Accounting and capital markets Essay Example | Topics and Well Written Essays - 2000 words

Accounting and capital markets - Essay Example In the above assessment, the expected value of dividend for 2013 has been measured by taking into account a dividend growth rate that has been proposed by board of each company which is atleast few percentage above the prevailing inflation rate. The expected value has been calculated using Gordon’s formula: D1=D0 (1+g); where g is the dividend growth rate. The dividend growth rates have been sourced from annual report of each company for 2012 (Pennon Group Plc, 2012; Severn Trent, 2012; United Utilities, 2012; National Grid, 2012). The risk free return value has been obtained by taking into account yield on 10 year UK government bonds. It was considered risk free because only government bond investments are considered absolutely safe. The data has been sourced from Open Knowledge (2015) and annual value has been taken into account. The beta represents systematic risk of an organisation. In this paper, the beta value of each company against all FTSE shares has been considered (Caldwell, 2013). The price earnings (P/E) ratio reflects healthy prospects of a company in the stock market. It is calculated as: Market price of share/ Earning per Share. As per instruction of the paper, the market price of share of each company has been calculated on 01 October 2012. However, the EPS value was measured from the respective annual reports. The expected market return has been calculated as reverse of the price earnings ratio. The cost of equity herein has been calculated as: Ke = Rf + ÃŽ ² * (Rm – Rf) and Stock valuation can be largely categorised as absolute valuation model and relative valuation model. For absolute valuation, the paper has considered dividend discount model. One of the important dividend models is Gordon’s dividend growth model. This model is essentially utilised for valuation of equity stocks and is based on the notion that

Investigating the Environmental Disaster in the Gulf of Mexico Essay

Investigating the Environmental Disaster in the Gulf of Mexico - Essay Example This has seriously impacted the human values of not causing harm to others. Thesis Statement: The purpose of this paper is to investigate the complexity and link between sustainability issues including natural laws and human values; and determine the ways in which human systems and ecosystems are linked. and the ethics of not causing harm (George 242). Moral law is a free will approach which gives people the freedom to decide the way in which they should act. â€Å"Moral law theory is morally absolute, not relativistic, connecting human nature and ethical life† (Houser et al 22). Ethical laws are natural, that is they apply to all human beings, irrespective of individual customs and beliefs. Significantly, natural laws are non-consequential, and the consequences of an act are not brought into the ethical analysis. In this respect, it is evident that the oil spill causing extensive destruction is the consequence of installing the particular oil rig, and this outcome is not included in the ethical analysis of the situation. According to natural law, human life has absolute value, hence a single life cannot be sacrificed to save several lives. Thus, it is in contrast with the utilitarian view of cost and benefit, and of achieving the greatest good for the greatest number of people (Houser et al 22). Additionally, natural law requires that moral judgments should take into account the intentions of the persons performing the act. In the oil rig disaster, it is not possible to make any moral judgment of right or wrong based on the intentions of the British Petroleum Company, since the occurrence of such a magnitude, which has caused extensive financial losses for the company was not deliberately intended to happen by them. However, the element of carelessness towards ensuring thorough safety in all aspects appears to have played a part in the catastrophe. The ongoing leakage from the oil well in the Gulf of Mexico, 48 miles

Executive summary on the Thornton case study

Executive summary on the Thornton case study This report is subsequent to the Thornton public limited company case study. A little, bit introduction about Thornton public limited company. Thorntons is one of the most prestigious brand names in the business of chocolate in the world and especially in the Great Britain (U.K.). The company has established around 100 years ago and has various products and different sources to marketing their product like own retail shops, cafà ©, franchisees, supermarket, and Thorntons direct, commercial channel etc. In this report, the concept of leadership and management in relation to Thornton will be review. Secondly, their stated aim of placing greater emphasis on retailing will be analyze and then their influence in situational factor on leadership in present and future will be critically examine through several leadership models INTRODUCTION: Before the report began with the Thorntons the report would like to define the term Leadership and Management what does it mean to organization? Leadership: According to http://sbinfocanada.about.com, Leadership means the art of motivating the employees of an organization to achieve their goals and help the organization for development in today competitive time. Management: In simple words generally use in organization to achieve their desired goals effectively and efficiently. Management involves planning, organizing, employees, and controlling the organization to develop business in todays competitive time. In addition, it is the exchanging of knowledge to create, to outsource, or to produce a new strategic or product for the development of organization. The report is dividing into two parts. In the first part of the report will consider the achievements and negligence of the last chief executive Mr. Mike Davies. Moreover, which model of leadership he has use in Thornton during his time along with the SWOT analysis of the company will be analyze and evaluate along with the way he has role in the company is a transactional leadership skills. In the second part of the report the model Mc Kinsey 7 s and contingency: path goal theory on the new leadership will be analyze and evaluate in Thorntons along with transformational leadership skills and how it will support Thorntons to achieve their goals in the field of retail sales of chocolate and other products along with their situational factors. Discussion: Where are we right now? Firstly, we will look at Last Chief Executive Mr. Mike Davies and his role in the Thornton public limited company. During the leadership period of Mr. Mike Davies, he has practice the leadership model Action Centered Leadership and SWOT analysis of Thorntons. Group needs: Strengthened our retail management team new initiatives to arise sales strengthened the senior retail management team with innovative marketing promotional programmes. Task needs: Manufacturing operations, the product range and performance of its commercial channel and innovative new product. Individuals needs: Tough trading environment, Reference: Action Centered Leadership Adair, john.(1983) Effective Leadership. Gower. SWOT ANALYSIS on Thornton public limited company: Weakness: Thornton direct failed to meet the expectations of the company. Clearing of access stock in shops and then selling them with heavy discount. Strength: Change of liabilities into assets, increase in eps (earnings per share) by 20.4% as compared to last year, Strong Balance sheet, and innovative new Products. THREATS: increase in cocoa prices by 25% and butter prices has increased by 66%. Opportunities: Introducing of Haiti charity bloc, new moulding line to increase productivity, design your own box with personal photo printed for consumers. From the above analyzing, Mr. Mike Davies performance in Thorntons public limited company and while looking at his past work experience in mars of 20 years along with his own consultancy, he has performed as a transactional leadership skills in Thorntons plc. During his period of leadership, he has reconstructed the company and made a valid change in manufacturing operations along with innovation of chocolate box for the exclusively customers which had grown up by 84% in the last year and in the current year also increased by 5% in the current year. Now, Thornton has more than 30% of inlaid chocolate box market. Moreover, he shows strong balance sheet during the time of world economic crisis. However, he wants to reduce the dependence of Thorntons public limited company. As the chocolate is a seasonal product large number of staff is temporary staff on production and own stores of Thornton that should a major problem in the management of the company. 2). Where are we going now? Secondly, what company aspects from the new leader in Thornton should observe the situational factors and strategic development of retail sales and management of the company? The report will analyze the Mc Kinsey 7s model in Thornton and evaluate how it will help them to restructuring the management and retail sales along with the overcome of situational factors. Analyze of Mc Kinsey 7 s model in Thornton has to look after the situational factors. Structure: Change of working environment of staff from temporary to permanent staff in production and management. Strategy: How to achieve goals and proposal to overcome with situational factors. System: Innovation of technology, government support etc. Skills: Assets or resources provided by company. Goals: Improvement in retail sales, situational factors and management. Style: Leadership should concern with employees regarding motivation training. Employees should feel free to share new ideas .regarding the new business source. Staff: Looking after the employees. Like rewards and position in company. Evaluation how does Mc Kinsey 7s model work in Thornton. The new leader should adopt the McKinsey 7 s model approach in the Thornton along with transformational skills so that the employees should be able to share new ideas and new business source of development the organization and they should feel free to share their ideas with the leader directly. Therefore, that will help them achieve their goals in retail and over come with the situational factor. In addition, the new leader should overlook at the changes done by the last chief executive, and try to adapt some changes that are good for the company to cover up with the management in Thornton. How contingency: path goal theory does help the leader and employees to achieve the goals. Nature of employees: How should employees perform to cover up situational factors and improve retail sales, with determination or with disinterest in task? LEADER SHIP BEHAVIOUR 1).Directive 2). Supportive 3). Participative 4). Achievement Oriented Nature of task: situational factors and emphasis on retail sales of Thorntons; it is an ambiguous structure task or manageable structure task. Employees approach and motivation towards this situation in Thorntons. Goal Clarity shows the improved performance of the retail sales, situational factor, and job satisfaction of employees. Evaluation how does contingency: path goal model work in Thornton public limited company. From the above analysis of the path goal model in the Thornton public limited company. We can examine that the working conditions of management need to be friendlier between the leader and the employees so that each task should be structure first so that management could complete the task properly within a period, it will give job satisfaction to employees, and company performance will be improve accurately. Conclusion: This report has analyzed and evaluated Action Centered Leadership and SWOT analysis under the leadership of Mr. Mike Davies and he performs as a transactional leader in Thornton. Mc Kinsey 7s and contingency: path goal theory has analyzed and evaluated for the role of new leadership that is require by Thornton and it will help the cover up all the situational factor of management as the employees are on temporary basis they should be on permanent so they will be interested in their work. Recommendations: From the case study of Thorntons and this report, I would like to share my opinion that Thorntons should go for vertical integration process of their daily needs product like milk etc. As this project is a low investment project, nevertheless it will help the organization to improve their strategic goals describe in the case study. They just need some greenery area or farm house to where they can take care of cows, and in return, they will get 100% fresh milk daily. That milk they could make butter, because it prices was arose by 66% in the year 2009. Moreover, milk can be use in the mixing of chocolate. This business is ecological and neither will it occur any global warming. Also with the help of vertical integration, they can improve the quality of chocolate that will stay for a longer period. Besides this, they can sell their own milk in their own brand name as a new product; they can launch different kinds of milk shakes in their own cafà © in the U.K. and Ireland. That could h elp them to increase their own retail sales. It will also turn unemployment into employment that will help the government in terms of tax increase.

Politics and Religion in the Herbert’s Dune Novels Essay -- Dune

Politics and Religion in the Herbert’s Dune Novels There are a variety of political and religious concepts throughout the Dune novels that varies so much through the novels which makes it a complex and cogitative science fiction series. The Dune novels are popular with many fans and partly this is due because of its political and religious structures. This essay will be focussing primarily on the first four Dune novels written by Frank Herbert. In the first novel, the Qizarate is composed of missionaries and is a religious body that carries Muad'dib's religion across the universe (Herbert Dune Messiah 8). Muad'dib is a character in three of the Dune novels and originally was named Paul Atreides who was heir to the Atreides throne of power. After living on a planet called Arrakis also known as Dune, the Fremen renamed him Muad'dib after they accepted him into their society. The Fremen are native people that had lived on Arrakis for a long time but were never political or religious leaders of the planet as they were mostly detached from off world influence. The Qizarate maintains control of the planets it occupies with Muad'dib's religion. The population of the universe see Muad'dib as their god whether they like it or not and they can not deny his power religiously. Korba, the person in charge of the Qizarate in Dune Messiah, works with Muad'dib about Muad'dib's religion and is a panegyrist who delivers eulogies and pr aise for his god (Herbert Dune Messiah 8, 57). Korba seems to be fanatically involved with this religion. Korba goes far enough to attempt to create a martyr of Muad'dib, all for the sake of his religion (Herbert Dune Messiah 9). The Bene Gesserit wanted to control the religion of the univers... ...l structure struggles with internal and external forces. The Dune series is popular because it requires the reader to think, and there is more to that than just a story. Works Cited Herbert, Frank. Children of Dune. New York : Ace Books, 1987. Herbert, Frank. Dune Messiah. New York : Berkley, 1969. Herbert, Frank. God Emperor of Dune. New York : Putnam, 1981. McLean, Susan. "A Question of Balance: Death and Immortality in Frank Herbert's Dune Series". Death and the Serpent: Immortality in Science Fiction and Fantasy. (1985): 145-152. O'Reilly, Timothy. Frank Herbert. Frederick Ungar Publishing Co., Inc. 1981. Palumbo, Donald. "The monomyth as fractal pattern in Frank Herbert's Dune novels". Science Fiction Studies 25.3 (Nov. 1998): 433-58. Touponce, William F. Frank Herbert. Boston: Twayne Publishers, 1988.

LGBT

A social movement is a reform concept that characterizes individual collective effort with some degree of organization or community. This move is at least partially outside the normal political process and institutions, to bring about societal change. In the realm of Lesbian, Gay, Bisexual and Transgender rights, activists have played a vital role in reshaping the societal norms, culture and politics. The LGBT are different and unique persons in the world and exhibit an exemplary self-confidence. A common purpose and the goal of the LGBT, in the society is promoting equity the minority. However, some individuals have also focused in building and nurturing LGBT community. They also work towards promoting social liberation for the broader society from sexual stigmatization and discrimination. The LGBT movement in the world today, constitute of a wide rang of political activism and cultural activity. They therefore strategically adopt lobbying, street demonstrations, community participation and social grouping to push for their agenda. The LGBT communities have a universal way of identity. Symbols and art of social movement provide meaning, express social and political solidarity with a particular identity. The symbol mostly used by the LGBT community particularly during the 1980-19990 is the pink triangle among others. The pink triangle for example was mostly used by the Nazi community in Germany to label homosexual and lesbianism. The LGBT movements’ advocates for unique way of lifestyle defined by the world as â€Å"not normal† Consequently, people with such preferences faces a mixed reaction from the normative section of the community. The LGBT community has therefore continually faced opposing both from individuals and organizations. It is widely believed that people with negative attitude towards lesbians and gays are more likely to be male, politically conservatives, religious and older persons who particularly have little personal contact with openly gay individuals and supports the traditional roles. Lesbians, Gay, Bisexual and Transgender lifestyle violates the principles of God on sexuality. The true sexual identity acceptable by God is the sexual union a man and a woman. Other forms of sexual relation are evil and therefore unacceptable before God and humanity. Culturally the actions of the LGBT community are strongly condemned. Their sexual relation is termed as â€Å"not normal† and therefore adoption of such sexual preferences tend to alter the system of values defined by the strict spirit of culture. Thus the acts of LGBT go against the cultural law concept of morality. The LGBT is therefore an Politics establishes structures that promote healthy living in the society. In fact, the spirit and law of politics has its root from religious and cultural principles.   For many years government institutions have not appreciated the rights and freedoms of the LGBT individuals. This is partly because LGBT sexual relation violates the principles of political morality. LGBT is a group of normal people and therefore deserve democratic space consideration. They should be granted the right and freedom of assembly and expression. However, LG BT community appreciate that they are swimming against the wave of normativity. Thus stigmatizations and discrimination will still continue. In response to the social; seclusion and moral uncertainty that surrounds the LGBT community, my consciousness, culture and faith will not allow me to identify with the LGBT community. I therefore will not accept to wear the identification pin. Reference Goodwin J. and James M.J, â€Å" The Gay Liberation Movements.† In the social Movement Reader: Cases and Concept

Acute Hepatitis B

Acute Hepatitis B GNUR543 St. John Fisher College Mr. Wilson is a 47 year old man being evaluated for complaints of fatigue, anorexia and abdominal distention. On examination, it is noted that the skin is jaundiced and the liver enlarged. D. W. denies significant alcohol or drug use. He denies any known exposure to hepatitis and has never been vaccinated for hepatitis. He is taking no medication. Laboratory tests reveal the following and a diagnosis of acute hepatitis B is made: 1. Review and analyze the laboratory data. What diagnosis is supported by these values? Give your rationale. Mr.Wilson’s lab work is reviewed below: * AST142 IU/L * AST (Aspartate aminotransferase) is an enzyme and blood sample results can detect if there is liver damage. AST is found in the heart and liver with much lower levels in muscles and kidneys. In a healthy person the AST is between 10-40 IU/L. If the liver is damaged, AST is released into the blood stream (Hepatitis B, 2011). * ALT120 IU/L * ALT (Alanine aminotransferase), if elevated can also be an indication of liver damage. ALT is an enzyme that is normally in the liver and kidneys. If the individual is healthy, the ALT is low, between 7-56 IU/L.Elevated ALT is an early indicator of liver damage usually elevating prior to a patient becoming jaundice (Hepatitis B, 2011). * GGT 42 IU/L * GGT (Gamma-glutamyl transferase) is an enzyme that is found in the liver but may also be in the spleen, kidneys and pancreas. As with AST/ALT, GGT is elevated when there is liver damage. The normal test range is 0 – 51 IU/L. GGT will be elevated when there is acute damage to the liver (or bile ducts) (Hepatitis B, 2011). * Alk Phos 84 IU/L * Alk Phos (Alkaline Phosphatase or ALP) is an enzyme found in the liver, bone, kidney and GI tract. Normal range for this blood test is 44 – 147 IU/L.Alk Phos, if elevated generally indicates that there is a blockage in the bile ducts. Also, if it is found to be high this means the pat ient can either have kidney disease or bone disease. To differentiate, a GGT test is also taken. If that result is high as well, a liver disease is present; if the GGT is within normal limits then the patient has bone disease (Hepatitis B, 2011). * Total Bilirubin1. 0 mg/dl * Total bilirubin is the product of damaged or broken down red blood cells in the body. The bilirubin is processed through the liver and the normal levels in the body are; 0. 3 – 1. 9 mg/dL.If this level is increased, it means that the liver is not processing the bilirubin due to liver disease (Hepatitis, 2011). * Albumin4. 3 g/dl * Albumin (ALB) measures the level of albumin in the patient’s plasma. Albumin is a protein that is made in the liver and is sensitive to any changes in liver function. Albumin mainly ensures that the cells in the body don’t leak, keep the tissues nourished and transports vitamins, calcium, hormones through the body. The normal range for Albumin is 3. 4 – 5. 4 g/dL. Albumin will be lower than normal in the case of malnutrition or liver disease (Hepatitis, 2011). HBsAgpositive * Anti-HBSnegative * Anti-HCVnegative * HIVnegative Test Name| Mr. Wilson’s Result| Normal Ranges| | AST| 142 IU/L| 10-40 IU/L| Elevated| ALT| 120 IU/L| 7-56 IU/L| Elevated| GGT | 42 IU/L| 0 – 51 IU/L| Normal| Alk Phos | 84 IU/L| 44 – 147 IU/L| Normal| Total Bilirubin| 1. 0 mg/dl| 0. 3 – 1. 9 mg/dL| Normal| Albumin| 4. 3 g/dl| 3. 4 – 5. 4 g/dL| Normal| Mr. Wilson’s labs indicate that he has chronic Hepatitis B. This is chronic because the indicators for acute liver damage are within normal limits. For example, if the patient were having an acute onset of Hepatitis B his Albumin would be low.Albumin is made in the liver and is very sensitive to any changes in the liver. If there was acute damage to the liver the Albumin value would not be in normal range. Also, Mr. Wilson’s bilirubin would be higher if he was having a cute hepatitis B. For the skin to be noticeably jaundiced the bilirubin level would usually be >2. 0 mg/dL (Hepatitis, 2011). The patients GGT would be elevated also if he was experiencing an acute episode of hepatitis B. Additional tests that might be helpful to making an accurate diagnosis would be; IgG-anti-HBc and IgM-anti-HBc.These tests show if the hepatitis is acute or chronic. The IgG-anti-HBc is positive if the patient is chronically infected. The IgM-anti-HBc would show positive if the patient is acutely infected with hepatitis B. The HBs-Ag will be positive in both acute and chronic cases. See the table below for an overview of the assessment and tests that are generally given when a new Hepatitis B diagnosis is reached. (Lok A. S. , 2011) 2. Explain the hepatocellular changes that occur with the above diagnosis. The liver has many roles in the body that associate it with many systems.For example, it acts as a digestive organ by secreting bile for the breakdown of fat (Co pstead, 2010). The liver also removes bilirubin from the blood, temporarily stores blood and synthesizes the blood clotting factors (Copstead, 2010). Other functions of the liver are; removing toxins from the blood, metabolizing both sex hormones and steroid hormones. Any damage to the liver can in turn disrupt any of these processes and functions that it performs. Some of the processes and functions can be changed in the following ways: * Liver inflammation: Inflammation in chronic hepatitis is associated with scarring.Severe inflammation can bridge together portal tracts within the liver, this is called â€Å"bridging necrosis† (Mani & Kleiner, 2009). It can also bridge to central veins, confluent necrosis (Mani & Kleiner, 2009). This leads to scarring, the creation of fibrous strands and in many cases will lead to fibrosis. Throughout the liver cells are becoming damaged therefore blocking and limiting the livers functionality. Hormone secretion, chemicals and toxins in th e blood, clotting factors and other defense fighting macrophages are interrupted (Copstead, 2010).Along with the inflammation, the patient will feel fatigued and will have a lowered immunity. * Ascites and peripheral edema: Abdominal distention, ascites, is a result of the damaged cells within the liver and more specifically the membrane of the cell has been damaged. There is an intra-abdominal buildup of sodium, water and protein. The cells in the liver are unable to maintain the appropriate osmotic gradient across the pleura (Copstead, 2010). This extra fluid is likely to accumulate in the dependant areas of a person’s body, such as ankles, legs, and arms (Kukka, 2010). Jaundice: Red blood cells have a short life span and as they die and/or are damaged the body will break them down and dispose of them. This is referred to as bilirubin metabolism and this happens in three phases; pre, intra and posthepatic. (Copstead, 2010). The red blood cells should be broken down, deliver ed to the liver and then transported through the biliary system and thus be wasted via the kidney’s or the colon. With damaged liver cells, the bilirubin is not excreted from the liver and there is a buildup of the conjugated bilirubin and the result is jaundice (Copstead, 2010).Other changes due to the liver damage are portal hypertension, gastric and esophageal varacies, vitamin mal-absorption, poor blood clotting and altered mental status (Copstead, 2010). The liver has such far reaching effect on so many organs and systems in the body that any damage to the liver will result in decreased functioning of other systems. Immediate tests to determine the cause and extend of the damage would be imperative to managing the disease going forward. 3. How should the disease be managed and monitored? Explain your rationale.If pharmacotherapeutics are used, explain your rationale and their mechanism of action. First steps would be to order additional labs including, IgM-anti-HBc, IgG- anti-HBc, HBeAg, HBV DNA, CBC with PT and electrolytes. In cases of acute hepatitis B, symptoms sometimes go unnoticed. The virus will normally go away on its own and if treatment is given, it is for the symptoms and most adults recover fully (Hepatitis B, 2011). But in the case of chronic HBV, the patient will need to be monitored to see if the virus is replicating (Lok A. S. , 2011). In patients with chronic HBV, the treatment oals are to reduce the long term effects of liver damage, prevent the transmission of the virus to others and manage any complications along the way (Lok A. S. , 2011). A clear diagnosis of chronic hepatitis B is needed. Results of blood work will determine the course of treatment. In Mr. Wilson’s case, with only the first lab results, it appears that he is in the active chronic infection stage. At this point the liver damage is still minimal. Because there does not seem to be significant liver damage a liver biopsy would not be indicated at this poin t (Lok A. S. , 2011).As the practitioner, I would recommend more blood tests, as noted above, and ongoing monitoring of the virus every few months. This will help in determining the activity of the virus. The medications used to treat chronic hepatitis B tend to have serious side effects. The patient must be willing to make a commitment to continue the therapy and adhere to close monitoring during any drug treatments (Hepatitis B, 2011). Supportive medicines are important to assist in treating side effects of the virus. For example, diuretics are prescribed if edema is not resolving on its own.Vitamins and minerals are indicated if labs show deficiency due to decreased liver function. If it is determined that Mr. Wilson’s virus is active (meaning he is able to infect others) there are new drugs available to choose from. Antiviral treatments include (Hepatitis, 2011): 1. Entecavir – a. A pill taken once a day for up to a year b. Used when DNA viral cells are actively re plicating 2. Interferon Alpha c. Injection a few times per week for up to a year d. Used when patient has compensated liver disease 3. Pegylated Interferon e. Injection once per week for up to a year f.Used when patient had compensated liver disease and evidence of viral replication and liver inflammation 4. Lamivudine g. A pill taken once a day for a year or more h. Used when patient has active liver inflammation and active viral replicating 5. Adefovir Dipivoxil i. A pill taken once a day for a year or more j. Used in patients with chronic HBV 6. Telbivudine k. A pill taken once a day for a year or more l. Used in patients with active viral replication, persistent elevations in ALT or AST or histologically active disease 7. Tenofovir m. A pill taken once a day for a year or more n. Used in patients with chronic HBVThe medicines listed above are used alone or more likely in conjunction with others. These are currently the only hepatitis B drugs that are approved by the FDA (Lok & M cMahon, 2009). According to the American Association for the Study of Liver Diseases (AASLD) Practice Guidelines, the ultimate goal of therapy is to suppress the replication of the virus and put the liver disease into remission (Lok & McMahon, 2009). This is monitored by watching the patients ALT, AST and other liver, viral and blood tests. The viral tests are imperative to determine the proper adjustments in medications.For example, interferon has been shown to reduce the viral replication and inducing liver disease remission (Lok & McMahon, 2009). Also, a newer drug, tenovir has shown significant promise in reducing viral levels in patients as compared to adefovir (Lok & McMahon, 2009). Practitioners need to watch for resistance as well when using the anti-viral drugs. As noted, the drugs are used in combination as well and these have shown to be more effective than when they are used alone. The effects of combined usage are better antiviral effects and delayed resistance (Lok & M cMahon, 2009).Mr. Wilson’s ALT, HBeAg lab values and his HBV DNA will be a main determinate to the type of therapy he will receive. A liver biopsy will be indicated later on if his  HBsAg is positive for more than six months, his serum HBV DNA is greater than >20,000 IU/mL and he has persistent or intermittent elevations in his ALT/AST levels (Kukka, 2010). Summary Hepatitis B can be chronic or acute. When a person has acute hepatitis B they generally don’t even notice and never need treatment. If treatment is needed it is supportive treatment for the symptoms of the acute virus infection.Chronic hepatitis B patients are at risk for cirrhosis and HCC (hepatic cellular carcinoma) (Kukka, 2010). Patients that have chronic HBV need to be educated on the risk of infecting others and will, in some cases, need to alter their lifestyle to protect others from getting the virus. Treatment is dependent on the blood work up that is obtained. It is very important that a patient that goes on antiviral treatment remain on it to reduce drug resistant strains. Also, patients must be evaluated and treated for the side effects of the anti-virals as well as the symptoms of other affected organs and systems in the body.References Copstead, L. -E. C. (2010). Pathophysiology. St. Louis: Saunders. Hepatitis. (2011, July 6). Retrieved March 26, 2012, from Lab Tests Online: http://labtestsonline. org Hepatitis B. (2011, July 6). Retrieved March 25, 2012, from Lab Tests Online: http://labtestsonline. org Hepatitis B. (2011, September 1). Retrieved March 24, 2012, from Mayo Clinic: http://www. mayoclinic. com/health Kukka, C. M. (2010). Hepatitis B Fact Sheet. HCSP Publications. Lexicomp. (2012). Retrieved February 5, 2012, from Lexicomp: https://online-lexi. com Liver Blood Tests. (2012, March 28).Retrieved March 30, 2012, from e Medicine Health: http://www. emedicinehealth. com/ Lok, A. S. (2011, February 16). Overview of the management of hepatitis B. Retrieved March 24, 2012, from UpToDate: http://www. uptodate. com Lok, A. S. , & McMahon, B. J. (2009). Chronic Hepatitis B: Update 2009. Alexandria: American Association for the Study of Liver Diseases. Mani, H. , & Kleiner, D. E. (2009, May 1). Liver Biopsy Findings in Chronic Hepatitis B. Retrieved April 1, 2012, from University of Pennsylvania, Department of Medicine: http://webdev. med. upenn. edu