By N. Mezir. Webb Institute. 2018.
It is therefore important to make a careful balance between the risks and benefits of radiation exposure artane 2 mg amex. Ionising radiation is formed as a product of the radioactive decay of natural radioactive atoms and is part of the environment in which we live 2 mg artane amex. Terrestrial radiation is mainly emitted by radioactive atoms of uranium, thorium, radium and other atoms that are present in naturally occurring materials such as soil, rocks, bricks and tiles. There is some variation from place to place and certain types of rock, such as those found in the south-west of England, emit more radiation than others. Radium in building materials may decay and generate a radioactive gas, radon which may then be found in some homes. Low levels of natural radioactive materials are also present in food we eat, air we breathe and water and other drinks we consume, so a proportion of the radioactive atoms in our diet is also incorporated into our body tissues. The largest component is radiation from outer space although there is also a smaller component from the sun. The component from outer space consists of mainly high energy protons which reach the earth at a fairly constant rate. There are also lower energy protons originating from the sun although these are much less significant except when given off in bursts during solar particle events. Protons are charged particles and are affected by the earth’s magnetic field with more coming into the atmosphere at the poles than at the equator. In addition, as cosmic rays penetrate the atmosphere, they initiate complex reactions to produce a cascade of secondary radiation. However, all of the rays, whatever their origin, are absorbed to some degree by the atmosphere and the dose decreases as altitude reduces. Cosmic radiation intensity is generally constant although there are variations in solar activity and, as a result, both short and long term changes in the intensity and dose rate of cosmic radiation are observed. Solar activity follows a normal 11 year cycle which does affect the intensity of cosmic radiation directly. The sun emits electrons and other charged particles, the movement of which causes a solar electromagnetic field around the earth. During the solar activity maximum, the solar electromagnetic field intensity is higher than during the solar activity minimum. The stronger magnetic field around the earth provides shielding for galactic cosmic radiation which will therefore be greater during the solar maximum than during the solar minimum. The intensity of cosmic radiation at commercial aircraft altitudes is approximately 20% higher during the solar minimum than during the solar maximum. The lower energy particles of solar radiation do not contribute significantly to levels of cosmic radiation except at times of increased activity from the sun and solar particle events when the sun contributes directly to cosmic radiation intensity in the upper atmosphere by emitting high energy protons and alpha radiation. Whilst this solar cosmic radiation may not increase the cosmic radiation intensity at sea level, the exposures of aircraft occupants can be elevated. Overview of cosmic radiation The intensity of cosmic radiation in the earth’s atmosphere is not constant. Cosmic radiation is effectively absorbed by the atmosphere and as a result, higher doses are obtained at altitude than at sea level. The earth’s magnetic field also decreases the cosmic radiation penetrations through the atmosphere. Because the earth’s magnetic field has a higher intensity above the Equator than above the Poles, charged galactic cosmic radiation penetrates through the atmosphere more easily above the Poles than above the Equator. The intensity of cosmic radiation is therefore higher in the Polar Regions than above the Equator. The effect on the body therefore depends on the latitude and altitude at which the aircraft is flying and also the length of time of the exposure. A simple recording of total dose, such as may be given by a Geiger counter, will therefore give little indication of the effective dose to biological tissues. Nevertheless, radiation can be measured directly using sophisticated equipment as was carried on board the supersonic Concorde of British Airways and Air France, or indirectly using computer software programs. The latter, when supplied with such details as the route, altitudes flown, time at each altitude, and the phase of the solar cycle, are able to calculate an estimate of the radiation dose received by crew for a particular flight. Many studies have been undertaken comparing actual measurements with computer estimation with the two showing good agreement. As a result, most major European carriers estimate doses for each sector flown using a computer model taking into account all the factors which have an influence on the dose received. These include the aircraft climb and descent profiles, latitude of the flight, altitude, time of year and point in the solar cycle. These factors are taken into account in arriving at the Dose Equivalent which is measured in Sieverts (Sv). However, doses of cosmic radiation are so low that figures are usually quoted in milliSieverts (mSv), that is thousandths of a Sievert, or microSieverts (*Sv), that is millionths of a Sievert.
Percentages of responses from all respondents to "When did you last take antibiotics? More than half of respondents in Egypt reported having taken antibiotics within the past month (54%) artane 2mg, and more than three quarters (76%) of respondents in Egypt 2mg artane with visa, Sudan and India took them in the past six months. In contrast, respondents in Barbados and Serbia are noticeably less likely to have taken antibiotics recently, with only 19% reporting having taken them within the past month in both cases. Respondents in Barbados are also the most likely to have never taken antibiotics at 13% (Figure 2). Percentages of responses from all respondents to “When did you last take antibiotics? Percentages of responses from all respondents to “When did you last take antibiotics? There are also some notable differences between countries of different income levels across the 12 countries surveyed. Percentages of responses from all respondents to “When did you last take antibiotics? Percentages of responses from all respondents to “When did you last take antibiotics? How people obtained antibiotics Respondents who reported having taken antibiotics were then asked if they had obtained them (or a prescription for them) from a doctor or nurse on the occasion when they last received them. Overall, the vast majority of respondents (81%) report that they got their antibiotics (or a prescription for them) from a doctor or nurse. This was relatively consistent across the countries surveyed ( Figure 6), though the findings from the Russian Federation were particularly low on this measure, with only 56% of respondents reporting that they got their antibiotics in this way. The proportions of survey participants reporting that they got their antibiotics from a doctor or nurse in South Africa (93%), Mexico (92%), Barbados (91%), Sudan (91%) and India (90%) were all above the overall average, with at least nine out of ten. Percentages of responses from all respondents to “On that occasion, did you get the antibiotics (or a prescription for them) from a doctor or nurse? From a socio-demographic perspective, the survey finds relatively little variation around how respondents reported getting their antibiotics. Suburban respondents are slightly more likely than those in urban or rural areas to report having gotten antibiotics from a doctor or nurse, with 85% of suburban respondents obtaining antibiotics in this way compared with 80% of those in urban areas and 79% of rural respondents. Whether people received advice from a medical professional on how to take them The vast majority of respondents in all countries surveyed said they had received advice from a medical professional on how to take the antibiotics they last took (86%) (Figure 7. Percentages of responses from all respondents “On that occasion, did you get advice from a doctor, nurse or pharmacist on how to take them? Where people obtained the antibiotics Almost all respondents across the 12 countries surveyed report having obtained the antibiotics they last took from a medical stall or pharmacy (93%) (Figure 8. China and India are the only countries in which any respondents report having gotten antibiotics online, with 5% and 2% of respondents respectively saying that they got their antibiotics in this way. China is also the country with the highest number of respondents reporting that they got their antibiotics from a friend or family member, though this response was still low, at 4%. Nigeria is the country with the highest number of respondents who report getting antibiotics from a stall or hawker, though this response is low too, at 5%. Percentages of responses from all respondents “On that occasion, where did you get the antibiotics? From a socio-demographic group perspective, the data show relatively few significant differences, though Figure 9 shows that respondents in rural areas are more likely than those in urban or suburban areas to report having received antibiotics from somewhere other than a medical store or pharmacy, at 14% and 6% respectively. Percentages of responses from all respondents to “On that occasion, where did you get the antibiotics? How and when to take antibiotics Respondents were first asked whether they thought the following statement was true or false: “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” Overall, 25% of the survey respondents think this is true, whereas it is in fact a false statement. However, the findings show noticeable differences between the countries surveyed (Figure 10. In comparison, more than one third of respondents in Nigeria (37%) and Egypt (34%) think that this statement is "true". Percentage of responses from all respondents to “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” by country surveyed. Percentage of responses from all respondents to “It’s okay to use antibiotics that were given to a friend or family member, as long as they were used to treat the same illness” by education level. Survey respondents were then shown a second statement and again asked whether they thought it was true or false: “It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before” Across the countries surveyed, 43% of respondents think this is true, whereas it is in fact a false statement. The findings again show some notable differences between countries surveyed on this statement (Figure 12). Respondents in Mexico and Barbados are most likely to agree that this statement is false, with 67% and 66% respectively selecting this response. In contrast, more than half of respondents in Nigeria (56%), India (52%), Egypt (51%) and Indonesia (51%) think this incorrect statement is true. Percentage of responses from all respondents to “It’s okay to buy the same antibiotics, or request these from a doctor, if you’re sick and they helped you get better when you had the same symptoms before” by country surveyed.
Segmentation: the communicative process of targeting specific messages to a particular group of individuals rather than the public at large  2 mg artane. Social marketing: the application of marketing theories and techniques to the planning buy 2mg artane with amex, implementation, and evaluation of programmes and interventions to influence pro-social voluntary behaviour change in order to improve personal welfare, and the welfare of society . Stakeholder management: the process of identifying and engaging with stakeholders (individuals or organisations who are affected by an outcome) to help an organisation to achieve its strategic goals . Sustainability: [health promotion actions] that can maintain their benefits for communities and populations beyond their initial stage of implementation. Sustainable actions can continue to be delivered within the limits of finances, expertise, infrastructure, natural resources and participation by stakeholders . Sustaining the issue: keeping the awareness of the issue of health communication for communicable diseases high on the agenda of all stakeholders, including the public, community partners, and decision-makers . Sustaining programmes: Integrating activities through health communication for communicable diseases (e. Sustaining a partnership: developing productive working relationships and taking full advantage of the benefits of using health communication for communicable diseases with a wide range of stakeholders . Emerging zoonoses: responsible communication with the media-lessons learned and future perspectives. A literature review on effective risk communication for the prevention and control of communicable diseases in Europe. A literature review of trust and reputation management in communicable disease public health. A literature review on health information-seeking behaviour on the web: a health consumer and health professional perspective. Systematic literature review of the evidence for effective national immunisation schedule promotional communications. Strengths Weaknesses Models & theories Were there any models, theories or frameworks identified in the review? Strengths Weaknesses Tools Did the review identify any tools that facilitate step-by-step practical application? Strengths Weaknesses Evidence What evidence was identified in the review and what is the quality of this evidence? Strengths Quality Weaknesses Quality Health & communicable What evaluation outcomes were used? Strengths European focus Targeting including hard-to-reach populations Weaknesses European focus Targeting including hard-to-reach populations The reference numbering system used in this table does not stem from the completed review, published in the technical report series as: [insert full reference of relevant review]. Legend for matrix strengths and weaknesses table above Concept: Is there a commonly agreed conceptualisation for the main focus of the review? Models & theories: Are there any models, theories or frameworks identified in the review? Comment if they are specific to the topic area or health communication communicable disease. Tools: Does the review identify any tools that facilitate practical step-by-step application? Comment if they are specific to topic area or health communication/communicable diseases. Where possible, this should section should also include: Europe – is the identified application within Europe? Focus – are the applications focused on specific health topics, including communicable diseases/health communication? Targeting (hard-to-reach groups) – do the applications target hard-to-reach groups? Evidence: What evidence is identified in the review and what is the quality of this evidence? For example, these could be indirect indicators of success such as awareness /knowledge and ‘behavioural and other changes’, e. Evidence reviews A rapid evidence review of interventions for improving health literacy 10. Health literacy as a public health goal: a challenge for contemporary health and education and communication strategies into the 21st century. Complex interventions to improve the health of people with limited literacy: a systematic review. Interventions to improve health outcomes for patients with low literacy: a systematic reviewGeneIntern Med 2005; 20:185-92 18. Orthop Nurs 2008 Sep-Oct;27(5):302-17 A rapid evidence review of health advocacy for communicable diseases 20. Stop The Global Epidemic of Chronic Disease: A practical guide to successful advocacy. Public health campaigns to change industry practices that damage health: an analysis of 12 case studies. Advocacy, communication and social mobilisation for tuberculosis control: collection of country-level good practices [internet].
An increased risk of cataract formation was found in people with the highest intakes of butter artane 2mg on-line, total fat order 2 mg artane with mastercard, salt, and oil, with the exception of olive oil. Carotenoids may reduce the risk of posterior subcapsular cataracts in women who have never smoked. Observational studies have shown that regular users of vitamin E supple- ments may halve the risk of cataracts. In a longitudinal study researchers found that lens opacities were 30% less in regular users of a multiple vitamin, 57% less in regular users of supplemental vitamin E, and 42% less in those with higher plasma levels of vitamin E. A statistically significant relationship has been found between past vitamin E supplementation and prevention of cortical but not nuclear cataracts. Riboflavin and niacin supplements exert a weaker protec- tive influence on cortical cataracts. Folate 262 Part Two / Disease Management appears to be protective against nuclear cataracts, whereas both folate and vitamin B12 supplements are strongly protective against cortical cataracts. Despite data from experimental and observational studies suggesting that micronutrients with antioxidant capabilities may retard the development of age-related cataracts, overall, results of prospective trials have been disap- pointing. An uncontrolled clinical trial suggested that up to 1 g of vitamin C daily com- bined with riboflavin, 15 to 25 mg/day, and zinc, 30 mg/day, decreased the risk of senile cataracts. Diabetic cataracts are the result of prolonged sorbitol accumulation, oxidation and glycation. Flavonoids, particularly quercetin and its derivatives, are potent inhibitors of aldose reductase. Lipoic acid, with its potent antioxidant effect, may protect both vitamin C and E and reduce the risk of cataract for- mation in these patients. A combination of bilberry, standardized to contain 25% anthocyanosides (180 mg twice daily), and vitamin E in the form of dl-tocopheryl acetate (100 mg twice daily), administered for 4 months, has been found to be somewhat effective in retarding the progression of cataracts. Tavani A, Negri E, La Vecchia C: Food and nutrient intake and risk of cataract, Ann Epidemiol 6:41-46, 1966. Weber P, Bendich A, Schalch W: Vitamin C and human health—a review of recent data relevant to human requirements, Int J Vitam Nutr Res 66:19-30, 1996. Bravetti G: Preventive medical treatment of senile cataract with vitamin E and anthocyanosides: clinical evaluation, Ann Ophthalmol Clin Ocul 115:109, 1989. Patients wake from sleep at night with tingling, which subsides on shaking the hand. Mills S, Bone K: Principles and practice of phytotherapy, Edinburgh, 2000, Churchill Livingstone. Infection with oncogenic type human papilloma viruses is associated with most cases of cervical cancer; however, it is believed that nutritional status may be linked with cervical dysplasia and progression to cancer. Possible primary preventive strategies include reducing risky sexual behaviors and using dietary supplements, vaccines, and other chemopre- ventive agents. Cervical cancer should be suspected in women with an offensive, watery, brown, or clear vaginal discharge; dyspareunia; or postcoital or any other abnormal vaginal blood loss. Clinical evidence sug- gests that women deficient in folic acid, beta-carotene, selenium, and/or vitamins A, C, or E may have an increased risk for cervical dysplasia. Although the relationship with vitamin E status is less consistent, low vita- min C and carotenoid levels are associated fairly consistently with both cer- vical dysplasia and cancer. A prospective study showed that the rate of progression of carcinoma in situ or invasive cervical cancer was 4. Kwasniewska A, Tukendorf A, Semczuk M: Folate deficiency and cervical intraepithelial neoplasia, Eur J Gynaecol Oncol 18:526-30, 1997. Eichholzer M, Luthy J, Moser U, et al: Folate and the risk of colorectal, breast and cervix cancer: the epidemiological evidence, Swiss Med Wkly 131:539-49, 2001. Nagata C, Shimizu H, Higashiiwai H, et al: Serum retinol level and risk of subsequent cervical cancer in cases with cervical dysplasia, Cancer Invest 17: 253-8, 1999. Mills S, Bone K: Principles and practice of phytotherapy, Edinburgh, 2000, Churchill Livingstone. Postulates range from a psychosomatic disorder to immune dysfunction following var- ious triggers including viral infection, food, and chemical sensitivity. Vague complaints of myalgia, migratory arthralgia, sore throat, postexertional malaise, unrefreshing sleep, sleep disturbance, mild fever, and lymphadenopathy are common. In the case of the former, detection of food sensitivity and elimination of suspected problem foods may be helpful. In the case of the latter, intervention may focus on cor- recting nutritional deficiencies and improving the efficiency of cellular energy generation. Fatigue has been linked to sensitivity to sugar and grains such as wheat, corn, and rice. Elimination diets for sensitive patients and correction of gut dysbiosis with lactobacilli and bifidobacilli deserve consideration. Supplementation with at least 300 mg of magnesium and 1200 to 2400 mg of malate daily pro- duces variable results. In one group of patients, after 3 months of taking 100 mg of coenzyme Q10, daily exercise tolerance improved and clinical symptoms and postexercise fatigue decreased. Clinical trials of oral L-carnitine (up to 1 g three to four times daily) had mixed results, but in one study statistically sig- nificant improvement in a number of clinical parameters was observed between 4 and 8 weeks of treatment.
If this is not possible because you order stocks very frequently then carry out a stock take at least three times a year discount artane 2 mg online. Inventory of stock An inventory is a list of non-expendable supplies and equipment that are kept at the health facility (see Figure 2 generic artane 2 mg with mastercard. The person in charge of the health facility should keep a master copy of all items and update this list each time an item is received and issued. The person in charge of each service should keep an updated list of all the equipment and supplies they receive and include items damaged, broken or sent for repair. An inventory should be carried out at regular intervals (at least once a year) to check the condition and location of supplies and equipment in use and in stock. Checking the inventory of stock is an important part of stock control and helps to identify purchasing requirements. However, it is often forgotten and so it may be useful to have a set time or times each year for inventory checking. If packaging is damaged, products should only be used if they can be re-sterilised before use. Poorly maintained equipment deteriorates more quickly and is more likely to break down. A steriliser, for example, with a leaky seal will not sterilise its contents properly. User maintenance Health facility staff play an essential role in routine care and maintenance of instruments and equipment, especially cleaning, checking for damage and reporting any defects. You can help to remind staff about these care and maintenance tasks by putting written instructions near the equipment. Section 2 Procurement and management of supplies and equipment 29 Practical tips for steam steriliser care and maintenance ● Clean the inside of the steriliser after use and check regularly for signs of wear and damage. If there is a problem, turn off the heat, open the pressure valve and wait for the steriliser to cool. Checking the rubber seal is in ● If you cannot solve the problem, use another steriliser and place and is in good condition inform your supervisor. For example, a microscope will last around 15 years with proper care and maintenance but only around 8 years if it is not looked after properly. Refrigerators and weighing scales should last for about 8 years, sterilisers for about 6 years, and ward beds about 12 years. Manufacturers and suppliers usually provide maintenance and repair services, but may not have representatives or authorised service agents in every country. All maintenance and repair should be carried out according to the manufacturer’s instructions. Keeping the microscope clean and dust free ● Before using the microscope, wipe it with a clean cloth to remove any dirt and dust, and clean the lens with lens tissue or a separate piece of clean cotton cloth. Planned Preventive Maintenance: ● Periodically check and clean mechanical parts (adjustment, focus, stage etc). Place the checklist, which should include a cleaning and maintenance schedule and action to be taken if the equipment fails, near the equipment. Equipment can be damaged if technicians without appropriate skills or experience try to repair it. If there are long delays between fault reporting and fault repairing, review your system. On one side of the card, record details of the model, date of purchase, source, replacement parts, accessories and consumables and the manufacturer’s recommended maintenance schedule. Instruments containing tungsten carbide are easily recognisable because they have gold plated bows. Choosing new instruments Stainless steel instruments have no standard names and are often known by the name of the person who designed them or by specific features. As a result there is a wide range of instruments with the same function but different names, e. There are also groups of instruments that share similar names but perform different functions, e. Remember that the most important factor to consider when choosing an instrument is its function and purpose. Quality is important, especially for instruments that you expect to use frequently and to last a long time. Buying the cheapest, low grade instruments can be a false economy, because they may need to be repaired or replaced more often. However, it may not be cost-effective to buy top grade instruments, because it will be expensive to replace them if they get lost. To help you judge the quality of instruments before you buy them, check that: • Edges of jaws and handles are even and smooth. Section 2 Procurement and management of supplies and equipment 33 • Surface is smooth, polished or stain finished.