published_or_final_version / Nursing Studies / Master / Master of Nursing

Thesis (M.Nurs.)--University of Hong Kong, 2009. / Includes bibliographical references (p. 54-57).

This thesis offers a new rationale that helps explain the phenomena of elective provisions in tax law. I analyze tax elections with reference to a particular election offered to individual taxpayers —the choice to itemize expenses or to take the standard deduction to determine taxable net income under section 63(e) of the Internal Revenue Code. I make three arguments concerning the section 63(e) election that are relevant to evaluating tax elections more generally. First, the ability to itemize deductions can be seen as having an efficiency rationale in addition to its more well-recognized horizontal equity rationale. For taxpayers with lower incomes, the election to itemize acts as a screen that reveals the taxpayer’s unobservable cost-type to the government and allows the income tax to be more optimally “tailored” in the direction of a first-best lump sum tax by lowering itemizers’ marginal tax rates. Second, I show that the elective standard deduction introduced in 1944 can be viewed as a mechanism that bolsters the separating function of the election by reducing the itemizing propensity of would-be tax avoiders and low-ability taxpayers on the boundary between itemizing and not itemizing, while saving government enforcement and taxpayer compliance costs. Third, I argue that one of the drawbacks of using elective provisions such as section 63(e) to optimally tailor the income tax—deliberation costs borne by lower-income taxpayers who are uncertain about whether they should make the election—can be mitigated by viewing elections as call options written by the government in favor of the taxpayer. By structuring the election within a real option framework, the taxpayer will have higher net utility with no loss in equity as compared to an election structured outside the real-option framework. The flexible election rules of section 63(e) comport with this utility-enhancing real option approach. Moreover, the real option analysis suggests that little-noticed details of tax elections more generally may have more important effects on their efficiency than previously recognized.

This thesis offers a new rationale that helps explain the phenomena of elective provisions in tax law. I analyze tax elections with reference to a particular election offered to individual taxpayers —the choice to itemize expenses or to take the standard deduction to determine taxable net income under section 63(e) of the Internal Revenue Code. I make three arguments concerning the section 63(e) election that are relevant to evaluating tax elections more generally. First, the ability to itemize deductions can be seen as having an efficiency rationale in addition to its more well-recognized horizontal equity rationale. For taxpayers with lower incomes, the election to itemize acts as a screen that reveals the taxpayer’s unobservable cost-type to the government and allows the income tax to be more optimally “tailored” in the direction of a first-best lump sum tax by lowering itemizers’ marginal tax rates. Second, I show that the elective standard deduction introduced in 1944 can be viewed as a mechanism that bolsters the separating function of the election by reducing the itemizing propensity of would-be tax avoiders and low-ability taxpayers on the boundary between itemizing and not itemizing, while saving government enforcement and taxpayer compliance costs. Third, I argue that one of the drawbacks of using elective provisions such as section 63(e) to optimally tailor the income tax—deliberation costs borne by lower-income taxpayers who are uncertain about whether they should make the election—can be mitigated by viewing elections as call options written by the government in favor of the taxpayer. By structuring the election within a real option framework, the taxpayer will have higher net utility with no loss in equity as compared to an election structured outside the real-option framework. The flexible election rules of section 63(e) comport with this utility-enhancing real option approach. Moreover, the real option analysis suggests that little-noticed details of tax elections more generally may have more important effects on their efficiency than previously recognized.

This study was designed to determine the effect upon reading achievement of students who choose an elective course in either life science, creative writing, or accelerated reading in lieu of regular reading classes.

Thesis (Ph.D.)--Duquesne University, 2006. / Title from document title page. Abstract included in electronic submission form. Includes bibliographical references (p. 162-171) and index.

The aim of this research is to establish the bond between Friedrich Nietzsche and the anarchists, through the apparatus of elective affinity , and to challenge the boundaries of several anarchist trends especially 'classical' and 'post' anarchism and 'ideologies' like anarchism and libertarian Marxism. Moreover, it highlights the importance of reading Nietzsche politically, in a radical way, to understand his utility for the contemporary anarchist movement. The review of the literature concerning the Nietzsche-anarchy relationship shows the hitherto limited bibliography and stresses the possibility of exploring this connection, with the methodological help of Michael Löwy s concept of elective affinity . The research opens with a discussion of anarchism, following the dominant model for categorizing anarchist traditions, presenting its basic features and currents and drawing on its historical development. This leads to the introduction of two points (the questioning of the anarchist canon and the exposure of the diversity that basic anarchist concepts bear among different anarchist currents) which contest the rigid ideological perception of anarchism in favour of a fluid and dynamic anarchy. There emerges the elective affinity with Nietzsche, serving a double goal: the unification of the distinct anarchist tendencies and the definition of the anarchist parameters in relation to other ideologies. The following section of the thesis examines Nietzsche, by presenting the evolution of his philosophical thought and the fundamental theses of his perception of politics. It, then, continues with a detailed analysis of the main concepts of his philosophy based on the interpretation made by Gilles Deleuze, Alexander Nehamas and Keith Ansell-Pearson, thus structuring its interpretative context for establishing the Nietzsche-anarchy connection. This establishment is realized in a dual way. Firstly, by exploring the elective affinity through the presence of Nietzsche in the thought and politics of anarchist/libertarian thinkers (Goldman, Landauer, Benjamin) and currents (post-anarchism), and secondly by recognizing the anarchist worldview in the Nietzschean philosophy. The first path (Nietzsche in anarchism) shows how Nietzsche has interacted with or has been absorbed by the anarchist way of thinking, whereas the second path (anarchism in Nietzsche) reveals the affinal worldview of the two parts by extensively using the interpretation context mentioned above. The final section of the thesis applies the whole analysis above on a Nietzschean reading of the December 08 revolt in Athens based on the Of the Three Metamorphoses discourse from Thus Spoke Zarathustra. What has been found is the existence of a clear bond, between Nietzsche and the anarchists, which even reaches the upper levels of Löwy s elective affinity , that is Nietzschean Anarchism as a result of the two parts interactive fusion. The significance of this finding is that the relevant affinity may contribute to an alternative, to the dominant, perception of anarchism as an ideology. It may also designate its special features together with its weaknesses, meaning the objections of Nietzsche to certain aspects of the anarchist practices and worldview (violence, resentment, bad conscience), thus opening a whole new road of self-criticism for the anarchists of the twenty first century. In addition, the location and analysis of the elective affinity serves the debunking of the Nietzschean concepts used by conservative and right-wing readings in order to appropriate Nietzsche, and of the accusations that the German philosopher had unleashed against anarchists, which reveals his misunderstanding of anarchist politics.

Background: The postnatal failures of expression of the hepatic glucose-6-phosphatase system suggest there are developmental deficiencies in the mechanism to ‘switch-on’ this key enzyme of gluconeogenesis at the time of birth in both preterm and term infants. The evidence for hormonal regulation of this critical enzyme system in animal studies, in adult humans, and studies of cell lines make the possible failure of hormonal control around the time of birth an important hypothesis to test, but before this can be done, further studies of perinatal metabolism and its hormonal control need to be undertaken. Objective: To describe the hormonal and metabolic profiles of ‘unstressed’ term infants delivered by elective caesarean section. Methods: One hundred and fifty three women who had an elective caesarean section for a singleton pregnancy at term in Ninewells Hospital and Medical School, Dundee were recruited between July 2004 and April 2006. Maternal venous blood was taken for glucose and lactate estimations. Umbilical venous cord blood was obtained for the measurement of glucose, lactate, 3-hydroxybutyrate, free fatty acids, amino acids (alanine, arginine, citruline, cystine, GABA, glutamic acid, glutamine, glycine, histidine, isoleucine, leucine, lysine, methionine ornithine, phenyalanine, serine,taurine, threonine, tyrosine and valine), insulin, glucagon, human growth hormone, cortisol, catechols (EPI, NE, DA, DOPA, DHPG, DOPAC) and their sulfated conjugates (EPI sulfate, NE sulfate, DA sulfate, DOPA sulfate, DHPG sulfate, DOPAC sulfate), and blood gas and acid-base profiles. Results The mean maternal glucose and lactate levels were 4.28 mmol/l and 1.8 mmol/l respectively. Three infants were hypoglycaemic with umbilical blood glucose levels of less than 2.6 mmol/l. The mean infant glucose and lactate levels were as expected for full term infants at 3.3 mmol/l and 2.2 mmol/l respectively. High mean levels of insulin and catechols were noted at birth. There was a significant positive association between umbilical venous cord glucose levels and maternal venous glucose levels (p=<0.001) but no association of umbilical venous cord glucose levels with amino acids, insulin, glucagon, human growth hormone, cortisol and catechols. Conclusions: This extensive data set of levels of metabolites and hormones in infants at birth acts as a reference source and will be valuable for evaluating any effects of antenatal or intrapartum factors on the hormonal and metabolic profiles of infants at birth as well as to investigate the mechanisms to ‘switch-on’ the key enzyme glucose-6-phosphatase. Objective: To describe the hormonal and metabolic profiles of ‘unstressed’ term infants delivered by elective caesarean section. Methods: One hundred and fifty three women who had an elective caesarean section for a singleton pregnancy at term in Ninewells Hospital and Medical School, Dundee were recruited between July 2004 and April 2006. Maternal venous blood was taken for glucose and lactate estimations. Umbilical venous cord blood was obtained for the measurement of glucose, lactate, 3-hydroxybutyrate, free fatty acids, amino acids (alanine, arginine, citruline, cystine, GABA, glutamic acid, glutamine, glycine, histidine, isoleucine, leucine, lysine, methionine ornithine, phenyalanine, serine, taurine, threonine, tyrosine and valine), insulin, glucagon, human growth hormone, cortisol, catechols (EPI, NE, DA, DOPA, DHPG, DOPAC) and their sulfated conjugates (EPI sulfate, NE sulfate, DA sulfate, DOPA sulfate, DHPG sulfate, DOPAC sulfate), and blood gas and acid-base profiles. Results: The mean maternal glucose and lactate levels were 4.28 mmol/l and 1.8 mmol/l respectively. Three infants were hypoglycaemic with umbilical blood glucose levels of less than 2.6 mmol/l. The mean infant glucose and lactate levels were as expected for full term infants at 3.3 mmol/l and 2.2 mmol/l respectively. High mean levels of insulin and catechols were noted at birth. There was a significant positive association between umbilical venous cord glucose levels and maternal venous glucose levels (p=<0.001) but no association of umbilical venous cord glucose levels with amino acids, insulin, glucagon, human growth hormone, cortisol and catechols.

The New Zealand health system is two-tiered with elective treatments are performed by both publicly funded state hospitals and by private hospitals. Publicly funded operations are rationed using a prioritisation system which was introduced in 1998 to curtail expanding waiting lists for elective surgery. One of the aims of the new booking system was to generate national tools for prioritising patients in order to improve the equality of access to public elective surgery throughout New Zealand. However, priority scoring systems were not implemented in a consistent manner and access to elective surgery remains very unequal. Despite large media attention and a high public profile, waiting times have attracted little research in medical geography or within the wider social sciences community. The subject has been partly reserved for public health commentators within the medical field, who have found that variation in waiting times has much to do with the referral practices of physicians, the management of waiting lists by District Health Board (DHB) staff and the amount of private practice that occurs within each district. Most notably several studies have identified that in areas associated with high private admissions, patients tend to suffer higher waiting times for the same procedures in the public hospital system. This study examines the performance of the New Zealand Booking System (NZBS) during the years 2004 to 2007 to assess the equitable delivery of publicly funded elective surgery procedures. Waiting times (NBRS) and admissions (NMDS) datasets were sourced from the New Zealand Health and Information Service (NZHIS) of The Ministry of Health. Mean and Median waiting times were compared spatially between each of New Zealand’s 21 DHBs, compared with Australian waiting times and then broken down into five common medical specialties. Waiting times were then analysed by ethnicity, level of material deprivation and other individual factors using data from the 2006 New Zealand Census. Finally, rates of admissions were calculated for the public and private hospital sectors during the study period. These were used to correlate waiting times results with the amount of private practice in each DHB. ACC cases were extracted from the dataset to avoid bias in waiting times as much of this work is contracted out to the private sector and not subject to lengthy waiting times for treatment. A number of medical specialists and hospital administrators were interviewed to discuss results, explain prioritisation tools and management practices. Results showed large variations in the median waiting times of New Zealand DHBs. A north south gradient is observed in which southern DHBs suffer longer waits for care. Vastly better results were observed for Australian public hospitals than those seen in New Zealand. For waiting times as determined by individual factors, Maori and Pacific Island patients and those from lower socio-economic backgrounds suffered longer waiting times nationwide although, in certain DHBs inequalities for access to elective surgery were exacerbated. However, ethnic differences were more pronounced than socio-economic variations. Admissions results showed significant positive correlations between the amount of private practice and the waiting times experienced in each DHB which are supported by previous research. Feedback from interviews confirmed inconsistency in the use of scoring tools, manipulation occurring on behalf of the DHB management to achieve performance goals set by the Ministry of Health and provided some further explanation of the other quantitative results. Access to elective surgery is determined partly by location of residence, ethnicity, deprivation and where hospital resources are located but most importantly by the willingness to pay for treatment within the private hospital sector and the ability to manipulate the public prioritisation system.

Physical inactivity is a serious public health concern in Canada, especially among the country’s youth. Adolescent girls, in particular, suffer many life-long consequences due to inactivity. Physical Education (PE) can offer a solution. However, the vast majority of girls discontinue enrollment in PE as soon as the mandatory credits are met. Tailored PE courses designed to meet the needs and interests of girls may motivate girls to continue participating in PE. This narrative inquiry explored three girls’ stories of their past experiences in elementary, middle, and high school PE, as well as their current experiences in a tailored elective PE course entitled Girls Actively Living (GAL). The goals of this study were to explore how the girls’ experiences with the course content, learning environment, and assessment in GAL affected their perceptions of physical education. Additionally, it was of interest how their experiences outside of PE influenced their desire to continue in elective PE and how their experiences in GAL affected their perceptions of physical activity. Findings emphasized the importance of (a) variety and cooperation within PE course content, (b) a fun and welcoming PE learning environment, (c) fair and private assessment, and (d) feelings of confidence, social safety, and competence for girls in PE. / Graduate / 0523 / jgruno@uvic.ca