History and Physical Examination free essay sample

: Patient is gravada 2, para 1, abortus 1. The patient’s only child is a 15 year old daughter who lives in Texas with her grandmother. PAST MEDICAL HISTORY: Patient had a Pilonidal cyst removed. Had plastic surgery on her ear as a child. SOCIAL HISTORY: Patient is married and has 1 daughter. She works as a substitute teacher. Smokes 1 pack of cigarettes on a daily basis. Denies EtOH. Smoked marijuana last night. No IV drug abuse. Patient complains of her lower abdominal pain the past week that apparently got much worse last night by this morning was intolerable. She is also having some nausea and vomiting. Denies hematemesis, hematochezia, and melena. She has had vaginal spotting over the past month with questionable vaginal discharge as well. Denies urinary frequency, urgency, and hematuria. Patient also denies arthralgias.Otherwise essentially negative. Vital signs temperature 97 degrees, pulse 53, respirations 22, blood pressure 108/60.

Mammogram Is A Radiograph Of The Breast Tissue Health Essay Essay Example

Mammogram Is A Radiograph Of The Breast Tissue Health Essay Essay Example Mammogram Is A Radiograph Of The Breast Tissue Health Essay Essay Mammogram Is A Radiograph Of The Breast Tissue Health Essay Essay The definition of a mammogram is a radiogram of the chest tissue ( refer to the attached transcript of a mammogram ) . It is an effectual non-invasive agencies of analyzing the chest, normally seeking for chest malignant neoplastic disease. Cancer is non preventable, but early sensing leads to a much higher opportunity of recovery and lowers the mortality rate from this disease. Breast tissue composing varies with age and endocrine degrees in a adult female. Generally, a younger adult female has denser or fibro-glandular chests. Her mammogram will look really white or cloudy ( Figure 8-dense chest ) and the middle-aged adult females have a mixture of hempen and glandular tissues ( Figure 8-50-50 chest ) . Their mammograms look black and white. In a mature chest, most of the hempen tissue is replaced with fatty tissue. The mammograms tend to look black or grey. Mammography Procedure The adult female is escorted to the changing room, where she undresses from the waist up and alterations into the showing centre gowns. She is asked to pass over off any deodourants, aromas or pulverizations that she may hold used that twenty-four hours, as these can mime micro calcifications on the movie. She is taken into the mammography room, where the mammographer or technologist reappraisals her history sheet. The history sheet has inquiries refering to the adult female s old mammograms, anterior surgeries ( if any ) , if she felt any balls, superficial Markss ( such as outstanding moles, cicatrixs from an scratch ) , household history of chest malignant neoplastic disease, figure of kids, her age when the first kid was born, and last day of the month of menses or post-menopausal ( Addendum 2 ) . Then, the mammography process is explained. This opens communicating channels and the adult female feels free to voice her concerns, therefore increasing her comfort degree. It is of im port to fix the adult female for the compaction that would be used for imaging. This device causes uncomfortableness, but should non ache the adult female. A Compression Paddle, ( see Figure 6 and Figure 7 ) is a device used to compact the chest tissue. This helps to distribute out and separate chest tissue, enabling the Radiologist to acquire an unobscured position of possible pathology. Compression besides lowers patient radiation dosage and prevents patient gesture. The needed positions are performed and the adult female is dismissed with instructions that she might experience sore for a twenty-four hours or so from the compaction. Besides that, the mammography equipment has progressed quickly over the last 10 old ages. In developed states, a dedicated mammography unit is used. A whole scope of makers make these machines, for illustration the GE, Bennett, Lorad, Siemens, Fischer, Phillips. They by and large have a reciprocating grid to cut down scatter radiation therefore avoidin g fog and bleary image. The Filter ( to do the beam hard and more penetrable ) used, is 0.03 millimeter Molybdenum. Film Processing is done under specific conditions. The two ways to develop an open movie are foremost Standard Processing and secondly is Drawn-out Processing. The pick depends on the type of movie used. The technique used for a mammogram is low Kilo-voltage Peak ( KvP ) about 24 to 30. The milli-Ampere-seconds ( ma ) vary depending on chest tissue denseness. When the exposure timer cells are used, it provides the optimal ma for the tissue to be imaged. This technique consequences in mammograms with a high movie contrast, doing it easier for the Radiologist to read. Besides that, the Films used for mammography are individual emulsion fast movies to heighten image acuteness by extinguishing geometric deformation. Films normally used are the Kodak Min- RE, Agfa, Fuji, Dupont, and Konica. Then, the screens consist of a rare Earth phosphor called Tb activated Gd oxysulfide . Screens have to be compatible with the movie. The newest film-screen combination is responsible for dose decrease by 30 50 % . The markers are used to bespeak the side and position demonstrated on that peculiar movie. Markers are placed on the side of the armpit ( armpit ) of the patient. This acts as a mention point to understand the orientation of the chest, particularly in the CC position. Screening Mammograms These positions are done as a regular showing procedure to acquire an overall image of the chests and guarantee that all is good. The protocol depends on the specific installation. In America, four movies are required of the chests: two positions for each chest. In Europe, most states do one position ( MLO ) of each chest and if an country of intuition is notice, so 15 % of the times, extra CC positions are taken. Screening for chest malignant neoplastic disease referred to a survey to look into chest persons who did non demo a clear indicant of which symptoms. This was done to place if there are marks emerging in the early phases of chest malignant neoplastic disease. Such actions at the beginning will let medical practicians to stunt the outgrowth of the possibility of chest malignant neoplastic disease at the degree that can harm patients. There are assorted methods of chest imagination, such as the Mammography X ray movie, the ultrasound, the magnetic resonance imagination ( Magnetic Resonance Imaging ) , the radionuclide scanning ( Radionuclide scans ) , A the xeromamografi ( Xeromammography ) , the computed Tomography ( Computed Tomography ) , the thermography ( Thermography ) , the transilluminasi ( Transillumination ) and the elektropotensi ( Electropotentials ) ( for the debut of mush / for tangible lesions ) . New method is computer-based digital mammography and ultrasound 3-D. Despite the find of assuring new engineerings to place possible chest malignant neoplastic disease more efficaciously, but until now there has non truly proven to equal the traditional methods used in the concern. This is apparent from the Institute of Medicine ( IOM ) and National Research Council of the National Academies of America reported in a March 2001 study that the method of movie mammography is still the gilded criterion in plac ing chest malignant neoplastic disease. Now it s up to digest the new engineering is the challenge to turn out their methods is superior. Harmonizing to the U.S. Preventive Task Force in the latest recommendations issued in 2002, persons who reach their 40s adult females are advised to acquire mammograms every twelvemonth or two old ages. Mammography is non needfully 100 % accurate. It can merely be detected merely 85 % of chest malignant neoplastic disease. Accuracy decreased when chest tissue becomes more heavy. Small malignant neoplastic diseases can be hidden by heavy tissue can non be seen in a mammogram. Womans who have dense chests that contain milk secretory organs inordinate compared with fat tissue. Menopausal adult females given endocrine therapy besides had a dense chest tissue. The denseness of the chest secretory organ has nil to make with the size, form and visual aspect of the chest. Womans who do non hold a batch of fatty tissue ( which has a dense chest ) may profi t from an ultrasound scrutiny in add-on to a mammogram. Now, a new method utilizing high frequence ultrasound has been reported to observe little tumours or calcification in the chest. However, it can non be recommended as the primary tool for observing chest malignant neoplastic disease. This is because ultrasound can non demo the overall characteristics of the chest tissue, can non observe little calcification in the malignant neoplastic disease, and it is extremely dependent on the ability to steer the machine. Mammography continues to be first pick for testing for chest malignant neoplastic disease. Combination of mammography and ultrasound will turn out to be of import to increase the sensitiveness in observing malignant neoplastic disease in heavy chests. The survey is still ongoing on the benefits, hazards, costs, and long-run effects on the life of person who undergo testing utilizing ultrasound entirely. At present it is excessively early to pull decisions about the ultrasound scrutiny without mammography, including the dense chest. Are mammograms painful? While mammography is, the chest tissue is compressed for a minute and feeling sick. The compaction procedure allows mammography performed with low radiation dosage and besides allows the chest tissue more clearly seeable. The compaction procedure is merely brief and acceptable to many patients. Many adult females think the hurting is non as expected. Trouble depends on the person. Anxiety and fright of adding farther hurting. Lack of treatment between the translator and the patient s mammography will besides add a feeling of hurting. Feelingss of uncomfortableness during mammography is little compared with the hurting during childbearing but the hurting during childbearing is acceptable because the exhilaration and accept parentage. Pain during mammography may salvage your life. Mammography equipment now have a modern design of the sensing procedure with optimum compaction. Most of them have detectors that will halt the compaction of the compaction procedure every bit shortly as bran d exposure. If you go acquire a mammogram with an unfastened head, it would non be a acrimonious experience for you. Is pattern a positive attitude and you will get the better of the fright to undergo mammography showing. Mammogram is non harmful. It is wise for us to cognize about the dangers of radiation, but we may non cognize about our didedahi radiation. We are exposed to radiation from outer infinite, the environment, little sums of nutrient, by exposure at work, out of fuel and medical scrutiny. However, intelligence on the radiation does non intend you are afraid of radiation. Furthermore, we frequently forget we are ever confronting menaces, such as traversing the route without utilizing prosaic Bridgess or we are still smoking coffin nails despite the apparent relation to lung malignant neoplastic disease. A mammogram the same as soaking up the Sun for 2 hours or 2 hebdomads of exposure to the radiation environment Mammogram centre has a staff of skilled and specialised mo dern equipment for mammograms. The combination of high engineering and accomplishments to bring forth high-quality mammograms with low radiation dosage exposure. A mammogram with hazard same with the air trip every bit far as 70 stat mis, the driving 10 stat mis, the suctions 1 / 8 sticks and 3minute live at the age of 60 old ages. Smoke is more unsafe than because a mammogram is a mammogram one time a twelvemonth than smoking that 365 yearss a twelvemonth. Cancer hazard of 1 decease per twelvemonth in each of the 6,000,000 adult females who are making mammograms for 10 old ages. It is identified after 10 old ages as the effects of malignant neoplastic disease may non originate for at least 10 after exposure.The warning are with the tools now, radiation dosage is minimum. Cancer is non detected early is more unsafe than pendehadan low radiation doses. The chief mammographies are non all malignant neoplastic diseases form a ball and non all malignant neoplastic diseases can be detected by physical scrutiny or touch except when it becomes big plenty. There are types of malignant neoplastic disease that can merely be felt after one or two old ages at the rate of growing of the malignant neoplastic disease. Although mammograms are non one hundred per centum accurate, it can be detect lesions ( lesions ) in the early phases, detect lesions that can non be felt by manus, detect lesions before they can be felt by manus. Provide of import information about chest balls or alterations are detected by you or your physician. Mammograms are performed should be compared with a old mammogram to obtain new information that helps radiotherapists to observe little alterations caused by malignant neoplastic disease. Mammograms are done on a regular footing to supply a better chance to place malignant neoplastic disease at an early phase when compare d with the mammogram is done merely on occasion. Differences between diagnostic and testing mammograms should be identified in progress by the patients and medical practicians who carry on their intervention. This is because the single adult females who are diagnostic or at high hazard require different methods of experimental probe against the single adult females who undergo a showing mammogram. Although there is no specific hours to undergo mammography terutamnya if symptoms such as clinical marks are foremost observed ( Internet Explorer, when sick persons show symptoms such as balls, inspissating of tegument, the consequence of pregnant chads on the tegument ) . Such state of affairss require a diagnostic mammogram should be done every bit shortly as possible. Furthermore, if suspected sick persons face malignant neoplastic disease, it is better to undergo the scrutiny every bit shortly as possible. Mammography mammography showing or scanning is for an single adult female who did non demo a clear indicant that symptom will penghidapan disease. Typically, a sum of 4 show scan will be performed on persons who undergo chest scans are. However, to acquire satisfaction and certainty, at times several extra methods will be used to track any unnatural marks. If the method of scanning a whole demands to be done, so the facet of whether it is necessary or worth the cost in footings of ever acquiring the attending. However, for those aged more than 50 old ages old or between 40-49 old ages, it was considered worthwhile, and non relied on the cost facet. However, this issue continues to be controversial and will be farther discussed in the subdivision entitled. Everyday scanning for adult females aged less than 40 old ages are by and large non recommended for chest glandular tissue denseness is higher at this age is likely to forestall the show of the tumour ( ie non seeable ) and active in the chest tissue is likely sensitive to the effects of radiation. Although there was no finding of the highest age to undergo mammography scans, but something that must be remembered that the hazard of chest malignant neoplastic disease. To undergo mammography processs are simple, you need non travel hungry or empty tummy before undergoing mammography. In footings of appropriate vesture to have on, it is best if you wear apparels based on two sheets ( 2-piece outfit ) as bloomerss with a blouse. Although there are no compulsory frock processs to follow, but be certain to take vesture that easy removed, particularly in the chest. Avoid the usage of pulverization, aroma, deodourant on one side of your organic structure and besides in the axilla. This will ensue in belaying on your mammogram ; it would hold an impact on the reading of the consequences of your mammogram scans by radiotherapists. If you experience pain in the chest, particularly during menses, so you can schedule a mammography scan once more after the terminal of your period. This is because during the catamenial experience, chests are in a less soft or tense and more sensitive. For those who had undergone scans a mammogram before, so it is best to take it with you. This will enable radiotherapists to do a comparing with the old mammogram consequences and place any unnatural development. The ability to do comparings and research will surely assist them do more accurate studies. Make certain you do non take or extinguish the long-mammogram. The mammogram is the consequence of the study is really of import to your wellness. If you have a mammogram, make certain the old mammograms taken together, it decidedly will assist radiotherapists to compare and reexamine the probe if there is an unnatural growing, peculiarly in the countries of intuition and invite possibly tumour or malignant neoplastic disease. Do non bury, the advantage of mammography is the sensing of chest malignant neoplastic disease before you feel or see any symptoms. The procedure of imaging X ray of the chest. And you surely have heard another term associated with the mammogram mammography. Is really a movie mammogram x-ray images. To implement the imagination / scanning, a device called a mammography machine used. Look at the images that show the machine. These machines normally you will happen the visit to undergo testing mammography. In Malaysia, the undertaking of making mammography managed and supervised by a trained female radiographer mammography. Methods and processs performed during the mammography scrutiny is simple. First, you will be dismantling dressing from the waist. This is to let the undertaking to look into your chest. Scaning for the intent of this reappraisal will usually be taken from two waies. Both the scan to be performed is from the top and sides of that border. You will so be positioned by the operator of mammography at the appropriate place and comfy to scan the chest showing. Then, you ll be pressed to obtain the comp action ; the end is to flatten the tissue exhaustively. This is to ease the procedure of placing any abnormalcies with a low degree of radiation. While executing this undertaking, the operator and the supervisor in charge of adult females will make with attention and cautiousness. They hate to seek to do certain you do non see uncomfortableness when undergoing the procedure of testing mammography. To obtain a high degree of quality showing, the demand to make the place of the chest is compressed and over is of import. You need non experience dying or worried about this state of affairs. This can do you to experience non so comfy but the execution of this compaction is merely an blink of an eye. If the filter engine is of a modern and sophisticated, the place of your chests are compressed and depressed will be released every bit shortly as the scan completed. While mammography scans are taken, the supervisor will ever be with you and make non necessitate them to remain out of the roo m. In fact, they will run the machines that press the mammography machine to take a scan. Almost the bulk of adult females are frequently harassed by a misinterpretation of the term hurting is pressed and when the chest is compressed. A more appropriate term to utilize when the chest is compressed is some uncomfortableness. However, it is something that is subjective and each person has different perceptual experiences about the experience. However, to do certain your showing is in a comfy state of affairs, you should esteem and bipartisan communicating with mammography operators to enable them to custom-make the scanning of the fortunes and needs your clip. It is really of import for you to undergo a showing procedure to guarantee the best possible manner. Positive mentality will bring forth more than happy to go through review. Remember, testing mammography is able to salvage your life. If benefits are taken into history, what is painful chest is non compressed until some clip! If you have a catamenial period, so it is best if you schedule the day of the month for testing mammography performed after dry periods. This is to avoid experiencing uncomfortableness in your chests. Some adult females are really concerned to undergo testing mammography if they had undergone intervention of chest implants. They are dying and worried that the alleged showing mammograms will do harm to breast implants. This impression is non true, needs to undergo a showing mammogram is dependent on medical advice. It will besides take into considerations whether the implants are made that are portion of Reconstruction surgical intervention for chest malignant neoplastic disease. In states where there is some art groups of people who participate in the showing mammogram, those who had undergone chest implant procedure are besides advised to undergo a showing mammogram, particularly if they are of the age group at hazard. The United States is an illustration of states that adopt such an attack. Before making mammography showing, the adult females who underwent mammograms must inform the operator of mammography testing before get downing work on the being of silicone in chest implant s. This is because its presence would forestall a clear position of tissues that protect the silicone implant behind. This is more marked if the Si had placed the bows alternatively of the chest wall musculuss in the dorsum. If notified in progress of this state of affairs, the operator of mammography and an experient radiotherapist to guarantee that the focal point be more careful and be given to guaranting silicone implants have non broken or damaged. Besides, different techniques will besides be implemented, such as infixing an implant behind the chest tissue and exciting place frontward. This is to ease attempts to place any unusual fortunes in the chest tissue. When there is a consequence tissue ( scar tissue ) around the implants or silicone from implants has melted into the tissue, it will be hard for concerns to place abnormalcies in your chest in a mammogram. Accuracy or the ability to happen abnormalcies in the mammogram is non so satisfactory as to the chest in a natur al. Implants will besides fell portion of the chest tissue, depending on the size of the implant compared with the size of your chests. Therefore, although the implants are non unsafe to your wellness, it will cut down the truth of mammograms to observe marks of malignant neoplastic disease. If your mammogram is unnatural is found during the initial scrutiny, farther probe is needed to find its true or non. If this is true upset, a biopsy scrutiny is recommended for verification. ( A biopsy is an probe in which some chest tissue will be taken for laboratory surveies. ) Examination of the biopsy can be performed utilizing a all right acerate leaf ( needle biopsy ) or by taking a subdivision of tissue ( nucleus biopsy ) . You do non hold to remain in the infirmary for scrutiny of a biopsy may be performed as outpatient processs. It was done at room mammography or ultrasound in the room. This cheque requires no particular readying, and you can return place after undergoing a biopsy scrutiny. A concluding diagnosing of chest malignant neoplastic disease can merely be made by taking a sample of tissue from the breast country of aˆâ€ ¹aˆâ€ ¹a coagulum can be detected. This is known as a biopsy. In the instance of a ball can be felt clearly, so surgical biopsy performed.

Marketing strategy Assignment Example | Topics and Well Written Essays - 2250 words

Marketing strategy - Assignment Example It is anticipated that new courses will be added once the initial set up has been completed and has bedded in, allowing expansion of the university’s courses to a global market place through a new company set up specifically for the purpose. The venture should payback the initial capital investment within a period of three years, providing a relatively short period of risk as far as the investment is concerned. The marketing strategy focuses on niche marketing and will target those who might be interested in starting up their own business. With the potential for mass redundancies in both the public and private sectors over the next few years, there is a huge opportunity to help many people set up their own business and achieve the freedom and success that such a venture brings. This report sets out the analysis and marketing strategy supporting the introduction of a range of new e-learning courses for global consumption. A strategic analysis is provided, which considers the external environment within which the university operates, together with an analysis of actual and potential sources of competition. The strengths and weaknesses of the university will be combined with the opportunities and threats present in the current climate, to provide a solid foundation for a focused marketing strategy that analyses the proposal using the extended services marketing mix, segmentation and targeting strategies and the profile of the â€Å"typical† customer. The report concludes with a summary of the marketing strategy and why it will be successful for the university as a medium-to-long term project. Following the recent decision by the government to cut the teaching budgets for universities, it has become necessary for the university to focus on more income-generating activities to enable continued funding of vital activities. After much discussion, it has been decided that the university needs to

The Concept of Organizational Culture and Its Importance to Any Essay

The Concept of Organizational Culture and Its Importance to Any Twenty-First Business Organization - Essay Example The researcher states that organizational culture cannot be explained via a rigid definition. It is something that emerges naturally through the conduct of the individuals in an organization and the way they transform themselves.   Change is an integral part of life. Thus businesses are also not excluded from the process of change. Change is the way forward to innovation, achievement and to growth. Managing change is an important task for the managerial personnel in any growth-oriented organization. Experts acknowledge the fact that â€Å"change is a task fraught with complexity and challenge†. Completing the change management process successfully is a challenging process and intense. The simplest starting point is to try and gain a superior understanding of the problems faced by the organization and identify the variables that are at the cause of these problems. The leaders face various kinds of complexities while they tackle organizational change. They are required to â₠¬Å"envision the content of change†, handle the distinctive features of the process of change; collaborate with the tumultuous process that is going on worldwide, adapt with the stunning technological advancements and employ the dynamic workforce intelligently to fulfill the profit maximization objective. Change management deals with the notion of change and the keys to the approaches to managing change. Culture has been regarded as a metaphor for an organization which is innovative and helps in developing new forms of understanding. A metaphor lets one view an entity in the perspective of another. A metaphoric representation tends to hint that we think of an organization as a culture. By taking organizations as a culture (organization ‘is’ a culture) one might understand the activities and orientation of the organization better and the nature, behavior, and performance of people in their organizational lives and positions of decision-making.

Without middleware, the integration of application in distributed Term Paper - 1

Without middleware, the integration of application in distributed application environment is difficult - Term Paper Example This delay can cause increase in queuing time and can lead to slower system response and the system can even crash. Middleware acts as a broker between different software applications in the form of coded request processing. This paper examines the importance and role of Middleware in distributed computing. A literature review and case studies with examples from Middleware implementations are analyzed. The findings indicate that Middleware is very important in modern distributed computing environment considering the huge variety of third party applications. The paper concludes that it would be very difficult to integrate the vast variety of applications without Middleware applications. Middleware has been described as the software glue that integrates objects distributed across a large number of heterogeneous IT systems. It is also regarded as software that helps to make integration of application easy by providing standard program interfaces that act as hooks and software developers need to make their applications latch to these hooks. Middleware is called as software that allows different applications to talk with each other, exchange data and complete the transactions. Thus, Middleware acts as a broker between software applications. The software industry complexity has increased with new languages, platforms, operating systems, applications and their new versions being launched almost continuously and Middleware helps in the integration of these applications (Maximilien, et al, 2009). With thousands of developers and different flavors of software application, operating systems and platforms would not be able to process connectivity and compatibility requests from these entities. In other words, a web program written in Java would want to connect to another server program written in say VC++. There would be differences in syntax, procedures, calls, and sub routines and so on. It would not be possible for

Financial Analysis of the Coca Cola company

Financial Analysis of the Coca Cola company The Coca-Cola Company (founded in 1919 Georgia, USA) today is the largest global manufacturer, distributor and marketer of non-alcoholic beverage concentrates and syrups in the world. Its strategy is to become more competitive by using its vast assets-brands, financial strength, unrivalled distribution system and the strong commitment by management and employees worldwide. This report analyses Coca Colas financial performance during the period from 2005 to 2009 through the following steps: 1. Industry analysis 2. Firm Analysis 3. Financial Analysis in comparison with PepsiCo and the industry. 4. Evaluation and Conclusion The entire industry is under pressure because of currency fluctuations and high fuel prices. It cannot be concluded, however, that the beverage industry is being threatened more than other industries. The main threat is increasing consumer and regulatory awareness on health and nutrition considerations. There are 3 big players in the beverage industry. Buyers power and rivalry is quite significant throughout the industry. Coca Colas strengths are based on its global resources such as brand value, marketing innovation, strong capital base and distribution channels. Coca-Cola has achieved impressive profits records and ROCE exceeding by far the industry norms and PepsiCo. Although Coca Cola maintains low liquidity ratios, its ability to turnover the stock within a short period of 39 days and enjoy longer credit period with its suppliers, give sufficient comfort to meet its financial obligations. This implies that Coca-Cola has strong bargaining power. Historically, Coca-Colas dividend payouts have been over 50% of the net income of any given period. It is observed that Coca-Colas debt-financing strategy justifies the reasons for maintaining high debt-to-assets and debt-to equity ratios. Coca-Cola has the largest market share in the beverage industry and has a market capitalization of US$102bn which is far above an industry average of US$75bn. Coca Colas profits have steadily grown above industry norms and operational efficiency is quite impressive as indicated by revenue/employee which are twice as high as its main competitor and the industry. However, ROA declined year-by-year from 2005 thru 2009 couple with a decline in the share price. Nonetheless, the new leadership and management team has managed to improve the performance as evidenced by the excellent Q-3 2009 financial results and the resultant increase in EPS. Coca Cola has sound risk management policies that have enabled it to remain stable given the high foreign currency fluctuation, interest rate risks and political instability associated with the wide operation in over 200 countries. In particular, introduction, revision and implementation of effective marketing strategies, quick-decision-making, effective asset utilization, overall asset management policies and the dividend payout policies need immediate management attention, in view of the competitive nature of the beverage industry. Otherwise Coca-Cola may lose more grounds to its competitors. Table of Contents 1 Introduction.5 2 Macro Industry Analysis .6 3 Micro Industry Analysis ..7 4 Financial Analysis9 4.1 Profitability.9 4.2 Liquidity and Funds Management.10 4.3 Asset Management12 5 Evaluation.13 6 Conclusion14 7 References..15 8 Appendices 8.1 Appendix I Definitions of ratios used in the financial analysis.16 8.2 Appendix II Coca Colas Financial Ratios..20 8.3 Appendix III PepsiCo Financial Ratios22 8.4 Appendix VI Financial Statements 8.4.1 Coca Cola Financial Statements 8.4.2 PepsiCo Financial Statements 1 Introduction Coca-Cola (the beverage) was invented in May, 1886, in Atlanta, Georgia and the first drink was sold at a soda fountain in Jacobs Pharmacy in Atlanta by Willis Venable. The idea was if he could just get people to try Coca-Cola they Would buy it. History proved him right. In the beginning sales of Coca-Cola accumulated 50 US$ for the first year. Today the Coca-Cola Company is the largest manufacturer, distributor and marketer of non-alcoholic beverage concentrates and syrups in the world. The company provides a wide variety of non-alcoholic beverages, including carbonated soft drinks, juices and juice drinks, sports drinks, water products, teas, coffees and other beverages. Along with Coca Cola, this is recognized as the Worlds most valuable brand, the company markets four of the worlds top five Soft-drink brands, including Diet Coke, Fanta and Sprite. The companys main rival is the PepsiCo, although Coca Cola considers Tap water a long-term-indirect competitor. (Newstarget.com) Coca Colas global operating structure includes the following operating segments: North America, Africa, Asia, Europe Eurasia and Middle East, Latin America and Corporate. This report analyses Coca Colas financial performance. The structure of the report is as follows: à ´Ã¢â€š ¬Ã¢â‚¬Å¡Ã¢â‚¬ ° The first part of the report includes a Macro and Micro industry analysis in which the beverage industry is analyzed The second part is the Firm Analysis, which highlights Coca Colas Capabilities, Competences and Recourses The core of the report is the Financial Analysis, in which Coca Colas financial ratios are compared with its main competitor (PepsiCo) and with (the non-alcoholic beverage) industrys standards where possible Finally the report ends up with an evaluation and a conclusion 2 Macro Industry Analysis As a global company operating within the soft-drink industry, Coca Cola has to content with the traditional Macro Environmental factors. The applicable laws within the United States and in many countries around the world impose restrictions for Coca Cola and the beverage industry. New deposit laws in the United States and in Europe require beverage bottlers and distributors charge a refundable deposit on beverage containers. Implementing this system requires significant capital investment to develop the capability to handle and process empty beverage containers. (Reuters). Many continue to associate health risks with consuming carbonized drinks. A recent study in the United States links the consumption of soft drinks with Type 2 diabetes and weight gain. This idea is supported somewhat by the medical community with statements such as: Anyone who cares about his/her health or the health of their family would not consume these beverages. Although this study was localized within the United States, from a Political and Legal perspective it has potential global implications throughout the industry. Beverage industry is affected, by a number of Economical factors that range from the cost to manufacture and distribute products, to foreign currency exchange fluctuations, fuel prices and weather patterns. Coca Cola has a global manufacturing network and it is also affected by these and other economical factors. For example Nestles (50% owned by Coca-Cola) sales increased with 12.6% in 2005 but due to the impact of foreign exchange rate the sales decreased by 6.3%. (www.dailyreporter.com) Danones profits margins have also been significantly affected by the increase in oil costs and hence, decided to increase their prices by up-to 12%. However it cannot be concluded that the beverage industry is more vulnerable than other industries. The beverage industry also faces environmental challenges. In India, for instance, where there is a serious shortage of water supply, the industry giants were strongly criticized on their use of water that constitutes 90% of the raw materials. This could invite governments to introduce new legislations that may have global implications on the global industry. Additionally, the company experienced culturally imposed operating restrictions when marketing its product in some countries, due to risks related to the socio-cultural factors such as obesity, that have potential adverse effects on the beverage industry. (NewsTarget.com) 3 Micro Industry Analysis The non-alcoholic sector is dominated by three major players, which together control 90% of the global market. However, the rivalry is fierce among the competitors: Nestle, Cadbury Sweppes PLC, Groupe Danone and Kraft Foods, with PepsiCo being the number one Rival for Coke. Coca Cola focuses primarily on carbonated soft drinks and fruit juices, while all of it competitors supply the market with other food products in addition to soft drinks. Coca Cola is continuing its diversification efforts, however and now owns 50% of Nestle, which currently dominates bottled water sales in some regions. Nonetheless, as a result of its past focus of relying primarily on the soft drink market, Coca Cola more vulnerable to fluctuating market conditions than its competitors. The non-alcoholic beverages market remains somewhat vulnerable to the threat of substitutes. The market has become saturated with the introduction of an array of soft drinks, sports drinks and bottled waters. By its own admission , Coca Cola considers tap water one of the main Substitute Products, and possibly a long-term indirect threat. Although many consider the consumption of soft drinks such as Coke (and Pepsi) a social event, the need to quench thrust remains a primary factor. Coca cola views the ready availability of tap water as a long-term threat, especially considering the decreasing reputation of carbonized soft drinks. One of the most significant threats to the beverage industry and Coca Cola is that of buyers power. Consumers can change their decision to buy at once. In 1985 for example, Coca-Cola decided to change the taste of its Cola. The consumers stopped buying Coca Cola even though taste tests demonstrated an improvement. (Hoovers) Coca Cola has long enjoyed limited vulnerability to Suppliers Power. Coca Cola maintains a solid position. Several resources providing global access to the main ingredients, such as Sugar, Artificial Sweeteners and Fruit Juice. However, this can change somewhat because Coca Cola recently experienced some limitation with the availability of raw materials due to increased activity in India. (Reuters) The key to success for all beverage companies is differentiation. The right product along with an effective marketing and branding campaign could create a formula for success. However, when it comes to New Entrants, it is unlikely that new entrants are going to form any creditable threat. Competition from PepsiCo remains the main threat for Coca-Cola. 5 Financial Analysis The financial analysis is based on the consolidated audited accounts of Coca-Cola Company and Subsidiaries made-out by Ernst Young for the past 4 years from 2005 to 2009 and comparisons are made against one of its main rivals PepsiCo. The accounts have been prepared in accordance with USA generally accepted accounting principles and standards of Public Company Accounting Oversight Board. The audited accounts / reports bear an unqualified auditors opinion. 5.1 Profitability Coca- Cola has been able to maintain impressive gross profit margins (GPMs) during 2005 to 2009 ranged between 66% and 63% which is better than its main competitor PepsiCo, whose GPMs from2005 thru 2009 stood consistently at 54% and industry standard of 42.28% (http://yahoo.finance.com). NET REVENUE Apparently, the cost structure of Coca-Cola and its overall cost-position is relatively better than PepsiCo although PepsiCo was able to achieve higher revenues than Coca-Cola by up-to 33%. This is further evidenced by the cost-to revenue ratio which was in the range of 75% and 69% for Coca-Cola and 82% and 83% for PepsiCo. NET INCOME Further, better overall cost-position by over 50%, and prudent cost-control enabled Coca-Cola to comparatively achieve better net incomes than PepsiCo as indicated by Net-Profit-Margin (NPM). On an average basis (from 2005 thru 2009) Coca-Cocas NPM stands at 29.815% higher than PepsiCos 18.765% by 59%. 5.2 Liquidity and Funds Management While current ratios for both companies are maintained at a reasonable standard of above 1:1 and are constant over the four years, quick ratios are also maintained at almost 1:1 and hence found to be relatively reasonable in meeting the short-term financial obligations. The cash ratio stands at 0.62:1 (slightly higher than PepsiCos 0.51:1) in 2009 which has improved, compared to 0.44:1, 0.32:1 and 0.23:1 in 2008, 2007 and 2006 respectively, mainly due to the increase in cash and cash equivalents balances to US$6.71bn in 2009 from US$3.36bn in 2008, US$2.13bn in 2007 and US$1.88bn in 2006. Generally, Coca-Cola has been maintaining better cash ratios than PepsiCo. CASH GENERATED FROM OPERATING ACTIVITIES TO MATURING OBLIGATIONS Furthermore, although cash provided by operating activities have been steadily increasing at an overall growth rate of over 10%, Coca-Colas Cash-Generated-from-Operations-to-Maturing-Obligation (CGOMO) ratio declined to 0.59:1 in 2009 from 0.58 and 0.54 in 2008 and 2007 respectively due to the increase in current liabilities by over 39%. The key components to the overall increase in current liabilities are: à ¢Ã¢â€š ¬Ã‚ ¢ Increase of maturities of the long-term debt to US$1.5bn in 2009 from US$0.3bn, US$.18bn, US$0.1.6bn and US$1.4 in 2008, 2007, 2006 and 2005 respectively. à ¢Ã¢â€š ¬Ã‚ ¢ Increase of loans and notes payable to US$4.5bn in 2009 from US$2.6bn in 2008, US$2.5bn in 2007, US$3.7bn in 2006 and US$3.0 in 2005. Nonetheless, there shouldnt be major concerns as Coca-Colas ability to collect its debts within 35 39 days and pay its creditors in almost 200 days while turning over its stock in 63 days, giving sufficient comfort to meet its financial obligations. Coca Cola has strategized in 2005 that by 2009 it intends to generate cash from its operating activities to the extent of 39 billion us$ 5.3 Asset Management Comparatively, Coca-Colas average stock holding period of 64 days is higher than PepsiCos 40 days, as indicated (STR in 2009). The trend shows that both companies have been consistently maintaining their STRs at almost the same levels. The better PepsiCos ratio could be attributed to the diversified nature of its product lines to include foods as compared to Coca Cola which is purely in drinks. Therere negligible differences in the debt collection periods where the number of days range between 35 and 39 for both Coca-Cola and PepsiCo, which is considered reasonable in an industry which is highly competitive and where the norm is 60 days. This implies that both companies have the competitive edge that may enable them to avoid tiding-up the capital in the receivables and generate sufficient cash to meet their short term financial obligations. Credit payment period shows Coca-Cola enjoys a longer credit period of almost 200 days than PepsiCos 147 days. This implies that Coca-Cola has st ronger bargaining-power than PepsiCo, thus basically gives Coca-Cola a free interest loan. Notably, the fundamental difference in asset management policies between Coca-Cola and PepsiCo is Equity-method-investments by Coca-Cola which historically is among the key components of its asset-base. Coca Cola key Asset Components in 2009 6 Evaluation The global beverage industry is highly regulated and instabilities, changes and uncertainties in worlds political and economic environments pose risks and challenges to the beverage companies, especially those which operate in a global fashion. The sluggish global economy, budget deficits of major economic powers, steep rise in oil prices and sharp currency fluctuations are matters of concern in general that may potentially have adverse implications and put the profit margins under pressure for many companies. This is due to the increase in energy cost needed to run the plants and transport the products to the marketplace. Competition in the beverage industry is fierce; companies that are not widely diversified remain more vulnerable to threats such as, rivalry, buyers and suppliers powers. Product substitution and new entrants form a minor threat in the beverage industry. Coca-Cola, the largest global company with the largest market share in the beverage industry, has a market capitalization of US$102bn which is far above an industry average of US$75bn and slightly higher than PepsiCos US$98bn. Its global presence, wide and reliable distribution channels, strong capital and asset base and global brand recognition provide it with a competitive edge over its rivals and in achieving better economies of scale. However, ROA declined year-by-year from 2009 thru 2005 couple with a decline in the share price. Nonetheless, the new leadership and management team has managed to improve the performance as evidenced by the excellent Q-3 2009 financial results and the resultant increase in EPS. 7 Conclusion Coca Colas leadership and management structure and the overall organizational culture have recently been initiated by hiring the new CEO (E Neville), who now focuses on revamping the organizational structure and the strategies. His primary objectives are to promote Coca Colas historical strengths such as innovation, motivation, training and development, knowledge management and blow-up the bureaucracy that has long been existing in the company in order to achieve sustainable growth and competitiveness. Coca Cola has got sound risk management policies that have enabled it to remain stable given the high foreign currency fluctuation, interest rate risks and political instability in view of the wide operation in over 200 countries. In particular, introduction, revision and implementation of effective marketing strategies, quick-decision-making, effective asset utilization, overall asset management policies and the dividend payout policies need immediate management action in view of the competitive nature of the beverage industry, Otherwise Coca-Cola may lose more grounds to its competitors. The overall financial position of Coca Cola is fantastically sound. The notable decline in ROA is not a matter of great concern particularly when the companys leadership and management team has got a breath of fresh air whose effectiveness is evidenced following the announcement of impressive Q3 2005 financial performance. The new CEO (E Neville) may have set a new course for the worlds number 1 soft drink giant.

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In 1890 there was the Triple Alliance which was an agreement among Germany, Austria-Hungary and Italy to help each other under certain circumstances. The Germans also had a secret Re-Insurance Treaty with Russia to ensure that they never had to fight a war on two fronts. Neither France nor Britain were members of these agreements. In 1893 the Germans refused to renew the Re-Insurance Treaty with Russia, preferring closer links with Austria-Hungary. In 1894 Russia and France came together in an alliance backed up by financial, industrial and military help. Germany now found herself surrounded by potential enemies and having to face the real possibility of fighting a war on two fronts. Faced with this threat the German General Staff began to plan for a war against both France and Russia and this eventually became the Schlieffen Plan with its emphasis on speed and the need to invade neutral Belgium. France and Germany were bitter enemies because of France's defeat in the war of 1870-71 and the resulting loss of Alsace and Lorraine to Germany. Their bitterness was worsened by the actual defeat of 1870, the Siege of Paris and the German march down the Champs Elysee. Britain was isolated in 1890. She had no allies or even friends on the continent. She had quarrelled with France over colonies in Africa and with Russia over a possible Russian threat to Persia and India. The Boer War of 1899-1902 showed how dangerous it was for Britain to have to friends on the continent. The Germans refused to sign an agreement with Britain and so Britain settled her differences with France in the Entente Cordiale of 1904 This agreement was not an alliance but simply an agreement not to quarrel any more about colonies in Africa and North America but growing tension with Germany especially after two crises in Morocco in 1905 and 1911 led to a secret military agreement in 1909 and a secret military agreement in 1912. These agreements which were only known to very few senior members of the government committed Britain to sending an army to France (BEF) in the event of war with Germany and after 1912 the Royal Navy agreed to defend Calais and the other French Channel ports from a German attack. In 1906 the new British super battleship, HMS Dreadnought, was launched. This had more and bigger guns than any other ship in the world and it was faster and better armoured as well.