Neonatal Screening Prenatal Alcohol Exposure Health And Social Care Essay

Methods: We assessed whether adult females would be willing to partake in a pilot testing plan for antenatal intoxicant exposure in a bad obstetric unit antecedently shown to hold a high prevalence of FAEE-positive meconium when tested anonymously. The testing plan involved voluntary testing of meconium for FAEEs and long-run developmental followup of positive instances through an bing public wellness plan. Consequences: The engagement rate in the showing plan was significantly lower than when proving was offered anonymously ( 78 % vs. 95 % , severally ; p & lt ; 0.05 ) , and the positiveness rate was 3 % A in contrast to 30 % observed under anon. conditions ( P & lt ; 0.01 ) . Interpretation: These low rates suggest that the bulk of imbibing female parents refused to take part. We conclude that despite the possible benefits of such screening plans, maternal involuntariness to consent, probably due to fear, embarrassment, and guilt, may restrict the effectivity of meconium proving for population-based unfastened showing.Introduction:Fetal Alcohol Spectrum Disorder ( FASD ) encompasses the wide scope of physical, cognitive, and behavioural disablements that can originate due to antenatal intoxicant exposure ( 1 ) . Affecting an estimated 9.1/1000 unrecorded births, it is a taking preventable cause of mental deceleration in the western universe ( 2 ) , with estimated one-year costs in Canada transcending $ 5 billion in productiveness losingss, medical costs, particular instruction, societal services, and projecting behaviors ( 3 ) . Although the primary alcohol-induced harm is lasting, early diagnosing is good and associated with a reduced hazard of secondary disablements such as disrupted school experience, unemployment, institutionalization, and problem with the jurisprudence ; probably because it permits early intercession and specialised support ( 4 ) . Unfortunately, acknowledging FASD is highly ambitious and diagnosing is frequently contingent upon set uping a history of important in-utero intoxicant exposure ( 1 ) . Since maternal studies are undependable in providing this information due to remember prejudice and common underreporting ( 5 ; 6 ) , nonsubjective biomarkers have been investigated. Fatty acerb ethyl esters ( FAEEs ) are non-oxidative metabolites of ethyl alcohol formed by esterification of ethyl alcohol to endogenous fatty acids or fatty acyl-CoA ( 7 ; 8 ) that sedimentation and accumulate in foetal meconium ( 9 ; 10 ) . Numerous surveies have validated meconium FAEEs as biomarkers of heavy antenatal intoxicant exposure happening in the last two trimesters of gestation ( 11-19 ) ; understanding between meconium FAEEs and assorted alcohol-related results has been demonstrated ( 18 ; 20-23 ) ; and this trial has been used anonymously to obtain epidemiological informations on antenatal intoxicant exposure in selected populations ( 23-25 ) . It has been recognized that meconium analysis may function as a neonatal showing tool for the designation of alcohol-exposed neonates, and could potentially be implemented as a cosmopolitan screen or targeted to bad populations ( 26 ) . Such testing would non merely supply accurate exposure history required for diagnosing, but if implemented along with a comprehensive follow-up plan and intercessions, could ease early acknowledgment and intervention of FASD ( 26-28 ) . As an added value, it may place and let for intercession in problem-drinking female parents, which, in bend, may forestall future alcohol-exposed gestations ( 7 ) . However, since informed consent from a competent patient or appointed guardian prior to intervention or testing is an ethical and legal constituent of medical pattern ( 29 ; 30 ) , a testing plan of this nature would necessitate consent of the kid ‘s legal defender ( typically the parent ) . This may decrease the value of meconium showing in a clinica l scene since embarrassment, guilt, and frights of stigma and child apprehensiveness may discourage adult females who consumed intoxicant from accepting to proving despite the possible value to child wellness. To find if adult females would volitionally take part in a neonatal showing plan for antenatal intoxicant exposure, we offered meconium proving with subsequent followup, intercessions and societal supports, to adult females from a regional Ontario population presenting in a bad obstetric unit antecedently shown to hold a high prevalence of alcohol-exposed newborns as determined by anon. meconium proving. We assessed the rates of voluntary engagement and positiveness for intoxicant exposure, and compared these with the rates observed with anon. proving.Methods:Capable enlisting:Written informed consent for meconium FAEE analysis and followup of those proving positive was sought from all Grey-Bruce adult females presenting at St. Joseph ‘s Health Care in London Ontario from November 1st, 2008 to May 31st, 2010. Briefly, Grey-Bruce occupants identified by nurses were informed of the survey, offered showing, and given an Informed Consent papers to reexamine and subscribe if they ch ose to take part. Womans were besides informed of the survey through booklets and postings in the pregnancy ward. It was stressed that a positive trial or self-report of imbibing in gestation would non ask engagement of kid protection bureaus, but would be used to originate follow-up by the Public Health nurse and her section and to mobilise support services if needed.Meconium aggregation, handling, and analysis:Meconium specimens from newborns born to accepting adult females were collected into 50-mL screw cap conelike polypropene tubings ( Sarstedt AG & A ; Co. , Numbrecht, Germany ) by nursing staff and labeled with the capable figure to guarantee confidentiality. Samples were stored onsite at -20A °C and shipped on dry ice to the Motherisk Laboratory at Hospital for Sick Children in Toronto, Ontario on a fortnightly footing where they were stored at -80A °C until analysis. Meconium FAEEs were measured utilizing headspace solid-phase microextraction and gas chromatography-mass spectroscopy. The method involves the sensing and quantification of four FAEEs ( ethyl palmitate, linoleate, oleate, and stearate ) utilizing matching d5-ethyl esters as internal criterions. It has been developed and validated in our research lab, and published in item elsewhere ( 31 ; 32 ) . Heptane, ethyl esters ( palmitate, linoleate, oleate, stearate ) , fatty acids ( palmitic, linoleic, oleic, stearic ) , anhydrous ethanol-d6, and thionyl chloride were obtained from Sigma-Aldrich Co. ( St. Louis, MO ) . Acetone was obtained from EMD Chemicals Inc. ( Gibbstown, NJ ) . Chromatograms were analyzed utilizing LabSolutions GCMSsolution package version 2.50SU1 ( Shimadzu, Kyoto, Japan ) . A cumulative amount of a†°?2.00 nmol FAEE/gram meconium was considered positive, bespeaking heavy imbibing with 100 % sensitiveness and 98.4 % specificity as was established in a population ba seline survey that measured meconium FAEEs in newborns born to ascetics, societal drinkers, and confirmed heavy drinkers ( 16 ) .Maternal and neonatal features:Capable features along with gestation and bringing information were obtained from charts of accepting adult females. Additionally, information on intoxicant usage was obtained by the nursing staff utilizing the Parkyn Screening Tool ; a everyday postpartum questionnaire.Follow-up and neurodevelopmental appraisal:Children with positive meconium consequences were followed-up through Ontario ‘s †Healthy Babies Healthy Children † ( HBHC ) plan that involves postpartum home-visits by public wellness nurses who provide personalized support and instruction to households with neonates ( 33 ) . In this survey, the nurse assigned to a positive instance was notified of meconium trial consequences, conducted an in-depth household appraisal ( including a screen for intoxicant usage upsets ) , and enrolled the household i n an on-going home-visiting plan with an individualised household service program that included regular appraisals of developmental mileposts utilizing the Ages and Stages QuestionnairesA ® ( ASQ ) . Children with positive trial consequences besides received neurodevelopmental appraisal by a certified clinical psychologist during two place visits ; around 3 months and 1-1.5 old ages of age. The Bayley Scales of Infant and Toddler Development, Third Edition ( Bayley-IIIA ® ) was used, which measures infant cognitive, lingual, and motor operation. If developmental holds were detected, extra service suppliers were engaged through referrals to intercession plans and specialized services that were provided through HBHC plan and Grey-Bruce Health Unit at no cost to the household. Need for referral to diagnostic services at the Hospital for Sick Children was assessed. Extra support services for the household were available if needed, including dependence intervention, guidance, rearing support, instruction on FASD, nutrition, employment, and diversion.Comparison with anon. meconium testing:The showing plan was launched in a bad obstetric unit where a old survey, utilizing anon. meconium testing, observed a 12-fold higher hazard of FAEE-positive meconium in adult females referred to this site as compared to the general population of the part ( 30 % vs. 2.5 % ) . About 95 % of adult females participated in that survey. To find whether adult females who consumed intoxicant during gestation agreed to take part in the pilot unfastened t esting plan, the rates of voluntary engagement and positiveness for antenatal intoxicant exposure observed in our unfastened plan, were compared to rates observed in that old anon. survey conducted in the same obstetrical unit a twelvemonth before ( 25 ) . Fisher ‘s Exact Test was used to compare the consequences of the two surveies. Two-tailed P-value & lt ; 0.05 was considered statistically important.Ethical motives:The survey was approved by the research moralss boards of the Hospital for Sick Children and the University of Western Ontario.Consequence:Willingness of female parents to take part in unfastened testing plan:Sixty female parents from Grey-Bruce were identified at St. Joseph ‘s Hospital and offered meconium showing, of which 47 adult females consented, numbering a 78 % consent rate ( Figure 1 ) . The maternal and neonatal features of accepting topics are presented in Table 1. The consent rate was significantly lower than that observed in old survey in which meconium was tested anonymously ( 95 % vs. 78 % ) ( P & lt ; 0.05 ) ( Table 2 ) . Of involvement, we documented one case where a adult female recalled take parting in the anon. prevalence survey with her old babe, but refused to take part in this unfastened testing plan when told there would be follow-up of positive instances. Additionally, we encountered a adult female who, although agreed to take part, was uncooperative, repeatedly pretermiting to advise the nurses that meconium had passed and flinging the samples so that none were collected.Positivity for antenatal intoxicant exposure in pilot testing plan:Samples were collected from 50 newborns of which 39 were successfully analyzed ( Figure 1 ) . Merely one of the 39 samples tested above the positive cut-off ( a†°?2 nmol/g ) for FAEE ( 52 nmol/g ) , which translated to a 3 % positiveness rate for antenatal intoxicant exposure. Eleven samples were non-analyzable because of presence of contaminations and/or postpartum stool that impeded chromatography. The ascertained 3 % positiveness rate for antenatal ethyl alcohol exposure was tenfold lower than the 30 % positiveness rate observed under anon. conditions in the old survey ( P & lt ; 0.01 ) ( Table 2 ) .Maternal self-report of intoxicant usage in gestation:Chart reviews did non uncover that substance maltreatment ( intoxicant or drugs ) was the primary ground for referral to St. Joseph ‘s Health Care in any of the instances. Three adult females admitted to devouring any sum of intoxicant in gestation on their antenatal consumption signifiers, including the adult female whose babe ‘s meconium tested positive for FAEEs. However, none reported refering intoxicant usage, with one adult female saying that she drank a†°Ã‚ ¤2 drinks per hebdomad, another coverage that she consumed an â€Å" occasional drink † , and the 3rd saying she drank merely prior to her cognition of gestation without traveling into farther inside informations.F ollow-up and neurodevelopmental appraisal of positive instance:One newborn tested positive for heavy antenatal ethyl alcohol exposure ( 52 nmol FAEE/g meconium ) . Follow-up was arranged as per protocol through the HBHC plan and a public wellness nurse assigned to the instance initiated an appropriate household service program affecting place visits and frequent appraisals of the baby ‘s development. Neurodevelopmental appraisal conducted by a certified clinical psychologist at 3 months of age utilizing BSID-IIIA ® did non uncover any holds ; nevertheless, holds in motor development became evident in 6-month and 8-month appraisals conducted by the public wellness nurse utilizing ASQ. At the 14-month appraisal conducted by a clinical psychologist utilizing BSID-III, the kid scored in low mean scope on motor and linguistic communication graduated tables, exposing holds peculiarly in gross motor and expressive linguistic communication operation, which were good below age outloo ks ( in the 9th and 5th percentile, severally ) . The baby was enrolled in an Infant and Child Development plan and will be referred to a Language and Speech development plan. Referrals to diagnostic clinics have non yet been made, and it is non known whether the ascertained holds are alcohol-related or possibly due to other factors.Interpretation:We observed that engagement and positiveness rates in our unfastened pilot testing plan were significantly lower than those observed when the trial was offered anonymously in the same bad unit, proposing that many adult females who consumed intoxicant in gestation refused to take part, non wishing to be identified by the showing plan. Of involvement, if we assume that all refusals were in fact positive samples, the positiveness rate in our population would number 27 % , which is similar to the positiveness rate observed by Goh and co-workers with anon. meconium testing ( 25 ) . To our cognition, this is the first survey to use biomarkers of foetal intoxicant exposure in an unfastened showing plan designed to ease diagnosing and intervention of alcohol-affected kids. Our consequences suggest that, despite the possible benefits that such screening plans may supply ( as was exemplified by the positive instance ) , adult females ‘s involuntariness to consent may decrease the value of unfastened population-based showing. Schemes to better engagement would necessitate to be investigated if meconium showing is implemented in clinical pattern. For illustration, the â€Å" opt-out † method to derive consent was shown to give higher proving rates in neonatal HIV showing ( 34 ) . Engagement rates may besides increase with societal selling, public instruction, and as the trial becomes established in society. If this occurs, the testing plan piloted here may function as a theoretical account for a plan that can be implemented in a clinical scene since it ut ilized presently bing services in the community. The developmental followup of kids identified by the screen was integrated into Ontario ‘s HBHC plan, and aid to kids exposing holds was provided through bing community wellness plans and services, such as address and linguistic communication, baby and kid development, and rearing support ; which may all be adapted to integrate intercessions and schemes shown to be effectual in helping kids with FASD and their households ( 35 ; 36 ) . Low engagement is non the lone possible obstruction to implementing testing in clinical pattern. The costs and resources required for proving, follow-up, diagnosing, and intercessions, every bit good as, system capacity to manage these instances, must be considered. Two cost-effectiveness surveies analyzing similar conjectural showing plans showed that decrease in secondary disablements and primary bar of FASD by intercession and instruction of female parents may take to social nest eggs ( 27 ; 28 ) . However, more surveies with concrete cost input variables are needed to find this. Furthermore, several ethical considerations could besides impede testing execution. Although showing can better quality of life through early diagnosing, observing maternal imbibing during gestation and labeling kids as â€Å" at-risk † may transport serious psychosocial deductions for these kids and their households, and affect relationships both within the household and between the household and society, including their service suppliers ( 37 ) . The trial consequences may potentially be misused by tribunals, societal services, insurance companies, and even within the health-care system through stigmatisation of patients ensuing in their under-treatment. To guarantee that households experience maximal benefits and minimal hazards, issues environing confidentiality, entree to consequences, and their usage, must be carefully considered. Our survey has restrictions. The pilot testing plan was implemented at a third parturition site, which was chosen due to the high prevalence of FAEE-positive meconium shown in a old anon. survey. Because Grey-Bruce communities are reasonably little in size, the consequences may hold been different if showing was implemented at a primary parturition site, where patients may be more trusting of their wellness attention suppliers, who probably provided them with antenatal attention. Alternatively, because the community is little, adult females may be even less likely to accept because of frights of stigmatisation and other societal deductions that may be more marked in a little community. Whatever the instance may be, the consequences may non be applicable to a primary health-care scene in a little community. To sum up, this is the first survey to implement an unfastened neonatal testing plan for antenatal intoxicant exposure aimed at easing sensing and direction of FASD. Follow-up, intercessions, and support plans were individualized and offered within the model of presently available services in the country, thereby patterning a plan that could be implemented in clinical pattern. We demonstrated that adult females ‘s involuntariness to partake in this showing, particularly of those who consumed intoxicant in gestation, may impede the execution of such testing plans in clinical pattern. Future surveies should research schemes that may better adult females ‘s willingness to consent, every bit good as, evaluate and reference other possible barriers to testing by finding the cost-effectiveness, logistics, and best patterns for plan execution.

Whistleblowing Ethics Essay Sample

Whistleblowing Ethics Essay Sample Whistleblowing Ethics Essay Perhaps, one of the most difficult things to do when inside an organizational setting is saying when â€Å"enough is enough†. Although it is true that every organization, workplace, or community has their own flaws, just as how they have their own rules, delineating what is ‘going beyond’ is not exactly as easy as it sounds like. Therefore, any individual regardless of his/her rank, gender, class, age, etc. must know when to blow the whistle. In order to do this, one must first know what is enough and even this is subject to limitations. As for many experts out there, the belief is that the threshold for any flaws or mistakes that are committed within an organization is if it poses certain threats to the organization and the people around it, or if it crosses and undermines the ‘rule of law’ as established by the society. In this equation, one might ask about the ethics of whistleblowing in doing this, since at times conflicts might arise in terms of â€Å"loyalties† especially if the one doing the mishaps is a friend, colleague, or even a family member. However, by looking into it, it is also more unethical to let someone get away with their wrongdoings since it might not only damage the system or the organizations as well as the people around them but even the people that someone cares for. Nevertheless, this debate is still ongoing today with plenty of people being subscribed to both sides. In other situations, it might still be harder to blow the whistle, even if ethics is not on the line. This is most likely due to inefficiencies and other difficulties in the system itself such as the method or channels of reporting or even the hierarchy with which to do things. Perhaps, the system is too bureaucratic that it takes a long time for these reports to go to the right people who could and would do the necessary steps to cull these mishaps. In these cases, people how directly sees the action might feel a little bit frustrated and ‘unethical’ since their actions are not reaping what is needed. Thus, this is the time when these people do unnecessary steps which, instead of helping improve the situation, lead to conflicts and other actions which lead to other circumstances that make matters worse. These actions are usually outside of simply â€Å"whistle blowing† (which is healthy in the correct circumstances) are now also considered unethical since they tr y to circumvent the established laws are regulations which are designed to deal with these matters. Although there are other people who believe that these are acts of heroism, most of the times stepping out of these established notions could just lead to more trouble and are not exactly the best thing to do in order to bring peace and harmony to each and every member of the organization. Nonetheless, ethics in itself is a very complicated matter. What might seem ethical for one person, might not be for another. This is exactly the case for whistleblowing and thus for any individual who experiences this dilemma, it is important to know that when confused and frustrated about what to do, the best way might be to stick with the pre-established channels and methods of dealing with conflict. By doing this, not only are these individuals doing their part for the betterment of society, they are also doing a part for both the betterment of themselves (as a member of a collection of individuals) and at times, the betterment of the people whom they â€Å"blow the whistle† for.

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Competition Bike Incs Essay Horizontal analysis compares a company’s performance from year to year. I will be reviewing Competition Bikes Inc(CBI) balance sheets and income statements. During CBI year 6, 7 and 8 I have found their net sales , cost of goods to be fluctuating, and few various other items. The net sales from year 6 to 7 increase 33.34 %. The cost of goods from year 6 to 7 was 31.82 %. The gross profit increase 30.89. Comparing year 6 and 7 I found that year 7 improved, but when I compared year 7 to 8 the results were not good for year 8. The company had experienced a 15 percent reduction in net sales. Cost of goods drops 14.8 % from year 7 to 8. Advertising Expenses CBI advertising expenses increased by 37.5 % from year 6 to 7. CBI made a great investment from year 6 to 7 because the net sales increase at a higher rate the increased advertising cost. CBI reduced their advertising expenses by 16.3 % from year 7 to 8. I believed this was done because of the fragile economy. Many companies are trying to make cuts back during a weak economy. These reduces expenses will hold them over until the economy becomes stronger. Website/Sales The website creation and maintenance expenses during year 6, 7 and 8 stayed the same price. Sales commission increase 33.371 % during year 7 from the previous year. Sales commission decrease by 15 % the following year (8). Distribution Network The Distribution network expenses had a positive increased in year 7 by33.3 % jump from the previous year. Distribution expenses are normally supposed to maintain similar numbers, but when you have an increase in sales it is acceptable to increase the distribution expenses. Distribution network expenses decreased 15 percent in year 8. This was caused due to less revenue. Transportation CBI had 33% transportation increase from year 6 to 7. This was caused CBI had more products sold and required more products to be shipped. CBI saw 15 % transportation decrease from year 7 to 8. CBI had less products sold and this caused transportation to decrease in year 8. Administrative Expenses from year 6 to 7 saw 21.43% increase. Administrative Expenses maintain the same expenses from year 7 to 8. Executive expenses increased 29.42 % from year 6 to 7. Year 7 and 8 maintain the same level of expenses. Employment taxes rose by 25.81 % increase from year 6 to 7. Year 7 and 8 maintain the same level of employment of expenses. Administrative expenses are expected due to company having increase production and sales. Utilities expenses rose 3.84 % from year 6 to 7. CBI operation worked proficiently in year 7, and this helped them experienced only an increase of 3.8% in utilities. This was caused due to increase production. CBI utilities increased by 11.11 during year 8. I would suggest CBI have their utilities monitor from day to day to see how they can prevent an increase in expenses when the company is not performing well compared to the previous year. Research CBI saw research and development saw a 37.5 % percent increase from year 6 to 7.During year eight CBI reduces their research and development expenses by 16.3 %. A company should never reduces their research and development if they company perform well in the previous year. I believe this was one of the reasons why CBI had a great year during 7 because they knew what consumers wanted. Due to lack of spending on research and development this caused their sales to drop. Research and development is an important component of competition against other companies without a company will fail to succeed. Interest Income CBI interest income rose 38.1% from year 6 to 7. During year 7 CBI income was properly invested. During year 8 CBI investments had a 3.4% reduction. The reduction was small, but small things do add up over time. I would suggest CBI to monitor their investments and make plans to move around their money if the current trend continues. Balances sheets CBI accounts receivable rose 164.3% from year 6 to 7. During year 8 CBI accounts receivable drop 15 percent. CBI should monitor accounts receivable more closely to make sure past due balances are paid on time. This was caused due to the company noticing a large increase on accounts receivable during year 7 and they tried to capitalize on it. This caused their accounts receivable to drop. Raw Materials CBI manages their raw materials well during year 7. CBI had 3.1% percent reduction in year 8. CBI should incorporate lean production method and Just in time production to avoid wasteful spending and production. Liabilities CBI liabilities increase 1.2% from year 6 to 7. This is expected due to year having 7 having an increase in sales and productions. CBI reduces their liabilities by 3.1% from year 7 to 8. This is good because CBI had a 15 percent reduction in net sales. Vertical analysis A method of financial statement analysis in which each entry for each of the three major categories of accounts (assets, liabilities and equities) in a balance sheet is represented as a proportion of the total account. The main advantages of vertical analysis are that the balance sheets of businesses of all sizes can easily be compared. It also makes it easy to see relative annual changes within one business(Investopedia,2013). Income Year 7 net sales were 7% higher than year 6.CBI preserved their selling expenses at 6.7% of total Net Sales. CBI reduced General Admin Expenses from 17.1% during year 6 to 15.5% during year 7.This would lead to an increase in Operating Income from 2.8% of Net Sales from year 6 to 5.3% in year 7 and CBI Net Earnings would increase from 1.1% (year 6) to 3.3% (year7). CBI did not perform well in year 8 because their expenses increase during year 8. This caused CBI net earnings to reduce.. CBI Administrative expenses increased 15.5% from year 6 to 7. CBI net sales increase 18.4% from year 7 to 8. CBI operating expenses income was reduce 5.3%of net sales to 1.9 % causing CBI net earnings from 3.3% to a .7%. I would recommend CBI to monitor their general and Admin expenses. Majority of expenses stayed the same during year 6,7 and 8. However during year 8 the CBI did not perform well. I believed CBI needs to find ways to reduces expenses when the company is having a low sales volume. CBI should incorporate just in time principles and lean manufacturing principles. I believe this would help reduce wasted production and this would help reduce utilities expenses. Just in time principles and lean manufacturing principles could also reduce employee expenses. ASSESTS CBI in the cash and cash equivalent accounts drop from 6.2 % in year 6 to 2.7%. However, during year 7 more products were sold compared to year 6. CBI accounts receivable had a major increase from year 6(6.5%) to year 7(16.6%).CBI needs to monitor their accounts receivable accounts more closely and make sure they’re collecting the amount owed to them. During year 8 CBI cash and cash equivalents had risen from 2.7 %( year 7) to 10.3%(year 8). The reason why this happen was due to CBI had started to monitor their accounts receivable. This helped them collect the money they were owed on past due accounts. I would recommend CBI to avoid making purchase on accounts and find ways to use the cash in a more efficient way. CBI should realize it important they have enough reserves during a recession. This will help hold them over until the economy bounces back. â€Å"Trend Analysis is the practice of collecting information and attempting to spot a pattern, or trend, in the information (Wikipedia,2012).†CBI sales were lower than year 7, but they still were able to make a profit. CBI should expect to see growth in the next few years based on their current trend. CBI is expected to have 3,510 units sold in year 9. CBI will have 3,660 units sold in year 10. Finally during year 11,CBI will sell 3,800 units. The forecast numbers are based on the economy recovering. This will encourages CBI sponsors to invest in professional riders and this will increase new bike sales. Currently is cost CBI 1,047.50 to make each product. I would recommend CBI find suppliers who have the same quality parts, but at a lower cost. I would also make recommend CBI is following just in time and lean manufacturing principles. This could help CBI increase their profit margin. Ratio analysis- analyzes numbers Ratio analysis is a method used by businesses to assess their financial situation by comparing two sets of linked data. Current ratio will measure a companys ability to pay short-term obligations. CBI had a reduction from year 7 (5.9%) to 8(5.35%). Two wheel racing (TWR) current ratio was 4.2% for year 7 and 8. A debt ratio will determine if a business is able to handle any unexpected liabilities it that may come up. A business needs to make sure they enough money to pay off debt to avoid problems with their debt. During year 7 CBI debt ratio was 46.8%. The follow year the debt ratio was 46%. The debt ratio only drops .08 percent during year 8. TWR debt ratio was 38% in year 7 and 8. An acid test ratio will determine if a company can back their liabilities. CBI is doing better than (TWR) by 1.12% and .85%. Inventory turnover- determines the number of times a company can sell it average level of inventory throughout the year. CBI bicycles are customizes for customers so I am unable to compared CBI and TWR. Average collection period, This determines how well a company is able to collect money to the customers they extended credit to.CBI has higher collected amount compared to TWR. CBI was 11.3% higher in year 7 and 8. Gross Profit Margin, will tell investors how much revnue was gain after selling the product(Cost of Good-revenue/gross profit. TWR profit margin is 32.10% higher than CBI profit margin in year 7(27.4%) and 8(27.0%). TWR is operating more effectively. Operating profit margin Measures management efficiency (Operating income/total sales). CBI year 7 was 5.3% and TWR was 5.2%. Year 8 TWR performed better with 5.3% compared to CBI(1.9%). Net Profit Margin show investors the percentage of each sale dollar earn as net income. During year 7 CBI net profits was 3.3% and in year 8 it was .8%.TWR was 5.14% year 7 and 8. The portion of a companys profit allocated to each outstanding share of common stock. Earnings per share serves as an indicator of a companys profitability(Investopedia,2013).TWR was $.08 for year 7 and 8. CBI was $.20 during year 7 and $.04 in year 8. Return on total assets-determine how successful a company is to earn profit with their assets. TWR total assets was 4.8% for year 7 and 8. CBI was 4.5% in year 7 and year 8 was .8%. Return on Common Equity- Income between net income and stockholder equity. During year 7 CBI equity was 8.5% AND TWR was 8.1%. CBI equity in year 8 was 1.5% and TWR was 8.1% Price / Earnings Ratio- Stock prices and company earning. CBI earning share 49.67 and TWR was 29. During year CBI price jump to 83.73 and TWR was still 29. Times Interest Earned Determines the numbers of times operating income can pay interest expense. Year 7 interest earn was 5.27 and TWR was 4.24. During year 8 CBI interest earn drop to 1.77 and TWR remained 4.24. ‘Working capital is a financial metric(current assets minus company liabilities) which represents operating liquidity available to a business, organization or other entity, including governmental entity(Wikipedia,2013).† The financial metric system will analyzes if a company will be able to pay their short term liabilities or do they need to take an alternative solution. CBI working capital in year 6 was $382,394: CBI working capital at the end of year was 1,306,617. CBI increased their working capital by 70.7% at the end of year 8. After reviewing CBI working capital the results indicated they will be able to pay their short term liabilities Recommendation I would recommend CBI to have their accounts executives to build a better relationship with customers and make sure they’re satisfied with the work they are receiving. One of the most important things a company can do is listen to their employees. I would also recommend CBI to reduce their accounts receivables. This could be done by making sure that larger orders from customer are sent out faster. CBI inventory cost increase over 24% from year 6 to year 8.CBI should follow the just in time and lean manufacturing principles. This will reduces inventory cost for CBI. CBI transportation expenses are one of their highest expenses. I would recommend CBI to consider to purchasing their own delivery truck and see if this will help them reduce their transportation expense. Internal controls Internal controls helps a company infrastructure run smoothly. Internal controls also help protect and prevent fraud. Internal control will try to remove the temptations for employee to act unethically in the aspect of putting the company at risk of lawsuit. CBI purchase department (PD) will purchases orders from suppliers based on their monthly budget. Once the order has been received the PD will evaluate bids from different suppliers. Once the order has been received they’re given to the production line. The invoice will be sent to the PD. If there are any supplies left they will be sent to raw materials. The PD will then send an accounting department who issues a check to the supplier. Recommendation I would recommend the whole entire processed be revamped. The first thing I would recommended is to separate the duties of researching the bid and purchasing orders. The next thing I would suggest is to make the receiving department in charge of verifying the shipping when the packages arrive. The receiving department needs to verify every item is there from the supplier and their no missing item from the delivery. The receiving department should maintain an inventory control system. After the receiving department has approved the invoice, they should forward to the purchasing department. The purchase order will be forward to the accounting department for payment. Accounting has currently been only receiving unverified invoices. Risk Accounting has currently been only receiving unverified invoices. The lack of verification could cause CBI to get double charge for item they already paid for. Currently their lack of inventory control system. Currently unused supplies are being sent to raw material without anyway of tracking it. This would make it easy for employees to steal because lack of inventory control system. Recommendation I would suggest an inventory control system be implemented. I would make sure all packages received by receiving department be verified by management to avoid being double charge. The inventory control system will help prevent theft from employees. I would also hire outside firm every quarter to check inventory levels to make sure no one is stealing from the company. Sarbanes-Oxley Act Sarbanes-Oxley Act is government regulation that congress pass in order to improve financial disclosures. This would help prevent accounting fraud and improve financial disclosures from corporations(Wikpedia,2013).†Section 302: A mandate that requires senior management to certify the accuracy of the reported financial statement Section 404: A requirement that management and auditors establish internal controls and reporting methods on the adequacy of those controls. Section 404 had very costly implications for publicly traded companies as it is expensive to establish and maintain the required internal controls (Investopedia,2013). CBI does not mention that they were audited by outside firm. I highly recommend CBI to hire auditing firm to review the company’s annual statement before releasing the numbers to the public to make sure there is no accounting errors. Internal controls are implemented and effective at the end of year 8(Dec 31). The CEO, and CFO certification is need because it is required by SOX and this could not be located. Auditor releases the following statement to shareholders. A material weakness is a control deficiency, or a combination of control deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of the company’s annual or interim financial statements will not be prevented or detected on a timely basis Recommendations CBI needs to make sure they are in compliance with the regulations set forth by Sarbanes-Oxley CB. The first thing I would recommend is to conduct a internal control assessment. The next thing I would recommend CBI to hire accounting firm to review their internal controls. The control needs to be based on Sox guidelines. The CEO and CFO needs to certify they’re aware of the CBI internal control and the actions the company have taken to protect investor’s investments. It is very vital CBI CEO and CFO certifies they’re aware of internal control because Sarbanes-Oxley requires this to be done. Since the accounting firm made assessment that the internal control is effective their might be some problems that could arise from the following statement, â€Å"A material weakness is a control deficiency, or a combination of control deficiencies, in internal control over financial reporting, such that there is a reasonable possibility that a material misstatement of the company’s annual or interim financial statements will not be prevented or detected on a timely basis.† I would recommend the CEO or CFO to take action fix the internal control problem because they could face jail time for making statements that were not true. .† CBI should base their guidelines set forth by the Committee of Sponsoring Organizations of the Tread Way Commission(CSOTWO). CSOTWO is joint inivate five private sector organizations devoted to providing leadership through progress and guidance on enterprise risk management, internal control and fraud dictation. This is a great way for C BI to improve the internal control process. References Free Dictionary(2013) http://legal-dictionary.thefreedictionary.com/Sarbanes-Oxley+Act+of+2002 Investopedia(2013) http://www.investopedia.com/terms/h/horizontalanalysis.asp#axzz2Hh4rgfuE True Bussiness(2013) http://truetobusiness.com/finance/ratio-analysis Wikipedia(2013) http://en.wikipedia.org/wiki/Internal_control