Assisted Laparoscopic Radical Prostatectomy Specimen Removal

Assisted Laparoscopic Radical Prostatectomy Specimen Removal Removing the specimen with traction during robotic radical prostatectomy Serkan Altinova, Abidin Egemen Isgoren, Ziya Akbulut, Muhammed Fuat Ozcan, Abdullah Erdem Canda, Ali Fuat Atmaca, Mevalana Derya Balbay Key words: Prostate cancer, radical prostatectomy, specimen, traction Abstract Purpose: Our aim was to show if removing the specimen with traction during robot assisted laparoscopic radical prostatectomy cause positive surgical margin or not. Materials and Methods: 169 patients with localized prostate cancer who were performed robot assisted laparoscopic radical prostatectomy were included in the study between 2009-2011. Patients were divided into 2 groups. Patients’ characteristics, preop and postop evaluation were recorded. Results: There were 111 and 58 patints in group 1 (with traction) and group 2 (without traction), respectively. Patients’ ages, follow up time, body mass indexes (BMI), prostate spesific antigen (PSA) values, preop and postop Gleason score values, pathological stage, positive surgical margin rates and biochemical PSA reccurrence rates were evaluated. There was no statistically significant difference between groups for age, preop PSA values, BMI, preop and postop Gleason scores, positive surgical margin rates and biochemical reccurrence rates. There was significant difference between prostate weight, tumor volume and clinical stage between groups. ( Conclusions: Removing the specimen with traction during robot assisted laparoscopic radical prostatectomy does not cause positive surgical margin. The incision can be as small as possible for cosmetic sight. Introduction Robot-assisted laparoscopic radical prostatectomy (RALP) has become the most preferred surgical technique for localized prostate cancer. One of the most important factor pointing out the oncologic success is the surgical margin status.(1) Positive surgical margin (PSM) status may be related both with the surgeon, surgical technique and disease burden. (1,2 ) Our aim was to evaluate the effect of traction, probably the cause of PSM, during the specimen removal. Ther are many studies comparing the PSM acording to techniques, pathologic findings and clinical stage but we found none acording the technique of specimen removal. (3) Materials and Methods 169 patients who were performed RALP for localized prostate cancer between 2009 and 2011 were included in this study. All the patients were evaluated and Ethic Committee permission were given for each. The reason why we planned this study was the patients with postoperative PSM (positive surgical margin) but no PSA (prostate spesific antigen) reccurrence. Patients were randomized as two groups, A and B, acording to their status of traction was done or not while removing the specmen. Traction can be defined as removing the specimen from a small incision that may let the specimen removed by traction. No traction can be defined as removing the traction from an incision larger than prostate that make easy removing the specimen without any difficulty. Student-t test was used for follow-up, age, BMI (body mass index), PSA, prostate weight and tumor volume. Chi-square test was used for Gleason grade, stage, SMI (surgical margin invasion) and BCR (biochemical reccurrence rates). All the values were calculated as mean and SD. SPSS 16 was used. Results Group A (traction group) had 111 patients while group B (no-traction group) had 58. There was statistically significant difference between groups for prostate weight, tumor volume and clinical stage. Age, BMI, preoperative PSA levels, biopsy Gleason score, prostatectomy Gleason score, pathological stage, SMI status and BCR were similar for both groups. Patients’ preoperative and postoperative characteristics are summerized in table 1 and 2. Although there are pT0 patients in both groups we have to say that we have given no additional therapy like androgen deprivation therapy preoperatively. Discussion Nowadays robot-assisted laparoscopic radical prostatectomy is the main surgical technique for localized prostate cancer. In the United States 85% of radical prostatectomies are performed robotically. (4) Generally PSM rates after different techniques for radical prostatectomy seems to be equal but sometimes surgical technique may effect the rates.(5,6) Oncologic outcomes of robotic surgery are generally similar with laparoscopic and open surgery (7-10) although there are some other results suggesting that the rates are different for the techniques. (11-13) The well known object is that the PSM may be related with disease burden, surgeon and also the technique. Robotic surgery has some differences from laparoscopic surgery. The adventages of robotic surgery are related both with the patient and the surgeon. This provides a comfortable operation for the surgeon. In order to find out if traction may cause a PSM, we randomised the patients into two groups as traction or non-traction. We believe that traction may cause a damage on the prostate capsula and show a pseudopositive surgical margin. In our study PSM rates are similar in both groups. Higher tumor volume and stage can effect PSM rates. (2) Although traction group has higher tumor volume rates and lower clinical stage PSM rates are similar. Also prostatectomy Gleason scores are similar for both groups. All the operations were performed by the same person as PSM rates can differ among surgeons performance. Some outhors have described â€Å" Capsular Incision Index† to show the damages on the capsula that may cause pseudopositive surgical margin.(2). We beleive, because of the traction made by the fourth arm of the robot may cause pseudopositive surgical margin, pahologist must reveal that if there is a positive margin coloured with the ink they use, they must also see the capsula of the prostate. If no, this may not be really a positive margin. This is very important as sometimes may affect the extra t herapy options. In order not to give any unneccesssary treatment both the surgeon and the pathologist must be very careful as this may not only increase the morbidity but also the cost. Conclusion Surgical margin status after radical prostatectomy is an important topic. Surgical technique is important in order not to cause a positive surgical margin but pathlogical findings are maybe more important for the possible additional treatment. Removing the specimen with traction during robot assisted laparoscopic radical prostatectomy does not cause positive surgical margin. The incision can be as small as possible for cosmetic sight. References Wiezer AZ, Strope S, Wood DP. Margin control in robotic and laparoscopic prostatectomy: What are the REAL oucomes. Urol Oncol. 2010; 28:210-14. Hong H, Mel L, Taylor J, Wu Q, Reeves H. Effects of robotic-assisted laparoscopic prostatectomy on surgical pathology specimens. Diagn Pathol. 2012; 7:24-30. Tewari A, Sooriakumaran P, Bloch DA, Seshadri-Kreaden U, Hebert AE, Wiklund P. Positive surgical margin and perioperative complication rates of primary surgical treatments for prostate cancer: A systematic review and meta-analysis comparing retropubic, laparoscopic and robotic prostatectomy. Eur Urol. 2012; 62:1-15. Lowrance WT, Parekh DJ. The rapid uptake of robotic prostatectomy and its collateral effects. Cancer. 2012; 118:4–7. Philippou P, Waine E, Rowe E. Robot-assisted laparoscopic prostatectomy versus open: comparison of the learning curve of a single surgeon. J Endourol. 2012; 26:1002-08. Coelho RF, Rocco B, Patel MB, et al. Retropubic, laparoscopic and robot-assisted radical prostatectomy: a criticai review of outcomes reported by high volume centers. J Endourol. 2010; 24:2003-15. Parsons JK, Bennett JL. Outcomes of retropubic, laparoscopic, and robotic-assisted prostatectomy. Urology. 2008; 72:412–16. Ficarra V, Novara G, Fracalanza S, et al. A prospective, non-randomized trial comparing robot-assisted laparoscopic and retropubic radical prostatectomy in one European institution. BJU Int. 2009; 104:534–39. Schroeck FR, Sun L, Freedland SJ, et al. Comparison of prostate-specific antigen recurrence-free survival in a contemporary cohort of patients undergoing either radical retropubic or robot-assisted laparoscopic radical prostatectomy. BJU Int. 2008; 102:28–32. Laurila TA, Huang W, Jarrard DF. Robotic-assisted laparoscopic and radical retropubic prostatectomy generate similar positive margin rates in low and intermediate risk patients. Urol Oncol. 2009; 27:529–33. Williams SB, Chen MH, DAmico AV, et al. Radical retropubic prostatectomy and robotic-assisted laparoscopic prostatectomy: likelihood of positive surgical margin(s) Urology. 2010; 76:1097–1101. Cathcart P, Murphy DG, Moon D, Costello AJ, Frydenberg M. Perioperative, functional and oncological outcomes after open and minimally invasive prostate cancer surgery: experience from Australasia. BJU Int. 2011; 107(Suppl 3):11–19. Magheli A, Gonzalgo ML, Su LM, et al . Impact of surgical technique (open vs laparoscopic vs robotic-assisted) on pathological and biochemical outcomes following radical prostatectomy: an analysis using propensity score matching. BJU Int. 2011; 107:1956–62. Table 1. Preoperative characteristics of patients Table 2. Patients’ postoperative findings 1

Discuss the following Essay

A staff meeting has been called for all members of the administrative department at the hospital where you work. Due to a change in patients’ needs, the hours of operation need to be modified.   Several scheduling options are presented and a decision has to be made. Should this decision be made by a majority vote, or a consensus? Support your choice with   reasoning from the decision making section on page 98 of your GMC. I think that due to the time and hours of operation that it should be a majority vote for the reason or reasons outlined below: 1.Since there is only the matter of counting votes, decisions can be reached much more quickly with majority rule. Majority rule does not require the same level of interpersonal communication. It is a democratic process which ultimately comes down to simple mathematics. This method of decision-making, outside of registration, is often anonymous. The nature of the process, in many cases, allows individuals to maintain their privacy, as others cannot know with certainty, for whom or what a person has voted. A disadvantage of majority rule is the majority’s ability to vote against the interests and preferences of those in the minority without those groups or individuals being heard or involved in the discussion. Those in the minority may be disenfranchised and remove themselves from the decision-making process because they are aware they do not have the numbers to win or significantly impact the vote.

Tale of Two Cites: Drowning Motif

English 12u Essay Rough Draft Justina Van Maren Splashing, gasping for breath. Sinking, darkness, and then; death. Death by drowning is, in the beginning, a conscious, agonizing end. The realization of an imminent death is the first step that strikes fear into the heart of the victim. Shore is too far away, the person is too tired, and if rescue is not near, death is inescapable. Contrary to popular understanding, a drowning person is not easy to spot. People picture a drowning victim screaming or calling for help, but in actuality all his/her efforts are used to breathe, making calls for help impossible.Drowning is not the death most people envision it. It is a silent killer. Creeping up slowly, it takes its victims by surprise, and often before five minutes have passed, death has them in its cold, cruel clutches. This silent action is paralleled in Charles Dickens novel, A Tale of Two Cities. Dickens speaks of a woodman, personified as fate, and a farmer, who is used to picture dea th, working silently but purposefully towards the French Revolution, getting ready wood for scaffolds, guillotines and tumbrels. As well as portraying the silent nature of drowning, Dickens also uses this motif to bring out another aspect of the revolution.In A Tale of Two Cities, Dickens uses the motif of drowning to portray the stages of the revolutionaries’ attitudes towards their condition. â€Å"The first step towards getting helped is realizing that you have a problem. † (Anonymous) This well known quote clearly illustrates the first step of drowning. A man cannot save himself if he does not realize that he is in danger. When drowning becomes reality to its victims, their whole vision changes, and panic sets in. In A Tale of Two Cities, the peasant’s vision changed as they realized that if they did not act right away, they would die as victims of a tyrannical system.If this fact in itself did not move the peasants into action, it was the fact that not only them, but their children and their children’s children would perish, smothered under the iron fist of the aristocracy. Their vision became visions of desperate people, as drowning people. This outlook was in many ways created and helped along by Monsieur and Madame Defarge. They showed the shrunken, wasted Doctor Manette to the Jacques, in order to change the way they looked at things and strike fear of their condition into their hearts. Dickens also uses the motif of drowning very strongly in the personal lives of his characters.A quote found on page 255 reads, â€Å"All this was seen in a moment, as the vision of a drowning man. † This quote refers us back to the Manette’s, where Jarvis Lorry reveals the terrible grindstone scene to the horrified Doctor. Doctor Manette’s vision changed at that moment as well, realising that death, though not for himself, was sure for Lucie’s husband if immediate action was not taken. When a drowning person obtai ns the vision that he or she is dying, panic takes control over both mind and body. From panic stems desperation and a desperate man is someone who will do anything to change his situation.A drowning man no longer thinks about right and wrong, about what morals he practices, or what values he ought to follow. One thought consumes his mind, and that is to save himself. The means used to achieve deliverance does not matter, nor does the suffering person stop to consider if he is harming another in saving himself. In the novel, this is illustrated by the conflict between Miss Pross and Madame Defarge; â€Å". . . Miss Pross . . . held her round the waist, and clung to her with more than the hold of a drowning woman,† (Dickens 357).This situation clearly reminds the reader of the desperate circumstances in which the peasants found themselves. Just as Miss Pross’ hold on Madame Defarge was a matter of life or death, so the actions of revolutionaries were determining their e nd; a better future for all peasants, or a continuation of oppression from the ancien regime. In the above quote Dickens also speaks about the hold of a drowning person. A rescuer must always be careful when swimming up to such a person, because in panic, the victim may grab hold of him/her so tightly that both perish.In the same way, the revolutionaries harmed others while trying to save themselves. In the senseless slaughter of those guilty and innocent alike, the revolutionaries drowned themselves along with their victims in a pool of immorality and revenge. For, even though they bettered their physical condition and brightened the future for their children, their conscience was passed over and ignored. Like a drowning man who before the actual act of death becomes unconscious, so the consciences of the revolutionaries were pushed away until they were silenced, no longer able to warn against the upcoming spiritual death. Death is the final outcome.If a person has drowned, death h as come to claim this person and there is no longer any chance of being rescued. In A Tale of Two Cities, Dickens speaks of the gaoler of Charles Darnay, his description being, â€Å". . . this gaoler was so unwholesomely bloated, both in face and person, as to look like a man who had been drowned and filled with water,† (Dickens 249). This man seems to point to all the revolutionaries, not in the physical description, but in a spiritual sense. The consciences of the revolutionaries have been drowned, silenced forever, and the people themselves have been filled with thoughts only of bloodthirsty revenge.The picture of a drowned man is not a pleasant one. The death is most often an agonizingly conscious one, causing the expression to be one twisted in agony, the horrified expression of one without hope of survival. The lack of oxygen causes the skin to turn a sickly blue, and the water soaks into the pores and causes the persons face to be swollen and bloated. Ultimately, the person’s appearance is so altered that it is usually difficult, if not impossible to identify the person from the way they looked before.Similarly, the revolutionaries were not a pretty picture in the way that they cared nothing for their fellow man and executed any who seemed to oppose them callously, without proof or proper trial. Proof of this callousness can be found in the example of the little seamstress towards the end of the novel, a representation of thousands of innocent victims sent to the guillotine. We read of how the women knitting below the scaffold counted the severed heads calmly, not in the least disturbed at the horrific amount of bloodshed occurring right before their eyes.The wood-sawyer is another prime example of the uncaring attitude of the peasants when he talks flippantly to Lucie of the guillotine; â€Å". . . Loo, loo, loo! And off her head comes! Now a child. Tickle, tickle; Pickle, pickle! And off its head comes. All the family! † (Dickens , 341). We are horrified as we read of the Jacques gleefully talking about the way they enjoy seeing a woman with blonde hair and blue eyes being guillotined, and we are even more appalled when they speak with eager anticipation at the thought of seeing Lucie’s pretty child put to death.Throughout all these examples we can see that Dickens has brought the motif of drowning to a close and the final outcome, death of the revolutionary’s morality, has been achieved. At the end of the novel, A Tale of Two Cites, the motif of drowning has come full circle. We read of how the peasant’s desperate situation causes their vision to be that of drowning people as they realize that death is imminent. Dickens moves on to portray the panic that causes morality to be ignored in the frantic attempt to preserve one’s own life.Dickens shows that drowning people will do anything to save themselves, even drown their rescuer if they feel it will improve their own condition. In the same way the revolutionaries brutally disposed of any that seemingly hindered their desperate attempt to break their chains of oppression. The plot lines of the characters also vividly portray the way in which the consciences of certain characters are silenced, and the way in which no other thought than revenge is allowed into the minds of the revolutionaries. And then finally, death, the end of all morality.The guiding principles of mankind were destroyed as the revolutionaries thirst for bloodshed did not abate, but instead grew more intense, as each day they longed for more heads to be added to the ever growing number. The motif of drowning is used very powerfully by Charles Dickens, and is employed in a way that effectively portrays the desperate position of the revolutionaries. The way in which Dickens uses this motif clearly parallels the changing attitudes of the revolutionaries, giving us a better understanding of them.

Beowulf And The Epic Hero - 1407 Words

In the epic hero poem, Beowulf, the main character Beowulf, is a prideful, boastful and extremely strong individual. He is faced with a few tasks during the course of the poem; the first of which is fighting and killing an evil, dangerous and disgusting creature, named Grendel, which terrorized the town of Herot. Soon after that, Grendel’s devious mother â€Å"the she-wolf,† attacks Beowulf and the town forcing Beowulf to fight her off as well. After the mother-son duo, Beowulf is then faced with the biggest task of his existence, both literally and figuratively. During each of these battles Beowulf fights and kills these creatures in different ways with different weapons and different tactics. He also changes during each fight, and at the end of the poem is quit a different man. How does he manage to fight each creature off and what kind of tactics did he use? Well that’s a great question, let me elaborate. First and foremost, Beowulf is a very strong warrior; he hails from the land of the Geats and is their best soldier. He is what many would call a thrill seeker and is drawn to danger, adventure but most of glory. Beowulf sets off in search of such glory and lets the seas take him where it may; this leads him to the town of Herot. Once there he is given a great opportunity by the great King Hrothgar, to prove his strength and obtain much glory. The task is to kill the terrible creature that haunts the town night after night, a creature named Grendel. Beowulf finds out moreShow MoreRelatedThe Epic Of Beowulf As An Epic Hero1519 Words   |  7 Pagesaway following a journey, you have most likely read an epic. An epic by definition is â€Å"a long poem, typically one derived from ancient oral tradition, narrating the deeds and adventures of heroic or legendary figures or the history of a nation†. Every epic has a main character that undergoes the same archetypal journey as all ot her heroes, an epic hero. There are specific qualities one must have to be considered an epic hero. Each epic hero possesses superhuman strength, displays a strong sense ofRead MoreThe Epic Of Beowulf As An Epic Hero711 Words   |  3 Pagesthan the writer. These â€Å"epic heros† are protagonists that fulfill their potential of greatness through using their bravery, strength and humility for good. The near ancient tale of Beowulf is a classic example of an epic story that contains an epic hero. In this tale Hrothgar, the king of the Danes, has been terrorized by a beast known as Grendel. This beast has been murdering the king’s people and no one has come close to stopping this killer. A Geat warrior named Beowulf hears of the King’s predicamentRead MoreBeowulf : An Epic Hero930 Words   |  4 Pages The story of Beowulf shows its reader many characteristics of why this Anglo-Saxon poem is an epic. 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Beowulf is described as an epic hero becauseRead MoreThe Epic Hero Of Beowulf866 Words   |  4 PagesAn epic hero is someone who is of great importance, they have supernatural abilities, have some form of connection with the Gods, and accomplish great deeds. In Beowulf, translated by Seamus Heaney, Beowulf is the epic hero in his tale and he is considered great by those who know of his life. There are two versions of his story which portrays him in a certain way. The video version does not do its best to portray him as an epic hero but instead show that he is a liar, a womanizer, and a coward. TheRead MoreBeowulf : An Epic Hero894 Words   |  4 Pages The character of Beowulf demonstrates several characteristics that make a great epic hero. Throughout his lifetime he displayed several characteristics such as honor, bravery, physical superiority, leadership, and glory. These characteristics all formed how the Anglo-Saxons believed one should live their life. 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One such tale, over a thousand years old, stands out from all the rest: Beowulf, the tale of a great warrior, on his quest to achieve eternal glory, defeating great opponents. Throughout the whole story, Beowulf demonstrates most –if not all- of the qualities that an archetypal hero possesses. He embodies the highest ideals of his cultureRead MoreBeowulf : The Epic Hero960 Words   |  4 PagesPotter, and Beowulf all have in common? They all demonstrate the qualities of epic heroes. Beowulf represents several characteristics of an epic hero and demonstrates the values of the Anglo-Saxons. He is the main character of his story, he has a main goal, he travels and fights with a group of people, and he accomplishes many valorous deeds; the values of the Anglo-Saxons are also shown through the actions of Beowulf, such as courage, loyalty, an d fame. For example, when Beowulf heard a cry

Leadership Models And Organizational Culture - 885 Words

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Authentic leadership Leaders who demonstrate authenticity when leading multinational organizations are called authentic leaders (Johansson, Miller Hamrin, 2014). Their central premise is to build relationships with subordinates of diverse cultures. Valuing subordinate input and building trust on ethical principles is the foundation upon which the organization is built. Authentic leadership promotes tolerance and objectivity in building trust and transparency that bridge the levels of management. Subordinates are allowed to take ownership of their work assignments with enthusiasm knowingShow MoreRelatedLeadership Models And Organizational Culture852 Words   |  4 PagesLeadership Models Organizational Culture Cornelius Cash Grand Canyon University LDR804-Leading across Cultures September 7, 2016 Ethical Leadership Models Leaders that demonstrate a commitment to behaving in an ethical manner are viewed as trustworthy and subordinates gravitate toward them. 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Reflections Of A Nursing Student - 926 Words

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Strategic Analysis of Woolworths Limited †MyAssignmenthelp.com

Question: Discuss about the Strategic Analysis of Woolworths Limited. Answer: Introduction Strategic position can be understood as positioning of a company in future considering changing environment and systematic positioning realization (Abushova, Burova and Suloeva 2016). The objective of the paper is to conduct strategic position analysis of Woolworth Limited along with describing the financial conditions and strategic analysis of the company. Moreover, the report also intends to evaluate the ethics, values and social responsibilities of the company in order to recognize the issues faced by the company. Based on such issues certain recommended actions will be provided for improvement of Woolworths Limiteds financial and strategic position. This will also pose implications and certain suggestions for the future study. Company Background Woolworths Limited is positioned as an Australian based company that is involved in retail business operations. Business segments of the company includes Australian petrol and food segment, Endeavor drinks group, BIGW, New Zealand supermarkets and Hotels(Akbar and Ahsan 2014). The Australian petrol and food segment is involved in procurement petroleum and food products for resale to the Australian consumers. The New Zealand supermarket is centered on acquiring food and liquor products resale to the New Zealand consumers (Van Niekerk 2015). The hotel segment is involved with provision of a segment of hospitality and leisure services encompassing alcohol and food, entertainment, accommodation along with gaming within Australia. The brands of WoolworthsLimited encompass Dan Murphys, BWS and Woolworths. The New Zealand food segment is associated with acquiring along with resale of food and drinks to all its consumers. The company has its business operations in 84 countdown supermarkets a nd it is involved with wholesale operations (Amaldoss, Desai and Shin 2015). Analyzed Issues Financial Conditions of Woolworths While carrying out quantitative analysis of Woolworth Companys financial position, balance sheet along with profit and loss statement of the company facilitated in analyzing whether the performance has resulted in negative and positive loss/gain for the company (Balasubramanian, Bhattacharya and Krishnan 2015). The financial situation analysis of the company revealed that Woolworths Company is under-performing over the past financial year. This might be attributed within the slide in the first quarter sales all through the business as per the records of Australian stock exchange. From the financial condition investigation of the company, it is revealed that there are mixed results over a five-year duration. This might bring in some poor results in the financial year as losses are associated with Masters joint venture along with increased competition within the core liquor and food business initiating to take hold (Barney and Hesterly 2015). Poor financial performance of Woolworths Li mited resulted in drop of share price drastically from $27.87 to $23.60 just after four days. From the profit and loss statement analysis of the company it is gathered that the operating expenses decreased from 5% to 3% in the upcoming years. Unfortunately, because of the poor revenue figures in the year 2017, certain increased expenses cost although trending lower led to a soft EBIT figure of $3,350,000 (Bayne, Schepis and Purchase 2017). Values, Ethics and Social Responsibility Woolworths Limited is dealing with issues associated with its social responsibility strategies. Taking into account the food waste it is observed that their private standards along with in-store practices generates considerable food waste in stores (Cheng, Green and Ko 2014). The managers of the company are struggling to make sure that any surplus vegetables and fruits are disposed in the bin and is donated within food rescue companies. The company is also dealing with the concern of deforestation taking place from the high impact commodities for its own brand products that includes timber, palm oil, paper, pulp along with packaging. The company focuses on setting goals for decreasing its carbon emissions by 10% in the upcoming years (Das Nair and Dube 2017). The ethical audit indicated that the company is involved in unethical practices, child labor use and ingredients while a staff of the organization was all edged of taking kickbacks. From this scandal it is observed that Woolwort hsLimiteddid not comply with policies on work conditions, pay and corruption. It is also revealed that some of its suppliers was involved in the acts of corruption and bribery and was also involved in falsifying all its records and documents (Feigin 2016). Evaluation of Identified Issues Financial Conditions and Analysis In order to analyse the financial condition of Woolworths, the financial figures of the previous two years have been taken into consideration. The financial data of the last two years depict that the firm is improving its performance in terms of profitability, since the profit level of the organisation has increased from ($1,234.80) in 2016 to $1,533.50 in 2017 (Frederick Rose, Hawryszkiewycz and Kang 2014). On the other hand, the liquidity position of the business has not been able to match with the industrial average. This could be better illustrated with the help of quick ratio, which helps in evaluating the ability of a firm to meet current obligations with short-term asset base.From the financial condition investigation of the company, it is revealed that there are mixed results over a five-year duration that might bring in some poor results in the financial year as losses associated with Masters joint venture along with increased competition within the core liquor and food busi ness initiating to take hold (Hubbard, Rice and Galvin 2014). Particulars Details 2016 2017 Current assets A $7,227 $6,994.20 Inventories B $4,558.50 $4,080.40 Current liabilities C $8,992.70 $8,824.20 Quick ratio (A-B)/C 0.30 0.33 In this case, the ideal industrial standard is considered as 1 and the ratio is quite below the industrial average, which denotes that Woolworths is suffering from cash flow problems. Such issue might result in insolvency in future, which might reduce its debt paying capacity (Hubbard, Rice and Galvin 2014). If the organisation could not pay such debt, it would need to borrow money that would influence its profitability level. With such lower revenue, it would not be able to fetch higher returns to its investors due to fall in share price in the market. As a result, the investors might not be willing to invest in the shares of the organisation. However, it is to be borne in mind that their numerous revenue streams for Woolworths, which would help in ensuring consistency in cash flow (Johnston et al.2017). In addition, Woolworths is involved in operating retail stores, consumer electronics outlets and departmental stores, which are dependent mainly on cash sales. As a result, the organisation has a fixed source of cash flow flowing into the organisation. In addition, the organisation has financial priorities, as it acts on its portfolio for maximising the wealth of the shareholders. Furthermore, it has formulated a new strategy, in which it has planned to open 39 new supermarkets, which would raise its income and profit levels. With such higher growth, the organisation would be able to receive greater amount of dividend to its shareholders (Karmanov et al. 2016). However, if the stores could not work as per the planning, it might have adverse impact on the financial performance of the organisation. Ethics, Values and Social Responsibility It is of utmost significance for each organisation to assure ethics and values with its stakeholders for maintaining effective relationship with them. The values and ethics explain the primary framework within which all the firms are required to operate (Kilroy and Schneider 2017). Hence, it is significant for Woolworths Limited to assure ethics and values, which implies that it would follow the primary guidelines and business rules as well as of the society. Woolworths ensures ethics and values of its suppliers by undertaking efforts in enhancing the social and environmental practices with them. Due care is exercised in order to assure that it is involved in working regularly with the suppliers for increasing their satisfaction level. The intention is to obtain timely delivery of the raw materials. The firm is involved in providing clear and understandable directions to the purchasing staffs in order to encourage and motivate them (Morioka, Evans and de Carvalho 2016). In addition, it needs to maintain its brand level by ensuring that its actions do not influence its corporate reputation and image of its individual brands. Effective working conditions are provided to the staffs for safeguarding the basic human rights along with ensuring overall protection of the surrounding environment. The company is involved in functioning maturely the primary guidelines of the society. For assuring the continuing success of the business, it is significant to maintain the ethical and moral standards along with maintaining its reputation. Woolworths is involved in assuring labour right regulation where the workers are free to select the employment of their choice(Parkinson 2016). They are not compelled to work in the company; instead, they could leave the organisation at the time they wish. A reasonable notice is to be provided on the part of the staffs before they decide to leave the organisation. Along with this, the staffs could form trade unions and they could involve in collective bargaining with the management of the organisation over their problem areas. The employer openly accepts the trade union activities in the organisation (Thorlakson, Hainmueller and Lambin 2018). Along with this, the organisation maintains sustainability by maintaining effective ethical practices. It is a serious challenge for Woolworths to maintain the strong employee base present in Australia and New Zealand (Sewell, Mason and Venter 2017). In addition, the company is devoted in meeting the targets along with delivering quality products and services to its customers. Thus, it could be stated that Woolworths has maintained its social responsibility in an effective manner. Recommended Solutions Through observing the issues faced by Woolworths Limited regarding ethics, social responsibility and maintaining efficient financial position, certain effective recommendationsare provided to the company. From evaluation of financial and social responsibility strategy it is gathered that despite of the companys successful corporate strategy as the basis of its major operations, there are some major areas where the process is lacking. Certain effective recommendations are explained below: There must be a performance measurement along with control process existing within the sustainable growth strategy. A suitable performance evaluation at different stages alongwith regular feedback on performance might facilitate in decreasing gaps within the level along with efficient decision for addressing objectives. This must also consider actual attainment of such objectives. For maintaining effective social responsibility, the company is recommended to inform all its stakeholders regarding the strategy. In its financial planning the management must be properly communicated. This is for the reason that such information is simply grasped by the concernedparties and makes it simpler for the employees for contributing towards attainment of company strategy. Woolworths is provided with recommendations regarding increasing online sales aggressively to more than 20% of overall Australian sales through regular investment within innovative digital development. This is deemed to offer a highly connected retail experience to all the consumers. This also involves focusing on personalization and digital accessibility through improving mobile platform and target communications. The company is also recommended to increase its operational efficiencies along with savings associated with water, energy and waste. This must be made possible with increased focus on developing green stores along with integrating sustainability within its new office within Melbourne. Partnering with the suppliers to ensure positive ethical, social along with environment change beyond compliance. Woolworths Limited is recommended to design products with sustainability attributes and driving responsible sourcing strategies for all the major commodities that includes cellulose, cotton, leather, timber and wool. The company is also contusing to partner with major charity companies to make certain difference along with offering opportunities for the teams to be associated with supporting local communities. Woolworths must focus on implementing a hygiene, disposal along with recycling program in which they can re-use packaging for various purposes along with implementing hygiene for enhancing cleanliness within the surrounding. In return it can also enhance the companys public image along with generating high exposures due to a good cause. Future Study The current paper focused on analyzing the strategic position of Woolworths Company considering the financial situation analysis along with social responsibility evaluation of the company. Despite of having certain implications, the report did not cover evaluation of some factors for strategic position analysis of the company. Considering the same, the future study will focus on evaluating the industry and competitive evaluation along with analysis of diversities strategies (Tan and Carrillo 2017). This indicates that evaluation of multi business companies. The future study will also focus on corporate social responsibility that can describe a situation where an organization attains sustainable development not just in the economic dimension but also within environmental and social dimension. The paper will also reveal that the companys ethical policies that includes analysis of its commitment towards implementing and sustaining an efficient program of corporate social responsibility which includes social and environmental responsibilities. The future study will also recognize that success is not possible to be measured in consideration to growth and profit along with the ways in which Woolworths Community Group. This will be considered in the manner through which it is possible to decrease the environmental impact. It I also believed that associating the companys financial performance with non-financial segment that can increase value for the stakeholders and the members. Conclusion The objective of the paper is to conduct strategic position analysis of Woolworth Limited along with describing the financial conditions and analysis of the company. Based on such issues certain recommended actions will be provided for improvement of Woolworths Limiteds financial and strategic position. It is gathered from the paper that while carrying out quantitative analysis of Woolworth Companys financial position, balance sheet along with profit and loss statement of the company facilitated in analyzing whether the performance has resulted in negative and positive loss/gain for the company.For marinating effective social responsibility, the company is recommended to inform all its stakeholders regarding the strategy. References Abushova, E., Burova, E. and Suloeva, S., 2016. Strategic analysis in telecommunication project management system. InInternet of Things, Smart Spaces, and Next Generation Networks and Systems(pp. 76-84). Springer, Cham. Akbar, S. and Ahsan, K., 2014. Analysis of corporate social disclosure practices of Australian retail firms.International Journal of Managerial and Financial Accounting,6(4), pp.375-396. 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