Hemolytic Disease of the Newborn

Hemolytic Disease of the Newborn ————————————————- What is hemolytic disease of the newborn (HDN)? Hemolytic disease of the newborn is also called erythroblastosis fetalis. This condition occurs when there is an incompatibility between the blood types of the mother and baby. * â€Å"Hemolytic† means breaking down of red blood cells * â€Å"Erythroblastosis† refers to making of immature red blood cells * â€Å"Fetalis† refers to fetus ————————————————- What causes hemolytic disease of the newborn (HDN)?HDN most frequently occurs when an Rh negative mother has a baby with an Rh positive father. When the baby's Rh factor is positive, like the father's, problems can develop if the baby's red blood cells cross to the Rh negative mother. This usuall y happens at delivery when the placenta detaches. However, it may also happen anytime blood cells of the two circulations mix, such as during a miscarriage or abortion, with a fall, or during an invasive prenatal testing procedure (e. g. , an amniocentesis or chorionic villus sampling). The mother's immune system sees the baby's Rh positive red blood cells as â€Å"foreign. Just as when bacteria invade the body, the immune system responds by developing antibodies to fight and destroy these foreign cells. The mother's immune system then keeps the antibodies in case the foreign cells appear again, even in a future pregnancy. The mother is now â€Å"Rh sensitized. † In a first pregnancy, Rh sensitization is not likely. Usually, it only becomes a problem in a future pregnancy with another Rh positive baby. During that pregnancy, the mother's antibodies cross the placenta to fight the Rh positive cells in the baby's body.As the antibodies destroy the red blood cells, the baby can become sick. This is called erythroblastosis fetalis during pregnancy. In the newborn, the condition is called hemolytic disease of the newborn. ————————————————- Who is affected by hemolytic disease of the newborn? Babies affected by HDN are usually in a mother's second or higher pregnancy, after she has become sensitized with a first baby. HDN due to Rh incompatibility is about three times more likely in Caucasian babies than African-American babies. ———————————————— Why is hemolytic disease of the newborn a concern? When the mother's antibodies attack the red blood cells, they are broken down and destroyed (hemolysis). This makes the baby anemic. Anemia is dangerous because it limits the ability of the blood to carry oxygen to the baby's organs and tissues. A s a result: * The baby's body responds to the hemolysis by trying to make more red blood cells very quickly in the bone marrow and the liver and spleen. This causes these organs to get bigger.The new red blood cells, called erythroblasts, are often immature and are not able to do the work of mature red blood cells. * As the red blood cells break down, a substance called bilirubin is formed. Babies are not easily able to get rid of the bilirubin and it can build up in the blood and other tissues and fluids of the baby's body. This is called hyperbilirubinemia. Because bilirubin has a pigment or coloring, it causes a yellowing of the baby's skin and tissues. This is called jaundice. Complications of hemolytic disease of the newborn can range from mild to severe.The following are some of the problems that can result: During pregnancy: * Mild anemia, hyperbilirubinemia, and jaundice The placenta helps rid some of the bilirubin, but not all. * Severe anemia with enlargement of the liver and spleen   When these organs and the bone marrow cannot compensate for the fast destruction of red blood cells, severe anemia results and other organs are affected. * Hydrops fetalis This occurs as the baby's organs are unable to handle the anemia. The heart begins to fail and large amounts of fluid build up in the baby's tissues and organs.A fetus with hydrops is at great risk of being stillborn. After birth: * Severe hyperbilirubinemia and jaundice The baby's liver is unable to handle the large amount of bilirubin that results from red blood cell breakdown. The baby's liver is enlarged and anemia continues. * Kernicterus Kernicterus is the most severe form of hyperbilirubinemia and results from the buildup of bilirubin in the brain. This can cause seizures, brain damage, deafness, and death. ————————————————- What are the symptoms of hemolytic disease of the newborn? The following are the most common symptoms of hemolytic disease of the newborn. However, each baby may experience symptoms differently. During pregnancy symptoms may include: * With amniocentesis, the amniotic fluid may have a yellow coloring and contain bilirubin. * Ultrasound of the fetus shows enlarged liver, spleen, or heart and fluid buildup in the fetus's abdomen. After birth, symptoms may include: * A pale coloring may be evident, due to anemia. * Jaundice, or yellow coloring of amniotic fluid, umbilical cord, skin, and eyes may be present.The baby may not look yellow immediately after birth, but jaundice can develop quickly, usually within 24 to 36 hours. * The newborn may have an enlarged liver and spleen. * Babies with hydrops fetalis have severe edema (swelling) of the entire body and are extremely pale. They often have difficulty breathing. ————————————————- Ho w is hemolytic disease of the newborn diagnosed? Because anemia, hyperbilirubinemia, and hydrops fetalis can occur with other diseases and conditions, the accurate diagnosis of HDN depends on determining if there is a blood group or blood type incompatibility.Sometimes, the diagnosis can be made during pregnancy based on information from the following tests: * Testing for the presence of Rh positive antibodies in the mother's blood * Ultrasound – to detect organ enlargement or fluid buildup in the fetus. Ultrasound is a diagnostic imaging technique which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasound is used to view internal organs as they function, and to assess blood flow through various vessels. * Amniocentesis – to measure the amount of bilirubin in the amniotic fluid.Amniocentesis is a test performed to determine chromosomal and genetic disorders and certain birth defects. The test involves inserti ng a needle through the abdominal and uterine wall into the amniotic sac to retrieve a sample of amniotic fluid. * Sampling of some of the blood from the fetal umbilical cord during pregnancy to check for antibodies, bilirubin, and anemia in the fetus. Once a baby is born, diagnostic tests for HDN may include the following: * Testing of the baby's umbilical cord blood for blood group, Rh factor, red blood cell count, and antibodies * Testing of the baby's blood for bilirubin levels ———————————————— Treatment for hemolytic disease of the newborn Once HDN is diagnosed, treatment may be needed. Specific treatment for hemolytic disease of the newborn will be determined by your baby's physician based on: * Your baby's gestational age, overall health, and medical history * Extent of the disease * Your baby's tolerance for specific medications, procedures, or therapies * Expectat ions for the course of the disease * Your opinion or preference During pregnancy, treatment for HDN may include: Intrauterine blood transfusion of red blood cells into the baby's circulation   This is done by placing a needle through the mother's uterus and into the abdominal cavity of the fetus or directly into the vein in the umbilical cord. It may be necessary to give a sedative medication to keep the baby from moving. Intrauterine transfusions may need to be repeated. * Early delivery if the fetus develops complications If the fetus has mature lungs, labor and delivery may be induced to prevent worsening of HDN. After birth, treatment may include: * Blood transfusions  (for severe anemia) Intravenous fluids  (for low blood pressure) * Help for respiratory distress using oxygen or a mechanical breathing machine * Exchange transfusion to replace the baby's damaged blood with fresh blood   The exchange transfusion helps increase the red blood cell count and lower the levels of bilirubin. An exchange transfusion is done by alternating giving and withdrawing blood in small amounts through a vein or artery. Exchange transfusions may need to be repeated if the bilirubin levels remain high. ————————————————- Prevention of hemolytic disease of the newbornFortunately, HDN is a very preventable disease. Because of the advances in prenatal care, nearly all women with Rh negative blood are identified in early pregnancy by blood testing. If a mother is Rh negative and has not been sensitized, she is usually given a drug called Rh immunoglobulin (RhIg), also known as RhoGAM. This is a specially developed blood product that can prevent an Rh negative mother's antibodies from being able to react to Rh positive cells. Many women are given RhoGAM around the 28th week of pregnancy. After the baby is born, a woman should receive a second dose of the drug with in 72 hours.

Managing across culture Essays - Cross-cultural Psychology

Managing across culture Essays - Cross-cultural Psychology Managing across culture Final choice of location Group members: Introduction A place to start a new operation has been looking by a multinational Corporation (MNC) from the food & beverages industry. This MNC already has main operations in France, USA, India and New Zealand. To select the location of new operation, national cultural values, optimization of productivity, efficiency, market penetration and cultural value-added should be taking into account. Hofstedes model was used to analyze the cultural differences between the potential new locations (Brazil and South Africa) and the existing locations. 1.Hofstedes model analysis As seen from the bar chart (Appendix1.1) Brazil, South Africa, France, USA, India and New Zealand show many differences on each dimensions of Hofstedes model. 1.1 Power Distance Power distance is defined as the extent to which the less powerful members of institutions and organizations within a country expect and accept that power is distributed unequally. It has to do with the fact that a societys inequality is endorsed by the followers as much as by the leaders. In corporations, power distance can indicate the social distance between employees and employer. India achieved the highest score compared with 5 other countries which is 77. This was followed by Brazil and then France at 69 and 68 respectively. In contrast, New Zealand, USA, and South Africa scored 22, 40, and 49 which are quite low. Consequently, power distance is far in India, Brazil, and France, which reflect that inequalities amongst people are acceptable in these societies. In that countries, the privilege of supervisors to be considered as a problem of course which significantly contribute to the implementation of authority and those features clearly not helpful to build harmonious relations between employees and managers. (Laura M. Milner, Dale Fodness, 1993). 1.2 Individualism- collectivism The fundamental issue addressed by this dimension is the degree of interdependence a society maintains among its members. It has to do with whether peoples self-image is defined in terms of I or We. In Individualist societies people are only supposed to look after themselves and their direct family. In Collectivist societies, people belong to in groups that take care of them in exchange for unquestioning loyalty. Brazil and India gained low points in individualism dimension indicate that these societies are more collectivism, in which countries employee depend more on psychological contracts with the group. However, individual freedom and individual achievement are greatly important in the countries with high score on this dimension such as USA, New Zealand, France, and South Africa. The countries often consider encouragement and awareness of individual competitions. 1.3 Masculinity- femininity The masculinity societies will be driven by competition, achievement and success, with success being defined by the winner or best-in-the-field while in femininity countries, dominant values are caring for others and quality of life that is the sign of success and standing out from the crowd is not admirable. South Africa got highest mark on this dimension at 63, followed closely by USA with one lower, and then New Zealand and India (58, 56 respectively) . In these countries, behavior in work is based on the shared values that people should strive to be the best they can be and that the winner takes all. Also, people live in order to work, managers are expected to be decisive and assertive, the emphasis is on equity, competition and performance and conflicts are resolved by fighting them out. By contract, with a score of 43, France has a somewhat Feminine culture. At face value this may be indicated by its famous welfare system, the 35-hour working week, five weeks of holidays per ye ar and its focus on the quality of life. 1.4 Uncertainty avoidance This dimension is the extent to which the members of a culture feel threatened by ambiguous or unknown situations and have beliefs and institutions to try to avoid these. France and Brazil got high score on this dimension, which is 86 and 76 respectively, in those people are hard- working and supervisors tend to control employees strictly. However, in countries with low uncertainty avoidance, such as New Zealand (49), South Africa (49), USA (46),India (40), uncertainty in life can be accepted easier and people can accept more suggestion and critics. Furthermore, employees in the low uncertainty avoidance countries

The Lion, the Witch and the Wardrobe - C.S. Lewis essays

The Lion, the Witch and the Wardrobe - C.S. Lewis essays The Lion, the Witch, and the Wardrobe are C.S. Lewiss second book of the Chronicles of Narnia. In this book, four characters embark on an adventure after they discover a way into Narnia from a secret wardrobe. Peter, Susan, Edmund, and Lucy embark on many adventures while they were staying at a huge mansion due to the war in London. Edmund meets a wicked witch whom he sides with, and the rest of his brothers and sisters desperately try to rescue Edmund for the sake of all their lives. The plot of the novel is first started when the four children have been staying at a country mansion because of the war in London. Lucy, the youngest of all, explores the house one day to uncover the secret wardrobe. She decides to get inside the wardrobe to see what is in it. To her surprise, there is no back wall to the wardrobe, and as she travels further into it, she eventually ends up in a forest full of snow. She then meets a faun, half man, and half goat, whom she visited with and then returned home. When she arrived back in the room, she realized that no time had passed by so she went to talk to her friends. No one believed Lucy about the wardrobe and the forest, so she was made fun of the whole day. Edmund, the youngest of the boys, decides to see if Lucy is right so he heads into the wardrobe and even he ends up in the forest. Well, he travels around and meets the bad witch who tells him to bring all of his brothers and sisters back to the forest so she can take them to the stone table. Edmund goes back and tells everyone that Lucys story was a hoax because he made fun of her for the story being fake. Everyone was tired of all the lying, so they all hid in it one day from the grownups and ended up all being in the forest. While they were there, they met up with a family of beavers whom they stayed with. While with the Beavers, Edmund sneaks out to find the Witchs home because she told him to meet her there next time he...

Spoken English - Definition and Examples

Spoken English s Definition: The ways in which the English language is transmitted through a conventional system of sounds. Compare to written English. Spoken English, says linguist David Crystal, is the more natural and widespread mode of transmission, though ironically the one which most people find much less familiarpresumably because it is so much more difficult to see what is happening in speech than in writing (The Cambridge Encyclopedia of the English Language, 2nd ed., 2003). In recent years, linguists have found it easier to see what is happening in speech through the availability of corpus resourcescomputerized databases containing real life examples of both spoken and written English. The Longman Grammar of Spoken and Written English (1999) is a contemporary reference grammar of English based on a large-scale corpus. The study of speech sounds (or spoken language) is the branch of linguistics known as phonetics. The study of sound changes in a language is phonology. See also: Speech (Linguistics)ColloquialConversationConversation AnalysisDialogueKey Events in the History of the English LanguagePresent-Day English (PDE)Standard EnglishVernacularWhat Is Standard English? Examples and Observations: Academic Bias Against Spoken English[L]inguists have inevitably had a long-standing and intensive contact with standard English. The nature of standard English as primarily a written variety, together with the immersion of academics in written English, does not augur well for their recognition of structures that may be more typical of spoken English than written English.(Jenny Cheshire, Spoken Standard English. Standard English: The Widening Debate, ed. by Tony Bex and Richard J. Watts. Routledge, 1999) The Relationship Between Spoken and Written English[I]n the course of the languages history, the relationship between spoken and written English has come nearly full circle. Throughout the Middle Ages, written English predominately served transcript functions, enabling readers to represent earlier spoken words or (oral) ceremony, or to produce durable records of events, ideas, or spoken exchange. By the seventeenth century, the written (and printed) word was developing its own autono mous identity, a transformation that matured in the eighteenth, nineteenth, and first half of the twentieth centuries. (However, through at least the end of the nineteenth century, spoken rhetorical skills were also seen as critically important to people with social and educational aspirations.) Since World War II, written English (at least in America) has increasingly come to reflect everyday speech. While writing on-line with computers has hastened this trend, computers didnt initiate it. As writing growingly mirrors informal speech, contemporary spoken and written English are losing their identity as distinct forms of language.(Naomi S. Baron, Alphabet to Email: How Written English Evolved and Where Its Heading. Routledge, 2000) Teaching IlliteracyOne main danger is that spoken English continues to be judged by the codified standards of written English, and that teaching pupils to speak standard English may, in fact, be to teach them to speak in formal written English. A test of spoken English may become a test of ones abilities to speak a very restricted codea formal English used routinely by dons, civil servants, and cabinet ministers. It is not very far removed from the language of formal debate. Such a view of spoken English can produce an artificial and unnatural English and can even promote a kind of illiteracy which is as damaging to users of English as not being able to write literate English; for to have everyone speaking and writing only one codea standard written English codegenerates an illiteracy almost as grave as would be the case if everyone were only able to use a local dialect.(Ronald Carter, Investigating English Discourse: Language, Literacy, and Literature. Routledge, 1997) Henry Sweet on Spoken English (1890)The unity of spoken English is still imperfect: it is still liable to be influenced by local dialectsin London itself by the cockney dialect, in Edinburgh by the Lothian Scotch dialect, and so on. . . . [I]t changes from generation to generation, and is not absolutely uniform even among speakers of the same generation, living in the same place and having the same social standing.(Henry Sweet, A Primer of Spoken English, 1890) The Value of Teaching Spoken English (1896)Not only should English grammar be taught with reference to the nature of language and the history of English, but it should also take account of the spoken, as distinct from the written, form. The reasons for this seem to me many and excellent. For instance, it is a misfortune that the English language makes its appeal to the educated mind, mainly through the written and printed form. The appeal to the ear and the appeal to the eye, which should strengthen one another, are thus distinctly separate and divergent. Our orthography encourages this separation. It is, therefore, the more important that textbooks of grammar should make some attempt to counteract this tendency.(Oliver Farrar Emerson, The Teaching of English Grammar, 1896) The Lighter Side of Spoken EnglishIf Opals goin to be a school-teacher, mebbe she wants summat to practice on, grinned her father.Oh, Pa, you mustnt say summatit isnt a word, remonstrated his daughter.Aint a word ! shouted her father with increasing excitement. Well, hear that! How do you know it aint a word?It isnt in the dictionary, said Opal.Shucks, disparaged Pa, whats the dictionary got to do with it? The words that git into the dictionary aint common talkin words nohow; theyre written wordsnobody puts talk into a dictionary.Why not? questioned Opal, astonished at her fathers apparent knowledge of the making of dictionaries.Cause why? Cause spoken words is too lively for emwho can go round and keep track of every word thats spoke? I can make up a hull mouthful myself, and no dictionaryll ever know anything about itsee?(Bessie R. Hoover, A Graduated Daughter. Everybodys Magazine, December 1909)

The Effects of the Vietnam War on American Soldiers Essay

The Effects of the Vietnam War on American Soldiers - Essay Example The South Vietnamese forces along with the United State depended on the air force and fire power with which they conducted search and destroy operations. "The Vietnam War, like the other two world wars before it, was a conflict that defined war for a generation. Unlike those previous wars, it was not fought on a broad international battlefield but rather in a narrow stretch of land far distant from America. Moreover as our study shows, it left not a single overwhelming image, but conflicting visions and meanings over which we continue to fight, though less stridently than at the height of that bitterly divisive conflict" (Wouters and Laufer 316). The United States entered the war to avoid the takeover of South Vietnam by the communist. The strategy behind this support was called containment. U.S. Military advisors arrived in 1950. In the early 1960s the U.S. involvement grew and the early 1965 they deployed combat units. The involvement of the U.S. was the highest in 1968 during the Tet Offensive. Later U.S. forces withdrew under a policy called Vietnamization, as South Vietnamese troops were armed and trained. The fighting in Vietnam continued even after a peace treaty was signed by all parties involved in January 1973. The U.S. Congress passed the Case-Church Amendment in June 1973, responding to the anti-war movement. The Case-Church Amendment banned U.S. Military intervention. North Vietnam captured Saigon in April 1975. In 1976, North Vietnam and South Vietnam were reunified. The Vietnam War had a huge impact on the culture, foreign relations and politics of the United States. The American citizens were very upset over the government's justification for the war and the means of fighting used. The war encountered a large human cost, which included the loss of 58,159 U.S. soldiers. The Vietnam War did not only result in the loss of life of American soldiers. The war had lasting effects on the soldiers who were in Vietnam. The soldiers not only suffered physical pain and injuries, they also suffered many psychological disorders. The fact that their own country men had turned against them affected the soldiers psychologically and emotionally. "Going to war creates a gulf between the warrior and his fellow citizens who have not directly experienced warfare" (Wouter and Laufer 40). The effects on the psychic of the soldiers were devastating up to the extent that they also stared committing suicide due to depression. The soldiers also faced problems which had lasting effects, these included drug addiction and the effects of Agent Orange on the soldiers and their children. "With the Vietnam war came widespread drug use, anti-military activism, racial tensions and increasing crime, all of which debilitated the training and readiness of the U.S. forces" (Baker 64) . Soldiers faced extreme conditions like hunger, fatigue, diseases and the like. Due to the intense conditions the soldiers faced in Vietnam, war memories were not forgotten easily. This resulted in a psychological disorder called delayed stress syndrome, which is described as extreme stress or even disorder of the brain caused by shocking memories of the past. Studies show that almost 15 per cent of the 3.3 million Americans who were a part of the Vietnam War were diagnosed with delayed stress sy

Global disaster Research Paper Example | Topics and Well Written Essays - 1750 words

Global disaster - Research Paper Example Ultimately, the paper draws a conclusion on why drought is important, the effects of ignoring it, and the need for future research to address this global disaster. Scientists agree that drought is hazardous to the environment and relates to the scarcity of water in the earth surface. Apparently, the globe is encountering alarming water levels in MENA that define global drought. As such, drought is a global disaster subject to its adverse effects on the environment and global population especially in the developing nations (Pozzi et al. 776). The 2012 National Drought Forum report asserts that drought is the third most dominant global disaster after floods and earthquakes. Drought has been a prevalent global disaster for almost three decades subject to the magnitude and frequency of its motivation factors. It is inherently difficult to understand and define drought since its effects vary from one region to another. Different nations have distinct ways of defining drought. Generally, drought emanates from the lack of precipitation in a given area for a long time (The National Drought Mitigation Center 1). We can only define drought in seasons and shortage of water supply in the environment. Humans consider drought with reference to precipitation where we assess the level of dryness and the duration of a dry season. The consideration relates to meteorological drought that applies to a specific region as defined by varying precipitation levels (Saddleback Educational Publishing 17). Hydrological drought is another form of drought and relates to how decreasing precipitation influences stream flow, soil moisture, reservoir and lake levels, and groundwater recharge (Saddleback Educational Publishing 17). Moreover, we have agricultural drought that relates to a situation where the level of water supply cannot meet agricultural water demands (Saddleback Educational Publishing 17). There are various ways that drought can occur. Numerous scientists have

Beck Manufacturing and Plan Capacity Assignment Example | Topics and Well Written Essays - 750 words

Beck Manufacturing and Plan Capacity - Assignment Example Therefore, for the expansion of the capacity, this is the centre where Beck Company should be putting its focus. By definition, a bottleneck is an operation with the least effective capacity of a given operation in any machine centre and hence thwarts the systems output. Therefore, based on the individual capacity of the machine centers, boring operation centre is a bottleneck that restricts the output to 11.25 pieces per hour, while the operation with the maximum highest capacity is grinding centre with 78.75 pieces per hour. This means that for boring to reach this capacity, it will require 67.50 extra capacity. According to Vonderembse, & White, (2013), meaningful expansion of the system’s capacity can only take place when the bottleneck is expanded. Initially, increasing capacity of the boring operation without expanding that of drilling, milling and grinding would ultimately expand the capacity of the system. However, when the boring operating capacity reaches 78.75 pieces per hour, drilling, milling and grinding operations must also be increased at the same time further expand the capacity of the system. In sizing capacity cushions, an average usage rate should not reach a 100 percent and if this happens, that shows a sign to expand the capacity or reduce order acceptance to prevent declining the productivity of the system. Vonderembse & White (2013) defines capacity cushion as the amount of reserve capacity that a business organization upholds to take care of any unexpected boom in demand or impermanent losses of production capacity; On the other hand, Mr. Beck can apply timing and Sizing Expansion strategy and in this strategy, he ought to understand when to expand the capacity and by how much. There are two tremendous strategies, which are the expansionist strategy that entails huge, infrequent jumps in capacity, and that of wait-and-see strategy, which entails lesser, more frequent