Monday, January 27, 2020
Comparative in-vitro Quality Evaluation of Cephalexin
Comparative in-vitro Quality Evaluation of Cephalexin A COMPARATIVE IN-VITRO QUALITY EVALUATION OF DIFFERENT BRANDS OF COMMERCIALLY AVAILABLE CEPHALEXIN IN KARACHI (PAKISTAN) SHAHBAZ AHMED NOOR Abstract: Approximately 600 generic drug applications (ANDAs) approved each year, 65 % of prescriptions are for generic indication from oncology to insomnia without repeating clinical trials .Every generic molecule references a previously approved drug. Cephalexin Monohydrates was first sold by Eli Lilly in 1972. The availability of many brands of cephalexin 500 mg capsules in Pakistan market today place healthcare providers in a difficult situation of choice of a suitable brand or alternate use possibility .The objectives of this study was to carry out pharmaceutical equivalence studies on different brands of cephalexin 500mg capsules available in local market of Karachi. The invitro parameters include all pharmacopeia and non-pharmacopeia tests that were dissolution rate( in 0.1 N Hydrochloric Acid at 37 à ¢Ã à °C ) ,weight uniformity , disintegration time , moisture content ( with the help of suitable Karl Fischer Titrator ) , appearance (observed physically before and after opening of the shell) , Identification ( compare manually retention time in HPLC chromatogram of sample with chromatogram of reference standard ) and HPLC assay of cephalexin (as describe below based on HPLC assay method AM1172) were also analyzed. Along with the inappropriate use of antimicrobials drugs, substandard antibiotic medicines may also contribute in resistance development against susceptible organism. The study will be helpful to evaluate the efficacy and justification of generic substitution of cephalexin 500 mg capsule brands in Karachi (Pakistan) INTRODUCTION: Antibiotic, being the wonder drugs, are widely prescribed in the developing countries. In reality, 25 to 40 % prescriptions contain one or more antibiotic (Public Sector studies, 1990-1993) Antibiotic resistance can be developed through its wide and inappropriate use without following any standard guidelines. This Alarming situation has been addressed in several scientific journals (Glass et al.,1980; Farrar , 1985; Saha et al., 2003;Lina et al.,2007;Hassan et al.,2009) Post ââ¬âmarketing surveillance include complete procedures undertaken to obtain more data and information about a product after it had been granted marketing authorization and made available for public use, this data used for product improvement ,development standard and regulations. Regulatory agencies rely on limited information get from clinical trials and from scientific literature as guide to granting to marketing authorization of medicine for public use. Post-marketing surveillance of approved dosage forms is to assess the quality, effectiveness and safe use of medicine to large population. To Assess the standard of a product, invitro dissolution test is widely used because , for any solid dosage forms, gastrointestinal absorption first requires dissolution of the tablet or capsules that librates the drug into solution (Goodman Gilman`s ââ¬âThe Pharmacology basis of Therapeutics,2006) The dissolution characteristics of a drug from the dosage form depend on many factors including its formulation and manufacturing process (Augsburger et al., 1983). Cephalexin Chemically, Cephalexin is {(6R, 7R)-7-[(R)-2-Amino-2-Phenylacetamido]-3-Methyl-8-oxo-5-thia-1-azabicyclo [4.2.0] oct-2-ene-2-carboxylic acid monohydrate} is a first generation cephalosporins for oral administration which is bactericidal, and mainly used in the treatment of various bacterial infections caused by gram +ve and gram -ve microorganisms. .( Ralph R et.al 1970).Excellent oral absorption and lack of serum binding of cephalexin compensates significantly for the lower in vitro activity.( Warren E. Wick et.al 1967). Antibacterial Spectrum of Cephalexin: Cephalexin appears to be a highly effective antibiotic. It possesses the qualities of rapid oral absorption, production of high drug levels in the blood and urine, and near absence of side effects. It is effective against infections due to gram-positive cocci infections, with the exception of Enterococcus, and for most infections caused by E. coli and Klebsiella. It is useful in the treatment of a wide variety of infections in infants and children, and particularly valuable with susceptible infections in patients who do not require parenteral antimicrobial therapy. (R.C. Rudoy, M.D.1977) The first-generation cephalosporins, epitomized by cephalothin and cefazolin, have good activity against gram-positive bacteria and relatively modest activity against gram-negative microorganisms. Most gram-positive cocci (with the exception of enterococci, methicillin-resistant S. aureus, and S. epidermidis) are susceptible. Most oral cavity anaerobes are sensitive, but the B. fragilis group is resistant. Activity against Moraxella catarrhalis, E. coli, K. pneumoniae, and P. mirabilis is good (Goodman Gilman`s ââ¬âThe Pharmacology basis of Therapeutics,2006) Literature Survey: A ) Helio et.al in 2007 In this study, they observed the antibacterial spectrum of the orally prescribe cephalosporin (cefaclor, cefdinir, cefpodoxime, cefprozil, cefuroxime axetil, cephalexin) and amoxicillin/clavulanate, as these drugs were widely prescribed for community acquired respiratory tract infections. Narrowest zone was of Cefaclor and Cephalexin against evaluated pathogens. Overall, the 3rd Generation of cephalosporin is more useful in respiratory tracts and other infections when administered orally, as compared with older generation or amoxicillin alone. B ) Chalermporn et.al in 2005 ,they studied for rapid and sensitive identification of cephalosporins drugs such as cefoxitin , cefazolin , cephalexin, cefadroxil , cefaclor and cefoperazone, a flow injection (FI) method was used. This method was applied successfully for the identification of cefoxitin, cefazolin, cephalexin, cefadroxil , cefaclor and cefoperazone. The method was successfully applicable for the identification of cefoxitin ,cefazolin , cephalexin and cefadroxil in the pharmaceutical formulation with a sample throughput of 90hâËâ1. C ) Rist et.al in 2002, they studied on Oral Cephalexin compared with mupirocin calcium cream with respect to safety and efficacy in secondarily infected eczema treatment. The adverse effect most common , they observed was diarrhea and nausea, effective clinical dose of mupirocin cream was apply three times daily as compared to cephalexin orally four times daily in secondarily infected eczma as topical regimen was preferred by the patient that enhance patient compliance. D ) Lennart Venemalm et.al in 2001, worked for the diagnosis of allergy against à ²-lactams, prazinone-polylysine conjugate was able to bind with antibodies IgE in sera from patient with suspected allergy to cephalosporinââ¬â¢s. This information may be used for diagnosis of allergy against à ²-lactams. E ) Yagnesh P. Patel et.al in 1998 They studied, modern data on the isocratic assay of five antimicrobial drugs ,five different assay were performed to one single report, antibiotic used in this study were cephalexin and cefaclor (cephalosporinââ¬â¢s), isoniazid and pyrazinamide (anti-tubercular drugs) and minocycline (tetracycline series) . Overall they concluded that any one of the drug could be used as internal standard for other four drugs. F ) Godfried Owusu-Ababio et.al in 1995 Sustained release of cephalexin ciprofloxacin, was evaluated in open chemostat sytem. They concluded that chemostat system is convenient for sustained release drug testing as a function of formulation parameter. G ) Anne H. et.al in 1992 In this study, the Cefaclor uptake was observed concluded that it was sodium-independent, but proton-dependent and also the energy dependent , dipeptides inhibited uptake of à ²-lactam antibiotic but amino acid had no effect on uptake , the overall data from this study concluded that a single proton-dependent dipeptide transport carrier support the orally absorbed antibiotic uptake into Caco-2 cell shows correlation for the use of Caco-2 cell for cellular model of the intestinal proton-dependent dipeptides transporters for study purpose. H ) R. Wise et.al in 1991 Cefibuten, invitro activity was studied against 572 bacterial strain and was compared with orally administered à ²-lactams. Cefibuten being more active against Enterobacteriaceae. There was less activity of cefibuten cefexime against Staphylococci and reduce activity against streptococcus pneumonia. I ) Luis J et.al in 1982 They studied, Acid degradation of cephalexin in presence of formaldehyde, produce 2-Hydroxy-3-phenyl-6-methylpyrazine.In 5M HCL this product gives well defined reduction wavelength with half wave potential of -0.45 vs. SCE. The wave was diffusion ââ¬âcontrolled irreversible, linear relation with the cephalexin conc. was shown with diffusion current and cephalexin in plasma can be determined through it. J ) Ralph R et.al in 1970 They performed to detect various crystal forms of compounds, the employment of solubility versus solvent composition diagram. This appears to be a convenient sensitive method for detecting new crystalline phase. Aim of Project: The objective of this study is to carry out pharmaceutical equivalence studies on different brands of cephalexin 500mg capsules available in local market of Karachi. The invitro parameters include all pharmacopeia and non-pharmacopeia tests that are dissolution rate, weight uniformity, disintegration time, moisture content, appearance, Identification and HPLC assay of cephalexin will also be analyzed. The susceptibility test of drug will also be evaluate by ICLS ( Formerly NCCLS ) Reference Disk Diffusion (Kirby-Bauer) method against different clinical isolates of Staphylococcus aureus (03), E. coli (03), Klebsiella pneumonia (03), Pseudomonas aeruginosa (02), Importance of study: This is a growing concern that if a health care provider, providing the substitute of the generic is also the Bioequivalent. For the health care providers to use these brands interchangeable, the bioequivalence of these brands have to be ascertained, this mean that there should be continued post marketing monitoring of the medicines. EXPERIMENT: TESTING PROCEDURE: Test # 1: Cephalexin Monohydrate (As base): Procedure: Perform HPLC assay of Cephalexin as describe below based on HPLC assay method AM1172. Test # 2: Identification: Procedure: Compare manually retention time in HPLC chromatograms of sample with chromatograms of reference standards. Test # 3: Moisture Content: Procedure: Three times separately the moisture content in the powder of the product with the help of suitable Karl Fischer Titrator will be determine and then calculate their mean. Test # 4: Appearance: Procedure: From the 20 capsules take 10 capsules and observe physically before and after opening of the shells. Test # 5: Weight Variation: From 20 capsules take 10 random capsules from composite sample and note individual weight of filled capsules. Calculate their average, minimum, maximum and COV%. Test # 6: Disintegration: Procedure: Prepare a 0.6% v/v solution of HCl (Add carefully 16.2ml of 37% HCl into 500ml of distilled water and then make the solution up to 1000ml with distilled water) and fill the vessel of a suitable disintegration test apparatus with this solution up to recommended height. Maintain the temperature between 35 à °C and 39 à °C. Place 1 capsule in each of the 6 tubes of the basket and run the equipment. Start the stopwatch and note the time when all capsules are disintegrated. If 1 or 2 capsules fail to disintegrate, repeat the test on 12 additional capsules. The requirements of the test are met if not less than 16 of the 18 capsules tested have disintegrated. Test # 7: Dissolution: Procedure: According to USP 2007 page # 1691. HPLC ASSAY OF CEPHALEXIN BASED ON HPLC ASSAY AM1172 (1.01) FOR CEPHALEXIN CAPSULES.500 MG / CAPSULES. I.PRINCIPLE: The sample is dissolved in water and the insoluble component removed by filtration. An aliquot of the filtrate is diluted with water and examined by reverse phase HPLC. II.APPARATUS 1. A suitable high performance liquid chromatographic system equipped with a variable Wavelength UV Detector. 2. A suitable analytical balance with tolerance of +/- 0.1 mg. 3. A suitable Ultrasonic bath. 4. Suitable Syringes such as BDà ¯Ãâà ¤, 10ml. 5. Analytical Column: 150 Ãâ" 4.6 mm. i.d stainless steel column packed with S5 ââ¬â ODS2 or equivalent column. 6. Pre-Column: 50 Ãâ" 4.6 mm .i.d stainless steel column packed with 80à µm Porasil or equivalent is fitted between the pump and injector. 7 Detector Condition: 254nm range 0.5 aufs 8. Pump Condition: Flow rate 1.0 ml / minute. 9. Injection volume: 20à µl 10. pH meter. 11. Mobile phase: See reagents. B) REAGENTS Cephalexin analytical reference standard Methanol HPLC grade Acetonitrile HPLC grade 1- Hydroxybenzotriazole, Reagent grade. Triethylamine ( T.E.A ) analytical grade Orthophosphoric acid, analytical grade 1- Pentanesulfonic acid, sodium salt, Reagent grade (8) Mobile Phase: Dissolve 1g Pentanesulfonic acid sodium salt (Monohydrate) and 15ml of Triethylamine in 850 ml of distilled water, adjust the pH to 3.0 with Orthophosphoric acid. Add 50 ml of Methanol and 100 ml of Acetonitrile, Mix well and degas before use. Note: Caution should be taken when degassing the mobile phase to avoid evaporating the mixture. Internal standard solution: Dissolve 1 gm of 1- Hydroxybenzotriazole in 1000ml of mobile phase, mix well. C) PROCEDURE: This procedure contains the minimum recommended sample and standard Preparation for assays performed manually. Alternate weights and volumes may be substituted if necessary, as long as they are documented and provide nominally equivalent concentration of the analyte. PREPARATION OF REF. STANDARD SOLUTION Accurately weigh approximately 32, 40 and 48 mg of Cephalexin reference Standard in to into three separate 200ml volumetric flasks respectively, pipette 30 ml of the internal standard solution in to each flask and swirl to dissolve, Dilute to volume with distilled water and mix well. SAMPLE PREPARATION Take 20 random capsules from composite sample and note individual weight content of each capsule and determine average content weight of 20 capsules. Accurately weigh about 500 mg sample from composite sample of weight content of 20 capsules in 500ml volumetric flask and record the weight, add water to dissolve and make up the volume with water up to 500 ml mix well and filter. Take 20ml of above dilution in 100ml volumetric flask, add 30ml Internal Standard and then add water upto 100ml mix well and filter through 0.45à µm filter paper. d) CHROMATOGRAPHY Make 20 à ¯Ã à l injection of a standard to ensure the chromatography system complies with the system suitability criteria. The peak tailing should not be greater than 1.5, peak efficiency should be greater than 4000 plates. The resolution between the two peaks should be greater than 2.5. A typical chromatogram is attached. LIMIT OF CEPHALEXIN MONOHYDRATE CONTENT. CEPHALEXIN THEORY LABEL 500MG / CAPSULE 500MG / CAPSULE (As Cephalexin anhydrous) ( As Cephalexin anhydrous) Acceptance Limit: 475 ââ¬â 525mg per capsule (95 ââ¬â 105 %). Regulatory Limit: 462.5 ââ¬â 550 mg per capsule (92.5 ââ¬â 110 %) (British Pharmacopeia) REFERENCES: (Augsburger LL,Shangraw RF,Giannini RP, Shah VP, Prasad VK and Brown D (1983) Thiazides VIII: Dissolution Survey of marketed Hydrochlorothiazides tablets. J.Pharma Sci.,72(8):876-881) Anne H. Dantzig, Linda B. Tabas, Linda Bergin , Cefaclor uptake by the proton-dependent dipeptide transport carrier of human intestinal Caco-2 cells and comparison to cephalexin uptake Biochimica et Biophysica Acta (BBA) Biomembranes, Volume 1112, Issue 2, 9 December 1992, Pages 167-173. Chalermporn Thongpoon, Boonsom Liawruangrath, Saisunee Liawruangrath, R. Alan Wheatley, Alan Townshend , Flow injection chemiluminescence determination of cephalosporins in pharmaceutical preparations using tris (2,2â⬠²-bipyridyl) ruthenium (II)-potassium permanganate system , Analytica Chimica Acta, Volume 553, Issues 1-2, 30 November 2005, Pages 123-133. (Farar WE (1985) Antibiotic resistance in developing countries. The Journal of Infectious Diseases,152(6):1103-1106 ) (Glass RI, Huq I, Alim ARM and yunus M (1980) Emergence of multiply antibiotic-resistant vibro cholerae in Bangladesh . The Journal of Infection Disease , 142(6):939-942 ) (Goodman Gilman`s-The Pharmacological Basis of Therapeutics (2006) 11th Edition, McGraw ââ¬âHill Medical Publishing Division, Digital Edition , Chapter1.) Godfried Owusu-Ababio, James A. Rogers, Hosmin Anwar , Method of evaluation of sustained release microsphere formulations using the open chemostat system. (Goodman Gilman`s-The Pharmacological Basis of Therapeutics (2006) 11th Edition) (Hassan SMR, Hossain MM,Akhter R,Karim SMH, Haque S,Kamaluddin M and Ghani A (2009) Pattern of antibiotic use at the primary health care level of Bangladesh : Survey report -1.S.J. Pharm. Sci.2 (1) : 1-7) Helio S. Sader, Michael R. Jacobs, Thomas R. Fritsche, Review of the spectrum and potency of orally administered cephalosporins and amoxicillin/clavulanate, Diagnostic Microbiology and Infectious Disease, Volume 57, Issue 3, Supplement 1, March 2007, Pages S5-S12. (Lina TT,Rahman SR, Gomes DJ(2007) Multi-antibiotic resistance mediated by plasmids and integrons in uropathogenic Escherichia coli and Klebsiella pneumoniea . Bangladesh Journal of Microbiology,24 (1):19-23) Lennart Venemalm , Pyrazinone conjugates as potential cephalosporin allergens Bioorganic Medicinal Chemistry Letters, Volume 11, Issue 14, 23 July 2001, Pages, 1869-1870. Luis J. Nuà ±ez-Vergara, J. A. Squella, M. M. Silva, Polarography of an acidic degradation product from cephalexin, Polarography of an acidic degradation product from cephalexin, Talanta, Volume 29, Issue 2, February 1982, Pages 137-138s. (Public Sector Drug use studies (1990-1993) International Network for Rational use of Drugs, Virginia,USA. ) Ralph R. Pfeiffer, K. S. Yang, Mary Ann Tucker, Crystal pseudopolymorphism of cephaloglycin and cephalexin, 19 June 1970, 10.1002/jps.2600591222 R.C.Rudoy,M.D. 1977, Cephalexin: Clinical and Laboratory Evaluation in Infants and Children , Clinical Pediatrics, Vol. 16, No. 7, 639-644 (1977) Rist T, Parish LC, Capin LR, Sulica V, Bushnell WD, Cupo MA, A comparison of the efficacy and safety of mupirocin cream and cephalexin in the treatment of secondarily infected eczema., 2002-01, Clin Exp Dermatol., 27(1):14-20 R.Wise, J. M. Andrews, J. P. Ashby, D. Thornber, Ceftibuten: A new orally absorbed cephalosporin in vitro activity against atrains from the United Kingdom ,Diagnostic Microbiology and Infectious Disease, Volume 14, Issue 1, January-February 1991, Pages 45-52. (Saha SK Baqui AH, Darmstadt GL, Ruhulamin M, Hanif M,Arifeen SE, Santosham M,Oishi K, Nagatake T and Black RE (2003) Composition of carriage and invasive pneumococci among Bangladesh children:implication for treatment policy and vaccine formulation. Journal of Clinical Microbiology,41 (12):5582-5587) Warren E. Wick, Cephalexin, a New Orally Absorbed Cephalosporin Antibiotic , Appl Environ Microbiol. 1967 July; 15(4): 765-769). Yagnesh P. Patel, Nehal Shah, Indravadan C. Bhoir, M. Sundaresan, Simultaneous determination of five antibiotics by ion-pair high-performance liquid chromatography Journal of Chromatography A, Volume 828, Issues 1-2, 18 December 1998, Pages 287-290. 1 | Page
Sunday, January 19, 2020
Humanitys Fate in King Lear :: English Literature Essays
Humanity's Fate in King Lear Many tragedies have been written throughout history. The purpose of these tragedies were to illustrate some type of moral lesson. The tragic situation involves man's miscalculation of reality and the fatal results of those miscalculations. Our tragic hero must endure a great deal of suffering. It ends in his ruin or destruction. We must also understand that tragedy not only destroys the guilty, but also the innocent. The tragic hero represents what could happen to humankind. He is responsible for his society. He is a representation of our own fate. The fate of humanity will be discussed in King Lear, by William Shakespeare. In this moving play, our tragic hero was King Lear. Our tragic hero must also have a tragic flaw. Lear's tragic flaw was his vanity. Lear is so full of himself that he doesn't realize the truth. First of all, Lear wants to divide his kingdom up into three parts for his three daughters. Each daughter's portion depended on how much they would proclaim their love for him. Lear says, "Give me the map there. Know that we have divided in three our kingdom, and 'tis our fast intent to shake all cares and business from our age, conferring them on younger strengths while we unburdened crawl to death."(Act I, i, l. 38-41) Lear should not have relinquished his powers in the first place. He expects to be treated like a king when he no longer will have the power of a king. Secondly, he says, " Great rivals in our youngest daughter's love, long in our court have made their amorous sojourn, and here are to be answered. Tell me, my daughters ( Since now we will divest us both of rule, Interest of te rritory, cares of state), which of you should we say doth love us most? That we our largest bounty may extend where nature doth with merit challenge."(Act I, i, l. 47-53) Within these few lines, we see Lear's first sign of vanity. For one daughter to receive more land than another, one must proclaim their love to be more than the other. He is measuring their love with land. Naturally, his first two daughters, Goneril and Regan, will lie to him, but his vanity blinds him from the truth. Lear's first miscalculation was dividing his land between the daughters. The second is allowing his vanity to get the best of him.
Saturday, January 11, 2020
Health Information Management System Proposal Essay
Health information technology can be best described as the point where information science, medicine, and healthcare all meet. The foundation of healthcare delivery consists of three major elements: cost, access, and quality. The U.S. government reportedly ââ¬Å"hopes most Americans have electronic health records by 2014â⬠(Ramachandran, 2013) .It is my proposal to upgrade to a current, cutting-edge health information management system in our office. Potential Benefits to the Practice Private practices are not a thing of the past. According to the AMAââ¬â¢s recent survey,â⬠53.2% of physicians were self-employed in 2012, 41.8% were employed and 5% were independent contractorsâ⬠(Robeznieks, 2013). Keeping that in mind, I have listed a few of the potential benefits of HIT to our practice: â⬠¢Increased access to care ââ¬â Having patient records stored electronically is in many cases, distance becomes irrelevant when consulting with a physician or the practice. For the patients that are out of the country or simply in another town, we can access their medical records and help them over the phone or allow other physicians access to their records at the patientââ¬â¢s request. â⬠¢Allows for faster diagnosis when knowing the patientââ¬â¢s medical history and prescription history. Could possibly mean the difference between life and death. â⬠¢Allows for a patient to record health information they measure at home, i.e. blood pressure, pulse, weight, blood glucose levels. This updated information can be used by the practice to keep tabs on patients for future visits or the need to schedule a visit. Potential Benefits to Staff In an online article written by Ken Terry, he stated that ââ¬Å"41% of those who donââ¬â¢t have online access to records would consider switching physicians to obtain itâ⬠(Terry, 2013). Therefore, we need to look at other aspects that will benefit our staff in the long run. â⬠¢Time equals money. Staff will spend less time retrieving, finding and filing patient charts. Now they can enter a patientââ¬â¢s name into the system and all their information will populate the screen. â⬠¢Less money will be spent through the elimination of a transcription service as well as the transferring and transporting of patient charts. â⬠¢Automated billing and accounting Necessary Training As one consulting company I spoke with stated, ââ¬Å"understanding that one of the most important factors in a successful implementation is the quality of user training that takes place prior to the system activationâ⬠(Coastal Healthcare Consulting Inc., 2013). Due to the fact that we are a small practice, it will benefit everyone who has any contact with patients will be included in the training. Challenges with Implementing a New System â⬠¢Over reliance on the accuracy of EMRs may lead to significant errors if a patient record contains false information. â⬠¢Privacy and security risks due to hackers can include: identity theft, unauthorized access and corruption of patient data. â⬠¢The cost of the equipment as well as the training that needs to be done. According to the Congressional Budget Office report written back in 2008 stated, ââ¬Å"No aspect of health IT entails as much uncertainty as the magnitude of its potential benefitsâ⬠(Devon M. Herrick, 2010). Our world has been radically changed in the last 5-10 years due to digital technology. Smart phones, tablets and web-enabled devices have changed the face of health care as we know it. This is our time to get involved and bring our practice into the present and solidify our future. References Coastal Healthcare Consulting Inc. (2013). Training. Retrieved September 22, 2013, from Coastal Healthcare Consulting Inc.: http://www.coastalhealthcare.com/services/training/ Devon M. Herrick, L. G. (2010). Health Information Technology: Benefits and Problems. Dallas: NCPA. Ramachandran, V. (2013, August 15). Technology Changing Healthcare. Retrieved September 20, 2013, from Mashable: http://mashable.com/2013/08/15/healthcare-and-it-health-informatics-infographic/ Robeznieks, A. (2013, September 17). Not All Doctors Giving Up Private Practice. Retrieved September 20, 2013, from Modern Health Care.com: http://www.modernhealthcare.com/article/20130917/BLOG/309179996 Terry, K. (2013, September 17). Patients Seek More Online Access To Medical Records. Retrieved September 19, 2013, from Information Week: http://www.informationweek.com/healthcare/policy/patients-seek-more-online-ac
Friday, January 3, 2020
Quotes From the Famous Novel Catch-22
Catch-22Ã by Joseph Heller is a famous anti-war novel. Even if youve never read the book, youve likely heard about its premise. The title of the book refers to a situation where no matter what choice you make the outcome will be bad. The concept has been widely referred to in popular culture.Ã Here are a few quotes from the novel to refresh your memory, to give you a taste for this classic, or just for you to enjoy the language and lines of Joseph Hellers famous work. Catch-22 Quotes Chapter 2 An unreasonable belief that everybody around him was crazy, a homicidal impulse to machine-gun strangers, retrospective falsification, an unfounded suspicion that people hated him and were conspiring to kill him. Chapter 3 He had decided to live forever or die in the attempt, and his only mission each time he went up was to come down alive. Chapter 4 Youre inches away from death every time you go on a mission. How much older can you be at your age. Chapter 5 Fortunately, just when things were blackest, the war broke out. There was only one catch and that was Catch-22, which specified that a concern for ones own safety in the face of dangers that were real and immediate was the process of a rational mind. Orr was crazy and could be grounded. All he had to do was ask; and as soon as he did, he would no longer be crazy and would have to fly more missions. Or would be crazy to fly more missions and sane if he didnt, but if he was sane he had to fly them. If he flew them he was crazy and didnt have to, but if he didnt want to he was sane and had to. Yossarian was moved very deeply by the absolute simplicity of this clause of Catch-22 and let out a respectful whistle. Thats some catch, that catch-22,Ã he observed. Its the best there is,Ã Doc Daneeka agreed. Chapter 6 Catch-22...says youve always got to do what your commanding officer tells you to. But Twenty-seventh Air Force says I can go home with forty missions. But they dont say you have to go home. And regulations do say you have to obey every order. Thats the catch. Even if the colonel were disobeying a Twenty-seventh Air Force order by making you fly more missions, youd still have to fly them, or youd be guilty of disobeying an order of his. And then the Twenty-seventh Air Force Headquarters would really jump on you.Ã Chapter 8Ã History did not demand Yossarians premature demise, justice could be satisfied without it, progress did not hinge upon it, victory did not depend on it. That men would die was a matter of necessity; which men would die, though, was a matter of circumstance, and Yossarian was willing to be the victim of anything but circumstance. But that was war. Just about all he could find in its favor was that it paid well and liberated children from the pernicious influence of their parents. Clevinger was a troublemaker and a wise guy. Lieutenant Scheisskopf knew that Clevinger might cause even more trouble if he wasnt watched. Yesterday it was the cadet officers; tomorrow it might be the world. Clevinger had a mind, and Lieutenant Scheisskopf had noticed that people with minds tended to get pretty smart at times. Such men were dangerous, and even the new cadet officers whom Clevinger had helped into office were eager to give damning testimony against him. The case against Clevinger was open and shut. The only thing missing was something to charge him with. Ill tell you what justice is. Justice is a knee in the gut from the floor on the chin at night sneaky with a knife brought up down on the magazine of a battleship sandbagged underhanded in the dark without a word of warning.Ã Chapter 9 Some men are born mediocre, some men achieve mediocrity, and some men have mediocrity thrust upon them. Ã With a little ingenuity and vision, he had made it all but impossible for anyone in the squadron to talk to him, which was just fine with everyone, he noticed, since no one wanted to talk to him anyway.Ã Chapter 10 Major Major never sees anyone in his office while hes in his office. Chapter 12 Open your eyes, Clevinger. It doesnt make a damned bit of difference who wins the war to someone whos dead. The enemy, retorted Yossarian with weighted precision, is anybody whos going to get you killed, no matter which side hes on, and that includes Colonel Cathcart. And dont you forget that, because the longer you remember it, the longer you might live.Ã Yossarian sidled up drunkenly to Colonel Korn at the officers club one night to kid with him about the new Lepage gun that the Germans had moved in. What Lepage gun? Colonel Korn inquired with curiosity. The new three hundred and forty four millimeter Lepage glue gun, Yossarian answered. It glues a whole formation of planes together in mid-air. Yossarians heart sank. Something was terribly wrong if everything was all right and they had no excuse for turning back. Chapter 13 You know, that might be the answer - to act boastfully about something we ought to be ashamed of. Thats a trick that never seems to fail.Ã Chapter 17 There was a much lower death rate inside the hospital than outside the hospital and a much healthier death rate. Few people died unnecessarily. People knew a lot more about dying inside the hospital and made a much neater, more orderly job of it. They couldnt dominate Death inside the hospital, but they certainly made her behave. They had taught her manners. They couldnt keep death out, but while she was in she had to act like a lady. People gave up the ghost with delicacy and taste inside the hospital. There was none of that crude, ugly ostentation about dying that was so common outside the hospital. They did not blow up in mid-air like Kraft or the dead man in Yossarians tent or freeze to death in the blazing summertime the way Snowden had frozen to death after spilling his secret to Yossarian in the back of the plane. Chapter 18 Dont tell me God works in mysterious ways, Yossarian continued, hurtling on over her objection. Theres nothing so mysterious about it. Hes not working at all. Hes playing. Or else Hes forgotten all about us. Thats the kind of God you people talk about - a country bumpkin, a clumsy, bungling, brainless, conceited, uncouth hayseed. Good God, how much reverence can you have for a Supreme Being who finds it necessary to include such phenomena as phlegm and tooth decay in His divine system of creation? What in the world was running through that warped, evil, scatological mind of His when He robbed old people of the power to control their bowel movements? Why in the world did He ever create pain?Ã Pain? Lieutenant Scheisskopfs wife pounced upon the word victoriously. Pain is a useful symptom. Pain is a warning to us of bodily dangers.Ã Chapter 20 He had failed miserably, had choked up once again in the face of opposition from a stronger personality. It was a familiar, ignominious experience, and his opinion of himself was low. Chapter 36 And looking very superior, he tossed down on the table a photostatic copy of a piece of V mail in which everything but the salutation Dear Mary had been blocked out and on which the censoring officer had written, I long for you tragically. R. O. Shipman, Chaplain, U.S. Army. Chapter 39 Morale was deteriorating and it was all Yossarians fault. The country was in peril; he was jeopardizing his traditional rights of freedom and independence by daring to exercise them. Chapter 42 Run away to Sweden, Yossarian. And Ill stay here and persevere. Yes. Ill persevere. Ill nag and badger Colonel Cathcart and Colonel Korn every time I see them. Im not afraid.
Thursday, December 26, 2019
The Importance Of Books On The Government s Support Of...
From an extremely young age children are told stories, either from their parents memory, or from storybooks. As they become older they start choosing their own books, they read different series on any topic. The importance of books is shown in the governmentââ¬â¢s support of libraries. Little children can get their own library cards and read as many books as they wish. These books and stories have an impact, the stories that are internalized can teach important lessons that have the ability to influence in a positive way. I believe that books are the tools in which young people will build their ideas. Therefore it is so important for the correct reading material to be out in the world. If a book is required reading in a school, there is a guarantee it will be read and discussed. When I was in school, it was required to read the works of William Shakespeare, the writing is so different, and it is almost a whole different type of English. The students where at first a little confuse d, yet after the initial confusion came to appreciate beautiful writing. I think it is so important to read about the past, the world is a different place than it was one hundred years ago. At the last lesson in the semester, we learnt about flash fiction, super quick short stories that send a message in a couple of sentences. Compare that kind of writing to Shakespeareââ¬â¢s flowery sentences and it is a completely different thing. Everything is constantly changing, which is why IShow MoreRelatedProfessional Practice Issues Of Health Care Essay1072 Words à |à 5 PagesProfessional Practice Issues in Health Care - Ethics Introduction Medical ethics play a huge role in the health care industry. A crucial part of a health care professional s role is to apply appropriate ethical guidelines into clinical settings. Due to its importance there is unlimited amount of references available in different forms regarding to this specific topic, however, the quality, reliability and relevance of each reference can remain questioned and requires further consideration. InRead MoreIntroduction. The Pateman Vincent Statement From 20101486 Words à |à 6 Pagesstatement from 2010 suggests that the library profession is either oblivious to, or choosing to ignore the plight of those most in need in society. Seven years on, there is no halt in the growing gap between rich and poor and public libraries are still justifying their existence, in a climate of declining funding for services. Changes to the UK welfare system have accelerated, with a drive for government services to be ââ¬Ëdigital by defaultââ¬â¢ (Rust, 2014). Public libraries and their staff are amongst theRead MoreVolunteering At The Sacramento Public Library1500 Words à |à 6 PagesIt is once said that ââ¬Å"A library is not a luxury but one of the necessities of lifeâ⬠- Henry Ward Beecher. This quote has proven to be true as I volunteered at the Sacramento Public library. Volunteering at the Sacramento Public Library led me to various work experience, and I see it as one of the most important necessities of life, especially for education. At the library, I learned to work around for my social skills as I helped others when in need, I learned to always be punctual, or sometimes earlyRead MoreD. Kinds Of Programs Or User Needs Support1541 Words à |à 7 Pagesinformation, reference, etc.) The library offers a weekly storytime for babies to age 5 and one after school program a month for school age children between 5 and 10 years old. A Saturday afternoon book club and one after school program a month is offered for Tweens (ages 10-12). Two after school programs a month are offered for Teens ages 12 - 18. The public library staff visit all schools within the Ellsmore community once a month during lunch time to promote library programs. A Homeschool programRead MoreThe Development and Provison of Prison Library for Juvenile1106 Words à |à 5 Pagesperson, they also will have difficulties reinstating back into society and understanding the technological changes that have occurred. In achieving the transformation of inmates, there is a need for training and education of inmates. Though the prison library will be the important facilities to play the role for inmates training and education. BACKGROUND OF STUDY Increasing number of teenagers involved in crime in Malaysia in recent years is worrying. According to Section 2, the Prisons Act 1995Read MoreThe Awareness of Alzheimerââ¬â¢s Disease and the Effect it has on Alzheimer Research1718 Words à |à 7 Pagesinterchangeably with Dementia. However, there are many types of different Dementias, but Alzheimerââ¬â¢s is the most well recollected type of the disease. (Lu, 2) Lu give a great definition as to what contribution a normal individual has in the community in her book Alzheimerââ¬â¢s Disease, and relays that this is not what Alzheimerââ¬â¢s patients can do (Lu, 1). ââ¬Å"In order to function independently in our society, one must be able to perform certain basic activities, such as eating and grooming. When someone has DementiaRead MoreEssay on South Africa: A Country on the Rise1327 Words à |à 6 Pagesglobal stage and now is an influential player in world affairs. Senior enlisted leaders must understand the importance of South Africaââ¬â¢s continued development and support to United States national interests so that commands will be informed facilitators to the strong bond between these two nations. This paper will discuss South Africaââ¬â¢s background information, government, strategic importance, and future direction of this emerging nation. Background Information South Africa occupies the southernRead MoreHow A Company Needs Help Expand Into New Markets1538 Words à |à 7 PagesA company needs funds to expand into new markets, while governments need money for everything from infrastructure to social programs. The problem large organizations run into is that they typically need far more money than the average bank can provide. The solution is to raise money by issuing bonds (or other debt instruments) to a public market. Thousands of investors then each lend a portion of the capital needed. Really, a bond is nothing more than a loan for which you are the lender. The organizationRead More Comparing Confucianism and Christianity Essay1140 Words à |à 5 Pageselder and younger brother, and friend and friend (Hopfe). These relationships led a push for a revolution of the political system to adopt the methods of Jen. Confucius sought to revive the ancient Chinese culture by redefining the importance of society and government. He described a society governed by à ³reasonable, humane, and just sensibilities, not by the passions of individuals arbitrarily empowered by hereditary statusà ² (Clearly). He felt that this could be achieved through education andRead MoreImportance of West Point During the American Rev Essay2246 Words à |à 9 Pagesand through them with the St, Lawrence, the great river of the Canadaââ¬â¢sâ⬠¦by a short portage to the basin of the great lakes and to the magnificent river system of the Mississippiâ⬠. [iii] This further show the Hudson River not only represented an importance of military commerce, but communication as well. Communication was another big advantage point of the Hudson River during the American Revolution. Losing the Hudson River for the Continental Army would have meant the isolation between
Wednesday, December 18, 2019
Summary Of The Great Gatsby - 1327 Words
Livingston English III H Date: 11/7/2017 Dà ©cor From the 1920 s One of the major aspects of the 1920 s was dà ©cor. Art and decoration obtained a role in nearly everything during this time. From parties to everyday life dà ©cor was a very influential aspect during this time. Jesse James In the novel The Great Gatsby, readers are treated with many examples of artistic, decorative, and architectural design by Fitzgeralds excellent descriptions of the colorful environments and locations in the novel. Nick stated, Gatsby s house - The one on my right was a colossal affair by any standardââ¬âit was a factual imitation of some Hà ´tel de Ville in Normandy, with a tower on one side, spanking new under a thin beard of raw ivy, and a marbleâ⬠¦show more contentâ⬠¦Coco Chanel created a fashion that began to grow rapidly in the 1920 s. She created suits and dresses for women and they became very popular and still are today. Another person that impacted design in the 1920 s was Thomas W. Lamb. He was known as a famous theater and cinema designer. For example, Thomas W. Lamb was known for designing hundreds of theaters and later known as the king of theaters (Gray). Thomas helped to design movie theaters and this sparked an impact on the 20th century. Many people enj oyed and took advantage of how much of an impact people, like Coco and Thomas, had on the 1920 s. If it wasnââ¬â¢t for people like them, we wouldnââ¬â¢t have movie theaters and a cute fashion for women today. Bryant Morgan Among many other things, art began to flourish and change during this era. One 1920 s dà ©cor critic stated, The Art Deco Movement influenced the way that buildings were erected and clothes were made (Modras). Art was such a major aspect during the 1920 s that it changed the way architects were expected to design buildings. This created a new perspective on the way houses and major buildings were looked at. In fact, these buildings were no longer just used for practical purposes but were now created to be pleasing to the eye. In addition, in The Great Gatsby Nick notes, Gatsby s house is also a very lavish building (Fitzgerald 14). Gatsby sShow MoreRelatedThe Great Gatsby Summary1036 Words à |à 5 PagesSummer Project 2012- ââ¬Å"The Great Gatsbyâ⬠: FULL SUMMARY OF ââ¬Å"THE GREAT GATSBYâ⬠: During the 1920ââ¬â¢s era, within the various movements of prohibition, womenââ¬â¢s rights, and the Jazz Age, F Scott Fitzgerald bore a timeless novel by the name of ââ¬Å"The Great Gatsby.â⬠The predominant character, Nick, who duals as narrator, is indecisive but thoughtful. He lives in West Egg on Long Island Sound, amidst the aristocratic air and luxurious titles. Gatsby, Nickââ¬â¢s neighbor, whose affairs apart from his partsRead MoreSummary Of The Great Gatsby 1277 Words à |à 6 Pages Nick Lopez Ms. McCauley CP English III 4 April 2017 Death to the American Dream In F. Scott Fitzgerald s novel, The Great Gatsby, all of the characters attempt to achieve a state of happiness in their lives. The main characters are split up into two groups: the rich upper class and the poorer lower class, which struggles to achieve a better, happier life. Although the major characters only seem to look to make their lives even better, the ideal and reality of the American Dream is almost completelyRead MoreSummary Of The Great Gatsby Essay1937 Words à |à 8 PagesNoah Myers The Great Gatsby Reading Logs Chapter 1: In the Great Gatsby Chapter 1, The table has been set figuratively and literally. Figuratively because we meet Nick Carraway our narrator for the first time. Plus the rest of the great gatsby main characters, Daisy, Tom and jordan. Nick starts out having dinner with tom, daisy and jordan. The setting is in east egg, but the dinner takes place in west egg at the buchanans house. I think this passage from the great gatsby in the opening of theRead MoreShort Summary of the Great Gatsby11203 Words à |à 45 Pagesexceedingly ambivalent about the notion of the American dream: for him, it was at once vulgar and dazzlingly promising. It need scarcely be noted that such fascinated ambivalence is itself typically American. Like the central character of The Great Gatsby, Fitzgerald had an intensely romantic imagination; he once called it a heightened sensitivity to the promises of life. The events of Fitzgeralds own life can be seen as a struggle to realize those promises. He attended both St. Paul AcademyRead MoreSummary Of The Great Gatsby By F. Salinger904 Words à |à 4 PagesJ.D. Salinger Jerome David Salinger, one of the most influential authors to arise after World War II, was born on January 1, 1919 in New York City. Little is known about his early life except for his education. He attended schools on the upper west side of Manhattan, which would later be the setting of his most famous novel, The Catcher in the Rye. After flunking out of several prep schools, including McBurneyââ¬â¢s, his parents sent him to Valley Forge Military Academy. At Valley Forge he maintainedRead MoreSummary Of The Great Gatsby By Richard Rodriguez869 Words à |à 4 Pagesmaterialism is the classic novel, The Great Gatsby written by F. Scott Fitzgerald. Though it has many concepts within it, the one ambiguous term that comes to mind when talking about The Great Gatsby is materialism. The Great Gatsby is centered upon the ideal of materialism. It is surrounded by the flashiness of being wealthy and having all that money can buy. All the characters such as Jay Gatsby, Daisy Buchanan, and Tom Buchanan hold material things very highly. Mr. Gatsby and Mr. Buchanan show this significantlyRead MoreSummary Of The Great Gatsby By F. Scott Fitzgerald1061 Words à |à 5 Pagesthat, most people were doubled over gasping to catch their breath. Next, they did hand to hand combat. Last they did some strength training and then they were done for the day. That night he realized something, as he lay awake that he had gained a great friend and overcame his fear. Read MoreSummary Of The Great Gatsby By F. Scott Fitzgerald1732 Words à |à 7 Pagessay that would take it all back? No, that would only cause more problems. It was time to talk, butâ⬠¦that was terrifying. How do you start a conversation about the fact that you both wanted to relive the past so badly that you sent yourself there? Jay Gatsby would be jealous. Was this justâ⬠¦making matters worse? They werenââ¬â¢t totally unprepared, after all: this was the past, not the future. No flying hovercrafts or houses on Mars orâ⬠¦marriage to Willow. It was just a thought, really. No rings were purchasedRead MoreSummary Of Sir Taran s The Great Gatsby 956 Words à |à 4 PagesWell past the middle of the night, on a clear autumn evening, Bili clapped his hands together. ââ¬Å"Everyone! Calm down and take your seats. Itââ¬â¢s about to begin and youââ¬â¢ll never see such a spectacle again in your lives, so sit.â⬠None of the children seemed to heed his instruction, and with a slight scowl, Bili sat next to Asla on a blanket in front of the lake. ââ¬Å"What a gaggle of wild ones.â⬠Taran chuckled. ââ¬Å"Are you accusing our grandchildren of being wild?â⬠ââ¬Å"The grandchildren? No, theyââ¬â¢re perfect. Itââ¬â¢sRead MoreSummary : The Great Gatsby By F. Scott Fitzgerald847 Words à |à 4 Pages Anna Duke, Jordan Shawn What Happened: Duke and Anna planned to runaway together and give love a second chance. Before meeting up, Duke (Ian Buchannan) unsuccessfully tried to call off the hit on Jordan (Vinessa Antoine) for being a police informant (she was able to get the upper-hand and kill the shooter; 5/8). On Julian s orders, Carlos (Jeffrey Vincent Parise) cornered and shot him in the abdomen (5/7). Duke made it to the docks and died in Anna s arms. Carlos bragged that he would likely
Monday, December 9, 2019
Auditing and Materiality Analysis on K and S Corporation
Question: Discuss about the Auditing and Materiality Analysis on K and S Corporation. Answer: Introduction: Financial statements tends to assist investors in their decision making process through transparency in the preparations of balance sheet, income statement and other financial statements. The presence of principle agent relationship, whereby the agent that is the companys executives have a tendency towards behaving in a manner so as to further their own agendas and interests at the cost of the principles, the shareholders. External auditor has been provided to operate independently towards examining the financial statements and other relevant documents in order to identify any form of material misstatements. The ceiling upon the non-audit service fees accepted by the auditors followed by compulsory declaration by the external auditors regarding whether audit has been conducted with due independence reiterates the external auditors role. The credibility of a companys financial proceedings is gathered from the external auditors report. In terms of regulatory measures to be undertaken, the roles of external auditors are imperative as based upon the audited financial statements the evidences can be gathered about a corporate entity. The inputs from the external auditors report is relevant to the management, stakeholders and regulators of the organization, thereby the requirements towards standardization of auditory proceedings in order to mitigate audit risks is paramount. ASA 210, paragraph A23, A24, A25 and A26 states that the auditor, at the inception of audit engagement requires preparing a written financial document that may result towards declaration of the scope of financial report auditing. Further, the aforementioned articles requires the auditor to mention through writing the responsibility on the part of the auditor and companys management team, evaluating the framework utilized for the different sets of auditory proceedings. Such measures are undertaken to ensure a clear notion of the degree of reliabilit y in case of occurrence of material misstatements and misrepresentation of sensitive facts. Purpose of the report: The report is focused upon deriving an audit planning based upon the relevant sets of data regarding financial statements and corporate proceedings that has been provided in the K Ss Annual Report for the financial year 2015. This report seeks to assist in evaluating the different forms of audit risks that are prevalent in the organization through standardized auditory proceedings. Further, the report involves identifying five accounts that are imminently at risks towards being misstated in terms of the material data or information contained in them. The assessment of audit risks relating to the aforementioned five account are to be undertaken in order to gauge the degree of reliability upon the data of these accounts. Inferences and conclusion has been drawn concerning the different set of factors that has been assessed about auditory programs and evaluation of risks pertaining to material misstatements. Understanding the clients business: In order to initiate auditory proceedings, it is imperative to analyze KSs business operations, the quantum of mergers and acquisitions that has been undertaken by the company followed by the financial data pertaining to the different financial periods. Further, analysis of the effects of different sets of economic variables upon the companys operations, such as change in overall degree in demand owing to slow growth process is significant. It is in the sense that such analysis may result towards proper evolution of the companys current financial position and the probability of material misstatements in the company affairs. Entity Analysis: Kain Shelton (KS) is engaged primarily in logistics, freighting and transportation business since its incorporation as a public listed company in 1984 (Ksgroup.com.au. 2016). The company has undertaken several key acquisitions in transportation, haulage and carriers. During the past two decades the company has had made acquisitions of Stepnell Transport, Cochrane Transport, Truganina, Regal Transport and Pacific Transport amongst others (Ksgroup.com.au. 2016). These acquisitions show the level of diversification and market consolidation that the company has undergone. The varied forms of businesses such as oil carrier, manufacturer logistics, liquid and semi liquid carriers, transportations for mining products, warehousing has resulted towards presence of varied sets of assets and investment in KSs portfolio. The company has been found actively involved in financial fraud to the tune of over $7 million as ascertained by McGrathNicol (Ksgroup.com.au. 2016). Despite efforts on the part of the company management, towards recovering back the aforementioned amount the company has not been able to display any material proceedings regarding the claim. In case of the financials, the operating revenue has considerably highlighted a large quantum of increase over the past five years with an increase from $523.4 million in financial year 2011 to $699.2 million in 2015. Moreover, the operating revenue has displayed a considerable increase from $586.2 million to the present $699.2 million highlighting an increase of over 30% in the past 12 months . Comparatively, its operating cash flow has seen a marginal increase in from $47.3 million to $48.1 million showing an increase by just $0.8 million (Ksgroup.com.au. 2016). Economic and Industry Analysis: The slowdown in economic growth has affected the logistics and carrier sector largely owing to the fact that the consumer demand for products has fallen resulting in downsizing of production level in order to mitigate the risks regarding cost overruns. Moreover, territory wise the demand for logistics has subdued owing to the fact that the growth of the manufacturing sector has been hampered severely. The dynamism observed in the context of changing preference levels has resulted towards changing production patterns followed by changing levels of logistical requirements. In terms of road freights, the sector has highlighted slow growth while the B-Doubles, which KS owns by a significant number, has contributed the highest revenues derived from road freights. Figure 1: Road Freight during the last 50 years (Source: bitre.gov.au, 2016) However, it is also imperative to note that the B-Double carriers can operate on a limited sets of routes, thereby the prospects of high-income generation by the road transport has been subdued. Further, the advent of rapid growth in international logistical movements has resulted towards implementation of new sets of logistical contracts whereby the imported goods are delivered directly into the importers premises by the third party logistics (3PL) provider. This has diminished the practice of loading freights from the ports and terminals in order to deliver them to the customer/importers premises. Figure 2: Major Road Freight routes (Source: austlogistics.com.au, 2016) Moreover, companies with large sets of distributional requirements have been actively seeking to develop their own sets of logistics. For instance, the US based online retailing company Amazon has since its inception relied upon 3PL providers such as FedEx to deliver its goods until shifting to develop its own logistical systems. The advancement in terms of trucking and logistics through newer sets of energy efficient and technology driven carriers have the potential towards reducing the cost margins pertaining to logistics industry. In addition, launching of B-Triples carriers may result towards high levels of growth. KS has highlighted vast amount of investment in terms of acquiring numerous sets of transport agencies. Thereby, the company has an affinity towards customizing itself with the new sets of technologies and market penetration activities. The company has displayed optimum levels of adaptation to market scenarios through acquiring different routes and mediums of freight t ransport. Regulatory Analysis: The Australian Logistics Council (ALC) tends to regulate the different sets of policy formulation, policy implementations regarding transport and logistics business in Australias states (pc.gov.au, 2016). The different sets of operations and management of logistical industry are moderated by the council. The delay in terms of documentation on the part of local governments, metropolitan councils and resolving of issues pertaining to the companies engaged in logistical operations has been streamlined through the presence of ALC. The Council provides additional benefits to its corporate members through increasing the threshold levels of freights that can be transportation by a single carrier. Thereby, being a member of ALC results in aggravated levels of benefits derived by KS. The National Regulator on Heavy Vehicles (NHVR) tends to regulate the quantum of logistical activities conducted by the companies using heavy road carriers (pc.gov.au, 2016). Further, in terms of ownership of logistical assets, transport carriers and the different sets of heavy vehicles, the NHVR takes up annual evaluation of the degree of assets ownerships. Thereby, the company has additional sets of regulations pertaining to the assets held by it. The framing of policies during the period between the transportation of goods and the loading and unloading can result in limiting the revenue generating capability of logistics companies. The different sets of zoning issues regarding statewide operations can result towards potential adverse impacts upon the level of issues pertaining to different sets of data. However, recent reforms with the objective of improving the national infrastructure has created high growth and revenue generating opportunities for companies such as KS through de velopment of transport corridors, extending the intermodal connections and undertaking different sets of measures concerning the future expansions logistical businesses. Material Misstatements: Several factors are required to take into account in order to ascertain the accounts that are susceptible towards material misstatements. The primary determinants based on quantitative materiality tend to come from the accounts that contain transactions of significant financial figures (Bigus, 2012). Further, the quantum of transactions taking place through such materially significant accounts can also be taken into considerations in selecting the material accounts. Moreover, the changes in the composition or value of such account over the previous financial years can also be construed as a basis for determining materiality (Sharbatoghlie and Sepehri 2015). For instance, an unusual increase in the figures of an account and its subsequent repercussions on the profitability and performance measures can be regarded as a material change. In addition, the accounts that are deemed relevant for computation of key financial ratios such as solvency, efficiency, liquidity and profitability can be considered as accounts containing risks of material misstatements. In the current report, the selection of accounts with material degree of risks tends to be formed after taking consideration the industry dynamics, the rate of growth and the degree of increase in a particular figure over last year. The five accounts with high risks of material misstatements are: Revenue Account Depreciation and Amortization Account Employee Expense Account Fleet Expense Account Cash A/C and Marketable Securities A/C Calculation pertaining to planning materiality: ASA 320 states the framework pertaining to planning materiality in terms of financial statements (auasb.gov.au, 2016). The net profit after tax is prescribed to have a percentage of 5% materiality benchmark in usual circumstances. Moreover, the benchmark upon revenue figures usually is approximately 1%. Paragraph 10 of ASA 320 states the fact that the benchmarks should be stated for the financial statements as a whole. Further, paragraph 11 and 12 of ASA 320 states the fact that the auditor can review the materiality benchmark from time to time as assess whether there arises any requirement pertaining to changing the benchmark level (auasb.gov.au, 2016). The degree of past involvement of the company in fraudulent activities followed by unusual degree of changes in the levels of revenue figures, depreciation figures coupled with cash, fleet and employee expenses provides for situation to reduce the benchmark. Thereby, the benchmark upon the revenue levels can be ascertained to be at 3%. The acceptable levels of misstatements can be ascertained at a level of 40 percent of the 3 % benchmark level. Thereby, the acceptable set of misstatements comes at 1.2 % of revenue (0.40 * 3%). The above benchmarking has been undertaken after taking account the degree of sensitivity of the shareholders and other stakeholders towards presence of material misstatements in KSs financial figures. The aforementioned degree of overall risks of material misstatements has been ascertained after taking into account the different levels of data. Assessment of the five accounts: ASA 450 tends to highlight the degree of examinations conducted upon the financial statements of the entity towards locating or ascertaining the degree of material misstatements (auasb.gov.au, 2016). The different sets of data pertaining to the different degree of assessment relating to the aforementioned five accounts can have adverse repercussions pertaining to the decision making of the investor s Preparation of Audit Documentation under ASA 230 shows the evidence as regards to the conclusion or inferences draw from the audit clients financial statements (auasb.gov.au, 2016). The revenue or operating revenue account can have a high degree of increase owing to the inclusion of previous years receivables. The cost of goods sold in the account tends to display the fact that the operating and input costs have declined over the past financial period from the levels of $63,545 to $56,936. Therefore, it can be inferred from the above figure that the COGS has declined while the revenue margins has increased over 30% as compared to previous financial periods. Thereby the degree of data pertaining to the different sets of revenue and COGS highlights anomaly in the revenue figures. The employee expenses has showcased an increase from $185,218 in the financial period of 2014 to $219,172. An increase of over 18% in the employee expenses raised queries regarding significant amount of development in the degree of employee benefits and facilitating the degree of benefits towards the level of employee salaries, bursaries and bonus income. The annual report along with the website does not declare any material levels of initiatives in terms of improvement in employee strength or any kind of significant employee based programs. Further, the expenses could arise from a high degree of nonlinear and unaccountable bonuses that are linked with high levels of revenues in order to mitigate the high jump in the revenue figures. The depreciation and amortization expenses have displayed high levels of increase by over 45% from figures pertaining to financial year 2014. The depreciation expenses have highlighted such a high level of increase without a substantial increase in the asset levels of the organization. The degree of data that tends to be showcased by the amortization expenses displays a deliberate measure on the part of the company to undervalue its profitability. The cash and cash equivalent account has displayed a drop in its levels over the past financial period. This can be attributed to high degree of payments made by the company or high quantum of credit sales undertaken by the company. However, the degree of increase in the debtors and receivable levels tends to highlight the fact that the data pertaining to the companys cash levels may be resulted from misappropriation, manipulation or the degree of data regarding cash and quick assets. Moreover, it can also be observed that the figure pertaining to the creditors highlights the fact that the company has paid off its creditors substantially. Thereby, with a large degree of increase in the levels of revenues coupled with lowering of cash levels raises queries regarding financial management policies undertaken by the company. The lack of substantial increase in the levels of debtors and no material changes in the levels of creditors in terms of the level of financial data suggests that th ere is a high probability in terms of material misstatements. Further, the fleet expenses have shown a high degree of increase in value as compared to previous periods. This can be attributed from the fact that the operations of the company has increased exponentially. However, the increase in the levels of assets held by the company is insignificant compared to the rise in revenue levels, amortization and depreciations costs resulting in an inference that such as high quantum of increase in the fleet expenses is not rational in financial terms. Conclusion: The assessment pertaining to KS results displayed that the company has experience high revenue margins over the past financial period. The company is engaged in the logistics and transportation business and has operations in Australia and New Zealand. For the past 25 years, the company has highlighted large degree of acquisition in terms of transport agencies, logistics and road freight carriers. However, the company has been founded to be indulgent towards fraudulent activities resulting in losses by the margins of $7 million. The degree of data pertaining to the financial statements published in the annual report and the official website has been evaluated in order to gauge the current financial position if the company. The current levels of data relating to the transportation and logistics business has been assessed in terms of present opportunities and future prospects. The levels of data pertaining to economy and regulatory authorities has showcased the fact that the company has been able modify its levels of operations and has undergone diversifying tactics in order to provide a high degree of buffer to adverse market conditions. Analysis of the financial statement has been in order to highlight the fact that the company has several sets of unusual increases in terms of revenue levels, cash and marketable securities owned by the company followed by the degree of depreciation and amortization pertaining to the assets held by the company. The assessment made in light of ASA standards has resulted towards evaluation of tendency of the company towards showing misrepresented financial statements. References and Bibliography: Arnold, D.F. and Bernardi, R.A., 2013. An examination of British, Irish, and US partners' responses to ethical dilemmas.Arnold, DF Bernardi, RA:(1997). An Examination of British, Irish, and US Partners' Responses to Ethical Dilemmas, Research in Accounting Regulation,11, pp.149-172. auasb.gov.au, (2016). [online] Available at: https://www.auasb.gov.au/admin/file/content102/c3/Jun11_Compiled_ASA_320.pdf [Accessed 30 Sep. 2016]. austlogistics.com.au, (2016). 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[online] Available at: https://www.ksgroup.com.au/ [Accessed 30 Sep. 2016]. Louwers, T.J., Ramsay, R.J., Sinason, D.H., Strawser, J.R. and Thibodeau, J.C., 2013.Auditing and assurance services. New York, NY: McGraw-Hill/Irwin. pc.gov.au, (2016). [online] Available at: https://www.pc.gov.au/inquiries/completed/regulation-benchmarking-local-government/submissions/sub015.pdf [Accessed 30 Sep. 2016]. Sharbatoghlie, A. and Sepehri, M., 2015. An Integrated Continuous Auditing Project Management Model. In4th International Project Management Conference. Titera, W.R., 2013. Updating audit standard-Enabling audit data analysis. Journal of information systems,27(1), pp.325-331. Yang, K. and Jia, X., 2013. An efficient and secure dynamic auditing protocol for data storage in cloud computing.IEEE Transactions on Parallel and Distributed Systems,24(9), pp.1717-1726. Ye, M. and Simunic, D.A., 2013. The economics of setting auditing standards.Contemporary Accounting Research,30(3), pp.1191-1215. Yoon, K., Hoogduin, L. and Zhang, L., 2015. Big Data as complementary audit evidence.Accounting Horizons,29(2), pp.431-438. Zadek, S., Evans, R. and Pruzan, P., 2013.Building corporate accountability: Emerging practice in social and ethical accounting and auditing. Routledge.
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