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7.03 Patients with Infectious Disease The center adheres to infection control policies to ensure the safety of patients, physicians, and staff members. Patients who are currently being treated for an infectious disease or condition that is transmitted via the contact route may not be treated at the center. Patients with disease spread via droplet (e.g. influenza) or airborne (e.g. tuberculosis, measles) routes will reschedule their procedures in consultation with their physicians. The infection control nurse, in consultation with the infection control consultant, will determine whether the patient requires isolation or other additional precautions. If a patient with current Clostridium difficile-associated diarrhea is treated at the center, all rooms where the patient was housed, even briefly, should be cleaned by housekeeping under supervision of the staff at the center. Physicians must document relevant information in their pre-admission documentation. Standard Precautions will be followed in the care of all patients. Cigarroa Interventional Institute establishes policies to ensure compliance with infection control policies for the care of patients with drug-resistant organisms. The physician will screen patients through the medical history review prior to scheduling a patient at the center. During the pre-operative (pre-op) phone call or interview, a pre-op screening of the patient will be conducted. Strict isolation policies are required to treat patients with active MRSA, VRSA, or tuberculosis. Since this facility has no provisions for strict isolation, those patients with active infections will be referred elsewhere for treatment. Patients who are undergoing or completed a course of antibiotic therapy, are colonized and/or are not actively infected may be treated at the center. Patients with active infections requiring transmission-based precautions are not appropriate candidates for this facility and will be referred to another facility or rescheduled. Procedures cannot be scheduled for patients currently undergoing an infection with transmission based precautions. The patient must finish the course, and they will be rescheduled. Definitions and Standards: The following definitions and standards are provided for informational purposes only: Airborne Transmission and Precautions: This mode of transmission occurs by the spreading of either airborne droplet nuclei (small particle residue of 5 microns or smaller), of evaporated droplets which contain microorganisms that remain suspended in the air for long periods of time) or dust particles containing microorganisms. Patients must be isolated in private rooms with special air handling and ventilation, and the door must remain closed. Patient transport should be restricted to essential transport only. Respiratory precautions must be taken when in the presence of patients with active tuberculosis, including respiratory masks. Droplet Transmission and Precautions: Droplets are transmitted from the host source by coughing, sneezing, talking, or during procedures such as suctioning or bronchoscopy. Patients must be isolated, and a distance of 3 feet maintained between the infected patient and others. Caregivers within 3 feet of the patient should wear a mask. Patient transport should be minimized. Contact Transmission and Precautions: Direct contact transmission involves direct body surface to body surface contact with physical transfer of microorganisms between a susceptible host and an infected person. Indirect contact transmission involves contact with an intermediate object (usually inanimate) and a susceptible host. Patients should be isolated as much as possible. Gloves and hand washing are essential for all contact with the patient and contact with objects, which come in contact with the patient. Gloves should be changed after each contact. Reportable Condition If the patient is determined to have a reportable condition at any time during pre-admission, the Director of Operations/Nurse Manager will be notified. The procedural physician will be contacted and the case will be canceled. The Department of Health will also be notified the same day following state regulations regarding Reportable Communicable Diseases. To report a disease or condition, contact: The City of Laredo Epidemiology 24/7 Reporting Line: (956) 763-2915, if unable to report locally, call The Texas Departmrent of Health Services epidemiology program: 24/7Number for Immediately Reportable – 1-800-705-8868

Micromarketing is an advertising strategy that allows a corporation to target a niche group with a particular product or service. With micromarketing, a company defines an audience by a specific trait, such as gender or job title or age range, and then creates campaigns geared toward that specific group. Macro-marketing is a multidisciplinary domain that deals with the impact that marketing has on the economy and society. It specializes in marketing-society interrelationships, such as green marketing, fairness and ethics, social management, market control, consumer conduct, and others. Customer relations refers to the methods, strategies, and processes a company uses to build and maintain customer relationships. Every customer interaction has an impact, and it's more important than ever for companies to consistently meet expectations.s PRODUCT DEVELOPMENT is strategy involves the improvement of current products or services or the development of the new products with the purpose of increasing sales. MARKET DEVELOPMENT is a strategy involves the introduction of existing products or services into a new geographical area or market. STRATEGIC PLANNING a broad process that can address the entire business, or a portion of the business. PLANNING the process of predicting future events and conditions and of determining the best way to attain the goals and objectives of the organization. CUSTOMER VALUE relationship between benefits and the costs including money, stress, and time to sacrifice that is necessary to get those benefits. POLITENESS Saying ”hello”, good afternoon sir/ma’am, and thank you very much are a part of good customer services. PRODUCTION PROCESS it is the process must conform to standards in terms of product quality. RELATIONSHIP MARKETING involves creating, maintaining and enhancing strong relationships with customers and other stakeholders. KEY PERFORMANCE INDICATOR a tool used to check the marketing activities and to track performance to make sure the company is on track to meet specific objectives. REACTIVE salesperson sells the product and encourage the customer to call whenever he or she has any questions or problems. MARKET PENETRATION the objective of this strategy is to increase market share of current products or services in current markets through greater and more intensive marketing efforts. LIQUIDATION this involves selling all of a company’s assets, in parts or as a whole, for their tangible worth. PRICING TEST can be utilized by marketers to calculate a product’s or service’s optimal price, to determine price elasticity. POSITIONING the process of communicating the image of a brand into the minds of consumers. INDUSTRIES business organizations that purchase goods and services for the purpose of producing other products and services or for use in their products and operating processes.

All living things are made up of one or more cells. A cell is the smallest unit that can carry on all of the processes of life. Beginning in the 17th century, curious naturalists were able to use microscopes to study objects too small to be seen with the unaided eye. Their studies led them to propose the cellular basis of life. Hooke In 1665, English scientist Robert Hooke studied nature by using an early light microscope, such as the one in Figure 4-1a. A light micro- scope is an instrument that uses optical lenses to magnify objects by bending light rays. Hooke looked at a thin slice of cork from the bark of a cork oak tree. “I could exceedingly plainly perceive it to be all perforated and porous,” Hooke wrote. He described “a great many little boxes” that reminded him of the cubicles or “cells” where monks live. When Hooke focused his microscope on the cells of tree stems, roots, and ferns, he found that each had similar little boxes. The drawings that Hooke made of the cells he saw are shown in Figure 4-1b. The “little boxes” that Hooke observed were the remains of dead plant cells, such as the cork cells shown in Figure 4-1c. SECTION 1 OBJECTIVES ● Name the scientists who first observed living and nonliving cells. ● Summarize the research that led to the development of the cell theory. ● State the three principles of the cell theory. ● Explain why the cell is considered to be the basic unit of life. VOCABULARY cell cell theory Robert Hooke used an early microscope (a) to see cells in thin slices of cork. His drawings of what he saw (b) indicate that he had clearly observed the remains of cork cells (300) (c). FIGURE 4-1 (a) (b) (c) Copyright © by Holt, Rinehart and Winston. All rights reserved. 70 CHAPTER 4 Leeuwenhoek The first person to observe living cells was a Dutch trader named Anton van Leeuwenhoek. Leeuwenhoek made microscopes that were simple and tiny, but he ground lenses so precisely that the magnification was 10 times that of Hooke’s instruments. In 1673, Leeuwenhoek, shown in Figure 4-2a, was able to observe a previ- ously unseen world of microorganisms. He observed cells with green stripes from an alga of the genus Spirogyra, as shown in Figure 4-2b, and bell-shaped cells on stalks of a protist of the genus Vorticella, as shown in Figure 4-2c. Leeuwenhoek called these organisms animalcules. We now call them protists. THE CELL THEORY Although Hooke and Leeuwenhoek were the first to report observ- ing cells, the importance of this observation was not realized until about 150 years later. At this time, biologists began to organize information about cells into a unified understanding. In 1838, the German botanist Matthias Schleiden concluded that all plants were composed of cells. The next year, the German zoologist Theodor Schwann concluded the same thing for animals. And finally, in his study of human diseases, the German physician Rudolf Virchow (1821–1902) noted that all cells come from other cells. These three observations were combined to form a basic theory about the cel- lular nature of life. The cell theory has three essential parts, which are summarized in Table 4-1. Anton van Leeuwenhoek (1632–1723) is shown here with one of his hand-held lenses (a). Leeuwenhoek observed an alga of the genus Spirogyra (b) and a protist of the genus Vorticella (c). FIGURE 4-2 TABLE 4-1 The Cell Theory All living organisms are composed of one or more cells. Cells are the basic units of structure and function in an organism. Cells come only from the reproduction of existing cells. (a) (b) (c) www.scilinks.org Topic: Cell Theory Keyword: HM60241 mb06se_csfs01.qxd 5/18/07 10:54 AM Page 70

Rhythm. Is the most basic element of music, because music can do without the other elements but cannot exist without rhythm. Music played, or sung brings out a regular rhythmic pattern or pulsation which we call beats. Beats are grouped in a measure that contains units of four, three, or two beats called a meter. Rhythm is that movement through time of the arrangement of tones and silences, of the order of short and long notes, and the accents of these tones so that a regular movement is produced.

Food and other form of poisoning - some substances when consumed can be dangerous to the health of human beings and can even cause death. Some substances are called poisons or toxins. Poisons can get into the body by swallowing, inhaling, by injection or via absorption through skin. Management of Food and Other Form of Poisoning • Ensure safety • If possible, find poison consumed • Avoid contact with the poison • Do not give drink or eatables • Do not induce vomiting • Arrange urgent transport to nearest healthcare facility Choking - Foreign body airway obstruction (FBAO) is one of the more common life-threatening emergencies that is seen and can be treated by the lay public. Management of Choking • Encourage to cough • Bend forward and give up to 5 back blows • Give 5 abdominal thrusts if still choking • Call for medical help Wounds are injuries that cause a break in the skin such as cuts, scrapes, or punctures. Management of Wounds • Wash hands or wear gloves if available. • Stop the bleeding by applying gentle pressure with a clean cloth or bandage. • Clean the wound using clean running water to remove dirt. • Apply antiseptic or antibiotic ointment if available. • Cover the wound with a clean bandage or gauze. • Observe for signs of infection such as redness, swelling, pain, or pus. • Seek medical help for deep, large, or heavily bleeding wounds. Hyperventilation is rapid or deep breathing often caused by anxiety, fear, or stress. Management of Hyperventilation • Stay calm and reassure the person. • Encourage slow, deep breathing through the nose and out through the mouth. • Ask the person to sit or lie down in a comfortable position. • Move the person to a quiet and well-ventilated area. • Loosen tight clothing around the neck or chest. • Do not give food or drinks during the episode. • Seek medical help if symptoms persist or the person becomes unconscious. Heat-related conditions include heat cramps, heat exhaustion, and heat stroke caused by exposure to high temperatures. Management of Heat-Related Conditions Move the person to a cool, shaded, or air-conditioned place. Loosen or remove tight clothing. Cool the body by fanning or applying cold compresses. Give cool water to drink if the person is conscious. Let the person rest in a lying position. Seek immediate medical help if there is confusion, fainting, vomiting, or very high body temperature.

全部ぜんぶ all 全然ぜんぜん not at all 注文ちゅうもん order 知り合いしりあい acquaintance ゴミ garbage にっき diary からかう to tease さわぐ to make noise たたく to hit 習うならう to learn 注意ちゅうい attention, warning 注意するちゅういする to warn, to call attention to おこる to get angry ひく to play the piano or stringed instrument かたづける to clean up, to organize にっきを付けるにっきをつける to keep a diary

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