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By: Michael A. Gropper, MD, PhD
- Associate Professor, Department of Anesthesia, Director, Critical Care Medicine, University of California, San Francisco, CA
https://profiles.ucsf.edu/michael.gropper
Incidence rate the number of new cases diagnosed or reported with a certain disease during a defined time period (usually 1 year) divided by the to antibiotic resistant staphylococcus aureus cheap stanicid 10gm amex tal population in which the cases occurred infection 5 weeks after abortion purchase stanicid 10 gm overnight delivery. Incubation period the interval from the time of infection to bacteria lab buy stanicid 10gm with visa the time clinical signs of illness appears. Index case A person who acquires a disease through exposure and brings it in to a population. Indica to r A measure that reflects or indicates the state of a defined population. It is used to measure and communicate the result of programs as well as the process or methods used. At least 85 percent of dwellings must be sprayed for this method to give mass protection across the community. Infectious agent Bacteria, viruses, fungi or parasites or their products that can cause disease. Inputs Resources (staff, supplies, equipment, money, information) needed to carry out project activities in a given time. Intermediate Intermediate events causing temporary displacement include events event such as flooding and hurricanes and even armed conflict. Isolation Keeping infected persons or animals in separate places or under certain conditions for as long as they can transmit disease. This prevents or limits the direct or indirect transmission of the infectious agent to those who are susceptible to infection. K Term Definition Kwashiorkor Severe acute malnutrition indicated by the presence of edema of both feet. L Term Definition Leader Someone who inspires people to face challenges in order to achieve the desired results. Logistics cycle the logistics cycle of drug management includes the selection, procurement, distribution, and use of drugs. Public health guide for emergencies I 589 Annex 2 M Term Definition Malaria Person with onset of fever or his to ry of fever within the past 48 hours (with or without other symp to ms such as nausea, vomiting and diarrhoea, headache, back pain, chills, muscle pain) with positive labora to ry test for malaria parasites (blood film (thick or thin smear) or rapid diagnostic test). Management Searching for the best use of resources in pursuit of objectives subject 4 to change (Keeling). Mass An emergency such as refugees fleeing from a neighbouring country displacement or internally displaced persons such as those in Northern Uganda, with potentially longer term needs for a select population. Mass event An emergency that my have long-term or immediate health effects on the health system. Mass events with long-term implication include disasters such as earthquakes and tsunamis. Mass events with immediate implications may be caused by a bus or train or plane crash, biological warfare, fire or explosive incident, or a localised natural disaster. Maternal mortality the death of a woman while pregnant or within forty-two days of termination of pregnancy (by birth, abortion or miscarriage) due to complications from the pregnancy, delivery or management of either, or due to existing medical conditions that were aggravated by the 1 pregnancy or delivery. Maternal mortality the number of maternal deaths per 100,000 women of reproductive rate age. Calculated by adding the individual values in a group of measurements and dividing the to tal by the number of values. Means of Information or data required to assess progress against set indica to rs verification and their sources. In patients aged <12 months, a suspected case of meningitis occurs when fever is accompanied by a bulging fontanels. Probable case of bacterial meningitis Suspected case of acute meningitis, as defined above, with turbid cerebrospinal fluid. Probable case of meningococcal meningitis Suspected case of meningitis, as defined above and gram stain showing gram-negative diplococcus or ongoing epidemic or petechial or purpural rash. Mid-Upper-Arm A measure of fat and muscle in the mid-upper arm, which can be used Circumference for rapid assessments and screening. Generally, midwives are able to handle basic obstetric problems but will refer more serious complications to a physician. Minimum the minimum acceptable level (of service) to be attained in standard humanitarian assistance.
In primary infection antibiotic vancomycin order stanicid 10gm with visa, IgM antibody appears approximately 2 to antibiotics for mastitis buy stanicid 10gm on-line 3 weeks after onset of illness bacteria mod discount 10 gm stanicid with amex, but caution is advised when interpreting a single IgM antibody titer for diagnosis, because a single result can be either falsely positive because of cross-reactivity with other Chlamydia species or falsely nega tive in cases of reinfection, when IgM may not appear. C pneumoniae can be isolated from swab specimens obtained from the nasophar ynx or oropharynx or from sputum, bronchoalveolar lavage, or tissue biopsy specimens. Culturing C pneumoniae is diffcult and often fails to detect presence of the organism. A positive culture is confrmed by propagation of the isolate or a positive polymerase chain reaction assay result. Nasopharyngeal shedding can occur for months after acute disease, even with treatment. Immunohis to chemistry, used to detect C pneumoniae in tissue specimens, requires control antibodies and tissues in addition to skill in recognizing staining artifacts to avoid false-positive results. For suspected C pneumoniae infections, treatment with macrolides (eg, erythromycin, azithromycin, or clarithromycin) is recommended. Tetracycline or doxycycline may be used but should not be given routinely to children younger than 8 years of age (see Tetracyclines, p 801). Newer fuoroquinolones (levofoxacin and moxi foxacin) are alternative drugs for patients who are unable to to lerate macrolide antibiotics but should not be used as frst-line treatment. Duration of therapy typically is 10 to 14 days for eryth romycin, clarithromycin, tetracycline, or doxycycline. However, with all of these antimicrobial agents, the optimal duration of therapy is not clear. Extensive interstitial pneumonia can occur, with radiographic changes characteristically more severe than would be expected from physical examination fnd ings. Endocarditis, myocarditis, pericarditis, thrombophlebitis, nephritis, hepatitis, and encephalitis are rare complications. The term psittacosis com monly is used, although the term ornithosis more accurately describes the potential for nearly all domestic and wild birds to spread this infection, not just psittacine birds (eg, parakeets, parrots, and macaws). In the United States, psittacine birds, pigeons, and turkeys are important sources of human disease. Importation and illegal traffcking of exotic birds is associated with an increased incidence of disease in humans, because ship ping, crowding, and other stress fac to rs may increase shedding of the organism among birds with latent infection. Infection usually is acquired by inhaling aerosolized excrement or secretions from the eyes or beaks of birds. Handling of plumage and mouth- to -beak contact are the modes of exposure described most frequently, although transmission has been reported through exposure to aviaries, bird exhibits, and lawn-mowing. Excretion of C psittaci from birds may be intermittent or continuous for weeks or months. Pet own ers and workers at poultry slaughter plants, poultry farms, and pet shops are at increased risk of infection. This assay has been validated in birds but has yet to be validated for use in humans. Treatment with antimicrobial agents may suppress the antibody response, and in such cases, a third serum sample obtained 4 to 6 weeks after the acute sample may be useful in confrming the diagnosis. Culturing the organism is diffcult and should be attempted only by experienced personnel in labora to ries where strict measures to prevent spread of the organism are used during collection and handling of all specimens because of occupational and labora to ry safety concerns. Therapy should be a minimum of 10 days and should continue for 10 to 14 days after fever abates. Erythromycin and azithromycin are alternative agents and are recommended for younger children and pregnant women. All birds suspected to be the source of human infec tion should be seen by a veterinarian for evaluation and management. Birds with C psittaci infection should be isolated and treated with appropriate antimicrobial agents for at least 30 to 45 days. Birds suspected of dying from 1 C psittaci infection should be sealed in an impermeable container and transported on dry ice to a veterinary labora to ry for testing. All potentially contaminated caging and housing areas should be disinfected thoroughly before reuse to eliminate any infectious organisms. People cleaning cages or handling possibly infected birds should wear personal protective equipment including gloves, eye wear, a disposable hat, and a respira to r with N95 or higher rating.
Drugs should also be well organised by their type such as by route of administration: internal antibiotics for uti prescription discount 10gm stanicid overnight delivery, external antimicrobial sensitivity testing 10 gm stanicid otc, injectable and alphabetised so that they can be easily found infection 1 game 10gm stanicid for sale. Within each administration route category, liquid and solid drugs should be separated. Liquid medications should be kept below tablet or dry medications to prevent possible spoilage of dry medications by leakage. Use of drugs the use of drugs involves educating both the health care providers and the patients. Ensure that the labels are in a language that can be read and unders to od by the providers and patients for proper prescription and dosage. Note that the treatment pro to cols of various infectious and communicable diseases can vary greatly by region such as malaria. While collaboration between local and expatriate staff is generally not a problem in emergency settings, disagreements and cooperation problems might arise about the use of drugs. Prescription habits in many developing countries also include a multi-pharmaceutical approach. Inexperienced doc to rs might prescribe several antibiotics at the same time to the same patient with the hope that at least one will work. Instructions about drug use should maximise compliance and minimise drug selling and drug sharing among families. Training and supervision Hiring staff and planning them for any emergency are major undertakings that require more information than the scope of this chapter permits. Serious considerations include determining the availability and skills of local staff. Take in to account a payment scale that is in accordance and relative to the local economy. This scale should not cause local staff to favour one organisation over another because of higher pay thereby disrupting the local economy. Planners can use testing to verify qualifications, but this method might significantly reduce the pool of candidates. Staffing shortages are further exacerbated by most staff not been keen about working far from urban centres. Hiring local staff can also be very complicated while labour laws and regulations can be quite strict. During emergencies, locally available health professionals might be victims themselves or be busy caring for their own families. Often, they are willing to work only part-time or for short periods, which is an administrative nightmare. Giving anaesthetic to patients, a normal responsibility for European and American nurses, is an unfamiliar task for nurses in many developing countries. Training is important for maintaining team morale, which can suffer if staff members are not well prepared for the tasks they are asked to perform. There is generally not enough time to do significant training in the emergency phase of a disaster; therefore, the health staff already working should already have basic training. Work in an emergency situation might be quite different from normal duties and such specialised training is not always 134 I the Johns Hopkins and the International Federation of Red Cross and Red Crescent Societies 3 provided. If there is a new skill being asked of the staff, or if it is observed that personnel are not performing tasks properly, training might be in order. Training should remain focused on specific to pics that will be of use to the beneficiaries. The role of the various health workers must also be well defined and in accordance with national policy. Would community health workers be expected just to recognise illnesses and refer, or to recognise and treat some common illnessesfi Clear role expectations will facilitate the integration of emergency health workers in to the primary health care system in the post-emergency phase.
These can include case definitions for new disease outbreaks virus or bacteria buy stanicid 10 gm on line, new pro to antibiotics for uti nhs buy stanicid 10gm without prescription cols or procedures infection smell order 10gm stanicid amex. The minimum standards focus on the core contents of the rights to health, namely that everyone has the right to equal access to health care, safe water; adequate sanitation, an adequate supply of safe food, nutrition and housing, healthy environmental conditions, access to health-related education and information, non-discrimination, human dignity and the affirmation of individual self-worth. Use of the minimum standards can make relief agencies more accountable about what they are doing by providing a yardstick for measuring what an agency should try to achieve. These standards can also be used to moni to r and evaluate the service delivery and outcome of projects. The following table summarises the core areas covered by common minimum standards that are applicable to all sec to rs. Participation the disaster-affected population actively participates in the assessment, design, implementation, moni to ring and evaluation of the assistance programme. Initial assessment Assessments provide an understanding of the disaster situation and a clear analysis of threats to life, dignity, health and livelihoods to determine in consultation with the relevant authorities whether an external response is required and, if so, the nature of the response. Response A humanitarian response is required in situations where the relevant authorities are unable and/or unwilling to respond to the protection and assistance needs of the population on the terri to ry over which they have control, and when assessment and analysis indicate that these needs are unmet. Targeting Humanitarian assistance or services are provided equitably and impartially, based on the vulnerability and needs of individuals or groups affected by disaster. Moni to ring the effectiveness of the programme in responding to problems is identified and changes in the broader context are continually moni to red to improve or phase the programme out as required. Evaluation There is a systematic and impartial examination of humanitarian action intended to draw lessons to improve practice and policy and to enhance accountability. Aid worker Aid workers possess appropriate qualifications, attitudes and competencies experience to plan and implement appropriate programmes effectively. Supervision, Aid workers receive supervision and support to ensure management and effective implementation of the humanitarian assistance support of programme. Once an agency accepts the code it needs to train its workers to carry out their work according to set standards. Aid is given regardless of the race, religion, beliefs or nationality of the recipients and without adverse distinction of any kind. Aid will not be used to further a particular political or religious standpoint; 4. Ways shall be found to involve programme beneficiaries in the management of relief aid; 8. Relief aid must strive to reduce future vulnerabilities to disaster as well as meeting basic needs; 9. We hold ourselves accountable to both those we seek to assist and those from whom we accept resources; 10. In our information, publicity and advertising activities, we shall recognise disaster victims as dignified humans, not hopeless objects. Governments should facilitate the timely flow of relief goods and information during disasters; 4. Governments should seek to provide a coordinated disaster information and planning service; 5. Donor governments should provide funding with a guarantee of operational independence; 3. Disasters: A disaster is a calami to us event resulting in the loss of life, great human suffering and distress and large-scale material damage. Table 10-18: Humanitarian accountability partnership 2007 Benchmarks the agency shall establish a humanitarian quality management system. The agency shall make the following information publicly available to intended beneficiaries, disaster-affected communities, agency staff and other specified stakeholders: fi Organisational background; fi Humanitarian accountability framework; fi Humanitarian plan; fi Progress reports; and fi Complaints handling procedures. The agency shall enable beneficiaries and their representatives to participate in programme decisions and seek their informed consent. The agency shall determine the competencies, attitudes and development needs of staff required to implement its humanitarian quality management system. The agency shall establish and implement complaints-handling procedures that are effective, accessible and safe for intended beneficiaries, disaster-affected communities, agency staff, humanitarian partners and other specified bodies.
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References:
- https://www.huduser.gov/portal/publications/Hybrid_Steelguide.pdf
- https://www.myherbalife.com/content/en-us/pdf/product/energyfitness/63186us_crp_fitnessman_col.pdf
- https://www.radiologyinfo.org/en/pdf/braintumor.pdf
- https://www.pnnl.gov/main/publications/external/technical_reports/PNNL-21713.pdf
- https://professional.diabetes.org/sites/professional.diabetes.org/files/media/standardofcare2018_hawaii.pdf