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Glossary 562 Caring for Our Children: National Health and Safety Performance Standards A Abdominal pain h pylori gastritis diet order 15mg prevacid with amex. See Infants Background screening gastritis diet natural buy prevacid once a day, 9­11 gastritis lasting weeks discount prevacid 15mg with visa, 401­402 gastritis reflux diet cheap prevacid 30mg with visa, 408 maintenance of record, 392 process for substitutes, 32 Back injuries, facilities arrangements to minimize, 241 Balloons, 284­285 Ball pits, 276 Balusters, 208, 210 Barriers/guards for heating equipment and units, 216 Basements condition of, 204, 261 exits, 206 use of, 201 Bathrooms. See also Human milk benefits of, 151 caregivers/teachers encouragement of, 151 duration of, 8 importance of, to infant, 163 preparing, feeding, and storing human milk, 165­166 reasons for choosing not to , 151 Breast milk. See Animals Ceilings, 240­241 height of, 204 Celiac disease, dietary modifications, 158-159 Centers. See Developmental activities Child exploitation, recognizing and reporting suspected, 123­124 Child maltreatment. See Influenza Fluoride toothpaste, regular tooth brushing with, 101 Fluoride varnish, reduction in decay rates and, 102 Food allergies care for children with, 160­161 dietary modifications and, 158-159* Food and nutrition service policies and plans, 361 Food areas and equipment, cleaning, 193 Food avoidance, successful, 160­161 Food-borne illness. See also Infectious diseases food brought from home and, 182 outbreaks of, 361 restriction of staff from food preparation and handling, 188­189 Food brought from home nutritional quality of, 183 selection and preparation of, 182 Food poisoning, food brought from home and, 182 Food preparation area, 185­186 Foods burns from hot liquids and, 181 categories of, 155­156 experience with familiar and new, 181 feeding age-appropriate solid, to infants, 173­174 introduction of age-appropriate solid to infants, 172­173 introduction of new, 159­160 maintaining safe temperatures, 187 nutritional quality of, when brought from home, 183 prohibited uses of, 182 selection and preparation of, brought from home, 182 storage of dry bulk, 192 supply of, for disaster, 192­193 that are choking hazards, 181 training of staff** with responsibilities for handling, 29­30 Food safety cleaning food areas and equipment, 193 compliance with Food and Drug Administration, U. See Age-appropriate solid foods Introduction of new foods, 159*, 173, 181, 183 Invasive infections, notification of parents/ guardians, 145 Iron-fortified infant formula as alternative to human milk, 163 microwave ovens, 188 ventilation over cooking surfaces, 187­188 L Lactose intolerance. See Soy-based formula and soy milk Landings, 209 Language development, fostering, in three-tofive-year olds, 62 Large family child care homes, xxii child-staff ratio for, 4­6 continuing education for directors and caregivers/teachers in, 26 defined, 407 dishwashing in, 194 food service staff at, 176 frequency of inspections for, 409 locks in, 207 transportation policy for, 373­374 written daily activity plan and statement of principles, 49­50 written human resource management policies for, 375­376 Latchkey children, 416 Latex, ongoing exposures to , 116 Latex gloves, hypoallergenic, 116 Laundry area location of equipment and water temperature for laundering, 251 service and equipment, 251 Laundry equipment, location of, 251 Laundry service and equipment, 251 Lawn care treatments, chemicals used in, 228 Lead effects of toxicity, 161 in paint, 162, 237­238, 259, 260 in plastic, 232­233, 284 and poison center as a resource, 229 in soil, 93, 200, 236 in tableware and feeding utensils, 178 test results for, 378, 380, 384 testing for, 235­236 testing for levels of, in drinking water, 222­223 Lead teachers, qualifications of, 12­13 Learning, space and activity to support in infants and toddlers, 58­59 Learning experiences for children, 183­185 Learning/play environments, transitioning within programs and indoor and outdoor, 54­55 Leftovers, 191 Lice. See Head lice Licenses licensing agency procedures prior to issuing, 408 record of valid, 384 Licensing agency, 398­407 availability of records to , 380 collaborative development of child care requirements and guidelines for children who are ill, 400 community participation in development of rules, 398­399 J Juice. See Child abuse and neglect Physical activities active opportunities for, 90­93 barriers to , 353 caregivers/teachers encouragement of, 95­96 policies and practices that promote physical activity, 353­364 time spent on, 90-91 weight management and, 151 Physical activity consultant, availability of, to facilitate, 404 Physical aggression, handling, 72­73 Physical restraint, using, 76­77 Physical therapy equipment, 244, Appendix X space for, 255-256 Pica, 161 Pick-up, 289 Pick-up child authorized persons for, 371­372 documentation of, and parents/guardians communication, 372­373 Pick-up points, 209 Picky eater, 152 Pillows, 252 Pink eye. See conjunctivitis Pipes, installation of, 224 Plagiocephaly, concern about, 98 Planned program of daily activities, written description of, 49­50 Plants prohibition of poisonous, 234 safe, 234, Appendix Y Plastic bags, storage of, 257 Plastic containers, 232­234 Plastic toys, 118, 232­234 Play and teaching equipment, storage of, 256 Play area and playground surfacing inspection of, 277­278 prohibited surfaces for placing climbing equipment, 273­274 Play areas/playgrounds clearance requirements of, 273 elevated, 266­267 enclosures for outdoor, 268 inspection of, 277­278 inspection of indoor and outdoor, 277 location of, near bodies of water, 267 policies on, 374­375 577 Index Caring for Our Children: National Health and Safety Performance Standards Play areas/playgrounds (cont. See Obesity Preventive health services provision of routine, 90 written policy for obtaining information, 355­356 Primary care provider, defined, xxiii Privacy. See Child-staff ratios Rational basis of regulations, 398 Reading, 67 Reasonableness as legal standard, 340 Recalls. See Product recall monitoring Recipes, provision of, in nutrition education for parents/guardians, 185 Records, 377­393. See Sleep Safety strangulation hazards, 129 sun, 126­127 Safety covers for electrical outlets, 219 for swimming pools, 279 Safety guards for glass windows/doors, 205 Safety straps for diaper changing table, 106109 Salmonella, See Exclusion for illness; food safety; animals Salmonellosis, 190, 315 St. See Child abuse and neglect Shading of play areas, 267­268 Shaken baby syndrome/abusive head trauma preventing and identifying, 125 prevention of, 18 Shelter-in-place, 366-368* Shelter-in-place drills evacuation and records of, 385 Shigella. See Expulsions Therapeutic equipment, 244 Therapy services, space for, 255­256 Thermometers for taking human temperatures, 135­136 type and placement of room, 214 Threatening incidents, written plan and training for handling urgent medical care or, 364­365 Three-to-five year olds. See Preschool-age children Thrush (candidiasis), 321 Ticks protecting children from, 128 removal of, 128 Tinea capitis and tinea cruris (ringworm), 319­320 Title V, 35 Tobacco drug use and, 118­119 policies prohibiting, 363 Toddlers appropriate amount of physical activity for, 92 caregivers/teachers qualifications for, 12-15* child-staff ratio for, 3-4 cleaning of individual bedding for, 118 encouraging self-feeding by older, 175 guardrails and protective barriers for, 210 importance of low child-staff ratios for, 3 interactions with caregivers/teachers, 57­58 limiting time in crib, high chair, car seat, etc. See Standard precautions Unrelated business in child care area, 201­202 Unscheduled access, to rest areas, 101 Unspecified respiratory tract infection, 311 attendance of children with, 311 Upper respiratory infections, exposure to cold air and, 94 Urgent care, review of written plan for, 365­366 Urinals, ratios of, to children, 246 Use zone for fixed play equipment, 272 Utensils, tableware and feeding, 178 V Vaccines. See Immunizations Varicella-zoster (chickenpox) virus, 328­329 *Corrected page number in second printing, August 2011 Index 582 Caring for Our Children: National Health and Safety Performance Standards supervision near bodies of, 68­69 supply of, for disaster, 192­193 Water (cont. See also Pertussis Wind chill advisory, 93 Wind chill temperature, 93 Windows covering cords as strangulation hazard, 129 possibility of exit from, 204­205 Wireless communication device, availability and use of, 243 Wood/corn pellet stoves, 215­216 Wood frame construction, buildings of, 201 Written daily activity plan and statement of principles, 49 Written discipline policies, 351 Written plan and training for handling urgent medical care or threatening incidents, 364­365 Z Zoning, 384 583 Index. The album contains nearly 200 original photographs (numbered sequentially at the top), most of which were autographed by their subjects. President Lincoln believed that most Americans understood this, for he liked to boast that while large numbers of Army and Navy officers had resigned their commissions to take up arms against the government, not one common soldier or sailor was known to have deserted his post to fight for the Confederacy. Unfortunately, secessionist leaders also believed that their cause was just, if not God ordained. Any attempt to coerce the newly independent states back into the Union was both an act of aggression and a violation of individual liberty. This ideological impasse resulted in the bloodiest war ever fought by the American people. Nowhere is the story of the Civil War better told than in the papers and records of the participants held by the Manuscript Division of the Library of Congress. But even the most talented researcher must have access to a specially prepared subject guide to survey effectively the Civil War manuscript holdings of a repository that contains over 40,000,000 original items in 10,000 separate collections. Civil War Manuscripts evolved from a checklist prepared between 1965 and 1967 by Lloyd A. Sellers, an expert in 18th- and 19th-century American military history who personally examined each collection, with the following results.

If terrorism flares in the United States and Canada gastritis gurgling generic prevacid 30mg without a prescription, yet tighter border restrictions could further limit movement within the region gastritis snacks prevacid 15 mg fast delivery, with political gastritis questionnaire prevacid 15 mg discount, economic and social consequences gastritis symptoms pain back purchase genuine prevacid online. Violence is particularly rampant in northern Central America, as gangs and organized criminal groups have undermined basic governance. El Salvador, Guatemala, and Honduras rank among the most violent countries in the world, as shown by their high murder rates for women, which have contributed to migrant flows northward, particularly of unaccompanied children in recent years. In much of the region, activist civil society organizations can fuel social tension by increasing public awareness of elite corruption and mismanagement in their push for better governance. Given its extended engagement in Afghanistan and Iraq, highly polarized politics, and the domestic focus of the election campaign, outside observers wonder if Washington has the will and the means to continue exercising broader international leadership. North American security could become a greater concern if economic and political stresses in key states such as Mexico or Cuba spark destabilizing protests that result in changes in government or surges in migration. In addition, wide variations in local and state government efforts allow for experimentation that may generate momentum for more successful approaches-or highlight the risks of poor governance. Ultimately, frustrated citizens may become more willing to take to the streets to vent their anger if they judge conditions are worsening-with no prospect for improvement. In the past dozen years, poverty and inequality have declined considerably in Latin America because of rising wages, greater access to schooling, and increased female employment. One of the chief causes for the slowdown is the dramatic drop in commodity prices, down 40 percent since their peak in 2011. In the spring of 2016, the evangelical caucus, known as the "Bible block," helped drive the effort to impeach President Rousseff on corruption charges. However, charges of corruption against several Evangelical politicians in Brazil could damage their political clout. Opinion polls suggest that many citizens identify crime as the most serious problem facing their countries, but economic concerns will probably gain more prominence as countries manage slowing economies. Countries affected by large drug trafficking organizations may see an increase in violence as well as erosion of the quality of their institutions and the authority and legitimacy of their governments. Health systems in the region are important sources of political legitimacy and state-building, arguably more than in other regions. The ongoing threats of the Zika virus and dengue fever put additional pressure on the region, especially the poorer populations. Large-scale instability and economic collapse in Venezuela looks likely, absent a change of government and major economic reform, and even these may not prove sufficient without substantial outside assistance. Regional security threats will grow, with the threat of large-scale instability in Venezuela, booming coca production in Colombia fueling crime in Central American and Mexico, and the persistence of drug trafficking and organized crime throughout the region. As illicit markets grow in many countries of the region, violence-and political and security institutions weakened by corruption-will become more pressing concerns. Latin American governments will press the United States and other developed countries to legalize drugs. The rightward turn in the region could be slowed or halted by corruption scandals in conservative governments. Other trends to watch are failures of governments- leftwing or rightwing-to narrow the socioeconomic gaps as economies slow. Such failures may lead to increasingly polarized societies, in which class, ethno-racial, and ideological cleavages largely reinforce each other. These inequalities could fuel the growth of indigenous and Afro-Latino movements in some Latin American countries in the years ahead. Warming twice as fast as the rest of the planet, the Arctic will continue to produce dramatic and newsworthy images that have become established earlywarning signs of the changing climate, such as stunning, high-resolution video of melting glaciers and thinning ice sheets and vivid photos of starving iconic mammals. Fully ice-free summers probably remain a decade or more away, but an increasingly navigable Arctic makes the region a more salient economic and security issue. The melting of sea ice raises the possibility of drastically shorter commercial routes between major trading blocs, such as exports from China, Japan, and South Korea to Europe and North America. A more open Arctic, however, brings substantial hurdles-and potential calamities-as the unpredictability of ice, weather, and fog increases in already harsh conditions. In the next five years, pioneering efforts will outpace improvements in infrastructure needed for operation in the region, such as ship-to-shore communication nodes, transshipment facilities, refueling stations, and vessel tracking.

Training Training should be offered for all staff members atrophic gastritis symptoms mayo prevacid 30mg discount, including secretaries gastritis nec order prevacid 15 mg overnight delivery, nurses gastritis diet ������ cheap prevacid 30mg, counselors gastritis what to eat order prevacid online now, supervisors, and managers, to ensure a strong knowledge base so that staff members do their best and to affirm that all staff members are valued members of the treatment team. One way to address negative staff attitudes is to include successful patients in training (Bell 2000). Medical staff members should be able to assess patients and determine, with input from other treatment team members, which medication is most appropriate. Training should ensure that staff members are knowledgeable about drug abuse trends in the community. The importance of emphasizing sensitivity to patient needs should be reviewed periodically. No matter how creative and naturally sensitive a staff member may be, factors such as burnout can affect how he or she responds. A program physician might educate staff members about the etiology Administrative Considerations of addiction and effects of medications. A psychiatrist might distinguish primary mental disorders from those that are substance related and provide information on psychotropic medications. Therapists and social workers might teach behavior management techniques, parenting, and resource allocation. Nurses might provide training on gender and wellness, as well as the side effects of pharmacologic regimens. Federal and State agencies and profesThe importance of sional associations offer seminars, courses, and worktraining has shops. Professional societies, such as the American Society of Addiction Medicine, American Academy of Addiction Psychiatry, and Osteopathic Academy of Addiction Medicine, offer training for medical personnel in various therapeutic techniques. National counseling organizations, such as the Association for Addiction Professionals, and professional nursing societies also offer treatment courses. Reception staff members, often the first to speak with patients, play an important role. If possible, all staff members should receive annual training in such areas as confidentiality requirements, cultural competence, prevention of workplace violence, and patient rights. A random-callback policy avoids patient complaints of being unfairly мpicked onо by staff members. Programs also can require patients to undergo drug tests when they bring in their medications. The policy should be clarified at the beginning of treatment and enforced consistently. Reducing the Possibility of Diversion by Patients Patients considered for take-home medication must meet Federal criteria. Even so, protocols should be in place to reduce the risk that staff will divert medications. All scheduled substances should be accounted for rigorously and inventoried continuously. Working stocks should be logged and tracked from receipt through dispensing and measured at the beginning and end of each workday. Measurements and daily reconciliations should be monitored by supervisors and checked Chapter 14 230 periodically by dispensary managers. The dispensary manager, executive director, and medical director should follow up on investigation findings. The security of computerized records and systems also should be ensured to prevent employee theft of medication. Within the dispensary, employees should open the safe or work with scheduled substances only in the presence of other staff members. Many prevention and treatment programs are becoming increasingly responsive to the needs of cultural and ethnic groups. These successes provide models for effective community relations in other settings. These connections increase the need for effective outreach to other community services and entities. Facilities for onsite patient activities to limit outside loitering are beneficial.

This would be his perfect diet pill because he could not imagine ever being able to stop eating once he started gastritis main symptoms buy prevacid toronto. As an athlete in school gastritis diet ������� cheap prevacid 30 mg fast delivery, he had always worked out harder and longer than everyone else on the team no xplode gastritis generic prevacid 15 mg on line. Because of this work ethic gastritis diet therapy purchase prevacid 30mg with mastercard, he became a star member of the team and eventually its captain. More than any other employee, Jamie would persist in pursuing clients until he landed the deal. However, eating disorders do not consist solely of pleasurable, rewarding behaviors. To understand the full array of symptoms, one must examine both the consequences of a given behavior and the consequences that would result from not engaging in the behavior. Like positive reinforcement, negative reinforcement increases the likelihood of a behavior recurring. The behavior prevents such an undesirable consequence or terminates an undesirable experience. For example, selfstarvation may be negatively reinforced if it contributes to emotional numbing and reduces distress (Kaye et al. Similarly, binge eating may be negatively reinforced if it offers even a temporary respite from negative feelings (Heatherton & Baumeister, 1991). Although feeling nothing is not necessarily pleasurable, it is preferable to feeling distress. In a metaanalysis of studies examining emotional changes immediately before binge episodes, HaedtMatt and Keel (2011) found consistent evidence that an increase in negative affect predicted binge eating. Although purging is not an effective form of weight control, it does decrease anxiety (Haedt-Matt & Keel, 2011). This reduction in anxiety provides powerful negative reinforcement for purging-even in the absence of a binge-eating episode. In reviewing the diary, Valerie was able to see that some purging episodes were triggered by what she had eaten. For example, if she went out to dinner with friends and tried to eat "like a normal person" without restricting, she would usually excuse herself after the entrйe and go the bathroom to purge before returning to order dessert, which she would also get rid of once she got home. Instead, the consistent pattern that emerged was how she felt before and after the eating episode. Any time that she felt highly anxious before eating, she was very likely to purge after eating, and after purging her anxiety would go down. In these instances, it seemed as though she was eating solely to trigger a purging episode to alleviate her anxiety. In addition, sometimes her eating triggered feelings of extreme fullness, which made her feel anxious about becoming fat. In these cases, even if the type and amount of food fell within her accepted rules for being "safe," she would purge to relieve the feelings of fullness and anxiety. These days were marked by lower levels of negative affect and higher levels of positive affect and a general absence of physical discomfort after eating. Even though purging is not inherently rewarding (it does not make Valerie feel happy) it eliminates a range of negative experiences. Haedt-Matt and Keel (2015) recently documented that increases in negative affect preceded episodes on purging in purging disorder, and negative affect decreased after purging, supporting the role of negative reinforcement in maintaining this behavior. In many cases, negative reinforcement is more powerful in maintaining a behavior than positive reinforcement is. Each time someone engages in the behavior, that person experiences both the actual and the perceived consequences. In positive reinforcement, the pleasurable consequence is experienced exactly as it is. In negative reinforcement, the consequence is experienced both as the actual elimination of something undesirable and as the prevention of something that is undesirable. For example, Valerie experiences her purging as reinforcing because it decreases her anxiety and because she believes it prevents her from gaining weight. Thus no matter what the real consequences of a negatively reinforced behavior are, each time people engage in the behavior they can conclude that they would have been worse off had they not engaged in it. This assumption may well be wrong; Valerie, for example, was much happier and healthier before she developed purging disorder. The only way to challenge this assumption is to stop the purging so that the person can learn that it does not make life better.

Lead exposure gastritis diet ����� buy prevacid 30mg low price, for example congestive gastritis definition order discount prevacid line, can increase blood pressure gastritis diet what to eat for breakfast lunch and dinner purchase cheap prevacid online, which in turn increases the risk of cardiovascular disease gastritis and esophagitis order prevacid 15 mg line. Other environmental risks can be generated by stressful conditions in the workplace and ischaemic heart disease has been linked to stress at work (Bosma et al. Stressful workplace conditions include an imbalance in the effort-reward mix, long work hours, shiftwork, psychosocial stressors and physical exertion (Karasek et al. In Finland, it was estimated that occupational risks accounted for 17% of the deaths from ischaemic heart disease, and 11% of those from stroke (Nurminen and Karjalainen, 2001). This estimate was based on the specific risks of job control, noise, shift work and environmental tobacco smoke at work (Steenland et al. In Denmark, it has been estimated that about 16% of the cardiovascular disease burden could be prevented in men with nonsedentary occupations, and 22% in women with non-sedentary occupations. These figures increased to 51% and 55%, respectively, if men and women with sedentary work were included in the analysis (Olsen and Kristensen, 1991). In total, 16% (7-23%) of the total burden of cardiovascular disease was attributed to the environment, corresponding to 2. Workplace conditions, including the demands of assembly line work, can be a factor in stress. Most other risk factors are occupational or environmental, including dusts and chemicals in the workplace, air pollution, and environmental (second hand) tobacco smoke (National Heart, Lung and Blood Institute, 2005). In countries where solid fuel is widely used in homes for cooking or heating, indoor smoke levels can be high, and mean attributable fractions often exceeded 40%, with higher values for women than for men. In more developed regions, with little reliance on burning solid fuel in the home, mean attributable fractions were between 10% and 30%, with higher values for men because of occupational exposures to smoke. Indoor exposures to dampness, dust mites and fungal allergens may account for 20% of asthma prevalence (Melse and de Hollander, 2001). The estimate for environment exposures did not include outdoor exposure to pollen, as this is not realistically modifiable. The mean attributable fraction was generally higher for men than for women (41% versus 32%), because men were more frequently engaged in occupations that exposed them to risk. Rheumatoid arthritis and osteoarthritis have both been linked to occupational risks, such as exposure to vibrations, repetitive trauma, knee bending or lifting heavy weights. The incidences of these diseases are higher in occupational groups such as farmers, truck drivers and unskilled workers (Maetzel et al. It was estimated that environmental factors account for 17% (7-29%)% of the disease burden from rheumatoid arthritis and 20% (13-26%) of that from osteoarthritis. The group of "other musculoskeletal diseases" includes other forms of arthritis, arthropaties, joint disorders, systemic connective tissue disorders, muscle and soft tissue disorders. Evidence indicates that these diseases are also linked to occupational conditions, and it was estimated that 15% (7- 23%) of the disease burden for this group of musculoskeletal diseases was attributable to occupational risk factors. Other environmental issues include poor street lighting and signs, poor road maintenance and narrow roads (Qin et al. Other successful measures include designating segregated bicycle lanes on urban roads, introducing barriers along the roadside, and pedestrian crossings (Forjuoh and Li, 1996; Peden et al. It is relatively difficult to assess the contribution of environmental factors using intervention studies, because most such studies must be implemented within an existing built environment, with only minor constructional modifications possible. Also, longer-term environmental changes, such as modifications to the urban geography, density or road layout, or changes in the use of motor vehicles, could not be measured. Despite these limitations, it was estimated that 25% (12- 59%) of road traffic injuries in Western Europe were attributable to the environment, 17% (5-50%) in Australia, North America and Japan, and 42% (26-60%) in developing countries. The global average for road accidents attributable to environmental factors was 40% (25-57%). Traffic calming measures and improved design for cyclists and pedestrians can help reduce road traffic injuries. Suicides and homicides, attempted or actual, as wedrug abuse, and other intentional poisonings were not included in this category. Food poisonings, or contact with venomous animals or plants, were analysed, but under a separate category ("other unintentional injuries").

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