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I do not think we want a society where people sell children that they intended to depression symptoms rage buy genuine clomipramine raise because they cannot affrd it depression chemical imbalance test cheap clomipramine american express. They object to depression symptoms emotional numbness 25mg clomipramine mastercard commoditizing gestational care depression symptoms oversleeping order generic clomipramine line, but this argument does not provide any explanation because it appears to be based on a moral position. I believe any discussion about whether or not surrogacy harms the dignity of women should consult the surrogates themselves. In the United States, there is no evidence that most surrogates feel their dignity is harmed by selling gestational care; rather, they feel they have been able to do something very meaningful. She states that "women who chose to become surrogate mothers did so as a way to transcend the limitations of their domestic roles as wives, mothers, and homemakers while concomitantly attesting to the importance of those roles and to the satisfaction they derived fom them. One surrogate we interviewed in India told us, "The thought of giving a child to someone else is incomparable, there is nothing else that makes me so happy. The correct focus of the dignity-based concerns should be the women who undertake the practice and in both the United States and India. There is no evidence that women feel that selling gestational care violates their sense of dignity. Even if they were provided with counsel, there is still a risk that the lawyers will not provide robust representation. First, the majority of surro gates surveyed by the Center for Social Research were promised pay ment only for a successful pregnancy and were not compensated fr undergoing medical procedures if no pregnancy resulted. Mul tiple surrogates are kn own to have been implanted with diferent em bryos of the same intended parents, and if more than one surrogate becomes pregnant, some surrogates are given aborti fcients, sometimes without their knowledge. Gestational Care Markets and Regulation in the United States Feminist writing on surrogacy in the United States was arguably at its peak during the custody battle between Mary Beth Whitehead, a sur rogate mother, and Richard Stem, the intended fther, over a child known as Baby M. Patel, Medical Director of Akanksha Hospital & Research Institute in Anand, Gujarat, India, ivf-surrogate. Empirical studies of surrogates do not reveal that they are dis proportionately minority or fom poorer economic classes. The laws relevant to gestational care markets tort,contract,and fmily law-are within the domain of state law. On the other hand,four states specifcally prohibit the enforcement of compensated surrogacy contracts. This imbalance can only increase as embryo transfer fom one woman to another makes the use of women of color for gestation of white fetuses more likely"). It should be noted that in some of the American states that have adopted legislation to legalize surrogacy, the statutes provide protections to surrogates. For example, legislation in Illinois re quires that the surrogate have a health insurance policy that covers the pregnancy and post-partum period. Matching entities act as intermediaries connecting intended parents to surrogates. Nevertheless, there is still a potential confict of interest given that the intended parents typically pay fr frtil ity services, but the surrogate is the patient of the frtility specialist. In other words, the obstetrician can provide pre-natal care fr the surrogate without considering the desires or needs of the intended parents in situations where those interests may con fict. The code of ethics of the American Academy of Assisted Reproduc tive Technology Attoreys, a voluntary organization of lawyers, states that lawyers can undertake legal representation in surrogacy contracts only when the surrogate has independent legal representation. Industry actors have developed customary norms and standards that provide basic rights and protections to surrogates. The Center fr Bioethics and Culture is one of the most vocal opponents of surrogacy in the United States,yet it does not provide any information about system atic abuse of surrogates. By pointing to the experiences of some women, they argue that surrogates are harmed when they have to give up the child. However, psychological studies of surrogates do not support the argument that surrogates sufer trauma fom the separation with the child. According to that organization, taking into account every hour of the pregnancy, a surrogate is paid about $3. I do not mean to suggest that there are no problematic situations in the gestational care markets in the United States. Ye t there are sig nifcantly diferent customary practices in the gestational care markets in India and the United States. The customary norms in the United States are more surrogate-protective than those in India. In this section, I argue that the legal context of India and the United States helps to explain these difering outcomes. First,in the United States (both in unregulated and regulated states), industry actors, medical doctors, matching entities, and lawyers operate in an environment where they have good reason to believe that a surro gate could sue them fr malpractice or sue intended parents to invalidate the surrogacy contract. American legal practice permits contingent fes, and as a result tort lawyers may be willing to represent surrogates and intended parents with no upfont cost to the surrogate. The ability of surrogates to access courts and the perception of industry actors that sur rogates can access courts helps explain why the industry developed sub stantively fairer contract terms and a procedurally firer contract formation process than exists in India. Time fames for adjudication are relatively speedy-it takes approximately one year for a lower court to reach a decision. Lawyers and doctors who are part of the industry may be motivated by a sense of justice and firess, but are also concered about their own lia bility when they develop standards of care. Second, industry actors, particularly medical profssionals,are con cerned not only about the prospect of being sued, but are also worried about large damages awards. According to a lawyer who practices in a state that regulates surrogacy through legislation, agencies and lawyers take extra precau tions when dealing with surrogacies as they are concered about lawsuits against themselves. Similarly, in unregulated states, it is likely that industry actors create industry norms and standards that are well within the shadow of the com mon law. Third, industry actors in the United States may also create surro gate-protective norms because they worry that courts will invalidate un fair surrogacy contracts using policing doctrines such as duress and unconscionability. With the Baby M case looming in the background, lawyers that represent intended parents and matching agencies will likely advise their clients not to include extremely un fair contract provisions to ensure procedural fairess in the process. If a surrogate brings a lawsuit against the intended parents, a court might invalidate a surrogacy con tract altogether if it fnds it to be procedurally or substantively un fir. In India,on the other hand,industry actors do not operate in a simi larly litigious environment. While litigation rates are increasing in India as the economy grows, the per capita litigation rate is still relatively low. This is,in part,because lawyers in India cannot base their fes on the outcome of the litigation. The Bar Council of India, the body that regulates lawyers, prohibits lawyers fom taking contingent fes. Even if a surrogate were to sue, the resolution of the case could take so long that defndants would not have an imminent far of liability,and lengthy time fames fr 90 See Telephone Interview with Delaware Lawyer fom Ithaca, N. Third, while both Indian and American common law have policing doctrines (such as duress and unconscionability) and substantially similar legal tests fr negligence, the lack of access to the courts and lengthy 93 See Rukmini S. In India, there is a unitary court system-one set of courts adjudicate all disputes. The common law rules in whose shadow in dustry actors operate include doctrines such as duress,unconscionability, and public policy that demand that surrogacy contracts and the con tracting process be procedurally and substantively fair. Courts and juries sometimes award eye-popping punitive damage awards, which play a role in guiding the behavior of industry actors that provide profssional services. Fear of a contract being invalidated,large tort awards,and mal practice suits encourage industry actors to self-regulate and ensure that contracts are procedurally and substantively fair and that surrogates re ceive in frmed consent. On the other hand,the common law does not cast as wide or long of a shadow over industry actors in India. Because most surrogates will never be able to bring a suit against industry actors or intended parents, industry actors and intended parents are not worried that courts might invalidate procedurally and substantively un fair contracts or situations. Lawyers and doctors in the gestational care market are not concerned about large tort awards assuming a surrogate would be able to sue in the first place. And even if the suit moved frward, the delay in a fnal ver dict diminishes the signifcance of the verdict to the in jured party. There have been well-publicized surrogacy cases at the Indian Su preme Court,such as the Baby Man ji case and the Jan Balaz case. Jayashree Wad, a senior Indian lawyer, did bring a public-interest litigation on be half of surrogates (though no surrogate was consulted nor named as a plaintiff, asking the Indian Supreme Court to prohibit all gestational care markets. Notably, surrogates in India are fom poorer economic classes than surrogates in the United States.
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These projects included coordinating surveys bipolar depression cycling generic clomipramine 75mg without a prescription, community focus groups bipolar depression nami generic 25mg clomipramine amex, strategic planning to bipolar depression nami order clomipramine overnight identify potential challenges and solutions depression exercise routine buy clomipramine in india, and distilling themes and findings from a variety of qualitative information to share with key stakeholders. Melissa is a board member for the Illinois Rural Health Association and is the chair of its Research and Education and Conference Committee. Jeanna earned program last fall, an administrative intern in Algonquin in 2014-15, intern for Kane County Health Department in 2014, and a Congressional intern in the U. Jeanna will assist with the project to coordinate surveys, strategic planning exercises, distill themes and findings from qualitative and quantitative information sources important to stakeholders. Ballard will also be joined and assisted by other staff members of the Center for Governmental Studies and the University for certain project elements or at critical junctures of the project. The value of such processes continue to be recognized by leaders at the policy and administrative levels in both private and public organizations. The world in which we all operate continues to rapidly change and grow more complicated. In turn, the challenges and choices that you face in establishing policies, providing vital services, and setting priorities are likewise more complex and challenging than ten years ago, five years ago-even two years ago. As Winnebago County, and the larger, population dynamics evolve and change, the various services the County provides to meet its mission will continue to evolve, as a more challenging electorate critiques critical public services that are needed or desired. Consider some of the trends within and beyond your borders: changing demographics, value shifts, growth, economic contraction, development and re-development, changing attitudes, tax limitations, demands for service, mandates, economies of scale, technology changes, etc. In reality, the needs and demands on the County, and you as its leaders and decision-makers, far outstrip the available resources to tackle all of them. The answer is not an organic approach that might guide the County but rather to set aside time to methodically-"strategically" determine where it is you want to go as a County and put in place the priorities and actions that will allow you to get there. According to noted writer John Carver, governing and leadership challenges are not so much a problem of people as it is a problem of process. What makes the difference between effective and ineffective leadership groups is the ability to get beyond narrow issues and focus on the long-term vision, trends, and 5 Winnebago County Updated Project Outline July 2017 critical functions of the organization, and then communicating those consensus visions and priorities to the staff that execute goals and fulfill the mission. As Carver states, the heart of governance is setting priorities, making policy, articulating the mission of the organization, and sustaining its vision. Leaders need to commit themselves to effectiveness by learning to govern not only the County setting directions that are clear, concise, and focused on a defined future. Responsible stewardship and leadership is the essence of the considerable responsibility citizens place in their local governments and local service agencies. It should be seen as an avenue to not only map out the future, but as a means to foster a sense of ownership, and boost overall effectiveness in setting the course for the County and the community it serves. The end result of this process should be a viable listing of identified and prioritized goals that mesh with your overall vision of the County term future. Proposed Phases & Process the following outline presents a general description of the key components of the planning process. No matter the eventual combination of components chosen, the core of the process will be a series of discussion exercises that will include the County the format for all the discussion sessions outlined below is highly participative and interactive. The process relies heavily on a group discussion approach called Nominal Group Technique where participants are assured equal opportunities to speak and share opinions by the facilitator. During sessions, individuals will have an opportunity to generate and share individual ideas, work together as a group and in small teams to develop ideas, weigh alternatives, and further refine their thinking. As these ideas are shared and debated, the group will be working steadily toward a consensus of future directions and priorities. The project team envisions a tri-part initiative that includes the key elements of an effective and holistic strategic planning process: Environmental Scanning, Visioning, and Goal Setting: Part ITaking Stock: Listening and Learning fi County Senior Staff and County Leadership 6 Winnebago County Updated Project Outline July 2017 fi Administrators and key support (project coordination) fi Tier I-Organization Views o County Administrator, Deputy Admin. Cycle of Planning, Action, and Scanning Taken as a whole, the strategic planning process that is envisioned and described here, can be represented in a model of the various steps and elements in a cycle of input, scanning, goal setting, prioritization, action planning, and re-examination. An illustration of the strategic planning cycle described is presented below: Strategic Planning Model* Converting Vision & Strategies into Goals State the Mission Goals into Action Steps Explore the Organize Prioritize Operationalize Develop Goals Goals Vision Goals Goals Goals Scan the Environment Action Steps into Outcomes Monitor & Implement Develop Action Evaluate Action Steps Steps Outcomes * Model generally represents the steps that are taken for this type of initiative. Demographic Data Gathering (optional analysis cost can be provided if desired) Changing demographics play a crucial role in the service expectations of the community. Planning for facilities, programs, staff, and space are unavoidably linked to the socio-demographic character of a community. Using the Center for Governmental Stu researchers will be able to develop a complete demographic profile for the County. The Center is able to capitalize on the Northern Illinois Business and Industry Databank and manages and responds to requests for data from businesses and individuals in the Northern Illinois region including the Chicago, Kankakee, Rockford, and Quad Cities metro areas. Strategic Planning Workshop[s]: County Board and Senior Staff the identification of strategic issues and goals is the aim of any strategic planning process. The process is designed to create an effective environment where leaders can spend sufficient time to identify what is truly important for the organization to accomplish given the breadth of circumstances and information (at both the policy and operational levels) that confront the County as a vital part of the community. Identifying strategic issues can be compared to pouring your assessment of all the issues and circumstances the County faces into a filtered funnel. What County Leadership workshop session [s] will be a viable listing of identified and prioritized goals that mesh with the overall vision of the County near and long-term future. Mission Affirmation and Visions of the Future Exploration and identification of the County nching point once the framework of the organization mission has been explored and affirmed or fine-tuned Each participant will be asked to articulate what he or she perceives to be the preferred future state of the County one, three, five, and ten years down the road. What services, programs, staffing levels, capital needs, and general facets would or should be present in the County at these intervalsfi Participants will be asked to jot down their ideas ahead of time and then be ready to share them with the group. It helps the group to focus on a realistic identification of the environmental factors within and beyond the County organization that can inhibit or assist in the achievement of the future vision. Again, the group is not asked to focus on overcoming strengths or weaknesses, but to only identify what they may be. Given the futuristic statements of the preceding session, it is important for team members to identify and discuss what constraints and practical difficulties are likely to be encountered, or would make it difficult, to achieve the desired future state. These elements include both internal and external factors, conditions, trends, regulations, agencies, resources, etc. Review and Reflections on the Collected Listening/Stakeholder Data County leaders will be presented with a synopsis of the data gathered via interviews, focus groups, or other means selected by the County. During this session, results on what stakeholders shared about the preferred future state of the County will be reviewed along with perceived challenges, strengths, opportunities, etc. Nominal Group Goal Identification the collaborative establishment of strategic goals and objectives is the focus of the next phase of the strategic planning retreat/workshop activities. Each participating member will be allotted time to highlight the most important policy/program goals that he or she thinks the County should accomplish in the next two to ten years. Some should perhaps be accomplished immediately; others may be initiated but not completed for several years. This process will continue as long as time permits which may include some refinement or consolidation of similar goals statements. Identification of key issues of the future (as defined and anticipated by the County Board and senior administrative leaders) will also be part of this phase. This exercise takes advantage of the professional experience, perspective, and hands-on knowledge of the County staff. Management team members are called upon to identify and explain three to four key issues that the County should be aware of and incorporate into their future goals and needs. As part of this phase, the County Administrator, as the appointed Chief Administrator, will be asked to identify additional constraints/opportunities in the administrative apparatus of the County as well as react to those presented by management team members and stakeholders. Open Group Discussion and Classification this phase of the discussion will serve as the forum for workshop participants to discuss, evaluate, and debate the ideas and goals offered by each participant in the previous sessions. Participants 10 Winnebago County Updated Project Outline July 2017 are asked to give their opinions, evaluations, and judgments of the worthiness and value of different policy objectives. At the end of the open discussion, participants will be asked to classify each goal according to a matrix model of complexity and time. Agreed upon criteria will be used to classify a goal as either shortor long-term and as either complex or routine. The purpose is to group goals roughly the Prioritization Following the classification exercise, the group will be asked, through a post-workshop exercise, to delineate why certain goals should be given high priority, why some should not be considered, and why some goals, although worthy, should receive low priority or be re-defined. The resulting consensus ranking of shortand long-term goals to achieve the future vision will be the final outcome of this phase of the process. The final prioritized rankings will be presented in a 2x2 time and complexity matrix as illustrated below: Goal Classification Grid by G. Implementation: Action Planning and Strategy Development Kick-off** Once an agreed upon grid of goals and priorities is developed, the focus must move to effective approaches for implementation. Action plans, scheduling, and structural assignments will produce the necessary levels of awareness and accountability that are necessary for success.
However bipolar depression lows order clomipramine with a visa, if you cannot afford the fee anxiety tumblr buy cheap clomipramine line, you still have the right to depression podcast discount generic clomipramine uk review and receive the records anxiety disorder in children purchase clomipramine 75 mg. The school district may charge a reason able cost for copies of records, unless the cost would effectively prevent you from inspect ing or reviewing those records. Records may be needed for other purposes such as obtaining social security benefits. The rights of parents concerning education records are given to the student at age 18 unless you have obtained guardianship. In this case, you must ask for a hearing from your school district to change information in your child’s education records if the school district refuses to do so. If the hearing officer decides that the records do not need to be changed, you must be notified in writing. Personal information about your child may not be released without your consent unless it is: 1. The term does not include basic tests given to groups of children in a school, grade or class. However, if you withdraw your consent, it is not retroactive (it will not apply to actions already taken by the district). In this case, you must be notified that if you refuse to allow the school district to access (use) your private insurance, the district is still responsible to provide all required services at no cost to you. The request for consent will include information about the records that will be released and to whom they will be given. If you, as a parent of a school-age child, do not provide consent for an initial evaluation, the district will inform you that you may ask for an informal meeting with the school district to discuss the eval uation. You may ask questions about the evaluation and may bring someone to advise you to the meeting. At that meeting, you will meet with the person who made the initial referral for special edu cation and someone who is most familiar with the evaluation. If at the meeting, you and the person 18 who made the referral agree in writing that there is no need for a referral, the referral will be with drawn. If, within 30 calendar days after the referral is received, you and the school district do not agree to withdraw the referral and you continue to refuse consent, the district must initiate (start) an impartial hearing to decide whether to conduct the evaluation. For preschool children, the district will take steps to make sure that you have received and under stand the request for consent. If you, as a parent of a preschool child, do not provide consent for the evaluation, the district will not take any further action on the referral. Notice As a parent of a child with a disability or suspected disability, you will receive notices to tell you about proposed special education services, meetings and your rights. There are three kinds of notices that you will receive at various times throughout the special education process. Notice is a written statement provided to you in the language you speak or other kind of communi cation that you understand unless it is clearly not possible to do so. If the language you speak at home (your native language) or other kind of communication you understand is not a written lan guage, the district must take steps to make sure that the notice is translated orally or by other means (such as sign language) so that you understand the notice. You have the right to ask for an inter preter, translator or reader for the meetings. Prior Notice Prior notice is written notice that is given to you a reasonable time before the school district propos es to or refuses to start or change the identification, evaluation or educational placement or the provi sion of a free appropriate education to your child. It must be provided to you in the language you speak or other kind of communication that you understand unless it is clearly not possible to do so. This legal protection is called proce dural safeguards and they are listed in procedural safeguards notice. If the procedural safe guards notice is not included with the prior notice, the prior notice will describe the ways you can obtain (get) a copy of a description of the procedural safeguards. It must be provided to you in the language you speak or other kind of communication that you understand, unless it is clearly not possible to do so. You must receive a written meeting notice at least five days before the meeting unless you and the school district agree to meet within five days or in certain meetings relating to discipline procedures. If the proposed meeting time or place is not good for you, you may call the school district to ask for a change that is good for both of you. If you are unable to attend the meeting, the district can use other ways to encourage your partici pation. They may call you before a meeting occurs to talk about evaluation results and ask you for information, or they may ask you to participate in the meeting by telephone. These activities are not considered “meetings” for which the school is required to send you a “meeting notice. The school district must make sure that the procedural safeguards notice is provided to you in the lan guage you speak or other kind of communication that you understand, unless clearly not feasible to 20 do so. If necessary, the district must take steps to make sure that the notice is translated orally or by other means so that you understand the notice. Procedural safeguards notice is provided: • upon initial referral for evaluation of your child. State complaint procedures, including information about how to file a complaint and timelines (page 30). However, if you place your child in a private school because you and the school district disagree that an appropriate program has been made available for your child, you have the right to request an impartial hearing to seek reimbursement for the private school placement. If you are the parent of a child who previously received a special education program and/or services through the school district and you place your child in a private school without the consent or referral of the school district, you may be entitled to reimbursement for the cost of the private placement if you can prove at an impartial hearing or State-level or court appeal that: • the school district did not provide your child with a free appropriate public education in a timely manner prior to that enrollment in private school and • the private placement is appropriate to meet your child’s educational needs. A hear ing officer or court may find that a parental placement is appropriate even if it does not meet the State standards that apply to education programs provided by the school district or the State. However, the cost of reimbursement may not be reduced or denied because you did not give this notice if you are unable to read and cannot write in English; or if providing notice would likely result in physical or serious emotional harm to your child; or if the school prevented you from providing the notice; or if you did not receive the procedural safeguards notice that tells you about this requirement, then the cost of reimbursement may not be reduced or denied because you did not give this notice. If the school district gave you written notice prior to your removing your child from public school that it wants to evaluate your child, you must make your child available for the eval uation. If you refuse to make your child available, any request for tuition reimbursement may be reduced or denied. If you do not inform the school district or make your child available for the evaluation, or if there are other unreasonable actions on your part, an impartial hearing officer or court may reduce or deny the reimbursement of costs of the private school for your child. Initial Evaluation If your child is being evaluated for the first time to decide whether he or she has a disability, the Board of Education must arrange for appropriate special education programs and services within 60 school days of receiving your consent to evalu ate your child. If the recommendation is for placement in an approved in-State or out-of-State private school, then the Board of Education will arrange for such pro grams and services within 30 school days of the Board receipt of the recommen dation from the Committee. Review If your child is a child with a disability whose special education programs and services are being reviewed, the Board of Education must arrange for appropriate special education programs and services within 60 school days of the referral for review. If the recommendation is for placement in an approved in-State or out-of-State private school, then the Board of Education will arrange for such programs and services within 30 school days of the Board receipt of the recommendation from the Committee. Informal discussions If you have concerns about your child’s educational program, discuss these concerns with appro priate staff at the school district. If you disagree with evaluation results or other proposed actions of the Committee, such as the recommendation, placement or implementation of the program, you should express your disagreement and dissatisfaction. By clearly sharing your concerns and the rea sons for your concerns, you are making sure that the other members of the Committee understand your point of view. Try to work out differences informally with your school district as soon as they happen. W rite down what was discussed at the meeting, staff present and steps identified to resolve your concerns. If necessary, request a follow-up meeting within a reasonable amount of time to revisit your concerns and to ensure that the steps identified above were implemented as planned. If it is not possible to resolve disagree ments informally, mediation is a good method to work differences out in a timely way. If you decide to use mediation, you must ask for it by writing to the Board of Education (see form on page 35). Any agreement reached by the parties is set forth in a written mediation agreement. W ritten agreements may be presented as part of the record at an impartial hearing. Parties to the mediation process may be required to sign a confidentiality pledge before starting the mediation. Benefits of Mediation Unlike an impartial hearing where the hearing officer makes the final determination as to what is appro priate for your child, a mediator assists you and the district to reach a mutually agreeable determination.
Body lice have been associated with outbreaks of typhus depression symptoms feeling worthless generic clomipramine 50mg with mastercard, trench fever depression symptoms bupa purchase 25mg clomipramine free shipping, and other epidemic conditions in the past among soldiers and refugees depression part 2 buy generic clomipramine 50 mg online. Mode of Transmission Transmission occurs through contact with a person who has body lice or with personal articles such as clothing or bedding that are infested depression symptoms nice purchase cheapest clomipramine. Support the family in accessing showering or bathing facilities and regular changes of clean clothing and bedding. Crab lice are parasitic insects measuring less than 1/8 of an inch that feed on human blood. Because their bodies and claws resemble sea crabs, they are nicknamed “crab lice” or “crabs. Infectious Period Body lice can be spread as long as lice remain alive on the host or in clothing. Individuals with crab lice should be examined by a licensed health care professional for other sexually transmitted infections or diseases. All potentially-affected persons (such as sexual partners or those sharing a bed) should be examined and treated simultaneously to avoid re-infestation. Refer to district infection control program protocols and policy on infectious diseases. Head lice are parasitic insects less than 1/8 of an inch in length that feed on blood from the scalp. Some chemical agents used in the past to eradicate head lice have proven to be dangerous and toxic to children. The information in this section reflects the current thinking of professional groups regarding head lice in schools. The American Academy of Pediatrics provides current clinical reports that clarify and update the protocols for diagnosis and treatment of head lice, and provide guidance for the management of infested children in the school setting. This is because head lice are not able to hold onto these materials or survive without the warmth and blood source of a human scalp. Students with live head lice can remain in class and go home at the end of the school day, be treated, and return to school after the appropriate treatment has begun. Discreetly manage lice infestations so that the student is not ostracized, isolated, humiliated, or psychologically traumatized. Follow-up with the student and family to ensure that the infestation is being addressed appropriately until the infestation has ended. Such policies are not effective in controlling head lice outbreaks for the following reasons: • Many nits are more than 1/4 inch from the scalp, which means they have already hatched and have left an empty casing, or will not hatch because they are too far away from the warm scalp to survive the nit stage. Assure students, parents/guardians, and staff that anyone can get head lice, and it is not an indication of lack of cleanliness. Resources American Academy of Pediatrics: Head Lice Policy (2002) Statement of reaffirmation (2009) Policy revision (2010) aappolicy. National Association of School Nurses, Position statement: Pediculosis Management in the School Setting. These complications include ear infections, diarrhea, pneumonia, encephalitis, and even death. Two to four days after the symptoms begin; a raised, red rash will appear on the head and spread downward to become a full-body rash, usually lasting 5–6 days. Any student with a rash illness, especially if fever and/or other symptoms are present, should be referred to a health care provider for diagnosis. Report to your local health jurisdiction of suspected cases by telephone is mandatory and must be immediate. However, there are still some adults born prior to 1957 that have had neither the vaccine nor the disease and thus remain susceptible. If a student in your school develops confirmed measles, your local health officer may require implementation of the following control measures: a. Outbreak control measures listed above also apply to all staff at the affected school. Diagnosis is made by a spinal tap and a blood or joint culture, depending on the symptoms. Report to your local health jurisdiction immediately suspected or confirmed cases of meningitis or outbreaks associated with a school. Referral to licensed health care provider of suspected cases is immediate and mandatory for meningitis. Exclude from school until licensed health care provider releases student in consultation with your local health jurisdiction. Teachers and the parent/guardian should contact their licensed health care provider or local health jurisdiction if they have further questions about preventive measures. Your local health jurisdiction will provided specific guidance in these situations. Instruct students not to share items that may be contaminated with saliva such as beverage containers. The meningococcal conjugate vaccines can be used at ages as early as 9 months for certain high risk infants/toddlers. Follow standard precautions when doing wound care or touching a patient’s mucous membranes. Cover any wound that is draining or has pus with a clean, dry bandage that is closed on all four sides. If a draining wound cannot be safely covered, consult with health care provider to determine when it is safe for a student to return. Strongly encourage showering with soap immediately after participating in sports involving close personal contact. Having atopic dermatitis, the most common type of eczema, also increases the risk of getting Molluscum Contagiosum. In healthy individuals, these lesions ultimately disappear without scarring, unless there is excessive scratching, which may leave marks. Because Molluscum Contagiosum is self-limited in healthy individuals, treatment may be unnecessary. Participation in close-contact sports such as wrestling and basketball, or those that use shared equipment like gymnastics and baseball should be avoided unless all lesions can be covered by clothing or bandages. Seek guidance from the licensed health care provider to determine when the student can safely return to these activities. Other items and equipment (such as kick boards and water toys) should be used only when all bumps are covered by clothing or watertight bandages. In some cases, covering the lesions with a bandage may help stop scratching and spread of the virus. Around 80 percent of people infected with West Nile virus will not show any symptoms. Encephalitis is an inflammation of the brain with severe symptoms including high fever, headache, neck stiffness, disorientation, convulsions, muscle weakness, vision loss, numbness, paralysis, and coma. Over 30,000 cases of West Nile virus infection have been reported in this country with 45 cases acquired in Washington State. Mosquitoes become infected with the West Nile virus when they feed on infected birds, particularly crows and related birds. Encourage field trip participants to wear a long sleeved shirt, long pants, and a hat when going into mosquito-infested areas such as wetlands or woods. Mumps patients may have fever, headache, and mild respiratory symptoms or may have no symptoms other than parotitis. Mode of Transmission Transmission is by direct contact with or droplet spread of the saliva of infected persons. It should be remembered that approximately one-third of all susceptible individuals exposed to mumps will not develop apparent disease but will still be infectious. Infectious Period Mumps virus has been found in the saliva from 7 days before to 9 days after the onset of parotitis (salivary gland infection). However, persons with mumps are most contagious from 2 days before the onset of illness to 4 days after swelling first appears. Infectious Period Peak viral shedding is 2–5 days after infection, and may continue for 2 weeks or more. Noroviruses are highly contagious and as few as 10 viral particles may be sufficient for infection. Immediately report to your local health jurisdiction suspected or confirmed foodborne outbreaks associated with a school.
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