Pre-existing Conditions

To some extent, the benchmarking activity can be carried out in parallel with the stakeholder survey of expected proficiencies that was described in the previous chapter. Once the program goals are clearly established, the pre-existing conditions understood, and the existing curriculum has been benchmarked, curriculum design can truly begin. 

Underlying structure of the curriculum. Virtually all universities have an underlying structure that dictates the length of the university school year, the length and intensity of the terms or semesters, and the atomic unit of instruction, which is referred to as a course in this book. Established academic units and total number of allowable units can limit the flexibility of a curriculum plan. 

1 Connections Between Mandatory Courses in Applied Physics and Electrical Engineering, Linkoping University  

Strong connection (dark gray box). A row in the matrix illustrates how the content of a particular course is used in subsequent courses. A column in the matrix shows the extent to which a particular course uses knowledge from previous courses. 

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When working with chemicals that have target organ effects it is critical to prevent exposure. This is especially true if you have a pre-existing condition, disease, or injury to that particular organ. Read the MSDS to fmd out the most effective personal protection equipment (PPE) for dealing with the chemical and be certain to minimize release of the chemical in the first place. 

As noted earlier, routes other than inhalation must also be considered. Thus exposure to a substance which can be hazardous upon ingestion, absorption through the skin or mucous membranes, or contact with skin or mucous membranes needs control to a standard such that nearly all the population could be exposed repeatedly without any adverse health effect. (Note that this will not necessarily protect those who are atopic or with a relevant pre-existing condition, e.g. dermatitis.)... 

Other effects. The most common skin side effect with steroid use is acne, which is reversible, and occurred in 48% of AAS users in one study. Cysts, and oily hair and skin have also been reported. Other possible effects include small increases in the number of red blood cells, and a worsening of pre-existing conditions such as sleep apnea, a condition where people stop breathing during sleep and muscle twitches called tics. 

The lowest LOAEL value (0.083 mg/kg/day) in healthy humans ingesting white phosphorus for an intermediate duration was identified in the Sontag (1938) study. Lower LOAEL values have been identified in children with rickets (Phemister 1918). Because these children had a pre-existing condition, these data were not considered reliable. Other systemic effects and neurological effects were observed at this dose. This study was not selected as the basis of an intermediate-duration oral MRL because it is a case report of a single child and no assessment of hepatic or renal toxicity (liver and kidneys are two primary targets of white phosphorus toxicity) was made. 

Toxic dermatitis (Dathe and Nathan 1946) and subcutaneous hemorrhages (Hann and Veale 1910 Humphreys and Halpert 1931) have been reported. It is not known if the dermatitis is related to phosphorus exposure, or due to a pre-existing condition. The subcutaneous hemorrhages are consistent with other studies which found hemorrhages in the liver, brain, and kidneys. 

Several reports of health effects in individuals treated with potassium dichromate are discussed below (Brieger 1920 Major 1922 Smith 1931). The results of these studies should be interpreted cautiously because pre-existing conditions may have contributed to the observed effects. The highest NOAEL value and all reliable LOAEL values for dermal effects in each species and duration category are recorded in Table 2-3. 

A failure that occurs while an independent device is awaiting repair represents but one failure during the time frame of the initiation of the emergency and is therefore credible. The lack of availability of the unrepaired device is a pre-existing condition. 

The actual conditions that are the cause of coffee staining continue to generate debate mostly centred on the question of whether the contact line is initially pinned. Deegan used droplets of a colloidal suspension on atomically smooth mica to explore the issue of self-pinning. He said that rings form because the contact line cannot move and that some pre-existing conditions on the substrate temporarily anchor it until sohd material accumulates. However,... 

Complications cannot be attributed to endoscopy itself, but to the pre-existing conditions localized perforations, risks associated with aspiration, cardiac problems, lowered blood pressure, etc. Premedication may therefore be inappropriate in individual cases, and endotracheal intubation or endotracheal anaesthesia is then indicated. 

The clinical presentation, the interval after starting treatment, the evolution of the episode, and the results of cerebral spinal fluid analysis and electroencephalography in this case were similar to those seen in cases of encephalopathy following treatment of L. loa with ivermectin or diethylcarbamazine. However, pretreatment filaremia was relatively low and L. loa microfilariae were not detectable in the cerebral spinal fluid. Thus, pre-existing conditions might increase the susceptibility to encephalopathy. 

Ephedra was implicated in the deaths of eight patients, and although it was pointed out that several had pre-existing conditions such as chest pain and hypertension (30), the authors justifiably responded that these were contraindications to the use of Ephedra in the first place, and they cast doubt on the adequacy of the warnings provided (31). 

Job-lock the inability of an individual to change employers for fear of losing health coverage, particularly if the employee or a dependent has a pre-existing condition which might not be covered, at least for an initial period of new employment. 

CHRONIC HEALTH RISKS lung fibrosis aggravation of pre-existing conditions, including sinus problems, pulmonary disease, and skin disorders. 

Down-modulation of the immune response (immunosuppression), which may result in an impaired ability to deal with neoplasia and infections. This is of particular concern if the therapeutic agent is intended to be used in patients with pre-existing conditions such as cancer, severe infection, or immunodeficiency diseases. 

Working within the pre-existing conditions of common university poficies and regulations, curriculum designers have identified several approaches to building more flexibility into curriculum structure. Figure 4.5(b through f) illustrates these alternatives to the conventional structure (a). 

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