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.

Starting From Scratch Or Buying An Existing Business

Starting From Scratch Or Buying An Existing Business If you're about to have a business, you'll think about how to get it, by staring a new one or buying an existing one. Anna Bryant bought an existing salon when she had the chance instead of starting her own.The reasons for that are because she had no business experience or skills but she believes that she have the capabilities to run this salon, also she's an entrepreneur for the first time and this will save her the time of the stating period plus the effort of building the business name and make it stand in ground, it also have customers and taff and already been running for years so she can start making sales from the first day.Before buying the business there are some steps to be taken, studies, plans and more, like knowing the first owner decided to sell the business and if there are major problems within the business and figuring out how to solve them. Appraising the business is a must too because she wouldn't want to pay mor e for the business. She should get help and ask experts about all the details as she also need to sit plans about how she'll run the business and about the changes needed to be made and ake expectations to be reached. Also evaluating the risks and see how to avoid them.After finding the reasons and applying the required steps before buying, Anna Bryant is now able to make her decision. Successful Entrepreneur Effectiveness A Successful entrepreneur have special characteristics, passion, willingness to take risks, Positive attitude, Confidence, respect, and trust are all needed in the entrepreneur character. Commitment, leading skills, team building and flexibility also makes a good entrepreneur. knowledge in markets and how to run businesses and ow to communicate with others, all these characteristics build a Successful entrepreneur.Having no previous experience as an entrepreneur doesn't mean that the business won't be successful. Anna's first business succeeded because she had a l ot of a successful entrepreneur characteristics, the first was her love to the business and her passion about fashion. Courage, Wisdom, and excitement all were in her heart, and the desire to take the business to the next level all made her a great entrepreneur. Anna didn't have an experience but she was determined to gain it by consulting and getting help from others. She sat goals and put plans, she had a vision and this is one of the entrepreneur characteristics. ne of the challenges that face any business is financial management, high expenses, low sales and insignificant protlts, these problems and more which were facing Anna's business can be solved by using analysis techniques and take the right action based on the analysis process. Anna was able to improve the business finance by hiring a professional team and using their help, also by working on herself and gaining knowledge about the business market and learning some marketing techniques,. By studying the businesses' hance s, opportunities, strengths and weaknesses she was able to manage it Just right.After that she started to make changes in the business and make it more effective and attractive, by offering new services and new fashionable designs that are desirable which brought her new customers, Anna didn't wait until she make the salon exactly as she wants, she stared to work and make profits right away plus working in making the needed improvements, taking an advantage of all the available opportunities of the existing business made in easier for her to manage all the financial matters and this made her a great entrepreneur.My references Nitish. (2011). Main Reasons to Buy an Existing Business. Available: http:// accessed 29th April 2013. From E-library Slavec, Alenka-Prodan, Igor. (2012). The influence of entrepreneur's characteristics on small manufacturing firm debt financing. East European Management Studies. 17 (2), 22-23-24. The Advantages Of Franchising Owning and running a franchise ins tead of starting a business is an action taken by a lot of business people, John is one of them.Franchising have advantages which makes it a better option, as for John, a franchise have a lot benefits to offer like having big known brand to stand by you and support you for different aspects like the product knowledge, training development and sales. It was way easier that staring his own business. A franchise makes profits quickly, and it have a proven business format and it's supported by the Franchisors. It have lower risks and worries and a help is available when needed from the Franchisors who have powerful motivation.From my point of view franchising have five main advantages, Branding, it offers a strategic identity which impact on the market, big businesses spend millions on their branding and ranchisee gets the advantage of that, and the Franchisors are mostly well known for customers. Advertising, advertising takes a lot of the business expenses and a business can't survive without expensive and effective advertising. Name Recognition, which makes people guarantee the quality of the products and a known name gives them that.Reputation, which enable the Franchisee to enjoy protectiveness against lawsuits or accidents or any issues with the employees. Support, running a business needs training, and by have a Franchise you'll get all the train you need, they want you to be successtul because your success is ll possible ways. A Successful Franchise Business their success so they'll support you in Acquiring a franchise is a successful business to run, as it's cleared by the advantages of franchising. t have the benefit of having an access to the franchiser established system which have been running for a long time, franchisers spend a lot of time to modifying their system to the best it can be and hand it over to the franchisees, the system includes information about the products or services and all the details of the market methods, plus they make researc h to determine the best ocation for the franchise and some of them also manage the building and the renting matters which leave less worries for the franchisees.Another thing is, franchisees are not alone, the are supported by the franchisers who really want them to success, they train them to operate the business effectively , this is a very important reason why franchising can be a successful business. Moreover, franchisees' customers have a full awareness of the business and its products so they can trust without even trying it, means that loyal customer exists with any effort.John made it in his business and he became very successful because he had the experience of running a franchise before, he picked a good company with sound model to franchise and he started with full energy and high confidence. He received different trainings in different parts of the company, and used what he have learnt effectively and ran the business properly, he succeeded perfectly and became one of th e best too.Here are a study which clears the success of franchising: franchises success rate is 90% comparing to only 15% of business staring from scratch, meaning hat a franchisees will surely succeed as long as they follow the franchisors the instructions and use the support system effectively. My references: Don Daszkowski. Higher Likelihood of Success with a Franchise Business . Available: http://franchises. about. com/od/buyingafranchise/a/franchise-success. htm. Last accessed 1st may 2013. From the E-library: Abell-Mark1. (2010). The franchising advantage. Managing Intellectual Property. 9 (1-2), 16-17-18.GOING FOR A BUISNESS Starting a business is never easy whether it was a franchising, entrepreneurial enture or an independent small business. If I'm about to start my own business I wouldn't go for franchising, not because it won't be successful or because it's hard, it's Just that I'd rather to come up with new idea and add something to the world rather that applying the ide a of someone else, franchising may be profitable and better option tor those who are seeking tor cash and high incomes but I'm one ot those who cares more about changing the world and putting my fingerprint on it.Becoming an entrepreneur of an existing business is a good idea which will save a lot f preparing time in the starting period, still the existing business may not apply my own perspectives which means I'll have to do a lot of changes and this may cost me more that what I'll may pay if I started it myself, That's why my best option is to start from the ground. My new small business is about handmade stuff trade, not going to say it's growing fast but I follow the saying: think big and start small.My band is LA FEMME TOM and it's a one-person business so far, it's growing slowly but it's giving me all I need at the moment, plus it's helping me to spread the awareness of the mportance and the value of the handmade stuff which is one of the business aims, it is about selling my handmade stuff, giving courses on how to make them and supporting those who have a talent in this field.I sell my stuff online and in some places, I don't have my own shop yet but soon I'll do as it's planed for. The business approach is to grow and have many branches, it's in a progress development and aiming to have partners and hire working hands to take the production to the next level. Basically the business activities are about girls hobbies to fell the spear time with useful and beneficial things.

Proposal Letter Adult learning Essay Example | Topics and Well Written Essays - 250 words

Proposal Letter Adult learning - Essay Example Through this program, a drastic improvement has been recorded with most of the learners increasing their reading ability from two to three grade levels. Problem posing and problematization in overall learning processes: In this proposal, a reflection on the role of posing questions while learning processes are ongoing has been made. This is one of the best teaching methods for adult learners. Question posing in learning processes is an implicit aspect of many modern cognitive psychological theories and parody, which are the psychological parody of action and interacting. Learning and teaching of mathematics, for example, must start with the students’ discourse (dialogical attitude). My potential focus concerning adult learning relies on the knowledge of my own cognitive processes. My study of problem posing has been precisely motivated by a desire to approximate a process of problematization to come up with an effective argument for advocating problem posing as a means of attaining knowledge. Lastly, my beliefs and complexities in relation to problematization in adult learning are based on reflections, which underlay the problematization process. In order to synthesize problematization in the adult learning, questions such as why did I choose to investigate problematization as a means of learning and teaching of adults and why did I opt for problematization or problem posing in the planning of daily classroom activities must be critically analyzed. Belzer, Alisa. Improving Professional Development Systems: Recommendations from the Pennsylvania Adult Basic and Literacy Education Professional Development System Evaluation." Adult BasicEducation 15.1 (2005): 33-55. ProQuest. Web. 30 June 2015. Internet Source. Golbeck, Amanda L., Carolyn Ahlers-Schmidt, and Angelia M. Paschal. Health Literacy and Adult Basic Education Assessments. Adult Basic Education 15.3 (2005): 151-68. ProQuest. Web. 30 June 2015.

Lowe's vs. home depot Essay Example | Topics and Well Written Essays - 250 words

Lowe's vs. home depot - Essay Example That is one of reasons that statistics show more sale revenue for Home Depot which is more accessible due to more branches! Lowe’s and Home Depot, being in the same business, have distinctly differentiated market strategy. Lowe’s is more focused to the needs and requirements of women and housewives who are more incline to buy dà ©cor accessories and unique products that can make a fashion statement for them. Home Depot, on the other hand, caters to the bulk buyers like contractors and retail customers, men especially, who are seriously into DIY (do it yourself) products. Home Depot has a better competitive image because they not only have more stores but they have also realized the need to improve on their quality and customer service. They are also thinking of expanding their product line to cater to wider customer base. Lowe’s, on the other hand, is just intending to improve on its customer service which is inadequate in the current scenario of recessive trend and highly competitive business

Employee Reward and Development Essay Example | Topics and Well Written Essays - 1500 words

Employee Reward and Development - Essay Example (Armstrong, 2004) According to CIPD, the following are the characteristics of a total reward system : 1. Holistic 2. Best fit 3. Integrative 4. Strategic 5. People-centred 6. Customisation 7. Evolutionary 8. Distinctive. The concept of total reward is fairly recent. The traditional â€Å"Salary administration† approach of the 1960s and the 1970s focused on the competitive attributes of the employees rather than as a strategic/ tactical tool. This approach gave way to the â€Å"Reward Management† line of thought wherein the emphasis was on all employees contributing to the success of the organization. This was a more dynamic approach which brought in non-financial rewards in the form of intrinsic and extrinsic motivation, into the ambit of compensation of an employee. The â€Å"New Pay† model (Lawler, 1990) factored in the challenges of a competitive global economy and recommended that employees be paid for the value they bring to the organization. The popular mod els of total reward (Armstrong, 2004) are – Engaged performance model, WorldAtWork, Wyatt model, Towers Perrin model and Armstrong model. Of these, the Towers Perrin model reiterates, almost entirely, the Brown model of total reward. The Brown model (Brown, 2001), depicted above, deals with four elements of compensation – Pay, Benefits, Learning & Development and Work environment. A comprehensive model dealing with both the financial and non-financial components of pay. A good compensation approach to attract, motivate and retain the employee. Addresses the short-term as well as long term needs of employees. Pay component looks at base pay as well as variable pay whereby the employee is assured of a minimum income every month. Performance of the employee as an individual as well as a group is considered. Employee gets a part of profits of the company. This combined with the availability of the shares of the organization brings about a strong sense of ownership. Benefit s which are both individual and family based enables the employee achieve work-life balance. The Pension component assures an independent life style for the individual even after retirement. Learning and Development provides opportunities to develop and grow in the workplace so that the overall productivity is enhanced. Continuous learning takes place and the organization can move toward becoming a Learning organization and develop core competencies and competitive advantages in the market place. Career development helps become aware of the career progress and this helps to plan one’s life in the short term as well as the long term. Succession planning helps bring out the managerial and leadership skills in the individual for mutual benefit of the individual and the organization. Another highlight of this model is the work environment component. Organisational culture and non-financial recognition are highly effective motivation tools. Human dignity is fostered through work-l ife balance. Communication channels, especially grapevine, can be utilized to create a rich organizational climate. From the above, it is clear that Total Reward can be used as a corporate strategy to attract, motivate and retain employees in an organization and derive tremendous advantages over competition in a globalised and highly competitive

REC, Inc. and seatle coffee products Essay Example | Topics and Well Written Essays - 2000 words

REC, Inc. and seatle coffee products - Essay Example On the basis of the previous results the company prepares projected income statement for the next accounting period in order to estimate the likely outcome of its operations and sales. This also helps the company to determine variances observed in the actual financial results of the company. The company’s expectations from its business for the complete year 2004 are given as budgeted income statement in Exhibit 2 which indicate that the company expects a monthly average profit of $60,000 (Profit Before Taxes: $720,000/12). These projections are based on the expected number of sales of equivalent units for the year 2004 i.e. the company estimated sale of 10,000 equivalent units which implies an average monthly sale of 830 or 840 units. Based on the comparison between the actual financial results of REC, Inc. and its budgeted income statement it could be ascertained that the company’s profit results for the month January 2004 have felt short by $78,000. This has been against the expectation of the company’s management as the business followed the trend that it has experienced in the last few years related to the market conditions and business cycle. The variation in the actual financial results from the budgeted income statement can be evaluated by examining every element of the actual income statement and comparing it to the budgeted figures for these elements. One of the limitations of the above presented budgeted financials on a monthly basis is that it does not take into account the changes in the business cycle and market conditions which may occur during the financial period. For example, sales of the business could be affected due to the seasonal downturn in a particular month. Therefore, better analysis would have been possible if the company was preparing budgeted income statement on a monthly basis. The table above indicates that the

Employment Law Essay Example | Topics and Well Written Essays - 500 words - 6

Employment Law - Essay Example In the first category of immediate termination, there are various conditions under which an employee may be dismissed with the first one being if the employee is found guilty of going against the rules and regulations set for operations in the work environment (Batson and Shirouzo, 2010). The second rule stipulates that if an employee is found guilty of a crime they can be dismissed without notice. The third law states that in an event where the employee does something that causes damage to the employer, they can be dismissed since this infringes on the employer’s interests (EuroChinaJob, 2009). With this in mind, it follows that if an employee has a relationship with another employer, which affects the way the employee accomplishes tasks they can dismissed on grounds of not adhering to the regulations of the employer because they fail to accomplish tasks assigned to them. The fifth law that may cause dismissal of an employee without notice is if the employee acquired the job through fraudulent means, which amounts to cheating in order to be employed. In addition to the above, an employee is subjected to dismissal without notice if they are found not to be competent in regards to the job description to which they were employed on. I contrast to the employment law in China, the one in the in the United Kingdom stipulates that employment could be terminated by either the parties to the contract at will with or without notice. The employee is also subject to dismissal if the contract signed expires and it has not been renewed. The employee can also decide to terminate employment on grounds of constructive dismissal whereby there are circumstances that are reasonable basing this on the employer’s behavior. In addition to this if termination comes about because of the workers performance there are guidelines to be followed in order to ensure that the dismissal is in