Explain the importance of monitoring plateau pressures and its use in calculating static compliance

Learning Objectives Covered:
1. Explain the importance of monitoring plateau pressures and its use in calculating static compliance
2. Explain the use of volume-controlled ventilation and pressure-controlled ventilation
3. List and describe ventilatory support treatment plans for patient’s based on their clinical diagnosis
Background
Compliance is a measurement of the distensibility of the lung or the ability of the lung to distend. It is expressed as a change in volume divided by a change in pressure using the standard units of Liters/cmH20. The normal lung + thorax compliance of an adult is around 0.1 L/cmH20. When the compliance is low, more pressure will be needed to deliver a given volume of gas to a patient. Diseases that cause low lung compliance are classified as restrictive diseases and include Adult Respiratory Distress Syndrome (ARDS), pulmonary edema, pneumonectomy, pleural effusion, pulmonary fibrosis, and pneumonia among others. Emphysema is a typical cause of increased lung compliance.
When measuring lung compliance one must know the delivered tidal volume and must also know the change in alveolar pressure that results from the addition of that known tidal volume. Alveolar pressure is the pressure in the distensible parts of the respiratory tract and is determined by the tidal volume and the lung/chest compliance. Airway pressure is the pressure measured at the patient’s airway during mechanical ventilation. Airway pressure is equal to alveolar pressure when there is no occurrence of airflow. At the end of a mechanical inspiration, flow to the distal parts of the lungs continues even after inspiratory flow from the ventilator stops, as time is required for gas to reach the periphery of the lung. To measure alveolar pressure, one must measure the airway pressure at a time when both pressures are equal, i.e. when there is no flow.
We normally assume that alveolar and airway pressure starts out at atmospheric (our zero reference) before an inspiration starts. To equalize airway and alveolar pressures, we only have to prevent exhalation after inspiration has ceased by utilizing an inspiratory hold maneuver. The actual calculation is to divide the delivered tidal volume by the plateau pressure where the plateau pressure is the steady-state pressure measured during an inspiratory hold maneuver. Since approximate values are adequate for clinical use, clinicians use the plateau pressure minus the end expiratory pressure that is then divided into the exhaled tidal volume as measured by the ventilator. This compliance measurement is referred to as static compliance since it is measured after an inspiratory hold and there is no gas flow during its measurement.
Cstatic =                    exhaled VT (ml)                                    Pplat (cmH2O) – PEEP (cmH2O)
Where:
VT – Tidal Volume
Pplat = Plateau Pressure
A spontaneously breathing person has a normal compliance of approximately 100mL/cmH2O. In intubated patients, normal compliance is approximately 50mL/cmH2O.
Volume Control Ventilation is a type of ventilation in which a clinician sets a constant preset volume that is delivered to the patient’s lungs. In order for volume to remain constant with each breath, if compliance or airway resistance is changed then the ventilator changes the amount of pressure needed to deliver the breath. In other words, pressure will adjust to ensure that the preset tidal volume is delivered. For example, a patient receiving mechanical ventilation has developed congestive heart failure. Congestive heart failure is a restrictive disorder that results in pulmonary edema filling the interstitial spaces of the lungs. The edema makes inflating the lungs difficult. Since the ventilator is set to deliver a specific tidal volume, the pressure needed to deliver the tidal volume will be increased because the pressure needed to overcome elastic compliance is increased. Using excessive pressures to deliver ventilatory support increases the risk of injury to the lungs. This type of injury an is referred to as barotrauma. Barotrauma is injury to the lungs as a result of pressure changes. A specific type of injury that commonly occurs during delivery of mechanical ventilation is a pneumothorax, which is a rupture of one or both lungs.
The pressure used to overcome both elastic compliance (of the lungs and chest wall) and airflow resistance of the airways is referred to as the Peak Inspiratory Pressure (PIP or Ppeak). Peak inspiratory pressure is the maximum pressure in the circuit reached during delivery of a mandatory breath from a ventilator. Therefore, if volume remains constant then pressure must be adjusted to ensure that the set tidal volume is delivered despite any changes that occur in the lungs. The advantage of volume control ventilation is that alveolar ventilation remains constant so PaCO2 is not affected. During volume control ventilation, a minimum minute ventilation can be guaranteed which is useful when stabilizing ventilation.
Pressure Control Ventilation is a type of ventilation in which the ventilator delivers an inspiration until a preset pressure is reached. During pressure control ventilation, pressure is limited and if the compliance or airway resistance is changed then the volume of air delivered is changed. In other words, the preset pressure will not be exceeded but the tidal volume will change depending on changes that occur in the lungs. Take for example a patient who has developed secretions in the airway. Secretions accumulate in the airways and cause airflow resistance. The more airflow resistance that is encountered on inspiration the more pressure that is needed to overcome the obstruction. Think of pressure as a driving force. Inspiratory pressure overcomes the resistance and compliance of the lungs to inflate the lungs so the lungs can be filled with air. However, in pressure control ventilation the delivered pressure is limited. Once the set pressure is reached inspiration is terminated. This may result in the lungs may not being fully inflated which means less air delivered to the lungs with smaller tidal volumes. The more airway resistance affecting the lungs the less volume of air will be delivered. The same works for compliance. The lower the compliance (stiffer lungs) the less volume of air will be delivered.
Prompt
For this assignment, you will provide detailed responses to the following questions.
Be sure to review the link below regarding Calculations Commonly Performed in Respiratory Care
RT Equations
1. Describe the difference between dynamic compliance and static compliance. What useful information do we receive by monitoring dynamic compliance? What useful information do we receive by monitoring static compliance?
2. Calculate compliance given Vt = 500 ml, Peak airway pressure = 30 cmH2O, Plateau pressure= 25 cmH20, PEEP = 10 cmH2O.
3. Calculate static and dynamic compliance given Vt = 760 ml, Peak airway pressure = 38 cmH2O, Plateau pressure= 33 cmH20, PEEP = 7 cmH20.
4. Calculate static and dynamic compliance on a patient who is on a volume ventilator and has the following measurements: Tidal Volume = 780 ml, Peak Airway Pressure = 45 cmH20, Plateau pressure 40 cmH2O,  PEEP = 10 cmH2O.
5. Calculate static and dynamic compliance: Tidal Volume 800 ml, Peak Airway Pressure 20 cmH2O, Peak Inspiratory Pressure 30 cmH2O, Plateau pressure 35 cmH2O, Peep 10 cmH2O.
6. Explain permissive hypercapnia and why this strategy is used for ventilating COPD patients in acute respiratory failure.
7. What is the recommended strategy for ventilating patients with ARDS?
8. What is the recommended strategy for ventilating patients with traumatic brain injury?
Submit your answers in at least 500 words on a Word document. You must cite at least three references to defend and support your position.

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discuss your experience in the self-help simulation this week

Psychology homework help
Journal on group simulation
In 450-500 words, discuss your experience in the self-help simulation this week. If you facilitated this week, discuss what you liked, disliked, learned, and felt. If you were a group member, discuss what it was like trying to change your identified behavior. Include any internal struggles with changing your behavior. Also discuss what you liked, disliked, or learned from the facilitator’s approach. You do not need to use APA style, but I will score on grammar and mechanics

I am the facilitator during this power point. We met to discuss the power point and who was going to do what. We also research for the presentation and got information. A lot of communication went on for this power point and as a team communication plays a big part with our team because we all work and have different schedules and some of us are married meaning that we can only meet during certain hours. We did our first group meeting at UOP and also through text and emails.

We talked about the high and lows that a person goes through, although that seems funny the high from cocaine is an all time high but the low is in fact so low it can deteriorate your life and kill you. What stood out to me is how common this drug is used and it come to no surprise because I’m aware of what it does to the user and also how it destroys families, but the negatives do not seem to out weigh the positives with this drug. During our meeting we talked about how famous people such as Tim Allen, Whitney Houston, Thomas Edison, Chris Farley, Len Bias and the list goes on all had deaths relating to cocaine use. Not only were they effected but also their family and we saw Whitney’s daughter fall in the same footsteps of her mother and even died of a drug overdose. Cocaine use is also more common and how its portrayed in movies, to music, and how frequently you see celebrities busted with it I feel it is becoming almost socially acceptable and this is a problem.

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If you were the CEO of a United States based Managed Care Organization that wished to open or operate abroad, what types of services would you want to offer, how would you offer them, and why

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Nursing homework help

Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.
Mr. B, a 70-year-old male client, presented to his primary care physician with complaints of blurred vision and headaches over the last two months. On several visits, Mr. B’s blood pressure was found to be elevated, so the physician started him on hydrochlorothiazide 25 mg by mouth daily. One month later, Mr. B began to have chest pains and shortness of breath, so his primary care provider referred Mr. B to a cardiologist for further evaluation.
The cardiologist ordered an echocardiogram and stress test which revealed heart enlargement and a reduced ejection fraction (volume of blood pumped out of the heart per minute). As a result, the cardiologist started Mr. B on a beta-blocker (metoprolol 25 mg by mouth daily).
A few days after taking the new medication (in addition to the hydrochlorothiazide ordered by the primary physician), Mr. B suffered a fall at home. Upon arrival at the emergency room, Mr. B’s blood pressure was 80/50. The emergency room physician suspected the cause of Mr. B’s fall was hypotension secondary to the medications he was taking. The ER physician recommended that Mr. B follow up with his primary care physician and cardiologist, but hold the medication until seen by them.
As recommended, Mr. B visits his primary care physician for a follow-up. During the visit, Mr. B’s blood pressure is found to be elevated (160/90), so his physician tells Mr. B to restart taking his blood pressure medication.
Imagine that you are the nurse attending to Mr. B and that he indicates that he’s afraid to restart the medication because of his recent fall.
1. What considerations/actions should the nurse make regarding the client’s refusal to restart his blood pressure medication?
2. What considerations/actions would have helped the healthcare team to prevent the client’s fall?

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Nursing homework help

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.
When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.
Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.
To Prepare
· Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
· Reflect on situations in which children should be prescribed drugs for off-label use.
· Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.
Write a 1-page narrative in APA format that addresses the following:
· Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
· Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.
Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
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SPECIFY COMMON LAW QUALITY INITIATIVES THAT ARE STILL FOUND IN 21ST CENTURY HEALTHCARE ORGANIZATIONS.

Pre-Built Course Content
If you are using the Blackboard Mobile Learn iOS App, please click “View in Browser”
Click the link above to submit your assignment.
Students, please view the “Submit a Clickable Rubric Assignment” in the Student Center.
Instructors, training on how to grade is within the Instructor Center.
Assignment 3: Healthcare Quality
Due Week 6 and worth 200 points
Assume that you are a Quality Officer who is responsible for one of the state’s largest healthcare organizations. You have been told that the quality of patient care has decreased, and you have been assigned a project that is geared toward increasing quality of care for the patients. Your Chief Executive Officer has requested a six to eight-page summary of your recommended initiatives.
Note: You may create and /or make all necessary assumptions needed for the completion of this assignment.
Write a 6 page paper in which you:

Analyze three (3) quality initiatives for your organization.
Determine the supporting factors that would aid in the reduction of healthcare cost in your organization without reducing quality of care for the patients.
Differentiate between quality in a free market healthcare system and in single payer government system with three (3) examples for each.
Specify three (3) common law quality initiatives that are still found in 21st century healthcare organizations.
Defend your position on the importance of healthcare quality for your organization. Provide support with at least three (3) examples that illustrate your position.
Assemble a plan to protect patient information that complies with all legal requirements.
Use at least three (3) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

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Personal statement or philosophy statement relating to your role as an APN


2 . Nursing Philosophy (from prior course) as your personal statement. It is what it is your hallmark as an Advanced Practitioner.

Example as follow:

Personal statement or philosophy statement relating to your role as an APN

Nursing is an art that can never be defined in one word or way. I remember before I decided to enroll in nursing school, I cared for an old lady through a home health agency. She kept telling me how wonderful I was to her, how patient, compassionate and always willing to assist her with her daily activities. She kept saying it is not about doing it, it is how you do it. She made me realize how much I could enjoy being a nurse and she constantly encouraged me to pursue a career in nursing.

When I enrolled in nursing school, it was not a smooth journey either because it was a very hard and demanding program but I learned a lot. It was then I realized nursing was not all about giving medication and helping someone to the bathroom. I learned about the importance of establishing rapport with a patient as soon as you assume care with them.

I challenged Practical Nursing boards and started working as a LPN before I completed my BSN program and the idea of nursing grew even more. Working as an LPN made me realized at times I may have to provide care to the family member may be a little more than the patient him/herself. I learned daily that nursing is way more than just what you learn in books and school and completing the care plan interventions.

Nursing to me is all about the relationship you establish with your patients, understanding them from their perspective. Asking them what they think is going on with their health or what has been changing in their body. I like to ask, how do you feel? What do you think? Asking these questions to my patients gives me a door to see them in a holistic manner. It helps me as a nurse to understand if their symptoms are just physical or are psychological as well. Someone may be experiencing a lot of life stressor and not eating right, or not drinking a lot of water. As a result they start experiencing a lot of headache. Instead of thinking it is a migraine and heavily medicate them. It is fair to give this person a little does of Tylenol. Encourage them to perform some relaxation exercises, eat well and drink plenty of water. I have come to learn that, food, water and our brains is what makes us or breaks us. If we think positive, we excel and do better in every aspect of our lives including our health. If we think negative them the vice versa will occur.

Another thing I learned from being a nurse is that we should always be reminded that we are advocates for our patients both verbal and nonverbal patients, but we do not have the last say. Most times we know more things related to the healthcare field compared to our patients. Our patients look at us and establish a lot of trust before you decide to do anything to them like giving them medication, sticking a  needle on them, putting them on some times of machine. They establish some kid nog trust. So we should always be willing to educate our patients on what we think is going on with them and why we are doing certain interventions on them. Advocacy also comes with utilizing the ethical principles in our nursing care like autonomy, respect, nonmaleficence, beneficence, and justice

 I currently work as a nurse in the emergency department, prior to that I word in medical surgical, home-health, rehab, and long term acute care. Nursing was not the same in all these areas. I took care of different kinds of patients in their different stages of life. While all was very interesting, I really love working in the Emergency room. The ER is the combination of all in one visit or sometimes in part of the visit. We do a lot of patient teaching, stabilizing, and referrals. We do not necessarily see the same patients every day, and that Is what makes me grow as a nurse. Prior to working in the ER, I never worked with the pediatric population. And I was amazed how wonderful working with all age groups can be. I am always curious and willing to learn more about nursing and wanting to do more for my patients. I decided to enroll in the Family Nurse Practitioner- Doctor of Nursing Practice (DNP) program because I knew the program will give me all what I mentioned and more

The DNP program will not only allow me to earn the knowledge of what will make  me a great family nurse practitioner but also it has a research part that will allow me to research on the current issue related to health care and/ or the nurse practitioner role in the society. As nurse practitioners we see a lot of patients from hospital to home setting and understanding research is vital to improve the care we provide to the communities we serve. Research in nursing is what bring about evidence-based practice which is the best way of practicing our daily nursing activities.

I took a theory class in the spring 2016 when I began my DNP course and I was amazed how all the nursing theories were pretty much what makes modern nursing better today. One of my favorite theories was “the theory of goal attainment” by Dr. Imogene King. This theory talks about the importance of nurses and patients having mutual goals that will improve patients’ health (King & Fawcett, 2012). For example, if a patient comes to the ER with several symptoms, instead of only telling them this is what we are going to do and this is what you are going to do. It is best to say, this is what I think we should do and give them a chance to say what they want done and what they do not want done. This does not mean you should not explain the rationale of your interventions but allow the patients to participate in their own care by making decisions with you. This will make it easier for the both of you because you will not have to struggle trying to do something to a patient that she/he does not like or later get sued because you did something that the patient did not agree to.

The DNP class has also allowed me to learn the importance of cost effectiveness and how nurse practitioners can be more cost effective compared to primary care physicians in providing their care. Learning all this information also allows me later as a nurse practitioner to be a great mentor to staff nurses and student nurse practitioners as well. Encouraging them on the constant use of evidence-based practice during direct patient care. And explain all the whys that they may have so that they feel better and understand what they have to care for the patient(s) in a different way compared to what they are already used to base on the current evidence and research at the time.

Having all that said, I believe nursing is an art that can never be explained in one simple word. The art of nursing is fulling to both patients and nurses themselves. Being a nurse practitioner will allow me to continue to advocate for my patients and do more for them like diagnosing and treating their symptoms in a cost effective manner, adhering to the ethical principle and the holistic approach at all times. I will also continue to learn more about nursing, medicine and all the current evidence based studies to ensure I provide the best care to my patients.

                                            Reference

King, I. M., & Fawcett, J. (2012). Imogene King. interacting systems framework. [electronic resource (video)] :. Athens, OH : FITNE, 2012.

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This example has been downloaded from /giving credit to it and be used only for educational purpose: https://maryville.instructure.com/eportfolios/21286/PracticeBased_Evidence/2b_Personal_statement_or_philosophy_statement_relating_to_your_role_as_an_APN

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HSC 0003, Health Care Career Paper

HSC 0003, Health Care Career Paper (Rev. 2014, PL)
Health Care Career Paper Instructions
HSC 0003, Introduction to Healthcare
Health Sciences and Related Studies
Medical Campus
Miami Dade College
Topic
The purpose of this paper is for students to research, learn and write about specific elements of a
health care worker’s career. Students are recommended to choose the health care worker in the
field they are planning to enter. Examples of paper topics include: Registered Nurse; Diagnostic
Medical Sonographer; Physician Assistant; Pharmacy Technician; Massage Therapist or
Radiographic Technologist. The Miami Dade College Campus’s (Medical Campus) Library has
resources dedicated to these careers. Do not choose physicians or dentists as a topic as this paper
is not designed for those careers.
Format
 The required format is APA 6th ed.
o Using MS Word, the paper is to be neat, and well organized using correct spelling
and grammar,
o Students need to use the information and resources located
MDC Learning Resources Website at http://www.mdc.edu/library. There you will
at Search Resources, go to the Subject Guide, on the dropdown menu select
Health and Medicine, then scroll down to HSC 0003 Health Care Career Paper.
There is an APA 6 th
ed style Microsoft Word Template for you to use for this
paper.
 A Cover Page
o In APA 6th ed. format
o All pages are numbered
 Body of the Report
o In APA 6th ed. format
o No abstract or introduction
o The body length is three to five pages. No less than 3 and not to exceed 5 pages.
o New Times Roman, 12-point font
o One inch margins
o Double spaced
o Left justification
o No lists, bullets, graphics, tables or pictures
o Work is to be expressed in paragraph form only

http://www.mdc.edu/library
2
HSC 0003, Health Care Career Paper (Rev. 2014, PL)
 References Page
o The title is References not Works Cited or Bibliography
o Indicate the exact source of the specific information used in the paper by citing all
references on the reference page.
o Only references cited in the paper with in text citations are to be included on the
reference page.
o Include a minimum of six different sources of information (books, professional
journal articles, electronic sources, websites, etc.).
o Wikipedia is not acceptable as a reference
Plagiarism
The health care career paper is to be the student’s original work. Plagiarism is the improper
borrowing of another person’s words, ideas, or methods. If you use another person’s material, you
must acknowledge your source. When you cite a source properly, you have given credit where it
is due, and you have also given your readers a way to locate the original material on their own.
But, there is more than that to plagiarism. Copying material directly without placing it between
quotation marks, even if you provide the source, is an act of plagiarism.
3
HSC 0003, Health Care Career Paper (Rev. 2014, PL)
MIAMI DADE COLLEGE
MEDICAL CAMPUS
HSC 0003, INTRODUCTION TO HEALTH CARE
COURSE PROJECT: HEALTH CARE CAREER WRITTEN PAPER
GRADING RUBRIC
20% of overall course grade
CONTENT AND APA CITATION (90% of written paper grade)
I. JOB DESCRIPTION
 Describe the care/service provided by the healthcare professional, (used correct APA ciations)
 Describe the limits of authority and responsibility legislated “scope of practice” for this health care career. (used correct APA citations)
 Describe the “Code of Ethics” for this health care occupation (used correct APA citations)
II. EDUCATION /REGISTRATION/CERTIFICATION
 Describe the requirements for the profession/occupation (using correct APA citations)
 Identify at least two different types of educational institutions/schools offering the program. (using correct APA citations)
 State how much time it takes to complete the program (using correct APA citations)
 Describe the approximate cost for each of the educational institutions required using correct APA citations) (using correct APA citations)
 What degree or certification that can be earned for this health care career (using correct APA citations)
 Identify the professional certification or registration required (using correct APA
 citations)
III. EMPLOYMENT
 What is the job availability for this profession? (using correct APA citations)
 Growth trends in the field (using correct APA citations)
 Number of jobs advertised locally for example in the Sunday Herald or other publication (using correct APA citations)
 Is experience required? explain (using correct APA citations)
 Salaries – Entry level and with experience (using correct APA citations)
 Advancement Opportunities, with or without additional education (using correct APA citations)
4
HSC 0003, Health Care Career Paper (Rev. 2014, PL)
IV. PROFESSIONAL ACTIVITIES
 Local/State/National Professional Organizations (cost to join as a student) (using correct APA citations)
 Professional journals with address and cost. (using correct APA citations)
 Are Continuing Educational Units (CEUs) required for this profession? If so how many and how often (using correct APA citations)
 Describe ways that members of a professional organization can gain continuing education requirements and earn CEUs (using correct APA citations)
V. REFLECTION / PERSONAL CAREER PLAN
 Reflect on how you see yourself “fitting” into this profession.
 Describe a personal career plan for you to enter this field. Include goals, objectives and strategies.
SOURCES, ORGANIZATION, FORMAT, SPELLING & GRAMMAR (10% of written
paper grade)
SOURCES OF INFORMATION
 At least 6 substantial references are used. They may include: books; professional journal articles; and web sites.
 All references are correctly cited on the Reference page in correct APA 6th ed format.
ORGANIZATION, FORMAT, SPELLING, GRAMMAR
 Well organized, with each section containing appropriate content
 Double spaced, 12-pt font size, 1” margins.
 Body of paper 3 – 5 pages with separate cover page and reference page.
 Correct spelling and grammar.
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Government homework help

Psyc 164: Assignment 3
For the following questions (1-3), read the small vignette
and then using the underlined behaviour as the behaviour
of interest, show the behaviour of interest, the stimulus
consequence and whether the behaviour increased or
decreased. Then label the procedure as an example of
either positive reinforcement, negative reinforcement or
avoidance.
Questions
1.When I was about 7 or 8, my usually very sane parents let me watch the movie “Poltergeist” while we
were visiting my uncle. This was the scene that scarred me for life. 😊 (there was originally a clown on
that chair, by the way) https://www.youtube.com/watch?v=JlUwfuB3pxI So…since that time, two
things have happened. If I happened to be at an event where a clown showed up, I immediately left, so I
wouldn’t have to see the clown anymore. And that behaviour continued to increase through to
adulthood. The second thing that would happen is that I started refusing to go anywhere where there
might be a clown – parades, birthday parties, etc. That behaviour also increased through to adulthood.
While I’m now okay around clowns, that was definitely not the age for me to see Poltergeist. 😊
Note: Question 1 will have 2 separate analyses – one for “immediately leaving” and one for
“refusing to go anywhere there might be a clown”.
2. My shins have a complicated relationship with my coffee table. They seem perversely drawn to
banging into the corners, which causes a sharp pain and throbbing sensation. However, if I take my palm
and firmly compress the whole area and keep it compressed, the pain goes away. I’m not only more
likely to use this technique with my shins, but with other areas as well, when they have been injured.
3. I have two dogs…Nula and Balla. They are both just about 14 years old and starting to show signs of
aging. Nula, in particular, really enjoys her naps now. Balla, every once in a while, will channel her inner
puppy, and she’ll dance around Nula like she’s a boxer, diving in, giving Nula jabs to the head, and
jumping back, to avoid retaliation. Nula will ignore her for quite a while, no doubt hoping her sister will
give up, but Balla has surprising staying power. 😊At some point, Balla will lunge forward and tap Nula
on the head, and Nula will jump up and start to wrestle with her. We’ve noticed over time that Balla has
become more likely to engage in this behaviour with Nula, with increasing persistence. (poor Nula 😊)
4. If you’ll recall from this module, a sick social cycle exists when one person’s behaviour is being
reinforced by positive reinforcement, and the other’s is being reinforced by negative reinforcement.
(e.g. room-mate nagging you to take the garbage out and you finally do because it stops the nagging –
your room-mate’s behaviour of nagging is positively reinforced by you taking the garbage out, while
your behaviour of taking the garbage out, is negatively reinforced by the nagging stopping.) Look for an
example of the sick social cycle in your own environment, and describe it here, being careful to identify
the behaviours of interest, the consequences and which person’s behaviour was reinforced by positive
or negative reinforcement.

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Accounting homework help

ASSIGNMENT :
State the 5 steps to revenue recognition using a diagram that you develop.  The diagram should include the steps and rule/definitions pertaining to each step.  There should also be a place for explaining differences between IFRS 15 and ASC 606
In two sentences, state two differences between IFRS 16 and ASC 606 that you believe are significant differences that never the two shall converge.  In one additional sentence explain why.
Complete the following two examples.
Collectability threshold:
Assessment based on goods or services to be transferred. Company C contracts with Customer D to sell 1,000 units for a fixed price of 1 million. D has a poor payment history and often seeks price adjustments after receiving orders and so C assesses that it is probable that it will collect only 70% of the amounts due under the contract. Based on its assessment of the facts and circumstances, C expects to provide an implicit price concession and accept 70% of the fixed price from D.  Is the collectability probable?  Explain in 2 sentences or less
2. Significant financing component: Change in expected completion date.
Company K enters into a contract with Customer C to construct and deliver a piece of equipment. K determines that the contract contains a single performance obligation that is satisfied at a point in time when the equipment is delivered to C. Construction is expected to take two years. K and C agree consideration of 80, which is payable and paid on the date the contract is signed. At contract inception, K considers the terms of the sale and determines that the contract includes a significant financing component because: – there is a significant period between payment and delivery of the asset; – the asset is regularly sold at a higher price; and – there is no evidence to suggest the advance is for another reason. K determines the discount rate, based on its credit characteristics, to be 12%. Therefore, to reflect the financing that it is receiving from the advance payment, K recognises interest expense of 20 in the construction period and revenue of 100 (80 × 1.122) on the delivery date. After Year 1, K determines that the construction will take three rather than two years.  Should K record a revised transaction price and date?  Answer each question (price and date) with a one-sentence explanation for each.
 

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