Qualitative description is a useful qualitative method in much medical research if you keep the limitations of the approach in mind. It is especially relevant in mixed method research, in questionnaire development and in research projects aiming to gain firsthand knowledge of patients', relatives' or professionals' experiences with a particular topic. Another great advantage of the method is that it is suitable if time or resources are limited.
Tiffany Tran discusses her experiences in the Health Academy program. During the first week, they had an orientation that included a hospital tour and introductions. Tiffany then describes several clinical rotations, including in the CICU, operating room, NICU, burn unit, and NCCU. She observes various medical procedures and cares for patients. Tiffany finds the experiences fascinating and says Health Academy has exposed her to many healthcare career options. After high school, she plans to study pre-medicine in college with the goal of a career in healthcare on the west coast.
Knowledge and attitudes of primary school teachers toward first aid in al naj...حسين منصور
Unintentional injuries as well as sudden sicknesses is one of the important noteworthy reasons that lead to impairments and mortality in children, particularly those who are in school age. From this standpoint, primary school teachers’ knowledge about first aid is necessary in order to be prepared for providing first aid when needed for children during school time.
Based on the information provided:
- The patient developed sudden cardiac failure in the postoperative period after cesarean section.
- She has signs and symptoms of heart failure like weakness, shortness of breath, palpitations, nocturnal dyspnea, cough and peripheral edema.
- On examination, she has tachycardia, arrhythmia and S3 gallop with no murmur heard.
The most probable diagnosis is peripartum cardiomyopathy. This presents as heart failure in the last month of pregnancy or within 5 months postpartum with no identifiable cause for heart failure.
This document provides an overview of stool examination. It defines stool and describes its normal composition as 3/4 water and 1/4 solid matter. It outlines precautions for stool collection such as avoiding certain foods/medications prior. Collection details like using a clean container and preserving samples are provided. The types of examination covered are physical, chemical, and microscopic. Physical examines properties like color, consistency, and contents. Chemical analyzes pH, fats, nitrogen, and occult blood. Microscopic looks for parasites, bacteria, epithelial cells, and other components under stained and unstained preparations with concentration techniques.
This document appears to be a pathology report listing various findings from a central nervous system exam, including signs of hemorrhage, infarct, hypertension, tumors like pilocytic astrocytoma and glioblastoma, contusions, tubers, neurodegenerative diseases like Pick's disease, and other abnormalities such as AV malformations, ependymoma, meningioma, and peripheral nervous system findings.
This document is the fifth edition of the WHO laboratory manual for the examination and processing of human semen. It provides standardized procedures for semen analysis, including sample collection, initial macroscopic and microscopic examination, assessment of sperm motility, vitality, concentration, and morphology. The manual establishes reference values and diagnostic criteria and ensures uniformity in reporting results across laboratories worldwide.
Pathology of Central nervous system /certified fixed orthodontic courses by I...Indian dental academy
This document summarizes various pathologies of the nervous system including:
1. The main cell types of the central nervous system and their functions and regenerative capacities.
2. Mechanisms of disease including structural abnormalities, metabolic lesions, and increased intracranial pressure.
3. Specific disorders are discussed such as tumors, demyelinating diseases, vascular disorders like strokes, infections, and traumatic injuries. Imaging techniques and microscopic findings are presented.
Urine examination how to approach final.ppt1Sachin Verma
This document provides information on urine examination, including the composition, collection, physical characteristics, and chemical analysis of urine. It discusses normal ranges and clinical significance of various urine components like pH, specific gravity, proteins, glucose, ketones, bile pigments, and more. Detection methods for different analytes include dipstick tests, precipitation, electrophoresis, and quantitative assays. Causes of abnormalities in urine components related to kidney and metabolic diseases are also outlined.
Tiffany Tran discusses her experiences in the Health Academy program. During the first week, they had an orientation that included a hospital tour and introductions. Tiffany then describes several clinical rotations, including in the CICU, operating room, NICU, burn unit, and NCCU. She observes various medical procedures and cares for patients. Tiffany finds the experiences fascinating and says Health Academy has exposed her to many healthcare career options. After high school, she plans to study pre-medicine in college with the goal of a career in healthcare on the west coast.
Knowledge and attitudes of primary school teachers toward first aid in al naj...حسين منصور
Unintentional injuries as well as sudden sicknesses is one of the important noteworthy reasons that lead to impairments and mortality in children, particularly those who are in school age. From this standpoint, primary school teachers’ knowledge about first aid is necessary in order to be prepared for providing first aid when needed for children during school time.
Based on the information provided:
- The patient developed sudden cardiac failure in the postoperative period after cesarean section.
- She has signs and symptoms of heart failure like weakness, shortness of breath, palpitations, nocturnal dyspnea, cough and peripheral edema.
- On examination, she has tachycardia, arrhythmia and S3 gallop with no murmur heard.
The most probable diagnosis is peripartum cardiomyopathy. This presents as heart failure in the last month of pregnancy or within 5 months postpartum with no identifiable cause for heart failure.
This document provides an overview of stool examination. It defines stool and describes its normal composition as 3/4 water and 1/4 solid matter. It outlines precautions for stool collection such as avoiding certain foods/medications prior. Collection details like using a clean container and preserving samples are provided. The types of examination covered are physical, chemical, and microscopic. Physical examines properties like color, consistency, and contents. Chemical analyzes pH, fats, nitrogen, and occult blood. Microscopic looks for parasites, bacteria, epithelial cells, and other components under stained and unstained preparations with concentration techniques.
This document appears to be a pathology report listing various findings from a central nervous system exam, including signs of hemorrhage, infarct, hypertension, tumors like pilocytic astrocytoma and glioblastoma, contusions, tubers, neurodegenerative diseases like Pick's disease, and other abnormalities such as AV malformations, ependymoma, meningioma, and peripheral nervous system findings.
This document is the fifth edition of the WHO laboratory manual for the examination and processing of human semen. It provides standardized procedures for semen analysis, including sample collection, initial macroscopic and microscopic examination, assessment of sperm motility, vitality, concentration, and morphology. The manual establishes reference values and diagnostic criteria and ensures uniformity in reporting results across laboratories worldwide.
Pathology of Central nervous system /certified fixed orthodontic courses by I...Indian dental academy
This document summarizes various pathologies of the nervous system including:
1. The main cell types of the central nervous system and their functions and regenerative capacities.
2. Mechanisms of disease including structural abnormalities, metabolic lesions, and increased intracranial pressure.
3. Specific disorders are discussed such as tumors, demyelinating diseases, vascular disorders like strokes, infections, and traumatic injuries. Imaging techniques and microscopic findings are presented.
Urine examination how to approach final.ppt1Sachin Verma
This document provides information on urine examination, including the composition, collection, physical characteristics, and chemical analysis of urine. It discusses normal ranges and clinical significance of various urine components like pH, specific gravity, proteins, glucose, ketones, bile pigments, and more. Detection methods for different analytes include dipstick tests, precipitation, electrophoresis, and quantitative assays. Causes of abnormalities in urine components related to kidney and metabolic diseases are also outlined.
This document summarizes the secretions of the stomach and small intestine. It describes the cells that secrete hydrochloric acid, mucus, intrinsic factor, electrolytes, and digestive enzymes in the stomach. These include parietal cells, goblet cells, chief cells, and mucous glands. It also discusses the secretions of the small intestine, including enzymes in the microvilli and hormones like somatostatin, CCK, and secretin. The composition of duodenal contents is outlined, including pancreatic, bile, and intestinal secretions. Key components of the pancreatic exocrine secretion are listed.
Sperm formation involves two steps - spermatogenesis and spermiogenesis. During spermatogenesis, spermatogenic cells form spermatids which then differentiate into sperm cells during spermiogenesis. These processes occur within the seminiferous tubules of the testes. Semen is the fluid that is ejaculated and contains secretions from the seminal vesicles, prostate, and other glands as well as mature sperm. A semen analysis evaluates various parameters of the ejaculate including volume, concentration, motility, morphology, and other markers. This provides information about male fertility and identifies any abnormalities.
This manual provides guidelines for performing a basic semen analysis, including procedures for assessing sperm concentration, motility, morphology, and other semen parameters. Safety protocols and quality control measures are outlined. Samples should be collected via masturbation and analyzed 30 minutes after ejaculation. Tests include examining liquefaction, viscosity, and wet preparations under a microscope to determine motility, vitality, and presence of debris. Sperm concentration is assessed using a hemocytometer, and morphology is examined on stained smears.
The document discusses sputum examination and sputum smear microscopy. Sputum is mucus coughed up from the lower airways that is used for microbiological and cytological investigations of respiratory infections and systems. A good sputum sample is purulent with white blood cells, debris and viscous liquid. Sputum collection and smearing procedures are outlined as well as staining techniques like fluorescent staining for acid-fast bacilli examination to detect infections like tuberculosis. The standard operating procedure for sputum smear microscopy and common bacteria detected from cultures are also summarized.
New who standards for semen analysis - highlights and implications Sandro Esteves
The document discusses the new WHO standards for semen analysis from 2010. It provides the following key points:
1. The new standards are based on semen samples from 1,953 men in committed relationships whose partners conceived within 12 months.
2. Reference values were established using the 5th percentile cut-off of semen parameters from these men across multiple studies in different world regions.
3. While the new standards provide a global reference, the studies used were not evenly distributed worldwide and some regions were under-represented.
1. Cytology of body fluids involves examining fluids from various body cavities including cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid, and synovial fluid. Specimen collection and laboratory analysis includes gross examination, cell counts, biochemical analysis, and microscopic examination.
2. Transudates and exudates are distinguished based on characteristics like protein content and cell differentials. Infection, inflammation, and malignancy can be identified by analyzing changes in fluid characteristics.
3. Cytology of body fluids provides diagnostic information for conditions affecting various organ systems. Proper collection and analysis of physical and chemical properties aids in differential diagnosis.
This document provides information about evaluating semen quality through various tests and examinations. It describes how to collect and transport semen samples, the normal characteristics of semen, and different abnormalities that can be detected through physical, microscopic, biochemical and other analyses of semen samples. The goal of semen analysis is to assess male fertility and detect any issues that may be causing infertility.
Far too many people struggle to fall pregnant and conceive a child naturally. This generally drives most people to visit a doctor or specialist to find out why they have so much trouble conceiving and giving birth to healthy, happy babies.
In most cases, they’re given a diagnosis of infertility. Unfortunately, there are many different reasons for infertility, so this doesn’t always help. It’s known that ovarian cysts, PCOS and endometriosis can affect your fertility rate, as can a low sperm count. Some people are affected by other hormonal issues or more complicated problems, such as blocked or obstructed fallopian tubes.
Knowledge, Attitude And Practice Regarding Breast Self...Mindi Schneider
Here are the key findings I would expect to note in the physical assessment of Jane:
- Inspection: Note any changes to breast symmetry, size, shape, skin changes like dimpling, redness.
- Palpation: Feel for the mass in the right breast, noting size, shape, borders, tenderness, mobility.
- Axillary exam: Feel lymph nodes in right axilla for enlargement, tenderness, mobility.
- Breast exam: Note any other masses, tenderness in left breast or axilla.
- General exam: Note any signs of distant metastases like bone pain, shortness of breath.
- Vital signs: Check for fever, tachycard
This document provides information for parents on diagnosing childhood cancer, including common symptoms, diagnostic tests and procedures used to identify the type and stage of cancer, the importance of having biopsies done at specialized hospitals, and questions to ask about tests and results to understand the diagnosis and plan treatment. It explains that childhood cancers are different than adult cancers and lists the most common types such as leukemia, brain tumors, lymphoma, and others.
A study of lifestyle of women in breast cancer in kailash cancer hospital and...Samit Shah
This document summarizes a study conducted on women with breast cancer at the Kailash Cancer Hospital and Research Center in Goraj, India. The study was conducted by Archana Bhatt and Anita Rakhe to fulfill their master's degree requirements. It examines the situation of women diagnosed with breast cancer, including their physical and mental health, family support, and treatment experiences. Key findings included that most participants were illiterate and complained of tumors in their breasts. The document provides context on breast cancer risks, symptoms, screening and theories of progression. It aims to understand patient experiences and provide recommendations to support women's healthy and happy lives.
This document discusses reasons for infertility in both men and women and proposes natural remedies as alternatives to medical treatments. For women, common causes mentioned include ovarian cysts, polycystic ovarian syndrome, endometriosis, and blocked fallopian tubes. For men, low sperm count is a primary reason discussed. Throughout, the document suggests natural remedies may have higher success rates than expensive medical procedures and drugs in addressing infertility issues.
111 questions & answers about cervical cancer preventBasalama Ali
Here are the key points about HPV vaccination:
- HPV vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers. The vaccines also protect against HPV types 6 and 11, which cause 90% of genital warts.
- HPV vaccination is recommended for preteens at age 11-12. It can be given starting at age 9. The vaccine works best when given before any exposure to HPV through sexual contact.
- A two-dose schedule is recommended for those starting the series before their 15th birthday. A three-dose schedule is recommended for those starting the series at or after their 15th birthday and for immunocompromised individuals.
- Vaccination provides excellent protection against HPV
Polygeia Women's Health - Obstetric Fistulas Finnoula Taylor
Obstetric fistulas occur due to prolonged obstructed labor without medical intervention and result in incontinence. They disproportionately impact women in developing nations. Integrating the efforts of NGOs and governments is key to effectively reducing fistula incidence and prevalence. NGOs can provide initial funding, resources, and training, while governments oversee long-term solutions. Collaboration between various organizations worldwide has increased, but localized services mean many women still lack access to care. Strengthening health systems and expanding training of birth attendants is needed for widespread prevention and treatment of obstetric fistulas.
(Nutrition) eating hints for cancer patients before,during & after treatment ...Elisabeth Curiel
This document provides eating guidelines and nutrition recommendations for cancer patients undergoing treatment. It discusses how cancer treatments can affect appetite and the ability to eat through side effects like nausea, soreness, and taste changes. The document encourages cancer patients to eat healthy, high-calorie foods before treatment to build strength, and provides tips for managing eating problems and coping with side effects during and after treatment through diet and lifestyle. Recipes and meal suggestions target specific side effects.
This document contains 70 questions and answers about human papillomavirus (HPV) and cervical cancer prevention. It discusses HPV vaccination, HPV transmission, HPV screening, and treatment of HPV and cervical lesions. The contributors are experts in gynecologic oncology from King Abdulaziz University and Dalhousie University who aim to increase awareness of cervical cancer prevention and evidence-based practices through answering common clinical questions.
Has fertility been an issue for you? Use this book to help learn the reason for infertility and the naturals way you can get pregnant. Giving life is a wonderful gift and everyone should experience it. Don't resort to IVF until you've tried these methods.
The document provides instructions for curing cancer through eliminating a parasite found to be the cause of all cancers. It describes using herbal remedies and electrical devices to purge the parasite from the body. Over 100 case studies are presented of people who were cured of various types of cancer by following the provided parasite elimination protocol.
The document provides instructions for curing cancer through eliminating a parasite found to be the cause of all cancers. It describes using herbal remedies and electrical devices to purge the parasite from the body. Over 100 case studies are presented of people who were cured of various types of cancer by following the parasite elimination protocol.
This Localised Prostate Cancer Book includes guide for men and their families. Know more about this sickness and how to avoid this. Read more at http://qprostate.com/prostate-cancers/overview/ or simply download this book.
This document summarizes the secretions of the stomach and small intestine. It describes the cells that secrete hydrochloric acid, mucus, intrinsic factor, electrolytes, and digestive enzymes in the stomach. These include parietal cells, goblet cells, chief cells, and mucous glands. It also discusses the secretions of the small intestine, including enzymes in the microvilli and hormones like somatostatin, CCK, and secretin. The composition of duodenal contents is outlined, including pancreatic, bile, and intestinal secretions. Key components of the pancreatic exocrine secretion are listed.
Sperm formation involves two steps - spermatogenesis and spermiogenesis. During spermatogenesis, spermatogenic cells form spermatids which then differentiate into sperm cells during spermiogenesis. These processes occur within the seminiferous tubules of the testes. Semen is the fluid that is ejaculated and contains secretions from the seminal vesicles, prostate, and other glands as well as mature sperm. A semen analysis evaluates various parameters of the ejaculate including volume, concentration, motility, morphology, and other markers. This provides information about male fertility and identifies any abnormalities.
This manual provides guidelines for performing a basic semen analysis, including procedures for assessing sperm concentration, motility, morphology, and other semen parameters. Safety protocols and quality control measures are outlined. Samples should be collected via masturbation and analyzed 30 minutes after ejaculation. Tests include examining liquefaction, viscosity, and wet preparations under a microscope to determine motility, vitality, and presence of debris. Sperm concentration is assessed using a hemocytometer, and morphology is examined on stained smears.
The document discusses sputum examination and sputum smear microscopy. Sputum is mucus coughed up from the lower airways that is used for microbiological and cytological investigations of respiratory infections and systems. A good sputum sample is purulent with white blood cells, debris and viscous liquid. Sputum collection and smearing procedures are outlined as well as staining techniques like fluorescent staining for acid-fast bacilli examination to detect infections like tuberculosis. The standard operating procedure for sputum smear microscopy and common bacteria detected from cultures are also summarized.
New who standards for semen analysis - highlights and implications Sandro Esteves
The document discusses the new WHO standards for semen analysis from 2010. It provides the following key points:
1. The new standards are based on semen samples from 1,953 men in committed relationships whose partners conceived within 12 months.
2. Reference values were established using the 5th percentile cut-off of semen parameters from these men across multiple studies in different world regions.
3. While the new standards provide a global reference, the studies used were not evenly distributed worldwide and some regions were under-represented.
1. Cytology of body fluids involves examining fluids from various body cavities including cerebrospinal fluid, pleural fluid, peritoneal fluid, pericardial fluid, and synovial fluid. Specimen collection and laboratory analysis includes gross examination, cell counts, biochemical analysis, and microscopic examination.
2. Transudates and exudates are distinguished based on characteristics like protein content and cell differentials. Infection, inflammation, and malignancy can be identified by analyzing changes in fluid characteristics.
3. Cytology of body fluids provides diagnostic information for conditions affecting various organ systems. Proper collection and analysis of physical and chemical properties aids in differential diagnosis.
This document provides information about evaluating semen quality through various tests and examinations. It describes how to collect and transport semen samples, the normal characteristics of semen, and different abnormalities that can be detected through physical, microscopic, biochemical and other analyses of semen samples. The goal of semen analysis is to assess male fertility and detect any issues that may be causing infertility.
Far too many people struggle to fall pregnant and conceive a child naturally. This generally drives most people to visit a doctor or specialist to find out why they have so much trouble conceiving and giving birth to healthy, happy babies.
In most cases, they’re given a diagnosis of infertility. Unfortunately, there are many different reasons for infertility, so this doesn’t always help. It’s known that ovarian cysts, PCOS and endometriosis can affect your fertility rate, as can a low sperm count. Some people are affected by other hormonal issues or more complicated problems, such as blocked or obstructed fallopian tubes.
Knowledge, Attitude And Practice Regarding Breast Self...Mindi Schneider
Here are the key findings I would expect to note in the physical assessment of Jane:
- Inspection: Note any changes to breast symmetry, size, shape, skin changes like dimpling, redness.
- Palpation: Feel for the mass in the right breast, noting size, shape, borders, tenderness, mobility.
- Axillary exam: Feel lymph nodes in right axilla for enlargement, tenderness, mobility.
- Breast exam: Note any other masses, tenderness in left breast or axilla.
- General exam: Note any signs of distant metastases like bone pain, shortness of breath.
- Vital signs: Check for fever, tachycard
This document provides information for parents on diagnosing childhood cancer, including common symptoms, diagnostic tests and procedures used to identify the type and stage of cancer, the importance of having biopsies done at specialized hospitals, and questions to ask about tests and results to understand the diagnosis and plan treatment. It explains that childhood cancers are different than adult cancers and lists the most common types such as leukemia, brain tumors, lymphoma, and others.
A study of lifestyle of women in breast cancer in kailash cancer hospital and...Samit Shah
This document summarizes a study conducted on women with breast cancer at the Kailash Cancer Hospital and Research Center in Goraj, India. The study was conducted by Archana Bhatt and Anita Rakhe to fulfill their master's degree requirements. It examines the situation of women diagnosed with breast cancer, including their physical and mental health, family support, and treatment experiences. Key findings included that most participants were illiterate and complained of tumors in their breasts. The document provides context on breast cancer risks, symptoms, screening and theories of progression. It aims to understand patient experiences and provide recommendations to support women's healthy and happy lives.
This document discusses reasons for infertility in both men and women and proposes natural remedies as alternatives to medical treatments. For women, common causes mentioned include ovarian cysts, polycystic ovarian syndrome, endometriosis, and blocked fallopian tubes. For men, low sperm count is a primary reason discussed. Throughout, the document suggests natural remedies may have higher success rates than expensive medical procedures and drugs in addressing infertility issues.
111 questions & answers about cervical cancer preventBasalama Ali
Here are the key points about HPV vaccination:
- HPV vaccines protect against HPV types 16 and 18, which cause 70% of cervical cancers. The vaccines also protect against HPV types 6 and 11, which cause 90% of genital warts.
- HPV vaccination is recommended for preteens at age 11-12. It can be given starting at age 9. The vaccine works best when given before any exposure to HPV through sexual contact.
- A two-dose schedule is recommended for those starting the series before their 15th birthday. A three-dose schedule is recommended for those starting the series at or after their 15th birthday and for immunocompromised individuals.
- Vaccination provides excellent protection against HPV
Polygeia Women's Health - Obstetric Fistulas Finnoula Taylor
Obstetric fistulas occur due to prolonged obstructed labor without medical intervention and result in incontinence. They disproportionately impact women in developing nations. Integrating the efforts of NGOs and governments is key to effectively reducing fistula incidence and prevalence. NGOs can provide initial funding, resources, and training, while governments oversee long-term solutions. Collaboration between various organizations worldwide has increased, but localized services mean many women still lack access to care. Strengthening health systems and expanding training of birth attendants is needed for widespread prevention and treatment of obstetric fistulas.
(Nutrition) eating hints for cancer patients before,during & after treatment ...Elisabeth Curiel
This document provides eating guidelines and nutrition recommendations for cancer patients undergoing treatment. It discusses how cancer treatments can affect appetite and the ability to eat through side effects like nausea, soreness, and taste changes. The document encourages cancer patients to eat healthy, high-calorie foods before treatment to build strength, and provides tips for managing eating problems and coping with side effects during and after treatment through diet and lifestyle. Recipes and meal suggestions target specific side effects.
This document contains 70 questions and answers about human papillomavirus (HPV) and cervical cancer prevention. It discusses HPV vaccination, HPV transmission, HPV screening, and treatment of HPV and cervical lesions. The contributors are experts in gynecologic oncology from King Abdulaziz University and Dalhousie University who aim to increase awareness of cervical cancer prevention and evidence-based practices through answering common clinical questions.
Has fertility been an issue for you? Use this book to help learn the reason for infertility and the naturals way you can get pregnant. Giving life is a wonderful gift and everyone should experience it. Don't resort to IVF until you've tried these methods.
The document provides instructions for curing cancer through eliminating a parasite found to be the cause of all cancers. It describes using herbal remedies and electrical devices to purge the parasite from the body. Over 100 case studies are presented of people who were cured of various types of cancer by following the provided parasite elimination protocol.
The document provides instructions for curing cancer through eliminating a parasite found to be the cause of all cancers. It describes using herbal remedies and electrical devices to purge the parasite from the body. Over 100 case studies are presented of people who were cured of various types of cancer by following the parasite elimination protocol.
This Localised Prostate Cancer Book includes guide for men and their families. Know more about this sickness and how to avoid this. Read more at http://qprostate.com/prostate-cancers/overview/ or simply download this book.
The document discusses clinical trials and subjects. It emphasizes that behind every successful clinical trial are thousands of subjects. It highlights the important role and responsibilities of subjects in clinical trials. It also discusses challenges in subject compliance and retention, and provides some solutions sites can implement, such as education, training, relationship building, and sensitization of subject responsibilities. The document advocates for including vulnerable populations in clinical trials.
Breast cancer Reconstruction Surgery- Breast cancer Reconstruction procedures provides correction of the absence or abnormality of the breast for whatever reason - be it cancer, infection, trauma or congenital.
This document provides guidance from NICE on the diagnosis and management of ectopic pregnancy and miscarriage. It recommends:
1) Early pregnancy assessment services should be provided to assist in the diagnosis and management of women with pregnancy-related complications.
2) Initial assessment of women with possible ectopic pregnancy or miscarriage should involve taking a medical history and performing a physical examination and transvaginal ultrasound scan.
3) Surgical or medical treatment options can be considered for managing confirmed ectopic pregnancies, depending on the individual woman's circumstances and preferences.
This document is the 2015 annual report for the cancer program at CHI Memorial hospital. It provides an overview of the cancer committee's activities and services in 2014-2015. The report summarizes statistics on cancer cases seen at CHI Memorial in 2014, including the most common tumor sites and counties of residence for patients. It also describes the comprehensive services offered to cancer patients, such as navigation, support, education, screening, and multidisciplinary care conferences where all aspects of a patient's case are discussed.
Social care information packs
This is a series of short information sheets and matching slide sets about how social care staff can support people with learning disabilities to have better access to health services. They provide an introduction to each area and links to where further information and useful resources can be found.
This document summarizes the key findings of a survey conducted by the Working Mother Research Institute on women's knowledge and attitudes around breast cancer screening and breast health. Some of the main findings include:
- 9 out of 10 women consider mammograms an important part of health management and 80% have had at least one mammogram, with 70% getting screened annually.
- However, many women lack knowledge about breast density and its health implications, and options for screening technologies. Nearly half did not know if they had dense breasts.
- Of women who had a mammogram, 5 out of 10 were called back for additional testing, with most finding nothing suspicious but some receiving cancer diagnoses.
- The document reviews
Modern plastic surgery makes it possible for mothers to look as young as they feel. "Mommy makeover" is a term that has become common in today's plastic surgery lexicon, and it describes a special approach to body contouring that caters to mothers who wish to restore a youthful, flattering figure.
Satisfying Spa Massage Experience at Just 99 AED - Malayali Kerala Spa AjmanMalayali Kerala Spa Ajman
Our Spa Massage Center Ajman prioritizes efficiency to ensure a satisfying massage experience for our clients at Malayali Kerala Spa Ajman. We offer a hassle-free appointment system, effective health issue identification, and precise massage techniques.
Our Spa in Ajman stands out for its effectiveness in enhancing wellness. Our therapists focus on treating the root cause of issues, providing tailored treatments for each client. We take pride in offering the most satisfying Pakistani Spa service, adjusting treatment plans based on client feedback.
For the most result-oriented Russian Spa treatment in Ajman, visit our Massage Center. Our Russian therapists are skilled in various techniques to address health concerns. Our body-to-body massage is efficient due to individualized care and high-grade massage oils.
Research, Monitoring and Evaluation, in Public Healthaghedogodday
This is a presentation on the overview of the role of monitoring and evaluation in public health. It describes the various components and how a robust M&E system can possitively impact the results or effectiveness of a public health intervention.
The facial nerve, also known as cranial nerve VII, is one of the 12 cranial nerves originating from the brain. It's a mixed nerve, meaning it contains both sensory and motor fibres, and it plays a crucial role in controlling various facial muscles, as well as conveying sensory information from the taste buds on the anterior two-thirds of the tongue.
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
nursing management of patient with Empyema pptblessyjannu21
prepared by Prof. BLESSY THOMAS, SPN
Empyema is a disease of respiratory system It is defines as the accumulation of thick, purulent fluid within the pleural space, often with fibrin development.
Empyema is also called pyothorax or purulent pleuritis.
It’s a condition in which pus gathers in the area between the lungs and the inner surface of the chest wall. This area is known as the pleural space.
Pus is a fluid that’s filled with immune cells, dead cells, and bacteria.
Pus in the pleural space can’t be coughed out. Instead, it needs to be drained by a needle or surgery.
Empyema usually develops after pneumonia, which is an infection of the lung tissue. it is mainly caused due in infectious micro-organisms. It can be treated with medications and other measures.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
The Ultimate Guide in Setting Up Market Research System in Health-TechGokul Rangarajan
How to effectively start market research in the health tech industry by defining objectives, crafting problem statements, selecting methods, identifying data collection sources, and setting clear timelines. This guide covers all the preliminary steps needed to lay a strong foundation for your research.
"Market Research it too text-booky, I am in the market for a decade, I am living research book" this is what the founder I met on the event claimed, few of my colleagues rolled their eyes. Its true that one cannot over look the real life experience, but one cannot out beat structured gold mine of market research.
Many 0 to 1 startup founders often overlook market research, but this critical step can make or break a venture, especially in health tech.
But Why do they skip it?
Limited resources—time, money, and manpower—are common culprits.
"In fact, a survey by CB Insights found that 42% of startups fail due to no market need, which is like building a spaceship to Mars only to realise you forgot the fuel."
Sudharsan Srinivasan
Operational Partner Pitchworks VC Studio
Overconfidence in their product’s success leads founders to assume it will naturally find its market, especially in health tech where patient needs, entire system issues and regulatory requirements are as complex as trying to perform brain surgery with a butter knife. Additionally, the pressure to launch quickly and the belief in their own intuition further contribute to this oversight. Yet, thorough market research in health tech could be the key to transforming a startup's vision into a life-saving reality, instead of a medical mishap waiting to happen.
Example of Market Research working
Innovaccer, founded by Abhinav Shashank in 2014, focuses on improving healthcare delivery through data-driven insights and interoperability solutions. Before launching their platform, Innovaccer conducted extensive market research to understand the challenges faced by healthcare organizations and the potential for innovation in healthcare IT.
Identifying Pain Points: Innovaccer surveyed healthcare providers to understand their difficulties with data integration, care coordination, and patient engagement. They found widespread frustration with siloed systems and inefficient workflows.
Competitive Analysis: Analyzed competitors offering similar solutions in healthcare analytics and interoperability. Identified gaps in comprehensive data aggregation, real-time analytics, and actionable insights.
Regulatory Compliance: Ensured their platform complied with HIPAA and other healthcare data privacy regulations. This compliance was crucial to gaining trust from healthcare providers wary of data security issues.
Customer Validation: Conducted pilot programs with several healthcare organizations to validate the platform's effectiveness in improving care outcomes and operational efficiency. Gathered feedback to refine features and user interface.
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
Enhancing Hip and Knee Arthroplasty Precision with Preoperative CT and MRI Im...Pristyn Care Reviews
Precision becomes a byword, most especially in such procedures as hip and knee arthroplasty. The success of these surgeries is not just dependent on the skill and experience of the surgeons but is extremely dependent on preoperative planning. Recognizing this important need, Pristyn Care commits itself to the integration of advanced imaging technologies like CT (Computed Tomography) and MRI (Magnetic Resonance Imaging) into the surgical planning process.
Solution manual for managerial accounting 18th edition by ray garrison eric n...rightmanforbloodline
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
Solution manual for managerial accounting 18th edition by ray garrison eric noreen and peter brewer_compressed
1. 1
PRACTICES ON SELF BREAST EXAMINATION AS RELATED TO BREAST
CANCER AMONG WOMEN OF CHILD BEARING AGE (18-40 YEARS) ATTENDING
MCH/FP CLINIC IN MANDERA GENERAL HOSPITAL.
BY
ABDIFATAH MOHAMED ISSACK
+254722234375
A RESEARCH PROPOSAL SUBMITTED TO.
ALL PEOPLE
2. i
DECLARATION
1 hereby declares that this is my original work that has not been presented before for any
academic purpose or otherwise. It should not be produced without prior written permission by
the author.
Abdifatah Mohamed
Signature: _______________________ Date: ________________________
DEDICATION
This research proposal is dedicated to my family and friends for their prayers, encouragement,
understanding and financial support during the entire process of this research. Thanks for your
concern.
3. ii
May God Bless You All.
ACKNOWLEDGEMENT
I give all the glory to the almighty God for this abundant grace, which has seen me through my
study period. In all ups and downs that I went through, He renewed my strength each day and
this far he is worthy of my praise.
4. iii
The success of this study depended on a team of people who have contributed psychologically,
materially and theoretically.
I hereby wish to express my heart felt gratitude to the university supervisor Mrs. Monica, for her
guidance and advice throughout the project, may god bless her abundantly,
I also pass my gratitude to my beloved sister Faiza Hassan for the financial support.
I would also wish to pass my regards to the team that helped me in data collection. Finally I
thank the staff Mandera General Hospital for according me cooperation during this period.
OPERATIONAL DEFINATIONS
Knowledge - Level of awareness on information about self breast examination related to breast
cancer.
Attitude - A tendency to think or behave in a certain way.
5. iv
Practice - The method used to the examination.
Breast cancer - Malignant disease that affects the mammary glands
LIST OF ABBREVIATIONS
BSE - Breast Self Examination
PGH - Provincial General Hospital
MCH/FP - Maternal Child Health and Family Planning
6. v
MOH - Medical Officer of Health
CME - Continuous Medical Education
LIST OF FIGURES
Figure 1…………………………………………………………………………………………7
7. vi
TABLE OF CONTENTS
DECLARATION ..............................................................................................................................i
DEDICATION..................................................................................................................................i
ACKNOWLEDGEMENT ...............................................................................................................ii
OPERATIONAL DEFINATIONS .................................................................................................iii
8. vii
LIST OF ABBREVIATIONS.........................................................................................................iv
LIST OF FIGURES .........................................................................................................................v
ABSTRACT....................................................................................................................................ix
CHAPTER ONE ............................................................................................................................. 1
1.0 INTRODUCTION.......................................................................................................... 1
1.1 PROBLEM STATEMENTS ......................................................................................... 2
1.2 PURPOSE OF THE STUDY ................................................................................................ 2
1.3 JUSTIFICATION FOR THE STUDY.................................................................................. 3
1.3.1 CLIENT (COMMUNITY) ............................................................................................. 3
1.3.2 HEALTH WORKERS.................................................................................................... 3
1.3.3 NATION ......................................................................................................................... 4
1.3.4 THE RESEARCHER...................................................................................................... 4
1.4 BROAD OBJECTIVE........................................................................................................... 4
1.5 SPECIFIC OBJECTIVE ....................................................................................................... 4
1.6 HYPOTHESIS..................................................................................................................... 4
CHAPTER TWO .......................................................................................................................... 5
2.0 LITERATURE REVIEW.............................................................................................. 5
2.1 KNOWLEDGE ON SELF BREAST EXAMINATION IN WOMAN OF CHILD
BEARING AGE.......................................................................................................................... 5
9. viii
2.2 ATTITUDE TOWARDS SELF BREAST EXAMINATION IN WOMEN OF CHILD
BEARING AGE.......................................................................................................................... 5
2.3 PRACTICE OF SELF BREAST EXAMINATION ............................................................. 5
2.4 STEPS IN PERFORMING SELF BREAST EXAMINATION ........................................... 6
2.5 PALPATION......................................................................................................................... 7
2.6 ROLE PLAYED BY HEALTH WORKERS IN SELF BREAST EXAMINATION .......... 8
CHAPTER 3 ................................................................................................................................... 9
3.0 METHODOLOGY......................................................................................................... 9
3.1 STUDY AREA...................................................................................................................... 9
3.2 STUDY DESIGN.................................................................................................................. 9
3.3 DEFINATION OF VARIABLES ......................................................................................... 9
3.4 INCLUTION AND EXECUTION CRITERIA .................................................................... 9
3.5 SAMPLE SIZE DETERMINATION.................................................................................. 10
3.6 SAMPLING METHOD ...................................................................................................... 10
3.7 TECHNIQUE METHOD OF DATA COLLECTION........................................................ 10
3.8 DATA COLLECTION INSTRUMENT............................................................................. 10
3.9 ETHICAL CONSIDERATIONS........................................................................................ 10
3.10 STUDY LIMITATIONS................................................................................................... 11
3.11 DATA ANALYSIS AND PRESENTATION................................................................... 11
10. ix
ABSTRACT
The study was cross sectional study design. The main purpose of the study was to determine
knowledge, attitude and practice of self breast examination amongst women of child bearing age
attending Mandera General Hospital clinic.
The study targeted women of child bearing age. A total of 80 women were selected and
interviewed using systematic sampling method. From the study self breast examination was
known by majority of women attending MCH/FP clinic as it was represented by
77.5%.
11. x
Also the study revealed that majority of the women attending MCH/FP clinic Mandera practiced
self breast examination as represented by 60%. Those who practiced BSE practiced it at any time
which was attributed to by lack of proper health education on the appropriate time for BSE. I
have explained the five steps carried out by a woman in order to rule out any abnormality
especially the development of a lump. The study therefore recommends the World health
organization to make BSE a public policy so that there is community mobilization through
creating awareness. I would also make an appeal to the Ministry of Health to incorporate BSE as
one of the services among the services offered in MCH/FP services in order to reach the 40% of
women who do not practice BSE. This will help in early detection of breast cancer hence reduce
mortality.
12. 1
CHAPTER ONE
1.0 INTRODUCTION
Breast disorders may be non-cancerous (benign) or cancerous (malignant). Most of them are
non-cancerous and not life threatening often they do not require treatment. In contrast breast
cancer can mean a loss of breast or life. However potential problems can be detected early
enough when women regularly examine their breast themselves and have mammograms.
Common problems include breast pain, lumps and a discharge from the nipple.
Breast symptoms do not necessary mean that a woman has breast cancer or another serious
disorder. However, if a woman has any of the following symptoms, she should see her doctor.
A lump that feels distinctly different from other breast tissue or that does not go away. Dimpling
in the skin of the breast, scaly skin around the nipple, change in the shape of the breast.
Changes in the nipples such as turning in-ward, discharge from the nipple especially if it is
bloody.
Many women experience breast pain. Breast pain maybe related to hormonal changes for
example, it may occur during or just before menstrual period (as part of the premenstrual
syndrome) or early in pregnancy. Women take oral contraceptive or who take hormone therapy
after menopause commonly have this kind of pain. The pain is due to growth of breast tissue.
Such pain is usually diffuse making the breast tender to touch. Pain related to menstrual period
may come and go for months or years. Other causes of breast pain include breast cysts, infections
and abscesses.
13. 2
Breast pain that persists for more than one month should be evaluated. Lumps in the breasts are
relatively common and are usually not cancerous, but because they may be cancerous, they
should be evaluated by a doctor without delay.
One or both nipples sometimes discharge a fluid. A nipple discharge occurs normally during
milk production (lactation). After child birth or as a result of mechanical stimulation of nipple by
fondling, suckling or irritation (Beer B mark fietcher, Adrew 2003).
Self breast examination helps in early detection of breast cancer.
1.1 PROBLEM STATEMENTS
In the world breast cancer causes 10,000 deaths annually. It is said that 1:17 female born will
develop breast cancer in their life time (Beer B Fietcher J Adrew 2003).
Self breast examination remains the most reliable method of detecting the signs of breast cancer.
Early detection and diagnosis remains the most important of obtaining a prime diagnosis in most
cancer patients.
However though many women notice a lump on the breast, they do not seek medical advice
because it is painless and they do not know its implication.
In Africa the rate of breast cancer is lower than the western countries. However women in Africa
presents at advanced stages hence high mortality rate.
1.2 PURPOSE OF THE STUDY
This is to assess the knowledge, attitude and practice on self breast examination among women
of child bearing age. Create awareness on development of cancer of the breast among women of
14. 3
child bearing age. Also address the importance of self breast examination since it helps in early
detection of breast cancer.
1.3 JUSTIFICATION FOR THE STUDY
Since breast cancer is a major health problem, which can occur to any woman, self breast
examination remains the most affordable and simple way of early detection of breast lumps.
Therefore the research will benefit the following.
1.3.1 CLIENT (COMMUNITY)
By assessing their knowledge, attitude and practice on self breast examination, more health
education will be provided to them on breast cancer. They will see the need to examine their
breast monthly to rule out or detect breast lumps early. They will also seek medical assistance
early before the cancer will invade other breast tissues. This will cost a lot and bring suffering to
the victim, family and community because when one member of the family is affected the whole
community is affected.
When large numbers of clients become aware of self breast examination, they will spread news
to their family members which will result to the whole community getting informed about the
benefits of self breast examination.
1.3.2 HEALTH WORKERS
The research on self breast examination will help the health worker as well because after
indentifying the knowledge, attitude and practice on self breast examination among their clients
they will know the effectiveness of their services and hence the need to work more towards
improving their services.
15. 4
1.3.3 NATION
When clients detect breast lumps and seek medical intervention before cancer cell invade other
breast tissue, the nation will benefit because the cost of treatment will be reduced. Treatment of
advanced cancer is very expensive.
The nation will also have healthy women hence a healthy working nation. This will reduce the
morbidity and mortality rate among women of child bearing age.
1.3.4 THE RESEARCHER
The researcher will develop skills, which will help in future researches. It will also act as a
partial fulfillment in award of Diploma in Environmental Health Science.
1.4 BROAD OBJECTIVE
To determine the knowledge, attitude and practice on self breast examination as related to breast
cancer among woman of child bearing age attending MCH/FP clinic in Mandera General
Hospital.
1.5 SPECIFIC OBJECTIVE
To assess knowledge on self breast examination in woman of child bearing age in Mandera
General Hospital.
To determine the attitude toward self breast examination in woman of child bearing age.
To assess the practice on self examination among woman of child bearing age attending
MCH/FP clinic in Mandera General Hospital.
To establish the role played by health workers in self breast examination.
1.6 HYPOTHESIS
Clients attending MCH/FP clinic in Mandera General Hospital has deficient knowledge on self
breast examination.
16. 5
CHAPTER TWO
2.0 LITERATURE REVIEW
2.1 KNOWLEDGE ON SELF BREAST EXAMINATION IN WOMAN OF CHILD
BEARING AGE.
Breast cancer appears to be a disease of both developing and developed countries. Among
Turkish women breast cancer is the second leading cause of cancer related deaths.
A study carried out among Turkish women revealed that they used self breast examination as a
tool for early detection of breast cancer.
Level of breast cancer knowledge was the only variable significantly associated with the self
breast examination (Parkin DM 2005).
2.2 ATTITUDE TOWARDS SELF BREAST EXAMINATION IN WOMEN OF CHILD
BEARING AGE.
Many women believe that the size and shape of the breast determine their sexuality desirability
or lack of it. The breast also defines their acceptability as women in society eyes. The loss of a
breast therefore threatens the fundamental components of a woman’s identity cause that’s her
feminism, herself image and her measure of self as a person.
Accordingly women are often reluctant to do anything even if they detect a lump in their breast,
yet it has been recognized that one of the best means of obtaining an early diagnosis in breast
cancer is periodical self breast examination. (Smelter c Suzanne 2000)
2.3 PRACTICE OF SELF BREAST EXAMINATION
It is estimated that only 25% to 35% of women perform self breast examination proficiently each
month. Some find breast examinations to be exciting, others find it too difficult to differentiate
17. 6
between normal changes and worrisome findings. Younger women may find self breast
examination particularly difficult because of the density of their tissue.
Even women who perform self breast examination and detect a change may delay to seek
medical attention because of fear, economic factors, lack of education and modesty (Brunner
Suddaths 2007).
Cancer of the breast can be detected early through self breast examination, doing it regularly will
help a woman learn what is normal for her breast and she will be able to notice changes.
Self breast examination should be performed at least once in a month and at the same time even
after menopause. If the breast has to be removed self breast examination should be done on the
site of the surgery.
Self breast examination does not involve many parties and no cost is involved.
2.4 STEPS IN PERFORMING SELF BREAST EXAMINATION
STEP 1
INSPECTION
The client should stand in front of a mirror and check both breasts for discharge from the nipple
dimpling and discolored area of the skin.
STEP 2
The client raises her hand over the head and observes changes in the contour of the breast.
18. 7
STEP 3
The client puts her hand on her hips, press against her hips which tightens the muscles
underneath the breast. She observes again for dimples again for dimples or flattered places which
look different between the two breasts.
The client observes for any ulcers, rashes or discharge. Observes if one nipple is inverted and the
other one is not.
For step 1-3 the client observes herself in front of a mirror.
2.5 PALPATION
The breast is divided into 4 quadrants with the tail extending into the axilla. (Under arm)
PALPATION Figure 1
Raise
the left
arm, using three or four fingers of the right hand, palpate the breast thoroughly with the flat part
of the fingers in small circles around the breast. Begin at the outer edge and gradually move in
towards the nipple. Press gently but firmly feeling for any unusual lump or mass under the skin,
be sure to check the whole breast. Also carefully probe the area between the breast and the arm
(including the under arm for lump) squeeze the left nipple gently and look for any discharge.
19. 8
Repeat palpation on the other breast using the left hand. A woman should repeat this procedure
at the same time each month. She should report anything abnormal or uncertain about her breast
to the doctor for further investigation diagnosis and early treatment in case of any need.
2.6 ROLE PLAYED BY HEALTH WORKERS IN SELF BREAST EXAMINATION
The nurse plays an important role in breast examination (BSE) education, a modality used for
early detection of breast cancer.
BSE can in a variety of setting either on a one basis or in a group. It can also be initiated by a
health care practioner during a patient’s routine physical examination.
Variations in breast tissue occur during the menstrual cycle, pregnancy and the onset of
menopause. Women on hormone therapy can also experience fluctuations. Normal changes must
be distinguished from those that may signal disease. Most women notice increase tenderness and
lumpiness before their menstrual periods; therefore, BSE is the best performed after menses
(Brunner Suddaths 2007).
A study carried out among Turkish women reported that they had acquired information on BSE
from health professionals (Parkin DM 2005).
20. 9
CHAPTER 3
3.0 METHODOLOGY
3.1 STUDY AREA
Mandera County General Hospital was the study area. It is located in Mandera location,
Municipality Division, Mandera Central District in North Eastern Province. It is one kilometer
from Mandera Town Centre. It is one of the major hospitals from Mandera Districts.
Also acts as a referral Hospital for the neighboring Districts.
The hospital has an outpatient department in which there is casualty department, consultation
rooms and maternal child. Health clinic whereby integrated services are carried out. These
services include immunization as per Kepi schedule, family planning, antenatal care which
includes prevention of mother to child transmission of HIV. Post natal care p is also done.
3.2 STUDY DESIGN
Descriptive study was used to determine knowledge, attitude and practice of self-breast
examination among women of child bearing age.
3.3 DEFINATION OF VARIABLES
Dependent variables – breast examination
Independent variables – knowledge, practice and attitude.
3.4 INCLUTION AND EXECUTION CRITERIA
INCLUSION CRITERIA – women of child bearing between 15-49 years
EXECUION CRITERIA - clients aged below 15 years and above 49 years.
21. 10
STUDY POPULATION
The study populations were women of child bearing age 15-49 years
3.5 SAMPLE SIZE DETERMINATION
Maternal child health records and family planning had a total of 822 clients who had been seen at
the clinic for the last three months.
To determine sample size 10% of the study population will take i.e.
10/100 x 822
=82.2
82 clients
3.6 SAMPLING METHOD
Systematic sampling method was used whereby the first 20 clients were picked every day and
were interview.
3.7 TECHNIQUE METHOD OF DATA COLLECTION
The method of data collection was by interviewing clients attending MCH/FP clinic.
3.8 DATA COLLECTION INSTRUMENT
The instrument/tool for data collection was an interview schedule which consisted of 4 sections.
Demographic data, knowledge, practice and attitude.
3.9 ETHICAL CONSIDERATIONS
Permission to collect data was obtained from Mandera Further permission to collect data was
obtained from nursing officer in charge MCH/FP clinic Mandera
Hospital.
22. 11
3.10 STUDY LIMITATIONS
Time to collect data was too short. Harsh weather condition data was collected during winter
season.
Lack of enough resources in terms of money to train more people to collect data making data
collecting difficult.
3.11 DATA ANALYSIS AND PRESENTATION
The interview schedules were checked for errors and corrected.
The data was manually analyzed and findings were presented in tables, bar charts histograms and
percentages.