Tb Case Holding

Case Holding -Ensures treatment compliance -Indirectly, this will translate to treatment success or cure -Poor treatment compliance may lead to the following outcomes: oChronic infectious illness oDrug resistance oDeath Poor Case Holding 1. Inadequate drugs and poor drug distribution 2. Patient’s non-adherence 3. Physician’s non-adherence 4. Low motivation of health workers SLU PPMD Unit: Operations PTB Suspect -Cough > 2 weeks with or without the following oFever oHemoptysis oBack pains oWeight loss oEasy fatigability Refer to SLUPPMD unity for sputum AFB smear v PTB YesNo vv TreatRefer to TBDC v Send back to referring physician -Importance of taking the drug -Role of treatment partner in the family -Possible side effects -Regular physical examination Classification of TB cases 1. Pulmonary TB a. Smear positive o>2 (+) sputum AFB + radiographic abnormalities consistent with TB, OR o1 (+) sputum AFB + radiographic abnormalities consistent with active TB as determined by a physician, OR o1 (+) sputum AFB + sputum culture (+) for MTB b. Smear negative o> 3 (-) sputum AFB with radiographic abnormality consistent with active PTB, AND ono response to a course of antibiotics, AND oTBDC decides to treat the patient . Extra-Pulmonary TB (EP) a. A patient with at least one mycobacterial smear/culture positive from an extra-pulmonary site, OR b. A patient with histological &/or clinical evidence consistent with active extra-pulmonary TB and there is a decision by the TBDC to treat the patient with anti-TB drugs. -Note: All EP cases shall undergo DSSM prior to treatment Types of TB Cases -New – no Tx or 2 months -Treatment failure – still (+) on the 5th month -Other – became (+) on 2nd month; interrupted Tx but smear (-) Recommended Category of Treatment Regimen CategoryType of TB PatientTB Treatment Regimen IntensiveContinuation INew smear (+) PTB New smear (-) PTB with extensive parenchymal lesion on CXR (TBDC) EPTB and severe concomitant HIV disease2HRZE4HR IITreatment failure, RAD, relapse, other2HRZES/ HRZE5HRE IIINew smear (-) PTB with minimal parenchymal lesions on CXR (TBDC)2HRZE4HR IVChronic (still smear (+) after supervised re-treatment)Refer to specialized facility or DOTS plus center Directly Observed Treatment (DOT) -Success depends on having a responsible treatment partner. – any of the following could serve as a treatment partner: 1. DOTS facility staff such as midwife or the nurse 2. A trained community member such as the BHW, local government official or former TB patient. Schedule of DSSM Follow-up (Categories I and III) Schedule of DSSM follow-upCategory I (2HRZE/4HR)Category III (2HRZE/4HR) Regular treatment Regular1 month extension Towards the end of 2nd monthYes (if positive)Yes Towards the end of 3rd month(if negative)Yes Towards the end of 4th monthYes Towards the end of 5th monthYes Beginning of 6th monthYes Beginning of 7th monthYes Schedule of DSSM Follow-up (Category II) Schedule of DSSM follow-upCategory II (2HRZES/HRZE/5HRE) Regular Treatment1 month extension Towards the end of 3rd monthYes (if positive) Towards the end of 4th month(if negative)Yes Towards the end of 5th monthYes Towards the end of 6th monthYes Beginning of 8th monthYes Beginning of 9th monthYes Guide in Managing Adverse Reactions to Anti-TB drugs Adverse ReactionsDrug(s) probably responsibleManagement Minor GI intoleranceRHGive meds at HS or small meals Mild skin reactionsAnyGive antihistamines Orange/red color urineRifampicinReassure the patient Pain at the injection siteStreptomycinWarm compress. Rotate sites. Burning sensation in the feet due to neuropathyINHPyridoxine 100-200 mg/day for treatment; 10 mg for prevention Arthralgia due to hyperuricemiaPZAGive ASA/NSAID Flu-like symptomRifampicinGive antipyretics Major Severe skin rashAny (especially Streptomycin)Discontinue anti-TB drugs and refer to DOTS physician JaundiceRHZDiscontinue anti-TB drugs and refer to DOTS physician Impairment of visual acuity – optic neuritisEMBDiscontinue EMB and refer to ophthalmologist Hearing impairmentStreptomycinDiscontinue streptomycin and refer to DOTS physician Psychosis and convulsionINHDiscontinue INH and refer to DOTS physician Thrombocytopenia, anemia and shockRifampicinDiscontinue anti-TB drugs and refer to DOTS physician

Our Children and the Avalanche of Crud

In the essay â€Å"Buried Alive: Our Children and the Avalanche of Crud†, David Denby argues that pop culture is distinctive and damaging to children in the United States today. Pop culture is damaging because media has changed to become three- dimensional, inescapable, omnivorous, and self-referring. Media, according to Denby is everywhere; you cannot step away from the system of it. It has been known to be a commercialized aggression that puts parents on defense. Children now days have become commoditized towards television because they are being sold.Children are being treated as objects because of how television is influencing them. Television is teaching a child that is it cool to be vulgar. Denby suggest that vulgarity is a concept children do not understand because the makers of commercial cultures teach them not too. Denby argues that the old dream that parents and teachers would nurture the development of a child is now lost. Media has taken over the parental role bec ause it is teaching children negative concepts and parents do not have control over this.Irony plays a part in this aspect because this is a form of commodity. Media does not only influence children through television but also through the products that you can buy in store or online. I agree with Denby because television shows have taught children to become vulgar and stereotypical. Television shows have become increasingly influential towards children because it has been teaching children about vulgarity and stereotypes in a negative way. In the article, â€Å"Why Greek Girls are Tired of ‘Big Bang' Bullshit,† Kristy Pirone analyzes the elevision show The Big Bang Theory.The Big Bang Theory according to Pirone is a sexist and stereotypical television show that portrays men to hold a higher archery towards women. Pirone identifies this show by being sexist because â€Å"†¦ Lit] accepts the idea that only men can be â€Å"geeks† with open arms. † Chuck Lorre created The Big Bang Theory, the same man who created Two and a Half Men. Lorre is known to create shows with perpetuating stereotypes that could be insulting to men as well as women. These shows are constantly reducing women to nothing more than sex- providers and men to predatory creeps.

DIET ANALYSIS REPORT Essay Example | Topics and Well Written Essays - 1000 words

DIET ANALYSIS REPORT - Essay Example It has been found that the BMI scores that range between 20 and 25 show that an individual is normal. An individual is referred to as overweight when the BMI ranges from 25 to 30. Therefore, BMI provides a dependable indicator of an individual’s body fatness and is useful in screening for weight categories that may result in health problems. Nutrients are referred to as substances that are needed for metabolism, body growth, and other functions of the body (Morton, David, and Perry 131). Macronutrients are those nutrients that provide energy or calories. There are three classes of macronutrients: fats, proteins, and carbohydrates. The daily intake of macronutrients determines an individual’s health. The macronutrient distribution should include 10-35 percent of total calories from proteins, 45-65 percent of total calories from carbohydrates, and 20-35 percent of total calories from fats (Morton, David, and Perry 134). It is evident from the project that the subject observed the normal and healthy intake of macronutrients to some extent. Saturated fat is defined as fat that is comprised of triglycerides which contains saturated fatty acids as the only elements (Morton, David, and Perry 123). Various fats are characterized by different proportions of unsaturated and saturated fatty acids. The recommended level of the saturated fat in the body should be less than 10 percent of the daily energy intake. It is evident from the records that the subject’s saturated fat intake is within the recommended level. The subject’s saturated fat intake is 12.5 g which is about 56.0 percent of the total calorie intake per day. High level of saturated fat intake is the possible cause of overweight in human population, and can be associated with various problems, such as high blood pressure and heart attack. The subject should avoid eating large quantities of meals that contain coconut oil, chocolate, butter, cheese, cream, and cottonseed oil. Reduction of the

Discretion, Accountability & Future of Policing Essay

Discretion, Accountability & Future of Policing - Essay Example The essay will explore several theories advanced in elucidating on police discretion and how effective are these policies are in addressing the challenges facing law enforcers. Current Theories on Police Discretion Several theories have been advanced to analyze the behaviour of the police in undertaking their duties. One of the theories that have been advanced to explain the approaches to policing includes the Barley and Nixon theory. According to these authors, policing is a state of analysing the needs of the people in the society with the idea of providing security. These authors explore the activities of the police in the United States during in the 80’s and offer several lessons on policing. One of the lessons that we get to learn is that the police do not prevent crime but deal with criminal situations when they arise. However, these authors advance the theory that policing is best practised when it is analysed from a professional and constitutional manner (Broderick, 19 77). For instance, they analyse the state of policing in the United States with the aim of providing solutions and setting up policing institutions. According to Barley and Nixon, through the solution of the problems facing the police we get to solve the problems associated with policing in the society. Another theory that was advanced in the analysis of policing was done by Bernard and Angel, whereby they elucidated on the aspects of the criminal justice system. Their theory analyses the differences in police discretion from a rational goal against the functional system model. Several theories are advanced by Bernard and Angle, whereby they talk of the theory of police professionalism as highlighted by Bittner in 1974. Other theories that were analysed include the theory that looks into problem-oriented issues and community policing. One of the theories that was analysed was the broken window theory, whereby researchers looked into a system where neighbourhood order was essential, using this model it was concluded that mutual regard for the system was good. The broken window theory was in effect an approach whereby people in different neighbourhoods felt safe when the police patrolled around their homes (Broderick, 1977). However, these activities had no effect in reducing the crime rate around these neighbourhoods. Most of the theories on policing were activity oriented and thus in the late 1990’s, new theories and approaches to policing were introduced to deal with realities and complexities of criminal justice. The criminal justice system is organised in a manner where the police force remain an integral part of the system. These new theories were aimed at total re-organization of entire areas of the criminal justice system. Some theories have been linked to the societal developmental changes such as economic changes or change in imprisonment rates. The court system which operates hand in hand with the police in the criminal justice system was refor med to improve on efficiency thus leading to changes in the policing sector (Gottfredson, 1979). New and improved systems of police operations were adopted across different countries with the aim of improving the effectiveness of the different police forces. For instance, the city of Cincinnati police force has adopted the use of crime prevention data obtained through research into crime (Duffee, 1980). The city has collaborated with

American Political Parties Essay Example | Topics and Well Written Essays - 1500 words

American Political Parties - Essay Example 791, divisions began to grow as Madison urged Jefferson to join him in organizing against Hamilton leading to formation of the Democratic - Republican Party mainly by anti-federalists. The founders of this party included: Madison, Jefferson, Robert Livingstone and George Clinton of New York and Senator Aaron Burr of Virginia. In midterm Congressional elections, the party garnered majority seats in Congress with 65 members. Madison was supported by Virginia, North Carolina, Georgia, New York and Pennsylvania while New England opposed him (Reichley 32). The Democratic - Republican Party appealed to rural population and farmers; it was an agrarian party. It also advocated economic and social equality and liberal ideals. The French revolution also was an issue at the time and its supporters formed democratic societies (Democratic or Republican) and campaigned in 1794 elections for Republicans (Democratic - Republican Party). They were joined by some federalists’ to become majority party in 1795. Washington did not seek reelection for third term thus the 1996 elections pitted Adams a federalist against Jefferson a Republican. The Republican Party was defeated narrowly by Adams with 71 votes against 68. Thomas Pinckney a federalist got 59 votes and Burr (Republican) 30 votes. Jefferson became the vice president (Reichley 39). The party build up organizations to support Republican candidates and in mid elections Republicans garnered majority seats in Congress. In New York, Burr managed to get a uniform vote for the party ticket. The party got support from evangelicals who were Presbyterian New lights. Support also came from converts of rural families in South and Western frontier (Baptists and M ethodists) and Catholics because of it equalitarian ideals (Maisel, 31-75). In 1800 elections Republicans won with narrow margin with Jefferson 73 votes and Aaron Burr 73 votes, Adams 65, Pinckney 64. Due to tie, the winner was decided by House of Representatives whereby

Fat, Sick and Nearly Dead Essay Example | Topics and Well Written Essays - 500 words

Fat, Sick and Nearly Dead - Essay Example Roughly a hundred pounds overweight, stuffed with steroids and ill with an encumbering autoimmune illness, Joe Cross is unable to find hope. Fat, Sick and Nearly Dead is an inspirational and a moving documentary film that records Cross personal undertaking to gain back his fitness and health. With doctors and medication incapable to provide lasting help, Cross is left with no choice but to rely on the body's capability to cure itself. He throws the junk food out of the window and travels all across America with a juicer and generator, declaring to drink only fresh fruit and vegetable juice for the following two months. Lugubriously overweight and so close to death’s door, Phil Staples starts his personal journey to live a normal healthy life once again. What arises is astoundingly remarkable, an inspirational story of recovery and human relationship. Fat, Sick and Nearly Dead present an exceptional and heartening tale of two individuals from two different worlds that, with a c ommon goal, unite. This movie has undoubtedly opened my eyes to the reality of obesity in our society. It is a serious condition and has serious effects. There are so many people in this world right now who are suffering from overweightness. They must take action right away before their downhill path gets any worse. The consequences of obesity are great and sometimes, irreversible. Sickness and illnesses, susceptibility to heart diseases and cancer are far greater than people with a healthy weight. Discipline and the determination are the key aspects that will surely help one in regaining their health and the many years they have lost due to obesity. Your lifestyle is of utmost importance because it determines your everyday life. It defines who you are and what you are capable of. However, most importantly, your lifestyle determines how long you will live.

Managerial Accounting Essay Example | Topics and Well Written Essays - 1750 words

Managerial Accounting - Essay Example Anything in which a firm excels than its competitors is considered as its competitive advantage. Michael Porter has mentioned three main strategies in order to gain the market share by acquiring competitive advantage. They include: Cost Leadership Differentiation Focus Differentiation Cost Leadership Parts Limited is that company which doesn’t earn through number of units sold, but it maximizes its profits through the price of units. Parts Limited charges higher prices to its customer which means that they sell their products on relatively premium prices. When it comes to cost differentiation, this strategy is an option for Parts Limited. There is a possibility that the company start focusing on generating revenue not through premium prices but through number of units sold. ... In my opinion, this strategy is currently availed by Parts Limited because it is selling its unique products and charging premium prices for them. These products are perceived as unique and important in the eyes of the customers and the firm utilizing this strategy, usually is aware of the needs and unique demands of its customers. Focus Differentiation This strategy usually consists of two variants. In focus strategy a firm can either go for: a) Focus differentiation in its own target market b) Cost focus to seek cost advantage within its target market In this regard, usually targeted customers have unusual needs or the delivery of production system. Cost focus assist in acquiring cost advantage of a particular segment whereas focus differentiation fulfills the special and unique needs of the customers. As far as Parts Limited is concerned, this type of strategy cannot be applicable for a company dealing in machines industry. The reason is hardly customers are concerned about using unique and high priced parts for their machines. In fact, the emphasis is basically on sustainable and good quality products. This type of strategy mostly applies in the apparel & garment industry, cellular industry, electronics industry (including personal computers, T.Vs etc.), cosmetic industry etc. Implications of Porter’s Generic Strategy In the above section, a brief analysis has been done of each of the three porter’s strategy. Coming to back to Parts Limited and before analyzing which strategy can prove to be productive for Parts Limited; all the three strategies need to be analyzed in respect of Parts Limited. a) Product Differentiation Parts Limited has been utilizing product differentiation strategy. It

Reflection Paper 2 Research Example | Topics and Well Written Essays - 750 words

Reflection 2 - Research Paper Example In my particular case, for the past ten years, I have worked as an Instructor and Instructor Trainer of Basic Life Support (BLS) among other courses for a company owned by Jose, RN-EMT, a Florida Region American Heart Association Community Training Center (CTC) Faculty Coordinator. Jose, RN-EMT continues to limit his communication process to utilizing email with Nurse Instructors. Indeed, this communication strategy is quite good but in order to promote effective communication, there is need for improvement of this system. For instance, verbal communication through telephones and video conferencing can also act as viable strategies that can improve the communication between the parties involved. As Nurse Instructors, I think there should be more open communication channels in order to operate effectively. This enables us to create mutual understanding with different people we will be dealing with in our operations. A critical analysis of Nancy Blake and Colleen Young (2013) article t itle â€Å"How to Be an Effective Charge Nurse: Excellent communication skills, flexibility, clinical competency, and ability to make quick decisions required† shows that there are various traits that an individual should possessed in order to be an effective charge nurse. Blake and Young (2013, p.1) affirms, â€Å"The role of a charge nurse is unpredictable. It requires a person with excellent communication skills who is flexible, clinically competent and able to make decisions quickly.† In most cases, charge nurses function as liaison between middle management, staff, physicians, patients and families among other groups. Charge nurses deal with different people in their tasks hence, the reason for them to possess effective communication and leadership skills. According to Blake and Young (2013, p.1), â€Å"An effective charge nurse needs to incorporate leadership and communication skills with conflict resolution, time management and organizational techniques, delega tion, mentorship, education, and role modelling to be successful.† These characteristics are very important in as far as the effectiveness of charge nurses in dispensing their duties is concerned. This notion is supported by Grossman and Valiga (2009), who state â€Å"Leadership and followership are two separate concepts that are complementary or reciprocal, not competitive†(p. 36).   This also goes hand in hand with the aspect of culture which shapes the behavior of the employees in each department. According to Hawkins & Kratsch (2004), each unit has a culture that shapes the behavior of the people working there.   It is therefore the role of the leader to foster this culture, thus positively influence the other members to improve their performance. Non verbal communication is also important in order Aspects such as body language, facial expressions as well as tone have an impact on the way communication is carried out. The article also states that charge nurses s hould be good in delegating certain tasks to their followers in order to achieve quality patient care. One important role played by the charge nurse is to solve conflicts among the followers. This is not a very simple task since it requires someone with good communication skills in order to create mutual understanding among the warring parties. Overall, Blake and Young

Museum paper Research Example | Topics and Well Written Essays - 1000 words

Museum - Research Paper Example I choose this art because of its importance among the Egyptians. The Egyptians believed about life after death, I wanted to do more research on the art and understand why they Egyptians strongly believed in life after death. Also, wanted to know why they made the coffin to Pedi-Osiris. My curiosity to know the art features made me focus on the art. According to Witcombe, the Women from Willendrof art served as a fertility idol, which includes all the female body parts that are required for a woman to conceive and in nurturing children (3). Because of the art does not have feet, Witcombe argues that is, it may have meant to curtail the figurine’s power, that is to leave whatever responsibilities had been placed on her (8). It is because the art is also seen as a carving of an ancient goddess. If one were to ignore its religious function and fertility purpose, it could only be identified as a Stone-Age toy for a kid. However, this is unsatisfactory because of its artistic ability shown is sculpting her figure. The purpose for the coffin of the priest Pedi-Osiris art was to put Pedi-Osiris, who as a priest of the god Osiris (The Museum of Fine Arts). It severs the purpose that Egyptians believed in life after death. Since it was made in the similitude of the gods and goddess, Coffin of the priest Pedi-Osiris was to protect the deceased and help him overcome the obstructions in the journey ahead, as it would be dangerous. Placing the Women from Willendrof art, its purpose slightly changed, where looking at the art describe the beauty of a woman (Dobres 740). As opposed to these days how people view a beautiful woman as being slim, the prehistoric people appreciated the body of their women. In addition, how the breasts are big can depict that the woman can fully satisfy a young child breastfeeding. I did not see it as a religious figure, but as a symbol of fertility in prehistoric art. After seeing the Coffin of the