Direct to Consumer Advertising of Prescription drugs

Direct to Consumer Advertising of Prescription drugs Abstract In Pharmaceutical industry, promotional advertisements are mostly targeted towards physicians but in recent years trend has shifted towards consumer advertisement. In many cases of Direct to Consumer Advertisement (DTCA) the pharmaceutical marketers and manufactures creates hype among patients towards disease and ultimately towards brand. It provokes the patients to seek additional information on the brand and push for its prescription generation. Objective of this study is to determine attitude of the physicians towards DTCA, and what extent patients request for particular brand leads to actual prescription generation of the advertised drugs. This study reveals that the doctors generally have positive attitude towards DTCA and are willing to provide relevant information to the patients and in some cases even provide sample of medicines or go for direct prescribing, if found relevant, as asked by the patient. This study justifies the pharmaceutical industry manufacturers sp ending in DTCA. It is also thought provoking for health policy makers that prescription drugs are being advertised directly which may lead to increased medication cost and misuse of medicine. Key words: Direct to consumer advertising, Direct to Consumer Advertised Brand, Over the counter drugs, Prescription drug. Physicians attitude. I INTRODUCTION Companies rely heavily on product detailing to physicians, which are the customer, (Zangla, 2004). To increase overall sales figures marketers started advertising directly to consumers of disease and even drug brands, (Amaldoss He, 2009). DTCA is not allowed specially for prescription drugs, (Donohue Berndt, 2010). One argument is that DTCA is a public service message about a particular disease and only plays a role as information provider and motivates people to seek proper treatment if required (Kuhn, 2006). Many researchers found DTCA good for General public health, (Bradford, Kleit, Nietert, Ornstein, 2005) and beneficial for patient care (Murray, Lo, Pollack, Donelan, Lee, 2004). So it is considered as DTCA has both merits and demerits, (Murray, 2003) 1.1 Research Objective In recent years Pharmaceutical Companies drastically increased their spending on Direct to Consumer Advertising (DTCA) (Herzenstein, Misra Posavac, 2005). In 1997 Federal drug authority (FDA) permitted DTCA and subsequently pharmaceutical companies started increasing their expenditure on direct advertisement to provoke consumers to ask their doctors about the drug (Green, 2007). Patient is more comfortable in using drug brand which is familiar to patient, (Zuvekas, 2008). Consumers have positive attitude towards DTCA and tries to find out additional information about Directly to Consumer Advertised Brand (DTCAB). To get additional information patient consults their doctor, (Herzenstein, Misra, Posavac, 2005). Asking questions by patients has strong influence on doctors selection criteria of drugs (Iizuka Jin 2005). General attitude of physicians towards DTCA its impact on prescription generation is still unknown (Herzenstein, et al., 2005). If physicians have positive general attitude towards DTCA, it may lead to actual prescription generation. Moreover if patients shows more likelihood of searching additional information tries to inquire additional information by asking questions from physician about DTCAB also leads to prescription generation (Herzenstein, et al., 2005). Information inquired from the physician about DTCAB of medicine is taken as second independent variable, pressurizes physicians towards prescribing that specific brand of drugs. Patients adherence influenced by DTCA motivates patients to seek additional information about the drug from physicians (Amaldoss Chuan, 2009). 1.2 Rationale of study 1.2.1 Increased spending on DTCA from pharmaceutical companies. Pharmaceutical companies have increased their spending in last decade, and they are planning to do more (Atherly Rubin, Feb 2008). Physicians are considered to be the best judge to decide medicine , keeping in view the patients and drugs characteristics. Due to information flow and access through electronic and print media, consumer tries to get more information about the drug and disease. With this the pharmaceutical companies started promoting prescription drugs directly to consumers. At the end of many advertisements it is advised to consult your doctor for further information, but ultimate goal is the prescription generation. These advertisements provokes patients to visit their physicians and asking information and if it is appropriate then whether it can be used or not. It is presumed by the companies that doctor will prescribe the medicine as per patient request, but it is still unknown that what is the general attitude of doctors towards direct to consumer advertisement This study will help marketers of pharmaceutical companies in finding the answer to the question, whether they are helping people in getting medication, from physicians perspective, and are they really making returns on this investment on DTCA. 1.2.2 Health policy makers. Drugs are classified in two categories, one is Over the Counter Drugs (OTC) and other is called Prescription drugs (PD). OTC drugs are usual drugs which have comparatively lesser side effects and can be used without consultation of physicians. Conversely the PD which are of either critical use or may be associated with serious side effects, and can only be used if advised by physicians. In like manner promotion of PD were made only to the physicians through detailing. Pertaining to the severity of life and death related to use of PD, DTCA should not be done for PD. But PD are being advertised under the head of Disease Advertising (DA). It should be the major concern for health policy maker either the PD are being used appropriately as per physicians advice or not. As extensive DTCA of PD may lead to misuse of medicine, increased treatment cost and unnecessary visits to physicians. DTCA should not have that much impact to generate prescription of DTCAB, if it is then specific policies should be developed to balance the usage of DTCA with its risks. 1.2.3 Knowledge contribution. It has already been explored in many researches that DTCA has both merits and demerits. Some physicians generally perceive that DTCA is good for patient overall health but from other school of thought it is just in favor of pharmaceutical companies, only physicians can better decide which drug to be used or not. In medical sciences the selection of medicine is based on mainly three factors, kind of disease, doctors judgment, patients affordability and liking or psychological experience factor of any brand (Prosser, Almond and Walley, 2003). In previous researches the impact of both physicians and consumers have been explored. But the combined impact of both variables has not been studied before. This study for the first time explores the combined effect of the two main independent variables. My research will find out the preference of physicians towards DTCA and whether information seeking by the patients leads to prescription generation. II LITERATURE REVIEW Pharmaceutical industry is heavily driven by customers (doctors) and very marketing and selling intensive (Scherer, 1990). Primarily the focus was only on doctors (customers) but recently the trend is also shifting towards addressing consumers directly (Matthews, 2001). The medium used for accessing consumers is electronic media including the internet and television advertisements, consumers are now able to freely access information about drugs and their brands which in some cases can lead to misuse of medicine and increased cost of treatment (Matthews et al., 2001). Pharmaceutical companies are now targeting advertisements towards patients which entice patients to ask for prescription of only advertised drug, the patients behavior is also effecting and directing the health systems. Matthews (2001) quoted Dr. Reardon, ex president of American Medical Association (AMA), has insightfully noted, Patients themselves are also creating a strong impetus for change. Disillusioned by restrictions on coverage and care, they are increasingly demanding choice of physician, hospital, and even type of health plan. More than ever, patients see physicians as the essential point of trust in a changing system, and demand choice and stability in their vital relationships with their doctors. At the same time, patients themselves are becoming better educated, not only about insurance options but also about medical treatments. Today, thanks to the Internet, trends in product advertising, and the massive proliferation of medical information, patients are better equipped to take part in their care than ever before. Rather than simplifying the physicians job, however, this increased patient knowledge base is creating new challenges. The other argument that supports DTCA says that it encourages hard to reach sections of populations to seek information about diseases, but it should be balanced against the increased cost of medicine from unnecessary requests generated by DTCA (Murray Pollack Donelan and Lee, 2003). DTCA has both positive and negative effects on health behaviors, health service utilization (Murray et, al., 2003). Almost five years back ads for prescription drugs were very rare but these are becoming very common in recent years, and are being advertised like any consumer goods, direct to consumer advertising (DTCA) has grown rapidly (Scherer, 2004). On the other side consumers behavior is supportive towards DTCA and would like to get more information and ask for a particular brand from physicians (Herzenstein, 2004). Another research shows that DTCA had no statistically significant effect on the choice of antidepressant (Donohue Berndt, 2004). There are three variables involved in prescription cho ice, one is Patient characteristic, second is features of medication and third is physicians preference for medication choice, moreover detailing is found to be the most effective in physicians preference for medication choice (Donohue Berndt, 2004). Increase in pharmaceutical pricing is due to increase in expenditure incurred on DTCA. 2.1 Conceptual framework Now the question arises that whether there is an impact of DTCA on sales or not (Scherer, 2004). It is also found that DTCA encourage patients to visit physicians and use specific brand medicine (Iizuka, 2005). It is agreed that DTCA has decreased the time between diagnosis and use of medicine and promotes the patients to consult their physician. 2.1.1 Inquiry about additional information or request for prescription. It has been argued that patient may demand the product just because of the attractiveness and persuasion of the advertisement, rather than look in to the effectiveness of the drug and go for proper consultation from doctor (Bradford, 2005). This is not unusual in pharmaceutical, as is a significant change from the traditional emphasis on physicians detailing, it has been found that the traditional selling of pharmaceutical brands to physicians is changing and prescription drugs is being marketed directly to consumers, as other consumer goods, as detailing and price are found to be complementary strategies for the firms in addition to the traditional detailing, (Brekkea, 2006) 2.1.1 Actual prescription generation. Still questions arises about the impact of DTCA on welfare of patients, if allowed then will lead to More visits to physicians, and they pressurizes to get prescription of desired medicine. (Brekkea et al., 2006). It is also shown that the pharmaceutical manufacturers are also facing challenges from DTCA because they has to do extensive detailing to physicians because of DTCA is also being done, so it should be banned as to keep focus on detailing (Brekkea et al., 2006). It will induce demand for new users of antidepressant medicines and can exaggerate the usage if already that medicine is being used, and will lead to misuse of brand (Chad Meyerhoefer, 2007). Direct to consumer advertising is very important and of course controversial part, advertising in journals, detailing and distribution of samples are used along with direct to consumer advertising which may leads to induce demand and generate more sales (Pasdirtz, 2009) III RESEARCH METHODOLOGY Research methodology is a system or methods followed by particular discipline of an inquiry or investigation into a subject in order to discover or revise facts, theories, applications etc. (Oxford Dictionary, 2007). This study is an applied form of research leading to the basic knowledge contribution, and is an extension of work done by Zachry, (2003). As pharmaceutical industry is very important, it has to play an important role, on one side it claims to be for better health of patients but no doubt they are making huge profits, here comes the role of health policy makers to make it justified. Moreover it is to find out the general attitude of physicians about DTCA and information asked by patients about any particular DTCAB, and its relation with actual prescription generation if asked by patient. 3.1 Problem Statement Hypothesis Pharmaceutical companies in Pakistan are promoting their brands directly to consumers (patients), now the question is What is the attitude of physicians towards DTCA, and do they provide relevant information and prescribe medicine if asked by patient. Positive attitude of physicians and information asked by patients of advertised medicine leads to prescription generation Now the objective of study is qualitative estimation of attitude, and what physicians are most likely to do if patient inquires information after exposure of pharmaceutical advertisement. Even patient may ask for prescription of specific drug, then what is the usual response of physician. 3.2 Hypothesis H-1 : Attitude of physicians towards Direct to consumer advertisement is positive. H-2: Physicians provides information of drug which is asked by patient after exposure to pharmaceutical advertisement. H-3: If found relevant, physicians prescribe the particular drug which is requested by patient on exposure to pharmaceutical advertisement. H-4: Positive attitude of physicians towards DTCA and query about information of a particular brand of medicine leads to actual prescription generation. ATTITUDE3.3 Model Independent Variable 1 PRESCRIPTION GENERATION Attitude of Physicians towards Direct to Consumer Advertising of prescription drugs Dependent Variable Actual Prescription Generation on request from patient of DTCAB medicine INFORMATION Reaction on request of information about particular DTCAB medicine Independent Variable 2 PRESCRIPTION GENERATION Dependent Variable Actual Prescription Generation on request from patient of DTCAB medicine 3.4 Data Collection Data was collected in field setting, respondent were general practicing Doctors/Physicians in hospital setting, as per previously done by (Friedman, 2006) to know the attitude of doctors. We selected hospitals because it has been found that hospitals play an important role in direct to consumer advertising (Adeoye Bozic, 2007),. 3.5 Sample and Population we choose leading hospitals of Rawalpindi/ Islamabad which have high patient turnover, i.e Pakistan institute of medical Sciences, Rawalpindi general hospital, Nescom Hospital and Shifa International. Within these hospitals we selected doctors on judgmental basis, as doctor who is dealing with more than 50 walk-in patients as previously done by (Taneja, Arora and Kaushik, 2007) and found appropriate. Sample size was taken 250, as per sample size taken by other researchers for the same kind of purpose (Bhanji, Baron, Benjamin, Lacy, Gross, Goin, Summner, Fischer, and Slaby 2008). 3.6 Instrumentation A questionnaire was adopted from two authors. Questionnaire has three parts, in first part general attitude of physicians towards direct to consumer advertising (Donhue Berndt, 2004), and in second part the likelihood behavior of physician if patient asks for more information related to drug being advertised directly, and in last part the likelihood of physician if patient asks for prescription of certain medicine (Zachry,Dalen, and Jackson, 2003). 3.7 Data Analysis These two were independent variable and one variable of prescription generation is dependant variable. Quantitative method were used, Microsoft Excel and SPSS was used to calculate percentages and relative comparison in questions through as per previous research done by Bhanji, 2008. IV FINDING AND ANALYSIS 4.1 Data Reliability and Normality Collected data is validated from Cronbachs-Alpha value which is used by many researchers like Zachry; Dalen, and Jackson, (2001,2003). The value came up to 0.8 which is acceptable as it should beis more than 0.6. Taneja, Arora and Kaushik, (2007) used descriptive statistical data analysis, I moreover used SPSS to regress two independent variable with dependent variable. 4.2 Descriptive Statistics of Respondents 4.2.1 Independent variable 1, attitude. In first part of questionnaire it is found that 40 % agree and 20 % strongly agree that it makes patients better informed and 46% agree with 32% strongly agree that it causes them to seek medical doctor. 40% agree that it also informs about side effects, although the data shows that there is increase in medication cost. Little agreement on suggesting medicine from patients. More that half percent of people suggested that it is good trend in health care, and causes more time spent in front of doctor while discussing disease. 42% agree that this also helps in increases motivation towards treatment. 39% think that it not only provokes patients to visit doctor for better health but also encourages, 41%, patients to talk to their doctor about right concern. 41% agree that it also helps in following treatment instructions and 58% with 7% strongly agree that it improves the understanding of medical conditions and treatment.1 is for strong agreement, 2 is for agreement, 3 is neutral and 4 is for disagreement while 5 is strongly disagreement.General description and frequency analysis is given in Table 4.1 OVERALL ATTITUDE OF PHYSICIANS TOWARDS DIRECT TO CONSUMER ADVERTISING ATTITUDE Questions Asked Variance Std Deviation Make patients better informed about their medical problems 1.18 1.08 Motivate patients to seek medical care 1.21 1.1 Provide enough information on other treatments 1.41 1.18 Do a good job of informing patients of side effects 1.3 1.15 Have less or no impact on increase in medication cost 1.08 1.03 Helps doctors in suggesting medicines from patients 1.06 1.02 Are a positive trend in health care 0.94 0.97 Increase in time spent with doctor 1 1.01 Increases motivation towards treatment, overall drug consumption 0.8 0.89 Increase more doctor visit for better health 1.47 1.21 Encourages patients to talk to their doctor about their right concerns 1 1 Encourages people to follow treatment instructions or advice from their doctors 1.15 1.07 Helps patients get treatments they would not otherwise get 1.16 1.07 Have less of no impact on driveing up the cost of prescription drugs 1.17 1.08 Improves peoples understanding of medical conditions and treatments 0.89 0.94 4.2.2 Independent variable 2, information. 44% agree that they become frustrated, 37% get annoyed but 52% agree and 32% strongly agree that they answer patient question about medication if asked. Only 35% agree that they provide more information. General description and frequency analysis is given in Table 4.2 LIKELLIHOOD OF PHYSICIANS WHEN ASKED FOR SPECIFIC BRAND DUE TO DTCA INFORMATION Questions asked Variance Std. Deviation You become frustrated with patient for asking for more information about disease or medicine 1.57 1.25 You become annoyed with patient for asking for more information about disease or medicine 1.42 1.19 Answer patient questions about the medication 0.79 0.89 Provide more information to patient beyond original inquiry 1.39 1.18 Attempt to change subject rather than discuss the medication 1.4 1.18 Explains that the information is probably beyond patients comprehension 1.42 1.19 4.2.3 Dependent variable, actual prescription generation. It is revealed from data that 37% get frustrated, 36% get annoyed if asked to prescribe certain brand and 36% feel uncomfortable with this request, and even less willing to communicate to the patient 33%, mostly 41% are neutral. With this if samples are available then 61% agree and 17% strongly agree to provide samples on patient request, it is also supported by agreement of 51% and strong agreement 24% that they will prescribe medicine if no medicine is available. But if found relevant, as while asking question of simply prescribing the medicine if is anyway relevant , to satisfy the patient then the agreement was 47% and only 8% with strong agreement. General description and frequency analysis is given in Table 4.3 LIKELIHOOD OF PHYSICIANS ON REQUEST OF PATIENT FOR SPECIFIC BRAND PRESCRIPTION GENERATION Dependent Variable Questions Asked Variance Std. Deviation Become frustrated with patient for asking to try the medication 1.13 1.06 Become annoyed with patient for asking to try the medication 0.96 0.98 Feel uncomfortable with the medication request 1.34 1.16 Communicate to the patient your discomfort with the medication request 0.87 0.93 Attempt to prescribe different medication to keep from promoting patient to ask for medication, if available 0.93 0.96 Provides samples of the medication, if available 0.73 0.86 Provide prescription of the medication if no samples available 1.2 1.09 Simply prescribes the medicine if is anyway relevant, to satisfy the patient 1.11 1.06 4.3 Correlation Regression Analysis SPSS was used to show the relationship between two independent variables i.e attitude of doctors towards DTCA and behavior likelihood if information asked by the patient and its impact on dependent variable which is actual prescription generation if requested by the patient. 4.3.1 Model summary and ANOVA. R value shows 40% relationship between dependent variable and independent variables. R square shows 16.6% of the variant in dependent variable can be predicted by the combination of two independent variable. Durbin Watson value is 2.08 showing that there is very less multicollinearity. ANOVA statistics shows overall model significance, f value is 15.09, and sig value is less than 0.00 which is less than 0.05, and is the indicator of significance, so that we can go for regression analysis of independent variables on dependent variables. Durbin Watson value should be between 1.5 to 2.5 means that there is no or less multicollinearity, here the value is 2.08, it shows less chances of multicollinearity. 4.4 If two independent variables combined collectively, Information + Attitude Data results with individual variables shows very weak relationship. with model significance. So It is considered combined effect of both independent variables on dependent variables. 4.4.1 Model summary and ANOVA. Model Summary shows overall model significance, which is less than 0.05, showing overall model fit, R value shows 78% dependence of dependent variable on independent variable. R square value is 0.61 showing magnitude of relationship between independent variable with dependent variable. 1% change in independent variable with 61 % change in dependent variable. Adjusted R square is the pure magnitude of relationship which is always less than the R square, 0.60. F Change statistics is 239.45 which is more than 1 then we can go for coefficients. ANOVA shows overall model significance with less than 0.05 value, it means the regression analysis be proceeded. Additionally according to second school of thought the regression sum of square should be greater then residual sum of square for better model fit. 4.4.1 Coefficient If t value is greater then 2 means it is significant. And significance value should be less than 0.05 to make a significant relationship. Here t value is 15.47, showing significant relationship, and sig value is less than 0.000. 4.2. Discussion This is similar finding with Ryan Vaithianathan, (2009). Which shows that the attitude of consumer is positive towards information provision to patient if asked and similar with the Brekke Kuhn, 2006 study which shows that the doctors rely on the information provided to them through DTCA. I accept the hypothesis that physicians have positive attitude towards DTCA. And it is accepted that the physicians are comfortable in providing information if asked by patents about any DTCAB. According to statistics shown by Data analysis I accept the hypothesis of positive relationship between general attitude of physicians towards DTCA and behavior of physicians if patient asks information has positive relationship and are correlated with actual prescription generation. Very interestingly it is found that information asking by physician and general attitude are weakly negatively correlated, it can be the area for further research that if more information is asked by patients about any brand may lead to negative attitude of physicians towards DTCA. It is found that through DTCA and patients, it is a way of putting pressure on physicians to change their prescribing behavior, (Ryan Vaithianathan, 2009) It was major concern showed by (Morgan, Mintzes barer, 2003) that the regularities authorities should consider DTCA regulations if it has impact on prescribing behavious, and in this study it has shown that the consumer advertising is creating impact in prescription choosen. This study is providing valueable information for pharmaceutical manufacturers and marketers. If more patients would ask for further information of specific drug, it may lead to the actual prescription generation. This study is also a thought provoking study for physicians that in choosing brands they are influenced by patients which may lead to increased cost and unnecessary medicines prescription. This study can be an eye opener for regularity authorities, DTCA is considered as good by physicians but it should be clearly monitored because it also creates pressure on physicians to prescribe certain brands. VI CONCLUSION Physicians have positive attitude towards DTCA and consider it supplementary in overall health care system. It stimulates patients to visit physician and seek appropriate treatment. Physicians feel comfortable in providing relevant information about DTCAB if asked, and they do not hesitate to prescribe the medicine if it is relevant to disease and patient economic characteristics. Focus of this study was to find the combined impact of attitude and information gathering on actual prescription generation. In future it may be further extended to specific disease area. However pharmaceutical companies should be monitored by regulatory authorities to check DTCA messages. Companies should focus on disease awareness rather on brand focused advertisements. REFERANCES Adeoye S, B. K. (2007 ). Direct to consumer advertising in healthcare: history, benefits, and concerns. Clinical Orthopaedics and Related Research , Volume 457, pp 96-104. Amaldoss, W., He, C. (2009). Direct-to-Consumer Advertising of Prescription Drugs: A Strategic Analysis. MARKETING SCIENCE , Vol. 28 (No. 3), pp. 472-487. Atherly, A., Rubin, P. (Feb 2008). The cost effectiveness of direct to consumer advertising for prescription drugs. Journal of Law Economics , pp. 08-28. Berndt, J. M. (2004). Effects of Direct-to-Consumer Advertising on Medication Choice: The Case of Antidepressants. Journal of Public Policy Marketing , 23 (2), 115-127. Berndt, J. M. (2004). Effects of Direct-to-Con sumer Advertising on Medication Choice: The Case of Antidepressants. Journal of Public Policy Marketing , 23 (2), 115-127. Bradford, D., Kleit, A. N., Nietert, P., Ornstein, S. (2005, August 8). The Effect of Direct to Consumer Television Advertising on the Timing of Treatment. Working Paper Series . Kurt R. Brekkea, Kuhnb, M. (2006). Direct to consumer advertising in Pharmaceutocal markets. Journal of Health Economics , pp. 102-130. Brekke, K. R., Kuhn, M. (July 2005). Direct to consumer advertising in pharmaceutical markets . Journal of Family medicine , Vol.18 (2) pp. 238-321 Donohue, J. M., Cevasco, M., Rosenthal, a. M. (2007). A Decade of Direct-to-Consumer Advertising of Presescription drugs. The new england journal of medicine , Vol . 81 pp. 357-673. E. Murray, L. Pollack, K. Donelan (2003), Direct-to-Consumer Advertising Physicians views of its effects on quality of care and the doctor patient relationship, JABFP, Vol. 16 No. 6 Pg. 513-524 Elizabeth Murray, P. M., Donelan, K., lee, K. (2004). Direct to Consumer Advertising Public Perception of its effects on Health Behaviours, Health Care, and the Doctor-Patient Relationship. The Journal of family Medicine, Vol.17 No. 1, pp. 6-18 Gould, M. F. (2007). Physicians attitudes toward direct-to-consumer prescription drug marketing. Journal of Medical Marketing , Vol. 7 (issue 1 ), 33-44. Green, R. M. (2008). Direct to consumer advertisment and pharmaceutical ethics The case of VIOXX. Journal of Business Ethics , Vol. 15, pp.749-759. Helen Prosser, S. A. (2003). Influences on GPs decision to prescribe new drugs-the importance of who says what. Journal of Family Practice , Vol. 20, (No. 1), 61-68. Herzenstein, M., Misra, S., Posavac, S. S. (2005). How Consumers Attitudes Toward Direct-to-Consumer Advertising of Prescription Drugs Influence Ad Effectiveness, and Consumer and Physician Behavior . Marketing Letters , Vol. 15 ( Number 4), 201-212. Iizuka, T., Jin, G. Z. (2005). The Effect of Prescription Drug Advertising on Doctor Visits. Journal of Economics and Management Strategy , 22 (3). Kurt R. Brekkea, Kuhnb, M. (2006). Direct to consumer advertising in Pharmaceutocal markets. Journal of Health Economics , Vol.19 (2) , Pg.102-130. Lack of Impact of Direct-to-Consumer Advertising on the

Pdhpe Essay- Sports Medicine

Physical preparation is very important to enhance the well-being of an athlete and to ensure that it keeps the players fit and injury free during a long season of sport. Physical preparation involves ensuring the body is prepared for an activity that it is to be involved in. Proper physical preparation is a major aspect in the prevention of sports injuries. There are many ways that a coach of a sports team can utilise physical preparation to enhance the wellbeing of the players.The preparation techniques include; conducting pre-screening, promoting particular skills and techniques that are required, developing physical fitness and following sufficient warm-up, stretching and cool-down procedures. Pre-screening is the first step to physical preparation for a sport or some sort of physical activity. It is an important preventative measure that is to be done before beginning an exercise. Pre-screening is done so that the coach/head person can determine the athlete’s current fitne ss level, goals and also to become familiar with the athlete’s medical history.This source of physical preparation is usually completed prior to joining a team sport e. g. Basketball, soccer, cricket, boxing and so on. It is also completed when joining a fitness club/organisation such as; a gym, aerobics, water aerobics, zumba and so on. Pre-screening allows exercise programs to be modified to the needs of the individual and with pre-screening being done, the coach will be able to know whats going on with each player because he will know the individuals medical history, health status, previous experience in physical activity and what their aiming to achieve.It will help the coach to know where the players’ weakness and strengths are, and what areas they’re struggling with. The next physical preparation method is skill and technique. Many sports injuries occur due to poor skill or technique. To ensure that athletes remain fit and active with no injury, the coach of the sports club needs to encourage appropriate skill and correct technique. The coach is responsible to ensure that the players they’re in charge of are capable with the basic skills of the game, especially those relevant to self-protection. Poor skill and technique could cause major injuries to an individual, e. . a soccer player who is constantly running/jogging across the field and doesn’t wear appropriate footwear; it will cause them to have stress fractures in the foot. If the coach encourages the players to wear appropriate footwear and safety equipment, along with learning the basic competent skills, then it will keep players injury-free during the long season. With this technique, the coach needs to be aware of other certain conditions and situations that may be hard to avoid and will need to modify the game location or other aspects affecting it such as wet conditions and slippery surfaces.The coach has a very important role to play in ensuring the safe mov ement of the athlete through the different stages of learning a skill. Another main important aspect of physical preparation is being physically active. The coach and players can work together and prevent injuries by placing special importance on developing the physical components specific to their activities. For example, a netballer needs to work on their speed, agility, coordination and strength in the legs. To develop their physical fitness level, the coach needs to do intense training sessions with the players to build their physical component skills.Coaches also have other things to be looking out for such as individuals who need specific physical preparation for various reasons which include; a previous injury, a medical condition, a disability, an identified personal playing weakness. Coaches and trainers need to be aware of these individual needs, and must provide for these differences in their physical preparation programs. For e. g. if a tennis player has a tennis elbow, you will have to work around them to not make it worse. One other physical preparation technique that is highly significant is ‘Warm-up, stretching and cool-down’.A warm-up prior to starting any physical activity prepares and heats your body up for physical training or competition. The coach should ensure that the warm-up routine focuses on the muscles and movements relevant to the activity. Also the coach should ensure that the warm-up period should last between 20 and 35 minutes. It is very important to encourage a warm-up routine before a physical activity to prevent injuries. This is done by increasing body and muscle temperature, stretch ligaments and muscles to allow greater flexibility.After a basic warm-up, the coach must make sure of a stretching routine for 10-15 minutes. If stretching is done properly, it will outcome in increased length of muscle, reduce muscle tension, increase blood circulation and improve joint movement. When stretching, the coach should encourage both the two types of stretching which are static and PNF stretching to get the best results. Then the final 10-15 minutes of the warm-up, the coach should involve more intense exercises such as sharp sprints, agility movements, modified games and skill/technique drills.For e. g. in soccer, it would be appropriate to do a dribbling activity. Finally, a cool-down routine is critical in physical preparation. Reason for this being, a cool-down is to help the body to change from the intense activity back to a normal state. A coach should ensure that a cool-down routine is followed after any physical activity because it will reduce muscle soreness and tightness and that will allow the athlete to recover more quickly. The coach should make the cool-down routine run for 2 minutes of jogging followed by 3-5 minutes of walking.A coach needs to obey and follow all the areas of physical preparation to keep his players injury-free for long seasons and thoroughly prepared to perform to their best of their ability. To get the best outcome possible, the coach will have to encourage each of these areas and to do it properly. All the above aspects are all as important as each other. You can’t do some and ignore the others, to be physically prepared and hope for no un-necessary injuries, you have to perform all the components required of physical preparation; otherwise you will develop injuries that could have been prevented.

An Explanation of Spring and Fall

An Explication of Spring and Fall: To a Young Child Hopkins starts his poem, Spring and Fall: To a Young Child, with a question to a young girl, perhaps his granddaughter: â€Å"Margaret, are you grieving[? ]† (line 1). This quotation suggests that Margaret is watching the leaves fall from the trees in the fall and is sad to see the leaves go. Margaret is a young child, and in being young, she would have no knowledge of the seasons and why the leaves are falling. â€Å"Over Goldengrove unleaving? (line 2), Goldengrove may be metaphorical for her childhood and her lack of knowledge in life and death, because Goldengrove sounds very playful and beautiful like a garden or playground. †Leaves, [like the things of man]/ With [her] fresh thoughts care for, can you? † (line 3 and line 4), once again Hopkins uses questioning his poem, asking the young girl how she could care about such unimportant things as leaves. With line three of his poem, Hopkins also implies that Ma rgaret is showing characteristics of man by caring about the leaves. He continues that idea in: â€Å"Ah! s the heart grows older/†(line 5). Hopkins is trying to tell Margaret that as she grows older into womanhood, her heart will as well. â€Å"It will come to such sights colder. † (line 6), this idea is even further continued in line six, where Hopkins tells Margaret that leaves falling from a tree is only the beginning of her sadness, because as she gets older, she will see worse things than that. â€Å"Nor spare a sigh/[Though worlds of] wanwood leafmeal lie†(line 8) Hopkins tells Margaret that as she grows older and sees how bad things are she will not dare to cry at the sight of fallen leaves ever again.But, Hopkins assures her that she will indeed still cry, â€Å"Now no matter, child, the name† (line 10). Hopkins then tells the child that she won’t know or be able to verbalize why she feels so sad: â€Å"Nor mouth had, no nor mind, express ed† (line 11). Hopkins continues with â€Å"It is the blight man was born for,† (line 13) meaning that everyone is born to do one thing, and that is die. As Hopkins’s poem comes to an end, the last line reads, â€Å"It is Margaret you mourn for. † (line 14). This says that Margaret will mourn her whole life away, grieving about her own unavoidable demise, and that she will never even realize that is why she is sad.

Complex Organizations And Its Evolution - 1944 Words

Complex Organizations and its Evolution Change and evolution are key elements for proper development. Our society wouldn’t be the same today if it didn’t change in different phases of time. As humans, we have an ever-changing perspective and for generations, we have been changing our views and perspectives. Organizations are no different. They also had to go through different sets of changes in order to evolve into what we see them as now. Organizations are a class of socially assembled innovations, and it’s constructed deliberately to act as solutions to specific social or financial problems. There are different forms of organizations. Some forms have been around for centuries, such as the army, Churches or solitary camps (Child, 2012). But the term ‘complex organization’ had only come to light after the Industrial Revolution. That was the time when people started taking complexity theories for granted. These organizations are molded by the environm ents or perspectives in which they are established. Modern organizations that we see today are reflections of their historical origins, and they are enjoying more and more influences over the society these days. Organizations come in a wide and puzzling variety of forms, as they have been specifically designed to deal with a vast range of problems and also because they have emerged from a diverted range of environmental conditions (Child, 2012). So this essay will talk about the evolution of complex organizations over the years,Show MoreRelatedEvolution and revolution as organizations grow757 Words   |  4 Pagesï » ¿Evolution and revolution as organizations grow Growing organization move through 5 phases of development, each of which contains a relatively calm period of growth that ends with a management crisis. Each developmental phase is strongly influenced by the previous one. 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Essay on Atkins or Fadkins - 667 Words

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The Influence of Salah Al-Din Yusuf Essay - 603 Words

Salah al-Din Yusuf was born in Tikrite, Iraq in 1138. He is known today as Saladin. His father, Ayyub, was promoted to the Head of Damascus Militia. Saladin was raised in the center stage of where the main political decisions regarding the Crusades were made. With his religion and education his reputation grew for his politics and leadership over the militia and his people. With these Saladin would hold many positions in government and military, and he would eventually conquer Jerusalem and defeat the third crusade. In the Middle Ages life expectancies were low so men were given responsibilities early in their adulthood. Saladin got married at the age of fourteen and was sent to his uncle Shirkuh, a senior command officer of the†¦show more content†¦The Crusaders of Kerak made an attack on the Muslim pilgrims in 1187. In response Saladin moved his forces to northern Palestine and won a battle against a much larger Crusader army in the battle of Hettin, defeating the King of Jerusalem. Three months later he took Jerusalem in a siege. After signing a treaty giving over the city to Saladin except for a quarter of the city designated for the Franks. No Christian blood was spilled after that point. Foot soldiers were sold into slavery and Saladin offered a fee to leave the city in peace, but if people couldn’t pay he helped them get out of the city indirectly. Western Europe were stunned by the success of Saladin, and Pope Gregory VIII immediately called for the Third Crusade. This was led by Richard I, Emperor Frederick Barbarossa of Germany, and King Phillip II of France. Fredrick was drowned on his march and little of his army continued on without him. Richard and Phillip continued up the coast taking ports as to keep their soldiers with supplies. No matter how many supplies were given they still lacked from the heat. Phillip became exhausted after the siege of Acre and left for France leaving only Richard. Richard started to march inland but he c ame to realize that Saladin had stripped the countryside of food and fodder. He pleaded to Saladin for water and fruit, and being a strict Muslim he sent it but also got a glimpse inside of their encampment. Seeing the little army that RichardShow MoreRelatedThe Great Leaders Of Time2360 Words   |  10 PagesHistory has been marked by the great leaders of time. In the middle to late 12th century, one man from northern Iraq by the name of Saladin (Salah al-Din), born Yusuf ibn Ayyub, shown in this painting, changed the course of history and still influences it today. Saladin lived in Muslim controlled land during the age of the Crusades. He worked his way up the military before taking power in during the Third Crusade. The Crusades saw and bred many great leaders during its time both on the Christian

Corporate Decision Making Plays A Crucial †Myassignmenthelp.Com

Question: Discuss About The Corporate Decision Making Plays A Crucial? Answer: Introduction: Corporate decision making is a process which takes place at every stage in an organization. This process helps the company to make a better decision. These decisions are taken to support the organizational growth. Corporate decision making plays a crucial role in an organization. These decisions are mainly taken by the leader to manage the performance and the profitability of the organization (Lee. Lee, 2006). Further, it has also been found that the corporate decision making helps the organization to set a link between the budgeted outcome and goals of audit company and the actual goals of the company. In this report, capital budgeting has been taken into consideration and it has been analyzed that how corporate decision making process helps an organization into making the best decision about various investment opportunity and plans (Damodaran, 2011). This report briefs the user about various tools of corporate decision making which are helpful for the organization to make a better decision. Further, it has also been found that the following are some of the tools which could be useful for the company to manage the capital budgeting techniques: Sensitivity Analysis: Sensitivity analysis is a technique which is useful for the companies to evaluate the various values of an independent variable which makes an impact over the specific dependent variable under some assumptions. Sensitivity analysis technique is technique which 9s mostly uses by the organization to make a better decision about various investments such as return from one project and risk from other investment project. This analysis is helpful for the organizations to make and develop an effectual and effective business plan which is required by the companies to handle entire risk variables from the business functioning of the company and economical circumstances (Bornholt, 2013). Further, it has been observed that the sensitivity analysis aids the organization in managing the various activities in terms of choosing the best investment project for the company which offers high return to the company and the cash outflow is quite lesser than the cash inflow of the company. Sensitivity ana lysis is used by the companies to identify and evaluate the best project into the available projects. Moles, Parrino Kidwekk, 2011 In concern of capital budgeting, it has been found that the sensitivity analysis offers an analysis over various variable factors and aspects such as cost, sales, investment plans, interest on loan, present value factor, present value etc. it has been observed that in sensitivity analysis, present value factor must be calculated according to the various assumption which is taken for evaluating the factors which could affect the condition of the company and investment project. Such as if an organization is required to earn $ 10,00,000, $ 20,00,000 and $ 30,00,000 in next 3 years (Peterson, Fabozzi, 2002). And for it, he invest into a project where the internal rate of return is expected 10% than the investor must invest $ 60,00,000 so that the entire expenses could be get back by the company in given time period. further, it has been analyzed that the if IRR rate is changed in this case than the entire expense would be get back by the company soon and thus the BEP point would also be get earlier. Internal rate of return and net present value would be quite high if all the related factors would be influenced positively by the company or vice versa. Scenario analysis: Scenario analysis is a technique which is useful for the companies to evaluate the various values of an independent variable which depicts the different result in different scenario. Scenario analysis technique is technique which is mostly uses by the organization to make a better decision about various investments such as return from one project and risk from other investment project (Reilly Brown, 2011). This analysis is helpful for the organizations to make and develop an effectual and effective business plan which is required by the companies to handle entire risk variables from the business functioning of the company and economical circumstances. Further, it has been observed that the Scenario analysis aids the organization in managing the various activities in terms of choosing the best investment project for the company which offers high return to the company and the cash outflow is quite lesser than the cash inflow of the company. Scenario analysis is used by the companies t o identify and evaluate the best project into the available project management (Ross et al, 2008). Factors Normal case Best case Worst case Yield - + 10 % - 20% Exchange rate - + 10 % - 10% Transportation cost - -5% +20% Marketing cost - -5% +20% Sales cost - + 10 % - 20% Sales price 1.03 1.05 1.00 Cash inflow 17 % 29 % 1 % NPV 1 2.2 -2.7 In concern of capital budgeting, it has been found that the scenario analysis offers an analysis over various variable factors and aspects such as cost, sales, investment plans, interest on loan, present value factor, present value etc. it has been observed that in scenario analysis, various aspects are taken into consideration and this study is done to make a better scenario for the company such as if company require a fixed amount after a fixed period than in which market company is required to invest and how much amount is required to invest for a fixed time period (Ross, Westerfield Jaffe, 2007). For this study, various tools such as NPV, IRR, payback period, ARR are calculated and after evaluating every tool, a scenario is prepared. If the best scenario is made by the company than the Internal rate of return and net present value would be quite high of the company or vice versa. Break even analysis: Break even analysis is a study which is used by the companies to determine a point where the entire revenues which has been received by the company are equal to the entire associated cost. Break even analysis is a technique which is useful for the companies to evaluate the various level of a companys profitability condition. Break even analysis technique is a technique which is mostly uses by the organization to make a better decision about various investments such as the total time period in which company would be able to get back the entire associated cost. This analysis is helpful for the organizations to make and develop an effectual and effective business plan which is required by the companies to handle entire risk variables from the business functioning of the company and economical circumstances (Seitzinger et al, 2010). Further, it has been observed that the Break even analysis aids the organization in managing the various activities in terms of choosing the best investment project for the company which offers high return to the company and the cash outflow is quite lesser than the cash inflow of the company. Scenario analysis is used by the companies to identify and evaluate the best project into the available projects. (Tian Jiang, 2015) In concern of capital budgeting, it has been found that the Break even analysis offers an analysis over various variable and fixed factors and aspects such as cost, sales, investment plans, interest on loan, present value factor, present value etc. it has been observed that in Break even analysis, various aspects are taken into consideration and this study is done to make a better scenario for the company such as if company wants to make an investment into a particular project than how much time would it take to the company to get back the entire cash outflow amount. The capital budgeting decision is taken according to the total time period in this technique (Tsanakas Millossovich, 2016). The lesser the time would be taken, the more likable the project is. For this study, various tools payback period, discounted payback, fixed amount, variable amount etc. are calculated and after evaluating every tool, a break even analysis study is prepared. If the time period is lesser in a projec t than there are quite more chances of the project to become profitable and vice versa (Zabarankin, Pavlikov Uryasev, 2014). Simulation techniques: Lastly, simulation techniques have also been analyzed to identify the capital budgeting techniques and tools. In simulation techniques, probability distribution and sensitivity analysis is taken into consideration. Simulation techniques are a study which is used by the companies to choose a point where the company would be more profitable. Simulation techniques analysis is a technique which is useful for the companies to evaluate the various level of a companys profitability condition. Simulation techniques analysis technique is a technique which is mostly uses by the organization to make a better decision about various investments such as the total time period in which company would be able to get back the entire associated cost (Barlow, 2006). This analysis is helpful for the organizations to make and develop an effectual and effective business plan which is required by the companies to handle entire risk variables from the business functioning of the company and economical circums tances. Further, it has been observed that the simulation techniques analysis aids the organization in managing the various activities in terms of choosing the best investment project for the company which offers high return to the company and the cash outflow is quite lesser than the cash inflow of the company. Simulation techniques analysis is used by the companies to identify and evaluate the best project into the available projects (Lumby, Jones, 2007). For conducting the research over the simulation analysis, it is required by the company to firstly choose a random number and then carry on the study on the basis of that random number. In concern of capital budgeting, it has been found that the Simulation techniques offers an analysis over various random numbers, factors and aspects such as cost, sales, investment plans, interest on loan, present value factor, present value etc. it has been observed that in Simulation techniques, various aspects are taken into consideration and this study is done to make a better decision for the company such as if company wants to make an investment into a particular project than how much time would it take to the company to get back the entire cash outflow amount (Batra Verma, 2014). The capital budgeting decision is taken according to the random numbers in this technique. The plot where the probability distribution would be plotted, it would be the place of project level risk. For this study, va rious tools have been calculated to examine the level of risk which could be faced by the company if company would make an investment into that particular investment program. And after evaluating every tool, a Simulation techniques analysis study is prepared. Conclusion: Thus through the above study, it could be concluded that there are various factors which are available for a company into the market to make a better decision about the investment into the various projects. Through this study it has been learned that the sensitivity analysis look over various dependent and independent variables. Scenario analysis looks over the related factors and makes a scenario for investment. Break even analysis estimate the level of revenue and cost to make a better decision and lastly, the Simulation techniques are evaluated to examine the level of risk which could be faced by the company if company would make an investment into that particular investment program. And after evaluating every tool, a Simulation techniques analysis study is prepared. References: Barlow.J.F.,2006, Excel models for business and operations management, 2nd edition, John Wiley sons ltd, England Batra, R. Verma, S. 2014, "An Empirical Insight into Different Stages of Capital Budgeting", Global Business Review, vol. 15, no. 2, pp. 339-362. Bornholt, G. 2013, "The Failure of the Capital Asset Pricing Model (CAPM): An Update and Discussion: The Capital Asset Pricing Model", Abacus, vol. 49, pp. 36-43. Damodaran, A, 2011, Applied corporate finance,3rd edition, John Wiley sons, USA Lee.C.F Lee, A, C,.2006,Encyclopedia of finance, Springer science, new York Lumby,S Jones,C,.2007, Corporate finance theory practice, 7th edition, Thomson, London Moles, P. Parrino, R Kidwekk, D,.2011, Corporate finance, European edition, John Wiley sons, United Kingdom Peterson, P,P Fabozzi,F,J,. 2002, Capital budgeting: theory and practice, John Wiley sons, Canada Reilly.F.K Brown.K.C,.2011,Investment analysis portfolio management,10th edition, South western Cengage learning, India Ross, A,. Westerfield, R,W,. Jaffe,J,. Kakani,R,K,.2008, Corporate Finance, 8th edition, Tata McGraw hill education private limited, New Delhi, India Ross, S, A,. Westerfield, R, W,. Jaffe, J,.2007, Corporate Finance, the McGraw-hill, India Seitzinger, S.P., Mayorga, E., Bouwman, A.F., Kroeze, C., Beusen, A.H.W., Billen, G., cht, v., G, Dumont, E.L., Fekete, B.M., Garnier, J. Harrison, J. 2010, "Global River Nutrient Export: A Scenario Analysis of Past and Future Trends", Global Biogeochemical Cycles, vol. 24, pp. GB0A08-GB0A08. Tian, D. Jiang, L. 2015, "Quasiconvex risk statistics with scenario analysis", Mathematics and Financial Economics, vol. 9, no. 2, pp. 111-121. Tsanakas, A. Millossovich, P. 2016, "Sensitivity Analysis Using Risk Measures", Risk Analysis, vol. 36, no. 1, pp. 30-48. Zabarankin, M., Pavlikov, K. Uryasev, S. 2014, "Capital Asset Pricing Model with drawdown measure", European Journal of Operational Research, vol. 234, no. 2, pp. 508.