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Oncefeedsarestopped hypertension images cheap 10mg inderal visa,mostinfants can be managed without a gastric tube blood pressure during pregnancy discount inderal 40mg amex, and this helps to minimise electrolyte losses arteriosclerosis vs atherosclerosis order generic inderal canada. Mostneonatal seizuresoccurasacute arrhythmia from caffeine order inderal australia,reactiveevents,butawiderangeofcongenitaldisorders mayalsobeimplicated,includingstructuralbrainabnormalities,inbornerrorsof metabolism and epilepsy syndromes (Table 3. Clonic seizures consist of rhythmic jerking of one limb or one side of the face or body and may be multifocal and migratory. Many subtle phenomena do not represent seizures, but distinguishing subtle seizures from other behaviour is difficultonclinicalgroundsalone. Tonicseizuresaretheleastcommontypeand involve sustained posturing of the limbs or trunk or deviation of the head or eyes. Several types of benign neonatal hyperkinetic movements are readily discriminated from seizures. Jitteriness resembles a tremor, is triggered by stimulation and is suppressed by gentle restraint. Jitteriness is common in preterm infants, can be exacerbated by metabolic disturbances such as hypoglycaemia, and is frequent during neonatal drug withdrawal, particularly with selective serotonin reuptake inhibitors. Benignneonatalsleepmyoclonusinvolvesmyoclonic jerks during non-rapid eye movement sleep, either focally or bilaterally, but stopsabruptlyonarousal. No treatment is needed, and resolution occurs by 6 months of age in most cases (95%). Intraventricular haemorrhage, while common in preterm infants, is rare at term and should prompt further investigation for sinovenous thrombosis. Infants with unilateral clonic seizures who are well appearing and have normal Apgar scores are likely to have middle cerebral artery stroke, which occursmorecommonlyontheleft(right-sidedsymptoms). Thus, many risk factors for neonatal stroke are related to placentaldisease,suchasfetalgrowthrestrictionandpre-eclampsia. Intracranial infections usually present after the first week, and group B streptococcus and Escherichia coli are the most common bacterial causes. Herpessimplexviruscanmimicbacterialmeningitisasapproximatelyone-third of cases occur without cutaneous lesions, and mothers frequently do not have activegenitalherpesatthetimeofbirth. First-line investigations for suspected seizures include blood gas, lactate, glucose,electrolytes(sodium,calciumandmagnesium),fullbloodcountand,if notalreadycompleted,newbornmetabolicscreen(Guthriecard). Bloodculture and lumbar puncture are usually performed but may be omitted if the baby appears extremely well and a non-infectious aetiology is likely. If intracranial haemorrhage is detected, screening for coagulopathy and for haemophiliainmalesiswarranted. Levetiracetam is increasingly being used either as a first-line agent or as an adjunct to phenobarbitone. Theneonatewithbreathingdifficulty Signs of respiratory distress include tachypnoea (>60 breaths per minute), increased effort (intercostal and subcostal recession, grunt and tracheal tug), apnoea (a pause in breathing >20 seconds or pause of <20 seconds associated with bradycardia) and stridor. In neonates with breathing difficulty the oropharynx,chestandcardiovascularsystemshouldbecarefullyexaminedanda chestX-rayperformed. Bloodworkwillgenerallyincludebloodgas,fullblood count, inflammatory markers and blood culture, with further investigation according to likely aetiology. The causes of respiratory distress can be broadlydividedintopathologyoflungparenchyma,airwayobstructionandnonpulmonarydisease. Lungparenchymalpathology Aftertheimmediatenewbornperiod,respiratorydistressfromparenchymallung disease is mainly caused by pneumonia and rarely congenital lung malformations. Congenital bacterial pneumonia is transmitted via the amniotic fluidandpresentswithrespiratorydistressinthefirst12to24hours. GroupB streptococcus is the most common aetiology followed by Escherichiacoli and occasionally other bacteria such as Haemophilus influenzae, Streptococcus pneumoniaeandListeria. In the later neonatal period acquired viral pneumonias predominate, especially respiratory syncytial virus, with adenovirus and parainfluenza also common.

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They recommend an examination of the quality of online participation rather than measuring the number of hits as indicator of online participation in their original study blood pressure yoga asanas order inderal on line amex. Regarding this aspect heart attack grill locations purchase inderal without prescription, Yang prehypertension 2013 order inderal 80 mg without prescription, Quadir prehypertension in late pregnancy buy generic inderal 40mg line, Chen, and Miao (2016) found that online presence, as measured by teaching, cognitive presence, and social presence, is significantly correlated to learning performance. Online participation and social capital Social capital is a concept that has been conceptualized from different perspectives and embodied several dimensions. While Putnam (2000) views social capital as a public good that is embedded in the social netwroks of a given community, Williams (2006) and Zhang and Kaufman (2015) view social capital as an individual asset. Previous research has established a positive relationship between online interaction and social capital. For examples, Su and Chan (2017) found that the more university students used Facebook, the more increased bonding and bridging social capital was gained. Regarding the nature of online interaction taking place in different social networking platforms, Phua, Jin, & Kim (2017) found that interacting with members in Twitter results in the greatest bridging social capital, followed by Instagram, Facebook, and Snapchat. As for bonding social capital, the greatest bonding social capital development was derived from online interaction in Snapchat, followed by Facebook, Instagram, and Twitter. In 80 explaining the differences found, Phua et al (2017) refer to the nature of relationship among the members in these platforms. For example, Twitter users are able interact and follow those they do not know whereas Facebook users can only exchange information mostly with their friends and family due to the privacy policies specific to each platform. Nevertheless, findings from Su and Chan (2017) and Phua et al (2017) support the hypothesis that online interaction is a significant predictor of social capital. Apart from virtual environments, in adult education settings, Cocquyt, Diep, Zhu, De Greef, and Vanwing (2017) found that adult learners perceived greater enhancement of social capital as a result of following an online or blended learning program. Combining this initial findings from Cocquyt et al (2017) and the established relationship between online interaction and social capital in virtual settings, it is reasonable to hypothesize that online interaction between peers in a blended learning program are likely to increase their bonding and social capital. The online interaction among peers in program is slightly different from those in virtual settings such that the primary goal is to help each other construct knowledge. In addition, Hrastinski (2009) defined online participation as "a process of learning by taking part and maintaining relations with others. It is a complex process comprising doing, communicating, thinking, feeling and belonging, which occurs both online and offline"(p. This definition underlines different types of content contributed by the learners to the discussion under questions. Diep, Cocquyt, Zhu, and Vanwing (2016) by examining different perspectives on online participation, have categorized online participation into three types: discussion contribution, collaborative facilitation, and social interaction. In this paper, we adopt this categorization as this reflects online learning theory proposed by Hrastinski (2009) and overcomes the limitation in the measurement of online interaction by means of frequency indication. Methodology Research context and participants the present study employed a cross-sectional design and data were collected at one time using convenience sampling. Participants were adult learners following a blended program, namely Specific Teacher Training, at different adult education centers in Flanders. Another 39% have obtained a higher education degree, and only a small portion of them (3. Instrument In the present study, the independent variables, namely online participation, include discussion contribution, collaborative facilitation, and social interaction, are scales adopted from Diep et al (2016). The collaborative facilitation dimension consists of seven items and reflects how the learners engage in facilitating and encouraging their peers in order to achieve the group learning goals. The social interaction dimension refers to those online interactions that are non81 content related and focuses on informal social exchanges among the learners, presented by four items. Social capital including bonding and bridging ties was adopted from the scales validated by Williams (2006) and comprised of 16 items. The learners were requested information about their age, gender, highest degree obtained, and their employment status. It was expected that the more adult learners engaged in online participation, the better their learning performance. Nevertheless, the result from multiple regression analysis shows that neither socio-demographic variables nor the different types of online participation are significant predictors of learning performance.

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However blood pressure range buy 80 mg inderal with amex, these bodies were not elected through universal suffrage and some were entirely appointed blood pressure medication with low side effects order 80 mg inderal amex. Can adult education be designed to strengthen its role in zartan blood pressure medication cheap inderal 40 mg with mastercard, between and for communities Quality assured provision is important but in situations where communities are fragmented or fragile blood pressure 300 order inderal 80mg on-line, it is easy to excuse dips in quality due to the irregular nature of the adult education. There is little recognition that low quality adult education will usually be ineffective in strengthening communities. However, simply having regard to the checklist at Figure 1, which is a synthesis of the principles and standards that are prioritized for post conflict adult education will assist policymakers and practitioners. In checking for sustainability, it is important to assess the impact of the programme or policy. The ideal is to move towards the right of the spectrum at Figure 2, aiming as a minimum for self-sustaining provision. Figure 2: the impact spectrum of adult education Counterproductive One-off Self-sustaining Expansive Conclusion In this brief paper, it has been shown that adult education is rooted in a community context: it is delivered to individuals within their communities and community involvement in designing and managing the provision is valuable. However, there is a risk that strong community groups can be formed by exclusion of others and some adult education is focused on separate provision for distinct groups, and in building cohesion between them. In particular, education for communities of refugees (either when they return home or in the country of settlement) often addresses the lack of links between groups. Similarly, means to address different communities in a society divided into ethnically-defined groups were considered. Finally, the role of adult education in strengthening communities (education for community) was examined, with social capital, democracy programmes and community capacity building being three ways in which this might happen. Given the importance of quality adult education in, between and for strong communities, the sustainable impact spectrum and a quick quality checklist which addresses community aspects of adult education provision were offered. Funders, policy makers and practitioners alike are invited to view adult education projects through a new lens that allows a golden thread of adult education to be woven through initiatives to re-establish cohesive social communities where people can thrive. Tanil S (1997) Final report of the meeting workshop on educational destruction and reconstruction in disrupted societies (pp. World Bank (2005) Reshaping the future: Education and postconflict reconstruction. This reflects the belief that more students in higher education is a positive thing for both the students themselves and for society at large. There seems to be an unspoken understanding that students at colleges are in some way different from students at universities perhaps academically weaker or less ambitious although this has been shown to be not necessarily the case (Avis and Orr, 2016). Methodology this article is taken from a broader study and focuses here on attitudes to costs. They were encouraged to discuss the factors influencing their decision to study at the college. The participants reflected the (small) student population although this is not to claim they are a representative sample. They ranged from 19-34 years old, both men and women (although only men studied computing). The analysis of the data compared themes appearing across the interviews, an analysis of narratives as opposed to a narrative analysis (Heath et al, 2009; Goodson and Sikes, 247 2001). The qualification provides high returns (higher wages, better access to jobs) that outweigh the costs (fees, living expenses, delayed wages). This approach underpins the decision to introduce fees because, as the individual is the primary beneficiary, it should be the individual who bears the costs. A neo-liberal assumption is that for a rational agent the only barrier to making the beneficial investment in a university education is access to funding (financial liquidity). However, there is not much evidence that the introduction of fees has had a direct impact either positively or negatively. Patterns of participation have not significantly shifted and absolute numbers have increased over the period since fees were introduced, Although young participation rates increased in both advantaged and disadvantaged areas, with proportional increases of +16 and +52 per cent respectively, the participation gap between them has remained broadly stable at around 40 percentage points. In their research they found overall that the lower-income group was more debt averse than the other groups, even after holding constant the type of educational institution they attended (for example, state school, further education college), gender, ethnicity and age. Although their data was not statistically significant, they found a clear indication that for those from low income groups who had taken A-levels (final high school exams) there was little debtaversion, in contrast to those who had not taken A levels. Hesketh (1999) used Bourdieu to suggest that different classes and backgrounds will have different relationships to debt, so people with apparently similar financial situations will make 248 different decisions.

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Superficialburns Smallsuperficialburns Burns which consist of just erythema or some simple small (<1 cm) blisters shouldbeleftopenanddressedwitheitherVaselineorskinmoisturizer pulse pressure variation ppt order inderal pills in toronto,i arteria volaris indicis radialis order inderal without a prescription. Areasofsuperficialburnslargerthanthisbut less than 5 cm should be covered with Mepitel heart attack song buy inderal now, Melolin and crepe bandage securing this with Hyperfix hypertension signs and symptoms 40mg inderal. Mepitel is a low-adherent wound-contact dressing madeofsiliconegelboundtoaflexiblepolyamidenet. IntraSite Conformable is a soft hydrogel dressing that combines the advantage of IntraSite gel with a non-woven dressing. Patients should be reviewed between 3 and 7 days for a change of dressingandtoassessifskingraftingisneeded. Theburnshouldalsobeprotectedfromthe sun, as sunburn of an already burnt area causes increased pigmentation to the skin. In this case, the dressing should be changed earlier and the burn inspected, as antibioticsmaynotbeindicated. Astheskinhealsunderadressing,itbecomes pruritic, which may require an antihistamine or cooling of the dressing (particularlyinhotweather). Tetanus prophylaxis is important in major burns or minor burns (which are contaminated). Antibiotics should be used only when a definite infection is presentandnotsimplyforasmellydischarge. Electrical injuries are more commonly seen in two age groups: toddlers within the home settingandmaleadolescentsinvolvedinrisk-takingbehaviour. These may be due to frayed electrical cords or children inserting metal objects into power sockets. In most states in Australia, safety switches are installed in all new houses, cutting the current when overloaded, thus preventing many severe electrical burns. These low-voltage exposures rarely result in significant internal injury, and most children are asymptomatic apartfromdistressfromthecutaneousburn. Thesehigh-voltageexposureshaveamoreseriousoutcome,astheyare more likely to be associated with injury to internal structures. Clinicaleffects Electricalcurrentspreferentiallyflowalonglow-resistancetissuessuchasblood vessels, nerves, and muscles, rather than the skin, causing internal injury particularlyifextremitiesareinvolved. Wet or moist skin increases current flow dramatically by decreasing the tissueresistance. A search for an entrance and exit wound should occur to determine the potential for deeper burns. Fluids Fluidrequirementsforsignificantelectricalburnsareunderestimatedusingthe Parkland formula, as most of the damage is internal. Myoglobinuria Muscle involvement leads to myoglobinuria, which may cause renal failure. Caustic chemicals tend to give deeper burns than thermalinjury,asthereisgenerallyalongdurationofcontact. If chemicals are introduced into the eye, thenirrigationshouldcontinueuntilpHisneutral. A Morgan lens is a good method of flushing eyes, as this requires less cooperation from the patient. Some chemicals may cause systemic toxicity from absorption through the burnedskin,andtheseshouldbemanagedaccordingly. Introduction A disaster occurs when the needs from a hazardous event exceed the coping capacity of a community. Looking at disasters in a generic manner enables researchandlearningfrompastexperienceandplanningforfutureunidentified eventstomitigatetheimpact. Phasesofdisasterresponse Planningforadisasterresponseshouldbeflexibleenoughtocoverallhazards, including unanticipated ones, and also identify specific roles and concrete actions for staff to take.