a) Issue Analysis
Article 1: “Standards of Medical Care in Diabetes—2017 Abridged for Primary Care Providers”
Issue by American Diabetes Association
Key Messages:
1. Promoting health and reducing disparities in populations are the responsibility of each individual especially medical practitioner.
2. General medical evaluation and the role of medical practitioners in caring diabetes patient
3. Recommendations are given for overall assessment and treatment plan with all forms of diabetes.
The article gives the useful clinical practice guidelines which are important in improving population health. Thus, such efforts require a combination of all clinical level and high patient-focused level of care, “the care refers to respectful of and responsive to individual patient preferences, needs, and values that all medical practitioners should acknowledge for the near future real practices”.
On the other hand, the studies mentioned the general medical evaluation which comprises the initial and ongoing assessment, the complications, rather, the participation of the patient throughout the treatment process. Medical Practitioners do notice that diabetes patient should receive the healthcare from many interdependent sides that may include physicians, exercise specialists, nurses care, caregiver, families….Especially each of patient or potential patient with diabetes must acknowledge how important they care themselves. The engagement of care also includes the awareness of not only the care team, but also the family side to refer assessment and treatment plan. In which, the lifestyle management, as well as psychosocial care, are highly recommended in the article. Accordingly, “Patients should be referred for diabetes self-management education (DSME), diabetes self-management support (DSMS), medical nutrition therapy (MNT), and psychosocial/emotional health concerns if indicated”.
One of the most important thing was mentioned in the article is that the medical practitioners should take notice for the preventive care services; even it is the less crucial things but may have a big result for the patient e.g., immunizations and cancer screening; ophthalmological, dental, and smoking cessation counseling,…
Article 2: “The associations of self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with Type 1 Diabetes Mellitus”
Issue by Taylor & Francis Group
Key Messages:
1. Adolescents in Singapore with Type 1 Diabetes Mellitus with poorer metabolic control tend to have poorer self-care behaviors.
2. The importance of treatment control cognitions (i.e. patients perceived treatment impact
over illness) and illness perception in Singaporean youth with Type 1 Diabetes Mellitus.
3. General psychological distress was not predictive of poor metabolic control and Type 1 Diabetes Mellitus
The study did the examination for the role of self-care, illness perceptions and psychological distress in T1DM management conducted through the research of sample of 41 Singaporean adolescents (age 14 – 20) The findings of this research highlighted the importance of the perceptions of treatment control and dietary self-care in diabetes outcomes for adolescents with T1DM. Besides, it also noted the relationship between self-care, illness perceptions and psychological distress with metabolic control in Singaporean adolescents with T1DM. Indeed, it is hypothesised that the poorer metabolic control will be associated with lower adherence/self-care behaviours, the more negative illness perceptions (i.e. lower perceptions of control; more perceived consequences and symptoms, stronger identity) and higher distress.
Individuals need to coordinate a number of self-care behaviors on daily basis including blood glucose checks, calculating and administering insulin doses, and keeping to dietary and exercise recommendations for Singaporean adolescents with T1DM should try to work on strengthening perceptions of treatment control as well as improving self-care behaviours, or intrinsic motivation which is reflected as better self-care behaviours.
The study used the Kessler psychological distress scale (K10) which is a generic questionnaire, consisting of 10 items designed to measure level of psychological distress over the past four weeks (Kessler et al.,2005) in the survey. And results showed low distress scores and hence insufficient variation to allow relationships (if any) to emerge in the investigation. This all research and findings are enriched information and statistic practitioners and for the DSS.

Article 3: “A qualitative study of patient experiences of Type 2 Diabetes care delivered comparatively by General Practice Nurses and Medical Practitioners”
Issued by Journal of Clinical Nursing (JCU)
Key Messages:
1. The efficient and effective care makes treatment on Type 2 Diabetes patients.
2. The collaborative approach in Type 2 Diabetes patient’s care delivery
3. The care to inform would more supportive if it has taken by the medical practitioners
The articles try to examine the patient experiences of type 2 diabetes mellitus and the care delivered by nurse, caregivers and in collaboration with the general and medical practitioners. The studies based on the Australian general practice nurses contexts as they have substantial role in caring the patient in type 2 diabetes and other type of diabetes.

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Accordingly, the research has applied the qualitative method under purposeful sampling of the 10 patients. All of them were invited to join into the research and after that, results were gathered from semi-structured face-to-face interviews. Eventually, all the agreed patients have been gone through the General Practice Nurse consulting process. At the meantime, the patients were asked to tell what have they faced with the ongoing challenge of living with T2DM and moreover, the study aimed to identified how need and important of additional awareness and advice properly.
What they have feel and face with the challenging living with type 2 diabetes were obviously come out and the results highlighted the need of general practice nurse go along with the care delivery. Being acknowledge the essential of effective delivered care in Diabetes treatment, nonetheless, the collaborative approach withdrawn from the study require the cooperation of assessments, necessary education, and self-supportive care and other duty of inform conducted by General Practitioners.


Date: 04 June 2018

The growing concern is given on the diabetes, both globally and in Singapore. One third the Singapore population is in risk of life with this growing diabetes disease.

Mr Yong Chiang Boon, the President of the Diabetic Society of Singapore (DSS), mentioned “If we do not take action today, it is estimated that one million Singapore residents will have diabetes by 2050. In April this year, MOH declared War on Diabetes, and set up the national Diabetes Prevention and Care Taskforce”.

For medical practitioners, the forehead is effort to address diabetes in three key aspects: lifestyle management, disease management and caring management. Moreover, the responsibilities of each of Singapore citizens is rising the own and public awareness. Mr. Yong also addressed: “The War on Diabetes is a whole-of-nation effort which requires the commitment of every Singaporean”. Everyone should recognize that health is absolutely important and that is crucial to take the awareness about it. An appealing for everyone is needed to take action from this moment.

– ENDS –
For more information,
The Diabetes Society of Singapore site is an initiative support. http://www.diabetes.org.sg
Q and Jurong Diabetes Education ; Care Centre
Blk 528 Jurong West St 52
#01-353 Singapore 640528
Tel : (65) 6564 9818, (65) 6564 9819

a) A financial statement is a statement that records the financial and travel of a company. Therefore, there had a lot of objectives in producing financial statements. According to the conceptual framework, the objectives of producing financial statements is to provide financial information about the reporting entity that is useful to the external user which is investors, lenders and other creditors to make a decision about providing the resources to the entity. (general purpose financial report and general purpose financial reporting). The information provided in the financial statement also shows how a company’s financial performance is bringing the profits or loss that can be caused by the increased of debt. In Addition, with the financial statements, the company and any other users can make a differentiated information from last year with the current year and also the user can make comparisons with another companies and therefore the
Second, to provide information about cash flow which can evaluate the financial level of the company primarily involving cash. Through the cash flow company and other users can assess how the company uses the money. This is because in the cash flows there is a record of how much money is spent and received as a result. Through the cash flow statement, the company can find out where the money is used and for what purpose the money is used. For example, increase in the sales will make the increase in the profit of business and shows the developments in the business.
Third, to see how the financial performance and how the company manage their financial and the business. The financial statement is used to records all activity that has been used to see how the impact to the society. Without good accounting information, misallocation of capital would occur and result in inefficient production and shortages. Information for which provide a financial performance can help improve a financial performance and can help to improve management performance, assist in solving problems that cause the company to lose and impact the company.

b) According to the Framework, ‘qualitative characteristics are attributes that make the information provided in financial statements useful to users’. The Framework identifies four principle qualitative characteristics which are Understandability, Relevance, Reliability and lastly Comparability.
The First qualitative characteristics are Understandability. Understandability defined that all information in the financial statement must be able to understand. Not only for the company uses but also for another user. For those who want to know about how the business in the company grows, they will look at the information provided by the company. They will evaluate how the company finances and how the company grows. If the users do not understand the content written, the company cannot blame them. This is because such thing happened for mistakes and negligence in recording and making information. Definitely, an entity cannot do anything about users and it upon the user to have a basic level of understanding about the financial statement. However, an entity can present the information in such manner that it helps in understanding which is do a proper explanation of financial statements to be more understandable.
Second, Relevance. Information must be relevant when it influences the economic decisions of users by evaluating past, present and future or confirming, or correcting, their past evaluations. Through relevant information users can estimate, evaluate and improve financial and budget for a company and for other things of interest to the user, example likely dividend or wages rise. In addition, relevant information can help in ensuring that the business is in line with planning and improvement. According to the Framework, relevant information should have predictive value or confirmatory value. Information that has the predictive value helps the user to evaluate the past, present or future events. Most of the information is taken from last year, it is intended to plan the financial stage in the coming year. Information with confirmatory value is helping users to confirm or corrects their past evaluation and assessments. The relevance of information is affected by its nature and materiality. Information is materiality if its omission or misstatement. An example, in the accounts of a limited liability company, is the amount of remuneration for example salaries and other rewards paid to the directors of the company. The assessment of an item as material or immaterial may affect its treatment in the accounts it is not only the value of the item but the context is important.
Third characteristics are reliability. Information must have the quality of reliability when it is free from material error, free from deliberately or systematic bias which is classified under neutrality and can be depended upon by users to represent faithfully that which its either purports to represent or could reasonably be expected to represent. According to the framework, the UK equivalent, The ASB’s statement of Principle for Financial Reporting, states that a material error can cause a false and error in financial statement and it does not reliable anymore. If something happens in making decision or judgement, therefore, there is not neutral anymore if there any bias.
Lastly, comparability. Comparability means that the financial statement can be compared of an entity depends form the changes and performance in the financial position. Usually, a company will make a comparison between last year and current year based on financial position and use that information to make a future budget. This is required for economic decision making, such as deciding whether to buy, sell or retain a holding of equity shares in the entity.

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(c) Many different groups have a direct and indirect relationship with a modern business corporation. These include suppliers of capital which is from both equity and loan capital; suppliers of other resources; employees; customers; and government agencies. Usually, in accounting, the users of the financial statements are divided into two which is internal and external. Internal user interested parties who need the accounting information to make a decision such as a plan, organization and run the business. External users are those users which are indirectly in the organisation or which are contact with the organisation but from outside. There had a lot of potential users of a company’s financial statements. Which is managers of a company, shareholders of the company, trade contacts which is suppliers and customers, employees, government and other agencies and so on.
First, managers of the company. Managers are appointed by the company’s owners to supervise the day-to-day activities of the company. The managers also use this financial statement to see whether the business is profitable, what are the financial resources of the business and is the company achieve the target. As the internal users of financial information, the managers won’t expect and they are not limited to information in the financial statements and have a full access that not only to public information but also internal information of an organization. Their information not only on the basis of financial accounting but also of managerial accounting. Managers usually many and varied targets and often complex. Management needs to focus on two main objectives which are profitability and liquidity. An important role of managers is to make the reality existing in the organization compatible with the needs and expectations of other users. They need information about company’s financial situation as it currently and as is expected to be in the future to make sure the business is operations efficiently and make an effective decision. For example, If the profit and Loss account showing that the previous year expenses are more than revenue, so by checking it or by analysing it, a manager can know how many expenses are incurred and how to reduce it. So that the managers can decide what to do in the future by watching the previous Profit and Loss account and etc.
Second, employees of the company. The employee has the right to know information about the company’s financial situations because their future careers and the size of wages and salaries are depending on it. If the company loses, the employee will be exposed to consequences. The company will reduce the salary or fired employees because they want to revive their company and to reduce costs. Regarding professional opportunities, this information knowledge can stimulate the workers to follow different training programs, other than those offers through the organization, to continue their studies, aspect that will have beneficial influence over the future business of the entity. The interest of the employees is oriented on information beyond the field of financial accounting, such as the incidence over the working conditions of production programme, the general evolution of the orders, the forecasted measures for improvement, transform, replace the equipment or the methods of production and exploitation.
Third, Investors and known as shareholders. Shareholders use financial position to see how the business operations and how profitable the business. They not only look at the past financial performance but also to view about likely future performance. Providers of capital are concerned, primarily, of the risk of investment they have been committed or intends to engage and profitability which it produces or will produce. Investors need information to access the stewardship of management. For example, in safeguarding the entity’s resources and using them properly, efficiently and profitably. The investor also takes a decision about management especially in assessing the need for new management. The functions of the financial statement are to make sure that they invest in the right company and make them profitable if they invest in the company. If a financial statement in a given year shows a decline or even some company losses for almost a year, the investor can withdraw their investment and move to another company. Future profit may be estimated from the target company’s past performance. An investor can take a decision about their investment or potential investment. For example, Investor can decide whether to hold, buy, or sell and assessing the ability to pay the dividends. An investor can increase the dividend percentage if the company raised a profit
Fourth, Suppliers. The supplier is an entity that supplies goods and services to another organization. This entity is part of the supply chain in the business, which may provide the bulk of the value contained within its products. Suppliers use the financial statement to decide whether to sell the entity to the company or not. Suppliers will determine whether the company can pay on time or not. They can make us as a longer-term stability because the company is a major customer to them.
Lastly, the lender for example bank and other institutions. The lender is an individual, a public group, a private group or financial institutions that make funds available to another with the expectation that the funds will be repaid. Lenders use Financial statement because they want to determine whether their loans and interest will be paid on time and to decide whether to lend on what terms and also to know financial soundness before giving credit. This is often referred to as a loan creditor group. It would include the long, medium and short-term lenders of money.” A short-term loan creditor will immediately consider cash flow and the Cash Flow Statement based on FRS 1, will be of particular interest here. The banks make up much of this grouping and would also have an interest in the (NRV) Net Realisable Value of the assets.

A) Plaintiff Catherine & Meghan wants to claim on negligence that Defendant Australia Post owes her a duty of care and so the plaintiff have to provide evidence accordingly.

1) Duty of Care: The defendant, Australia Post, has caused the plaintiff Meghan a heart attack and Catherine a permanent lifetime injury where she cannot walk for the rest of her life because of the defendants’ negligence. The defendant owes a duty of care to its customers and to the society because Australia Post is a monopoly in Australia and so owes a duty of care not only towards its customers but also to the society.

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2) Breach: the plaintiff, Meghan ; Catherine, has to establish a breach of duty according to the S5B(1)(2) of the Civil Liability Act (CLA) 2002 as per below:

– Risk or Harm was foreseeable as Harry and Will realised that the parcel looked suspective, so they should have monitored it or should have left it in a locked or a safe place. They did the right thing by informing the police, but as the parcel was not monitored, the snakes escaped out of it which caused harm to Meghan and to Catherine. The risk has been very significant but Harry and Will did not foresee the harm coming with it.
– The risk was significant in this case, as one plaintiff Meghan has suffered a heart attack, and the other one, Catherine, is not able to walk for the rest of her life. both the plaintiffs have undergone a life threatening situation where they both could have potentially lost their lives because of the defendant’s negligence.
– As per S5B(2) CLA 2002, the court will consider the following factors where Harry and Will should have taken precautions against the risk of Harm.
a) The probability of this particular harm occurring if no care was taken.
The plaintiff’s Meghan and Catherine would not have undergone life threatening situations if care was taken in handling the risk involved when the parcel was received.
b) The likely seriousness of the harm has been significant.
This incident has caused both the plaintiff’s a very serious harm as Catherine is now unable to walk for the rest of her life and Meghan has suffered a heart attack, which could have been life threatening as well in both the cases.
c) The burden of taking precautions to avoid the risk of harm.
If Harry and Will would have strictly monitored the parcel and should have not left it unattended as risk was already attached to it as soon as they suspected the parcel.
d) Social utility is relevant because the defendant Australia Post not only owes a Duty of Care to its customers but to the whole Australian society. The plaintiff’s Meghan and Catherine, not being the Australia Post customer in this situation, but have been seriously injured because of defendant’s negligence.
Therefore, Meghan and Catherine are eligible to claim their physical damages that they both have suffered.

3) Damage: under S5D, the plaintiff’s have the below points to prove their case:
– Factual causation
The physical injury would not have occurred to both the plaintiff’s if the breach would not have occurred. Proper actions taken by the defendants would have massively reduced the impact both the plaintiffs have to go through or may not even have occurred at all.
– Scope of liability, is appropriate in this case, as the defendant’s negligent behaviour extended the harm caused to the plaintiff’s Meghan and Catherine.

Defence: Therefore, the defendant, Australia Post, is to be sued for their negligence and ignoring their duty of care to the society by plaintiff’s, Meghan and Catherine for their physical damages.

B) Plaintiff Pablo and his parents Edvard ; Frida wants to claim on negligence that Defendant BNQ owes them a duty of care and so the plaintiff have to provide evidence accordingly.

1) Duty of Care: the defendant BNQ owes a duty of care to the plaintiff’s Pablo and his parents, Edvard and Frida, as it has caused them financial loss because of their unaccredited financial advisor.

2) Breach: the plaintiff, Pablo and his parents, have to establish a breach of duty according to the S5B(1)(2) of the Civil Liability Act (CLA) 2002 as per below:

– Risk was foreseeable as the defendant BNQ’s financial adviser, Merlin, was unaccredited to promote investments in real estate’s
– The risk was significant because the plaintiff, Pablo, is wheelchair bound and so him and his parents were relying on the compensation charges of 3.2M awarded to Pablo, after his accident. Also, his parents were not competent to deal with complex matters so they all three plaintiff’s heavily relied on advice from Caveat, their solicitor.
– As per S5B(2) CLA 2002, the court will consider the following factors where BNQ should have taken precautions against the risk of Harm.
a) The probability of this particular harm occurred as no precautionary measures were taken by the defendant, BNQ. The financial adviser, Merlin, at BNQ, was not authorised to promote Investments in real estate.
b) The likely seriousness of the harm is significant because of the defendants wrong financial advice, the plaintiff’s financial position has been effected where one plaintiff is already wheelchair bound and the other two do not have enough knowledge for complex matters and dealing with business.
c) The burden of taking precautions to avoid the risk of harm.
If the defendant, would have realised his duty of responsible financial advice given to the plaintiff’s, this incident would not have occurred.
d) Social utility is relevant because the defendants action will affect their impression in the society. This will adversely affect its existing customers and anyone who is looking to be a new customer of BNQ. Their own customers will not have faith by any advice given by the defendant.
Therefore, Pablo and his parents are eligible to claim their financial damages that they have experienced.

3) Damage: under S5D, the plaintiffs have the below points to prove their case:
– Factual causation:
The plaintiff’s would not have not suffered the financial damage if the defendant was not negligent of their duty which is giving the plaintiffs the responsible legal advice and not something which the defendant is not even authorised to discuss.
– Scope of Liability: is appropriate in this case as the defendant have taken advantage of the plaintiff’s condition, as one of them is wheelchair bound and the other two were not in a condition to make complex decisions. The defendant even organised trips for the plaintiff’s to inspect the properties and once they were in into buying two of the units, the defendant also suggested them not to contact their solicitor, Caveat, to help them with conveyancing. The defendant organised conveyancing by convincing them that they will be charged less if they deal with their conveyancer, which the plaintiffs believed and did everything according to the defendant’s advice.

Defence: the defendant, BNQ, owes a duty of care to plaintiffs, Pablo and his parents, Edvard and Frida, as they provide financial advice about investment and possible savings and investment plans; but the financial adviser, the plaintiffs were dealing with, was not authorised to promote investment in real estates, and he not only give them the advice, but also helped them with the trips for inspection of the properties and purchase including conveyancing. The plaintiffs put their full faith in the defendant because of their area of expertise, but was mis-leaded by the defendant. Even, Merlin is not working for BNQ anymore, but this incident happened when Merlin was an employee at BNQ and was doing everything under his employer BNQ. So, therefore the defendant, BNQ, owes a duty of care to the plaintiff’s.

a) Background: the background of a child affects the child in many ways.
For example, most children from broken or unstable family background with lack of parental guidance, can lack self confidence, some parents do not spent quality time with their children, may lack confidence. They may not be good in studies and fight in school with fellows easily.
On the other hand, children from stable family with both parents and parental guidance, would have confidence, is more likely to be attentive in class and emotionally stable.

(b) Health: the health of a child can affect the child all aspect of development of the child.
Example: a child that is suffering from some medical condition, will not be able to participate in sports, therefore would not be physically strong like the others. This ill health can create lack of confidence in the child. The child is likely not to have many friends. The child may be reserve.

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(c) Environment: when a child lives in a poor and deprived environment, this
affects the child. Children from deprived background are less likely to thrive and achieve well. Similarly a child that grows up in the countryside have more opportunities to play outside. Which helps them to develop physically, whereas child in the city usually plays indoor or in playgrounds. Moreover if a child lives in rough area known for crime and violence then that behaviour can come onto the child because of the influences that surround the child.


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