Essay The Importance of Prenatal Care - 1658 Words

The Importance of Prenatal Care Prenatal care is widely accepted as an important element in improving pregnancy outcome. (Gorrie, McKinney, Murray, 1998). Prenatal care is defined as care of a pregnant woman during the time in the maternity cycle that begins with conception and ends with the onset of labor. A medical, surgical, gynecologic, obstretic, social and family history is taken (Mosbys Medical, Nursing, and Allied Health Dictionary, 1998). It is important for a pregnant woman as well as our society to know that everything that you do has an effect on your baby. Because so many women opt not to receive the benefits of prenatal care, our society sees the ramification, which include a variety of complications primarily†¦show more content†¦8oz. and were thus considered low birth weight births. Preterm births increased from 9.4% in 1984 to 11% in 1993(as cited in MCN, 1998). African Americans had low birth weights that more than doubled those of whites and very low birth weights were three times higher. Many of the low birth weight births resulted in death. According to the National Vital Statistics Report, the figures for the United States from 1998 are as follows: 82.8% of mothers received first trimester care 3.9% received late or no care 63.2% of teen mothers age 15-19 received first trimester care 8.8% of teen mothers received late or no care 12.6% was the median number of care visits Literature Review While some women who received no prenatal care had normal, uncomplicated births, others did not. Most of the women who did not receive adequate prenatal care gave birth to an underweight and underdeveloped infant. Among the benefits of early, comprehensive prenatal care are decreased risk of preterm deliveries and low birth weight (LBW)-both major predictors of infant morbidity and mortality. (Dixon, Cobb, Clarke, 2000). Preterm deliveries, deliveries prior to 37 weeks of gestation, have risen. Since the studies in 1987, which showed the rate of preterm deliveries as 6.9% of births, the 1997 rate shows an increase to 7.5%. Low birth weight, defined as an infant weighing less than 2500 grams (5lbs. 5oz) is often preceded by preterm delivery. LowShow MoreRelatedThe Importance Of Prenatal Care843 Words   |  4 PagesThe Importance of Prenatal Care Pregnancy can either be the most wonderful time in a woman’s life or the scariest and quite often it is both at the same time. One of the first things that most women do when they become pregnant or even before they become pregnant is focus on their prenatal care. This time in the womb is very important in a baby’s development and taking care of the body is something that is extremely beneficial to the wellbeing of a newborn. Prenatal care is probably one of the mostRead MoreThe Beginning Stages Of Life Start With Prenatal Development855 Words   |  4 Pagesstart with prenatal development. This is the most essential part of the human development process. Prenatal care for a woman starts from the egg is fertilized until the actually delivery of the new born. When it comes to prenatal development, there are many concerns in care. Some of the main areas of concern are the actually care that woman received while being in this stage. Most writing and viewpoints that are s hined on this topic are for the advancement and importance in prenatal care. The generalRead MorePrenatal Care For Young Women Essay1082 Words   |  5 PagesPrenatal Care for Young Women Most young mothers are worried about a number of new changes that will impact them socially, physically and emotionally. Prenatal care can be neglected due to an unexpected pregnancy, not being educated on what to do, or not having resources to get care. Prenatal care is very important to a child’s early development. Prenatal care can mean several things like cutting back on caffeine and stopping smoking. It can also mean soon after conception beginning to care for yourselfRead MorePrenatal Contraception And Prenatal Care Essay1133 Words   |  5 Pagesincreasing access to early and adequate prenatal care (Chapman Durham, 2010). The prenatal period provides an opportunity to make positive changes in all aspects of a women s health status and health maintenance behaviors. Early and adequate prenatal care provides the opportunity to identify significant risks to the pregnant women, and develop interventions to reduce or eliminate potential complications (Chapman Durham, 2010) . Prenatal care encompasses the health care services provided to a women, fromRead MoreChild And Maternal Mortality Rate For Mothers And Children1528 Words   |  7 PagesIntroduction Women all around the world get to experience the wonderful gift of pregnancy and all that comes with it. Although, one would think that the process is similar throughout all women that is not the case. Prenatal, labor, postpartum, and newborn care differ greatly throughout the different cultures and regions of the world. Being a nurse you get to see and experience all these differences in cultures in practice. It is important to be considerate of each cultures needs during each stepRead MoreHow Prenatal Care Is Associated With Child s Health1249 Words   |  5 PagesAs I attempted to search for an article on how prenatal care is associated with child’s health I initially did a google search and typed â€Å"prenatal care†. I was overwhelmed with the number of articles and websites available to choose from. I thought it was necessary to be specific in what exactly I wanted to research and that’s when I typed in â€Å"prenatal care† and â€Å"health† into the search bar. Once I found a website that looked resourceful and appealing I made sure that it was published by an educationalRead MoreBirth Practices Of Prenatal Care920 Words   |  4 PagesCultural Paper: Prenatal to Neonatal in the Netherlands Sara Stewart Daytona State College â€Æ' Birth practices around the world vary greatly from one culture to another. I chose to take a look at the practices of the Netherlands to see how they differed and how they were the same in comparison to here in the United States. Most Dutch women seek prenatal care around week ten or eleven for first pregnancies and slightly later for subsequent pregnancies. The majority of prenatal care is provided byRead MoreCultural Diversity For A Haitian Client1343 Words   |  6 Pagespart of the health care system. In the challenging field of nursing, nurses need to be aware of cultural differences and should provide each client with cultural competent care. Each and every year, Haitians enter this country legally and illegally but regardless of how they enter the US, it is inevitable that they will need to be cared for at some time in their life. The astute nurse must understand the need for cultural sensitivity and what to assess for prior to providing care for a Haitian clientRead MoreInfant Mortality Rate ( Imr )872 Words   |  4 Pages E., Williams, H., 2015). Although, multiple analysis supports negative a relationship between IMR and health spending, many of the low health spending nations have much better ou tcomes when it comes to IMR than countries with high level of health care expenditures. Therefore, health spending not automatically guarantees better results when it comes to IMR. On the other hand, multiple research suggests that factors outside of the quality and efficiency of the healthcare system, like income inequalityRead MoreFactors and Hazards of Infant Development Essay627 Words   |  3 Pagesvery important I believe these three are most important. A factor I believe to be the most important is obtaining early prenatal care. Two hazards I find important to avoid are alcohol consumption and addictive drugs. In this paper I will explain the importance of these three factors and hazards. The most important factor in an infant’s development is obtaining early prenatal care. Women should make an appointment as soon as she suspects she is pregnant (Marotz amp; Allen, 2012). It is not good to

ESL Beginning Opposites Lesson Plan

Learning new vocabulary often requires hooks - memory devices that help students remember the words they have learned. Here is a quick, traditional and effective exercise focusing on pairing opposites. The opposites have been divided into beginner, intermediate and advanced level lessons. The exercise can be done as a matching exercise, or, for a greater challenge, students can be asked to come up with the opposites themselves. Both types of exercises are included in the resource section of this lesson. Aim: Improving vocabulary through the use of opposites Activity: Matching opposites Level: Beginner Outline: Divide students into small groups and distribute the opposites worksheet. Ask students to either match the opposites (exercise 1) or write the opposites (exercise 2). If you have more time, you can ask students to first match the opposites and then write out the opposites individually. Alternatively, you could give exercise as follow-up homework. Correct in class. Expand the exercise by asking students to provide synonyms. Exercise 1 - Match the Opposites boyspeakoldrightfarfootsisterwifeblackcoolbuycleansmallwomanbegindrinkfullfatstand upfathershorthardcoldlight big, largebrotherdark, heavydirtyeatemptyendgirlhead, handhothusbandleft, wronglistenlong, tallmanmothernear, closenew, youngsellsit downsoft, easythinwarmwhite Exercise 2 - Fill in the Opposites boyspeakoldrightfarfootsisterwifeblackcoolbuycleansmallwomanbegindrinkfullfatstand upfathershorthardcoldlight Intermediate Level Opposites Advanced Level Opposites Back to lessons resource page

The Adventures of Tom Sawyer - 822 Words

â€Å"Outsiders often have an insight that an insider doesnt quite have,† said Diane Abbott. In the 2004 edition of the book The Adventures of Tom Sawyer written by Mark Twain, a couple of interesting people were mentioned which were society outsiders. Some outsiders, such as Huckleberry Finn, know how hard it is to find food and shelter. On the other hand, some city people don’t understand what people like Huckleberry Finn have to go through almost everyday. Society outsiders, such as Huck, who fends for himself; Muff, who has drinking problems; and Injun Joe, who kills people; are all unique in their own ways, but together their lives make for interesting events and stories throughout The Adventures of Tom Sawyer. The first outcast in the novel is the evil Injun Joe. For this reason, the Indian culture and the town of St. Petersburg, Missouri, don’t really accept him. Injun Joe is known as the â€Å"killer† throughout the whole book. He went to the graveyard with Muff Potter and Dr. Robinson, of course Huckleberry Finn and Tom Sawyer were there trying to cure warts. The text stated, â€Å"Five years ago you drove me away from your father’s kitchen one night when I come to ask for something to eat, and you said I warn’t there for any good; and when I swore I’d get even with you if it took a hundred years, your father had me jailed for a vagrant.† (65). Regrettably, Injun Joe is all about revenge. He kills Dr. Robinson and lies. Injun Joe says Muff Potter killed himShow MoreRelatedThe Adventures of Tom Sawyer500 Words   |  2 Pages Mark Twain’s novel, The Adventures of Tom Sawyer, is about a boy going through many adventures as a chi ld. The story begins with Aunt Polly hollering at Tom which tells the reader right away that Aunt Polly is the strict, authoritative figure in his life. As the story progresses, Twain introduces the main characters in the book: Tom’s girlfriend, Becky Thatcher; and his closest companions, Huckleberry Finn and Joe Harper. Later in the novel, we explore many adventures that he goes on; mostly withRead MoreThe Adventures Of Tom Sawyer2307 Words   |  10 PagesIn the first chapter Huckleberry Finn relays his version of the events that transpired in the conclusion of The Adventure of Tom Sawyer. He explains that he and Tom Sawyer became very wealthy after uncovering a cache of gold that was hidden by a band of local robbers, and how after this, under the supervision of Judge Thatcher, Huckleberry’s money was invested and he was placed into the care of the Widow Douglas to be â€Å"civilized†. Huckleberry reveals that Judge Thatcher and the Widow Douglas’s ju stificationRead MoreThe Adventures of Tom Sawyer600 Words   |  3 PagesThe Adventures of Tom Sawyer: A novel written by Samuel Langhorne Clemens also more commonly known as Mark Twain. Samuel was born in 1835 in what he called â€Å"the almost invisible village† in Florida, Missouri. In his younger years he and his family moved to Hannibal Missouri on the Mississippi River. He later used this town as his fictional town of St. Petersburg in â€Å"The Adventures of Tom Sawyer†. While Samuel Clemens was savoring all of his fame he and his family were living in Hartford, ConnecticutRead MoreThe Adventures Of Tom Sawyer1158 Words   |  5 PagesThe Adventures of Tom Sawyer is one of the classic examples of purely American literature, it is about American people, who have American ideals, and live in a definitively American town. Many aspects of Mark Twain s are paralleled in The Adventures of Tom Sawyer and in many ways it is Twain s expression of what his life was like as a boy growing up in Missouri. It is in essence, A novel about the mischief that typically accompanies being a child. Along with these childish aspects of the novelRead MoreThe Adventures of Tom Sawyer5112 Words   |  21 PagesThe Adventures of Tom Sawyer The main idea behind this story is just an average little schoolboy getting into loads of trouble all the time and learning things through experience. Hes not the role model little boy at all, but hes certainly not the one everyone would pick on and such. Tom Sawyer goes out on all sorts of adventurousÂ… adventures, some thought up through imagination and others as serious as a heart attack. Throughout this book you will notice how Tom Sawyer grow up into a moreRead MoreThe Adventures Of Tom Sawyer . __________________. A Book1061 Words   |  5 PagesTHE ADVENTURES OF TOM SAWYER __________________ A Book Review Presented to Mr. Parsons and Mrs. Amy Lack Woodville High School __________________ U.S. History I and English 10 __________________ by Arian Campbell April 19, 2017 The Adventures Of Tom Sawyer The Adventures Of Tom Sawyer by Mark Twain is a 271-page novel. Tom is a boy, and merely and exactly an ordinary boy on the moral side. What makes him delightful to the reader is that on the imaginative side he is very much more, andRead MoreEssay about The Adventures Of Tom Sawyer1042 Words   |  5 Pages The main character in the book is Tom Sawyer. Throughout the book, the author compares himself to Tom and his adventures. Tom is all boy he hates anything that places limits on his boyhood freedom including, church, school, and chores and he will do anything to get out of them. Toms character is a dynamic one. Harper Academic states, A good student? A polite nephew? A hard worker? Not Tom Sawyer. He never wanted to be the model boy. His sights were set on beingRead MoreThe Adventures Of Tom Sawyer By Mark Twain1558 Words   |  7 PagesThe Adventures of Tom Sawyer In 1876, a novel about a young boy growing up along the Mississippi River was written. Set in the fictional town of St. Petersburg, Mark Twain, the author of this fictional piece, based ‘The Adventures of Tom Sawyer’, largely on his personal memories of growing up in Hannibal, Missouri in the 1840s. Through ‘The Adventures of Tom Sawyer’, by Mark Twain we are able to not just appreciate an amazing piece of literature, but also be able to explore through the fiveRead MoreThe Adventures of Tom Sawyer by Mark Twain734 Words   |  3 PagesThe Adventures of Tom Sawyer â€Å"Then he (Injun Joe) put the fatal knife in Potters open right hand, and sat down on the dismantled coffin. Three -- four -- five minutes passed, and then Potter began to stir and moan. His hand closed upon the knife; he raised it, glanced at it, and let it fall, with a shudder. Then he sat up, pushing the body from him, and gazed at it, and then around him, confusedly. His eyes met Joes.† (9.53). In this Quotation from the novel– The Adventure of Tom Sawyer, MarkRead MoreCritical Analysis Of The Adventures Of Tom Sawyer904 Words   |  4 PagesThe Adventures of Tom Sawyer Critical Analysis â€Å"Sometimes problems don’t require a solution to solve them, instead they require maturity to outgrow them.† (1). Eventually in life we will have to grow up and face our problems maturely, and it’s a large price to pay. In The Adventures of Tom Sawyer, Tom faces a challenge of maturity. The question is, did Tom mature socially or morally more? My thesis is Tom matured morally over socially in the book, due to how much he doesn’t learn to obey those

Canadian Charter Of Rights And Freedoms - 1888 Words

The Canadian Charter of Rights and Freedoms protects the rights of Canadian citizens and provides them with assurance that all Canadians will be treated equally under the law. The Charter claims to guarantee rights and freedoms, fundamental freedoms, democratic rights, mobility rights, equality rights, language rights, legal rights, and enforcement rights, and Aboriginal rights. Although the Charter claims to guarantee the rights and freedoms of Canadian citizens, the government is still able to restrict these freedoms under circumstances. It is not, however, easy for the government to do so as there is a process it must initially undergo in order to restrict freedoms from Canadians. Consequently, some claim that the Canadian Charter of Rights and Freedoms does not adequately safeguard individual rights of Canadian citizens from inequitable governmental or other interference. Section 1 of â€Å"the Charter of Rights and Freedoms guarantees the rights and freedoms set out in it subj ect only to such reasonable limits prescribed by law as can be demonstrably justified in a free and democratic society† (Boyd, 2015, p. 118, para. 4). This section of the charter protects the rights of Canadian citizens by ensuring that the government must justify their reasons to place limits on the rights of individuals and must ensure that their objective is of sufficient importance (Boyd, 2015, pg. 118, para. 6). Luckily, the government cannot simply interfere without the ruling of a judge as theShow MoreRelatedThe Canadian Charter Of Rights And Freedoms1617 Words   |  7 Pages Since its inception in 1982 the Canadian Charter of Rights and Freedoms, very much like its primary architect Pierre Trudeau, has been one of the most celebrated yet controversial elements of Canadian politics and governance. Revealing how this dynamic emerged requires a nuanced understanding of the motivation behind the Charter and the techniques it employed to succeed. The Canadian Charter of Rights and Freedoms, like the entire patriation process, was motivated by and mobilized support throughRead MoreThe Canadian Charter Of Rights And Freedoms1258 Words   |  6 PagesThe Canadian Charter of Rights and Freedoms was established in 1982 and was put into place by the Trudeau government. The purpose of the Charter was to protect the rights of Canadian individuals and to establish independence from Britain. However, one section of the charter sparked much controversy, this was section 33, also known as The Notwithstanding Clause. The purpose of this clause was to allow the state to override a right protected by the charter, for various reasons. These reasons includeRead MoreThe Canadian Charter Of Rights And Freedoms1531 Words   |  7 PagesBasing the Basics on a Belief in Something Bigger The Canadian Charter of Rights and Freedoms, implemented in 1982 outlines the rights and freedoms that Canadians have as citizens of this country. In this paper I will ask whether we need such a charter, whether we can trust the interpretation of the Charter by the Supreme Court and how the Charter balances power in a democratic way. I will then contemplate the foundational place morality holds in the lawmaking process. In all of this I argue thatRead MoreThe Canadian Charter Of Rights And Freedoms1613 Words   |  7 Pages The Canadian Charter of Rights and Freedoms simply referred to as the â€Å"Charter†, is a significant document in regards to the Canadian constitution. Its primary aim is to uphold individual rights and freedoms and promote equality in administering justice. However, its passage in 1982 has led to increased controversies given that the Charter gives courts more power in interpreting its provisions while sidelining the legislature (Boyd 118). This means that the advent of this Charter was the end ofRead MoreThe Canadian Charter Of Rights And Freedoms840 Words   |  4 PagesThe Canadian Charter of Rights and Freedoms is an important milestone in Canadian history. An effort through rigorous debate and compromise gave birth to this document that defines our collective values and principles by guaranteeing and protecting the fundamental rights of its citizens. Prior to the Charter, there was no gurantee in Canada that rights and freedoms would not be taken away by legislation. T he Charter also allows courts to render the constitutional duty so that any decisions made areRead MoreThe Canadian Charter Of Rights And Freedoms1386 Words   |  6 Pagesprinciple by entitling an accused of even the most heinous crimes to civil liberties and processes as not to compromise the criminal trial process. A fair trial is an intrinsic right of all members of society making it fundamental to our being, and is ergo ensured to us all under s.11 of the Canadian Charter of Rights Freedoms. Provided with other preemptive measures to guarantee justice is achieved in the criminal trial proceedings. Additionally, the courts help facilitate an understanding of theRead MoreThe Canadian Charter Of Rights And Freedoms883 Words   |  4 PagesRainbow Nation of South Africa in 1994, the first democratically elected government was tasked with drawing up a new constitution that would properly enshrine the human rights that had so long been denied the majority of citizens. One source drawn upon in developing the new constitution was the Canadian Charter of Rights and Freedoms, itself then little more than a decade old. It is not necessary to be a constitutional scholar to detect many similarities between the two; indeed, Canada’s pride in thisRead MoreThe Canadian Charter Of Rights And Freedoms2016 Words   |  9 PagesFreedom of expression, set under section 2(b) of the Canadian Charter of Rights and Freedoms, is one of Canada’s most valued rights in the bill of r ights of the Constitution. It has paved the way for the society in which thirty-five million people reside today. With this level of influence and admiration, it is truly a fundamental right. However, many ground-breaking cases have illustrated the need to limit freedom of expression. A prime example is the landmark case that took place in 1990 surroundingRead MoreThe Canadian Charter Of Rights And Freedoms1504 Words   |  7 PagesThe Canadian Charter of Rights and Freedoms(CCORAF) Guarantees a Free and Democratic Society The Charter of Rights and Freedoms upholds the individual rights of all Canadians. Agree or disagree with the following statement. The Charter is part of Canada’s constitution; the highest law of Canada, which sets out the framework for how Canada is to be governed. The CCORAF sets out those rights and freedoms that Canadians feel are necessary to maintain Canada as a free and democratic community. The CharterRead MoreThe Canadian Charter Of Rights And Freedoms1635 Words   |  7 PagesThe Supreme Court of Canada uses the Canadian Charter of Rights and Freedoms to limit the scope of legislation and administrative power by implementing section one of the charter; which results in an open dialogue between the government and the courts on various legislation deemed unconstitutional. In this essay I will discuss the extent in which section one of the Canadian Charter allows the Supreme Court of Canada to dictate legislation, how they go about narrowing legislation and administrative

Loewen Case Free Essays

This growth through acquisitions was funded primarily through debt which was evident as long term debt increased $922. Lion from 1994 to 1998; this was a 195. 88% increase. We will write a custom essay sample on Loewen Case or any similar topic only for you Order Now One benefit of debt financing was that it provided a tax benefit. From 1994 to 1998 Lone had paid $488. 6 million in interest. Lowness tax rate was 45% therefore; debt financing resulted in a tax savings of $219. 87 million. Another advantage of debt financing was that It did not afford the lender ownership. Therefore, the lender had no say In how one’s business was conducted. In order for one to reap the benefits of debt financing though one must be able to comply with all aspects of the debt agreement. When unable to do so the consequences can be devastating too equines. Unfortunately, aggressive growth through debt financing did not bode well with the Lone Group. With the 30% average revenue growth one would expect to see their earnings grow too, but this was not the case. Lone lost $599 million for 1998 compared to earning $43 million the previous year, an approximate 149% decline in one year. Within 5 years of the start of their â€Å"acquisition frenzy† of larger established funeral chains they were facing what one in the financial world would call â€Å"financial distress†. Financial distress is defined by Investigated as â€Å"A condition where a many cannot meet or has difficulty paying off its financial obligations to its creditors. The chance of financial distress increases when a firm has high fixed costs, illiquid assets, or revenues that are sensitive to economic downturns. † Lone Group unfortunately had a few of the above Issues and then some. Fixed costs for funeral homes were approximately 65%; this was due In part to the fact that a funeral home may only have one to two funerals a week but still had to be maintained. Their competitor, SIC, would â€Å"cluster† the funeral homes together which reduced fixed costs to an average of 54%. 4% is still high but better than 65%. Such a plan also afforded SIC the ability to sell off assets, eliminating redundant cost and reducing the total cost of the acquisition. Funeral home assets were not in great demand at this time as the death rate had declined; therefore funeral home assets were very illiquid. Though the above financial distress pre-cursors were in place, internal issues also played a large role in creating Lowness financial distress. Lowness aggressive acquisition strategy seemed only to focus on the acquisition with little to no thought to the next step of the process. Lowness competitor, SIC, acquired full ownership of all acquisitions whereas Lone took a majority ownership and made payments for the rest to help ease taxes. These calculations were funded largely with debt in which the terms of such debt were very complicated Succession with Blackstone Group. If Lone bought out Blackstone by exercising their option it would effectively pay an amount that would give Blackstone a 24% return on its investment. Lenses’ ROAR (using actual assets as bag assets were not given) in 1996 was only 1. 83%. This was an extremely high return to negotiate. Blackstone also had a put in which they could sell their stock to Lone using a calculation based on EBITDA. This definitely did not favor Lone due to most acquisitions were purchased largely through debt. Lone did not market the acquisitions instead decided the funds would be better spent on courting independent funeral home and cemetery owners who were potential acquirers. Though they did not market their acquisitions their SO A increased by 25. 3% to $125. 2 million from 1997 to 1998 whereas their competitor’s SO remained constant at $66. 8 million. Marketing and integrating acquisitions into one’s business are a ere important part of the success of an acquisition. A reversal of $3. 7 million in sales plus a $2. 1 million increase in allowance for loan losses were attributed to the decrease in gross margin. Such an increase in allowance for loan losses would lead one to believe that due diligence in evaluating the collegiality of the accounts receivable of the acquired companies had not been performed. The $5. 7 million adjustment resulted in a 9. 07% decrease in income for 1996. A lawsuit awarded in the amount of $500 million occurred from accusations of Lone reneging on the purchase of two homes, plus certain insurance services. Lone reported an expense of $165 million for the year to settle this and other lawsuits. Had Lone honored the agreement the properties were only worth a few million therefore, it would have saved them a considerable amount of money. Also, after the announcement of the award Lowness stock decreased in value by 15%. In 1996, an offer to purchase Lone stock was made by SIC in which they offered to purchase the stock at $43 per share which was $3. 00 per share higher than it was trading for at that time. SIC increased their offer to $45 per share yet Lowness Board of Directors effused the offer stating the stock was undervalued due to the lawsuit. At the end of 1996, Lowness debt/equity ratio was 1. 4:1; company policy was in the range of 1 to 1. 5. Lowness plan was to reduce the debt/equity ratio with equity issues. Due to concerns over an antitrust lawsuit Lone had filed against SIC and Lowness current high debt to equity ratio SIC withdrew their offer to Lone. This leads us to the Board of Directors who are appointed to act on behalf of the shareholders to run the day to day affairs of the business along with ensuring the availability of adequate uncial resources, evaluating the CEO and approving the budget. One can see from the description of the responsibilities of the Board of Directors that Lowness Board of Directors had greatly failed their shareholders. Lone, now facing financial distress, as they had not yet missed a payment but had $875 million in debt due the next year, had to determine how best to recover from too much debt, too little death and too little governance. John Lackey, the newly appointed CEO, was to begin his daunting task of bringing Lone back from the brink of death. With $875 million in debt due in 1999 Mr.. Lackey had little time to develop a plan of action. Unfortunately, Lowness original plan of reducing debt by issuing equities was no longer an option as the stock price year; a decrease of 67. 2%. Lone should have given this option consideration earlier and they might not have found themselves in this position. Mr.. Lackeys options all had pros and cons but a decision had to be made and made fast. Option one would be to meet with creditors regarding the soon to be due debt obligations and discuss amending the terms, a workout. Most creditors cringe at the word bankruptcy so that may help to earn the ear of th eir creditors. Prior to approaching the bank or their creditors, Lone must first determine whether there is any way to turn the business around. Creditors are normally repaid by future cash flow, new financing, or equity infusion. Lone must first devise a restructuring plan that would demonstrate it can be sustainable on a going forward basis. Mr.. Lackey must review the historical financial of the business and prepare projections of cash flow, profit and loss, and balance sheet through the term of the proposed repayment plan. The projections should demonstrate that the business not only has sufficient ash flow to maintain current operations but also has enough additional cash flow in the foreseeable future that will enable creditors to receive a return on the delinquent debt. The amount of such additional positive cash flow will determine the amount of time necessary to repay creditors. The pros of this option would be that it would be less expensive than bankruptcy. Bankruptcy would require attorneys, court costs and other expenses. Costs that would have been spent on bankruptcy can be used in restructuring the business. It would also give Lone the opportunity to address the tuition privately between the creditors and themselves. This would hopefully help to minimize negative publicity. The cost of negative publicity knows no bounds. This option would also buy Lone some time in which to begin the process of possibly selling off less profitable operations and time to evaluate expenses and cut the fat. A workout is also effective in preventing creditors from taking legal action which again would buy Lone some time. The cons of this option would be the terms of Lowness’s debt were very complicated in that the company’s debt was almost all secured, or collateralized by various assets. There were also covenants that restricted the company’s ability to sell assets. Creditors would have to all agree to the terms of the sale of assets. Lone had a covenant in their bonds that stated if the ownership of the company’s stock changed significantly Lone had to repurchase the bonds for 101% of face value. The scofflaws may not be sufficient to show the company sustainable enough going forward for the creditors. All of these covenants and restrictions would make it difficult to restructure the company’s debt. Option 2 would be to recommend Lone meet with a professional in the equines of securing equity investors for troubled companies. Pros would be though it may be costly it would still be cheaper than bankruptcy and may be the only option for Lone to continue its operation should no agreement be reached with its current creditors. Cons of course would be the cost. With Lowness current situation equity investors would be hard to come by also. Option three would be to meet with their three main competitors to discuss each entity purchasing some of the acquired funeral homes and cemeteries. This option would allow Lone to sell their assets for cash. Avoid bankruptcy and the additional sots associated with bankruptcy. Big is not always better. Lone could then focus option would possible be the anti-trust laws. If the sale of assets to Lowness three main competitors was seen as threatening fair competition then the sale could not take place. Another con is again the terms of Lowness debt would make this a difficult task. Option four would be the last resort, Chapter 11 bankruptcy. The con of this option is that it would give Lone the ability to develop a plan to restructure on their terms. Lone would no longer be required to pay interest on unsecured debt. They would also be able to borrow from new lenders through debtor-in-possession financing. A con of this plan would be the costs incurred to file bankruptcy. Another issue is the company conducted about 10% of its business in Canada where the bankruptcy law made it much simpler for creditors to remove management. Canadian law also only provided one chance to provide a reorganization plan. In conclusion our recommendation would be to develop a reorganization plan showing the company was a sustainable company going forward, positive cash flow would provide payment on delinquent debt and then present it to its creditors for approval. How to cite Loewen Case, Papers

Sdlc Final Project free essay sample

Cost- the cost will include the process in data materials and supplies. Constraints- Address any problems that may affect the project through the implementation process. Risk- Identify any risk that may occur during or after the project. The Goals of the Project – The goal will be to create documentations for the development of a patient management system. The system should be designed for all patients to be documented confidentially, wait time for procedures should be limited or punctual, and patients should be checked on for security reasons. Supporting Measures for Success Patton-Fuller Community Hospital needs more unified patient experience and seeks an evaluation for the development of a patient management system to track patient check-ins, appointments, and surgeries. Physical measures are to determine the virtual degree of success, which includes improved reduced wait times, and improved patient satisfaction scores. The RPMS system is a selection of hardware, software, telecommunications components that are designed to work together or independently depending on the specific need (Resource and patient management system, n. d. ). The RPMS system not only works within its own resources it also has the capabilities of linking with other software programs to enhance the users experience. The patient management system will benefit the health care providers by allowing them access to all facets of the patient’s current and upcoming visits. The RPMS software has a administrative category is used to put together patient demographics, schedule appointments, check-in patients, discharge patients, and transfer patients to other departments or facilities within the health care system (Resource and patient management system, n. . ). The data captured in this application can be to evaluate and improve quality of patient care (Resource and patient management system, n. d. ). The RPMS administrative functions will provide the ability to track supplies and resources through electronic management that could provide substantial cost savings to the organization. The administrative application has the option to create ins urance claims, compile manual billings, conduct electronic billing statements, and track accounts receivables making it an efficient investment for the company (Resource and patient management system, n. . ). The RPMS is a system that can grow with the organizations future needs without the need for a complete restructuring of the system. The software applications can be interfaced with a large variety of software programs, the hardware has adaptable scalability, and the networking options are limitless (Resource and patient management system, n. d. ). The RPMS offers the ability to meet the demand for quality patient care and options that can improve the overall performance of Fuller-Patton Community Hospital. Senior management will have access to reports on financial aspects and patient care trends in the community. Health care providers can obtain reports on patient status and administrative personnel will have access to billing, account receivable information, and current and historical hospital census data at the click of the key board (Resource and patient management system, n. d. ). Summary of project feasibility The team was recruited for the purpose of analyzing existing work flow processes and to determine the feasibility of system improvements versus implementing a new patient management system (PMS). Evaluation of the current system revealed deficiencies in productivity, quality of care issues, redundancy errors, and inadequate outputs—specifically with statistical reporting. Additionally, user interviews revealed inadequacies with user interfaces. Analysis of business processes suggest inappropriate usage human resources for tasks which are more effectively completed by automation. After completion of analyses processes, it was determined that the existing system lacked the functionality needed to adequately accomplish the task at the desired level. Therefore, a new system is recommended—goals for which include improvements to the following: user interfaces, functionality, report generation, accessibility, error reduction, and quality of care. Despite the initial investment, the project is deemed feasible because the overall benefits far-outweigh the associated costs. That is, quality of care improvements yield widespread positive effects throughout the organization and allow it to remain competitive within its local marketplace. Current Business Process Summary Proposed system requirement list The service-request ph-001 for the Patton-Fuller Community Hospital and it is for a system that will track the patient check-in, appointments, and surgery. They need a customized solution capable of growing and shifting with the practice over time. Master Patient Index * Keeps a unique identifier for each patient * Mapped to multiple medical records if needed Scheduling * User friendly screens with flexibility and control * Intuitive and straight forward scheduling, viewing, and navigating * . Verify patient eligibility electronically and prevent revenue loss * Collect co-pay and patient balance Manage and track appointment requirements by visit type * Tracking of patient flow from check-in and through multiple stages of care Surgery * Surgery scheduling module provides complete out-of-office procedure and surgery scheduling functionality * Surgical and out-of-office-procedure appointments interact with compliance rules for tracking the compliance rules for tracking the completeness of documentation and regulatory compliance * Communicate with hospitals and surgery facilities Revenue Management Comprehensive patient accounting, billing and collection system * Design to increase clinic cash flow by improving the quality and efficiency of operation and workflow * Fully manage receivables, collections, and bad debt * Generates electronic patient statement resulting in cost saving in paper supplies, and printer costs Determination of Requirements The requirements of the proposed patient management system were strong-minded through a top-down method of analysis that first determined the scope of the problem and then identified the details of the problem (Satzinger, Jackson, amp; Burd, 2009). The project team used the habitual method in analyzing the system requirements and will use the same method in the design process to establish the requirements needed to meet the user’s needs. When determining the planning and software required in the development of the system we looked at how the system are used such as remote access, manual applications, and how the system will support these different applications (Satzinger, Jackson, amp; Burd, 2009). The following step in the determination of requirements is determining the user interfaces required and defining how the user will be interacting with the patient management system (Satzinger, Jackson, amp; Burd, 2009). The interfacing requirements will fluctuate by each user type in regards to the level of access and functionality the user will need. The administrative users will require access via standard PCs and physicians and nurses may require access via a PC, smart phone, and a personal digital assistant (PDA). Then the project team must decide the design of the interface in regards to the look and action (check boxes, data entry fields, and drop down selections, mouse interaction, and sound, video, and voice commands) of the screens (Satzinger, Jackson, amp; Burd, 2009). The response time required by the users is developed in the technical phase of the interface design process. The determination of the system controls needed to protect the data integrity and to safeguard the organizations assets is completed as the inal design activity (Satzinger, Jackson, amp; Burd, 2009). The user-interfaced controls define the user’s access, the system interface controls protect the system from other systems, application controls monitor transaction processing, and data controls protect the data from unauthorized user access (Satzinger, Jackson, amp; Burd, 2009). The final control is the network control which ensures that communications are protected within the system (Satzinger, Jackson, amp; Bu rd, 2009). Confirmed Requirements The mandatory system requirements are as follows: * System security detection and protection * System operational on PCs and portable electronic devices * Server components written in Java * System communication interaction using CORBA * Simultaneous viewing of patient information by multiple users * System auto-updates state and federal requirements * System generates alerts for missing or errors in patient information * System generates patient wait list * System monitors hospital census for bed availability System regulates physician and nurse patient assignments * System monitors physician and nurse department assignments * System auto-assigns patients to departments based on diagnosis, medical needs, or bed availability * System manages surgery schedules to avoid over-booking There are currently no optional requirements designated by the project team as all requirements of the system are needed to ensure the needs of the users are met. Proposed Systems Requirement List Now at Patton-Fuller Community Hospital, they want to make a more cohesive experience for patients. Therefore, it is important that all the system requirements are user friendly for patient and meet user requirements. Particularly, this system should abolish scheduling issues and keep a record of patient visits. This consists of keeping track of patient check-in, appointments, and surgery. Beneath is a list of the system requirements. Patton-Fuller Community Hospital’s patient management system needs the capability to: * Identify security/data breaches Operate on portable and desktop personal computers (PC) running the Windows operating system and using Internet Explorer * Server components are to be written in Java and communicate with one another using component interaction standards such as Common Object Request Broker Architecture (CORBA) * Be collaborative to allow viewing at the same time of patient demographics and medical charts. * Collect patient data requirements * C ollect state requirements * Collect federal requirements * Collect generic data requirements * Determine design specifications * Identify application requirements Construct interface design * Administer the waiting list keep an eye on to see if there are any patients waiting for available beds and assigning them to doctors and beds once these become available * Required to schedule patient according to the following physicians cannot be schedule to work a area and operate at the same time * Patient scheduling assigning nurses and doctors to patients * Admissions admitting patients and assigning the patients to appropriate area * Surgery Management ensure no double booking Functional Requirements * Registration: add patients and assign ID Consultation: add area and assign to waiting list * Medical matter management: assign doctor, assign nurse, inform doctors, inform nurses, generate patient status reports hourly * System Database: include patient mandatory information (example- first name, last name, phone number, etc. ), allow users to update patient information, allow user to search for patient * Web-based application Non-Functional Requirements * Security: Patient identification and log on ID for users * Alteration any Alteration shall be done by the administrator in the department * Compliance The system must comply with the Regional Health Authority Regulations * Performance: Response time – one minute response time after checking patient’s information * Availability shall be available all the time * Capacity must support 1000 people at a time * User interface screen must respond with 5 seconds * Submission Must match Microsoft accessibility guidelines * Maintainability – Back-up system, error log * Consistency Proposed system process view The proposed implementation for the hospital is to increase customer satisfaction and to ensure the confidentiality of all patients. Through the process of a patient check in time and through the order of process that one must go through will be the catalyst of the improvement. These proposed processes will allow one to be successful in the improvement of the hospital. will now follow these steps: * Functional allocation modeling * Each of these proposed process will ensure that the Patton-Fuller Hospital will have a greater success than their past. It is normal during the analysis that more requirements and needs can reasonably be included into the processes. Through carefully prioritizing and planning each process can be carefully implemented and risk can be eliminated for a greater success rate in the effectiveness of the patient care. Logical system model Working on a project for Patton-Fuller Community Hospital, they want an evaluation for the development of a patient management system to track patient check-ins, appointments, and surgeries. The RPMS system is a selection of hardware, software, telecommunications components that are design to work together or independently depending on the specific need Preliminary design model Design trade-off approach the To accomplish intended goals of the project, several considerations must be made. Chiefly, the project must be delivered within the scope as described by stakeholders. Secondly, considerations such as associated costs, desired performance levels, and scheduling constraints must be evaluated. While upgrades to the existing system represent the lowest expense, this approach would not address the need for process and work flow reorganization. Additionally, the inherent scheduling and cost benefits do not justify this option. Consequently, it is advisable to forgo usage of the existing system in favor of implementing a new system. Designing the new system with new components is recommended because existing components lack the functionality, speed, and performance needed to automate many of the needed tasks under the newly designed work flow design. It also lacks the capacity needed to organize and store the amounts of data needed for report generation. Therefore, in lieu of a less costly, time-wise approach of overhauling the existing system, the more costly, yet more efficient new system will be implemented. Physical system model (Stacey) Testing Process Summary The System testing stage operates an important function in the software development cycle. The strategy for input must contain an application overview that will be tested in respect to its scope, functionality, criticality, and complexity. All specifications have to be met to mollify the stakeholders. Documents associated with the baseline application such as requirement, function, and design specification documentation should be included. Test scripts used consist of multiple test events that will include checkpoints, instructions, and results that are expected. Standards and procedures should include organizational, technical and client/stakeholder level standards and procedures that remain uniform. The tools and techniques used to establish the patient management system for Patton-Fuller Community Hospital are most important as well. Discussions held with major stakeholders to collect information is essential. A walkthrough of the application is a necessity as well as reviewing the documentation of baseline and test-ware ease. Substantiation has been established with the imposed model correlated with the system testing stage. The output phase of testing functions remains consistent with the strategy documentation. The strategy document are updated constantly throughout the entirety of the project and is made up of several sectors. Risk management is an intricate part of the testing process, which is also continual throughout the lifecycle of the project. Team C has used qualitative analysis, quantitative analysis, and has established a risk response plan as well as a team associated with monitoring and controlling identified risks. Testing are performed to assure all aspects of the project have been held up to the standards and expectations of the client and stakeholders, is within the budget that was established, and remains in the timeline determine by the client and stakeholders. The testing stage is a critical part of the quality and assurance plan and this stage of the project was implemented with the appropriate labor and tools needed to complete the assessment for Patton-Fuller Community Hospital. This section of the software development cycle takes up 30% of the completed process for the implementation of a system. Installation process and training plan summary (1st Section) Installation process has a priority in the development of any implementation. The overall job must be critically planned and data should be collected. The installation process will be developed from a group of individuals that has been setting meetings and analyzing the risks and the non-risks. The time to implement should not be longer than a week in order to keep the budget of training at a minimum and the costs of supplies at a standard. Each individual will be responsible for delivering feedback to ensure proper protocol for the hospital. Resources should be the knowledge of the system, the data that was acquired from stakeholders, and also the tools to carry the implementation in a positive direction. From this basic type of collecting and analyzing data one can come to the second stage of implementation that includes the method. Installation process and training plan summary (2nd Section) Installation, as with all aspects of the development process will be done in accordance with a structured methodology. Despite the inherent constraints—namely time, budget, and resources, in order to ensure a successful installation, this phase must adhere to the established standards. That being said, in consideration of time, the following schedule has been developed. Installation has an allotted timeframe of four business days and will take place on a department by department basis. By incrementally installing the system, the team will be able to identify any final issues that need to be addressed. Training will take place as installation is completed—in a similar department by department method. That is, as the system is installed in department one, training will begin for members of that department. This method of staggering training by department will lead to an overall allotment of five to six days of training which will exceed the installation allotment by two days—minimizing the number of days the development team will be needed on-site. This methodology will address the time and resource constraints of the project as external human and financial resources will be applied for shorter periods of times. Additionally, shut down of the existing system is limited and done in smaller increments. Documentation plan summary Systems Documentation: * Information needed for the ongoing maintenance and operation of the computer system * Structured for the technical systems professional Examples: technical diagrams, flow charts, database management structures, etc. User Documentation: * Easy to read (step by step) instructions for using the application system * Structured for non-systems professional It is important to keep clear and factual documents, because the maintenance staff will have to learn system, because the original system developers will have moved on to other new development projects. Also so the system development staff can add to the models to incorporate new aspects to the system. User documentation is to reduce the number of problem telephone calls that the developer receives from the customers and to minimize the amount of the new system training needed. Support and Maintenance Plan Summary Provide a plan outlining the responsibilities and resources necessary to support and maintain the proposed system, such as software, hardware, and networks. It is good practice to have documentation about your computing environment, have procedures in place and thoughts around other areas such as disaster recovery. I t is also important to have a backup person to go to if your main IT person is not around. Start with a description of your current infrastructure: * Inventory all equipment * Make a list of vendors contact data and account numbers * Create a detail network map Make a list of tools and applications you are currently use and what they do * Document any special configuration Maintenance Procedures: * Start a log book for keeping records of all activities * Set a time (downtime) when you can take the network down. Example: last Friday of the month from 1am to 3am Sever Maintenance * Check Hardware clean when necessary (machines, cables, switches, battery backup) * Review lo gs for errors. * Run MS Baseline Security * Make sure Antivirus protection up to date * Disk cleanup and Defrag. Updates: Install only during downtime. Before running updates make sure you back up the machine. Plan ahead with what updates you need to run (Microsoft, Firmware and other utilities) References Apollo Group, Inc. (2011). Patton-Fuller Community Hospital. Virtual Organizations Portal. Retrieved from BSA/376 – Systems Analysis and Design course website. Apollo Group, Inc. (2011). Patton-Fuller Community Hospital. Service Requests – Virtual Organizations Portal. Retrieved from BSA/376 – Systems Analysis and Design course website.