Financing Small Businesses

SOAP Notes Coursework

SOAP Notes Coursework Coursework on Soap Notes for New Patient: S: subjective O: objective A: assessment P: plan (S) SUBJECTIVE CC): Chief Complaint: Runny Nose John O’Shea is a 32 year-old single white male. He presents a â€Å"Persistent head ache for 5 days† and â€Å"Sore throat for the last 2 to 3 days.† He also complains of â€Å"Right facial pain† which he aan over the counter â€Å"Tylenol† which gave him some relief but the running nose persisted. History of present illness (HPI) This 32 Year old man presents with a chief complaint of a runny nose for six days with accompanying head ache and sore throat. Patient has been experiencing severe headache for over 5 days on the sides of the head, right behind the eyes. The first onset of the pain was five days ago, after the pt retired home from work with a fleet of sneezes and runny nose. Pain was relieved with painkillers (ibuprofen) for the best part of the night only for the pt to wake up with a serious purulent drainage through the nasal passages. The drainage subsided by itself after the pt had taken breakfast and plenty of water only to appear again within a matter of hours. The runny nose is aggravated by any form of dust and coldness. Pt reports slight pain above cheekbones which he uses over the counter Tylenol which offers some relief to the pain. Pt would sometimes experience mild pain behind their eyes when they strain their sight or when they try to roll their eyes sideways. Running nose is intense du ring the night and in the mornings. Pt has experienced nausea especially during the day. With nausea, pt denies vomiting. For 2 days now, pt has had a bad sore throat accompanied by fever. Pt also denies skin rashes or hives, abdominal pains, pain above cheekbones, joint pains or coughing. The mild pain above the cheekbones subsided upon use of OTC Tylenol. Allergies: Pt reports Allergic rhinitis – Headache, diarrhea, frequented urination, sneezing, runny, stuffy nose, itchiness and difficult breathing. Food allergy for meat and fish Generalized rashes, abdominal, diarrhea, skin itching, vomiting, cramps, swelling of soft tissues and the lips, and breathing complications. Denies allergies to latex and medication. The patient reports Acute Sinusitis. Current Medication Patient reports taking a dosage of 1 gram of Excedrin by mouth in duration of 5 to 6 hours up to 4 grams daily for 3 days, as it has been prescribed over the counter by a pharmacist. The patient has also been taking OTCs; pseudoephedrine nasal decongestant in form of tablets by mouth for 2 days. A total of 12 tablets had been taken so far following the pharmacist’s prescription of â€Å"a total of 2 tablets every 4 to 6 hours without exceeding a max of 8 tabs in 24 hrs. The patient had labels for both medications as noted. Pt denies any alternative or complementary treatment and Vitamins with similar specifics. The patient also reports oral tablets o Tylenol 6 tablets a day or the last 3 days. PMH / PSH Past Medical History (PMH): Pt reports history of hypothyroidism and HTN. Pt also reports history of allergic rhinitis and Acute Sinusitis Past Surgical History (PSH): Pt reports appendectomy, 1994; TA, 2005. Fam Hx (Family History) Patient reports family history of HTN (Father diagnosed with HTN at the age of 39); CAD (mother with stent at age 43); hypothyroidism (sister). Denies family history of nasal allergies, and Migraine headache. Family history therefore is non-contributory and not useful for Chief Complaint (CC). Soc Hx (Social History) Work History: The patient has worked as a coal miner for 15 yrs. currently unemployed. Pt. single, lives alone in a rented flat house, never married. Pt. reports a history of cigarette smoking 1 PPD for 15 YRS. Cessation 2009. Pt. reports a history of consuming a pack of beer over the weekends for 15 yrs. Reports 1 beer weekly since March, 2011. Pt. denies current use or history of illicit drugs. ROS (Review of Systems) CS (constitutional systems): Reports fever. Pt. denies weight loss, night sweats, lethargy/fatigue, and change in appetite, rash or itch. Eyes: Report headache and pain beneath the eyes. Pt. denies visual changes, double vision, and eye pain, floaters or blind spots (scotomas). Neuro: Pt. denies weakness, dizziness, numbness or changes in mood, sleep or memory. Ears, nose, mouth and throat (ENT): Reports runny nose, sinus pain, pain with swallowing, sore throat. Pt. denies stuffy or painful ears, toothache. Cardiovascular: Pt. denies shortness of breath, loss of consciousness, oedema, chest pains or palpitations. Respiratory: Reports cough. Pt. denies haemoptysis, exercise intolerance, wheezing, sputum or Trouble with breathing. States asthma is well-controlled. Lungs are not clear to auscultation and are not resonant to percussion. Abd: Pt denies abdominal pain, constipation or diarrhea, N/V, or changes in stool pattern. (O) OBJECTIVE PE (Physical examination) VS: P 85, B/P 127/82, HR 69, RR 18, height 6’5’’, Weight 182lb: pt is overweight, VS seems to be fine. General: Alert oriented x3, well nourished, well groomed, appropriate affect, in no acute distress (NAD), responds appropriately to interview and questions. HEENT (head, eyes, ears, neck and throat): Normal Skin: Dry and warm, no rashes or skin lesions, Lungs are CTA bilaterally. Cardiovascular: Femoral pulses 2+, RRR having S1, S2, no murmurs, gallops or rubs. Respiratory: Bilateral breath sounds (BBS) clear to auscultation, absence of adventitious breath noises. Abdomen: BS present x 4 quads, normoactive, soft, non-distended, non-tender. Neuro: Cranial Nerves Intact and functioning well. Neck: Supple, no lmphadenopathy, no bruits, and trace evidence of thyromegaly. Lab/Xray/Procedures Recent labs, X-ray, procedure and special test results Ex: Na+ 136, K+ 4.2, BUN 9, Cr 0.8, glucose 82 (17/7/2011); Normal screening colonoscopy (10/05/2011); Abdominal ultrasound (18/6/2011) – single 10mm gallstone. No supportive treatments. Pt advised to use hand wash regularly to avoid transmission of germs in future infections. (A) ASSESSMENT Allergic rhinitis Tearing or runny nose not accounted for sinuses or cold symptoms. Early hypothyroidism and HTN Tympanic membranes pearly grey with a sharp reflex of light. Right maxillary tenderness. Acute Sinusitis Preventive care should be observed. Pt should use hand wash and clean handkerchief all the time. Patient should avoid alcohol or any other drugs when under medication. Pt should keep a clean environment within the house. Avoid dust and other allergens. Always use prescription drugs and avoid over the counter medicines. (P) PLAN This is a plan based on all the symptomatic conditions presented by the patient. Examine nasal secretions to determine allergic or infectious infections. Repeat labs, X-ray and tests for Ex, K+, BUN, Cr Gluc Allergies: Give dosages for allergy antihistamines (Beclomethasone, cromolyn, or triamcinolone) + cough suppressants as well as oral decongestants (tablets). For antihistamines consider tabs or injection. Apply fluticasone nose spray allergy symptoms when noticed. Runny Nose: Cough suppressants + decongestants to be taken by mouth following the right prescription. Treat with Amoxicillin 500 mg per day three times and a decongestants for a whole week. Follow up if symptoms persist. Sore throat: mild antibiotics will be given to the patient. Supportive treatment to pt such as taking plenty of fluids and having a good rest should also be incorporated. Advice pt regarding preventive measures for runny nose in adults e.g. frequent hand wash to cleanse germs which may cause cold flu, avoidance of nose, eye and mouth touch. Pt is advised to avoid allergens whenever possible. Provide pt with referrals and consultation contact information incase of any issues that may arise from worsening condition and reaction on medication; this could be allergy or intolerance. In this case, signed pharmacy student name and contact information. Pt follow up will have to take place in three days to assess the progress of the prescribed medication on the condition. Narrative The patient is a 32 Year old man who presents with a chief complaint of a runny nose for six days with accompanying head ache and sore throat. Pt has been experiencing severe headache for over 5 days on the sides of the head, right behind the eyes. Based on my assessment of the patient’s condition and response to the previous modes of treatment, my advice to the pt would be to take the prescribed doses of allergy antihistamines. I will also offer a cough suppressant and tablets for oral decongestion. For the case of the antihistamines there is a choice between tabs and injection. The pt is also advised to keep off alcohol and any other drugs not prescribed for the period of treatment. Pt must also ensure clean house environment free of dust and other allergens that might aggravate his situation. Pt advised to install window screens and vacuum clean house always. Pt should avoid outdoors in the woods when its sunny or windy. I urge the pt to take plenty of fluids and rest. Avoid touching the nose, eyes and mouth as this could lead to infection with germs which cause cold flu. Alternatively you can be sure to use hand wash regularly to cleanse germs capable of causing such infections. The pt is also advised to seek medical follow up if symptoms persist. If the pt agrees to this mode of treatment, he is on a sure path to recovery.

LAW Business Associations Assignment Example | Topics and Well Written Essays - 3000 words

LAW Business Associations - Assignment Example The Act includes certain common principles related to the directors’ duties. Directors’ remuneration’ has occupied a vital position in usual discussions in recent years. This happens primarily owing to the fact that often there lays a huge difference between the remuneration of the directors and the employees. In accordance with a news report presented by Wcbn (2011), the latest trends in directors’ remuneration have been demarcated from the review made by PricewaterhouseCoopers (PwC). It depicts that remuneration levels usually depend upon the industry within which the company is operating and the company size1. In accordance with a report presented by KPMG UK, it is ascertained that the scenario related to directors’ remuneration in the year 2013 has gone through certain decisive changes. The report states that in the modern day scenario for designing the salary structure, a shift of focus from the market median to the linkage between pay along wi th performance has been made. The latest trends in the remuneration structure can be best understood by following the pictorial representation given below2. Source:2 Companies Act 2006 provides a detailed understanding of the appointment and removal of directors. The Act states that initial appointment of the directors are done by ‘subscribers’ to the memorandum’. Furthermore, the Act also states that ‘article of association’ determines the appointment of directors. In accordance with article 17 of the new model, it states that directors are selected by the members of the annual general meeting and by the Board of Directors. The appointment regulations state that a person must be willing to act as a director. Whereas, s167 (2b) CA 2006 states that â€Å"consent by that person, to act in that capacity† must be informed to the companies house3. According to a report presented by Ernst & Young, the changing landscape pertaining to directorsâ€⠄¢ remuneration has been revealed. The observations reveal that the United Kingdom’s recovery pertaining to the global recession is slower. This is resulting in a decrease in consumer spending and business confidence. The latest trends related to the shareholders’ voting rights with regard to the new remuneration structure has highlighted that companies have been compelled to make transparent communication regarding directors’ remuneration4. Correspondingly, director’s remuneration has accelerated at an alarming rate. In nations such as the UK, all the companies that are listed are required to comply with company law, as directed in the Companies Act, 1985. Subsequently, in 2002, certain reforms had been made to the set out Companies Act 1985 with regard to the enhancement of accountability and transparency for the companies that are listed. In terms of a crucial directive, under the requirement of company law, listed organisations will be necessitated to publish a report relating to directors’ remuneration within annual reporting cycle. Despite such reforms the company law has remained noticeably ineffective to establish specific

Prospective Analysis Assignment Example | Topics and Well Written Essays - 750 words

Prospective Analysis - Assignment Example The random walk model outlines that the stock price or earnings change have same distributions and are independent of each other thus past movements of stock price or earnings cannot be used to predict the future stock price movement. I disagree with John’s forecast strategy since the assumption of unchanging mean and variance is debatable. b. A merger or acquisition is will increase the future net income due to higher sales growth and more revenue generation from the acquisition. The merger or acquisition will reduce competition thus enhance the future net income. The best model that describes a better pattern of the earnings per share is the mean-reversion model since competition in the market will drive abnormal levels of profits to mean while reinvestment of the earnings will likely earn more levels of earnings. According to many analysts, the Earnings Factory is a ‘darling’ of the ASX. Its current market price $ 15 per share and its book value is $ 5 per share. Analysts forecast that the organisation’s book value will grow by 10 per cent per year indefinitely and the cost of equity is 15 per cent. The market’s expectation of the organisation’s long-term average ROE is calculated as follows; Companies with a high ROE can have a low PE ratio when the investors expect the firm will continue generate positive abnormal ROEs. The PE ratio is the market price per share divided by the earnings per

Israeli and Arab conflict Essay Example | Topics and Well Written Essays - 1250 words

Israeli and Arab conflict - Essay Example It starts with the Biblical story of Abraham who moved from the land of Ur in present-day Iraq/Iran to the land of Canaan as it was then called. According to Biblical traditions, Abraham was promised the whole land adjacent to the Red Sea and within the west of the Jordan river. However, there were some native Canaanites on the land. Abraham's grandson, Jacob (Israel) moved to Egypt with his children and grandchildren. They lived in Egypt for a few hundreds of years and became a great and populous nation. They then returned to the land of Canaan a few generations after Abraham. The descendants of Abraham became known as the Israelite community. They lived side-by-side with the natives of the land of Canaan. This include the Philistines, the Jebusites, the Hittites and many other native tribes. After a few centuries, the Israelite community became more numerous in the land and with the rise of David as king and leader of the community, it was transformed to a state and its capital was established in Jerusalem. The State of Israel was however divided into two: Judah in the South and the Northern Kingdom. The northern Kingdom was destroyed and the people were sold into nations around the world. The people from Judah however remained a united state around the capital Jerusalem. Eventually, the Roman defeated Judah in AD63 and the remnants of Judah were sold as slave in the Diaspora (Safrai 1). In the Diaspora, the people of Judah continued to maintain their traditional practices and maintained their identity. They became known as the Jews. Meanwhile, the Romans renamed the State of Israel Palaestina which became known as Palestine (Safrai 1). As the Roman power faded, the land of Palestine was inhabited by people from other Middle Eastern origins and this include the Canaanites, Philistines and others who lived in the land before Abraham moved onto it. After the Romans, the land came under the control of the founder of Islam and his successors. As a result of that, they converted to Islam and assimilated to the main sphere of Arab communities. However, the land of Canaan/Israel became known as the Holy Lands and it changed hands for generations before the Crusaders contested over the land for generations. Eventually, it became part of the Ottoman Empire in the 1500s and it remained under Ottoman rule until 1918. British Rule & Palestine The Ottomans were Muslims, however, they never considered themselves Arabs (Willner et al 487). There was therefore a clear distinction between Ottomans or Turkish Muslims and Arabs of the Middle East and North America. During the era of the Ottoman domination of the Middle East and North America, the Arabs were ruled by Ottoman governors. Hence, the British defeat of the Ottoman Empire came with a promise of liberating the Arabs after the war (Willner et al 489). Britain used a complicated system of forming alliances and diplomatic ties with different peoples around the world during the First World War period which was fought between 1913 and 1917. The defeat of the Ottoman Empire was part of the â€Å"Asian Theater† of a larger war that was fought in Europe and other parts of the world. Britain had used the help of the Americans, Monarchical Russia and many others to defeat the Germans in the European War. They had also promised the Jewish Group seeking a homeland for the Jewish people known as the Zionists in Europe and around the world that they will help

Online Shop Web Design

Online Shop Web Design Shop Online Web Application system, allows the customer to shop online for their required items, and also represents an associated window for the orders selected by the customer. Each Customer will be having their desired page when they login or signup into the Shop Online Web Application. The Customer can select the required items into the cart without logging into their account. But the purchase of the items in the cart has to be done using their registered account in the System using either credit or debit card, they can also cancel the payment or return the items purchased only after a detailed specification of the reason for it. The Logged In customers will be having a wish-list function so that they can put the items they wanted to buy in the wish-list and can buy later. There is one more function price checker, which intimates the customer regarding the item selected by them whenever there is a cut-off in the price of that item, but only for a few selected items. There is also a desired page for the history of items bought by the customers.   The customer can maintain their account and address details. The customer also can reset their password if forgotten by getting a link to reset password to their concerned web mail. Requirements for the system are we will be using Ruby On Rails for the development, and for the web design HTML, Javascript and CSS. The Backend is managed by MySQL. The Database for the System consists of shop online development database which consist of tables for categories, products, product images, users. The Columns for the categories are id, title, weight, products_counter, created_at, updated_at, ancestry. The Columns for products are id, category_id, titile, status, amount, uuid, msrp, price, description, created_at, updated_at, lprice. The Columns for the product images are id, product_id, weight, image_file_name, image_content_type, image_file_sizee, image_updated_at, created_at, updated_at. The Columns for the users are id, email, crypted_password, created_at, updated_at,activation_state, activation_token, activation_token_expires_at, remember_me_token, remember_me_token_expires_at, reset_password_token, reset_password_token_expires_at, reset_password_email_sent_at. Entity Relationship Diagram: FIG. 1 (Relationship between the tables) In ruby on rails the web application code is divided into model, view, controller. Model represents the database access, View represents the html pages before and after access of the database, and controller represents the action to be done once the we get a request from the Web Application. Model Code: (Category) class Category < ApplicationRecord    validates :title, presence: { message: Empty name! }    validates :title, uniqueness: { message: Repeated name! }    has_ancestry orphan_strategy: :destroy    has_many :products, dependent: :destroy    before_validation :correct_ancestry    def self.grouped_data   Ã‚  Ã‚   self.roots.order(weight desc).inject([]) do |result, parent|   Ã‚  Ã‚  Ã‚  Ã‚   row = []   Ã‚  Ã‚  Ã‚  Ã‚   row { where(status: Status::On) }    module Status   Ã‚  Ã‚   On = on   Ã‚  Ã‚   Off = off    end    private    def set_default_attrs   Ã‚  Ã‚   self.uuid = RandomCode.generate_product_uuid    end end (product image): class ProductImage < ApplicationRecord    belongs_to :product    has_attached_file :image, styles: {   Ã‚  Ã‚  Ã‚  Ã‚   small: 60^x60,   Ã‚  Ã‚  Ã‚  Ã‚   middle: 200^x200,   Ã‚  Ã‚  Ã‚  Ã‚   big: 960x    }    validates_attachment_content_type :image, content_type: /Aimage/.*Z/    validates_attachment_size :image, in: 0..5.megabytes end (User): class User < ApplicationRecord    authenticates_with_sorcery!    attr_accessor :password, :password_confirmation    validates_presence_of :email, message: Email cannot be empty!    validates_format_of :email,message: Email format mistake!,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   with: /w+([-+.]w+)*@w+([-.]w+)*.w+([-.]w+)*/,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   if: proc { |user| !user.email.blank? }    validates :email, uniqueness: true    validates_presence_of :password, message: Password cannot be empty!,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   if: :need_validate_password    validates_presence_of :password_confirmation, message: Password confirm cannot be empty!,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   if: :need_validate_password    validates_confirmation_of :password,message: Password not right ,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   if: :need_validate_password    validates_length_of :password, message: Password at least 6 digits, minimum: 6,   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   if: :need_validate_password    def username   Ã‚  Ã‚   self.email.split(@).first    end    private    def need_validate_password   Ã‚  Ã‚  Ã‚   self.new_record? || (!self.password.nil?||!self.password_confirmation.nil?)    end end Controller Code: (Category) class CategoriesController < ApplicationController    def show   Ã‚  Ã‚   @categories = Category.grouped_data   Ã‚  Ã‚   @category = Category.find(params[:id])   Ã‚  Ã‚   @products = @category.products.onshelf.page(params[:page] || 1).per_page(params[:per_page] || 12)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   .order(id desc).includes(:main_product_image)    end end (Product): class ProductsController < ApplicationController    def show   Ã‚  Ã‚   @categories = Category.grouped_data   Ã‚  Ã‚   @product = Product.find(params[:id])    end end (Session): class SessionsController < ApplicationController    def new    end    def create   Ã‚  Ã‚   if user= login(params[:email],params[:password])#loginsorcery   Ã‚  Ã‚  Ã‚  Ã‚   flash[:notice]=You have logged in!   Ã‚  Ã‚  Ã‚  Ã‚   redirect_to root_path   Ã‚  Ã‚   else   Ã‚  Ã‚  Ã‚  Ã‚   flash[:notice]=Emails or Password mistake   Ã‚  Ã‚  Ã‚  Ã‚   redirect_to new_session_path   Ã‚  Ã‚   end    end    def destroy   Ã‚  Ã‚   logout   Ã‚  Ã‚   flash[:notice]=You already logged out!   Ã‚  Ã‚   redirect_to root_path    end end (User): class UsersController < ApplicationController    def new   Ã‚  Ã‚   @user = User.new    end    def create   Ã‚  Ã‚   @user= User.new(params.require(:user).permit(:email,:password,:password_confirmation))   Ã‚  Ã‚   if @user.save   Ã‚  Ã‚  Ã‚  Ã‚   flash[:notice] = sign up successfully! Please log in   Ã‚  Ã‚  Ã‚  Ã‚   redirect_to new_session_path   Ã‚  Ã‚   else   Ã‚  Ã‚  Ã‚  Ã‚   render action: :new   Ã‚  Ã‚   end    end end (Welcome): class WelcomeController < ApplicationController    def index   Ã‚  Ã‚   @categories = Category.grouped_data   Ã‚  Ã‚   @products = Product.onshelf.page(params[:page] || 1).per_page(params[:per_page] || 12)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   .order(id desc).includes(:main_product_image)    end end

Essay --

Andrea Beverly Professor McClendon ENGL 1301.A002 17 March 2014 Cause and Effect of Human Trafficking: Sexual Exploitation Cause and Effect Essay On the news and all over the world you hear the term human trafficking. What exactly is human trafficking? â€Å"Human trafficking is essentially modern-day slave trading, which ensnares millions of people in debt bondage or forced conditions.† (Siddharth).As many know today human trafficking has become a phenomenon all over the country. Human Trafficking is a global activity where women and young girls are being traded and used as sexual exploitation. As Siddharth stated that human trafficking is slowly becoming one of the most involved criminal activities all over the world. Two causes and two effects on how strongly our human beings are encouraged to take action. One cause of human trafficking is vulnerability of grieved criminals.(cite). Most grieving criminals are vulnerable, because of their living conditions. When they see how easy it is to be a trafficker makes this issue much more horrifying for women and young girls to be manipulated...