Health and Socail P1 Essay

P1 – Explain potential hazards and the harm that may arise from each in a health or social care setting Relating to the physical environment The physical environment is everything that is around you, this includes; 1. The building 2. The air 3. The temperature 4. Objects 5. People 6. Pets The physical environment has a huge impact on the staffs and individuals well-being. The spread of Airborne infections are increased when the ventilation is poor, airborne infections such as colds and influenza, so it is important to have fresh air circulating at all times in a health and social care setting, especially in elderly homes as older people tend to catch things more easily as do younger children. Individuals should never be in a draught and should always be warm enough. Older people, babies and people with disabilities find it harder to keep their body at an adequate temperature; you should always cater to their needs. Fumes and smoke shouldn’t contaminate the air that should be clean. The ventilation should remove stale air and provide air movement. All the rooms in the environment should have central heating; each should be able to be controlled to the specific temperature the individual wants. The lighting in each room should be bright enough and in a position for the individuals in the environment to read and participate in other activities. Emergency lighting should also be in place in case a light breaks or electrical problems occur; it should come on if there is a power failure. When the lighting is poor is can cause numerous problems and is hazardous to those who are in that setting, it will affect those with a vision impairment, with people that have limited vision you should make sure that they are in a well-lit area. Equipment Hazards from equipment could include * Untidiness e.g. toys, equipment left in corridors on stairs or blocking fire exits. * Poor maintenance, e.g. frayed wiring or broken equipment * Unsafe practice, e.g. overload sockets or trailing flexes * Lack of awareness of hazards, e.g. hot surfaces or moving parts All equipment must work and function correctly; it must be full maintained at all times. This could include fire fighting equipment, hoists and medical diagnostic equipment such as ECG or x-ray machines, it is very important that these are checked on a regular basis for any faults because the individual could be wrongly diagnosed. Computers and laptops now play as an important role in the care industry as they do in any other aspect of work. If they are positioned in an awkward place the individual can suffer from strain injuries, they can strain their vision if they have too much exposure to the screen, and incorrect sitting can lead to neck strain and back pains. Anything they need should be in reach or this can cau se them to overstretch and this could cause a fall. Infections You should always follow policies and procedures that are put in place; they are they to keep you and others around you safe. If you do not follow them you could cause unnecessary harm to you, your colleagues or individuals in your work place. Babies and older people are at a much greater risk of complications if they catch food borne infections, the incidence of MRSA in hospitals has highlighted the potentially devastating outcomes and effects of poor personal hygiene practices and over-prescription of antibiotics. On the national statistics website it shows that the number of deaths linked to MRSA in the UK from 1993 to 2006 rose to 1,625. But on the death certificates that mentioned it declined, and then in 2008 there was a fall of 23%. If the bacteria are on the skin then they can spread by touch, if it is in the nose or lungs then it can be passed on by droplet spread, by breathing or coughing over someone. But if the person is healthy then when they leave hospital it can just d isappear, this applies for people living with them; if they are healthy special precautions don’t need to be out in place. If it gets into the bloodstream through a wound then it can cause serious illness such as 1. Bone marrow infection 2. Blood poisoning 3. Septic shock 4. Septic arthritis 5. Meningitis 6. Abscesses anywhere within the body 7. Infection of the heart lining 8. Pneumonia Substances The hazardous waste does not stop after disposing of it as if his disposal of hazardous waste is not correct it could damage the health of all in the environment if not disposed of at all it can lead to infection and a spread of infection also. So when dealing with waste especially hazardous you has to make sure you depose of it correctly. Type of waste | Risk| How to dispose of the waste | Sharps (needles or syringes) | Risk of getting an infection off a dirty needle | All dirty needles must be out in a yellow box it can be small or large, it must be shut once it’s at its limit and it will not open once it has been closed. | Clinical dressings | Infection can occur | Must be placed in a yellow box which must be sealed with arrangements of the collection.| Body fluid (blood, urine, faeces, vomit. | A risk of infection | When cleaning up any of the waste you have to ensure gloves are worn it must be flushed down the toilet and then the toilet must be disinfected and if it was on the floor, disinfect where the waste was.| Soiled linen| Another risk of infection | They must be out in the special laundry bags which disintegrate when being washed.| There are a number of substances used in health and social care settings that are hazardous if misused. Cleaning fluids, medications and x-rays are all examples of substances found in health and social care settings. Chemicals can cause burns to the throat and oesophagus if swallowed by accident. Care should be taken at all times when administrating medication as it could be given to the wrong person which could lead to them suffering, or something as simple as the wrong dose. This type of mistake can have a devastating result for example in 2005 2 nurses miscalculated the dose of a drug needed to slow down a baby boys heart rate. He was given 10x the dose and he died. Hazardous working conditions Working conditions are aspects of your job, the hours that you work, the staffing levels and the staff relations. Even though we have tried to improve in the quality of health and social care as a result of regular inspections there are still with staff turnover and staff shortages this can lead to the staff rushing what they are doing with results in them ignoring the policies and procedures, this can lead to a risk of injury or accidents. Pay rates are low for early years workers and health and social care assistants, they are often only paid the minimum wage this can make people feel undervalued and make them less likely to follow policies and procedures. When there are staff shortages it can cause staff to be expected to do overtime, being a care worker or being in care work is physically and mentally demanding and too much of it is likely to cause staff to not perform to the best of their abilities, the more tired the staff are the more likely they are to make mistakes like miscalculating medication does, they will be less alert which could lead to them missing a sign that someone is ill. Stress is another reason of staff shortages, stress can be shown in many different ways people suffer from anxiety, sleep problems, digestive disorders, high blood pressure, and mood swings. None of these are good for a member of staff to be suffering with, it can lead to all sorts of problems in the health and social care setting. The vacancy rates for health and social care are higher than any other employment sectors in England, many care homes cannot recruit sufficient staff, and the shortages of staff have an impact of the quality of care given to those in the environment. Hazardous working practices The jobs you do when caring for people are called working practices. They include: 1. Moving and handling 2. Preparing food 3. Changing nappies 4. Giving injections/supervising 5. Giving injections 6. Supervising individuals with challenging behaviour You should always follow the procedures correctly because if you do not you can out yourself and others at harm. Care workers still suffer injuries related to moving people they care for even despite the manual handling regulations 1992. It was reported in 2003 that 80,000 nurses sustain back injuries at work each year, one third of all reported accidents involve moving and handling. The main hazards with moving and handling are that the handler may slip or trip over, stand in an awkward position, twist and overstretch, this can cause the handler to have neck or back pain, it can cause strain, and sprain or they could fracture a bone this could happen to either the handler or individual. They could end up with a permanent disability. Hazardous security systems Security systems are to keep staff and individuals safe from intruders, security systems are fitted in most health and social care settings. Residential homes normally keep the main door locked and only the people there have special keys and there family, or you have to buzz to get in. although this is a good thing, it could also be a bad thing as in fires it could waste time that could possibly save lives. All confidential information about the residents is withheld on the computer system and should be password protected all the filing cabinets should also be kept locked at all times. Section 2. Residential care There are different types of residential care homes, those for the older generation, people with disabilities and children who are looked after. In each of these settings health and safety has to taken extremely seriously, the carers have to make sure that the residents can escape in a fire, they have to make sure they are not putting one another in danger and that infections do not spread. It is important that the residents are informed about keeping themselves and others safe. In some of the residential homes the residents can come and go as they please but in a place where there may be little children or people that are confused that would not be allowed. They could put themselves in danger of getting ran over or hurt themselves. In winter time or in the colder weather, if they cannot find their way back or they don’t want to go back they could develop hypothermia. Child minder Settings where there are children should be very safe. Little children are curious and want to see and touch everything, they put things into their mouths lie toys or objects, this can cause them to choke or if they swallow a liquid such as a cleaning detergent they could be poisoned. They could open a gate and go wandering, cupboards, drawers could be opened which have poisonous substances in them, and they could climb and get stuck or distressed. When working in a preschool setting you have to be constantly vigilant and always alert and on the lookout for anything dangerous. Staffs is responsible for all activities the children take part in and therefore have to ensure that they are safe and not hazardous. Public environment Most parks are away from busy roads but there are a few which aren’t, in his case there is a danger of the child opening the gate and running out into the road, you have to watch your child at all times to ensure the safety of him/her. You also have to be vigilant of those in the park also, as there could be bigger children which could run into the child. Also if there is a skate park where the older children and teenagers chill you have to be careful for any empty glass bottles, also if older people are unsteady on their feet this can create a hazard for them. Sometimes people like to vandalize the park equipment and leave it in a dangerous state if you are looking after a child you should always check the park equipment before allowing your child on, this can easily stop an accident which may have happened. You may also have to asses if the child is age appropriate, if not you shouldn’t let the child on it in case of an injury, parks do have an impact absorbing floor normally which cushions the child’s fall, but accidents can still happen and you should always keep a close eye on your child. Some parks are frequente d by drug abusers; they may leave needles on the ground which would be extremely harmful to young children, so it would be a good idea to scan the ground. Dog owners tend to walk their dogs in the parks, dog faeces is a threat to children. There is such thing as toxicara which is a roundworm that can be present in dog faeces; this can potentially result in total blindness in one or both eyes. Parks are an idea place to take children to allow them to get some exercise and socialise with other children. Section 3 * Those receiving care, link to an older person and a young child: Young children are unable to recognize hazards themselves, their coordination is still developing. If substances are left lying around the child could get hold of them, this could lead to devastating consequences or even fatal, the child could be poisoned. You should always put locks on drawers and cupboards to ensure the children cannot get hold of hazardous substances. If things are left lying around such as toys a child could get hold of it and put it into their mouths if it too small or a toy is broken the child could choke. An older person could walk into things if they have limited vision or the lights are not bright enough. You should always make sure that the care setting is suitable and fits the residents needs. The main doors should always be locked in case there are residents who are confused, they may try to leave. An older person can be harmed if they need to be lifted into a bath or onto a bed, care should be taken when handling individuals and procedures should always be followed correctly. Workers in a setting: Workers sometimes come across Violent service users, this can put them at harm and they can be hurt. They could potentially fracture a bone. There may be faulty equipment which could be hazardous to the service provider as if they are lifting a service user and the equipment is broken the whole weight could be out on them and themselves and the individual could hurt themselves. If there is a shortage of staff and it is very busy the workers could feel stressed, stress can cause them to have anxiety and lack of sleep. If a member staff has had lack of sleep this will cause them to feel tired and they may not be als alert as they should be which can cause harm to themselves and the individual. If there are staff shortages tsome members of staff will be asked to work overtime, this can cause them to feel tired which again means that are not as vigilant as they would be. Support staff (eg caterers, cleaners, administrative), Cleaners are at a risk of being harmed by hazardous waste, if someone has soiled there bed sheets the cleaners have to take the sheets off the bed and put it into the wash, they come into contact with it which means germs can be passed. They also have to clean after someone has been sick again they can catch a bug or become unwell. Cleaners have to dispose of used dressing and needles they could catch an infection if they come into with them. * Visitors (eg relatives, friends, volunteers) Visitors need to be signed in and out in case of fires, if there was a fire and they are not signed in no one would know that they are there and they could at risk of being trapped in the building. Visitors are also at risk of catching infections or any bugs that are going around within the care setting. They should be informed of any infections before they visit. *

Classical Education Essay

Some people hold the view that the classics are classics because they have stood the test of time. Therefore, they are to be treasured by people of all generations, ours being no exception. Others believe that the classics represent the wisdom of the past. As we are advancing towards the future, it is our responsibility to venture into the unknown and generate new understanding of man and nature. What is your view on this issue? Write an essay in 300 – 500 words in response to this question and give reasons to support your position. Classical education is ‘ communicates to the mind †¦ a high sense of honor, a disdain of death in a good cause, and a passionate devotion to the welfare of one’s country’ , which proposed by Oxford classicist Edward Copleston. Classics studies indeed have stood the test of time and represent the wisdom of the past which treasured by all generations. Therefore, it is our responsibility to venture into the unknown and generate new understanding of man and nature. Traditionally, the study of classics was the principal study of the humanities. It is connected to the study of languages, history, art, literature, philosophy, archaeology and other culture of the ancient Mediterranean word, especially Ancient Greece and Ancient Rome. For example, every European language today such as the Romance languages and Modern Greek was evolved and influenced by the classical language of the Ancient Mediterranean. Nevertheless, classical study now expanded to Northern Africa and Middle East. It has become our references in many different arenas and immensely contributed to our culture today which proves that classic studies have the ability to transform self’s understanding. According to Charles Augustin Sainte-Beure’s idea and belief, a true classic is an author who has enriched the human mind and revealed some eternal passion through his thought, observation, or invention. Therefore, it could be opposed by anyone since each and everyone have different thoughts and ideas influenced by their present lifestyles, culture or even discovery.

Classic Theology vs. The Contemporary Case Study

Classic Theology vs. The Contemporary - Case Study Example His judgment of people is conditioned on his â€Å"changeless purpose concerning sin and conversion.   The scriptural embodiment of the doctrine of immutability is probably captured best in 1 Samuel 15:29 (RSV) where it is written, â€Å"And also the Glory of Israel will not lie or repent; for he is not a man, that he should repent.† The scriptural basis of the doctrine of Immutability is fully developed with numerous citations and succinct specificity to unchangeableness that enlightens the doctrine. Scriptures offer confirmation that God is not mortal with the qualities of lying or a changeableness of mind (Numbers 23:19; 1 Samuel 15:29). There is a timelessness, unchanging quality to God in a time-dependent, changing world (Psalm 102:26). The promises of God are of an eternal nature not capriciously offered to people (Psalm 110:4; Isaiah 31:2). His steadfastness is apparent in his constancy of presence and love (Isaiah 40:28). The final book of the English Old Testament rings with the words of Malachi in Chapter 3, verse 6 (RSV), â€Å"For I the LORD do not change; therefore you, O sons of Jacob, are not consumed.† The New Testament has few direct citations regarding changeableness. God’s unchangeable nature is restated for these readers in a new context (Hebrews 1:11; 7:21). While scripture offers examples that can be interpreted to show a disparity in whether God has a changeable nature, the major points of consideration would be that the New Testament offers no distinct contradiction to the attribute of God’s unchangeableness. A modern reformulation of the classic doctrine of immutability has been penned by James Packer. God is simple (that is, totally integrated), perfect and immutable. These words affirm that he is wholly and entirely involved in everything that he is and does and that his nature, goals, and ways of acting do not change, either for the better (being perfect, he cannot become better) or for the worse. His i mmutability is not the changelessness of an eternally frozen pose, but the moral consistency that holds him to his own principles of action and leads him to deal differently with those who change their own behavior towards him. †¢ Would you agree more with Vanhoozer or Nygren on this issue? Why? No, They state, â€Å"†¦from Plato, Aristotle, and the subsequent Hellenistic tradition, the church arrived at the notion that God was altogether unmoved, impassible, immutable, nontemporal and purely actual.† Open theists uniformly teach that the church fathers were so influenced by Greek philosophy when they formulated their theology, that the church’s historical and theological understanding of God reflects a more philosophical understanding than a biblical one. Carl Henry rightfully noted, â€Å"It is true that medieval theologians were aware of the teaching of certain Greek philosophers in discussing God’s immutability.

Domestic Violence Against Women In 2010 Has A Greater Affect Than It Dissertation

Domestic Violence Against Women In 2010 Has A Greater Affect Than It Did 50 years ago - Dissertation Example The research is intended to reflect more meaning than might be found through quantitative research with deeper meanings emerging through conversational style interviews with five participants. The participant pool consisted of three women and two men who had been involved in male violence upon female victims. Through these interviews, an understanding of the discourse about the topic emerged. The topic has been examined through a literature review of relevant secondary resources and through primary research of five interviews that were collated into case studies to provide context for emerging themes. In looking at the previous research and the case studies, the concepts that are within the public discourse emerge and become a framework in which to understand why violence against women is perpetuated and has not come to its end. Acknowledgements Table of Contents Abstract Acknowledgements Table of Contents 1. Introduction 1.1 Background 1.2 Theoretical Frameworks 1.3 Research Questio ns 1.4 Hypotheses 2. Literature Review 2.1 Introduction 2.2 Fifty Years Ago 2.2.1 Feminism 2.2.2 Violence 2.3 Media 2.4 Public Discourse 3. Methodology 3.1 Introduction 3.2 Secondary Research 3.3 Primary Research 3.3.1 Participants 3.3.2 Ethics 3.5 Summary 4. Findings and Discussion 4.1 Introduction 4.2 Case Study # 1: Female 4.3 Case Study # 2: Female 4.4 Case Study # 3: Female 4.5 Case Study # 4: Male 4.6 Case Study # 5: Male 4.7 Summary 5.0 Conclusion References Appendices List of Appendices Appendix 1: Questions for Interviews Appendix 2: Contextual Frameworks: Potency vs. Width Domestic Violence Against Women In 2010 Has A Greater Affect Than It Did 50 years ago Chapter One 1. Introduction 1.1 Background The nature of gender relations have changed dramatically in the last fifty years which has framed the dialogue about violence against women in a different context than it was considered in previous time periods. The state of the female status has evolved from a sense of propert y to a sense of autonomy, the objectification of femaleness made subjective, part of the public sphere and relevant to all aspects of life. In being subjective, the nature of the female present is many things, her situated presence manifesting a number of roles that are both defined by the concept of female, and some by the concept of human. More rarely, she is a the subject of a male identity, her presence part of the discourse of gender role identification that are now virtually all interchangeable. However, this has not discounted the vulnerability of being female, her sex providing a violent access that males are not as vulnerable to in the context of domestic life. The domination of the male, his need to express his maleness through subjugating others in the domestic sphere, has led to violent outbursts that intend to define that dominance. When no other recourse seems available, some men will reduce their ability to convince into an action of violence, manifesting their domina nce through pain and oppression. Threat of further action brings the female into line, her life reduced to self-protection and in protecting other aspects of their life including children, reputation, and the appearance of tranquility. The postmodernists view male violence towards women through looking at the way in which gender divisions have been determined by linguistically framed, the language of violence encouraging aggression attitudes. The emphasis on typical language where power relationships are

Envision a business you would like to own that would employ at least Research Paper

Envision a business you would like to own that would employ at least 20 people (either manufacturing or services) but I want it - Research Paper Example 44). The operations strategy of my business involves the use of low inventory levels as this will help to keep the prices low thus generating faster sales because of the low prices and the high value of the products. Furthermore, keeping of low levels of inventory will help to ensure that the business will be able to keep the prices low for the customers. This will help to maintain the existing customers and attract new customers as well. The use of low inventories will help to ensure that products are replaced with new items as soon as the inventory is exhausted and as a result this will increase the demand of the products. Increased demand, coupled with low prices, will lead to increased sales for a company and therefore this will in turn lead to increased profits for my business (Slack, & Lewis 2008) Supply chain management Supply chain management involves the active management of supply chain activities so as to ensure that customer value is maximized and a sustainable competitiv e advantage is achieved. Supply chain activities involve product development, product and material sourcing, production, logistics and the necessary information systems that help to coordinate these activities. Efficient supply chain management strategy will ensure that the print business is exposed to several opportunities that will provide competitive advantages. Examples of the competitive advantages that will be achieved include lower product costs for the materials that have been produced, reduced carrying costs in relation to the inventory because of the fact that no inventory will be kept, improved in store value and selection due to the different materials that will be produced, and finally a very competitive pricing for the customers. This therefore will work to ensure that the print business will become a dominant force to reckon with and to ensure that the focus is maintained on innovative processes and systems which work to improve the supply chain and achieve greater ef ficiency (Mentzer 2001). The key elements of a supply chain include structuring, sourcing, purchasing, and managing. The supply chain will begin with structuring and this usually involves the creation of the organization and forming together with recruiting members into the organization that are able and willing to take the business to a higher level. The staff that has been recruited will then allocated to different sections of the business for instance in my print business; sourcing manager will be recruited who will help to source for materials, purchasing managers who will ensure that the required materials are purchased on time and finally managers will be involved with the overall management of the business. Sourcing as a component of supply management involves the process of sourcing for items to print from clients. This is done by the sourcing managers who will deal with souring for product suppliers and vendors and also procuring the products that are used on printing at pr ices and terms that ensure the profitability goals of the firm are met (Mentzer 2001). Purchasing element in the supply chain will involve determining the products that the business requires and then procuring them from the client at a favorable price. The other element in the supply chain is the managing element. This usually focuses on demand planning,

Global & International Business Contexts Essay Example | Topics and Well Written Essays - 2250 words

Global & International Business Contexts - Essay Example Figure 1: The Ranking of Australian Wine Industry in the Global Market Source: (Australian Wine and Brandy Corporation, 2006). Hence, it is quite evident that the Wine Industry due to its increasing contribution has gained a significant position in the Australian economy and the world economy as well. However, the global outlook of the industry has changed much in the recent years. Noteworthy, the industry in its long term periodisation has witnessed numerous fluctuations, offering various challenges and opportunities to its contributors. To be precise, the Australian Wine Industry similar to any other industry, also posses few major opportunities and drawbacks which in turn affect the participating companies. The discussion of the report therefore shall focus on the analyses and the identification of the business opportunities and the challenges laid by the industry as a result of the influences of various factors from a business perspective. The analyses of Australian Wine Industry in this case shall be conducted with the assistance of Porter’s National Diamond model and Product Life Cycle framework. Hence, the aim of the report shall be to suggest certain significant strategies to the company willing to establish its business in the Australian economy, i.e. The F.LLI Gancia & Co. Company Overview Gancia, propounded by Carlo Gancia in 1829, is in the present context one of the most renowned leaders in the Italian wine market. The company today serves a few of the most royal blend of wines such as the Piedmontese wines to its targeted market including Japan, Portugal, Belgium, Russia, China, Korea, France, Finland and United States. The products which the company presently deals with are the Sparkling Wines, Wines, and Aperitifs. The company by its origin manufactures wine solely in its Italian farms comprising of 30 hectares of its own vineyards and 2000 of its controlled vineyards. However, the company deals with the aspects of marketing not only by s erving the national markets but also by exporting its products to the international markets (Gancia, 2009). With a point of view to expand its market to the Australian boundaries, the company shall consider the business opportunities along with the challenges existing in the Australian Wine Industry. The report thereby, shall emphasise on relating the target market trends with the current status of the company in order to suggest an appropriate strategic alliance for the company to enter the Australian Market. Contextual Analysis Porter’s National Diamond Model Figure 2: Graphical Representation of Porter’s National Model Source: (Dagmar Recklies, 2001). The Porter’s National Diamond Model exhibits four major variables related to the macro and micro economic conditions of an industry. They are the factor conditions, the demand conditions of the market, related supporting industries and firm strategy, structure and rivalry. These factors, as is evident from the a bove represented diagram, shall be elaborated in the paper further. Factor Conditions This

Social Systems and Constructivism Essay Example | Topics and Well Written Essays - 5000 words

Social Systems and Constructivism - Essay Example Constructivism is a learning-making or meaning-making theory, which offers an explanation about the nature of knowledge as well as how human beings learn. It sustain that individuals build or construct their own new knowledge via the interaction which have been believed, known and the ideas as well as activities with which are encountered. In a constructivist setting, learning activities are characterized by lively engagement, problem solving, inquiry, and collaboration by the learners. Teachers are considered as the facilitator, guide and co-explorer who motivate learners to question, and not just dispenser of knowledge. As to Brooks and Brooks (1993: vii), constructivism is a theory about learning. The author believe that learner uses a â€Å"self-regulated mechanism† in order to resolve inner cognitive conflicts which often become obvious through concrete experience, reflection and collaborative discourse. Integrating the idea of constructivism to education is not anymore a new phenomenon. Trace back the efforts of Jean Piaget (1973), a Swiss developmental psychologist and also Russian psychologist Lev Vigotsky (1978). The idea has further influenced by the developmental philosopher Jacques Rousseau, followed by the theories of John Dewey, Arnold Gesell and G. Stanley Hall. Matthews Vadeboncoeur (1997) classifies three important strands in interpreting Jean Piaget’s socio-cultural, and emancipatory constructivism. The said strands vary primarily by; its subject of study, views.

A geographer assesses the impact of diamond mining on South Africa Research Paper

A geographer assesses the impact of diamond mining on South Africa - Research Paper Example Mining is South Africa (SA) started in 1880s after the discovery of diamonds on the banks of river Orange. The mining of diamonds and other metals like gold, platinum and cadmium have significantly contributed to making SA the richest nation on the African continent.The impact of diamond mining in SA is a profound phenomenon whose results can be noticed with turn of the eye. The discovery of the first diamond on the banks of river Orange saw the subsequent change of the regions name from Vooruitzigt to New Rush to Kimberly (Ritter 372). This is just an example of how diamond mining had a life changing influences on the lives of everyone in SA. The discovery of diamonds in Kimberly led to a rush or a massive migration of people from other places who came there to mine this new found treasure. According to historical records, in 1873 Kimberly became the largest and most populated town in SA just a few months after the confirmation of diamond deposits in the region. Kimberly is today kn own as a town with one of the largest holes dug by hand held tools, which has contributed to the site being named as a world heritage site by UNESCO (Sharma 132). Kimberly a city in the Northern cape of SA is nowadays better known as the historic town that pioneered the mining revolution in SA, and helped forever shape the fortunes of the country as a leading producer of precious metals and gemstones. Diamond mining, in SA, can be attributed to have had a significant impact on the lives of communities and individuals who got directly or indirectly involved with the mining activities of SA. A notable character or name that is synonymous with mining and especially diamond mining and trade in the world De Beers. The second large diamond to be discovered in Kimberly was discovered on land belonging to the De Beers brothers who later came to dominate diamond mining and trade in SA and all over the world up to this date. This was made possible by the consolidation of the small mining comp anies of time to form the De Beers Consolidated Mines which has a monopoly over diamond trade in the world up to this date (Afolayan 68). Diamond mining caused elevated levels of rural-urban migration especially of black Africans who sought employment in the mines and the great city life experience that Kimberly as the largest town in SA provided. The De Beers encouraged this rural-urban migration because it provided cheap labor that was vital to the profitable running of the mines. The urbanization of this region in SA contributed to a myriad of both negative and positive social cultural factors that were directly or indirectly affected by mining activities. A good example of a vice or social ill that can be construed to be as a direct result of mining and the miners who worked there is prostitution (Marsh 230). Women and girls from every part of SA moved to Kimberly in an effort to cash in on the gold and diamond rush that was taking place. There were other varieties of socio-cult ural ills that are usually spawned by urbanization and they were all present in Kimberly. Mining helped create a phenomenon called the status quo, which saw the establishment of classes within the society. These classes saw black Africans occupying the lowest class in that society, which was the poorest, least educated and most oppressed by the rich and educated class of mainly white people (Pitzl 141). This unequal stature in society is still present today albeit diminished or in represented differently compared to that period. Urbanization meant that people got exposed to the white man’s education which can be said to have significantly contributed SA’

Macbeth Essay Example for Free

Macbeth Essay Women have a very strong influence on their husbands and husbands will usually take their wives opinions in important matters. Lady Macbeth was the dominant of the two characters. She had very strong persuasive skills over Macbeth and though show her control of Macbeth in public, in private she often uses emotional and testing his manliness to manipulate him to do what he wants. Lady Macbeth is the more evil character than Macbeth in the play through her ambition, cruelty, and manipulation. Lady Macbeth used her words to control Macbeth throughout the entire play and caused him to do many things he wouldn’t have normally done like kill Duncan. Lady Macbeth mocks Macbeth and his manliness throughout the play to get him to do exactly what she wants like for him to kill â€Å"What beast wast, then, that made you break this enterprise to me? When you durst do it, then you were a man; And, to be more than what you were, you would be so much more the man.† Macbeth being a man in the era he grew up in being the most manly you could be was very important so a women questioning his manliness would have set most men over the edge especially someone as persuasive as Lady Macbeth Lady Macbeth has many delusional moments in the play that lead readers to believe she is either crazy or evil. She talks about being infected with evilness to killing babies throughout the play. â€Å"I have given suck, and know How tender tis to love the babe that milks me: I would, while it was smiling in my face, Have pluckd my nipple from his boneless gums, And dashd the brains out, had I so sworn as you Have done to this.† Lady Macbeth in my opinion is a sociopath with her not feeling remorse for anything her and her husband do no matter the effect it has on other individuals. She fits the profile of a sociopath with the abilities to manipulate people easily and have no shame doing it but also feel nothing towards anyone or anything she harms. Lady Macbeth also is a very private person that is very submissive when with other people and does not show her evil and dark side to anyone other then her husband. She is also very protective over a Macbeth and would do anything to protect him from being found out for murdering Duncan. Lady Macbeth is both responsiple for the death of Duncan and is also the cause of Macbeth becoming insane throughout the course of the play. She is a silver tounged women who knows how to manipulate for her own self gain. Through these point I think that she is not only responsible for duncans death but is more evil then Macbeth.

Epidemiology of Schizophrenia Essay Example for Free

Epidemiology of Schizophrenia Essay Medical experts view schizophrenia as the cancer of all mental illness. This is because it is possibly the most dangerous and devastating mental illness known to man. Today, about one in every 100 mature American suffers from schizophrenia. This translates to nearly 2.5 million people. At the present, the disease has no known cure and it can only be managed. Although schizophrenia can manifest itself in any age, majority of the schizophrenic people show signs in their early twenties. In most cases, males show the first signs of schizophrenia at an earlier stage compared to females but unlike most other mental illnesses, the disease is evenly distributed across gender (McGrath, et al. 2005). Although there has been much research touching on this disease, the exact cause of schizophrenia is still unknown. However, researchers have found out through brain scans of individuals suffering from the disease that there are notable differences from a brain scan done on a person who does not have the diseases. However, the biggest cause of schizophrenia is believed to be genetic factor since the disease runs in families. There is also a belief among researchers that people develop schizophrenia due to the absence of some fundamental genes. In order to best understand the epidemiology of schizophrenia in the U.S., this paper will first seek to define epidemiology in order to make it easier to understand this disease in a better way. The paper will then proceed to define and illustrate the epidemiology triangle and give an illustration of how this is related to schizophrenia (Jablensky, 2003). Epidemiology Epidemiology is the investigation of the occurrence, distribution, and causes of diseases among other health-affiliated situations in human beings. Additionally, epidemiology also deals with how the investigation of these factors can be utilized to promote better health and to prevent and manage health problems. In trying to address the issue of epidemiology, the focus is usually on the outcome of disease on a certain population rather than on individuals. Ideally, some certain diseases might prevalent in some areas while others are rare. Although the rare disease might be more deadly as compared to the prevalent one, epidemiology tends to give more emphasis on the prevalent disease since it affects many people (Hennekens, Buring, 1987). Ideally, the fact that epidemiology deals with the issue of frequency goes ahead to prove that it is a quantitative science. Epidemiology specifically deals with the rate of occurrence of diseases and supplementary health related conditions. The frequency of diseases is determined by morbidity and the rate of death. Ideally, epidemiology goes beyond the confines of the disease to cover other health related conditions because every human activity has a direct effect on health. Health related conditions are factors, which have a direct or indirect consequence or influence on human health (John, 2001). When discussing distribution in epidemiology, the issue that is considered is the geographical distribution of infections, the circulation in relation to time, and distribution in the manner of the individuals that are affected in a certain region. In addition to distribution, epidemiology also examines the determinants issues, which are the determining factors on whether or not a person will contract an illness. Lastly, epidemiology seeks to investigate the issue of how the clinical investigations of the disease can be used to promote better health and to prevent and control related health problems (John, 2001). Disease Causation In order to carry out an epidemiology of a certain disease, it is critical to examine how diseases are caused. Ideally, the cause of a disease means the events, conditions, characteristics or an amalgamation of all these factors, which plays a significant role in bringing out the disease. In examining the cause of any disease, the first thing to examine is the primary causes. Generally, primary causes are the factors, which are critical for an illness to happen. In order to make the examination of disease causes to sound more scientific, the term etiologic agent is used in place of the primary cause. For example, in the epidemiology of pulmonary tuberculosis, Mycobacterium tuberculosis is considered the etiologic agent or the main cause (Mausner, Bahn, 2010). In addition to the primary causes in the examination of disease causes, the risk factors are also considered. Although risk factors might not be necessary for a disease to occur, the truth is that they have a significant role in the formation of diseases. Ideally, any factor that is linked with heightened incidence of a disease is a risk factor for the exposed population. In most cases, risk factors have an association to the agent but in other cases, they might have a direct relation to the population and the surroundings (Mausner, Bahn, 2010). The Epidemiologic Triangle Fig 1.1 Diagrammatic Representation of the Epidemiologic Triangle Agent Host Environment The epidemiologic triangle shows the association among the agent, environment, and host in the incidence of disease. In this triangle, the agent is considered a factor whose existence or nonexistence, insufficiency or surplus is essential for a particular illness to happen. On the other hand, the environment incorporates all the outside factors, other than the agent that can affect health. These two factors are then classified according to whether they fit in the societal, bodily or genetic environments. Ideally, the societal environment covers a wide spectrum of factors including the education level, unemployment, and many other factors as pertains to political and the legal systems (Mausner, Bahn, 2010). Epidemiology of Schizophrenia According to statistics, an average of 1 percent of American adults suffers from schizophrenia at any given year thus bringing the figure to more than 2.5 million people. According to the World Health Organization (WHO), schizophrenia affects an average of 24 million people worldwide with the worldwide prevalence standing at 8 percent. Given that 2.5 million of these people live in the U.S., it is clear that the country has the highest cases of schizophrenic cases (Eaton, 1991). Ideally, it is important to note that schizophrenia is fundamentally different from incidence of the disease. When talking about an incidence of 8 percent – 1 percent, this does not indicate the number of people diagnosed with schizophrenic cases in any given year. On the contrary, the prevalence rate refers to the average number of people who are suffering from schizophrenia at any given time thus demonstrating on how widespread the disease is. On the other hand, the incidence rate depicts the number of people who are freshly diagnosed with schizophrenia at a specific time and it is used to gauge the possibility of contracting the disease. Since schizophrenia is considered a chronic disease meaning that sufferers stay with it for life, the prevalence rate is higher compared to incidence. According to statistics, the incidence rate of schizophrenia is about 3 in every ten thousand people and one of the three people is an American (Jablensky, 2000). Diagnosis of Schizophrenia Despite all the medical advances today, mental illness remains hard to diagnose. However, with schizophrenia being viewed as a serious condition, much research is being carried out to develop ways of diagnosing the disease before its manifestation. At the present time, the diagnosis is based on the presence of clinical indications. Unlike other diseases, a qualified psychiatrist or psychologist can only conduct schizophrenic diagnosis. Despite this, a person suspected to be suffering from schizophrenia is still subjected to laboratory tests in order to rule out the presence of other related medical disorders such as brain tumors (Eaton, 1991). In the U.S., a person suspected to be schizophrenic is interviewed and observed by a healthcare professional and by the people around the individual in order to obtain a clear clinical image. If after ruling out the presence of other mental conditions the person still demonstrates signs of the disease, then a diagnosis of schizophrenia is specified. The biggest challenge of diagnosing schizophrenia in both the U.S. and elsewhere in the world is that the individual might be paranoid and hence become opposed to examination. In most cases, the individual does not think that he has a problem and this means that he/she does not seek medical attention without any prompting (Eaton, 1991). Incidence Ideally, the incidence rate of schizophrenia in the U.S. differs significantly among various groups. Although the disease is believed to be present in nearly every group, this rate is believed to be higher among migrants. In addition to this, the disease is also believed to be higher among twins but this might be due to the genetic factor that the disease posits. By way of incidence estimates, the average estimate among migrant groups is close to 15.2 percent for every 100,000 migrants with the average among natives standing at about 10.2 percent for every100, 000 people. This goes ahead to show that the disease is evenly distributed among Americans despite of race. Despite this, the various studies conducted to determine the incidence rates between migrants and Native Americans have shown significant differences. In the past, the disease was believed to be prevalent in urban centers but this belief has been discounted with the passage of time. The distribution of the incidence estimate does not also show any difference according to economic status (Eaton, 1991). Prevalence The prevalence rate of schizophrenia in the U.S. has been consistent across the various studies conducted over the years. Ideally, the lifetime prevalence rate stands at 5.0 per every 1,000 individuals. Overall, schizophrenia is believed to affect one in every a hundred Americans and this estimate is based on the data collected by government agencies on lifetime morbid risk data thus making it reliable (Jablensky, 2000). Mortality Rate Schizophrenia is believed to be one of the leading causes of death in America. Compared to the ordinary person, a schizophrenic person has a two-threefold increased possibility of dying. This risk in increased by the fact that schizophrenic people are most likely to commit suicide. However, schizophrenic people are still most likely to die due to the comorbid somatic conditions presented by the disease. In the last few years, the mortality rate of schizophrenia in the U.S. has been on the rise. This is because schizophrenic people do not share in the improved health enjoyed the rest of the society. The increased mortality rate could also have been increased by the increase of generic antipsychotic medicines that have flooded the American market (Jablensky, 2000). Outcomes after Diagnosis The statistics on the outcome of America citizens diagnosed with schizophrenia is not encouraging at all. According to researchers, 25 percent of people diagnosed with schizophrenia end up leading normal lives after ten years of living with the disease while 25 percent of those improve but still require personalized treatment. However, the remaining 50 percent end up hospitalized where 10 percent of those end up committing suicide (Brown, 2000). Although there have been significant strides in diagnosing and treating schizophrenia cases in the U.S., the fact remains that so much still needs to be done. The government has been supporting legislations that seek to fund studies on the function of brain chemistry, brain enhancement, and genetic configurations and how these can be used to find a cure for this mental cancer. Doctors have also become adept at diagnosing the disease at an early stage although the drugs to treat the disease are still not as effective and this has hampered the efforts to control the disease in America (Brown, 2000). Conclusion In the conclusion, it must be stated that medical experts consider schizophrenia as the cancer among all the mental illness. This is because it is possibly the most dangerous and devastating mental illness in existence. Despite the numerous breakthroughs in medical science, the cause and cure for schizophrenia has not yet been found. Today, America is believed to be the leading country in the world in schizophrenia cases. Unlike other conditions, the incidence and prevalence rates are equal across the gender and the ethnic divide. Despite this, the prevalence rate of schizophrenia is believed to be higher among migrants as compared to Native Americans. References Brown, S. (2000). Excess Mortality of Schizophrenia: A Meta-Analysis. Br J Psychiatry 171: 502-508. Eaton, W. (1991). Update on the Epidemiology of Schizophrenia. Epidemiol Review 2: 105-126 Hennekens, C. and Buring, J. (1987). Epidemiology in Medicine. Toronto: Little, Brown and Company. Jablensky, A. (2000). Epidemiology of Schizophrenia: The Global Burden of Disease and Disability. Psychiatry Today 2 (250): 274-285. Jablensky, A. (2003). Schizophrenia: The Epidemiological Horizon. Oxford: Blackwell Science. John, M. (2001). A Dictionary of Epidemiology. London: Oxford University Press. Mausner, G. and Bahn, K. (2010). Introductory Text of Epidemiology. Second Edition. W. B. Saunders. McGrath, J., Saha, S., et al. (2005). A Systematic Review of the Incidence of Schizophrenia; The Distribution of Rates and the Influence of Sex, Urbanicity, Migrant Status and Methodology. BMC Med 2, (13): 56-100.

Comparison of Chicken Feed Effects on Development

Comparison of Chicken Feed Effects on Development All six significant domesticated agricultural animals today chicken, cow, goat, horse, pig and sheep had been domesticated in Eurasia by 5000 BP. (Thompson, 2002) The earliest evidence of domestication of chickens relies on interpretation of archaeological discoveries of bones and artefacts. (Crawford, 2003) Archaeological discoveries in China indicate that chickens had been domesticated by 5400 B.C. (Crawford, 2003) People of Cishan Culture (Neolithic Yellow River culture in northern China) had chickens then, but it is not known whether these birds made much contribution to modern domestic fowl. (Crawford, 2003) The jungle fowl (G. gallus), has without a doubt been a major contributor to domestic fowl (Crawford, 2003). The chicken (Gallus, gallus or Gallus domesticus) is generally considered to have evolved from the jungle fowl (G. gallus). (Kennth Kriemhild, 2000) The jungle fowl (G. gallus) ranges throughout the area between eastern India and Java. (Kennth Kriemhild, 2000) There are four key steps to domesticating poultry which were that in early stages of domestication poultry had to forage on their own. (Crawford, 2003) They had to be able to reproduce in captivity (Crawford 2003) the ability to imprint was important in initial taming. (Crawford 2003) and the species had to have a social order that allowed the keeping of large numbers of individuals. (Crawford, 2003) The main role of chickens now is to produce eggs and meet for the market. In 2004/2005 the gross value of production in Australia for the chicken meat and egg industries was estimated at approximately $1.3 billion. (Department of Primary Industries, 2008) Poultry meat is now the most consumed meat in Australia. . (Department of Primary Industries, 2008) Although chickens are strongly associated with egg production, they also have very different associations. (Kennth Kriemhild, 2000) In much of Southeast and East Asia they have been bred both for fighting and as a decoration. (Kennth Kriemhild, 2000) There are four different types of poultry enterprises: broilers (production of chicken for meat), layers (birds producing table eggs), rearing farms (production of point of lay pullets) and breeder farms. (Department of Primary Industries, 2008) The layout of the shed and type of housing differs between the types of poultry operation. (Department of Primary Industries, 2008) The aims of this experiment are to monitor and assess the development of chickens on different feeds using a feed conversion ratio, and to observe and describe their physical and behavioural development over time. On appointed days chickens were to be fed and given water on a daily basis. Excess foods were weighed and recorded so ratios could be calculated and obtained. Chickens were weighed on a weekly basis, on Wednesdays, so that the calculation of growth rate could be put monitored and observed. Along with this observations were made of chickens on various days, if not everyday for behavioural studying purposes. It was hypothesised that chickens fed on broiler feed would have a greater weight gain than chickens fed on layer feed over the 5 week period. METHODS The chickens were obtained from a poultry farm known officially as Wagners Poultry Enterprises. The chickens given were White Leghorn cross New Hampshire at the age of one or two days old. The chickens were divided into groups of six and student groups of approximately sixteen students were assigned to one group of chickens each. Chickens were placed in pens and in turn students were assigned to the pens where the chickens were kept through out the five week duration. The chickens pens located at La Trobe Universitys Agricultural Reserved housed a total of twelve chicken pens. The type of feed given to the chickens was decided by the group number the pen was given. Groups assigned to even number pens were to feed their chickens broiler feed, brand named Brastoc Turkey and Meat Chicken Starter, and odd numbered pens were to feed their chickens layer feed, Barastoc Pullet Starter. The pens were isolated, self-contained and about 1 x 1 x 2 m in size. The floor of the pens was concrete which was covered in black lining and contained a sawdust base. The top of the pen had a plastic mesh over it to prevent escape. The chickens were provided with heat lamps, feeders and water dispensers all attached to a chain and hooked to a pole above the mesh. The feeders and water dispensers along with the heat lamps were adjusted in accordance with the chickens age. Observations were carried out as much as possible, sometimes even twice in the one day, but generally all days except Tuesday was observed in accordance with the students university timetable and their availability. The duration of the observations under went intervals of fifteen minutes, where all aspects of behaviour and development were documented. Observations were done under the least amount of outside influence as possible, in respect to this only two students were allowed in the shed where the chicken pens were being kept and students were encouraged to keep noise to a minimum. As the weeks went on chickens behaviour that was recorded included those such as grooming, resting, drinking, interacting, alarming, ambulatory and aggressive. Above all the behavioural and developing attributes the hierarchy if any of chicken formation was also documented. All observations were recorded and documented into a plain exercise book by each student of the group, with clear indication of whom the observations were done by. Chickens were feed every second day, Monday, Wednesday and Friday, with enough food given on each day to last the chickens for days not fed and on Fridays for the weekend. Initially a total of 240g were placed in the feed dispensers to accommodate the 20g required for each individual chicken and to compensate for the day the chickens would not be fed. The amount given to the chickens on feeding days was adjusted to accommodate for their growth further along in the project. Along with accommodating for the size of chickens the amount of feed to be given to chickens in further weeks was also based upon amount of feed offered and refused, all of which was weighed and kept a record of. Food was weighed on an electric scale in a container provided. The amount of food given and refused was always recorded on a sheet given to us indicating the date and feed given and refused. The sheet was stored along with our observation book, hooked onto a nail on the outside of the allocated chicken pen. Chickens were checked on a daily basis and were given fresh water daily if needed, except for weekends, providing the chickens with fresh drinking water. Replenishment of water was recorded alongside on the same sheet of paper where the feed record was being kept. Table 1. A timetable showing jobs carried out each day over the 5 week period Monday Feed, water check and observations Tuesday Water and chicken check Wednesday Feeding, weighing, water check and observations Thursday Observation, chicken and water check Friday Food, water and observation RESULTS Table 2. Composition of feeds Composition:Â  Crude Protein (minimum) (%) Layer feed:Â  19.5 Broiler feed:Â  22 Composition:Â  Crude Fat (minimum) (%) Layer feed:Â  2.5 Broiler feed:Â  2.5 Composition:Â  Crude Fibre (minimum) (%) Layer feed:Â  6 Broiler feed:Â  5 Composition:Â  Salt (maximum added) (%) Layer feed:Â  0.3 Broiler feed:Â  0.3 Composition:Â  Copper (added) (mg/kg) Layer feed:Â  0.8 Broiler feed:Â  8 Composition:Â  Selenium (added) (mg/kg) Layer feed:Â  0.1 Broiler feed:Â  0.3 Composition:Â  Calcium (minimum) (%) Layer feed:Â  1 Broiler feed:Â  1 Table 2. Shows that layer and broiler feed had the same amount of crude fat, salt and calcium. Broiler feed has more crude protein, copper and selenium than layer feed, whereas Layer feed has more crude fibre than broiler feed. DISCUSSION The results support the hypothesis that chickens fed on broiler feed would have a greater weight gain than chickens fed on layer feed over the 5 week period, as table 3 and figure. 1 show that chickens fed broiler feed had a higher average weight gain then chickens fed on layer feed. The aims of this experiment to monitor and assess the development of chickens were carried out over the five weeks and observations were made describing their physical and behavioural development over time. The experiment was carried out on chickens with different feeds and a feed conversion ratio was calculated. We also provided the chickens with clean drinking water, sufficient food amounts of food according to their age and feed refusal and a suitable environment in which they could grow and develop certain behaviours. The broiler chickens had a higher growth rate, as shown by table 3 and fig. 1. By the end of the 5 weeks, the broiler chickens reached a live-weight of 467 ÂÂ ± 58 where as chickens who consumed the layer feed for the duration of the experiment reached a live-weight of 429 ÂÂ ± 61. The difference between the growth rates of the broiler and layer chickens is closely related to live-weight. Through out the process, beginning in week one, chickens being fed broiler as opposed to layer maintained a higher growth ratio and remained heavier that the chickens being fed the layer product. In respect to this broiler chickens are capable of higher growth rates and greater weight gain than layer chickens. In the poultry industry, broiler chickens are selected for their carcass processing characteristics and meat density, whereas layer chickens are genetically bred to achieve smaller body weights than those of the broilers (Department of Primary Industries, 2009). Another factor of the growth and weight gain in chickens could also be the composition of the feeds. As seen in table 2 the broiler feed contained 2.5% more crude protein, 7.2 mg/kg more copper and 0.2 mg/kg more selenium than the layer feed. All these factors couldve influenced the growth in chickens and could be why chickens fed broiler feed would gain more live-weight as well as maintain a higher growth ratio. The increase in growth rate found within broiler chickens has been found to be linked to an increase in the deposit of fats and the use of energy. (Geraert et al 2006) All ingredients fond within the chickens feed contributes some part to their growth and weight gain. Coppers influence on health and growth within a chicken is present as the antimicrobial properties found within Cooper help to improve an animals performance such as; increase growth in poultry, improved growth rate, feed intake and feed efficiency (Forbes Shariamatdari 1993). Crude protein also influences the diet energy of a chicken when they are still young (Hayashi et al 2000) as well as their metabolic ability. (Hayashi et al 2000) From the experiment as show in table 4, it shown that broiler chickens have a slightly better feed conversion ratio of 1.5 ÂÂ ± 0.129 g but also maintain a higher feed intake 3889 ÂÂ ± 534 g than that of layer chickens, whose feed conversion ratio is similar to that of the broiler chickens at 1.52 ÂÂ ± 0.051 g and less of a feed intake at 3549 ÂÂ ± 247 g. Calcium levels also differ between that of the layer and broiler feeds. Layer feed has 0.5% more calcium than broiler feed. Calcium ratio plays a vital role in the quality of an egg produced, (Department of Primary Industries) As the chickens grew and developed more, so too did their behavioural characteristics. To begin with the chicks were hardly active at all being under the heated lamp majority of the time, however after a fortnight the chickens activity level was significantly higher, showing signs of flapping wings and a lot more running around within the pen. This behaviour of flapping of the wings is a mechanism known as break used by chickens. (Rogers 2006) Within the second week it was observed that chickens were preening one another, this type of behaviour was commenced whilst the chickens were flocked together in a group always near a wall. Preening aids in the removal of lice and is done using the beak (Gush 2006). As the chickens progressed with age in the 4th week a lot of the time was spent sitting perched up above the food and water dispensers. This type of behaviour is normal and is to be expected after four weeks of age. (Rogers 2006) Through out the five week period and supported by table 6 interactions was the most common behaviour during the experiment. Among these interactions were behaviours such as pecking and scratching, which were major contributors to the interaction database. The behavioural interaction of pecking and scratching are present during all ages of a chicken (Rogers 2006) and are the major ways in which chickens interact and assimilate with their surroundings. (Gush 2006) Through out the 5 week period no formal hierarchical establishment appeared to be present. However there was the mild sign of aggression where chickens would kick at each other within the third week but this type of behaviour was rare and unseen after later dates. A hierarchy within chickens is not formed up until about the sixth week or onwards within domestic chickens (Rogers 2006) and thus no aggressive behaviour was present either as aggression is derived from the sequence of the hierarchy. (Rogers 2006) It was found that roosters were among the chickens which were handed out to us. Roosters in general like male and female humans tend to be heavier than that of their female counter. The inclusion of roosters within the results could be erroneous to the over all weight gain results. This experiment could be improved by regulating the gender of the two strains of chickens being introduced to the artificial environment thus giving more accurate and reliable end results and will nullify the problem of genetic variability.

Global Economy And The Environment Essay -- essays research papers

Global Economy and the Environment As the global economy gets integrated, national or local corporations will gradually transform in to a multinational corporation (MNC). When this type of development occurs, the host countries are usually the ones that become the immediate stake holders. This is because when a MNC sets its foot into a host country, there are economic, political, social and environmental impacts that result from their corporate actions. In many cases, it is certainly possible that it can end up in a win-win situation, if the host country and the MNCUs both work mutually. However there have been unfortunate examples, where this has not been the case. In general, international agreements have its advantages, due to the fact that we can harmonize international standards. Therefore environmental concern is one of the key issues that the policy makers and MNCUs should set a high priority on. This is because growth and development is strongly correlated with environmental degradation. Furthermore, it is fair to say that the MNCUs are more likely to have a more harmful environmental impact from growth and development, as opposed to the local corporations. This is because MNCUs may not be as knowledgeable as local corporations in resource utilization and land management. This also refers to the notion of Rthe locals know their land better than anybody elseS. The tropical rain forest of Brazil is a good example of this. The RindigenousS or the local people have a g...

Code-switching as a Resource in Content and Language Integrated Learnin

Introduction Currently, teaching content in foreign language and second language, for example, content and language integrated learning (CLIL) or bilingual teaching approach has become a trend in education world. Some countries such as Malaysia, Africa, and European countries have adopted this model of learning in their education system. There are some reasons behind adopting CLIL or bilingual teaching approach in their education system, for example, to improve cross countries (cross language) traffic, and as a respond to the important of English language as a dominant language in the world (Samala, 2009). Cummins stated that there is a minimal level of language proficiency (treshold), that students should reach in order to be able to learn the task effectively (1981, cited in Lim & Presmeg, 2010). As students in bilingual or CLIL classroom do not learn the content of the lesson in their mother tongue, code-switching is often occurred in their classroom. The teacher in the classroom would switch classroom discourse from the target language to students first language when he find that the students difficult to understand the concept of the lesson in the target language. Code-switching in the classroom should not be considered as a failure to teach in the target language, but it should be considered as a resource in the classroom. In this essay, I will discuss both advantages and disadvantages of code-switching in classroom. Definition of Code-switching According to Baker, code-switching is a situation where an individual switched from one to another language in one utterance, and the switching is done deliberately (1993, cited in Lim & Presmeg, 2010). In general, Setati (1998) defined that code-switching is â€Å"the ... ...might feel neglected by the application of code-switching in their classroom (Cook, 2002, Sert 2005, both cited in Stephen-Kalong, 2008). Therefore, she suggested that, code-switching only can be applied effectively in the classroom where all students have the same main language. According to Sert, Code-switching in teacher instruction might lead students to feel bored and lost their attention to the previous instruction in the target language (2005, cited in Stephen-Kalong, 2008). It happen because, the teachers often repeat their instructions in students main language. Conclusion Overall, considering a lot of benefits that teachers and students might obtain from applying code-switching in the classroom, we should consider it as a resource in the classroom. However, Code-switching only can be fully understood in the actual context in which it takes place.

Budgeting Practices and Performance in Small Healthcare Businesses

Management Accounting Research 21 (2010) 40–55 Contents lists available at ScienceDirect Management Accounting Research journal homepage: www. elsevier. com/locate/mar Budgeting practices and performance in small healthcare businesses Robyn King a , Peter M. Clarkson a,b,? , Sandra Wallace c a b c UQ Business School, The University of Queensland, Brisbane 4072, Australia Faculty of Business Administration, Simon Fraser University, Burnaby, Canada V5A 1S6 Department of Accounting and BIS, The University of Melbourne, Victoria 3010, Australia a r t i c l e i n f o a b s t r a c tWe present evidence linking primary healthcare business characteristics, budgeting practices, and business performance. Based on a sample of 144 responses from a survey of members of the Australian Association of Practice Managers (AAPM), we ? nd that factors identi? ed by contingency-based research are useful for predicting a business’s budgeting practices. Speci? cally, we ? nd the adoption of w ritten budgets to be related to size and structure, and for businesses using written budgets, the extent of use is related to business structure, strategy and perceived environmental uncertainty.Finally, we ? nd evidence of a relationship between budgeting practice and performance. Here, we initially ? nd a business’s performance to be positively associated with the use of written budgets. More re? ned tests of the â€Å"? t† between business contingency factors and extent of operating budget use then provide evidence of a positive association between the extent of â€Å"? t† and performance. Crown Copyright  © 2009 Published by Elsevier Ltd. All rights reserved. Keywords: Budgeting SME Healthcare businesses . Introduction This study investigates the relationship between contextual factors identi? ed from contingency-based research, the adoption and extent of use of budgets, and business performance within the Australian primary healthcare setting. 1 We focus on budgets because they are considered to be one of the main management control systems This study is based largely on Robyn King’s Honours thesis completed in the UQ Business School at the University of Queensland.The authors would like to thank the editor and the two anonymous referees, as well as workshop participants at Monash and Swinburne Universities, the 2007 AFAANZ Annual Conference, and especially Aldonio Ferreira, Axel Schultz, Shannon Anderson and Julie Walker for comments on an earlier version of the manuscript. ? Corresponding author at: UQ Business School, The University of Queensland, Brisbane 4072, Australia. Tel. : +61 7 3346 8015; fax: +61 7 3365 6788. E-mail address: P. [email  protected] uq. edu. au (P. M. Clarkson). Primary healthcare is the initial care of a patient as an outpatient excluding diagnostic testing; tertiary healthcare is that provided in a hospital setting. (MCS) in organisations, have been found to be the earliest MCS that a business ad opts, and continue to receive signi? cant attention in the research literature and in teaching material (e. g. , Davila and Foster, 2005, 2007; Sandino, 2007). We select the Australian primary healthcare sector as our experimental setting both because of its importance socially and economically, and because it is likely to be comprised of businesses that vary broadly in their budgeting practices.Contingency-based research proposes that there is no single MCS suitable for all businesses. Instead, the suitability of a particular MCS is argued to be contingent upon characteristics of a business including its size, strategy, structure, and also management’s perceptions of the uncertainty of the environment within which the business operates. We begin by examining the relationship between a business’s budgeting practices and these four contextual factors. In so doing, we view the development of a budgeting practice as consisting of two stages, the initial decision regarding adoption and the subsequent decision regarding extent of use.Here, the term ‘adoption’ re? ects the decision by a business to use a formal process to project its future 1044-5005/$ – see front matter. Crown Copyright  © 2009 Published by Elsevier Ltd. All rights reserved. doi:10. 1016/j. mar. 2009. 11. 002 R. King et al. / Management Accounting Research 21 (2010) 40–55 41 ?nancial performance (Davila and Foster, 2005). Alternatively, the term ‘extent of use’ refers to both the number of different types of budgets the business uses and the frequency of their use. In our analysis, we develop arguments for, and investigate, these two stages separately.We then turn to consider the relationship between a business’s budgeting practice and its performance. The relative â€Å"? t† of the business’s MCS with its contingency factors is argued to impact on performance, with performance increasing with the degree of â€Å"? t† (Chenhall, 2003). Thus, ceterus paribus, businesses using a practice which does not â€Å"? t†, whether by â€Å"over-budgeting† or â€Å"under-budgeting†, are expected to experience weaker performance. We argue that not all of our sample businesses are likely to exhibit â€Å"best budgeting practice† because of the dif? ulties associated with identifying and implementing best practice, and the discontinuous nature of upgrades (Luft, 1997). We examine the relation between â€Å"? t† and performance using the method proposed by Ittner and Larcker (2001) and classi? ed as a Cartesian/Contingency approach (Gerdin and Greve, 2004). Degree of â€Å"? t† is measured as the difference between the extent of budget use and that predicted by the business’s contingency factors. This approach assumes that at any point, not all businesses will in fact have implemented their optimal practice.To conduct our investigation, a written survey of 988 members of the Australian Association of Practice Managers (AAPM) was undertaken. In brief, we ? nd that larger, more decentralised healthcare businesses are more likely to adopt written budgets. Further, for the subset of businesses that use written budgets, we ? nd that the extent of budget use is positively associated with structure (decentralisation) and strategy (cost leadership), and negatively associated with perceived environmental uncertainty (dynamism). Finally, we document a relationship between choice of budgeting practice and performance.Here, we initially ? nd performance to be positively associated with the use of written budgets. More re? ned tests then provide evidence of a positive association between the degree of â€Å"? t† and performance. Our study makes several contributions. First, we present evidence that contingency factors do indeed provide insights into both the adoption of budgets and the extent of their use for our sample of small Australian prim ary healthcare businesses. Interestingly, the results suggest that size and structure capture the business’s initial decision to adopt a formal budgeting practice.However, once a business has adopted a formal practice, strategy, structure, and perceived environmental uncertainty appear to be the primary determinants underlying the subsequent decision regarding the extent of budget use. We also present evidence that the â€Å"? t† of our sample business’s budgeting practices is associated with performance. To our knowledge, there has been relatively little empirical evidence on this relationship documented in the literature to date. Second, contingency-based research has predominantly been conducted in the large business sector.We extend this work by examining a small business setting. We argue that our setting has the advantage of allowing for an examination not only of the extent of budget use but also of the initial decision to adopt a budgeting practice. In c on- junction, it also provides an opportunity to examine more closely the different underlying theoretical constructs of size that the two most commonly used proxies, gross fees and full-time equivalent employees, may be capturing. Finally, from a practical perspective the healthcare sector is under continuing pressure to increase its ef? iency. This study contributes by examining the contexts in which the use of budgets is associated with enhanced performance in primary healthcare. The results should be of bene? t to both practitioners and those who advise practitioners on MCS design. The remainder of this paper is structured as follows: Section 2 presents background material; Section 3 describes our experimental setting; Section 4 presents the hypotheses, Section 5 the method and Section 6 the results; and Section 7 provides a summary and conclusions. 2. Background MCS have been de? ed as all devices and systems that businesses use â€Å"to ensure that the behaviours and decision s of their employees are consistent with the organisation’s objectives and strategies† (Malmi and Brown, 2008). We focus on a business’s decision regarding its budgeting practices. Budgets are considered an MCS because they can in? uence the behaviours and decisions of employees by translating a business’s objectives into plans for action, communicating the objectives, and providing a benchmark against which to assess performance.We view budgets as both an important and appropriate focus given that they are considered to be one of the main MCS in organisations, have been found to be the earliest system adopted in startup businesses, and continue to receive signi? cant attention in the research literature and in teaching material (Davila and Foster, 2005, 2007; Sandino, 2007). Within the MCS literature, the term ‘budgeting’ is used to refer to a broad range of topics (see Chapman et al. (2007) for a review). In this study, we de? e a budget as a forward looking set of numbers which projects the future ? nancial performance of a business, and which is useful for evaluating the ? nancial viability of the business’s chosen strategy or deciding whether changes to the overall plan are required (Davila and Foster, 2005). Budgets have been identi? ed as playing a number of roles which include making goals explicit, coding learning, facilitating co-ordination, promoting accountability, facilitating control, and contracting with external parties (Davila et al. 2009). Bene? ts of budgeting include increasing ef? ciency through planning and co-ordination, supporting both control and learning through the comparison of actual results with plans, and more globally â€Å"the ability to weave together all the disparate threads of an organisation into a comprehensive plan that serves many purposes† (Hansen and Otley, 2003). Given these various roles and potential bene? ts, one might expect all businesses to adopt a formal bu dgeting practice.In fact, this view appears to underlie much of the empirical MCS research predominantly conducted in a large business setting, as it is often assumed that large businesses will already have formal MCS that can be readily examined (Chenhall, 2003). Here, the focus has typically 42 R. King et al. / Management Accounting Research 21 (2010) 40–55 been on the adoption and performance implications of speci? c MCS â€Å"innovations† like activity based costing (ABC) (Ittner et al. , 2002). However, it is argued in the MCS literature that a rational adoption decision should require an evaluation of the associated costs as well as the bene? s (Davila and Foster, 2005). Costs of a formal MCS include the easily measured out of pocket costs associated with implementing and operating the system (Hansen and Otley, 2003; Hansen and Van der Stede, 2004). Other costs that are not so easily measured are the possibility that budgets create rigidity thereby limiting co-op eration and creative response, over-emphasise short-term cost control and top down authority, encourage gaming, and de-motivate employees (Hansen and Otley, 2003; Hansen and Van der Stede, 2004). Further, arguably the bene? s and costs associated with adopting a formal budgeting practice will not be the same for every business but will depend on business-speci? c contextual factors. Thus, ex ante, it is not clear that adoption of a formal budgeting practice is necessarily a rational outcome for all businesses. Our study distinguishes itself from the majority of the MCS literature by focusing on the small business setting, speci? cally the primary healthcare business sector. Within this sector, we argue that it is likely that for some businesses, the costs of budgeting will outweigh the perceived bene? s whereas the converse will likely be true for others. Thus, we argue that this setting provides the opportunity to gain insights into both the decision regarding the adoption of budge ts as well as the subsequent decision regarding the extent of their use. We investigate the contextual factors that delineate the costs and bene? ts associated with budgeting from a contingency framework perspective. Our initial focus is on the contextual factors that differentiate adopters from non-adopters.We then consider those factors that drive the decision regarding the extent of budget use and conclude with an investigation into the relationship between the ? t of a business’s budgeting practice with its contextual factors and its performance. In adopting a contingency framework perspective, we acknowledge that research referring to contingency theory has been subject to the criticism that contingency is a general idea rather than a theory as â€Å"there is no a priori intuition of its own as to what the pertinent factors are and as to their likely consequences† (Spekle, 2001).In this study, we do not consider contingency as a theory but rather as a framework fo r investigating identi? ed factors for which we have a priori intuition based on other organisational, economic and sociological theories. A further criticism of the contingency-based literature is its simplistic nature of investigating one contextual factor or MCS at a time (Fisher, 1995). In the face of this criticism, some studies have begun investigating multiple contextual variables simultaneously (Hansen and Van der Stede, 2004; Cadez and Guilding, 2008). We also consider multiple contextual factors, speci? cally those identi? ed in Chenhall’s (2003) review of the MCS literature since 1980. This review con? rms environment, technology,3 structure and size as â€Å"the descriptors of the fundamental generic elements of context†. Strategy is also included as it emerged in the 1980s as an important factor that in? uences the design of MCS (Lang? eld-Smith, 1997). Finally, contingency-based research has its roots in sociology. The underlying premise of sociology is t hat humans are boundedly rational and satis? cing (March and Simon, 1958).Bounded rationality can impede decision-making as not all possible alternatives are known with certainty at a given point in time. One identi? ed role of MCS is to assist managers in decision-making (Lawrence and Lorsch, 1967). However, the decision on the optimal MCS is itself restricted by bounded rationality, as well as the personal incentives of the manager. Thus, while conceptually organisations may be expected to use the optimal MCS, this is not always possible. Businesses facing the same contextual factors may therefore choose different MCS, with the differences re? cted in their performance. In our study, we investigate the effect of a mismatch between the contextual variables and the extent of use of budgets on performance. 3. Experimental setting We adopt the Australian primary healthcare sector as our experimental setting for two reasons. First, we view it as an inherently interesting research setti ng in its own right, given its importance both socially and economically. Second, we believe it to be an ideal setting within which to conduct an investigation into budgeting because as argued below, it is a sector within which there are likely both signi? ant incentives and disincentives to budget. Thus, this setting provides the advantages of the controls that arise from working within a single industry while at the same time, one within which variation in budget use can reasonably be expected. 4 In detail, the Australian primary healthcare sector plays a uniquely important role in terms of both the services it provides and its place in the economy. In terms of services, it represents the gateway through which patients most typically enter the health system. Initial contact with For a sample of 57 organisational units, all with budgeting practices in place, Hansen and Van der Stede (2004) undertook an exploratory study focusing on four contextual factors (strategy, structure, envi ronment, and size) as possible antecedents to identi? ed reasons to budget. Alternatively, for a sample of large businesses, mostly manufacturing from Slovenia, Cadez and Guilding (2008) ? nd that superior performance results from an appropriate match between the contingent factors strategy, size, and market orientation, and strategic management accounting applications. We initially considered technology as an additional contextual variable but decided against its inclusion given our choice of experimental setting. Recent advances in medical technology have impacted on diagnostic specialties such as pathology and radiology (specialties not included in our study) to a much greater degree than primary healthcare. With the exception of three opthalmologists, the only specialists included in the survey were those that provide outpatient services from private rooms and like GP’s, still largely rely on their skill and basic instruments such as the stethoscope.From an administrative and medical records perspective, the use of technology is widespread, with computers being used in 89. 8% of all GP practices and 94. 5% of all specialist practices in 2002 (ABS, 2002). 4 In this regard, Merchant (1981) suggested that a desirable extension of budgeting studies guided by contingency frameworks would be to collect data from samples chosen to magnify the variation on the dimensions of interest while controlling for the many possible interacting factors which obscure or distort the ? ndings. R. King et al. Management Accounting Research 21 (2010) 40–55 43 the health system is through a general medical practitioner (GP). For specialised care, patients are then referred to specialist medical practitioners. GPs and specialists provide this primary care from private consulting rooms and refer on to other providers for diagnostic tests. 5 Economically, the sector contributed 1. 71% of GDP in 2007 (AIHW, 2008). 6 Faced with rising costs, doctor shortages and increasin g waiting times, primary healthcare businesses are increasingly under pressure to become more ef? ient (Department of Health and Ageing, 2005). Here, budgeting has been identi? ed as a management accounting tool that enhances ? nancial performance and improves ef? ciency (Davila and Foster, 2007). Further, the majority of the existing management accounting research has been focussed on in-hospital care so little is known about MCS in the outpatient setting (Abernethy et al. , 2007), with the exception of a recent U. S. -based study of the relation between performance-based compensation and ownership of primary healthcare businesses (Ittner et al. 2007). Taken together, these facts reinforce our view that the primary healthcare sector within Australia is an important and potentially fruitful setting for the conduct of MCS research generally, and research into budgeting practices more narrowly. More directly to the current investigation, we seek an experimental setting with variation in budget use, including the presence of both adopters and non-adopters. We believe that a number of factors conspire to make the primary healthcare sector a reasonable choice, ex ante.First, the small business sector has been argued to have lower levels of formal planning and control (Chenhall and Lang? eld-Smith, 1998). As such, it might also be expected to include non-adopters. 7 In Australia, primary healthcare is largely provided by private businesses owned by the doctors working in the business as sole traders, in partnership, or through a company. Management of these businesses has traditionally been by the owner, although there now appears to be a trend towards the delegation of management to practice managers. 8These primary healthcare businesses typically have fewer than 50 employees and would thereby most often be classi? ed as small businesses according to the OECD de? nition (Holmes and Kelly, 1989). 9 Second, prior research also ? nds that rapid growth small-to-medium enterprises (SME) provide more extensive future-oriented ? nancial reporting than matched non-growth concerns (McMahon, 2001). Arguably, small primary healthcare businesses are less likely to be rapidly growing as there is currently an undersupply of primary healthcare workers due to an ageing workforce and restrictions on training places. 0 These limited organic growth prospects further our expectations of ? nding non-adopters. Third, ? rms within the service sector typically do not need to account for stock, thereby eliminating one driving force behind the use of sophisticated MCS. Finally, research on small and family business supports the view that necessary management skills are required before planning can be initiated (Gibb and Scott, 1985). Since there is a lower likelihood that primary healthcare owners, the majority of whom are doctors, have formal training in MCS, non-adoption is even more likely relative to other service sectors.Conversely, there are also economic incent ives to adopt budgets. As noted, primary healthcare businesses are under increasing pressure to become more ef? cient. The National Health Performance Committee has adopted a framework speci? cally designed for measuring healthcare system performance, with one of the identi? ed components being ef? ciency. In response, a number of institutions and private management consultants now offer education on managing primary healthcare practices that includes training on budgeting. 1 In conjunction, there is the added incentive to undertake these education programs in that continuing education is a requirement of the accreditation process for GP practices. Further, only accredited practices can access Practice Incentive Payments (PIP) from the Federal Government which can represent signi? cant additional revenue. 12 5 There is currently no Medicare funding for diagnostic services provided within the primary healthcare setting and so, these businesses do not invest in the associated technolo gy. The specialist practices included in the study were the private rooms of orthopaedic surgeons, opthalmologists, ermatologists, gynaecologists, and gastroenterologists. These specialists conduct initial consultation and post operative follow up from their private rooms but perform procedures in hospitals or day surgeries for which they have visitation rights, using equipment supplied by the hospital/day surgery where a fee is charged directly to the patient for its use. 6 Overall, the healthcare industry contributed 8. 98% of GDP in 2006–2007, with 19% of recurrent health expenditure on medical services provided by GP’s and specialists. In 2006–2007, Medicare paid $4029. million for GP services, representing an average 4. 93 items per capita (AIHW, 2008). 7 In contrast, international studies of formal budget use have focused on large businesses, ? nding the vast majority use annual ? xed budgets (Horngren et al. , 2006). Australian evidence is consistent, wit h 97% of large businesses found to use budgets (Chenhall and Lang? eld-Smith, 1998). 8 The exact extent to which management is being delegated to practice managers is uncertain given a lack of studies into the prevalence or role of practice managers (Department of Health and Ageing, 2005). There were 9600 private GP practices operating in Australia at the end of June 2002. Of these, 68. 5% were single practitioner practices employing 2. 9 persons on average, and only 100 employed more than 10 practitioners. At the same time, there were 9864 private specialist practices, 89. 7% of which were solo specialist practices employing an average 3. 2 persons and only 19. 2% had greater than 10 practitioners (ABS, 2002). 10 There has been a recognised unfavourable long-term trend since 1999 towards an increasing percentage of primary care practitioners aged 55 years or over.In conjunction, the World Health Organisation (WHO) predicts a global workforce shortage of 4. 25 million health workers over the next decade (Cresswell, 2007). 11 The 2008–2009 Federal Government Budget proposal includes administered Program 5. 3—‘Primary Care Policy, Innovation and Research’ which among other things, â€Å"funds initiatives to improve service delivery and help GPs access current best business practice. † As a part of their response, the Australian Medical Association (AMA) and the AAPM have made available speci? cally tailored business education programs for healthcare managers. 2 The Royal Australian College of General Practitioners (RACGP) standards for general practice include: â€Å"Our administrative staff can describe (and there is evidence of) training undertaken in the past 3 years that is relevant to their role in our practice. † The practice manager is speci? cally mentioned in the standard, as is the term practice management training. In order to access Practice Incentive Payments, GP practices must have complied with the RACGP st andards. In 2007, 80% of GP practices were accredited (AIHW, 2008).By way of context, an accredited practice with 44 R. King et al. / Management Accounting Research 21 (2010) 40–55 However, notwithstanding, for some businesses, given their lack of size and sophistication, these incentives are unlikely to outweigh the costs of budgeting which include the initial investment in software, skills, and the added labour hours. 4. Hypothesis development 4. 1. Overview This study investigates the relationship between factors identi? ed from contingency-based research, the adoption and extent of use of budgets, and business performance. The speci? contextual factors we consider are size, structure, strategy, and perceived environmental uncertainty (Chenhall, 2003). We argue, based on how each identi? ed factor is expected to impact both a business’s needs for and thereby the bene? ts it derives from budgeting, and also its ability to meet the costs of a budgeting practice, that the four contingency factors play different roles relative to the two stages of the budgeting decision. Speci? cally, we predict that a business’s adoption decision primarily related to its size and to a lesser extent, its structure (decentralisation).For businesses that make the threshold adoption decision, we predict that those that are more decentralised, employ a cost leadership strategy, and for which management perceives a lower level of environmental uncertainty will use budgets to a greater extent. Quite clearly, however, the roles played by the various factors ultimately remain an empirical question and as such, we give consideration to each when we empirically model the two stages of the budgeting decision. Finally, we predict that the match between the contextual factors and extent of budget use will be re? ected in business performance. These predictions are formalised below. . 2. Determinants of budgeting practice 4. 2. 1. Size The construct of size has frequentl y been viewed as re? ecting two dimensions, complexity and availability of resources, with both argued to be increasing with size (Fredrickson and Mitchell, 1984; Mintzberg, 1994). While small, single-business organisations can often be controlled with largely informal mechanisms such as direct supervision and oral communications, larger organisations require more formal controls as the increased complexity associated with a larger number of employees creates problems in social control, communication, and co-ordination (Lawrence and Lorsch, 1967).Here, Davila (2005) argues, following Levitt and March (1988), that to regain ef? ciency in managing the organisation, co-ordination and control mechanisms are formalised with the objective of coding and documenting organisational learning and reducing the demand that routine activities impose on the management team’s time. Further, in terms of a business’s ability to invest in a formal budgeting practice, it is widely accepte d that larger businesses are better positioned given their greater resources, ? nancial and otherwise.Larger businesses not only have the resources required to acquire software and skills but they can also more ef? ciently achieve these administrative tasks through economies of scale and the greater technical specialisation of their employees (Merchant, 1981). Chenhall (2003) ? nds that size has been considered as a contextual variable in only a few MCS studies as most examine relatively large businesses. Such a ? nding ? ts well with Banbury and Nahapiet’s (1979) argument that there should only be a relationship between resource availability and the introduction of formal systems in organisations of relatively small size.Consistent with these types of arguments, small business studies reveal size as in? uencing the acquisition and preparation of accounting information including budgets (Holmes and Nicholls, 1989; McMahon, 2001). Further, evidence from longitudinal studies of startup businesses suggests that size in? uences the decision to adopt operating budgets, with larger ? rms adopting the budgets sooner (Davila and Foster, 2005, 2007). They ? nd that when the business is small, control and co-ordination happens through frequent informal interactions but that the ef? iency of an informal system requiring direct contact with employees rapidly decreases with increasing size, thereby making it more ef? cient to use a formal control system. In the primary healthcare setting, we view the ? xed costs associated with the adoption of a budgeting practice to be signi? cant and thus, following the arguments of Davila and Foster (2005), propose size as a determining contingency factor underlying the adoption decision. In this sector, businesses are required to comply with substantive â€Å"red tape† that places onerous demands on their resources (Productivity Commission, 2003).As such, it is likely that only larger businesses have both the need for and the resources to devote to budgeting. Smaller practices are unlikely to be able divert resources away from their primary revenue generating clinical activities. Thus, we predict a positive relationship between business size and use of budgets. However, we also argue consistent with Banbury and Nahapiet (1979) that once a business has reached a critical size and uses a budget, size is unlikely to play a signi? cant further role in the determination of budgeting practice. Thus, our ? st hypothesis, expressed in the alternative, is: H1 . The adoption of written budgets by primary healthcare businesses is positively associated with business size. 4. 2. 2. Structure The structure of a business relates to â€Å"the formal speci? cation of roles for organisational members or tasks for groups to ensure that the activities of the organisation are carried out† (Chenhall, 2003). While two components, differentiation and integration, have been identi? ed in the literature, we focus only on differentiation because of the small size of our sample businesses. Differentiation is de? ed as the extent to which managers act as quasi-owners and is achieved through decentralisation of authority (Lawrence and Lorsch, 1967). A centralised busi- 4 FTE urban GPs would receive $60,000 per annum from PIP (Medicare, 2009). R. King et al. / Management Accounting Research 21 (2010) 40–55 45 ness structure is characterised by decision-making that is restricted to owners and upper management whereas a decentralised business delegates decision-making to lower levels of management and operational staff. Given the closer links between the ownership and control of the business, ecision-making in centralised businesses should require relatively fewer MCS. Herein, existing evidence reveals centralised businesses as having relatively few administrative controls and less sophisticated budgets while decentralised businesses have more formal controls (Bruns and Waterhouse, 1975; Merchan t, 1981). We thus argue that structure has the potential to play a role in a business’s initial decision to adopt a budgeting practice, although we view its role as secondary to size since it is unlikely that the business’s ability to meet the ? ed costs associated with a budget practice will be directly related to its structure. Further, we argue that for small healthcare businesses that have reached the threshold size and use budgets, structure also has the potential to play a role in its subsequent decision as to the extent of use. As the business becomes more differentiated, decentralisation increases and thereby so does the need for formal MCS (Lawrence and Lorsch, 1967; Merchant, 1981). Our second hypothesis, expressed in two parts and in the alternative, is then:13 H2a .The adoption of written budget by primary healthcare businesses is positively associated with business structure (decentralisation). H2b . The extent of written budget use by primary healthcare b usinesses which opt to use written budgets is positively associated with business structure (decentralisation). 4. 2. 3. Strategy Business strategy, de? ned as how a business chooses to compete within its particular industry (Lang? eld-Smith, 1997), has been the focus of much of the research on MCS as opposed to corporate or operational strategy (Chenhall, 2003).While there are a number of different typologies of business strategy, we use Porter’s typology which focuses on cost leadership and product differentiation strategies. Porter’s cost leaders are characterised by competitive prices, consistent quality, ease of purchase, and a relatively restricted product selection. In contrast, differentiators offer the market something perceived as unique. Different types of MCS will be suited to different strategies due to their differing information and feedback requirements. Cost leadership strategies are argued to require speci? operating goals and budgets to facilitate co st containment at an operational level (Chenhall and Morris, 1995). Alternatively, product differentiator strategies would require more outward focussed, broadscope, MCS to collect infor- mation on competitors for planning purposes (Simons, 1987). Since primary healthcare businesses have constraints on the total number of services they can provide such as opening hours and the number of medical practitioners, a cost leadership strategy should require that tighter cost controls be in place in order to maintain overall pro? ability. In contrast, a product differentiator strategy operating with higher margins under the same constraints should require fewer controls. While we do not expect strategy to be determinative of the threshold decision to use budgets as it is unlikely to either affect the business’s ability to meet the initial ? xed costs or contribute suf? ciently to the business’s primary need for a budgeting practice, based on the arguments above we do expect it to impact on the desire to invest in marginal costs associated with a greater extent of budget use.Thus, formally, our third hypothesis, expressed in the alternative, is: H3 . For small healthcare businesses, which opt to use written budgets, those following a cost leadership strategy will use budgets to a greater extent than those following a product differentiation strategy. 4. 2. 4. Perceived environmental uncertainty (PEU) PEU is de? ned as a situation where managers perceive elements of the environment to be uncertain, with uncertainty distinguished from risk â€Å"as uncertainty de? nes situations in which probabilities are not attached† (Chenhall, 2003).In a general sense, PEU is seen to be an important contextual factor in the design of MCS because increased PEU makes managerial planning and control more dif? cult (Lawrence and Lorsch, 1967). PEU is, however, a general term and a number of researchers have provided more speci? c classi? cations of the environment (Wa terhouse and Tiessen, 1978; Ouchi, 1979). In this study, we focus on the two most commonly researched elements of PEU, the dynamic nature of the environment (dynamism) and the level of competition (hostility).Contingency-based research in large business has found that greater dynamism is associated with a need for more externally focussed, broad scope and timely information (Chenhall and Morris, 1995). Planning becomes more dif? cult in more dynamic conditions as probabilities cannot as easily be attached to future events and controls such as static budgets may quickly become outdated. Thus, greater informal communication is required for effective decision-making and formal controls are less bene? cial or desirable (Chapman, 1997). Alternatively, large business research focussed n hostility has found that businesses facing greater competition rely on more formal controls and emphasise budgets (Khandwalla, 1972). Thus, in addition to con? rming PEU as an important contextual factor, these ? ndings also reveal the importance of specifying the dimension of interest (Chenhall, 2003). Consistent with the research on dynamism in large business but in contrast with that on hostility, Matthews and Scott (1995) ? nd for small businesses, the sophistication of planning decreases with both increased dynamism and increased hostility.They argue from an economic perspective that for small businesses, the more uncertain 13 While it could be argued that it would be impractical for a small business consisting of a single medical practitioner and few administrative staff to have a decentralised structure, given the heavy demands of clinical work on the medical practitioner’s time, decentralisation is possible to the extent that operational and ? nancial decision-making is delegated to employees. This was con? rmed in discussions in the pilot study. 46 R. King et al. Management Accounting Research 21 (2010) 40–55 the environment the less likely the manager is to ex pend scarce resources on budgets with an unproven effect on performance. The rational manager trying to meet the fundamental goal of making a pro? t will weigh up the bene? ts against the costs associated with budgeting. Based on these arguments and ? ndings, we propose that as with strategy, neither dimension of PEU is likely to impact the manager’s threshold decision to adopt a budget as it does not directly impact on the ability to meet the costs.However, for businesses that have already identi? ed the need and ability to budget, both dynamism and hostility will impact on the decision to incur the added marginal costs of increased budget use. Consistent with Matthews and Scott (1995) and the large organisation literature, given the relatively small nature of our sample businesses and the likely resource constraints that they face, we predict a negative association between the PEU dimension of dynamism and the extent of use. 14 However, contrary to the large rganisation lit erature but consistent with Matthews and Scott (1995), we also predict a negative association between the PEU dimension of hostility and the extent of use. Our fourth hypothesis, expressed in the alternative, is then: H4 . The extent of written budget use by primary healthcare businesses which opt to use written budgets is negatively associated with the PEU elements of dynamism and hostility. 4. 3. Performance and budgets Budgets have been recommended for planning, monitoring, and controlling business activities, with each thought to assist businesses to achieve pro? ability (Horngren et al. , 2006). However, the effect of budgets on pro? tability has not as yet been clearly demonstrated in the literature (McMahon, 2001). There is evidence of a positive association between the use of budgets and performance as proxied by growth in small and medium enterprises (Gorton, 1999). Even without extensive empirical evidence, planning and the use of appropriate budgets are promoted by academ ics, educators and accounting practitioners as a means of enhancing ? ancial performance (Hansen and Otley, 2003; Gorton, 1999). Thus, we might expect that primary healthcare businesses using budgets experience better performance than those that do not. More carefully, according to ‘contingency-based’ research, a state of equilibrium in the relationship between the contingency factors and the type of MCS is best described by â€Å"? t† (Covaleski et al. , 2003). â€Å"Fit† occurs when the organisation designs its practices in such a way that it has a positive impact on performance relative to alternative practices.Thus, there will be no universally effective ‘extent of budget use’, as each combination of contingency factors will â€Å"? t† with different practices. The positive impact on performance of attaining â€Å"? t† is due to the ef? ciencies that result from using the most suitable MCS. When there is a lesser â€Å"? tâ €  between the extent of budget use and the contingency factors, performance will be â€Å"impaired†. Further, mis? t will be associated with lower performance irrespective of whether it arises from â€Å"over-budgeting† or â€Å"under-budgeting†. Thus, our ? th hypothesis, stated in the alternate form, is: H5 . A business’s performance is positively associated with the degree of ? t between the extent of budget use and its contingency factors. The inef? ciencies arise because the need for a budgeting practice is incongruent with the adopted practice. If the business over-commits to budgeting, it is likely to have expended scarce human and ? nancial resources without enjoying commensurate bene? ts. Conversely, if it under-commits, its performance will likely suffer because of control and/or co-ordination problems.To illustrate, consider the various contextual factors identi? ed above. First, regarding size, a relatively small business that uses an exte nsive budgeting practice will have unnecessarily expended resources implementing and operating the practice when in fact informal communication is practical and likely preferred. Conversely, a relatively large business without a formal budgeting practice will likely ? nd both communication and co-ordination problematic given the complexity associated with a larger number of employees.In a similar fashion, a relatively centralised business with an extensive budgeting practice has likely expended resources on a level of control that is greater than required to encourage employees to make decisions that are in keeping with the organisational objectives. In terms of strategy, a cost leadership strategy requires more speci? c controls than a differentiation strategy. Thus, the adopted business strategy will likely be less effective if an incompatible budgeting practice is implemented to support the strategy. Finally, high levels of PEU make it much more dif? ult to plan with certainty, t hereby reducing the need for and advantages of budgeting. Finally, notwithstanding equilibrium-type arguments, we believe that there will be variation in the degree of â€Å"? t† in our setting given the dif? culties that primary healthcare businesses likely face in identifying and implementing their best budgeting practices. Given their size and medical focus, it is likely that many of our sample businesses approach budgeting from a relatively unsophisticated perspective and/or view it as a lower priority. This makes the process of identifying a practice that â€Å"? s† relatively slow and involves ‘trial and error’ type of learning. Here, Luft (1997) argues that while static equilibrium theories â€Å"can predict the techniques the ? rm should end up with† they cannot predict â€Å"how long it will take to complete the process or what the path to the solution will be. † Thus, it is likely that there will be a lag between the need for and th e use of a particular budgeting practice. Milgrom and Roberts (1992) also argue that organisations are dynamically learning and moving towards an optimal level of management accounting practice. The problem of implementing a budget practice that â€Å"? s† is further complicated by the fact that implementation of new budget practices is likely to 14 The variation in PEU of managers from different industries has typically been the focus of previous research. In this study, industry is a constant but arguably PEU is still of interest, as it has also been found to vary among the managers of businesses within the same industry (Boyd et al. , 1993). R. King et al. / Management Accounting Research 21 (2010) 40–55 47 occur in a â€Å"lumpy† fashion because when increasing the extent to which they use budgets, businesses are forced to do so in larger rather than smaller increments.As Luft (1997) argues, â€Å"changes in information systems are often sharply discontinuo us†. 5. Method 5. 1. Sample frame and description For this study, a cross-sectional research design is used and the quantitative measurement tool is a mail questionnaire. Recognised problems associated with the implementation of survey-based studies include the initial dif? culty of identifying and accessing appropriate respondents, and then of achieving acceptable response rates (Dillman, 2000). In light of this, since budgets are considered to be a traditional management tool and there is an identi? d trend towards delegating management responsibilities to practice managers, practice managers were chosen as the target subjects for the survey (Department of Health and Ageing, 2005). The further problems of contacting practice managers via a cost effective means and encouraging participation were addressed by approaching the Australian Association of Practice Managers (AAPM) for support. The AAPM is the only recognised professional body for practice managers in Australia and c onsists of managers of dental, medical, and allied health businesses.Currently, there are 1200 members of the AAPM from medical practices, representing approximately 6% of the small private medical businesses operating in Australia. Membership in the AAPM is voluntary subject to an annual subscription fee. There are a number of bene? ts associated with membership including discounts for management education courses and national conferences. Thus, it is likely that members of the AAPM are interested in staying informed about current management trends, wish to become part of a professional network, and have the means to pay the membership fee.While no demographic data currently exist for practice managers who join the AAPM and those who do not, member businesses appear slightly skewed towards larger practices relative to the population of GP businesses. For 2005–2006, 83% of GP businesses had between one and ? ve GPs, with the remaining 17% having six or more (PHCRIS, 2008). In comparison, for our sample practices, 66. 4% had between one and ? ve GP’s and the remaining 33. 6%, six or more. However, notwithstanding this potential bias, the advantages of accessing the AAPM practice manager mailing list and having the AAPM recommend participation are considered to dominate.The questionnaire was initially developed from the existing literature and then pilot tested on a sample of 20 members of the AAPM and ? ve academic researchers. Based on this testing, a number of changes were made to wording and layout to enhance understandability in this setting. The ? nal questionnaire consisted of 35 questions presented in 10 sections and was estimated to require between 20 and 30 min to complete. Questions relating to each of the relevant constructs discussed in Section 4 were presented in dedicated and clearly labelled sections.The ? nal questionnaire was sent to a random sample of 1000 of the medical practice members of the AAPM. Of the 1000 surveys distribut ed, 12 were returned unopened. From the remaining 988 questionnaires, 144 complete and usable responses were received, representing a 14. 6% response rate which is comparable with those achieved in other studies of small businesses (Dennis, 2003). 15 Requested demographic data reveal 112 of the practices to be GP practices and 32 to be specialist practices, and that they employed between 2 and 42 full-time equivalents (FTE).Further, 98. 6% indicate that they use computers in some capacity. The average age of the practices is 23. 94 years, and for the 114 organisations that responded to the question, their average gross fees were $1,553,919, ranging from $206,816 to $11,000,000. 5. 2. Budgeting practice 5. 2. 1. Empirical model The ? rst stage of this study seeks insights both into the factors underlying a business’s decision to adopt a budgeting practice and into its subsequent decision as to the extent of budget use.To do so, it appeals to contingencybased research to identi fy four contextual factors (size (SIZE), structure (STRUC), strategy (STRAT), and perceived environmental uncertainty (PEU)) argued to drive the decisions, although in different combinations. Given this framework, we employ the following common empirical model to formally examine each of these two decisions: BUDGi = + 1 lnSIZEi 0 + 2 STRUCi + 3 STRATi + 4 PEUi + 5 TYPEi +? (1) where the various measures are described below. For the decision to adopt, based on H1 and H2a , 1 and 2 are predicted to be positive.For the decision as to the extent of use, based on H2b , H3 , and H4 , 2 and 3 are predicted to be positive and 4 negative. Practice type (TYPE) has been included in the model to control for potential structural differences (Hair et al. , 2006). Speci? cally, identi? ed differences in the pricing (higher) and supply (lower) of services by specialist versus general practices suggest that the market for specialist services may be relatively more heterogeneous (Department of Health and Ageing, 2005). We measure TYPE as a dichotomous variable, set equal to 1 for general practices and 0 for specialist practices. . 2. 2. Dependent variable measurement To examine the decision to adopt, we measure BUDG as a dichotomous variable set equal to 1 if the business indicates, in response to an explicit ‘yes/no’ question, that it 15 The mailing was restricted to 1000 questionnaires due to ? nancial constraints. Standard techniques to discourage non-response were employed including a personalised cover letter from the AAPM, promised con? dentiality, brevity of questions, the inclusion of a reply-paid envelope, a follow-up e-mail reminder, and a promise to make results available to participants (Dillman, 2000).Testing for non-response bias, undertaken by comparing 15 responses received in the ? rst month to the ? nal 15 responses received, revealed no statistically signi? cant differences. 48 R. King et al. / Management Accounting Research 21 (2010) 40–5 5 uses a written budget and 0 otherwise. We base this analysis on all 144 respondents and run Eq. (1) as a logistic regression. For this and all subsequent analysis, reported p-values are one-tailed since we have predictions relating to each of the contingency factors. To examine the extent of budget use, we restrict our tests to the 65 respondents using written budgets.Here, the survey questionnaire asked respondents to indicate on a 5-point Likert scale how systematically their business used operating budgets of various durations (annual, halfyearly, quarterly, monthly, and/or weekly), as well as cash ? ow, ? exible, rolling, long-term, or other budgets. These questions capture both the types of budgets used and the extent of their use, and are an adaptation of the alternative measurement approaches used in Chenhall and Lang? eldSmith (1998) and Jankala (2005). 16 The Cronbach’s alpha is 93. 8%. Panel A of Table 1 presents descriptive statistics for the responses relating t o the usage of each type f budget. To construct the ‘extent of budget use’ measure, we apply exploratory common factor analysis with orthogonal rotation to the responses. Two uncorrelated factors with eigenvalues of 3. 845 and 1. 234 are extracted, explaining 64. 14% of the total variance. The factor loadings are presented in the ? nal two columns of Panel A of Table 1. The ? rst factor aligns with operating budgets and the second with other types of budgets. As such, we consider two sub-categories (‘operating budgets’ and ‘other budgets’) and measure BUDG for each as the average summated budget usage score across the relevant budgets in the subcategory. 7 Here, Eq. (1) is run using OLS. Given a consistent lack of signi? cance, we do not report or discuss results based on our analyses of the ‘other budgets’ measure. 5. 2. 3. Contingency factor measurement Following the majority of contingency-based MCS studies, we measure size (SIZ E) as the number of full-time equivalent (FTE) employees (Chenhall, 2003). Respondents were asked to identify the number of FTE employees as administrative/reception staff, practice manager, nursing/allied health, medical, and other. Table 2 reveals that the mean (median) number of FTE employees for our sample businesses is 11. 31 (10. 500). For sensitivity purposes, we alternatively consider gross fees as a measure of size. Data on gross fees were provided by 114 of the businesses, with a mean (median) value of $1,553,919 ($1,322,359). For the remaining three contingency factors, the measures are based on responses across 7-point Likert scales to dedicated questions in the questionnaire survey. Panel B of Table 1 presents the questions and descriptive statistics for the responses. For STRUC and PEU which involve multiple questions, exploratory common factor analysis is then applied o develop the empirical measures. The factor loadings are presented in the ? nal two columns of Panel B. 18 In detail, the measure of structure (STRUC) is based on responses to six questionnaire items asking the extent to which decision-making authority has been delegated within the business and at which level operating decisions are made. The six items, originally developed by Gordon and Narayanan (1984), have been subjected to considerable scrutiny and empirical testing for reliability and validity in previous research (Chenhall, 2003). The Cronbach alpha is 82. 7%.Application of exploratory common factor analysis to the response scores leads to the extraction of only one factor with an eigenvalue of 3. 261, explaining 53. 81% of the variance. Thus, STRUC is measured as the average summated scores across the six items. Organisational strategy (STRAT) is based on Porter’s classi? cation scheme (Porter, 1980) and measured by the response to a single question drawn from Govindarajan (1988). This question asks the respondents to indicate their belief as to the best description of the business’s strategic emphasis, ranging from product differentiation to cost leadership.This was found in the pilot testing to be the only question from previous research applicable to our setting, Finally, we initially measure perceived environmental uncertainty (PEU) based on the responses to nine questions developed by Gordon and Narayanan (1984) to capture the intensity of competition, the dynamic and unpredictable nature of the external environment, and the potential elements of change in the environment. Based on the correlations among the responses, only ? ve items were eventually used with a Cronbach alpha of 64. %, as the responses to four items had correlations of less than the 30% level recommended for inclusion in factor analysis (Hair et al. , 2006). 19 Consistent with previous research (Gordon and Narayanan, 1984), application of exploratory common factor analysis with orthogonal rotation led to the extraction of two factors with eigenvalues of 2. 327 and 1. 122 explaining 67. 70% of the total variance. Following the literature, we label these factors as ‘PEU hostility’ (PEUhost ) and ‘PEU dynamism’ (PEUdyn ).PEUhost loads on the two questions relating to the competitiveness of the business environment whereas PEUdyn loads on the three questions relating to the predictability of the external environment. We include both in our empirical model, measuring each as the average summated response scores across the relevant questions. 16 Jankala (2005) prefers this measure of systematic use as a more reliable and precise measure of a business’s commitment to the use of budgets, rather than the more subjective scales used by, for example, Chenhall and Lang? eld-Smith (1998) that measure bene? t derived. 7 The yearly operating budgets did not load on either factor as a large majority of the businesses indicated that they used yearly operating budgets on a systematic basis. 18 The reported factor loadings, eig envalues, and percentage variation explained are based on the full sample of 144 respondents. When the exploratory common factor analysis is repeated based only on the 65 respondent businesses using budgets, all measures are qualitatively identical. 19 The four items removed were competition for manpower, new services marketed, ability to predict preferences for customers, and change in legal, political, and economic environment.Their removal is perhaps not surprising that as there was little variation in the responses received with the sample small businesses drawn from the same industry. R. King et al. / Management Accounting Research 21 (2010) 40–55 Table 1 Descriptive statistics and factor loadings for survey questionnaire responses. Question Descriptive statistics Mean Panel A: Budgeting BUDG 1 Which of the following budgets are prepared and how consistently? (5-point scale: 1 = not used, 2 = seldom, 3 = at times, 4 = often, 5 = systematically) a. Operating budget, yearl y b. Operating budget, half-yearly c.Operating budget, quarterly d. Operating budget, monthly e. Operating budget, weekly f. Cash ? ow budget g. Flexible budget h. Rolling budget i. Long-term budget Med SD Factor loadings #1 #2 49 2. 690 2. 064 2. 064 2. 092 1. 578 2. 079 1. 701 1. 704 1. 795 1 1 1 1 1 1 1 1 1 1. 899 1. 663 1. 659 1. 662 1. 315 1. 626 1. 317 1. 400 1. 473 0. 746 0. 614 0. 533 0. 668 0. 472 0. 149 0. 317 0. 168 0. 255 0. 322 0. 034 0. 346 0. 508 0. 823 0. 606 0. 715 Panel B: Contingency factors Structure (STRUC) STRUC 1 To what extent has authority been delegated to the manager or employee for each of the following decisions? Please indicate actual rather than stated authority) (7-point scale: 1 = no delegation, 7 = total delegation) a. Initiate ideas for new services b. Hiring and ? ring of personnel c. Selection of large investments d. Budget allocations e. Pricing decisions STRUC 2 Most operation decisions are made at what level? (7-point scale: 1 = owner level, 7 = manager level) 4. 999 5. 250 3. 173 3. 980 4. 311 4. 349 5 6 3 5 5 4 1. 517 1. 923 1. 963 2. 123 1. 900 1. 870 0. 531 0. 610 0. 732 0. 803 0. 761 0. 581 – – – – – – How would you best describe your practice’s strategic emphasis? 7-point scale: 1 = product differentiation; 7 = cost leadership) Perceived environmental uncertainty (PEU) PEU 1 How stable/dynamic is the external environment (economic and technological) facing your practice? (7-point scale: 1 = very stable, 7 = very dynamic) a. Economic environment b. Technological environment PEU 2 How would you classify the market activities of your competitors (i. e. , other healthcare practices) in the past 3 years? (7-point scale: 1 = becoming more predictable, 7 = becoming less predictable) How intense is each of the following in your industry, the healthcare profession? 7-point scale: 1 = negligible, 7 = intense) a. Bidding for purchases b. Price competition Strategy (STRAT) STRAT 1 2. 983 3 1. 127 n/a n/a 4. 134 4. 761 3. 691 4 5 4 1. 603 1. 596 1. 122 0. 968 0. 755 0. 369 0. 176 0. 185 0. 118 PEU 3 2. 446 3. 553 2 4 1. 352 1. 502 0. 147 0. 168 0. 676 0. 625 Panel C: Performance (PERF) PERF 1 Which best describes your response to the following statements over the past 3-year period? Compared to key competitors, my practice: (7-point scale: 1 = strongly disagree, 7 = strongly agree) a. Is more competitive b. Has more patients c. Is growing faster d. Is more pro? table e.Is more innovative f. Has more doctors 5. 082 5. 353 5. 105 5. 210 5. 320 4. 094 5 6 5 5 6 4 1. 607 1. 619 1. 644 1. 593 1. 643 2. 204 0. 660 0. 711 0. 849 0. 667 0. 592 0. 502 – – – – – For Panel A, the exploratory factor analysis was conducted based on the 65 businesses that produce written budgets. For Panels B and C, the exploratory common factor analysis was based on the full sample of 144 respondents. Items deemed to load on the identi? ed factor appea r in bold. 50 R. King et al. / Management Accounting Research 21 (2010) 40–55 Table 2 Descriptive statistics for ‘contingency-based’ model variables.Measure ‘Operating budgets’ Mean Median Standard deviation Min > max Size (SIZE) Mean Median Standard deviation Min > max Structure (STRUCT) Mean Median Standard deviation Min > max Strategy (STRAT) Mean Median Standard deviation Min > max PEUhost Mean Median Standard deviation Min > max PEUdyn Mean Median Standard deviation Min > max Performance (PERF) Mean Median Standard deviation Min > max Full sample (n = 144) 1. 948 1. 000 1. 376 1>5 11. 531 10. 500 6. 583 2 > 42 4. 344 4. 333 1. 381 1>7 1. 990 2. 000 1. 122 1>7 2. 987 3. 000 1. 199 1>6 4. 201 4. 333 1. 179 1 > 6. 6 4. 027 4. 083 1. 248 1>7 Written budget (n = 65) 3. 085 3. 000 1. 50 1>5 12. 893 12. 000 6. 367 3. 5 > 31 4. 862 5. 000 1. 212 1. 67 > 6. 83 1. 860 2. 000 1. 014 1>6 3. 231 3. 000 1. 183 1>6 4. 241 4. 333 1. 129 1 > 6. 67 4. 228 4. 333 1. 302 1>7 No written budget (n = 79) n/a p-Value – 10. 410 9. 250 6. 586 2 > 42 3. 918 3. 833 1. 372 1>7 2. 090 2. 000 1. 200 1>7 2. 785 2. 500 1. 181 1 > 5. 5 4. 169 4. 333 1. 224 1 > 6. 67 3. 861 3. 833 1. 184 1 > 6. 5 0. 024 0) or â€Å"under-budgets† (? < 0), the impact of ‘lack of ? t’ on ? nancial performance should be the same. Formally, the model we employ, illustrated using |? |, has the following form: PERFi = 0 we also requested objective measures of pro? ability from our sample businesses (Govindarajan and Gupta, 1985). Unfortunately, less than one-third of our sample provided the data. Thus, the use of objective measures for robustness purposes is also impractical. 6. Results and analysis 6. 1. Preliminaries Descriptive statistics for measures used in tests of our hypotheses are presented in Table 2, both for the overall sample of 144 respondents and for the sample partitioned on the basis of whether a written budget is adopted, along with te sts for differences in mean values between partitions. As revealed, there is considerable cross-sectional variation in each measure.Further, there appear to be several signi? cant differences between respondents adopting written budgets and those not. Speci? cally, businesses using budgets have more FTE employees (SIZE, p = 0. 024), are more decentralised (STRUC, p < 0. 001), face a more hostile enviro