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The obstacles of assertiveness toward premarital sexual behavior: Almost all participants recognize the obstacles in being assertive toward premarital sexual behavior diabetes 69 discount 50mg acarbose visa, which is difficult to convey their attitude diabetes type 2 icd 10 order acarbose amex. Teenagers are eager to forbid their partners to touch sensitive parts of the body but they are afraid of losing their partners8 diabetes 77 company buy acarbose 50 mg with mastercard. Research conducted by the occurrence of violence in dating because victims tend not to dare to reject or say "no" diabetes type 1 undiagnosed discount acarbose american express, close themselves and punish themselves6. Conclusion Premarital sex behavior carried out by teenagers such as holding hands, hugging, kissing is considered a reasonable dating behavior among teenagers. Dating is used as a way of approaching between individuals of the opposite sex, which is characterized by knowing each other both the strengths and weaknesses of each. Experience of young womenin being assertive by limiting sexual activity during dating keeping in mind family, religious and community norms that become signs that must be obeyed. Adolescents who are able to be assertive are better able to say "no" to things that are negative and undesirable, able to submit requests, able to start, continue, and end a general conversation to reject pre-marital sexual behavior. Increasing the ability of adolescents to be assertive about premarital sexual behavior can be done through health education efforts. Pre-marital sex behavior of students in the management high school and computer science nation of Kendari (case study). Analysis of courtship behavior in students who experience pregnancy is not desirable in Kediri. Knowledge, perception and psychosocial preparedness for menarche among adolescent girls of Udupi District, Karnataka. The relationship between assertive behavior and premarital sexual behavior in young women. Relationship between assertiveness attitudes and trends in being victims of violence in dating of Teenagers. This research is descriptive research which aims to describe the dwelled phenomena. There are several stages in this method, namely hazard identification, risk analysis, and risk control. The data is gathered by conducting observation before doing data matching with Mr. The research results indicate that from two activities performed in the Laboratory of Medical-Surgical at Faculty of Nursing Universitas Airlangga, such as injection practicum and wound care practicum, there are six hazards discovered, namely medicine in ampoule packaging, needle stick, alcohol, NaCl 0. The risks ascertained are skin and eyes irritation caused by the exposure of chemical substances like alcohol, NaCl 0. Other than that, the risks found belong to the categories of the low-risk level and moderaterisk level. Introduction the rapid growth of civilization has been associated with various growth in technological sectors. One sector that is benefited by the development of technology is the educational sector. According to the book authored by Ramli (2010) entitled "Pedoman Praktis Manajemen Risikodalam Perspektif K3", accidents are most likely caused by the contacts between human and machine1. If compared, the number is equivalent to accidents experienced by 5,000 workers per day or 3 workers per minute. Risk management is a system that must be owned by a company, providing risk management itself is meant to protect a company from all things that can cause losses. The risk in the field of Occupational Safety and Health in a company usually focuses on negative risks, such as injuries, property damages, or operating disruption. Hazard identification is a process of identifying and distinguishing dangers and hazards in a working environment. The hazards can be in forms of physical, chemical, biological, psychosocial, or ergonomic/physiological hazards and also be caused by the workers, which also known as at-risk behavior. After passing through the stage, the results of the likelihood and severity will be inputted to risk matrix to figure out the level of each risk. Qualitative risk-matrix Level of Risk Likelihood A (Almost certain) B (Likely) C (Possible) D (Unlikely) E (Rare) Consequence 1 H M L L L 2 H H M M L 3 E H H M M 4 E E E H H 5 E E E E H Explanation: Extreme High: extreme risk, immediate action required: high risk, senior management attention needed Moderate: moderate risk, management responsibility must be specified Low: low risk, manage by routine procedures 3. Determining control is an endeavor or a program that is intentionally made to lessen losses or severity that may arise. An organization to make changes and controls need hazard identification and risk assessment to notice the severity level of hazards that are likely to occur.

Twenty-five percent (9/35) of the patients who claimed to have been suspended had scars after the lines diabetes medications metformin effective acarbose 25 mg, typically at the wrists and ankles metabolic disease symptoms in dogs purchase generic acarbose online. Fifty-three percent (19/35) had signs and symptoms of joint injuries or nerve lesions diabetes type 2 nursing diagnosis buy generic acarbose 50 mg. See generally Allen juvenile diabetes mellitus in dogs order 50 mg acarbose mastercard, supra note 37, Combination of blunt trauma and use of restraint has been implicated in the deaths of several detainees held by U. Mullah Habibullah died on December 2, 2002 at Bagram, Afghanistan following beating and physical restraint. Skolnick, Prison Deaths Spotlight How Boards Handle Impaired, Disciplined Physicians, 280 J. Valent stopped taking medication and his mental health deteriorated, he was ordered into a prison restraint chair by the prison psychiatrist. On release from the chair, he collapsed and died from blood clots that formed in his legs during his extended immobility and then traveled to his lungs. See generally John McCulloch, Health risks associated with prolonged standing, 19 J. Prevention, assessment & rehaBilitation 201 (2002), Prolonged standing contributes to chronic venous insufficiency, preterm birth in pregnant women, and musculoskeletal pain including foot and back pain. Venous insufficiency leads to varicose veins and burning sensations in the lower extremities. Peripheral neuropathy can also result, causing decreased motor sensation, decreased warmth and cold sensation and reduced vibration sensation. Prolonged standing refers to spending over fifty percent of the time during a full work shift in standing position. Beating the prisoner is subjected to forceful physical contact, either directly or through an instrument. Indeed, after much of the detainee abuse became public, the military explicitly prohibited the use of applied beating or other forms of physical pain when it issued the new Army Field Manual, in September 2006. Beating commonly results in blunt trauma - caused by the application of force to the human body but not penetrating the skin. Blunt trauma inflicted by beating may result in bruises caused by bleeding from ruptured blood vessels. The absence of a bruise, however, does not mean significant blunt trauma did not occur. Studies have observed the persistence of musculoskeletal pain (muscle and joint pain) caused by blunt trauma even a decade after the beating occurred. When released in sufficiently large amounts, breakdown products from damaged tissue can enter the circulation and result in life-threatening kidney failure in a condition known as rhabdomyolysis. A study of 34 victims of physical torture from India who presented with acute renal failure due to rhabdomyolysis found that all victims required renal dialysis. A slap diffuses the blunt trauma force over a greater area than a closedfist punch, but depending on where the slap is applied, it may nonetheless result in significant injury. Slaps delivered to vulnerable areas of the face including nose, eyes or mouth can result in severe pain and suffering, as well as soft tissue injury, bruising and lacerations. Facial bones may also be fractured, and a slap to the face may result in neck injury. MentalPainorSuffering the mental effects of beating are also relevant in determining whether beating amounts to criminal acts of "torture" or "cruel or inhuman treatment. The authors were able to demonstrate after-effects of beatings in torture victims showing remnants of hematomas in soft tissue and of periostal hematomas by bone scintigraphy. Nociceptive (pain arising from stimulation of nerve cells) and neuropathic pain (caused by injury or dysfunction of a peripheral nerve) were found in all patients. Beating and shoving were the most frequent forms of torture for these subjects (92%). Current musculoskeletal pain (almost a decade after their torture) correlated with the physical locations where they had been beaten. Banner, Forensic Medical Examination of Refugees Who Claim to Have Been Tortured, 26 am. The blunt trauma, fractures, and persistence of musculoskeletal pain (muscle and joint pain) support the argument that beating is an act intended to inflict "bodily injury" that involves "extreme physical pain.

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A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation diabetes test without fasting purchase acarbose from india. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing committee to revise the 2001guidelines for the management of patients with atrial fibrillation) diabetes mellitus news buy acarbose without a prescription. Therapeutically diabetes type 1 uk statistics purchase acarbose 50mg overnight delivery, patients at risk for sudden death usually fall into one of the two broad categories metabolic disease symposium 25mg acarbose amex. These individuals, having already demonstrated a propensity for lethal arrhythmias, are at substantial risk for subsequent sudden death. The second and much larger category consists of individuals who are at high risk but have not yet had sustained ventricular arrhythmias. The risk of sudden death for these patients, although demonstrably increased over normal levels, is generally not as high as for patients in the first category. Treatment of nonsustained ventricular arrhythmias the significance of ventricular ectopy Ventricular ectopy is generally classified as being either simple or complex. However, in the presence of underlying cardiac disease, complex ventricular ectopy does have prognostic implications. The presence of unexpected complex ventricular ectopy should thus prompt an evaluation for undiagnosed cardiac disease. If previous myocardial infarction or depressed ventricular function are present (as noted, the presence of complex ectopy alone carries no prognostic significance), the 1-year risk of sudden death is approximately 5%. If any two risk factors are present, the 1-year risk of sudden death is approximately 10%. Thus, patients who have survived myocardial infarction or who have depressed ventricular function from any cause have increased risk of sudden death. Treating ventricular ectopy the association between complex ectopy and the risk of sudden death has been recognized for decades, and for many years, it was assumed that antiarrhythmic drug therapy aimed at eliminating complex ectopy would improve that risk. Not only did getting rid of the ectopy fail to improve outcomes, but also the use of antiarrhythmic drugs itself (presumably due to proarrhythmia) increased mortality. In conceptualizing the treatment of complex ventricular ectopy, the bear droppings theory is instructive-if you are walking in the woods and see bear droppings, your chances of being eaten by a bear are higher than if there were no bear droppings. However, if you take out your gun and shoot the bear droppings, you are not reducing your risk. In fact, you might even induce the bear to come by to investigate the disturbance. Complex ectopy is best viewed as an indication of increased risk (like bear droppings), and not as an indication for therapy. The prophylactic empiric use of amiodarone has also been advanced as a way of treating patients with underlying heart disease who have complex ventricular ectopy, and several randomized trials have now examined this question. Unfortunately, these results do not provide definitive evidence that prophylactic use of amiodarone is helpful. Overall, these findings suggest that amiodarone-related toxicity may largely negate any reduction in sudden death. However, in distinct contrast to the Class I drugs, amiodarone is not associated with an 154 Chapter 12 Table 12. Yes No Yes No - No arrhythmic or cardiac mortality* - Reduction in total mortality* Yes increase in mortality when used in patients with complex ectopy and underlying heart disease. The bottom line is that treating ventricular ectopy with antiarrhythmic drugs has not been associated with an improved clinical outcome, despite the fact that numerous clinical trials have been conducted to examine this question. Therefore, it is not appropriate to treat these patients with antiarrhythmic drugs for the purpose of improving their survival. However, on occasion, it may be appropriate to treat ventricular ectopy if the ectopic beats themselves are producing significant symptoms. Here, obviously, the goal is to improve symptoms (and not necessarily to abolish the ectopy completely). Treatment of ventricular arrhythmias 155 In patients with no underlying heart disease, beta blockers should be the first drugs attempted, since they are well tolerated and have relatively few side effects. Unfortunately, they are also generally ineffective in suppressing ventricular ectopy.

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Further blood samples were taken from the study group it was found that anemia; thrombocytopenia and leucopenia were usual basic features to be found in breast cancer patients diabetes medicine on airplane buy acarbose online. This study also measured various biochemical factors like cholesterol diabetes diet carbs order acarbose 25mg on line, level of estrogen diabetes educator jobs buy generic acarbose 25mg on line, progesterone 1560Indian Journal of Public Health Research & Development diabetes definition type 1 order cheapest acarbose, January 2020, Vol. Conflict of Interest: the author would like to state that there was no conflict of interest whatsoever. The narrow treatment road to survival: Everyday life perspectives of women with breast cancer from Iraq and the former Yugoslavia undergoing radiation therapy in Sweden. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Medicinal Chemistry (Formerly Current Medicinal Chemistry-AntiCancer Agents), 16(4), 519-525. Tamoxifen for Prevention of Breast Cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. A Cross-sectional analytical study, there are 1,168 sampling groups; caregivers 584 persons, early childhood 584 persons, between April to May 2019. Introduction Children are important resource in society; therefore, the children should have efficient development so that they can grow up to be good children learn qualities that will help them become happy, and be able to create and do anything benefit to our society in the future. The children are significant to our county which we should invest them to get high number of returns around 6. Window of opportunity points us that if we evaluate or notice their delayed development in early before age of 6 years, that can stimulate their development and help them to be their normal developments2. A report from World Health Organization found out that the children all around the world 15-20%, their development are not appropriate3. In addition, department of health, ministry of public health 2017 has observed that children normal developments for Corresponding Author: Rajda Chaichit Department of Preventive Dentistry, Faculty of Dentistry, Khon Kaen University, Thailand 1562Indian Journal of Public Health Research & Development, January 2020, Vol. Regarding to family structure, some parents move out from rural area to city and leave their children to stay with grandparents, this situation has occurred so much in Northeast region, the children do not live with their own parents are 30%5, so family structure are members of grandparents and grandchildren which without parents. After literature review, there are risk factors which effect to the children developments involve with biological and economic and social. In the past, there are many studies related to risk factors which effects to the early children developments which still be problem. A part of this issue might cause of biological and economical and social risk factors. Inclusion criteria are Thai nationality children aged 0-6 years and been live in Northeast of Thailand. The caregivers are look after children at least 6 months up, their profiles can be given us completely and they must have the maternal and child health handbook. Regarding to exclusion criteria are disable children from birth which effect to their developments such as down syndromes, autism, cerebral palsy and children with seizure history, children with no cooperative to check development, children with no any age history and children who are not raised by their own blood relatives. Material: Socio-demographic Characteristics which compose of age, gender, occupation, education level, self-income, family income, income sufficiency, number of children per family and living with their own parents. Divide quality of life in each domain and overall for 3 levels which are poor, medium and good. The testing results are divided into 2 levels; Normal, develop a child without a delayed test and no more than one caution tests. In addition, assessor has been passed children development training from the National Institute for Child and Family Mahidol University. Using Multi Stages random sampling did in research for 20 provinces in Northeast region. Simple random sampling is used for 5 provinces at 25% out of all provinces in this region, next, for selected 2 districts out of each sampling province. If consider each domain development, language domain tends to be delayed the most 39. Table 4: Factors associated with suspected developmental delay: Bivariate analysis Factors 1. Quality of life in physical domain Good Medium Good Medium and poor 387 197 400 184 45.

The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research blood sugar at 5990 order acarbose visa. The effect of progressive muscle relaxation on the management of fatigue and quality of sleep in patients with chronic obstructive pulmonary disease: A randomized controlled clinical trial diabetes and pregnancy discount acarbose 25 mg without prescription. Efficacy of progressive muscle relaxation juvenile diabetes diet restrictions effective acarbose 50mg, mental imagery diabetes symptoms in males purchase acarbose 50mg on-line, and phantom exercise training on phantom limb: A randomized controlled trial. Pengaruh Hipnoterapi Terhadap Tingkat Stres Mahasiswa Fakultas Ilmu Keperawatan Universitas Padjadjaran Angkatan 2011. Diabetic foot is a source of significant morbidity and change in quality of life for diabetic patients. Objectives: to describe the characteristics of sample of patients with diabetic foot ulcer who attended Al Fayha Diabetic Foot Clinic and to evaluate the predictors of surgical intervention needed for treatment of these patients especially for those who are in need for amputation. Method: A cross sectional descriptive study conducted in Al Fayha Diabetic Foot Clinic, Basrah, Iraq. More than half of the cases who underwent debridement had wounds of grade 2 (University of Texas Classification) while 88% of cases who underwent amputation had wounds of grade 3. Conclusions: the majority of patients were females (60%),the age group of 50 years and above constitutes more than half of the cases,almost 80% have the disease for more than 10 years,all cases showed evidence of uncontrolled disease. Unfortunately complications end with morbidity and premature death in high proportion of cases. Marzoq Orthopedics department, Al Fayha Teaching Hospital, Basrah-(61030) e-mail: abdlhusseinmarzoq62@gmail. The benefit of surgical debridement is the change of infected ulcer into an acute ulcer. To describe the characteristics of sample of patients with diabetic foot ulcer who attended Al Fayha Diabetic Foot Clinic. To evaluate the predictors of surgical intervention needed for treatment of these patients especially for those who are in need for amputation, this can aid in planning of treatment. Patients were assessed in three levels: the patient as a whole,the involved limb and local examination of the wound. Diabetic foot wound classification according to University of Texas Classification (four grades and four stages). Surgical debridement has been done in the operating theatre and specimen from the wound has been sent to the laboratory for culture and sensitivity. All patients were followed twice weekly for twelve weeks,then monthly for six months. Exclusion Criteria: Patients who did not come for regular follow up were excluded. Patients and Method Study Design: this is a cross sectional descriptive study conducted in Al Fayha Diabetic Foot Clinic, Basrah, Iraq. It included patients name, age, sex, duration of diabetes, duration Results Demographics of the Studied Patients: Most of the patients were females 44(60. Table 1: Age and sex distribution of the studied patients Age (Years) <40 40-49 50-59 60 & above Total Sex composition Male No. In addition cases showed very unsatisfactory control indicated by the high level of random blood sugar (Almost 94. With respect of diabetic foot, it seems that it is a fairly recent pathology as the duration of symptoms and antibiotic use were both recent events. More than half of the patients delayed asking for doctor advice for 30 days or more. Duration of use of antibiotics before consultation (Days) None <10 10-19 20 Total Number 16 45 12 0 19 54 4 23 37 9 4 23 6 40 20 3 34 16 73 % 21. We attempted to use selected demographic and clinical characteristics to predict which patient needed debridement only and which patient needed amputation. Most patients who underwent debridement were females (30 cases), while there was no sex difference for those cases who underwent amputation. Three variables (wound stage, wound grade and random blood sugar) were independently significant predictors of surgical intervention in patients with diabetic foot. All other variables (age, sex, HbA1c, duration of diabetes, presence of ulcer, etc. Table 4: Predictors of Amputation Variable Wound Stage Wound Grade Random Blood Sugar B 0.

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