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  1. Advanced Management Accounting Case:

Harwood Medical Instruments PLC (HMI), based just outside ofBirmingham, England, manufactured specialty medical instruments andsold them in market niches that were becoming increasinglycompetitive and price sensitive because of pressures toreducehealth care costs. HMI was organized into nine divisions each runby a general manager. Over the years, HMI had gorwn bothorganically and by acquisition. Six of the divisions had beenacquired by HMI within the past decade. All of HMI's divisions soldmedical products to hospital, laboratories, and/or doctors, so theneed for product quality and reliability was high. The divisionsvaried significantly, however, in terms of the degree to whichtheir success depended on, for example, development of newproducts, efficiency of production, and/or customer service.Bonuses for division general managers were paid semi-annually. Upto the year 2009, these bonuses were calculated as 1% of divisionoperating profits. HMI's managing director, Andy Guthrie, hadconcerns though that the operating profit measure was too narrowlyfocused. He had been reading articles about performance measurementand decided to implemnt a "more balanced" scorecard. In November2009, just before introducting a new bonus plan, Mr. Guthrieexplained to his chief financial officer that he was willing to payout higher bonuses than had been paid historically if improvedperformance warrantd doing so. The new plan provided a base bonusfor division general managers of 1% of division operating profitsfor the half-year period. this base bonus was adjusted asfollows:

 

Increased by $5,000 if over 99%of deliveries were on time; by $2,000 if 95-99% of deliveries wereon time; or by zero if less than 96% of deliveries were ontime.

 

Increased by $5,000 if sales returnswere less than or equal to 1% of sales, or decreased by 50% of theexcess of sales returns over 1% of sales.

 

Increased by $1,000 for every patentapplication filed with the UK Intellectual Property Office.

 

Reduced by the excess of scrap and rworkcosts over 1% of operating profit

 

Reduced by $5,000 if average customersatisfaction rating were below 90%.

 

If the bonus calculation resulted in a negative amount for aparticular period, the maanger received no bonus. Negative amountswere not carried forward to the next period. Exhibit 1 showsresults for two representative HMI divisions for the year 2010, thefirst year under the new bonus plan. The surgical InstrumentsDivision (SID), one of HMI's original businesses, sold a variety ofsurgical instruments, including scissors, scalpels, retractors, andclamps. The markets for these products were mature, so growth wasrelatively slow. Not much innovation was needed, but controllingcosts was critical. The Ultrasound Diagnosti Equipment division(Ultrasound), which was acquired in 2007, sold and servicedultrasound probes, transducers, and diagnostic imaging systems. Theultrasound market promised excellent growth and profits if thedivision could keep its sophisticated products on the cutting edgetecnologically and control both product development and productioncosts effectively. In 2009, the total annual bonuses for the yearearned by the managers of SID and Ultrasoundn were approximately$85,000 and $74,000, respectively.

 

Operating results for the Surgical Instruments andUltrasound Diagnostic Equipment Div, 2010 ($ in 000s)

 

Surgical InstrumentsDiv. Ultrasound Diagnostic Equip. Div

 

1st half of2010 2nd half of2010 1st half of2010 2nd half of 2010

 

Sales $42,000 $44,000 $28,600 $29,000

 

Operatingprofit $4,620 $4,400 $3,420 $4,060

 

On-timedeliveries 95.4% 97.3% 98.2% 94.6%

 

Salesreturns $450 $420 $291 $289

 

Patent applicationsfiled 0 1 4 8

 

Scrap and reworkcosts $51.1 $45.0 $39.7 $28.2

 

Customer satisfaction(average) 78% 89% 81% 91%

 

The case describes a company whose manager is concerned that theoperating profit measure included in the company’s bonus plan wastoo narrowly focused. He implemented a new bonus plan that reducedthe weighting of importance placed on operating profit and thatincluded more measures, including on-time deliveries, salesreturns, patent applications, scrap and rework costs, and customersatisfaction.

 

1. What was the purpose of the change?

2. Calculate the bonus earned by each manager for each 6-monthperiod and for the year 2010.

3. Evaluate the new plan. Is there any evidence that it producedthe desired effects? What

changes to the new plan would you suggest, if any?

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THE ENDOCRINE SYSTEM
Hormonal, Humoral and Neural Control? Examples of each?
What is negative feedback? Thermostat example. Many hormones work this way.
Major hormones of pituitary gland
Anterior: GH, ACTH, TSH, many others
Posterior: ADH and oxytocin
Differences between release from anterior and posterior pituitary?
How does the hypothalamic-pituitary connection work?
Major hormones of adrenal gland:
Adrenal cortex: Aldosterone (Na+ retension), cortisol (stress)
Adrenal medulla: epinephrine (adrenaline, fight-flight), norepinephrine
Water-soluble vs. lipid soluble hormones – where are the receptors for each?
Know the roles and mechanism of release of each major hormones we’ve discussed: GH, ACTH, insulin, glucagon, leptin, ADH, oxytocin, etc. (not all are listed here)
How does the thyroid make TH? Whats the difference between T3/T4? Why is iodine important in this process?
Understand up and down-regulation of a hormone and how it relates to hormone receptors

THE CARDIOVASCULAR SYSTEM
What are all the different components that make up blood? (plasma, erythrocytes, etc.)
What is the cardiac cycle? What are the different steps and how do they match up with an ECG (P wave, QRS wave, T wave)?
KNOW THE WIGGERS DIAGRAM – be able to describe all the different steps of the cardiac cycle, including blood pressure changes, blood volume changes, valve changes, etc.
What is the major function of hemoglobin?
What is the major difference between cardiac muscle cells and
Where are the baroreceptors of the cardio system located? What do baroreceptors detect?
Understand resistance, vessel diameter, and mean arterial pressure (MAP) in relation to blood flow. How are flow and pressure different?
What cranial nerve(s) are responsible for parasympathetic and sympathetic innervation to the heart?
What is a capillary fenestration? And what is its significance in terms of different organ’s blood flow levels?
What is erythropoiesis? In what conditions does this occur and what does it affect?

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I need the answers of these questions ,,,,,,,, they are from the subject Pathophysiology and chapter Hormonal Disorders

please answer the following all questions

1- Define hormones understanding their role in the body.

2- Describe the endocrine feedback system as it relates to the release of hormones by the hypothalamus, pituitary gland, and other glands within the system.

3- Identify the hormones released by the anterior and posterior lobes of the pituitary gland and describe the function of each.

4- Examine the functions of growth, thyroid, cortisol, aldosterone, and anti-diuretic hormones.

5- Explore what causes or inhibits growth hormone release.

6- Differentiate between gigantism and acromegaly.

7- Discuss signs and symptoms of growth hormone deficiency and excess.

8- Discuss the differences in hyper- and hypothyroidism including most common causes, clinical manifestations, and complications.

9- Explore the differences in Addison’s Disease and Cushing Syndrome including most common causes, clinical manifestations.

10- Discuss the differences in SIADH and diabetes insipidus including clinical manifestations and causes.

11- Identify the roles of glucose, insulin, glucagon, and glycogen.

12- Define diabetes mellitus.

13- Discuss the differences in Type 1 and Type 2 diabetes mellitus including: Pathophysiology of each (i.e. beta cell desctruction or insulin resistance), contributing factors (causes), signs and symptoms of each, and complications that may occur with each such as hypoglycemia, DKA, HHNK, Somogyi Effect, and Dawn Phenomenon (be sure to know the specific differences in each complication).

14- Identify normal blood glucose levels.

15- Examine different diagnostic methods of diabetes mellitus such as the glycated hemoglobin test (Hgb A1C).

16- Discuss the many complications that may occur with diabetes mellitus including both macrovascular and microvascular effects.

17- Identify the disorders that make up metabolic syndrome and discuss the importance of early diagnosis.

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Reread Hamlet’s fourth soliloquy below; it is found in the play in Act 4, Scene 4. Then answer the questions on this page and provide director’s notes that indicate how you would instruct an actor to speak and behave while delivering this soliloquy.

Hamlet. … How all occasions do inform against me

And spur my dull revenge! What is a man

If his chief good and market of his time

Be but to sleep and feed? A beast, no more.

Sure he that made us with such large discourse,

Looking before and after, gave us not

That capability and godlike reason

To fust in us unused. Now, whether it be

Bestial oblivion, or some craven scruple

Of thinking too precisely on th' event—

A thought which, quartered, hath but one part wisdom

And ever three parts coward—I do not know

Why yet I live to say, “This thing's to do,”

Sith I have cause, and will, and strength, and means

To do 't. Examples gross as earth exhort me.

Witness this army of such mass and charge,

Led by a delicate and tender prince,

Whose spirit, with divine ambition puffed,

Makes mouths at the invisible event,

Exposing what is mortal and unsure

To all that fortune, death, and danger dare,

Even for an eggshell. Rightly to be great

Is not to stir without great argument,

But greatly to find quarrel in a straw

When honor's at the stake. How stand I then,

That have a father killed, a mother stained,

Excitements of my reason and my blood,

And let all sleep, while to my shame I see

The imminent death of twenty thousand men

That for a fantasy and trick of fame

Go to their graves like beds, fight for a plot

Whereon the numbers cannot try the cause,

Which is not tomb enough and continent

To hide the slain? O, from this time forth,

My thoughts be bloody, or be nothing worth!

Total score: ____ of 20 points

(Score for Question 1: ___ of 2 points)

1.What emotions do you think Hamlet experiences over the course of this speech?

Answer:

Type your answer here.

(Score for Question 2: ___ of 2 points)

2.What conclusion does Hamlet reach, or what does Hamlet realize, over the course of this speech?

Answer:

Type your answer here.

(Score for Question 3: ___ of 2 points)

3.How do you want the audience to feel about Hamlet and his situation after hearing this speech?

Answer:

Type your answer here.

(Score for Question 4: ___ of 14 points)

4. Now use your answers to the questions above to help you formulate your director’s notes. Remember to include details about tone of voice, volume, speaking pace, facial expressions, gestures, body language, movements on stage, and emotions in your notes. You may also need to define words and terms that your actor may not know. Write your director’s notes in the space provided below.

Answer:

Hamlet’s Fourth Soliloquy Director’s Notes

Hamlet. … How all occasions do inform against me

And spur my dull revenge! What is a man,

If his chief good and market of his time

Be but to sleep and feed? A beast, no more.

Sure he that made us with such large discourse,

Looking before and after, gave us not

That capability and godlike reason

To fust in us unused. Now, whether it be

Bestial oblivion, or some craven scruple

Of thinking too precisely on th’ event—

A thought which, quartered, hath but one part wisdom

And ever three parts coward—I do not know

Why yet I live to say, “This thing’s to do,”

Sith I have cause, and will, and strength, and means

To do’t. Examples gross as earth exhort me.

Witness this army of such mass and charge,

Led by a delicate and tender prince,

Whose spirit, with divine ambition puffed,

Makes mouths at the invisible event,

Exposing what is mortal and unsure

To all that fortune, death, and danger dare,

Even for an eggshell. Rightly to be great

Is not to stir without great argument,

But greatly to find quarrel in a straw

When honor’s at the stake. How stand I then,

That have a father killed, a mother stained,

Excitements of my reason and my blood,

And let all sleep, while to my shame I see

The imminent death of twenty thousand men

That for a fantasy and trick of fame

Go to their graves like beds, fight for a plot

Whereon the numbers cannot try the cause,

Which is not tomb enough and continent

To hide the slain? O, from this time forth,

My thoughts be bloody, or be nothing worth! Type Notes here::

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