Primary Care Practices For An Existing Ehr System - 933 Words

The goal of my case study was to understand the current use of EHRs in primary care practices. The objectives were to determine whether primary care practices are using advance EHR functions, what challenges they face, and how advanced functions are successfully incorporated into the care they provide. The case was a qualitative case study of 6 primary care practices with an existing EHR system in the state of Virginia only. The selection was based on a maximum variation of quality-related activities, location, and ownership. The sample included small independent practices as well as practices that are fully owned and operated by larger healthcare systems. The practices had only 1 to 9 physicians and were reimbursed $2000 for data collection efforts. A multidisciplinary research team did the data collection in order to draw different perspectives. The team included subject matter experts from family medicine, healthcare management, information technology, nursing, and social work. 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Representation of Indigenous Cultures in the Rabbits and...

Representation of Indigenous Cultures Since the European settlement of Australia, the Indigenous people have been represented in a myriad of ways. The Rabbits (1998), an allegorical picture book by John Marsden (writer) and Shaun Tan (illustrator) and Rabbit Proof Fence (2002), a film directed by Phillip Noyce, are just two examples of this. Techniques such as music, changing camera angles and symbolism are utilised in Rabbit Proof Fence to represent the Aboriginal people as strong-willed and spiritual and in The Rabbits, exaggeration, different colour themes and perspective are used to portray the Aborigines as technologically inferior and overwhelmed against the Europeans. In both texts, the Indigenous people are represented as†¦show more content†¦When the girls do collapse onto the ground, Molly sees an eagle soaring in the sky above them. This eagle, as explained by Molly’s mother in opening scene, was a symbol of protection and safety in Aboriginal culture. The appearance of this eagle in their time of need emphasises how the Aboriginals are truly bonded, psychologically and physically, to their land and culture. In this scene, the camera shifts back and forth between their elders back at Jigalong and the girls in the desert. This constant transition conveys the relationship between the girls (protected by the eagle) and the elders praying in an Aboriginal dialect for the girl’s safety. With these few examples, we can see how the Indigenous people have a special bond with their land through their cultural religion, which, in return, assists them when it is needed. Powerlessness of the Numbats (Aboriginals) against the Rabbits (Europeans) in The Rabbits is shown through the use of words within the mise en scene. Within this picture book, Marsden contributes to the meaning of the story to the readers through very short, but powerful sentences such as: â€Å"Sometimes we had fights/But there were too many rabbits/We lost the fights.† The way these sentences are structured so that it places emphasise the appropriate scenario that is occurring in each panel. With Shaun Tan, he conveys the powerless nature of the Indigenous by placing theShow MoreRelatedRabbit Proof Fence By Sally Morgan Essay1911 Words   |  8 PagesMy Place by Sally Morgan and Rabbit-Proof Fence by Phillip Noyce successfully portray the isolation, identity and discrimination of Aboriginal Australians and Torres Strait Islanders. Although being set in different time periods, both texts explore the effects of the stolen generation on Indigenous Australians and how they fit within society. Sally Morgan characterises herself as an outcast within school symbolising the isolation of Indigenous Australians within society. 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Nursing Care Plan Common Diseases

Question: Discuss about theNursing Care Plan for Common Diseases. Answer: Secondary Prevention: Asthma is one of the common diseases of the childhood. This can happen due to the gene environment interplay. As per the case scenario, Stuart has asthma form the early childhood but he stooped to visit the doctor after leaving his home at the age 19. In such condition, the nurse should arrange the oxygen cylinder for him at first and anti allergic injection should be pushed. Matricardi (2014) mentioned that patients should avoid ventolin puffer without asking the GP form a discount chemist. However, Stuart did the same thing and lied to the chemist to buy the product. The nurse can provide the patient H1 antihistamine cetirizine and antihistamine H1 ketotifen, which will give relief to Stuart. The nurse should check the heart beat of the patient and oxygen mask should be put on (Pechter 2014). The nurse should advise Stuart to quit smoking if he has the habit of smoking and should avoid the dust. Primary Prevention: Avoid the smoking and dusts in the workplace Stay in well ventilated house and avoid the dump house. Use proper doses of puffs and should not change the doses without asking the doctors and nurses (Beasley, Semprini and Mitchell 2015) Provide subcutaneous immunotherapy and sublingual immunotherapy. Avoid the allergic foods and substances. The nurse needs to give anti allergic injection to Stuart after he has been admitted to the hospital (Tartibian, Yaghoobnezhad and Abdollahzadeh 2014) The necessary tests like ECG, nitric oxide test, allergy test and sputum eosinophils test. The nurse should teach Stuart after his recovery about the use of inhaler. The chest x-ray is necessary to check the position of the lungs and computerized tomography scan is necessary to check the nasal condition. Health Condition of Pathophysiology: Bronchoconstriction: this is a clinical symptom of asthma. The airflow rate is decreased and the air path became narrow for which the patient feels difficulty in inspiration and expiration (Jackson 2014). Airway edema: the inflammation increases with time and mucus plugs is formed that includes the hypertrophy and hyperplasia. Airway hyperresponiseness: airway hyperresponsiveness is the exaggerated bronchoconstrictor that has a major impact on the patient. The dysfunctional neurogulation happens. Airway remodelling: the airflow became limited and partially reversible. The lung function can be reduced. The cell structure became changed. Goals of Care: The care plan gives the direction to the particular care to a particular patient. A care plan should be unique for the individual patients. The care plan includes the proper communication and consult with the other nursing staffs (Jackson et al. 2014). For the asthma patient, the nurse should be very careful before confirming his diet or medication. The nurse should know the patient history first that in which food, the patient allergy or problem. The nursing plan should have proper goals, treatment plan and proper outcomes. The nursing plan should be documented properly and presented to the patient and his family to teach them about the treatment. References Beasley, R., Semprini, A. and Mitchell, E.A., 2015. Risk factors for asthma: is prevention possible?.The Lancet,386(9998), pp.1075-1085. Jackson, D.J., 2014. Early Life Viral Infections and the Development of AsthmaA Target for Asthma Prevention?.Current opinion in allergy and clinical immunology,14(2), p.131. Jackson, D.J., Hartert, T.V., Martinez, F.D., Weiss, S.T. and Fahy, J.V., 2014. Asthma: NHLBI workshop on the primary prevention of chronic lung diseases.Annals of the American Thoracic Society,11(Supplement 3), pp.S139-S145. Matricardi, P.M., 2014. Allergen?specific immunoprophylaxis: Toward secondary prevention of allergic rhinitis?.Pediatric Allergy and Immunology,25(1), pp.15-18. Pechter, E., 2014, June. Primary Prevention of Asthmathe Role of Occupational Asthma in Pushing the Agenda. In2014 CSTE Annual Conference. Cste. Tartibian, B., Yaghoobnezhad, F. and Abdollahzadeh, N., 2014. Effects of Physical Activity and Sleep Quality in Prevention of Asthma.Journal of Physiology and Pharmacology Advances,1(4), pp.356-359.

Corporate Finance Productions of Accessories

Question: Describe about the Corporate Finance for Productions of Accessories. Answer: Company overview: Billabong international limited is a surf company, which functions as clothing retailer. The company is also engaged in the productions of accessories like watches, backpacks, skateboard and snowboard under the same brand name. Gordon and Rena Merchant founded the company in the year 1973. As the company started developing further it acquired new brands and number of retail outlets to expand its business beyond the boundaries of wholesale. The company first traded on the stock exchange of Australia on 11 August 2000. It is worth mentioning that from the late 2012 the company experienced a declining period. The company has been the subject of protracted bidding process in which the former chief of Billabong has been a key participant. However, it should be noted that from last couple of years the company has undertaken the strategy of corporate turnaround to return to the profitability. Analysis: A detailed analysis of Billabong International is performed with the help of financial ratios in order to understand the business and operating functions of the company. The ratios provides an insight into the guidelines of the company and a special focus is paid to identify the special issues concerning the business. To begin with the analysis several parameters are undertaken to evaluate the performance such as profitability, efficiency, liquidity, gearing and investment ratio. Profitability: Profitability ratio are those class of ratios which defines the fiscal metrics of an organisation by evaluating the business ability to generate earnings in comparison to the business expenditure and other important cost incurred during a specified period of time (Cantoni, 2012). In the current evaluation of Billabong financial situation the profitability ratio is undertaken consisting of the gross profit ratio, net profit ratio, return on capital, assets and equity. The gross profit ratio of Billabong for the financial year of 2014 consists of 50.4 while in the year 2015 the ratio stood 52.9. The gross profit reflects a growth of 2.5% prior to the previous year cash and cash equivalent and other short-term are readily convertible to the amount of cash (Sridharan, 2015). While on the other hand, the net profit ratio does not reflects a positive scenario as net profit reflects a negative amount of -20.84 since the company was under the loss and reported a net loss of $202,949 million from its continuing operations. Profitability 2014-03 2015-03 Net Margin Ratio -20.84 0.39 The net profit ratio for the financial year 2015 reflecting a positive view as it grew to 0.39% as the company reported a profit of $2,552 million. The return on capital and return on assets for the financial year of 2014 stood -32.73 and -26.49 respectively due to the significant and prolonged decline in the fair value of the cost of assets (Kim, et al., 2013). Profitability 2014-03 2015-03 Return on Assets -26.49 0.53 This is due to the cumulative loss on acquisition cost and current value of market. However, the company reported a growth in 2015 with return on assets and capital employed stood 0.53 and 5.17 respectively since the company introduced the strategy of corporate turnaround to return to profitability. Profitability 2014-03 2015-03 ROEC -32.73 5.17 Liquidity: The liquidity ratio is concerned with the liquid assets and the liabilities of a bank. The framework measures the ability of the company to pay off its long-term debts and liabilities as and when they become due. The liquidity ratio of Billabong consists of current ratio quick ratio along with inventory turnover ratio. The current ratio of the company seems to be stable as in the financial year of 2014 and 2015 represents 2.2 and 2.19 respectively. There is no such significant change in the ratio as the company is capable enough to pay off its long-term debt and short term liabilities (Kim, et al., 2013). While the quick ratio on the other hand represents 1.32 and 1.35 since the cash and cash, equivalents in the balance sheet stood 153, 334 and 145,070 respectively. The cash and cash equivalents consist of the deposits, which are held, in the financial institutions. Liquidity Ratio 2014-03 2015-03 Current Ratio 2.2 2.19 The Liquidity ratio is largely used to analyse the effective use of the companys assets and liabilities internally. The ratio usually takes into the considerations the time it takes to collect cash from its customers and the time undertaken to convert its inventory in to cash (DoÄÅ ¸an, 2013). Thus, it is worth mentioning that whatever be the environment of the company it must make an optimum utilisation of its assets to understand the operational functionality. Liquidity Ratio 2014-03 2015-03 Quick Ratio 1.32 1.35 The fixed assets turnover ratio of Billabong represents 1.27 and 1.35 for the financial year of 2014 and 2015 respectively. The financial assets were valued at fair amount and the profit and loss are subsequently carried at fair value. The translation differences between the two financial year is largely related to the change in the amount of amortised cost and other changes in the carrying amount were identified by Billabong. Efficiency Ratio 2014 2015 Fixed Assets Turnover 10.53 11.44 The liquidity ratio of Billabong also consists of Receivables turnover, which represents the 6.26 and 6.61 for the financial year of 2014 and 2015 respectively. These changes represents that the receivables are identified at initially fair value on the date at which it is invoiced on a thirty-day policy (Bandt et al., 2014). They are represented as the current assets unless the collection is anticipated for more than 12 months after the balance sheet date. The inventory turnover ratio for the financial year 2014 and 2015 represents 2.49 and 2.7 respectively. Liquidity Ratio 2014-03 2015-03 Inventory Turnover 2.49 2.7 This shows that those raw materials are determined by the organisation through using the FIFO method, which estimates the actual cost, involved including the direct materials and direct labour. The company allocates the inventory under the normal operating capacity after determining the rebates and discounts (Clor-Proell et al., 2015). On the other hand, the assets turnover ratio represents 1.27 and 1.35 for the financial year of 2014 and 2015 respectively. The assets are carried and amortised at cost by the organisation (Delen, et al., 2013). The company values the financial assets at fair value through the help of profit and loss account. It is worth mentioning that the financial assets are recorded on the date of trade on which the company commits its self to purchase or sell the assets of the ownerships. Management also classifies the assets at initial recognition date until it is held to maturity by re-evaluating the assets at the time of their disposal. The accounts receivables ratio shows the same amount for the financial year of 2014 and 2015 respectively with 20.46 is estimated as the average days of accounts receivable by the organisation (Sridharan, 2015). This represents that the collectability of the trade receivables is largely viewed because of ongoing accounting entries by the organisation. An allowance is also established by the organisation with the objective that group will not be able to collect all the amounts of the receivables. Gearing ratio: Gering ratio can be defined as the ratio, which compares the owners equity with the funds borrowed by the equity owners. The ratio is primarily concerned with the measurement of proportion of companys borrowed funds in contrast to its equity. The gearing ratio of the company represents the figure of 0.76 and 0.91 for the financial year of 2014 and 2015 respectively (Robinson et al., 2015). The borrowing of company is usually recognised at the fair value for the net transactions cost incurred. Therefore, the ratio signifies that any difference between the proceeds and redemption amount should be recognised in the income statement over the period covered. On the other hand, the gearing ratio of the company also includes Debt ratio. Gearing 2014-03 2015-03 Debt ratio 1.23 1.08 The debt ratio consists of 1.23 and 1.08 for the financial year of 2014 and 2015 respectively. The debt ratio indicates that the debts incurred by the company are at cost for the construction of qualifying assets are capitalised during a period of accounting year in order to complete and prepare the assets which is intended to be used for sale. Hence, the other borrowing cost consist of long term debt and expenses (Kim, et al., 2013). Gearing 2014-03 2015-03 Interest Coverage -0.64 0.41 The gearing ratio also consists of the interest coverage ratio which represents a negative value for the financial year of 2014 however, the ratio grew to a positive benchmark with 0.41 for the financial year of 2015. Gearing 2014-03 2015-03 Gearing Ratio 0.76 0.91 Investment ratio: Investing can be considered as a daunting task and very often a complex procedure. This ratio is largely used by the investors in order to estimate the attractiveness of a potential or existing investment opportunity in an organisation and obtain an idea of the valuation. Thus, this ratio primarily attempts to simplify the relationship between the money invested and the amount of profits derived from it (Clor-Proell et al., 2015). The investment ratio of Billabong consists of the earning per share. In the year 2014, the company reported a poor investing ratio with poor earnings per share of -1.43 for the financial year of 2014 where as in the year of 2015 the earning per share of the company however improved and moved towards positive scale with 0.02. The company reports the earning per share after adjusting the figure derived from the determination of basic earnings per share. Therefore, it should be noted that the weighted average number of additional ordinary shares is assumed to have been utilised by the company in the conversion of diluted potential ordinary shares. Investment ratio 2014-03 2015-03 Price Earning -0.6713 60.5 The company reports that the basic amount of earning per share is computed through subdivision of profits, which is attributable to the equity holders of the company excluding the cost of servicing equity other than the non-ordinary shares (DoÄÅ ¸an, 2013). The earnings per share of the company is largely based on the weighted average number of the ordinary shares outstanding for the year which is adjusted with the bonus elements for the ordinary shares which is issued during the year after excluding the treasury shares. Investment ratio 2014-03 2015-03 Earnings Per Share SGD -1.43 0.02 Efficiency ratio: The efficiency ratio is used to analyse the procedure employed by the company to use its assets and liabilities internally. An efficiency ratio takes into the consideration the turnover which is receivables from the debtors along with the repayment of liabilities. Efficiency ratio on certain occasion looks to evaluate the cash collection period from the customers and the time it takes to convert the inventory into cash (Bandt et al., 2014). The efficiency ratio of Billabong represents receivables turnover. In the financial year of 2014, the receivable turnover represents 6.26, which considerably increased to 6.61 in the financial year of 2015. The company follows the policy of valuating the receivables at fair value by subsequently measuring the amount at cost on a term of 30 days. On the other hand, efficiency ratio also includes the inventory turnover ratio with 2.49 and 2.7 for the financial year of 2014 and 2015 respectively. The inventory turnover rate was lower in the financial year of 2014 however; it grew to 6.61 for the financial year of 2015, which represents that the inventory is used at a faster rate for production of goods (Cantoni, 2012). The raw materials are determined at cost the company makes the use of First In and First out method in approximating the actual cost involved in inventory. The inventory is largely allocated at cost after subtracting the rebates and discounts. Fixed asset turnover ratio represents the figure of 10.53 and 11.44 for the financial year of 2014 and 2015 respectively. This largely because the assets are carried forward in the accounting year are amortised at cost, representing th e present value of future amount of cash flow. Efficiency Ratio 2014 2015 Asset Turnover 1.27 1.35 Conclusions and findings: The financial statement of the organisation shows a contrasting view that the organisation does have a potential market share. Though the company was under loss for few years however with the implementation of new business policies it has been noticed that there has been an upward rising trend for the company in the parameters of earnings per share and working capital. The earnings per shares is one of the positive factor in terms of revenue growth. The comparative shows that firm is back on the path of progress through extensive research and developments. Thus financial provides a positive indication that company is deriving extra ordinary returns where the leverages (financials) are far above the ground and superlative due to its ROIs (Return on investments) is greater comparative to other relative costs and expense. Recommendations: Speaking considerably about recommendations the operational efficiencies of the company is visibly having enormous spaces to develop and progress that subsequently increase margins. Billabong international should focus and line up its hard work to incorporate its resources with the capability to exploit the corporation vital competencies, potencies and opportunities as well. This will assist the company to achieve its competitive lead and increasing its worth as well as reducing production and management costs. Therefore, the investigation performed under this report suggest that the company should diversify its product line through employing the promotional strategy of its existing product and emphasising the its potential investors to actively participate in the capital raising programme.Strategically, Billabong should protect the brands and to image monetarily. It is worth mentioning that the corporation should sufficiently spotlight on the formation of capital with the help of enhanced innovation and marketing. It is recommended that the company should reorganise its process of research and development approaches in order to remain ahead of its competitors and return to profitability. Reference List: Bandt, D., Camara, B., Pessarossi, P. Rose, M., (2014).Regulatory changes and the cost of equity: evidence from French banks(No. 11). Banque de France. Cantoni, E., (2012). Financial statement analysis and insolvency forecast models: a proposal for local firms.Economia Aziendale Online, (4), pp.1-17. Clor-Proell, S., Koonce, L. White, B., (2015). How do financial statement users evaluate hybrid financial instruments?. Delen, D., Kuzey, C. Uyar, A., (2013). Measuring firm performance using financial ratios: A decision tree approach.Expert Systems with Applications,40(10), pp.3970-3983. DoÄÅ ¸an, M., (2013). Does firm size affect the firm profitability? Evidence from Turkey.Research Journal of Finance and Accounting,4(4), pp.53-59. Kim, S., Kraft, P. Ryan, S.G., (2013). Financial statement comparability and credit risk.Review of Accounting Studies,18(3), pp.783-823. Li, K. Mohanram, P., (2014). Fundamental Analysis: A comparison of Financial Statement Analysis Driven and Intrinsic Value Driven Approaches. Robinson, T.R., Henry, E., Pirie, W.L. Broihahn, M.A., (2015). International financial statement analysis. John Wiley Sons. Sridharan, S.A., (2015). Volatility forecasting using financial statement information.The Accounting Review,90(5), pp.2079-2106. van den End, J.W. Kruidhof, M., (2013). Modelling the liquidity ratio as macroprudential instrument.Journal of Banking Regulation,14(2), pp.91-106.