Sunday, December 29, 2019

Analysis Of Karen Abbott s Liar, Temptress, Soldier

Tayler Meneguin Mr. Dittmar American History 2nd Quarter Book Report December 18, 2014 Liar, Temptress, Soldier by Karen Abbott was a great book explaining the role of four women had during the civil war. In books, we readers do not alway read about the women and their phenomenal actions and duties during the war. In many peoples minds they just think, the women do not play a role, but in all reality the North would have never won if the women would not have stepped up and took over the farm, industries and help out in the battle field much like Clara Barton did, sadly she is not in this book, many other amazing women in the American history are in this book. Lets start by learning a little about the great civil war these miraculous women fought in. This story had taken place during the time of the civil war. The Civil War is one of the most important war in the history of the United States. This war was also one of the most deadly, it had ended almost 600 thousand young american lives. The war was the most important to the African Americans or what most call them tod ay, the â€Å" blacks†. The civil war had brought so many changes to the great country The United States of America. Those changes included positive changes to the financial system, federal government and many other organizations that would have never come together if the union and confederate armies would not have fought for the independence and the idea to combine ideas to come together to be one great nation.

Friday, December 20, 2019

The Issue Of Jail Over Populace - 1325 Words

Consistently, state and government jails are filled to limit with peaceful crooks. This puts weight on parole sheets to discharge lawbreakers who under typical circumstances would not be discharged because of the way of their violations. Each State s Department of Corrections needs to spend a greater amount of citizens cash each year for jail upkeep, prison guards and jail social insurance. The issue of jail over populace can without much of a stretch be put under control with the execution of the new advancements as of now accessible for remote observing what s more, radio recurrence finding frameworks. Electronic observing and house capture has turned into a reasonable different option for imprisonment, probation, and parole†¦show more content†¦The expense of keeping a peaceful wrongdoer in prison is costly and the cash originates from state and government charges. The normal expense for medicinal services for a jail prisoner in the condition of Arizona is $2319.00 a yea r(Arizona Department of Revisions. Medicinal services Cost Statistics.). Increased by the quantity of current prisoners the aggregate is around $ 60,900 million a year, this is just for medicinal services this does exclude whatever other jail costs. The present number of peaceful wrongdoing guilty parties detained in the condition of Arizona make up generally 33%(Arizona Department of Corrections. Prisoner Statistics.). On the off chance that just 50% of Arizona s peaceful crooks where put under house capture the state would spare no less than 10.5 million a year in human services costs, this does exclude the diminishment in the expense of security and the aggregate number of detainees in jail. An essential issue in Arizona and most different states is jails packing. Congestion prompts various issues that as of now numerous remedial offices are not ready to control legitimately. In over swarmed detainment facilities there is dependably the danger of a mob which could jeopardize the lives of detainees as well as the prison guards. Despite the fact that the medicinal services framework in today s penitentiaries is worthy they can t control episodes of socially and sexually transmitted

Thursday, December 12, 2019

Critical Evaluation Report on Quantitative Study

Question: Discuss about theCritical Evaluation Report on Quantitative Study. Answer: Introduction Critical evaluation involves a balanced appraisal of a study requiring logical and objective identification of the systematic manner of enquiry that underpins a research study (Steen, 2011). Critical appraisal should be undertaken by the nurses to determine the applicability of research into practice (Polit, 2016). The models as Rees model, Critical- Appraisal skilled program, Parahoo and Crombie model, Consolidated-standards of reporting trial, etc are used for critiquing studies (Baker, 2014). This study was published in Annals journal- of Emergency-medicine, which is an international, peer-reviewed journal that is published by the ACEP (American college of Emergency- Physicians). Annals publishes research reports, articles and facts of emergency-medicine including out-of-hospital, paediatric and toxicology emergencies, disaster management, injuries and prevention with other speciality topics. Annals are published in United States. Annals impact factor-5.008, CiteScore-1.81, 5-Years Impact- Factor-5.041, Source- normalized Impact/Paper (SNIP) -2.287 and SCImago- Journal Rank-1.942 suggests that it is the largest circulating journal in emergency-medicine with over 33,000 subscribers (ACEP, 2016). Almost half of the research articles could be accessed through Science-Direct and were downloadable in several countries. In 2015, Annals received submissions from 65 countries as Canada, Australia, etc with 46% outside US (Callaham, 2017). These informations drive me to use the research finding in my practice with evidence. The authors of this study Simon Bugden, Mark Scott, Sean Clark and Christopher Johnstone are experts in the emergency department of Caboolture-Hospital at Queensland as well as works in Centre for Health-practice innovations and members of Critical-care research group, Griffith-University. The author Mihala has contributed 29 articles, 101 citations and Fraser with 462 articles, 3,697 citations whereas Rickard with 191 articles, 2,231 citations. This study was carried-out in Caboolture-community hospital at Queensland. The information about author gives me confidence to carry out this research study in my clinical care effectively. Abstract The studys title is clear, concise and congruent with the text. They have stated a concise and achievable objective, which is to determine whether the skin glue application with standard peripheral intra-venous catheter (PIVC) care could minimize the failure rate of PIVCs. The abstract includes a clearly focused hypothesis and concise research design of single insertion-site, two-arms, non-blinded, randomized with controlled trial with sample descriptions of 380 participants. It explains about the standardized securement and skin glue group and measurement instruments for primary outcomes of PIVC failure at 48 hours and secondary outcomes with detailed findings and conclusions. Structuring the Study The authors have clearly demonstrated their motivation in the current study by their structured literature-review. They have given that PIVCs are one of the most common medical-invasive devices that are used in the hospitals. Approximately 80% of the hospitalized patients are inserted with PIVC with majority in emergencies (Limm, 2013). According to Marsh (2015), 33% to 69% of PIVCs fails because of infections, catheter occlusions, phlebitis or dislodgement with majority occurring because of inadequate fixation of PIVC. As there are no clear evidences to practice skin-glue securement, the researchers have proposed this study on the effect of addition of skin-glue securement with standard catheter-care based on guidelines of Queensland (2015). The quoting of study by Marsh et al (2015) was not relevant as it describes about PIVC failure only in wards. The literatures were recent, clear, summarized, well-organized and comprehensive. The literatures were relevant to the study title with correct citations. The literature could have concentrated more on PIVC failure in ED and evidences to compare the effectiveness of skin-glue with comparators. Their evidences to demonstrate effect on skin glue on arterial and epidural catheters are highly informative. They have performed a single-site, 2-arm, randomized with controlled-trail among 360 patients having 380 PIVCs. They have randomized the samples through the software (Randomizers for clinical trials) in 1:1 ratio to the standard group and skin-glue group (not blocked/stratified). The researchers have kept a drop of cyanoacrylate-glue at the catheter insertion-site and PIVCs hub in skin-glue group and have measured the primary and secondary outcomes. They have stated a clear hypothesis which predicts relationship between variables (Polit, 2016) as the addition of ski-glue at the PIVC insertion-site could reduce PIVC failure rate at 48 hours. They used scientific hypothesis and has expressed interest in testing the rela tionships between variables. Sample They have described the samples clearly. The samples were determined by three research nurses in emergency department for 16 hrs per day for one week (7 days). The research nurses have included the samples having peripheral intra-venous catheter insertion in any of the upper limbs (with intact skin) that is inserted by the emergency nurses or doctors and has given informed consent. The researchers have determined the sample-size with 174 patients in each group (standard securement and skin-glue group). They have included the samples only after confirming the patency of PIVC by flushing the line with 10 ml (0.9%) normal saline. They have excluded the patients who are known allergic to skin securements, infections at catheter-site, phlebitis with thrombotic features in the insertion-site, unwilling and agitated patients and persons who doesnt speak English. Data Collection They have collected the base-line demographic with possible confounder details from all the patients during the enrollment through a self-structured questionnaire. Its variables include age, sex, medication intake, no. of PIVC insertions, insertion-site, limb of insertion, person of insertion, the gauge size of PIVC and time from insertion of PIVC to intervention as well as follow-up time. They have measured the primary outcomes by one of three research nurses as suggested by Rickard (2012) through directly visualizing the patients for in-patients or by telephoning to the discharged patients and collecting informations about the presence of failure features by 48 or more hours (Webster, 2010). The researchers have collected informations for secondary outcomes by directly observing, reviewing the charts and through structured-patients questionnaire. They have described about the method of collecting data but they have not adequately given about the method of measuring data. The resear chers have mentioned that they have measured the infection, occlusion, phlebitis and dislodgment but they have not mentioned through which measurement they have graded the features. The researchers have clearly measured primary outcomes data by self-structured questionnaire (direct observation/telephoning) and secondary outcomes through direct-visualization, reviewing medical charts as well as standard- patients questionnaire. The researchers have not adequately indicated about the measurement instruments origin. But, they have clearly included their use of study instruments given by Rickard in 2012 through their quote. The researchers have not clearly indicated about their study instruments for both outcomes. They have not mentioned about the validation of their study instruments which questions about the reliability of the study instruments. Moreover, they have not indicated the reliability of their study instruments anywhere in the study which suggest that they have not checked t heir reliability. They have mentioned about any ethical issues they have faced other than their procedural issues. Data Analysis The follow-up by the researchers was adequate enough to judge the study findings credible. They were able to manage their follow-up loss appropriately as only 0.83% of the samples loosed from both groups. They have tackled this issue by eliminating the follow-up loss patients which is evident in their data description. The researchers havent blinded the samples as they were unable to blind due to the presence of similar color as well as appearance of samples during data collection (intervention and following-up time). The data-analysis shows that significant differences are noted in the rate of failure of PIVC between skin-glue group as well as standard- group with 10% increased failure rate in standard group at CI-95% between 18 to 2%, p=.02. The significant difference was also noted in the secondary outcomes of dislodgement at CI-95% from 13 to 0%, p=.04 with 7% reduction in skin-glue group and phlebitis and occlusion was also found to be reduced in skin-glue group yet statistical- significance was not shown. There are no infections in both groups. As given by Newcombe (2012), they used inferential statistics with point estimation-Confidence Interval to demonstrate inferences. The primary statistical-analysis shows that PIVC failure was significantly low in skin glue group than that of standard group indicating a statistical difference between them at p.05 and hence the given statistical hypothesis is accepted. The secondary-data shows that the differences in dislodgement of both the groups were also statistically-significant indicating statistical difference between both the groups at p.05 levels, which shows that statistical-hypothesis is accepted. The differences of phlebitis between both the groups are low with CI-95% between 5% to 3% indicating that they are not statistically-significant. Occlusions with CI-95% between 8 to 4% indicate that they are not statistically-significant and there was no infection in both groups. Findings The findings were expected and they have presented with complete informations to generalize the results. They have clearly given their findings as per objectives. Their findings indicates that the PIVC failure-rate was significantly (10%) lowered in skin glue group patients (17%) as related to the standard group (27%) with CI-95% from 18% to 2%, p=.02) and secondary outcome because of dislodgement was identified to be (7%) lesser in skin-glue group as compared to the standard group with 14% at CI-95% between 13% to 0%. The findings suggest that the PIVC failure rate because of phlebitis and catheter occlusions was noted to be reduced in skin glue group than that of standard- care group yet has no statistical significance. There are no infections (0%) in skin- glue and standard group. The data analysis in standard care group with 179 patients and skin-glue group with 170 patients indicates that the PIVC failure-rate was 52 31 respectively and the secondary PIVC-failure was 51 28. Li mitations were noted as it was conducted in particular setting with specific cultured people. Their confounder details should have included with other potential drug use (sclerotics, anti-coagulants) with dwell time, etc (Wallis, 2014). Their evaluation over phones may not give appropriate results yet nowadays the patients know the features clearly. The researchers have mentioned that they will conduct cost-benefit analysis study (if they get adequate funding) in the future. The implications for this study were given as the usage of skin glue is shown to minimize PIVC failure. They are highly and are simple and quick method to be performed even in emergencies. They have not mentioned about permitting others to conduct similar study. Conclusion The researchers have concluded by suggesting that the addition of skin glue along with the standard care guidelines as given by Queensland can minimize the failure rate of PIVC specifically in patients in ED. When the PIVC failure rates are reduced, it will promote the patients values by avoiding unnecessary expenses of cost, time, resources, staffs effort, etc. By practicing appropriately, this method will promote patients comfort, improve their outcomes as well as reduce the number of admissions in the hospitals because of complications caused by PIVC failure. The study findings indicates that when skin- glue is used to attach PIVC to insertion-site, unnecessary interruptions to therapies will be prevented completely and hence comfort of the patient will be maintained. In his study, Stuart (2013) showed that at-least in 0.1% of the PIVC failure acquire sepsis that endangering the life of the patient adversely yet it could be avoided completely. Relevance to Nursing Practice The nurses are the primary care- givers to all the patients of all ages irrespective of caste, creed and in all the settings. Their principal duty is to provide a quality care to all the patients based on their ethical principles. The nursing care should provide some benefit to the patients (beneficence) rather than any harm to them (maleficience) with justice and fair treatment (Polit, 2016). Hence, recently more emphasis has been given to practice evidence based care to protect the life of the patient. According to the International Nurses council (2010), a professional nurse should be able to prevent illnesses, promote health of all the people and protect their health which means protecting from harmful deeds. All the nurses should conduct relevant research studies to gain more evidences to protect our profession (ANA, 2010). The nurses are the front line workers in emergency department of any hospitals to provide life saving measures in which peripheral intra-venous catheter inse rtion is most needed as it helps to initiate treatment process. Rebelem (2016) has mentioned that the nurses have to be expertise to protect patients from peripheral intra-venous catheter failure such as phelibitis, infection at the catheter insertion site itself and catheter dislodgement and occlusions. Majority of the patients in ED should have to be started with infusions through peripheral intra-venous catheter and the nurses has to protect the patient from failure of 33% - 69% of peripheral intra-venous catheter leading to discomfort, thus affecting the value of patient severely. The main contributing factor to this premature device failure is due to the improper fixation of the peripheral intra-venous catheter causing dislodgement and affecting micro-motion causing vein irritation (phlebitis and occlusion) resulting in infection. It occurs mostly during first 48 hours after insertion which implies that securement methods have to be improved. Hence, nurses should use skin securement at the catheter insertion site to develop adherence of cath eter with the patients skin. OGrady et al (2011) has suggested that many researches have to be conducted to study about the intravenous catheter replacement. PIVC failure causes disruption of therapies as hydration therapy, antibiotic and analgesic therapy resulting in the deterioration of patients heath adversely causing burdening of the patients and their family members by increasing the cost, producing anxiety and re-inserting the catheter (Aymes, 2016). Moreover, it increases the costs of the health- care including increased man power requirement and increased length of stay (Stuart, 2013). Hence, by using skin glue for securing patients with PIVC, the nurses will surely enhance the patients values as well as prevent disease and death rates of people within their ethical principles. Reference ACEP- (American college of Emergency- Physicians). (2016). Annals of Emergency Medicine. Retrieved from https://www.acep.org/annals American Nurses Association (ANA). (2010). What is nursing?. Retrieved from https://www.nursingworld.org/Especially ForYou/StudentNurses/ Aymes, S. (2016). Skin Glue Reduces IV Failure Rate in the Emergency Department. Retrieved from https://www.acepnow.com/skin-glue-reduces-iv-failure-rate-in-the-emergency-department/ Baker, K. (2014). How to make critiquing easy: The Royal College of Midwives. Retrieved from https://www.rcm.org.uk/news-views-and-analysis/analysis/how-to%E2%80%A6-make-critiquing-easy Callaham, M. L. (2017). Annals Journal of Emergency Medicine: Official Journal of theAmerican College of Emergency Physicians. Retrieved from https://www.journals.elsevier.com/annals-of-emergency-medicine International Council for Nurses. (2010). The International Council for Nurses definition of Nursing. Retrieved fromvhttps://www.ich.in/definition.htm Limm, E. (2013). Half of all peripheral intravenous lines in an Australian tertiary emergency department are unused: pain with no gain?: Ann Emerg Med. 62:521-525. Marsh et al. (2015). Securement methods for peripheral venous catheters to prevent failure: a randomized controlled pilot trial: J Vasc Access.16:237-244. Marsh, N. (2015). Devices and dressings to secure peripheral venous catheters to prevent complications [review]: Cochrane Database Syst Rev. 6:CD011070. Newcombe, R.G. (2012). Confidence Intervals for Proportions and Related Measures of Effect Size. Retrieved from https://books.google.co.in/books?isbn=1439812780 OGrady, N.P. (2011). Guidelines for the prevention of intravascular catheter-related infections: Clin Infect Dis. 52: e16293. Polit, D.F Beck, C.T. (2016). Nursing Research: Generating and assessing evidence for nursing practice. Lippincott Williams Wilkins: New Delhi. Queensland- Department of Health. (2015). Centre for Healthcare Related Infection Surveillance and Prevention, Australia: PIVC guideline. Retrieved from https://www.health.qld.gov.au/publications/clinical-practice/guidelines-procedures/diseases-infection/governance/icare-pivc-guideline.pdf. Rebelem. (2016). Should We Use Skin Glue to Secure Peripheral IVs: R.E.B.E.L. E.M. Retrieved from https://rebelem.com/should-we-use-skin-glue-to-secure-peripheral-ivs/ Rickard, C.M. (2012). Routine versus clinically indicated replacement of peripheral intravenous catheters: a randomized controlled equivalence trial: Lancet. 380:1066-1074 Steen, M. Roberts, T. (2011).The handbook of midwifery research. Wiley-Blackwell: West Sussex. Stuart, R.L et al. (2013). Peripheral intravenous catheterassociated Staphylococcus aureus bacteraemia: more than 5 years of prospective data from two tertiary health services: Med J Aust. 198:551-553. Wallis, M.C. (2014). Risk factors for peripheral intravenous catheter failure: a multivariate analysis of data from a randomized controlled trial: Infect Control Hosp Epidemiol.35: 63-68. Webster, J. (2010). Clinically-indicated replacement versus routine replacement of peripheral venous catheters: Cochrane Database Syst Rev. 3: CD007798.

Thursday, December 5, 2019

Golden Spring Publish and employ benefit - MyAssignmenthelp.com

Question: Discuss about the Golden Spring Publish and employ benefit. Answer: In treatment of fringe benefits during taxation, the company pays taxes on behalf of the employee or an associate of the employee eg a family member in the place of wages and salaries. This is very separate to income tax and is the taxable value of fringe benefits. In this case, Charlie is an employee of Shiny Homes Pty Ltd(Shiny Homes) and works as an agent in its real estate segment. He has been given several benefits which are taxable including a 4 wheel sedan which is valued at $70,000. In fringe benefits the taxable amount that is attributable to Charlie is in case the car was used partly for personal engagements or private use. In this case, Charlie uses 70% of the car for official use and the remaining 30% is used in private engagements (Engdahl, 2011). The Law 27/2014, of November 27, of the Corporation Tax (LIS), has supposed a radical change in the treatment of the double taxation of fringe and participation of benefits, since it has entailed that, for the tax periods initiated on 1 June 2016 to 30 June 2017 (Langbein et al., n.d.). For taxation purposes, the following are to be taxed on the side of the shiny homes. The cost used by Charlie on 50,000 kilometers. The remaining 30,000 will be taxed on Charlie as it was for personal use. The petrol and oil per month will cost a total of $ 2000. This will be multiplied by the number of months in the calendar year which are 12 months. This is equal to $24,000. However, Charlie had maintained a logbook for 3 months or 12 weeks which is presumably for personal use of the vehicle. Therefore the taxable benefit on the car is only 9 months. The repairs and maintenance per month is $ 3,500. Therefore the total repairs and maintenance will be multiplied by 12 months. The registration per annum is $ 240 while insurance per annum were $ 960. All these expenses were incurred by the employer shines homes (Fringe benefit tax guide, 2010). Shine Homes taxable benefits Taxable item Amount $ Amount $ Petrol 9 months 18000 Repairs and maintenance-12 months 42,000 Registration 240 insurance 960 Parking fee( 200*52) 10400 Total 71,600 For Charlie the following are the taxable deductions that he will have to face. 30 % of all the expenses which was for private use $ 1000, car hire which the company paid to allow Charlie and his wife Deborah to go on a honeymoon in gold coast. Accommodation for the honeymoon which was paid by Shine homes amounting to $ 3000. Charlies taxable benefits Taxable item Amount$ Amount$ Car hire 1000 accommodation 3000 Total taxable benefit 4000 For taxable benefits, all work related costs should be taxed to the company while Charlies personal and private use should be taxed on Charlies (Mellon, 2016). The parameters or essential requirements for the deduction for economic double international taxation for benefits and participation in benefits paid by a company. In the case of distribution of reserves, the designation contained in the partner agreement will be considered, the last amounts allocated to said reserves being understood as applied. The deductible items include business expenses, charitable donations to charities registered in Australia and tax payments of complementary benefits (Mellon, 2016). Tax benefits are offered to Australian tax residents, as well as to dependents. Advice in regard to income tax consequences to Allan In Australia, no Capital gain tax (CGT) is paid for a home that one lives in. In this Case, Allan and Betty will not pay tax for money received when they sold their house in Melbourne. They also, cannot claim any deduction in income tax for cost associated with buying the country house sitting on a 10 hectare farm in Victoria (this is under the main residence exemption). If the house was a holiday house, it would be subjected to capital gain tax (Barkoczy, n.d.). However, the fee paid to both Allan and Betty for providing professional services in their respective areas of expertise has to be declared and taxed. Gifts received as part of a income earned when providing a professional service as an employee or a contractor are taxed. Therefore, the wine value of $360 from the clients will be taxed. Distinguishing between hobby and Business in taxation When determining if an activity is a business or a hobby, the following factors need to be considered: does the activity have a registered business name, or has it obtained an ABN. For a business the owner intends to make a profit, he also carries the activity in an organized, planned and business-like manner (Australian master tax guide, n.d.). For example, keeping records, having a separate bank account, operating in another business premise, having qualifications and licenses e.t.c. Another factor to consider is if a similar type of activity is repeated. On the other hand, hobbies do not have any additional tax or reporting obligations. Also, an activity that is considered to be a hobby does not have an ABN. The most relevant case law is IRs VS Robert Miller, where the court was to determine is operating a horse business was a hobby or business. Tax implication to Betty and Allan Allan and Betty have been practicing and enjoying gardening and have been planting vegetables and grape vines as a hobby. At first, when they have been practicing farming as a hobby, they had no obligation to report and pay taxes. However, after Betty opened a stall at Newtown market, the tax implication of this is that she has to pay income tax for the proceeds of the marmalade sales (Coleman et al., 2013). This will increase the tax payable. Allan will also pay taxes from the proceeds of supplies that he regularly takes to some retailers in the town. Even if they do not keep records, they are required to pay the taxes of $500-$600 gross income they receive each month. Barter trade transaction is assessable and is deductible for income tax purposes. When exchange happens there is a liability for tax, which includes GST (Coleman et al., 2013). Advice to participants of the barter trade Suzie will have to pay GST tax for services provides through the barter trade system. The value of the goods exchanged will be assessed in terms of the barts, and the value of the goods or exchange is then taxed. This applies to all other participants including Betty and Allan (Deutsch, 2008). References Australian master tax guide. (n.d.). . Barkoczy, S. (n.d.).Australian tax casebook. Coleman, C., Hart, G., Bondfield, B., McKerchar, M., McLaren, J., Sadiq, K. and Ting, A. (2013).Australian tax analysis. Pyrmont, N.S.W.: Thomson Reuters (Professional) Australia Limited. Deutsch, R. (2008).Australian tax handbook. Pyrmont, N.S.W.: Thomson. Engdahl, S. (2011).Taxation. Farmington Hills, MI: Greenhaven Press. Fringe benefit tax guide. (2010). [Wellington, N.Z.]: Inland Revenue. Langbein, J., Pratt, D., Stabile, S. and Stumpff, A. (n.d.).Pension and employee benefit law. Mellon, A. (2016).Taxation. San Francisco: Golden Springs Publishing.