Bioterrorism In America Essays

Bioterrorism In America Essays Bioterrorism In America Paper Bioterrorism In America Paper Bioterrorism is a word that gained much attention in the United States of America and other developed countries during the recent years. Even though biological weapons were tried by different countries during World War II, the potential of these weapons in causing a mass destruction silently have made them the preferred weapon for terrorist activities. These ‘weapons of mass destruction’ can produce devastating results as they are powerful enough to eradicate people from a whole nation. Intelligence reports reporting that extremist groups are planning to attack few developed countries, have made these countries go on red alert many times. These countries have understood the need for strengthening their public health mechanisms and disease control organizations like CDC, and other defense mechanisms to avert the occurrence of a bioterrorism event. There is no universally accepted definition for bioterrorism. WHO (World Health Organization) has defined bioterrorism as the use of biological agents in terrorism which includes the malevolent use of bacteria, toxins or viruses against people, plants and animals (WHO, 2007). The looming threat of bioterrorism started haunting United States of America since 1998 (No-authors-listed, 1999). The initial biological threats were due to the spread of anthrax powder containing letters. On October 30th 1998, three letters containing anthrax were sent to health clinics in Tennessee, Kentucky and Indiana states. Similar reports of anthrax contaminated letters were obtained by the CDC (Centers for Disease Control) till December 23 1998. There were similar threats telephonically received at the public health agencies saying that ventilation systems of a few buildings were contaminated with anthrax. The Federal Bureau of Investigation (FBI) started investigating these reports and threats and they found that these were all hoaxes. But later on, CDC surveillance team identified about 22 cases of anthrax in the same year, out of which majority of cases were from New Jersey, Florida, New York city and District of Columbia. Out of these, 12 cases were having cutaneous anthrax and 10 cases were having confirmed inhalational anthrax. Majority of these patients were US postal department personnel who contracted this disease when these anthrax containing letters were sent through high-speed sorting machines, handled or when opened (No-authors-listed, 2001). Later on, five of these inhalational anthrax patients died due to the disease. Centres for Disease Control (CDC) has classified Bioterrorism agents/diseases into three categories entitled Category A, B and C, based on the priority. The highest priority is given to diseases which can result in high mortality rates, cause public panic, needs special public health preparedness and are easily transmitted from one person to another. These diseases are classified as Category A diseases. Category B includes diseases that are moderately easy to disseminate, which can produce moderate levels of mortality and morbidity, and which require specific enhancements of CDC’s diagnostic capacity. Category C includes disease that can be genetically modified in future and used for bioterrorism activities due to the ease of production, availability, and the ability to cause high mortality and morbidity rates. The diseases according to the different categories are given in Table 1. Based on these categories, the preventive strategies, planning and preparation of health and other law enforcement agencies differ. Anthrax is an acute bacterial infection caused by Bacillus anthracis. The disease occurs when human beings come into contact with the spores of the bacteria. It can infect the human being through contact, inhalation, and ingestion or by insect bites. Anthrax is a zoonotic disease and human to human spread of anthrax is not reported. It can cause cutaneous anthrax (on direct contact with spores), inhalational anthrax (by inhaling the spores), gastrointestinal anthrax or oropharyngeal anthrax (after consumption of spore contaminated material). Cutaneous anthrax is manifested as a localized cutaneous lesion that progresses through papular, vesicular and pustular stages to form an ulcer with blackened necrotic eschar surrounded by brawny edema. Inhalational anthrax is characterized by the presence of increasing fever, dyspnea, stridor, hypoxia and hypotension, with a symmetric mediastinal widening seen radiologically due to hemorrhagic mediastinitis. The symptoms of gastrointestinal anthrax are variable and include fever, nausea and vomiting, bloody diarrhea, abdominal pain and occasionally, rapidly developing ascitis. The major findings of oropharyngeal anthrax are fever, sore throat, dysphagia, painful regional lymphadenopathy and toxemia. The diagnosis of anthrax is confirmed by the identification of bacteria in body fluids and skin scrapings by staining methods, and by using polymerase chain reaction method to detect spores of B. anthracis. Anthrax is treated by using antibiotics like penicillin, ciprofloxacin, erythromycin, tetracycline or chloramphenicol. Botulism Botulism is a paralytic disease caused by the neurotoxins released by Clostridium botulinum, which begins with cranial nerve involvement and progresses caudally to involve extremities. Botulism is of different types. Cases can be classified as food-borne botulism (from pre-formed toxin in food contaminated with the bacteria), wound botulism (from wound infected with C. botulinum), and infant botulism (by ingestion of spores and production of botulinum toxin in the intestines). Botulinum toxin is considered as one of the deadliest toxins found in nature. It is proposed that terrorists may use botulinum toxin to contaminate food material extensively leading to mass mortality. The unsuspecting nature of this disease (being a naturally occurring problem), the lethality of the toxin and the ability for easy administration to a large population within a short span of time makes this agent a deadly weapon in the hands of terrorists. Plague Plague is an acute febrile zoonotic disease caused by infection with Yersinia pestis. Although human cases are curable, plague is one of the most virulent and potentially lethal infectious diseases ever known. It can infect human beings through insect bites, respiratory droplets from infected person, or from exposure to infected tissues. Plague occurs in different clinical forms like bubonic plague (characterized by regional lymphadenitis), septicemic plague (septicemia occurs), pneumonic plague (due to hematogenous spread to lungs) and pharyngeal plague (due to pharyngitis caused by infection from droplets). The deadly potential of plague to cause epidemics is well documented. In United States, the last outbreak of urban plague occurred in Los Angeles in 1924 and 1925. Plague is treated with antibiotics like gentamicin, tetracyclines and chloramphenicol. Smallpox Even though WHO declared in 1980 that smallpox is eradicated after the last case of smallpox was reported in 1977 from Somalia, there is a possibility that this pox virus caused disease may be used by terrorists to cause panic among people. Human beings are the only reservoir of this disease. Smallpox is spread through close contact. The disease is characterized by the presence of high grade fever, macular rash, and progression to vesicular and pustular lesions. Even though the chances of reintroduction of this disease are low, if reintroduced, this disease may confuse healthcare providers with other similar respiratory infections where there will be high grade fever and rashes. The disease is diagnosed by the identification of antigens in serum and polymerase chain reaction test to detect the pox virus DNA. Tularemia Tularemia is a zoonotic disease caused by Francisella tularensis. It is spread through the bites of a tick, or through inhalation. It can cause oropharyngeal or gastrointestinal tularemia, glandular tularemia, oculoglandular tularemia, pulmonary tularemia and typhoidal tularemia. Usual symptoms include high grade fever, chills, headache, generalized myalgias and arthralgias. The disease, if untreated can cause a mortality of up to 30%. But with appropriate treatment, the mortality is less than 1%. Can we stop Bioterrorism? This is a question which many of the developing countries would be looking at now. The answer to this question may be in the negative, at least for the time being. It is very difficult to stop the bioterrorism acts presently even with a well equipped intelligence network and well established state and public administration systems. It is very difficult to detect a bioterrorism act before it gets to show up by a substantial population being affected. The usual agents used by the extremists are usually not detected rapidly, and usually spreads rapidly among the population. From a single point of source, these diseases may silently spread across the nation without being evident due to the rapid migration of people from one place to another. There were suggestions that restricting the genome data would stop bioterrorism as this would make it difficult to modify the genetic data by genetic engineering to change the virulence and resistance properties of the organism, to make it more lethal. But an article published in 2002 shows that restricting the genome data would not prevent bioterrorism (Read Parkhill, 2002). In the present situation, the best measure that can be adopted is to take preventive measures by equipping health care providers, public health departments, State and public administration departments and law and order departments to handle a situation where a bioterrorism event occurs. There should be constant surveillance on the occurrence of suspect diseases to ensure that no bioterrorist activity exists behind the occurrence of the disease. Surveillance measures CDC advocates the adoption of surveillance measures to counteract bioterrorism. The surveillance measures are divided into measures that are specific for particular diseases and other general measures. Surveillance for specific diseases include the surveillance for anthrax and smallpox, which are commonly expected diseases in bioterrorism acts. Surveillance preventive measures for anthrax The most important measure is timely recognition and detection of the disease. Health care providers should be adequately trained in detecting this disease. The easiest way of detecting the occurrence of this disease is the development of autonomous detection systems that can detect the occurrence of a biologic agent like the spores of anthrax bacilli. Such an autonomous detection system has been installed in many of the postal distribution centers across the United States (Meehan et al. , 2004). This step would help in the timely identification of the existence of a bioterrorism event, which can help in management planning, rescue and evacuation, decontamination, quarantine, and treatment of individuals exposed to the disease. Public health officials are urged to take frequent samples of air and scrapings from the surfaces of buildings for detection of the existence of anthrax bacilli. These samples should be evaluated using the polymerase chain reaction technique for the detection of genetic material of B. anthracis. These devices are very expensive, but are very sensitive and specific in detecting the organism. Once established after validation, these systems would give rapid results which would buy more time in taking preventive measures to restrict the disease occurrence. Surveillance preventive measures for Smallpox (CDC, 2006b) Smallpox is currently nonexistent in this world. This makes it difficult to be detected by the laboratories during the routine tests. National laboratories should be enabled and alerted to do the appropriate tests in case of a suspected epidemic so as to detect the disease at the right time. The positive predictive values of the tests for smallpox are low. This makes clinical detection the most important measure in case identification. Health care providers should be trained in detecting smallpox case detection and guidelines should be established to detect and take preventive measures for restricting the spread of this disease. There is an algorithm provided by the CDC to evaluate patients with smallpox which is freely available in the net at www. bt. cdc. gov/agent/smallpox/diagnosis/evalposter. asp . In suspected patients, lab testing should be done to detect the existence of this disease. If the lab tests turn out to be positive, the occurrence should be reported to state/local public health authorities. Measures should be taken to isolate and quarantine the affected persons and their relatives to prevent further spread of the disease. Contact tracing should be done thoroughly and they should be vaccinated. The remaining people in that area should be given smallpox vaccination to enable immunity in them to overcome this attack. This should be followed by a well conducted epidemiological investigation to identify the source of infection. Identification of the most likely source of infection should be supported by the identification of the population at risk, and the chain of outbreak of the disease. General surveillance measures General surveillance measures should include the detection of disease patterns b y by the health care providers. An unusual pattern of disease outbreak should point fingers to the possibility of an intentional outbreak of the disease. The disease occurrence pattern should be studied in detail using epidemiological methods to identify the disease clusters, the impact of geographical and environmental factors on the spread of the disease and the temporal association of cases with the index case. This information should be collected from different centers and should be provided to CDC to evaluate the disease pattern and take necessary actions to curtail the spread of disease. Infection-control personnel should be aware of the disease occurrence and should be able to recognize the disease as early as possible to alert the health care system. State health care departments should take necessary steps to educate and train health care professionals and other related personnel in detecting and aborting a bioterrorism event. Preparation Planning Public health emergency response system should be established that can prepare the community in facing a bioterrorist attack. CDC, National Center for Environmental Health (NCEH) and Division of Emergency and Environmental Health Services (EEHS) have formed a public health emergency response guide to counteract a bioterrorist attack. These guides are used in educating and providing guidance to health care providers, for facing an attack (CDC, 2006a). Guidelines for protecting buildings and environments from bioterrorist attacks are also available with CDC. Bioterrorism readiness plan has been formulated to incorporate health departments and other administrative and law and order departments to take the required steps in preventing an attack, and in the event of an attack, to ensure that the casualties due to the disease attack are limited. Conclusion Bioterrorist attacks are predictable to a certain extent and are preventable to a certain level. But these events are not completely preventable at present. The best measure to do in case of an attack is to take preventive measures to avoid further occurrence and to limit the spread of the attack. These should be given utmost priority in the public health system. There should be a coordinated activity from various departments to ensure that the nation remains safe in case of a bioterrorist attack. Systems have been developed and put in place to counteract biological attacks. How far these systems are effective in preventing casualties will be shown only when these systems are put to the real test.

ISSUES IN PROFESSIONAL NURSING PRACTICE Term Paper - 1

ISSUES IN PROFESSIONAL NURSING PRACTICE - Term Paper Example From the different social reforms to organization of nursing programs, technology has taken the larger proportion of social changes in nursing (American Nurses Association, 2010, p. 130). According to the study, distance education is the answer to the nursing shortage being experienced in the United States in a way that students see distance education learning system associated with flexibility of learning in terms of time and place, access to more resources, more and varied teaching and learning strategies and individuation of learning (Carlton, Siktberg, Flowers & Scheibel, 2003). However, studies also find out that level of satisfaction was not as high compared to students who are involved in active learning and discussion. Other participants of the study even believed that learnings acquired through distance education are of poor quality and little educational value as there is laxity of human interaction or contact. Meanwhile, distance education also affects patient care and safety. Distance education has broadened the number of patients who will received medical and nursing care. Distance education can offer nursing care in the underserved population, who because of geographical, employment, and family responsibilities, cannot avail health services offered in the rural area. Patient’s safety in traveling to the healthcare areas is preserved as people have no longer have to go in far away areas. Economic crisis in U.S. began in 1990s and more women intend to enter a workforce capable of supporting the cost of living with fewer days of work but more money generated (Cherry & Jacob, 2011, p. 21). Shortage of nurses are experienced and advancement made in technology has increased health care costs. Thus, the professional nursing organization has the responsibility to uplift the standards of nursing profession and addressed the nursing shortage despite economic crisis. Likewise,

Eric Fromm and his human needs theory Essay Example | Topics and Well Written Essays - 2500 words

Eric Fromm and his human needs theory - Essay Example Erich Fromm, who was born in Germany in the year 1900, was exposed to the horrors of the first world war (Boeree, n.d., p.3). The evil nature of the leaders, the mute submission of the civilians to the dictatorship and the way the society functioned developed Erich Fromm’s interest in psychology and social structure. He tried to find the answer to his search for the question, â€Å"what drives man to behave the way he does?†, in the psychoanalytical theories of Freud and social theories of Karl Marx (Boeree, n.d., p.4). However, he found that both the theories are incomplete as they treat man either as an individual or as a social animal (Boeree, n.d., p.4). He thinks that human being’s personal and social aspects are related and hence, his behavior and motives cannot be explained by separating the individual and the social aspects of his life (Boeree, n.d., p.4). Hence, Erich Fromm postulated a theory called ‘Human Needs Theory’, to explain those ne eds of human beings which drive them to behave the way they do and in doing so, has touched every aspect of the human personality(Boeree, n.d., p.10). By explaining how human behavior is not just a result of personal needs but also is a result of his dynamic relationship with existential aspects of life, Erich From has given us one of the most complete theories of human behavior (Boeree, n.d., p.10). According to Erich Fromm, the conditions of the society in which the human being exists, give birth to his needs (Wozniak, 2000, p.44). He does agree with other behaviorists when they say that every human being has basic biological needs like adequate nourishment and shelter, and meeting those biological needs can provide them with a sense of satisfaction

Potential Appraisal for Career Development

Potential Appraisal for Career Development Go to the library or search on internet and gather the information on following topics: Potential Appraisal Career Development Analyze the relationship between them, and explain how potential appraisal help employee in career development. Summarize all the points in writing and also prepare for group discussion in the class. The potential appraisal refers to the evaluation i.e. understanding of the hidden talents and skills of a person. The individual might or might not be aware of them. Potential appraisal is a future oriented appraisal whose main goal is to identify and evaluate the potential of the employees to achieve higher positions and responsibilities in the organizational hierarchy. On the other words, Potential appraisal helps to determine what can happen in the future so that it can be guided and directed towards the performance of individual and organizational development and goals. Therefore, many organizations assess and manage potential appraisal as a part of the performance appraisal processes. Moreover, the role of potential appraisal is to determine the potential of a given workers to occupy higher positions in the organizational hierarchy plus handle higher responsibilities. Potential appraisals are required to: Inform employees about their future prospects; Help the company check out of a appropriate succession plan; Update training efforts from time to time; Advisee employees about what they must learn to develop their career prospects. Potential appraisal can perform the following purposes: To advise employees about their overall career development and future prospects Help the company to chalk out succession plans Motivate the employees to further enhance their skills and competencies. To identify the training needs. Techniques of potential appraisal: Self appraisals Peer appraisals Superior appraisals Psychological and psychometric tests Management games like role playing Leadership exercises etc. Introducing a enormous Potential Appraisal System The following are some of the steps needed to be followed at the time introducing a potential appraisal system: Role Descriptions: Organizational functions along with functions should be defined simply. To this end, job descriptions should be prepared for each job. Qualities required completing the functions: Based on job descriptions, the functions to be played via individuals must be prepared (i.e., technical, managerial jobs as well as behavioral dimensions). Rating mechanisms: Besides listing the functions along with qualities, the potential appraisal process must provide mechanisms of judging the qualities of staffs as: Rating through others: The potential of a candidate might be rated by the current employer who is acquainted with the candidates work earlier, just his technical abilities. Tests: Managerial as well as behavioral dimensions can be measured via a battery of psychological tests. Games: Simulation games in addition to exercises (assessment centre, besides business games, in-basket, along with role play, etc.) could be used to display the potential of a nominated staff. Records: Performance records along with ratings of a nominated staff for his earlier jobs could be examined carefully on various dimensions such as motivation, creativity, besides risk taking ability, etc., which may play a vital concern in discharging his responsibilities in a new job. Organizing the system: After completing the earlier preliminaries, he should set up a way that will allow the introduction of the time quietly giving answers to specific puzzling questions: How much load time to assist in conditions of seniority in promotions? How much weight age to each of the performance dimensions; such as technical, besides managerial, in addition to behavioral qualities? What would be the mechanisms of assessing the body on different indicators of his potential and via what reliability? Feedback: The system should provide an option for every employee to see the works of his assessment. He might be assisted to understand the qualities most needed for performing the purpose for which he thinks he gets the potential, the mechanisms utilized through the companies to evaluate his potential along with the results of such an appraisal.

Characteristics of Adolescents Essay

Intellectual, moral, physical, emotional, and psychological development of Middle School students. Middle Schoolers undergo profound changes during their adolescent years, and unlike infancy, they are witnesses to these changes. Complicating things further is the fact that these changes do not occur at the same rate in each individual. While all adolescents do not share these characteristics, it is safe to say that many do. Understanding that these characteristics are developmentally â€Å"normal† is helpful. At the same time, while these changes are necessary and natural, they present challenges to parents, teachers, and Middle Schoolers themselves. Intellectual Development * Display a wide range of intellectual development. * Are in transition from concrete to abstract thinking. * Are intensely curious and dabble in a wide range of pursuits, few of which are sustained. * Prefer active over passive learning activities. * Prefer interaction with peers during learning activities. * Respond positively to opportunities to participate in real life situations. * Are often preoccupied with self. * Have a strong need for approval and may be easily discouraged. * Develop an increased understanding of personal abilities. * Are inquisitive about adults, often challenging their authority, and always observing them. * May show disinterest in conventional academic subjects but are intellectually curious about the world and themselves. * Are developing a capacity to understand high level or sophisticated humor. Moral Development * Often show compassion for those who are downtrodden or suffering and have a special concern for animals and environmental problems. * Are moving from acceptance of adult moral judgments to development of their own personal values. (Nevertheless, they tend to embrace values consistent with those of their parents.) * Are capable of and value direct experience in participatory democracy. * Greatly need and are influenced by adult role models who will listen to them and affirm their moral consciousness and actions as being trustworthy role models. * Are increasingly aware of and concerned about inconsistencies between values exhibited by adults and the conditions they see in society. Physical Development * Experience rapid, irregular growth. * Undergo body changes that might cause awkward, uncoordinated movements. * Have varying maturity rates, with girls tending to mature one-and-a-half to two years earlier than boys. * May be at a disadvantage because of the varied rates of maturity that require the understanding of caring adults. * Experience restlessness and fatigue due to hormonal changes. * Need daily physical activity because of increased energy. * Develop sexual awareness that increases as secondary sex characteristics appear. * Are concerned with body changes that accompany sexual maturation and changes resulting in an increase in nose size, protruding ears, long arms, and awkward posture. * Prefer junk food but need good nutrition. * Often lack physical fitness, with poor levels of endurance, strength, and flexibility. * Are physically vulnerable because they may adopt poor health habits or engage in risky experimentation with drugs and sex. Emotional and Psychological Development * Experience mood swings often with peaks of intensity and unpredictability. †¨ * Need to release energy, often in sudden, apparently meaningless outbursts of activity. * Seek to become increasingly independent, searching for adult identity and acceptance. * Are increasingly concerned about peer acceptance. * Tend to be self-conscious, lacking in self-esteem, and highly sensitive to criticism. * Exhibit intense concern about physical growth and maturity as profound physical changes occur. * Increasingly behave in ways associated with their gender as gender role identification strengthens. * Are concerned with many major societal issues as personal value systems develop. * Believe that their personal problems, feelings, and experiences are unique to them.

Lumpkin Plumbing Essay

Lumpkin experienced a steady increase in sales since it began 1990 and has recently expanded inventories to accommodate a relatively larger sales increase. Richard Lumpkin borrowed $150,000 to expand the warehouse to hold more inventories and include a model to attract retail sales. The expansion will benefit the company as long as inventories are managed well and the increase in production does not harm profit margins. Lumpkin Plumbing projected figures for the balance sheet, income statement, and cash flows for 2000. Lumpkin anticipated growth for the 2000 year but underestimated the increase in total assets and liabilities by 47. 37%. Lumpkin also projected a 20% increase in sales and realized an actual increase of 63. 15%. Though the company underestimated the sales increase, it was able to manage costs and increase net income 63. 42%. If Lumpkin can maintain its’ profit margin and take advantage of increased demand then the expansion would be beneficial to the health of the company. Lumpkin is managing the expansion and should be able to make its loan repayments of $50,000 per year. Lumpkin also underestimated the growth of its inventories and accounts payable. Inventories at Lumpkin increased 89. 39% though the increase was projected at 10. 48%. Lumpkin had $628,800 in inventories at the end of 2000 which raises concern for the liquidity of the company. Accounts payable projections were also off, with a projected decrease of $2,000 and an actual increase of $216,400. The increase in accounts payable is partly due to the extension of A/P days from 10. 40 to 45. 10 from 1999 to 2000. The extreme A/P could be from inventory costs and also account for the large increase in inventory holdings. Lumpkin could be planning for an increase in sales growth and hold inventories to meet the demand. Even if the discrepancies between the projected and actual figures for the inventories and A/P are explained by increases in sales, these should have been accounted for in the projections and should not have been so dramatically different. Lumpkin Plumbing effectively used the loan to grow the company and is in fair financial health to repay the loans. Though the company has met the increased demand and managed operating costs, the difference in some projections raises reasons for concern. If Lumpkin is not able to forecast financial conditions accurately, the financial future of the company is uncertain, increasing its default risk. I recommend Lumpkin Plumbing be considered for future loans after financial statements are analyzed repayment of the current loan is complete.

Downriver Gynecology Environmental Assessment - 785 Words

Downriver Gynecology builds an environmental assessment to effectively improve our standing in the community. The environmental analysis is used by marketers to calculate the financial influences that will guarantee that the worth of what is being used in the activity is increased in return, the political influences that may influence functioning of, or the selections for the progression of the organization also the social factors which are the demographic changes (as people move around to look for jobs), and movements in the way people live, work, and think. As well as cultural influences, the differentiated populations how they will influence the business, whether the neighborhood’s is ready to attack new and old problems, and the enthusiasm to learn about the new technology. The population estimated at 1,775,273 in 2013, has declined significantly in that the estimated number in 2012, and is now at -2.5 percentage wise. The unemployment rate has decreased and it is at 7.5% (Economic Research, 2014) and the population is shrinking because of those residents who move out of their homes and move to other cities to look for jobs (United States Census Bureau, 2014). That makes it hard when we lose clients to job migration. However when people move out there will always be people moving in and then we can start. Marketing, you can find us in the career section of the Detroit News and Free Press, also online at the Career Builder.com, the Monster.com, the Job Fairs, and the