Case Study( Paramedics assessment) Essay Example | Topics and Well Written Essays - 2500 words

Case Study( Paramedics assessment) - Essay Example However, it should be realized that this is not the sole cause of chest pain, and that it may be due to â€Å"classical angina† (Devonshire Lodge Practice, 2011) whose symptoms generally appear during, or immediately after exercise and subside after resting. However, it must also be said that where someone complains of â€Å"discomfort across the center of the chest coming on during exercise that stops on rest and then GTN [glycerine trinitride] tablets relieve the pain within 5 minutes he/she is going to have ischemic heart disease almost without doubt† (Devonshire Lodge Practice, 2011). ... It is hoped that the task will be made easier by paramedic assessment, which should be thorough enough to eliminate many uncertainiies. That is why a systematic stepwise series of protocols such as those advocated by Domanovits et al. (2002) and Anderson (2002) is essential. 2. Case History of paramedic’s assessment of ischemic chest pain Complete History & Assessment of Patient Presenting Complaint Chest Pain Allergies None Communicable Diseases None PHx- Past History O/A – On Arrival O/E – On Examination Med’n- Medication Patient’s Name: William Templeton: Age 57 Address: 12 Andover Terrace, STAINES Bucks. SL4 3TR O/A - Emergency services called by patient’s family at 0956 hrs, arrived at patient’s home 1015 hrs..William, a white male, complained of severe chest pain, breathlessness, nausea and dizziness. He also appeared pale and slightly sweaty. PHx – Patient was normally in good health, a non-smoker, moderate drinker and at e healthy meals at home. He also took regular exercise. His grandfather had been gassed in WWI and his grandmother had suffered intermittent asthma attacks in her later years. As to childhood illnesses, William reported German measles, two bouts of chicken pox, and tuberculosis at the age of 6, which had affected stomach and neck glands and also the lungs. Chicken pox and TB raised alarm signals since the former could have returned as shingles (pain comes some time before the rash, and lung damage may have contributed to ischemic heart disease. O/E – The assessment procedures followed the guidelines established by the York Region Base Hospital Program (Anderson, 2002). For clarity and consistency during patient questioning the following mnemonic

Abraham Lincoln and the Self-Made Myth Essay Example for Free

Abraham Lincoln and the Self-Made Myth Essay An ambitious ascent from a poor Illinois farm boy to occupying the highest political office during one of Americas most turbulent times makes for the literature of hero worship. In the essay entitled Abraham Lincoln the self-made myth Rich Hofstadter challenges the reader to penetrate beneath the surface of the American political tradions and investigate the event and actions that contributed to the Lincoln Myth. To begin with Hofstadter states that one of Lincolnà ¢Ã¢â€š ¬Ã¢â€ž ¢s most endearing qualisties to Americans was his humble origins and the fact that, à ¢Ã¢â€š ¬Ã…“Lincoln was a preeminent example of that self-help which Americans have always so admired,à ¢Ã¢â€š ¬Ã‚  (121). But he further goes on to state that Lincoln used this to his advantage. First in his campaign speeches always eluding to himself as humble Abraham Lincoln and in the way he addressed his own wife in public as à ¢Ã¢â€š ¬Ã…“motherà ¢Ã¢â€š ¬Ã‚  (122). See more: Foot Binding In China essay He received distinguished guests in shirtsleeves, and once during his presidency hailed a soldier out of the ranks with the cry, à ¢Ã¢â€š ¬Ã…“Bub! Bub!à ¢Ã¢â€š ¬Ã‚  The concept of the self-made, simple man played well with the American public thus became à ¢Ã¢â€š ¬Ã…“fully absorbed into his political being,à ¢Ã¢â€š ¬Ã‚  (124). Historical novels and fictionalized biographies about Lincoln would be amiss of the greater portion of its contents were not dedicated to the slavery issue. Many only give, à ¢Ã¢â€š ¬Ã…“a tiresome celebration of the America past with a progressive interpretation of American history of her-worship and national self-congratulation,à ¢Ã¢â€š ¬Ã‚  (Forward 2). In Hostadterà ¢Ã¢â€š ¬Ã¢â€ž ¢s essay he discusses the slavery issue not with a sentimental approach but with critical analysis. Lincoln was a Southerner by birth. He grew up in communities in Illinois where slavery was rare. Laws against runaway slaves were in force when Lincoln served in the s tate legislature. It was here that Lincoln made his first public statement on slavery by voting against a proslavery resolution.

Social Conformity Essay -- essays research papers

Human beings are defined as ''social animals'' because in every aspects of life they live together, they form a variety of groups and improve relationships with each other. Interaction with others is a natural result of living in society. In the process of interaction, society and its rules has a social impact on each individual. If people face with any kind of social impact such as group pressure, great part of them show conformity by changing their behaviors, ideas, decisions in expected way. A person conforms if he or she chooses a course of action that a majority favors or that is socially acceptable. Some kind of conformity is natural and socially healthy but obeying all the norms, ideas, and decisions without thinking or accepting is harmful for the society and its democratic norms....

Black Theology & Black Power According to James H. Cone Essay -- Black

I believe the best place to start this essay would be with an explanation of Black Power. Black Power according to James H. Cone â€Å"is an emotionally charged term that can evoke either angry rejection or passionate acceptance.† Critics see it as blacks hating whites, while advocates see Black Power as the only viable option for black people. Advocates see Black Power meaning black people are taking a dominate role in deciding what the black-white relationship should be in American Society. Rev. Jeremiah Wright, Jr. is preaching this right now. He sees that blacks need to go back to their blackness and no longer live their lives as the white society wants them to. What these two men are encouraging can be very difficult for most people to understand. Most of us see this as a call to violence. What Cone is really saying is that Black Power means the complete emancipation of black people from white oppression by whatever means black people deem necessary. The methods to reach this can include selective buying, boycotting, marching, and even rebellion. Black Power means black freedom, black self-determination, where black people no longer see themselves as without human dignity, but as people, human beings with the ability to carve out their own destiny. Paul Tillich’s analysis of â€Å"the courage to be† further clarifies the meaning of Black Power. He says that â€Å"the courage to be† â€Å"is the ethical act in which man affirms his being in spite of those elements of his existence which conflict with his essential self-affirmation† Black Power is then a humanizing force because it the black man’s attempt to be recognized as a â€Å"thou† in spite of the â€Å"other,† the white power which dehumanizes him. The courage they feel gives them the... ... What it really means is that your heart, your soul, your mind, and your body are where the dispossessed are. Your mind, soul, and heart need to be reconciled to God. Cone ends his book, Black Theology & Black Power with this thought, â€Å"The real questions are: Where is your identity? Where is your being? Does it lie with the oppressed blacks or with the oppressors? Let us hope that there are enough to answer this question correctly so that America will not be compelled to acknowledge a common humanity by see that blood is always one color.† We need to put aside our pasts and try to find the common ground we share in Christ and become reconciled to each other that neither black or white is superior, but we are just the same in God’s eyes and we all bleed in the same color. Work Cited James H. Cone . "Black Theology and Black Power" Orbis Books, 1997

Caltron Inc

Over the past ten years the importance of accounting cannot be overemphasized, as we've seen our share of national scandals. In today's society accounting principles and standards are severely important in driving the formation of financial statements. Without principles and standards, financial reporting would not fairly present the financial position of a company. Accounting has changed and evolved vastly over time and continues to change.Because of this I am going to breakdown the way your financial reporting team has been recognizing revenue for the fourth quarter of the current year and assess the implications it may have on your financial statements. I will also take you through the process of how the accounting standards are created to give you a better understanding of what my conclusion is. Revenue Recognition Implications As you know Caltron Computers, Inc. s a publicly held company with a total market capitalization in excess of $450 million, and you have a proposed second ary public stock offering coming in early February 20X2. Therefore the auditors are concerned about the impact of these transactions and want to bring it to your attention before it misrepresents the reported earnings. Caltron reported net revenues from four transactions equal to $1,710,000 in Q4, while cash received only totaled $495,000.The quality of earnings issue surfaces and gives the auditors reasons to question the accounting methods and possibly their honesty and ethics. The company policy for recognizing revenue is when the products are shipped, and because of this, a potential issue has come about relating to some of the transactions. Typically revenues are earned when the earning process is complete and an exchange has taken place. Once this happens the risks of ownership are transferred to the buyer, unless an arrangement for the sale states otherwise.Collectibility of the sales price is questionable for three of these transactions. According to FASB, revenue generally is realized or realizable and earned when all of the following criteria are met: persuasive evidence of an arrangement exists, delivery has occurred or services have been rendered, the seller's price to the buyer is fixed or determinable, and collectibility is reasonably assured. (FASB, 2008) Now I will follow this with a breakdown of all the

Deudas, mal crédito, bancarrota y efectos migratorios

Deudas, mal crà ©dito, bancarrota y efectos migratorios Al iniciar un trmite migratorio como, por ejemplo, una peticià ³n de familiar o naturalizacià ³n para obtener la ciudadanà ­a americana es comà ºn preguntarse si las deudas pendientes, un mal crà ©dito o la bancarrota  pueden afectar negativamente a la solicitud. La razà ³n de esa preocupacià ³n nace, por una parte, del requisito de tener una situacià ³n situacià ³n econà ³mica saneada para solicitar ciertos beneficios migratorios, como por ejemplo la peticià ³n de cà ³nyuge, hijos, hermanos o padres y, por otro, porque cierto tipo de deudas impide que salgan adelante peticiones migratorias.   Por su importancia, en este artà ­culo se explica en quà © casos y  cà ³mo esas situaciones pueden afectar a los casos migratorios, destacando en primer lugar cuando son irrelevantes y, en segundo lugar, cuando sà ­ se tienen en cuenta a la hora de decidir si se aprueba o no una peticià ³n migratoria. Adems, se seà ±alan quà © beneficios recibidos del gobierno se consideran carga pà ºblica y, por lo tanto, afectan negativamente y, por otro lado, cules se pueden recibir sin problemas porque no tienen consecuencias migratorias. Casos en los que las deudas y mal crà ©dito no tienen consecuencias migratorias Si se tiene una deuda por no pagar, por ejemplo, a la compaà ±Ãƒ ­a de telà ©fono, una deuda privada, la factura de un mà ©dico, etc, no tiene generalmente efectos ni consulares ni migratorios negativas. Es decir, no afecta a lo que se resuelve con respecto a la peticià ³n. Y ello es asà ­ porque se considera que son asuntos civiles. Lo mismo sucede con el mal crà ©dito. En el caso de peticiones para un familiar de la tarjeta de residencia permanente, tambià ©n conocida como  green card,  lo que importa es que el solicitante tenga ingresos y/o patrimonio  suficientes y demostrables para cubrir las obligaciones del affidavit of support, tambià ©n conocido como declaracià ³n de sostenimiento. Si tiene mal crà ©dito o deuda pendiente, es irrelevante. Casos en los que las malas finanzas sà ­ tienen efectos migratorios Cuando la deuda se convierte en un asunto penal, como por ejemplo, en una estafa u otros semejantes entonces sà ­ que tiene efectos migratorios y puede ser causa para que nieguen visas, peticiones de residencia permanente o de ciudadanà ­a por naturalizacià ³n. Tambià ©n puede ser una causa para que se impida en el control de paso migratorio  el ingreso a Estados Unidos de un extranjero. Si la deuda es con la Hacienda de Estados Unidos (IRS), tambià ©n es un problema que hay que resolver antes de iniciar los trmites con inmigracià ³n o los consulados. Si la deuda es mà ©dica y el importe de la factura lo pagà ³ Medicaid, tambià ©n puede ser muy problemtico si se considera que fue un caso de carga pà ºblica. Por ejemplo, si una mujer extranjera tiene a un bebà © en Estados Unidos y no paga por el parto y luego se regresa a su paà ­s, tanto esa mam como el pap el bebà © pueden perder la visa de turista. Con el agravante de que no hay forma de salirse de este problema en concreto. Si se trata de una deuda por no pagar pensià ³n alimenticia (child support), segà ºn las circunstancias del caso puede tener como consecuencia que no se pueden obtener visas americanas, ni la residencia permanente y la ciudadanà ­a por naturalizacià ³n. Y, en casos extremos, puede dar lugar incluso a la deportacià ³n. Incluso, dependiendo del monto de la deuda, los ciudadanos americanos pueden encontrase con que no pueden sacar el pasaporte y, por lo tanto, no pueden viajar internacionalmente. Destacar que el child support puede ser solicitado no sà ³lo para nià ±os que viven en Estados Unidos sino tambià ©n en el caso de residir en otros paà ­ses cuando tienen a al menos el padre o la madre viviendo en Estados Unidos. En estos casos, tener en cuenta que  la Embajada americana en el paà ­s de residencia del menor no puede ayudar en estos casos. La razà ³n es que este es un tema de los estados,  no del gobierno federal. Algunos paà ­ses, como  Mà ©xico, tienen firmados acuerdos de reclamo de pensià ³n alimenticia con varios estados.  En los casos en los que no hay tales acuerdos y se desea exigir el pago de dicha pensià ³n, contactar con la agencia de  child support  del estado en el que vive el pap o la mam. O contratar a un  abogado en dicho estado. Adems, tener en cuenta que el tener un pap que es estadounidense  no da automticamente derecho a adquirir la ciudadanà ­a americana  cuando se nace fuera de los Estados Unidos. Adems  que en el caso de reclamar pensiones de alimentos en el caso de nià ±os nacidos fuera de matrimonio primero es necesario  establecer legalmente la filiacià ³n. Quà © beneficios son considerados como una carga pà ºblica Uno de los requisitos legales para ser admisible a los Estados Unidos es no ser considerado una carga pà ºblica. Y es que por esta causa se pueden negar un amplio abanico de peticiones o solicitudes migratorias como, por ejemplo, una  visa no inmigrante o una visa inmigrante o el ajuste de Estatus o para adquirir la ciudadanà ­a por naturalizacià ³n. Se considera que es una carga pà ºblica haber recibido del gobierno beneficios monetarios como, por ejemplo, el Suplemento de Ingresos de Seguridad (SSI, por sus siglas en inglà ©s), o Asistencia Temporal a Familias en Necesidad  (TANF, por sus siglas en inglà ©s). Destacar que estos beneficios pueden recibir otros nombres dependiendo del estado. Por ejemplo,   en California al programa TANF se le conoce como CalWorks. Finalmente, tener en cuenta que la regla general sobre los efectos migratorios de recibir beneficios considerados como carga pà ºblica tiene importantes excepciones. Por ejemplo, asilados y refugiados pueden recibir TANF y SSI sin problemas. Quà © beneficios no se consideran carga pà ºblica Se puede recibir del gobierno sin problemas WIC para infantes y embarazadas, cupones o estampillas de alimentos, que en California reciben el nombre de Calfresh. Asimismo, se puede aceptar ayuda a la vivienda o para guarderà ­as, Headstar o Medicaid para menores. En otras palabras, recibir este tipo de  beneficios no perjudica a peticiones o solicitudes migratorias que se realicen despuà ©s. Quà © hacer si se tiene una deuda con posibles consecuencias migratorias Si se tienen dudas sobre si una deuda puede afectar negativamente a una peticià ³n migratoria, antes de presentarla es recomendable contactar con un abogado de buena reputacià ³n o con una organizacià ³n de apoyo legal a migrantes para determinar si realmente tiene impacto migratorio y, en caso afirmativo, decidir quà © pasos tomar.   Generalmente en estos casos, lo ms recomendable es contactar con la agencia encargada del cobro de la deuda (collection agency  en inglà ©s) e intentar llegar a un acuerdo sobre la cantidad a pagar y los plazos para hacerlo. Este es un artà ­culo informativo. No es asesorà ­a legal.

Richard Ewell - Civil War - Lieutenant General - Army of Northern Virginia

Richard Ewell - Civil War - Lieutenant General - Army of Northern Virginia Richard Ewell - Early Life Career: The grandson of the first US Secretary of the Navy, Benjamin Stoddert, Richard Stoddert Ewell was born in Georgetown, DC on February 8, 1817. Raised in nearby Manassas, VA by his parents, Dr. Thomas and Elizabeth Ewell, he received his initial education locally before electing to embark on a military career. Applying to West Point, he was accepted and entered the academy in 1836. An above average student, Ewell graduated in 1840 ranked thirteenth in a class of forty-two. Commissioned as a second lieutenant, he received orders to join the 1st US Dragoons which were operating on the frontier. In this role, Ewell assisted in escorting wagon trains of traders and settlers on the Santa Fe and Oregon Trails while also learning his trade from luminaries such as Colonel Stephen W. Kearny. Richard Ewell - Mexican-American War: Promoted to first lieutenant in 1845, Ewell remained on the frontier until the outbreak of the Mexican-American War the following year. Assigned to Major General Winfield Scotts army in 1847, he took part in the campaign against Mexico City. Serving in Captain Philip Kearnys company of the 1st Dragoons, Ewell took part in operations against Veracruz and Cerro Gordo. In late August, Ewell received a brevet promotion to captain for his heroic service during the battles of Contreras and Churubusco. With the end of the war, he returned north and served at Baltimore, MD. Promoted to the permanent grade of captain in 1849, Ewell received orders for the New Mexico Territory the following year. There he conducted operations against the Native Americans as well as explored the newly-acquired Gadsen Purchase. Later given command of Fort Buchanan, Ewell applied for sick leave in late 1860 and returned east in January 1861. Richard Ewell - The Civil War Begins: Ewell was recuperating in Virginia when the Civil War began in April 1861. With the secession of Virginia, he resolved to leave the US Army and seek employment in the Southern service. Formally resigning on May 7, Ewell accepted an appointment as a colonel of cavalry in the Virginia Provisional Army. On May 31, he was slightly wounded during a skirmish with Union forces near Fairfax Court House. Recovering, Ewell accepted a commission as a brigadier general in the Confederate Army on June 17. Given a brigade in Brigadier General P.G.T. Beauregards Army of the Potomac, he was present a the First Battle of Bull Run on July 21, but saw little action as his men were tasked with guarding Union Mills Ford. Promoted to major general on January 24, 1862, Ewell received orders later that spring to take command of a division in Major General Thomas Stonewall Jacksons army in the Shenandoah Valley. Richard Ewell - Campaigning in the Valley Peninsula: Joining Jackson, Ewell played key roles in a string of surprising victories over superior Union forces led by Major Generals John C. Frà ©mont, Nathaniel P. Banks, and James Shields. In June, Jackson and Ewell departed the Valley with orders to join General Robert E. Lees army on the Peninsula for an attack on Major General George B. McClellans Army of the Potomac. During the resulting Seven Days Battles, he took part in the fighting at Gaines Mill and Malvern Hill. With McClellan contained on the Peninsula, Lee directed Jackson to move north to deal with Major General John Popes newly-formed Army of Virginia. Advancing, Jackson and Ewell defeated a force led by Banks at Cedar Mountain on August 9. Later in the month, they engaged Pope in the Second Battle of Manassas. As the fighting raged on August 29, Ewell had his left leg shattered by a bullet near Brawners Farm. Taken from the field, the leg was amputated below the knee. Richard Ewell - Failure at Gettysburg: Nursed by his first cousin, Lizinka Campbell Brown, Ewell took ten months to recover from the wound. During this time, the two developed a romantic relationship and were wed in late May 1863. Rejoining Lees army, which had just won a stunning victory at Chancellorsville, Ewell was promoted to lieutenant general on May 23. As Jackson had been wounded in the fighting and subsequently died, his corps was divided in two. While Ewell received command of the new Second Corps, Lieutenant General A.P. Hill took command of the newly-created Third Corps. As Lee began moving north, Ewell captured the Union garrison at Winchester, VA before driving into Pennsylvania. The lead elements of his corps were nearing the state capital of Harrisburg when Lee ordered him to move south to concentrate at Gettysburg. Approaching the town from the north on July 1, Ewells men overwhelmed Major General Oliver O. Howards XI Corps and elements of Major General Abner Doubledays I Corps. As Union forces fell back and concentrated on Cemetery Hill, Lee sent orders to Ewell stating that he was to carry the hill occupied by the enemy, if he found it practicable, but to avoid a general engagement until the arrival of the other divisions of the army. While Ewell had thrived under Jacksons command earlier in the war, his success had come when his superior had issued specific and precise orders. This approach was counter to Lees style as the Confederate commander typically issued discretionary orders and relied on his subordinates to take the initiative. This had worked well with the bold Jackson and the First Corps commander, Lieutenant General James Longstreet, but left Ewell in a quandary. With his men tired and lacking room to re-form, he asked for reinforcements from Hills corps. This request was refused. Receiving word that Union reinforcements were arriving in large numbers on his left flank, Ewell decided against attacking. He was supported in this decision by his s ubordinates, including Major General Jubal Early. This decision, as well as Ewells failure to occupy nearby Culps Hill, were later severely criticized and blamed in causing the Confederate defeat. After the war, many argued that Jackson would not have hesitated and would have captured both hills. Over the next two days, Ewells men mounted attacks against both Cemetery and Culps Hill but with no success as Union troops had time to fortify their positions. In the fighting on July 3, he was hit in his wooden leg and slightly wounded. As Confederate forces retreated south after the defeat, Ewell was wounded again near Kellys Ford, VA. Though Ewell led Second Corps during the Bristoe Campaign that fall, he later fell ill and turned command over to Early for the subsequent Mine Run Campaign. Richard Ewell - The Overland Campaign: With the beginning of Lieutenant General Ulysses S. Grants Overland Campaign in May 1864, Ewell returned to his command and engaged Union forces during the Battle of the Wilderness. Performing well, he held the line at Saunders Field and later in the battle had Brigadier General John B. Gordon mount a successful flank attack on the Union VI Corps. Ewells actions at the Wilderness were quickly offset several days later when he lost his composure during the Battle of Spotsylvania Court House. Tasked with defending the Mule Shoe salient, his corps was overrun on May 12 by a massive Union assault. Striking his retreating men with his sword, Ewell desperately attempted to get them to return to the front. Witnessing this behavior, Lee interceded, berated Ewell, and took personal command of the situation. Ewell later resumed his post and fought a bloody reconnaissance in force at the Harris Farm on May 19. Moving south to the North Anna, Ewells performance continued to suffer. Believing the Second Corps commander to be exhausted and suffering from his previous wounds, Lee relieved Ewell shortly thereafter and directed him to assume oversight of the Richmond defenses. From this post, he supported Lees operations during the Siege of Petersburg (June 9, 1864 to April 2, 1865). During this period, Ewells troops manned the citys entrenchments and defeated Union diversionary efforts such as attacks at Deep Bottom and Chaffins Farm. With the fall of Petersburg on April 3, Ewell was forced to abandon Richmond and Confederate forces began retreating west. Engaged at Saylers Creek on April 6 by Union forces led by Major General Philip Sheridan, Ewell and his men were defeated and he was captured. Richard Ewell - Later Life: Transported to Fort Warren in Boston Harbor, Ewell remained a Union prisoner until July 1865. Paroled, he retired to his wifes farm near Spring Hill, TN. A local notable, he served on the boards of several community organizations and also managed a successful cotton plantation in Mississippi. Contracting pneumonia in January 1872, Ewell and his wife soon became gravely ill. Lizinka died on January 22 and was followed by her husband three days later. Both were buried in Nashvilles Old City Cemetery. Selected Sources Civil War Trust: Richard EwellCivil War: Richard Ewell HistoryNet: Richard Ewell at Gettysburg