FOOD PREPARATION

the five keys to safer food

Keep clean Separate raw and cooked Cook thoroughly Keep food at safe temperatures Use safe water and raw materials

LEPTOSPIROSIS
Other names: weils disease, mud fever, trench fever, flood fever, spirochetal jaundice, japanese sven days fever. a bacterial zoonotic disease caused by spirochaetes of the genus Leptospira that affects humans and a wide range of animals, including mammals, birds, amphibians, and reptiles first described by Adolf Weil in 1886 when he reported an acute infectious disease with enlargement of spleen, jaundice and nephritis

Causative Agent : leptospira interrogans- bacteria spirochete. Rat is the main host. Mode of transmission : skin contact ( open wound) , infected urine Incubation period : 7- 19 days average of 10 days Period of communicability : not usually transmitted from person to person Pathognomonic sign : leptospiremic phase : leptospires are present im blood and CSF, onset of symptoms is abrupt, fever,headache,myalgia,nausea,vomiting,cough,chest pain, scanty urine output. Immune phase : correlates with the appearance of circulating IgM. Diagnostic procedure : clinical manifestations, culture of organism, examination of blood and CSF during the first week of illness and urine afetr the 10th day, leptospira agglutination test. Medication : penicillins and other related B-lactam antibiotics , tetracycline ( doxycycline) , erythromycin. Most common complcation : kidney failure Prevention : Protective clothing, boots and gloves Eradication of rats

Segregation of domestic animals Awareness and early diagnosis Improved education of people Avoid wading or swimming in water contaminated with urine of infected animanls

Concurrent disinfection of articles soiled with urine. Causative Agent: Leptospira-genus bacteria was isolated in 1907 from post mortem renal tissue slice commonly found: Leptospira pyrogenes, Leptospira manilae, & other species like L. icterohemorrhagiae, L. canicola, L. batavia, L. Pomona, L. javinica in animals often is subclinical; an infected animal may appear healthy even as it sheds leptospires in its urine; humans are dead-end hosts for the leptospire Predisposing Factors: age: < 15 years of age sex: male season: rainy months geographic: prevalent in slum areas Source of Infection Infection comes form contaminated food and water, and infected wild life and domestic animals especially rodents. 1. Rats ( L. leterohemoragiae) are the source of Weils disease frequently observed among miners, sewer, and abattoir workers. 2. Dogs (L. canicola) can also be the source of infection among veterinarians, breeders, and owners of dogs. 3. Mice (L. grippotyphosa) may alos be a source of infection that attacks farmers and flax workers. 4. Rats (L. bataviae) are the source of infection that attacks ricefield workers. Modes of Transmission Incubation Period: 6 15 days/ 2 8 weeks Clinical Manifestations: 1st stage: Septicemic/ Leptospiremic Phase (4 7 days) - onset of high remittent fever, chills, headache, anorexia, nausea & vomiting, abdominal pain, joint pains, muscle pains, myalgia, severe prostration, cough, respiratory distress, bloody sputum. 2nd stage: Immune/ Toxic Phase (4 30 days) - if severe, death may occur between the 9th & 16th day 2 types: Anicteric (without jaundice) return of fever of a lower degree with rash, conjunctivalinjection, headache, meningeal manifestations like disorientation, convulsions & signs of meningeal irritations (with CSF finding of aseptic meningitis)

Icteric (with jaundice) Weil syndrome; hepatic & renal manifestations: hemorrhage, hepatomegaly, hyperbilirubinemia, oliguria, anuria with progressive renal failure; shock, coma & congestive heart failure in severe cases 3rd stage: Convalescence Phase - Relapses may occur during 4th or 5th week Diagnosis: culture: blood (1st week) CSF (5th to 12th day) Urine (after 1st wk til pd of convalescence) agglutination tests ( 2nd or 3rd week) Complications: pneumonia iridocyclitis, optic neuritis peripheral neuritis Prognosis: cause of death: renal & hepatic failure dse usually last 1 3 weeks but may be more prolonged; relapse may occur Treatment: specific measures: beneficial if done < 4 days of dse Aqueous penicillin G (50,000 units/kg/day in 4-6 divided doses intravenously for 710 days Tetracycline (20-40 mg/kg/day in 4 doses); may not be given to children < 8 years old general measures symptomatic & supportice care administration of fluid, electrolytes & blood as indicated peritoneal dialysis (for renal failure)

Nursing Interventions: isolation of patient: urine must be properly disposed health teachings: keep a clean environment

Different developmental theories of growth and development

ERICK ERIKSON Erikson's Psychosocial Stages
Erikson's Stages of Psychosocial Development

Stage

Importa Outcome nt Events Infancy (birth Trust vs. Feeding Children develop a sense of trust when caregivers to 18 months) Mistrust provide reliabilty, care, and affection. A lack of this will lead to mistrust. Early Autonomy Toilet Children need to develop a sense of personal Childhood (2 vs. Shame Training control over physical skills and a sense of to 3 years) and Doubt independence. Success leads to feelings of autonomy, failure results in feelings of shame and doubt. Preschool (3 Initiative Explorati Children need to begin asserting control and to 5 years) vs. Guilt on power over the environment. Success in this stage leads to a sense of purpose. Children who try to exert too much power experience disapproval, resulting in a sense of guilt. School Age (6 Industry School Children need to cope with new social and to 11 years) vs. academic demands. Success leads to a sense of Inferiority competence, while failure results in feelings of inferiority. Adolescence Identity vs.Social Teens need to develop a sense of self and (12 to 18 Role Relation personal identity. Success leads to an ability to years) Confusion ships stay true to yourself, while failure leads to role confusion and a weak sense of self. Yound Intimacy Relation Young adults need to form intimate, loving Adulthood (19 vs. ships relationships with other people. Success leads to to 40 years) Isolation strong relationships, while failure results in loneliness and isolation. Middle GenerativitWork Adults need to create or nurture things that will Adulthood (40 y vs. and outlast them, often by having children or creating to 65 years) Stagnation Parentho a positive change that benefits other people. od Success leads to feelings of usefulness and accomplishment, while failure results in shallow involvement in the world. Maturity(65 to Ego Reflectio Older adults need to look back on life and feel a death) Integrity n on Life sense of fulfillment. Success at this stage leads to vs. Despair feelings of wisdom, while failure results in regret, bitterness, and despair.

Basic Conflict

JEAN PIAGET
Stages of Cognitive Development
Stage Sensori-motor (Birth-2 yrs) Characterised by Differentiates self from objects Recognises self as agent of action and begins to act intentionally: e.g. pulls a string to set mobile in motion or shakes a rattle to make a noise

Achieves object permanence: realises that things continue to exist even when no longer present to the sense (pace Bishop Berkeley) Pre-operational (2-7 years) Learns to use language and to represent objects by images and words Thinking is still egocentric: has difficulty taking the viewpoint of others Classifies objects by a single feature: e.g. groups together all the red blocks regardless of shape or all the square blocks regardless of colour Concrete operational (7-11 years) Can think logically about objects and events Achieves conservation of number (age 6), mass (age 7), and weight (age 9) Classifies objects according to several features and can order them in series along a single dimension such as size. Formal operational (11 years and up) Can think logically about abstract propositions and test hypotheses systemtically Becomes concerned with the hypothetical, the future, and ideological problems

. Kohlbergs Stages of Moral Development LEVEL AND STAGE LEVEL I: Pre-conventional (Birth to 9 years) DESCRIPTION Authority figures are obeyed. Misbehavior is viewed in terms of damage done. A deed is perceived as wrong if one is punished; the activity is right if one is not punished.

Stage 1: Punishment & obedience orientation Stage 2: Instrumental-relativist orientation

Right is defined as that which is acceptable to & approved by the self. When actions satisfy ones needs, they are

right. LEVEL II: Conventional (9-13 years) Stage 3: Interpersonal concordance Stage 4: Law and order orientation Cordial interpersonal relationships are maintained. Approval of others is sought through ones actions. Authority is respected. Individual feels duty bound to maintain social order. Behavior is right when it conforms to the rules. LEVEL III: Postconventional (13+ years) Stage 5: Social contract orientation Stage 6: Universal ethics orientation It is wrong to violate others rights. The person understands the principles of human rights & personal conscience. Person believes that trust is basis for relationships. Individual understands the morality of having democratically established laws.

Fowlers Stages of Faith

STAGE Pre-stage: Undifferentiated faith Stage 1: Intuitiveprojective faith AGE Infant CHARACTERISTICS Trust, hope and love compete with environmental inconsistencies or threats if abandonment. Imitates parental behaviors and attitudes about religion and spirituality. Has no real understanding of spiritual concepts. Stage 2: Mythicalliteral faith School-aged child Accepts existence of a deity. Religious & moral beliefs are symbolized by stories. Appreciates others viewpoints.

Toddlerpreschooler

Accepts concept of reciprocal fairness. Stage 3: Syntheticconventional faith Stage 4: Individuativereflective faith Stage 5: Conjunctive faith Stage 6: Universalizing faith Adolescent Late adolescent & young adult Adult Adult Questions values & religious beliefs in an attempt to form own identity. Assumes responsibility for own attitudes & beliefs.

Integrates other perspectives about faith into own definition of truth. Makes concepts of love & justice tangible.

Harry Stack Sullivan Sullivan saw interpersonal development as taking place over seven stages, from infancy to mature adulthood. Personality changes are most likely during transitions between stages. Infancy The period from birth until the emergence of syntaxic language is called infancy, a time when the child receives tenderness from the mothering one while also learning anxiety through an empathic linkage with the mother. Anxiety may increase to the point of terror, but such terror is controlled by the built-in protections of apathy and somnolent detachment that allow the baby to go to sleep. During infancy children use autistic language, which takes place on a prototaxic or parataxic level. Childhood The stage that lasts from the beginning of syntaxic language until the need for playmates of equal status is called childhood. The childs primary interpersonal relationship continues to be with the mother, who is now differentiated from other persons who nurture the child. Juvenile Era The juvenile stage begins with the need for peers of equal status and continues until the child develops a need for an intimate relationship with a chum. At this time children should learn how to compete, to compromise, and to cooperate. These three abilities, as well as an orientation toward living, help a child develop intimacy, the chief dynamism of the next developmental stage. Preadolescence Perhaps the most crucial stage is preadolescence, because mistakes made earlier can be corrected during preadolescence, but errors made during preadolescence are nearly impossible to overcome in later life. Preadolescence spans the time from the need for a single best friend until puberty. Children who do not learn intimacy during preadolescence have added difficulties relating to potential sexual partners during later stages. Early Adolescence With puberty comes the lust dynamism and the beginning of early adolescence. Development during this stage is ordinarily marked by a coexistence of intimacy with a single friend of the same gender and sexual interest in many persons of the opposite gender. However, if children have no preexisting capacity for intimacy, they may confuse lust with love and develop sexual relationships that are devoid of true intimacy. Late Adolescence Chronologically, late adolescence may start at any time after about age 16, but psychologically, it begins when a person is able to feel both intimacy and lust toward the same person. Late adolescence is characterized by a stable

pattern of sexual activity and the growth of the syntaxic mode, as young people learn how to live in the adult world. Adulthood Late adolescence flows into adulthood, a time when a person establishes a stable relationship with a significant other person and develops a consistent pattern of viewing the world.

JOHN WESTERHOFF
Our lives as people of faith can best be understood as a pilgrimage that moves slowly and gradually through ever-expanding expressions. 1. Affiliative Faith The beginning, typical of children through the high-school years, I have characterized as a iliative faith . . .it comes through feelings or sensory experiences in the form of interactions with others and our world. The foundations of faith are found in experiences in which we learn to trust other people, ourselves, and our world, not because we are told we are of worth and the world is trustworthy, but because we experience it as such . . .our actions with our children influence their perceptions and hence their faith much more than the words we speak. Our actions frame what our children will experience . . .Affiliative faith looks to the community and its tradition as its source for authority. We depend on significant others for the stories that explain our lives and how our people live. Belonging to a community is very important in order to fulfill our need to be wanted and accepted. 2. Searching Faith Begins during high-school years and extends through early adulthood. It is characterized by questioning, critical judgement, and experimentation. It comes in the form of doubt and the struggle to frame philosophical formulations. Through a personal search for truth, we move from dependence on others' understandings to autonomy and independence. To find a faith of our own, we need to doubt, question, and test what has been handled down to us. 3. Mature Faith .which integrates the seeming contradiction of affiliative and searching faith. Possible for adults who have passed through the earlier stages, mature faith begins in middle adulthood and develops until death. In this final stage we are governed by neither the authority of the community nor our own intellectual authority, but by personal union with God

through free acts of the will. Interdependence integrates the dependence of affiliative faith and the independence of searching faith. Belonging is still important, but people with mature faith are secure enough in their convictions to challenge the community when conscience dictates . . .We all grow by being with others, who affirm where we are and share with us lives of more expanded faith. So it is that we adults need to concerned first of all about our own growth, and we need always to remember that even mature faith has at its core a childlike faith

Legal basis of the school health program

Legal Bases of the School Health Program In line with the Preamble of the 1986 Constitution of the Philippines promulgated in order to build a just and humane society, establish a government that shall embody our ideals and aspirations and promote the common good of the Filipino people, the School Health and Nutrition Program an integral part of the total school program with special focus on the health development of the child, anchors on the following legal bases;

1.PD 603 Child and Youth Welfare Code 2. 1986 Constitution of the Philippines 3. Executive Order No. 14 s. 1946 Creation of the Medical and Dental Services granting authority for the voluntary contribution of 50 centavos per pupil for the maintenance of the service. 4. RA No. 951 s. 1947 Medical inspection of school children enrolled in private schools, colleges and universities in the Philippines. 5. RA No. 847 s. 1953 Return of the Medical and Dental Services from the Department of Health to the Department of Education. 6. RA No. 1082 s. 1954 An act strengthening health and dental service in the rural areas and providing funds thereof. 7. RA No.2620 s. 1961 Nationalization of the Medical and Dental Services of the Bureau of Public Schools, Deparrtment of Education. 8. Presidential Proclamation No. 255 s. 1967 Observance of National Health Education Week on October 10-16 of every year. 9. Article V Sec. 29 s. 1972 Dangerous Drug Act- Integration of Drug Education concept in the School Curricum. 10. PD No. 491 s. 1974 Designated July as Nutrition Month for the purpose of creating greater awareness among the people on the importance of nutrition. 11. PD No. 491 s. 1974 Nutrition Act of the Philippines- Creation of a National Nutrition Council with DECS as a member. 12. RA No. 856 s. 1975

Code of Sanitation of the Philippines 13. LOI No. 441 s. 1976 Mandated the integration of Nutrition Education in the school curriculum. 14. LOI No. 764 s. 1977 Creation of School Health Guardian Program. Its concept was focused on the training of the teachers to assume responsibilities in providing school health services in the absence of school health personnel. 15. LOI No. 764 1978 Declaring the School Health Program a priority program of the national government with the aim of educating teachers and school children in the use of medicinal plants as simple remedies for common ailments. 16. Section of 938 of the Revised Administrative Code Provides that the Bureau of Public Schools shall have specified powers regarding health teaching physical education and to prescribe rules on personal hygiene within the public school premises. 17. E.O. No. 234, s. 1987 Reorganizing the National Nutrition Council- The revised function of member agencies like DECS have been affected. 18. P.P. No. 335, s. 1988 Observance of Drug Abuse Prevention and Control Week every 3rd week of November. 19. Republic Act 7624, s. 1992 An act integrating Drug Prevention and Control in the Intermediate and Secondary Curricula as well as in Non-Formal and Indigenous Learning Systems and for other purposes. Historical background of school health in the Philippines 1900- health instruction and health service started in the public schools with the classroom teacher as the central figure. This period was occasioned by frequent out breaks of epidemic such as cholera, smallpox, and dysentery. 1904- school health services were formally instituted. Health bulletins were issued by the Director of Health for enlightenment of the school personnel and the public. 1911- Physical examination of children was required by law.

1924- school nursing was rendered by a nurse employed by the Bureau of Health in Tacloban City. 1915- provincial school nurses were employed with the primary aim of preventing diseases among children and providing remedial health work. 1917- four graduate burses paid by the City of Manila were employed to work in the City Schools. Provinces that afford to carry out school health services were encouraged to employ a district nurse. 1919- the School Nursing Service in the Philippines formally emerged as an integral component of the School Health Program under the Bureau of Education. A systemic nursing and health and health education service in the schoolwas established by DR. Luther Bewly. 1923- The Medical Services of the Bureau of Health, the Dental Services of the American Junior Red Cross and the Health Education Section of the Bureau of Public Instruction worked cooperatively as a team under the School Health Program until the outbreak of World War II on December 8,1941. 1931- Preliminary group training of teacher-nurses was initiated in the General Office of the Bureau of Education. The Philippine Normal School started to offer health education courses followed by other private teacher training institutions. 1946- The Medical and Dental Service Division in the Bureau of Public Schools was established. 1960- The Medical and Dental Services in the Department of Education was nationalized. 1972- Drug Abuse Education was integrated in the school curriculum. 1975- As an offshoot of the decentralization of the Department of Education, Culture and Sports, Medical, Dental, and General Education Supervisor items were created in the regional offices. Nutrition Act of the Philippines was approved into law. 1977- The School Health Service and Program Unit was changed to School Health and Nutrition Center per Letter of Instruction 764. 1987-The School Health Program Manual was developed in Banilad, Cebu City. DECS- TB Control Program was launched.

DECS through the School Nutrition Program was mandated to integrate the ANP, PL480, Food Assistance Program and the Applied School Nutrition Program. 1989- The School Health Program Manual was revised at Teachers Camp, Baguio City. 1992- The School Health Nutrition Program Manual had its second revision at Banilad, Cebu City. 1995- The National Drug Education Program was institutionalized in all regions.

1996- School-Based AIDS Education Project was implemented in all elementary and secondary schools nationwide. 1997- Third Revision of the School Health and Nutrition service Manual at Imus Sports Center, Imus, Cavite.