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By: I. Bengerd, M.B.A., M.D.

Professor, Louisiana State University

A Problem of Terminology the early modern European dialogue about contagion is illustrative of how easy it has been for historians to blood pressure medication verapamil cheap 5mg nebivolol with mastercard project an anachronistic view hypertension drug quality 5 mg nebivolol. The word blood pressure low discount 2.5 mg nebivolol with mastercard, "contagium" is taken from the Latin word "contactu" which means touching, and was often interchangeable with the Latin term for infection, "infectio. Unfortunately medical historians sometimes interpret "contagious" as passing from one person to another. Likewise, the term infection means establishment of pathogenic microbes in the host by direct contact with another infected person, or through indirect contact with water, food, or contaminated droplets in air or from inanimate objects. In the 16th century contagion did not necessarily mean what passed from person to person was a disease entity. This time period was well before the elucidation of living disease entities in the late nineteenth century. It was, nevertheless, clear early on during the epidemic of syphilis, that the disease was transmitted by venery. Since syphilis was thought to be sexually transmitted contagion theory was kept alive in the early sixteenth century. The ambiguous concepts of contagion, infection, and miasma developed layers of meaning over time with each time period adding a different nuance. Historians have tended to oversimplify the definitions in retrospective accounts consistent with the spirit of authors writing about the Renaissance and the heroes of science. One difficulty for historians has been in arriving at workable definitions without over-simplification or discrediting old ideas. According to Margaret Pelling, contagion was used more in the context of practical folk beliefs in medicine, agriculture, horticulture, animal 15 husbandry and technologies such as dyeing and wine making. In a purely medical sense, the term was used during epidemics, or when there were changes in the prevalence of endemic diseases. Changing political, economic, or social contexts could also influence usage of the term contagion in relation to medical theory and practice. For example, notions about individual morality in the context of behavior were altered after gaining knowledge about American Indians. Due to the advent of the printing press, there were changes of expression designed to include either a more or less specialized reading audience. Finally, the concept of contagion is difficult to separate from public measures of isolation and quarantine, which in turn influenced ideas about individual morality, new issues in caring for family, and community 16 involvement. Sometimes medical theories changed local public health policies lending support to practical measures of sanitation and quarantine laws. Likewise, medical practices tended toward confinement for the patient, and refined evaluations of occupational stress for physicians. Syphilis can be a confusing historical term since the bacteria discovered to be responsible for veneral syphilis, Treponema pallidum, also causes two other diseases that are not veneral, yaws in certain tropical areas, and bejel in Middle Eastern areas. Although I will use the term syphilis in order to be consistent in this paper, from 1496 to the mid-sixteenth century, local Italian laity recorded a disease called Morbus Gallicus, or "French Disease. In retrospect, it is possible that some of the troops had traveled with Christopher Columbus to the New World and contracted a virulent form of spirochete from Native Americans and transmitted it to Europe. Italians sometimes called the disease the Neopolitan disease or "Mal de Napolitano" echoing the 19 belief that the disease had first been brought to Italy from Spain. Francesco Guicciardini blamed 20 the "Indies Indians" for having infected the Europeans. An alternative explanation for blaming Spain rested with a Roman chronicler, who had recounted the specific way the disease was transmitted by Jews driven out of Spain by King Ferdinand, and living in Naples. In any case, the syphilis epidemic took place during a time of nation-state building. The French blamed the Spanish, the Germans blamed the French, while the Polish blamed the Germans. By the end of the sixteenth century, "Morbus Gallicus" was commonly referred to as lues venerea, meaning venereal disease. Medical practitioners like William Clowes, an English surgeon writing about lues venerea in 1594, typify 21 the trend away from nation blaming.

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Such studies will contribute to prehypertension cdc order 2.5mg nebivolol with mastercard our understanding of the bases of hereditary and other congenital defects in humans arrhythmia etiology buy nebivolol online pills, and may ultimately be useful in developing gene therapies blood pressure chart daily buy nebivolol on line amex. Genetic, phylogenetic, and comparative biochemical studies of bacteria, protists, fungi, helminths, and other parasites will help to identify targets for antibiotics. The rapid evolution of antibiotic resistance in previously susceptible pathogens presents a critical need for evolutionary study, aimed at understanding the mechanisms of resistance, its rate of evolution, factors that may limit such evolution, and ways of preventing or counteracting it. Evolutionary studies of parasite/host interactions, using both model systems and human parasites and pathogens, are only beginning to determine the conditions that lead parasites to become more virulent or more benign. Analyses of genetic variation in resistance to pathogens in humans and other hosts are also needed. New and resurgent diseases have emerged as major threats to public health, and more will probably do so in the 40. Evolutionary biologists can aid in the effort to counter these threats in several ways. Screening for and studying the phylogeny of organisms related to known pathogens. Experimental studies of model systems, including organisms related to known pathogens, can identify mechanisms of virulence and the genetic and environmental factors that influence drug resistance. Agriculture and biological resources We noted above the many ways in which evolutionary biology has had an intimate relationship with agriculture and the management of biological resources such as forests and fisheries. Despite new alternative methods of pest management, judicious use of pesticides will undoubtedly remain indispensable. The evolution of pesticide resistance in insects, nematodes, fungi, and weeds is a serious economic problem that should receive major attention. This will require studies of the genetics and physiological mechanisms of resistance, population dynamic studies, and modeling of methods to limit or delay the evolution of resistance. Evolutionary considerations will be important in evaluating many alternative methods of pest management, such as mixing different crops or crop varieties (intercropping), or developing transgenic crops that carry resistance factors protecting them against insects or other pests. Experiments have shown, for example, that tobacco pests can adapt to transgenic tobacco carrying a bacterial toxin, highlighting the need for studies of genetic variation in insect responses to transgenic crops. There is enormous potential for transgenic use of the innumerable secondary compounds and other properties of wild plants that protect them against insects and pathogens. Experimental and phylogenetic screening of these natural resistance factors should prove rewarding. The large field of evolutionary ecology concerned with secondary plant compounds and the interactions between plants and their insect and fungal enemies is relevant to this effort. It will be important to analyze the physiological effects of natural resistance factors on pest organisms, the mechanisms by which some insects and fungi overcome their effects, and genetic variation in the responses of target species to natural resistance factors. Production of food, fiber, and forest products has historically been greatly improved by exploiting genetic variation, and the methods for doing so have been deeply informed by evolutionary biology. Such studies will also serve the interests of basic scientists interested in the adaptations of plants to environmental factors. Similar studies on wild plants will locate genes for useful traits that can be genetically engineered into crops. Several kinds of evolutionary studies have been and will continue to be important in managing commercial and sport fisheries. Molecular genetic markers will aid researchers in distinguishing breeding populations and migration routes of species such as cod and salmon. Studying the evolution of life history characteristics such as growth rate and age at maturity will enable managers to evaluate the genetic and demographic effects of harvesting on fish populations. For certain fish species that are widely stocked, genetic and physiological studies of adaptation to and fitness in different environments will be useful. Stocking plans will also include the use of transgenic fish, which are in the early stages of development. Natural products and processes Pharmaceutical and other industries are actively searching for novel products and processes by screening plants, animals, and microorganisms (33).

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Natural resources consist of the nonhuman inputs to heart attack test generic 5mg nebivolol otc be processed or to hypertension with stage v renal disease buy discount nebivolol on-line be used in combination with the human element to hypertension nos generic nebivolol 2.5mg with visa provide other resources. A steel mill uses people and blast furnaces (along with other tools and machinery) to pro cess iron ore into steel and steel products. An auto manufacturer takes steel, rubber, plas tics, and fabrics and (in combination with people, tools, and equipment) makes cars. A firm survives as long as its output is purchased in the market in quantities at prices that enable it to replenish its depleted stock of inputs. A university uses its resources to teach students, to perform research, and to provide technical information to society. To the extent that its patients are restored to the level of health consistent with the severity of their disease or injury, the hospital is effective. Therefore, criteria of effectiveness must reflect both considerations and we must define effectiveness accordingly. Stakeholder Approach to Effectiveness the application of systems theory concepts to the discussion of organizational effective ness identifies the importance of the external environment. Systems theory also identifies Chapter 1 Managing Effective Organizations 23 stakeholder approach the importance of achieving a balance among the various parts of the system of which an to effectiveness organization is but one part. Individuals and groups of individuals having stakes in an organization include its em ployees (nonmanagers and managers), customers, stockholders, directors, suppliers, creditors, officials at all levels of government, managers of competitive and cooperative organiza tions, and the general public. Each of these individuals and groups of individuals expects the organization to behave in ways that benefit them; these expectations may or may not be compatible with those of other individuals and groups. This relative view assumes that all claims on the organiza tion are valid and that no basis exists for ordering their importance, so no basis exists for making an overall judgment of organizational effectiveness. One answer is provided by the idea that each of the stakeholders controls resources that are valuable to the organization. At any point in time, the resources they control are more or less important and the organization is effective to the extent that it satisfies the interest of the group controlling the most important resource. This new view can be extended to a concept of the organization as an arena in which the different groups negotiate their claims by developing coalitions capable of combining the power of each member of the coalition. Managers of the organization achieve effective ness by identifying the most powerful coalitions and satisfying the demands of the most influential members of these coalitions. Whether the organization is effective when satisfying the most powerful group involves value judgment.

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Syndromes

  • Yellow skin or eyes
  • Pneumonia
  • Write this information down. Put this information in a pocket or other place on their person.
  • Generalized darkening of skin color (often referred to as bronzing)
  • Reactions to medicines
  • Cardiac magnetic resonance imaging (MRI)
  • Enlarged prostate, straining to urinate
  • Sensation of feeling the heart beat (palpitations) or a rapid heartbeat
  • Infection (a slight risk any time the skin is broken)

Camfak syndrome

Working Groups were formed for each country to blood pressure medication starting with d purchase nebivolol 5mg without a prescription identify what needs to prehypertension causes and treatment purchase nebivolol amex be done in each case to arrhythmia atrial fibrillation order nebivolol 5 mg otc improve the impact of national laws. The common problems encountered in the development of occupational health service include: 1. Lack of awareness among workers, employers, health planners, policy makers, health professionals and public at large. Inadequate, inaccessible, and inequitably distributed health service institutions. Lack of multidisciplinary staff, absence of field-testing equipment for conducting environmental and biological monitoring of the work place and the health of the workers. Insufficient budget for carrying out regular inspections, conducting research activities. The characteristics of the workers, the majorities are poor, illiterate or poorly educated. Unfavourable climatic condition and heavy load of endemic disease: such as bilharzia, onchocerciasis, malaria, leishhuhumaniasis, and trypanosomiasis. Absence of integration of occupational health and safety with general health service Principles of occupational Health and Safety the basic principles for the development of occupational health and safety services are as follows: a) the service must optimally be preventive oriented and multidisciplinary. Scope of occupational health and safety Factory management spends large amount of expenses for health insured workers. The workers compensation expenses include medical payments (hospital and clinic treatment); partial, temporary, and permanent disability costs; death benefits; and legal costs. The cost claims may steadily rise up if the employers do not take measure to intervene the problem. The role of occupational health and safety, therefore, lies in designing ways and means for cost reduction through workers proper health service provision. Occupational diseases, accidents, and death prevention are the issues to be addressed. The causes of these problems may be chemical, physical, biological, psychological, and ergonomical environments. The second scope includes evaluation of the recognized problem, which encompasses mainly data collection, analysis, interpretation, and recommendations. Finally, the third scope involves the development of corrective actions to eliminate or limit the problem. Generally, the work frame of occupational health and safety is wide and needs multidisciplinary approach. It requires the knowledge of physics, biology, chemistry, ergonomics, medicine, 29 Occupational Health and Safety engineering, and related sciences. It also requires public health management skills for proper communication and decision making. Elements of the work environment the basic elements in an occupational setting such as a manufacturing plant, industry, or offices are four. The work environment 1 the worker In developing countries like Ethiopia, the work force has several distinct characteristics: 1. Most people who are employed to work in the informal sectors, mainly in agriculture, or in small-scale industries, such as garages, tannery and pottery. In huhumany developing countries the rates of unemployment and under employment is increasing each year. In general, workers are at greater risk of occupational hazards for a variety of reasons because of low education and literacy rates; unfamiliarity with work processes and exposures, inadequate training, predisposition not to complain about working conditions or exposures because of jobs, whether or not they are hazardous, are relatively scarce; high prevalence 30 Occupational Health and Safety of endemic (mainly infections) diseases and malnutrition; inadequate infrastructure and human resources to diagnose, treat, and prevent work related diseases and injuries. Women, who make up a large proportion of the work force in many developing countries and often face significant physical and psychosocial hazards in their work. Children, who account for a significant part of the work force in many developing countries, often undertake some of the most hazardous work. In many of these countries, primary education is not required and there are no legal protections against child labor.

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