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Plan

Training is an essential activity to a programmer as it gets one equipped with the required skills and good knowledge of acquiring competence in the field of programming. I got my iteration of training into several tiers. I began with preparation for the upcoming training. The preparation defined the first division of my activities during the implementation of the training program. The process took a duration of three days where I got involved in reviewing the concepts related to.NET technology. Alongside that, I had to have a good understanding of what it entails a.NET programmer to possess, so that to get acknowledged according to his/her competency.

The second phase of the iteration was the development of the training which was outlined in five typical stages. I began with defining the needs that had purposed me to conduct the training on.NET programming. The needs were the major inputs for me to determine the training objectives easily. The training objectives were defined to enable me to have the good knowledge of what I am supposed to gather during the training session. And this was the second stage of the training program

The follow –up sub-session of the training session was the individual assessment of what I have before getting into the actual training process. This phase was once more a session that was conducted to outline the aspects I understand about the.NET programming career. The activities prepared me well for the actual training. After that, I got to the fourth stage where I was trained of all that entails.NET programming. I finalized the session by measuring or rather assessing myself over the knowledge acquired. The training process took the duration of seven days.

Action
The training was undertaken with the aim of getting me with the knowledge and good understanding of.NET programming. I began the implementation of the iteration by undertaking a preparation towards the actual training. I went to the nearby cyber café in the city center where I had to surf the internet for the.NET programming tutorials. In supplement to that, I consulted the.NET programmers who provided the guideline on the things that I have to make sure that I possess to get regarded as a competent.NET programmer.

I moved to the actual training session. During the program, I outlined the need for the training and it was revealed to be a guideline to getting the knowledge.

I defined the objectives of the training process. These objectives were obtained from a brainstorming session where I analyzed the information from the.NET programming experts and the research undertaken. I extended my assessment through outlining what I know and understand about.NET programming. The activities enabled a good preparation for train session. I got into the training processes where I began with understanding the.NET technology concepts. I moved to outlining and studying the tools applied by the.NET programmers. Subsequently, I got trained in the skills that I have to possess as a.NET programmer as well as the roles, duties and responsibilities that are undertaken by a.NET programmer.

After finishing the training, I went ahead to have an assessment of what I had learned. The trainers gave me some testing scenarios where I had to respond to an approach as a.NET programmer. The training had equipped me with the mechanism of coding and approaching different situations. The assessment defined the end of my training session that was concentrated on the programming mechanisms as far as.NET technology is concerned. Alongside that, I moved to undertake the personal practice of the knowledge acquired.

Observation
The training was educative as I acquired very useful knowledge that I believe can get me grow well in my career. The prior action of training preparation got me to discover that the organization had a well-organized archive that had good guiding materials to trainees. The materials obtained outlined the basics and details of expectations of the.NET programmer. The.NET programming had a major concentrate on designing applications that are internetworked oriented. The applications were focused on their accessibility to the network, and it meant that the skills required must have to do with internetworking.

The training process began with the appreciation of the.NET technology where the trainers described the Java technology, the ASP. NET, XML and extended to the.Net programming languages such as the Java language, Javascript, PHP, CSS, HTML and others. It was a very educative session. They coding procedures were also described and they instead on having a pseudo codes and flowcharts to easy the task of coding as they describe the modules and utilities of the application.

The desirable skills that a.The net programmer should possess included the database working skills, good knowledge of design patterns, programming analytical skills, strong ability with object oriented programming (Wallen, 2005), skill sin SQL server. Good skills with scripting languages such as the HTML, DHTML, CSS, XML, JavaScript, VBscript, Ajax and others. In-depth knowledge in software development lifecycle. Also, good analyzing, communication, presentation, reporting and interpersonal skills are desirable.

A.NET programmer has some distinctive roles, duties and responsibilities. They got defined and implemented according to the competency of the candidate. However, the main responsibility and duty are to develop applications, implement and support the software and the web pages.

Reflection
The.NET programmer training was a good mechanism for getting me equipped with the required knowledge that can get me determined in undertaking the responsibilities and the overall growth of application developing a career (Mattwriter, 2015). The entire training process got associated with some challenges such as the difficulty in outlining some aspects during the practical session. The theory part was concentrated much than the practical, and this got me some difficulties in responding to the scenarios assigned. However, I appreciate the advice of Mr. Kim, the company.NET senior programmer who requested me to have a good study and understanding of aspects relating to the topics of study.

The definition of the training objective process was easily handled as I began with describing the basic need for the training. The training needs to be described the objectives. The assessment of my understanding was also a good and enjoying session that got me enough courage in handling aspects as well as other technical utilities. The IT department ensured the availability of development and practice tools. The tools made the activities much friendly and easily handled.

In my opinion, the entire process was successful by it was my wish that the senior and professional persons in the developing section were our trainers. This could have got the process more friendlily and much could have been gathered as the world is dynamic and diversifying in all directions. The training was not enough, and I had to interact with the experts in the field to have a good understanding of the required skills.

Hemophilia
Case

A 24-year-old white man has a diagnosis of hemophilia at the age of about 5 to 6 years. He has recently visited the hematology clinic for the follow-up after hospitalization for an accidental knife cut that caused excessive bleeding. The patient has a history of excessive bleeding from tooth extraction, excessive bruising since childhood and the upper gastrointestinal bleeding in the past three years. He has reported chronic pain of his joints and ankles and denied hemarthroses. The patient has given reports about the episodes of excessive bleeding treatment by use of factor VIII and fresh frozen plasma (Remor, 2013).

The patient has the FVIII deficiency (hemophilia A) which is a common type of hemophilia that affects about 5, 000 males at births. The disease approximately affects about 25, 000 people in the United States. Individuals with hemophilia suffer from deficiencies in clotting factor. The mild hemophilia bleedings problems do mainly occur after surgery, trauma and injury. The condition can accompany some symptoms. Almost 25% of the population with hemophilia has the mild deficiency. Those with moderate hemophilia experience bleeding episodes after minor injuries and may lead to spontaneous episodes of bleeding. The server hemophilia happens after trauma, injury and surgery. It has the spontaneous bleeding into muscles and joints characteristics. Recurrent bleeding of the joints also known as hemarthrosis causes hemophilic arthropathy that causes disability at a very young age (Department of Genetics 2015).

Causes

Hemophilia is a disease happening as a result of gene mutation, and it is a genetic disease. About 70% of hemophilia cases are inheritable from parents. However, the other 30% of patients do not have the family history. In such cases, the main cause of the condition is by a spontaneous gene mutation during the fertilization stage. Hemophilia is also a condition that is linked to sex since the FIX and FVIII geneses are found on the X chromosome. It is the chromosome X that determines the gender of the baby. Thus, the condition’s clinical manifestation has a link to sex. Therefore, females may not express the bleeding symptom like the males (McPhee, & Hammer, 2012).

Pathophysiology
The main source of factor VIII (FVIII) production is thought to be from the reticuloendothelial and the liver system. Transplantation of the liver can correct FVIII deficiency to persons with hemophilia. It is because of the increasing cases of individuals with mild hemophilia having progressive liver diseases. Thus, it is an indication that the liver is the main site for FVIII synthesis (Cayir, Yavuzer, and Sayli, 2014).

The RNA messenger for FVIII is also detectable in spleen and liver among other issues. Studies indicate that the production of FVIII in cells lines that are transferable show that after synthesis the FVIII shifts to the endoplasmic reticulum lumen. It is then within other protection that functions in regulating secretion. It particularly regulates the immunoglobulin binding protein in which it has to dissociate in a process that depends on energy. The FVIII’s signal peptide cleavage, as well as oligosaccharides, also takes place in the endoplasmic reticulum. The calnexin, chaperone proteins, and calreticulin, enhance both FVIII degradation and secretion. Regarding genes, the location of the FVIII (F8C) is at the X chromosome arm at Xq28 region. This gene becomes large comprising of 25 intones and 26 exons. A mature FVIII will have about 2332 amino acids. FVIII deficiency is as a result of gene inversion that causes disrupt to the FVIII gene. The disruptions are insertions, point mutations, and deletions. The low levels of FVIII happen as results of external FVIII gene defects (Huether, &McCance, 2012).