Bats are mammals of the order Chiroptera. Bats are more manoeuvrable than birds, flying with their long spread-out digits covered with a thin membrane or patagium; the smallest bat, arguably the smallest extant mammal, is Kitti's hog-nosed bat, 29–34 mm in length, 15 cm across the wings and 2–2.6 g in mass. The largest bats are the flying foxes and the giant golden-crowned flying fox, Acerodon jubatus, which can weigh 1.6 kg and have a wingspan of 1.7 m. The second largest order of mammals, bats comprise about 20% of all classified mammal species worldwide, with over 1,200 species; these were traditionally divided into two suborders: the fruit-eating megabats, the echolocating microbats. But more recent evidence has supported dividing the order into Yinpterochiroptera and Yangochiroptera, with megabats as members of the former along with several species of microbats. Many bats are insectivores, most of the rest are frugivores. A few species feed on animals other than insects. Most bats are nocturnal, many roost in caves or other refuges.
Bats are present throughout the world, with the exception of cold regions. They are important in their ecosystems for dispersing seeds. Bats provide humans at the cost of some threats. Bat dung has been used as fertiliser. Bats consume insect pests, they are sometimes numerous enough to serve as tourist attractions, are used as food across Asia and the Pacific Rim. They are natural reservoirs such as rabies. In many cultures, bats are popularly associated with darkness, witchcraft and death. An older English name for bats is flittermouse, which matches their name in other Germanic languages, related to the fluttering of wings. Middle English had bakke, most cognate with Old Swedish natbakka, which may have undergone a shift from -k- to -t- influenced by Latin blatta, "moth, nocturnal insect"; the word "bat" was first used in the early 1570s. The name "Chiroptera" derives from Ancient Greek: χείρ – cheir, "hand" and πτερόν – pteron, "wing"; the delicate skeletons of bats do not fossilise well, it is estimated that only 12% of bat genera that lived have been found in the fossil record.
Most of the oldest known bat fossils were very similar to modern microbats, such as Archaeopteropus. The extinct bats Palaeochiropteryx tupaiodon and Hassianycteris kumari are the first fossil mammals whose colouration has been discovered: both were reddish-brown. Bats were grouped in the superorder Archonta, along with the treeshrews and primates. Modern genetic evidence now places bats in the superorder Laurasiatheria, with its sister taxon as Fereuungulata, which includes carnivorans, odd-toed ungulates, even-toed ungulates, cetaceans. One study places Chiroptera as a sister taxon to odd-toed ungulates; the phylogenetic relationships of the different groups of bats have been the subject of much debate. The traditional subdivision into Megachiroptera and Microchiroptera reflected the view that these groups of bats had evolved independently of each other for a long time, from a common ancestor capable of flight; this hypothesis recognised differences between microbats and megabats and acknowledged that flight has only evolved once in mammals.
Most molecular biological evidence supports the view that bats form a monophyletic group. Genetic evidence indicates that megabats originated during the early Eocene, belong within the four major lines of microbats. Two new suborders have been proposed. Yangochiroptera includes the other families of a conclusion supported by a 2005 DNA study. A 2013 phylogenomic study supported the two new proposed suborders. In the 1980s, a hypothesis based on morphological evidence stated the Megachiroptera evolved flight separately from the Microchiroptera; the flying primate hypothesis proposed that, when adaptations to flight are removed, the Megachiroptera are allied to primates by anatomical features not shared with Microchiroptera. For example, the brains of megabats have advanced characteristics. Although recent genetic studies support the monophyly of bats, debate continues about the meaning of the genetic and morphological evidence; the 2003 discovery of an early fossil bat from the 52 million year old Green River Formation, Onychonycteris finneyi, indicates that flight evolved before echolocative abilities.
Onychonycteris had claws on all five of its fingers, whereas modern bats have at most two claws on two digits of each hand. It had longer hind legs and shorter forearms, similar to climbing mammals that hang under branches, such as sloths and gibbons; this palm-sized bat had short, broad wings, suggesting that it could not fly as fast or as far as bat species. Instead of flapping its wings continuously while flying, Onychonycteris alternated between flaps and
Cultural competence in healthcare
Cultural competence in healthcare refers to the ability for healthcare professionals to demonstrate cultural competence toward patients with diverse values and feelings. This process includes consideration of the individual social and feelings needs of patients for effective cross-cultural communication with their health care providers; the goal of cultural competence in health care is to reduce health disparities and to provide optimal care to patients regardless of their race, ethnic background, native languages spoken, religious or cultural beliefs. Cultural competency training is important in health care fields where human interaction is common, including medicine, allied health, mental health, social work, oral health, public health fields; the term cultural competence was first used by Terry L. Cross and colleagues in 1989, but it was not until a decade that health care professionals began to be formally educated and trained in cultural competence. In 2002, cultural competence in health care emerged as a field and has been embedded into medical education curriculum since then.
Although cultural competence in healthcare is a global concept, it is practiced in the United States. Cultural competence is defined as a set of congruent behaviors and policies that come together in a system, agency, or among professionals and that enables them to work in cross-cultural situations. Essential elements that enable organizations to become culturally competent include valuing diversity, having the capacity for cultural self-assessment, being conscious of the dynamics inherent when cultures interact, having institutionalized cultural knowledge, having developed adaptations to service delivery reflecting an understanding of cultural diversity. By definition, diversity includes differences in race, age, size, sexual orientation, physical and mental ability. Accordingly, organizations should include these considerations in all aspects of policy making, administration and service delivery. Cultural competence involves more than having awareness of cultures, it necessitates an active process of learning and developing skills to engage in cross-cultural situations and re-evaluating these skills over time.
Cultural competence is used interchangeably with the term cultural competency. A healthcare system, sometimes referred to as health system, is the organization of people and resources that deliver healthcare services to meet the health needs of target populations. A culturally competent health system not only recognizes and accepts the importance of cultural diversity at every level but assesses the cross-cultural relations, stays vigilant towards any changes and developments resulting from cultural diversity, broadens cultural knowledge, adapts services to meet the needs that are culturally-unique; as more and more immigrants are coming to America, healthcare professionals with good cultural competence can use the knowledge and sensitivity that they obtain in order to provide holistic care for clients from other countries, who speak foreign languages. The challenges for American healthcare systems to meet the health needs of the increasing number of diverse patients are becoming obvious; the challenges include but are not limited to the following: Sociocultural barriers Poor cross-cultural communication Language barriers Attitudes toward healthcare Beliefs in diagnosis and treatment Lack of cultural competence in the design of the system In response to a rapid growth of minorities population in the United States, healthcare organizations have responded by providing new services and undergoing health reforms in terms of diversity in leadership and workforce.
Despite improvements and progress seen in some areas, minorities are still underrepresented within both healthcare leadership and workforce. To improve the weak minorities representation in leadership and workforce, an organization must acknowledge the importance of cultures, be sensitive to cultural differences, establish strategic plans to incorporate cultural diversity. According to the national survey of the U. S. healthcare leaders conducted by the search firm Witt/Kieffer, respondents viewed diverse leadership as a valuable business builder. They associated it with improved patient satisfaction, successful decision-making, improved clinical outcomes, stronger bottom line. To recruit and coach minority leaders in healthcare, it is important to keep these social science principles and cultural values in mind: Branding - how health care leaders brand diversity in their organizations? Without inclusion, branding would not be complete The concepts of self-categorization and "othering" Lack of leadership commitment - diversity and inclusion should be an imperative of their organization The compelling national demographics of healthcare leadership and workforce.
To provide culturally sensitive patient-centered care, physicians should treat each patient as an individual and respecting his or her beliefs and care seeking behaviors. However, many physicians lack training in cultural competence. With the changing demographics, their patients are getting diverse as well, it is utterly important to educate physicians to be culturally competent so that they can treat patients of different cultural and ethnic backgrounds. Implicit bias aimed towards certain races or ethnicities is frequent in the healthcare field in the United States with Black Americans, Hispanic Americans, American Indians. Subconscious discrimination occurs regardless of the advancement of disease prevention in the United States, as sho
Nature is a British multidisciplinary scientific journal, first published on 4 November 1869. It is one of the most recognizable scientific journals in the world, was ranked the world's most cited scientific journal by the Science Edition of the 2010 Journal Citation Reports and is ascribed an impact factor of 40.137, making it one of the world's top academic journals. It is one of the few remaining academic journals that publishes original research across a wide range of scientific fields. Research scientists are the primary audience for the journal, but summaries and accompanying articles are intended to make many of the most important papers understandable to scientists in other fields and the educated public. Towards the front of each issue are editorials and feature articles on issues of general interest to scientists, including current affairs, science funding, scientific ethics and research breakthroughs. There are sections on books and short science fiction stories; the remainder of the journal consists of research papers, which are dense and technical.
Because of strict limits on the length of papers the printed text is a summary of the work in question with many details relegated to accompanying supplementary material on the journal's website. There are many fields of research in which important new advances and original research are published as either articles or letters in Nature; the papers that have been published in this journal are internationally acclaimed for maintaining high research standards. Fewer than 8% of submitted papers are accepted for publication. In 2007 Nature received the Prince of Asturias Award for Humanity; the enormous progress in science and mathematics during the 19th century was recorded in journals written in German or French, as well as in English. Britain underwent enormous technological and industrial changes and advances in the latter half of the 19th century. In English the most respected scientific journals of this time were the refereed journals of the Royal Society, which had published many of the great works from Isaac Newton, Michael Faraday through to early works from Charles Darwin.
In addition, during this period, the number of popular science periodicals doubled from the 1850s to the 1860s. According to the editors of these popular science magazines, the publications were designed to serve as "organs of science", in essence, a means of connecting the public to the scientific world. Nature, first created in 1869, was not the first magazine of its kind in Britain. One journal to precede Nature was Recreative Science: A Record and Remembrancer of Intellectual Observation, created in 1859, began as a natural history magazine and progressed to include more physical observational science and technical subjects and less natural history; the journal's name changed from its original title to Intellectual Observer: A Review of Natural History, Microscopic Research, Recreative Science and later to the Student and Intellectual Observer of Science and Art. While Recreative Science had attempted to include more physical sciences such as astronomy and archaeology, the Intellectual Observer broadened itself further to include literature and art as well.
Similar to Recreative Science was the scientific journal Popular Science Review, created in 1862, which covered different fields of science by creating subsections titled "Scientific Summary" or "Quarterly Retrospect", with book reviews and commentary on the latest scientific works and publications. Two other journals produced in England prior to the development of Nature were the Quarterly Journal of Science and Scientific Opinion, established in 1864 and 1868, respectively; the journal most related to Nature in its editorship and format was The Reader, created in 1864. These similar journals all failed; the Popular Science Review survived longest, lasting 20 years and ending its publication in 1881. The Quarterly Journal, after undergoing a number of editorial changes, ceased publication in 1885; the Reader terminated in 1867, Scientific Opinion lasted a mere 2 years, until June 1870. Not long after the conclusion of The Reader, a former editor, Norman Lockyer, decided to create a new scientific journal titled Nature, taking its name from a line by William Wordsworth: "To the solid ground of nature trusts the Mind that builds for aye".
First owned and published by Alexander Macmillan, Nature was similar to its predecessors in its attempt to "provide cultivated readers with an accessible forum for reading about advances in scientific knowledge." Janet Browne has proposed that "far more than any other science journal of the period, Nature was conceived and raised to serve polemic purpose." Many of the early editions of Nature consisted of articles written by members of a group that called itself the X Club, a group of scientists known for having liberal and somewhat controversial scientific beliefs relative to the time period. Initiated by Thomas Henry Huxley, the group consisted of such important scientists as Joseph Dalton Hooker, Herbert Spencer, John Tyndall, along with another five scientists and mathematicians, it was in part its scientific liberality that made Nature a longer-lasti
Biological hazards known as biohazards, refer to biological substances that pose a threat to the health of living organisms that of humans. This can include samples of a virus or toxin that can affect human health, it can include substances harmful to other animals. The term and its associated symbol are used as a warning, so that those exposed to the substances will know to take precautions; the biohazard symbol was developed in 1966 by Charles Baldwin, an environmental-health engineer working for the Dow Chemical Company on the containment products. It is used in the labeling of biological materials that carry a significant health risk, including viral samples and used hypodermic needles. In Unicode, the biohazard symbol is U+2623. Bio hazardous agents are classified for transportation by UN number: Category A, UN 2814 – Infectious substance, affecting humans: An infectious substance in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans or animals when exposure to it occurs.
Category A, UN 2900 – Infectious substance, affecting animals: An infectious substance, not in a form capable of causing permanent disability or life-threatening or fatal disease in otherwise healthy humans and animals when exposure to themselves occurs. Category B, UN 3373 – Biological substance transported for diagnostic or investigative purposes. Regulated Medical Waste, UN 3291 – Waste or reusable material derived from medical treatment of an animal or human, or from biomedical research, which includes the production and testing; the United States Centers for Disease Control and Prevention categorizes various diseases in levels of biohazard, Level 1 being minimum risk and Level 4 being extreme risk. Laboratories and other facilities are categorized as P1 through P4 for short. Biohazard Level 1: Bacteria and viruses including Bacillus subtilis, canine hepatitis, Escherichia coli, varicella, as well as some cell cultures and non-infectious bacteria. At this level precautions against the biohazardous materials in question are minimal, most involving gloves and some sort of facial protection.
Biohazard Level 2: Bacteria and viruses that cause only mild disease to humans, or are difficult to contract via aerosol in a lab setting, such as hepatitis A, B, C, some influenza A strains, Lyme disease, mumps, scrapie, dengue fever, HIV. Routine diagnostic work with clinical specimens can be done safely at Biosafety Level 2, using Biosafety Level 2 practices and procedures. Research work can be done in a BSL-2 facility, using BSL-3 procedures. Biohazard Level 3: Bacteria and viruses that can cause severe to fatal disease in humans, but for which vaccines or other treatments exist, such as anthrax, West Nile virus, Venezuelan equine encephalitis, SARS virus, MERS coronavirus, tuberculosis, Rift Valley fever, Rocky Mountain spotted fever, yellow fever, malaria. Biohazard Level 4: Viruses that cause severe to fatal disease in humans, for which vaccines or other treatments are not available, such as Bolivian hemorrhagic fever, Marburg virus, Ebola virus, Lassa fever virus, Crimean–Congo hemorrhagic fever, other hemorrhagic diseases and rishibola.
Variola virus is an agent, worked with at BSL-4 despite the existence of a vaccine, as it has been eradicated. When dealing with biological hazards at this level the use of a positive pressure personnel suit, with a segregated air supply, is mandatory; the entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release. There are no bacteria classified at this level; the biohazard symbol was developed by the Dow Chemical Company in 1966 for their containment products. According to Charles Baldwin, an environmental-health engineer who contributed to its development: "We wanted something, memorable but meaningless, so we could educate people as to what it means."
In an article he wrote for Science in 1967, the symbol was presented as the new standard for all biological hazards. The article explained that over 40 symbols were drawn up by Dow artists, all of the symbols investigated had to meet a number of criteria: Striking in form in order to draw immediate attention; the chosen symbol scored the best on nationwide testing for memorability. The design was dropped in the succeeding amendment. However, various US states adopted the specification for their state code. There are four circles within the symbol, signifying the chain of infection. Agent: The type of microorganism, that causes infection or hazardous condition. Host: The organism in which the microorganism Infect; the new host must be susceptible. Source: The host from which the microorganism originate; the carrier host might not show symptoms. Transmission: The means of transmission direct or in
A veterinary physician called a vet, shortened from veterinarian or veterinary surgeon, is a professional who practices veterinary medicine by treating diseases and injuries in animals. In many countries, the local nomenclature for a veterinarian is a regulated and protected term, meaning that members of the public without the prerequisite qualifications and/or licensure are not able to use the title. In many cases, the activities that may be undertaken by a veterinarian are restricted only to those professionals who are registered as a veterinarian. For instance, in the United Kingdom, as in other jurisdictions, animal treatment may only be performed by registered veterinary physicians, it is illegal for any person, not registered to call themselves a veterinarian or prescribe any treatment. Most veterinary physicians work in clinical settings; these veterinarians may be involved in a general practice. As with other healthcare professionals, veterinarians face ethical decisions about the care of their patients.
Current debates within the profession include the ethics of certain procedures believed to be purely cosmetic or unnecessary for behavioral issues, such as declawing of cats, docking of tails, cropping of ears and debarking on dogs. The word "veterinary" comes from the Latin veterinae meaning "working animals". "Veterinarian" was first used in print by Thomas Browne in 1646. Ancient Indian sage and veterinary physician Shalihotra, the son of a Brahmin sage, Hayagosha, is considered the founder of veterinary sciences; the first veterinary college was founded in France in 1762 by Claude Bourgelat. According to Lupton, after observing the devastation being caused by cattle plague to the French herds, Bourgelat devoted his time to seeking out a remedy; this resulted in his founding a veterinary college in Lyon in 1761, from which establishment he dispatched students to combat the disease. The Odiham Agricultural Society was founded in 1783 in England to promote agriculture and industry, played an important role in the foundation of the veterinary profession in Britain.
A 1785 Society meeting resolved to "promote the study of Farriery upon rational scientific principles." The professionalization of the veterinary trade was achieved in 1790, through the campaigning of Granville Penn, who persuaded the Frenchman Benoit Vial de St. Bel to accept the professorship of the newly established Veterinary College in London; the Royal College of Veterinary Surgeons was established by royal charter in 1844. Veterinary science came of age in the late 19th century, with notable contributions from Sir John McFadyean, credited by many as having been the founder of modern Veterinary research. Veterinarians treat disease, disorder or injury in animals, which includes diagnosis and aftercare; the scope of practice and experience of the individual veterinarian will dictate what interventions they perform, but most will perform surgery. Unlike in human medicine, veterinarians must rely on clinical signs, as animals are unable to vocalize symptoms as a human would. In some cases, owners may be able to provide a medical history and the veterinarian can combine this information along with observations, the results of pertinent diagnostic tests such as radiography, CT scans, MRI, blood tests and others.
Veterinarians must consider the appropriateness of euthanasia if a condition is to leave the animal in pain or with a poor quality of life, or if treatment of a condition is to cause more harm to the patient than good, or if the patient is unlikely to survive any treatment regimen. Additionally, there are scenarios where euthanasia is considered due to the constrains of the client's finances; as with human medicine, much veterinary work is concerned with prophylactic treatment, in order to prevent problems occurring in the future. Common interventions include vaccination against common animal illnesses, such as distemper or rabies, dental prophylaxis to prevent or inhibit dental disease; this may involve owner education so as to avoid future medical or behavioral issues. Additionally veterinarians have the prevention of zoonoses; the majority of veterinarians are employed in private practice treating animals. Small animal veterinarians work in veterinary clinics, veterinary hospitals, or both.
Large animal veterinarians spend more time travelling to see their patients at the primary facilities which house them, such as zoos or farms. Other employers include charities treating animals, colleges of veterinary medicine, research laboratories, animal food companies, pharmaceutical companies. In many countries, the government may be a major employer of veterinarians, such as the United States Department of Agriculture or the Animal and Plant Health Agency in the United Kingdom. State and local governments employ veterinarians. Veterinarians and their practices may be specialized in certain areas of veterinary medicine. Areas of focus include: Exotic animal veterinaria