassioned speech before 4,000 students at the University of Michigan, Obama delivered an election-year pitch to the type of youthful audience that buoyed his 2008 campaign, saying his administration was putting colleges â€Å"on notice† that they must rein in soaring prices. (WP Politics, 2012). â€Å"You can’t assume you’ll just jack up tuition every single year,† Obama said to cheers at Glick Field House (Obama, 2012), the school’s indoor football facility. â€Å"If you can’t stop tuition going up, your funding from taxpayers will go down. We should push colleges to do better; we should hold them accountable if they don’t† (Obama, 2012). With all the talk during the run for president, it will be great to see if all the plans for college tuition being lowered are true. We have thousands of students graduating from colleges across the country, and if they cannot find jobs that will pay them enough to pay back student loans, they will find themselves drowning in debt, and this will not be good for the student or the economy. These people will not be able to establish credit, buy a home or even purchase a vehicle. They will fall further in debt as the interest rate on the loan accumulates. This is why tuition fees need to be reduced, so even if a student does not come straight out of school with a high paying job, they will be able to make affordable payments on their loans without being overwhelmed. Tuition fees are scary. References 25 Ways to Reduce the Cost of College Tuition. (2006, September). Retrieved from Center for College affordability: http://centerforcollegeaffordability.org/uploads/25Ways_to_Reduce_the_Cost_of_College.pdf Negotiating Your College Tuition. (2012). Retrieved from Campus Explorer: http://www.campusexplorer.com/college-advice-tips/422D4AF3/Negotiating-Your-College-Tuition/ WP Politics. (2012, November 02). Retrieved from The Washington Post: http://www.washingtonpost.com/politics/obama-outlines-incentive-plan-to-reduce-college-tuition-costs/2012/01/27/gIQAc92fVQ_story.html

Financial Report for Furniture Company | Example

Financial Report for Furniture Company | Example Financial Report Scenario: Must Have Furnishers TABLE OF CONTENTS (JUMP TO) INTRODUCTION TASK ONE: Effect of Policies on Company Performance TASK TWO: Effect of Product Diversification and Promotions TASK THREE: Risk Analysis   TASK FOUR: Production and Profitability TASK FIVE: Buying Out and Merging CONCLUSION REFERENCES APPENDICES A-E TABLE 1. CASH FLOWS TABLE 2. SIMPLIFIED PROFIT AND LOSS TABLE 3. SIMPLIFIED BALANCE SHEET TABLE 4. PROFIT AND LOSS FOR MARCH 2001 THROUGH MARCH 2002 TABLE 5. BALANCE SHEETS FOR MARCH 2002 AND MARCH 2003 FOR COMPARISION INTRODUCTION A company with staying power within the marketplace will have a keen understanding of ebb and flow, be able to communicate change and put into practice strategies that also reflect flexibility and values for growth situations. The relationship between values and culture, leaders and teams of employees must maintain a healthy balance in order for the status quo of everyday operations to remain but also for the strategies to remain in place and augmenting in flux with market variables. This paper presents an interesting scenario of five tasks for you as the management trainee to explore and devise a financial report based on the company’s financial statements such as Profit and Loss, Year End results and other balance sheets. There is a new sales manager, who has promoted new policies toward change to increase sales and production but in other words created growing pains toward an organisation that will require investment, acquiring equipment and employees. It is part of your job to remain focused and subjective to the task at hand and evaluate each of the five tasks with the future of the organisation in mind but also the validity of such growth and the future investments needed. While outside investment is warranted at times, with a growing successful venture, it is assumed that some capital can come from within. However it is curious if her â€Å"tried and true† scheme will work for the present economic state. So many consumers purchase ticket item s on instalment credit but will this happen when consumer confidence is down and what will this mean for the organisation? TASK ONE: Effect of Policies on Company Performance There is concern that the company cannot keep up with production for this new promotion scheme set into place by the new sales manager who has promoted credit related sales. The director is concerned and has asked you to compile a report elaborating on whether the performance of the company and it’s financial position at the year-end has improved because of the new policies put into place. What is your opinion and rationale? According to the end year statements, operation costs are down which means the factory has reached a new level of efficiency. This indicates that something is going right at the shop room floor when compared with the prior year. It can be expected that the future productivity will be even higher with that rate of growth and profitability in consideration. However part of the scheme has been to introduce a line of credit to the consumer as a way of purchasing high ticket items and furnishing their homes. The main concern here when looking at the year-end statements comparatively should be cause of alarm on the point of the director. The prior year 2002 there were 166 debt accounts to the company. This year 2003 there are 1166 debt accounts and this is at a growth rate of a thousand new accounts or a rate 14 percent for this segment. The main concern here is the rate of repayment that needs to be established over time with these debtors. How quickly are they paying off their accounts a nd at what rate of interest? This could become a problem should some of them fall behind because then the company needs to implement a debt collection service, which will be an additional expense to the company. Sometimes it is impossible to collect on such merchandise. While the promotion may have spawned a tremendous amount of growth, it has also opened up the company for increased risk in the future for profit and loss. The year 2003 was a good one but one must also consider should the present promotion continue for 204, what are the long-term benefits and risks to having extended credit lines to consumers? TASK TWO: Effect of Product Diversification and Promotions Pricing strategies usually change as the product passes through its life cycle. There are a number of different methods of determining price depending on the product. In today’s game, diversification of products and product add-ons is the key to success especially in a saturated market like furniture. There is much competition. It is with this in mind that companies usually develop multiple promotions as opposed to just one. This way, the company has a promotion that can be priced for every budget. For your organisation, this may mean running ad campaigns, for instance a two for the price one during the winter season or provide extra perks for the customer who buys package deal. Right now free delivery seems to be a front runner of what the consumer is concerned about when shopping for furniture. As well as the credit offer, which may not drive many to purchase right away, have a sweepstakes drawing or a movie night that features your most comfortable display model. In a satur ated market, it is important for the prices to remain competitive, even reduced at certain times of year. By employing another marketing scheme, it is quite possible that you may see a reduction in credit accounts and more people spending cash especially if the price is right. Still one must be careful to get a return on the product as a profit because also one must consider the cost of acquiring the product, keeping it in stock and delivering to the customer. It is important to always keep in mind the cost of keeping the unit per unit in inventory. This goes beyond what it just costs to produce the unit. Still with the introduction of a counter promotion with reduced price, you will see more inventories out of the warehouse and less debtor credit involved in the transactions. TASK THREE: Risk Analysis The manager has asked you to assess the validity of two projects that are independent of each other and require proper recommendation. You will need to run a risk analysis as well as a net present value analysis in order to determine which project to recommend as both will reduce the handling cost and warehouse stock levels as a means to better manage inventory. We use different pricing models as a framework to aid in the analysis. Such models as CAPM and APT aid in figuring out the levels of risk involved with both projects. For financial professionals it is of utmost importance to assess risk as accurately as possible in order to sell in this case the project. Companies are more than often risk adverse and do not want to take a loss with the money invested. In this respect most companies enjoy a conservative approach, which means the less risk involved the better. Because APT builds upon CAPM and takes the theory to a new level, it requires further analysis to prove the point. Still first in order to understand APT, one must first have a grasp of CAPM works. CAPM can only work to assess risk in the long run scenario. CAPM also assumes the investor does not have inside knowledge and that the Beta is known. This is the only way an expected return can be determined with CAPM. Mark McCracken defines Beta as â€Å"equals 1.0000. 1 exactly. Each company also has a beta. A companys beta is that companys risk compared to the risk of the overall market. If the company has a beta of 3.0, then it is said to be 3 times more risky than the overall market† (par. 1). For this scenario each project has a beta. The amount of risk and the type of risk can be determined by diversification. Systematic risk, which is market risk or undiversified risk, is the portion of an assets risk that cannot be eliminated via diversification. The systematic risk indicates how including a particular asset in a diversified portfolio will contribute to the risky nature of the portfolio. Unsystematic risk, which is firm-specific or diversifiable risk, is the portion o f an assets total risk that can be eliminated by including the security as part of a diversifiable portfolio (Mathis, par. 1). So obviously there are some projects that will not be included in a diverse portfolio because of its defined risk under this theory. CAPM digs deeper to assess for an expression, which relates the expected return on an asset to its systematic risk. This in turn gives the financial professional better idea of the project’s risk behaviour. The equation used is as follows: (Mathis, par. 3) The measure of systematic risk is considered Beta or bi while E[Ri] is equal to the expected return on asset I and Rf is the risk-free rate. E[Rm] is the expected return on the project and E[Rm] – Rf is the market risk premium for the company stock. Once the Beta is known then the risk and rate of return can be found. APT is different because not only can forecast for the long term, it can also work for the short-term scenario. This fact makes it the better of the two theories because it gives the financial professional more tools to assess risk and the rate of return. APT does this by using a model that captures all the data. Other things this model can perform for risk assessment take into account company needs. Risk Estimates such as Tracking Error, Value-at-Risk (VaR), forecast volatility, systematic active risk, beta to benchmark, correlation with benchmark. APT carries out these calculations in a linear framework with a number of different variables. This is how different time frames can be used. For the APT model there are several outside factors to take into account. The ‘Now’ asset is defined by a number of beta possibilities, each of them representing asset sensitivity to a particular factor and characterizing systematic risk associated with this factor, and, as before, residual yield E. In this respect the risk allotted to this particular venture is less. This multi-factored model brings up many questions for the finance assistant. One thing to keep in mind is that not all factors carryover to risk in this area. There are factors that remain assets to an organisation faced with such decisions. This is one reason why periods of growth need solid leadership. This effectively assesses the risk involved for the furniture company’s returns. The NPV is assumed as the present value of the projects cash inflows minus the present value of the projects cash outflows (Mathis, par. 2). This relationship is expressed by the following formula: (Mathis, par. 2) TASK FOUR: Production and Profitability Your company is considering purchasing another machine due to the increase of production of furniture products and advanced sales of select models featured in the current marketing scheme. You are faced with figuring out if purchase of the machine is a profitable idea and if so what is the long-term cost? And how should it be funded? There are factors one is aware of when purchasing a new piece of equipment. Revenues will not change if the machine is purchased. Both the present machine and the new machine will last 5 years and will have no disposal value in five years. The new machine will cost  £400,000. The old machine can be disposed of right now for a disposal value of  £10,000. The new machine will reduce operating costs by $ £100,000 per year (assume cash flows at the end of the years). Assume a required rate of return or discount rate of 9%. Is it feasible for the company and cost effective? From the standpoint of long-term investment, it seems the new machine will be a valued addition to the team and allow production to not only run at current levels but also maintain new levels of efficiency. Also because it is considered a long-term investment, the company should also consider it an investment and possibly obtain a credit line for the local bank to cover this asset. In this way, the company can also apply for extended warranties to cover any maintenance or break down of the machine over the life of the loan. If the company has prime credit, a low interest rate of 6% is guaranteed and look into possible incentives with the local bank as a regular customer who pays on time, it may be possible to reduce the interest if there is not a pre-payment penalty. Suffice it say, there is cash flow that could be allocated for the purchase but also used for reinvestment in other areas of the company. Traditionalists will want to pay as much upfront as one can but if the long-range benefit outweighs the short-term loan, then by all means allow the company a li ttle space to get ahead with the new machine. Like above the net present value for the machine can be determined with the following equation. The NPV is assumed as the present value of the projects cash inflows minus the present value of the projects cash outflows (Mathis, par. 2). This relationship is expressed by the following formula: (Mathis, par. 2) TASK FIVE: Buying Out and Merging Every business needs planning or a defined strategy in place for future growth and control of known issues. There is a certain amount of power that comes from knowing what’s next. Smaller firms are vital to the economic health and stimulus of the world, mainly western nations like the United States and those found in Europe. Much of the success of these firms falls into the hands of leaders involved with everyday management but also the planning for future generations. Sir Adrian Cadbury writes, â€Å"Firms form the basic building block for businesses throughout the world. The economic and social importance of regional family enterprises has now become more widely recognized† (p. 5). In fact, it has been found that many firms do not survive the transition a generational business can represent. Many do not see life after the transition, which leads to decreased economic mobility and health. With this in mind, it is very important to have a transition strategy in place. T his requires proactive information sharing with all members even if some are not directly involved with day-to-day operations. This will ease the burden of conflict that may arise later. As with any organisation, knowledge management is key to good communication but with a small firm also instrumental for a successful future. This leads one to wonder how the structure of a smaller firm may differ from larger corporations? Is there a chain of command? How does leadership work?   It seems recently the trend of one company buying out another or merging to become one larger company is on the rise. It is in the news everyday, only drawing minimal concern from the public as regulators call into question the legality of such actions. Do mergers and acquisitions make the world a better place for consumers or do they just offer less for the consumer to choose from in the marketplace. It seems that most large companies see this practice as a means of redefining the marketplace by getting rid of the competition and making the competition work for them. In this respect, governments are able to make the rules of the merger and acquisition, setting the standard by which products of both companies can continue to compete with each other in a given market. This in turn, fuels the fire for increased advantage, working toward the goal of ultimately feeding off each other’s energy until it is exhausted. One finds this type of government control more in telecommunicatio ns and banking than other industries. For the retail industry, it seems a foregone conclusion that eventually opportunities will present themselves. From the looks of their balance sheets of Furniture Concepts there is a reason the company seeks a merger with another company. There seems to be a large amount of sales but not enough profit being generated. Within the last year their expenses have tripled but the production has not. They look to be in trouble. Another concern is founded within their name it self. Why call them selves a Furniture Concepts store when they sell carpet? It should be Carpet Concept. It may be that they have diversified their production schemes so far that this amounts to the increase of expenses? The recommendation would be to acquire the company, keep high performing employees on board and cut the lard. Expenses may also be attributed to bad debts acquired to maintain production or inflated management salaries? This would be a good move for the organisati on and also allow our furniture store to diversify without much overhead or inventory issues. CONCLUSION An organisation needs a clear picture of financial health in order to maintain operations and continue a path of growth toward market share. Many things go into deciphering this financial status. Part of what has happened here is a need for new tactics that are tried and true but without great risk affiliation like the credit offer. This strategy while well meaning for the short term has caused long-term ramifications for the organisation starting with growing pains. Lastly, research shows that the greatest obstacle to accepting new policies is fear of change. Therefore, this makes the transition period crucial and should be handled with kid gloves by management. Communication should be open and clear. REFERENCES 2003, ‘Capital budgeting needs vision’, Business Line, Islamabad, 21 July. Allen, G 1999, Introduction to Marketing, Mountain View College, Mountain View. Anonymous 1991, ‘Risk and Return’, The Economist, p. 1-2. Brozik, D 2006, Time Value of Money, Marshall University, Huntington, West Virginia. Cadbury, S A 2000, Smaller Firms and their Governance Creating Tomorrow’s Company from Today’s, Egon Zehnder International, London. Colli, A 2001, Knowledge and Leadership Succession in Small and Medium Family Firms. Evidence and Generalization From the Italian Experience, Bocconi University, Milan. Lefley, F 1997, ‘Management Accounting’, Journal of Accounting, vol. 75, iss. 1, p. 64. Mathis, R 2004, ‘Corporate Finance Live: Capital Asset Pricing Model’, viewed 10 September 2008, http://www.swlearning.com/web-resources/CAPM.htm.> Mathis, R 2004, ‘Corporate Finance Live: Present Value’, viewed 10 September 2008,  http://www.swlearning.com/web-resources/timevalue.htm.> Mathis, R 2004, ‘Corporate Finance Live: Risk and Return’, viewed 10 September 2008,  http://www.swlearning.com/web-resources/riskandreturn.htm.>. McCracken, M 2004, ‘CAPM’, viewed 10 September 2008, http://www.teachmefinance.com/capm.html>. Miller, D Whitney, J 1999, ‘Beyond Strategy: Configuration as a Pillar of Competitive Advantage’, Business Horizons, vol. 42, no. 3. Wignaraja, G 2004, ‘Building Business Competitiveness,’ International Trade  Forum, 1 April. APPENDICES APPENDIX A Table 1. Cash Flows APPENDIX B Table 2. Must Have Furnishers Ltd. Simplified Profit and Loss Account for the year ended 30/09/03 2002 2003 APPENDIX C Table 3. Must Have Furnishers Ltd. Simplified Balance Sheet for Must Have Furnishers Ltd. for the year ended 30/09/03 APPENDIX D Table 4. Furniture Concepts Ltd Profit and Loss Account for the period March 2001 to March 2002 Profit and Loss Account for the period March 2002 to March 2003 APPENDIX E Table 5. Balance Sheets for March 2002 and March 2003 for Comparison Balance Sheet as at 12 March 2002 Furniture Concepts Ltd Balance Sheet as at 12 March 2003

Dehydration Effect On Human Tissue :: essays research papers

The human body consists of massive amounts of different tissues and oranges, all doing different things. It’s inevitable that these tissues need a large amount of energy to maintain health and to stay productive. When the body encounters a famine, it reacts to the lack of food by many different starvation endorse tactics. When the body enters into a lack of water, there is very little it can do but stop the production of urine and sweat.   Ã‚  Ã‚  Ã‚  Ã‚  The human body consists a mass of eighty percent water plus or minus five percent. Water is in many forms of nature. There are three forms of water as the forms of water, ice and heated vapor in the air. Water also known as H2 O acts as a major component in plasma, liver function, and the aid of the lymphatic system of the human body.   Ã‚  Ã‚  Ã‚  Ã‚  When the body does not eat, many things go into affect to help you stay alive during a famine. They are: your hormones; blood sugar decreases to make you tired while conserving energy and your metabolism process decreases to make your retain fat from the food you do eat. It will take about three weeks to die from starvation when not consuming food. The average person should consume around 1800 calories a day.   Ã‚  Ã‚  Ã‚  Ã‚  When the human body goes with out water the whole system will start to shutdown. Without water the liver will stop filtering blood and cause kidney’s to fail. Also cell activities will stop because the water acts as a transition stage for nutrients going in and out of the cell. After the water is gone, cells can not survive for more then three days.   Ã‚  Ã‚  Ã‚  Ã‚  The cell during a lack of water goes in to a state of â€Å"suspended animation† which is when all cell processes slow down. The mitochondria slow down and reduce the production of energy forming materials. In plant cells the chloroplast stops responding to light and the energy of the cell then slows down and goes dominant. Dehydration Effect On Human Tissue :: essays research papers The human body consists of massive amounts of different tissues and oranges, all doing different things. It’s inevitable that these tissues need a large amount of energy to maintain health and to stay productive. When the body encounters a famine, it reacts to the lack of food by many different starvation endorse tactics. When the body enters into a lack of water, there is very little it can do but stop the production of urine and sweat.   Ã‚  Ã‚  Ã‚  Ã‚  The human body consists a mass of eighty percent water plus or minus five percent. Water is in many forms of nature. There are three forms of water as the forms of water, ice and heated vapor in the air. Water also known as H2 O acts as a major component in plasma, liver function, and the aid of the lymphatic system of the human body.   Ã‚  Ã‚  Ã‚  Ã‚  When the body does not eat, many things go into affect to help you stay alive during a famine. They are: your hormones; blood sugar decreases to make you tired while conserving energy and your metabolism process decreases to make your retain fat from the food you do eat. It will take about three weeks to die from starvation when not consuming food. The average person should consume around 1800 calories a day.   Ã‚  Ã‚  Ã‚  Ã‚  When the human body goes with out water the whole system will start to shutdown. Without water the liver will stop filtering blood and cause kidney’s to fail. Also cell activities will stop because the water acts as a transition stage for nutrients going in and out of the cell. After the water is gone, cells can not survive for more then three days.   Ã‚  Ã‚  Ã‚  Ã‚  The cell during a lack of water goes in to a state of â€Å"suspended animation† which is when all cell processes slow down. The mitochondria slow down and reduce the production of energy forming materials. In plant cells the chloroplast stops responding to light and the energy of the cell then slows down and goes dominant.

Major Life Event Development Through Life

As people live their lives, they usually and often experience various life events that influence their lives. If people suddenly experience a major life change it is likely that they will feel stressed and out of control. For example both Gloria and have experienced life events that have changed their lives forever. These events can either be predicted or unpredicted and these events are explained below. Predictable events Parenthood: As was seen in the case study, Gloria was not married to Ted before she unexpectedly found herself pregnant.Fortunately she had a beautiful baby girl. However, she and her baby daddy Ted have had to cope with being parents. This means that they had to learn new parental skills which involve learning how to take care of their child. For example, Ted, although at first did not assume responsibility, had to changed his old previous lifestyle. That means that both of them have to be able to bond with their daughter, and their free time for going out and â⠂¬Ëœhang out’ with friends are forever reduced, due to the arrival of Sunshine.Both Jason and Jasmine, Gloria’s parents and Lucy have experienced this life event; they had children. Retirement: During old age, usually at sixty five years of age, people are required to retire and leave their job, meaning that they no longer have any role in the society. Well some roles anyway. This also means that people may have more time for them-selves and their family as well as disengaging from work. At this point of people’s life, it may be hard for them to establish a new lifestyle, because they have worked all their lives – for Lucy, she had to join the bingo club.This also means that contacts with friends may be lost. On the other hand, Lucy, although is retired, still keeps active and has contact with people at her bingo as well as having a positive relationship with her family. Unpredictable events Illness or serious injury: It has been noted in the case study t hat Ted, as very young as he is at the age of twenty two, has been involved in motor bike accident, resulting to injury, leading to him lose his job.Due to this injury, it is obvious that Ted has to learn to cope, adapt and live with this physical change – changes may have included broken body parts, leading to disability, although the case didn’t mention that much. This may lead to Ted being depressed and feeling angry and wishing he was his old self. Many people who suffered serious injury – that leads to disability – may find it very hard to adapt to their situation. Bereavement: Due to the loss of their loved ones, people’s, both children and adult, physical, social and emotional lifestyle may change dramatically.People usually feel angry and depressed and are unable to cope with their losses. People who experience bereavement may lose dramatic weight due loss of apetite, they may not be able to concentrate, and their sleep may be disturbed. Re search shows that children who experience bereavement are likely to develop psychiatric disorder in later childhood and are also likely to develop difficult behaviour. References: http://www. pearsonschoolsandfecolleges. co. uk ( accessed on the 31/10/12)

Placenta Previa

Placenta Previa High Risk Pregnancy Placenta previa occurs when an embryo implants itself in the lower uterus and the developing placenta thereby implants low in the uterus and covers the internal cervical os. The previa can be complete, which involves the placenta covering the internal cervical os completely, or partial, which involves only a portion of the placenta covering the cervical os. The diagnosis is of placenta previa is often made in the second trimester by ultrasonography testing and is monitored for placental migration away from the os which occurs with uterine growth.Placenta previa in the second trimester puts the client at risk for developing vasa previa and thought to be a result of inflammatory atrophic changes to the placenta. In the third trimester, placenta previa is the leading cause of painless bleeding leading to hemorrhage. The bleeding occurs as the placental attachment is disrupted from thinning of the area as the cervix and uterus prepare for labor. Due to the location of the placenta, the uterus is unable to contract to stop the flow of blood from the vessels.When bleeding occurs, Thrombin is released and stimulates uterine contractions, which thereby disrupt the placental attachment from the uterus even more, causing increased bleeding and can eventually lead to hemorrhage (Joy, 2012). The incidence of placenta previa is in approximately one in 200 pregnancies, has a mortality rate of 0. 03%. Common risk factors include previous placenta previa, previous cesarean births, suction curettage for miscarriage, carrying more than one baby, delivery of six or more pregnancies, and tobacco or substance abuse (Perry, Hockenberry, Lowdermilk, & Wilson, 2010).For first time pregnancies, placenta previa occurs in about 1 in 1,500 pregnancies but the risk for women who have had more than five pregnancies increases to about 5 in 100 pregnancies.References: J oy, S. M. (2012, June 5). Placenta Previa. Retrieved September 29, 2012, from Medscape: emedicine. medscape. com/article/262063-overview#a0104 Perry, S. E. , Hockenberry, M. J. , Lowdermilk, D. L. , & Wilson, D. (2010). Maternal Child Nursing Care. Maryland Heights, MO: Elsevier.