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Mitigation and Adaptation. The Philippines is situated in a disaster risk area where hazards will always be present. The government's response to mitigate and adapt to these hazards is through the creation of hazard maps. Hazard maps are developed to indicate the places where most natural hazards occur or will most likely occur. Identifying these places can aid in informed land-use and the persons-in-charge can create emergency response plans. With the proper knowledge of hazards and the actions to be taken if ever they occur will help in the reduction and mitigation of the dangers of these natural hazards to life and property. In the Philippines, the Department of Environment and Natural Resources (DENR) created a Geohazard Mapping and Assessment Program implemented by the Mines and Geosciences Bureau, which identifies areas vulnerable to geologic hazards or geohazard. They are also responsible for developing the hazard maps. High susceptibility to landslide. • Areas with high susceptibility rating have active/recent landslides and tension cracks that would directly affect the community. Those with steep slopes and drainages that are prone to landslide damming are also highly susceptible to landslides. Moderate susceptibility to landslide. • Areas with moderate landslide susceptibility rating have inactive/old landslide and tension cracks which are located away from the community. These areas usually have moderate slopes. Low susceptibility to landslide . • Areas with low to gentle slopes and lacking tension cracks have low landslide susceptibility rating. High susceptibility to flooding . • Areas with greater than 1-meter flood height. These areas are usually flooded for several hours during heavy rains include landforms of topographic lows such as active river channels, abandoned river channels and areas along river banks; also prone to flashfloods. Low to moderate susceptibility to flooding. • Areas with less than 10-meter flood height. These are usually inundated during prolonged and extensive heavy rainfall or extreme condition. Aside from the development of hazard maps, action plans should be conceptualized to identify the priorities for action and plan for the possible impacts affecting the country. Local programs should be established to help the people who are most affected by natural disasters to recover from their losses. Such programs can include training the people to innovate and think out of the box to come up with ideas or solutions that will be more effective for their livelihood. Education is also a means for people to mitigate and adapt to natural hazards. It can increase mass awareness regarding natural hazards; thus, increasing their chances of survival. It is also a means of promoting access to information and resources that will help individuals be better prepared for natural hazards. Lastly, formal education can empower individuals to be more adaptive with their responses to and recovery from natural hazards. In preparation for natural hazards, information regarding what to do before during, and after a natural hazard is disseminated all over the country. The following are the things to do to be prepared for each natural hazard..

In this video we take a look at the 0:02 fetch to code 0:03 execute cycle including its effect on 0:06 the various registers we've previously 0:12 [Music] 0:14 discussed a computer is defined Definition 0:17 as an electronic device that takes an 0:20 input 0:22 processes data 0:25 and delivers output 0:29 in this simple example you can see we're 0:31 taking the input 5 0:35 we're multiplying it by 2 that's our 0:37 process 0:39 and we're outputting 10. 0:44 but this could be way more complex for 0:46 example of a game console 0:48 the input could be the buttons you press 0:50 on a controller 0:53 the processes would then be carried out 0:55 by the console itself 0:59 and the output would be some form of 1:01 update to a monitor 1:02 and sound out for a speaker possibly 1:04 vibration feedback through the 1:06 controller 1:10 to process data a computer follows a set 1:13 of instructions 1:14 known as a computer program 1:18 if we take the lid off a typical desktop 1:20 computer we can identify 1:22 two critical components the memory 1:26 that stores the program and the central 1:29 processing unit or processor 1:31 which is under this large fan and 1:33 carries out the instructions 1:37 a computer carries out its function by 1:40 fetching 1:41 instructions decoding them and then 1:43 executing them 1:44 in a continuous repetitive cycle 1:46 billions of times a second 1:48 let's look at each of these stages in a 1:50 little more detail Fetch 1:53 so let's start with the fetch stage the 1:55 very first thing that happens 1:57 is the program counter is checked as it 2:00 holds the address 2:01 of the next instruction to be executed 2:07 the address stored is then copied into 2:09 the memory address register 2:14 the address is then sent along the 2:16 address bus to main memory 2:18 where it waits to receive a signal from 2:21 the control 2:22 bus so it knows what to do 2:27 as we want to read the data that's 2:29 stored in memory address 2:30 0 0 0 0 the control unit sends 2:34 a read signal along the control bus to 2:36 main memory 2:41 now main memory knows the data needs to 2:44 be read 2:45 the content stored in memory address 000 2:49 can be sent along the data bus to the 2:51 memory data register 2:56 now as we're currently in the process of 2:58 fetching an instruction 3:00 the data received by the memory data 3:03 register gets copied 3:04 into the current instruction register 3:11 the instruction effectively has now been 3:14 fetched from memory 3:16 just before we proceed to the decode 3:18 phase we now 3:19 increment the program counter so that 3:22 the address it contains 3:24 points to the address of the next 3:26 instruction which will need to be 3:30 executed 3:32 the instruction now being held in the 3:33 current instruction register 3:35 is ready to be decoded 3:39 now as we mentioned in the previous 3:41 video the instruction is made up of two 3:43 parts 3:44 we have the op code that's what it is we 3:47 need to do 3:50 and we have the operand what are we 3:53 going to do it to 3:55 now the operand could contain the actual 3:57 data 3:58 or indeed it could contain an address of 4:01 where the data is to be found 4:06 by decoding this instruction we can see 4:08 the operation we need 4:10 is a load operation so we need to load 4:14 the contents of memory location0101 4:18 into the cpus accumulator 4:25 in the exam a simple model will be used 4:27 to describe the 4:29 structure of any given instruction 4:32 you're not going to be expected to 4:34 define how an opcode is made up 4:36 but simply to interpret opcodes in the 4:39 given context of an exam 4:40 question in the example here 4:44 you can see there's a total of 16 4:46 different opcodes available 4:48 and this is because we're using four 4:50 bits for our representation 4:56 so now we've fetched the instruction and 4:59 we've decoded it so we know what we need 5:00 to do 5:01 we're finally ready to execute it 5:05 so we now send address 0101 5:08 to the memory dress register 5:13 now we're in the memory address register 5:15 we can finally send the address 5:18 down the address bus to main memory 5:24 this time we want to read the data 5:26 that's stored in memory 5:28 and so the control unit again sends a 5:30 read signal along the control bus 5:36 so main memories now receive an address 5:38 and a read signal 5:40 so the content stored at memory location 5:43 0101 5:44 can now be sent along the data bus back 5:46 to the cpu 5:47 and into the memory data register 5:54 finally the contents of the memory data 5:56 register are copied to the accumulator 5:59 and this is one of a number of general 6:00 purpose registers found in the cpu 6:04 this first instruction is now complete Branching 6:11 so what does this program actually do 6:14 you should be able to work it through 6:16 carefully and figure it out 6:19 we're now pointing instructions zero 6:21 zero zero one in the program counter 6:23 and we're ready to fetch the second 6:25 instruction 6:27 at the end of this video we're gonna 6:29 provide you with the answer 6:34 so let's talk a second about programs 6:37 that branch 6:40 on the left here we have a very simple 6:42 piece of pseudo code 6:44 line zero says first execute this line 6:46 of code 6:47 line 1 now execute this line and then 6:50 line 2 says 6:52 if the age is greater than 18 then 6:56 we're going to execute lines 3 and 4 6:58 otherwise 6:59 we're going to execute lines six and 7:02 seven 7:03 so this program doesn't necessarily 7:05 follow strictly in sequence from line 7:07 zero through to seven there's a chance 7:10 here the program may branch and jump 7:14 around 7:16 so we're going to pretend that this 7:17 program has been loaded into memory 7:20 each line of code on the left here has 7:23 ended up 7:24 as a location in memory now this is not 7:27 strictly how this would happen in this 7:28 one-to-one way 7:29 but for the purpose of example it's 7:31 absolutely fine 7:35 so the program counter starts by 7:37 pointing to memory address zero 7:39 and we fetch the first instruction 7:41 decode it and execute it 7:44 it then updates and tells us the next 7:47 instruction 7:48 is zero zero zero one because remember 7:50 the program counter is being incremented 7:52 so we fetch it decode it and we execute 7:55 line one of our program 7:59 we then fetch line two which in binary 8:01 is one 8:02 zero 8:06 now at this point depending on what 8:10 happens during the execution 8:11 of line two the program may be required 8:15 to fetch line three from memory or 8:18 line five from memory 8:25 so let's look at how this actually works 8:27 because we've said the program counter 8:28 simply gets incremented 8:31 well in the current instruction register 8:33 we have an instruction with the op code 8:36 0 1 1 0. 8:41 now when we look this up in the decode 8:43 unit we discover that this 8:45 code means branch always 8:51 this replaces the value held in the 8:54 program counter 8:56 with the contents of the operand that's 8:58 the second part of the instruction 9:01 from the current instruction register so 9:03 this case 9:04 one zero zero one 9:09 now when the next fetch cycle begins the 9:12 program counter is obviously checked 9:14 and as its contents have been previously 9:16 updated to a new memory location 9:19 and not simply incremented the program 9:22 effectively is able to jump 9:24 around memory 9:28 so having watched this video you should 9:30 be able to answer the following key 9:32 question 9:33 how does a cpu work 9:39 okay so let's um answer the question we 9:41 posed 9:42 earlier what did that program actually 9:48 do 9:50 so this is the first fetch to code 9:53 execute cycle 9:55 and this is the one that we ran through 9:57 in detail earlier 9:58 it effectively loaded the contents of 10:01 the memory 10:02 stored at location location0101 10:05 into the accumulator in other words 10:08 the dna number 3 is moved 10:11 from memory into the cpu 10:18 we then proceed onto the second fetch 10:20 decode execute cycle 10:23 now this one adds the contents of memory 10:27 located at 0 1 1 0 10:30 to the current contents of the 10:32 accumulator 10:34 so in other words the dna number one 10:38 because that's what's stored at address 10:40 zero one one zero 10:43 is added to the number three that was in 10:45 the accumulator 10:46 the results are stored back over the 10:48 accumulator 10:49 so effectively we've done three plus one 10:53 equals four 10:58 the third fetch to code execute cycle 11:00 stores the contents which are in the 11:02 accumulator 11:03 into memory location zero one one one 11:07 and that's because the op code the first 11:09 part of this current instruction 11:10 zero zero one one is the command to 11:13 store when we look it up in the decoder 11:15 unit 11:16 so in other words the result of the 11:17 previous calculation three plus one 11:19 equals four 11:20 is now written back into main memory 11:28 the fourth fetch decode execute cycle 11:30 outputs the contents of the accumulator 11:33 remember they were copied into main 11:34 memory but they're still held in the 11:35 accumulator 11:37 so in this simple abstraction the number 11:40 four is now 11:41 output to the user so they can see the 11:43 result of the calculation 11:49 the fifth and final fetch code execute 11:51 cycle 11:52 brings a halt to the current program 11:58 so this very simple program which has 12:01 five 12:02 fetch decode execute cycles has 12:04 performed the calculation 12:06 three plus one is then stored the result 12:09 in main memory 12:10 and displayed the result four to the 12:12 user 12:13 and in a high-level language this may 12:15 look something very similar to the 12:17 following two lines of code 12:20 sum variable equals num1 plus num2 12:24 print sum to the user 12:27 so you can start to get an appreciation 12:29 here of how the high level code you 12:32 write actually ends up being fetched 12:34 decoded 12:35 and executed inside a processor 12:38 of course your processor is doing 12:40 billions and billions of these 12:42 operations a second 12:43 which when you think about it is really 12:45 very impressive 12:52 [Music] 13:03 you. make 10 questions for a standerd of a level

Between 1775 and 1782 (the years of the American Revolution) a smallpox epidemic spread across North America. By 1782, the disease had reached the villages of the Mandans and Hidatsas. The death rate was very high. The Dakotas attacked the weakened Mandan villages including On-a-slant village (today the villiage is in Fort Lincoln State Park) and Double Ditch village. By 1790, the survivors (of both disease and war) left the Heart River area and moved north to establish villages near Painted Woods Creek and at the mouth of the Knife River. The Mandans who had once occupied six large villages now lived in two small villages. There were only two remaining Hidatsa villages and another village where both Mandans and Hidatsas lived. The populations of the two tribes had been reduced by 75 percent. The Mandans and Hidatsas also suffered cultural losses because of the smallpox outbreaks. The Mandan villages had always shared some common cultural traits, but each village had a slightly different language. As the survivors were forced to move together for security, the differences disappeared. There were similar cultural losses for the Hidatsas. The Arikaras who lived farther south along the Missouri River also experienced the smallpox epidemic. By 1790, the Arikaras had been reduced from a large population living in 32 villages to a group that occupied two villages. Only 500 men of military age remained of the 4,000 Arikara warriors who had protected their villages in previous decades. In 1801, smallpox struck the people of the northern Great Plains again. This time, the epidemic killed fewer people. It is possible that the survivors of the 1782 epidemic were still immune to the virus this time. In 1830, the Army identified smallpox as a dangerous disease at Indian agencies on the lower Missouri River (in modern-day Missouri, Kansas, and Nebraska). The Secretary of War, L. G. Randolph, authorized Indian agents to hire doctors to vaccinate American Indians living at the agencies. However, these agents were not ordered to vaccinate Indians. Many mothers feared the vaccine. They had seen many babies become sick because doctors did not use sterile procedures (which were unknown at the time). Sometimes vaccine was not effective and the children became sick anyway. For a variety of reasons, the Army’s vaccination campaign did little to stop smallpox epidemics among the Indians of the frontier. Indian agents on the frontier were concerned about smallpox. Non-Indian settlers were approaching the lands where the tribes lived. Disease was spreading and the agents begged the Office of Indian Affairs (part of the War Department) to provide vaccine for Indians. Finally, in 1832, Congress passed the Indian Vaccination Act. The bill appropriated $12,000 to purchase vaccine and hire doctors to vaccinate Indians. Exactly which tribes would be vaccinated was not specified in the bill. Secretary of War Lewis Cass, who administered the program, decided that the vaccination program would be extended to tribes that were friendly to the United States, those with important economic roles, and those tribes (Cherokee, Choctaw, Chickasaw, Creek, and Seminole) that were being forced out of southern states to relocation sites in the West. Cass specifically excluded the Mandans, Hidatsas, and Arikaras (along with other tribes living farther up the river) from the vaccination program. Cass believed the fur trade on the Upper Missouri River was no longer economically important. He also stated that the treaties that all three tribes signed in 1825 identified them as hostile towards the U. S. and its citizens. (See Document 1.) Other tribes, including the Teton Sioux (Lakotas) did not have such statements in their treaties. Cass excluded the Upper Missouri tribes from vaccination because he considered them to be far removed (both geographically and socially) from “civilized man.”

*1. What is the primary objective of Step 3 in the adolescent health program development process?* a) To gather evidence for situational analysis. b) To decide on the priority issues and behaviors for the program. c) To implement interventions for various health problems. d) To assess the effectiveness of the program. *Answer: b) To decide on the priority issues and behaviors for the program.* *2. What key question is addressed in this step regarding health problems and resources?* a) How many resources can be allocated to each health problem? b) How many health problems can be addressed given the available resources? c) Which health problems have the highest prevalence in the community? d) How do we measure the success of the program? *Answer: b) How many health problems can be addressed given the available resources?* *3. Why is it necessary to prioritize health outcomes for the adolescent program?* a) To ensure that all health problems are addressed simultaneously. b) To accommodate the preferences of community leaders. c) Due to limited resources, focusing on the most immediate needs of adolescents is crucial. d) To align with evidence gathered during the situational analysis. *Answer: c) Due to limited resources, focusing on the most immediate needs of adolescents is crucial.* *4. How does the worksheet help in prioritizing health outcomes for the adolescent program?* a) By providing a list of health problems without any scoring system. b) By assigning equal scores to all health problems. c) By listing general health outcomes and specific health problems with a scoring system. d) By excluding the opinions of adolescents and community leaders. *Answer: c) By listing general health outcomes and specific health problems with a scoring system.* *5. What does the example on the prioritization worksheet illustrate about early pregnancy?* a) It is a low priority health problem. b) It has a low magnitude of the problem. c) It has a moderate level of importance in the community. d) It is the highest priority health problem with a score of 6. *Answer: d) It is the highest priority health problem with a score of 6.* *6. What does a SMART health status objective entail in the context of adolescent health program development?* a) It is a short-term outcome without specific indicators. b) It focuses solely on individual behaviors without considering community perspectives. c) It is specific, measurable, attainable, realistic, and time-bound. d) It does not require baseline data or target year for achievement. *Answer: c) It is specific, measurable, attainable, realistic, and time-bound.*

7.015 Hand Hygiene: Practice observation of hand hygiene compliance via the use of a hand hygiene survey tool to be reviewed quarterly at the QAPI committee. (Chapter 10.14 Handwashing & Surgical Antisepsis) Continue infection control education through ongoing orientation to center staff routinely and annual mandatory in-service. Continue to promote hand hygiene awareness for patients and staff by means of educational materials placed throughout the center which references the CDC/WHO guidelines. Needle-stick Injuries: (Refer to Exposure Control Plan) Use of designated safety engineered needles for injections (safety glide needles for injection and autoguard IV catheters) and blood draw. New employee and annual clinical competency for injections will be provided to all staff. The staff will be trained yearly on OSHA, blood borne pathogens and PPE. 7.016 Hand Hygiene Quality in the ASCs: based on AORN (Association of periOperative Registered Nurses) Standards and guidelines Policy: All ASC staff, including physicians, nurses, and other healthcare workers, are required to perform hand hygiene before and after any direct contact with patients, before and after any procedure, and after any contact with potentially contaminated items or surfaces. Hand hygiene must be performed using either an alcohol-based hand rub or soap and water. The alcohol-based hand rub must contain at least 60% alcohol. Staff members must ensure that their hands are free of debris and visible dirt before performing hand hygiene. Hand hygiene must be performed for a minimum of 20 seconds, and hands must be dried thoroughly after washing. Staff members must be trained on proper hand hygiene techniques and will be educated on a regular basis to ensure compliance with this policy. All staff members must comply with this policy and demonstrate compliance during inspections by ASC management and regulatory agencies. Any staff member who fails to comply with this policy will be subject to disciplinary action. ASC management will monitor compliance with this policy through regular inspections and audits and will take appropriate action to address any noncompliance issues. The ASC will maintain records of staff compliance with this policy as part of its infection control program. The ASC will review and update this policy on an annual basis or more frequently as needed to ensure that it remains current with the latest guidelines and standards for hand hygiene quality.

7.012 Employee Health The Center provides a safe working environment for all employees through a collaborative effort with them and the organization’s infection control program to identify infectious conditions that may put staff, patients and visitors at risk. Health evaluations, immunity testing for measles, mumps rubella and chickenpox, tuberculosis screening and immunity testing for hepatitis B and if not immune either signs declination form or accepts 3 dose vaccine series. (Rrefer to the Employee and Occupational Health Section policy Chapter 3.21) It is the center’s policy to monitor Health Care Associated Infections (HAI) in patients and personnel working in the Center as part of its ongoing program in Infection Prevention and Control. Staff should be encouraged to stay home when they have signs and symptoms of an infectious disease. If a staff develops signs and symptoms while at work, the person of other personnel and patients who may have been exposed to a staff member with a communicable disease should be taken into consideration. Patients and personnel can be told that they were exposed to a certain disease without disclosing the index case’s identity. In addition we work together to provide an annual influenza vaccination program that includes all staff who have patient contact, and licensed independent practitioners. Environmental Rounds - Environmental rounds are performed daily by assigned staff members, ie. “safety officer”. Feedback on opportunities for improvement is given to the Infection Control Coordinator and QAPI committee and then reported to the board Education – Employee education includes: General information about infections Techniques for prevention, surveillance, investigation and control Review of policies and procedures related to infection control: (See attachment B, policy and procedure reference list) Employee health practices; refer to Administration 3.16 Orientation and Training Offer of Hepatitis B vaccination & post exposure evaluations Annual TB skin testing Provides access to influenza vaccinations. Educates staff and licensed independent practitioners about influenza vaccination; non-vaccine infection control measures (such as the use of Droplet Precautions); and diagnosis, transmission, and potential impact of influenza. Annually evaluates vaccination participation and non-participation in the influenza immunization program and reports to Department of Health.

Dialog for Question number 1 And 2 A: What would you like to do after you graduate from school? B: I would like to take undergraduate program on law education A: Are you going to prepare yourself as a lawyer? B: Yes, I love studying law. I would like to become a good lawyer. A: What a nice goal you have B: Thank you. What About you? A: Well I am going to apply for English program. I want to be a teacher B: wow that’s cool. 1.What is The expression of asking for intention found in the dialouge?

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