Critical reflection practice Essay

Introduction The area of critical reflection is generally understood to be a difficult and contested terrain, that appears to be attractive on paper but is complex to put into action. Educators say this is an important capability for students to develop as it contributes to greater depth of understanding and learning (Boud, Cohen, & Walker, 1993; Lay & McGuire, 2010; Moon, 2006; Wolf, 2010). The wide range of approaches to critical reflection suggests the focus of learning is placed on technique rather than the broader purpose and outcomes of critical reflection. Critical reflection should not be a prescriptive activity (Moon, 2006) but guidelines should enable the student to develop their own style. This paper begins a conversation on the challenging topic  of critical reflection in cooperative education. Defining Critical Reflection There appears to be lack of a clear understanding of critical reflection, as it is a contested term reflecting the ideology of the user. Depending on one’s perspective critical reflection can be understood to mean very different things (Boyd & Fales, 1983; Brookfield, 2009; Gardner, 2009; Harvey, Coulson, Mackaway, & WinchesterSeeto, 2010; Hatton & Smith, 1995; Smith, 2011; van Woerkom, 2010) and varies within individuals and contexts. Critical reflection is widely recognised as a key component in the learning processes of individuals and is advocated in many areas of professional practice (Brookfield, 2009; Jarvis, 2010; Leijen, Valtna, Leijen, & Pedaste, 2011), especially within programmes where there is rich learning possible through specific experiences (Harvey et al., 2010). The terms reflection, critical reflection, reflective practice, reflective thinking and reflexivity have similar meanings and application in educational literature, as well as, used interchangeably (Black & Plowright, 2010; Rogers, 2001). Authors consider that not all reflection is critical reflection and critical reflection maybe at higher, more complicated level that challenges the learner and the educator (Harvey et al., 2010; Hatton & Smith, 1994). Further unpacking is required to clearly identify the true nature of ‘critical’ reflection. Fook (2006) suggests work needs to be done from a â€Å"common basis of understanding† so the practice of critical reflection maybe refined and improved. Mezirow (1990) considers critical reflection as a precursor to transformative learning, which may lead to changes in personal understandings and potentially behaviour. Students can use critical reflection practices for engaging in metacognition (Eames & Coll, 2010). It is associated with a number of learning outcomes including improved thinking, learning and assessment of self and social systems (Smith, 2011). Dewey (1938) states that while we cannot learn or be taught to think, we do have to learn how to think well and especially to acquire the practice of reflection. To use knowledge critically we do not accept the situation at ‘face value’. This  requires the ability to look beneath the surface to see what may influence the situation, resulting in critical depth to understanding. In addition, the ability to examine the bigger picture and view the situation more holistically develops critical breadth. These enable us to develop a fuller understanding of experiences so we are better equipped to manage similar future situations (S. Thompson & Thompson, 2008). This ability to think critically is developed over time (Crowe & O’Malley, 2006) through guidance and support. Critical reflection is advocated in many areas of professional development and practice, including the all areas of health care education, teaching, management, and research, as it encourages practitioners to gain insight into their own professionalism through their experiences. These programmes generally require some form of fieldwork to be closely integrated with academic study. Consequently there is wide variation in the techniques and approaches used in the practice of critical reflection. Approaches may range from informal discussions to highly structured formats. Guidelines in the literature on how to determine, facilitate and assess critical reflection in practice appear to be limited (Leijen et al., 2011; Smith, 2011). Models of critical reflection This vast area in the literature, which explores models of critical reflection, lacks clarity. There seems to be similarities within and across the various applications from many fields or disciplines of education that may have little or no areas of overlap (Fook & Gardner 2007). Many models of reflection based on a philosophical approach, may be considered to assist students develop an understanding of critical reflection. These have been briefly outlined in table 1.0 to help visualize the relationship between the models and frameworks. The framework chosen to guide students’ reflections may be determined by the expectations of the learning outcomes. Some models of reflection may not encourage critical reflection. Models may guide the process of reflection but should not impose a prescription of what reflection is. It is not essential to follow a model and some practitioners choose not to. There is some criticism of models that reduce reflection to levels but this approach maybe useful for teaching what the focus of  reflection entails. The student may choose whether or not to adopt a model to frame their reflection as a temporary measure until confidence in the reflective activity is gained and understood. Table 1.0: Three models of critical reflection identifying two frameworks that provides guidance for reflecting within each model. Model of critical reflection Framework General comments Dewey’s model of reflective Knowledge can be constructed learning through active reflection on past and present experiences. Pragmatic approach. Gibb’s model A cyclic generic framework. A general and nonspecific approach to reflection. Novices may find it too vague requiring further guidance. Stephenson’s framework A detailed set of cue questions. Focuses on consequences of actions and examines practice knowledge. Habermas’s model of critical Based on 3 areas of knowledge: reflection technical, practical and emancipatory. Critical theory approach. Taylor’s framework Describes activities associated with 3 types of reflection: technical, practical and emancipatory. Highly structured. Kim’s framework Called critical reflective enquiry. Three phases of reflection: descriptive, reflective, critical/emancipatory. Processes and products applied to each phase. Kolb’s model of reflexive Attempts to integrate thinking and learning practice. Experiential learning approach. Borton’s framework Simplified model using 3 questions: What? So what? Now what? Very easy to remember. Rolfe’s framework Expanded Borton’s framework. Added questions to each step. Turned the last step back to form reflexive cycle. Generic, easily adapted to suit most situations. * Adapted from Rolfe et al (2011). Critical reflection in cooperative education According to Martin and Fleming (2010) cooperative education is more than work experience but a recognised pedagogical approach to learning. Critical reflection is an essential component of the pedagogy of cooperative education and other forms of work integrated learning. The process of critical reflection needs to be facilitated with structured strategies within the course that encourage engagement in reflection. It is important to create a culture where reflection is valued as a learning tool and it is safe to be honest. Practice and feedback on reflection throughout the program are important to enable the student to progress through their learning experience. Van Gyn (1996) suggests that reflective practice to enhance student-learning outcomes requires an organised partnership between the student, academic and industry supervisors. There is a widespread  assumption that reflection has positive outcomes for student learning. Cooperative education is student driven learning, which increases the need for the student to be self-motivated, proactive, organised and reflective. Critical reflection encourages students to be willing and able to question, explore and critique ways of behaving and thinking as they engage in workplace experiences (Higgins, 2011) and into the future. Consequently the student is better able to understand and gain insights into his/her skills, competencies and knowledge. The use of critical reflection in cooperative education increases the chances of the learning being relevant and meaningful to the student. Therefore the student’s engagement in reflection can assist them in making sense of themselves, their learning experience and preparation for the future. The importance of the social context (Fook, White & Gardner, 2006) of reflection should be considered, as personal reflection is part of the broader context of the organization culture and structure (Thompson & Pascal, 2012). The industry context is complex and may challenge other dimensions of reflection, such as emotional demands of the learning experience, power relationships and time constraints. The strategies that facilitate reflection should cater for the individual needs of the student, suit the learning environment and guide the development of students reflective skills (Martin & Fleming, 2010). Strategies may include learning contracts, reflective journals, progress reports, reports and oral presentations providing the student with many opportunities to practice critical reflection. Conclusion Critical reflection is used in education to encourage the integration of theory and practice while enhancing student learning and self-confidence. However, an extensive literature search on the role of reflection for learning through experience by Harvey et al (2010) concluded that the relationship between reflection and positive student learning outcomes was inconclusive. This suggests there is scope to explore the role of critical reflection in learning and the development of a theoretical basis in cooperative education. There is increasing interest in the concept of critical reflection (Boud & Walker, 1998) in work-integrated education and research (Brookfield, 2009). References Black, P. E., & Plowright, D. (2010). A multi-dimensional model of reflective learning for professional development. Reflective Practice, 11(2), 245-258. doi:10.1080/14623941003665810 Boud, D., Cohen, R., & Walker, D. (1993). Using experience for learning. Buckingham [England] ; Bristol, Pa.: Society for Research into Higher Education and Open University Press. Boud, D., & Walker, D. (1998). Promoting reflection in professional courses: The challenge of context. Studies in Higher Education, 23(2), 191. Boyd, E. M., & Fales, A. W. (1983). Reflective learning. Journal of Humanistic Psychology, 23(2), 99-117. Brookfield, S. (2009). The concept of critical reflection: promises and contradictions. European Journal of Social Work, 12(3), 293-304. Crowe, M., & O’Malley, J. (2006). Teaching critical reflection skills for advanced mental health nursing practice: a deconstructive-reconstructive approach [Article]. Journal of Advanced Nursing, 56(1), 79-87. doi:10.1111/j.1365-2648.2006.03982.x Dewey, J. (1938). Experience and education. New York: Touchstone. Eames, C., & Coll, R. K. (2010). Cooperative education: Integrating classroom and workplace learning. In S. Billett (Ed.), Learning through practice (pp. 180-196) Fook, J. (2006). Beyond reflective practice: reworking the â€Å"critical† in critical reflection. presented at the meeting of the Professional Lifelong Learning: Beyond Reflective Practice, Leeds. Fook, J., & Gardner, F. (2007). Practising critical reflection : a resource handbook. Maidenhead: Open University Press. Fook, J., White, S., & Gardner, F. (2006). Critical reflection: a review of contemporary literature and understandings. Critical reflection in health and social care, 3-20. Gardner, F. (2009). Affirming values: using critical reflection to explore meaning and professional practice [Article]. Reflective Practice, 10(2), 179-190. doi:10.1080/14623940902786198 Harvey, M., Coulson, D., Mackaway, J., & Winchester-Seeto, T. (2010). Aligning reflection in the cooperative education curriculum| Macquarie University ResearchOnline. Asia-Pacific Journal of Cooperative Education, 11(3), 137-152. Hatton, N., & Smith, D. (1994, July 3-6, 1994)). Facilitating Reflection: Issues and Research. presented at the meeting of the Conference of the Australian Teacher Education Association (24th), Brisbane, Queensland, Australia. Hatton, N., & Smith, D. (1995). Reflection in teacher education: Towards definition and implementation. Teaching and Teacher Education, 11(1), 33-49. Higgins, D. (2011). Why reflect? Recognising the link between learning and reflection. Reflective Practice, 12(5), 583-584. doi:10.1080/14623943.2011.606693 Jarvis, P. (2010). Adult education and lifelong learning : theory and practice (4th ed.). New York: Routledge. Larrivee, B. (2000). Transforming Teaching Practice: Becoming the critically reflective teacher. Reflective Practice, 1(3), 293-307. doi:10.1080/713693162 Lay, K., & McGuire, L. (2010). Building a Lens for Critical Reflection and Reflexivity in Social Work Education [Article]. Social Work Education, 29(5), 539-550. doi:10.1080/02615470903159125 Leijen, A., Valtna, K., Leijen, D. A. J., & Pedaste, M. (2011). How to determine the quality of students’s reflections? Studies in Higher Education, 1-15. doi:10.1080/03075079.2010.504814 Martin, A., & Fleming, J. (2010). Cooperative education in outdoor education. Australian Journal of Outdoor Education, 14(1), 41-48. Mezirow, J. (1990). How critical reflection triggers transformative learning. Fostering critical reflection in adulthood, 1-20. Moon, J. A. (2006). Learning journals : a handbook for reflective practice and professional development (2nd ed.). London ; New York: Routledge. Rogers, R. R. (2001). Reflection in higher education: A concept analysis. Innovative Higher Education, 26(1), 37-57. Rolfe, G., Freshwater, D., & Jasper, M. (2011). Critical reflection in practice (2nd ed.). Houndmills, Basingstoke, Hampshire ; New York, N.Y.: Palgrave. Smith, E. (2011). Teaching critical reflection. Teaching in Higher Education, 16(2), 211-223. Thompson, N., & Pascal, J. (2012). Developing critically reflective practice. Reflective Practice: International and Multidisciplinary Perspectives(iFirst Article), 1-15. doi:10.1080/14623943.2012.657795 Thompson, S., & Thompson, N. (2008). The critically reflective practitioner. Basingstoke [England] ; New York: Palgrave Macmillan. Van Gyn, G. H. (1996). Reflective Practice: The Needs of Professions and the Promise of Cooperative Education. Journal of Cooperative Education, 31(2-3), 103-131. van Woerkom, M. (2010). Critical Reflection as a Rationalistic Ideal. Adult Education Quarterly, 60(4), 339356. Wolf, K. (2010). Bridging the distance: the use of blogs as reflective learning tools for placement students. Higher Education Research & Development, 29(5), 589-602. Copyright  © 2012 Patricia Lucas The Author assign to the Australian Collaborative Education Network (ACEN Inc.) an educational non-profit institution, a nonexclusive licence to use this document for personal use and in courses of instruction, provided that the article is used in full and this copyright statement is reproduced. The author(s) also grant a nonexclusive licence to the Australian Collaborative Education Network to publish this document on the ACEN website and in other formats for the Proceedings ACEN National Conference Melbourne / Geelong 2012. Any other use is prohibited without the express permission of the author(s).

Sg Cowen

9-402-028 REV: JANUARY 19, 2006 THOMAS DELONG VINEETA VIJAYARAGHAVAN SG Cowen: New Recruits We are who we recruit. — SG Cowen professional Chip Rae, director of recruiting at SG Cowen, looked out the conference room window at the falling flakes and wondered how fast the snow was accumulating. Most of the firm’s bankers had come in from Connecticut or Westchester to participate in the Super Saturday recruiting event, and he knew they were anxious to get home before the weather deteriorated and made travel dangerous. The interviews had finished at noon, and the candidates from various graduate schools had left for their flights right away.Now, the bankers were eating lunch, discussing interview results and making decisions. They were sitting in â€Å"Giants Stadium,† the bank’s largest conference room, and Rae had set the tables up in a U-shape so that he could stand in the front and still communicate with all 30 bankers. He posted placards with all the cand idate names on the bulletin board and moved them around as they came up for discussion. The hiring meeting had moved rapidly through a number of candidates. The decision makers had agreed on candidates who were firm â€Å"yeses† and some other clear â€Å"nos. † Now was the tricky part: there were four candidates still left.Each person had some strong support among their interviewers but had also raised some questions. To reach the ideal class size after factoring in expected yield, Rae wanted to give out only two more offers. Investment Banking Industry in 2001 Consolidation in the investment banking industry was widespread, as major firms bought small banks, bought retail brokers, and considered partnering with commercial banks. Mergers and acquisitions (M&A) and equities remained the highest-margin businesses but also very volatile, as deal volume and initial public offering (IPO) issuances could dry up very quickly in a downturn.In a down market, fixed incomeâ€⠄¢s more stable revenue stream was especially welcome. Integrated banking groups such as Citigroup or JP Morgan Chase were sometimes able to win investment banking business away from the traditional bulge-bracket firms because of their ability to offer loans and other commercial banking capabilities. Some strategists believed the lending business was the ________________________________________________________________________________________________________________ Professor Thomas DeLong and Research Associate Vineeta Vijayaraghavan prepared this case.HBS cases are developed solely as the basis for class discussion. Cases are not intended to serve as endorsements, sources of primary data, or illustrations of effective or ineffective management. Copyright  © 2002 President and Fellows of Harvard College. To order copies or request permission to reproduce materials, call 1-800-545-7685, write Harvard Business School Publishing, Boston, MA 02163, or go to http://www. hbsp. harvard. edu.No part of this publication may be reproduced, stored in a retrieval system, used in a spreadsheet, or transmitted in any form or by any means—electronic, mechanical, photocopying, recording, or otherwise—without the permission of Harvard Business School. 402-028 SG Cowen: New Recruits wave of the future, while others targeted the custody business. The custody business, which involved holding and processing the buying and selling of securities for investors, was a low-risk fee-based business that was considered mundane but offered regular opportunities for interaction and service to potential clients.Several investment banks reported declining profits, and some laid off staff to cut costs. The biggest expense on Wall Street was compensation costs, averaging 50% of revenue. 1 In the prosperous years on Wall Street in the late 1990s, some firms had salary and bonus costs upwards of 60%, since firms signed multiyear contracts promising fixed bonus payouts to keep tale nt and also signed separate profit-sharing agreements with individual business groups to prevent them from spinning out on their own.Investment banks were also under increased scrutiny from regulators and the public, who were concerned about conflict of interest. Many new equity issues, especially in technology, had been supported by research analysts, particularly at the firms that had executed the IPOs. This loyalty to the banking clients came at the expense of the investors who followed analyst recommendations and bought stock in companies that often continued to decline. Firms were now developing better guidelines for keeping research teams independent from bankers and their clients.Investment banks fought for talent with firms in venture capital, private equity, hedge funds, consulting, and, for the last few years, tech companies. Banks were reassured to see students return to the fold, as they exhibited much more interest in established brand-name companies for secure jobs. Ho wever, the interest level had gone from one extreme to the other. Where banks had once feared they were only seeing second-tier candidates, now they had recruiting yields much higher than expected and struggled with how to handle all the new recruits as business slowed down.SG Cowen SG Cowen was born when Societe Generale purchased Cowen and Company in July 1998. Societe Generale was an international bank based in France, founded in 1864, nationalized in 1945, and privatized in 1987. By 2000, it was one of the world’s largest banks, with assets of over $430 billion as of December 2000. Like many European banks, it wanted a foothold in investment banking in the United States. Many of these banks had tried to create a beachhead in the U. S. but had not succeeded.Societe Generale had flirted with buying one of the CHARM banks for the past five years and decided Cowen was the best match culturally. 2 By 2000, Societe Generale’s $600 million purchase of Cowen had started to pay off: SG Cowen went from an operating loss of $75 million in 1999 to an operating profit of $34 million the following year. Cowen began business as a bond brokerage house in 1918 and grew into a firm known for top-tier research and strong equity sales and trading capabilities. It was now also focused on building up its investment banking and M&A advisory services.The new entity SG Cowen, numbering 1,500 professionals, planned to remain a boutique-sized firm but had access to the parent firm’s balance sheet. SG Cowen’s investment bankers focused on emerging growth companies in two volatile but highly profitable areas, health care and technology. This focused approach to banking depended on deep knowledge collected through its equity research team, highly regarded for its coverage of both 1 The Economist, August 4, 2001. 2 CHARM banks was the Wall Street nickname for this set of boutique banks: Cowen, Hambrecht & Quist, Alex Brown,Robertson Stephens, and Montgomery S ecurities. 2 SG Cowen: New Recruits 402-028 health care and technology. Kim Fennebresque, president and CEO of SG Cowen, often described research as the â€Å"edge of a wedge† that created inroads with new clients. The firm had strong roots in Boston but had now opened several other offices, as far apart as San Francisco, Dallas, and London. This raised concerns about making sure employees in smaller offices were not isolated and also that they had full knowledge of and access to the resources of the global firm.As the firm grew, there were concerns that groups should make sure there were frequent interactions and that people should know about one another’s deals and proposals and make sure they coordinated their client activity. Fennebresque believed that SG Cowen should continue to grow geographically but stay industry focused: â€Å"We will, under all circumstances, remain an emerging growth investment bank. Our geographical reach will extend to Europe, Asia, and o ther parts of the world, but we will not stray from that focused sectoral agenda.We have in our midst, and will continue to attract, the highest-quality professionals who believe in that business model. † The Hiring Process Like most firms on Wall Street, SG Cowen made hiring decisions in the early winter and spring of each year to fill a new class of associates who would begin that summer. Some associates had previously been employed by SG Cowen as analysts and were promoted to first-year associate at the end of their third year with the firm without going to business school. Other associates started out as interns in the summer between their first and second year of business school and subsequently were offered full-time employment at the end of their internship commencing the following summer. The hiring process for new outside associate hires began in the fall, when SG Cowen would make company presentations at its â€Å"core business schools,† where it participated in the on-campus recruiting programs. These schools were NYU, Chicago, Columbia, Cornell, Emory, USC, Washington University, Notre Dame, and Berkeley.SG Cowen would also accept resumes from students at noncore schools, where it was not participating in the on-campus program. Often SG Cowen professionals would conduct â€Å"informational interviews† with students in the office in advance of official first-round interviews. These interviews, which were not part of the formal process, were a chance for SG Cowen to gauge how serious and enthusiastic the candidates were and a chance for candidates to learn more about the firm and the industry before the interview in which they would be actually evaluated.Rae assigned team captains to every school at which SG Cowen recruited on campus so that students had a constant and familiar point of contact. Ideally, these team captains were banking professionals and not human resource professionals, and as often as possible, Rae would try to match up alumni with their own school. Gregg Schoenberg was team captain at the Johnson School of Business at Cornell, the school that currently provided SG Cowen’s highest recruiting yield. Schoenberg had joined the firm in August 1998 and now worked in the Equity Capital Markets Group.He became actively involved in recruiting at Cornell upon joining for two reasons. First was that he believed SG Cowen would benefit from the high quality of candidates at Cornell. Second was that he wanted to make it easier for Cornell grads to obtain investment banking positions on Wall Street. Schoenberg averred: In the bull market years, the Goldman’s of the world would back up the recruiting truck to places like Harvard and invite slews of students to climb aboard.It was tougher for us because 3 Analysts were recruited from Babson, Colby, Columbia, Georgetown, Harvard, New York University, University of Pennsylvania, Tulane, Vanderbilt, Massachusetts Institute of Technology, and Ya le. 3 402-028 SG Cowen: New Recruits we didn’t have the alumni base in New York. We came down here on our own nickel and really pounded the pavement. But you can turn a negative into a positive. Because Cornell students who do want to do banking have to show more initiative and be more focused, generally this makes them great hires.When Schoenberg had been hired, Cornell was not a core school, and Schoenberg described SG Cowen at the time as â€Å"so-so receptive† to people from noncore schools, mostly because the lack of an on-campus round made for disproportionate hassles to pin bankers down to do interviews and set up individual interview times in the middle of a regular workday. Coming from a nontraditional background in politics, Schoenberg felt SG Cowen’s interest in him really gained momentum once they knew he had been called back for second rounds at Lazard Freres.When Schoenberg recruited for SG Cowen, he said he always told candidates, â€Å"It doesnà ¢â‚¬â„¢t matter what you did before, what matters is that you have demonstrated a pattern of success. † But he also said candidates had to be realistic about their â€Å"fit,† as he himself was. â€Å"I couldn’t outmodel a former Morgan Stanley analyst,† he said. He moved to Equity Capital Markets from M&A within his first few months because â€Å"it played to my interests in the markets and my personality. † People need to be fast learners, he said, because â€Å"Wall Street doesn’t have the patience to allow someone to develop slowly. Rae’s Strategy Schoenberg’s advocacy for making Cornell a core school converged perfectly with Rae’s new strategy for choosing core business schools. â€Å"We used to go to the top 10,† Rae said, â€Å"but at some of the top schools we were getting people in the middle of the class. † Paying more attention to the next 15 schools in the top 25 was Rae’s new strategy. R ae, who graduated from Amos Tuck School of Business at Dartmouth, had originally been a banker himself at JP Morgan before moving into recruiting positions there and at Merrill, Smith Barney, and then SG Cowen.His previous employers were giants on the top 10 campuses, with huge recruiting budgets, recognized brand names, and, most importantly, much larger hiring needs, which meant that they received immediate student interest. At schools such as Emory and USC, SG Cowen could be a relatively bigger player and attract more attention from the best students. There was resistance initially from senior management, as this was viewed as going downstream. But Rae said, â€Å"Senior managers eventually saw the wisdom. We were hiring at the top of the class, and these students also tended to be more loyal.We were not missing much by not going to the top schools. † At each of the core schools, Rae scheduled a company presentation in advance of the interview dates. At the presentation, R ae guided the team captains to make sure they answered four questions quickly: who are we, what do we do, what distinguishes us from competitors, and what are the next steps. SG Cowen promoted the advantages of a boutique firm, arguing that there was less bureaucracy than at larger banks, that people could move much faster in their careers than at other banks, where they would be hired and promoted lockstep as part of a large class.Team captains talked about the advantages of small deal teams, which allowed for more exposure to clients, more responsibilities, and more entrepreneurship. Rae encouraged team captains to make a very short formal presentation and then allow a substantial amount of time to informally talk and answer questions. At schools like NYU, SG Cowen would be represented by an MD, who made the presentation, and then perhaps 20 alumni who could then have fairly substantial interaction with the expected 100 students who would show up.Some team captains like Schoenberg would tell students they could call him or come and see him (at their own expense) for informational interviews. This would help self-select students who really wanted to be prepared for first-round interviews by knowing more about the firm and also establishing a 4 SG Cowen: New Recruits 402-028 relationship with him. However, he admitted there was a fine line between helping students who were self-starters and giving them unfair advantage in the process. Some team captains put in a lot of time and effort, while some put in less.SG Cowen did not directly compensate or reward bankers for being involved in recruiting activities, but recruiting was included on the performance reviews leading to year-end bonuses. On-Campus Round At every core school, SG Cowen had two or three schedules comprising at least one open one, whereby students signed up based on interest, and the rest closed, whereby SG Cowen selected among previously submitted resumes. Rae said, â€Å"In the past, I’ ve found as many good people on the open as the closed list. † In the first rounds, interviewers tried to focus on which of these candidates could make it through Super Saturday.Schoenberg said, â€Å"When I go up to interview, I’m tough on candidates because I don’t want to embarrass myself later on by endorsing weak candidates. † Interviewers knew they would be held liable for the quality of candidates they brought back for Super Saturday, and their own reputation was diminished if they wasted the time of senior bankers at the firm interviewing candidates at Super Saturday who were clearly not appropriate. At the same time, Schoenberg said, â€Å"When I see people who are prepared and have the eagerness, I fight very hard for them. †While some bankers were especially tough, others were especially easy and wanted to be generous in their assessments of all the candidates. Rae said, â€Å"This is where you see the beauty of writing comments down. â €  At the end of a day of first-round interviews, the two or three people who had been interviewing would discuss whom they had seen. Rae tried to make detailed notes on resumes or on the evaluation sheets he had created, and he encouraged the bankers to do the same so they could recollect specific details about each candidate (see Exhibit 1 for a sample of Rae’s notes from past interviews).Most often there were two schedules, which would amount to 24 candidates. They would then try to narrow the list to six candidates and quickly have a second round, even that same night, on campus in order to cut half and invite the other half to Super Saturday. Rae said the firm usually wanted associates or senior associates to conduct first-round interviews: â€Å"We’re not aggressive about sending our most senior people out; we want to downstream the identification of talent and upstream the responsibility of closing on offers to senior people. Rae felt that often the senior-m ost people were removed from day-to-day concerns and tended not to be as demanding about the basic skills an associate needed, whereas those just a few years ahead of a firstyear associate would be much more rigorous about assessing skills. He made sure senior bankers would be at Super Saturday, however, to judge whether potential associates also had the makings of a good long-term banker. In Rae’s view, long-term success did not come from building models, it came from loving the work, loving to teach and sell, and loving the hunt.The successful bankers had to feel the excitement of serving clients and the excitement of competing at the highest level. In this first round, he also instructed interviewers to test for culture fit. This could be as simple as asking someone whose work and education experience was entirely in the Midwest, â€Å"Are you comfortable living and working in New York? † Rae said, â€Å"Sometimes they might be a diamond in the rough and they can m ake the transition, but cultural fit is important. † Other bankers at SG Cowen agreed. One banker, Ryan Daws, pointed out, â€Å"It’s mportant having Chip in the process because there are only so many personality types in the world, and he’s seen a lot more than we have. † Daws said, â€Å"HR at every bank has to earn credibility with bankers, but when you have someone like Chip who used to be a banker, it makes it easier. † He also said, â€Å"Certain types 5 402-028 SG Cowen: New Recruits fail to succeed once they get here, which colors the interviewing process. † For Daws, alarm signals went off when people did not dress appropriately, or when they asked questions like, â€Å"Are the hours really as bad as they say? He acknowledged there was some ego involved on the interviewing side. â€Å"No one’s ever as good as I thought I was,† he joked. Super Saturday Super Saturday in fact began on Friday afternoon, when candidates ar rived from their various schools and convened with many of the interviewers for dinner and cocktails in the wine cellar of an elegant midtown restaurant. Fennebresque spoke at dinner, and, because he was a great speaker and because it was rare to get the attention of a CEO during recruiting, candidates were usually visibly impressed.On Saturday morning, interviews began at nine, and each interviewer and each candidate had five half-hour sessions with short breaks. Rae tried to keep these interviews moving and spent a lot of time gently tapping and then firmly knocking on bankers’ doors when they lost track of time. Super Saturday was exhausting for the interviewers as well as the interviewees, and Rae wanted to make sure the bankers saved some energy for the collective decision making. Thirty candidates had attended, which meant Rae had commandeered 30 bankers to come to Super Saturday.Rae said, â€Å"They’re giving up a Saturday, and they want to get out of here as f ast as they can. But they get to make the decisions, and that brings them in here every year. † Rae estimated from previous years that he should make 20 offers if his target was 15 acceptances. There were already eight hires from the summer associate program, and seven third-year analysts were being promoted, so this would achieve his objective of a full associate class of 30. Successful candidates received offers to join investment banking.Those who accepted returned for an orientation in April to meet with the banking groups that interested them most. By the time the training program started, each new associate was assigned to a group. The hiring meeting started as the bankers ate their lunch. The bankers usually felt very confident that they could whip through the list of candidates quickly, as they often assumed that others would have shared their view on the interviews they conducted. Bankers were always surprised at these meetings to find out how strong the disagreement could be.One managing director might be turned off by a candidate for â€Å"being too salesy, I thought he was trying to snow me,† and that same candidate could have appealed to another director for having â€Å"great attitude, eager to contribute. † Rae had to figure out how to let everyone weigh in and then build consensus around a decision. Building a Culture through Hiring Rae said, â€Å"I try to get people to act and behave like a firm. † He wanted to make sure bankers were not overly partial to candidates from their own alma maters and also that bankers did not hire people who would only succeed in their own group.At the same time he wanted to make sure that bankers did not relax standards and hire a candidate whom they thought of as â€Å"good enough for the firm† but â€Å"not good enough for my group. † Sometimes he would try to push a banker to a conclusion by saying, â€Å"If you could only take one new associate to the CEO’s of fice with you, which one would it be? † Or at the other extreme, â€Å"If I can’t place her, she’s going to be yours, how do you feel about that? † 6 SG Cowen: New Recruits 402-028 One HR manager at SG Cowen commented:People on Wall Street are too hard on people who took some time to figure out what they want to do. But look at Kim Fennebresque, our CEO. He started out as a lawyer, and he’s been incredibly successful in banking. But when people are hiring, they don’t think of that. Personally, I think anyone who tells you in an interview that they wanted to be an investment banker since age 12 has led an incredibly dull life. Fennebresque said, â€Å"We want to make sure people who are attracted to a place like this understand what this is. We want to ferret out people who love technology, who love emerging growth. Making the firm more visible to both potential clients and potential employees was one reason Fennebresque agreed to frequent ap pearances on CNBC and business segments on other news shows. â€Å"So many people come to Wall Street for the wrong reasons,† he said. â€Å"They’re dazzled by dough and dazzled by stature. People should figure out what they like to do, it matters even more than what they’re good at. I was perfectly good at law, but I sat in that law library at night and I thought the librarian was the Marquis de Sade torturing me.If you don’t like what you’re doing, even if you’re good at it, eventually you and God are going to figure it out. † Fennebresque spoke fondly of having started out in banking at First Boston in the 1980s during the firm’s heyday and in close view of the rise of Joe Perella and Bruce Wasserstein. Fennebresque said, â€Å"I used to believe culture was an overrated Harvard buzzword,† but First Boston made him realize how much culture mattered. â€Å"We were young punks trying to elbow in on the big boys, and it worked,† he said proudly. He was trying to bring some of that dynamism to SG Cowen.Because the investment bankers had all been hired from different firms to build SG Cowen’s banking platform, Fennebresque often used the metaphor of Ellis Island to exhort his bankers to come together and create a unified new culture. He also wanted to make sure they felt they had the support they needed to get their work done, and Fennebresque tried to give bankers as much autonomy and decisionmaking power as possible. Fennebresque’s involvement in recruiting events and his visibility with new and young employees stemmed from this desire to provide support. â€Å"The most important clients are inside, not outside. I really believe that,† he said.Hiring Criteria Rae tried to formalize the criteria by using grid sheets for the bankers to fill out and having them vote and make a case on behalf of their candidate. There were definitely bankers who resisted any kind of â€Å"sc ience† in this process. Bill Buchanan, HBS ‘86, was head of Equity Capital Markets and had also come to SG Cowen from First Boston, like Fennebresque. â€Å"The type of person who does well here doesn’t want to be told what to do. He or she is far less regimented. This is not the Navy. We want the self-starter. † Buchanan said he did put a lot of stock in resumes: â€Å"It makes a big difference if they have been an entrepreneur. Most important, though, he hired for fit. He was even known to change the structure for fit, in that he had created jobs for people he thought SG Cowen should hire. As Buchanan put it, â€Å"We can stretch for personality, and we can stretch for sparkle. † Especially in ECM, Buchanan said, â€Å"The human element, especially our creativity and energy, is why a company chooses us as financial advisor in the first place, especially on commoditized products. We’re very hands on and high touch. We’re not the volu me leader, but we are a service leader. † 7 402-028 SG Cowen: New Recruits Candidates for HiringThe bankers assembled had assigned almost all the magnetic placards representing the applicants into decision groups. They had two spots remaining and four people in the â€Å"maybe† category from whom to choose. 4 Natalya Godlewska Natalya Godlewska was an MBA student at Cornell and had earned an undergraduate degree in finance at an eastern European university. As an undergraduate, she had been the student with the highest grade point average (GPA) in the finance department, and she went on to serve as a graduate teaching assistant in the finance program at Cornell’s business school.She was originally from Poland and had moved to the U. S. at the age of 22. She spoke fluent Russian, Polish, and German and some French. Prior to business school, she had worked for four years for CommScan, a company that developed M&A modeling software used by many major Wall Street fir ms. She had gone to the SG Cowen presentation at Cornell, called the bankers she had met to have informational interviews, and then had been one of the top candidates from Cornell sent on to Super Saturday.At Super Saturday, her interviews had mostly gone well, although there was some hesitation from two interviewers. Everyone was uniformly impressed with her finance background, her analytical knowledge, and her understanding of the financial markets. When one of the bankers had telephoned her references, her previous supervisor had responded positively about Godlewska’s skills and also commented, â€Å"This is the person I would want to bring to a tough negotiation. † She seemed very determined, ambitious, and ready to work hard.But one associate and one managing director each expressed strong reservations for different reasons. The associate felt that Godlewska might not be a good culture fit with the other associates and that she had seemed stiff and uncomfortable d uring small talk at the opening of the interview and also at dinner the night before. The managing director felt that some bankers might lose patience with Godlewska’s less-thanperfect English and that this would affect her ability to work smoothly with her managers. Other people on her interview schedule spoke up in her defense.Associates should be made to deal with people with different backgrounds, and it was all too easy to use â€Å"culture† as an excuse. One banker said he thought Godlewska would be a hit with clients because she was a go-getter and radiated positive energy and a â€Å"can-do attitude. † He said that though it might be an issue with impatient bankers on her team, her language skill would definitely not be an issue with clients because â€Å"most of our clients think Wall Street types speak too fast anyway. † Martin Street Martin Street was a second-year Wharton MBA who had previously served four years in the military.He had no busin ess experience, but he had substantial leadership experience, most notably having led a rescue operation in war-torn Bosnia. He was president of his section at Wharton and also of the Running Club, having completed two marathons and one triathlon in the past year. All of his interviewers agreed that he came across as a dynamic personality and that he was confident and articulate. SG Cowen came to Wharton toward the middle of the recruiting period, so as one banker said, â€Å"People either really want SG Cowen, or they didn’t get offers from other firms. Street had told them he was taking several finance courses, but SG Cowen was not allowed to ask him about his grades because that was forbidden under Wharton recruiting rules. Cowen had difficulty scheduling Street for Super Saturday because he was always involved in recruiting events at other firms. He had said that he liked smaller firms and liked SG Cowen’s areas of specialization, but they still were 4 Note: These candidates are composites of many candidates and are not meant to describe any actual candidate. 8 SG Cowen: New Recruits 402-028 nsure what the likelihood was that Street would accept the offer if it was extended. They were also wary of whether he would play firms against one another in terms of wanting additional time to interview and consider offers, which might prevent SG Cowen from being able to fill that slot with another top-choice candidate. One professional in recruiting said, â€Å"If a person doesn’t sign and accept the offer letter right away, we’ve made a mistake. † Ken Goldstein Ken Goldstein was a second-year MBA at Berkeley who had previously worked at PricewaterhouseCoopers for five years.He had quickly risen to be a manager at PWC, managing multiple audit teams simultaneously, drawing up budgets and pricing for projects, making presentations to win business, and resolving technical accounting issues for clients. When SG Cowen called his refere nce at PWC, he confirmed, â€Å"Ken’s performance appraisals put him in the top 5% of the firm. † Everyone who had interviewed Goldstein liked him and thought he would represent SG Cowen well. In fact, when Rae looked over the written comments on all the evaluation forms, they were uniformly positive.Why hadn’t Goldstein been an immediate â€Å"yes,† why was he one of the â€Å"maybes† that warranted this discussion? One banker said, â€Å"I can tell you what everyone’s afraid to say. Ken is married and has two sons, a newborn and a two-year-old. Whatever he did at PWC, we can’t tell at this stage of his life whether he really will be willing to work 24/7 like the rest of the associates. † One of the senior associates said, â€Å"It’s hard on the other first years if we make allowances for Ken to pick up his kids at daycare or not work on a weekend when his wife’s away.None of the first years expect to have a lif e, so what happens when they see Ken having a life? † Some interviewers said Goldstein had openly talked about his intention to be able to balance a family with being a banker. One of his interviewers said, â€Å"I commend him for trying, but I break promises to my kids all the time, to take them to the first day of school, to get home for a game. † Another banker said, â€Å"It’s weird to say this, because we always say we’re looking for maturity, but I almost think Ken’s too mature. If he were on my team, I wonder if he would do what I tell him to do, or if he’ll dislike taking orders.He’s used to having a lot of responsibility and being in charge. † Andy Sanchez Andy Sanchez was a second-year MBA at the University of Southern California and had completed his undergraduate degree in economics at UCLA. Sanchez had found early success as an entrepreneur, having started his own business during his first year of college, a Kaplans tyle tutoring business to prepare students in Los Angeles for high school achievement tests and the SATs in both English and Spanish. After college, he ran the business full time for three years and then continued to run it while he enrolled in business school.Last year, his business had served 4,000 students at an average price of $500 per course, resulting in $2 million in revenue and clearing $400,000 in profits divided between himself and an equity provider. Sanchez’s interviewers all found him enthusiastic and personable. He had talked to a lot of people at SG Cowen and had stopped into the New York office to have informational interviews or talk to other associates on several occasions when he was in the city for other meetings. He always sent follow-up e-mails and notes to everyone he spoke to, was friendly to the other candidates at Super Saturday, and was great at making people relax.He was well informed about the firm, telephoned other alumni from USC to talk to the m about their banking experiences, and seemed as though he had been reading up on investment banking, speaking very cogently about recent landmark deals in some of his interviews. When asked whether he was sure he wanted to leave his business, he said he was ready for new challenges and that his younger brother was going to run it in his absence. The biggest concern interviewers had with Sanchez was from his resume, which listed a 2. 8 for his undergraduate GPA.When asked about his business school GPA, Sanchez had said it was a 3. 1. At a time when most schools including USC had a fair amount of grade inflation, SG Cowen bankers were 9 402-028 SG Cowen: New Recruits concerned that he had had so many â€Å"Cs† on his record over the years. â€Å"We’re not looking for rocket scientists, but a 2. 8 really sticks out,† one banker said. Sanchez had pointed out to one of his interviewers that his SATs and GMATs were quite high and that his low grades only reflected th e amount of work he was putting into running his business.Rae looked over the other resumes of the Super Saturday candidates, and Sanchez had a very competitive SAT score and one of the highest GMAT scores. Sanchez had told one of his interviewers, â€Å"There was a lot of demand for our services, so we got excited and grew the business pretty fast, and I also needed to make enough money to put myself through school and then put my two brothers through school. Unfortunately, that left me little time for studying. † Decision Time The bankers were having a hard time deciding among the four candidates, and they were running out of energy. The snow was coming down faster, and most f the food was gone, the bankers now going back to the buffet for a second sandwich or some lukewarm pasta. They had made good progress, but choosing these last two candidates was not turning out to be an easy task. Rae remembered Fennebresque’s admonition to make the hiring process â€Å"our mo st important priority. † One banker spoke up, â€Å"Chip, let’s keep this meeting moving. The roads look bad, and it’s my anniversary tonight. If I don’t get home soon, I’m in deep trouble. † 10 SG Cowen: New Recruits Exhibit 1 402-028 Sample Pages from Rae’s Evaluation Book (Prior Candidates) Candidate: Bill Berry Bill BerryLarry Larry Fromkin,Vice President, Health Care Linda Conway, Managing Director, Technology Daniel Jones, Associate Technology Lynn Smith Carl Havens, Vice President, Technology Gloria Watson, Associate, Barr Devlin K. C. *K. C. 11 402-028 SG Cowen: New Recruits Exhibit 1 (continued) Candidate: Damon Sam Sam Damon Vijaya Vijaya Parbhu, Managing Director, M&A Aaron Solomon, Associate, Technology Sam Chung/Lewis Anderson, Associates, Technology M&A Lynn Smith Tom Tedlow, Director, Technology Danny Lewis, Director, Technology 12 SG Cowen: New Recruits 402-028 Exhibit 1 (continued) Candidate: William XuWilliam Xu Ken K en Arendt, Associate, Technology Samantha Adams/Lewis Anderson, Associates, Technology M&A Charlotte Williams, Managing Director, Equity Private Placements Lynn Smith Michael Brennan, Associate, Barr Devlin Cal Pava, Managing Director, Technology with maturity 13 402-028 SG Cowen: New Recruits Exhibit 1 (continued) CSara Wicher Wicher andidate: Sara Mitch Mitch Madison, Director, Technology Sam Downing, Managing Director, Equity Private Placem ents Daniela Galvin, Associate, Technology Lynn Smith Bill Friedan, Associate, Technology Darrell Rawlins, Managing Director, TechnologySource: Company. 14 SG Cowen: New Recruits Exhibit 2 402-028 Associate Evaluation Form SG Cowen Investment Banking Division Associate Evaluation Form CANDIDATE: SCHOOL: EVALUATOR: DATE: GROUP INTEREST: OUTSTANDING GOOD FAIR UNSATISFACTORY COMMITMENT TO FIRM JUDGMENT/MATURITY INTERPERSONAL SKILLS Impact/Presence Communication Skills LEADERSHIP Initiative Motivation TECHNICAL SKILLS Creativity Modeling Accountin g/Finance Prioritizing WORK ETHIC Team Player Flexibility/Versatility Motivation OVERALL RATING COMMENTS: RECOMMENDATION(CIRCLE ONE): HIRE DON’T HIRE Source: Company. 15

Dealer's choice Essay Example | Topics and Well Written Essays - 1000 words

Dealer's choice - Essay Example From this definition, it is clear that politics exist in only in the presence of divided popular opinions. A political philosophy is the principal ideology defining how best to manage collective institutions such as government, economic systems and other social structures (Cahn & Talisse, 15-300). It involves individual or collective analysis and interpretation of ideas like freedom, justice, authority and democracy followed by application of the derived meaning in collective institutions (Cahn & Talisse, 15-300). The term prejudice refers to inflexible and often irrational opinions held by someone or section within a population. The provocative question from this analysis of the above quote can be stated as: Is politics governed through political philosophies or merely a systematic organization of prejudices? Political philosophies are defined around reflection on prevailing social and political issues. Philosophers meditate on the in-depth meaning of such conditions and their impli cation to resource distribution and human interactions (Cahn & Talisse, 15-300). For instance the industrial revolutions that finally lead to urbanization economist pondered between private property ownership versus collective ownership that existed. Some supported capitalism engaging in the popularization of this philosophy against communism and all this is due to the systematic organization of hatred involved with politics (Cahn & Talisse, 15-300). Capitalism dominated over communism based on positive implication in motivating individual and collective economic growth. During this era, political leadership is complied with either of these two philosophies (Cahn & Talisse, 15-300). Another example is the debate between having absolute separation between church and politics which prevailed mainly in the 19th century when religious missionaries were used to gain political control of new territories. Absolute separation of the two institutions was perceived to allow for independent co ntrol and monitoring of events in each objectively (Cahn & Talisse, 15-300). Through the integration of church issue in politics and vice versa was supported in the view of ensuring ethical political conduct and institutionalization of church issue, it lead to compromise of the same factors due to subjective approach to problem solving. Currently globalization and increased social liberalization has elicited varied opinions supporting social permissiveness and conservative social structures. Democracy has been advocated as the political philosophy that offers allows leadership to thrive through gaining majority support based on ideologies that best address individual freedom of expression (Cahn & Talisse, 15-300). Conservative political leaders insist on strict adherence to established structures with minimal adjustment to fit the context (Cahn & Talisse, 15-300). Based on these arguments politics is based on philosophical ideas. Democracy gains more popularity due to advantages whi ch includes allowing individual freedom within organizations and equal representations of stakeholders. Despite this philosophical approach to politics, it remains undefined whether these philosophies have universal validity or are just representation of sections within the society. Are they based on inherent human characteristics? Are these ideologies based on selfish interest or universal

Why is it important to have a Masters Degree Essay

Why is it important to have a Masters Degree - Essay Example Bachelor Degree is basically the minimum qualification required for a profession whereas Masters Degree is essential for higher opportunities in career. This paper briefly analyses the importance of Masters Degree for one’s career development. In industry sector, Masters Degree is essential for the career development. For example, it is difficult for a person with a Bachelor of business administration degree to excel whereas a person with a Master of Business Administration may help him to achieve higher places in his organization. Some people use Master degree for a change of their profession. For example, a Bachelor in economics can opt for a Master in Business Administration if he/she decides to change their profession after the completion of their bachelor degree in economics. Master Degree provides the maturity in learning to the student. Most of the students up to their bachelor degree may not give much emphasize to their education. On the other hand, most of the Master Degree students avoid all other leisure activities and give more importance to their studies. In other words, most of the students become well matured during their Master Degree studies. For a teaching profession in universities and colleges, Masters Degree is essential since majority of the college or university students are studying either the Masters Degree courses, Graduate courses or undergraduate courses. It is impossible for a Bachelor Degree holder to teach a Master Degree student. Even for doctoral degree, it is better for a person to achieve Masters Degree first. In fact Masters Degree is the base for a Ph.D. In terms of course works, Masters Degree always provides the base of Ph.D. People often achieve Masters Degree during their early twenties during which they would be more matured compared to other stages of their student-hood. Masters Degree often gives the choice of specialization. Up to Master Degree level, students often study subjects on a

Globalization - Containerization Case Study Example | Topics and Well Written Essays - 250 words

Globalization - Containerization - Case Study Example Even though CBP has in past been able to counter security threats posed by containerization trade significantly in the past, there has been rising fear that the increasing international trade through ocean transportation might endanger national security. Indeed, almost 95% of cargos arriving in America are undertaken through sea. Thus, there has been an opinion that the international trade needs to be slowed down to ensure the national security is not compromised. However, it is possible to look after the national security without slowing down the international trade through employment of advanced technology on sensors. The ability of developing a multisensory device that is capable of detecting diverse threats when the container is en-route will ensure the national docks are secure from potential threats since the threat will be detected in advance (Grillot, Cruise and DErman 178). However, the security measures at the dock currently are not similar to measures at train stations and airports since the threats are undetected before they arrive at the dock. There have been improved security measures at train stations, airports, and other places compared to docks since a potential threat is detected before a security agency undertakes a screening exercise through sophisticated surveillance cameras amounted across the country. Consequently, the Federal government and maritime industry needs to invest heavily in technology of detecting illegal content and potential threat of container en-route to ensure the threat is countered efficiently and effectively. This will help in promoting secure and safe containerization

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Mangement of the arts - Essay Example Area, an Italian restaurant situated in Montpelier Street, Knightsbridge, London, is a good reference example. Area is owned by a man from south Italy called Franchisco. The business was started fourteen years ago as a small regular restaurant. It drew customers from the lower and middle socio-economic backgrounds. With time, people from good socio-economic backgrounds began to visit the restaurant. This included wealthy people and famous football players for example Chelsea’s Frank Lampard and Arsenal’s Sagna among other footballers. The new wealthy good pool of customers made Franchisco to think of a way to upgrade his low financial status. To achieve this, he increased the prices of food, beverages and drinks served at the restaurant by 50%-100%. This created the impression of quality. As a result of this, the restaurant attracted many richer customers mainly Arabic. According to Pinson and Jinnett (1996), entrepreneurs must track the needs and preferences of their customers so as to satisfy and retain them. It is from this perspective that Franchisco created an Arabian atmosphere in and outside the restaurant in order to maintain the large pool of Arabian customers. He made Arabian designs of various features in the restaurant and played Arabic music. Changing the atmosphere to Arabic made the business attract more Arabian customers. Sheesha is offered outside the restaurant until 11pm. This is an Arab custom in which flavored tobacco is smoked using shisha pipes. This created a good social atmosphere for lovers of sheesha. Customers express their love and appreciation for Area by pinning or placing different currency notes on its walls or on a board. Franchisco choose ‘Area’ as the name his business because it is a neutral term. This has allowed the business to attract people from all cultural backgrounds. Sheesha is strictly offered outside the restaurant. This is because smoking in all public

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Silent films VS films from our time Research Paper

Silent films VS films from our time - Research Paper Example Sound design is one of the most noticeable and transformative elements of film art due to its capacity to heighten the emphasis of other film elements such as the Mise-en-scene and Editing. Accordingly, this research studies the sound design of Metropolis and LOTR with the intention of identifying the influence of sound design on the overall structure of the films. Basically, this research contends that Metropolis and LOTR have similar usage of sound film as a supporting aspect of the action-filled characters and events in the two films. 2.0. Film Sound In filmmaking, film sound includes the process of creating and manipulating sounds; it covers both the technical and creative aspects of audio presentation that may contribute to the overall effect of the film (Dakic, 2009, p. 1). For instance, filmmakers may create new sets of sounds that could backup their preferred videos and images appropriately while they could also alter existing sound to achieve their desired effects. In discus sing the significance of sound design, Pramaggiore and Wallis (2005) state that sound design is a vital aspect of filmmaking, both in the Silent and Contemporary film periods, because of its capacity to extend the story of the film even without lengthening the dialogues of the characters (p. 209). For instance, any subtle, or explicit changes in the sound effects either corresponds to changes in the mood of the characters, or even signals a forthcoming, unexpected event in the film. Consequently, Dakic (2009) mentions that such an influence of sound design in cinemas contributes to the overall interplay of cinematic elements such as dialogues, characters, and events while maintaining little attention to itself as a cinematic element, as well (p. 1). According to King (1996), silent films still use sounds, regardless of the misconceptions about the lack of sound effects of the said film genre (p. 31). In addition, King (1996) explains that such misconceptions are rooted in the preval ence of synchronized audio-visual imagery in today’s contemporary films wherein audio recordings and videos are successfully edited and integrated to form the overall visual and auditory reality of the film. Instead, King (1996) contends that Silent Film uses sounds as the primary aspect that helps audience understand the emotional impact of the film, considering that the conversations of the characters are not audible enough for the audience to hear. Relatively, Silent Films rely heavily on the expressionist actions of the actors, as well as the live performances of the musical ensembles in the cinema. Contemporary action films also highlight the role of sound film in the overall impact of the movie. In the words of Sergi (2005), the significance of sound film rises to prominence along with the invention of digital audio technologies wherein the audience derive insights from the subtle changes in the sound effects, as much as changes in the personalities and actions of the c haracters (p. 3). In modern films, film sound functions as an integral part of the movie; it fills the silence and gaps while it also supports the transitions of videos. It also has a significant emotive impact that is similar to its usage during the Silent Film period. For instance, modern filmmakers emphasize the interplay between videos and sounds, particularly in foreshadowing certain cinematic events, as well as aiding the visual

Week 4 discussion questions Essay Example for Free

Week 4 discussion questions Essay Describe a time when your assumption about a situation was incorrect. What do you think led to your incorrect assumption? How did your assumption interfere with your ability to think critically about the situation? A: When I first became a student at the University of Phoenix I assumed that I would take class in the morning once a week. What lead me to believe this assumption was that I thought it would be like any other normal college. This assumption affected my ability to think because I originally set my mind to morning mode, when class was night. Use your favorite Internet search engine to locate three automobile commercials. Identify a fallacy used in each commercial. How are these fallacies used in the commercials? Why do you think they were included? A in the first commercial Toyota Camery, they focus more on the acting scene then promoting the Camary. They make it seem like those situations happen. The second commercial was a mustang commercial. the fallacy is that they make people believe that by having that care it makes you look cool that way people can go out and buy it. The third was a fiat commercial, they say that the interest and payments are low and no credit check, but once your in the dealer none of what the commercial promoted is applied. They do this type of advertisement to try an get the consumer to buy and to make the commercial interesting and so the audience is engaged. How might you use critical thinking to help someone who is struggling with low self-esteem and a low sense of self-worth to see beyond the media messages they receive on a daily basis? A: The best thing that I can do to help someone is by giving them my self knowledge and what I know about it. that no one is perfect and there is no need to follow what celebertys do because its all show. We can then discuss this particular topic, then research about it and show what the consequences and lead to. In his inaugural speech, President Kennedy used means of persuasion to win over his supporters and those who were possibly dissatisfied with his election. Suppose you opposed President Kennedy’s ideas and wanted to find  fault with his speech. What steps would you take to evaluate his arguments? A: I would carefully listen to what the speech is about and carefully go over it and find simple cons and consequences to a particular topic that he addresses or want s to make happen. Reading, re-reading, looking for main points, researching, questioning, and finding information that is opposed to what he thinks he can make happen. How do you think being open to criticism might help you solve problems in your daily life? Being open to criticsm can help in my daily life because I can simply take that criticsm and use it in a positive way to improve myself in any situation. What types of questions would you use as you talk with her to help her make a decision based on critical thinking rather than emotion? Why are questions such a valuable aspect of critical thinking? A: I would help her focus more on the facts and details rather than the emotional part on how she feels. After focusing on the facts she can develop feelings towards it that are positive. Asking questions are important because once they are answered they can change a persons perspective on a certain topic.

E-tailoring Online: Customer Views and Impacts on Services

E-tailoring Online: Customer Views and Impacts on Services Abstract An increasing number of customers are turning to the Internet to make their purchases, as a vast array of goods and services are now only a mouse click away. E-tailing clothes is even more challenging, with new e-tailers hoping to attract and retain satisfied online customers, are constantly creating new opportunities for them, and in order to do that they need to know what evaluative criteria customers use when selecting an e-tailer as well as what they will purchase online. Past research has provided some insight into what characteristics customers assess whilst making this choice. This report has not been without its limitations. Consequently, the present study utilizes a literature review, qualitative and quantitative research to identify the core customer behavior towards this channel, In addition, results of the analysis show that the type of product on offer and the web attributes (determinants) are predictors of customers attitude toward online shopping for clothing and their perception hence, providing an understanding of how they are responding to the new online buying opportunities. 1. Introduction This research report is divided into 5 Chapters. Chapter 1 is meant to introduce the background of the research area with aims and objectives and focus of the study providing guidelines into subsequent chapters. This then will be followed with Chapter 2 having literature review of the matter giving an insight of the research area that will be referred, compared with the data collection and analysis will be made in Chapter 4. However, Chapter 3 will be discussed prior to the actual data collection as it is necessary to identify Research Methodology to be used for the research. Finally, Chapter 5 will have conclusions and recommendations with any limitations faced and with the mention of area for further research if any. The expansion in electronic commerce (E-commerce) has been phenomenal, with most of todays business transactions being conducted through the Internet. The emergence of this electronic retail (E-tail) market has been extraordinary. E-tailing is also a gaining popularity and changing the retail landscape, it is pervasive in what we thought of it six months ago is probably different to what we think of it today and also what we will think of it in six months time. Customers decision making process has also altered greatly with the introduction of this medium and more so as an alternative channel for shopping. Online shopping concept has already caused a stir in the retail industry in the UK, as more people are opting to buy online due to various reasons, a vast array of goods and services are increasingly being made available now through a click of the mouse, creating a new experience and culture. Many retailers are already delivering high value, personalised products and services at a fraction of the cost thereby making it more low cost and also appealing to the consumers (Birch et al, 2000). The number of consumers shopping online has increased markedly, according to Jardine (1999) people have increasingly become price sensitive and often compare prices of goods both online and offline before making the final purchase, in turn increasing competition amongst the retailers. This is the general overview of the e-tailing concept, as understood b y most of us. However, the purpose of this study is to concentrate on the online clothing market in the UK specifically London, in order to determine predictors of customers purchase intentions for clothing products via this channel. E-tailing of clothing items online has always been debatable, especially since clothing are â€Å"feel-and-touch† products, and cannot be bought without engaging this sensory aspect, unlike other cognitive products like books, computer software, dvds and music which do not really require this. Nevertheless, customers tend to buy more clothing products when they perceive the features of the online store, such as a convenience and secure system of ordering and payment, returns policy, the focus on product display, and the offering of products that have a range of acceptable fits as opposed to a precise fit and most of all choice this are some of the most general attributes a customer considers whilst shopping online for clothes. The attributes that enhance the online experience can be particularly influential for products such as clothing, which generally require physical interaction and evaluation prior to purchase. Web experience attributes can affect early decision making stages (search and pre-purchase evaluation) and influence purchase intent of the customer. With the current fragmented nature of the subject area and to keep up with the rapidly developing technology as well the customer attitudes, the author aims to build on the current body of knowledge, investigating and drawing together the key aspects which influence online shopping for clothes, so as to understand how the customers are responding to the new buying opportunities presented to them by the e-tailers in UK then concentrating on London where the survey was conducted by collecting data from a sample of participants, which aided in exploring the capabilities and further to determine consumer behaviour and customer relationship management p atterns in relation to E-tailing, thus the research objectives being set as: 1. To explore the impact of e-tailing in London. 2. To determine customers attitude towards shopping online. 3. To investigate customers perception of shopping online for clothing in London. In order to achieve the results of the set objectives, the author has explored the determinants the customers consider most important when making a purchase online and to what extent they create an impact on their perceptions. The first hand elements collated from the survey has helped to gain rich insights into customers behaviour and attitudes towards this channel. The secondary data which is covered in the second chapter under the literature review the author here has studied and explained the general E-tailing concept and picked relevant data to help understand the subject matter and provide a better insight into the field of e-commerce, covering a wider area (UK), then narrowing it down to specific location (London) which in turn has helped to achieve the set objectives and later also support the resultant findings in terms of the primary data collected via the survey by the author. 2. Literature Review Xing (2001) stresses that â€Å"The emergence and explosive growth of e-commerce through online trading have ushered in a new era of retail business†. 2.1 The Commercialisation of the Internet The Internet, once a tax-sustained and a government-regulated endeavour, is no longer restricted to non-commercial traffic. The early commercialisation of the Internet, in the mid 1990s gave rise to the e-commerce phenomenon. The Internet population has since grown tremendously, as a result of its opening to the commercial traffic in 1991. Its utilisation has since become remarkably more wide and varied in businesses; the application of internet has grown rapidly over the last several years, due to its contribution of the ever evolving new information technology and its positive gains to the business organisations. Its use apart from being internal its also employed externally and its used more commonly referred to as E-business (electronic business) derived from such terms as e-mail and e-commerce, which is the conduct of business on the Internet, not only buying and selling but also servicing customers and collaborating with business partners. IBM was one of the first organisations to use the term E-business (electronic business) when, in October 1997, it launched a thematic campaign built around the term. Today, major corporations have reconsidered their businesses in terms of the Internet and its new culture and capabilities. Companies are utilising the Web to buy parts and supplies from other companies, to collaborate on sales promotions, and to do joint research, exploiting the convenience, availability, and world-wide reach of the Internet, using it successfully. 2.2 The E-tailing Concept â€Å"The emergence and explosive growth of e-commerce through online trading have ushered in a new era of retail business† says Xing (2001). It was seen as a new channel for sale of products and services along with the traditional channels as well as a market penetration strategy for others. E-tail or E-retail the term, came into discussions or rather its origins as early as 1995, its an addition in the computing subject such as, e-mail, e-business and e-commerce. The business of e-retail has been defined as the sale of goods and services via internet or other electronic channels, for personal or household use by consumers (Harris and Dennis, 2002). Its more efficiently used as a marketing tool, which is integrated into traditional business strategies, and also being viewed as a new marketplace by existing businesses as well as new business ventures as the market place becomes more competitive and unpredictable, due to this, the growth of the electronic retail market has been rapid, significantly expanding reach in terms of people, location and range being variety of information, the World Wide Web has created benefits for both the marketers as well the consumers. For consumers, the Web can provide access to a wide range of products and services with low cost (Bakos, 1997), extensive and tailored information, at home convenience for product comparisons, enhanced interactivity (Cross and Smith, 1995), hence facilitating the formation of virtual communities for users with common interests. E-tailing and E-trading operates in all four of the major market segments; business to business, business to consumer, consumer to consumer and consumer to business. Initially, much direct selling (or e-tailing) was taking place on the internet of computer-related equipment and software, one of the first to report successful sales in the millions of dollars directly from the Web was Dell Computer, there after other businesses started employing the concept in various fields from; Travel bookings, Holidays, Books, Clothing and other accessories, this has particularly grown in the Business to Consumer market segment directly or indirectly as a result of the wide usage of the internet. The Internets greatest commercial advantage is said to be the reduction in transaction cost that directly lowers the prices for consumer (Pavitt, 1997), and therefore E-tailing is said to be a low-cost, efficient way to display merchandise, attract customers, and handle purchase orders (Bellman, 2001). 2.3 Online shopping in the UK Home shopping in various forms has been available to the consumer market for more than 100 years in the UK, paper catalogue being the first and the oldest form illustrated with Victorian ladies and do-it-yourself house kits a lot has changed since, in terms of improvements and choice, then came the emergence of home shopping television, however none has had the influence or the expected impact of shopping, as much as the World Wide Web. E-commerce has grown steadily in the UK since the early 1990s. According to Exley (2006, cited in Haymarket, 2006) consumers have become comfortable shopping on the internet and e-tailing is clearly a part of retails future. He adds that e-tail does not have to replace traditional bricks and mortar stores, â€Å"all retailers need to do is to provide a good in-store experience† (Exley, 2006, cited in Haymarket, 2006). â€Å"Since 2000, Internet shopping has soared by over 5,000% with UK consumers spending an astounding  £200 billion during this period. Internet shopping is clearly the bright spot in the UK retail sector, but this industry is still young and has potential for further growth.† (Tina Spooner, director of information, Interactive Media in Retail Group (IMRG), cited in press release, May 2009). No doubt, online shopping is rising steadily in the UK (from a consumers perspective) as internet access has become cheaper, high street cyber cafà ©s are increasing and Internet service providers (ISPs) have already eliminated subscription fees (Daniel, 2000). Furthermore as technology is set to get even more advanced, hand-held devices have become internet-enabled and nowadays most mobile phones connect to the web (Daniel, 2000). With all the above possible ways of shopping more customers are getting accustomed to the online shopping experience and utilising the new channel. This exc eptional growth of Internet shopping is also driven by greater emphasis on customers efficient use of time, as well as the ever increasing number of computer trained customers, hence giving it a positive outlook and a further opportunity for growth to the existing and perspective e-tailers. A wide range of products and services are available for the customers in the UK to buy online from a variety of retailers, which also gives them a better choice, so why would they go buy anywhere else? Although one reason may be convenience, sadly another is fraud; fraud poses the biggest threat to online shopping (Economist, 2004) but according to Pavitt (1997) consumers fear of shopping online is already resolved by the use of encryption technology. Moreover, the security systems are rapidly improving by the day, further dispelling the notion which is perceived by a majority of people worldwide that online shopping is a risky business. For example, secure digital systems such as encryption tools, digital signatures and the guarantee about security or privacy concern provided by the e-tailers have reduced security inhibitors and thus have increased consumers willingness to visit or purchase from sites (Ah-Wong et al., 2001; Han and Maclaurin, 2002). UK is the second largest e-taling market in Europe like Germany, it combines a large consumer market with internet penetration above the European average (Datamonitor, 2002). There are six leading online shopping companies that dominate the UK e-tailing market. These are; streetsonline.co.uk, Jungle.com, Amazon.com, Lastminute.com, Thomascook.com and Egg.com, all these providing a variety of products and services. What is the future of high street stores when most analysts agree that in five years time, online shopping could be worth  £200billion? This does represent some form of concern to high street stores in the UK as a percentage or it could be of the sales they lose. Nevertheless according to Brewer (2006); cited in Haymarket (2007) the future is brightest for those high street stores that could adopt a multi-channel strategy. However, Murphy (2006); cited in Haymarket (2007) says that â€Å"we have the most vibrant, competitive high street in the world and high street shopping is one of our biggest leisure pursuits. Can high street shopping be our biggest leisure pursuits since they boast to sell a variety of diverse products in-store? It is the refore inconceivable that the future of retail would be solely online†, although the number of customers making purchases online is also on the rise in the UK as mentioned earlier in this report. 2.4 The extent to which e-tailing builds relationships The impact of e-tailing will be felt differently and at different times by various retailers. In the context of buyer behaviour preferences (Daniel, 2000) says that e-tail is a transactional-sales medium rather than a relationship-building medium which means that e-tail cannot substitute personal contact such as customer service advisors, that makes it the most critical differentiation aspect to high street stores today. This emphasises the need further research on the customers perception of e-tail, i.e. to what extent does e-tailing build relationships? If empirical research suggests that e-tailing is a transactional sales medium then ultimately there may be an opportunity for e-tail to focus building relationships with customers that will create the need for further research on how e-tail may be able to become a relationship-building medium. Personal contact with highly trained and motivated salespeople, the service factor is still the critical differentiator for such businesses, and on-line experiences have yet to match that or offer a suitable counter value (Quelch, 1999 cited in Maruca, 1999). As Pavitt (1997) states that the impact of e-tail on high street stores may result in changes on three key fronts; â€Å"change in the nature of product offerings, customer buying patterns and its place in the value chain†. The changes in product offering may alter as a result of advances in digital technology. For example media products delivered via the internet or newspapers being published electronically, that would be a direct impact on high street stores (Pavitt, 1997). There is lack of empirical evidence to show what customers perceive of digital medium against physical goods, as an simple example, would customers prefer buying a DVD from a high street store, so as to get a feel of the physical aspect of this product as well as more information from the back cover of the DVD case, or from the Internet where information on the product is limited in two dimensional form. â€Å"There will be a great deal of change in the value chain as well due to shrinkage in distribution channels†, (Bellman, 2001). E-tailing eliminates traditional chain of wholesalers, agents, and other intermediaries thus creating a new distribution model focusing on manufacturer to consumer direct that implies a great potential for savings (Bellman, 2001). Today, majority of the manufacturers do not want to take the responsibility of dealing with single customer queries, which is one reason why they sell their products through intermediaries even on the Internet. With lack of evidence it still remains to be investigated as to what extent is the internet an intermediary? Another common question which arises in this case is; do e-businesses have any storage for products they advertise or do they order them directly from the manufactures or other traders as required? However, this can also be different in the case of businesses which use internet as a secondary channel for sell or distribution of their products, which they also sell in their physical store. Another issue that arises is to investigate potential shoppers perception in relation to price. Smith et als (1999); cited in Lii and Lee (2005) indicated that online shoppers believe that online stores enjoy a cost advantage over traditional channels in terms of administrative cost, overheads and transaction cost. These features of the online retail channel add to the perception of online shoppers that prices generally tend to be much lower online than that of the high street stores. Considering this then, do customers shop online because they perceive it to be cheaper? If so then how and in what w ays is online shopping cheaper compared to the high street stores where lots of products are reduced at competitive prices even at times with offers such as buy one get on free or a second product at half price, are always there. Is price an issue of concern or is it about building relationships? Would customers be willing to pay that extra price in exchange for good service, remains to be investigated? Good service may be classed by online shoppers such as providing a tracking system for their ordered goods, free return policy and delivery of the goods or a full money back guarantee on items that customers return which is in place with most e-businesses today. With regards to customers online shopping behaviour, Brown (2000) states that a survey by BT found out that consumers choose well-known brands when shopping online and those consumers want to be served immediately, be remembered and treated as individuals. Therefore, in what ways can e-businesses build relationships? According to Kalyanarm and Winer, (1995); Chandrashekaran, (2001); cited in Lii and Lee (2005) prior studies have revealed that in the off line retail channels, customers may use the advertised original price as a frame for reference to assess the accompanying sale price. The resulting price comparison between the original price and the sale price makes the price promotion more appealing (Biswas and Blair, 1991; Grewal et al, 1996; cited in Lii and Lee, 2005). On the other hand on line retailing enables potential customers to have quick and easy access to price and other product attributes and information necessary for price evaluations. An example is amazon.co.uk websit e. The Internet has empowered on line shoppers to better detect price discrepancies and bargains (Balasubramanian, 1997; Bakos, 1997; Hoffman and Novak, 1997; cited in Lii and Lee, 2005). Today Majority of e-tailers attract customers through promotion codes normally available through advertisement and marketing media from which customers, can usually claim some money off or some percentage of discount on their online shopping. What remains to be assessed is whether the promotional codes attract new customers and also retain existing customers to shop online? If e-tailers start providing regular promotion codes to new customers as well as regular customers with this, then will it add up to building a relationship? 2.5 Customers general online shopping preferences in the UK On the basis of the objectives of this research, its crucial to investigate customers e-tail shopping preferences in the UK in general first, since ultimately perception leads to action. â€Å"When consumers are confronted by new forms of retail channels such as on line shopping, they may decide whether the difference between the on line shopping and off line shopping is significant to them. If the difference is perceived to be insignificant, customers may classify the two retail channels as the same. On the other hand, if the differences are perceived as significant, customers may classify the two shopping channels as different and make their purchase decision differently† (Lii and Lee, 2005). â€Å"Perception involves the process of categorization, and people tend to place new experiences into existing classifications of familiar experiences† (Monroe, 1990; cited in Lii and Lee, 2005). Late night shopping in the UK is fast becoming a way of life and a new culture, since for many people 24-hour high street shopping is invaluable as it allows them to fit it around their lifestyles, this is very common in the larger cities like London where this sort of service fits in well with the metropolitan lifestyle whereby time is crucial, however having said that, its also being almost equally favoured by people living in smaller towns or suburbs. The changes occurring in buyer behaviour patterns are alarming to high street retail stores as more and more people are beginning to work partly or wholly from home and they may prefer their goods bought online to be delivered at home, this is also rapidly picking up for supermarkets where the consumers prefer their grocery as well as other items shopped on line to be delivered at their doorstep (Haymarket, 2006). Whatever may be the case, Cottam (2006, cited in Haymarket, 2006) says that high street retailing is facing stiff competition with on line ‘anytime culture, meaning that customers are shopping 24/7 and therefore even high streets supermarkets such as Asda and Tesco have also launched 24-hour stores. Customers perceptions about 24/7 shopping remain to be investigated, since some high street supermarkets that tend to provide 24/7 services are closed on Sunday afternoons due to Sunday trading laws, but this has also changed in recent years. Once more it raises the question, what are customers perception of 24/7 culture in relation to the internet and high street stores, a fair example to portray, the 24/7 concept proved to be costly, in comparison to profitability against cost, for a superstore like Sainsburys as Sainsbury failed in its attempt, even though it believed it had the winning formula (Haymarket, 2006). The reason behind the failure was that Sainsburys could not attract enough customers as there is no guarantee that a fair percentage of existing or new customers will change their habits to take advantage of 24-hour shopping (Haymarket, 2006). Indeed this is a lesson for others (organisational learning) and thus most retailers are being cautious in their approach to 24/7 services. Bearing this in mind customers are constantly taking advantage of such facility and are trying or even getting used to shopping around the clock says Gladding (2006, cited in Haymarket, 2006). Analysts argue that 24-hour retailing is less likely to grow beyond its current levels as retailers have raised little awareness of the fact, hence stores such as Asda and IKEA are being cautious about this approach by advertising their long opening hours in the form of outside signage and flyers (Haymarket, 2006). The key question that arises from this scenario is the customers perception of the availability of 24/7 online shopping versus the high street 24/7 timings. Do customers really want go to shopping at high street stores and supermarkets at night (freely) compared to doing online shopping at night? Security is another issue that could be a vital sign of failure for high street stores or supermarkets to remain open 24/7 and be able to achieve their budget. Depending on the type of product, Andrew and Currim,(2004) have highlighted some key characteristics of customers shopping on line, despite the additional aspects. They say that consumers shopping online for products such as groceries differ from those who shop in high street stores claiming that on line grocery shoppers tend to be more frequent, heavy shoppers, less price sensitive, prefer larger sizes and do more screening on the basis of brand names. Alternatively, Morganosky and Cude ,(2000) suggest that convenience is the main motivation for on line shoppers, and according to Keh and Shieh,(2001) on line shopping is ideal for time-starved customers such as couples with two careers, children, and above-average income who want to spend time with their families instead. These suggestions are valid and can be applied to the reasons for consumers behaviour towards shopping online, however it also differs to the type of market and the products on offer. Hence, for those people, conven ience is more of a priority than price stresses, Keh and Shieh, (2001). Also Professionals, working women and single independent hard working individuals are just some of the people who do not have time on their hands and their perceptions of online shopping especially for items such as grocery remains to be determined. Keh Shieh, (2001) simply claim, with being deficient in practical evidence, that such customers dislike grocery shopping and only those with busy schedules will consider on line purchasing as a viable option. Online shopping may save time and money as the frustration of dealing with children at a store or supermarket that involves pushing carts up and down the aisles, waiting in long lines at checkout counters, and finding parking spaces, could be eliminated, Keh Shieh,(2001).Whilst on the other hand, as more people today having the opportunity to â€Å"surf† from their offices, they are more likely to shop during office hours and thus may prefer to collect their online shopping at ‘convenient stores on their way back home (Pavitt, 1997). Vaughan (1999); cited in Jardine (1999) head of consulting at Retail Intelligence says that â€Å"consumers might do their main shopping on the internet once a week but will still need to stock up on fresh foods locally† and this is the alternative method that supermarkets have taken by opening ‘convenience stores such as Tesco Express, Sainsburys Local, and MS Simply Food, (Jardine, 1999). According to Lii and Lee (2005), their study on examining customers perception of shopping on line suggests competitive pricing being the main reason. It allows them to compare prices of products more quickly and easily than when shopping in stores. (Korgaonkar and Wolin, 1999; Ernst Young, 2001; cited in Lii and Lee, 2005). According to the author, Mysupermarket.co.uk is a classic example; The website allows registered shoppers to compare their online shopping from high street supermarkets in the UK which are Tesco, Asda, Sainsbury and Ocado which is fully online based. Furthermore it allows users to switch at a click if they decide to change their preference to the cheapest supermarket. The problem associated with this is that it may be time consuming going through the tedious process of comparison because consumers may dislike switching from their preferred supermarket. In the authors view high street supermarkets also offer this service. A good example is that of Sainsburys supe rmarket where there is often a price comparison sheet placed next to their own shelf edge price tags showing their prices as compared to Tesco and Asda. If not then Sainsburys have opened small kiosks often located towards end of an isle where the customer advisor can compare their prices for customers with other competing supermarkets and if their prices are high then they do price match or sell the item even cheaper. This shows that the high street physical stores are also doing their best to match the benefits of on line shopping. Another factor that may drive away consumers from shopping on line is transportation cost. Bellman (2001), says that growing numbers of e-tailers are eliminating these costs as they find that customers often cancel orders after going through the entire ordering process and then considering the transportation cost being high, and this may be the key factor that drives potential customers away. The other fear of shopping online is privacy. Most web users refrain giving out their details, especially data in the form of credit card details as they fear exploitation of their privacy (Bellman, 2001). Insufficient product information on screen also contributes to decline of purchase. Apart from this, all secured websites do have a ‘time-out function where user sessions are based on time limits. If ‘time-out occurs, customers risk losing their entire shopping basket, which is quite frustrating from a customers point of view. These are some of the most common factors which may keep away customers from shopping online and reason their preference to shop in high street stores simply because they are well aware of the location, store layout, product selection and return policies as well as the stores reputation (Greenbury, 1999; cites in Maruca, 1999). Online e-tailing has a great and growing future, but the high street is still an important destination for customers. The limiting factor of e-businesses could be, a simple example, such as one cannot buy a piece of fruit via shopping online but can do so from a store. Furthermore, there is no empirical evidence to justify what drives customers to shop on line instead of high street stores, ultimately questioning what customers online shopping preferences are? 2.6 The E-tail clothing sector in UK Fashion is a sensitive and rapidly moving market which is growing at a faster pace in the UK, in comparison to its other European counter parts. Shopping on line for clothing products is also fast gaining popularity in the UK. Although buying over the Internet remains small in comparison with buying through the traditional channels, such as the brick-and-mortar physical stores, it is growing and clothing is a substantial portion of the e-tail sector in the UK. The online clothing sector caters for almost all segments of the UK market starting from the low cost value clothing to high end designer clothing including bespoke tailoring to couture clothing, the choice is unlimited and the options ever increasing. One can buy a single handkerchief to a full suit online, even clothing and accessories for all age ranges are available, whereby the customer can buy clothes for new born babies to clothes for senior citizens, therefore making this shopping Diabetes: Questions and Answers Diabetes: Questions and Answers DIABETES Diabetes Mellitus The medical name for diabetes mellitus comes from the Greek word that means to siphon and the Latin word that means sweet like honey. Diabetes mellitus is the name given to a group of conditions where there is too much glucose in the blood. It affects approximately 3% of the population. There are currently 1.4 million people with diabetes mellitus in the UK and it is expected that by 2010 that there will be a further 1 million. It costs the NHS 4.9 billion a year and affects a million people without them even knowing that they have it. (Devendra et al 2004) RELATED BIOLOGY Which organ is involved in the regulation of Blood Glucose Levels? The pancreas. Where is it located? Retroperitoneally, within the curve of the duodenum and with the tail extending to the posterior surface of the spleen. What type of tissue is it made up of? Primarily glandular tissue that has both endocrine (Insulin) and exocrine (Pancreatic digestive enzymes) functions. Which area of this organ is responsible for producing the hormones involved in the regulation of blood sugar levels? The Islets of Langerhans What are the main functions of insulin? To reduce the levels of blood sugar by facilitating the uptake of glucose from the bloodstream into the cells. It increases the rate of glycogen synthesis in the liver It promotes the synthesis of fatty acids in the liver It inhibits the breakdown of fatty acids in adipose tissue It stimulates the uptake of amino acids It increases cell permeability to potassium (after Wills C et al 2003), What type of substance is insulin made of? Circle the correct answer. Carbohydrate Protein Fats Name the calls that produce the hormone glucagon. Alpha cells What are the main functions of glucagon? An insulin antagonist, it raises blood glucose levels by increasing hepatic glycogen breakdown. It activates hepatic glyconeogenesis It enhances lipolysis of triglycerides One of these hormones has a Catabolic action and the other an Anabolic action. State what these terms mean and identify which hormone falls into which category. CATABOLIC Catabolism is the breakdown of complex biological molecules into smaller component ones Glucagon ANABOLIC Anabolism is the synthesis of complex biological molecules from simpler components. Insulin What are considered normal limits of blood sugar readings? Fasting blood sugar 3.0 to 6.1 mmol/l (Client note: this is variable I have quoted WHO figures – check what your tutor recommends and add it here!) Those with levels of 6.1 to 7.0 mmom/l are said to have impaired glucose tolerance (WHO 1985) CLASSIFICATION OF DIABETES MELLITUS State the 4 main categories. To the client: this is a loaded question. There are many different classification schemes. I quote the categories as defined in RECD 1997 Type 1 diabetes mellitus Type 2 diabetes mellitus Gestational diabetes mellitus Secondary diabetes mellitus – includes: Genetic defects of beta-cell function Genetic defects in insulin action Diseases of the exocrine pancreas Pancreatitis Trauma/pancreatectomy Neoplasia Cystic fibrosis Hemochromatosis Endocrinopathies Acromegaly Cushings syndrome Glucagonoma Pheochromocytoma Hyperthyroidism Somatostatinoma Aldosteronoma Drug- or chemical-induced Vacor†  Pentamidine Nicotinic acid Glucocorticoids Thyroid hormone Diazoxide Beta-adrenergic agonists Thiazides Phenytoin Alfa-interferon Infections Congenital rubella Cytomegalovirus Uncommon forms of immune- mediated diabetes Other genetic syndromes sometimes associated with diabetes Down syndrome Klinefelters syndrome Turners syndrome Wolfram syndrome Friedreichs ataxia Huntingtons chorea Lawrence-Moon Beidel syndrome Myotonic dystrophy Porphyria Prader-Willi syndrome (RECD 1997) Diabetes mellitus can be due to a deficiency in insulin synthesis, secretion and also in some cases resistance. It is also thought that some diabetics may have a combination of both. State 5 causes of Primary Diabetes Mellitus [aetiology]. Primary Diabetes Mellitus is subdivided into Type 1 and Type 2 varieties Aetiology of Type 1 is multifactorial. It is auto immune and trigger factors can be genetic or environmental Environmental causes include exposure to Coxsackie B virus, Rubella virus and Cytomegalovirus and exposure to cows milk. Aetiology of Type 2 is also multifactorial. It includes genetic factors and environmental factors including: western diet, lack of exercise, obesity and hypertension (Todd W et al 2000) NB Causes are still unknown, the above are thought to be trigger factors. State 4 causes of Secondary Diabetes Mellitus. Causes of secondary Diabetes Mellitus. There are several types of secondary Diabetes Mellitus including: gestational diabetes malnutrition-related diabetes pancreatic diseases causing diabetes endocrine diseases causing diabetes drugs and chemicals causing diabetes genetic conditions causing diabetes Causes depend on the variety but include pregnancy, pancreatitis and various drugs including: steroids thiazide diuretics phenytoin diazoxide streptozotocin Pancreatic diseases can cause Diabetes Mellitus including: acute and chronic pancreatitis pancreatic carcinoma cystic fibrosis haemochromatosis Disease processes can also cause secondary Diabetes Mellitus including: acromegaly Cushings syndrome glucagonoma phaeochromocytoma Complete the following chart by using the recommended textbooks to compare the two main types of Diabetes. TYPE 1 TYPE 2 Age at onset juvenile ( % of all cases about 10% about 90% Acute/insidious acute insidious Body build lean obese Genetic link high low Prone to ketoacidosis yes no Autoimmune Disease yes no Treatment insulin diet, oral hypog’s (Harris M 1995). What age group in the general population has the highest incidence of Type 2? Typically the 55-75 age range (Harris M 1995). Certain groups in the general population have an increased risk of developing Type 2 and currently Diabetes UK is promoting a campaign to identify those most at risk earlier, so that they do not develop the major complications associated with this chronic disease. This is called the Missing Million Campaign. Names these â€Å"At Risk† Groups 1. History of Heart Disease 2. History of Stroke 3. Obese (BMI>30) 4. Over 50s 5. Over 40s if from African Caribbean or Asian backgrounds PATHOPHYSIOLOGY / CLINICAL FEATURES DEFINITIONS Define the terms:– Gluconeogensis Biosynthesis of glucose from sources other than glycogen Glycogenolysis Oxidisation of hepatic glycogen into glucose Briefly describe how insulin deficiency / absence can cause the above processes to occur. Insulin deficiency and/or low glucose levels promote the secretion of glycogen Glucagon promotes the activation of the enzyme adenylate cyclase in the liver which triggers glycogenolysis. This is exactly the opposite process to gluconeogenesis and is mediated by a number of enzymes, the most significant being pyruvate kinease Clinical Presentation – Complete the following When blood glucose levels arise above a certain amount the renal threshold in the kidneys is exceeded and glucose spills over in to the urine. This is called glycosuria. This excess glucose sucks up the water so that it can flow from the body; this is called. Large amounts of urine are excreted. This is called polyuria. Excessive thirst is called polydipsia. Excessive urination can result in lowered blood pressure and shock. Blurred vision can be caused by fluctuations in the amount floaters and water in the lens of the eyes during periods of dehydration. This is called osmotic myopia of the lens. Cells are not able to access glucose so they do not receive any fuel and as a consequence cannot produce energy. This triggers the brain to send a message of hunger. This excessive hunger is called polyphagia. Lack of energy makes the individual feel tired and weak. Other sources of energy are sought. Fat stores are broken down to provide energy. This may result in ketosis. Breakdown of fats results in the production of ketone bodies which are excreted in the urine. These are acidic and alter the blood PH. There is a sweet smell of ketones on the breath. This is called ketotic respirations. Weight loss also results. Breakdown of protein stores results in muscle wastage. Skin infections are common e.g. Staph boils, erysipelas . Excess glucose suppresses the natural defence mechanisms and the action of the lymphocyte* cells. Electrolyte imbalances occur. The electrolyte potassium affects cardiac muscle causing arrythmias if deficient. Urea and electrolyte imbalances also result in the following symptoms 1. Dry mouth 2. Thirst 3. Muscle weakness 4. Lethargy 5. Cardiac arrythmias. Numbness and tingling in the feet and cramps may result from peripheral neuropathy. Client Note (*)– this is debatable – your tutor may have a specific answer in mid for this one The recommendations of the W.H.O â€Å"Definition, Diagnosis and Classification of Diabetes Mellitus and its Complications† were formally adopted in the UK on the 1st June â€Å"2000. The key recommendation, with regard to diagnosis is that fasting plasma glucose should be lowered from 7.8mmol/L to 7mmol/L. What is an OGTT? The Oral Glucose Tolerance Test In the oral glucose tolerance test the patient, after fasting for 15 hours, drinks 75 g of glucose in 300 ml of water, over 5 minutes. Blood glucose is measured before the drink and after 30, 60, 90 and 120 minutes. Urine is collected before the drink, and after 60 and 120 minutes. Before the test, for a period of 6 hours, the patient should avoid smoking and drinking coffee. There is a normal glucose tolerance if the venous plasma value is less than 7 mmol/l after the 2 hour period, If after 2 hours after the glucose load the value is between 7 and 11 mmol/l, then there is impaired glucose tolerance. If glucose is greater than or equal to 11.1 mmol/l this is diagnostic of Diabetes Mellitus OTHER TESTS / SCREENING PROCEDURES What is an HbA1c Test and why is it carried out? This is a measure of glycosylated haemoglobin in the blood. It is a longer term measure of the degree of blood glucose control. (DCCRG 1993) NICE target is 6.5 7.5 HbA1c When would Urea and Electrolyte levels and Blood Gases be tested? Normally only if metabolic imbalance is suspected, dehydration, renal involvement or occasionally as a screen for end-organ pathology (kidneys). U’s + E’s may be requested as part of a monitoring procedure. Blood gases may be useful if severe ketoacidosis is present. When would a Full blood count, specimen check and chest X-rays be carried out? This is more likely to be done as a screening or monitoring procedure (FBC or Urinalysis) unless there was an obvious clinical reason for doing them such as suspected anaemia etc. A CXR would be less likely to be carried out unless pulmonary or cardiac pathology was suspected (Client: this is contentious – as different clinicians have different rationales for these investigations.) When would and ECG and Lipid levels be checked? ECGs are likely to be checked on diagnosis, as a monitoring procedure or if arrythmias have been detected. They may also be done as a baseline investigation, with hypertension or if cardiac involvement is suspected. Lipids are very likely to be abnormal in Diabetes Mellitus. They would be checked as a monitoring investigation at most visits. (DCCRG 1993) When would a neurological assessment and inspection of the lower limbs be carried out? Peripheral neuropathy and vascular impairment are common sequelae to Diabetes Mellitus and this would be actively considered and evaluated at each monitoring visit. Probably at least twice a year or more frequently if indicated. (DCCRG 1993) Why are protein levels checked? Proteinuria is a good indicator of diabetic nephropathy. Urine protein should be checked at every monitoring appointment. Serum proteins are less sensitive but if renal pathology is established then it may be a useful investigation. (DCCRG 1993) When is urine checked for ketones? In the presence of dehydration, clinical suspicion of ketonuria, pregnancy and as a monitoring procedure. (DCCRG 1993) When would an eye inspection / photography be carried out and why is this done? Retinopathy is a potent cause of visual impairment and commonly found in the diabetic state. It is commoner with poorly controlled Diabetes Mellitus and Type I diabetes mellitus. It is one of a number of ophthalmic complications seen with diabetes and should be actively screened for at every routine visit. (DCCRG 1993) Why would a diabetic require having their blood pressure regularly recorded and what value is recommended? Hypertension is a common cardiovascular complication of Diabetes Mellitus and is an independent risk factor in Type II diabetes mellitus. The presence of hypertension and Diabetes Mellitus coexisting in the same patient will increase the overall morbidity risk of both cardiovascular disease and cerebro-vascular accident. A blood pressure reading below 130/85 mmHg is an ideal goal for most people with diabetes who dont have kidney complications, but some authorities may recommend an even lower blood pressure goal (below 120/75 mmHg) for people with diabetes who have kidney complications. (DCCRG 1995) State the main complications Short-Term Hypoglycaemia, dizziness, lethargy, impaired conscious level – drowsiness. Hyperglycaemia, nausea, headache, malaise, ketosis. Coronary heart disease, Cardiovascular disease (macro- microvascular disease) Retinopathy which can lead to blindness Nephropathy, which can lead to kidney failure and the need for dialysis Neuropathy which can lead to, among other things, ulceration of the foot requiring amputation Microvascular Retinopathy, Nephropathy Neuropathy These are generally related to HbA1c levels with the highest incidence of complication occurring when HbA1c levels are above 12% Atherosclerosis Arteriosclerosis Both processes can lead to : heart disease stroke peripheral vascular disease (Stratton I et al 2000) What are the SIGN Guidelines and name those that relate to Diabetes. A set of guidelines originally drawn up by Scottish Intercollegiate Guidelines Network. They include: visual impairment (SIGN 4) pregnancy (SIGN 9) children and young people (SIGN 10) renal disease (SIGN 11) foot disease (SIGN 12) cardiovascular disease (SIGN 19). Treatment- Give Principles   Type 1 Always insulin dependent. Active treatment involves titrating insulin dose against glucose levels and then maintaining levels by manipulation of the insulin regime Constant monitoring by either patient or physician Constant vigilance for complications Type 2 Depends on cause, but in most cases treatment involves lifestyle modification, weight loss, dietary carbohydrate restriction. If not successful then progression to oral hypoglycaemics and occasionally to insulin. Constant monitoring for the presence of complications Reduction of secondary causes of complication i.e. cessation of smoking. INSULIN Insulin was identified as a substance that prevented diabetes in the early 1890’s. Banting and Best extracted insulin from the pancreas of a dog in 1921 and the first human received a crude extract of insulin from the pancreatic glands of cattle in 1922. Over the years there have been many advances in the synthesis of insulin. Insulin is a protein. Insulin injections are vital for people with Type 1 diabetes as they are unable to produce insulin them selves and also for many with Type 2 diabetes whose condition has progressed to a point where tablets and diet cannot control it adequately. The aim of this treatment is to ensure that blood glucose levels are maintained at less that 6.5 mmol/l. (Client: see previous comments) Name 4 factors which influence control 1. Weight 2. Severity of disease process 3. Diet 4. Level of exercise (Wing RR, et al 2001) There are a variety of insulins available on the market. The two main sources are animal and human. How is human insulin produced? By recombinant DNA technology inserting human genes into bacteria such as E.coli which then produces insulin in commercial quantities. The majority of diabetics are now on Human insulin but unfortunately some people are still required to take animal insulin. Many drug companies are wishing to phase out animal insulin and at present Diabetes UK is campaigning to maintain these. Why does insulin have to be given by injection? Being a protein it cannot be given by mouth as it would be denatured in the gastro-intestinal tract. What other route is being researched as an alternative? A great deal of research has been lavished on alternative modes of drug delivery. Transdermal routes do not give reproducible and consistent blood levels. Oral insulin has not been a possibility in the absence of a specific peptide carrier system that would work in the gut. Nasal administration has been tried, but there was low bioavailability and absorption enhancers were needed, in addition the clinical effect was only over a very short period. Pulmonary routes appear to be promising but we already know that the pulmonary route is comparatively inefficient and requires ten times the amount of insulin to achieve the same clinical effect. Initial clinical trials show no side effects and research is currently continuing. (Heinemann L 2001) SIDE EFFECTS Initially on the commencement of insulin people may experience sensitivity around the injection site. How would you recognise this? This is a form of allergy. It can be local, in which case the local skin becomes red and itchy at the injection site. It may (rarely) be systemic giving rise to a uticarial reaction, tachycardia and tachypnoea. Very rarely a patient may experience anaphylaxis. Symptoms of hypoglycaemia may occur if too much insulin is injected or if not enough carbohydrate is consumed or if there is increased exercise without taking extra food. Hard lumps under the skin may occur at injection sites if they are not rotated. What is the correct medical term for these? Lipodystrophy The number of units prescribed is calculated depending on time of day, age, weight and lifestyle. Typical dose is 0.7-1.0 units per Kg of body weight. WARNINGS Insulin should never be administered in cases of HYPO. The body may get used to low levels of blood glucose and therefore the warning signs for HYPOs are reduced. Individuals who have lost these may be advised to raise their blood glucose levels slightly for up to 3 months to resensitise themselves to symptoms. Some people have also found that they have lost some or all of their symptoms of HYPO when transferring from animal to human insulin. Insulin dosages may have to change if there is disease of the adrenal pituitary and thyroid glands and also in the presence of liver and kidney disease. Taking of steroids will increase the insulin requirement. During illness, puberty or emotional trauma glucose levels can become elevated and therefore insulin doses require to be adjusted and more regular blood sugar monitoring is essential. During pregnancy insulin requirements may decrease in the first trimester and increase in the second and third trimester. The following drugs may increase blood glucose levels and therefore lead to a need for more insulin – Steroids Contraceptives Asthma Inhalers Some drugs lower blood glucose levels and therefore result in a reduction in insulin. These are:- Aspirin Beta blockers Mono-amine oxidase inhibitors. There are four categories of insulin. Give an example of each. Very short acting [ANALOGUE] – e.g. Humalog. Short acting [SOLUBLE, NEUTRAL] – e.g. Actrapid, Human Velosulin. Medium and long acting [ISOHANE, PROTAMINE ZINC] e.g. Human Insulotard. Combination of short and medium acting [MIXED, BIPHASIC] e.g. Human Mixtard. Who would most likely be prescribed very short acting insulins? The very unstable or out of control diabetic. Children more likely than adults. How long before a meal does short acting insulin require to be injected? Depends on type. Sol. Insulin starts working within 30-60 mins and lasts about 6-8 hrs. Other types such as Insulin aspart and insulin lispro both start working within 15 minutes and last for up to five hours. The glucose rise after a meal typically begins within about 15 mins so the insulin should ideally be in the system to counteract it. How often daily would you require to take the following insulins:- Short acting – about 2-4 times a day( when stable) Medium acting – about twice a day Long acting – Once (or perhaps twice) a day These answers depend on the age and size of the patient, as well as the severity of the disease process. Why is short acting insulin sometimes given with medium acting insulin? To give a smoother blood glucose profile and also to â€Å"fill in the gap† before the medium acting insulin becomes biologically active. Where should insulin be stored? In the fridge, but not frozen. Briefly discuss the types of equipment that are used to administer insulin? Commonest is still the disposable insulin syringe. Syringe should always be calibrated to match the insulin type. Most are U-100 now. Other options include the pen devices (expensive but convenient and largely â€Å"fool proof†). Jet injectors are occasionally seen, but not very common. In hospital surroundings insulin pumps (drivers or infusers) can be used. Ambulatory subcutaneous pumps are increasingly used to deliver continuous infusion. Very expensive but arguably capable of producing the best control. (HSG 1997) What advice would you give to a diabetic who is planning to go abroad on holiday with regard to their insulin? Take plenty with you as your brand may not be available abroad. Make sure you can keep it refrigerated. Run your blood glucose levels slightly higher than you are used to a) because of probable increased exercise and b) to reduce the risk of Hypo whilst away from home. Be extra vigilant with the blood sugar monitoring. Strange diet may have unexpected consequences. ORAL HYPOGYCAEMICS Below are the main categories of drugs. Give an example of each, including daily dosage and side effects? Sulphonylureas Chlorpropamide 250 mg (100 mg in the elderly) This is a very long acting drug, usually taken once daily with breakfast. Alcohol may cause flushing to the face. Biguanides Metformin Start at 500 mg twice a day or 850 mg once daily. The maximum daily dose is 2550 mg given in three divided doses Gastrointestinal side effects are a common occurrence in people taking metformin. Problems often include bloating, flatulence, nausea, stomach cramps and diarrhoea Occasionally a metallic taste in the mouth. Rare complication lactic acidosis (Knowler WC et al 2002) Prandial glucose regulator Repaglinide 0.5 to 4 mg with each meal Occasional gastro intestinal side effects (Bokvist K et al 1999) Alpha glucosidase inhibitor Acarbose 50 mg then titrated against clinical effect. Flatulence soft stools or diarrhoea. Glitazones [new drug] Rosiglitazone 4mg as starting dose increasing to 8mg if required Possible toxic effects on the liver (theoretical rather than practical) (Park JY et al 2004) ACUTE COMPLICATIONS The most common is Hypoglycaemia. It results from an imbalance between glucose intake, endogenous glucose and glucose utilisation. A decrease in the blood glucose level normally leads to stimulation of catecholamine secretion. Identify 5 causes. Insufficient carbohydrate intake Excessive carbohydrate utilisation (exercise) Intercurrent acute illness Overdose of insulin Other illnesses (viz glycogen storage diseases) Alcohol Name 8 clinical features that the patient experiences. Pallor Shaking Perspiration Fatigue A feeling of weakness Rapid heartbeat (Tachycardia) Hunger Agitation Difficulty concentrating Irritability Blurred vision Temporary loss of consciousness Confusion Convulsions Coma. What would be given in order to treat it? Depending on severity. If minor, warm sweet (glucose containing) drinks If major, IM Glucagon. Monitoring essential until fully recovered. What is ketoacidosis? A clinical condition almost invariably associated with low insulin levels. As a result, the blood glucose levels rise and the intracellular glucose levels fall. This requires the metabolism at a cellular level to be fuelled with fat derivatives rather than carbohydrates and this produces acidic ketones. These ketones normally require the presence of insulin for their catabolism. In its absence, they build up causing a metabolic acidosis and spill over into the urine when the concentration is high enough. Identify 5 causes Fluctuations in insulin regime Intercurrent illness Trauma Reduction in carbohydrate intake Dehydration +- severe exercise State 10 clinical features of this clinical state High blood sugar levels Frequent urination (polyuria) and thirst Fatigue and lethargy Dry skin Facial flushing Nausea Vomiting Abdominal pain Fruity odour to breath Rapid, deep breathing (Air hunger) Muscle stiffness or aching Coma The principals of management are:- Prompt administration of insulin (usually on a sliding scale) to reduce the hyperglycaemia and ketonaemia Replacing fluid loss (from polyuria and vomiting) usually by intravenous fluids Restabilising electrolyte imbalances secondary to dehydration, metabolic acidosis and hypokalaemia. Treatment for any underlying cause such as infection. LONG TERM COMPLICATIONS There are 10 steps that the diabetic patient can take to reduce his chances of developing complications. Regular screening of BP and maintain at 140/80 or lower. Regular HbA1c testing. Maintain blood glucose levels between 4-7mmols/L before meals. A