How to write course work clearly

• Start work on assignments early - preferably as soon as you get them.

• Spend time understanding what is required before beginning to research and write. Underline or highlight key words in the topic to help you focus on what is required.

• To reduce the possibility of straying from the topic, write it out in large letters and place it above your computer or work desk so that you can easily refer to it.

• Planning is the most important step in organizing your writing. Few people can 'start at the beginning and write to the end' without planning their route.

• Learn how to develop concept maps. As you research and read, you can alter the concept map.

• Once you have a concept map you can convert the parts of it to sections, paragraphs and even sentences in your essay.

• Use a computer with software that assists reading and writing.

• Do not write long, complex sentences. It is easier to write grammatically and convey meaning clearly if your sentences are simpler.

• If you have difficulty thinking, writing, spelling and remembering all at once, try tape recording a sentence or paragraph and then writing/typing it out.

• If you have difficulty detecting errors in your work, reading aloud may help you find them.

• If you read aloud what you think you have written, rather than what you actually wrote, trying using read-aloud screen reader software and listening to it instead.

• Ask the learning skills staff at your university, a family member or a friend to read through what you have written and explain your frequent errors to you. For example, you may have problems with punctuation, capitalisation, word usage, spelling, grammar or sentence structure.

• Buy a basic grammar book from the university bookshop and revise the relevant rules. Look for a book which is not too complex, which explains rules clearly and which gives helpful examples.

• If your writing difficulties are significant but your oral language is good, consider using voice dictation software. Although this is easier for many students, it is still necessary to plan carefully, use formal academic language and adhere to word limits.

• Try not to use time extensions for assignments. If you are late with one assignment the next one (and later ones) will almost inevitably be late too, and then you will be left with less time than others for examination preparation.

Nosocomial pneumonia

Nosocomial refers to a disease coming from a hospital. Pneumonia refers to an infection in one or both lungs. Bacteria, viruses, and fungi cause it. The infection causes inflammation in the air sacs in your lungs, which are called alveoli. The alveoli fill with fluid or pus, making it difficult to breathe. Therefore, nosocomial pneumonia refers to Hospital- acquired pneumonia that has been contracted by a patient in at least 48-72 hours after being admitted in a hospital.

This disease is the most common cause of death among nosocomial infections and is the primary cause of death in intensive care units.
Ventilator-associated pneumonia (VAP) represents a significant sub-set of HAP occurring in intensive care units (ICUs) and is defined as pneumonia that occurs more than 48 to 72 hours after tracheal intubation and is thought to affect 10% to 20% patients receiving mechanical ventilation for more than 48 hours

The incidence of hospital-acquired pneumonia (HAP) is not well studied outside the intensive care unit, but estimates range from 

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Common pathogens of HAP

 These include; aerobic gram-negative bacilli (e.g. Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter spp,  Acinetobacter spp) and gram-positive cocci (e.g., Staphylococcus aureus, which includes methicillin-resistant S. aureus, Streptococcus spp).

Symptoms may include

cough, expectoration, a rise in body temperature, chest pain or dyspnea. Signs include fever, tachypnea, consolidations or crackles.

According to Eman Shebl; Peter G. Gulick, Bacteriologic Evaluation of this disease can be done by; Blind tracheobronchial aspiration (TBAS), Bronchoscopy with bronchoalveolar lavage (BAL) and Protected specimen brush (PSB). All respiratory tract samples should be sent for microscopic analysis and culture.

Microscopic Analysis

The microscopic analysis includes the analysis of polymorphonuclear leukocytes and a gram stain. The microscopy can be helpful in determining a possible pathogen and the antibiotic selection until the results of the culture are available. The presence of abundant neutrophils and the bacterial morphology may suggest a likely pathogen.

Quantitative Cultures

Diagnostic thresholds include:

• Endotracheal aspirates 1,000,000 colony forming units (CFU)/mL
• Bronchoscopic- or mini-BAL 10,000 CFU/mL
• PSB 1000 CFU/mL

New Molecular Diagnostic Tests

New molecular diagnostic tests like multiplex polymerase chain reaction assay, which detects an array of respiratory bacterial pathogens and many antibiotic resistance genes, offer the advantage of rapid identification of pathogens and resistance patterns for rapid choosing the antibiotic regimens.

Treatment

Treatment of this disease is highly dependent on the study of drug resistance and sustability and it’s only done by specialists in the hospitals