Improvements In Life Expectancy India Health And Social Care Essay

Improvements In Life Expectancy India Health And Social Care Essay Life expectancy of Indians during the past fifty years has been steadily increasing exponentially matching the trend that took several hundred years shown in Developed countries. 23Some of the possible reasons for such exponential rises gained by Indians in years are controlling deaths caused by epidemics and pandemic infectious diseases, and absence of famines or wars since Indias independence. The high death rates due to infectious diseases were dramatically curtailed due to availability of antibiotics and further with introduction of Universal Immunization program. This was followed by improved living conditions, advances in public health, and availability of advanced medical interventions. Figure.1: Improvements in Life Expectancy-India (1960-2009) Source: The World Bank Group  [4]   Results from estimates of World Bank indicate that India has share of her good and bad news. The good news so far has been that Life expectancy is increasing until now and bad news is whether such rate of increase can be maintained over next few decades. Currently India has excellent health service delivery mechanisms, which are efficient in extending the lives of her people by treating chronic conditions and cancer. However, the question is whether such improvements in technology are addressed only to cure ailing population or can India address preventive programs aimed at decreasing the burden of obesity and chronic conditions. Hence, the next big threat to Life Expectancy improvements appears to be stemming from obesity and chronic diseases in middle and old age, which are directly linked to an increased risk for death and morbidity. Attempts to predict life expectancy of Indian population, in terms of whether it is improving or getting worse becomes even more intricate in the absence of scientific data available for such evaluations. Figure 2. Observed and Projected composition of age-groups for Indians (1960 to 2010). Evidence from studies indicates that obesity and overweight in adulthood are associated with large decreases in life expectancy and increases in early mortality.  [5]  678This paper aims at explaining the intricacies involved in the interplay of obesity and old age in their impact on Life expectancy. Challenges in measuring the effects of Obesity and Old Age on Life expectancy Ice-berg phenomenon The health risks of obesity in the elderly are mostly underestimated due to survivor bias seen in the elderly people (only those who have survived fatal effects of obesity and chronic diseases), inability to separate competing mortalities due to relatively shortened life expectancy in older persons and longitudinal effects of confounding conditions (eg., smoking) are difficult to measure.  [9]   Definition of Obesity in Elderly The appropriateness of definition of obesity in the elderly is a debatable issue. Obesity should be defined as the amount of excess fat storage associated with elevated health risk. For this practical definition, Body Mass Index (BMI) has been largely used in younger adults as well in older ages. BMI gets altered in old age due to age-dependent changes in numerator and denominator in calculation. Several studies have shown that there is age-related decline in height, probably because of spinal deformity with thinning of the inter-vertebral discs as well as loss of vertebral body height due to osteoporosis. Hence, age-dependent height decrease leads to incorrect overestimation of obesity. Body weight in old people reflects a higher amount of total fat because of age-dependent loss of lean body mass. This may lead to underestimation of obesity as a result of increase and redistribution of fat inside the body. Hence, aging influences both numerator and denominator of BMI, in opposite di rections. Further, larger waist and waist-to-hip ratio have found to be significantly associated with mortality in older subjects, whilst BMI was not. The higher the age, the shorter is the remaining lifespan for persons regardless of degree of obesity. Most obesity related consequences take years to develop even among susceptible population; hence, obesity related complications in old age are not seen if susceptible die of non-obesity-related conditions. It is observed that weight change, both weight loss and weight gain, is a strong predictor of mortality. Further, many studies showed lower mortality in subjects with lower BMI, or at least a U-shaped relation between BMI and mortality. The underlying diseases such as cardiovascular disease and cancer can result in spurious inverse relation between low body weight and increased mortality.  [10]   Interaction of Obesity, Old Age and their toll on Life Expectancy Weight gain or fat redistribution in older age confers adverse health risks in the form of early mortality and co-morbidities amounting to functional decline. Obesity has been recognized to be associated with several disorders that confer morbidity and may also be related to increased mortality. Obesity, and more importantly body fat distribution are associated with metabolic syndrome even in old ages.  [11]  There is higher prevalence of both systemic and pulmonary hypertension and a higher risk of cardiovascular disease morbidity and mortality in old age, especially among those with pulmonary complications and obstructive sleep apnea syndrome (OSAS).  [12]   Role of Smoking There is stronger evidence that smoking plays an important role in the interaction of obesity and old age. It is well known that smokers are thinner and have an elevated mortality compared with nonsmokers. However, when only people who never smoked were studied, there is an observed linear relation between BMI and mortality among older subjects, suggesting that increased mortality associated with the lowest weights were a function of cigarette smoking, and that, among never-smokers, very low weights were associated with the greatest longevity. Summary The steady rise in life expectancy observed in the modern era may soon come to an end and the youth of today may, on average, live less healthy and possibly even have shorter lives than their parents. There are many challenges to delineate the association between obesity and mortality in the elderly. Since confounding effects by different variables in this association accumulate over the lifetime, it is difficult to accurately measure and account for these factors. Mortality is not the only end point that should be considered in the evaluation of the impact of overweight and obesity on health status in older people. There is increasing evidence that obesity is reduces life expectancy due to direct and indirect causes. Obesity will not only increases the risk of death for most people at most ages, but also consistently leads to a much higher level of disability and disease at all ages. Voluntary weight loss may have beneficial health effects in elderly similar to the effects in young age. Studies on the effect of weight loss in the elderly are scarce, but they suggest that even small amounts of weight loss (between 5 to 10% of initial body weight) may be beneficial. It is well known that increased physical exercise is associated with decreased mortality risk in middle-aged as well as in older people.  [13]   India is surpassing through dual burden of diseases and consequences of obesity might take a greater toll. Hence policy makers should focus on promoting prevention and treatment of obesity related conditions, especially among old age. Based on priorities in public health expenditure, the country can effectively implement population-level interventions to reduce obesity. Health care providers should engage in complete evaluation of co morbidity and weight history, in the elderly obese persons to comprehensively address potential adverse health effects of o obesity.

The Business Activities Study

This case study is related to the business activities of a hedge fund which performs a macro investment strategy. Its investment manager Troy Dexter seeks for profits which arise from shifts in the real economy. As he considers an end of the Australian housing market boom as likely, he anticipates that Australia's overall economic growth will slow down, whereas the prices for energy will go up. In reaction to those expectations he decides to purchase treasury bonds and stocks of energy companies Against this background Case Study 1 is aimed at classifying Troy Dexter's two investment decisions as either direct or indirect investments. Such a classification provides different results depending on the party from whose perspective it is assessed. Thus, it is the purpose of the following section of this work to distinguish between the terms direct and indirect investment based on the corresponding point of view using practical illustrations whenever possible. This is to be done after clarifying key terms associated therewith first. Term definition A hedge fund is an alternative investment vehicle which excessively uses financial instruments such as derivatives and leverage and in which an aggressive management strategy is usually applied (Fung & Hsieh, 2004). As Capocci and Hà ¼bner (2004) state, a hedge fund's major purpose is to generate active return (called alpha) for its typically wealthy investor base. As hedge funds are less exposed to capital market regulation than other fund types, they are able to generate – on average – higher returns, but associated with higher levels of risk as well (Lederman, 2012). Troy's decision to purchase energy stocks is related to his expectation of rising oil prices. Given his expectation turns out to be correct, the share price of oil producing companies will increase. The term â€Å"energy stock market†, however, comprises not only oil producing companies, but all other kinds of energy producing firms, as well as energy infrastructure and energy service providers, too (Henriques & Sadorsky, 2008). As Henriques and Sadorsky (2008) note, a rise in the oil price will not only increase the share price of oil and gas producers, but also the market value of those firms which offer substitutes (e.g. solar and wind energy) will increase. This holds as their products become more competitive in such an environment and their turnover is likely to increase. Stockholders who have purchased such stocks directly for their own stock portfolio before a rise in the oil price has taken place, will profit. Their profits, on the one hand, consist of the 4 chance to sell those shares at a higher price at the stock market and, on the other hand, of (increased) dividend payments (Bodie, 2013). Treasury bonds purchased in the debt market are usually characterized by less risk than any kind of stock market investment (Sharpe et al., 1999). Given Troy's expectation about the future economic environment of Australia, his decision to purchase such long-term fixed interest debt instruments is reasonable. This holds as they are issued by the Australian government which is very unlikely to default (Chaudhuri ; Smiles, 2004). On the contrary, as the Australian government has several tools at hand which allows it to make interest payments as promised (e.g. increase taxes), a treasury bond is considered as one of the safest investment forms available in the market (Hull et al., 2005). Investors who have decided to hold treasury bonds in their stock portfolio (direct security investment) can expect a fixed interest on their investment. The historic development of the Australian 10-year treasury bond is illustrated below.   Source: Reserve Bank of Australia, 2017. From this graph it can be derived that the long term trend of Australian treasury bonds is downward sloping. Starting from a level of more than 10.0% in 1995, the interest rate went down to about 3.0% in 2013. Interest rates in the short run are stagnating on a relatively low level of about 3.0%. Based on the fact that Troy Dexter has founded the hedge fund in 2009, it can be stated that his decision was right in the short run: Interest rates, indeed, went up from 4.0% to 6.0% between January 2009 and January 2010. However, it has to be noted that in the subsequent years his expectation turned out to be incorrect: Starting from January 2011, interest rates on the Australian 10-year treasury bond went down to about 3.0% in January 2013. This implies for Troy Dexter as the fund manager that his hedge fund may have generated losses from 2011 onwards as the interest rate of Australian treasury bonds have lacked his expectations. The figure adds value to the topic of this work as it illustrates that the fund manager's decision to invest in treasury bonds could not have been a smart decision in the long run: Fund investors are indirectly suffering from this decision as they have decided to provide Troy Dexter with parts of their funds which are now invested in a non-optimal security. 1. Direct vs. indirect securities – Northwest Capital Management perspective In order to classify Northwest Capital Management's investments in treasury bonds and energy stocks from the firm's perspective, one has to understand the business concept of capital management firms first. Firms such as Troy Dexter's hedge fund business aim at professionally managing private investor's funds. They do so by investing customers' money in a broad range of asset classes, restricted by particular investment goals (Fung ; Hsieh, 2001). However, as Brav et al. (2010) notice, the service such firms provide is not just related to the optimum asset allocation, but financial statement analysis as well as the monitoring of existing investments plays an important role, too. Hedge funds – in contrast to more conservative capital management firms – invest a relatively high percentage of its assets in risky asset classes such as the stock market of even emerging market economies (Jansen et al., 1998). The portfolio composition of an exemplary hedge fund is illustrated in the graph below. Source: Blair, 2001. The figure above already reveals that it is the hedge fund manager Troy Dexter who is responsible for the investment decisions of his fund and who chooses between the above asset classes (asset allocation). It is important to understand that the private investor is not involved in the daily investment process of the hedge fund, but hands over any responsibility for the invested amount of money to Troy Dexter. 0.50% 0.50% 31% 19% 15% 14% 7% 6% 3% 2% 2% Strategy composition of a hedge fund Short selling Other Equity long/short Macro Relative value arbitrage Event driven Fixed income Convertible arbitrage Distressed securities/high yield Equity markets neutral Emerging markets 6 Derived from this line of reasoning it can be stated that Troy Dexter's intended purchase of treasury bonds and energy stocks can be considered as a direct securities investment from the firm's point of view. This holds, because there is no third party involved in Troy's securities acquisition process (Bodie, 2013). In contrast, it is likely to be assumed that Troy himself owns a trading platform which he can use to exercise any stock market transactions personally and immediately. Even if Troy does not own such a trading platform, the consultation of a stock broker can still be considered as a direct securities investment from Northwest Capital Management's point of view. This holds because a stock broker can simply be considered as an entity which executes buy and sell orders on behalf of someone else for a particular fee or commission (Pollock et al., 2004). As Pollock et al. (2014) note, brokers are not allowed to alter the order, but execute the transaction only. 2. Direct vs. indirect securities – Investor perspective Taking the viewpoint of an investor in Troy Dexter's hedge fund, Troy's investment decisions can clearly be considered as indirect investments. As stated above, the fund manager decides about the allocation across available asset classes. The investor knows about the financial risks tied to Troy's investment decisions from the prospectus and may have expectations about a desired return, but cannot alter Troy's daily sell and buy orders. However, this would be a vitally important characteristic of a direct securities investment. As soon as customers have decided to invest in the fund, they have to sign a declaration of consent in which they transfer the responsibility for managing their funds to the portfolio management team (in our case to Troy Dexter) (Philpot ; Jonson, 2007). Not the investors themselves engage a broker who carries out financial market transactions, but Troy Dexter does that on behalf of them using his financial market knowledge. In this context it is important to note that – although restrictions are less strict in a hedge fund – fund managers have to stick to the proposed fund objective and are not allowed to invest in anything which is not related to the praised goal of the fund, although it may be a lucrative investment (Philpot ; Jonson, 2007). This assignment of any kind of right to alter the investment decision related to maximizing investors' own monetary wealth underpins the indirect nature of a fund investment from an investor's point of view. The incentives for customers of Northwest Capital Management to provide Troy Dexter with the rights to manage their savings on behalf of them (indirect investment) is related to Troy Dexter's expertise about financial markets (Capon et al., 1996). Additionally, as Capon et al. (1996) state, the pooling of large amounts of money in the hedge fund provides customers with a lot more market power than they would have when investing on their own. This shows that although private investors cannot actively decide about each investment decision on their own, the indirect securities investment through Troy Dexter's Northwest Capital Management is utterly worthwhile for its investor base. It can be summarized that investing in a hedge fund implies no direct securities investment from the private investors' perspective. This is compounded by the fact that private investors of a hedge fund do not own any securities themselves (Droms & Walker, 1996). Instead, those securities are entirely controlled by the fund managers who either own a trading platform themselves or contact brokers to carry out deals which are likely to benefit the fund's investor base. Shareholders are not able to access the fund's existing investments on a daily basis, but have to rely on the fund managers' expertise (Droms ; Walker, 1996). This trust, however, may be the basis for higher returns compared to investing individually on any kind of capital market. 7 Furthermore, the indirect securities investment from the investor's point of view implies that each single investor gains or loses proportionally to his or her investment in Troy Dexter's hedge fund. This fact stands in sharp contrast to a direct securities investment in which an investor is on his own and has a claim on any gains and losses related to this investment (Bodie, 2013). Instead of having the chance to convert profits right away in a direct securities investment, an indirect investment via a fund prohibits an investor from this right and makes him dependent on the decisions of the fund manager. Recommendations: A common way of how to classify securities is to divide them into either direct or indirect securities. In this context it is of particular importance to distinguish between either an investment manager's or a private investor's perspective (Davis, 2004). Conclusion: The statements above have shown that the classification of any kind of investment as being either direct or indirect depends on the party from whose perspective such a classification is made. In the case of a hedge fund one can categorize an investment as an indirect one from the investor perspective and as a direct one from the fund manager's perspective. This holds as it is not the investor who makes any kind of investment decision, but the fund manager on his behalf. The investor puts trust in the fund manager's capital market expertise when deciding to invest in a fund and – at the same time – cedes any kind of rights to alter the fund manager's perspective on the future development of the capital market. In contrast, the fund manager, on a daily basis, has to directly â€Å"step† in the capital market and has to sell or buy certain types of investments. References Blair, F. (2001): Managing the equity portfolio: South-Western College Publishing. Bodie, Z. (2013): Investments: McGraw-Hill. Brav, A.; Jiang, W.; Kim, H. (2010): Hedge fund activism. A review. In: Foundations and Trends in Finance 4(3), p. 185–246. Capocci, D.; Hà ¼bner, G. (2004): Analysis of hedge fund performance. In: Journal of Empirical Finance 11(1), p. 55–89. Capon, N.; Fitzsimons, G. J.; Prince, R. A. (1996): An individual level analysis of the mutual fund investment decision. In: Journal of Financial Services Research 10(1), p. 59–82. Chaudhuri, K.; Smiles, S. (2004): Stock market and aggregate economic activity. Evidence from Australia. In: Applied Financial Economics 14(2), p. 121–129. 8 Cristodoulou, A. (2016): The internal rate of return problems and manners of solution. In: Prospettive e Proposte Mediterranee-Rivista di Economia, Agricoltura e Ambiente. Online available at http://www.iamb.it/share/img_new_medit_articoli/802_32cristodoulou.pdf. Davis, E. P. (2004): Institutional investors. In: MIT press. Droms, W. G.; Walker, D. A. (1996): Mutual fund investment performance. In: The Quarterly Review of Economics and Finance 36(3), p. 347–363. Fung, W.; Hsieh, D. A. (2001): The risk in hedge fund strategies. Theory and evidence from trend followers. In: Review of Financial Studies 14(2), p. 313–341. Fung, W.; Hsieh, D. A. (2004): Hedge fund benchmarks. A risk-based approach. In: Financial Analysts Journal 60(5), p. 65–80. Hasan M. (2013): Capital budgeting Techniques used by small manufacturing companies. In: Journal of Service Science and Management. Henriques, I.; Sadorsky, P. (2008): Oil prices and the stock prices of alternative energy companies. In: Energy Economics 30(3), p. 998–1010. Hull, J. C.; Preduescu, M.; White, A. (2005): Bond prices, default probabilities and risk premiums. In: Working paper. Jansen, A.; Mathieson, M. D. J.; Eichengreen, M. B. J.; Kodres, M. L. E.; Chadha, M. B.; Sharma, M. S. (1998): Hedge funds and financial market dynamics 166. Jung, K.; Yong-Cheol, K.; Stulz, R. M. (1996): Timing, investment opportunities, managerial discretion, and the security issue decision. In: Journal of Financial Economics 42(2), p. 159-186. Layton, A., Robinson, T., & Tucker, I. (2015): Economics for today (5th ed.). Thomson, South Melbourne, Australia. Lederman, S. J. (2012): Hedge fund regulation. Philpot, J.; Jonson, D. T. (2007): Mutual fund performance and fund prospectus clarity. In: Journal of Financial Services Marketing 11(3), p. 211–216. Pollock, T. G.; Porac, J. F.; Wade, J. B. (2004): Constructing deal networks. Brokers as network architects in the US IPO market and other examples. In: Academy of Management Review 29(1), p. 50–72. Reserve Bank of Australia (2017). Online available at http://www.rba.gov.au/statistics/historicaldata.html. Rudolph, S. (2008): Net Present Value Rule in comparison to the payback and internal rate of return methods. In: Working Paper. Sharpe, W. F.; Alexander, G. J.; Bailey, J. V. (1999): Investments: Upper Saddle River, NJ: Prentice-Hall 6. Titman, Sheridan (2015): Financial Management. Principles and Applications. (7th ed.). Frenchs Forest, NSW: Pearson.

Answers to Main Idea Worksheet 1

Compare and Contrast Hispanic Culture and American...

Compare and Contrast Between Hispanic Culture and American Culture I. Introduction The Hispanic population has experienced an incredible growth in the past decade in the United States of America. In 2006 it was estimated that the Hispanic cover 11 % of the population in North America. Their Origin is in Mexico and the few Spanish speaking countries in the Caribbean. American culture is derived from people who originated from the European nations like Italy and the Great Britain. Cultural identity is very important for every ethnic group as it shapes the culture of that particular faction and therefore, a certain culture cannot realize its own values until it is exposed to another one. II. Nationalism Nationalism revolves around the†¦show more content†¦The two languages also differ in their phonology, grammar and vocabulary (Arreola 13). Race and ethnicity is another important aspect in the nationalism of a nation. In the United States, racial differences are usually based on one’s skin color and physical characteristics as well as one’s origin, and they do not change due to varying classes or cultures (Marger 212). Before the twenty first century, the racial minority were highly discriminated, both socially and economically. But currently, there exist several races in America like the Asians, African Americans, Native Americans and the European Americans. On the other hand, Hispanics are racially assorted and are therefore an ethnic group rather than a race (Marger 133). Language is argued as the sole binder of the Hispanics other than skin color or other physical characteristics. They are in fact of mixed racial ancestry (Arreola 19). Nati ons will always have famous people who act as icons of nationalism or who historically acted as nationalists. Both cultures draw their cultural icons from various classes of individuals, ranging from political figures to movie stars. 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