Management of a patient withan allergic rhinitis Essay

Management of a patient withan allergic rhinitis - Essay Example Allergic rhinitis is also known as hay fever and is supposed to be mediated by type-I hypersensitivity which is an extreme response of immune system against foreign bodies by build-up of antibodies. General nursing process begins with assessment of patient’s health history which involves their personal and family history (Burns, 2007). Secondly, an allergy assessment is performed by examining obvious symptoms and state of patient before these symptoms became apparent. Thirdly, occurrence of these symptoms is examined with relation to seasonal changes and related physical mental and physical problems. In the last stage of assessment, nature of antigen causing allergy is identified (Denise and Scandale, 2010). A patient is said to have this allergy when an ineffective breathing pattern and continuous sneezing is observed when encountered with triggers. Ineffective coping of chronic disorders is often followed by need for changes in environment of the patient. Possible problems e ncountered during management of the disorder include anaphylaxis, disturbed breathing pattern and failure to follow suggested therapy. The goal of interventions used for treating this patient were to restore normal breathing pattern, identify causes and control them, improve coping mechanism and avoid any complications. 2. History of the Patient A patient’s history must be comprehensive enough to provide information regarding onset and duration of the symptoms being experienced by the patient along with possible triggers. In addition to that, co-morbidity, family history of allergies, environmental exposure, and quality of life also play an important role in diagnosis. After preliminary form filing, the patient complained about seasonal flu in last five years which showed persistence despite usage of OTC medication without prescription. This was the first incident where patient entered into medical settings. The patient complained of frequent episodes of sneezing with large p roduction and exhalation of clear mucus. Since some of the symptoms mentioned later were similar to Sinusitis therefore discharge of mucus and drainage were observed to identify if the patient has Sinusitis or allergic rhinitis. Furthermore, localized itching also confirmed it. 2.1 Response to Allergens Patient complained of 10-15 paroxysms when experiencing sneezing along with nasal congestion leading to breathing through mouth. The symptoms grew severe in the springs and especially near plantation. Patient also mentioned having episodes of atopic eczema. It is important to note that patients with atopy are at risk of developing allergic rhinitis (Burns, 2007). Lara also complained of reduced energy level and fatigue especially in late winters and spring while experiencing this state. Lara further complained of itchy nose which made her rub her nose repetitively and a crease was visible in the middle of her nose (Lang, n.d; Plaut and Valentine, 2005). Furthermore, she mentioned tha t the sneezing and itching is more aggressive right after waking up and in the morning. Out of symptoms defined by the patient, it was evident that she had experienced sneezing, pruritus, congestion and drainage which are some of the common symptoms of allergic rhinitis (Spector et al., 2003; Harvey, 2012). The onset of pruritus was more evident in palate, nose and throat leading to aggressive coughing. In addition to these conditions, Lara also complained about sleep apnea, overbiting and episodes of asthma. She also mentioned that her mother

Remote Access Computer Trojan Research Paper Example | Topics and Well Written Essays - 1000 words

Remote Access Computer Trojan - Research Paper Example RATs are broadly defined as the malevolent computer programs which are entered into the victim’s computer in order to gain access to his confidential information and general activities. These are usually attached to some gaming program or anything else which is often executed by the victims. Once the Trojan is ready to perform its task the intruder is immediately informed through an e-mail. In some cases, the hacker is able to use victim’s IP address, while in case of corporations the financial transactions or other business operations are usually intervened. Let’s consider an example of China where 72 organizations including government offices, corporations and non-profit companies were infected by Remote Access Trojan. This violation was a typical criminal attack in order to leak out confidential information and also to interrupt various financial transactions. However, hunger for country secrets is considered less threatening than financial loss according to M acAfee investigation report covering this breach. Shady RAT, which is a latest Remote Access Tool, was used in this particular cyber-crime. MacAfee detections reveal that Shady RAT specifically slows down the computer system and hence it is generally known as â€Å"low and slow† cybersecurity attack. Experts could not identify the real culprits of this case with complete authenticity however, few individuals were seriously suspected. Initially, the RAT attack was identified in 2009 by the MacAfee officials while investigating a defence contractor.se contractor [Mat11]. Thereafter the MacAfee team identified spear-phishing attack which implies that the breach had occurred through entering the command in HTML comments on the web links. MacAfee investigated that the Shady RAT attack had actually initiated in the mid-2006. These attacks were then expanded to 38 Chinese organizations by 2008 [Mat11]. Losses of confidentiality, integrity and availability Much of the confidential information held by the government offices was lost in addition to financial statements. Moreover the intruders were able to penetrate different business operations over a longer period of time and hence it became a matter of

How Effective Is The Child Protection System?

How Effective Is The Child Protection System? Literature highlights some of the challenges for social workers assessing and making decisions about African children and families whose cultures differ from the majority of the white population in United Kingdom. The critical evaluation of knowledge and research in child protection and prevention of child abuse in black African children is important to the forming of social work policy, services and appropriate intervention. This is because there is need to provide appropriate intervention services which are culturally sensitive but at the same time preventing child abuse. It is important that black African children perspectives form part of policies and legislation. Several authors have critically analysed the evidence on service provision for black families in general. A pathologising approach to black families may lead to unnecessary coercive intervention and on the other hand a cultural relativist approach may lead to a non-intervention when services are required (Dominelli 1997 , Chand 2000). The purpose of the review is to explore if the child protection system is effective in preventing child abuse in black African children and their families. By child protection, the review will be referring to all the agencies and services involved in protecting and preventing child abuse. By relating to theory and research, there is hope to uncover gaps, themes and debates and also, raise questions which can be useful for future research. The literature review starts by setting the parameters that is, defining the terms that will be used, such as, child protection and child abuse. The literature review goes to set the historical and theoretical context because it is important to know how long literature and research has existed on the topic and what has been happening including research on culture differences, poverty, power issues and child protection. The review goes on to address the theoretical perspectives on the topic to analyse the theories that form the knowledge base in rese arch. The review goes on to look at the major findings in research and literature by exploring the key themes such as factors that impact African children that can result them in being involved in the child protection system for example, child rearing practices, poverty and limited knowledge in cultural practices by social work professionals. Finally the review will look at the anti-discriminatory practice and user-involvement to show how professionals can work sensitively and provide culture appropriate services. The literature search Child protection system aims to prevent situations that can result in a child or young person aged sixteen and under experience abuse that puts them in danger of not developing appropriately or losing their life (Save the Children UK, 2008). The abuse can fall under the category of child abuse which could be in form of neglect, emotional, physicals and sexual, (Woolfson et al 2009). The search involved these terms. After establishing the specific area to be reviewed; the focus was on black African children and the child protection system. The area of child protection and black African children is a controversial area that has been neglected in literature and research and there is need to analyse themes and identify gaps in literature. The sources selected were journals, books, government records and articles. Electronic search engines were used because they provided a readily available wide range of literature and research articles which have been accepted for publishing. These sourc es were used as evidence and source of information because they had been accepted for publishing hence they would not provide with false information. Review of the literature Historical Context In setting the historical context, the most important development in child protection is the formulation of the Children Act 1989 which was influenced by the public inquiries of the 1970s and 1980s child deaths, for example, the Maria Cowell. The Act stressed that the Local Authoritys duty is to safeguard and promote the welfare of children. However, research into how the Children Act was being put into action found that the child protection system was still focusing on single incidents of child abuse rather than planning to meet the wider requirements of children in need (DoH, 1995a). The studies also noted that many children and families received little or no support, the assessment of risk was low (Stevenson, 1998) and ignored the influences of poverty, unemployment and poor housing. This meant that a new way in thinking was needed about working with families. The result was publication of the Framework for Assessment of Children in Need and their Families (DoH et al, 2000) and Wo rking Together to Safeguard Children (DoH et al, 1999). A Common Assessment framework was also developed to promote more effective earlier identification of childrens additional needs and improve inter-agency working. A review into previous deaths of children indicates failures to listen to children, sharing of information, follow procedures and recognising indicators of abuse. The main response to the deaths of children due to local authorities failures has been to seek bureaucratic solutions such as introducing new guidelines, laws and procedures (Ferguson, 2005). However, the Laming 2003 enquiry into the tragic death of Victoria Climbie in 2000 is particularly significant because it pointed out the inter-agency approach established after Maria Cowells death in 1973 was not followed and it considered implications for the whole of the child protection system (Batty, 2003). Laming (2003) highlights the misjudgements made on the Climbies case based on cultural assumptions that led to a tragedy. However, Garret (2006) argues that the Laming report (2003) appears to detach a childs race from core assessments and this was echoed in the Every Child Matters which appears to mention very little about the needs of children from other races. After the Victoria Climbie enquiry there has been recent death of children known to social services such as, baby P (2007) and Khyra Ishaq (2008). This begs the question, where is the child protection system going wrong? There are debates on how to provide social work interventions and family support that are culturally sensitive and competent to African children and their families who are at risk of significant harm (Stobart, 2006; Holland 2004, Robinson 2007; Mama 2004). This was highlighted in the Laming Progress Report (2009) which set out challenges faced in safeguarding children such as: à ¢Ã¢â€š ¬Ã‚ ¦ there is still need to improve knowledge and skills to understand children and their family circumstances. Also the laming report noted that despite the progress in inter-agency wor king there are still problems of day to day reality of working across organisational boundaries and cultureà ¢Ã¢â€š ¬Ã‚ ¦ , Laming Progress Report (2009). When reviewing literature it is important to note that there is a sparse of research on black African children and the child protection system in the Britain hence it is difficult to set out the historical and theoretical context. Where research and literature exists, the data is still not plausible because it is mixed with other research data from minority ethnic populations and their experience differs widely. Theoretical and research perspectives that shape knowledge Different theories and perspectives inform knowledge base in literatures surrounding African children and the child protection system. When researching this area there is need to look at experiences of African people and their involvement with child protection hence researchers can use the black perspective which is based on the notion of common experiences that black people share. The black perspective criticises repressive research and theories that are likely to oppress black people, (Robinson 2007). African families will always refer to their culture as frame of reference to their parenting capacities (Bernard and Gupta, 2008) and understanding and acknowledgement of the black frame of reference will enable social workers to come up with accurate and comprehensive assessments of African black children involved with the child protection system, (Robinson 2007). Other literature is based on the ecological perspective and highlights the importance to analyse the impacts of social ex clusion, poverty and immigration on black African children and their families, (Gibbs and Huang 2003). However, Robinson 1998 argues that there is a danger of over-generalising and stereotyping because individual members from the same culture can behave differently from the pattern that is typical of that culture. However, other researchers argue that postmodern theories have gained popularity in social work, (Pease and Fook 1999; Leonard 1997). Researchers have argued against postmodern theories who want a better understanding of identity, combining personal with structural elements of living (Dominelli 2002; Graham 2002), drawing on the idea of what holds people together, (Badiou 2001). The lack of appropriate preventative support services which are culture sensitive often result in social work operating against the interests of black children involved in child protection, (Barn 1993, Graham 2002). Social work has operated within a problem oriented framework which is characterised by deficit and dysfunctional theories of black families (Robinson 2008). Major finding in literature and research Research agrees that black African children and their families are disproportionately represented in child protection (Graham, 2006; Barn et al 1997; Bernard and Gupta 2008). When looking at experiences of black African children and their families and how best to offer them appropriate intervention it is important to acknowledge background in terms of religion, culture, language and beliefs (Bernard and Gupta 2008; Gibbs and Huang 2003; Robinson 2007). Research shows that black African families may experience oppression and discrimination within the child protection system (Chand, 2008). A lot of literature appears to draw attention to the parenting in African families and how their culture is neglected in a lot researches and there is little empirical evidence especially about African parenting in Britain (Bernard, 2002; Graham 2006). Parenting by African families is entwined into an already debate of what constitutes child abuse (Francis, 1993; Chand 2000). Barn, 2002 argues that c hild abuse is a socially constructed phenomenon and most of literature surrounding child abuse is based on western societys views and middle-class. This can lead to discrimination and stereotypes towards African families rearing practices and lead to unwanted intervention and social care involvement. There is well documented literature focused on how culture influence parenting of African families involved with child protection system, (Brophy et al 2003, Bernard, 2002; Graham 2006). However, the empirical research is limited but the little data that exists poses the notion that cultural practices appear to play some part in African children being involved in the child protection system, (Mama, 2004). Literature suggests that African families practice harsh punishment for children, however, Barn et al 2006; Thoburn et al 2005; Nobes and Smith 1997, challenge such stereotypes and in their study, they found no significant differences between ethnic groups with regard to physical punis hment. However, these studies cannot be generalised to African families easily because the majority of the participants where white parents. There is gap in research on the parenting by black African families and a recurrent theme in literature is the need to acknowledge cultural and social contexts of parenting and experience of African black families to make sense of child abuse and provide appropriate intervention for children and families involved in the child protection system, (Holland 2004, Robinson 2007, Stobart 2006). A focus on ethnicity or identity, preclude issues of power and oppression operating in the everyday experiences of childrens lives to be appreciated, (Graham, 2007). Research found that most black African families live in poverty and social exclusion and how this impacts on parenting, (Bernard and Gupta 2008; Gibbs and Huang 2003; Robinson 2007; Platt, 2007). A study of more than 7,000 children looked after by 13 Local Authorities found that children who were not of the white origin where more likely to be put into care due to poverty (Sinclair et al, 2007). Sinclair et als study is very important b ecause it is a comprehensive qualitative study which focuses on the needs of children in care systems involving their perspectives and investigates the outcomes for children. The study also suggests how the care system should function and managed which is important to social work professionals and policy makers. However, data produced cannot be easily generalised to the entire population of African children because their experiences varies. There has been research critically examining the treatment of asylum seeking children and the child protection system and there is argument between the Children Act 1989 and immigration legislation and policy and Jones (2001) argues that social work profession singularly failed to provide critical scrutiny on the status and relationship of immigration and child care law and the erosion of childrens rights. Other researchers agree with Jones, that vulnerability of asylum seeking children has emotional and legal aspects, (Woodcock, 2003; Chase, 2009). Kohli 2006, argues that legislation obstruct the provision of preventative services to vulnerable children and their families. Research has highlighted the fragility of African children who claim asylum such as having suffering trauma due to their circumstances that led them to claim asylum such as war and torture, (Hodes, 2000, 2002; Ehntholt and Yule, 2006; Dyregrov and Yule, 2006). Research shows that there is a gap in research on asyl um seeking children and social work to inform practice, (Kohli and Mather 2003; Okitikpi and Aymer 2003). Rustin 2005, states that there is a complicated interaction between social workers knowledge in asylum seeking children and the existing stereotypes regarding these groups of service-users, (Bernard and Gupta 2008; Robinson 2007; Barn 1993; Owen and Statham 2009). Bernard and Gupta (2008) go on to cite other factors that affect African children such as asylum seeking, AIDS, loss and separation and this is important because when providing intervention to African children there is need to comprehend their background to offer appropriate services which do not discriminate them any further. Young (1990) states that black children often experience multiple-oppression for example, they suffer from stereotypes from society and also they are invisible to the child protection system. Graham (1999) goes on to argue that intervention with African families is at the centre of wider debates and conflict; and evidence from research continues to show over-representation of African children and their families in child protection. The debates seem to focus on power imbalances and how to involve African families to gain control over their lives, (Graham, 1999; Young, 1990). Other researchers highlight the issues of language in child protection and the provision of appropriate intervention services, (Chand 2000, Ahmed et al, 1982). The use of children as translators in sensitive child protection issues is unethical and inappropriate, and also the use of an interpreter can distort the assessment process, (Chand, 2000). Bernard and Gupta (2008) go further to look at other factors that affect black African children that other literature seems to neglect such as how gender norms place women in an inferior position within African cultures and this can limit mothers to protect their children in the environment of domestic violence, however Owen and Statham (2009) argues that the is limited evidence to maintain or challenge this notion. Nevertheless, in Masson et al (2008) study, domestic violence was evidenced as a cause of concern in the court files of half the children of Black African mothers implicated in their study of care proceedings. Research and evidence from Climbie enquiry propose that social work professionals involved with black and minority ethnic families might not act in child abuse cases because of fear of being regarded as a racist (Scorer, 2005; Bernard and Gupta, 2006). Nevertheless, literature and research fail to provide a large amount of evidence to support this notion for example, Gordon and Gibbons (1998) in their study found no differences between ethnicity in terms of children being placed on the child protection register and factors such as parents mental health problems, criminal activities or the child not fitting in a reconstituted family were the reasons for involvement than ethnicity (Williams and Soydan, 2005). However, Selwyn et al 2008 found that social work professionals were more uncertain and occasionally puzzled regarding how best to promote the needs of ethnic children and they felt further self-doubting in their assessment. Recurring themes in literature is the significance of so cial work professionals to build up on culturally sensitive work with black and ethnic families (Gray et al., 2008; Sue, 2006; Laird, 2008; Stirling et al., 2009; Hodge, 2001). Anti-discriminatory perspectives and the incorporation of knowledge from service users Thompson, (2008) states that anti-discriminatory practice has been used in Britain to account for good practice in social work to counter structural disadvantages however, Graham 1999, argues that anti-discriminatory practice fails to provide a knowledge base for social work that is engaged in the collective development of the black community. Professionals can indirectly oppress African children and their families through practice for example, by imposing their personal values or power, (Dominelli 2007). Research and literature talks about the child protection providing cultural sensitive services and training social work professionals have the knowledge and skills in working with different cultures. However this can actually create further oppression and social divisions. The majority of the workers will have dominant Eurocentric views which encourage further social divisions for example, excepting the view that African families live in poverty and not fight and challenge this view by providing services that help families to counter these structural inequalities in society. Dominelli (2007) argues that there is need to address the systems that reaffirm racist dynamics rather than challenging them. Dominelli (1992) argues that black children and families are over-represented in the controlling aspects of social work and under-represented in the welfare aspects of social work. Problems with communication and working in partnership have been highlighted in literature. Chases (2009) study found that young people described complex relationships with social workers and other social care professionals and were also more mistrustful of the interplay between social care and immigration services. There is limited research that incorporates service user involvement (Buchanan 2007; Bernard 2002) taking in their lived experiences however, an important study by Chase 2009 found that young people often described complex relationships with social workers and other social care professionals and were also more mistrustful of the interplay between social care and immigration services. Recent policy has tried to enforce advocacy as a way of promoting social justice and incorporate disadvantaged groups views on the services that are appropriate for them. In Bowes and Sims (2006) empirical study, they found that black and minority ethnic communities gave support to advocacy s ervices, however, they were still marginalised by the services they were already using. There appears to be a need of qualitative research and literature that includes an extensive study of black African childrens perspectives and experiences, (Graham 2007) which forms a value base to inform practice in social work. Relevance to policy and practice Using the ecological approach the Framework For Assessment of Children in Need and their Families (DoH, 2000), places a requirement on social work professionals to take account of cultural background and socio-economic positions of families paying attention to power imbalances in relationships, (Dalrymple and Burke, 1995). Dalrymple and Burke (1995) argue that an understanding is needed of the association between personal experience and structural realism of inequality. Therefore service users perspectives should form part of policies and legislation respecting and literature highlights that childrens rights may still lack from policy and legislation, therefore, these notions challenge professionals to take childrens views seriously and appreciate their contribution to research, (Aubrey and Dahl 2006). Lots of research appears to focus on empowerment through cultural knowledge inviting new thinking about the challenges faced by black communities, (Aubrey and Dahl 2006). The complex s ocial circumstances experienced by many African families pose challenges for social work professionals working to safeguard and promote childrens welfare. In order to safeguard and promote welfare of African children acknowledgement of sources of discrimination and oppression, a commitment to human rights and social justice must be met. Several authors have critically analysed the evidence on service provision for black families in general. A pathologising approach to black families may lead to unnecessary coercive intervention and on the other hand a cultural relativist approach may lead to a non-intervention when services are required (Dominelli 1997, Chand 2000). Either way appropriate intervention is not provided for black and ethnic minority children. The quality of services in black communities is a focus for debate and raises important issues about the lack of policy initiatives based upon needs and aspirations of local communities (Graham, 2002). By drawing on strengths perspective professionals can illuminate how parents draw on cultures as a resource to parents in circumstance of adversity whilst not excusing behaviour that is harmful to children. Conclusions There is gaps in research on child protection and black African families and a recurrent theme in literature is the need to acknowledge cultural and social contexts of parenting and experience of African black families to make sense of child abuse and provide appropriate intervention for children and families involved in the child protection system, (Holland 2004, Robinson 2007, Stobart 2006). Research shows that there is a gap in research on asylum seeking children and social work to inform practice, (Kohli and Mather 2003; Okitikpi and Aymer 2003). There is need for research centred on black African children and there is also need to involve them in forming of policies, challenging the notion that only ethnicity causes the experiences faced by African children. This is because by having cultural sensitive intervention, there can be reinforcement of stereotypical services and discrimination ignoring other things such as gender, age and class.

Essay --

Child Soldiers: Child soldiers need to be psychologically deconstructed after they’re programmed by warlords. They spent most of their childhood fighting in a war or running away from it. The world needs to start helping children around the world that go through war and fighting in it. Psychology abuse effects on former child soldiers were more likely to present severe mental health problems such as symptoms of posttraumatic stress disorder (PTSD) and depression. As children continue to be exploited by armed groups all over the world, special mental health interventions for child soldiers are ever more necessary. Children who were abducted at younger ages were more likely to report symptoms of depression over time than those who were older. The emotional consequences for the majority of the children are sad moods, preoccupations, suicidal thoughts and fears. Most of them experienced loss in relation to the death of members of their family and social status as a result of their actions. Most of the child soldiers were separated from their parents for a long period and many have lost the sense of family belongingness. Their family ties are wrecked. These children are separated from their cultural, social and moral identity, and it makes them vulnerable to psychologi cal and social ill effects. Those with PTSD have intrusive memories of the war, flashbacks, emotional arousal, emotional numbing and various other anxiety related symptoms. Many avoid places and conversations related to their past experiences. Some children are reluctant to go back to their native villages may be due to shame or guilt. In order to make children pliable, it is essential that recruitment be as traumatic as possible so that they will be psychologically w... ...ainwashing as well as brutal treatment to motivate them to fight and endure the deprivations of the campaigns. Children are sometimes abducted from their families and communities by warlords and military groups in need of fresh troops. Others join â€Å"voluntarily† they join because of hunger and extreme poverty or family dissolution. Children who find themselves orphans as a result of war may decide to join a paramilitary group in order to get food, clothing and relative protection. However, whichever way they became part of armed forces, children are all initially submitted to cruel and brutal treatment, beatings and humiliation of different sorts to make them dependent upon the armed group and deter escape attempts. When military leaders are the sole protection against widespread violence, children identify with them and become dependent on them for their every need. Essay -- Child Soldiers: Child soldiers need to be psychologically deconstructed after they’re programmed by warlords. They spent most of their childhood fighting in a war or running away from it. The world needs to start helping children around the world that go through war and fighting in it. Psychology abuse effects on former child soldiers were more likely to present severe mental health problems such as symptoms of posttraumatic stress disorder (PTSD) and depression. As children continue to be exploited by armed groups all over the world, special mental health interventions for child soldiers are ever more necessary. Children who were abducted at younger ages were more likely to report symptoms of depression over time than those who were older. The emotional consequences for the majority of the children are sad moods, preoccupations, suicidal thoughts and fears. Most of them experienced loss in relation to the death of members of their family and social status as a result of their actions. Most of the child soldiers were separated from their parents for a long period and many have lost the sense of family belongingness. Their family ties are wrecked. These children are separated from their cultural, social and moral identity, and it makes them vulnerable to psychologi cal and social ill effects. Those with PTSD have intrusive memories of the war, flashbacks, emotional arousal, emotional numbing and various other anxiety related symptoms. Many avoid places and conversations related to their past experiences. Some children are reluctant to go back to their native villages may be due to shame or guilt. In order to make children pliable, it is essential that recruitment be as traumatic as possible so that they will be psychologically w... ...ainwashing as well as brutal treatment to motivate them to fight and endure the deprivations of the campaigns. Children are sometimes abducted from their families and communities by warlords and military groups in need of fresh troops. Others join â€Å"voluntarily† they join because of hunger and extreme poverty or family dissolution. Children who find themselves orphans as a result of war may decide to join a paramilitary group in order to get food, clothing and relative protection. However, whichever way they became part of armed forces, children are all initially submitted to cruel and brutal treatment, beatings and humiliation of different sorts to make them dependent upon the armed group and deter escape attempts. When military leaders are the sole protection against widespread violence, children identify with them and become dependent on them for their every need.

Ozone Depletion and Monthly Test English

Pick out the nouns in each sentence. Write them on the sheet provided, Then, write A if the noun names a person, B- a place, C-a thing, and D – an event. Example: The boys played their toys. Answer: boys – person , toys – thing 1. Do you have a map of the Philippines? 2. The children were tired after their field trip. 3. Our parents always remind us to respect the elders. 4. The earthquake originated in Martinique. 5. Aunt Ana forgot her umbrella. B. Stem-option Directions: Choose an appropriate noun to complete each sentence.Write the letter of your answer on the sheet provided. 1. The athlete wave the Philippine all day. A. Frog b. Flag c. Flood 2. The strong typhoon blew down the on the road. A. Balloon b. Trees c. People 3. Brenda can't pay the phone bill because she has no c. Pony 4. The loud scared the children. A. Thunder b. Typhoon c. Earthquake 5. Animals in the circus do funny c. Tricks a. Feet C. Identification . A. Honey b. Money noun. Directions: Id entify the underline noun as common or proper Example: Linda is baking a cake for her family. Answer: Linda – proper noun 1. The Philippines has three major islands .Basketball Is a very popular sports in our country. 3. Hans Christian Andersen Is an author of classic children's stories. 4. â€Å"The Little 5. Some modern appliances contribute to the depletion of the ozone layer. II. READING A. Stem Option Variety Directions: Write the missing last two letters of the words given below. Make sure that the completed words fit the description of the phrases. Write the whole word on the sheet provided. Example: the same as a present gig_ Answer: gift 1. To go up the stairs – clip 2. The color produced when red and white are combined -pi ace as a disguise – ma 4. Meeting that is worn on the waist be 5. To open and close the eyes blip . 3. Is placed on the A. Directions: Pick -out the words with consonant digraphs. Write your answer on the sheet provided. Prepared by : Ms. Railway P. Eternal Grade School Department

Nursing in preventing hospital Essay

The aim of this essay is to ascertain what hospital acquired infection entails, the detrimental effects it causes and to highlight the active role nurses can take in the prevention of this type of infection. Hospital acquired (or nosocomial) infection is: ‘one that originated in the hospital environment; i.e. was not present or incubating on admission and which appeared 48h or more after admission’ (Azzam et al. 2001). Infection is caused by pathogenic organisms which invade the hosts immunological defence mechanism; this can be through wounds left by invasive procedures whereby the host’s natural body defences have been bypassed. It is the nurses’ responsibility to know the factors that can increase patients’ susceptibility to infection (i.e. age, underlying disease, drug therapy, or if they are undergoing surgery), this enables nurses to be able to assess which patients are most at risk so that they can develop a care plan and therefore they will know what extra, if any, precautions to take and protocols to follow. Sproat and Inglis (1992) cited by Mallett et al. (2000, p, 40) suggest that the assessment of a patient’s risk of infection to others, in nursing care plans, before the commencement of any procedure is a fundamental principle of infection control. The Bowell-Webster risk assessment guide for identifying patients at risk of infection (1990) cited in Alexander et al. (2000, p, 595) can be used to decide which protocols to follow. Steed (1999) states that not all nosocomial infections relate directly to the patients’ underlying disease but that many are caused by the actions of healthcare workers. Therefore great care must be taken by healthcare workers, especially nurses, who are directly involved in the care of patients. In this essay I am going to discuss the procedures followed by nurses to eradicate, if at all possible, cross infection. There are two ways of acquiring an infection in hospital: Cross (or exogenous) infection is when the infection has been spread from other people, either patients, visitors, hospital staff or even food and the surrounding environment; whereas self (or endogenous) infection is when the  infection is caused by microbes carried by the patient on their body, usually from septic areas. Compliance with universal precautions should be rigorous as to avoid spread of infection. For example, failure to change gloves between interactions with different patients can lead to the spread of disease (Piro et al. 2001). Ayliffe et al. (1992) contended that the regularity of infection in hospitals, caused by multiple types of bacteria, could increase to epidemic amounts if aseptic and hygienic measures in the hospital collapsed. According to the Healthcare-associated Infection surveillance Centre (2000) approximately 30% of nosocomial infections are due to urinary tract infections, another 30% are due to bloodstream infections, 20% due to surgical site infections and 20% due to pneumonia. These infections tend to occur during invasive procedures or when the body is very susceptible due to illness. The NHSSB infection control manual (1996) states that the inter-hospital transportation of infected patients is the main means of spreading infection and in extreme circumstances of spreading an epidemic strain. The spread of infection in hospitals between patients, or between patients and staff, cannot be entirely eradicated but it can be reduced, especially by nurses using methods I will discuss later. Evidence supporting the importance of infection control can be seen in a study by Worsley (1993) cited in Mallett et al. (2000, p,47) who found that in 1991 out of 175 patients who had developed nosocomial Clostridium difficile diarrhoea, 17 died and the organism was a contributing factor in a further 43 deaths. The cost of managing this outbreak was at least  £75000. Also in a study conducted by Plowman et al. (2001) they concluded that approximately 10% of patients will get infected during a stay in hospital and that this can lead to costs of up to one billion pounds per year in the U.K alone. These pieces of evidence and others (Chaudhuri, 1993) demonstrate the prevalence of nosocomial infection, the dire effects of it and also the extreme financial losses it incurs. Hospital acquired infection has many different consequences, it can: Delay or prevent recovery; Cause increased pain, discomfort and anxiety; Increase the patients stay in hospital which has financial losses due to drugs bills and extra staffing costs; Cause psychological stress as a result of long periods spent in isolation (Knowles, 1993, cited by Mallett et al. 2000, p, 47); it is demoralising for both staff, patients and their families which can lead to decreased public confidence in hospitals and doctors. Mc Millan Jackson (1999) insists that infection prevention and control is essential in healthcare settings to reduce the risks of morbidity and mortality in patients and healthcare workers. Nurses share responsibility with other healthcare professionals to reduce the risk of infection in patients. Patients have a right to be protected from preventable infection and nurses have a duty to safeguard the well-being of their patients (King, 1998, cited by Mallett et al. 2000, p, 39). The Nursing and Midwifery Council (NMC) Code of Professional Conduct (2002) outlines the nurses’ professional code, and also has implications for the role of the nurse in infection control, requiring them to protect patients and fellow healthcare workers from risks such as cross-infection. Clause 1 of the code informs nurses that, ‘You have a duty of care to your patients and clients, who are entitled to receive safe and competent care’. To fulfil these criteria, nurses must ensure that care is taken to ensure that dangerous or potentially harmful substances (e.g. drugs) or articles are handled and stored safely and that all equipment and appliances are properly maintained. Nurses are role models to the people with whom they come into contact, whether it is patients, visitors, students, or any healthcare workers. Therefore they should insist on compliance with basic procedures and practices as part of their job. They must assume responsibility for these practices as they are also held accountable under the NMC code of conduct and so should be at the forefront of efforts to prevent and control infections. Many infections are acquired through the patient’s own lack of knowledge of the effectiveness of simple procedure, such as hand washing, therefore the nurse has role to fulfil in providing education for patients and their families to give them a greater understanding of the importance of the need for thorough compliance of these procedures. ‘Standard precautions are designed to define a high standard of routine care that will be effective in reducing the transmission of potential pathogens between patients/ clients whilst protecting staff from pathogens carried by patients/ clients’ (NHSSB, infection control policy, 1996). General principles of infection control which all nurses must adhere to according to the Royal College of Nursing (1995) are, to: Wash hands before and after general patient care; Cover all cuts and abrasions with impermeable dressings; Use disposable gloves and aprons where necessary; Clean up spills and body fluids immediately according to local guidelines; Use and dispose of sharps safely, do not resheath needles; Dispose of clinical waste according to local guidelines; Handle and transport specimens safely by following local guidelines; Handle soiled linen according to guidelines; Use disinfection and sterilisation procedures following guidelines. Healthcare professionals need to have basic knowledge about the steps in the chain of infection to be able to determine how to control infection itself. These are: the causative agent; the reservoir; the portal of exit from reservoir; the mode of transmission from reservoir to susceptible host; the portal of entry into susceptible host; and the susceptible host. The main ways to interrupt the transmission of infection between humans and therefore break this chain is through the mode of transmission, this is achieved by: hand washing; aseptic technique; sterilisation and disinfection; and isolation procedures. Overviews of epidemiological evidence (Gould, 1991, Sharir, 2001) have shown that hand washing techniques are often inadequate and infrequent, and that the quality of hand washing is more important than the quantity (Van der  Broek et al. 2001). These conclude that hand medicated transmission is a major contributing factor in the current infection threats to hospital patients. According to RCN guidelines (1995) hands should be washed: before and after any duty which involves close contact with a patient; before and after aseptic technique or invasive procedures; after contact with body secretions/ excretions; after handling contaminated laundry or equipment; after removal of gloves, masks and aprons; before administration of food, drink and drugs; and at the end of a span of duty. Precautions adopted to destroy pathogens, prevent the spread of infection and to protect patients against infection during their stay in hospital, include the use of barrier nursing and the aseptic technique. These are adopted to increase the patient’s resistance to infection, to eradicate the sources or potential sources of infection and to minimise, or if possible stop, the means of bacterial transfer to the uninfected patient. The idea of barrier nursing is to keep an infectious patient, and materials they have been in contact with, apart from vulnerable others. This can be achieved by isolating the patient in a single room or by isolating a number of infectious patients in a purpose built ward. Another method used is to isolate patients whose immune systems are severely depressed thereby protecting them from harmful organisms. This is usually referred to as reverse barrier nursing. Aseptic technique is the use of sterile equipment and fluids, when carrying out any invasive procedure that breaches the body’s normal anatomical defences, to prevent contamination of wounds and other vulnerable sites by pathogens in the operating theatre, the ward, and other treatment areas. These procedures can only be effective if the healthcare professional, i.e. nurses who are in contact with the patients adhere to the general policies relating to the care of patients, especially infectious ones, such as hand washing and protection of personal clothing. It is my personal responsibility as a student nurse to ensure that I am fully immunised against common diseases, and diseases I may be in contact with in the  healthcare setting, if there is a vaccine available. If I feel that I am ill and suspect that my illness may put patients at risk of infection, it is my duty to inform the necessary people and to stay off work. It is also my duty to remove any jewellery (with the exception of a wedding ring) before work, to keep my nails short and clean, and to keep my hair (if long) tied back. Recent studies have proven the importance of wearing a clean uniform each day to work, and that you should ensure that your uniform is laundered at as high a temperature as the garment allows (Perry et al. 2001). During my clinical placement I had to adopt barrier nursing techniques due to a patient on my ward having Methicillin Resistant Staphylococcus Aureus (MRSA). I was therefore required to adhere to more thorough precautions when dealing with this particular patient. Source isolation was partially used to deal with this patient as I was working in an open mental health ward, therefore the patient could only be segregated to a certain degree. The nursing staff then needed to be aware of this patient’s movement so that we were effectively able to disinfect the areas she came into contact with as detailed in the local procedure we used. During meal times this patient had her meal brought into the ward to her on a tray, once she was finished I had to follow the local procedure by washing my hands with chlorhexidine gluconate 4% before donning gloves, I then had to place her used tray in an alginate polythene bag (which dissolves in the dishwasher), where it would then have been brought to the kitchens to be cleaned separately and at a higher temperature from the usual dishes. Next I had to change my gloves and then disinfect the table and chair, at which the patient had been sitting, with Haz tab solution, then rinse the area with fresh water and let air dry. Finally I remove and dispose of my gloves appropriately and wash my hands, with chlorhexidine in 70% Isopropyl alcohol solution, and dry with paper towels. In this way staff and the other patients are protected from contamination. As I have shown many hospital acquired infections can be easily prevented by the compliance of simple procedures, thereby reducing the extra costs hospital trusts and governments have had to pay, and most importantly reducing the ill effects caused to patients and their families. Not all  hospital acquired infection can be prevented, but with nurses and other healthcare workers working together in the constant assessment and evaluation of all techniques utilised, so that they remain consistent and be improved if necessary, there is no reason why they cannot be severely reduced. In conclusion it is clear to see that it is the nurse who has the primary role in implementing procedures used for the control and prevention of infection, with the intension to curb its spread and thereby ensuring that all patients are able to be cared for in a safe environment, as is their right. REFERENCES Alexander, M.F., Fawcett, J.N. and Runciman, P.J. (editors) (2nd edition) (2000) Nursing practice: Hospital and Home – The adult. Edinburugh: Churchill Livingstone. Ayliffe, G.A.J., Lowbury, E.J.L., Geddes, A.M., Williams, J.D. (editors) (3rd edition) (1992) Control of Hospital Infection, A practical handbook. London: Chapman and Hall Medical Azzam, R. and Dramaix, M. (2001) A one-day prevalence survey of hospital- acquired infections in Lebanon. Journal of Hospital Infection, 49: 74-78. Chaudhuri, A.K. (1993) Infection control in hospitals: has its quality enhancing and cost effective role been appreciated? Journal of Hospital Infection, 25: 1-6. Gould, D. (1991) Nurses’ hands as vectors of hospital-acquired infection: a review. Journal of Advanced Nursing, 16: 1216-1225. Symth, E.T.M. (director) Healthcare- associated Infection Surveillance Centre (2000). Mallett, J. and Dougherty, L. (editors) (5th edition) (2000) The Royal Marsden Hospital: Manual of Clinical Nursing Procedures. Oxon: Blackwell Science. Mc Millan Jackson, M. Nursing Clinics of north America: Contemporary Infection Control for Nurses. The healthcare marketplace in the next millennium and nurses’ roles in infection prevention and control. Vol 34, number 2, June 1999. Northern Health and Social Services Board, (1996) infection control manual. Nursing and Midwifery Council, Code of Professional Conduct, (2002). London: NMC. Perry, C., Marshall, R. and Jones, E. (2001) Bacterial contamination of uniforms. Journal of Hospital infection, 48: 238- 241. Piro, S., Sammud, M., Badi, S. and Al Ssabi, L. (2001) Hospital acquired malaria transmitted by contaminated gloves. Journal of Hospital Infection, 47: 156-158. Plowman, R., Graves, N., Griffin, M.A.S., Roberts, J.A., Swan, A.V., Cookson, B. and Taylor, L. (2001) The rate and cost of hospital-acquired infections occurring in patients admitted to selected specialties of a district general hospital in England and the national burden imposed. Journal of Hospital infection, 47: 198- 209. Royal College of Nursing: Guidelines on Infection Control, for nurses in general practice. (1995) London: RCN. Sharir, R., Teitler, N., Lavi, I. and Raz, R. (2001) High-level handwashing compliance in a community teaching hospital: a challenge that can be met! Journal of Hospital infection, 49: 55- 58. Steed, C.J. Nursing Clinics of North America: Contemporary Infection Control for Nurses. Common infections acquired in the hospital, the nurses role in Prevention. Vol 34, Number 2, June 1999. Van der Broek, P.J., Verbakel-Salomons, E.M.A. and Bernords, A.T. (2001) Handwashing quality not quantity. Journal of Hospital Infection, 49: 297.

How to Meet People in College

How to Meet People in College Knowing how to meet people in college can be more challenging than you might have expected. There are tons of students, yes, but it can be hard to make individual connections in the crowds. If youre not sure where to start, consider one of these ten ideas: Join a club. You dont need to know anyone in the club to join; you just need to have a general interest about the clubs activities and mission. Find a club that interests you and head to a meeting even if its the middle of the semester. Join an intramural sports team. Intramurals can be one of the best features of being in school. Youll get some exercise in, learn some great athletic skills, and of course! make some great friends in the process. Volunteer on or off campus. Volunteering can be an easy way to meet people. If you find a volunteer program or group that shares your values, you can make a difference in your community while also making some personal connections with people just like you. Win-win! Attend a religious service on-campus. Religious communities can be like a home away from home. Find a service you like and the relationships will naturally bloom. Get an on-campus job. One of the easiest ways to meet folks is to get an on-campus job that involves interacting with lots of people. Whether its making coffees in a campus coffee shop or delivering mail, working with others is a great way to get to know a lot of people. Get involved with a leadership opportunity. Being shy or an introvert doesnt mean you dont have strong leadership skills. Whether youre running for student government or just volunteering to organize a program for your club, serving in a leadership role can allow you to connect with others. Start a study group. While the main goal of a study group is to focus on academics, theres also an important social side. Find a few people who you think would work well in a study group and see if everyone wants to help each other out. Work for the campus newspaper. Whether your campus produces a daily newspaper or a weekly one, joining the staff can be a great way to meet other people. Youll not only connect with your fellow staff members, but youll also connect with all sorts of other folks doing interviews and research. Work for the campus yearbook. Just like the newspaper, the campus yearbook can be a great way to connect. Youll meet tons of folks while working hard to document all that happ ens during your time in school. Start your own club or organization! it may sound silly or even intimidating at first, but starting your own club or organization can be a great way to meet other people. And even if only a few folks show up for your first meeting, thats still a victory. Youll have found a few people you share something in common with and who, ideally, you can get to know a little better.