Placenta Previa Essays

Placenta Previa Essays Placenta Previa Essay Placenta Previa Essay Abstract The paper discussion is about Placenta Previa a medical condition observed, and that occurs in women during birth. The paper begins b giving an introduction of the term Placenta Previa sampling the data survey together with the degree of the disease. The paper further presents a credible discussion on the pathology discussing some of the causes and risks. Diagnosis is also looked it with the article pointing out some of the significant procedures and care taken to help in prevention and treatment of Placenta Previa. Prognosis and management outline some of the primary managerial procedures to be taken and observed to prevent and help one with Placenta Previa. Finally, the paper gives a conclusion of the recap of all the discussion in the article. Introduction Placenta Previa is a condition in which the placenta implants in the lower portion of the uterus and covers all or part of the internal cervical os. The incidence according to the survey is that 1 out of 200 women giving birth. The major difficulty with classification system is accounting for the potentially changing relationship between the placenta and cervix during the third trimester, especially as labor progresses (Nyberg, 2003). Degrees of Placenta Previa are described concerning the internal os prior or the onset of labor. There are four types or degree of Placenta Previa: Total Placenta Previa is where the internal os is entirely covered by the placenta Marginal Placenta Previa is whereby the edging of the placenta is close to the internal os. Partial Placenta Previa is where the internal os is partly sheltered by the placenta. Low lying Placenta Previa is where lower uterine segment has a placenta implant such that the placental edging has a proximity of the internal os. The incidence of Placenta Previa varies widely with gestational age at diagnosis and the criteria used. The impact at the term of clinically significant Placenta Previa is approximately 0.5% (Nyberg, 2003). Placenta Previa is diagnosed in about 5% of second-trimester pregnancies before genetic amniocentesis. At least 90% of Placenta Previa, therefore, resolves to a standard position by the term. Possible reasons for this improvement are discussed in the following pathology section. Pathology Placenta Previa results from implantation of the blastocyst in the lower uterine segment. Some factors appear to increase the risk of this occurrence, including advancing age, multi-parity, smoking, cocaine use, prior Placenta Previa and parity, previous cesarean delivery and suction curettage related to pregnancy. The firm association between Placenta Previa and parity previous cesarean delivery and curettage suggests that endometrial damage is an etiologic factor. Subsequent pregnancies are more likely to implant in the lower uterine segment by a process of elimination (Mishell, Goodwin Brenner, 2002). Multiple pregnancies are at higher risk because of the reduced surface area of the endometrial available. Improvement in Placenta Previa with gestational age primarily reflects marketed growth of the lower uterine segment during pregnancy which pulls the placenta superiorly. At 20 weeks, the placenta covers approximately one-fourth of the myometrium surface area, but near term the placenta covers one-eighth the myometrial surface. Improvement may also be partly secondary to trophotropism in which the placenta atrophies at suboptimal sites of implantation and hypertrophies at more optimal sites. Diagnosis Placenta Previa is most often diagnosed by routine sonography. In other cases, the initial diagnosis is made at the time of presentation for vaginal bleeding through the second part of pregnancy. In these cases, sonographic confirmation of placental location is recommended before the digital cervical examination. The trans-abdominal ultrasound may confirm the suspicion of Placental Previa (Krishna, Daftary Tank, 1995). When sufficient visualization of the affiliation between the placenta and the internal cervical os is not possible with trans-abdominal ultrasound, the transperineal or transvaginal approach may be beneficial. Careful transvaginal may be beneficial. Careful sonography does not appear to increase the risk of hemorrhage in Placenta Previa. In general, prenatal ultrasound is highly sensitive but not specific for the diagnosis of placenta previa. Therefore, while false negative diagnoses are rare, false positive diagnoses are common depending on the gestational age, the sonographic technique used. This is especially true before the third trimester because of differential growth of the lower segment of the uterus in the second half of pregnancy. Placental Previa is readily diagnosed by the location of the placenta over the cervix. Placenta localization by trans-vaginal examination complements trans-abdominal scans and provides good visualization of the internal os and its relationship to the location of the placenta. Thus, may help to decrease the number of false positive diagnosed with Placenta Previa during early pregnancy (Nyberg, 2003). Prognosis and management Krishna, Daftary and Tank (1995) indicate that patients with a lower lying identify at mid-trimester should be observed with further ultrasound examination until at least 34 weeks, or unequivocal conversion has occurred. Placenta Previa diagnosed by custom second-trimester sonography is managed expectancy. The patient can be a measure that the likelihood of spontaneous resolution is greater than 90%. It is reasonable to recommend avoidance of strenuous activity, but further limitations probably are not necessary early in pregnancy. The placental location should be re-evaluated at 28-30 weeks (Mishell, Goodwin Brenner, 2002). If Placenta Previa persists, the patient should be cautioned that rigorous activity and intercourse might provoke bleeding. Cesarean delivery should be scheduled at a gestational age that will exploit the probability of fetal maturity and diminish the risk of hemorrhage that may effect from the standard commencement of uterine abbreviations. According to Mishell, Goodwin and Brenner (2002) the management of Placenta Previa complicated by acute hemorrhage is directed at optimizing the outcomes of the mother and the fetus. In many cases, bleeding resolves spontaneously and the patient may be managed expectantly. In other cases, severe hemorrhage may require intervention. The management varies dramatically with the severity of the condition. Through ultrasound with color and duplex Doppler should be performed. MRI should be considered. Mild cases of placenta accrete may be treated with hemostatic cultures and removal of the placenta or observation alone. Patients may also be treated with methotrexate (Nyberg, 2003). For more classic, severe cases the usual treatment is hysterectomy at the time of delivery. If the placenta also invades the urinary bladder, however, this may be insufficient to control the hemorrhage. Adequate blood for transfusion must be available at the time of delivery. The goal is to deliver a live, healthy baby and maintain the health of the mother. Conclusion In concluding Placenta Previa is a stipulation whereby the placenta implants in the lower portion of the uterus and covers all or part of the internal cervical. Degrees of Placenta Previa are described concerning the internal os prior or the onset of labor. It results from implantation of the blastocyst in the lower uterine segment. Some factors appear to increase the risk of this occurrence, including advancing age, multi-parity, smoking, cocaine use, prior Placenta Previa and parity, previous cesarean delivery and suction curettage related to pregnancy. Placental Previa is readily diagnosed by the location of the placenta over the cervix. Placenta localization by trans-vaginal examination complements trans-abdominal scans and provides good visualization of the internal os and its relationship to the location of the placenta. the management of Placenta Previa complicated by acute hemorrhage is directed at optimizing the outcomes of the mother and the fetus. References Krishna, U., Daftary, S., Tank, D. K. (1995).Pregnancy at risk: Current concepts. New Delhi, India: Jaypee Bros. Medical Publishers. Mishell, D. R., Goodwin, T. M., Brenner, P. F. (2002).Management of common problems in obstetrics and gynecology. Malden, Mass., USA: Blackwell. Nyberg, D. A. (2003).Diagnostic imaging of fetal anomalies. Philadelphia: Lippincott Williams Wilkins.

CDL Guide Indiana, Iowa, and Illinois

CDL Guide Indiana, Iowa, and Illinois This article is useful for anyone who wants to get your CDL in Indiana, Iowa or Illinois. If you want to learn about earning a CDL at other states, we have put together a comprehensive guide on how to get a commercial driver’s license in every state of the country. IndianaTo get a CDL  you must:be at least 18 years old if you will be  transporting property within state lines and 21 years old if you will be transporting peoplehave held an Indiana driver’s license, chauffeur’s license,  or public passenger chauffeur’s license  for at least one yearpresent documents of identification proving your identity, lawful status, Social Security number, and Indiana residencypass  the  appropriate  knowledge  test for  the  vehicle type that you plan to operateKnowledge Tests RequiredCommercial  vehicle drivers: General knowledge testSchool bus drivers: School bus endorsement test and passenger transport test  All bus drivers: Passenger transpor t testVehicle with air brakes:  Air brakes testCombination of vehicles: Combination vehicle testDrivers transporting hazardous material: Hazardous material testDrivers transporting liquids in bulk: Tanker testDrivers pulling double or triple trailers: Doubles/triples testYou may  receive only  three  CDL permits in  two years, and a CDL  learner’s permit is valid for six months.  Those with a  CDL learner’s permit may operate a commercial motor vehicle only when accompanied by a valid CDL  holder who has the proper class and endorsement(s).IowaTo get a CDL  you must:be 18 years oldprovide proof of full name, date of birth, Social Security number, and citizenship, permanent residency, or an I-94 documentproof of Iowa residencypass a vision screening testobtain and hold a commercial learner’s permit (CLP) for at least 2 weeks prior to your applicationcertify the vehicle type you plan to driveSteps to Obtaining a CDL1. Pass the knowledge test re quired for the commercial vehicle you want to operateGeneral knowledge for any CDLCombination vehicle for Class AAir brakePassengerSchool busDoubles/TriplesHazmatTankIowa operator (if applicable)2. Obtain a CLP3. Pass the required skills and driving test, which is comprised of 3 partsPre-trip vehicle inspection, making sure your vehicle is safe to driveSkills test, which tests maneuvers around cones and backin maneuversA driving testIllinoisTo get a CDL you must:be 18 years oldhold a valid Ohio State diver’s licenseprovide a valid Social Security cardmeet minimum medical standards as established by federal and state regulationspass the knowledge and skills testsTestingThe knowledge test is a written test required for each class of vehicle you hope to drive, each endorsement, and removing an air brake restriction.The skill test is a 90-minute driving test comprised of a pre-inspection and a road test. You will need to arrive with a vehicle appropriate to the class of license y ou seek.ExemptionsThe law exempts these categories from the CDL:A â€Å"Farm Truck†Fire EquipmentPublic Safety VehicleRecreational VehicleCommercial Motor VehicleVehicle Operated for Military PurposeNonbusiness Commercial Motor VehicleVehicle Designed for Transporting Goods

Human Resource Management Portfolio Research Paper

Human Resource Management Portfolio - Research Paper Example A job analysis based on background study facilitated development of job description. A study of the company’s strategies facilitated job analysis. The company’s strategy map proved to be the most essential part of this exercise. In addition, differing views from literature added greater knowledge and reasoning to the process of creation of a job description. The end result emerged as a detailed job description that highlights all key responsibility areas and essential skills required for the role. Based on these details, qualifications and experience needed for the role are identified. Overall, this effort has shed much light on the significance of human resources in organizational sustenance and growth; this process clarified the strategic link between job analysis, performance management and organizational sustenance. Table of Contents Content Page Section 1. Introduction 5 1.1. Job in context: Store manager at Tesco 5 1.2. Strategic position of Store manager at Tesco 5 Section 2. Job analysis 6 2.1. Job analysis for Store manager at Tesco 6 2.2 Job analysis method: Review of background records 7 2.3. Job analysis and organizational sustenance 11 Section 3. ... Link between Job Analysis and other management functions 11 Figure 4. Job Characteristics Model 12 Figure 5. Selection process at Tesco 16 Figure 6. Link between JD and performance management 17 List of Appendices Appendix 1: Job description for Store Manager, Tesco 21 Appendix 2: Job Advert – Store Manager, Tesco 23 List of Abbreviations HRM: Human resources management HR: Human resources JD: Job description Section 1. Introduction 1.1. Job in context: Store manager at Tesco. This discussion builds a portfolio for the manager’s position in a retail supermarket. The concerned workplace is the renowned supermarket Tesco, which is one of the top 3 supermarkets in the world. Tesco is about a hundred year-old multi-dimensional business that originated in the United Kingdom as a small retail shop. Tesco has its presence in more than 10 countries and employs about half a million people across the globe. Moreover, Tesco’s growth is not limited to retail groceriesâ€℠¢ sector but has invaded numerous other business areas such as investment, information technology, communications, petrochemical products, food, clothing, consumer electronics, telecommunications etc (McLoughlin & Aaker, 2010). With such vast business, Tesco operates based on systematic and planned strategy throughout the world. Its strategies invade every aspect of its widely diverse business operations including finance, production, service, retail, learning, customer service, and logistics. This report specifically evaluates the role of a team manager in the retail sector of Tesco, which is planning to open its new branch in Vietnam. This role is mainly responsible for store operations on a day-to-day basis along with management of a team of store representatives and their supervisors. 1.2.