Audit of Syphilis Screening in Pregnancy

Audit of Syphilis Screening in Pregnancy Tables Table 1: Syphilis confirmatory test results for forty nine   pregnant woman 18 Table 2: Syphilis s creening results of eleven new-borns of   positive syphilis mother 24 Table 3: Positive s yphilis confirmat ory test results for sixteen   pregnant woman 30 Figures Figure 1: The laboratory turnaround time of syphilis screening   for mothers 28 Figure 2: The laboratory turnaround time of syphilis screening   for new-borns 28 Tables Table 1: Syphilis confirmatory test results for forty nine pregnant woman 18 Table 2: Syphilis s creening results of eleven new-borns of positive syphilis mothers 24 Table 3 : Positive s yphilis confirmat ory test results for sixteen pregnant woman 30 Figure s Figure 1: The laboratory turnaround time of syphilis screening for mothers Figure 2: The laboratory turnaround time of syphilis screening for new-borns ABSTRACT Objective: A re-audit of syphilis screening in pregnancy was carried out to ensure that the improvements in laboratory and clinical aspects of management for the antenatal of pregnant women with positive syphilis screening and their new-born babies fully met were in accordance with the UK National Guidelines on the Management of Syphilis (Kingston et al., 2008) and the Guidelines for the Management of Syphilis in Pregnancy and the Neonatal Period (Stringer et al., 2013). Methods: Patients’ data were collected via query of the three databases: Clinisys Labcentre , Telepath and EuroKing . The n the data were analysed using Microsoft Access 2013. Results: Samples from F orty nine 49 pregnant woman with positive syphilis results serology were referred to a reference laboratory laboratory were sent to MRI for syphilis serological confirmatory testing. Sixteen pregnant woman with of these women were confirmed to have had had positive syphilis were identified . Ten pregnant woman were re-tested screened at least twice during their pregnancy and six pregnant woman were only screened tested once during pregnancy. Over-testing of for treponemal IgM were seen in nineteen patients [h1] with non-reactive RPR titre. Only eleven babies born to mothers with syphilis were followed-up with serial serological test s for syphilis. Only four new-borns were fully screened. Some of the new-borns were not tested with treponemal IgM due to sample insufficiency. Conclusion: There were some improvements seen since the first audit which includes the changes of the confirmatory testing schedule in MRI, lower screening false positive rate, and increased follow-up of the new-borns. There were also things to improve in the management of syphilis in pregnancy and the new-borns of positive syphilis mothers. Treponemal IgM test should be performed only when the RPR test were reactive to prevent over-testing of patients. The test algorithm for screening of syphilis in new-borns should give priority to RPR test and treponemal IgM to prevent under- testing [h2] . In-house confirmatory testing should be considered to allow reduction of test turnaround time’s thereby aiding patient management. Improvements [h3] should be made in the management of syphilis in pregnancy and the new-borns of positive syphilis mothers. Treponemal IgM test should be performed only when the RPR test were reactive to preven t over-testing of patients. The test algorithm for screening of syphilis in new-borns should give priority to RPR test and treponemal IgM to prevent under- testing [h4] . 1.0   INTRODUCTION 1.1   Syphilis Syphilis is an infectious disease caused by Treponema pallidum (T.pallidum) subspecies pallidum . The disease is transmitted from human to human, and humans are its only known natural host (Woods 2005). Epidemiologically, in the UK, cases of syphilis have increased in England since 1997 led by a series of outbreaks reported from Manchester, London and Brighton (Health Protection Agency 2009). Since 1999, diagnoses of infectious syphilis have been made in heterosexuals where the outbreaks are linked to sex work, students and young people. But, there was a changing pattern of infection between 1999 and 2008, when seventy three percent of new diagnoses of infectious syphilis were reported in men who have sex with men (Health Protection Agency 2009). The transmission is primarily by sexual activity (Zeltser & Kurban 2004) (vaginal and anal intercourse) and by direct contact with active primary or secondary lesions (Lafond & Lukehart 2006) for example through oral sex and kissing at or near an infectious lesion (Kent & Romanelli 2008). T.pallidum may invade the host through normal mucosal membranes and also through minor abrasions in the skin (Zeltser & Kurban 2004) such as from sexual trauma, causing an inflammation, ulcer and then spreading through the blood stream to other parts of the body (Goh 2005) .

Superintendent Office Coursework Example | Topics and Well Written Essays - 1500 words

Superintendent Office - Coursework Example Additionally, political developments within the district where the superintendents operate also infringe the course of service delivery and responsibility fulfillment by the representatives. Such politics include the processes of election leading to the selection of the board of governors alongside other education leaders in the district. These factors considered relating to the case that superintendent Mark faces within his locality of administration. The federal and state guidelines institute the position of the Superintendent within the district to operate in their capacity of overseeing education in the district (Sofo, 2008). The Superintendent is the CEO of the district school board and manages the entire responsibilities spanning from the hiring of staff to overseeing the education standards, budget, and resource planning and allocations and being the contact point to the government agencies (Sofo, 2008). Therefore, with these immense responsibilities, this core person in the education sector faces remarkably overwhelming challenges that institute the need to establish strong administrative guidelines. The federal and state laws are key in guiding the roles of the superintendent office, as they facilitate the regulatory frameworks of the office. First, the roles and responsibilities of the superintendent office are outlined within the confines of the federal law and recognized accordingly by each of the state laws as established. Thus, the federal and state laws influence the role of the superintendent accordingly from this perspective, that they facilitate and ensure the protection of the office from abuse and malpractices (Meek, 2012). The establishment of the responsibilities means that the superintendent office enjoys protection from the political influences that may impair the course of the decisions that the person in the office makes regarding education.

Managing for Competative Advantage Assignment Example | Topics and Well Written Essays - 2500 words

Managing for Competative Advantage - Assignment Example The review also includes an evaluation of the performance of both the management teams through financial and non-financial parameters, and finally gauges the true competitive position of M&S in the market. . Myners and Rose assumed control of the company's leadership by replacing the team of Vandevelde and Holmes. There seem to be significant distinction in the approaches of both the management teams in restoring the M&S competitive advantage. The main focus of the previous management had been on the enhancement of clothing market share and Roger Holmes (Annual Review 2003, p3) highlighted the three major domains of their efforts as furthering amelioration in the stronger clothing categories (women formal wear), following the growth chances in low share clothing categories (men's wear) and finally revolutionising the weak categories (children wear). However despite all these efforts, the previous management ended up in losing its significant market share in the clothing market, in particular womenswear which used to the core area of the company's business and profits (Annual Review 2003, p6). The entire focus of the new management team, however, seemed more strictly on the price and product innovation and improvement. They approached to regain the company's lost market share and competitive position through price benchmarking and product innovation to provide more value to the customers and consequently to win in the competitive environment (Annual Review 2005, p4). Marketing The previous management utilised marketing and advertisement in the course of various product campaigns (Annual Review 2004, p8). The company's marketing tactics also underwent change under the new management, which emphasised clearly on a unified M&S brand rather than focusing on a vast range of sub-brands. It focused on strengthening and bringing together the various M&S brands and reflected its traditional relationship with core customers in its marketing and advertisement campaigns (Annual Review 2005, p5). Human Resources Human resources and people management has been the core issue concerning both the management teams. The previous management was however less focused in its strategies to develop the M&S people. Furthermore, in the process of store refurbishment and improvement, the previous team (Annual Review 2004, p5) indicated an intention to lay off about 1000 workers in order to control costs. This could have led to a decline in employee morale and performance. The new management focused on a people amelioration approach, it further took care of its human resources in a much-enhanced manner through proper and evident training, rewarding, developing and listening strategies (Annual Review 2006, p17) to improve employee performance and motivation levels. . Operations The former management team posed great emphasis on opening new stores and carrying out renovation in the older ones making them look more contemporary and convenient so as to win more customers in the competitive marketplace (Annual Review 2004, p16). Furthermore, it also identified the need for ameliorating the supply chain management and sourcing of products to win a competitive edge in the market (Annual Review 2004, p9). The new management team came with a sharpened approach to revolutionising store

The role of Student Non-Violent Coordinating Committee (SNCC) in Research Paper

The role of Student Non-Violent Coordinating Committee (SNCC) in increasing the social equality in United States - Research Paper Example ons ultimately triggered SNCC and SCLC to be at prospects, the two establishments functioned next to each other all through the initial years of the civil rights activity. Student Nonviolent Coordinating Committee (SNCC), also known as (after 1969) Student National Coordinating Committee, United States political group that presented a main role in the civil rights action in the 1960s. Started as an interracial cluster encouraging nonviolence, it implemented better militancy overdue in the decade, reflecting countrywide fads in black activism. 1 The Student Nonviolent Coordinating Committee was established in initial 1960 in Raleigh2, North Carolina, to make the most of the results of a rise of sit-ins in Southern college places, in which black students turned down to go away from dining places wherein they were refused a job depending on their ethnic group. This type of nonviolent protest carried SNCC to nationwide interest, tossing a severe public light on white racism in the Southwest. In the many years following, SNCC reinforced its endeavors in local community group and backed Freedom Drives in 1961, together with the March on Washington in 1963, and activated for the Civil Rights Act (1964). In 1966, SNCC formally threw its assistance behind the much wider protest of the Vietnam Struggle. 3 As SNCC grew to become a lot more energetic politically, its people confronted amplified hostility. In reaction, SNCC migrated from a belief of nonviolence to certainly one of better militancy after the mid-1960s, as a supporter of the burgeoning â€Å"black power† activity, an area of late 20th-century black nationalism. The transition was personified by Stokely Carmichael, who substituted John Lewis as SNCC president in 1966–67. Although many initial SNCC participants were white, the newfound focus on African American identification resulted in larger racial separatism, which frightened parts of the white local community. More-radical aspects of SNCC, for example,

The Strange Case of Dr.Jekyll and Mr.Hyde Essay Example | Topics and Well Written Essays - 500 words

The Strange Case of Dr.Jekyll and Mr.Hyde - Essay Example He reveals the hypocrisy of the member of his society through the contradicting actions of the same person. Without law there is no crime. Law is about norms and the societal standards of what is considered good or bad in a particular community. This is a society in which the doctor was highly regarded. He was respected by all and this can be verified by the attitude of Utterson who is even concerned by what the doctor had written in his will. It is common knowledge that for every right and privilege that one enjoys there is attached responsibility. The doctor was overwhelmed by the responsibility attached to his title. He was supposed to be gentle, genuine, intellectual and a gentleman as such. Deep inside, he wanted to engage in activities that can be considered wild and may not well have been compatible to his title and status in the society. He is unable to engage in these wild dreams because of his conscious which dictates his action according to the expectations of the society of his status. As a result, he is unable to engage due to guilt. To be able to satisfy his fantancy and at the same save face for his original personality, he sets up a concoction that changes his personality at will and engages in his dreams. In His induced personality, Edward Hyde is reckless and is not as caring as is expected of a physician. In this state, he tramples upon a little girl and the scene is witnessed by Enfield. This indicates his hypocrisy in his original personality. As a physician, he would not have been expected to undertake such an act. Hyde is a major suspect. Through all the acts that Hyde is able to accomplish without the suspicion leading to the â€Å"Good Doctor† we are able to see that as much as the doctor enjoyed evil deeds likewise he enjoyed the prestige associated with the personality that ironically he felt bound to. In anonymity of the strange personality and secrecy of not being known as the culprit the doctor’s

Methods Of Research Essay Example | Topics and Well Written Essays - 500 words

Methods Of Research - Essay Example Horton found out that the treatment was effective in helping the girl to stop her spoon banging behavior (Interpreting, and Draw conclusion) In Project situation 2, Latane & Bidwell used observational method of research. Observational research method was used because Latane & Bidwell observed the number of students who entered the college cafeteria accompanied by student or with out company, and determined the gender differences in need for affiliation. In this project situation Latane & Bidwell determined the gender differences in need for affiliation (Identify the problem, and Gather and observing data). In this situation, Latane & Bidwell decided to prove if females need to have greater affiliation than male students (Formulating Hypothesis and testing the hypothesis). Latane & Bidwell found out that females were significantly more likely than males to be in the presence of another person when entering the cafeteria. (Interpreting, and Draw conclusion) This study basically focused on the number of students who entered in college cafeteria with accompanied student or with out accompanied student by gender. This study was also delimited to one school only. The researcher used correlational research method.

Getting Knowledge from Reading Essay Example for Free

Getting Knowledge from Reading Essay Reading is the best way to learn different kinds of things. Such as reading recipe books for making delicious dishes, or learning different kinds of language, or cultures. We are starting learning our children at the age of 1 or less. We always start from alphabets. So that, they can makes their habit to read books. I think which is really good for them. But nowadays mostly people don’t like to read books; they think that it’s very difficult to understand. Teenagers go to the library for fun, but they never read the books moreover, they think books are boring to read. However, for some people books are their life; wherever they go whether in the bus or somewhere else they start reading books, no matter what other people is going to think. Like in this book for these two authors reading is their life. They really think that books are gifts for them are Ricky Moody, who wrote, â€Å"The joy and enthusiasm of reading†, and â€Å"Alberto Manguel, who wrote, â€Å"Reading ourselves and the world around us†. Reading is become a passion for both of them. Moody talks about believes in the books and on the other hand MAnguel talks about the outside world. It gives the opportunity to think about differently and come up their conclusion. For Moody, reading is his believe he also mentioned when he first started his article that he believe in choosing difficult kinds of books so that he can come up with his own ideas. Moody also mentioned in his article that reading was not an option, â€Å"Mr.  Buxton, who probably had better things to do, nonetheless agreed to meet one night to go over the text line by line. â€Å"The first thing he did was point out the repetition of motifs. † (3) Moody did not give up for that he picks up the other book that intrigued him. Moody main motive is to teach other people that reading your own and come up with your conclusion that can give you freedom to think something bigger. You don’t need anybody to help you can explain you line by line. People should pick difficult books so that they can learn something new and challenge themselves. Furthermore, for Manguel, reading also teaches us to learn from your surroundings. In his article, Manguel states that, â€Å"The astronomer reading a map of stars that no longer exist; the Japanese architect reading the land on which a house is to be built so as to guard it from evil foces; the zoologist reading the spoor of animals in the forest†(6). Manguel means that sometime you don’t need the specific books to gain knowledge. However, sometime you can read the other person face. He also said that only mother can understand her child language when her child is hungry. Reading can gives an individual so much; books give a lot of knowledge and become us smarter, because some time we are too busy with our other works that we forget that books help us to think broader. But in these articles, for both author reading is their life and passion for them. They can come up with their conclusion; they are taking interest, sharing their view, and showing their passion so that other people can learn from them.