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Wednesday, 22 July 2015

MANAGEMENT- COMMUNICATION



Communication
The exchange of ideas, messages, or information by speech, signals, or writing.

Communication Skills
Communication skills are the tools that we use to remove the barriers to effective communication.

Goal
·         The goal of communication is to convey information &
·         the understanding of that information
from one person or group to another person or group.


THE COMMUNICATION PROCESS



The main components of communication process are as follows:
1.         Context - Communication is affected by the context in which it takes place. This context may be physical, social, chronological or cultural. Every communication proceeds with context. The sender chooses the message to communicate within a context.
2.         Sender / Encoder - Sender / Encoder is a person who sends the message. A sender makes use of symbols (words or graphic or visual aids) to convey the message and produce the required response. Sender may be an individual or a group or an organization. The views, background, approach, skills, competencies, and knowledge of the sender have a great impact on the message.
3.         Message - Message is a key idea that the sender wants to communicate. It is a sign that elicits the response of recipient. It must be ensured that the main objective of the message is clear.
4.         Medium - Medium is a means used to exchange / transmit the message. The choice of communication medium varies depending upon the features of communication.
5.         Recipient / Decoder - Recipient / Decoder is a person for whom the message is intended / aimed / targeted. The degree to which the decoder understands the message is dependent upon various factors such as knowledge of recipient, their responsiveness to the message, and the reliance of encoder on decoder.
6.         Feedback - Feedback is the main component of communication process as it permits the sender to analyze the efficacy of the message. It helps the sender in confirming the correct interpretation of message by the decoder. Feedback may be verbal (through words) or non-verbal (in form of smiles, sighs, etc.). It may take written form also in form of memos, reports, etc


FORMS OF COMMUNICATION:
Oral
Oral communication makes up the bulk of business communication today. Effectively communicating orally requires knowledge of the topic at hand, critical thinking ability and great interpersonal skills. Those skilled with oral communication are also typically good listeners who pay attention to verbal and nonverbal communication clues.
Nonverbal
People communicate nonverbally via body language and facial expressions. Eye contact, gestures and proximity to the speaker are all examples of nonverbal communication.  It's important to pay attention to your body language and posture when speaking or listening to someone else.
Written
Written communication in today's workplace commonly takes the form of email. Effective communication and proper etiquette are no less important in electronic form than they are on the written page. Keep business correspondence professional. Use correct grammar, punctuation and spell check every message before sending. Follow the same rules of etiquette in email that you would in any other business setting. Many employees consider email the most effective form of office communication.
  

COMMUNICATION BARRIERS
Communication Barriers are the various obstacles and hurdles which arise in between of an effective communication leading to misunderstandings and misinterpretations by the receiver. They result in distortion of the message and the goal is never accomplished.

Impatient Listener
The listener should be patient enough to absorb the complete information and then respond accordingly. Always jot down your points and start off with your queries once the sender is through with the communication. Don’t jump in between the conversation.
           
Misinterpretation
This can stem from poor communication efforts by the message sender. Language and communication differences are common as companies become more diverse. Additionally, noises and distractions in the work environment can cause confusion during the reception and interpretation of messages.
Low pitch and tone
Sometimes even the pitch and tone can play a communication barrier. Your content might be accurate and related, but if your pitch is low your information will never reach the listeners. The tone has to be very clear and loud for delivering correct information.
Ignoring the content
One should lay emphasis on the content of his speech. The content has to be clear and above all interesting. Don’t just speak; take some time to find out what you are speaking. Don’t make your speech monotonous otherwise the listeners after sometime will definitely fall asleep or bored.
Unorganized Thought
Unorganized and haphazard thoughts also are instrumental in poor communication and a very important barrier to effective communication.
Cultural level
In any organization, an individual can never think on the same line as his boss does. There is always a difference in their thought process.
Lack of Knowledge
 Employees generally lack knowledge about the company, its products and their jobs. This can contribute to poor production, creativity and results within the organization. It can also lead to poor communication and ineffective results during interactions with clients or customers.



7Cs OF COMMUNICATION
The 7 Cs provide a checklist for making sure that your meetings  , emails  , conference calls  , reports  , and presentations   are well constructed and clear ,so your audience gets your message.
According to the 7 Cs, communication needs to be:
Clear.
Concise.
Concrete.
Correct.
Coherent.
Complete.
Courteous.

1. Clear
Your messages need to be clear if they are to be effective. When writing or speaking to someone, be clear about your goal or message. What is your purpose in communicating with this person? If you're not sure, then your audience won't be sure either.
To be clear, try to minimize the number of ideas in each sentence. Make sure that it's easy for your reader to understand your meaning. People shouldn't have to make assumptions on their own to understand what you're trying to say.
2. Concise
If you want your messages to be read by busy people, make them brief. Remove all words phrases and sentences that serve no purpose. You can also eliminate wordiness by substituting one word for wordy, overused expressions.When you're concise in your communication, you stick to the point and keep it brief. Make sure to check,
Are there any unnecessary sentences?
Have you repeated the point several times, in different ways?

3. Concrete
When your message is concrete, then your audience has a clear picture of what you're telling them. There are details (but not too many) and vivid facts, Your message is solid. You have a choice in your writing to use concrete (specific) or abstract (vague) words. However, concrete items terms are typically mare accurate and, in some cases, more believable.

4. Correct
Correctness includes proposes spelling, grammar, punctuation, and format. For spelling, punctuation and grammar.
When your communication is correct, it fits your audience. And correct communication is also error-free communication.

5. Coherent
When your communication is coherent, it's logical. All points are connected and relevant to the main topic, and the tone and flow of the text is consistent. Ideas need to flow from on to the next through smooth transitions. You can achieve this by outlining your messages, writing simple sentences ad focusing each paragraph on one idea.
6. Complete
In a complete message, the audience has everything they need to be informed and, if applicable, take action. Make sure that you included all relevant information, contact names, dates, times and locations etc.
7. Courteous
Your message should be positive i.e. building goodwill and focused upon the reader. Courteous communication is friendly, open, and honest. There are no hidden insults or passive-aggressive tones. You keep your reader's viewpoint in mind, and you're empathetic to their needs.


 IMPORTANCE OF COMMUNICATION SKILLS:

Communication skills are very important for all managers and leaders.
Good communication skills allow managers and leaders to perform their role more effectively. Their role requires that they communicate. They must communicate many things to many people: they must communicate effectively to the team, to their suppliers, to their customers and financiers.
So it is important that leaders and managers are good communicators.
Communication skills for managers and leaders consist, mainly, of six subset skills:
1.         The ability to set out the goal or the target to be hit.
2.         The ability to communicate the plan of action that, it is hoped will describe successful action, capable of achieving the goal.
3.         The ability to communicate delegated actions: who is going to do which task?
4.         The ability to give corrective critical feedback to the people who are not performing in the proper manner and, in addition, to be able to get them to correct their performance and get "back on track".
5.         The ability to give praise and appreciation to those who are doing a good job.
6.         The ability to communicate the need for constant change, adaptation, refinement and flexibility to the conditions, whilst still remaining faithful to the overall goal and plan.


What are STEROID HORMONES

Steroid hormone is a steroid that acts as a hormone.

They are grouped on the basis of the receptors they bind.
vGlucocorticoids
vMineralocorticoids,
vProgesterone
vAndrogens

vEstrogens
The natural steroid hormones are generally synthesized from cholesterol in the gonads and adrenal glands.
These forms of hormones are lipids.
They can pass through the cell membrane as they are fat-soluble, and then bind to steroid hormone receptors which may be nuclear or cytosolic depending on the steroid hormone, to bring about changes within the cell.
Steroid hormones are generally carried in the blood bound to specific carrier proteins such as SHBPs and CHBPs.
Further conversions and catabolism occurs in the liver, in other "peripheral" tissues, and in the target tissues.
A variety of synthetic steroids and sterols have also been contrived.
Most are steroids, but some non-steroidal molecules can interact with the steroid receptors because of a similarity of shape.
Some synthetic steroids are weaker, and some much stronger, than the natural steroids whose receptors they activate.
Examples Of Synthetic Steroids
ØGlucocorticoids: alclometasone, prednisone,dexamethasone,
ØMineralocorticoid: fludrocortisone
ØVitamin D: dihydrotachysterol
ØAndrogens: apoptone, oxandrolone, oxabolone, testosterone, nandrolone (also known as anabolic steroids)
ØEstrogens: diethylstilbestrol (DES)
ØProgestins: danazol, norethindrone, medroxyprogesterone acetate, 17-Hydroxyprogesterone caproate.
Some steroid antagonists:
ØAndrogen: cyproterone acetate
ØProgestins: mifepristone, gestrinon

Thursday, 18 June 2015

ADRs

Introduction to ADRs


Adverse drug reactions (ADRs), also known as ‘side effects’, ‘adverse
drug events’, or ‘drug misadventures’, are a frequent cause of morbidity in hospital and the community. They have a significant cost both financially and in terms of quality of life. 
Few studies of ADRs have been carried out in the community so the effect on primary care is harder to assess, but studies in the hospital environment have shown the following.

• ADRs occur in 10–20 % of patients in hospital.
• ADRs are responsible for 5 % of admissions to hospital.
• ADRs might be responsible for 1 in 1000 deaths in medical wards.
• ADRs are the most common cause of iatrogenic injury in hospital
patients.

The World Health Organization (WHO) defines an ADR as follows:
‘ a drug-related event that is noxious and unintended and occurs at doses used in
humans for prophylaxis, diagnosis or therapy of disease or for the modification
of physiological function .’

However, this definition does not take into account the following
scenarios, all of which can also cause ADRs:
• overdose (including prescribing or administration errors)
• therapeutic failure
• drug interactions
• drug withdrawal.

Pharmacists have an important role in identifying, reporting, and preventing
ADRs.

Friday, 12 June 2015

Terminology in liver disease


Hepatocellular injury
Damage to the main cells of the liver (hepatocytes)

Hepatitis
 Inflammation of the liver, a type of hepatocellular injury. Could
be caused by viruses, drugs, or other agents, or could be
idiosyncratic.

Cirrhosis
 Chronic, irreversible damage to liver cells, usually caused by
alcohol or hepatitis C. If the remaining cells cannot maintain
normal liver function (compensated disease), ascites, jaundice,
and encephalopathy can develop (decompensated disease).

Cholestasis 
Reduction in bile production or bile fl ow through the bile
ducts.

Liver failure 
Severe hepatic dysfunction where compensatory mechanisms
are no longer suffi cient to maintain homeostasis. Could be
acute and reversible, or irreversible (e.g. endstage cirrhosis).

Anaphylaxis


Symptoms and signs of anaphylaxis
Anaphylaxis is defined as an immediate systems hypersensitivity event produced
by IgE-mediated release of chemicals from mast cells and basophils.
Theoretically, prior exposure to the agent is required and the reaction is
not dose- or route-related, but in practice anaphylaxis to injected antigen
is more frequent, severe, and rapid in onset than following exposure to
oral or topical antigen.
Agents which commonly cause anaphylaxis include:
• drugs — e.g. penicillins, aspirin
• insect stings — e.g. wasp and bee venoms
• food — e.g. nuts.
Urticaria and angioedema are the most common symptoms
and absence of these suggests that the reaction may not be anaphylaxis.
Airways oedema, bronchospasm, and shock are life-threatening and
immediate emergency treatment is usually required.
The onset of symptoms following parenteral antigen (including stings) is
usually within 5–30min. With oral antigen, there is often a delay. Symptoms
usually occur within 2h, but may be immediate and life-threatening.
A late-phase reaction may also occur with recrudescence of symptoms
after apparent resolution. Recurrence is a fairly frequent phenomenon
and healthcare workers should be aware of this. Patients should not be
discharged too quickly as they may require further treatment.
End-of-needle reactions
Some patients may experience an anaphylactic-like reaction during rapid
intravenous (IV) drug administration. This is known as an end-of-needle
reaction. Initial symptoms may suggest anaphylaxis, but in fact this is a
vasopressor effect and can be distinguished from anaphylaxis as bradycardia
occurs which is rare in anaphylaxis. Skin symptoms are also rare
in end-of-needle reactions. Stopping or slowing down the infusion or
injection usually leads to resolution of symptoms,and administration at a
slower rate usually avoids a repeat event.
Signs and symptoms of anaphylaxis
F Urticaria
R Angioedema
E Dyspnoea, wheeze
Q Nausea, vomiting, diarrhoea, cramping abdominal pain
U Flush
E Upper airway oedema
N
T
R Headache
A Rhinitis
R Substernal pain
E Itch with no rash
Seizure

ATOMIC EMISSION SPECTROSCOPY

ATOMIC EMISSION

Technique is also known as OPTICAL EMISSION SPECTROSCOPY (OES)
- The study of radiation emitted by excited atoms and
monatomic ions
- Relaxation of atoms in the excited state results in
emission of light
- Produces line spectra in the UV-VIS and the
vacuum UV regions
Used for qualitative identification of elements present
in the sample
- Also for quantitative analysis from ppm levels to percent
- Multielement technique
- Can be used to determine metals, metalloids, and some
nonmetals simultaneously
Emission wavelength and energy are related by
ΔE = hc/λ
- Does not require light source
- Excited atoms in the flame emit light that reaches the detector
(luminescence)
Techniques Based on Excitation Source
- Flame Photometry (flame OES)
- Furnace (Electrical Excitation)
- Inductively Coupled Plasma (ICP)

FLAME ATOMIC EMISSION SPECTROSCOPY
- Known as Flame OES
- Also called flame photometry
- Solutions containing metals (or some nonmetals) are
introduced into a flame
- Very useful for elements in groups 1A and 2A
INSTRUMENTATION OF FLAME OES
- No external lamp is needed
- Flame serves as both the atomization source and the
excitation source
Main Components
- Burner assembly
- Flame
- Wavelength selection device
- Detector

Burner Assembly
- The most commonly used is the Lundegarth or the premix burner
- Is the heart of the emission spectrometer
- Nebulizer introduces sample aerosol into the base of the flame
- Free atoms are formed and excited in flame
- Excited free atoms emit radiant energy
- Only about 5% of the aspirated sample reach the flame
General Process in Flame
- Liquid samples enter nebulizer
- Sample droplets of liquid enter flame
- Fine solid particles form
- Particles decompose to free atoms
- Excited atoms form
- Excited atoms relax and emit radiation
- Oxidation of atoms occur
Nebulizers commonly used
- Pneumatic
and
- Cross-flow
Wavelength Selection Device
Two wavelength selectors used
- Monochromators
and
 - Filters

Monochromators
- Diffraction grating is used as the dispersion element
Filters
- Good for detection of alkali metals due to simple spectrum
- Material is transparent over a narrow spectral range
- Desired radiation passes through filter and others are absorbed
- One element is determined at a time (single channel)
Multichannel Flame Photometers
- Two or more filters are used simultaneously
- Each filter transmits its designated radiation
- Detector is PMT
- Permits the use of internal standard calibration
Detectors
- PMT
- Solid-state detectors (CCD, CID)
- PDA
Flame Excitation Source
- Two gases (fuel and oxidant) are used
- Oxidant: air or nitrous oxide
- Fuel: acetylene (commonly used), propane, butane, natural gas
- Increase in flame temperature increases emission intensity
of most elements (exception: Na, K, Li)
Each element emits different characteristic wavelength of light
- Emission lines are characterized by wavelength and intensity
Emission intensity depends on
- Analyte element concentration in sample
- Rate of formation of excited atoms in flame
- Rate of introduction of sample into flame
- Flame composition
- Flame temperature
S = kN
S = intensity
k = proportionality constant
N = number of atoms in the excited state
- Increasing temperature increases N
- Atomic emission spectrometry is very sensitive to temperature
- Temperature must be carefully controlled for quantitative analysis

Elements with emission lines at shorter wavelengths give weak
emission intensity at low temperature
- High-temperature nitrous oxide-acetylene flame is used for
such elements
- High-energy electrical or plasma excitation sources may
also be used
- Ratio of fuel to oxidant also affects emission intensity
- The highest temperature is achieved when stoichiometric
mixture is used
INTERFERENCE
Two Classes
- Spectral interference
and
- Nonspectral interference
Spectral Interference
Two types
Background Radiation
- Broad band emission by excited molecules and radicals in flame
Overlapping emission lines
- Emission by different elements of the same wavelength as
the analyte element
Nonspectral Interference
Chemical Interference
- Occurs if anions that combine strongly with analyte element
are present in sample
Excitation Interference
- Result of collisions between unexcited atoms of an element with
excited atoms of a different element in sample
Ionization Interference
- Occurs when atoms ionize in flame and cannot emit atomic λs
APPLICATIONS OF FLAME OES
- For measurement of alkali metals in clinical samples such as
serum and urine
- Excellent method for qualitative determination of multiple
elements in sample
- Characteristic emission lines of analyte are compared
with literature (appendix 7.1)
- Also used for quantitative analysis (application of Beer’s Law)
- Deviation from linearity is generally observed at
high concentrations
- More free atoms are liberated in organic solvents than
in aqueous solutions
- Implies emission intensity is relatively higher in
nonaqueous solutions
- Atomization is exothermic and rapid in organic solvents
- Atomization is endothermic and relatively slow in aqueous
solutions
- External calibrations and standard addition methods are used