A 17-year-old African American female from the inner city complains of severe chest and abdominal pain. Upon examination, the attending physician performs an EKG, chest x-ray, and an abdominal and chest clinical examination and finds nothing. Assuming she is drug seeking, he sends her home. She comes back to the ER 4 hours later and now you see the patient. She explains that she was running track this past afternoon at school and that despite being very hot (100 F) she pushed on. Afterwards, she starts feeling extensive pain in her chest and abdomen. She has jaundiced eyes, her blood pressure is 98/50, pulse is 112, T = 99.9 F, R = 28. The pain seems out of proportion to the physical findings. During a review of her medical history, she tells the provider that she has history of sickle cell anemia. At this time, it is determined that she is in a sickle cell crisis. What is the etiology of sickle cell anemia? Describe in detail the pathophysiological process of sickle cell anemia. Identify hallmark signs identified from the physical exam and symptoms. Describe the pathophysiology of complications of sickle cell anemia. What teaching related to her diagnosis would you provide?
Truancy can occur through approved and unapproved nonattendance and these can be gathered into: situational, individual and participation factors. Causes: migraines, hang-over icy influenza, unchallenging occupations and poor administration are regular reasons for truancy and chiefs for the most part suspicious of workers' explanations behind non-appearance. Impacts: Unplanned nonattendance is disorganising, baffling and costly for associations. UK non-appearance rate in European is like Denmark, (see p11-12). Non-attendance is emphatically associated with worker inspiration and fulfillment. Battling non-attendance: nonappearance can be limited by giving testing occupations, compensating participation and keeping up a zero resistance to nonattendance. Come back to-work interviews are experimentally demonstrated strategy for lessening non-attendance in nearby government. Including, examining enterprises with bring down nonattendance rate may demonstrate a helpful apparatus for limiting truancy in neighborhood government. This report recognizes that confinements, for example, security and Human Rights laws shields laborers protection from being attacked by associations, HR administrators should know there impediments. 2.0-INTRODUCTION Non-appearance is the evasion of or inability to go to one's work environment henceforth unfit to play out a legally binding working commitment attributable to nonattendance. As it were, non-attendance is spontaneous or arranged nonattendance made by a worker purposefully, for example, intentionally staying away from work through non-participation for individual reasons or accidentally like maternity leave, deprivation and sick wellbeing. This examination article should bind the answer to purposeful or self made truancy which can be problematic, costly and hard to oversee, (Armstrong, 2006). Without a doubt, this type of non-attendance is the most exceedingly awful bad dream of all chiefs due to dealing with a similar workload with restricted workforces. As per Benington, (2000) site in (McHugh, 2001) the UK neighborhood government has turned into a ''last shot cantina'' which means inability to 'set up' will require government takeover or privatization. Besides, CBI, (2004) refered to in Taylor (2005), recognized that non-attendance costs the UK government £12 billion pounds yearly. Presenteeism is the inverse of non-appearance and it signifies '110%' participation with the view to awing one's manager. The most standard specified 'causes' of truancy revealed by workers particularly in nearby government are: migraines, cool, influenza, worry, back agony, nourishment harming and family issues. It must be expressed that different causes, for example, dreary employments, poor administration, initiative, and hierarchical atmosphere are factors. 3.0-LITERATURE REVIEW 3.1-CAUSES OF ABSENTEEISM Open area non-appearance has pulled in much research particularly in the nearby government most likely due to better checking frameworks, for example, broad documentation than the private division. Critical is the way that there are no all around concurred reasons for non-attendance notwithstanding; there are some consistent refered to ones are asserted to add to non-attendance. As indicated by Taylor, (2005), a think-tank called My Voice affirmed that 56% of workers confessed to taking a 'sickie'. That is quieting nonattendance from work under misrepresentation. Strikingly, the genuine reasons stipulated by the review for the nonappearance incorporates: hung-over, stress and disdain for the activity itself. Thus, chiefs are for the most part suspicious of representatives guaranteeing nonattendance on wiped out grounds in light of the above study. Such discoveries breeds doubt amongst directors and their representatives. Clearly, one can comprehend why supervisors may be disappointed by workers' nonappearance since it conveys turmoil to administration designs and the execution of planned exercises. Gennard, Judge, (2005) are of the view that passing, paternity leave, powerlessness to come back from arranged occasions and ' asserted ailment's are the primary driver of non-appearance. It is plentifully evident that mourning causes non-attendance yet on restricted scale in any case, this report is less worry with that type of non-appearance since it is common as opposed to deliberate. Paternity leave being a reason for nonattendance may sound astounding nonetheless, this report keeps up that paternity leave despite the fact that an arranged non-attendance, may potential reason some shape approved nonappearance for reasons like a sudden advancements, for example, mother falling wiped out, infant's wellbeing, family and family visits and get-togethers. This report keeps up that the likelihood of this type of non-appearance being manhandled isn't improbable. Including, arranged occasions may deteriorate into spontaneous nonappearance because of certain unanticipated conditions. This is probably going to influence the individuals who take occasions abroad. This type of spontaneous nonattendance may be caused by flight deferrals and cancelations because of political issues like wars and challenge as occurred in Thailand, catastrophic events, for example, illness episode, for instance the pandemic ''H1N1 Swine Flu'' which initially broke out in Mexico and so far as that is concerned the isolate of contaminated casualties must be done, seismic tremors as occurred in Indonesia. As per Armstrong, (2006), the reasons for truancy could be extensively credited to three (3) factors to be specific: 'Situational factors, Personal elements and Attendance factors': 'Situational elements' incorporate the idea of the activity itself; is it tedious and exhausting or fascinating and testing enough? Clearly, a tedious activity may create pressure and employment hatred. The kind of authority and authoritative atmosphere workers work under may create non-attendance. While consenting to some broaden that these situational elements may produce non-attendance, it merits recognizing that a few people abhor change and will dependably battle to keep up the norm. These individuals may preferably favor completing a redundant activity than a testing one. 'Individual elements' are: the value of a representative, his or her identity, age and sex may add to a worker nonattendance. This exploration report surrenders to the way that these expressed variables are influencer of non-attendance in neighborhood government in view of a substantial research: Barmby et al, 'review' (1999) refered to in Taylor (2005), p316 recorded that men were probably not going to be missing from work than their female partners and much more significant was the way that England has bring down truancy than any were else in the UK. Obviously, the wage difference over the UK has a ton to with it subsequently the least rate (truancy) in England than anyplace else in the UK. In conclusion, participation factors incorporate; the kind of motivators designated to compensating great worker conduct like standard participation and additionally infection arrangements. Most individuals react emphatically to impetuses and rewards both in kind and in real money. As per Jacqueline A.- M et al, (2003), the 'mental contract' assumes a critical part in contributing adversely or decidedly to worker execution and states of mind in the neighborhood government. Truancy is slowly picking up the attention it merits in the nearby government as per CBI, (1999); Local Government Auditor, 1999) refered to in (McHugh, 2001). This report is of the view that associations either private or the nearby government can never again stand to stay in a vacuum yet rather to look up to the difficulties like the capriciousness of the showcasing condition. This implies every single nearby government and associations are constrained to influence the essential investment funds they to can get from all regions to get by in this forceful however convincing advertising condition called 'the survival of the fittest.' indeed, there has never been a century that has forced and constrained change on all way of associations like the 21st century. The present business condition is one that continually says continue changing or you will be made outdated. Moreover, Johansson, Palme, (2002) recommended that an uplifting state of mind to 'a transient affliction and assessments' supports non-appearance. As such, reassuring 'caretaker culture, for example, paying for wiped out leave urges nearby government laborers to take off wiped out for private reasons other than honest to goodness ailment. So, such approaches however well meaning may rather be underestimated and rather manhandled. IDS, (2001b, pp2-3) refered to in (Taylor 2005), p329 recommended that people in general part laborers records higher non-attendance than the private division on the grounds that, there are less corrective measures taken against open workers than their private segment partners. This examination loans support to some reach out to the contention in any case, as opposed to the point; nearby government associations do set aside longer opportunity to act because of administrations yet does not really imply that correctional measures are not practiced in the general population area as guaranteed. Including, this report bolsters the view that non-attendance is more common in the private than the general population part. This is because of the way that open workers get better treatment and are esteemed reasonably than their private area partners (the mental contract), (Jacqueline A.- M et al, 2003). This report watches that specific gatherings are famous for recording high rate of truancy for example, Northern Ireland boards than those in England, (McHugh, 2002). In synopsis, there are abberations between England, Wales, Scotland and Northern Ireland as respects to non-attendance. What's more, in Europe all in all, the UK isn't doing seriously agreeing UK government insights. Likewise, poor record keeping supports non-appearance. On the off chance that associations and so far as that is concerned nearby government associations like the NHS, stays up with the latest records of all worker nonappearance, it would debilitate non-appearance on the grounds that the vast majority abhor being checked. Legitimate documentation and observing of worker nonappearance is probably going to create the required consideration truancy merits prompting an aggregate activity against the perpetrat>GET ANSWER