Saturday, May 23, 2020

The Holocaust And The Nazi Regime During World War II Essay

Introduction The Second World War is seen by the modern world to be the most famous war that shaped the communities of the world today, but for the Jewish community in Europe at the time this was the war to fight for their own existence. The Holocaust was the systematic extinction of six million Jews by the Nazi regime during World War 2. Of the millions of Jewish people that lost their lives there were many that did resist and did escape the Nazism and Nazi racial policy that was conducted on the Jewish lives throughout the war. There were different ways the Jews did resist through different dimensions of wellbeing, through uprising in the ghettos and camps in a stretch to revolting against their German captivators whilst secretly keeping their spiritual and religious beliefs as something that the Nazis could never physically take from them. The Jews showed resistance to German control also by escaping the camps, and creating Armies and Partisan Groups to fight back. In the findings I was able to establish an understanding of the different ways during the war the Jews managed to create upheaval and resist German authority and the fact that a percentage were able to resist. Uprising in the Ghetto During World War II eastern Europe was vastly controlled and occupied by Nazi forces in the bid of control for the German army to win the war. In a bid to win the war, Germany captured and forced Jewish inhabitants in Eastern Europe at the time and sent away either toShow MoreRelatedThe Most Effective Resistance Against Nazis And The Holocaust?1719 Words   |  7 PagesGroups Showed the Most Effective Resistance Against Nazis and the Holocaust? Many events in the world have been documented in our history books, but sometimes forgotten. However, the reminisce of events that took place during the Holocaust are the ones that are never forgotten. Neither should the groups and countries that showed resistance towards Hitler. Because of the antipathy towards Hitler s regime, resistance towards Nazi’s and the Holocaust was a combined effort from many different groups andRead MoreThe Perceived Perception Of Propaganda968 Words   |  4 PagesQuotes†). During World War II, the economy in Germany was struggling severely and the Germans wanted someone to blame. Under Hitler’s rule, he gave Germany just that, causing the persecution of millions of Jewish people. During the Holocaust, the Nazis used propaganda as a tactic to help people deceive themselves; Germans, Jews, and people from all around the world were affected by this propaganda, among them, a Jewish survivor, Martin Kapel, whose life was thrown off co urse and impacted by Nazi idealsRead MoreThe Nazis And The Nazi Regime1729 Words   |  7 PagesThe Nazis, who came to power with the leader Adolf Hitler in Germany in January 1933, believed in a radical â€Å"genetic† restricting of society where ethnic cleansing of Jews was the main priority. Nazi regime wanted to make German Aryan race â€Å"superior† and the Jews were considered â€Å"inferior† within German racial community. The Holocaust was state-sponsored organized oppression and homicide of six million Jews by the Nazi regime. During the era of the Holocaust, German authorities also targeted otherRead MoreEssay on The Holocaust1633 Words   |  7 PagesThe Holocaust †We are the children of the holocaust. We are both Germans and Jews. We are the children of the victims. We are the children of the oppressors. We started out on opposite sides but the memory of the holocaust will join us forever. We shall never let the victims be forgotten, for if we do, we will forget that the perpetrator can be in all of us.† This poem expresses quite well the sensation that most individuals feel when they hear the word â€Å"Holocaust.† Although they may not haveRead MoreNazi Propaganda and The Holocaust Essay1047 Words   |  5 PagesNazi propaganda played an important role in the Holocaust, the extermination of millions based on race, religion, and ethnicity. It successfully secured the acquiescence of the general public to the crimes committed by the Nazis. The Nazi Party used their control of the media to fuel anti-Semitic belief and to persuade Germans to support the Nazi cause throughout the Holocaust and World War II. Although the Nazis were the largest political party in Germay, they did not win a majority of votes inRead MoreAnalysis Of Timothy Snyder s Book Bloodlands : Europe Between Hitler And Stalin975 Words   |  4 Pagescentury was a time of mass murders and totalitarian regimes. Many know of the atrocities committed under Hitler’s Nazi Germany and consider it to be the cause of the highest death count of the time. However, this may not be the case. Timothy Snyder argues in his book entitled Bloodlands: Europe between Hitler and Stalin that Hitler was not the sole bad guy of the time period. Despite the differing goals of Adolf Hitler and Joseph Stalin, the two regimes intertwined to create a death toll in the bloodlandsRead MoreThe Holocausts Effect on the German Jew Essay1745 Words   |  7 Pagestarget of the Holocaust, but why they were a large part of the years before, during, and after the Holocaust. Hitler’s â€Å"final solution† almost eliminated the Jewis h population in Europe during World War II. At the end of the war and along with his suicide, the Jewish population would survive the horror known as the Holocaust and the Jews would eventually find their way back to their homeland of Israel as well as find new communities to call home. Hitler’s rise to power before World War II was due toRead MoreEffects of War on Children: Comparing Experiences of Children During the Holocaust and Children Affected by the War on Terrorism1746 Words   |  7 PagesPope John Paul II once said â€Å"We wish to remember. But we wish to remember for a purpose, namely to ensure that never again will evil prevail, as it did for the millions of innocent victims of Nazism.† (Paul, 2000) This speech goes with all wars that occurred in the past and present. This synopsis will focus on the effects of war on children and the different ways they survived through it. It will compare the children of the Holocaust and the children of the war on terrorism. War has a great effectRead MoreThe Lord Of The Flies1111 Words   |  5 PagesThe Lord of the Flies Research Project While the World War II was in act, Adolf Hitler once incited â€Å"You only have to kick in the door, and the whole rotten structure will come crashing down†(Adolf Hitler). The structure coming down symbolizes the fact that the boys’ structure of order, and civilization came crashing down as well. This is found throughout the book. Adolf Hitler is known for his dictatorship, his exquisite leadership skills, and violent warfares.. He uncovered that leadership skillsRead MoreSenderS Profile Photofrank E. Smart. Holocaust Essay.1023 Words   |  5 Pages Sender s profile photo Frank E. Smart Holocaust Essay Mr. Grosse Feb 9 The Holocaust The Holocaust was the state-sponsored persecution also murder 6 Million Jews by the Nazi regimes. holocaust is also a Greek word meaning â€Å"Sacrifice by Fire†. The Nazi came in power in Germany in January 1933. They all believed that Germans was â€Å"Superior† and that the Jews, were also alien threating to call German racial community. In 1933, The Jewish population of Europe they all stood over nine million

Monday, May 18, 2020

Using Bonds for long term obligations of debt securities - Free Essay Example

Sample details Pages: 19 Words: 5640 Downloads: 1 Date added: 2017/06/26 Category Finance Essay Type Analytical essay Did you like this example? Bond are long term, fixed obligation debt securities which affordable to sale to individuals and financial institutions. Bond is totally different from other debt, this is because bond is not sold directly to a single lender, and it will sell to the public. Organization that issues the bond is organization that needs fixed income for a certain period of time. Don’t waste time! Our writers will create an original "Using Bonds for long term obligations of debt securities" essay for you Create order During issuing the bond agreement are made in paying a fixed amount of interest periodically to the holder of record or repay a fixed amount of principal at the date of maturity. Intrinsic features such as coupon, par value, maturity, principal value, and the type of ownership are the features of the bond. Coupon bond mean interest income, coupon income, or nominal yield. This coupon of bond is an income that an investor of a bond received over holding period of the issues. Maturity mean number of bond matures or expires. Principal or par value, of an issue represents the original value of the obligation. Company can have many different bond issues outstanding at the same time. Bond can be different type of collateral such as either be senior, unsecured, or subordinate (junior) securities. Fact, of bond Bond When a company (or government) borrows money from the public or banks (bondholders) and agrees to pay it back later Par Value company borrows the amount of money usually PV is RM1000 Coupon Payments The organization makes regular payments to the bondholders, for example for every year or every 6 month (interest income) Indenture A written agreement between the company and the bond holder. Coupon payments will be stated, and the payment period ,money (par value) will be paid back to the bondholder. Maturity Date Date when the company pays the par value back to the bondholder Market Interest Rate Yield (it changes everyday) 1.1 Background of the Study The bond market in Malaysia has developed significantly in terms of market size, range of instruments and efficiency. The development of the bond market centre on the need to establish a well-diversified financial base to meet the changing needs of the Malaysian economy. This paper is focusing on AMBANK 8.250% (30.09.2039) BOND. However, in bond market growth the major role in developing efficient bond market in Malaysia is our own government. Malaysian bond market today also a fastest growing bond market in Asia. As at end-Dec 2009, the size of the bond market reached RM643.8 billion, approximately 90% of GDP.   The bond market has a balance mix of both public sector and private sector bonds each contributing 53% and 47% share of total bond outstanding respectively. Today, the corporate bond market makes up approximately a quarter of the total debt financing (including bank loans) to the economy compared with around 10% in 1997.  A wide variety of debt securities pro ducts are available in the Malaysian bond market, such as fixed coupon bearing bonds, floaters, asset-backed securities, convertible bonds, callable bonds, etc. Bond issuers include, among others, the Government of Malaysia, Bank Negara Malaysia, quasi government institutions, corporations as well as multilateral development banks (MDBs). To date, a total of seven issuances of MDB bonds, totaling RM3.7 billion have been issued in Malaysia. More importantly, Malaysia, among the key Islamic financial centre, offers a wide variety of Islamic bonds that are based on Shariah compliant concept. As at end-Dec 2009, Islamic bonds accounted for 38% of total bond outstanding. 1.2 Background of the company This study involving 2 organization that are:- AmBank Group AmBank Group is the sixth largest banking group in Malaysia and comprises AMMB Holdings Berhad and its subsidiaries AmInvestment Group Berhad, AmBank (M) Berhad, and AmAssurance Berhad the organization established in August 1975. These group provides a wide range of investment banking, commercial banking, retail financing and related financial services, which also include Islamic banking, underwriting of general and life insurance, stock, share and futures broking, investment advisory as well as asset, property and unit trust management. AmBank Groups core philosophy incorporates a deep-seated commitment to the satisfaction of its wide range of customers, with numerous customer-driven initiatives woven into all forms of communication and interaction with all customer groups. AMMB Snapshot Total Assets RM96.5 billion Shareholders Equity RM9.6 billion Profit after Tax and Minority Interests RM1,008.6 million Ear nings Per Share 34.7 sen basic 774 ATMs and 189 branch offices nationwide at present Staff strength of ~ 10,000 Unless otherwise stated, all figures are accurate as at 31 March 2010 (AMMB annual report). Bond Pricing Agency Malaysia (BPAM) BPAM, under the name Bondweb Malaysia Sdn Bhd, was incorporated on 27th September 2004 under the Malaysian Companies Act 1965. The organization registered as a bond pricing agency (BPA) by the Securities Commission on 28th April 2006 and has met and exceeded the requirements as outlined in the Guideline on the Registration of Bond Pricing Agencies. 18th April 2006 then, BPAM was officially appointed as First Malaysian Bond Pricing Agency. Bondweb Malaysia Sdn Bhd changed it name on 15th September 2008 to BPAM. The name change comes at a time when BPAM aims to consolidate its position as the pioneering bond pricing agency and further strengthen its position by focusing on its core business evaluated bond pricing With this status, BP AM is recognized as one of the official sources for evaluated prices on MYR bonds. 1.3 Problem Statement Bond is a fixed obligation debt securities, where the issuer need the fixed income for a certain period of time. In the case of Ambank bond, which is not frequently issue mean it not facing requirement of money problem on it area. In arising question on to what Ambank bond price affected, this study is to test the relationship between Dependent Variable (Bond price) and the Independent Variable (Trade amount, common stock price, coupon bond, and yield) of Ambank Bond in Malaysian market. It is to measure whether the variable follow the economic theory and significant to the study. 1.4 Objective of the Study General Objective: General objective of this study is to investigate the selected parameters and identify the major factors influencing the price of the Bond. Specific Objective To determine whether the common stock price, coupon bond, yield, and trading amount is statistically significantly with price of bond for Ambank and the relationship between it variable. To examine whether Ambank bond is rapidly growing in the Malaysian bond market and is it one of the bond which contributed to the growing market as stated by BPAM (Malaysian bond market is expanding). 1.5 Scope of Study This study is in the area of Malaysian bond market, where the data also gathered from Bursa Malaysia, Bond Pricing Agency Malaysia, Bank Negara Malaysia and Data stream which available at UiTM Arau Perlis. In running the data, daily basis is used for not more than 1 year. However journal from local and foreign country are used as a references. The duration that taken into consideration is from 11/2/2009 until 28/12/2010, and it is focusing on AMBANK 8.250% (30.09.2039). 1.6 Significant of the Study The significant of the study is measuring the bond price valuation for Ambank bond using the available data, where only few researcher have done the research. Now, Malaysia practically issuing Islamic Bond, and Conventional Bond. In this paper the measurement is only AMBANK 8.250% (30.09.2039), bond instrument. From the data that been collected, the result is then being analyzed. The findings of this study are supported by journal from past researcher who is local researcher or foreign researcher. The significances are about whether the Independent Variable affects the Dependent Variable. 1.7 Limitation of the Study Limitation on this paper is on availability to get the data, because of the instrument is only traded when the company need money, it not frequently issue by the issuer. The full data is only offer to the organization and not to the individuals user. The full data can be assess at bond stream where only by permission of BAPM. The data is exactly same like data stream, but it only provided by BAPM. Another limitation is on journal as a reference; because of only using specific Malaysian country the journal available may be limited. More over it also the study of the AMBANK bond . Bond that available in trading during that time is active bond rating of A2. The name of the stock is  AMBANK 8.250% (30.09.2039), this bond maturity date is more than 15 year. Bond also can be categorized as complex instrument yet to be study, it because it consist of several component that may gives varies result from the past researcher. Bursa Malaysia and Bond Hub provide some info of the bond , but it is not too detail, so this will be the limitation on the study. 2.0 Literature Review (Varma, 1996),study toward dynamic Indian interest rate, and the paper contain an applicable method for pricing interest rate options in India and valuing bonds with embedded interest rate options. The Black-Derman-Toy model (Black et al.,1994) give the most attractive tool for valuing interest rate option in India. (Varma, 1996), summarize that Indian interest rates show strong mean reversion. Interest rates do volatile more when they are high rather than when they are low. In fact, the dynamic of interest rates is proportional to the level of interest rates so that the proportionate changes in interest rates (known as volatility) are level independent. This type of model was initially proposed by Brennan and Schwartz (1979).The normal rate to which interest rates mean-revert is itself changing over time, and it too undergoes mean-reversion to a grand normal rate, this past researcher result is taken by (varma,1996). Bond prices, as we all know do not follow random walk at all. Random walk mean an investment theory which claims that market prices follow a random path up and down, without any influence by past price movement. As the bond approaches maturity, its price approaches the redemption value and all uncertainty rapidly disappears. Researchers around the world have faced a great deal on determining the dynamics of interest rates. However, a recent study (Tse, 1995) of eight different models in eleven countries found that no model was valid in all countries. Each of the three most popular models found applicability in some countries, but each was rejected in half the countries, so this mean that because of the variability of interest rate it also not applicable to a certain country. Then (Lochoff, 1993) classified in several different ways one of it, the price model are classified endogenously derived the term structure of interest rate. Hence these models are guaranteed to provide correct pricing of straight bonds. However this topic is aggressiv ely argues in Dattatreya and Fabozzi (1989). Based on it, ( Black et al,1994) create tool for pricing interest rate option in India. Black-Derman- Toy model to value bond, however the researcher study valuation of three bond and resulted to: Straight bond Rs 5300 (equal issue price) Advertise bond Rs 6300 (19% above issue price) Actual Bond Rs 5050 (20% below advertised bond and 5% below issue price) interest rate is independent of their level, valuing bond can be complex and need multiple embedded option for valuation and in bond can make big difference to their valuation some result of certain bond can be grossly misleading. Shamsher Mohamad, Taufiq Hassan, and Mohamad Ariff (2007) find 50 listed firms has issues corporate bond and having the highest ratio of corporate bond issued per dollar of GDP among all the emerging markets. Malaysia has 37.3%, even though it only issued only after year 1999( IMF working paper : 152, 2005). Topic discuss, is applyin g research could search for the price value of re-rating of companies, the spread between different ratings and also premium price for the rating can be different during to local and foreign rating agencies. Normaziah, et al (2006) examine the stock price and volume of trade cover the announce of private placement in the market. It was discuss under topic of Private Equity (Seasoned Equity) Announcements. To subject were examine over different economic condition starting from placement exercise, and of premium and discounted offer price. Result show Significant negative price reaction was observed when private placement proceeds are earmarked for working capital requirements. However, when the proceeds are earmarked for investment, the short-term reaction around the announcement day is negative but there is significant positive reaction in the post-announcement period. The average volume of trade increased significantly for the entire analysis period. Edith Hotchkiss, Gergana Jostova (2007),study topic on determinant of corporate bond trading have obtained significant positive related to bond trading for all bond and regressions. Hotchkiss and Ronen (2002) document the bond and stocks react simultaneously to firm specific information. They also state that calculating price impact toward liquidity measure remains problematic due to infrequent trading in corporate bond. Kamara(1994) has measure of immediacy risk which risk that relate to the price volatility of the bond and the time needed to execute a trade, and also is reduced with higher trading volume. Harris and Raviv (1993) theorized on trading volume is positive affected by return, cause support by Alexander, Edward and Ferri (2000) who find trading increase with bond return volatility. For Gallant, Rossi and Tauchen(1992) observe positive relation between market volatility and trading volume of NYSE- trade stock, while Chordia, Roll, and Subrahmanyam (2000) and Engle and Lange(1997) found opposi te result. On the other hand, Fleming and Remolona (1999) concluded that price reaction to public info do not have any relationship to a trading volume, but it been argue by Dungey, Frino and McKenzie. There are positive relationship between volume and prices changes, Kocagil and Shachmurove (1998). Norliza Ahmad, Joriah Muhammad, and Tajul Ariffin Masron(2009) examines the impact on four macroeconomic factors such as, KLCI, IPI,CPI and interest rate (IR) on bond yield spread of MGS and Corporate bond (CB). They also have generated : Yield spread i, t = ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²0 +ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²1 CPIi, t + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²2 IRi, t + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²3 KLCIi, t + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²5 IPIi, t + ÃÆ'Ã… ½Ãƒâ€šÃ‚ µi, t , for their study. Where it is a multiple regression analysis. The duration of this study is from January 2001 until December 2008. They found the result of findings support that CPI and IR are the major drivers that influence the changes in MGS yield spread, finding that can take into consideration is IR, CPI and IPI which have weak and no influence on MGS yield spreads, but have significant affect on yield spread of CB. From Hale (2003), bond market is able to provide fund to corporations at low cost compared to loan provides by bank. Ameer (2007) obtained result, that there were an extreme limited number of empirical evidence concerning relationship between macroeconomic variable and bond market in Asian economic. Chan, Ahmad and Wooldridge (2007), found the changes in microstructure of the Malaysian corporate bond market has led to significant improvement in liquidity. From Thau (2001) stated three type of yield in relating to invest in bond, where first, coupon yield is interest paid to bond holder as percentage of bond par values, second yield being measure by annual coupon income divide by bonds market price and lastly YTM provides measure of bond return by estimating the total amount of income for the whole duration of bond hold then bo nd been compared to the prices. Faerber (2000) stated that the inverse relationship between market rates of interest rate and bond prices in which the increase in interest rate will cause in the decrease of bond prices. Also, when decrease in bond prices will translate into wide of the yield spread and vice versa. Bonds with shorter maturity period are less sensitive to fluctuations (Bodie et al., 2008). In supporting how coupon bond will affect the price of bond, we need to understand the time value of money, using present value formula we calculated the discounting future cash flow. It is based on the assumption that each payment is re-invested at some interest rate, and when it received known as future value. BOND PRICE = C + C + ÃÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦ÃƒÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦. C + M (1+i) (1+i)2 (1+i)n (1+i)n C = coupon payment n = number of payment i = interest rate / required yield M = value at maturity or par value Or C x 1 1 BOND PRICE = (1 + i)n + M : i (1+i)n This formula gathered from book : Analysis of Investment and Management of port folios(chapter 18: The Analysis and the Valuation of bond). 3.0 Research Methodology Using BPAM data and daily data gathered, from date 11/2/2009 until 28/12/2010, and as commonly know bond is not same like common stock, this is because it only be issues by organization in certain period of time. However in this study, analyzing is on the bond price changes daily due the population of bondholder seems to grows from time to time which clearly show in the changes of the amount trading and rise on the price. The method is using secondary data, where it from government publication, the financial institution and website related. But some data is manually gathered at Uitm Perlis using data stream. 3.1 Data Collection Data are obtained from: Data stream which available at Uitm Perlis. (Price of common stock daily for Ambank) Bond pricing agency Malaysia, the daily trade list in secondary priority and active bond ( Internet Sources). Bank Negara Malaysia website. Website for certain journal and article as a reference. 3.2 Data Analysis and Findings 3.2.1 Multiple Regression Analysis This study is using multiple regression analysis, which mean more than one independent variables are used. The statistical test provided in regressing the data is coefficient value, R-squared, F-statistic, T-statistic and few other important statistics. Statistical Package for Social Science (SPSS) is conducted to get the result. The simple regression is as follow: Y = ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²0 + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²1X1 + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²2X2 + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²3X3 +ÃÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦.ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²nXn + ÃÆ'Ã… ½Ãƒâ€šÃ‚ µ Where, Where ; Y = Dependent variable X1,X2,X3ÃÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦Xn = Independent variables ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²0 = Intercept term or constant value ÃÆ'Ã… ½Ãƒâ€šÃ‚ ² = Coefficient for the independent variables ÃÆ'Ã… ½Ãƒâ€šÃ‚ µ = Error term 3.2.2 Regression Equation Regression equation shows that the relationship between independent variable and dependent variable. Two relationship may exist between them either positive relationship or negative relationship. Positive relationship indicates that an increase in independent variable, dependent variable will also increase. Whereas negative relationship indicates that an increase in independent variable, dependent variable will decrease. 3.2.3 Coefficient of Determination (R-Squared) R- squared is used to measure how well the overall equation explains changes in the dependent variables or know as goodness of fit. R ² = Total explained variation Total variation 3.2.4 T-statistic The T-statistic is used in the t-test to determine if there is a significant relationship between the independent and each independent variable. To carry out this Test, Standard error of coefficient (s) is needed to calculate the t-value. t- value = b S.e (b2) t- critical = t a /2, n-k-1 The critical value from t-distribution table with degree of freedom at 95% confidence interval will be used. Degree of freedom = n k 1 Hypothesis will be tested either to accept Null hypothesis or Alternate hypothesis. Accept Ho when observed T-statistic Critical T-Statistic Accept H1 when observed T-statistic Critical T-statistic The critical value for sampling at a = 0.05 with level of significant two tailed test. 3.2.5 F-Statistic F-statistic provides an overall appraisal of the regression equation to evaluate the significant of each individual component to the entire regression model. F = explain variation / ( k 1) Unexplained variation ( n k) Accept Ho when Observed F-statistic critical F-statistic Accept H1 when Observed F-statistic critical F-statistic 3.3 Theoretical Framework Common Stock Price Coupon Bond Price of bond Yield ( market rate of interest) Volume Traded Independent variable dependent variable 3.4 Hypothesis The purpose of hypothesis testing is to determine which of the hypothesis is acceptable. Ho : assigned the null hypothesis H1 : represented the alternate hypothesis 1. H0= CSP is not statistically significant to bond price H1 = CSP is statistically significant to bond price 2. H0= CB is not statistically significant to bond price H1 = CB is statistically significant to bond price 3. H0= INT is not statistically significant to bond price H1 = INT is statistically significant to bond price 4. H0= TA is not statistically significant to bond price H1 = TA is statistically significant to bond price 4.0 Data Analysis and Findings The data has been analyzed using Statistical Package for social science (SPSS) Software. In the data and finding the data is a) Measure the overall goodness of fit of the regression model by the coefficient of determination, R ². b) Examine the possible relationship between each independent variable on dependent variable using coefficient relationship. c) Using t-statistic to examine the significant relationship of each independent variable toward dependent variable. d) To examine the combination of independent variable that can be used as predictors to the dependent variables using F- Statistics 4.1 Regression Equation Regression linear function derived as : General function : f (CSP, CB, INT, TA) Multiple Regression Equation : Y = ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²0 + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²1CSP + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²2CB + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²3INT + ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²4TA + ÃÆ'Ã… ½Ãƒâ€šÃ‚ µ BP = -4.476 + 0.866 CPS 0.509CB + 14.064 INT + 0.285 TA + ÃÆ'Ã… ½Ãƒâ€šÃ‚ µ ÃÆ'Ã… ½Ãƒâ€šÃ‚ ²0 = constant value BP = Bond price CSP = Common Stock Price CB = Coupon Bond INT = Market Interest Rate (Yield) TA = Trading Amount 4.2 Research Analysis Table below show the result of regression output as stated VARIABLE CONSTANT CSP CB INT TA Beta -4.476 0.866 -0.509 14.064 0.285 t statistic -4.271 4.339 -2.293 51.388 4.742 TABLE 1 R2 = 0.98903 Adjusted R2 = 0.98890 F-statistic = 7799.50 The coefficient determination or R2 in Bond Price is 98.903%, more than 98.903% can be explained by common stock price, coupon bond, interest rate and trading amount. Another 1.097% is unexplained. The adjusted R2 show 98.890% it mean more than 98.890% can be explained by common stock price, coupon bond, interest rate and trading amount. Where another 1.11% is unexplained. Adjusted R2 is 98.890 % which is lower than R2. This is because if we add another variable (1- R2) will decrease and (n-k) will also decrease. The rises or fall of adjusted R2 and R2 is depend on the contribution of new variable to the fit of the regression more than offset the loss of degree of freedom. The coefficient of determination fit the model well, because the value more than 50%. Beta analysis (coefficient) is to examine the possible relationship between each independent on the dependent variable. From the result obtained, increase of 1 unit in common stock price will increase 0.866 units in bond price. This mean that this two variables also have positive relationship and it show the economic theory are not followed from past researcher result would be inversely relation ship but in this study, due to limitation of data the result might be affected using SPSS. This is because, when the price of bond increase, common stock price will decrease in order to make the investment equally attractive. In addition, during this time, Malaysian Bond Market is still recovering from the economic crisis that is on 2008. The economic crisis at the previous year are giving huge impact on the Malaysian economic, however most of investment instrument is having increasing in it own market. From the result obtained, it shows that increase by 1 unit of coupon bond, bond price will decrease 0.509 units . Mean that the two variables have negative relationship and it is consistent with the economic theory. This is because, only active bond are been consider and bond is daily traded and have maturity, it only being issue when organization need money, bond also long term debt and the bond rating constantly A2. The result from this finding is also because bond price is not following random walk theory, in the agreement bond holder will be paid constantly until maturity date. Instead using CB, YTM can also be used, and maybe the result can also be a positive relationship. From the result obtained, increase of 1 unit in yield will increase 14.064units in bond price. This mean that these two variables have positive relationship and it not follow the economic theory. Suppose high interest rate will give low value of bond, and low interest will give high value of bond or vice versa. However, bond is complex instrument, the relationship can also be explained by maybe there were modified d uration and cause convexity effect. Convexity is curvilinear relationship so this is maybe the reason it is not follow the economic theory. For trading amount, clearly picture that increase by 1 units of amount trade will increase 0.285 units of bond price for Ambank. This shows that, it has positive relationship and follows the economic theory. From the literature review there is some evidence that trading amount affect the bond price and till now it still being argued that whether trading amount have no relationship with bond price or connected to the bond price or also knows as price volatility. 4.3 T-statistic To examine the significant relationship of each independent variable toward dependent variable. From the t-distribution table, the book t-value is 1.960 at 95% confidence interval level. VARIABLE T-STATISTIC FINDINGS CSP 4.3391.960 Statistically significant CB -2.2931.960 Statistically significant INT 51.3881.960 Statistically significant TA 4.7421.960 Statistically significant TABLE 2 4.3.1 T-statistic for common stock price (CSP) From the above table, the calculated t-value is higher than the book t-value (4.339 1.960) at 95% confidence interval. 1. H0= CSP is not statistically significant to affect Ambank bond price in Malaysian market. H1 = CSP is statistically significant to affect Ambank bond price in Malaysian market. Discussion : accept H1 CSP is statistically significant and affect the bond price in Malaysian bond market. This result can be supported by Normaziah, et al (2006) examine the stock price and volume of trade cover the announce of private placement in the market. It was discuss under topic of Private Equity (Seasoned Equity) Announcements. To subject were examine over different economic condition starting from placement exercise, and of premium and discounted offer price. Result show significant negative price reaction was observed when private placement proceeds are earmarked for working capital requirements. TREND FOR AMBANK COMMON STOCK PRICE AND BOND PRICE IN THE STU DY TIME PERIOD BOND PRICE GRAPH 4.3.1 From the graph above, the result is significant to the study. As we can see when the price of common stocks is higher the price of bond will be lower. This can clearly picture from the price trend above, it is the nature of bond price and common stock price to affect each other and the reason is to make both of them equally attractive. 4.3.2 T-statistic for coupon bond (CB) From the above table, the calculated t-value is higher than the book t-value (2.293 1.960) at 95% confidence interval. 2. H0= CB is not statistically significant to affect Ambank bond price in Malaysian market H1 = CB is statistically significant to affect Ambank bond price in Malaysian market Discussion : accept H1 CB is statistically significant and affect the bond price in Malaysian bond market. This can be proved by formula in calculating the bond price using present value (PV). BOND PRICE = C + C + ÃÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦ÃƒÆ' ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬Ãƒâ€šÃ‚ ¦. C + M (1+i) (1+i)2 (1+i)n (1+i)n C x 1 1 BOND PRICE = (1 + i)n + M i (1+i)n where, C = coupon payment n = number of payment i = interest rate / required yield M = value at maturity or par value Or TREND FOR AMBANK COUPON BOND AND BOND PRICE IN THE STUDY TIME PERIOD AMBANK BOND GRAPH 4.3.2 From the above graph, the result from the regression using SPSS is si gnificant to the study. However because of the data using fixed coupon bond the result may varies from other previous researcher who is maybe using zero-coupon or other coupon bond that available. In supporting the result, what we need to be consider is in calculation of Bond Price using present value formula. 4.3.3 T-statistic for market interest (yield/INT) From the above table, the calculated t-value is higher than the book t-value (51.388 1.960) at 95% confidence interval. 3. H0= INT is not statistically significant to affect Ambank bond price in Malaysian market H1 = INT is statistically significant to affect Ambank bond price in Malaysian market Discussion : accept H1 INT is statistically significant and affect the bond price in Malaysian bond market. It can be support by Faerber (2000) stated that the inverse relationship between market rates of interest rate and bond prices in which the increase in interest rate will cause in the decrease of bond prices. TREND FOR AMBANK INTEREST AND BOND PRICE IN THE STUDY TIME PERIOD GRAPH 4.3.3 From the above graph, the result from regression is not consistent with economic theory, however from the data gathered and graph show that is when price of bond increase, the interest rate will decrease same as nature of coupon bond. From the graph this mean it affect the bond price and support by most researcher result. 4.3.4 T-statistic for trading amount (TA) From the above table, the calculated t-value is higher than the book t-value (4.7421.960) at 95% confidence interval. 4. H0= TA is not statistically significant to affect Ambank bond price in Malaysian market H1 = TA is statistically significant to affect Ambank bond price in Malaysian market Discussion : accept H1 TA is statistically significant and affects the bond price in Malaysian bond market. Support by Dungey, Frino and McKenzie(n.d). There are positive relationships between volume and prices changes. TREND FOR AMBANK VOLUME TRADING AND BOND PRICE IN THE STUDY TIME PERIOD VOLUME GRAPH 4.3.4 From the above graph, we can clearly see that bond price is increasing, and the trading amount is not frequently trade by the issuer. This is one of the reason why some past researcher state trading amount is not giving any impact or affect the bond price, but some says otherwise. 4.4 F-statistics Book F- value : Fa (k 1, n k) : F 0.05 (5-1, 351-5) : F 0.05 (4,346) : 2.46 Computed F-value is greater than book F-value (7799.504 2.46), mean that all the independent variable (CSP, CB, INT and TA) are statistically significant. H0= All the independent variable are not statistically significant to affect Ambank bond price in Malaysian market. H1 = All the independent variable are statistically significant to affect Ambank bond price in Malaysian market. From the result, the result would be accept H1 and reject H0 since it significant for the overall model. All the independent variable are statistically significant to affect Ambank bond price in Malaysia. Second objective of this study is achieved where Ambank bond is one of the bond that contributed to the rapid growing of Bond Market in Malaysia. TREND FOR AMBANK 8.250% (30.09.2039) BOND PRICE (STUDY PERIOD) GRAPH 4.4 From the graph above, it show that the Ambank Bond price is increasing so this can relate to second objectiv e, where Ambank bond is rapidly growing in the Malaysian bond market and is it one of the bond which contributed to the growing market as stated by BPAM (Malaysian bond market is expanding). From the graph it also strongly agrees to F-statistic result that all the independent variable are statistically significant to affect Ambank bond price in Malaysia. 5.0 Conclusion and Recommendation 5.1 Conclusion In conclusion, this paper can be summarized as, the research examines the relationship of some bond variable features that may affect the bond price in Malaysian market from time period not more than one year, this study is using daily data from 11/02/2009 to 28/12/2010. Bond in Malaysia is now rapidly in growing to be efficient market so it is an interesting topic need to be study. In conducting this study, Statistical Package for social science (SPSS) Software is used. Using independent variable such as common stock price, coupon bond, interest rate (yield) and amount of trading to measure the relationship where price of bond will affect by the variable. On conducting this data, the Multiple Regression Analysis technique was applied to examine the relationship between the dependent and independent variable. In measuring the relationship, statistic analysis is generated using Statistical Package for Social Science (SPSS). It been measure in term of Coefficient of Determinati on ( R2 ) , T-test (T-statistic), and F-test ( F-statistic). Based on Multiple Regression Analysis result, there is positive relationship between common stock price to the bond price of Ambank bond. However it not follows the economic theory, because many researcher and price theory stated it should be inversely relation, where stock price increase bond price will decrease, or vice versa. This result also hard to argue because of little number of researches done in Malaysia or Foreign. There also a positive relationship, between coupon bond and price of the bond, this can clearly support by present value formula. Coupon bond always connected to it maturity period. Coupon bond in this study is fixed, so the result may varies from other researcher. However it as discuss before coupon bond will reduce the bond price until it reach maturity. However, on finding toward interest rate, it is still positive relationship, but the result is not following the economic theory, suppose increase in interest will lower the value of the bond price, and vice versa. This result can be support by researcher as stated in literature review. Trading amount has positive relationship based on the finding, but result may varies from regression analysis. In this finding, we can see that it follow economic theory, where increase in amount trade also can increase the price of bond. The Coefficient of Determination ( R2 ) show from the findings is more than 50%, so the variable fit the model well. Lastly, the F-statistic result or also known as overall test for all dependent is statistically significant. Second objective that is to examine whether Ambank bond is rapidly growing in the Malaysian bond market and is it one of the bond which contributed to the growing market as stated by BPAM (Malaysian bond market is expanding) is proved, from the regression analysis of overall test is significant and the bond price trend can show the increasing price for Ambank bond. Mean it contributed to the expanding Malaysian bond market. 5.2 Recommendation Some recommendation can be made from this study: It is suggested that a longer time frame should be based for this study because bond is not frequently issued and if there a longer time frame it can may give the best result for the findings. The next research can take other economic variable as a measurement, because today Malaysian also issues Islamic and Conventional bond. These type of bond may have difference variable that can be taken into consideration. It is suggested, to do more research on bond, because there only few research that have done from previous period. So in the future it can be interesting subject to study and it also can be as future references. It is suggested that availability of the bond stream in the institution, so that the research will be more accurate in the future and finding will also significant to be study. This is because the data is only offer to the institution where it is same as the data stream provided.

Tuesday, May 12, 2020

Euthanasi An Alternative Mode Of Life Care - 1769 Words

End of life care is a prevailing issue in the United States that affects the terminally ill. It includes physician-assisted suicide, which is legal in five states and the practice of euthanasia which is illegal. (Barone, 2014). Delving deeper into the issue of end of life care reveals that this issue affects far more than the patient that is suffering. It raises the question of whether or not it is acceptable to reject the request of a person based solely on the socio-religious values of protecting life and ignoring the moral responsibility of ending the misery of another person even when they explicitly ask to end their suffering. Terminally ill, elderly, or disabled patients that are aware of the physical and mental deterioration caused†¦show more content†¦Patients, families, and physicians that oppose physician-assisted suicide, can seek alternative modes of end of life care, such as palliative care which intends to control suffering and not hasten the death of the patie nt. Physician-assisted suicide and its alternatives are options for competent patients to hasten death; however, what are the moral and ethical implications of such practices? Many people, young and old who are terminally ill or are facing a debilitating disease continually look for a way to ameliorate their pain and suffering. When the options for cure or successful recovery are bleak, the patient may ask for physician-assisted suicide. It is a procedure done with the consent of the patient and the patient administers the lethal dose. Physician-assisted suicide was first legalized in Oregon and four other states followed suit in 2008, legalizing physician-assisted suicide either through legislation or case ruling: Vermont, Washington, New Mexico, and Montana (Gonchar, 2014). Physicians in these five states are protected under the law, allowing them to write prescriptions for lethal medication if a terminally ill patient makes a request. The prescription drug administered by doctors to patients used to be pentobarbital, but is now out of production and instead doctors give secobarbital; the drug consists of a lethal dose of barbiturates, which ultimately l ead to the cessation of brain and nervous system activity (Barone, 2014). A common misconception

Wednesday, May 6, 2020

Gender And Sexuality During Medieval Europe - 1886 Words

Insert Title of Paper Here Sophia Lisowski History 302: Gender and Sexuality in Medieval Europe Dr. Susanna Throop October 4, 2014 Many historians have attempted to decipher the medieval body, especially the body of medieval women. The knowledge of what constitutes a body and how it works plays into major aspects of a society such as religion, science, and politics. Demystifying how medieval Europe defined the bodies of women can help provide an explanation for how this time period viewed sex and subsequently placed people into specific roles. While there was no concept of biological sex or gender during this expansive period of time, it is clear that biological sex was a determining factor of who a person could or could not be. As it is a very difficult task to study history objectively (one could argue it is impossible), it is common to compare these medieval bodies to our own. That is why it is important to question how medieval bodies were perceived, and why. 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Bony Anatomy The Knee Joint Health And Social Care Essay Free Essays

Introduction The undermentioned chapter intends to supply an overview of current literature pertinent to this survey. A brief lineation of related anatomy and biomechanics of the articulatio genus articulation will be discussed, every bit good as a theoretical association of articulatio genus degenerative arthritis and the lower kinetic concatenation. The clinical, aetiological and epidemiological facets of degenerative arthritis of the articulatio genus will be provided, along with the possible effects that assorted intervention option may hold on this disease. We will write a custom essay sample on Bony Anatomy The Knee Joint Health And Social Care Essay or any similar topic only for you Order Now Anatomy 2.2.1 Bony Anatomy of the Knee Joint The articulatio genus joint maps chiefly as a big hinge-type articulation, dwelling of three articulations ; two tibiofemoral articulations between the medial and sidelong femoral and tibial condyles, and one patellofemoral articulation between the posterior facet of the kneecap and thighbone ( Moore and Dalley, 1999 ) . Due to the comparative incongruence of the articulating surfaces, the articulatio genus articulation composite is inherently unstable, hence two fibrocartilage phonograph record ( semilunar cartilage ) exist in the infinite between the shinbone and thighbone, are attached to the intercondylar distinction of the shinbone, and farther addition the congruency of the joint every bit good as provide extra stableness ( Magee, 2008 ) . In add-on to the semilunar cartilage, legion environing ligaments play an of import function in stabilization of the articulatio genus. The name, location and specific map of these ligaments are outlined in the tabular array below. Table 2.1.1 Name Location and maps of articulatio genus ligaments Name Location Function Medial ( tibial ) collateral ligament ( MCL ) Anchored superiorly to the median femoral epicondyle, inferior to the adductor tubercle, and descends anteriorly to attach to the median border and median surface of the shinbone above and behind the fond regard of sartorius, gracilis, and semitendinosus sinews. Attaches by much of its deep surface to the underlying hempen membrane of the median semilunar cartilage. Stabilises the hinge-like gesture of the articulatio genus and prevents knee abduction Lateral ( fibular ) collateral ligament ( LCL ) Attaches superiorly to the sidelong femoral epicondyle, superior to the channel for the popliteus sinew. Inferiorly, it is attached to a depression on the sidelong surface of the fibular caput. It is separated from the hempen membrane by a Bursa Stabilises the hinge-like gesture of the articulatio genus and articulatio genus adduction. It is stronger than MCL Anterior cruciate ligament ( ACL ) Attaches to a aspect on the anterior portion of the intercondylar country of the shinbone and ascends posteriorly to attach to a aspect at the dorsum of the sidelong wall of the intercondylar pit of the thighbone Complect the thighbone and shinbone, stops tibia traveling frontward on thighbone, and prevents hyper-extension and inordinate internal rotary motion. ACL crosses sidelong to the PCL as they pass through the intercondylar part Articular capsule and the Bursa Articular capsule presents merely at the sides and posterior facets of the articulatio genus, where it covers the majority of the femoral and tibial condyles. It is stabilised and straighten by the joint ligaments and the musculus sinews. Bursa are extensions of the articulatio genus synovial pit and are filled with synovial fluid The capsule consists of an external hempen bed ( hempen capsule ) and an internal synovial membrane, which is uninterrupted with the synovial liner of the Bursa. They act to cut down clash between the sinews and implicit in castanetss ( hypertext transfer protocol: //andme26.hubpages.com/hub/Anatomy-of-the-knee-Bones-Muscles-Arteries-Veins-Nerves ) 2.2.2 Neurovascular Structures Table 2.1.2 Neuravascular constructions of the articulatio genus 2.2.3 Lower Limb Musculature The primary musculus groups responsible to making motion at the articulatio genus articulation are the quadriceps femoris ( extension ) and hamstrings ( flexure ) . The fond regards, excitation and action of the single musculuss within the quadriceps and hamstring are described in Table 2.1.3.1 and Table 2.1.3.2, severally. Table 2.1.3.1 Attachments, Innervation and Action of Quadriceps Femoris Components Muscle Proximal Attachment Distal Attachment Excitation Action Rectus Femoris Anterior inferior iliac spinal column and Troy superior to acetabulum Via a common sinewy interpolation to the base of kneecap ; indirectly via patellar ligament to tibial tubercle Femoral Nerve ( L2, L3, L4 ) Extend leg at articulatio genus articulation ; rectus femur besides steadies hip articulation and helps iliopsoas musculus flex the thigh Vastus Lateralis Greater trochanter an sidelong lip of linea aspera of thighbone Vastus Medialis Intertrochanteric line and median lip of linea aspera of thighbone Vastus Intermedius Anterior and sidelong surfaces of shaft of thighbone ( Table abridged from Moore and Dalley, 1999 ) Table 2.1.3.2 Attachments, Innervation and Action of Hamstrings Components Muscle Proximal Attachment Distal Attachment Excitation Action Semitendinosus Ischial tubercle Superior portion of shinbone on median surface Tibial division of sciatic nervus ( L5, S1, S2 ) Extend thigh ; flex leg and revolve it medially when articulatio genus is flexed Semimembranosus Ischial tubercle Posterior portion of shinbone on median condyle Bicepss Femoris Long caput: ischial tubercle Short caput: linea aspera and sidelong supracondylar line of thighbone Fibula on sidelong side of caput Long caput: Tibial division of sciatic nervus ( L5, S1, S2 ) Short caput: Common fibular division of sciatic nervus ( L5, S1, S2 ) Extend thigh ; flex leg and revolve it laterally when articulatio genus is flexed ( Table abridged from Moore and Dalley, 1999 ) 2.2.4 Lower Limb Biomechanics The primary motions of the articulatio genus are flexure and extension, with a smaller rotational constituent when the articulatio genus is flexed ( Moore and Dalley, 1999 ) . Table 2.1.4 outlines the chief motions of the articulatio genus articulation, every bit good as the name and action of the musculus bring forthing them. Table 2.1.4 Motions of the articulatio genus Motion and scope of motion Name Action Knee flexors 135A °-150A ° 1. Hamstrings ( semitendinosus, semimembranosus, biceps femoris ) 2. Popliteus Flexs and rotes leg medially, locks and unlocks the articulatio genus from beginnings of flexure Knee extensors 0A °-10A ° Quadricepss femoris ( rectus femur, vastus lateralis, vastus medialis, vastus intermedialis ) extends leg, ( but flexes thigh by action of rectus femur ) Medial rotary motion 0A °-10A ° Popliteus ( non-weight bearing articulatio genus extended ) , or semitendinosus and semimembranosus ( when knee flexed ) Weakly flexes articulatio genus, unlocks knee by revolving femur 5A ° laterally on fixed shinbone Lateral rotary motion 0A °-30A ° Bicepss femoris ( when knee flexed ) Weakly flexes articulatio genus, unlocks knee by revolving femur 5A ° medially on fixed shinbone ( hypertext transfer protocol: //andme26.hubpages.com/hub/Anatomy-of-the-knee-Bones-Muscles-Arteries-Veins-Nerves ) The comparative incongruence of the articular surface consequences in the articulatio genus being comparatively weak automatically, and a greater trust on the actions of environing musculuss, sinews and ligaments for strength and support ( Magee, 2008 ) . The anterior thigh musculuss are the most critical of these supports, with the quadriceps femoris musculuss being the most of import stabilizer of the articulatio genus articulation ( Moore and Dalley, 1999 ) . Because of the fond regard of the quadriceps femoris musculus across two articulations, it is capable of bring forthing action at both the hip and the articulatio genus ( Moore and Dalley, 1999 ) . The three vastus musculuss ( vastus intermedius, vastus medialis and vastus lateralis ) form the primary extensor musculus group of the articulatio genus ( Moore and Dalley, 1999, Magee, 2008 ) . The rectus femoris division of the quadriceps femoris musculus Acts of the Apostless, along with the iliopsoas, to flex the hip ( Moore and Dalley, 1999 ; Marieb, 2004 ) ; therefore its ability to widen the articulatio genus is compromised when the hip is flexed. As a consequence, the ability of the quadriceps femoris musculus group to bring forth knee extension is most effectual when the hip articulation is extended ( Moore and Dalley, 1999 ) . The hamstrings musculus group produces extension at the hip and flexure at the articulatio genus ( Moore and Dalley, 1999 ; Marieb, 2004 ) . These two actions of the hamstrings can non be performed maximally at the same clip, as full flexure of the articulatio genus requires so much shortening that the hamstrings can non supply the extra contraction needed for full extension of the hip, and frailty versa ( Moore and Dalley, 1999 ) . The hamstrings, nevertheless, demonstrate most activity when they are eccentrically undertaking to defy hip flexure and articulatio genus extension ( Moore and Dalley, 1999 ) . A survey by Wilson et Al ( 2011 ) aimed to look into the correlativity between articulatio genus articulation biomechanics and neuromuscular control and moderate articulatio genus degenerative arthritis radiographic and pain badness, higher articulatio genus adduction minutes ( during stance stage ) and lower articulatio genus flexure angles ( full pace rhythm ) were associated with higher RVAS. Higher hurting tonss were associated with lower pace velocities and reduced activation of the sidelong gastroc between early and late stance stage, which the writers suggested may be a mechanism to antagonize high median compartment articulation burden. Additionally, increased activation of the median hamstring between early stance stage and toe off may be declarative of higher coactivity of these musculuss in a guarding mechanism to increase joint stiffness and cut down the hurting, and perchance to compensate joint instability. 2.2.4.1 Kinetic Chain Theory The kinetic concatenation is defined as â€Å" a combination of several in turn arranges myofascial, articular and nervous constituents, representing a complex unit † ( Bergmann A ; Peterson, 2002 ) . In order for this system to map, it requires optimum alliance, mechanics and enlisting of these articulations. There are 3 sub-systems within a kinetic concatenation ( active, inactive and nervous ) , all of which contribute to the production of motion: In the lower limb there exists a functional relationship between the articulatio genus and the superior articulations in the hip and lumbopelvic spinal column, every bit good as the pes and mortise joint, inferiorly. When the pess are weight-bearing, the kinetic concatenation is closed and the links map interdependently, with a alteration in one articulation ensuing in an immediate consequence on the kinematics of other articulations in the concatenation. Therefore, a disfunction in the articulatio genus can hold a direct consequence on next articulation in the concatenation, and frailty versa. This highlights the importance of turn toing non merely the country of ailment, but besides next parts to rectify any potentially altered biomechanics of the kinetic concatenation in entirety. Overview of Osteoarthritis of the Knee Epidemiology Incidence and Prevalence By the age of 60 old ages, about 100 % of the population will hold histologic alterations of devolution in their articulatio genus gristle, over 80 % will hold radiographic grounds of OA in at least one articulation, about 40 % will describe clinical symptoms of arthritis, and 10 % will see activity restriction ( Loeser 2000 ) . Hazard Factors Harmonizing to the Framingham degenerative arthritis survey, the major hazard factors for KOA were age, female gender, fleshiness, non-smoking, occupational articulatio genus bending, physical labor, and chondrocalcinosis ( Felson 1993 ) . Other hazard factors identified are listed in the tabular array below. Table 2.2.1 Hazard factors and Protective factors for KOA harmonizing to the Framingham OA survey Hazard factors Age Female gender Geneticss Race Geographic Fleshiness Major articulation injury Occupational Immobilization High bone mineral denseness Joint hypermobility A ; instability Insistent articulation usage Peripheral neuropathy Prior inflammatory articulation disease Congenital/developmental defects Crystal deposition in articulations Oestrogen surplus Diabetess, high blood pressure, hyperuricaemia Protective factors Smoking Osteoporosis Weight decrease Age: Age is the strongest hazard factor for OA, with an addition in prevalence of diagnostic OA from 7.0 % in those aged 63-69 old ages old to 11.2 % in those over the age of 80. Radiographic grounds of OA increased from 27.4 % amongst those in their 1960ss compared to 43.7 % prevalence in those in their 1880ss ( Felson 1987 ) . Gender: Age related increased in OA were found to be more evident in females ; non merely with respect to incidence, but besides in badness and rate of patterned advance ( grade 3/4 alterations increased in prevalence by 7.9 % from the 6th to eighth decennary of life ( Felson 1990 ) . Although there was small or no difference in gender prevalence of mild OA ( Roberts 1996 ) , females tended to hold more terrible OA, a greater figure of joint engagements, more symptoms, and a higher prevalence of manus and articulatio genus OA ( Kellgren-Lawrence 1963 ) ( Felson1995 ) . Recent surveies suggest that post-menopausal oestrogen lack may play a function in development of KOA in older adult females ( Nevitt 1996 ) . Males, nevertheless, had an increased prevalence of hip OA ( particularly in those aged 55 and supra ) ( Kellgren-Lawrence 1963 ) Fleshiness: Fleshiness is the strongest modifiable hazard factor for development of KOA, particularly in adult females ( Loeser 2000 ) . Harmonizing to the Framingham survey, higher organic structure mass index ( BMI ) was associated with an odds ratio of 1.6 per 5-unit addition in BMI. Similarly, a weight loss correlated to a 40 % lessening in hazard of KOA per 10-lb ( ~4.5kg ) weight loss ( Felson 1988/1997 ) . Hazard for development of KOA increased exponentially when fleshiness was present with an extra hazard factor, such as heavy physical activity. Aged patients in the upper tertile of BMI who performed at least 3 hours of physical activity daily had an odds ratio of 13 for development of KOA ( McAlindon 1999 ) . Major joint injury: The comparative hazard for development of radiographic KOA following meniscectomy for direction of stray meniscal cryings was 14 ( Roos 1998 ) . Surveies besides suggest that quadriceps failing increased the hazard of both radiographic and diagnostic OA ( Slemendra 1997 ) . Insistent articulation usage: While there is deficient informations to propose that featuring activities may take to generalised OA ( Lane 1993 ) , it has been shown that certain businesss may do the overexploitation of peculiar articulations, therefore increasing the hazard of development of localized OA ( Croft 1992 ) . For illustration, occupational articulatio genus bending is strongly associated with KOA and mineworkers frequently exhibit marks of spondylosis ( Felson 1990 ) . Muscle dysbalance A ; wasting: Muscles play a major function in joint biomechanics as the green goods motions, absorb burden, and supply dynamic joint stableness. It is therefore possible that musculus failing due to aging or anterior injury my consequence in loss of the protective musculus control, inordinate joint motion and instability ( Slemendra 1997 ) . Ultimately this will do stress-induced microtrauma of the articular gristle due to the increased happening in physiological shear and extremum articulation forces. Over an drawn-out period of clip, this microtrauma will do gristle devolution, with pathological subchondral force per unit area addition and attendant subchondral induration, and joint prostration with axis maldeviation ( mention ) . Slemenda et Al. conducted a prospective survey in which reduced articulatio genus extensor strength was present in those topics who developed OA as compared to the unaffected participants ( Slemendra 1998 ) . Similar findings were seen in a survey by on patients with one-sided mortise joint OA, in which the affected side displayed reduced calf perimeter and decreased electromyography ( EMG ) frequences of lower leg musculuss ( Valdererrohano 2006 ) . In a healthy person, musculus biopsies have shown wasting of type-1 musculus fibers ( slow-twitch ) in the vastus lateralis following periods of articulatio genus immobilization. In KOA patients nevertheless, failing of the vastus lateralis was largely due to type-2 fiber wasting ( Nakamara and Suzuki 1992 ) . Fink et al so investigated the structural alterations in the vastus medialis and found type-2 fiber wasting in all specimens ( which was consistent with informations from Nakamara ) every bit good as extra type-1 fiber wasting in 32 % of patients ( Fink 2007 ) . Exercise preparation has been found to increase diameter of both type-1 and type-2 musculuss fibers ( Saltin 1977 ) , and was therefore the recommendation of the writers in order to antagonize the musculus wasting and therefore protract the oncoming of OA. As musculuss increase in size with exercising, it is suspected that wasting in creaky patients is non merely caused by neglect in the presence of joint stiffness and hurting, but besides by age-related sarcopenia ( generalized loss of skeletal musculus mass ) , physical immobilization and decreased physical activity ( Goodpaster 2006 ) . This musculus wasting, irrespective of its causative pathomechanism, has been found to be strongly correlated to the development of OA. Since exercising additions muscle mass and improves musculus map, it is likely to play an of import function in intervention and bar of OA. Pathology OA is characterised by focal loss of gristle with grounds of attach toing periarticular bone response. Clinically, it presents as joint hurting and crepitus in the aged age group, and is radiographically characterised by reduced joint infinite, osteophytes and a assortment of malformations that develop as the disease progresses. Pathogenesis and Morphology Normal hyaline gristle comprises chondrocytes ( 1-2 % ) embedded in extra-cellular matrix, which in bend is constituted by H2O, type-II collagen and proteoglycans. Articular gristle performs two chief maps: 1 ) along with synovial fluid, it provides virtually friction-free motion within the joint ; and 2 ) in weight-bearing articulations, it spreads the burden across the joint surface in a mode that allows the implicit in castanetss to absorb daze and weight. These maps require that gristle be elastic and have a high tensile strength. These properties are provided by proteoglycans and type II collagen, both of which are produced by chondrocytes. Articular gristle invariably undergoes matrix devolution and replacing. Any instability in normal chondrocytes ability to keep gristle synthesis and debasement can take to OA. Majority of the pathological alterations in OA occur in the gristle itself, nevertheless as the disease progresses, the organic structure and synovial constructions bes ides begin to demo marks of devolution. ( Reference ) Cartilage Changes: Chondrocyte map can be affected by a assortment of influences, including mechanical emphasiss, aging, metabolic and familial factors, increased bone denseness and high oestrogen degrees. Regardless of the inciting stimulation, early OA is marked by the degenerating gristle incorporating more H2O and less proteoglycan ( mention ) . This occurs as a consequence of an enzymatic debasement of the major structural constituents, aggrecan and collagen, which causes reactive proliferation of chondrocytes to organize bunchs ( ringers ) with increased production of matrix constituents. Although the turnover of aggrecan constituents is increased, the concentration finally falls. The lessening in size of hydrophilic aggrecan molecules increases the H2O concentration and swelling force per unit area in gristle, farther interrupting the staying staging of type II collagen. Overall, gristle tensile strength and resiliency are compromised doing it susceptible to supporting hurts. ( BOON ET AL ) Progression of these alterations leads to transgress of surface unity, crevices, opposing, flaking of gristle and development of perpendicular clefts ( fibrillations ) , localised chondrocyte decease and lessening in gristle thickness. Cartilage loss is focal instead than widespread and normally restricted to the maximal supporting portion of the joint ( BOON ET AL ) . Gross scrutiny at this phase reveals a soft farinaceous articular gristle surface ( kumar et Al ) . Bone Changes: The bone instantly below the compromised gristle responds by increasing its trabecular thickness ( subchondral induration ) , which in some instances reflects healed trabeculate microfractures or countries of osteonecrosis caused by the increased force per unit area in bone as the gristle fails in its load-transmitting map. The break gaps allow synovial fluid to be forced into the subchondral parts, organizing hempen walled cysts. At the border of the joint there is formation of new fibrocartilage, which so undergoes endochondral ossification to organize osteophytes. Despite cardinal and fringy new bone formation, with terrible gristle loss, crevices may intensify and expose the subchondral bone to have on, with the unprotected bone ends going ivory-like due to inspissating and vascularization ( eburnation ) , frequently with deep linear furrows ( BOON ET AL ) . Small breaks can free pieces of gristle and subchondral bone into the joint, organizing loose organic structu res ( joint mice ) . Bone remodelling and gristle thinning easy alter the form of OA articulations, increasing their surface Other Changes: The synovial membrane undergoes variable grades of hyperplasia, sometimes as aureate although less widespread as RA ( In terrible disease, a hempen synovial pannus covers the peripheral parts of the articular surface ) . Osteochondral organic structures normally occur within the synovial membrane, reflecting chondroid mataplasia or secondary consumption and growing of damaged gristle fragments. The outer capsule besides thickens and contracts, normally retaining the stableness of the remodelling articulation. The musculuss that act over the joint normally show non-specific type-II fiber wasting ( BOON ET AL ) . Natural History The class of OA is extremely variable. Those patients with multiple affected articulations tend to hold a more rapid patterned advance of OA in their single articulations ( Felson 1993 ) . Advanced age ( Felson 1993 ) and fleshiness ( Felson 1993 ) are besides associated with more rapid patterned advance. Primary OA is regarded as by and large easy progressive, which is apparent in one 3rd to two tierces of radiographic OA instances ; while it has been known to brace for many old ages, betterments are rare ( kumar et Al ) . Diagnostic OA may come on, or better, or may even be arrested due to the fact that symptoms have been shown to be ill correlated to radiographic patterned advance ( Kellgren-Lawrence 1963 ) . Osteophye encroachments on spinal hiatuss are a common cause of nervus root entrapment, which may ensue in neurological shortages such as radicular hurting, musculus wasting or cramp, and centripetal loss. With clip, entire articulation prostration may happen, but unlike Rheu matoid arthritis, does non ensue in joint anchylosis ( merger ) . ( kumar et Al ) Subsets of OA Primary OA can be categorised into three major subsets, although it may non be easy to find an exact differentiation between the subsets ( Doherty 1994 ) . Nodal Generalised OA: GOA is characterised by distal, and proximal to a lesser extent, interphalangeal ( IP ) articulation engagement, Heberden ‘s nodes ( cadaverous expansion of DIP articulation ) , Bouchard ‘s nodes ( cadaverous expansion of PIP articulation ) and familial bunch. It peaks at in-between age and is common in females ( Doherty 1994 ) . Erosive OA: Characterised by engagement of IP articulations of custodies, frequently with aureate redness and erosive alterations, that subsequently take to malformations and anchylosis. A little proportion ( 15 % ) may germinate into seropositive rheumatoid arthritis ( Doherty 1994 ) . Isolated big joint OA: Knee: This is the most common signifier of OA, frequently happening bilaterally. It may affect preponderantly the median femorotibial, sidelong femorotibial or patellofemoral compartment. Hip: Predominantly involves the superior pole or the median compartment. Spinal column: Apophyseal joint engagement is the lone true signifier of OA that can affect the spinal column and is typically manifested my hurting on extention on the spinal column. Intervertebral phonograph record ( IVD ) devolution with osteophyte formation is considered an built-in portion of OA, and normally affects the lumbar and cervical parts. Diffuse intraosseeous skeletal hyperostosis ( DISH ) and ossification of posterior longitudinal ligaments ( OPLL ) are considered to be discrepancies of spondylosis, and comprise fluxing calcification of the disc border and anterior and posterior longitudinal ligament, severally ( mention ) . Clinical Features Signs and symptoms of OA may take many old ages after the oncoming of the disease to go clinically apparent. This is due the fact that the patterned advance of the disease is extremely variable A ; there tends to be hapless correlativity to radiographic and microscopic patterned advance. Another possible ground that there may be a hold in the visual aspect of symptoms after devolution has taken topographic point is because due to a deficiency of excitation within the gristle ( Lane 1993 ) . Joints normally involved in OA are the articulatio genus, fingers, and spinal apophyseal articulations. Less normally are the hips, acromioclavicular and sternoclavicular articulations, while carpal, cubitus, mortise joint and glenohumeral articulations are seldom involved in isolation. Signs and Symptoms Symptoms if OA often have an insidious oncoming and an asymmetrical distribution, subsequently going symmetric as the disease progresses. Factors that may foretell the presence of diagnostic OA and rate of patterned advance include advanced age, fleshiness and multiple affected articulations. The central marks of OA include bony puffiness, synovial gush, crepitus, restricted scope of gesture, joint malformation and, musculus failing and wasting. Symptoms associated with OA include hurting, joint stiffness and functional damage, although all need n’t be present at the same clip A ; badness: Pain: Pain normally begins as an intermittent localised deep aching in and around the affected articulation, frequently exacerbated by motion. As the disease progresss, hurting may go more relentless, going nowadays at dark and during remainder. In KOA, hurting is normally localised to the front tooth and median facets of the articulatio genus and upper thigh, normally occurs with step usage, mounting in and out of vehicles, and making day-to-day activities such as bathing, standing from a seated place and utilizing a lavatory. These jobs may be amplified in the presence of attendant hip pathologies, where normal walking pace is likely to be altered as a consequence of the inguen and leg hurting. Stiffness: Stiffness in the involved articulations is typically present and worst first thing in the forenoon ( forenoon stiffness ) and lasts between five and 30 proceedingss. Stiffness may besides be present subsequently in the twenty-four hours after periods of remainder or inaction ( gelling ) , but is brief and relieved by soft motion ( Doherty 1994 ) . This stiffness is frequently associated with impaired motion within the joint and my consequence from a figure of causes ; joint adhesion, capsular tightening and thickener, inflexibleness of the overlying soft tissue and/or altered joint construction ( eg. as a consequence of osteophyte formation ) . Functional Damage: The badness of functional damage is mostly dependent on the grade of devolution, type of joint involved every bit good as the specific location of the devolution within the joint. For illustration, if there is pronounced devolution with osteophyte formation on next jointing surfaces, which make contact during motion, one would anticipate to happen that scope of gesture is impaired. Similarly, loose organic structures may ensue in reduced scope of gesture every bit good as possible lockup or buckling, particularly if located within the articulatio genus articulation. Crepitus develops as a consequence of gristle loss articulation and abnormalities on jointing surfaces such that they longer skid swimmingly over one another. This creates a stuttered-type gesture, which can be palpated on scrutiny of scope of gesture. In terrible instances this crepitus may even make hearable â€Å" dads † . Crepitus is present in over 90 % of patients with KOA ( mention ) . In terrible instances, joint subluxation may happen when there is uneven wear of the joint surfaces. Over an drawn-out period of clip this will ensue in asymmetrical joint infinite narrowing and finally prostration. When this occurs in the articulatio genus, the median tibiofemoral articulation to typically more affected than the sidelong and in over 50 % of patients will do the development of a knee varus ( â€Å" bow leg malformation † ) . Functional damage may besides ensue non merely from structural alterations to the joint surfaces, but besides from other alterations associated with OA, such as arthrogenic musculus suppression. In this instance, the patient may see failing due to wasting of the surrounding musculuss, every bit good as stiffness or reduced scope of gesture due to inflexibleness ( Hurley 1998 ) . Table 2.2.2 Outline of Typical Symptoms of Osteoarthritis Symptoms Patient over age of 45 Insidious onset over months or old ages Variable or intermittent hurting over clip Chiefly related to motion and weight-bearing, relieved by remainder Merely brief forenoon ( lt ; 15 proceedingss ) stiffness and â€Å" gelling † ( lt ; 1 minute ) after remainder Normally merely one or two articulations painful ( non multiple regional hurting ) ( Adapted from Davidson ‘s ) Table 2.2.3 Outline of Clinical Signs Characteristic of Osteoarthritis Signs Restricted motion ( capsular thickener, barricading by osteophytes ) Palpable, sometimes hearable, class crepitus ( unsmooth articular surfaces ) Bony swelling ( osteophytes ) around articulation borders Deformity, normally without instability Joint-line or periarticular tenderness Muscle failing, blowing No, or merely mild, synovitis ( gush, increased heat ) ( Adapted from Davidson ‘s ) 2.3.3.2 Arthrogenic Muscle Inhibition ( AMI ) AMI is defined as the failure of a functional musculus group to enroll all motor units during maximum voluntary contraction ( Suter et al, 2000 ) . When joint receptors are subjected to distention, compaction, ligamentous stretch, gush and hurting, this protective mechanism is activated, doing automatic suppression of the environing muscularure to forestall farther hurt to the joint ( Crossman and Neary, 1995 ) . The hurting, joint annoyance and musculus cramps frequently associated with KOA, taking to biomechanical alterations and redness, consequences in an suppression of the joint motorneuron pool and inability to enroll all the musculus fibers within the musculus groups that cross the affected articulation. The net consequence is: lessening musculus strength ( existent and/or evident failing ) , doing holds in the rehabilitation advancement ( Hopkins and Ingersoll, 2000 ) Altered motion forms due to a alteration in motor control and joint proprioception, increasing the hazard of hurting, re-injury and accelerated devolution because of the deformed articulation forces ( Lee, 4004 ) Diagnostic Standards Prior to the development of clinical standards for diagnosing of OA in 1981? , the diagnosing of OA was frequently based on radiographic visual aspect and standards proposed by Kellgren and Lawrence in 1957, which is accepted by the World Health Organisation. The diagnosing of OA is mostly clinico-radiographic, that is both clinical and radiographic characteristics are taken into consideration to find the presence and badness of the disease. It is widely acknowledged that radiographic alterations may non be present in the early phases of devolution, while merely 40-50 % of patients with radiographic grounds of OA are clinically symptomless ( Roberts 1996 ) . For this ground the American Rheumatism Association devised diagnostic standards for OA in assorted articulations. Table 2.2.4 Clinico-radiographic Classification Criteria for Osteoarthritis of the Knee Traditional format Classification tree format Knee hurting Osteophytes Plus One of three: Age gt ; 50 old ages Stiffness lt ; 30 proceedingss Crepitus Knee hurting and Osteophytes Or Knee hurting and age a†°? 40 old ages and forenoon stiffness a†°Ã‚ ¤ 30 proceedingss in continuance and crepitus on gesture ( Altman 1986 ) Table 2.2.5 Clinico-radiographic Classification Criteria for Osteoarthritis of the Hip Hip hurting At least two of the followers: ESR Westergreen lt ; 20mm/hr Radiographic femoral or cotyloid osteophytes Radiographic joint infinite narrowing ( superior, axial and/or medial ) ( Altman 1991 ) Table 2.2.6 Clinico-radiographic Classification Criteria for Osteoarthritis of the Handss Hand hurting, hurting, or stiffness Three or four of the followers: Hard tissue expansion of 2 or more of 10 selected joints* Hard tissue expansion of 2 or more DIP articulations Less than 3 conceited MCP articulations Deformity of at least one of 10 selected joints* * 10 selected articulations are 2nd and 3rd DIP articulation, 2nd and 3rd PIP articulation, and 1st carpometacarpal joint ( Altman 1990 ) Radiographic Diagnosis There are eight central marks of DJD: asymmetric distribution, non-uniform loss of joint infinite, osteophytes, subchondral induration, subchondral cysts, intra-articular loose organic structures, intra-articular malformation, and joint subluxation. The radiographic presentation of OA varies depending on the joint involved, the anatomic relationships, and the emphasis to which the articulation is subjected. Therefore all eight marks need non be present in order to set up a diagnosing of OA ; nevertheless they may be utile in in finding the grade of underlying diseased sequences affecting the joint compartments. The tabular array below is the scaling system used to set up radiographic badness of OA ( mention – Y A ; R? ) . Table 2.2.7 Kellgren-Lawrence Classification of Osteoarthritis Description Normal No alteration Class I Improbable narrowing of the joint infinite, possibleA osteophytes Grade II SmallA osteophytes, possible narrowing of the joint Grade III Multiple, reasonably sizedA osteophytes, definite joint infinite narrowing, some sclerosed countries, possible distortion of bone terminals Grade IV Multiple largeA osteophytes, terrible joint infinite narrowing, marked induration and definite cadaverous terminal malformation. mention Asymmetrical Distribution: There is often a seeable disparity when comparing the extent of joint engagement with the unaffected ( or lesser affected ) articulation on the contralateral side. The asymmetrical distribution of OA helps to separate it from inflammatory arthropathies, such as RA, when have a characteristically symmetrical engagement ( mention – Y A ; R? ) . Non-Uniform Loss of Joint Space: Decrease in joint infinite is most likely to happen at the parts of greatest intra-articular emphasis, which is particularly apparent in weight-bearing articulations such as the spinal column, hip, and articulatio genus ( mention – Y A ; R? ) . Osteophytes: Radiographically, these are seen as cadaverous branchs widening from the part of capsular interpolation into the joint infinite. In really terrible instances the osteophyte may wholly bridge the joint infinite, doing anyklosis of the joint ( cite – Y A ; R? ) . Subchondral Sclerosis ( Eburnation ) : This is normally apparent in countries where there is the greatest loss in gristle tallness. It occurs as a consequence of increased mechanical forces being transmitted to the joint surfaces that lack the daze absorbing consequence of normal gristle thickness. In order to antagonize these increased forces, the bing trabeculate bone thickens and new bone is formed. This is seen on radiogram as increased countries of radio-opacity in the subchondral bone underlying parts of reduced joint infinite ( mention – Y A ; R? ) . Subchondral Cysts ( Goedes ) : These are focal parts of loss in bone denseness, of variable size, which appear as rounded countries of radiolucency and frequently have a sclerosed border. They are located in countries of old subchiondral induration, and occur either as a consequence of synovial fluid invasion through the open articular home base or secondary to trabeculate break and subsequent mortification ( mention – Y A ; R? ) . Intra-Articular Loose Bodies ( Joint Mice ) : As joint devolution advancements, flaking and atomization may ensue in intra-articular accretion of free drifting organic structures, comprised mostly of gristle and on occasion subchondral bone ( mention – Y A ; R? ) . Articular Deformity: Progressive distortion of the articular surfaces may happen following insistent emphasis, doing big subchondral cysts, trabeculate remodelling, break and prostration, which may be exacerbated my mortification due to secondary vascular perturbations ( mention – Y A ; R? ) . Joint Subluxation: The joint finally becomes unstable and prone to displacement due to joint surface distortion, loss of joint infinite, and laxness within the construction of the ligaments and sinews. This alters in the burden distribution, farther increasing the unbalances emphasiss of the joint, speed uping the degenerative procedure ( mention – Y A ; R? ) . Clinical Diagnosis Altman et Al. ( 1986 ) developed sets of standards for the categorization of idiopathic OA of the articulatio genus. Table 2.2.8 Classification Criteria for Diagnosis of Idiopathic Osteoarthritis ( OA ) of the Knee * Clinical and research lab Clinical and radiolograohic Clinical ** Knee Pain + at least 5 of 9: Age gt ; 50 old ages Stiffness lt ; 30 proceedingss Crepitus Bony tenderness Bony Enlargement No tangible heat ESR lt ; 40 mm/hr RF lt ; 1:40 SF OA Knee Pain + at least 1 of 3: Age gt ; 50 old ages Stiffness lt ; 30 proceedingss Crepitus + Osteophytes Knee Pain + at least 3 of 6: Age gt ; 50 old ages Stiffness lt ; 30 proceedingss Crepitus Bony tenderness Bony Enlargement No tangible heat 92 % Sensitivity 75 % Specific 91 % Sensitivity 86 % Specific 95 % Sensitivity 69 % Specific * ESR = erythrocyte sedementation rate ( Westergreen ) ; RF = arthritic factor ; SF OA = synovial fluid marks of OA ( clear, syrupy, or white blood cell count lt ; 2000/mm3 ) . ** Alternative would be 4 of 6, which is 84 % sensitive and 89 % particular. ( mention ) Differentiation from other Arthritic Diseases Arthritic arthritis: associated with more marks of redness affecting the MCP, carpus, wrist bones and other peripheral articulations, every bit good as the cervical spinal column. Generalised OA involves the DIP, PIP and first CMC articulations in the manus and, cervical and lumbar spinal column parts. RA distinguished from erosive OA through positive research lab trial, such as arthritic factor, ESR, and synovial fluid analysis ( Boon et al, ) . Joints actively involved in arthritic arthritis seldom show osteophytes, therefore their presence is a utile index of OA if the patient presents with a assorted clinical image. If osteophytes precede arthritic engagement, it indicated that rheumatoid arthritis has evolved from an erosive OA. Conversely, they will merely develop in secondary devolution following RA burn out ( Yochum A ; Rowe, ) . Pseudogout: differentiated from OA by presence of CPPD crystals in synovial fluid, every bit good the in engagement of articulations that are non typically associated with primary OA, such as the cubitus and shoulder ( McCarthy 1998 ) . Table 2.2.9 Categorization for Subsets of Idiopathic Osteoarthritis Localised: Handss: Heberden ‘s and Bouchard ‘s nodes ( nodal ) Erosive interphalangeal arthritis ( non-nodal ) Scaphometacarpal Scophotrapezal Foot: Halux valgus Hallux rigidus Contracted toes ( hammer/cock-up toes ) Talonavicular Knee: Medial compartment Lateral compartment Patellofemoral compartment Hip: Eccentric ( superior ) Concentric ( axial, median ) Diffuse ( coxae senilis ) Spine ( peculiarly cervical and lumbar ) : Apophyseal Intervertebral ( phonograph record ) Spondylosis ( osteophytes ) Ligamentous hyperostosis [ DISH* or Forestier ‘s disease ] ) Other individual sites: Shoulder Temporomandibular Sacroiliac Ankle Wrist Acromioclavicular Generalised ( includes 3 or more sites listed above ) : Small ( peripheral ) and spinal column Large ( cardinal ) and spinal column Mixed ( peripheral and cardinal ) and spinal column * DISH = Diffuse Idiopathic Skeletal Hyperostosis How to cite Bony Anatomy The Knee Joint Health And Social Care Essay, Essay examples

Electronic Contracts and Contract Law Principles

Question: Discuss about the Electronic Contracts and Contract Law Principles. Answer: Introduction: A contract is a legally binding agreement with set defined promises which the law will enforce. Some of the essential elements of a valid contract comprises agreement, consideration, form, intention, genuineness of the consent, legality etc. Some of the guiding principles associated to consideration of contract includes the clauses like consideration must move from the promiser and the consideration must be sufficient but need not be adequate. Mistake in equity or misrepresentation in a contracts triggers remediation procedure(Fairhall, 2012). The business case refers to a situation where a contract between the seller (Sydney cbd caf) and the buyers (Bill and Jill) has signed, which essentially comprises three main statements. The first statement is about weekly taking of the outlet on sale. Second statement is related to the estimated cost of running the business while the third statement is promise on the part of seller not to indulge in the same business for next few years. After running the business for several months after signing the contract, the new buyers are in the position to validate each of the three statements as mentioned in the contract from business law perspective. The first statement on the weekly takings is turned out to be a misrepresentation given the fact that the weekly takings are far less than the stated amount in the contract. As per the business law, misrepresentation is false statement made by a party in a contract including a half-truth. Per law, a remediation action should follow the terms of the contract. In this case, before tagging the first statement as misrepresentation, we must judge whether the sudden fall in weekly takings has got any connotation with the third statement mentioned in the contract. The recommended approach in this case is to first judge the type of misrepresentation, i.e. whether it is fraudulent misrepresentation, negligent misrepresentation or innocent misrepresentation. One of three types of contrac ts void at common law includes the contracts in restraint of trades, which imposes restriction on future liberty of a party to carry out business. With anti-competitive agreement in place under one of the statements in the contract, first statement on grossly lower volume of sales could be termed as fraudulent misrepresentation in the contract given the fact that the seller have not get into the same business as promised in third statement. In this case, necessary remediation action needs to be taken in line with the terms of the contract. In case no specific remediation action has been prescribed in the terms of the contract then a lawsuit can be filed to seek remediation action seeking rescission to aim at restoring the parties to their pre contractual position(Iknow, 2014). On the other hand, if the third statement, which is a promise from the seller not to run a caf in Sydney cbd is an anti-competitive agreement. If it is found that the seller has violated this agreement, which might have resulted a deep dent in the weekly takings. This is a breach of contract and can either be referred to Competition Commission or to Court for legal remediation. What are the key areas of business law that are relevant in these facts? Hughes, who runs a pizza business, is a sole proprietor for his business. Initially the business owner has taken the service of UberEats, a logistics company, to deliver the products to the customer. The business owner continues to use the name of this logistics company even when he has discontinued their service in order to cut down the operational expense. As per business law, this can be treated as misrepresentation and as tortious liability under the law of tort. Disclosure of true owners name is mandatory for formation of business for the sole trader. In the present case the owners of the business, Huge and his son have not registered any documents to comply with the mandatory disclosure law. Also, the rule on disclosure doesnt apply for goodwill in this case as the logistics company, with which the current own had business relationship, is no longer part of this business. Hence, restriction on the choice of business name is also relevant in this context. Secondly, the business advertisement (disclosure) order provides necessary guidelines and mandates on the content, format or size. In the current case, the advertisement published by Huge and his son carries the contents, which has misled the consumers in terms of quality and freshness of the products and its ingredients. Hence, the misrepresentation of information in advertisement is very much relevant to this case(Koffman Macdonald, 2006). In order to take further cost cutting measure, the owner of the business has started compromising with the quality standard of the products. Although the advertisement demands fresh ingredients and a number of cases have been reported where the consumer have received sub- standard product from this pizza outlet. As per the business law, consumer transaction is associated to three main principles; viz. an individual who purchases goods and service; a supplier who is serving the business purpose and the goods or service associated to the transaction should be intended to be used for private use and/ or private consumption. This case spread across all the three principles associated to consumer transactions. The customers, who have ordered pizza, are the consumers, Huge and his son are the supplier who owns the business and the sub-standard pizzas are the goods which have been transacted. Sales of Goods Act is readily applicable for this type of transaction. Secondly, consumer protectio n from unfair trading regulations (CPRs) is also applicable under the purview of this transaction(MacMillan Stone, 2012). A number of other law enforcement directives given in consumer credit act, food safety act etc. is also applicable in connection of this scenario. Food Standard Agency (FSA) has become operations since long in accordance with food standards acts. To comply with the food safety and extending advice in relation to other consumer interests are the primary responsibility of FSA. As per the business law, to comply with FSA guideline is the responsibility of each business. The case in hand indicates that the owners of the business didnt comply with the FSA guidelines. Hence, the case in hand also falls under the purview of food safety act(Poullet, 2004). Who can take legal action and what remedies could be given by a court? The logistics service provider UberEats can file a lawsuit against Homeslice Pizza on accounts of using Ubers goodwill in the advertisement where the logistics service provider has no current business interest with the pizza firm. Although there is no formal binding contract exists between these two entities, however, as per the business law, even the third party has the authority to seek legal remediation against the misrepresentation in the form of using their brand name by another business entity. Although consumer protection regulations provide some defences against the innocent publication of advertisement and a provision of bypass does exist in business law, but the current case doesnt comply under the purview of this protection(Utz, 2015). A sole owner, who doesnt comply with the law is exposed to criminal offence on accounts of misrepresentation of the companys name and on account of non- disclosure of the necessary documents for conducting the business. As per the business law, the Court can execute the power to impose an order of dissolution of the business. Enforcement of regulatory statues and provision for consumer advice are the main roles of the local government to ensure consumer protection. Non-compliance with the quality standard is considered as the direct impact on consumer protection. The court has the authority to direct the local government to enforce necessary legal action in line with the direction given in consumer credit act and food safety act. Local government is also empowered to conduct sample testing to determine the quality standard of the pizzas that have been served to the consumers. Apart from the enforcement, a number of local authorities have been set up for the purpose of providing necessary advice on complaints. As an alternative, the impacts consumers can also seek legal advice to these local authorities. Administrative control under the enterprise act offers necessary protection for the consumers in the form of super-complaint, enforcement in line with fair trading act. Necessary legal action also be sough t in terms of violation of licensing of traders under the consumer credit act. The business owner, Huge and his son may have their license withdrawn in case they had obtained any license for selling the pizza(McComish Smith, 2008). General guidelines under business law are available for general safety standard and safe product. Per law, the business owner or a producer is required to furnish necessary information to the consumers so that the consumers can assess any risk associated to the products and can take necessary precaution to mitigate the risk. However, in the present case, Huge and his son have continued to claim the freshness and high quality standard of the products without furnishing necessary information or evidence of their products as no documents have been furnished to the regulatory authority. Hence, from the business law perspective, this is a violation on the basic regulation on the trading and licensing and is subjected to legal violation. The court is empowered to take necessary legal action for each of the trade violations. Reference: Fairhall, H., 2012. Australian Government Review of Australian Contract Law. [Online] Available at: https://www.lawsociety.com.au/cs/groups/public/documents/internetyounglawyers/644777.pdf [Accessed 30 August 2016]. Iknow, 2014. Legislation. [Online] Available at: https://www.iknow.cch.com.au/topic/tlp622/overview/long-service-leave [Accessed 10 September 2016]. Koffman, L. Macdonald, E., 2006. The law of contract; books.google.co.in/books?id=3WycAQAAQBAJpg=PA40dq. 7th ed. London: Oxford. MacMillan, C. Stone, R., 2012. Elements of the law of contract; https://www.londoninternational.ac.uk/sites/default/files/programme_resources/laws/ug_subject_guides/elements_law_contract-subjectguide4chapters.pdf. The real W.W.W, pp.1-52. McComish, S. Smith, G., 2008. AUSTRALIAN CONSTRUCTION LAW. [Online] Available at: https://www.allens.com.au/pubs/pdf/const/AustralianConstructionLaw2008YearinReview.pdf [Accessed 31 August 2016]. Poullet, Y., 2004. Electronic Contracts and Contract Law Principles. [Online] Available at: https://www.crid.be/pdf/public/5650.pdf [Accessed 29 August 2016]. Utz, C., 2015. Australian Contract Law - Association of Corporate Counsel. [Online] Available at: https://www.acc.com/legalresources/quickcounsel/australian-contract-law.cfm [Accessed 29 August 2016].