400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

0 Download8 Pages / 1,843 Words

Course Code: 400285
University: Western Sydney University

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Country: Australia

Question:

This is a  hypothetical Scenario.
You are required to prepare a Response Plan to the scenario below. The response plan should include: relevant stakeholders in the response, logistics, special considerations as a result of the scenario context (season, location etc), challenges, likely outcomes, conclusions and recommendations for the future. 
Scene:
It is the 2′ of January. The days have been unusually hot. The Scout Movement are holding their Annual Jamboree in the Cataract Scout Park between Campbelltown and Wollongong and around 10,000 scouts and their leaders and carers are settling into the park for a 10 day event. The park is situated in the middle of dense bushland. 
 
On the morning of day 4, the leaders awake to smell a strong smell of smoke. In the distance they can see plumes of smoke rising into the air. They call the rural fire service who confirm that there is a fire out of control about 5 km from the scout camp. At present the wind is not strong, but it is predicted to increase any time. 
Role:
You are the Chief of the Appin Rural Fire Service. You have found out there are 10,000 scouts in the Cataract Park and a bushfire is advancing on them. What would your response plan be given the timing and location of the outbreak? 

Answer:

Introduction
Those from the Cataracts Scout Park between Campbell town and around Wollongong are perhaps used to bushfires, a huge fire that spreads very fast and is very hard to control. Generally, this kind of bushfire spreads through the woodlands of Campbell town. One kind of bushfire recognized as a forest fire, a hysterical fire, which burns through bushes that is common in the country (Lindenmayer, Blanchard, & Gill, 2016). Similar to all bushfires, an inferno puts natural surroundings and human being in danger. This paper discusses the response plans to fire in a scenario at an annual Scout movement, which was being held at Cataracts Scout Park between Campbell town and Wollongong.
Disaster event
The park is located in the interior of thick bush land. The event was being held in 2nd of January when days are usually extremely hot. This is usually the summer season in the area. During the 4th day of the meeting, the leaders were woken up by strong odor of smoke. At a distance they could see a huge plumes of smoke rising into the air. As the chief of the Appin rural fire services, I would have done several things to respond to this problem. Having about 10,000 scouts in the park, there would be several factors to put in place.
Relevant stakeholders with their roles within the disaster management plan
Direct and indirect attack to the inferno by the scouts, use of fire suppression substances, use of earthmoving equipment among other methods would be used to suppress this bushfire.  More than one approach could be used to respond to this and control the bushfire (Whittaker, Eriksen  & Haynes, 2016). There would be a ground squad, which could directly enclose and conquer a fire front using water and hand apparatuses. This would be determined by the magnitude and strength of the inferno and the landscape the fire was razing. Our firefighters who are about 5 miles away would also be involved in this firefighting situation. They are skilled at using dry firefighting techniques of fire destruction, which do not depend on water being accessible (Bush, Correa-Metrio & Overpeck, 2016).
Appropriate Management of resources
The highly skilled remote region firefighter’s squads can make use of the airplanes to get to the unreachable regions to speedily put out fires before it gets in other regions.  As a measure to stop the bushfire speedily, enthusiastic remote inflight response squads could be put on hold in the high risky places throughout the fire period so that they could get to the fires swiftly. The 10,000 scouts would be distributed together with these experts to help in fighting this fire (Bush, Zimmermann & Silman, 2015).
The team of the devoted flying unit and aircraft crew who are responsible for aerial firefighting fire management, would be the first to go on the mission to put out the fire. The fleet would comprise 5 planes and 2 fixed-wing airplane. They would first identify the prevailing condition of the wind and predict the weather so that they would understand which technique to use. It is very important to note the direction of the wind so that they could identify the behavior of the fire. This also gives the firefighter protection against being razed in the bush by the extreme fire (Smith, Taylor & Thompson, 2015). If they are important assets, they need to be secured first by trying to put out fire in areas they are located. Other important factors to consider are the cultural heritage and biodiversity such as wildlife, natural physical features that could be destroyed by the fires.
The firefighting unit together with the scouts should carry out exploration of fire behavior and borders (by means of thermal cameras). A helicopter to be used in transporting fire crews and scouts from different places of the park to the most significant places to fight the fires.  As the chief I would offer a stage for aerial broadcasting repeaters, which would be done through walkie-talkie transmitter and receiver to retransmit two-way means of conversation signals over a long distances (Bryant, Waters & Sinnott, 2014). I would offer an observational or a command podium so that everybody in the firefighting region would communicate with one another.
The helicopters are would be used to carry and winch inferno squads against the fire ground, that is the region where fire-fighting process would be taking place. I would deliver operating support for squads on the fire ground and help in identifying hotspots by the use of infrared devices. They were to carry out investigation and offer air-attack administration, observational or command podiums. They also carried out aerial eruption and water bombarding (Hradsky, Christie & Di Stefano, 2017).
Huge air tankers could be used in the affected area to spray water. The scouts and the squad responsible for fire Service flight and experts would organize a lead aircraft to escort the trucks with water. This airplane could be used to assess the fire ground, determine the best airlift path for the trucks, and then lead them through the fire ground to demonstrate to them where to drop their cargo (Walters, Mair & Ritchie, 2015). The flight unit similarly would contribute to environmental and pest managing, as well as carrying of resources and training.
Another method that would be very crucial would be the backburning which is a method used to regulate and contain infernos. It comprises burning extra fire to consume fuel in the pathway of the major fire. Backburning is an efficient fire suppression method that could be cost efficient. It is similarly ecologically maintainable as the shrub could recuperate from this practice. A backburn is generally ignited from a safe control mark and permitted to burn in the direction of the major fire (Swan, Christie, Sitters, York & Stefano, 2015).
Factors that may affect the disaster response plan
Factors such as wind would cause spread of fires very fast and make it hard to put the fire. A good way to control this would be the use of backburing by use of barricade. A control mark is a barricade, which blocks spreading of the fire. It could be a prevailing aspect of the site for example a watercourse, stream or path or a barricade made by firefighters. An artificial control mark is a strip of ground, which has been excavated, burned out or else cleared of fuel ahead of a fire’s progress. A backburn is simply done only when both fuel and climate situations are appropriate for the suppression of the burn. This might be during the nighttime when it is calmer and moister, once the wind change or calm, or when a calm change. The causes for bushfires would be brought about by heat waves during the summer period. . They are particularly to cause risks of causing bush fires during the summer months.
Plans for managing psychological stressors plan
It is important that people stay up-to-date and linked to what is happening from one place to another and listening carefully to the situations of the place from the officials broadcasters of a nation. This is attributed to the point that the catastrophe administration section is should send disaster cautions and informs the public through different mass media stations. It is always essential to keep an eye on the fellow resident during these times, mostly the elders, youths and people with incapacities. Several ageing persons when left on their own might experience some unnecessarily difficulties and psychological stress since they are isolated from their supporters and families (Wilkinson, Eriksen & Penman, 2016). Elders and the rest who may be delicate to bush fires ought to connect with families, fellow citizen, or kinsfolks at least twice a day during such periods. Make sure that one safeguards his or her health and if possible, exclude themselves of the areas with bush fires. This would be a way to avoid stress for the aged, women and children.
Strategies for evaluating the effectiveness of the disaster management plan
The following are recommendations that should be put in place in responses to bushfires in future for disaster management plan

Manpower
Local Resources
Resources for Displaced Persons (evacuation and shelters)
Transportation
Medical Supplies and Resources
Emergency Facilities (emergency operations center
Electricity and Fuel
Food and Water
Fire and Emergency Medical Services (EMS)

Conclusion
Bushfires could affect wildlife in the forests and also the vegetation of a place. Destruction of forests could results to climate change and a resulted to effects on the environs, which are noticeable over period. The climate change not simply affects human beings but likewise wildlife and vegetation that are great attraction places for travellers across the world. This can affect the social and economic in various ways due to either negative impact of a country (Bush, Barry & Burgess, 2014).
Different human activities on the environment could lead to bushfires such as burning substances that could spread very fast to huge fires. Due to large numbers of people around an area, they may increase burning of substances that could trigger huge fires that explode in massive areas. In addition, there is usually massive winds blowing across the regions that would accelerate burning and spreading of bushfires. The most known and largest contributor of bushfires is the burning of the materials in the environment without any control.
References
Lindenmayer, D. B., Blanchard, W., & Gill, M. (2016). Temporal trends in mammal responses to fire reveals the complex effects of fire regime attributes. Ecological applications, 26(2), 557-573.
Whittaker, J., Eriksen, C., & Haynes, K. (2016). Gendered responses to the 2009 B lack S aturday bushfires in V ictoria, A ustralia. Geographical Research, 54(2), 203-215.
Bush, M. B., Correa-Metrio, A. & Overpeck, J. T. (2016). A 6900-year history of landscape modification by humans in lowland Amazonia. Quaternary Science Reviews, 141, 52-64.
Bush, M. B., Zimmermann, M., & Silman, M. R. (2015). Fire and climate: contrasting pressures on tropical Andean timberline species. Journal of Biogeography, 42(5), 938-950.
Smith, B., Taylor, M., & Thompson, K. (2015). Risk perception, preparedness and response of livestock producers to bushfires: a South Australian case study. Australian Journal of Emergency Management, The, 30(2), 38.
Bryant, R. A., Waters, E., & Sinnott, V. (2014). Psychological outcomes following the Victorian Black Saturday bushfires. Australian & New Zealand Journal of Psychiatry, 48(7), 634-643.
Hradsky, B. A., Christie, F., & Di Stefano, J. (2017). Responses of invasive predators and native prey to a prescribed forest fire. Journal of Mammalogy, 98(3), 835-847.
Walters, G., Mair, J., & Ritchie, B. (2015). Understanding the tourist’s response to natural disasters: The case of the 2011 Queensland floods. Journal of Vacation Marketing, 21(1), 101-113.
Swan, M., Christie, F., Sitters, H., York, A., & Di Stefano, J. (2015). Predicting faunal fire responses in heterogeneous landscapes: the role of habitat structure. Ecological Applications, 25(8), 2293-2305.
Brandt, M., Tappan, G., & Fensholt, R. (2017). Woody vegetation die off and regeneration in response to rainfall variability in the West African Sahel. Remote Sensing, 9(1), 39.
Wilkinson, C., Eriksen, C., & Penman, T. (2016). Into the firing line: civilian ingress during the 2013 “Red October” bushfires, Australia. Natural Hazards, 80(1), 521-538.
Bush, D., Barry, C., & Burgess, N. (2014). What do grid cells contribute to place cell firing?. Trends in neurosciences, 37(3), 136-145.

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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

0 Download3 Pages / 667 Words

Course Code: 400285
University: Western Sydney University

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Country: Australia

Question:

What is the difference between freedom of speech and hate speech?

Answer:

Introduction
United Nation aims at promoting dignity and equity to all human beings globally. Also, it encourages and supports mutual respect for fundamental freedoms and human rights to all without discrepancy as to religion, race, sex or language. Freedom of speech is recognized globally as the human right in international human rights laws (Djuric et al., 2015 pp.29-30). The paper seeks to explore the difference between freedom of speech and hate speech. Also, the paper will outline the impact of speech on health, the role of the press in free and hate speech.      
The Difference Between Freedom of Speech and Hate Speech
According to Waseem, and Hovy, (2016) freedom of speech is the power or right of a community or an individual to articulate their ideas and opinion without fear of legal penalties, censorship or restraint. Nevertheless, an individual may have to face the consequences of saying some things, however much they have the right to say them. For instance, it is against the law for one to shout the ward fire in a hospital or crowded place because one may get injured. On the other hand, hate speech is communicating in a way that attacks a group or a person by traits such as gender identity, sexual orientation, race, or ethnic origin (Van Spanje, and De Vreese, 2015 pp. 115-130). The concept freedom of speech and hate speech has brought a heated debate across the globe as there is no clear description of what constitute free speech and what truly is hate speech.
Moreover, in countries such as the United States, its press and citizens can communicate freely and criticize the government without fear of convictions but in some countries such as Russia and Chine the people and the press fear for their lives when they speak the truth especially if it is against the government or a prominent leader. It is clear that freedom of speech has not taken it root in many countries. Using, abusive, insulting or threatening wards towards a group is hate speech while giving your idea, opinion or view on which one might not agree is considered freedom of speech. Furthermore, speech plays a critical role in an infirmary as it promotes wellbeing and health of patients (Tsesis, 2015 pp. 1015). For instance, one might speak about poor services in a hospital which will facilitates improvement of quality health. Hate speech is a significant encounter among the journalist in today’s society. The role of the press is to speak without fear when criticizing corrupt politicians (Venkatraman, Garg, and Kumar, 2015 pp. 1422-1425). Also, it is the role of the press to ensure that their content does not incite or promotes violence against a particular group.
Conclusion
Freedom of speech is the power or right of a community or an individual to articulate their ideas and opinion without fear of legal penalties, censorship or restraint. For example, giving your insight, opinion or view to which one might not agree. On the other hand, hate speech is communicating in a way that attacks a group or a person on traits such as gender identity, sexual orientation, race, or ethnic origin.
Bibliography
Djuric, N., Zhou, J., Morris, R., Grbovic, M., Radosavljevic, V. and Bhamidipati, N., 2015, May. Hate speech detection with comment embeddings. In Proceedings of the 24th international conference on world wide web (pp. 29-30). ACM.
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Waseem, Z. and Hovy, D., 2016. Hateful symbols or hateful people? predictive features for hate speech detection on twitter. In Proceedings of the NAACL student research workshop (pp. 88-93).

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Leadership in the hospital is the ability to influence the staff toward providing quality health care. Leadership involves influencing human behavior to create a positive working environment (Langlois, 2012). Good leadership enables healthy relationships among staffs in the hospital enhancing quality delivery of health care services. Leadership is responsible to building teams that have trust, respect, support and effecti…
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Introduction
According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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Course Code: 400285
University: Western Sydney University

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Country: Australia

Question:

Is hospital readmission an indicator of poor delivery of health care? Why or why not?
What is your experience with hospital readmissions?
If one of your family members was readmitted to the hospital three days after a surgery for an infection, would the readmission be the responsibility of an individual or of the organization? Why or why not?

Answer:

Hospital readmission is the situation in which an individual who had been discharged by the healthcare staff is admitted again in the same hospital for a specified period of time. The rates of hospital readmission are being applied to measure the outcome of healthcare research as well as the benchmark for quality services for healthcare systems. Most of the healthcare centers have been punished under the patient protection and affordable act of 2010 if their readmission rates are higher than the stipulated rates. Thus, most healthcare organizations have introduced programs to reduce the rates of readmission and to improve the quality of services. Hospital readmission has proved problematic not only for the healthcare providers, patients, players, policymakers, but also the family of the patients. This is because hospital readmissions are not only expensive (Birmingham & Oglesby, 2018), but they are also an indication of inefficiency and poor quality in healthcare centers (Khouri Jr et al. 2017). It should be noted that Medicare program pays for almost all the readmission expect if an individual is readmitted within less than 24 hours after the first discharge for the same medical condition in which he or she had been hospitalized.
My experience with readmission has been worst since I was the one who got the first-hand experience. I was diagnosed initially with acute malaria. After two weeks I was readmitted again for the same reason. After an inquiry from the hospital management as to why was being readmitted for a similar condition, I was informed that the healthcare provider who handled my case did not effectively treat for the disease. This experience was terrifying since I lost confidence with the providers as I was not sure they would do the same mistake.
Hospital readmission after more than one day
Currently, hospital readmission after more than one day is normally catered for financially by an individual through Medicare program in the United States of America. For the individuals who are not in Medicare program, the readmission is the sole responsibility of the patient. This situation is normally burdening for the patient who has to use a lot of money treating the same condition in which they were initially hospitalized (Shebehe & Hansson, 2018).
References
Birmingham, L. E., & Oglesby, W. H. (2018). Readmission rates in not-for-profit vs. proprietary hospitals before and after the hospital readmission reduction program implementation. BMC Health Services Research, 18, 1–N.PAG. https://doi.org/10.1186/s12913-018-2840-4
Khouri Jr, R. K., Hechuan Hou, Dhir, A., Andino, J. J., Dupree, J. M., Miller, D. C., … Hou, H. (2017). What is the impact of a clinically related readmission measure on the assessment of hospital performance? BMC Health Services Research, 17, 1–6. https://doi.org/10.1186/s12913-017-2742-x
Shebehe, J., & Hansson, A. (2018). High hospital readmission rates for patients aged ≥65 years associated with low socioeconomic status in a Swedish region: a cross-sectional study in primary care. Scandinavian Journal of Primary Health Care, 36(3), 300–307. https://doi.org/10.1080/02813432.2018.1499584

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According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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Course Code: 400285
University: Western Sydney University

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Country: Australia

Question: 

Discuss the prevalence (health statistics) of this health area for the Australian population and compare data for Indigenous and non-Indigenous populations.
Outline the burden of disease for this health area for the Australian population, this includes outlining the DALY/YLL (you will need to find out what these mean). You may relate this to a chronic condition and present the burden of disease for this.
Briefly outline government health policies or health strategies which have been developed in association with this health area.

Answer: 

Introduction:
The purpose of the assignment is to provide a brief review on the 2016 Australia’s Health Tracker report presented by the Australian Health Policy Collaboration. In this regards the report will outline one of the risk factors, prevalence of the risk factor, burden of disease for the particular health area in Australia and health policies of Australian government for the particular risk factor. The chosen risk factor for this assignment is adults who are overweight or obese.
Risk factor:
According to the health statistics of WHO, it has been found that Australia has ranked third in the prevalence of obesity in adults. It has been found that obesity has the highest impact on people aged between 60-75 years old (who.int, 2018). The Australian government has targeted to reduce the prevalence to 61.1% within 2025. The report has shown that the trend is in the wrong direction and progress is poor against the target (Vu.edu.au, 2018). Risk of severe disease such as cardiovascular attack, diabetes, respiratory disorders and cancer is high for the obese people (Müller-Riemenschneider et al., 2013). Thus, it is important to provide adequate focus to the matter to address the risk factor of obesity in Australia to improve the health status.
Prevalence:
The prevalence of obesity is higher in case of Indigenous people as compare to non-indigenous people. The statistics provided by the 2016 Australia’s Health Tracker report has shown that the prevalence of obesity in adults is 63.4% for non-indigenous people whereas the prevalence is higher that is 71.4% for indigenous people (Vu.edu.au, 2018). Research has indicated lack of adequate information regarding the proper diet, nutrition and health risk as the main cause of such disparity in the status of health of indigenous and non-indigenous people (Anderson et al., 2016). Thus, it is required to introduce effective strategies in order to mitigate the issue of obesity and reduce the health inequality in the Australian population.
Burden of disease:
Burden of disease in a population can be understand with the help of the metrics known as Disability-adjusted life year or DALY. One DALY is considered as the one lost year of healthy life. It is calculated as the sum of Years of life lost (YLL) and Years lost due to disability (YLD). Increasing obesity has led to the increasing burden of disease. As mentioned before, risk of chronic disease even death is higher in case of obese people. In Australia it has been found that due to cardiovascular risk 507231 years of life lost has occurred (Who.int, 2018). Thus, it is clear that disease burden of chronic disease like cardiovascular risk is high in Australia due to high obesity rate.
Government health strategies:
In order to reduce the prevalence of obesity in adults the Australian government has introduced some strategies. For example, the Australian government has introduced National preventive health task force in order to develop effective strategies to resolve the issue of obesity and other health issues related to it. The Australian National Preventative Health Agency has been developed in 2011 to cope up with the health issue. In addition the government of New South Wales has announced weight loss surgery for morbidly weight patients (health.gov.au, 2018). Such steps are appreciable, however more focus needs to be provided to achieve expected outcome.
References:
Anderson, I., Robson, B., Connolly, M., Al-Yaman, F., Bjertness, E., King, A., … & Pesantes, M. A. (2016). Indigenous and tribal peoples’ health (The Lancet–Lowitja Institute Global Collaboration): a population study. The Lancet, 388(10040), 131-157.
health.gov.au (2018). Department of Health | Health Systems Policy Division. Retrieved from https://www.health.gov.au/internet/main/publishing.nsf/Content/health-systems-policy-division
Müller-Riemenschneider, F., Pereira, G., Villanueva, K., Christian, H., Knuiman, M., Giles-Corti, B., & Bull, F. C. (2013). Neighborhood walkability and cardiometabolic risk factors in Australian adults: an observational study. BMC public health, 13(1), 755.
Vu.edu.au (2018). Retrieved from https://www.vu.edu.au/sites/default/files/AHPC/pdfs/australias-health-tracker.pdf
who.int (2018). WHO | Metrics: Disability-Adjusted Life Year (DALY). Retrieved from https://www.who.int/healthinfo/global_burden_disease/metrics_daly/en/
who.int (2018). World Health Statistics 2017: Monitoring health for the SDGs. Retrieved from https://www.who.int/gho/publications/world_health_statistics/2017/en/

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Answer to question 1
I have conducted a survey at my workplace maned Lady’s Hospice and Care Services to observe the working environment. The aim of the survey is to find if it is a safe, healthy, secured and fulfilling place to work. A visual survey was conducted to locate and record the safety signs in the workplace. The objective of the survey is to observe and list different types of signs, location, their prom…
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Palliative care services are designed to improve the life of patient with progressive disease. People receiving palliative care have illness that has no prospect of cure.  As per the World Health Organisation, palliative care is a care given to patient suffering from life threatening illness to improve their quality of life by preventing and providing relief from sufferings by early recognition , assessment and trea…
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Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) is the spectrum of medical conditions caused due to human immunodeficiency virus (HIV) following which the patient suffers from a series medical complications due to suppression of the immune system of the body. With the progression of the disease, the patient is likely to suffer from a wide range of infections like tuberculosis and other opportu…
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Introduction
Leadership in the hospital is the ability to influence the staff toward providing quality health care. Leadership involves influencing human behavior to create a positive working environment (Langlois, 2012). Good leadership enables healthy relationships among staffs in the hospital enhancing quality delivery of health care services. Leadership is responsible to building teams that have trust, respect, support and effecti…
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Course Code: BL9412
University: University Of The West Of England

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Answer:
Introduction
According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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Question:
Critical review of the literature on one emerging or re-emerging communicable disease threat (choose from kit below); should include role of agent, host and environmental factors, potential policy responses. 
– Zika Virus
– MERS (Middle East Respiratory Syndtg’rne)
– Ebola – HIV
– MDR/XDR Tuberculosis 
Answer:

Introduction
Ebola is one of the most dangerous diseases found across the world particularly in Africa nations, affecting both nonprimate and primates (World Health Organization, 2014). Since the period 1976 to the year 2014 Ebola virus epidemics (24) have been confirmed to be caused by Zaire Ebola virus in equatorial Africa. The outbreaks of Ebola have been small, but it has captured the attention of many in the world due to the high fatality rate caused by it as well as the primal way in which it kills (World Health Organization, 2014).  In most cases the bat (fruit bat) are supposed seen as the virus carrier in nature, however, they spread the virus, but they are not affected by it (Gire, Goba, Andersen, Sealfon & Park,  2014).  The signs include experiencing pain in muscles, sore throat, diarrhea, vomiting, fever and headache.  A significant outbreak of Ebola virus was reported in the year 2014, in some parts of West Africa (Guinea, Sierra Leone, and Liberia) being the deadliest, most extended and most complex in history (Gire, Park et al., 2014). One of the reasons why Ebola is very critical is because the symptoms appear quickly and are varied. However it resembles those of other viruses making it difficult to be diagnosed. The best way to survive is early diagnosis shadowed with supportive care. Regular seasonal weather change is a crucial factor when dealing with EVD. Animal migration and behavior patterns are mostly determined by weather. For example shift in climate promotes migration of bats and other animal species to plants and the living environments of human beings in search of food (Team, 2015).
Presently, as people destroy the natural habitat of organisms, they seem to move to other areas to find better habitats. Humans cut down trees to sustain their population since the human population compared to the past has increased drastically (Team, 2015). Most infected countries experienced several challenges that affected how they responded to the emergence of the outbreak of Ebola.
Role of Agent
Ebola is a viral disease caused by filoviridae virus family, and it’s also known as Ebola hemorrhagic fever or EVD. It was discovered first in the year 1976 Zaire currently known as Congo (Baize, Pannetier , Oestereich, Rieger & Koivogui,2014). Ever since the Ebola virus has spread rapidly in Africa (central Africa). It has a high mortality rate of about almost 90%. The disease can affect both humans and its close relatives (primates). After contracting the disease, the signs begin to show after the second day and the third week immediately after disease contraction (BaizeKoivogui et al., 2014). The symptoms include experiencing pain in muscles, sore throat, diarrhea, vomiting, fever and headache. Consequently, the kidney and liver function begins to reduce and individuals start to experience internal and external bleeding. Ebola is a dangerous disease that kills at a faster rate (at least 25% and 90% of the individuals affected with it) (Dixon, & Schafer, 2014).  
  Direct contact of the fluids of the body spreads EVD, for example, if one gets in touch with humans and animals blood that is affected. Also, the contact involves direct contact with items that are contaminated with body fluids (Dixon, & Schafer, 2014).  The affected individuals that have been affected by Ebola virus may still contain the virus for many weeks and months. In most cases, the bat (fruit bat) are supposed seen as the virus carrier in nature. However, they spread the virus, but they are not affected by it (Qiu, Wong, Audet, Bello & Fernando, 2014)
The Ebola virus replicates competently in many cells, thus generating an enormous amount of virus in macrophages, dendritic cells, and monocytes. Since the period 1976 to the year 2014 Ebola virus epidemics (24) have been confirmed to be caused by Zaire Ebola virus in equatorial Africa The duplication of the virus activates the high level of signals of chemical (inflammatory) which leads to a state that is septic (Dixon, & Schafer, 2014).  The infection attacks mainly the body cells, for example, the cavity of the liver and immune cells such as macrophages, dendritic cells, and monocytes. The virus reproduces immediately after it’s carried to the lymph nodes by the immune cells. Thus the virus is spread rapidly and enters the bloodstream and the lymphatic system, therefore distributing to all over the body (BaizeKoivogui et al., 2014).  The viral agent infects the virus causing the death of the cells. It consequently causes abnormal lymphocytes concentration that is low in the blood. This leads to an immune system that is weak among infected individuals.
The Ebola virus does not divide through cell division, but they bring up their grown genetic sequence in the host cell DNA and therefore alter the normal cellular process in the body (Dixon, & Schafer, 2014).  The cell of the host starts to produce proteins that are viral. In the process they bloom from the host cell, taking the portion of the cell peripheral membrane, therefore, enveloping themselves against detection by the system of the host immune. In most cases, the human immune system usually produces antibodies to fight infection, but for the case of EVD, the virus always multiplies rapidly that the immune system cannot catch up (World Health Organization, 2014).  
Infection of endothelial cells happens after three days virus exposure, thus the cells breakdown causing injury of the blood vessels. The damage occurs as a result of glycoprotein synthesis of Ebola virus, which decreases particular integrins obtainability that help in adhesion of the cell to structures of the intercellular, hence causing damage of the liver, leading to inappropriate clotting (World Health Organization, 2014).   The people affected experience widespread bleeding that result in shock and swelling due to blood volume loss. The replication of the Ebola virus overpowers the synthesis of proteins (of the infected cells) and the host immune defense (Baize, Pannetier , Oestereich, Rieger , Koivogui, et al., 2014).
Host and Environmental Factors
Environmental factors have significantly attributed to the spread and development of EVD. International partners and health officials in Guinea took an extended period to identify the cause of Ebola virus (Alexander, Sanderson, Marathe, Lewis & Rivers,  2015). By this moment the virus had already spread quickly affecting an enormous population of people in the west part of Africa. Ebola was an ancient disease in a new context, thus changing a significant number of people since the counties were not prepared to handle EVD since it appeared to be unfamiliar. People, therefore, did not understand what hit them at that time. Additionally, the government hadn’t countered the social and economic confusion brought about by this disease. As a result, most were affected without understanding what was going on (Alexander, Rivers et al., 2015).
The epidemics of EDV begins specifically when one gets in contact with an infected individual or infected meat or body fluids of animals that are infected. Immediately the patients become sick or deceased; the virus can be transmitted to others who come in contact with the infected body, for example, contact with the skin, blood and other fluids of the body(Alexander, Rivers et al., 2015).
Climatic Change
Regular seasonal weather change is a crucial factor when dealing with EVD. Animal migration and behavior patterns are mostly determined by weather. For example shift in climate promotes migration of bats and other animal species to plants and the living environments of human beings in search of food (Watts, Adger, Agnolucci, Blackstock, Byass, et al,.2015). Thus in the process, they come in contact with a human, transmitting disease-causing organisms to them for example Ebola Ecoli. Also, the distribution of plants and water depend on the patterns of the weather; this influence infected animal movement into areas they would not be found. For example watts and colleagues found out a connection between the outbreaks of Ebola and shifts of unfamiliar drier than regular periods after rainy times (the animals that were infected moved deeper into the space of humans in search of food and water and/, or humans walked deeper into the forest also in search of food and water. Therefore it implies that during drier seasons Ebola outbreak is high (Watts, Adger, Agnolucci, Blackstock, Byass, et al,.2015).
Currently, the climatic change in West Africa is affecting the animal migration pattern because the region is becoming hotter. In this case may increase outbreaks of Ebola in the area because there will be an increase of humans contact with animals (Wesolowski, Buckee, Bengtsson, Wetter, Lu, & Tatem, 2014).
Presently, as people destroy the natural habitat of organisms, they seem to move to other areas to find better habitats. Humans cut down trees to sustain their population since the human population compared to the past has increased drastically (Wesolowski, Buckee, Bengtsson, Wetter, Lu, & Tatem, 2014). Therefore, the increase in genetic diversity of animals and interactions of humans in restricted areas signify a condition that is perfect for the evolution of the Ebola virus, which makes it develop into a vector that is exceedingly transmittable and deadly. Additionally, encroaching of animals and population of humans on each other space the chance of finding infected animals and feeding n contaminated crops is very high.
Filoviruses such as Ebola come about mostly in the tropical regions in Africa, specifically in rainforests that are humid. Thus the virus can move swiftly in both south and eastern part of Africa.  Apart from Africa the Philippines also present Ebola Reston virus, since it experiences similar climatic conditions as tropical regions in Africa(Wong, Liu, Liu, Zhou, Bi, & Gao, 2015).  The virus needs a host to be active biologically; thus they are an obligate and acellular organism. Some viruses can survive outside the body of the host while others cannot be able to survive outside the environment. In this case, the virus can be transmitted or transported both directly or indirectly (Wong et al., 2015). The Ebola virus enters the body and gets attached to the receptors in the body. Immediately the virus gets connected in the body the virus genome will be integrated into the DNA of the host. As the cell divides, the Ebola virus genome also divides rapidly. Thus the rate of mutation is high, therefore increasing pathogenicity (Wong et al., 2015).
Ebola virus is enveloped that causes harm to its host due to glycoprotein presence that causes the attachment to its host. Glycoprotein experience environmental exposure which binds to particular receptive of the host (Wesolowski, Buckee, Bengtsson, Wetter, Lu, & Tatem, 2014).  This play a critical role in the communication of other cells and the external environment. Ebola as an enveloped virus can be found in the external environment in a concentration that is high (Wong et al., 2015).  Nonetheless, this kind of environment enables the Ebola virus to persist outside the body of the host. It is this persistence of Ebola virus in the context that results in reoccurrence and infection risk among primates and non-primates. In this case, if the environment is adequately maintained the emergence of Ebola will be prevented. Most African countries experience sanitation problems thus presenting high risk to public health. Ebola virus disease is mainly ascribed to sanitation that is poor, as a result, the mortality rate is at its highest peak (Watts, Adger, Agnolucci, Blackstock and Byass, 2015).
Unsafe Water and Inadequate Excrete Disposal Facilities
The virus is transmitted among people through contact and contamination. For example, food scarcity promotes transmission of Ebola virus disease, since they decide to practice hunting and gathering thus they quickly come in connection with the animals that are infected. Additionally, nutrition lack required by the body of a person undergoes physiological disablement and incapability to react to the environment resulting to the vulnerability of the body, in consequence, EVD attacks readily (WattsByass et al.,2015).
Human beings may lack specific needs to sustain themselves (more especially the basic needs and a high number of infected individuals is the main reason for EVD spread more specifically in Africa) (Wesolowski et al., 2014).  Consequently, displacement of the population also initiates EVD outbreak among people, in this case, if a member of a particular group is a disease carrier. If movement is not well looked out upon people are at the risk of contracting EVD. EVD geography may assist perfect the outbreaks and random cases of the virus of Ebola.
Accordingly, due environmental factors stated above EVD keeps on reoccurring in Africa. The original virus reservoir remains unknown; it’s believed that during the first outbreak the virus might have persisted in the environmental permitting it to reoccur repeatedly over time. Environmental factors such as lack of sanitation, displacement, water supply, and geography stir up human possibility infection among the countries in Africa. They contribute to the biological, physical and chemical factors, which help in survival, transportation, and persistence of the Ebola virus. It’s necessary to understand the fate of the virus in the environment to properly study EVD, since they stand a high chance of infection, exclusively when the features are advantageous to them. People have to adapt to approaches that are therapeutic to prevent and control the disease.  Increase mortality, about nonexistence treatment and vaccines makes the virus of Ebola an essential pathogen in public health and a group A biothreat pathogen (Wesolowski et al., 2014).
Potential Policy Responses
Individual responses were put in place to control the development and spread of the Ebola virus. Ebola first outbreak in Guinea was published on WHO website (Scott, 2015). It consisted of a ministry of health measures in partnership with international partners and WHO to regulate the outbreak and the spread of EVD further on humans. Some of this measures consisted of deployment of a multidisciplinary team in the different field to manage, trace and detect cases of the virus. The laboratories in the region were well prepared to handle more instances of the disease outbreak. Additionally, they set up rapidly isolation facilities.
Due to the increase of Ebola outbreak in the Africa regions, the health ministries were stimulated to reinforce their alert system and implement the appropriate necessities of the regulations of international health (Scott, 2015).  New medical teams were mobilized (it involved physician experts) in preventing infection and also govern and support the clinicians at local hospitals. There was a need for the physicians’ experts to go beyond traditional areas of the epidemiology, services of the laboratory, prevention and control of infection, management of the clinical case, and logistics to initiates medical anthropology, social mobilization, and communication experts. Populations’ opposition decided to join insufficient facilities of treatment and inadequate human resources as a critical barrier to control (AbramowitzFallah et al., 2015).
Additionally, specific responses put in place to control the development and spread of the Ebola virus included mobilization of religious and community leaders to spread more understanding awareness about the illness (AbramowitzFallah et al., 2015). I addition they also strengthened case study, observation, and tracing of contact to minimize the transmission of the diseases. People became more aware of the virus. Consequently, they were also informed of the concentrated transmission of EVD. A significant number of staffs were deployed to the infected areas, and even most participants agreed to fund the countries to the response (Scott, 2015).  
Significant factors contributing to the spread of EVD were identified to be traditional and cultural practices, for example, burial practices. The virus is believed to be high after the death of individuals, since experiencing death means that replication is high, migrating patterns of the population within borders and countries, and insufficient handling with adequate measures of containment. Thus these factors contribute to the biological, physical and chemical factors, which help in survival, transportation, and persistence of Ebola virus (AbramowitzFallah et al., 2015). It’s necessary to understand the fate of the virus in the environment to properly study EVD, since they stand a high chance of infection, exclusively when the features are advantageous to them. During the outbreak, it was necessary to facilitate ban travel and trading. Additionally, isolation promoted the reduced rate of transmission of the virus to other populations. However, this response advanced crippling and intensification of the hardship faced by the community (Scott, 2015).  
Most infected countries experienced several challenges that affected how they responded to the emergence of the outbreak of Ebola. For example, the health systems were fragile, most lacked experienced in handling the disease (Ebola virus disease), profoundly moving population, the public did not have proper information concerning the virus (misconception) and the transmission mode.
Accordingly, international governments (UK and USA) in Sierra Leone and Liberia build treatment centers to facilitate the support and care of the infected population easily. Also, the UN Security Council emergency session was set up to analyze the epidemic implications as a threat to peace and security internationally (Scott, 2015).  Throughout history the disease marked the first time provoked emergency session of the Security Council. Air Bridge was established to increase staff and material flow, this comprised of vehicles and medicines that were essential. Protective equipment needed to be supplied in large numbers since even the smallest treatment facilities need several of this equipment per day (AbramowitzFallah et al., 2015). This implies that some controlling the disease were a difficult task that needed proper attention all the time. Thus the responses required approachability to ensure it worked.
In conclusion, Ebola is one of the most dangerous diseases found across the world particularly in Africa nations, affecting both nonprimate and primates. Thus it needs extreme attention to ensure that development and the spread are controlled. Influenced by several factors such as climatic change, lack of sanitation, displacement, water supply, and geography which stir up human possibility infection among the countries in Africa The cure is yet to be discovered, therefore support and isolation is still the proper way of controlling the virus.
References
Abramowitz, S. A., McLean, K. E., McKune, S. L., Bardosh, K. L., Fallah, M., Monger, J., … & Omidian, P. A. (2015). Community-centered responses to Ebola in urban Liberia: the view from below. PLoS neglected tropical diseases, 9(4), e0003706.
Alexander, K. A., Sanderson, C. E., Marathe, M., Lewis, B. L., Rivers, C. M., Shaman, J., … & Eubank, S. (2015). What factors might have led to the emergence of Ebola in West Africa?. PLoS neglected tropical diseases, 9(6), e0003652.
Baize, S., Pannetier, D., Oestereich, L., Rieger, T., Koivogui, L., Magassouba, N. F., … & Tiffany, A. (2014). Emergence of Zaire Ebola virus disease in Guinea. New England Journal of Medicine, 371(15), 1418-1425.
Dixon, M. G., & Schafer, I. J. (2014). Ebola viral disease outbreak–West Africa, 2014. MMWR. Morbidity and mortality weekly report, 63(25), 548-551.
Gire, S. K., Goba, A., Andersen, K. G., Sealfon, R. S., Park, D. J., Kanneh, L., … & Wohl, S. (2014). Genomic surveillance elucidates Ebola virus origin and transmission during the 2014 outbreak. science, 1259657.
Judson, S., Prescott, J., & Munster, V. (2015). Understanding ebola virus transmission. Viruses, 7(2), 511-521.
Qiu, X., Wong, G., Audet, J., Bello, A., Fernando, L., Alimonti, J. B., … & Johnson, A. (2014). Reversion of advanced Ebola virus disease in nonhuman primates with ZMapp. Nature, 514(7520), 47.
Scott, S. V. (2015). Implications of climate change for the UN Security Council: mapping the range of potential policy responses. International Affairs, 91(6), 1317-1333.
Team, W. E. R. (2015). Ebola virus disease among children in West Africa. The New England journal of medicine, 372(13), 1274.
Team, W. E. R. (2015). West African Ebola epidemic after one year—slowing but not yet under control. The New England journal of medicine, 372(6), 584.
Watts, N., Adger, W. N., Agnolucci, P., Blackstock, J., Byass, P., Cai, W., … & Cox, P. M. (2015). Health and climate change: policy responses to protect public health. The Lancet, 386(10006), 1861-1914.
Wesolowski, A., Buckee, C. O., Bengtsson, L., Wetter, E., Lu, X., & Tatem, A. J. (2014). Commentary: containing the Ebola outbreak-the potential and challenge of mobile network data. PLoS currents, 6.
Wong, G., Liu, W., Liu, Y., Zhou, B., Bi, Y., & Gao, G. F. (2015). MERS, SARS, and Ebola: the role of super-spreaders in infectious disease. Cell host & microbe, 18(4), 398-401.
World Health Organization. (2014). WHO: Ebola response roadmap situation report 15 October 2014.

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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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Critical review of the literature on ONE emerging or re-emerging communicable disease threat (choose from list below); should include role of agent, host and environmental factors, potential policy responses.
– Zika Virus
– MERS (Middle East Respiratory Syndrome)
– Ebola
– HIV
– MDR/XDR Tuberculosis

Answer:

Introduction
An emerging disease is referred to an infectious disease whose incidence has increased within a geographical area and threatens to spread and affect a huge proportion of the population. (Morse,2012) states that some of the factors contributing to emerging diseases include civil wars, the breakdown of public health policies, economic changes, increased immunosuppression and change in microorganisms genetic material. (National Institutes of Health,2013) states that a reemerging disease is one which in the past had been dealt with but is now becoming a health concern in a country or certain geographical area. Ebola is a reemerging disease according to the United States center for disease prevention and control. The first outbreak occurred in Zaire and in South Sudan in 1976 both outbreaks caused by different strains of the Ebola virus. In Zaire, there were 280 deaths while in South Sudan there were 151 deaths according to the World Health Organization. In 1977 there was another outbreak in Zaire with one fatality followed by an outbreak in Sudan in 1979 with 22 deaths.1994 was marred with two outbreaks in Gabon and Cote d’Ivoire. Zaire was again hit by the virus in 1995 and consequently Gabon in the year 1996. This continued in the twenty-first century with the worst epidemics occurring in the year 2014 to 2016 in Guinea with 2543 deaths reported representing a case fatality of 67%. At the same time, Liberia had reported 4809 deaths representing a case fatality of 45%. During the same period, Sierra Leone reported 3956 deaths a case fatality of 28%.In 2014 Nigeria reported 8 deaths while Senegal reported one case. The democratic republic of Congo reported 49 deaths in 2014. This virus was also reported in the United States of America, United Kingdom, Spain, and Italy in 2014.
(World Health Organization,2014) declared the 2014 Ebola outbreak as health emergency of warranting international concern since its spread was occurring at a very high rate. The outbreak was heavily attributed to geographical location and migration from the urban to the rural areas. Poor public health systems contributed to the rapid spread of Ebola in 2014 since the countries affected were recovering from war and hence little education among its citizens. The bad roads made it hard to transport the patient, especially in rural areas. Poor telecommunication services led to late emergency response since informing the health agencies was done when it was already too late. (World Health Organization,2015) states that the borders between these countries were porous meaning infected persons would cross to the other country easily transmitting the disease. Also, infected persons would seek health services in the other country while it had started improving causing new infections. Some practices performed such as washing the body of an infected person before burial or even touching it would lead to the spread of this virus since the viral load was still high in the corpse. The 2014 epidemic was manifesting differently compared to the previous outbreaks. This would lead to the slow detection of the virus while its spread continued. Shortage of health workers also led to the spread of the virus as some of them also ended up being infected and dying while there was no use of personal protective equipment at first while attending to the patients.
Role of Agent
Ebola is a viral hemorrhagic fever belonging to the family Filoviridae. The virus is known to affect both primates and nonprimates. The agent is a ribonucleotide acid, enveloped and it is negative sense single-stranded. (Cenciarelli et al,2015) states that there are five known Ebola viruses namely Ebola virus which was detected first in Zaire in 1976, Sudan virus discovered in 1976, Reston virus detected in 1989, Tai forest virus in 1994 and Bundibugyo virus in 2007. Reston virus is not pathogenic to humans. (Groseth, Fellmann, and Strong,2012) states that Ebola is zoonotic meaning it affects both humans and animal species. The virus is transmitted via direct contacts such as mucous membranes, body fluids and contaminated objects such as needles, sexual contact, and contact with infected persons or corpses.
Once infected with Ebola virus there is multiple organ dysfunction. According to (Falasca et .al, 2015) the virus replicates in the body, it affects the macrophages and the dendritic cells whose main function is to phagocytose foreign bodies. This is then followed by production of cytokines which causes inflammatory reactions causing damage to the tissues. It also affects the kidneys and the spleen which interferes with the clotting cascade leading to massive hemorrhage. The kidneys are involved in the balance of pH of the blood hence if affected the body is unable to regulate its pH and excrete wastes hence retention. (Bray, Hatfill, Hensley& Hugging, 2013) states that monocytes, macrophages, and dendritic cells are the early replication sites of the Ebola virus infection. These cells are responsible for the spread of the virus in the body after they migrate from the spleen. (Sanchez et.al,2012) also states that during this infection there is the excess production of nitric oxide which causes excessive tissue damage including the blood vessels leading to hemorrhagic shock. Nitric oxide is a vasodilator leading to decreased blood pressure which worsens an already deteriorating condition. Decreased blood volume to vital centers such as the brain and kidneys leads to cell death and consequently organ death hence the high mortality rates.
(MacNeil et.al,2010) states that the incubation period of the Ebola virus is between two and twenty-one days. This refers to the period between which one is exposed and when the symptoms first occur. However one is not infectious until the first symptom occurs. The symptoms include muscle pain, diarrhea, blood in the stool, fever, weakness, severe headache, fatigue, hemorrhage such as oozing from the gums. (World Health Organization,2014) states that the laboratory diagnosis is done through enzyme-linked immunosorbent assay, polymerase chain reaction, isolation of the virus from cell culture and recommends whole blood and oral fluids as specimens. The patient presents with low platelet count. There is no known drug used to treat Ebola virus infection neither a vaccine approved by Food and Drug Administration. (World Health Organization,2014) states that the candidate vaccines would require appropriate protocols, a platform that ensures transparency of data and safety monitoring board.
Prompt management of a patient with Ebola is the isolation of the patient to prevent further spread of the virus, providing intravenous fluids and electrolytes, maintaining the blood pressure. The patient has their own items which are not shared and thoroughly disinfected after use. The healthcare workers nurse the patient via barrier nursing while wearing personal protective equipment.
Host Factors
Fruit bats are known to be the reservoir hosts of the Ebola virus. The bats spread the virus to the primates. (Rewar and Mirdha,2014) states that in West Africa Ebola emerged as a result of human beings handling bushmeat and coming into contact with infected bats, chimpanzees, and antelopes. Also, the consumption of fruits with infected feces of the bat causes the infection in humans. The people in West Africa have hunted for bushmeat for ages and therefore convincing them otherwise is difficult yet this is the first contact with Ebola from the reservoir hosts. Poverty heavily contributes to this as they lack other sources of proteins except for bushmeat. The preparation of the raw meat increases the chances of transmission since there is contact with blood and feces and organs which have the virus. The meat is eaten raw or not cooked properly the virus is active and therefore transmission.
Another factor closely attributed to the spread of Ebola is caring for a person with Ebola. The culture in most African societies is compassionate care for the sick person and this meant coming into contact with bodily secretions and mucous membranes. As earlier stated Ebola is spread through direct contact and bodily fluids. This means even the healthcare workers who without their knowledge interacted with infected persons were also infected.(Dowell et.al,2012) conducted a study that involved family members infected with Ebola out of 95 members who had direct contact with an infected person 28 members became infected while 78 members who did not have direct contact were not infected.
Sexual contact with an infected person contributes to the spread of Ebola.(Deen et.al,2017) conducted a study on a cohort of male survivors of the Ebola virus on their semen, within different time spans and their semen was positive for RNA virus of Ebola. It advisable to ensure safe sexual practices such as nonpenetrative sex for Ebola survivors and male survivors testing their semen until its negative, use of condoms and abstinence till the semen tests negative.
Breastfeeding is the recommended the mode of feeding for infants under the age of six months. However, in mothers with Ebola, they should not breastfeed as breast milk contains Ebola virus and hence other alternatives should be sought.(Nordensten et.al,2016) conducted a study on a breast milk of an infected mother and found it was positive for Ebola virus hence advising women to stop breastfeeding immediately after a positive symptom of Ebola. This is contentious due to inadequate information and unavailability of alternatives to breast milk, especially in rural communities.
Use of traditional healers propagates the spread of Ebola. Traditional healers are highly sought due to poor access to health facilities. Many cases in Guinea in 2014 were traced back to visiting a traditional healer who had come into contact with an infected person or attending a healer’s burial which involves traditional funeral rites and practices. The epidemic spread the belief that hospitals were the source of Ebola making it even more difficult to seek medical care. (Manguvo and Mafuvadze,2015) states that burial practices such as washing the deceased body contributed to the spread of Ebola; farther encouraging raising awareness among traditional leaders and healers as they draw respect from the majority of the community.
Environmental Factors
Changes in weather conditions can cause animal migration such as bats to human settlements causing Ebola virus spread. A fruit bat Eidolon helvum during migration can travel a distance or greater than 2500 kilometers (Richter and Cumming,2010). This bat has tested positive for Ebola virus. The bats migrate in search for food and water and in the process there is human interaction with bats leading to spread of Ebola. According to a study conducted by (Leroy et.al 2012) before the Ebola outbreak in 2007 in the Democratic Republic of Congo, the locals reported a bat migration which settled in Ndongo and Koumelele. These bats were hunted for their meat and there was an Ebola outbreak and when contact tracing was done the first contact had consumed bat meat.
During dry seasons animals will migrate in search of water and during the process infection to humans. The risks of outbreaks are higher during dry seasons which occur after a rainy season. This is because animals migrate in search of food while humans also go into the forest in search of food. Dry seasons have since been associated with Ebola outbreaks and can be used to avert Ebola epidemics.
Human-wildlife conflict in West Africa has been largely faulted for Ebola outbreaks. Deforestation occurring massively to accommodate the ever-increasing population and displacing wild animals increasing contact. (Norris et.al 2010) states that in Sierra Leone the forests are home to 25% of the mammals found in Africa. Continuous deforestation increases the chance of human beings interacting with a wide variety of animals posing a great risk and increasing chances of spread of Ebola from infected animals to humans. Furthermore, if the animals are destroying crops on the farmers land they are at risk of being hunted down and eaten as bushmeat.
The movement of bats into farms in search of fruits poses a huge risk since they are densely populated and therefore the spread of Ebola by infected bats. They mainly feed on fruits and crops (Mickleburgh, Hutson and Racey, 2015).
Potential Policy Responses
This refers to the plan of action set and implemented by various health organizations to cease the spread of Ebola. The Australian government recognizes Ebola as a biologic agent that could be used in bioterrorism (Australia Institute of Health, 2015). The department of health in Australia has set several guidelines, for example, clinicians should inform public health reference laboratory for advice on the collection and transport of specimen. Confirmatory testing of Ebola should be done at National High-Security Quarantine Laboratory. The patient should be isolated and nursed via barrier nursing. The healthcare workers should use a P2/N95 mask and must ensure all skin is covered. There should be the use of disposable gown, gloves and shoe coverings. The visitors to the patients should be limited and adults only and they should also don personal protective equipment. A log in the entry for visitors should be maintained. Hospital staff should be trained on how to don the personal protective equipment, how to ensure the mask fits them, how to take off the personal protective equipment while ensuring no cross contamination.
The World Health Organization is the international agency concerned with public health all over the globe. It came up with policy measures during the 2014 West Africa Ebola epidemic. (WHO,2015) involved formation of Ebola treatment units with medical teams which work together with teams from infection prevention. Ebola community care centers were formed to involve the community. There was the formation of teams to conduct safe dignified burials while observing the set protocols in conjunction with faith-based organizations.WHO has been on the frontline in providing protective personal equipment to healthcare workers while at the same providing training on the use of the equipment, how to safely discard the equipment and safe burial practices. Formation of infection prevention guidelines in performing clinical procedures, laboratory investigations and discarding waste. Promotion of surveillance in conjunction with the center for disease control and prevention to collect data, case finding, contact tracing and data analysis which promotes prompt discovery of new cases. There has been involvement of the community by demystifying Ebola and education on signs to monitor for by use of posters and social media.
The Center for Disease Control and prevention is also involved in policy making of emerging and reemerging diseases. According to (Marston et .al, 2017) the CDC on the frontline of formation of national laboratories in the Liberia, Guinea and Sierra Leone with new technologies such as Gene expert to perform polymerase chain reaction test. Rapid antigen tests were used to perform tests on deceased patients to allow prompt internment. Sierra Leone has used Integrated Disease Surveillance and response to monitoring priority diseases and conditions. The Ebola epidemic has seen the rise of personnel involved in surveillance and teaching the community on Ebola. These personnel have engaged themselves in public health courses. This has foreseen formation of field epidemiology training programs which allow individuals to train on surveillance of various diseases and leadership during such outbreaks.
Conclusion
Ebola is regarded as a weapon of warfare and bioterrorism agent which can be used to cause biological warfare. It also causes so much anguish considering that the 2014 epidemic caused 11310 deaths in some cases wiping out the whole family. This is worsened by its biologic aspects of causing hemorrhage within a short time. This calls for prompt surveillance of Ebola while considering various strains of how it can manifest. It also requires the improvement of health systems especially in African countries to handle and contain this hemorrhagic fever. Strong communication and alert systems would go a long way in ensuring prompt response of outbreaks. The factor that culture is involved means that education about harmful practices such as some burial rites should be conducted by the traditional leaders or the community members who are conversant with such sensitive matters. The governments of all countries should also set policies regarding Ebola and educate its citizens on signs to look out for and hotlines to reach out to. The role of research should not be underestimated since Ebola virus has the ability to produce various strains which may manifest in different ways. Continued research on vaccines to provide immunity would be a stepping stone in the health sector. Curbing Ebola requires sustained efforts from international organizations, governments, healthcare workforce, and the community members.
References
Australian Institute of Health, & Australian Institute of Health. (2015). Australia’s health. Australian Government Pub. Service.
Bray, M., Hatfill, S., Hensley, L., & Huggins, J. W. (2013). Haematological, biochemical and coagulation changes in mice, guinea-pigs and monkeys infected with a mouse-adapted variant of Ebola Zaire virus. Journal of comparative pathology, 125(4), 243-253.
Cenciarelli, O., Pietropaoli, S., Malizia, A., Carestia, M., D’Amico, F., Sassolini, A., … & Palombi, L. (2015). Ebola virus disease 2013-2014 outbreak in west Africa: an analysis of the epidemic spread and response. International journal of microbiology, 2015.
Deen, G. F., Broutet, N., Xu, W., Knust, B., Sesay, F. R., McDonald, S. L., … & Liu, H. (2017). Ebola RNA persistence in semen of Ebola virus disease survivors. New England Journal of Medicine, 377(15), 1428-1437.
Dowell, S. F., Mukunu, R., Ksiazek, T. G., Khan, A. S., Rollin, P. E., & Peters, C. J. (2012). Transmission of Ebola hemorrhagic fever: a study of risk factors in family members, Kikwit, Democratic Republic of the Congo, 1995. The Journal of infectious diseases, 179(Supplement_1), S87-S91.
Falasca, L., Agrati, C., Petrosillo, N., Di Caro, A., Capobianchi, M. R., Ippolito, G., & Piacentini, M. (2015). Molecular mechanisms of Ebola virus pathogenesis: focus on cell death. Cell death and differentiation, 22(8), 1250.
Groseth, A., Feldmann, H., & Strong, J. E. (2012). The ecology of Ebola virus. Trends in microbiology, 15(9), 408-416.
Leroy, E. M., Epelboin, A., Mondonge, V., Pourrut, X., Gonzalez, J. P., Muyembe-Tamfum, J. J., & Formenty, P. (2012). Human Ebola outbreak resulting from direct exposure to fruit bats in Luebo, Democratic Republic of Congo, 2007. Vector-borne and zoonotic diseases, 9(6), 723-728.
MacNeil, A., Farnon, E. C., Wamala, J., Okware, S., Cannon, D. L., Reed, Z., … & Nichol, S. T. (2010). Proportion of deaths and clinical features in Bundibugyo Ebola virus infection, Uganda. Emerging infectious diseases, 16(12), 1969.
Manguvo, A., & Mafuvadze, B. (2015). The impact of traditional and religious practices on the spread of Ebola in West Africa: time for a strategic shift. The Pan African Medical Journal, 22(Suppl 1).
Marston, B. J., Dokubo, E. K., van Steelandt, A., Martel, L., Williams, D., Hersey, S., … & Redd, J. T. (2017). Ebola response impact on public health programs, West Africa, 2014–2017. Emerging infectious diseases, 23(Suppl 1), S25.
Mickleburgh, S. P., Hutson, A. M., & Racey, P. A. (2015). Old World fruit bats. An action plan for their conservation. Gland, Switzerland: IUCN, 263.
Morse, S. S. (2012). Factors in the emergence of infectious diseases. In Plagues and politics (pp. 8-26). Palgrave Macmillan, London.
National Institutes of Health. (2013). Understanding emerging and re-emerging infectious diseases. Biological sciences curriculum study. NIH Curriculum Supplement Series. National Institutes of Health, Bethesda, MD.
Nordenstedt, H., Bah, E. I., de la Vega, M. A., Barry, M., N’Faly, M., Barry, M., … & Ingelbeen, B. (2016). Ebola virus in breast milk in an Ebola virus–positive mother with twin babies, Guinea, 2015. Emerging Infectious Diseases, 22(4), 759.
Norris, K., Asase, A., Collen, B., Gockowksi, J., Mason, J., Phalan, B., & Wade, A. (2010). Biodiversity in a forest-agriculture mosaic–The changing face of West African rainforests. Biological conservation, 143(10), 2341-2350.
Rewar, S., & Mirdha, D. (2014). Transmission of Ebola virus disease: an overview. Annals of global health, 80(6), 444-451.
Richter, H. V., & Cumming, G. S. (2010). First application of satellite telemetry to track African straw?coloured fruit bat migration. Journal of Zoology, 275(2), 172-176.
Sanchez, A., Lukwiya, M., Bausch, D., Mahanty, S., Sanchez, A. J., Wagoner, K. D., & Rollin, P. E. (2012). Analysis of human peripheral blood samples from fatal and nonfatal cases of Ebola (Sudan) hemorrhagic fever: cellular responses, virus load, and nitric oxide levels. Journal of virology, 78(19), 10370-10377.
World Health Organization. (2014). Contact tracing during an outbreak of Ebola virus disease. World Health Organization.
World Health Organization. (2014). Statement on the WHO Consultation on potential Ebola therapies and vaccines 2014.
World Health Organization. (2014). WHO statement on the meeting of the International Health Regulations Emergency Committee regarding the 2014 Ebola outbreak in West Africa [Internet]. Geneva: WHO; 2014 [cited 2014 Aug 29]. World Health Organization: Geneva, Switzerland.
World Health Organization. (2015). 2015 WHO strategic response plan: West Africa Ebola outbreak. World Health Organization.
World Health Organization. (2015). Factors that contributed to undetected spread of the Ebola virus and impeded rapid containment. World Health Organization.

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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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A description of the issue you will discuss including reference to the texts (e.g. articles, books, video’s etc.) that have most influenced your thinking on the topic;
 
Discussion of the relevance of the issue for public health practice drawing on your reading and reflections from your own experience/observations if possible;

Answer:

Topic 1: Issue in the leadership domain in public health practice
Introduction
The multiple disciplines of the biology, medicine, anthropology, public health and education comprises of public health practice, which has immense importance in serving mankind (Friis& Sellers, 2013). I have observed that there are effective public health practices that are designed, however, they are not channelized properly due to lack of leadership efforts. This is the reason I feel that in order to have good public health outcomes, it is important to demonstrate effective leadership in the domain. This would lead to increased community outcomes so that there is increased disease prevention, increased education and more enhancement of the present policy development.
Discussion
Issues of leadership in public healthcare
The leaders are the persons with distant vision as well as they are known for good team building (Popescu & Predescu, 2016). It is important for the public health programs to display effective leadership so that they have a good outcome. The leaders have the power to properly execute a public health program so that there is good outcome (Fitzgerald et al., 2013). I can understand the fact that the effective leadership would improve the health outcomes of the society. I have witnessed the fact that the challenges of the public program leadership lay in equity as well as prevention of the health services. The leadership issues have led to an increase in the problems of the availability of the vaccines. The vaccine is important for decreasing the disease burden of the community (Feikin, Scott & Gessner, 2014). However, I have observed that the vaccines for major diseases are not available in every part of the world, especially in rural areas. I have done sufficient research on this field and have found out that there are several issues in the small pox vaccine availability. This can be attributed to the lack of leadership in this domain and the healthcare leaders have failed to make the essential vaccine available to all. After going through all these facts, I have selected this particular topic and advise some measures so that there is an overall increase in the public health leadership.
Importance of leadership in public health
The leadership skills in healthcare are important for improving the managed care as well as promotion of integrated delivery system (Stanhope et al., 2015). I am aware of the fact that leadership behavior is instrumental in guiding the organizational behavior and cultivating more inter-organizational relationships. I have seen that the leaders should be able to apply their scientific knowledge to the problems of public health. I have realized that they should try to create as well as sustain the different levels of community coalitions. I have realized the fact that the public health leadership is important for the areas in the areas of disease intervention such as HIV, Ebola and other. The public health leaders can help in minimizing the level of infection in the community and decreasing the disease burden of the society (Wager, Lee & Glaser, 2017). I have also realized the fact that the public health leadership would be required in the areas of public health research and increasing the overall awareness of the community. At present, there is inadequate leadership, which leads to global health epidemics.
Reflection of consequences of leadership in public health
I have realized the fact that the public health leadership can make important contributions to this field. I am sure that the leadership would be helpful in the areas where inadequate presence of the public health is. In the rural areas of the developing countries, it is important to display adequate levels of the leadership that would help in the more penetration of the public health services. I feel that this would lead to more utilization of the health services by the community. I am sure that this increased awareness would lead to an increased technical as well as systematic integration of the public health programs. I feel that building on the skills of the public health leaders would mean an increased health for all, especially for the economic and social backward classes of the society.
Conclusion
There is enough scope of development of the public health leadership, which is deeply concerned with the development of the shared vision and the creation of an effective leadership competency framework. I have understood the fact that healthcare leadership would be important for improving the public health condition of the community. It is important to provide adequate leadership to the public health programs so that it reaches its desired level. It would also likely to increase the public health effectiveness in the society.
Topic 2: Challenges faced during the monitoring and evaluation of public health programs
Introduction:
The monitoring and the evaluation function of the health programs do face several challenges. The main objective of the various public health campaigns is to put a control on disease outbreak and reduction of the instances of injury, disability and death. I have observed that the current state of monitoring and evaluation is not proper and hence I have decided that it is important to ponder over the issue. I also feel that it is important to understand the perceptions of the different stakeholders associated with this process.
Discussion
Monitoring and Evaluation issues in public health programs
I have realized that there are several loopholes in the monitoring as well as evaluation process of the health programs. I have realized that there is lack of experience of the health staffs regarding the public health programs. The public health programs lack proper monitoring and evaluation tools, which poses difficulty for program evaluation (Vedung, 2017). There is a lack of adequate manpower as well as well as financial resources that would be required for the evaluation purposes (Brownson, 2017). I have also seen that there are certain gaps in the technical knowledge of the staffs with a degree of confusion regarding the performance indicators. I have witnessed the fact that there are issues with the retrieval, collection, preparation and the interpretation of data concerning the public health programs. There are issues with the allocation of sufficient resources, which often is a problem for the public health programs. The monitoring and evaluation function may be impossible to carry out since there are not sufficient budget allocated for this purpose.
Relevance of monitoring and evaluation in public health programs
The systematic evaluation and monitoring of the process is responsible for the increase of the efficiency of the planning process as well as implementation of measures required for fulfillment of program objectives (Issel & Wells, 2017). I have felt that there is lack of comparable definitions regarding the prevalence of diseases across the public health domain. The monitoring and the evaluation process focus on the processes, outcomes and impact of the program, which is important for the success of the program. It is also important to understand the changes that have been inflicted by the public health program. I have seen that it is important for the community based management and understand the overall impact of the public health programs. The value of the public health initiatives is usually measured by the cost efficiency as well as impact on the community, which I think is not done properly. I have seen that there are often issues with the interpretation of data, which requires significant expertise.
Reflection on the implications of evaluation and monitoring issues in public health
There are several implications of the evaluation of the public health initiatives. I have seen that there are no monitoring techniques present in this domain, which makes it difficult to outcomes of the program (Eldredge et al., 2016). I have felt that the public health expenditure would be wasted if there is improper monitoring and evaluation technique. I also feel that if there is no proper data collection, then the health gaps in the community cannot be measured. This would also cause a lack of evaluation of the improvement of the health care services (Cameron et al., 2014). I also feel that it should be monitored about the individual strategies as well as observed outcomes should be recorded well. I have seen several multisector interventions and integrated programs in which it becomes imperative to understand the effectiveness of the program. Hence, I have decided on the thought that it is important to learn about the various techniques of monitoring and evaluation process, which would help in better health outcomes.
Conclusion:
The monitoring and the evaluation function is directly proportional to the success of the program. The monitoring of the health programs is important for measuring the success of the health programs. The monitoring methods should be carefully implemented and it is also important to know their correct usage. It is important to allocate significant budget for this purpose so that the monitoring process can be carried easily. There should be more attention given to the evaluation function so that it is possible to identify the loopholes. This would help in improving the next set of public health programs.
References for Topic 1
Feikin, D. R., Scott, J. A. G., & Gessner, B. D. (2014). Use of vaccines as probes to define disease burden. The Lancet, 383(9930), 1762-1770.
Fitzgerald, L., Ferlie, E., McGivern, G., & Buchanan, D. (2013). Distributed leadership patterns and service improvement: Evidence and argument from English healthcare. The Leadership Quarterly, 24(1), 227-239.
Friis, R. H., & Sellers, T. (2013). Epidemiology for public health practice. Jones & Bartlett Publishers.
Popescu, G. H., &Predescu, V. (2016). The role of leadership in public health. American Journal of Medical Research, 3(1), 273-273.
Stanhope, V., Videka, L., Thorning, H., & McKay, M. (2015). Moving toward integrated health: An opportunity for social work. Social work in health care, 54(5), 383-407.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2017). Health care information systems: a practical approach for health care management. John Wiley & Sons.
Bibliography for Topic 1
Callahan, R., & Bhattacharya, D. (2017). Public Health Leadership: Strategies for Innovation in Population Health and Social Determinants. Routledge.
Day, M., Shickle, D., Smith, K., Zakariasen, K., Moskol, J., & Oliver, T. (2014). Training public health superheroes: five talents for public health leadership. Journal of Public Health, 36(4), 552-561.
Rowitz, L. (2013). Public health leadership. Jones & Bartlett Publishers.
Smith, T., Stankunas, M., Czabanowska, K., De Jong, N., O’Connor, S. J., & Fowler Davis, S. (2015). Principles of all-inclusive public health: developing a public health leadership curriculum. Public health, 129(2), 182-184.
References for Topic 2
Brownson, R. C., Baker, E. A., Deshpande, A. D., & Gillespie, K. N. (2017). Evidence-based public health. Oxford University Press.
Cameron, A., Lart, R., Bostock, L., & Coomber, C. (2014). Factors that promote and hinder joint and integrated working between health and social care services: a review of research literature. Health & social care in the community, 22(3), 225-233.
Eldredge, L. K. B., Markham, C. M., Ruiter, R. A., Kok, G., & Parcel, G. S. (2016). Planning health promotion programs: an intervention mapping approach. John Wiley & Sons.
Issel, L. M., & Wells, R. (2017). Health program planning and evaluation. Jones & Bartlett Learning.
Vedung, E. (2017). Public policy and program evaluation. Routledge.
Bibliography for Topic 2
Bowling, A. (2014). Research methods in health: investigating health and health services. McGraw-Hill Education (UK).
Drummond, M. F., Sculpher, M. J., Claxton, K., Stoddart, G. L., & Torrance, G. W. (2015). Methods for the economic evaluation of health care programmes. Oxford university press.
Mills, A. (2014). Health care systems in low-and middle-income countries. New England Journal of Medicine, 370(6), 552-557.
Oleske, D. M. (2014). Epidemiology and the delivery of health care services. Springer.
World Health Organization. (2015). Guide to Monitoring and Evaluation for Collaborative TB/HIV Activities–2015 Update. World Health Organization.

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400285 Public Health

400285 Public Health

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400285 Public Health

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400285 Public Health

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Course Code: 400285
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Write a research report on public health.
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Introduction
Public health is termed as art and science used by individuals and healthcare professionals to prevent infections prolonging life span and enhancing the quality of life through standard efforts and choices of the organization, individuals and the society at large. With the following definition it is therefore easy to establish that the main role of public health is to minimize health inequalities by application of key concepts to ensure that all members of the society are treated equally and protected from infections that can be transmitted, promoting the health of the general population and improving the provision of services in healthcare systems. Public health and health promotion are highly associated because the idea behind health promotion is to encourage the public to attain greater control over the decisions that impact their entire health (Gagnaire et al., 2017). In Saudi Arabia, public health aims at maintaining a functional association between organizations and the public through communications to achieve its objectives. Public health influences the main structure of organizational practices.
Surgical site infections are some of the most prevalent in patients undergoing gastrointestinal operations. This is because the pattern of wounds the patient’s experience to keep on changing from time to time. A study from Saudi Arabia shows that out of the 5100 patients who underwent elective gastrointestinal between 2007 and 2010, 44 SSIs were identified (Morgenstern et al., 2016). This is a clear indicator the SSIs are one of the most critical issues in the surgical sites. The Saudi Arabian government has initiated tremendous improvements to improve the health care system of the country at a steady pace. This has seen many health sectors embrace technologies that affect their services.
Literature Review
Prevalence and Incidence of Surgical Site Infection in Saudi Arabia
Surgical site infections have a significant influence on the morbidity, mortality and healthcare expenditure of most economies. The worldwide incidence of SSI was 2.55% in 2013 which is below the reported figure of 2.6% to 41.9% in 2015 (Al-Mulhim, Baragbah, Sadat-Ali, Alomran& Azam, 2014). In Saudi Arabia, most of the patients experiencing surgical site infections were found to be aged 55 plus years. This shows that SSIs in Saudi Arabia is more prevalent on the aged people. Also, diabetic people are more likely to experience SSIs because they may undergo surgeries that cause them these sort of complications (Allegranzi et al., 2016). Men are as well most affected by SSI because they are addicted to smoking habits that expose them to the risk of SSIs more than their female counterparts.  In a cross-sectional study contacted across Saudi Arabia, it was found that smoking impairs tissue oxygenation and local hypoxia through vasoconstriction, therefore, influencing the healing of SSI wounds.
Risk factors for surgical site infection in the healthcare setting
There are multiple risk factors which are related to the development of surgical site infection (SSI) in various healthcare settings. Risk factors for surgical site infection can be categorized into modifiable such as weight and non-modifiable such as gender (Namba, Inacio&Paxton, 2013). Some of the risk factors which can expose a patient to surgical site infection include obesity which happens mostly after abdominal procedures. Malnutrition is considered another significant risk factor for SSI. According to recent studies which have been conducted, nutrition has been recognized as a significant factor for nosocomial infections which includes surgical site infection among patients who undergo any surgery. Patients, mostly from poor socio-economic backgrounds who are exposed to poor diets have a weak immune system which is not capable of fighting infections, and thus they are at very high risk of been infected by SSI. Use of tobacco is also related to SSI. This happens because patients who smoke cigarette have inhibited wound healing due to poor circulation of blood to the skin which is caused by micro vascular obstruction and thus it means the skin does not get enough platelets which are responsible for blood clotting (Korol et al., 2013). Poor hygiene in a healthcare setting is another main risk factor for SSI. This is because hygiene is essential for patients after surgery so that they can heal faster without been exposed to any infections.
Effective interventions which can manage surgical site infection in the healthcare setting  
There are various interventions which can be put in place to be able to control and manage surgical site infection in a healthcare setting. The first intervention includes healthcare professionals screening patients so that they can be able to determine if the patient has staph bacteria in their nose. Clients who are infected by this bacteria are given antibiotics which they are supposed to use up to the next five days after the surgery as instructed by healthcare professionals (Anderson et al., 2014). Another intervention which can be applied is preoperative which involves educating the patient regarding ways which they can use to manage and prevent SSI before they undergo surgery. This education consists in removing all the hair with electric clippers and use of an appropriate antiseptic agent for skin preparation.
Research study
Surgical Site Infection has a significant contribution towards the morbidity rate across the world. The paper is all about the post operative wound infection which may present up to 30 days after a surgical procedure (Olsen et al., 2015). In order to find the answer of main research questions, it is important to select an appropriate research population. A well-defined study question always identifies a target population. Target population can be of two types, a narrow or relatively large. In case of narrow target population, any particular organization or specifically, any hospital is selected but in the case of relatively large target population, a whole nation is selected. The eligible participants from the target population are selected as study population while performing any study (Minaei-Bidgoli, Parvin, Alinejad-Rokny, Alizadeh & Punch, 2014).
Study sample
In order to find the answer of main research questions, a study population will be selected. A particular hospital in Saudi Arabia, King Khalid University Hospital will be selected to perform the prospective study in this regard. It will be approved by the hospital authority but there will be no sponsorship from any external agency. Study population will be selected in such a way so that the participants are eligible for the specific research questions. Clustered sampling process will be chosen in which an area is divided in some geographic clusters and some clusters are selected for inclusion in the study.  
Selection of study sample
The study population is basically the member of sample population who are participating in the study and the result found from the study will be applicable to the target population (Minaei-Bidgoli et al., 2014). In this case, the patients from surgical ward of the specific hospital will be considered as study sample. The patients from surgical intensive care will also be included in the study population. The diagnostic criteria and demographic data of the patients will be collected by the treating surgical team.  
Selecting sample population and rationale behind that
The sample population consists of the participants who meet all the eligibility criteria. In this case, the paper is focussed to find answers of research questions that are related to surgical ward and due to this reason; the surgical ward of the hospital will be specifically chosen as sample population. Consent from the participants will be obtained prior to the study to avoid any ethical as well legal issue. In order to find the effective interventions to manage surgical site infection, the strategies used by the healthcare professionals will also be recorded as data for further analysis in this regard.  
Results
After the sampling process was completed, the results were found out based on the study based on the patients at the surgical ward. The number of patients to participate in this research was 217, out of them 100 were male patients and the rest 117 were female. The age group of the patients ranged from 10 years to 55 years. The results seemed to favour the fact that most of the patients are prone to post-surgical infections in Saudi Arabia. From the total 217 samples, 112 samples were positive and 105 samples were negative.
The patients were observed for six months, and it seemed that the patients ranging within the age group 30-40 years had 12.4% surgical wound infection and the age group of 50-60 years of age people showed a growth of 11.9%(“Clinical Study of Surgical Site Infection”, 2016). The patients acquired to conduct the research had different types of surgeries, such as some had gall bladder surgery, some had plastic surgeries; some had appendicitis and so on. The main reason for the extensive infection growth was determined as all the patients were kept in the same room. The patients encountered different types of viruses from the other patients, which weakened their immunity system and inflicted infection on the surgical sites.
Charts and Figure

Socio-demographic characteristics of the participants

Frequency, N=217

Percentage(%)

Male

100

46

Female

117

53.9

Total

217

100

Figure: list of the most common microorganisms infecting surgical sites wounds

Figure: Different sites of surgical wound infection and percentage
Discussion
The staffs of the hospital are responsible for the effective management of the infections in the recovery wards. The hospital should look into the proper identification of the prevailing germs in the recovery wards and take up effective measures to against them so that the patients are not exposed to the chance of catching the virus. The hospital should also upgrade their use of antibiotics to fight against the deadly germs. Antibiotics should be available in the hospitals at all times for the effective treatment of the post-surgical patients. Saudi Arabia faces an infection rate of 51.3%, which is much higher than the rest of the world(“Appraisal of Awareness of Surgical Staff about Surgical Site infection at Selected Surgical Units, Saudi Arabia”, 2017). The literature review part of the research provides enough evidence to support the facts and the reasons for this growth. Studies show that Surgical Site Infections are more common among the children and the adults over the age of 55 years. The bacterial infections vary from ward to ward, based on the activities of the ward, or the type of patients in it. For an instance, the bacteria S.aureus is most commonly found in the operating rooms. It has been suggested by many doctors and researchers that advanced surgical techniques can reduce the risk of the post surgery infections. Recent studies show that a Surgical Site infection is more prevalent with women than men in Saudi Arabia.
References
Allegranzi, B., Bischoff, P., de Jonge, S., Kubilay, N. Z., Zayed, B., Gomes, S. M., … &Boermeester, M. A. (2016). New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. The Lancet Infectious Diseases, 16(12), e276-e287.
Al-Mulhim, F. A., Baragbah, M. A., Sadat-Ali, M., Alomran, A. S., & Azam, M. Q. (2014). Prevalence of surgical site infection in orthopedic surgery: a 5-year analysis. International surgery, 99(3), 264-268.
Anderson, D. J., Podgorny, K., Berrios-Torres, S. I., Bratzler, D. W., Dellinger, E. P., Greene, L., … & Kaye, K. S. (2014). Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infection Control & Hospital Epidemiology, 35(S2), S66-S88.
Gagnaire, J., Verhoeven, P. O., Grattard, F., Rigaill, J., Lucht, F., Pozzetto, B., … & Botelho-Nevers, E. (2017). Epidemiology and clinical relevance of Staphylococcus aureus intestinal carriage: a systematic review and meta-analysis. Expert review of anti-infective therapy, 15(8), 767-785.
Korol, E., Johnston, K., Waser, N., Sifakis, F., Jafri, H. S., Lo, M., & Kyaw, M. H. (2013). A systematic review of risk factors associated with surgical site infections among surgical patients. PloS one, 8(12), e83743.
Minaei-Bidgoli, B., Parvin, H., Alinejad-Rokny, H., Alizadeh, H., & Punch, W. F. (2014). Effects of resampling method and adaptation on clustering ensemble efficacy. Artificial Intelligence Review, 41(1), 27-48.
Morgenstern, M., Erichsen, C., Hackl, S., Mily, J., Militz, M., Friederichs, J., … & Richards, R. G. (2016). Antibiotic resistance of commensal Staphylococcus aureus and coagulase-negative staphylococci in an international cohort of surgeons: a prospective point-prevalence study. PLoS One, 11(2), e0148437.
Namba, R. S., Inacio, M. C., & Paxton, E. W. (2013). Risk factors associated with deep surgical site infections after primary total knee arthroplasty: an analysis of 56,216 knees. JBJS, 95(9), 775-782.
Olsen, M. A., Tian, F., Wallace, A. E., Nickel, K. B., Warren, D. K., Fraser, V. J., & Hamilton, B. H. (2015). Impact of surgical site infections following common ambulatory procedures on healthcare costs. Value in Health, 18(3), A234.
Appraisal of Awareness of Surgical Staff about Surgical Site infection at Selected Surgical Units, Saudi Arabia. (2017). International Journal Of Science And Research (IJSR), 6(1), 2362-2365. doi: 10.21275/art2017504
Clinical Study of Surgical Site Infection. (2016). International Journal Of Science And Research (IJSR), 5(5), 1782-1786. doi: 10.21275/v5i5.nov163406

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Assignment 1
Answer to question 1
I have conducted a survey at my workplace maned Lady’s Hospice and Care Services to observe the working environment. The aim of the survey is to find if it is a safe, healthy, secured and fulfilling place to work. A visual survey was conducted to locate and record the safety signs in the workplace. The objective of the survey is to observe and list different types of signs, location, their prom…
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Course Code: 400837
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Introduction
Palliative care services are designed to improve the life of patient with progressive disease. People receiving palliative care have illness that has no prospect of cure.  As per the World Health Organisation, palliative care is a care given to patient suffering from life threatening illness to improve their quality of life by preventing and providing relief from sufferings by early recognition , assessment and trea…
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Human Immunodeficiency Virus Infection and Acquired Immune Deficiency Syndrome (HIV/AIDS) is the spectrum of medical conditions caused due to human immunodeficiency virus (HIV) following which the patient suffers from a series medical complications due to suppression of the immune system of the body. With the progression of the disease, the patient is likely to suffer from a wide range of infections like tuberculosis and other opportu…
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Introduction
Leadership in the hospital is the ability to influence the staff toward providing quality health care. Leadership involves influencing human behavior to create a positive working environment (Langlois, 2012). Good leadership enables healthy relationships among staffs in the hospital enhancing quality delivery of health care services. Leadership is responsible to building teams that have trust, respect, support and effecti…
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Country: United Kingdom

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Introduction
According to the researchers, it can be said that the management of the health care organizations has become a difficult task nowadays and the reason behind this is the occurrence of various issues in this sector (Hall et al., 2014). Therefore, the administrative employees of the organization should incorporate various revolutionized strategies for enriching the worth of care provided by the hospital to its clients and re…
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