Lab 4 Infectious Bacterial Identification from DNA Report

4 Infectious Bacterial Identification from DNA - Lab Report Example It is difficult to identify bacterial pathogens using the common lab processes which include morphological methods and biochemical procedures (Reece et al 2012). Bacteria that are difficult to identify yield inconsistent results when analysts use these manual procedures of bacteria identification. However, the DNA sequencing method offers a better solution of identifying different types of bacteria. This report offers the procedure of identifying Burkholderia cepacia, a bacterium that causes cold in small children. Finally, add 1 cm3 of culture to all the DNA strands from different blood samples that have undergone the above procedures to identify the Burkholderia cepacia bacterium from other similar bacteria that cause cold. Pyrosequencing becomes possible in the DNA of different bacteria that cause cold in children when culture and Carlsbad solution is added to the sample DNA strands because of some bacteria’s ability to assume different colors when these solutions used in this analysis are added to them (Luna et al 2007). Therefore, Burkholderia cepacia stands out distinctively as purple which makes it easy to identify its species when considering the various bacteria that cause cold. DNA sequencing stands out to be the most effective method of identifying the many infectious bacteria that

Raid Research Essay Example for Free

Raid Research Essay The word RAID stands for redundant ray of independent disks. Raid is usually used in environments with servers or at a business with large file servers, transaction of application servers, where data accessibility is critical, and fault tolerance is required. There are 8 types of raids, Raid 0 is technically not a raid level because it offers no fault tolerance but, it operates by providing data stripping which takes the information and spreads it out over all the disk drives. However, if one drive fails than the entire raid fails. Raid 1 is also referred to as disk mirroring; it basically takes the information from one disk and stores it on multiple disks, this is great for fault tolerance because if one disk fails the information is on another disk. The only drawback to raid 1 is data access speed and the cost because there are more disks involved. Raid 5 is considerably the most commonly used Raid level simply because it provides both stripping and parity. The parity block is distributed to all of the drives making it easier to access the information or have a balanced access load. The parity in raid 5 is used if one of the drives happens to fail, to recover that drive which makes the raid 5 the most common however the only drawback to this raid level is that it has a relatively slow write cycle. Lastly, RAID level 6 which is very similar to raid level 5 but provides two parity functions rather than just one. A minimum of four disks is required to create RAID level 6. Raid level 0, even though it offers no redundancy, is still of use mainly to those who use applications that require high bandwidth such as data streaming or video editing software. Raid level 0 is also used because it’s most simple to implement. Raid level 1 is most expensive because it requires more disks to implement. It also requires heavy software manipulation and configuration to implement Raid level 1. If I were to purchase raid it would absolutely be raid level 0 simply because its easy to implement and it would be efficient for my personal usage.

Management of Diabetic Foot Ulcers

Management of Diabetic Foot Ulcers Diabetic foot disorders are the rated as the number one cause of hospitalisation for diabetic mellitus patients in the United States and abroad. Among these disorders are, foot infection, ulcerations, cellulitis and gangrene. It is estimated that a 100 people per week lose a digit, foot or a lower limb due to diabetes mellitus8. Diabetic foot disorders and its long term complications account for direct medical budget of hundreds of millions of dollars annually, including lengthy hospital stay of patients and lengthened periods of disability. In the UK, diabetes cost the NHS over  £5 million pounds per annum and the cost of diabetic foot complications including amputations was  £252 million in 2003. Figures show that 1 in 10 foot ulcers result in the amputation of a foot or a leg. The most distinguishing foot complication of diabetes is the ulcer, which is of course a major risk factor for amputation. Mortality rates after amputation are as high as 50 percent in diabetic patients. Although the primary pathogenesis is neuropathy, immunopathy and vasculopathy (ischemia), diabetic foot ulcer is attributed to a number of other risk factors. Early detection of these risk factors as well as the foot ulcers themselves is crucial in the general management of diabetic foot ulcers and amputation prevention. Therefore, immediate and aggressive treatment of all diabetic foot ulcers can prevent worsening of the complication and the need for amputation. The objective of treatment as a result should be prompt intervention to allow good healing of the ulcer and once healed, to prevent its recurrence. However, the optimum care for foot ulcers rest upon the treatment teams understanding of the pathophysiology associated with diabetic foot ulcers, familiarity with current methods of treatment and the concept that the multidisciplinary team approach is the gold standard in preventing limb amputation. And above all, prevention of foot lesions should be ranked highest amongst all priorities. EPIDERMIOLOGY There is no concrete data illustrating the true picture of the incidence and prevalence of diabetic foot ulcers. However, majority of the information gathered about its aetiology is based upon national hospital discharge survey (NHDS) data, which does not include a vast number of patients with ulcerations treated on the outpatient basis. Cross-sectional and population-based studies help to approximate the distribution and frequency of diabetic foot ulcers, while prospective cohort studies and retrospective case-control studies are instrumental in detecting associated risk factors for the foot lesions. According to Reiber et als epidemiological review, chronic ulcers represented 2.7% of all diabetes related admissions and 46% of all admissions due to any ulcer condition. The 1983-1990 NHDS survey also revealed that the highest ulcer rates were found in individuals aged 45-64 years, with male preponderance over the female. The average length of stay (LOS) for diabetes pat ients discharged with ulcers was 59% more than in patients without ulcers, around 14 and 8 days, respectively. Numerous population-based studies record a yearly incidence of diabetic foot ulcers in the magnitude of 2% 3% in both type 1 diabetes mellitus (IDDM) and type 2 diabetes mellitus (NIDDM) patients, while the prevalence ranges between 4% and 10%. These studies also suggest a widespread trend for higher prevalence of ulcerations with increasing age and duration of diabetes. Once ulcerations have occurred, recurrence rate can get to 50% in 2 years and 70% in 5 years. Despite the fact that mortality linked with diabetic foot ulcerations has not been recorded, 70% to 80% of amputations of the lower extremity can be lead by foot ulcers. Amputation is one of the most common sequels in persons with diabetes mellitus now exceeds 100,000 per year in the United States and amputations involving the leg, foot or toe(s) are not uncommon. Approximately 15% of patients with diabetic foot u lceration will require amputations due to uncontrolled infection, gangrene or failure of the ulcers to heal. Unfortunately, there is a 3-year survival rate of 50% after the amputation of a lower limb, while the 5-year survival rate is approximately 40%. Subsequently, less than half of the patients who end up with lower extremity amputation (LEA) of one limb go on to develop a severe contralateral ulcer within a space of 2 years, thereby putting the future of the other limb at risk as well. AETIOLOGY/PATHOPHYSIOLOGY Several factors have been implicated in association with diabetic foot ulcers. These factors include the intrinsic complications of diabetes mellitus in affiliation with some extrinsic factors and together predispose the diabetic patient to the risk of developing foot lesions. The trilogy of peripheral neuropathy, peripheral arterial disease (ischemia) and susceptibility to infection (immunopathy) are the main predisposing factors for lesions on the foot. The impact of peripheral neuropathy may not be easily detectable, with little or no signs and symptoms. Notwithstanding, its pathology advances fast and the end stage of tissue necrosis quickly reached. Distal sensory neuropathy can be seen in 20% to 50% of patients with type 2 diabetes. This decreases the protective sensation in the feet, leading to abnormal spreading of foot pressure and shear stresses with subsequent callus formation. This in turn diminishes the patients ability to perceive minor trauma to the foot and this is de monstrable by vibration perception threshold (VPT) and insensitivity to a 10g monofilament, which conveys a 7-fold and 18-fold risk of foot ulceration respectively. Distal motor neuropathy precedes atrophy of the intrinsic and extrinsic musculature of the foot, with accompanying deformities of the toes and metatarsals heads on the plantar aspects of both feet and consequent bunions on the 1st and 5th metatarsal-phalangeal joints. However, these irregularities of the feet cause an increase in the foot pressures, particularly around the bony prominences, thus resulting in more calluses forming. These calluses then go on to further increase the local subcutaneous pressure, ultimately resulting into haemorrhage beneath the callus, a lesion known as the pre-ulcer is then formed. With progressive pressure mounting on the pre-ulcer, the overriding skin breaks down to produce an ulcer. In addition, distal autonomic neuropathy could as well spark a plantar ulcer directly by reducing sweating in the feet with consequent drying and cracking of the skin28.Peripheral arterial disease and impaired cutaneous circulation are also important risk factors for both ulcerations and LEA. Peripheral arterial ischemia sometimes produces ischemic ulcers, but these are rare occurrences i.e. (1% 2% incidence) than neuropathic ulcers (65%) or combined neuroischaemic ulcers (25%) 28. Transcutaneous oxygen tension (Tc pO2) levels less than 30mmHg and absence of peripheral pulses or past history of vascular surgery are strong separate predictors of ulceration. Diabetic foot infections often set in and complicate already settled foot ulcers. Although, infections play an integral part in the pathway to lower limb amputation, there is inconclusive data with regards to the position of susceptibility to infection in causing ulceration. Even though, most ulcers are caused by minor foot trauma, and in some cases the patient takes no notice of because of the sensory neuropathy. These minor injuries (i.e. extrinsic factors which include; wearing ill-fitting/brand new shoes, hot soaks occupational hazards and to a lesser extent self-induced trauma by cutting toe nails or calluses) constitute the leading cause of acute precipitant of diabetic foot ulcers. In addition, there are also a number of intrinsic factors which could predispose diabetics to developing foot ulcers and they include; longstanding diabetes, past history of ulcers or amputation, age, weight, retinopathy, nephropathy and structural deformities of the foot (i.e. Charcot foot) have al l been associated as risk factors for ulcerations. However, bad biomechanical function arising from the complications of diabetes generally leads to foot injuries in most diabetic patient. ASSESSMENT OF DIABETIC FOOT ULCERS A detailed and well organised evaluation of the lower extremities is crucial when commencing the treatment of a diabetic foot ulcer. Before carrying out the physical examination of the limbs, it is noteworthy to perform a quick inspection of the patients shoes for good fit, foreign objects and the wear and tear patterns. The clinical evaluation must include an appropriate assessment of the ulcers aetiology, its extent and depth, presence and severity of both local and systemic infection and peripheral vascular status. A comprehensive assessment of the patients general health and glycaemic control, extent of peripheral neuropathy, a careful, yet detailed dermatologic and musculoskeletal examination should also be included in the evaluation. These assessments determine the ulcers healing rate, potential progression to LEA, and the likelihood of reoccurrence. Therefore, they should be accomplished urgently in the ambulatory or hospital setting and require a multidisciplinary team approach, with possible consults to the infectious disease specialist, podiatry, vascular and orthopaedic surgeons. Bilateral lower limb pulses must be examined. When pulses are diminished or not palpable, Doppler segmental pressures to the toes or TcpO2 measurement are indicated and the vascular experts should be brought on broad. The neurological evaluation should assess the patients sensorium and deep tendon reflexes. The ankle and knee reflexes are tested with the aid of a simple neurological hammer, while the important aspects in the evaluation of the sensorium are: reduced sensation to pain, light touch, hot/cold and vibratory sensation. Pain sensation is easily assessed with a disposable needle. A piece of cotton ball, lambs wool or 10-g monofilament can be used to evaluate the light touch and a 128-Hz or 512-Hz tuning fork or biothesiometer are approved for vibratory evaluation. Cold perception is also assessed by submerging the metal arm of a neurological hammer into cold water and then placing it against the patients skin. Anatomical deformities such as hammertoes, previous foot amputation, or Charcot joints often produce high pressure areas which result in ulceration. The musculoskeletal evaluation cannot be done by visual inspection of structural findings alone, it must also include testing for muscle strength, weakness, atrophy and contracture. Assessment of joint range of movement and gait evaluation with computerised plantar pressure analysis will also be of great value in appreciating the abnormal dysfunction contributing to ulceration. Examination of the skin of both feet is also carried out with detailed attention to the quality and integrity of the skin around the interdigital areas. Changes in the colour of the skin often associated with spotted rashes and heel fissures are suggestive of a significant level of ischemia. Toenail changes and presence of subungual drainage are pointers to a proximal source of infection. Clinical assessment of the ulcer should include a detailed description of its appearance as well as the measurement of the ulcers diameter with a wound measuring guide. Outlines of the ulcer on a translucent film or plastic sheet can also promote this process. This must be documented and retraced at subsequent visits to assess the treatment process. The depth and extent of the wound should be carefully explored with a blunt sterile probe. Special care must be taken to probe for hidden sinus tracts and subcutaneous abscesses or to identify tendon, bone or muscle or joint involvement. Ulcer depth is a significant predictor of healing rate, possibility of concurrent osteomyelitis and the chances for amputation. The presence of infection is a huge cause of the need for hospitalization. Therefore, a general assessment with physical examination, laboratory investigations and radiographic studies is important in classifying infection as absent, mild, moderate or severe. This classification acts as a guide to determine or select the initial antibiotic therapy and to decide when to hospitalise the patient. Clinical signs of infection such as purulent discharge, odour, cellulitis, fever and leucocytosis must be documented. However, Leucocytosis and fever might not always be noticeable even in the presence of acute osteomyelitis. Approximately 54% of patients with diabetic foot infections had normal white blood cell count and no fever44. Bacteria cultures of anaerobes and aerobes (both gram positive and gram negative) should be obtained from the base of the ulcer, bone or blood or from all three depending on the clinical setting. This helps in clarifying the true hidden pathogens and may facilitate the decision to adjust initial antibiotic therapy. Physical examination of signs of infection in the patient centers on the presence or absence of systemic responses such as fever, tachycardia, sweats or hypotension and the appearance of the wound and adjacent tissues. Early signs of infection are evident by increased amount of exudates from the wound, base of the ulcer changes from pink granulation to yellowish- grey tissue, tenderness and induration around the ulcer. Infection should be considered severe when the patient present with systemic toxicity, signs of fascilitis or a rim of erythema around the ulcer greater than 2cm in diameter. Laboratory investigation to confirm the presence of infection should include white blood cell count and differential which could show leucocytosis or a shift to the left or both, erythrocyte sedimentation rate (ESR) which when elevated above 40mm/hr is a strong indicator of osteomyelitis28. In addition, glucose, bicarbonates and creatinine levels are tested to rule out possible hyperglycaemia, metabolic acidosis or azotemia from dehydration which strongly suggest the presence of a severe infection. Radiological evaluation should be obtained promptly to ascertain the presence of fractures, foreign objects or signs of osteomyelitis. Plain x-rays have a low sensitivity, thus they should be interpreted with caution as changes in the foot caused by Charcot foot could mirror those osteomyelitis when seen on a plain x-ray. However, a normal plain x-ray of the foot does not rule out osteomyelitis, a repeat should be requested 2 weeks later to exclude occult osteomyelitis. As indicated, other imaging modalities can aid in the diagnosis of osteomyelitis such as CT scans, magnetic resonance scan (MRI) or leukocyte scans and each having their own strengths and limitations. TREATMENT Management of the foot ulcer is mostly determined by its severity, vascularity and the presence of infection1. Recognition of its root cause will serve as a guide during the course of treatment. However, a multidisciplinary team consisting of specialist from podiatry, orthopaedic surgery, vascular surgery, the infectious disease service and diabetic education service should be involved in the management. The multidisciplinary team approach is due to the complicated nature of the disease itself as well as managing the various comorbidities associated with foot ulcers. In addition, the approach has been demonstrated in clinical trials to produce significant outcomes in terms of improvement and reduce the incidence of major amputations. The wound should be immediately relieved of all pressures, elevated and rested at first presentation. Effective local wound care must be carried out and ill- fitting footwear should be discarded and replaced with appropriate surgical or relief shoes for protection. And in cases where total nonweightbearing with crutches is impossible, a pressure felt padding or foam can be used in the surgical shoes. However, the total contact cast (TCC) is considered gold standard to protect neuropathic ulceration during ambulation due to its ability to eliminate high pressure areas under the foot. Adequate alternatives to the TCC are the Scotchcast Boot or removable walking braces. Treatment of hyperglycaemia, ketoacidosis, renal insufficiency and other comorbidities that may coincide in the ulcerated patient should be treated simultaneously with the foot lesion. Consultations to internal medicine, endocrinology and cardiology are generally frequent when managing acutely infected patient who need to be hospitalised. Such consultations are usually sought early in course of treatment to ensure good metabolic control. Diabetic foot infections are usually polymicrobial and as such initial antibiotic therapy should be broad-spectrum after obtaining good aerobics and anaerobic culture samples. Antibiotic therapy should be later modified according to the culture and sensitivity test and the patients clinical response to the initial therapy. Surgical debridement and drainage or local partial amputations are crucial adjuncts to antibiotic therapy. Underlying osteomyelitis usually present in moderate to severe infections and often requires aggressive bony resection of infected bone and joints accompanied by cultured -directed antibiotics for 4 6 weeks. Foot ulcer patients with underlying ischemia should undergo revascularization with angioplasty or vascular bypass procedure if its anatomically possible. Even with severe distal arterial obstruction, revascularization to return pulsation to the foot is a major part of the limb-salvage strategy and may be accomplished in such patients. However, where revascularization is not feasible or in cases of advanced infection or extensive necrosis, amputation at some level may be required. Wound care is also necessary after surgical or sharp debridement of all callus and necrotic tissue58. Practically, a warm, moist environment conducive for wound healing should be maintained.This can be arranged using saline wet/dry dressings or special dressings such as semipermeable films, hydrogels, calcium alginates and hydrocolloids. Tissue-engineering dermis is a more recent class of biologic dressing and has been tested to be more effective than saline dressings. There is little evidence to support the role of topical enzymes and should be avoided. Although the role of topical growth factors in the healing rate of ulcers is beneficial, however, they are expensive and should be limited to patients whose ulcers cease to improve after 4-6 weeks of adequate therapy. PREVENTION OF RECURRENCE AND AMPUTATION Prevention is regarded as a major aspect in avoiding ulcer relapse and diabetic lower limb amputation. Recurrence rate with diabetic foot ulcers and LEA are as high as 50% -70% over three years. Comprehensive intervention programs tailored to individual patients can lower these rates and can be accomplished with a multidisciplinary team approach. Control of both macrovascular and microvascular risk factors is also of great importance. Patient education and re-education plays a primary, yet active role in this program and involves instruction in foot hygiene, the need for daily inspection, proper footwear and the necessity of prompt treatment of new lesions. In addition, regular and frequent visit to a diabetic foot care program is crucial. The feet must be thoroughly inspected at every visit and should include debridement of calluses and ingrown toenails. This provides an excellent opportunity to back up self care behaviour as well as allowing early detection of new or imminent foot problems. Appropriate therapeutic footwear with pressure-relieving insoles and high toe box which protect the high risk foot are an essential element of the prevention program and have been associated with significant reductions in ulcer development. Subsequently, patients with major structural deformities may benefit from reconstructive surgery to prevent recurrent foot ulcers. Surgery may be especially suitable in patients who cannot be accommodated in therapeutic footwear. And because patients with healed ulcers are at risk for future ulceration, these preventive measures must be integrated into a long life strategy and treatment program. CONCLUSION Diabetic foot ulcerations, infections, gangrene and lower extremity amputations (LEA) are major causes of disability to patients with diabetes mellitus. And these often results in extensive periods of hospitalisation, substantial morbidity and mortality. Although not all such lesions can be prevented, it is certainly possible to reduce their incidence by proper management and prevention programs. A multidisciplinary team approach to diabetic foot disorders has been regularly proven to be the best method in achieving favorable rates of limb salvage in this high risk population. Foot care programs accentuating preventive management can reduce the incidence of foot ulceration through modification of self care practices, appropriate evaluation of risk factors and formulation of treatment protocols directed at patient education/re-education, early intervention, limb preservation and prevention of new lesions. The joint team of medical, surgical, rehabilitative and footwear specialist shou ld impart effective and coordinated services for acutely infected or ischemic inpatients as well as management for the outgoing patients. In general, the incidence and morbidity of diabetic limb amputations can be reduced if the above principles are embraced and integrated into everyday patient management protocol.

The Coach That Never Came :: essays research papers

The book, â€Å"The Coach That Never Came† was a very interesting book. In the beginning, John, Steve, Mike, and Craig were all talking about their new baseball coach that they were going to be getting that day. The boys had never heard of the man and no one in the town seemed to know who he was. The boys talk about their new coach all day while they are in school. After school was over that day, the boys went to the baseball field to prepare for their first day of baseball practice. Practice was to start at 3:30. It was 3:45 now, and their new coach hadn’t arrived yet. The boys, along with the rest of the team, waited around for awhile for their coach to come. After waiting for about an hour, they became curious and decided that they would go to Coach Anderson’s house to see why he wasn’t at practice. Craig said that he knew where the coach lived, because he had heard his mother talking on the phone about him. As the boys arrived at the house, they saw that the door was partially open, so they decided to let themselves in since no one answered the door when they knocked. As the boys entered the house, they couldn’t decide on which room they wanted to go in first. They quickly decided on that when they saw a person lying on the floor in the kitchen. The boys quickly ran out of the house and ran to Mike’s house to call the police. When the police arrived to Mr. Anderson’s house, they told the boys that their coach had a heart attack and died. The boys were very upset by this since they had never even met the man. Eventually, the story goes on and the boys get a new coach, but they never really get over what the found that day.   Ã‚  Ã‚  Ã‚  Ã‚  I feel that one of the main characters in this book would have to be Craig. He has black hair, green eyes and is of average height. Craig was just a usual guy until all of this happened to him. He received good grades in school, and was a great student. Craig’s parents were very proud of him and thought that he was the greatest son that anyone could ever have. Craig is a senior at Central High School, and was already crowned Homecoming King.

Research for a Database For a Travel Agents Essay

Introduction I have been given a task to make things easier for a travel agent called Type a Flight. Type a Flight is a travel agent which is situated in Warrington and it was established in 2005 and it also has about 500 customers. The company does all its work manually. They keep their documents in filing cabinets. So when customers call in to book flights then they have to look in the cabinets for a document. This is very time consuming and due to this problem they could loose a fantastic amount of customers because they will get tired on the phone. Filing cabinets also take up a lot of space. This is getting very difficult and time consuming as the number of customers is rising on a daily basis. One of the problems is that it takes time writing letters by hand .For this problem I have come to conclusion that I will create template letters for the company and these can be sent out to customers to tell the customers that their ticket is ready or for any reasons. The conclusion I have come to is that I am going to help the agency in every single way. My main aim is to make the agency more professional and more modern and make things easier for them. For me to do my task, I will need a computer and a few important application softwares with which I shall make a database, logo and other things. Research I had a look at a database which I was shown by my class teacher. It was called ‘Type of Flight’. In the database it had things like name, ID, gender, telephone number. Database: Type a Flight Comment: The logo is located on the centre of the switchboard. The logo is got to do with holidays and other things which the agency offers. Around the logo there are the buttons which will be needed. The database has things like name, town, address, telephone numbers, date of birth, gender postcode and other few things. The database makes things easier and quicker now. This was done by putting queries, forms and a switchboard. Tasks To do my task I have broke the task into the following five parts: 1. Getting information about the travel agency. 2. Design a logo and a slogan for the travel agency. 3. Create a database, Queries, Forms and switchboard. 4. Create a letterhead and design letter templates. 5. Writing reports at the end (User Guides). 1. Getting information about the travel agency a. I can do this task by going on the internet but I will not do it this way because on the internet it will not tell you how the agency works. b. I can also do this task by going around and asking a few people but will not use it because people might not have the correct and up to date information. c. I will do this task this by ‘Interviewing the agency manager’ because he will know the latest information and what problems there are in the agency. 1. What problems do you have in the agency? 2. How many customers does the agency have? Less than 100 100-250 250-500 More than 500 3. How are the documents of the customers stored? Filing Cabinet Other 4. What do you think of a computerized way to remove your problems? 5. Do your employees know how to use Microsoft Access? Yes No Do not know 6. Are your employees capable of using a switchboard? Yes No Do not know 7. Does the agency have letter templates? Yes No 8. Does the agency have a good logo? Yes No 9. Do the employees need a user guide? Yes No 10. What changes will the agency have if the computerized way was used? 2. Design a logo and a slogan for the travel agency a. I can do this task by using Microsoft Word but will not do it this way because it does not have many of the tools needed to make a logo but I can make the slogan on it. b. I can also do this task by using Adobe Photoshop but will not use it because the application is quite complicated for me. c. I will do this task this by using ‘Paint’ because It offers a good amount of tools which can be used to make a good logo and a slogan. 3. Create a database, Queries, Forms and switchboard a. I can do this task by using pen and paper but will not do it this way because it will be time consuming and many mistakes can be made. b. I can also do this task by using Open Office Base but will not use it because it is harder to use than Microsoft Access. c. I will do this task this by using ‘Microsoft Access’ because I can make databases, Queries, Forms and switchboards more quicker because I have used it many times before. 4. Create a letterhead and design letter templates a. I can do this task by using Microsoft Publisher but will not do it this way because it is a little hard to create a letter template but a letterhead can be produced easily. b. I can also do this task by using Paint but will not use it because it is not suitable for large amount writing. c. I will do this task this by using ‘Microsoft Word’ because this application is good for making letterheads and letter templates as it gives a step by step way of making it. 5. Writing reports at the end (User Guides) a. I can do this task by using WordPad but will not do it this way because it is not possible to put in arrows to make things clearer to people. b. I can also do this task by doing it on paper and there after scan it but will not use it because it may not be neat and professional enough. c. I will do this task this by using ‘Microsoft Word’ because I can take screen shots and then I can paste them onto the page. There after I will put in arrows and any other things if needed to label it clearly with information so that people fully understand. Input, Output, Process and Storage After my research and looking at the various tasks, I can establish what the input, output and storage of the system is. Ease of use The final product that I will make would consist of database, queries, forms and letterheads. It would be easy for the agency to use because I think the employees are more or less familiar with computers and using the applications needed. I will also supply them with a user guide. The user guide will be simple and very easy to use. It will have screenshots and clear labeling with arrows so if the employees get stuck any where then they could refer to the user guide which has clear instructions and easy step by step of using any application. After using the user guide the employees should have no doubt in using an application. Description of problem = 1 Plan of solution = 1 Methods = 1 Solution meets requirement = 1 Ease of use = 1

Current Issues in Nursing Essay Example

Current Issues in Nursing Essay Example Current Issues in Nursing Essay Current Issues in Nursing Essay Ph. D. and Ann L. Curley, Ph. D. , R. N. The challenges of operating 24/7, focusing on scheduling, training, and staffing. Despite projections that nursing is one of the top ten growth jobs for the next 15 years, our health care system is on the verge of an overwhelming nurse shortage and health care crisis. Adding to the problem is the fact that hospitals and many other health care facilities are extended hours operations that face unique challenges unknown to the 9-5 world. Hazards for nurses discussed in the book: * Health care shows the second highest turnover rate of all â€Å"extended hours† industries * Nursing is one of the ten industries with the highest levels of occupational injury or illness requiring days away from work. * The most prevalent injuries in nursing are musculoskeletal disorders and needlestick injuries. In 89% of needlesticks, the needle was contaminated. * Work related fatigue prompted nearly 20% of nurses to cite â€Å"having an accident while commuting back home† as one of the top three jobs related health and safety risks. * Nurses show high instances of sleep disorders severely affecting productivity. * High failure and short staffing severely affect quality of patient care. ?Problems With Nursing Informatics By: Heidi Cardenas Informatics is the process of advancing in a discipline with a combination of data, information and knowledge. Nursing informatics encompasses the devices, machines, resources, and methods of utilizing information, computers, and nursing science in nursing. Its a recognized specialty for registered nurses, but does present challenges that academics and medical practitioners are working to improve or eliminate. Significance * In 2007, the Healthcare Information and Management Systems Society Nursing Informatics Awareness Task Force estimated that 50 percent of a nurses time is spent on documentation. Because of explosive strides in information technology and the huge body of medical knowledge amassed, controlling medical errors and health care costs are paramount in the health care professions, including nursing. According to RN Journal, handwriting on a piece of paper has been largely replaced by reports from medical devices at the point of care, and nurses have to master electronic documentation. Function * Nursing documentation is complex and situation-dependent. With different technology and medical charting methods in use, consistent education and training on documentation is difficult to achieve, especially electronically. Considerations * There is no single device that generates a comprehensive patient record, stores it and makes it accessible to care providers in different locations. Bar codes on medicines, computerized physician order-entry, automated scheduling systems for nurse administrators, nursing student preparation for IT tools and HIPAA concerns are just a few of the problems in nursing informatics. Potential * Mobile devices, communication technologies, efficient applications, and enhanced workflow and documentation will be the norm going forward and in the future. Ideally, every nurse would learn a universal IT platform for all patient care, but that is an almost unobtainable goal with the rapid advances in research, medicine and information technology. One thing is certainnursing and information technology are integrally intertwined and will remain so in the future. ? Occupational Health and Safety Issues Among Nurses in the Philippines By: A. B. de Castro, PhD, MSN/MPH, RN, Suzanne L. Cabrera, MN, RN, Gilbert C. Gee, PhD, Kaori Fushijiro, PhD and Eularito A. Tagalog, RN, COHN Abstract * Nursing is a hazardous occupation in the United States, but little is known about workplace health and safety issues facing the nursing work force in the Philippines. In this article, work-related problems among a sample of nurses in the Philippines are described. Cross-sectional data were collected through a self-administered survey during the Philippine Nurses Association 2007 convention. Measures included four categories: work-related demographics, occupational injury/illness, reporting behavior, and safety concerns. Approximately 40% of nurses had experienced at least one injury or illness in the past year, and 80% had experienced back pain. Most who had an injury did not report it. The top ranking concerns were stress and overwork. Filipino nurses encounter considerable health and safety concerns that are similar to those encountered by nurses in other countries. Future research should examine the work organization factors that contribute to these concerns and strengthen policies to promote health and safety. ?The National Nursing Crisis: 7 Strategic Solutions By: Jaime Z. Galvez Tan M. D. , M. P. H. Introduction At the rate we are losing monthly our highly skilled nurses to the United States, the United Kingdom, Ireland and the Netherlands, and with the Philippine government, via the Department of Health raising its hands in helplessness, offering no strategic solutions in sight, expect a worsening of the health crisis already plaguing our country. It is not only the nurses the country is losing, our medical doctors are now enrolling in nursing schools offering an abbreviated course for doctors to become nurses. ? Ethical Dilemmas in Nursing By: Jenifer Wilson-Barnett Abstract. Nurses are increasingly realizing that they can offer relevant information and participate in decision-making involving ethical issues. However, inter-professional communications are frequently inadequate, and do not permit exchange of opinions. The consequences are often frustrating and upsetting for nurses whose care is affected by others policies. ? Unemployment * The Professional Regulation Commission estimates the number of jobless Filipino nurses to hit 298,000 this year, to include the 68,000 who took the local licensure exam in December. ? RN Heals Department Order No. 2012-0184 (DO 2012-0184). * The Order speaks of the following interesting points: * RNheals nurses are not ‘employed’ but rather are intended for learning and development. Nurses under the program are not regular employees but pre-service trainees. They are given stipend/allowances not salaries. * RNheals 4 tour of duty will be from January to December 2013. Nurses will be assigned in DOH Hospitals (Hospital Setting) or Rural Health Units (Community Setting). Stipend/allowance for RN Heals 2013 is still 8,000 per month with PhilHealth and GSIS Insurance. * Nurses are to be awarded with Certificate of Completion after satisfactorily completing the RNheals program. * RN Heals 4 Recruitment and selection period will be from October 29, 2012 to November 2012. * Application forms shall be submitted directly to CHDs for community setting and DOH Hospitals for hospital setting. * ONLY NURSES WITH PRC LICENSE are eligible to apply. * Nurses who have previously engaged in RNHeals are not qualified to re-enter the project. * In case of absences, a fixed amount of Php 363. 00 per day shall be deducted. * Stipend shall be given on or before every 10th and 25th day of the month. * Eight training hours per day shall be completed by the nurse.

Family Planning Research Paper Essays

Family Planning Research Paper Essays Family Planning Research Paper Essay Family Planning Research Paper Essay Camarines Sur Polytechnic Colleges Naga Campus FAMILY PLANNING PRACTICES OF COUPLES In Barangay Sto. Tomas, Camaligan Camarines Sur In partial fulfillment of the requirement in SOC. SCI 10, Society of Culture with Family Planning, HIV/AIDS Submitted by: Mayores, Dennis B. Olarve, Raymund Salveo L. Pacamarra, Hazel E. BSEd 3 – Physics Submitted to: Dr. Geronima Camano-Valenciano Professor October 4, 2010 TABLE OF CONTENTS Title Page Table of Contents CHAPTER I: Introduction CHAPTER II: Research Methodology CHAPTER III: Presentation of Findings, Analysis and Discussion CHAPTER IV: Summary of Conclusion and Recommendation BIBLIOGRAPHY APPENDICES Appendix A: Sample Questionnaire Appendix B: Letter of Permission to conduct survey Appendix C: List of Respondents Appendix D: Barangay Official of Sto. Tomas Appendix E: Documentation Appendix F: Curriculum Vitae CHAPTER III Presentation of Findings, Analysis and Discussion This chapter presents the overview of the results that was gathered from 40 respondents of Husband and Wife of their Family Planning Practices in Barangay Sto. Tomas, Camaligan Camarines Sur. Table 1: Educational Attainment of Respondents The table presents the Highest Educational attainment of Couples. 22. 5% said they reached Elementary level only, 40% said they reached High School, 35% said they reached the College Level and 2. 5% said they reached Vocational Course. Table 2: Married and Unmarried Couple The table presents the ratio of married and unmarried couple when they start living together. 36 respondents out of 40 said that they are married or 18 couples said they are married already while 4 respondents out of 40 or 2 couples are not married yet since they started living together. Table 3: Family Planning of Couples : The table presents the data gathered from three questions that answer if the Couple planned the no. of children to have, if the Couple talk about methods of Family Planning and if they consulted the Health Center for information about Family Planning. The result state that 40 respondents or 100% planned the no. of children they are going to have. The Couple that talked about Family Planning and consulted the Health Center is 75% while 25% answered no. Table 4: Use of Methods or Contraceptives between Couples The table presents the Methods or Contraceptives used of Couples. 17. % used Female Sterilization to stop bearing a child for mother, 2. 5% used Male Sterilization to stop giving birth to a child for Father, 12. 5% used Injection to avoid having a baby for few months, 12. 5% use male condom that is use before sexual intercourse, 2. 5% used the method of Rhythm Calendar that calculate what day in a month does a female is impossible to be pregnant, 2. 5% used traditional method tha t use herbal medicine, 5% used the Natural method and 32. 5% don’t or never used a method or contraceptive for Family Planning. Table 5: Medium that gives information for Family Planning The table shows the medium where couples see, hear, or read something that gives information about Family Planning. 33 respondents said they heard some from Radio, 38 respondents said they watched some from television, 18 respondents said they read it from newspapers, 9 respondents said they read it from Magazine, 7 respondents said they read some from Posters, and 6 respondents said they saw some from billboards. Table 6: Services or Information given from different Mediums. The table shows the information or services given by different medium (radio, television, newspaper, magazine, poster, and billboard). 6 respondents said the information was about Family Planning, 20 respondents said it was about the use of contraceptives or methods while 11 respondents said it was about vaccination. Table 7: Family Planning Effect The Table shows if Population growth can be controlled by the use of Family Planning between Couples and if abortion is a typr of Family Planning Method. 40 responden ts or 100% said that Family Planning can really help the control of Population growth and also 40 respondents or 100% said that abortion is not part of Family Planning Method. CHAPTER IV Summary of Conclusion and Recommendation CONCLUSION 1. Most of the couples finished college level before they started living as a couple but there are also couple that only reached the elementary level and decided to live with their partners. Studying is irrelevant for their parents don’t encourage them to pursue studies because of financial problem. That’s why they don’t know how can they took care of their children and how to plan a family because of lack of knowledge. In addition, they don’t have a high salary and can’t find a proper job. 2. Most of the couples started living together as married because they want it to be sure that they would be living together legally while only some are unmarried because they are quite young for their age. That explains how marriage is given importance before, but now, even if the girls got pregnant they are not still planning of getting married. 3. Couples normally planned on how many children are they going to have but this is usually not followed because of sexual desire of a person. Because not all are willing for family planning to be involved in their living as a couple. 4. Family Planning on later years was not yet organized that’s why old couples now are not aware and don’t even care to use methods or contraceptives regarding Family Planning. But some of them are willing to use these methods to control the population growth. 5. Information about family planning is not only given in the health center, because now there are many medium that shows the importance of family planning. It also leads to the discouragement of couples to consult to the health center because they can already find information they need in the radio, TV, newspapers, magazine, posters and even billboards. . Advertisements seen on TV or heard on radio and any other medium were more about Family Planning. Only few were about the use of contraceptives and Vaccination. It is because the Nation’s problem is population growth and advertisements can really help the citizen to get knowledge about proper family planning. 7. They all agreed that family planning is the be st way to success of each family. Because they can give their needs and wants of their children. But abortion is not an example of Family Planning because it is against the law of God. RECOMMENDATION Every person cannot control their sexual desire for their partners that’s why Family Planning method and use of contraceptives are imposed. But another reason for this is the lack of knowledge of the people or illiteracy. The government needs to put more focus on the education of citizens so that they would be taught of proper managing their lives as well as when to have a family and how to plan it. The government can give free seminar to those newly married couples and give information about the importance of Family Planning. Another thing to give prioritize are the citizens that live on rural areas where more uneducated and unemployed people are present. Because of this population explosion exists, that’s why more project about Family Planning for this place must be necessary. People are also conservative on the use of these methods and contraceptives, that’s why proper advertisements and information seen on TV or on any other medium must be made clear and simple so people won’t get the wrong interpretation about these things. Family Planning must be given emphasized and importance especially to couples for them to have the appropriate knowledge and how to use the methods involved in this and how to plan the number of children they can have. BIBLIOGRAPHY A. Books Omas-as, Roberta L. , et. al. , General Sociology:Family Planning Methods:Trinitas Publishing Inc. 2003. The New Websters International Encyclopedia. 2000 Srauss, James J. , The Media And Family Planning. Worth Publishers. Inc B. Unpublished Thesis Ross, Maricor G. , et. al. , â€Å"Socio Economic Profile of barangay San Felipe†. Camarines Sur Polytechnic Colleges, Naga City. October 2009. C. Internet aresearchguide. com/12biblio. html#4 jhuccp. org/research/download/tagalog. pdf D. Other Source LGU, Sto. Tomas, Barangay Sto. Tomas, Camaligan Camarines Sur Appendix A Camarines Sur Polytechnic Colleges Naga Campus Pangalan: ________________________________ Edad:______ father mother Trabaho:_________________________________ Bilang ng anak:________ Lugar: Barangay Sto. Tomas, Camaligan, Camarines Sur QUESTIONNAIRE about FAMILY PLANNING PRACTICES OF COUPLES Personal Data . Ano ang pinakamataas na antas sa pag-aaral ang naabot ninyo? ____________________________ 2. Ano po ang relihiyon ninyo? ____________________________ 3. Ilan po ba ang buwanang kinikita niyo para sa inyong pamilya? ____________________________ 4. Kayo po ba ay kasal na nang kayo ay magkaanak? ( )Oo( )Hindi 5. Kung Oo ilang taon na kayong kasal noon? ____________________________ 6. Ilang taon napo ba kayong nagsasama ngayon? __________________ __________ Awareness of Family Planning 1. Napagplanuhan po ba ninyo kung ilan ang magiging anak niyo? ( )Oo ( )Hindi 2. Napag-usapan ba ninyo ng inyong asawa ang tungkol sa mga pamamaraan at pagsasagawa ng pagpaplano ng pamilya? ( )Oo ( )Hindi 3. Kumunsulta na po ba kayo sa isang Health Center upang magkaroon ng impormasyon sa Family Planning? ( )Oo ( )Hindi 4. Gumamit po ba kayo ng mga method o contraceptives upang maiwasan ang pagkakaroon ng anak? ( )FEMALE STERILIZATION/TUBAL LIGATION: Ang mga babae ay maaaring mag-paopera/ magpatali para hindi na manganak ( )MALE STERILIZATION/VASECTOMY: ANG MGA LALAKI AY MAAARING MAG-PAOPERA PARA HINDI NA MAKAPAG-BIGAY NG ANAK ( )INJECTION/DMPA: ANG MGA BABAE AY MAAARING INIKSYONAN NG ISANG DOKTOR O NARS PARA HINDI MABUNTIS SA LOOB NG ILANG BUWAN ( )ORAL PILL: ANG MGA BABAE AY MAAARING UMINOM NG PILL ARAW-ARAW ( )MALE CONDOM: ANG MGA LALAKI AY MAAARING GUMAMIT NG KONDOM SA PAGTATALIK ( )FULL BREASTFEEDING OR LACTATIONAL AMENORRHEA (LAM) MAKAKAIWAS ANG MGA BABAE SA PAGBUBUNTIS HABANG NAGPAPASUSO NANG LUBOS ( )RHYTHM CALENDAR OR CALCULATION: SA PAMAMAGITAN NG KALKULASYON, RHYTHM, O CALENDARYO, ANG MAG-ASAWA AY IIWAS SA PAGTATALIK NG MGA ILANG ARAW SA ISANG BUWAN KUNG KAILAN ANG BABAE AY MAY MAS MALAKING POSIBILIDAD NA MABUNTIS ( )WITHDRAWAL: PAG-IINGAT NG LALAKI NA SA LABAS PALABASIN ANG PUNLAY ( )FEMALE CONDOM: ANG MGA BABAE AY MAAARING MAGLAGAY NG KONDOM SA LOOB BAGO MAKIPAGTALIK ( )DIAPHRAGM, FOAM, JELLY: ANG MGA BABAE AY MAAARING MAGLAGAY NG SPONGE, DIAPHRAGM, JELLY O CREAM SA LOOB BAGO MAKIPAGTALIK ( )TRADITIONAL METHODS: PAGGAMIT NG MGA HALAMANG GAMOT, SINTURON SA BAYWANG, ATBP. PARAAN ( )NATURAL FAMILY PLANNING ( )HINDI GUMAGAMIT 5. Nakakita/nakarinig/ nakabasa ba kayo ng patalastas/commercial o iba pang uri ng pagbibigay-alam tungkol sa FAMILY PLANNING sa ( )Radyo( )TV( )Dyaryo( )Magasin( )Poster( )Billboard 6. Kapag nakikita o naririnig mo ito, ano sa palagay ninyo ang klase ng serbisyong pangkalusugan o â€Å"health services† ang tinutukoy dito? ( ) Family Planning( )Contraceptive Method( )Vaccination 7. Naniniwala po ba kayo na ang kaalaman sa Family Planning ay makatutulong sa pagkontrol ng populasyon? ( )Oo ( )Hindi 8. Sa tingin niyo po ba, ang abortion ay isang Family Planning Method? ( )Oo ( )Hindi 9. Sa pangkaraniwan, kayo po ba ay sumasang-ayon o hindi sumasang-ayon sa paggamit/paggawa ng pamamaraan ng pagpaplano ng pamilya upang maiwasan ang pagbubuntis? ( )Oo ( )Hindi Appendix B September 28, 2010 Hon. JASMIN TRINIDAD Barangay Captain Sto. Tomas, Camaligan, Camarines Sur Dear Brgy. Captain Trinidad, Good Day! The undersigned students taking Bachelor of Science and Education are conducting a research on the â€Å"Family Planning Practices of Couples. † We selected your barangay as the best source of information about the matter. In this regard, may we ask permission to conduct interview to respondents of this Barangay that would greatly help us for our research. Thank you and more power. Very truly yours, The Third Year Students DENNIS B. MAYORES RAYMUND SALVEO L. OLARVEHAZEL E. PACAMARRA Noted: DR. GERONIMA CAMANO-VALENCIANO CSPC-Naga Campus, Professor Appendix C List of Respondents/ Couples Father Mother Antonino GonzalesMyrna Gonzales Arthur EspirituLorena Espiritu Benjamin GarciaAmalia Garcia Randy AyenMaricris Gonzales Rufino Sta. AnaErmina Sta. Ana Rufino Sta. Ana Sr. Asuncion Sta. Ana Noel AdversarioRose Adversario Rolando AliparMa. Gemma Alipar Romi CorpusMaria Flor Corpus Monico AlipanteRosa Alipante Rogelio RubioElizabeth Rubio Edgar RosarioCristina Rosario Joel AlbanielEvelyn Albaniel Emmanuel Del RosarioImelda Del Rosario Raul IsidroRuth Isidro Ronnie ReyesLinda Reyes Vicente ArroyoGermina Arroyo Conrado TrinidadLeticia Trinidad Domingo VillanuevaVictoria Villanueva Andres CelesteNelia Celeste Appendix D Barangay Officials of Sto. Tomas Barangay Captain Hon. Ma. Jasmin M. Trinidad Barangay Councilors Emnanuel A. Galias Ducenia A. Tolosa Maximo C. Corpus Jr. Manuel Javier H. Aurellano Nilo A. Almen Emmanel R. Abias Jovenial J. Flores SK Chairman Ma. Salone SC. Rubio Appendix E DOCUMENTATION THE RESEARCHERS, RESPONDENTS AND THE BARANGAY Appendix F Curriculum Vitae DENNIS B. MAYORES #25 Zone3, Brgy. Del Pilar, San Fernando Camarines Sur Mobile no: 09077436598 Email Address: [emailprotected] com PERSONAL INFORMATION Age: 18Date of Birth: March 5, 1992 Sex: MalePlace of Birth: San Fernando Civil Status: SingleFather’s Name: Melecio F. Mayores Nationality: FilipinoMother’s Name: Leonida B. Mayores EDUCATIONAL BACKGROUND College:Bachelor of Secondary Education Camarines Sur Polytechnic Colleges Penafrancia Ave. , Naga City 2008 – Present Highschool:San Fernando National High School Buenavista, San Fernando Camarines Sur 2004 – 2008 ElementarySan Fernando Central School Rizal, San Fernando Camarines Sur 1998 2004 RAYMUND SALVEO L. OLARVE 506 1ST st. Progress Homes Subd. Canaman Camarines Sur Mobile no: 09109696222 Email Address: [emailprotected] com PERSONAL INFORMATION Age: 17Date of Birth: June 2, 1993 Sex: MalePlace of Birth: Canaman Civil Status: SingleFather’s Name: Salveo S. Olarve Nationality: FilipinoMother’s Name: Nanette L. Olarve EDUCATIONAL BACKGROUND College:Bachelor of Secondary Education Camarines Sur Polytechnic Colleges Penafrancia Ave. , Naga City 2008 – Present Highschool:Camarines Sur National High School Penafrancia Ave. , Naga City 2004 – 2008 ElementaryTacolod Elementary School Annex Progress Homes Subd. , Canaman Camarines Sur 1998 2004 HAZEL E. PACAMARRA #015 San Jose, Camaligan Camarines Sur Mobile no: 09165235145 Email Address: [emailprotected] com PERSONAL INFORMATION Age: 18Date of Birth: May 30, 1992 Sex: FemalePlace of Birth: Goa, Camarines Sur Civil Status: SingleFather’s Name: Rannel V. Pacamarra Nationality: FilipinoMother’s Name: Mariam E. Pacamarra EDUCATIONAL BACKGROUND College:Bachelor of Secondary Education Camarines Sur Polytechnic Colleges Penafrancia Ave. , Naga City 2008 – Present Highschool:Sto. Tomas National High School Camaligan Camarines Sur 2004 – 2008 ElementaryCamaligan Central School Camaligan Camarines Sur 1998 2004