Jazz :: essays research papers

The conceptual idea of humanism has existed since before the years of Christ. Biblical records state that when man was created he was made in the image of God. This image has been passed down throughout the civilizations of Greece ,Egypt, and Roman times and it has been passed down to our civilization of today. The evidence of this is in the art of yesterday and the way we view art of today. The way we view art today is in such a way that we feel and conceptualize what we create. We create things in the image of how we view our life, our civilization, and our status in this civilization. In applying the things stated in the previous thought to the human life the result will be art . Culture is a distinct component of what society is. Culture is in all essence what culture does. The whole purpose of culture is to in a way define a specific race or creed. Culture is what makes us unique and very individual. An example of this is myself and my cousin named Brandon. We are both in the same family and we both have been raised with the same values but what makes us different is the culture we have adopted in our lives to help us define the way we feel about ourselves and the way we feel about society. I feel as if the afro-American race is moving in a progressive manner towards unity and he feels as if the Afro-American race as a whole is moving towards separation by the complexion of their skin. The culture that I have adopted has shaped my views and ideas and the culture he has adopted has shaped his thoughts and ideas. My ideas are not better than his nor are his better than mine ,just different. Civilization is defined as many things but you can only define what is civil for your own civilization. Many people have a definition of what a civilization is but when they make this definition it is by their own standards which is wrong. A civilization is a place or group of people who can defend themselves from enemies, get or create a quantity of food, establish a currency, and develop a trade with others. In America we view life as a sacred and very precious thing . In other countries death is viewed as the

Accounting Statement of Purpose

Hello! I am going to apply to Msc Accounting and Finance Management programme. I would be grateful if you could give me feedback. :::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::: :::::::::::::::::::::::::::::::::::::: I studied a Bachelor's degree in Accounting. During the undergraduate degree I took a variety of subjects in taxes, finance, auditing, economics, accounting and business management. Taking a variety of subjects in university allowed me to see where my interests and strengths lie.The subjects that grabbed my attention during the final year in the university were taxation, business management and finance. It was through doing these subjects that I discovered I would like to pursue my career in either of these fields. As part of my desire to have a broad knowledge in business management, I wrote the final-year dissertation focused on this field. Which was titled â€Å"How far proper management lead your business to success†. In July 2007, I was hired by one of the big four accountancy firms, where I develop an employment as tax consultant.Through this job, I have understood the important role played by the accountancy in business. Definitely book-keeping, preparing financial statements, establishing and maintaining accurate financial records provide a general overview of how business is doing. In my experience I have realized that accountants specialized in taxation besides technical-legal knowledge, they must have wide knowledge of accounting and its procedures as well as theory to properly evaluate financial information.With this knowledge the consultants must be able to ensure if records are accurate according with government regulations, identify companies' opportunities and provide advice on improving efficiency. The reasons mentioned above besides my long-term goal to pursue a career as a controller encourage me to seek for a professional accounting and finance management program, which allow me to obtain the abilit y to effectively analyze accounting records, interpret financial statements as well as acquired a wide overview regarding management functions within an organization.Selecting a graduate school is not an easy task; there are certain aspects to look at while considering a school. After comparing some accounting and finance programs provide by Dublin universities. I found the MSC at Griffith College like the one that meet my academic and professional goals. Other reasons to choose this colleges are: its prestige, it is recognized as one of the top private universities in Dublin, program' structure which fully meets my academic and professional objectives, the subjects that caught my attention are: international financial management.I am certain that the MSC in accounting and finance management provided by Griffith College will provide a lot of advantages besides helping me to achieve my academic and professional objectives, such as: improve foreign language skills, opportunity to work with people from diverse backgrounds, exposure to new learning environments, cultures, obtain an international perspective and by this way understand other points of view, enhance future job prospects. I am certain that the wide knowledge that the Msc in accounting and finance management provides, will give me with the necessary tools to succeed in my career.

Biography of Robert Kennedy, US Attorney General

Robert Kennedy was the attorney general of the United States in the administration of his older brother, President John F. Kennedy, and later served as a U.S. senator from New York. He became a candidate for the presidency in 1968, with opposition to the war in Vietnam as his central issue. Kennedy’s vibrant campaign energized young voters, but the great sense of optimism he represented ended in tragedy when he was mortally wounded immediately after declaring victory in the California primary. Kennedys death not only served to mark 1968 as a shocking and violent year, it changed the course of American politics for years to follow. Fast Facts: Robert F. Kennedy Known For: Attorney General of the U.S. during administration of his brother, John F. Kennedy; Senator from New York; presidential candidate in 1968Born: November 20, 1925 in Brookline, MassachusettsDied: June 6, 1968 in Los Angeles, California, victim of assassinationSpouse: Ethel Skakel Kennedy (b.1928), married June 17, 1950Children: Kathleen, Joseph, Robert Jr., David, Courtney, Michael, Kerry, Christopher, Max, Douglas, Rory Early Life Robert Francis Kennedy was born November 20, 1925, in Brookline, Massachusetts. His father, Joseph Kennedy, was a banker and his mother, Rose Fitzgerald Kennedy, was the daughter of the former mayor of Boston, John F. Honey Fitz Fitzgerald. Robert was the seventh child in the family, and the third son. Growing up in the increasingly wealthy Kennedy family, Robert lived a very privileged life as a child. When his father was named the U.S. ambassador to Great Britain by President Franklin D. Roosevelt in 1938, the Kennedy children were featured in news stories and even movie newsreels depicting their travels to London. As a teenager, Robert Kennedy attended Milton Academy, a prestigious prep school in a Boston suburb, and Harvard College. His education was interrupted when he enlisted in the U.S. Navy shortly after his oldest brother, Joseph P. Kennedy, Jr., was killed in action in World War II. He was commissioned a lieutenant in the Navy, but saw no action. He returned to college following the wars end, graduating from Harvard in 1948. Kennedy entered law school at the University of Virginia, from which he graduated in the class of 1951. While in law school he dated Ethel Skakel, whom he had met while helping to manage his brothers congressional campaign. They were married on June 17, 1950. They would eventually have 11 children. Their family life, at a Virginia estate known as Hickory Hill, would become a focus of fascination for the public, as celebrities from the world of show business and sports would visit for parties which often involved touch football games. Robert Kennedy (left) and John Kennedy in a Senate hearing room.   Bettmann/Getty Images Washington Career Kennedy joined the criminal division of the U.S. Department of Justice in 1951. In 1952, his older brother, Congressman John F. Kennedy, successfully ran for the U.S. Senate. Robert Kennedy then resigned from the Justice Department. He was hired as a staff attorney for the U.S. Senate committee run by Senator Joseph McCarthy. Kennedy worked for McCarthys committee for five months. He resigned in the summer of 1953, after becoming disgusted with McCarthys tactics. Following his interlude working with McCarthy, Kennedy moved to a staff job as an attorney working for the Democratic minority in the U.S. Senate. After the Democrats took the majority in the Senate in the elections of 1954, he became the chief counsel for the U.S. Senates Permanent Subcommittee on Investigations. Kennedy convinced Senator John McClellan, who chaired the Investigations subcommittee, to form a select committee on labor racketeering. The new committee became known in the press as the Rackets Committee, as it specialized in investigating organized crime infiltration in labor unions. Senator John F. Kennedy served on the committee. With Robert as chief counsel often asking the questions of witnesses in lively hearings, the Kennedy brothers became familiar figures in the news. Jimmy Hoffa gesturing to Robert Kennedy at a Senate hearing.   Bettmann/Getty Images Kennedy vs. Jimmy Hoffa At the Rackets Committee, Robert Kennedy focused on investigations of the Teamsters Union, which represented the nations truck drivers. The unions president, Dave Beck, was widely assumed to be corrupt. When Beck was replaced by Jimmy Hoffa, who was rumored to be deeply associated with organized crime, Robert Kennedy began to target Hoffa. Hoffa had grown up poor and had a well-deserved reputation as a tough guy in the Teamsters Union. He and Robert Kennedy could not have been more different, and when they squared off in a televised hearing in the summer of 1957, they became stars in a real-life drama. Hoffa, making wisecracks in a gravelly voice, was defiant in the face of Kennedys pointed questioning. To anyone watching it seemed obvious that the two men despised each other. To Kennedy, Hoffa was a thug. To Hoffa, Kennedy was a spoiled brat. Robert Kennedy at the Justice Department, 1964. Bettmann/Getty Images   Attorney General When John F. Kennedy ran for president in 1960, his brother Robert served as his campaign manager. After Kennedy defeated Richard M. Nixon, he began to select his cabinet, and there was talk of picking Robert Kennedy to be the nations attorney general. The decision was naturally controversial, as it sparked charges of nepotism. But the new president felt strongly that he needed his brother, who had become his most trusted adviser, in the government. As attorney general of the U.S., Robert Kennedy continued his feud with Jimmy Hoffa. A team of federal prosecutors became widely known as the Get Hoffa Squad, and the Teamster boss was investigated by federal grand juries. Hoffa was eventually convicted and served a term in federal prison. Robert Kennedy was also focused on organized crime figures, and at one point advised President Kennedy not to deal with Frank Sinatra because of the singers friendships with mobsters. Such events became fodder for later conspiracy theories that the assassinations of the Kennedy brothers were connected to organized crime. As the Civil Rights Movement gained traction in the early 1960s, Kennedy, as attorney general, was often monitoring developments and at times sending federal agents to maintain order or enforce laws. A serious complication developed as FBI Director J. Edgar Hoover, who hated Martin Luther King, wanted to tap Kings phones and plant listening devices in his hotel rooms. Hoover was convinced that King was a communist and a enemy of the United States. Kennedy eventually acquiesced and gave approval to the wiretaps. Senator From New York Following his brothers violent death in November 1963, Robert Kennedy went into a period of mourning and sadness. He was still the nations attorney general, but his heart wasnt in the job, and he was not happy working with the new president, Lyndon B. Johnson. In the summer of 1964, Kennedy began to seriously think of running for a U.S. Senate seat in New York. The Kennedy family had lived in New York for a time during his childhood, so Kennedy had some link to the state. Yet he was portrayed by his opponent, the Republican incumbent Kenneth Keating, as a carpetbagger, meaning someone who came into a state just to win an election. Kennedy won the election in November 1964, and took office as a senator in early 1965. As the brother of the recently assassinated president, and someone who had been in the national news a decade, he immediately had a high profile on Capitol Hill. Kennedy took his new job seriously, spending time studying local issues, visiting rural parts of New York State, and advocating for impoverished neighborhoods in New York City. He also traveled overseas, and put a focus on issues of poverty around the globe. One issue would begin to dominate Kennedys time in the Senate: the escalating and increasingly costly war in Vietnam. Though American involvement in Vietnam had been a feature of his brothers presidency, Kennedy came to believe the war was unwinnable and the loss of American lives needed to end. Robert Kennedy campaigning in Detroit in 1968. Andrew Sacks/Getty Images   The Anti-War Candidate Another Democratic senator, Eugene McCarthy, had entered the race against President Johnson and nearly beat him in the New Hampshire primary. Kennedy sensed that challenging Johnson was not an impossible quest, and within a week he entered the race. Kennedys campaign immediately took off. He began attracting large crowds at campaign stops in states holding primaries. His campaign style was energetic, as he would plunge into crowds, shaking hands. Two weeks after Kennedys entry into the 1968 race, President Johnson shocked the nation announcing that he would not run again. Kennedy began to seem like the favorite to win the Democratic nomination, especially after strong showings in primaries in Indiana and Nebraska. After losing the primary in Oregon, he came back strong and won the California primary on June 4, 1968. Death After celebrating his victory in a Los Angeles hotel ballroom, Kennedy was shot at close range in the hotels kitchen in the early hours of June 5, 1968. He was taken to a hospital, where he died of a head wound on June 6, 1968. Crowds lined railroad tracks as Robert Kennedys body returned to Washington. Bettmann/Getty Images After a funeral mass at St. Patricks Cathedral in New York City, Kennedys body was taken to Washington, D.C., by train on Saturday, June 8, 1968. In a scene reminiscent of the funeral train of Abraham Lincoln, mourners lined the railroad tracks between New York and Washington. He was buried that evening in Arlington National Cemetery, a short distance from President Kennedys grave. His killing, coming two months after the assassination of Martin Luther King, and less than five years after President Kennedy’s murder, became one of the most memorable events of the 1960s. Robert Kennedys assassination cast a pall over the election campaign. There was a feeling among many that he would have won the presidency in 1968, and the modern history of the United States would have been quite different. Kennedys younger brother, Edward Ted Kennedy kept the familys political tradition going, serving in the U.S. Senate until his death in 2009. Children and grandchildren of Robert Kennedy have also served in political office, including Joe Kennedy III, who represents a Massachusetts district in the U.S. House of Representatives. Sources: Edelman, Peter. Kennedy, Robert Francis. The Scribner Encyclopedia of American Lives, Thematic Series: The 1960s, edited by William L. ONeill and Kenneth T. Jackson, vol. 1, Charles Scribners Sons, 2003, pp. 532-537.Robert Francis Kennedy. Encyclopedia of World Biography, 2nd ed., vol. 8, Gale, 2004, pp. 508-509.Tye, Larry.  Bobby Kennedy: the Making of a Liberal Icon. Random House, 2016.

swot in nursing - 1224 Words

SWOT SWOT is an acronym for -Strengths -Weaknesses -Opportunities -Threats A SWOT analysis -helps to improve personal and professional development -to understand yourself better -to decide which areas you need to develop and set goals for. SWOT Analysis and Action plan Learning outcome 1 Illustrate the ability to develop and maintain a supportive relationship with the learner that promotes socialisation and integration in the workplace†¦show more content†¦SWOT analysis Strengths ââ€" ºIam organised at work and good at priortising my workloads. ââ€" ºI maintain a good profeesionalShow MoreRelatedNursing Swot Analysis1693 Words   |  7 PagesAssignment 2: Course Project Task 2 SWOT-As we learned swot stands for strengths, weaknesses, organization, and tasks. This is used in all firms to make necessary changes. This is especially useful in healthcare organizations. The Hartford (2017, n.d.), states that ‘A SWOT analysis examines four aspects of performance that typically determine the success or failure of a company, employees or even an individual. It’s one task/variable to make a list of your company’s strengths, weaknesses, opportunitiesRead MoreNur/598 Essay1229 Words   |  5 Pagesevidence-based practice SBAR (situation, background, assessment, and recommendation) program to approach the Director of Nursing to get approval for the project. The author will discuss the project with Director of Nursing and present this project for approval to the administration. Once approval has been obtained one of the manager will be appointed as project director by the Director of Nursing. The manager will appoint the team that will present t he project to the staff (nurses and physicians) that willRead MoreImpact Report to Senior Leadership Essay803 Words   |  4 PagesImpact Report to Senior Leadership Mary J Farmer Organizational and Systems Management for Quality Outcomes March, 2016 The Nursing Challenge Hospital readmissions and emergency room visits are on the rise particularly for patients with low socioeconomic status, limited resources, or who live in rural areas. Post-operative infections, asthma attacks, heart failure exacerbations and other conditions that could have been prevented seem to be driving this pattern. This has caused a downstreamRead MoreSwot Analysis : Hospital Organization1048 Words   |  5 PagesSWOT Analysis Hospitals in today’s world require organizations that have a variety of people on their boards. Hospitals are usually run by administrators, board of directors, and other departments. Each of the many tiers of the hospital organizations has varied goals and achievements that they wish to accomplish. This article is designed to discuss some of the strengths; weakness, opportunities and threats (SWOT) of the hospital organization (Roussel, 2013). Internal and external forces will be discussedRead MoreAssess and Workplace as a Learning Environment Essay1330 Words   |  6 PagesMENTORSHIP PREPARATION | Assess and critically analysis your workplace as a learning environment and identify any changes you could make | | | Appendix 1 SWOT analysis of my work place. A SWOT is an acronym for strength, weaknesses; Opportunities and Threats). A SWOT analysis is a successful way of examing your own mentorship role and helping you grow and move forwards. Strengths a) Good communication skills b) Good timekeeping c) Good team player d) OrganisationRead MoreReflection Personal Development Plan1163 Words   |  5 Pages(interpretation) and now what (outcome), (Kilgallon and Thompson, 2012). Reflecting on the SWOT Analysis, identified my, Strength (Determination)- completing tasks, work or university related. Weakness (Nervousness)- speaking in front of professionals/family members. Opportunities (Learning)- learning new things I enjoy in University. Threats (Distraction)- with a family/baby, I can easily be distracted (Nursing Time, 2011). Consequently using the Personal Development Plan (PDP)I will aim to overcomeRead MoreThe Presidio Army Health Clinic’s SWOT-Analysis Essay1269 Words   |  6 PagesThe Presidio Army Health Clinic’s SWOT-Analysis The current health care system can be difficult to navigate and often medical centers need management tools to help them develop strategic plans within their organizations. The SWOT-Analysis is one strategic tool that health care centers can use to formulate a roadmap for their organizations. The SWOT-Analysis examines internal capabilities (strengths and weaknesses) and external developments (opportunities and threats) when determining a strategicRead MoreEnvironmental Analysis of an Adult Day Care967 Words   |  4 Pagesvolunteer in nursing homes over the period of her mothers stay in a residential home. ï ¿ ½ ENVIRONMENTAL ANALYSIS OF AN ADULT DAY CARE According to Bryson and Alston (1996), the best way to carry out this plan is to use the SWOT methods which translate to Strength, Weakness, Opportunities, and Threats. The provider must not only use this for the external environment but it is just as important to use this method for the internal environment of the organization or providers office. The SWOT method shouldRead MoreReflection1218 Words   |  5 Pagescolleagues. Driscoll s Reflection Cycle (2007) is a recognized framework for reflection, there are three important steps which are, What (description), So What (Interpretation) and Now What (Outcome), (Kilgallon and Thompson, 2012). Reflecting on the SWOT Analysis I was able to identify my, Strength (Determination)- Due to staff shortages, I have been determined to completing tasks whether they are work related or university related. Weakness (Nervousness)- speaking in front of other professionals/familyRead MoreThe Current Incidents Of Poor Leadership Within The Health Service Essay1650 Words   |  7 PagesThis essay aims to define and analyse the leadership within the context of the NHS and specifically in the nursing profession. Further, this assignment will highlight some of the current incidents of poor leadership within the Health service. It will then briefly discuss some of the leadership theories whilst exploring my own leadership style along with rationale. SWOT (Strength, Weakness, Opportunity and Threats) analysis will be conducted to identify my leadership potential, which will be included

Analysis Of The Payment Practices Between Companies,...

While there is heterogeneity in the payment practices between companies, executive compensation plans must include four basic components: base salary, annual bonus tied to accounting performance or another agreed indicator between the parties, stock options and incentive plans long term (including restricted stock plans and performance plans based on accounting more exercise). Under the crossfire of public opinion, the bonus word became almost word, synonymous with unbridled greed, something to be fought. But despite all the weeping and gnashing of teeth the last two years, the variable compensation was off the list of fatal victims of the crisis. Capitalism still could not invent better way than the bonuses to reward those who deliver the†¦show more content†¦There is the difficulty of justifying wages like these when companies have laid off many employees. The expectation is that these excessive salaries are reduced this year, thanks to new rules imposed last month by the Securities and Exchange Commission. Besides super salaries and bonuses, companies offer a benefits package, which are very negotiable an executive to another, but it usually involves a high standard car, high level of health insurance for the family, specialized courses for professional education for the children, wife expenses and, the company sometimes also offers sophisticated houses. Multinationals also have policies to encourage the training and professional development of employees, with courses and trips. Professionals also have advantages to work in environments that emphasize the quality of life, health, and ergonomics. Over the past 15 years, the compensation of the executives rose to astronomical figures compared to the reality of other countries. With inflated salaries and high bonuses, directors and vice presidents had in their favor the market, so they could choose the employer who paid more. The party is now over. The unfavorable economic scenario that these same professionals who have been targets of true corporate auctions are now in the court of sight. In the dance of the restructuring, the most affected were and still are the top of the pyramid executives. Because of the shrinking of the

The assessment and treatment of a diabetic ulcer with be discussed. Free Essays

string(58) " the importance of good footwear as I was in the army†\." Introduction For this tissue viability assignment the assessment and treatment of a diabetic ulcer with be discussed. Wound healing and it properties will also be mentioned in regards to holistic factors affecting the chosen patient (pt). In accordance with the Health Professional Council (HPC) a standard of conduct, performance and ethics, a pseudonym has been used to protect the identity of the pt discussed (HPC 2008). We will write a custom essay sample on The assessment and treatment of a diabetic ulcer with be discussed. or any similar topic only for you Order Now I certify that confidentiality has been maintained, for the purpose of this assignment the patient will be called Mr Sim.An ulcer is a defect effecting loss of epidermis and all or part of the dermis (Lookingbill Marks 1993). The skin comprises of three layers, and is the largest organ in the body. The average adult has 21 square feet of skin (2 sq m) weighing up to 3.2 Kg (Benbow 2007). The three layers of the skin are, the Epidermis this consists of dead skin cells which shed continuously and it protects against certain bacteria. The epidermis also acts as a barrier to prevent evaporation and absorption of water. The Dermal Layer consists of capillaries, sebaceous (oil) glands, sensory receptors which transmit sensations such as itch, pain and temperature, and hair follicles all held together by elastin and collagen. The Subcutaneous layer contains fat and connective tissue that houses larger blood vessels and nerves. This layer is important in the regulation of temperature of the skin itself and the body. The size of this layer varies throughout the body and from person to person (Brannon 2007). The skin is a complicated structure with many functions. If any of the structures in the skin are compromised through poor blood supply, trauma, surgery etc. a wound may develop. â€Å"A wound is a loss of continuity to the skin â€Å"states Dealey Cameron (2008) The phases of normal wound healing †¢ Inflammation – a reaction to tissue damage / infection †¢ Reconstruction – granulation tissue starts to form. †¢ Epithelialisation – the wound becomes covered with epithelial cells. †¢ Maturation – scar tissue starts to fade and blend in with the normal tissue Case Study The subject of this study is a male patient aged 69 years, for the purpose of this case study the patient will be referred to as Mr Sim. Mr Sim attended as a new patient to the podiatry department at his local clinic complaining â€Å"something has been catching on my socks†. On examination of Mr Sim’s foot a large area of callus was observed on the plantar aspect of his right fifth toe (ball of foot under little toe) there was some brown discolouration due to extravasation (leakage of blood into the skin) indicating that there could be an ulcer under the callus. It was explained to Mr Sim that further assessment and treatment would be necessary to determine what and why the problem was occurring. The podiatry assessment tool was used to provide a holistic approach to assessment of medical history and social factors that may affect the foot health of the patient. The tool has a systematic problem based approach to undertaking clinical assessment and a detailed history; it is similar in outlay to a Patient Orientated Medical Review (POMR). Both the POMR and the podiatry assessment tool include a description of the presenting complaint which is an important part as it determines what the patient considers to be important and can be used to establish agreed expectations. Both models include previous and current medical history including any operations, illnesses or injuries which is of high importance in wound healing as systemic disorders or medication can have a large impact on wound healing. Both assessment tools include a detail of any known allergies, any family traits and social factors such as smoking or drug taking. The factors assessed in the above tools are recognis ed as being significant factors in wound healing. Rainey (2005) lists medication, illness, smoking, alcohol consumption and mobility as factors that affect wound healing. In addition to the POMR the podiatry assessment tool focuses on the factors that may affect the patients foot health for example previous or current occupations, an appraisal of the patient’s footwear and assessment of patients gait, vascular assessment, condition of skin, skin colour, skin temperature as well as palpating pedal pluses. A neurological assessment using a 10 gram monofilament, which is the standard neuropathy test in primary and community care in the united kingdom since National Institute for Clinical Excellence (NICE) guidelines for the management of the diabetic foot were published in 2004 (Boulton et al 2006). However the podiatry assessment tool does not include an assessment of the nutritional status of a patient which has been regarded as a key factor affecting wound healing (Dealey 2 005, Rainey 2005), and malnutrition is a very important cause in delaying the healing process (Morrison 1992). Using the podiatry assessment tool it was found that Mr Sim was diagnosed with Type 2 diabetes nine years ago and had recently moved to the area from abroad after losing his wife of to whom he was married to for forty four years, he now lives in the same road as his nephew. Mr Sims has good control of his diabetes taking metformin 500m mg twice daily, his recent HBA1C was 7.3 % this is regarded as tight glycaemic control (Lee et al 2006) His nutritional status adequate, he reports no strong family history of diabetes or heart disease, he occasionally has a glass of red wine. Mr Sims also takes medication to control hypertension (high blood pressure), bendroflumethiazide and aspirin, a cholesterol tablet as a precautionary method, and painkillers and antiflammatory treatment for osteoarthritis. He also mentioned that the pain in his back was increasing, and was taking a course of antibiotics for an infected cut on his hand obtained whilst gardening. For some time now he had been ex periencing bouts of tingling in both his hands and feet. He expressed that he takes good care of himself never smoked, eats well and keeps active, and he states he has â€Å"an awareness of the importance of good footwear as I was in the army†. You read "The assessment and treatment of a diabetic ulcer with be discussed." in category "Essay examples" All patients with diabetes should receive an annual foot check by a trained health care professional (NICE 2004), this includes the application of a 10g monofilament to five points on each foot, to assess the protective sensation in the feet and the extent of any sensory neuropathy. Peripheral sensory neuropathy is thought to affect 20 – 40% of the population (McIntosh et al 2004) and is a major factor in the development of diabetic foot ulceration. Both feet were tested using the 10g monofilament this resulted in 0/5 probes being detected on both feet indicating peripheral neuropathy, however the dorsalis pedis and posterior tibialis were palpable in both feet, skin colour, texture and temperature and capillary refill was 2 seconds indicating good blood supply (Dealey 2005). Baker, Murali and Fowler (2005) state that the palpation of foot pulses is not a good indicator for a good blood supply. A Doppler gives a more accurate result when assessing vascular status it assists the diagnosis by determining the presence or absence of a compromised arterial flow in the lower limb (Dughil 2006) Jeng et al (2000) concluded that if a person cannot identify the pressure from a 10g monofilament on their skin approximately 98% of the sensory ability has been lost. When the 10g monofilament is applied to the foot it buckles at a given force of 10g, inability to feel this is a significant indication that neuropathy is present and protective pain sensation is lost (Edmonds and Foster 2000). Neuropathy presents itself in various ways; motor, sensory and autonomic nerves are affected and there is no conclusive proof as to what causes neuropathy. Factors such as high glucose levels can cause chemical changes, harming blood vessels, which supply oxygen, to tissue. Motor neuropathy, causes abnormal foot pressures, the structure of the foot can change, giving abnormal pressure areas. Sensory neuropathy can give reduced sensation, masking pain, allowing for callus build up, and leading to ulceration. Autonomic neuropathy, which leads to dehydration of the skin, is commonly known as arteriovenous shunting (A.V). Neuropathy is detected by using a 10g monofilament. This is used on high pressure areas to detect if the patient can feel pain or not. These results, however, may not always be reliable, as they rely on patient feedback, therefore clinical judgement, must always be upheld at all times. Diabetes affects the vascular supply to the foot, leading to reduce or absent pulses, causing poor tissue viability, decreasing healing time. Excess glucose and cholesterol deposits in the lumen of blood vessels, reducing the diameter, which in turn, increases heart activity causing hypertension. Aspirin is used as a prevention, it is classed as an anti-platelet drug which reduces platelet aggregation. Aspirin inhibits enzyme COX, which reduces platelet production of TXA2, which is a powerful vasoconstrictor. Mr Johnson* is currently taking Atenolol, hypertensive drug as well as Aspirin to reduce the chances of thrombosis or MI. It was explained in detail to Mr Sim about the complications of diabetes and how it may affect the feet, during the discussion Mr Sim became upset about the loss of his wife, â€Å"she always looked after my feet particularly because of the diabetes†. It was important to establish a good rapour with Mr Sim, as the lesion was causing him no discomfort apart from catching on his socks. The recent loss of his wife, his back pain and hand infection had put a lot of stress on Mr Sim. Depression is twice as likely to occur in people with diabetes and this can have a link to fluctuating blood sugar levels. Mr Sim is also experiencing pain from his back and is still grieving about the death of his wife and coming to terms with living alone. Stress is recognised as a factor in delaying wound healing (Dealey 2005; Glasser et al 1999; Kiecolt-Glasser et al 1995). Cole-king and Harding (2001) found a statistically significant relationship between anxiety and depression and delayed i n chronic wounds. Communicating with patients can reduce anxiety and promote the natural healing process, conversely lack of communication may impair healing (Collier 1994) It was then explained to Mr Sim extenslevily about the lesion of his foot in regards to his general health without adding to his stress levels. Education has proven to be vital in the management of diabetes (NICE) . It was suggested that on debridement of the callus that there could possibly be foot ulcer, with Mr Sim’s consent the callus was removed using sharp debridement an ulcer was revealed. The ulcer measured 1cm x 1cm and probed to a depth of 5mm to tendon but not to bone, the base of the was ulcer was sloughy and yellow and appearance showed no sign of infection, sharp debridement was used very carefully to remove slough. Slough in the base of an ulcer is an ideal breeding ground for bacteria which increases the risk of infection and delays healing (Rainey 2005).If infection was noted healing will be delayed and may spread to surrounding tissue or bone. At the time of assessment Mr Sim’s ulcer showed no signs of infection, although he was taking a course o f antibiotics for the infection in the wound on his hand. Diabetic problems such as peripheral ischemia or neuropathy can mask signs of infection this was considered on assessment. The wound following sharp debridement was flat and pink, this was significant as rolled edges would indicate infection. The condition of the skin was dry and showed no signs of maceration. The use of tool to grade the ulcer can provide objectivity and help with communication between health professionals. The tool used in this study was EPUAP European Pressure Ulcer Advisory System 1998, in this case the ulcer was caused by excess pressure over an area affected by peripheral sensory neuropathy. There are many wound classification systems including SAD, SINBAD and PEDIS, however the EPUAP grading system was protocol for this particular community trust. The ulcer was classified as a grade four pressure ulcer which is described as extensive destruction tissue necrosis, or damage to muscle, bone or support ing structure with or without full thickness loss. The choice of dressing being â€Å"Activon Honey Tulle† produced by Advancis medical the gauze is impregnated with pure Manuka honey, this was used firstly to complete the debridement autolyticly. Secondly for the antimicrobial purposes and its aid to deslough and control odour in the wound. Benbow (2008) states a mosit environment is essential for optimal wound healing. Other dressings are considered also for their topical antimicrobial agents, such as Iodine and Silver. Iodine was an option although none where available in Clinic. Iodine is a popular choice for the use in Podiatry. Silver dressings are more expensive than the honey and also should only be used when there is clinical sighs of infection (British national Formulary: BNF, Nov 2009), so, as in Mr Sim’s case there was no signs. The secondary dressing was a foam dressing designed to absorb and retain any wound exudate to stop the wound from becoming macerated and inhibiting wound healing. ‘Biatai n’ was the dressing choice as this is one of the foam dressings used in the clinics. This was needed as the Activion Tulle does not have any absorption properties. These dressing were held in place with ‘Mefix’ an adherent tape. Mr Sim was given instructions to keep the dressing clean and dry until his next appointment Holistically the treatment plan was to contact Mr Sim’s, G.P regarding his depression over the loss of his wife, and referral to the local diabetes centre. A lengthy discussion was held on the importance of good footwear and changing shoes regularly, as although Mr Sim’s shoes where good shoes they were very old and the innersole had worn out penetrating to the outer sole (hole in bottom of shoe). A total contact insole referral was made to relieve the pressure long term. Temporally a pad was mad to deflect pressure away from the ulcer overlying the dressing in situ. Effective reduction in pressure relief is essential to heal a diabetic foot ulcer and to prevent reoccurrence (Armstrong et al 2001). A education booklet was supplied titled Diabetic foot Ulcer, if a patient has the knowledge and understanding of their treatment plan they are More likely to comply (Dowsett 2004). Mr Sim was as asked to return to clinic in five days as part of his dressing regime, he reported he had an appointment with the G.P the following day to discuss his depression. He had also received a letter from the diabetes centre with an appointment for the following week. The NSF (National Service Framework) and NICE the National Institute for Clinical Excellence set standards and put polices in place for every health care professional to follow, all patients with diabetes present with an ulcer must be referred on to a multidisciplinary team to receive the best care possible. The multidisciplinary team consists highly trained podiatrist, diabetologist, consultant, nurses, orthotists all of which specialises in complications of the foot and lower limb (NICE 2004). The dressing was removed the wound measured a reduction in depth and circumference 7mm x 6mm depth 3mm, exudate levels where low, there were no clinical signs of infection, no maceration or further callus formation, the same dressing was applied and along with padding. A further appointment was made for seven day’s time , ideally the dressing change should be five days but due to staff sickness this was not possible. At this appointment Mr Sim had seen the G.P who had referred him to a bereavement councillor. The diabetes Centre had furthermore made a referral to the orthopaedic department who are fitting Mr Sim for orthopaedic footwear for pressure relief in accordance with NICE guidelines (2008). On conclusion the outcome for this case study was a positive one, the patient was assessed holistically to identify and factors which may hinder the healing process, this not only includes the factors directly affecting the wound but also indirectly by affecting the patients qualit y of life including dealing with bereavement, housing issues etc. The Department of Health (DH 2008) stated â€Å"Delivering improvements for people with long term conditions is not just about treating illness, it is about delivering personalised, responsive, holistic care in the full context of how people live their lives. Our journey to achieve this has started, our challenge is to continue to take it forward and the evidence compels us to do this†. REFERENCES HPC Armstrong, D.G., Nguyen, H.C Lavery, L. A., (2001) offlanding the diabetic foot wounds. Diabetes care 24 (6) 1019 – 1022 Baker, N., Murali-Krishman, S., Folwer, D (2005) A users guide to foot screening, part 2, peripheral arterial disease, the diabetic foot 8 (2) 58-70 Benbow M (May 2007) Back to Basics – Skin and Wounds. Journal of Community Nursing Vol 21 (5) p34 Benbow M (2010) Ageing Wound healing, Journal of community nursing. 24 (5) 36-38 Brannon, H M.D former about.comguide Collier, M (1994) assessing a wound. Nursing standard 8 (49): 3-13 Dealey, C. (2005). The care of Wounds. A guide for Nurses. Blackwell Science, oxford. Dowssett (2004) Dughill, S., (2006) peripheral arterial disease. Why screen in primary care Nursing times 102 (16) 38-39 Glaser, R., Kiecolt-Glaser, J.K., Marucha, D.M.D MacCallum, R.C., Laskowski, B.F., and Malarkey, W.B (1999). Stress-related changes in pro inflammatory cytokine production in wounds. Archives of General Psychiatry 56 (5), 450-456. Cited in Dealey, C. (2005). Marcucha, P.T., Malarkey, W.B., Mercado, A.M Glaser, R. (1995).Slowing of wound healing by psychological stress. Lancet, 346 (8984) 1194-1196. Cited in Dealey (2005) Rainey, J (2005). Wound Care, A handbook for community Nurses. Whurr Publishing, London. Lookingbill ,D,P. Marks, J, G (1993) principles of Dermatology. London; W.B Saunders company. How to cite The assessment and treatment of a diabetic ulcer with be discussed., Essay examples

Resource Allocation for Care of Children-Free-Samples for Students

Question: In a Hospital Context, how would you prioritise what share of resources goes to care of children versus care of the elderly including Palliative Care? Answer: Introduction The current assignment focuses on the concept of allocation of resources and priority setting for catering to the care needs of children and old age people in a hospital setting. The resources could be diversified into different types such as financial resources, physical resources such as machines and equipments. The human resources also play a crucial role over here which includes recruiting the right healthcare professionals. The assignment emphasizes upon setting up of priority care needs of the children and the elderly. The requirements for both the age groups are different and require high degree of specializations. The assignment also focuses upon the economical and no-economical measures which further impacts upon the care strategies undertaken within a hospital environment. Care ethics As a pediatric care giver, one bears the responsibility of caring for many delicate and vulnerable lives each day. Its fully ethical to set priorities of quality care giving on every shift assigned to without fail which forthrightly includes physical presence. Even though the child medical profession is quite involving and overwhelmingly demanding, the individuals in these positions should ensure they attend to all children's emotional and physical needs (Ameritech College of Healthcare 2015). Openness to the child-patient family and any other supervisor(s) is a virtue to be upheld at all time. Commitment to provide the best care to the child should be paramount given that terminal illnesses aren't a usual occurrence in children. The "uncommonness" of the disease incidence presents the child's care provider with unique challenges in care provision to the child and his or her family (Get palliative care 2017). Although diverse clientele groups often demand various needs, the resources to satisfy these requirements are redundantly scarce. Nevertheless, these conditions still do require satisfying, and thus individuals or entities have to devise means to curb them. One way of achieving this is via ordering them in a hierarchical format beginning with the most sensitive/demanding. Priority setting culminates to the "process of involving clients and stakeholders in determining which needs are most important" (The University of Arizona 2010). Priority setting at the hospital level. In the recent past, priority setting research has delved on macro and micro level surprisingly despising the hospital level of health care provision (Barasa, Molyneux, English and Cleary 2015). Barasa, Molyneux, English, and Cleary quotes that the neglecting of the institutional level should now be covered given the essential responsibility that hospitals Harbor in providing health care services (2015). It's prudent not to view patient care provision as a comprehensive treatment practice since patient needs, across all demographics, are diverse and multifaceted (King University 2014). The changes in adults hold potential positive or negative health precursors even as many of the elderly's body functions continually deteriorate (King University 2014). Resource allocation for care of children The provision of optimum and standard care services are dependent on allocation of the right amount of resources. For the purpose of which the resource allocation system needs to be designed. As commented by Norheim et al. (2014), the funding for the personal budget is done by the council aimed towards the availability of supportive frameworks for meeting the care needs of the children. Therefore, in order to meet the diverse care requirements of children the Australian government, Department of Health (DOH), have inculcated a number of intervention policies aimed towards child health care within a clinical setup. As commented by Smith et al. (2013), the policies are aimed towards the allocation of optimal resources for implementing programs such as Child Health Check Initiative(CHCI) and Expanding Health Service Delivery Initiative (EHSDI). The resource allocation and the funding for the allocation of the resources are dependent upon differentiating and prioritising the levels of su pport needed by the children. The support levels can be differentiated into low support, some support, small support, lots of support and exceptional support requirements. The support service requirements can be divided into different bandings based upon the Resource allocation system (RAS) score. The RAS score can be divided into different score groups such as 0-69, 70-145, 146-185, 186-210, 211-220. As asserted by Nord and Johansen (2014), a score 69 or below means less support is required by the growing children. In this context, the health and well being outcomes are met through the provision of universal services. The score board of 131-145 points at small support service requirements, where the child depicts a mix of health needs. Therefore, children facing such adverse conditions need to provided with adequate support with the help of equipments and well trained staff and nurses. The score of 171-185 means that universal services alone are not sufficient to meet the health requirements of the children. Therefore, personal budgeting and continued support through social services can be helpful. This is further supported by high and very complex c are needs, which aims at providing care and support services through the integration of multidisciplinary channels. The multiple channels include health, education and social care services which are extended through EHSDI. The priority setting forms an important component of the care plan and treatment process. For catering to the care concerns of the children within a hospital setting the assessing cost effectiveness initiative had been applied over here. The method specifies the community value, combines technical and due process and is explicit in nature. As commented by Whitty et al. (2014), the care provision is based upon guidance from economic theory, social ethics, empirical experiences. This helps in addressing the patient centred needs by drawing upon a specified list of plan. Priority setting for elderly Allocation of resources for the elderly is dependent upon the setting up of and implementation of important instruments such as the Aged care functioning instrument (ACFI). The implementation of such policies helps in focussing upon the core care concerns for the budgeting and the allocation of policies. As commented by Hipgrave et al. (2014), the implementation of such approaches are useful in measuring as well as checking the average care costs in longer hospital stays. The funds are allocated based upon profiling of the care needs or concerns of the patients. As argued by Drake (2014), caring for old people often brings us to dealing with the concepts of end-of life palliative care. Thus, such care provisions are mainly provided to patients suffering from incurable chronic conditions. The only aim of the provision of such care treatments is to make death a less painful experience for the support users. The priority setting in the following area of care management is mainly non-economic in nature. This could be attributed to the dependency upon huge infrastructural support such as life support systems and modern diagnostic interventions and tools. However, a mixed method could be followed over here which includes Program Budgeting and Marginal Analysis (PBMA) along with consensus priority setting. The PBMA approach is based upon resource re-allocation and follows an explicit manner of decision making (Conklin et al. 2015). The process is supported by hard and soft evidences which help in implementing the resource allocation system. Additionally, implementing a consensus based approach helps in providing support services to the ones with impaired cognition and decision making approaches (Mitton et al. 2014). The consensus approach keeps the wishes and the demands of the patients at the centre of the care treatment process. However, the same also takes into consideration the valuable inputs from the attending physicians or the family members of the support users. Parameters of priority setting: The CDC quotes that immunization is not for the children alone (2017). This is because childhood vaccinations do wear-off as one age (CDC 2017). An individual may be prone to immunizable illnesses "due to age, lifestyle, health condition, job or travel" (CDC 2017). It is therefore proper for every individual to undergo childhood, traveling, career-related, health-related and age-related immunization procedures. It is prudent to note that adult vaccination is more condition-based than is child immunization. Also, more than ten Million children, under five years of age, are estimated to die every year with roughly 70% succumbing to preventable diseases. This shows the urgency of preteen and teenage vaccination over adult vaccination since the immunization procedures are essential steps towards children health and future protection (U.S. Department of Health Human Services 2017). Health care providers are usually the ones who administer vaccines and thus play a significant role in educ ating children caretakers of the vaccines' life-saving functionalities and safety (Miller et al. 2015). Medical institutions should, therefore, prioritize available resources focusing them on disease prevention practices like the preteen vaccination processes and awareness. Recent studies in the United States show that massive government expenditure savings ($1.38 trillion) were realized when the government adopted a children vaccination program for vaccine provision and administering to all children whose families could not support their acquisition (Whitney et al. 2014). The savings were realized due to prevented illnesses, hospital admissions and premature deaths which cut on the demographic working age group thus reducing and or terminating their respective economic input (Whitney et al. 2014). Health care facilities should, therefore, concentrate resources on child vaccination activities by providing required training to medical practitioners, public vaccine awareness, preventi on drugs and equipment, seasonal follow-up with the kids in learning institutions among other practices promoting child immunization (Miller et al. 2015). Physical activities Physical activities have been said to promote public health responsibilities achievement by local authorities in places where lost productivity is estimated at billions of dollars due to sickness absence and premature death (The National Institute for Health and Care Excellence 2013). Many of the chronic illnesses in the elderly are diet and lifestyle related which means that the individuals possess prior experience of physical exercise. The elderly sick can, therefore, perform physical activities with minimal supervision given their high cognitive abilities relative to the preteens. There are also several facilities and equipment in healthcare institutions that can be used by the sick elderly to perform physical exercises. On the other hand, children lack the prior experience of physical activities, the cognitive ability to comprehend the need for physical activities added to their inability to perform these tasks on their own. Despite the vitality of physical activities to the chil dren, the severely sick amidst them sometimes fail to get as much physical exercise as they require (Canadian pediatric Society 2011). To alleviate this situation, medical institutions should (New Jersey Department of Children and Families 2017): Set aside at-least 50 square feet room space per child to allow maximum child mobility and exercise space. Have personalized individual resources for children with different ailments to prevent spreading of communicable diseases while at the same time allowing the physical activity of each child. Acquire outdoor space for children physical activities. All in all, the healthcare facility should have adequate health care personnel due to the uttermost and constant care needed for the sick children as they perform the physical activities. Malnutrition Malnutrition, the nutrition imbalance, can also be defined as cause and consequence of ill health originating from proteins, energy or micronutrients deficiency in a human body. Malnutrition directly causes an estimated 300,000 deaths per annum and is indirectly causing roughly half of all under 5years children deaths. Contrary to the belief that malnutrition is a condition affecting starving children in third world countries, malnutrition is common in developed countries too especially in hospitalized populations (patient 2016). In these communities, the elderly suffer malnutrition if they are suffering from diseases or conditions that affect appetite, have gastrointestinal function problems or have severe mental health concerns. On the other hand, children who are susceptible to malnutrition if they are premature (weaning time), chronically ill, neglected by caregivers among other poverty related complexions (patient 2016). Health facilities should, therefore, be ultimately vigilan t of the sick pre teens dietary needs by providing balanced diets to the children thus managing and curbing malnutrition. Conclusion The assignment takes into consideration the different resource allocation procedures along with priority setting for the care and management of the old and the young. In the current assignment a Resource allocation system where scores have been provided to individual support users based on their care needs. The scores allocated further helps in designing of the care plan whether some and small support services are required or exceptional support services are required. The aged care however follows the ACFI framework for resource allocation. The setting up of the priorities forms another important constituent of the care management process. Thus, implementing approaches such as ACE and PBMA can help in sustaining the resources for long term care. References Ameritech College of Healthcare (2015), Blog,7 Pieces of Practical Advice for Nurses Raising Kids, viewed 21st August 2017, https://www.ameritech.edu/blog/7-pieces-of-practical-advice-for-nurses-raising-kids/. Barasa E. W, Molyneux S., English M. and Cleary S. (2015), Oxford Academic journals, Health policy, and planning, Setting health care priorities in hospitals: a review of empirical studies, Vol 30, no. 3, pages 386-396. Canadian Pediatric Society (2011), Caring for kids, growing and learning, Physical activity for children and youth with a chronic illness, viewed 23rd August 2017, https://www.caringforkids.cps.ca/handouts/physical_activity_with_a_chronic_illness. Coetzee M. (2005), University of Cape Town, School of Child and Adolescent Health, Article;Are children really different from adults in critical care settings?SAJCC, Vol. 21, No. 2. Conklin, A., Morris, Z. and Nolte, E., (2015). What is the evidence base for public involvement in health?care policy?: results of a systematic scoping review.Health Expectations,18(2), pp.153-165. Drake, T., (2014). Priority setting in global health: towards a minimum DALY value.Health economics,23(2), pp.248-252. Get palliative care (2017), Pediatric, Pediatric vs. adult, Adult vs. Pediatric Palliative Care, https://getpalliativecare.org/whatis/pediatric/adult-vs-pediatric-palliative-care/. Hipgrave, D.B., Alderman, K.B., Anderson, I. and Soto, E.J., (2014). Health sector priority setting at meso-level in lower and middle income countries: lessons learned, available options and suggested steps.Social science medicine,102, pp.190-200. Kidshealth (2017), For parents, when your child is in the pediatric intensive care unit, Nemours children health system, https://kidshealth.org/en/parents/picu.html. King University (2014), 7 Types of Nurses with Age-Specific Competencies; Nurse with young patient; Nurses bring comfort to patients of all ages, viewed 21st August 2017, https://online.king.edu/nursing/7-types-of-nurses-with-age-specific-competencies/ Kluge (2007), Medscape General medicine, Resource Allocation in Healthcare: Implications of Models of Medicine as a Profession, Vol 9 no. 1, PMC1925021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1925021/ Miller ER, Shimabukuro TT, Hibbs BF, Moro PL, Broder KR, Vellozzi C. (2015), The CDC supports nurses in promoting vaccination, Vaccine Safety Resources for Nurses,The American journal of nursing, Vol115 no. 8 page 55-58, doi:10.1097/01.NAJ.0000470404.74424.ee. Mitton, C., Dionne, F. and Donaldson, C., (2014). Managing healthcare budgets in times of austerity: the role of program budgeting and marginal analysis.Applied health economics and health policy,12(2), pp.95-102. New Jersey Department of Children and Families (2017), State of New Jersey, Department of Children and Families, Requirements for additional physical facilities for centers serving sick children, Regulations: 10:122-8.4. Nord, E. and Johansen, R., (2014). Concerns for severity in priority setting in health care: A review of trade-off data in preference studies and implications for societal willingness to pay for a QALY.Health Policy,116(2), pp.281-288. Norheim, O.F., Baltussen, R., Johri, M., Chisholm, D., Nord, E., Brock, D., Carlsson, P., Cookson, R., Daniels, N., Danis, M. and Fleurbaey, M., (2014). Guidance on priority setting in health care (GPS-Health): the inclusion of equity criteria not captured by cost-effectiveness analysis.Cost Effectiveness and Resource Allocation,12(1), p.18. Patient 2016, Professional reference, Malnutrition, Malnutrition, viewed 24th August (2017), https://patient.info/doctor/malnutrition. Smith, N., Mitton, C., Bryan, S., Davidson, A., Urquhart, B., Gibson, J.L., Peacock, S. and Donaldson, C., (2013). Decision maker perceptions of resource allocation processes in Canadian health care organizations: a national survey.BMC health services research,13(1), p.247. The Centre for Disease Control and Prevention (2017), Vaccine information for adults, What Vaccines Are Recommended for You, National Center for Immunization and Respiratory Diseases,viewed 24th August 2017https://www.cdc.gov/vaccines/adults/rec-vac/index.html. The National Institute for Health and Care Excellence (2013), NICE guidance, lifestyle, and well-being; physical activity, what can local authorities achieve by encouraging people to be more physically active?[LGB3], viewed on 24th August 2017 https://www.nice.org.uk/advice/lgb3/chapter/what-can-local-authorities-achieve-by-encouraging-people-to-be-more-physically-active. The University of Arizona (2010), Program planning and evaluation; Priority setting, College of Agriculture and Life Sciences; Cooperative Extension, The University of Arizona on 21st August 2017 https://extension.arizona.edu/evaluation/content/priority-setting. U.S. Department of Health Human Services (2017), Vaccines, who and when, viewed 23rd August 2017, https://www.vaccines.gov/who_and_when/index.html. Whitney C. G, Zhou F, Singleton J, Schuchat A. (2014), Centers for Disease Control and Prevention (CDC), Benefits from immunization during the vaccines for children program era - the United States, 1994-2013, MMWR Morb Mortal Wkly Rep. 2014 Apr 25; 63(16):352-5. Whitty, J.A., Lancsar, E., Rixon, K., Golenko, X. and Ratcliffe, J., (2014). A systematic review of stated preference studies reporting public preferences for healthcare priority setting.The Patient-Patient-Centered Outcomes Research,7(4), pp.365-386. World Health Organization 2008, Manual for the Health Care of Children in Humanitarian Emergencies. Geneva: (2008). 1, Triage and emergency assessment. https://www.ncbi.nlm.nih.gov/books/NBK143755/.