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AEI currently utilizes a RIEGL VZ400 Terrestrial Laser Scanner on various job sites.  This proecss utilizes a high accuracy 3D terrestrial LiDAR unit.  The data collected will be brought into a feature extraction software, TopoDOT.  TopoDOT utilizes a variety of tools to identify adn quickly extrapolate features within pointcloud data.  All features can then be imported into an AutoCAD drawing file.  AEI can provide an accurate 3D pointcloud of terrain plus any existing building or structures.  The pointcloud can also be converted for Building Information Models.

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Allen Engineering is involved with the civil design and surveying for the new park in Palm Bay, Flordia.  This Regional Park will feature 150 full service campsite hookups and is scheduled to break ground in 2018.  We are extremely proud to be involved in this project.

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Allen Engineering is beginning its 21st year associated with the Space Coast Post of the Society of American Military Engineers (SAME).  During our 21 years, we have helped raise over $350,000 in scholarships and endowments.  We are extremely proud to be associated with SAME and its continued commitment to offer opportunities for students pursuing careers in the engineering field.


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By: Stephen R. Thompson, MD, MEd, FRCSC

  • Cooperating Associate Professor of Sports Medicine, University of Maine
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  • Eastern Maine Medical Center Bangor, Maine
  • Cofounder and Codirector, Miller Review Course Part II, Denver , Colorado

To protect the skin and nails from the effects of d rying elem ents symptoms of flu 500 mg duricef amex, gloves should be w orn and m oisturiser applied to medicine reminder purchase duricef 250mg amex the skin and nails regularly symptoms lyme disease duricef 500 mg without a prescription. These are: D ermatitis treatment laryngomalacia infant cheap duricef 250mg otc, Eczema and Psoriasis We d iscussed nail d isorders w hich require special attention w hen applying m anicure. The m ost im portant outcom e of this Section is your ability to id entify irregular cond itions of the skin and nail and to know w hen to refer clients for m ed ical attention; w hen you can proceed with an unrestricted m anicure; w hich cond itions require special care and w hen cond itions are contra -indicated to m anicure. Three characteristics of a healthy skin are: it is soft, moist and pliable and it has an acid mantle with a pH of 5. When w e refer to d iseases of skin and nail, w e refer to cond itions that are infectious and / or contagious and w hich are contra-indicated to m anicure. These cond itions are absolutely contra-ind icated for m anicure and pedicure w hich m eans that you must not d o a nail treatm ent. It is im portant for you, as a m anicurist/ pedicurist, to recognise infectious and contagious cond itions, since they m ust be attend ed to by a d octor. Section 1: Disease causing m icroorganism s Section 2: Skin and nails d iseases Learning Outcomes By the tim e you have com pleted this Unit, you should be able to: d escribe briefly three types of infection state d iseases caused by three types of infection Study Time To cover the content of this Unit w ill take you abou t 2-3 hours. Causes of infection contamination the p resence of d isease cau sing bacteria Infection of skin and nail can occur in tw o d ifferent w ays ­ by direct or ind irect contam ination. Direct contam ination is w hen infection passes straight from one person to another. Direct contam ination m eans coming into contact with som eone w ho is ill and w ho is, sneezing and coughing. Ind irect contam ination is caused w hen the infection passes from one person to another through unclean objects. Used tow els, soiled linen and d irty tools are things found in the salon that can cause indirect contamination if not kept clean. Those that are harm ful to us are called pathogens like bacteria, viruses and fungi. Fungi Fungi (plural for fungus) are plant form s w hich are m ad e up of a m ass of tiny thread s and are parasites on the hum an bod y. Fungal diseases of the skin feed off the w aste prod ucts of the skin and grow w ell in w arm, dam p places, for exam ple betw een the toes. They are present alm ost everyw here around us, in the air, in soil, in w ater and on m ost surfaces includ ing the surface of the skin. They survive only in living cells and so cannot live for very long outsid e the hum an bod y. But viruses cause other diseases, an exam ple, is Verrucae, the technical term for w arts on the feet. Recognising the sym ptom s at an early stage could avoid d iscomfort and the cond ition spreading locally and to others. In this section w e w ill learn about skin and nail d iseases, their cause, w hat they look like and w here they are likely to occur. Fungal infections tinea the term u sed for ringw orm Tinea is the term used for ringw orm. For that reason m anicurist/ ped icurists m ust refer a client show ing sym ptom s of ringw orm to the d octor. It is also know n as Onychom ycosis (on -ih-koh-m eye-Koh-sis), causing the nail to becom e yellow / grey. They m ay spread to the sole and betw een the toes and nail fold infecting the nail. It causes red blisters on the feet w hich burst and then the skin goes d ry and scaly. It is a bacterial infection w hich could be caused by im properly sanitised nail im plem ents. They are contagious and are found on the hands, fingers, knees and / or sole of feet. H and w arts are contracted from contact with persons, for exam ple shaking hand s. Table 2 w ill help you to rem em ber the different types of infection com m only seen in a salon; w hat it looks like; the area affected; and how it is caused. Paronychia is an infectious and inflam m atory cond ition of the tissues surround ing the. True or False Feedback There was quite a lot to learn in this Unit but we think you should be able to answer these questions if you have studied carefully. It is very important that you understand the causes of different infections and know where on the body they might be found and how to recognise them. Unlike skin and nail disord ers d iscussed in the previous chapter, infectious/ contagious cond itions are strictly contra -ind icated to m anicure. You know that infection occurs in tw o d ifferent w ays: Direct contam ination can be caused by touching the skin, sneezing, breathing and coughing. Ind irect contam ination is caused w hen the infection passes from one person to another through unclean objects such as d irty tow els and contam ina ted instrum ents. You learned that bacteria are all around us: som e are d isease causing and others are harm less. Those that are harmful to us are called pathogens w hich are types of bacteria, viruses and fungi. Fungal d iseases feed off the w aste prod ucts of the skin and grow w ell in w arm, d am p places, for exam ple betw een the toes. An exam ple is an infectious and inflam m atory cond ition of the tissues surround ing the nails.

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A good example is India treatment 4 syphilis discount duricef 250mg on line, where rural people symptoms toxic shock syndrome purchase 500mg duricef, lower-caste people doctor of medicine duricef 500 mg line, religious minorities medicine 54 543 order duricef 250mg, tribal ethnic groups, women, and the poor in particular suffer gross health inequalities and lack access to good-quality care because of social, geographic, and economic barriers. Regional and district leadership involvement in the planning is just the beginning, since their participation is needed across all the areas discussed in this manual-supervision, training, support, supplies, and incentives. Specific questions to address in the situational analysis include: · What are the main health problems and who experiences them? Development of an operational model provides an opportunity to visualize how the health system functions, including service provision, human resources, technology and information management systems, and the supply and distribution of commodities. Specifically, using an operational model to map the dynamics of the current health system helps those involved in planning to characterize where further development of community health services fits into the broader health system. Using these measurement strategies to track progress of health system indicators ensures that continued improvement in health care and accountability at country and global levels is sustained. Before any implementation of program development or expansion, determining how the multiple levels of government will communicate and interact during the planning, funding, and implementation stages will ease the tensions and challenges that often accompany systematic program scale-up (See Chapter 13 on scale-up, for a more detailed description of these challenges). The level of coordination will depend on the country, the current degree of decentralization, and what responsibilities have been delegated. However, many countries have not succeeded in decentralizing health care, and in these cases, the mechanisms that exist to support health programs at the local and regional levels should be utilized. Regardless of who will be included in the planning process, coordinated communication is key. Health system planning and ongoing monitoring of performance must begin at the community level and provide feedback through various levels to the national level, where policy, funding, and evaluation can be periodically revised. The most effective planning mechanism is a feedback loop, where the community level feeds back information about their program through the multiple levels. Additionally, each level should have a defined set of responsibilities during each stage of program development. The establishment of responsible bodies at each level, with oversight from central level, helps to ensure clear roles and responsibilities are determined through the process of conducting the situational analysis and building the operational model (two stages of Phase 1). The national-level planning body is responsible for providing leadership for the development of community health services. A national committee can provide high-level leadership, make decisions on resource allocation, oversee the development of implementation guidance, monitor implementation, oversee national monitoring and evaluation (M&E), and adapt the program based on M&E findings. Draft December 2013 · · · · · · What specific planning documents will be needed, and when will they be needed in order to guide the regional- and district-level planning committees? How will the national-level committee document its meetings and share this information with sub-committees? Their responsibilities may include planning for the engagement and coordination of key partners in training and for the oversight of supervision activities and the supply chain. Health Center Roles and Responsibilities Further development or expansion of community health services, if not adequately planned and resourced, can over-burden an already over-stretched health facility staff due to new supervisory and mentoring responsibilities and additional paperwork, meetings, and field visits. As part of the situational analysis, the typical functional state and human resources capacity of health facilities that are expected to be involved in the provision of community health services will be documented. This documentation will help planners determine what additional resources are needed to ensure that health facility staff can take on the functions associated with these new community health services. The capacity of facility-based staff to take on new supervisory or support roles for communitybased cadres will vary by setting. A strong community commitment helps ensure more effective community health services and can mitigate stress points on the system. Yet, too often these promises are inadequately funded, lack proper legislative authorization, and are not integrated with the existing health system. For example, national and regional initiatives and goals are adopted and supported by political figures throughout sub-Saharan Africa, to end preventable maternal and child death by 2030. A critical component of ending preventable maternal and child death is to deliver health services at the household level and ensure referral networks begin at the household. Among other things, this preparation requires development of details for the specific sub-systems of the program, including governance, financing, selection and recruitment, training, supervision, relationship with the health system engagement with communities, scaling up, and M&E. Here, we will briefly focus on planning for training and deployment, supervision, and M&E. Supervision, Monitoring, and Evaluation Countries vary considerably in their approaches to supervision. However, this approach would not be appropriate in places where there are massive human resources shortages, such as Sierra Leone, where there are only 1. In many instances, clinics have only one or two providers and are bombarded with lines of clients starting at sunrise. Planning for supervision has to take into account the capacity of existing staff to take on additional time-consuming 3­8 Draft December 2013 responsibilities. Ultimately, adequate ongoing monitoring is necessary for sound community health services. As such, M&E tools and mechanisms for their use for feedback into modifying program operations are important when developing a detailed implementation plan. As a program is implemented, scaled up, or modified, an ongoing re-planning process is required. Based on M&E feedback, certain program components may be working very well, while others may not be functioning as intended. To know what is actually occuring requires adequate tracking of intervention coverage and its impact/effectiveness. Based on such findings, re-design of some program features may be needed to address performance problems. Re-planning at least once every 10 years and preferably every five years would seem reasonable.

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Practical skills can only really be learned in practice so it seems obvious to symptoms menopause duricef 500mg lowest price me that a lot of the training should occur in the community medicine man aurora buy duricef 500 mg online. Then they start "working" and they get paid much less because they are not working as much treatment question duricef 250mg fast delivery. In the words of two key informants medicine zofran purchase 250mg duricef with mastercard, Appendix A­4 Draft December 2013 the lack of time or attention to this reflects the fact that we are always in such a hurry. The approach to attaining and retaining skills is usually inadequate with initial training that offers too little practicum exposure and little or no program effort to confirm and ensure retention of skills. Informants emphasized repeatedly the importance of using a slower but more rigorous and phased approach to training. For example, start with family planning and breastfeeding, then let them practice these messages, then train on other issues. Also, a key informant highlighted how a phased approach to training can be more responsive to community needs because the flexible training structure can allow the community to decide on what health problems to address. So if they choose diarrhea as a problem they want to address, then you teach the diarrhea module, which includes hand washing and latrines, etc. I feel that very few programs have done this, and those that do, have strong programs. One key informant recommended the following: "There is a tendency for more and more tasks to be added on once the program starts. It is crucial to think about workload during the program development stage and create guidelines and expectations prior to program start. The more it is structured prior to the program start, Draft December 2013 Appendix A­5 the better off. Any optimal or prioritized sets of activities need to be defined before the program starts. It is also important to look at where that task fits in the curricula and how it will affect the ability to address previously outlined important tasks or goals. One key informant noted, "Where does the program situate itself in the bigger picture? One key informant, referring to the Jamkhed Comprehensive Rural Health Project (in central India) and the Barefoot Doctors in China, observed: Without somewhere to refer people who have trauma or significant illnesses, then the program is not as successful. The strength of Jamkhed and the strength of the Barefoot Doctors was their connection to the public health system. Joining in meetings at the clinic is also important for them to feel integrated into the system. One key informant recommended "engagement" or "active interface" with the peripheral health system over full integration. One key informant reported, "There is a failure of effective, institutionalized supervision. Initial program efforts consist of developing a training manual, doing mass training and deployment, and then. However, multiple informants have noted several challenges with this supervision set up. First, supervision is assigned to a staff in the clinic without consideration of whether this person has the time, skills, or desire to perform supervisory tasks. One of the keys to effective programs is making sure that the supervisors or trainers are in touch with the needs and realities of their workers. These findings may not be appropriate for extrapolation to scaled-up national programs. Several key informants noted it would be helpful to have some type of database where the basic features of large-scale programs are documented. Each program seems to be creating its own materials and is attempting to "recreate the wheel. The findings from this review of key informants suggests that as countries engage in these activities, the success of their efforts will depend to an important degree on the quality of realistic planning that is carried out initially, taking into account the real costs required for effective programming and then developing monitoring and evaluation systems that will make it possible for these programs to adjust to needs and problems as they emerge at the local level and at the various levels of management. Appendix A­8 Draft December 2013 Appendix A: Interview Guide Draft December 2013 Appendix A­9 Appendix A­10 Draft December 2013 References 1. They are trained to treat common medical conditions, to promote a wide variety of health behaviors, and to refer patients to preventive and curative services as appropriate. They also use this time to sell health products, such as basic medicine, sanitary napkins, and soap. The health status of the poor and vulnerable remains challenging, and families may suffer financial catastrophes if a member falls ill. New challenges of the epidemiological shift to chronic and non-communicable diseases are arising, along with environmental hazards from air and water pollution, injuries, and unhealthy behaviors such as tobacco use and violence. These all have different reach and quality, and the public sector is responsible for less than 20% of curative services. The public and private sector have a porous boundary and doctors move between the sectors. A second-level supervisor (the program organizer) takes these specimens to the district health facility, where they are tested. They serve as health promoters, as the first point of care, and as sellers of medical products. They are trained on treatment of everyday conditions such as skin and eye infections, common cold and cough, and diarrhea and other abdominal complaints. They receive incentives for good performance that are based on achieving specific objectives during that month, such as identifying pregnant women during their 1st trimester. Some teams also include a dentist, an assistant dentist, a dental hygienist, and a social worker. Roles/Responsibilities the scope of work for the health care teams varies with geographic distribution, but most teams provide comprehensive care through promotive, preventive, recuperative, and rehabilitative services. Supervisory nurses spend 50% of their time in these supervisory roles and the rest of the time working in the local clinic.

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We are required by applicable federal and state laws to treatment 1st degree heart block quality duricef 250mg maintain the privacy of your protected health information medicine effexor cheap duricef 250mg online. We are also required to treatment vaginal yeast infection generic duricef 250mg on line notify affected individuals following a breach of unsecured health information symptoms endometriosis cheap 500 mg duricef amex. We will inform you of these practices the first time you become a Highmark Delaware customer. We must follow the privacy practices that are described in this Notice as long as it is in effect. This Notice becomes effective September 23, 2013, and will remain in effect unless we replace it. Due to changing circumstances, it may become necessary to revise our privacy practices and the terms of this Notice. We reserve the right to make the changes in our privacy practices and the new terms of our Notice will become effective for all protected health information that we maintain, including protected health information we created or received before we made the changes. Before we make a material change in our privacy practices, we will change this Notice and notify all affected members in writing in advance of the change. Any change to this notice will be posted on our website and we will further notify you of any changes in our annual mailing. For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice. Uses and Disclosures of Protected Health Information In order to administer our health benefit programs effectively, we will collect, use and disclose protected health information for certain of our activities, including payment and health care operations. Uses and Disclosures of Protected Health Information for Payment and Health Care Operations the following is a description of how we may use and/or disclose protected health information about you for payment and health care operations: Payment We may use and disclose your protected health information for all activities that are included within the definition of "payment" as set out in 45 C. We have not listed in this Notice all of the activities included within the definition of "payment," so please refer to 45 C. For example: We may use and disclose your protected health information to pay claims from doctors, hospitals, pharmacies and others for services delivered to you that are covered by your health plan, to determine your eligibility for benefits, to coordinate benefits, to examine medical necessity, to obtain premiums, and/or to issue explanations of benefits/payments to the person who subscribes to the health plan in which you participate. Health Care Operations We may use and disclose your protected health information for all activities that are included within the definition of "health care operations" as set out in 45 C. We have not listed in this Notice all of the activities included within the definition of "health care operations," so please refer to 45 C. For example: We may use and disclose your protected health information to rate our risk and determine the premium for your health plan, to conduct quality assessment and improvement activities, to credential health care providers, to engage in care coordination or case management, and/or to manage our business. In connection with our payment and health care operations activities, we contract with individuals and entities (called "business associates") to perform various functions on our behalf or to provide certain types of services (such as member service support, utilization management, subrogation, or pharmacy benefit management). To perform these functions or to provide the services, business associates will receive, create, maintain, use, or disclose protected health information, but only after we require the business associates to agree in writing to contract terms designed to appropriately safeguard your information. In addition, we may use or disclose your protected health information to assist health care providers in connection with their treatment or payment activities, or to assist other covered entities in connection with certain of their health care operations. For example, we may disclose your protected health information to a health care provider when needed by the provider to render treatment to you, and we may disclose protected health information to another covered entity to conduct health care operations in the areas of quality assurance and improvement activities, or accreditation, certification, licensing or credentialing. Other Possible Uses and Disclosures of Protected Health Information In addition to uses and disclosures for payment and health care operations, we may use and/or disclose your protected health information for the following purposes. To Plan Sponsors We may disclose your protected health information to the plan sponsor of your group health plan to permit the plan sponsor to perform plan administration functions. Required by Law We may use or disclose your protected health information to the extent that federal or state law requires the use or disclosure. Department of Health and Human Services upon request for purposes of determining whether we are in compliance with federal privacy laws. Public Health Activities We may use or disclose your protected health information for public health activities that are permitted or required by law. For example, we may use or disclose information for the purpose of preventing or controlling disease, injury, or disability. Health Oversight Activities We may disclose your protected health information to a health oversight agency for activities authorized by law, such as: audits; investigations; inspections; licensure or disciplinary actions; or civil, administrative, or criminal proceedings or actions. Oversight agencies seeking this information include government agencies that oversee: (i) the health care system; (ii) government benefit programs; (iii) other government regulatory programs; and (iv) compliance with civil rights laws. Abuse or Neglect We may disclose your protected health information to a government authority that is authorized by law to receive reports of abuse, neglect, or domestic violence. For example, we may disclose your protected health information in response to a subpoena for such information. Law Enforcement Under certain conditions, we also may disclose your protected health information to law enforcement officials. For example, some of the reasons for such a disclosure may include, but not be limited to: (1) it is required by law or some other legal process; or (2) it is necessary to locate or identify a suspect, fugitive, material witness, or missing person. Coroners, Medical Examiners, Funeral Directors, and Organ Donation We may disclose protected health information to a coroner or medical examiner for purposes of identifying a deceased person, determining a cause of death, or for the coroner or medical examiner to perform other duties authorized by law. We also may disclose, as authorized by law, information to funeral directors so that they may carry out their duties. Further, we may disclose protected health information to organizations that handle organ, eye, or tissue donation and transplantation. Research We may disclose your protected health information to researchers when an institutional review board or privacy board has: (1) reviewed the research proposal and established protocols to ensure the privacy of the information; and (2) approved the research. To Prevent a Serious Threat to Health or Safety Consistent with applicable federal and state laws, we may disclose your protected health information if we believe that the disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. Military Activity and National Security, Protective Services Under certain conditions, we may disclose your protected health information if you are, or were, Armed Forces personnel for activities deemed necessary by appropriate military command authorities.

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