...practice, and utilize my chain of command. In accordance with my duty to maintain a safe environment, the use of maximum sterile barriers while placing central venous lines (CVL) and arterial lines to prevent infections will be exercised. Approximately 3 months ago, I was involved in a patient care situation that exemplified the need for accountability from professional nurses. A four year old boy came in with a ventriculoperitoneal (VP) shunt malfunction. He presented to the children’s emergency room with decreased level of consciousness, nausea, vomiting, and headache for two days. He rapidly worsened; by the time he was admitted to my unit, he was intubated, hypothermic, and hypotensive. He needed a VP shunt revision, but would have a lower chance of survival if he was not first stabilized. He came over with one peripheral IV, but it was not sufficient for the multiple boluses and vasopressors that were needed to sustain his rapidly dropping blood pressure. We needed more lines, immediately. The intensivist ordered insertion of a femoral CVL for fluids and medications and an arterial line for continuous monitoring of his blood pressure and blood draws. According to hospital policy, under patient care procedure 15.09.04, insertion of a CVL requires use of sterile technique. Statistically, femoral-placed lines come with the highest risk of infection (Henry, Jimenez, Lorente, Martin, & Mora, 2005). As the team began preparing the...
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...Dear Councilor, We are a facing traffic menace that seems to get no respite from frequent traffic snarls. Local residents in the Canterbury Bankstown region are unanimously groaning under the weight of the chaotic traffic management of some of Sydney’s busiest and well known roads and without a kinetic and curated strategy the quandary will continue to choke our city. Average travel times for commuting trips by both car and public transport for Greater Western Sydney residents are on a daily basis longer than for the rest of Sydney. With a constant foot on the brake, commuters are finding it hard to keep moving . In recent findings by the Department of transport, the average commuting time of residents within this region has crawled to an intolerable 34 minutes one way only to be further delayed in ravaging weather conditions. With the transport system unravelling everywhere, projections on other vital fronts are further cause for pessimism. Not surprisingly, public transport's decline is counterbalanced by growth in car ownership and increased saturation of traffic volumes on the city's packed roads. This limited choice for intra- regional travel and the lack of key public transport linkages to employment opportunities, facilities and services exacerbates the existing traffic dilemma. The State Government had hoped its Metropolitan Strategy would guide the city's growth. Instead, the strategy has become a lightning rod for all sorts of dissidents all yearning for a new...
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...roadway system and provide transportation planners the basic data in the evaluation of the effectiveness of capacity improvement measures. Information on highway traffic conditions is usually collected by organising and conducting traffic surveys and studies. Traffic studies may be grouped into three main categories as inventories, administrative studies, and dynamic studies. Of these three the dynamic traffic studies involve the collection of data under operational conditions and include studies of speed, traffic volume, travel time and delay, parking and accidents. This study is made to evaluate current conditions and develop solutions on highways. In this research this type of study is made into the speed-density relationship of an arterial road in the Kumasi metropolis – the case study of the road between the Komfo Anokye Teaching Hospital Roundabout and the Bekwai Roundabout. This corridor is located at the heart of the city and connects the different suburbs of the...
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...ANTECEDENTES La organización civil “México Tierra de Amaranto, A.C.” (MTA), surge de haber ganado el primer lugar de Biología en el VIII Premio Nacional Bachillerato Anáhuac, 2004. El proyecto consistía en demostrar que el Amaranto era un alimento prebiótico o funcional. Motivados por el triunfo, invitaron a Kellogg´s S.A. de C.V. a que desarrollara un producto que empleara el amaranto como ingrediente principal. Para 2005, Bimbo acepto sumarse a la propuesta, siempre y cuando garantizaran la producción y entrega optima del producto y con calidad. Se lograron algunos acuerdos con productores y apoyos por algunas entidades. Se implementaron cultivos traspatio en comunidades de escasos recursos para apoyo a productores, hubo personas involucradas en la elaboración de pan de amaranto ya que se contaba con panaderías. Se comenzó a cuestionar si el logro de las siembras debía ser responsabilidad de la Asociación ya que no contaba con la infraestructura, se encontraba limitada en maquinaria, también se cuestionaban si lograrían tener un grano de calidad y si se podían hacer compromisos con Sagarpa, Sedea, Inifap y los gobiernos municipales. DILEMA, RETO EL principal dilema es como presentar los logros obtenidos por la Asociación para seguir recibiendo apoyo de la Secretaria de Desarrollo Social de México, para el impulso de la transformación y consumo del amaranto en la entidad apoyando comunidades de escasos recursos. PARTES INVOLUCRADAS Ing.Mary Délano Frier. Iniciadora...
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...COMO AFECTA LA ALIMENTACION DURANTE LA JORNADA ESCOLAR Escrito por: López Pingarron Yazka y Pont Acosta Michelle Una mala nutrición puede reducir la inmunidad, aumentar la vulnerabilidad a las enfermedades, alterar el desarrollo físico y mental, así como reducir la productividad en la vida diaria. Según la OMS (organización mundial de la salud) la nutrición es la ingesta de alimentos en relación con las necesidades dietéticas del organismo. Una buena nutrición (una dieta suficiente y equilibrada combinada con el ejercicio físico regular) es un elemento fundamental de la buena salud. En estos tiempos, se puede ver que en la mayoría de los niños que están en edad escolar (4 a 15 años) presentan una serie de malos hábitos alimenticios: tales como el aumento en el consumo de comida chatarra y procesada, mientras que la comida casera y los alimentos de origen natural parecen estar inexistentes para ellos. Esta mala alimentación influye en el rendimiento escolar de manera negativa. Connie Crawley, especialista en nutrición infantil dice que “cuando los niños entran en la escuela, afrontan nuevas experiencias y desafíos. Uno de estas experiencias nuevas es el comer en la escuela. Los niños en esta edad y sobre todo en esta situación, toman la decisión que más les acomode, eligen que comer, cuál será la porción y a qué hora tomaran sus alimentos. En esta etapa, es bueno enseñarles la importancia de una dieta sana y balanceada, mostrarles como una mala alimentación afecta...
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... Traffic is everywhere around us. It is all around our country and state, and the world is multiplying at a rapid rate. Therefore, increasing the amount of people, and the quantity of drivers on the roads. Our city of Corpus Christi is expanding even more as well. As a result, this can be considered one of the strengths because more people means more profit for businesses and the city. According to the United Census Bureau, the last population count was taken in 2014. The results came out to 320,434. That is 15,219 additional people added to our community in 4 years since the last count in 2010. However, even though more people can be a good thing, it causes more issues. Some weaknesses of traffic is extra people means additional people driving which causes traffic jams, car accidents, and other vehicle related incidents. The congestion of traffic in our city has become so serious, it is causing a lot of issues, so some possible solutions that can help limit the congestion and make driving easier is, fixing damaged roads up, doing construction work overnight instead of during the day, adding individual red stop lights at the exits of major roads off of the freeway instead of yielding traffic, enforce the law about people utilizing their phones while driving, and the overall best solution is for more people to utilize public transportation. Initially, the first possible solution to reduce congestion is fixing up damaged roads. The roads in Corpus Christi are falling apart and...
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...Reasons behind traffic jam in Dhaka city (a) City lay-out (master plan) and over-population: The causes of traffic congestion in Dhaka city are multifarious. Starting from the city itself, it is observed that the skeleton, structure and lay-out of Dhaka City are not well-planned and well-directed. Dhaka is also a highly populated city. More than one crore people live here and the figure is increasing day by day. This huge population acts as an auto-catalyst of traffic congestion in Dhaka City. (b) Inadequate and unplanned roads: Dhaka City has very inadequate road networks. For a standard city, where the minimum road requirement is 25%, Dhaka has only 7.5% road of its total area. 30% of this 7.5% road is also occupied by the hawkers, salesman and shopkeepers. A significant portion is occupied by construction materials and waste-containers of the City Corporation. As a result, vehicles do not get sufficient space to move on. Besides this, in most cases roads are serpentine rather than being straight. This ultimately breeds a number of unnecessary junctions where vehicles automatically slow down. Again, these roads are also not well constructed and regularly repaired. City Corporation, DESA, WASA, BTTB excavate the roads randomly without any integrated and central plan. Lack of proper maintenance causes the vehicle to stop without any prior notice. During the rainy season the situation becomes more critical while the roads go under water due to heavy rain. (c) Heterogeneous...
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...with cars and people. At the same time, the airports are welcoming a large number of newcomers all over the world every day. Moreover, the number of roads and bridges is not sufficient to the increasing number of vehicles. In addition, in Jeddah there are approximately four million people both Saudis and expatriates who use over one million vehicles to move around the city. We also expect more. Causes of traffic congestion inside the cities Saudi Arabia is a modern Country, but it also has a modern and serious problem. Every day in the morning and evening, the roads and streets are so crowded with cars, taxis, buses and trucks. In this part will mention the causes of traffic congestion in Saudi Arabia’s major cities. In the next lines, we will speak about the several reasons for traffic problems in Saudi Arabia’s major cities. Firstly, there are many private cars in the streets because of the lack of public transportation such as buses, trains, trams, metro, etc (Putra, J). Secondly, current public transportation like buses is not well-organized. For example, bus drivers can stop anywhere they like carelessly without paying attention to the other cars on the road (Putra,j). In addition,...
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...GOAL: To alleviate traffic congestion in GTA and especially on the east-west route cost effectively and in as short a time as possible. INTERVENTION: To establish and privatize a new east-west route (407) to ease the congestion on the main route (401). The new privatized highway is intended to reduce traffic, therefore reducing the amount of time spent commuting, hence encouraging investors and stimulating the economy through productive time gained. ANALYSIS: This is a DIRECT intervention. The government is directly involved at A in supporting the decision to privatize the highway (407) to improve traffic flow and efficiency. At B: (i) the goal of reduce traffic congestion in the GTA is satisfied since another east-west route is introduced to relieve the pressure on the existing one (401). (ii) the intended goal is achieved by the government’s decision to lay the burden of developing, designing, building operating and maintaining of the new highway on the private sector. (iii) a new state of equilibrium is established because the change in government policies that allow for privatization enabled the government to share the financial burden with the private sector, resulting in quicker and more cost efficient building of highway 407. This curbed the traffic congestion problem faster and more efficiently than if the government was the only player. This intervention is COERCIVE because when the government...
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...not only affecting our business but the education sector as well. Students cannot do other tasks such as photocopying or collecting notes before attending class in the morning because a lot of time gets wasted on traffic congestions. It wastes lot of working hours of students as well as teachers. In many occasions, students and teachers fail to attend classes in due time. And it is more painful when students fail to reach exam halls and fails just due to a social problem. Now just think everyday how much national time is wasting, how much economical activities are losing, for the traffic congestion problem. This assignment is focusing current situation of traffic congestion problem in Dhaka city. What is Traffic jam? A traffic jam is a long line of vehicles that cannot move forward because there is too much traffic, or because the road is blocked by something. Over the last few years the traffic congestion problem of Dhaka City has visibly been deteriorating steadily. Limited resources, invested for the development of transport facilities, such as infrastructure and vehicles, coupled with the rapid rise in transport demand, existence of old transport and also huge number of non-motorized vehicles on roads, lack of application of adequate and proper traffic management schemes are producing severe transport problems in almost...
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...Traffic congestion on the freeway can turn it into a carpark at peak times. The increased number of traffic within Mitchell and Kwinana Freeways during specific times can adversely affect road safety, fuel consumption and greenhouse gas emissions. The term the third rush hour has been used to refer to a period of the midday in which roads in urban and suburban areas become congested due to a large number of people taking lunch breaks using their vehicles. These motorists often frequent restaurants and fast food locations, where vehicles crowding the entrances cause traffic congestion. Active senior citizens, who travel by automobile to engage in many midday activities, also contribute to the midday rush hour. At other times (such as evenings and weekends), additional periods of congestion can be the result of various special events, such as sports games, festivals, or religious services. Out-of-the-ordinary congestion can be the result of an accident, construction, long holiday weekends, or inclement weather. To ease traffic congestion Causes Population growth Working hours Jobs involve movement Solutions Building more train stations, purchasing more trains and buses, trains don’t have traffic jams Widening Mitchell freeway – was 2, now 3 lanes Mitchell freeway Extending- 6km 2014-15 The Traffic through The North -South Freeway at 10 a.m. was quite low seeing as this is the time most people are at work. At 12 a.m. however, the amount of vehicles passing the...
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...Estrategia de Prevención y Promoción de la Salud durante la Línea de Vida 1. ¿A qué se refiere el termino línea de vida? Se refiere a las diferentes etapas que recorre un individuo durante su vida, además de ciertos eventos que ocurren a lo largo de ésta, como podrían ser el nacimiento, la infancia, la adolescencia y el embarazo. 2. ¿Qué es la estrategia de prevención y promoción de la salud durante la línea de vida? Es un grupo de acciones básicas para evitar enfermedades y propiciar el autocuidado de la salud que se otorga a las personas de acuerdo a su edad y sexo, independientemente de la causa por la que visitan la unidad de salud. 3. ¿En qué grupos y eventos se divide la estrategia línea de vida? En 7 grupos: ▪ Recién nacidos ▪ Niñas y niños menores de 5 años ▪ Niñas y niños de 5 a 9 años ▪ Las y los adolescentes de 10 a 19 años ▪ Mujeres de 20 a 59 años ▪ Hombres de 20 a 59 años y ▪ Mujeres y hombres de 60 o más años Y para esta primera etapa se brindará especial atención en los siguientes casos o eventos de vida: ▪ Embarazadas ▪ Mujeres durante el puerperio (cuarentena) y ▪ Atención médica antirrábica. 4. ¿Qué acciones debe realizar el personal de salud al recién nacido? ➢ Identifique signos de alarma ➢ Verifique condiciones del parto ➢ Efectúe exploración física completa ➢ Detecte defectos al nacimiento ➢ Revise el cordón umbilical ➢ Realice el tamiz neonatal ➢ Aplique...
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...While many think improving a country’s transportation system solely means building new roads or repairing aging infrastructures, the future of transportation lies not only in concrete and steel, but also increasingly in using IT. IT enables elements within the transportation system—vehicles, roads, traffic lights, message signs, etc.—to become intelligent by embedding them with microchips and sensors and empowering them to communicate with each other through wireless technologies. In the leading nations in the world, IT’S bring significant improvement in transportation system performance, including reduced congestion and increased safety and traveler convenience. Imagine knowing real-time traffic conditions for virtually every highway or arterial roadway in the country and having that information available on multiple platforms, both in-vehicle and out. Imagine driving down an expressway with a telematics unit that, combining GPS with real-time traffic information, could audibly alert you that you are approaching a blind curve with traffic backed up immediately ahead and that you need to brake immediately. Envision enjoying a mobile device that can display real-time traffic information (while simultaneously helping to generate that information), optimize your route accordingly, and electronically pay tolls when you’re on the highway (or fares when you’re using mass transit). Imagine a performance-based transportation system that makes capital investment decisions regarding competing...
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...Información de Pasta Base Coordinación SIDA, Gob. De la Ciudad de Buenos Aires La pasta base es un derivado del proceso de elaboración de la cocaína. La cocaína se extrae de las hojas del arbusto de la coca (Erythroxylon coca), originario de la región andina de América del Sur. Esta planta posee más de 14 alcaloides y el principal es la cocaína. Elaboración En una primera fase mezclan las hojas con carbonato potásico, o potasa, para disolver los alcaloides. Luego lo rocían con queroseno y ácido sulfúrico, y lo filtran. Agregan al producto más ácido sulfúrico que deja sobrenadando el queroseno sobre un sedimento con los alcaloides de la coca. Con más carbonato de potasio se precipitan estos alcaloides con restos de hojas maceradas. El nuevo filtrado da una pasta terrosa que se conoce como "pasta base", que aún incluye hidrocarburos y restos tóxicos de los solventes utilizados. Agregando ácido clorhídrico a la pasta base se produce clorhidrato de cocaína, el que precipita en sal agregando bicarbonato de sodio y éter es un polvo blanco “cocaína”. El crack se obtiene sobreagregando a la cocaína bicarbonato de sodio, y luego agua, calentando hasta obtener un precipitado en forma de cristales que se llaman crack , por el sonido crepitante que producen cuando se calientan para inhalar sus vapores. En latinoamérica muchas veces se le denomina crack a la pasta base ...
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...Reasons behind traffic jam in Dhaka city (a) City lay-out (master plan) and over-population: The causes of traffic congestion in Dhaka city are multifarious. Starting from the city itself, it is observed that the skeleton, structure and lay-out of Dhaka City are not well-planned and well-directed. Dhaka is also a highly populated city. More than one crore people live here and the figure is increasing day by day. This huge population acts as an auto-catalyst of traffic congestion in Dhaka City. (b) Inadequate and unplanned roads: Dhaka City has very inadequate road networks. For a standard city, where the minimum road requirement is 25%, Dhaka has only 7.5% road of its total area. 30% of this 7.5% road is also occupied by the hawkers, salesman and shopkeepers. A significant portion is occupied by construction materials and waste-containers of the City Corporation. As a result, vehicles do not get sufficient space to move on. Besides this, in most cases roads are serpentine rather than being straight. This ultimately breeds a number of unnecessary junctions where vehicles automatically slow down. Again, these roads are also not well constructed and regularly repaired. City Corporation, DESA, WASA, BTTB excavate the roads randomly without any integrated and central plan. Lack of proper maintenance causes the vehicle to stop without any prior notice. During the rainy season the situation becomes more critical while the roads go under water due to heavy rain. (c) Heterogeneous...
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