Ica Gh Syslabus

Goals and Expected Performance Outcome of each part THE INSTITUTE OF CHARTERED ACCOUNTANTS (GHANA) Syllabus for ICAG Qualifying Examinations ACCRA 2009 Institute of Chartered Accountants, Ghana 1 Proposed Sylabus for ICAG Qualifying Examinations Contents Introduction Features and Inovations of the New Scheme Objectives and Expected Performance Outcomes of Each PART 1. 1. 2 1. 3 1. 4 Financial Accounting Fundermentals Business Management Economics Management Information Systems PART 2. 1 2. 2. 3 2. Quantitative Tools in Business Audit and Internal Review Business and Corporate Law Principles and Practice of Taxation PART 3. 1 3. 2 3. 3. 4 Financial Reporting Public Sector Accounting Cost and Management Accounting Financial Management PART 4. 1 4. 2 4. 3 4. 4 Advanced Financial Reporting Advanced Audit and Professional Ethics Corporate Strategy and Governance Advanced Tax Planning and Fiscal Policy Review of Qualifying Examinations Syllabus May 2010 Proposed Transitional Arrangements 1 2 3 4 11 17 25 32 37 42 50 55 61 68 73 80 86 98 108 115 116 2 Institute of Chartered Accountants, Ghana Financial Accounting FundamentalsINTRODUCTION After about four years of sorting out assessments on the current prospectus of the Institute of Chartered Accountants (Ghana), proficient program, the first was held in May 2005, it is presently viewed as fitting and opportune to reconsider and refresh it so as to align it with current condition of information and to make it progressively pertinent to the current requests of businesses and customers. The activity of the Chartered Accountant has become progressively refined in light of the impacts of globalization, improvements in data innovation and the intricacy of the advanced business organisation.The cutting edge contracted bookkeeper, for example, not just communicates an assessment on the exactness and decency of fiscal reports, yet in addition educates the executives on the practicality with respect to speculation ventures, cha rge matters and renders specific warning administrations, and so forth. By and large, he is called upon to serve the country as an individual from a unique examination board. So as to play out these capacities respectably, he needs to have gained capability in bookkeeping hypothesis and practice. The new prospectus would be analyzed in May 2010. The new prospectus endeavors to meet the double objectives of the plan through the subject structure and coverage.The 16-subject, 4-level-structure assessment joins subjects which address the down to earth abilities prerequisites of the possible expert bookkeepers with others which are for the most part of the hypothetical or reasonable nature and in this way fills in as a decent establishing for the Professional Accountant. Rundown OF NEW STRUCTURE Exhibit 1: Chart of New Examination Scheme 1. 1. 2 1. 3 1. 4 Financial Accounting Fundamentals Business Management Economics MIS and Business Systems 3. 1 3. 2 3. 3. 4 Financial Reporting Public Sector Accounting Cost and Management Accounting Financial Management PART 1PART 3 PART 2 PART 4 2. 1 2. 2. 3 2. 4 Quantitative Tools in Business Audit and Internal Review Business and Corporate Law Principles and Practice of Taxation 4. 1 4. 2 4. 3 4. 4 Advanced Financial Reporting Advanced Auditing and Professional Ethics Corporate Strategy and Governance Advanced Taxation and Fiscal Policy Institute of Chartered Accountants, Ghana 1 Proposed Sylabus for ICAG Qualifying Examinations FEATURES AND INNOVATIONS OF THE NEW SCHEME This new plan was created on an entrenched setting for a survey and change. The accompanying new highlights and developments stick out. A four-section structure of 16 papers altogether. †¢ Fusion and joining of certain courses. This is intended to energize an integrative learning approach and to limit the negative of the â€Å"tunnel vision† subject-by-subject preparing. The mix of related courses is in this way intended to infer additionally impor tance and collaborations. For instance, it isn't remarkable to discover fundamentally the same as questions and necessities on â€Å"Budgeting and Variance Analysis† in both the old [i. e. Current] Management Accounting and Cost Accounting papers. †¢ Clearly characterized and reachable taking in results from Part to Part.This ought to halfway determination the issues related with the situation of somewhat qualified competitors in industry and on different projects. †¢ A progressively sound, simple to-fit and actualize, graduate transformation and exception plot has been consolidated. It is trusted that this will spur higher evaluation up-and-comer entrantsâ€degree and certificate holders â€to obtain adequate bookkeeping skill and accelerate their possible expert capability. †¢ All understudies have ten (10) years from the date of enrollment inside which to finish all the assessments of the Institute of Chartered Accountants (Ghana).After the ten (10) year s time span any understudy who has not finished the assessments of the Institute won't be qualified to take the assessments. †¢ Better spotlight on business [financial] procedure and detailing or relational abilities, accordingly empowering contender to value the general real factors of the business condition and to utilize warning aptitudes all the more successfully. †¢ Introduction of some increasingly significant projects and fitting titles †the New Business Strategy is progressively about administration, settling on bookkeepers vital choices creators. Expanded accentuation on business warning abilities at the last Part 4. 2 Institute of Chartered Accountants, Ghana Financial Accounting Fundamentals OBJECTIVES AND EXPECTED PERFORMANCE OUTCOME OF EACH PART Each of the 4 Parts of this assessment plot has a wide target and expected execution result as expressed beneath. Moreover, inside each subject at any Part, the schedule inclusion just as the point by point howeve r explicit destinations and learning results are expressed. The expansive goal and learning results of the four (4) Parts are as per the following: PART 1 †¢ 4 fundamental/establishment papers. Arrangement of essential standards and information required to comprehend the Business Environment. Section 2 †¢ Four (4) customary center papers. †¢ Test of specialized mastery expected of a cutting edge bookkeeper. †¢ Acquisition of foundation information and abilities important for compelling execution at center administration level. Section 3 †¢ Four (4) center papers. †¢ Emphasis on business cases, methodology and warning aptitudes. Section 4 †¢ Four (4) center papers. †¢ Emphasis on business cases, technique and warning aptitudes. Result and Interpretation The pass mark is half. The outcomes will be distributed as â€Å"pass† or â€Å"fail.A competitor who comes up short has the choice of changing this paper in ensuing assessments till his /her candidature lapses. Establishment of Chartered Accountants, Ghana 3 Proposed Sylabus for ICAG Qualifying Examinations PROFESSIONAL PART 1 PAPER 1. 1: Financial Accounting Fundamentals 1. Goals AND LEARNING OUTCOMES This paper is intended to empower competitors gain and acknowledge principal bookkeeping information in associations. Toward the finish of the course, the up-and-comer ought to have the option to: Demonstrate sound information and comprehension of bookkeeping standards, ideas and their application in the readiness of monetary statements.To guarantee that understudies have a sound comprehension of the strategies of twofold section bookkeeping and can apply its standards in recording exchanges, changing money related records and getting ready non-complex budget reports. Ready to recognize and address exclusions and mistakes in bookkeeping records and fiscal summaries. Ready to indicate the segments of fiscal summaries and plan and present non-complex records for sole m erchants, associations and constrained organizations. Indicate why a substance keeps up budgetary records and gets ready monetary statements.Identify the wellsprings of data for the planning of bookkeeping records and fiscal summaries. Record and record for exchanges and occasions bringing about salary, costs, resources, liabilities and value as per the suitable premise of bookkeeping and the laws, guidelines and bookkeeping measures relevant to the fiscal reports. Set up a preliminary equalization from bookkeeping records and recognize the employments of the preliminary parity. Plan accounts and budget summaries from inadequate records. Comprehend the various bases of getting ready budget summaries. Apply some global monetary announcing standards.Define the subjective attributes of money related data and the key bases of bookkeeping FORM OF EXAMINATION The assessment will be a three-hour paper comprising of five mandatory inquiries. (All the five inquiries must be replied. ) 3. Pro spectus WEIGHTING GRID This matrix shows the general weightings of points inside this subject and should direct the relative investigation time spent on each. The imprints accessible in the evaluation will compare to the weightings beneath. 4 Institute of Chartered Accountants, Ghana †¢ 2. Money related Accounting FundamentalsHowever, there may be slight varieties in certain occurrences as they fill in as a guide in particular. Prospectus COVERAGE Conceptual Framework of Accounting, Maintaining Financial Records Principles of Double Entry and Books of Prime Entry Adjustments to Accounting Records and Financial Statements Accounting for non-current Assets (physical assets and intangibles) Preparation of Financial Statements including Cash Flow Preparation of Financial Statements for Non-benefit Making Organizations, Preparation of Financial Statements from Incomplete Records Accounting for specific exchanges Introduction to fiscal reports investigation TOTAL WEIGHTING (%) 0 15 2 0 15 10 100 Institute of Chartered Accountants, Ghana 5 Proposed Sylabus for ICAG Qualifying Examinations PAPER 1. 1 Financial Accounting Fundamentals MAIN TOPIC SYLABUS CONTENT (Cont

Buddhism And Hinduism In Usa Origins And Examples Essay Example For Students

Buddhism And Hinduism In Usa: Origins And Examples Essay The Unites States is home to the most assorted range of religions on the planet. There are portrayals of almost every religion on the planet. There are three essential ways religions show up in the US: import, fare, and things. Buddhism and Hinduism are two Asian religions that have made it over the Pacific Ocean and now exist close by numerous others in America. ISKCON, a type of Hinduism, and Zen, a type of Buddhism, are two such gatherings. Every single Indian development have consistently had a charming pioneer related with them. Bhaktivedanta Swami Prabhupada was the same. Conceived Abhay Charan De 1896-1977 was the organizer and otherworldly ace of ISKCON, International Society of Krishna Consciousness. He was given this crucial a young from his profound Visnuite pioneer upon his passing. He was an effective businessperson who had gone to the University of Calcutta. However it was not until he was 70 years of age and totally broke, that he went to the US. This was the ideal time, for it was the 1960s and it appeared everyone was investigating new types of otherworldliness. His convictions got on in this season of psyche expansionism. In each ISKCON sanctuary there will be an image of Bhaktivedanta Swami Prabhupada on a special stepped area like set up. This shows how much regard ISKCON lovers have for their previous pioneer. Each religion has a given arrangement of rules or certain specialists that lovers must follow. ISKCON individuals need to fundamentally surrender their lives to their otherworldly ace. Bhaktivedanta Swami Prabhupada created four guidelines that must consistently be followed: no eating meat, fish, or eggs; no inspire sex; no intoxicants; and no betting. ISKCON is by all accounts progressively centered around the orthopraxy of their ways as opposed to putting together themselves with respect to old ways. Individuals need to declare Krishna as their preeminent Lord in each structure. Sanctuaries have special raised areas and numerous sculptures or delineations of Krishna in which one can perform puja to Krishna. Mantras are additionally played out a few times day by day. These mantras are normally extremely straightforward like, ?Hare Krishna, Hare Rama.? Like different types of Hinduism, ISKCON holds the Vedas and the Bhagavad Gita truly obvious, yet doesn't follow customary Indian way s. Enthusiasts of Krishna accept that he lives in a paradisal world and with enough love and dedication for Krishna they can break free from the karmic cycle and go into this heaven. ISKCON convictions are gotten from the Chaitanya Krishnaite group, which was begun by Chaitanya Mahaprabhu. He is accepted to have been a manifestation of Radha and Krishna. He instructed that with enough love for Krishna, one could consume with smoldering heat from karma to accomplish moksha. ISKCON and Chaitanya Krishnaitism contrasts from other Vishnuite gatherings, since they don't hold Vishnu as there God, however only one of his manifestations. Moundsville, West Virginia is home to numerous ISKCON individuals. These individuals live and take a shot at common ranches. The profound ace leads ISKCON individuals through everything about their lives. They have conclusive timetables in which they follow day by day. These calendars are either isolated into time spent dealing with the ranches or missionizing, and performing puja or reciting a mantra to Krishna. Despite the fact that dating isn't permitted individuals might be hitched, yet the ace consistently organizes them. Sex is for reproduction just and furthermore must be conceded by the ace. ISKCON is continually trying to extend and acquire devotees of Krishna, consequently is a fare religion. It isn't extraordinary to see a part on the side of a road moving, singing ?Hare Krishna,? what's more, passing out solicitations to their gatherings. In contrast to ISKCON, Zen is an import religion. Zen is by all accounts related with the world class of society. This is expected for the most part to the way that either just taught individuals are presented to it or that numerous individuals can't manage the cost of the expense of retreats or potentially Zen books. In ISKCON, they essentially aside from any individual who is eager to take on their convictions. Zen is gotten from the kind of contemplation which is practice. Zen is a type of Mahayan Buddhism, which accepts that in an ?incredible vehicle? which will take everybody to the last goal of Nirvana. Everybody is or can turn into a Buddha in Mahayan convictions. This makes it look assuaging to potential fans. Since the Buddha had faith in adoration and empathy, he would not desert anybody. Thusly nirvana is accomplished through and with everybody. There seems to be much more opportunity engaged with Mahayan and Zen convictions then in ISKCON since one doesn't have a tremendous arrangement of rules and rules, but instead must have confidence in the Buddha. I do see a great deal of likenesses in the Zen with draws and the ISKCON cooperatives. The two of them have an unmistakable pioneer who makes a large portion of the guidelines and the supporters that have explicit devout obligations in which they perform every day. .uc74ae961c81a17d2734ba7cea71f7d47 , .uc74ae961c81a17d2734ba7cea71f7d47 .postImageUrl , .uc74ae961c81a17d2734ba7cea71f7d47 .focused content zone { min-stature: 80px; position: relative; } .uc74ae961c81a17d2734ba7cea71f7d47 , .uc74ae961c81a17d2734ba7cea71f7d47:hover , .uc74ae961c81a17d2734ba7cea71f7d47:visited , .uc74ae961c81a17d2734ba7cea71f7d47:active { border:0!important; } .uc74ae961c81a17d2734ba7cea71f7d47 .clearfix:after { content: ; show: table; clear: both; } .uc74ae961c81a17d2734ba7cea71f7d47 { show: square; progress: foundation shading 250ms; webkit-change: foundation shading 250ms; width: 100%; haziness: 1; progress: darkness 250ms; webkit-progress: mistiness 250ms; foundation shading: #95A5A6; } .uc74ae961c81a17d2734ba7cea71f7d47:active , .uc74ae961c81a17d2734ba7cea71f7d47:hover { obscurity: 1; change: murkiness 250ms; webkit-progress: haziness 250ms; foundation shading: #2C3E50; } .uc74ae961c81a17d2734ba7cea71f7d47 .focused content zone { width: 100%; position: relative; } .uc74ae961c81a17d2734ba7cea71f7d47 .ctaText { outskirt base: 0 strong #fff; shading: #2980B9; text dimension: 16px; textual style weight: intense; edge: 0; cushioning: 0; content embellishment: underline; } .uc74ae961c81a17d2734ba7cea71f7d47 .postTitle { shading: #FFFFFF; text dimension: 16px; textual style weight: 600; edge: 0; cushioning: 0; width: 100%; } .uc74ae961c81a17d2734ba7cea71f7d47 .ctaButton { foundation shading: #7F8C8D!important; shading: #2980B9; fringe: none; fringe span: 3px; box-shadow: none; text dimension: 14px; textual style weight: striking; line-tallness: 26px; moz-outskirt sweep: 3px; content adjust: focus; content improvement: none; content shadow: none; width: 80px; min-stature: 80px; foundation: url(https://artscolumbia.org/wp-content/modules/intelly-related-posts/resources/pictures/straightforward arrow.png)no-rehash; position: supreme; right: 0; top: 0; } .uc74ae961c81a17d2734ba7cea71f7d47:hover .ctaButton { foundation shading: #34495E!important; } .uc 74ae961c81a17d2734ba7cea71f7d47 .focused content { show: table; tallness: 80px; cushioning left: 18px; top: 0; } .uc74ae961c81a17d2734ba7cea71f7d47-content { show: table-cell; edge: 0; cushioning: 0; cushioning right: 108px; position: relative; vertical-adjust: center; width: 100%; } .uc74ae961c81a17d2734ba7cea71f7d47:after { content: ; show: square; clear: both; } READ: American Psycho College Essay PaperZen individuals don't follow the Buddhas eight-overlap way yet rather underscore more on benevolent acts. Zen appears to have broken liberated from increasingly customary Buddhist ways. Like ISKCON they are worried about the orthopraxy of their ways. They are not worried about doctrines or a great deal of customs however center around puzzles, known as koans, which are assume to invigorate the brain. Zen is likewise like ISKCON in the manner they each have an otherworldly pioneer that heads up practically all undertakings. The Zen ace as a rule will raise these koans so as to bring a satori or ?shock? to the psyche, which will cause edification. In Zen, arriving at Nirvana or accomplishing edification is going to the acknowledgment that one and everything is vacant. Like ISKCON, Zen can be very gathering focused. On withdraws, individuals have certain religious obligations that they need to perform. Zen is very group situated in contemplation just as in work and work. They perform zazen, bunch contemplation, to accomplish this feeling of void together. This contemplation is frequently thorough, and can keep going extended periods of time. This stun treatment is utilized to bring the brain to an abrupt halt to realize this condition of nirvana, which is truly vacancy. They have sutras or hallowed messages in Buddism, however Zen fans look more onto their reflections, mantras, and pioneers for power. Zen lessons are not drawn from content yet rather from brain to mind. An extraordinary feeling of heredity is found in Zen. Each Zen ace is believed to be the genuine Buddha. The Zen ace picks his replacement before his demise. The ace is held above every other person. He additionally directs a roshi, which are close to home meetings with the Zen unde rstudies. By doing this he can tell the understudy how they are getting along in there studies and musings. Both ISKCON and Zen have incredible intrigue to the majority at the simplicity of accomplishing bliss or edification. They as a rule include a basic mantra or contemplation. Retreats and mutual issues appear to be excessively severe on how they handle every one of their issues. I think opportunity and essential rights are lost to the detriment of the lover at the retreats or cooperatives. Despite the fact that ISKCON and Zen are gotten from two totally different religions, one can see numerous similitudes between them. I figure this might be connected tot he comparative time, the manner in which they arrived at the US, and the simplicity of making progress in them. Religion

Hale, Nathan

Hale, Nathan Hale, Nathan, 1755â€"76, American soldier, hero of the American Revolution, b. Coventry, Conn. A young schoolteacher when the Revolution broke out, he was commissioned an officer in the Connecticut militia, served in the siege of Boston, then went to take part in operations in New York. He volunteered for the dangerous mission of getting information about the British forces on Long Island, where he went in the natural disguise of a schoolmaster. Inexperienced, he revealed his mission to a former British officer, was captured, and was hanged without trial. He is remembered especially for the statement he is said to have uttered on the gallows, I only regret that I have but one life to lose for my country. See biography by H. P. Johnston (1914); M. Pennypacker, General Washington's Spies on Long Island and in New York (1939). The Columbia Electronic Encyclopedia, 6th ed. Copyright © 2012, Columbia University Press. All rights reserved. See more Encyclopedia articles on: U. S. History: Biographies

The Rebellion Of The Jamaica - 847 Words

On October 11, 1865, Paul Bogle and a group of free blacks marched into Morant Bay protesting a local trail, which resulted in a full-scale uprising that caused deaths and destruction. Free blacks had economic troubles and little to power in colonial society because of their limited access to resources. By July 8, 1865, the Jamaica Guardian captured the people’s discontent with Governor Edward John Eyre, who served as British official on the island. In this message of discontent, the people call for his removal because of his â€Å"weak, vacillating, and undignified† character and conduct. The people became quite discontent with the British official because of his actions regarding the Morant Bay Rebellion. He responded to the rebellion with force and violence by declaring martial law in Surrey County and accused George William Gordon, a free black businessman, of being part of the rebellion that led to death. This whirlwind of events caused many to question Eyre†™s leadership and led to the establishment of the Jamaica Committee, a group of men from England. This group wanted to imprison the governor for his actions, but their actions led to his removal from office. This event created much havoc and chaos in England and Jamaica because it disturbed the British masses, which questioned the effectiveness of colonial rule after the Sepoy Munity of 1857. The cases received a large amount of political and public attention because two schools of thought existed in the debate. OneShow MoreRelatedJamaica, A Large Melting Pot Of Many Cultures And Tourist Attractions1241 Words   |  5 PagesJamaica, a large melting pot of many cultures and tourist attractions, is one of most interesting places on earth. Jamaica currently has a population of 2.9 million, making it the third largest countries in the Caribbean region. 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The introduction of new technological advanced innovations...

The introduction of new technological advanced innovations and methods during the Market Revolution changed the means of production and transportation for the future, creating an easily accessible, interconnected world. As people rejoice over the positive outcomes due to the spread of ideas, goods, and services, many neglect the detrimental results. Due to modern mechanism of transportation and production, ideas, goods and services arent the only things transported across national borders. Human trafficking, the transportation of people across international borders, increased tremendously after the Market Revolution and continues to be a dominant issue in present day. Although some people cross borders in search of a better life, an†¦show more content†¦However, limited types of jobs are offered to uneducated and unskilled women. According to Lillian Robinson in her journal about the limited job market for women that increase the employment in the sex industry, â€Å"†¦all available jobs share the drawbacks of long hours, hard work in unsafe conditions, an absence of collective bargaining, fringe benefits, and protective legislation and little hope for advancement through workplace training or seniority† (Robinson, 56). Robinson explains that the most common types of job offered are domestic servants, factory or restaurant workers, and prostitution and due to gender inequality, employers offer employment for women with lower wages for strenuous hours in unsafe working conditions, thus copious women choose prostitution with the desire of earning more money to send home and having more control of their work in certain aspects. Furthermore, some women have no choice because many cultures value males more than females, thus daughters are more likely to be sold. Families often sell their daughter(s) to recruiters in exchange for a sum of money. While some women are able to buy themselves out of prostitution after working a certain amount of yea rs, many remain in the sex industry. As the sex industry becomes more prominent in society, copious individuals urge the government to take actions. These people argued for the total prohibition of prostitution with strict regulations against those participating in either the act ofShow MoreRelatedProstitution : Prostitution And Prostitution1169 Words   |  5 PagesProstitution is illegal in the United States, except for some counties in Nevada. However, prostitution is in most part of the United States, despite the fact that it has been legalized. Prostitution is an act whereby, one sells his/her body for sex. In the United States, Prostitution is divided into three broad categories; street, escort, and brothel prostitution. 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Canada is a nation renown for promoting the advancement of women in all parts of the world. However, it is a nation guilty of punishing women for the circumstances in which they find themselves. The prostitution laws in Canada showsRead MoreProstitution And The Law : Prostitution2362 Words   |  10 PagesProstitution and the Law Prostitution, also known as commercial sex or solicitation, is the business of preforming sexual activities in exchange for monetary compensation. Prostitution can be seen in many different outlets, from brothels and streetwalkers, to top of the line escort or call-girl services. Prostitution laws make it a crime to suggest, consent, or participate in a sexual act for the benefit of receiving payment (FindLaw, 2016). Prostitution is one of the first known female occupationsRead MoreProstitution, The Act Of Prostitution1324 Words   |  6 Pages Prostitution, the act of â€Å"providing or receiving sexual acts, between a prostitute and a client, in exchange for money or some other form of remuneration† (Hock 557). The idea of exchanging sex for valuables has been seen since the beginning of human society; the first reported data about prostitution was reported around 3000 B.C.E in one of the first known civilizations, Mesopotamia (Caraboi and Fierbinteanu 362). Also, prostitu tion is often referred to as â€Å"the world’s oldest profession.† TodayRead MoreLegalization Of Prostitution And Prostitution1612 Words   |  7 PagesLegalization of Prostitution Prostitution law varies widely from country to country, and between jurisdictions within a country. Prostitution or sex work is legal in some parts of the world and regarded as a profession, while in other parts it is a crime punishable by death. In many jurisdictions prostitution is illegal. In other places prostitution itself is legal, but surrounding activities are illegal. In other jurisdictions prostitution is legal and regulated. In most jurisdictions which

Possible Danger Signs on Gre Analytical Writing Solutions to the Real Essay Topics Pdf You Should Know

Possible Danger Signs on Gre Analytical Writing Solutions to the Real Essay Topics Pdf You Should Know It may be wise to generate a list of your personal go-to topics things it is simple to talk or write about. Since I read it every week, I typically have been thinking about a few present events I can apply to numerous Issue topics. It's possible that while explaining your stand, you divert from the subject and begin discussing another situation. This is going to be the first in a string of appetizer recipes that we plan on posting here on our site. Come to consider it, the book doesn't devote any time speaking about different scores and what the scorers are searching for. Dozens of books offered on the market give ample info about those topics that might or might not be required. I would entirely advise this book. A book could possibly be listed, but it doesn't mean that you will need to absorb the entire thing. The primary aim of technological advancement ought to be to increase people's efficiency so they have more leisure time. All necessary fields have to be filled out for us in order to process your form. Some people think that scientific discoveries have given us a far better mastery of the world around us. In reality, technology frees humanity to not just tackle new issues, but may itself create new issues which did not exist without technology. To understand the most essential features of a society, you must study its major cities. Some people today claim that the objective of politics ought to be the pursuit of an ideal. The ideal way to fix environmental problems brought on by consumer-generated waste is for towns and cities to impose strict limits on the total amount of trash they'll accept from every household. The new financial downturn was mostly due to financial leaders who wanted to earn plenty of money. There's a decently crafted essay response to several GRE essays. You will discover that you are able to use a lot of them for many essays don't let the very first thing that springs to mind box you in. The essays have to be written with regard to the provided instructions. Before you even begin writing an essay, it is crucial to understand what you would like to say. Continue reading for a discussion of the various ways this essay meets the requirements for an ideal score. You may observe that many Issue Essay prompts make statements that are tough to completely support. In the issue essay, you will be supplied a topic that's debatable. For more information regarding the different rubrics for the various essay tasks, read our articles about how to compose perfect-scoring GRE Issue and Argument essays. In addition, it tests the usage of grammar and sentence formation. The mixture of these 2 methods of connecting the 2 paragraphs causes a smooth logical flow from 1 idea to the next. If it's possible to write coherently the very first time, you can discover that saving time to reread your writing isn't that useful. Critical judgment of work in any certain field has little value unless it comes from a person who is a specialist in that area. However, this color is best worn while the weather is warm. Indeed, style isn't in any way mentioned. Governments should provide a totally free university education to any student that has been admitted to a university but who can't afford the tuition. Some individuals think that universities should require every student to have a wide variety of courses away from the student's field of study. Other people think that such competition seriously limits the standard of authentic learning. Inside my experience, this is the 1 portion of the test that students have a tendency to under-prepare for.

Intervention of Non-Communicable Disease-Free-Samples for Students

Questions: 1.Provide the reference of the article and describe the following: The intervention being employed, and how the intervention relates to the hypothesised aetiological mechanism by which the exposure is associated with the outcome The findings of the example article you selected 2.Summarise the evidence-base that supports (or does not support) the intervention in the article you selected Consider the following elements for this question: How many studies of the association? What type of intervention studies? Based on what samples, or population-bases? Are findings across these studies consistent and coherent, particularly from studies of similar or more powerful study designs? Are the results plausible in terms of a biological mechanism? Answers: 1.The article by Meeker et al. (2016) reviews the use of a behavioral intervention to prevent acute respiratory tract infection which is a non-communicable infection, to reducing antibiotic use that causes serious effects. The behavioral interventions can be implemented together or in isolation. They include suggested alternatives, accountable justification, and peer comparisons. Suggested options present electronic order sets that suggested nonantibiotic treatment. Responsible justifications involved clinicians in using patients file to prescribe antibiotics into the health records of the patient without seeing the patient. Peer comparison involved comparing the performance of top performance with their lower prescribed antibiotics rate. The behavioral intervention was going to be measured by the standards at which patient pick antibiotic drugs from the clinic. It was realized that during the baseline period when the intervention had not been done the rates were recorded very high at 24%. The rates after the three intervention had dropped to 11%. The use of the three interventions had led to the drop of inappropriate antibiotic prescribing for acute respiratory infections. 2.Despite free publications of how overuse of antibiotics exposes patients to the unnecessary risk of prevalence of bacteria. Most clinicians persist in giving out this drugs for the respiratory tract infection as is in the clinical guidelines. This leads to the rise of the need to find a behavioral solution. Researchers are also exploiting psychological issues as a way of remedying the stalemate. They focus on cognitive and psychological measures, like the ones used in this case. The research used being cognitive modeled adheres to the psychological demands. Several studies have shown that antibiotics are wrongly prescribed to patients instead of using alternatives method such as the ones used above. The intervention effect that was observed represent deductions inappropriate prescribing of drugs. The Hawthorne effect was the one applied to the control condition, this involved. The alteration of individual behavior for the impact and fear of being observed. As the patients were sure they were being seen as the disease, they changed their behavior to ones that suit them. The change of conduct led to low antibiotic rate, therefore, proving the intervention worked. Hawthorne theory was therefore relevant to the intervention. Previous studies on antibiotic justification notes have shown that when this method is used without public accountability to the patient, a negative result will be realized. With the target being peers intervention method prove the best in comparison with adult feedback. The findings across the two studies are consistent and consistent. Comparing to the model of Gerber et al. where the model trajectories are used (Meeker et al., 2016). The control taken early is inconsistent with the 24% recorded by the same that uses the same time of intervention, 18 months. This model measures the effect of each intervention on all the practices that did not receive the intervention (Kotwani, Joshi, Jhamb Holloway, 2017). The design also is in line with the approach of the primary model used when testing the diagnosis shift. The potential antibiotic, appropriate for infection diagnosed increased with the increase of the respiratory tract infection. Elements of analytic approach were also in line with the one used. Hierarchical modeling that involves performing the interaction based analysis. The original investigation used during the feedback produced the same result (Dekker et al., 2018). The result is plausible based on the following reasons; There isnt any potential harm .the three intervention as recorded within the 18 months of intervention did not cause any documented injuries to anyone. The damage that was feared for the group that was using all the three methods could deteriorate fast did not happen (Harris, Hicks Qaseem, 2016). This, therefore, proves that the technique was clinical and can be implemented without harm. None of the intervention required severe changes to the environment. The peer comparison was expected to change the primary care practices of some patients, but it did not. It turned to be most pragmatic and the simplest to perform. The intervention, therefore, is plausible as minimal changes are done to the environment (Hovi, Ollgren Savolainen-Kopra, 2017). There is a temporal relationship between the three interventions to the outcome; It is very likely that after the intervention. The rates might go up again especially for the group that used peer comparison as a way of intervention; this is because it did not involve a lot of changes, making it easier to slide back to the use of antibiotics. The healthy relationship between the methods and the outcome is present. The intervention methods accountable justification as the behavioral intervention cause a significant change in the environmental health of the individual. Therefore it is behavioral that the individual will adapt leading to a somewhat permanent outcome. The somewhat stable outcome shows, there is a healthy relationship between the result and the intervention. There was no restriction of a group that influenced the outcome, except the clinicians working on so many patients. Therefore fatigue might have affected the outcome. The rest of the result remained the same, including pay, choice of treatment and mode of treatment. There could be measurement bias on the part of the intervention group as each group was comfortable until intervention group that applied both the two intervention. They came back for frequent diagnoses (Little et al., 2015). This, therefore, recommends that for future use potential and further research should be done. The result was affected by particular limitation but of negligible units. The number of clinicians available was very few to prescribe and take a keen prescription for the individual. This limits generalizability and accuracy. The result that was dependent on variable factors could be difficult to compare. This factors that range from the environment, billing data and EHR, which might at some point affected the general measurement. The safety analyses were only based on the people who came back to the clinical organization. There could be people who went into other clinics or stayed at home but got harms (Cabral, Lucas, Ingram, Hay Horwood, 2015). In conclusion, the method used for intervention can be used to control inappropriate antibiotic for respiratory tract infection based on behavioral interventions. References Cabral, C., Lucas, P. J., Ingram, J., Hay, A. D., Horwood, J. (2015). It's safer to parent consulting and clinician antibiotic prescribing decisions for children with respiratory tract infections: an analysis across four qualitative studies.Social science medicine,136, 156-164. Dekker, A. R., Verheij, T. J., Broekhuizen, B. D., Butler, C. C., Cals, J. W., Francis, N. A., ... van der Velden, A. W. (2018). Effectiveness of general practitioner online training and an information booklet for parents on antibiotic prescribing for children with respiratory tract infection in primary care: a cluster randomized controlled trial.Journal of Antimicrobial Chemotherapy. Harris, A. M., Hicks, L. A., Qaseem, A. (2016). Appropriate antibiotic use for acute respiratory tract infection in adults: advice for high-value care from the American College of Physicians and the Centers for Disease Control and Prevention.Annals of internal medicine,164(6), 425-434. Hovi, T., Ollgren, J., Savolainen-Kopra, C. (2017). Intensified hand-hygiene campaign including soap-and-water wash may prevent acute infections in office workers, as shown by a recognized-exposure-adjusted analysis of a randomized trial.BMC infectious diseases,17(1), 47. Kotwani, A., Joshi, P. C., Jhamb, U., Holloway, K. (2017). Prescriber and dispenser perceptions about antibiotic use in acute uncomplicated childhood diarrhea and upper respiratory tract infection in New Delhi: Qualitative study.Indian Journal of Pharmacology,49(6), 419. Lee, M. H. M., Pan, D. S. T., Huang, J. H., Mark, I., Chen, C., Chong, J. W. C., ... Wong, C. S. (2017). Results from a patient-based health education intervention in reducing antibiotic use for acute upper respiratory tract infections in the private sector primary care setting in Singapore.Antimicrobial agents and chemotherapy,61(5), e02257-16. Little, P., Stuart, B., Hobbs, F. D. R., Moore, M., Barnett, J., Popoola, D., ... Yao, G. (2015). An internet-delivered handwashing intervention to modify influenza-like illness and respiratory infection transmission (PRIMIT): a primary care randomised trial.The Lancet,386(10004), 1631-1639. Meeker, D., Linder, J. A., Fox, C. R., Friedberg, M. W., Persell, S. D., Goldstein, N. J., ... Doctor, J. N. (2016). Effect of behavioral interventions on inappropriate antibiotic prescribing among primary care practices: a randomized clinical trial.Jama,315(6), 562-570.

Roman Economy Essay Essay Example

Roman Economy Essay Essay Roman Economy Essay BY lbtondi123 he Economics of the Roman Empire Ancient Rome consisted of a vast area of land, with many natural and human-built resources. Because of this, Romes economy benefited greatly. In addition, production of a variety of items was crucial for a strong economic empire. The economy of the early Republic was largely based on paid labor. However, by the late Republic, the economy was largely dependent on slave labor. Also, Rome had a very well organized system of money. Lastly, Infrastructure was huge in the Romans ability to trade and move efficiently throughout the empire as well. The economics of any strong empire were based on three simple components: production, distribution, and consumption. The Romans were especially successful in building an economically sound empire. As one would think, production is the first step in the process of making a profit. The Romans had a large variety of items that they produced. Examples include iron, lead, leather, marble, olive oil, perfumes, purple dye, silk, silver, spices, timber, tin and wine. They were able to produce most of these items due to their large range of labor, from slave farmers to wealthy merchants. But also, some of their products ere influenced from other cultures inside the empire, such as olives and wine from the Greeks. Romans also had the advantage of obtaining products such as milk and cheese from their domesticated animals, such as cows and goats. The saying, all roads did lead to Rome, is correct in the sense that Rome is located centrally in terms of trade. Having all of these brilliant items in their arsenal was crucial to Roman trade; however, it would mean nothing if they could not get them to their destinations. We will write a custom essay sample on Roman Economy Essay specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Roman Economy Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Roman Economy Essay specifically for you FOR ONLY $16.38 $13.9/page Hire Writer An astonishing component of the Roman Empire was infrastructure and ultimately heir ability to distribute. The development of infrastructure set the empire apart from the others and proved to be useful in trade. The roads that the Romans built totaled approximately fifty thousand kilometers in length and expanded all over the Mediterranean region. These roads provided easy transport of people and items. Because of the well-built roads, people could get from Britain to Egypt in Just a couple of months, expediting the trading process. In addition to roads, aqueducts were also built to distribute water to the cities. Also, products could be transported y means of sea travel on ships to islands on the water. Lastly, bridges such as the Trajan Bridge in Britain, which spans 1,135 m(l), were built over rivers to even further improve transportation. Due to Roman developments, the Romans were able to expand their trading options substantially, and as a result, the economy was boosted as well. Now that the Romans were able to produce and distribute their items, all that was left was consumption. Because they could reach many different cultures within their system of roads, a wide variety of people lead to an increase of supply and demand. The Romans themselves were also consumers. Imports such as silks from China, cotton and spices from India, ivory and wild animals from Africa, large amounts of world were received by the Romans. In fact, There was no luxury that the ancient world had to offer that the Romans didnt accept themselves(Hardy). On the contrary, these luxuries were only financially available to the wealthy; so, those that were not as wealthy were not able to obtain these luxury imports. The action of obtaining such a large diversity of items from others proved to be helpful in the Roman Empire. Overall, the ancient Roman Empire had all of the key components of economic success. The Romans created a wide variety of items and goods, even creating their own currency system. The infrastructure they created gave them the advantage when it came to distributing product and transportation altogether. In addition, their central location in the large Mediterranean region allowed their range of distribution to be enormous thus, increasing consumption. With the three components of economics: production, distribution, and consumption, the Romans were able to create a superior empire that thrived economically.

The Absent Male In Little Women Essays - English-language Films

The Absent Male In Little Women Essays - English-language Films The Absent Male in Little Women "No gentlemen were admitted" writes Louisa May Alcott in Little Women to describe the all-female private revue the March sisters perform. And as the novel progresses, one cannot help but wonder if this same sentiment does indeed echo throughout the novel, as male characters are conspicuously absent while all the pivotal parts are played by the women characters. This gender imbalance in that there are more female characters than male in Little Women is especially obvious when male authority figures such as Mr March and Mr Lawrence are markedly absent for most of the novel. When they do appear, they are in need of love and care from the women. Mr Lawrence, who is nursing a broken heart over the death of his daughter, is healed by Beth's gentle manners, while Mr March's broken constitution is nursed back to health by his loving wife and daughters. The only male character who appears prominently in Little Women is Laurie, who, although the richest and most eligible bachelor for miles, is drawn to the motherly smile and warmth of the little cottage, despite the luxuries of his mansion next door. John Brooke, Laurie?s tutor and Meg?s husband, too, is drawn to the homey atmosphere of the March residence, having recently lost his mother. In a bold move that differentiates Alcott from her contemporaries, the male characters in Little Women are all not capable of providing sustenance to their womenfolk as they are incapacitated (either by a war injury, an emotional scar, or an impoverished background). The women are thus forced to take on varied roles in order to provide materially and emotionally for the family. They are the ones who shoulder the burden in situations not unlike those of the Alcott family. Is it by chance, or is premeditation, that most of Alcott?s novels feature an absent father? And when he does reappear, he is very often silent, ill or injured. It is obvious Alcott has problems portraying strong male characters, probably from the fact that she hadn?t seen too many of them. Furthermore, Alcott is not able to describe a situation where love is emoted expressively from men. In all her novels, the male characters disappoint in one way or the other. In many ways, they are very similar to her own father. Bronson Alcott was a man who preferred dreaming, shirking his fatherly and husbandly duties, and was prone to going on extended trips without his family. Bronson Alcott deserted his family for months at a time purportedly to earn a living. But he was not very successful in that area. Once he came back with a new scarf and a dollar in his pocket to a hungry family waiting for the money to buy some much needed bread. He handed over the token that he was paid to Alcott with the careless remark: ?Well, Louisa, there?s little money, but I had a great time and was asked to come again.? In Little Women, the appearance of these hapless males in search of a mother figure to comfort them celebrates the Good Mother, a role played by Marmee and her four daughters. The Good Mother figure, as explained by French feminist writer Helene Cixous in her manifesto The Laugh of the Medusa, is a woman who is an omnipotent, generous dispenser of love, nourishment and plenitute. And in a departure from the patriachal system that she grew up in, Alcott proclaims women as the source of life, power, energy and advice. In Good Wives (pages 211 - 213), Marmee says to Meg, beginning with: "May I speak quite freely, and will you remember that it's mother who blames as well as mother who sympathises?" before concluding with "Don't shut yourself up in a bandbox because you are a woman, but understand what is going on, and educate yourself to take your part in the world's work, for it all affects you and yours." Then later on in Good Wives (page 318), Jo exclaim about Marmee: "How goo! d she is to me! What do girls do who haven't any mothers to help them through their troubles?" Alcott's portrayal of a strong mother figure is no

Gallery review Essay Example | Topics and Well Written Essays - 500 words - 1

Gallery review - Essay Example The lady by his side is, on the other hand, has the hair well attended to and everything on her appears organized. The second picture in the same row indicates both the lady and the gentleman holding on their cheeks as they focus keenly on the object before them. In the second row, there is the side view of the same lady, but now with very thick layer of side beards and the beards are also all over her chin. The second picture in the row shows the front view of the same lady’s face with the hair still around it. In the last picture, in the row, both are shown, the lady right in front of the gentleman, the man also with visible changes on his face. The hair on his head remains intact, but the hair around his face on the cheeks and the chin are all shaved, and these spots remain clear save for the moustache. In the last row, the first and the second pictures both show the two in front of the machine-like object, now standing side by side and starring at it. Both still have the changes introduced in their faces. In these two pictures, the two interchange their positions. The writing below the exhibition reads, â€Å"†¦is a unique work that examines the boundary of what is typical† What seems to be exhibited is the work of facial hair transplant from a man to a woman. I tend to believe that the exhibition would want to display to the judgment of the viewers, if the transfer of some of the external features like the facial hair, from a man to a lady would really make a man appear like a woman and a woman like a man. In my view and judgment, this does not really happen. This is because despite the hair being introduced on to face of the lady, as evidenced in the middle row pictures; the lady still looks feminine while the man whose facial hair has been shaved still appears masculine in all manner of appearance. I think this exhibition informs the viewers that the question of femininity or masculinity is not all about the physical appearance, and I would

Film Analysis - The Pianist Essay Example | Topics and Well Written Essays - 1250 words

Film Analysis - The Pianist - Essay Example However, just before he is about to board, one of the Jewish guards pulls him out of line and inadvertently saves Szpilman’s life. Over the next few years, Szpilman goes from place to place while trying to avoid the German troops. He manages this successfully, although there are a few close calls. In one apartment where he was staying, Szpilman tipped over some plates, creating a loud bang. Immediately a neighbor was banging on the door and asking who was there. Once Szpilman opened the door, the woman asked for identification. We he could produce none, the woman started shouting that he was a Jew and that he needed to be caught. Szpilman managed to run down the stairs and get away as fast as possible. A little while later, a key turning point in the film began. The Polish Uprising began in August of 1944 and resulted in the last remaining Jews being executed. Szpilman is almost killed throughout this battle, but manages to stay alive. Once the Germans are mostly forced to lea ve the city, Szpilman is one of the few to still be living in the war-ruined city of Warsaw. Barely managing to stay alive, Szpilman attempts to find whatever food he can. As he is trying to open a can of pickles, a German captain, Wilm Hosenfeld, discovers Szpilman all alone. After a few short questions, Captain Hosenfeld asks Szpilman if what he does for a living. Szpilman responds that he was a pianist. To this, Captain Hosenfeld simply said, â€Å"A pianist. Come. Play.† Szpilman decides to play â€Å"Ballade in G-Minor, Op. 23† by Chopin. At the sound of this, Captain Hosenfeld felt touched enough to spare Szpilman’s life. This scene is one of the most impacting in the movie because it shows that even though two people may be at war, they can still see the goodness in each other. The filmmaker, Roman Polanski, is trying to show the Holocaust through the eyes of one man’s true story. Quite often Holocaust movies focus on the Jewish race as a whole, wh ich is fine, but it maybe not always the best way to represent the Holocaust. In looking at it from one person’s point of view, the audience is able to feel the emotions of the character and how stressful that time would have been. In the piano scene with the German captain, Polanski is trying to show that not all Germans are as evil as many people think. The stereotypical German of that day, and to some extent of the modern day, is one who is always yelling and putting other people down because of their race. This German Captain Hosenfeld gives the audience a side of a German war character that is, for some, not normal. In many Hollywood movies, Germans are always portrayed to be the bad guys. This is because, generally, many Americans of Jewish descent wield great power in high places and can thus get their views across easily. When Captain Hosenfeld asks Szpilman to play something on the piano, he is giving the Jew a chance to display his talents. Many people would have ex pected Szpilman to be shot instantly simply for the fact that he was Jewish, yet Captain Hosenfeld saw something in Szpilman that perhaps many others could never see. Once he began listening to the piano, Captain Hosenfeld was so captured by what he was hearing that he felt mercy for Szpilman and his situation. It could be that hearing the piano triggered something in Captain Hosenfeld’s memory. Maybe he had a happy memory of the piano as a child. The point is that Polanski is showing how

Analysis of Model of Service Delivery in Paediatric Care

Analysis of Model of Service Delivery in Paediatric Care Successful implementation of a paediatric community home nursing service as a model of service delivery in acute paediatric care Abstract Aim: The aim of this pilot service development was determine if CommunityChildrensNursingOutreach Team (CCNOT) service as a model of care was effective in its delivery of reducing unscheduled care and admissions to hospital and improving patient satisfaction. Methods: The following outcomes were determined:1)reducing length of hospital stay 2) reducing Accident and Emergency admissions 2)reducing non-elective admissions 3) reducing readmissions and 4)improving patient satisfaction. Results: The data indicates that AE attendances had reduced by 5% per month, NEL admissions had reduced by 15.8%, readmissions had reduced by 17.3% and the overall LOS was increased by 2.3%. The results of the patent satisfaction survey shows overall a high patient satisfaction for the service. Conclusions: Paediatric CCNOT service as a model of service delivery in acute paediatric care is effective in reducing hospital admissions and increases patient and carer satisfaction with care provision for sick children in the home environment. Key Phrases: Paediatric community home nursing service as a model of service delivery within acute paediatric care is effective in reducing AE admissions, non-elective admissions and readmissions. It significantly increases patient and carer satisfaction with care provision for sick children with appropriate conditions in the home environment. Paediatric community home nursing should be implemented with nurses trained in paediatrics and with clear clinical governance, pathways and robust documentation. Introduction Paediatric emergency admissions and length of stay in hospitals in the United Kingdom are increasing (Kyle et al. 2013). Community home nursing service or CommunityChildrensNursingOutreach Teams (CCNOTs) have been developed to manage acutely ill children athome, to reduce length on inpatient hospital stay andto reduce demand for unscheduled care (Hall et al. 2005). The CCNOT model of care has been shown in a previous randomised controlled trial comparing an acute paediatric hospital at home scheme with conventional hospital care as a clinically acceptable form of care for management of acute paediatric illness (Sartain et al. 2002). Referral pathways to CCNOTs may reduce avoidable admissions and minimise the psychosocial impact of hospitalisation on children and families, and reduce the financial costs to the National Health Service (NHS). Paediatricians and commissioners face considerable challenges in light of recent budget cuts in the NHS. Research undertaken by the University of Central Lancashire and the University of the West of England for the Department of Health described the importance of reliable, accessible expert community home nursing provision to families to enable them to care for their child at home and recorded the families’ deep frustration at the patchy, fragmented postcode lottery provision of services that currently exists (Department of Health 2011). Background Services that meet the needs of children and their families must continue to be provided in a safe, high quality and sustainable manner. In our desire to improve the quality of care in paediatric services in the face of rising public expectations, there is a need for change within new working hours and new ways of providing. The case for change can be complex, with decisions made to balance key areas of clinical effectiveness, best practice, patient safety, accessibility, staff retention and sustainability. The Royal College of Paediatrics and Child Health (RCPCH) recognises the importance of ensuring that services for children are designed to provide high quality care as close to home as possible and that such services need to adapt and respond to the demands and needs of the patient. The Colleges current work to model the future configuration of paediatric services discussed the move towards delivering acute care within the community such as community home nursing service (RCPCH 20 05). The aim of this pilot service development was determine if CCNOT service as a model of care was effective and efficient in its delivery of reducing unscheduled care and admissions to hospital and improving patient satisfaction. Methods Clinical Commissioning Groups (CCGs) are responsible for planning and designing of the local health services in England. Within a dual-site integrated care organisation Southport and Ormskirk NHS Trust, a pilot CCNOT service was developed in March 2013 following negotiations between the Trust and the CCGs in Sefton and Lancashire. The remit of the pilot service specification aims were to determine the effectiveness of CCNOT in the following outcomes 1) reducing length of hospital stay 2) reducing Accident and Emergency admissions 2) reducing non-elective admissions 3) reducing readmissions and 4) improving patient satisfaction. Funding was sought for 7.2 WTE paediatric trained nurses at band 5 to 6 and 0.5 WTE admin and Clerical support staff. CCNOT referrals were taken from accident and emergency, the short stay paediatric admissions unit (SSPAU), the inpatient ward and from the tertiary hospital Alder Hey Foundation Trust for patients residing in North Sefton, Formby and West Lancashire, which covers a population of approximately 300,000. Collaborations were made with Pharmacy, IT and specialist services to develop robust e-discharge summaries from the community and the ability for CCNOT to deliver three times daily intravenous antibiotics in patient’s homes 7 days a week. The service ran from 7am to 10pm seven days a week. It was also necessary to set up all the operational aspects of the team including admission criteria, clear clinical governance and pathways, robust documentation and purchasing necessary equipment. The service was managed overall by the Paediatric and Neonatal matron. The CCNOT was led by the paediatric matron with regular supervision and mentorship of a lead CCNOT Consultant Paediatrician. Clear clinical criterias for referrals made to CCNOT were developed and clinical pathways were followed to ensure that each referral pathway was safe and robust. (see Figure 1) Any referral was discussed with the CCNOT between a Registrar or a Consultant. Each diagnostic pathway was clearly followed by the CCNOT team with any deviation discussed with the lead Consultant Paediatrician. Daily handovers from the medical teams were attended by a lead CCNOT member of the day to ensure that any referrals made were handed over verbally and any potential referrals during the day were anticipated. The handovers were also an opportunity to discuss the progress of any patient who remained under the care of the CCNOT. A structured patient satisfaction questionnaire was conducted with participants who were referred to CCNOT at the time of discharge. Hospital admissions between April 1, 2012 and September 30, 2013 from the Hospital Episode Statistics (HES) were obtained. HES is the national administrative database for hospital activity in England and contains data on all inpatient admissions in the National Health Service. Results The data collected shows activity from April 2012 to September 2013. The results of the pilot service for 1) average length of hospital stay (LOS) 2) Accident and Emergency (AE) admissions 2) non-elective admissions (NEL) 3) and readmissions are summarised in Table 1 comparing the period before CCNOT was implemented (April to September 2012) and the period after CCNOT was implemented (April to September 2013), during the same months of the year. The data showed that there were 28.3% referrals made from AE, 38.7% from inpatient ward, 11% from SSPAU, 8.9% from outpatient clinics, 12.5% from the regional tertiary centre and 0.6% from another district general hospital. The data indicates that following the implementation of the pilot, AE attendances had reduced by 5% per month, NEL admissions had reduced by 15.8%, readmissions had reduced by 17.3% and the overall LOS was increased by 2.3%. Figure 2 shows that there has been a 5% reduction in AE attendances since the introduction of the CCNOT team. NEL admissions was reduced by 15.8% a shown and although the drop in AE attendances will be reflected in the reduction in non-elective admissions, this will only account for 5% of the over 15% reduction. The readmission rate has significantly reduced by 17.3% since CCNOT service was implemented. The sources of referral overall were 28.3% from AE, 38.7% from inpatient wards, 11% from SSPAU, 8.9% from outpatient clinics, 12.5% from the regional children’s centre and 0.6% from other district general hospitals out of area. Overall patient satisfaction was very high and the results are shown in Table 2. Discussion CCNOT pilot service had a positive impact on the performance of the paediatric department in reducing Accident and Emergency admissions, reducing non-elective admissions and reducing readmissions. It was noted that there was a very slight increase of LOS by 2.3% which were noted to be an average of 0.88 days compared to 0.9 days which were not significant. The CCNOT service also improved the patient and family experience considerably from the results of the patient satisfaction survey. The confidence in CCNOT’s competence to safely manage acutely ill children athomeand secure rapid referral to the medical team if a childs condition deteriorated were supported by clear clinical pathways and the regular supervision given by the matron and Consultant Paediatricians. The effectiveness of hometreatment were evident from the results of the patent satisfaction survey. The National Service Framework for Diabetes have advised clinicians and Trusts to achieve current targets by providin g high quality care with novel strategies. One instrument to meet these challenges is the development of a paediatric community home nursing service with CCNOT teams as a service model of care in acute paediatrics in the face of reconfiguration of paediatric services. We have shown in this pilot service that CCNOT has been highly successful in achieving the targets for reducing length of hospital stay, reducing hospital admission from accident and emergency and improving overall patient satisfaction. CCNOT service compared to inpatient hospital stay have been found to be acceptable and preferable to parents and children although there is limited evidence about the clinical and cost-effectiveness of paediatric home care (Sartain et al. 2001, Spiers et al. 2011,Bagust et al. 2002). Concerns have also been raised that children’s emergency admissions in England may indicate that parents often bypass primary care when seeking care for their acutely ill child, perhaps due to lack of availability of out of hours services within primary care (Gibson et al. 2010) The option of referral to CCNOT provides care to children at home by nurses with paediatric training, and has the potential to avoid some onward referrals and preventable admissions. The CC NOT service may be further expanded to provide support within primary care service, however, within the remit of our pilot service specification, the current funding is not sufficient to allow coverage for the populations of GP referrals unless the number of WTE staff is further increased. The relative success of our CCNOT in securing high referrals suggests that an incremental approach to encourage GP referrals is likely to result in increased GP referral rates. This development must be underpinned by financial and organisational investment. In light of modern NHS in England, and in similar health systems, it is generally agreed that the main focus of paediatric acute services should be the care and support of vulnerable children and young people in the community and as close to home as possible (RCPCH 2009). Financial and organisational investment in the development of CCNOT in acute care pathways are a prerequisite for the success describe in this pilot scheme. It is anticipated that in the future, paediatric services will be delivered by consultants leading a team of trained doctors, nurses and health care professionals working within a multi-disciplinary and skill-mixed team delivering care in the community. Pressures in delivering acute paediatric care also relates to changes in the way junior doctors are trained and the recent years application of European Working Time Regulations have required an increase in numbers of trained doctors to provide 24/7 cover in hospital. This increase has sometimes been at the expen se high vacancy rates for medical staff and in particular a national shortage of middle grade paediatric medical doctors is experienced across England, Scotland and Wales (Royal College of Paediatrics and Child Health 2011). There remains limited existing research on the cost effectiveness, development, design and distribution of CCNOT service across acute paediatric care in the UK. Conclusion Paediatric CCNOT service as a model of service delivery in in acute paediatric care is effective in reducing AE admissions, non-elective admissions and readmissions. It also significantly increases patient and carer satisfaction with care provision for sick children with appropriate conditions in the home environment. Our findings identify key factors that may inform the development of a CCNOT service in acute paediatric care to safely manage children at home. Relevance to clinical practice Delivering acute care within the community such as community home nursing service may reduce demand for unscheduled care and reduce the financial cost to the National Health Service in UK. Paediatric community home nursing service as a model of service delivery within acute paediatric care is effective in reducing AE admissions, non-elective admissions and readmissions. It significantly increases patient and carer satisfaction with care provision for sick children with appropriate conditions in the home environment. Paediatric community home nursing should be implemented with nurses trained in paediatrics and with clear clinical governance, pathways and robust documentation. References Bagust A, Haycox A, Sartain SA, Maxwell MJ, Todd P. Economic evaluation of an acute paediatric hospital at home clinical trial.Arch Dis Child.2002;87:489–492. Department of Health 2011; NHS at Home: Community Children’s Nursing Services. Gibson NP, Jelnek GA, Jiwa M, Lynch A-M. Paediatric frequent attenders at emergency departments: a linked-data population study.J Paediatr Child Heal.2010;46:723–728. Hall D, Sowden D. Primary care for children in the 21st century.BMJ.2005;330:430. Kyle RG,Banks M,Kirk S,Powell P,Callery P.Avoiding inappropriatepaediatricadmission: facilitating General Practitioner referral to Community Childrens Nursing Teams. BMC Family Practice2013 Jan 5;14:4 Sartain SA, Maxwell MJ, Todd PJ, Jones KH, Bagust A, Haycox A, Bundred P. Randomised controlled trial comparing an acute paediatric hospital at home scheme with conventional hospital care.Arch Dis Child.2002;87(5):371–375 Spiers G, Parker G, Gridley K, Atkin KP. The psychosocial experience of parents receiving care closer to home for their ill child.Health Soc Care Comm.2011;19(6):653–660 Supporting Paediatric Reconfiguration: A Framework for Standards RCPCH 2009 Sartain SA, Maxwell MJ, Todd PJ, Haycox AR, Bundred PE. Users’ views on hospital and home care for acute illness in childhood.Health Soc Care Comm.2001;9:108–117. Royal College of Paediatrics and Child Health 2011 Medical Workforce Census Table 1: Outcomes Table 2. Results of the patient experience survey Number of responses: 33 (54% return) Legends: Figure 1: Referral pathway to CCNOT service Figure 2: AE Attendances April 2012-September 2013

Free College Admissions Essays: An opinion I have had to defend :: College Admissions Essays

Tell us about an opinion you have had to defend Tell us about an opinion you have had to defend. How has this affected your belief system? I chuckle to myself every time I think about this. I am perceived as a mild-mannered, intelligent individual until I mention that I am involved in riflery. It is interesting to watch someone's expression change. It is as if I instantaneously grew a pair of horns and a sharp set of claws. Believe me this gets worse; I am a member of the NRA. I try to tell these folks that I belong to the NRA to fire my rifle. "Oh my God! You fire real guns? with real bullets?!?" they remark with a perplexed look on their face. Besides having horns and claws, I now possess a tail and leathery wings. This is how it began five years ago. I had played on a soccer team for several years. As I grew older I began having difficulty playing soccer because of shortness of breath. I was diagnosed as having mild asthma which ended my soccer career and eliminated my participation in most physical sports. Shortly afterward, during a Boy Scout summer camp, I participated in riflery at their shooting range. This was the first time I had ever touched a firearm. To my amazement, I won the camp's first place award for marksmanship. I was more than eager when a friend of mine asked me if I would like to join a shooting club. My parents were wary when I asked to join the rifle club. My mother feared guns, but my father felt there was no problem with trying this sport. Gratefully, he gave me the opportunity to try rifle marksmanship, despite secretly hoping that I would quit. Both of my parents were afraid of what people would think about their son's involvement with guns. Like my parents a majority of people believe that all firearms are dangerous to our society. All they remember are the hysterical news releases of street violence and injured children. I am often asked how many deer I've shot. Frankly, I could never bring myself to injure another living creature and neither would most of the competitors I have met. Yet, I keep finding myself defending the sport from all of the misconceptions that surround it.

Habeas-Corpus Essay

Habeas-corpus is a Latin term which literally means â€Å"you may have the body†. Under the law of England, as a result of long usage, the term came to signify a prerogative writ; a remedy with which a person unlawfully detained sought to be set at liberty. It is mentioned as early as the fourteenth century in England and was formalised in the Habeas-corpus Act of 1679. The privilege of the use of this writ was regarded as a foundation of human freedom and the British citizen insisted upon this privilege wherever he went whether for business or colonisation.This is how it found a place in the Constitution of the United States when the British colonies in America won their independence and established a new State under that Constitution. In India, under the Constitution, the power to issue a writ of habeas-corpus is vested only in the Supreme Court and the High Courts. The writ is a direction of the Court to a person who is detaining another, commanding him to bring the body of the person in his custody at a specified time to a specified place for a specified purpose.A writ of habeas-corpus has only one purpose: To set at liberty a person who is confined without legal justification: to secure release from confinement of a person unlawfully detained. The writ does not punish the wrongdoer. If the detention is proved unlawful, the person who secures liberty through the writ may proceed against the wrongdoer in any appropriate manner. The writ is issued not only against authorities of the State but also to private individuals or organizations if necessary.

What Makes A Good Communicator - 1970 Words

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