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VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense).
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Mark Wadsworth: Killer Arguments Against LVT, Not (486)
'd have output VAT = input VAT but I doubt you'd ever see a bankruptcy with a net negative or zero VAT bill. So a straight up turnover tax? 7 January 2021 at 16:54 Mark Wadsworth said... M, no. <span>VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense). So there are (or were, or could be) plenty of businesses which would be profitable if there were no VAT. Assuming that most of the VAT is borne by the supplier, if there were no VAT, th




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the total tax bill of a VAT-able business would not be much different if they increased Employer's NIC to 30% and corporation tax to 37%. Which sounds as shit as it is.
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Mark Wadsworth: Killer Arguments Against LVT, Not (486)
suming that most of the VAT is borne by the supplier, if there were no VAT, their income would jump by about one-sixth. Happy times! 7 January 2021 at 17:20 Mark Wadsworth said... M, to sum up, <span>the total tax bill of a VAT-able business would not be much different if they increased Employer's NIC to 30% and corporation tax to 37%. Which sounds as shit as it is. 7 January 2021 at 17:48 mombers said... MW gross profits aren't very helpful for a business with fixed costs as these can't be deducted. So businesses who say make a £10k profit absent




Flashcard 6194745707788

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#Economics #mark-wardsworth
Question
VAT is a tax on gross profits i.e. sales minus [...]. There is no deduction for wages (usually the largest expense).
Answer
goods purchased

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VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense).

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Mark Wadsworth: Killer Arguments Against LVT, Not (486)
'd have output VAT = input VAT but I doubt you'd ever see a bankruptcy with a net negative or zero VAT bill. So a straight up turnover tax? 7 January 2021 at 16:54 Mark Wadsworth said... M, no. <span>VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense). So there are (or were, or could be) plenty of businesses which would be profitable if there were no VAT. Assuming that most of the VAT is borne by the supplier, if there were no VAT, th







Flashcard 6194748067084

Tags
#Economics #mark-wardsworth
Question
VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for [...] (usually the largest expense).
Answer
wages

statusnot learnedmeasured difficulty37% [default]last interval [days]               
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scheduled repetition interval               last repetition or drill

Parent (intermediate) annotation

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VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense).

Original toplevel document

Mark Wadsworth: Killer Arguments Against LVT, Not (486)
'd have output VAT = input VAT but I doubt you'd ever see a bankruptcy with a net negative or zero VAT bill. So a straight up turnover tax? 7 January 2021 at 16:54 Mark Wadsworth said... M, no. <span>VAT is a tax on gross profits i.e. sales minus goods purchased. There is no deduction for wages (usually the largest expense). So there are (or were, or could be) plenty of businesses which would be profitable if there were no VAT. Assuming that most of the VAT is borne by the supplier, if there were no VAT, th







Minor manifestations of alcohol withdrawal include anxiety, agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving, and often loss of appetite, nausea, and vomiting. Moderate and severe withdrawal syndromes can include hallucinations, seizures, or delirium tremens; the latter two can be life-threatening.
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opics are updated as new evidence becomes available and our peer review process is complete. Literature review current through: Dec 2020. | This topic last updated: Oct 29, 2018. INTRODUCTION — <span>Minor manifestations of alcohol withdrawal include anxiety, agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving, and often loss of appetite, nausea, and vomiting. Moderate and severe withdrawal syndromes can include hallucinations, seizures, or delirium tremens; the latter two can be life-threatening. Most people with alcohol use disorder do not experience significant withdrawal when they stop or reduce drinking, but withdrawal is common among medical and surgical inpatients and in e




for example, one study showed that an AUDIT-PC score of four or more was 91 percent sensitive and 89.7 percent specific for the development of alcohol withdrawal [5]
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cohol Use Disorders Identification Test and Alcohol Use Disorders Identification Test – (Piccinelli) Consumption (AUDIT-PC) can be used to identify these risk factors in a standardized fashion; <span>for example, one study showed that an AUDIT-PC score of four or more was 91 percent sensitive and 89.7 percent specific for the development of alcohol withdrawal [5]. Patients who have not had any withdrawal symptoms more than 24 hours after cessation are unlikely to develop such symptoms. Though alcohol withdrawal is usually mild, an estimated 20 p




Patients who have not had any withdrawal symptoms more than 24 hours after cessation are unlikely to develop such symptoms.
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in a standardized fashion; for example, one study showed that an AUDIT-PC score of four or more was 91 percent sensitive and 89.7 percent specific for the development of alcohol withdrawal [5]. <span>Patients who have not had any withdrawal symptoms more than 24 hours after cessation are unlikely to develop such symptoms. Though alcohol withdrawal is usually mild, an estimated 20 percent of patients experience more advanced manifestations such as hallucinosis, seizures, and delirium tremens [7]. Seizures




Though alcohol withdrawal is usually mild, an estimated 20 percent of patients experience more advanced manifestations such as hallucinosis, seizures, and delirium tremens [7]. Seizures and delirium tremens, which are sometimes grouped as “severe alcohol withdrawal syndrome,” are a frequent reason for both general inpatient and intensive care unit admissions; for example, alcohol withdrawal syndrome was found to account for more than 10 percent of intensive care unit admissions to a Detroit hospital [8]
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89.7 percent specific for the development of alcohol withdrawal [5]. Patients who have not had any withdrawal symptoms more than 24 hours after cessation are unlikely to develop such symptoms. <span>Though alcohol withdrawal is usually mild, an estimated 20 percent of patients experience more advanced manifestations such as hallucinosis, seizures, and delirium tremens [7]. Seizures and delirium tremens, which are sometimes grouped as “severe alcohol withdrawal syndrome,” are a frequent reason for both general inpatient and intensive care unit admissions; for example, alcohol withdrawal syndrome was found to account for more than 10 percent of intensive care unit admissions to a Detroit hospital [8]. The development of alcohol withdrawal contributes to the morbidity, mortality, and length of stay of patients admitted to the hospital for other primary medical or surgical indications




Without treatment, symptoms of alcohol withdrawal generally begin within 6 to 24 hours of the last drink or a sudden reduction in chronic alcohol drinking [12]. The onset and duration of withdrawal symptoms vary based on the severity of the syndrome (table 1). Symptoms may emerge before the blood alcohol level has returned to zero.
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y of alcohol withdrawal syndrome is reviewed separately. (See "Management of moderate and severe alcohol withdrawal syndromes", section on 'Pathophysiology'.) CLINICAL PRESENTATION AND COURSE — <span>Without treatment, symptoms of alcohol withdrawal generally begin within 6 to 24 hours of the last drink or a sudden reduction in chronic alcohol drinking [12]. The onset and duration of withdrawal symptoms vary based on the severity of the syndrome (table 1). Symptoms may emerge before the blood alcohol level has returned to zero. Mild withdrawal — Symptoms of early or mild alcohol withdrawal include anxiety, minor agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving




Mild withdrawal — Symptoms of early or mild alcohol withdrawal include anxiety, minor agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving. Patients often experience loss of appetite, nausea, and vomiting. Physical signs include sinus tachycardia (heart rates may exceed 120 beats/min), systolic hypertension, hyperactive reflexes, and tremor [7,12]. Symptoms of mild withdrawal resolve within one to two days
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cohol drinking [12]. The onset and duration of withdrawal symptoms vary based on the severity of the syndrome (table 1). Symptoms may emerge before the blood alcohol level has returned to zero. <span>Mild withdrawal — Symptoms of early or mild alcohol withdrawal include anxiety, minor agitation, restlessness, insomnia, tremor, diaphoresis, palpitations, headache, and alcohol craving. Patients often experience loss of appetite, nausea, and vomiting. Physical signs include sinus tachycardia (heart rates may exceed 120 beats/min), systolic hypertension, hyperactive reflexes, and tremor [7,12]. Symptoms of mild withdrawal resolve within one to two days. Some patients with mild withdrawal will go on to develop additional manifestations of withdrawal, such as alcohol hallucinosis, withdrawal seizures, or withdrawal delirium (delirium tr




Some patients with mild withdrawal will go on to develop additional manifestations of withdrawal, such as alcohol hallucinosis, withdrawal seizures, or withdrawal delirium (delirium tremens). The latter are sometimes considered together as “severe alcohol withdrawal syndrome.” Patients can have withdrawal seizures or hallucinosis without manifesting symptoms of mild withdrawal
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gns include sinus tachycardia (heart rates may exceed 120 beats/min), systolic hypertension, hyperactive reflexes, and tremor [7,12]. Symptoms of mild withdrawal resolve within one to two days. <span>Some patients with mild withdrawal will go on to develop additional manifestations of withdrawal, such as alcohol hallucinosis, withdrawal seizures, or withdrawal delirium (delirium tremens). The latter are sometimes considered together as “severe alcohol withdrawal syndrome.” Patients can have withdrawal seizures or hallucinosis without manifesting symptoms of mild withdrawal. Alcohol hallucinosis — Alcohol hallucinosis typically begins within 12 to 24 hours after the last drink and resolves in another 24 to 48 hours. The risk for alcohol hallucinosis may be




Alcohol hallucinosis — Alcohol hallucinosis typically begins within 12 to 24 hours after the last drink and resolves in another 24 to 48 hours. The risk for alcohol hallucinosis may be related to genetic factors [13] and/or decreased thiamine absorption [14].

Alcoholic hallucinosis refers to hallucinations that are usually visual and commonly involve seeing insects or animals in the room; auditory and tactile phenomena may also occur. In contrast to withdrawal delirium, alcoholic hallucinosis is not associated with altered cognition such as disorientation, and vital signs are usually normal

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ns). The latter are sometimes considered together as “severe alcohol withdrawal syndrome.” Patients can have withdrawal seizures or hallucinosis without manifesting symptoms of mild withdrawal. <span>Alcohol hallucinosis — Alcohol hallucinosis typically begins within 12 to 24 hours after the last drink and resolves in another 24 to 48 hours. The risk for alcohol hallucinosis may be related to genetic factors [13] and/or decreased thiamine absorption [14]. Alcoholic hallucinosis refers to hallucinations that are usually visual and commonly involve seeing insects or animals in the room; auditory and tactile phenomena may also occur. In contrast to withdrawal delirium, alcoholic hallucinosis is not associated with altered cognition such as disorientation, and vital signs are usually normal. Withdrawal seizures — Alcohol withdrawal-related seizures occur within 6 to 48 hours after drinking either stops or is significantly reduced. Such seizures occur in 10 to 30 percent of




Withdrawal seizures — Alcohol withdrawal-related seizures occur within 6 to 48 hours after drinking either stops or is significantly reduced. Such seizures occur in 10 to 30 percent of patients in alcohol withdrawal [15-17]. Risk factors may include concurrent withdrawal from benzodiazepines or other sedative-hypnotic drugs; other risk factors include relatively low potassium and platelet levels [4]. It has been observed that the risk of seizures increases as patients undergo repeated withdrawals, which has been described as the “kindling effect.” Genetic determinants are under investigation [18]
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tactile phenomena may also occur. In contrast to withdrawal delirium, alcoholic hallucinosis is not associated with altered cognition such as disorientation, and vital signs are usually normal. <span>Withdrawal seizures — Alcohol withdrawal-related seizures occur within 6 to 48 hours after drinking either stops or is significantly reduced. Such seizures occur in 10 to 30 percent of patients in alcohol withdrawal [15-17]. Risk factors may include concurrent withdrawal from benzodiazepines or other sedative-hypnotic drugs; other risk factors include relatively low potassium and platelet levels [4]. It has been observed that the risk of seizures increases as patients undergo repeated withdrawals, which has been described as the “kindling effect.” Genetic determinants are under investigation [18]. Seizures are typically generalized tonic-clonic convulsions, occurring singly or in clusters of two or three. In a study, 60 percent of patients with seizures related to alcohol cessat




Withdrawal delirium — Withdrawal delirium (also known as delirium tremens or “DTs”) is a rapid-onset, fluctuating disturbance of attention and cognition, sometimes with hallucinations, in the presence of alcohol withdrawal [21]. In its most severe manifestation, withdrawal delirium is accompanied by agitation and signs of extreme autonomic hyperactivity, including fever, severe tachycardia, hypertension, and drenching sweats.

Withdrawal delirium typically begins between 72 and 96 hours after the patient’s last drink and has been reported to occur in 1 to 4 percent of patients hospitalized for alcohol withdrawal [22]

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re reviewed separately. (See "Convulsive status epilepticus in adults: Classification, clinical features, and diagnosis" and "Convulsive status epilepticus in adults: Treatment and prognosis".) <span>Withdrawal delirium — Withdrawal delirium (also known as delirium tremens or “DTs”) is a rapid-onset, fluctuating disturbance of attention and cognition, sometimes with hallucinations, in the presence of alcohol withdrawal [21]. In its most severe manifestation, withdrawal delirium is accompanied by agitation and signs of extreme autonomic hyperactivity, including fever, severe tachycardia, hypertension, and drenching sweats. Withdrawal delirium typically begins between 72 and 96 hours after the patient’s last drink and has been reported to occur in 1 to 4 percent of patients hospitalized for alcohol withdrawal [22]. Genetic risk factors for delirium are under evaluation [23]. Retrospective studies have suggested the following clinical risk factors though not all are borne out consistently across d




Laboratory and other testing — Laboratory testing typically includes:

● A complete blood count.

● Serum electrolytes, including potassium, magnesium, and phosphate.

● Glucose.

● Creatinine.

● Liver function tests.

● Amylase and lipase.

● Blood alcohol level.

● Urine drug testing, which should include testing for benzodiazepines, cocaine, and opioids. The opioid test should include not only opiates, which include heroin, codeine and morphine, but also buprenorphine, oxycodone, methadone, and fentanyl, all of which are of increasing importance in the current opioid epidemic.

● Urine human chorionic gonadotropin test for premenopausal women.

An electrocardiogram is suggested for patients over 50 years or if there is a history of cardiac problems.

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. The neurologic exam must include assessment of gait and oculomotor function to rule out concurrent Wernicke encephalopathy, which requires specific treatment. (See "Wernicke encephalopathy".) <span>Laboratory and other testing — Laboratory testing typically includes: ●A complete blood count. ●Serum electrolytes, including potassium, magnesium, and phosphate. ●Glucose. ●Creatinine. ●Liver function tests. ●Amylase and lipase. ●Blood alcohol level. ●Urine drug testing, which should include testing for benzodiazepines, cocaine, and opioids. The opioid test should include not only opiates, which include heroin, codeine and morphine, but also buprenorphine, oxycodone, methadone, and fentanyl, all of which are of increasing importance in the current opioid epidemic. ●Urine human chorionic gonadotropin test for premenopausal women. An electrocardiogram is suggested for patients over 50 years or if there is a history of cardiac problems. Imaging — A head computerized tomography scan to rule out contributing or alternative pathology is indicated for patients who present with a first seizure or for a presentation that is




CIWA-Ar scale — Although several symptom severity scales exist for alcohol withdrawal, the Clinical Institutes Withdrawal Assessment Scale for Alcohol (CIWA-Ar) has been the most studied and is the most widely used (table 3) (calculator 1).

The CIWA scale can help determine the need for medically supervised withdrawal management. Patients with an alcohol use disorder who have not had a drink for five days or more and have a CIWA score of less than 10 will in most cases not need management.

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xam, or sedated mental status. An abdominal ultrasound or computerized tomography scan may be indicated in patients reporting abdominal pain or with abnormal pancreatic or liver function tests. <span>CIWA-Ar scale — Although several symptom severity scales exist for alcohol withdrawal, the Clinical Institutes Withdrawal Assessment Scale for Alcohol (CIWA-Ar) has been the most studied and is the most widely used (table 3) (calculator 1). The CIWA scale can help determine the need for medically supervised withdrawal management. Patients with an alcohol use disorder who have not had a drink for five days or more and have a CIWA score of less than 10 will in most cases not need management. For patients with a history of recent alcohol use who are able to communicate symptoms to their medical providers, the CIWA scale can be used to guide symptom-triggered treatment. Rando




Withdrawal from other sedating substances – Withdrawal from benzodiazepines, opioids, and other sedating substances may resemble mild alcohol withdrawal. Benzodiazepine withdrawal in particular can be virtually indistinguishable from alcohol withdrawal, although tachycardia and hypertension are typically more pronounced in the latter.
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hol withdrawal. The patient’s substance use history and urine drug testing can distinguish the conditions, though notably many synthetic cathinones are not detectable in standard drug testing. ●<span>Withdrawal from other sedating substances – Withdrawal from benzodiazepines, opioids, and other sedating substances may resemble mild alcohol withdrawal. Benzodiazepine withdrawal in particular can be virtually indistinguishable from alcohol withdrawal, although tachycardia and hypertension are typically more pronounced in the latter. Opioid withdrawal may be associated with mild hypertension, tachycardia, tremor, diaphoresis, nausea, and vomiting, but on exam, patients have pronounced mydriasis, piloerection, and rh




Opioid withdrawal may be associated with mild hypertension, tachycardia, tremor, diaphoresis, nausea, and vomiting, but on exam, patients have pronounced mydriasis, piloerection, and rhinorrhea, which are absent in alcohol withdrawal. Most patients with opioid withdrawal are also particularly troubled by muscle and abdominal cramps, which are less pronounced in alcohol withdrawal.
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ithdrawal. Benzodiazepine withdrawal in particular can be virtually indistinguishable from alcohol withdrawal, although tachycardia and hypertension are typically more pronounced in the latter. <span>Opioid withdrawal may be associated with mild hypertension, tachycardia, tremor, diaphoresis, nausea, and vomiting, but on exam, patients have pronounced mydriasis, piloerection, and rhinorrhea, which are absent in alcohol withdrawal. Most patients with opioid withdrawal are also particularly troubled by muscle and abdominal cramps, which are less pronounced in alcohol withdrawal. (See "Opioid withdrawal in adults: Clinical manifestations, course, assessment, and diagnosis" and "Medically supervised opioid withdrawal during treatment for addiction".) To rule out