Monday, January 27, 2020
Low Birth Rate in Hong Kong
Low Birth Rate in Hong Kong Nowadays, the world population just over 6 billion and consistently estimate to increase to 9 billion in the next 50 years. The growth rate is mostly come from those developing countries, especially from Africa. Nevertheless, the birth rate which we would call it as population growth rate is decreasing in Hong Kong. The local birth rate reached the lowest level in the world. According to the report from the Census and Statistics Department, around 30,000 babies will be generated by mainland couples while 69,000 will be born in Hong Kong each year. In 2006, 984 babies were produced each 1000 expectant mothers. The estimation of the following 30 years, the birth rate will be lower than 900 babies would be born with each 1000 expectant mothers. We can use the graph from Census and Statistics Department to indicate the change by birth rate. In the fig. 1.1, the lines are representing the population in 1996 while bars are representing the 2006s. We would see that the population in Hong Kong is going to form a reverse triangle as fewer are born in the base. Moreover, we would see that the birth rate was continuing decrease from 1981 to 2006. Basically, the government has been put aware on the issue. In one of a meeting of legislative council, the councilors have put out this as one the items of agenda. The decrease in birth rate may help to save the sustainable resources in the world, but it would cause out many society problems as well. Actually, aging problem is a serious issue happening in the society. And, this would cause out many consequences to make the society become poor. Aging problem will lead the tax payer having a heavy tax. As the decreasing birth rate cause out, fewer tax payers will need to fall into the tax system. While the number of elderly would increase to form an unhealthy population, the Government would have a financial problem on subsiding them. The government need to bear heavy costs on medical services, elderly health care and retirement such as social security allowance. On the other hand, the education system may need a reform. The demand would decrease as fewer children entering the education system. Those schools will be terminated by a low birth rate, and employers like teachers will be being unemployed. This is already happened in the society in 2006. Many schools are warned to shut down by insufficient students. As a result, encouraging the birth rate is a must. Recently, the government noticed that the importance of having a good birth rate and formed a committee to put concern and finding out solutions in low birth rate issue. The effective way is the government encourage the citizens to improve the birth rate. 1.2 RESEARCH OBJECTIVE In this study, we would like to help to find out the reason of causing low birth rate. Besides, we would not only want to know the causes but also want to find out solutions and the ways of government would able to give a hand. Therefore, our research objectives will be set as the followings: Understand the reason of low birth rate occur Evaluate the effectiveness of various methods to increase birth rate Understand the value of having baby (promotion purpose) Evaluate the impact of various media on the decision to have a child Obtain the demographic of response 1.3 CONTRIBUTION Through this marketing research, we would define clear why the low birth rate was caused out. Afterwards, we can find out the most effective solution to improve the birth rate, in order to prevent the next generation to pay the heavy tax to the government which is our generation and beyond. On the other hand, we would the report will be indicated out that the effective way of promotion by the government which he citizens would thinks it does work. It is beneficial to the government whether the aging problem is solved, the financial burden will reform. The government is able to put the subsidies on the other ways that make Hong Kong becoming a most successful city that people would like to live. 2.1 EXPLORARATY RESEARCH To begin our research, we may need to use exploratory research to provide the insights of the low birth rate problems. From the various types of exploratory research technique, we have used secondary data analysis and focus group when doing this project. Secondary data Low birth rate which is a big issue for the Hong Kong government, so there are plenty of data about this issue on the website of the Census and Statistics Department and also the newspaper. The reasons why we are using the secondary data are because they are low cost and useful as background information. Also, some of the data are realistic as those data are collected from the official department of Hong Kong Government. As the government highly concern about the low birth rate, there are policies and promotions about how to improve low birth rate, which helps us on creating the questions for our questionnaire. Focus Group Focus group is a form of qualitative research in which a group of people are asked about their attitude towards a product, service, concept, advertisement or idea. And there will be a moderator to introduce the topic of discussion and to encourage the group to discuss. Using focus group can allow the participants to discuss their true feeling and convictions, fast to collect data, easy to execute and flexible with low cost. Forming this focus group, our purpose is to understand the reason of low birth rate, evaluate the effectiveness of various methods to increase the birth rate, understand more the value of having a baby, evaluate the impact of various media on the decision to have a child, obtaining the demographic of response. After doing the focus group, we can combine the observations to understand the culture, the social group, sampling the sites to study, and creating news issues or topics we didnt think of. We would form 2 focus groups which consist of 6 respondents each. Besides, we need to hire a professional analyst to lead the focus group on the discussing track. Then, we need to book a one-way mirror room to observe the progress of the focus group. The most important is we should jot down the discussion by notes as an alternative way if the video recording devices does not work. The topic of discussion was focus on five main issues we focused on reasons affecting the birth rate, methods to improve birth rate, value on birth rate, ways to promote generation, demographic. To acquire the information we need, an analyst is needed to lead the focus group to discuss on the aspects. We did set the suggest questions: How do you think to generate a child? What are the costs to generate a child? What do you think the consequence to generate a child? Which ways do you suggest to encourage generation? How do you think the policies of government promotion? Summary of Findings Section We have been held focus groups in the March. After the focus group, we were given out some ideas of the low birth rate issue. In the focus groups people are all agree the late marriage is the trend in Hong Kong, many ladies are become focusing on their work. But they conclude that the cost of having a baby is the main cause of low birth rate. They need to quit their job, after the baby growth, their job opportunities will be probably lower as they disconnected with the society. They discussed that the birth rate from the middle class is important to improved. Later, they discuss that the method to improve the birth rate. Most of them thought that the government subsidies are the ways to help. Education allowance is the most effective as most of them agreed. It is because they think it is a long-term subsidy that their children need to study nearly 10 years. It is benefit if it would save their cost. However, no one concern on public housing because they thought that it is relate to the marry cost, not related to having a baby. They would think that the value of having a baby is to generate their breed. Most of them think that the TV commercial is the effective way to encouraged by government. It is because animation and sound would give them memorized. 2.2 QUANTITATIVE RESEARCH To choose a suitable method to fit with our case, we would like to use the mall intercept personal interviews for collecting primary data. The process involves stopping the targets, screening them for appropriateness, and either administering the survey on the spot or inviting them to a research facility located in the mall to complete the interview. And, we decided to set up in Women Health Centre and the Family Planning Association of Hong Kong etc, therefore we are able to get the result that related to our expectation and purpose. The characteristic of the method is confined place to conduct the survey but speed of data collecting is fast, and conductors are easier to reach the assigned quantity with a specific time. It will have the highest degree of interviewer influence of answers. Although geographical flexibility is confined in a selection place, we can poll a large number of target respondents with a successful planning. There will have low anonymity of respondents however, the respondents may not actively to cooperate. It is difficult to follow up or call back but it is not an actual problem. Essentially, interviewers can provide clear explanations for the questions asked, respondents will be clearer to answer the questions through face-to-face interview. So, the possibility of respondent misunderstanding will be the lowest. On the other hand, if the respondent cooperation is not enough to meet the planned quantity, we may also use phone survey to back up mall intercept personal interview. The advantages of using phone survey is competitive reduce cost and the respondent cooperation are good. So, it is a good back-up proposal for anything goes wrong in the mall intercept personal interview. There are some measurements guiding us in design our questionnaire. We should concern that each questions should have a reason behind asking and the type of answers you would like to receive y open-ended or close-ended. Later, we should concern on the questionnaire wording. In designing our questionnaire, we have avoided long questions that will give people confusing by using short and clear wording. Secondly, we avoid emotional and socially desirability response by loaded and assumption questions. So, the validity will be increased. Be sure all answer choices are mutually exclusive, check for ambiguity in wording the question, and ensure if the respondents can interpret the meaning of words differently. We also put aware on the personal pronouns (gender references) never use only him (his) or her (her) unless you are referring to a specific gender. Be specific, rather than general questions and word them so that they communicate uniform meaning. Avoid using double negatives, especi ally possible when using Agree/Disagree. 2.3 RESEARCH INSTRUMENT Scale There are several scale in setting questionnaire, interval scale, nominal scale, ordinal scale and ratio scale. We used Interval Scale in Q1, Q2, Q3 and Q4 in our questionnaire. An interval scale is a measurement scale in which a certain distance along the scale means the same thing no matter where on the scale you are, but where 0 on the scale does not represent the absence of the thing being measured. The Fahrenheit and Celsius temperature scales are examples. It is uniquely classifies, in preserves order and equal intervals. We used Nominal Scale in Q.5B, Q.5C, Q.5D, Q.5E in our questionnaire. A nominal scale is really a list of categories to which objects can be classified. For example, asking the gender and give Male and Female, for asking status, given Single Married and Divorce. The data so classified are termed categorical data, which are reflecting the classification of objects into different categories. We used Ordinal Scale in Q.5A, Q.5F and Q.5G in our questionnaire. An ordinal scale is a measurement scale that assigns values to objects based on their ranking with respect to one another. For example, Q.5G, we are asking about the monthly income of each target ordinance, from [1] Less than $5000 to [5] above $30,000. While you know that [5] is having more income than [1], but there is no implication that [5] is twice times more than [1]. All we know is that there are 5 categories, with obviously that [2] are having more income than [1], [3] are having more income than [2], etc. The higher the value assigned, the higher the category. 2.3.2 Pretest Procedure It is very important for us to do the pretest before the questionnaire being publicized; the aim of pretesting questionnaire is to ensure that it can be clearly understood. Since the questionnaire may have a lot of mistakes, therefore, we need to conduct and find out the information on that issue. Correct all the mistakes in the questionnaire are necessary, if the survey did not properly set, the purpose will not be achieved to conduct the accurate information what we looking for. For our questionnaire, in order to achieve the effectiveness of pretest, we are going to read the questionnaire for at least 15 times after setting. Besides, we are also going to ask for 15 respondents to test our questionnaire. Finding correct and relevant respondents can help to increase the efficacy of pretest. The varieties respondents would be desire for our Low Birth Rate questionnaires are the professionals, such as English teachers; lecturers, schoolmates from universities, and also our parents. We chose them for the questionnaire pretest procedure, since some of them have sufficient knowledge to state out our problems, for example, English teachers can correct our grammar and spelling mistakes, rectify the question wording into more format type. Lecturers can check the flow of questions and give suggestions on the question, ensure that we are using the multiple-grid format and have been separated them into variety of groups before conducting. And, some of them are easy to re ach, like our schoolmates, their feedbacks help us to predict our target ordinance reaction to the questionnaire, they also may help to estimate the time-taking. After all, we can rearrange the follow up and one by one. Use our questionnaire as an example, after the pretest procedure; we rectify the question wording to make the questionnaire become more clarify. Such as, using Very Unimportant and Very Important to replace Most Important and Least Important. Use full sentence, Are you working now? (If yes, please continue to answer the following questions. Otherwise, jump to à ¯Ã‚ ¹Ã‚ Hà ¯Ã‚ ¹Ã… ¾) instead of a single word Occupation etc. (Appendix fig. 2.2, fig. 2.3) 2.4 SAMPLING Sampling is the simple way to reach out targets with a subset of the population instead of reaching the entire population. Compare with reaching the entire population, sampling will help to save time, cutting cost for budgeting and manpower. Firstly, we should figure the target group out. Our target group is men and women who have visited Women Health Centre and the Family Planning Association. It is because they will have a brief concern and knowledge on the birth rate issue. To reach our target group, we would use the convenience sampling indeed. There is no sampling frame while it is actually a non-probability sampling method. Those respondents are unknown member form our target group because of using the non-probability sampling. Our interviews will select the most available targets arbitrary. However, we would set the 200 respondents as our sample size. As the mall intercept personal interview is suitable to associate with our research, it has many advantages indeed. First, the mall intercept personal interview can be conducted faster and inexpensive. Also, the mall intercept can poll a large number of respondents and control the speed of the survey. As we want to poll a large number of respondents in target group, we decided to interview in Women Health Centre and the Family Planning Association of Hong Kong within 3 days. As the mall intercept is a face-to-face contact with the interviewees, it will lead us easier follow-up and make corrections of the unclear or misunderstanding answers. These advantages will encourage us to conduct a better survey. Unfortunately, there is no perfect method existing in the world. We would just choose the method which consist the least disadvantages. In the mall intercept, we would require a lot of labour force to conduct. This will lead the research cost climb higher by hiring cost for interviewers. Furthermore, low accuracy of the survey is also a disadvantage of this method. It is difficult to follow up if we find out any problem while analyzing the answers. Further, the result sampling may not represent the entire population in a place. Therefore, we would find out some solutions to fix them. We would not employ volunteers as our group members can be the volunteers in the research. Perhaps, cost of the employment will be relatively lower. In order to improve the accuracy, setting up more intercept places for interview can enhance the representative level of the results. Also, after conducting the survey, interviewees would politely to ask the respondents to leave their contact information if they are willing to do that. Hopefully, it may improve the disadvantages of the survey method. We would do the survey over 3 selected places within 3 day. On 28th April, we would conduct in the Family Planning Association at Wan Chai while conducting in the Women Association in Tuen Mun in the following day (29th April). Finally, we would reach the Family Planning Association at Wong Tai Sin in 30th April. These 3 locations will be assigned a team to play the role as interviewers. Each team will consist of 3 member do stay within the place in the operation hours. The selection of those 3 places is due to improving the accuracy of the sampling over territories. In addition, easy to reach who concern birth rate, prepare to have a child or even avoid having child as well.
Sunday, January 19, 2020
Healthcare-associated infections (HAIs) Essay
BACKGROUND Healthcare-associated infections (HAIs) are bacterial infections acquired during a patient’s stay in a healthcare institution. It imposes a huge burden on healthcare institutions, costing billions of dollars for additional care costs as well as a significant fraction of lost lives (Houghton, 2006). Current estimates depict that approximately 2 million patients acquire healthcare-associated infections (HAIs) or nosocomial infections each year, of which 90,000 to 100,000 patients die (Houghton, 2006), making HAIs not only a national health problem, but a global threat as well. Common HAIs include hematological, surgical site, dermatological, respiratory, urinary and gastrointestinal systems. In order to control the increase in number of healthcare-associated infections, it is fundamental to identify key factors that make healthcare institutions susceptible to such outbreaks. There is a need to evaluate the sensitivity and efficiency of healthcare institutions to healthcare-associated infections in order to prevent future outbreaks. PROBLEM STATEMENT            This study will investigate the sensitivity of detection and efficiency of reporting healthcare-associated infections to the hospital administration, in the context of providing measures in improving the current surveillance program in the country. The guidelines to identification of a healthcare associated infection will be evaluated through personal interactions with healthcare workers using questionnaires which will be designed using a multiple choice approach. CONCEPTUAL/THEORETICAL FRAMEWORK            This study is based on the need to address the current epidemic of healthcare-associated infection that is emerging around the world. Before an effective solution to the problem is designed, it is essential that shortcomings in the standard procedures of healthcare institutions be identified. This may be done by determining the level of sensitivity of healthcare personnel to symptoms of healthcare-associated infections, as well as knowing what are the first set of actions to be done once an infection is confirmed within a healthcare institution. This study may serve as the first measurement tool that addresses these aspects of the global epidemic.  RESEARCH QUESTION/HYPOTHESIS            This investigation aims to address the question of whether the current hospital administration is sensitive enough to detect and substantially efficient to report to healthcare institutions any incidents of healthcare-associated infections. This will be directly evaluated using survey data collections from retrospective cases of particular health institutions as related to dates of hospital admission, confirmation of infection and treatment time.  SIGNIFICANCE OF THE STUDY            There is a need for an effective surveillance and control program for healthcare-associated infections that are based on current settings in a healthcare institution. Through surveys that inquire on common practices and responses of healthcare workers, any shortcomings or avoidable gaps in the hospital system may be reformed, which in turn will alleviate the spread of infection in the healthcare institutions. Review of medical records and interviews with attending healthcare personnel will be performed in order to determine whether there are certain discrepancies and gaps in the healthcare protocol that facilitate contamination and further spreading of infectious microbials around the healthcare institution. This study may facilitate the identification of key factors that influence the increase in frequency of nosocomial infections in hospitals. The results of this investigation may positively serve as a tool to healthcare workers such as nurses and laboratory technicians. STATEMENT OF THE PURPOSE (OBJECTIVES)            This research will determine the sensitivity and response rate of healthcare workers to healthcare-associated infections. This proposal aims to develop a measurement tool that will determine the sensitivity for identification, efficiency of reporting and the response rate to a healthcare-association infection, with the aim of designing a cost-effective and quick way of controlling and ultimately eradicating the healthcare-related problem.   LITERATURE REVIEW            The prevention and control of HAIs requires a comprehensive approach that addresses as many pathogens as possible (Wiseman, 2006). Urinary tract infections (UTI) associated with catheter use are the most common HAIs, with hospital-acquired pneumonia having the highest mortality rate (Houghton, 2006). These infections are frequently problematic to treat due to the fact that the microorganisms involved have become resistant to antibiotics (Broadhead, Parra and Skelton, 2001). Recent media coverage of meticillin-resistant Staphylococcus aureus (MRSA) has increased the awareness of healthcare professionals to the threat of this particular microbe. S. aureus infections can result in cellulitis, osteomyelitis, septic arthritis and pneumonia, and some of the systemic diseases such as food poisoning, scalded skin syndrome and toxic shock syndrome (Zaoutis, Dawid and Kim, 2002).            MRSA and vancomycin-resistant Enterococcus (VRE) are the primary causes of nosocomial infections and are significant factors in increased morbidity and mortality rates. These microbes are currently endemic in many healthcare institutions, particularly problematic in intensive care units (ICUs) (Furuno, et al. 2005).  VRE Infections have become prevalent in U.S. hospitals over the last decade, increasing in incidence 25-fold (Ridwan et al., 2002). Vancomycin is the antibiotic frequently used to treat infections caused by MRSA, but recent years have seen the emergence of Staphylococcus aureus infections that have high-resistance to vancomycin, which makes the future effectiveness of this drug questionable (Furuno et al., 2005). All known variants of the vancomycin-resistant Staphylococcus aureus (VRSA) isolates have possessed the vanA gene, which carries with it resistance to vancomycin. This development is believed to have been acquired â€Å"when the MRSA isolate conjugated with a co-colonizing VRE isolate†(Furuno et al., 2005, p. 1539). This means that patients who suffer co-colonization from MRSA and VRE have an increased risk for colonization and infection by VRSA (Furuno et al., 2005). Furthermore, Zirakzadeh and Patel (2006) stated that VRE has become a major concern due, in part, to its ability to transfer vancomycin resistance to other bacteria, which includes MRSA.            Infection of susceptible patients typically occurs in environments that have a high rate of patient colonization with VRE, such as ICUs and oncology units (Zirakzadeh and Patel, 2006).  In these healthcare settings, VRE has been known to survive for extensive periods and research has also observed that VRE has the ability to contaminate virtually every surface (Zirakzadeh and Patel, 2006). Efforts to control HAIs, such as VRE, have focused on prevention, such as through hand hygiene, as the first line of defense.            Hand hygiene has been improved by using â€Å"user-friendly, alcohol-based hand cleansers, but there still remains the goal of achieving consistently high levels of compliance with their use†(Carling et al., 2005, p. 1).  Screening-based isolation practices have likewise improved transmission rates of MRSA and VRE; however, logistic issues and the cost-effectiveness of these practices are still being analyzed (Carling et al., 2005). Additionally, despite isolation practices, outbreaks and instances of environmental contamination have been documented in regards to MRSA, VRE and Clostridium difficile, which cannot be screened with any practicality (Carling et al., 2005).            The numerous obstacles that exist in regards to effective screening practices suggest that a focus on improving existing cleaning/disinfecting practices may prove to be more effective in halting the spread of HAIs (Carling et al., 2005). Studies over the last several decades have shown that there is often contamination of surfaces in and around the patient, as pathogens associated with the hospital environment have been known to survive on surfaces for weeks or even months (Carling et al., 2005). Significant rates of contamination with Clostridium difficile have been connected with symptomatic and asymptomatic patients (Carling et al., 2005).            In 2002, the CDC issued guidelines that called for hospitals to â€Å"thoroughly clean and disinfect environmental medical equipment†surfaces on a regular basis (Carling et al., 2005, p. 2). Other organizations have followed suit and stressed repeatedly the need for healthcare provides to focus on environmental cleaning and disinfecting activities, yet these guidelines have not provided directives that address precisely how healthcare providers can either evaluate their ability to comply with professional guidelines on this topic or ensure that their procedures are effective (Carling et al., 2005). Nevertheless, literature on the subject does offer some guidance.            Surveillance, evidence-based infection control practices and the responsible use of antibiotics have been determined to be crucial to controlling HAIs (Wiseman, 2006). The establishment of comprehensive surveillance programs has facilitated the creation of national databases the compile cases of infection which may be useful to researchers investigating progression rates and causal factors. Evidence-based control practices may be implemented by distributing guidelines for aseptic hospital protocols, hospital hygiene, personal protective equipment and disposal of biohazardous sharps. A review of commonly used antibiotics in terms of proper dosage and length of treatment based on clinical evidence and best practice guidance should also be performed.            Curry and Cole (2001) reported that the medical and surgical ICUs in large inner-city teaching hospitals developed an elevated patient VRE colonization rate. A multi-faceted approach was instituted to correct this problem, which involved changing behavior by â€Å"shifting norms at multiple levels through the ICU community†(Curry and Cole, 2001, p. 13). This intervention consisted of five levels of behavioral change. These encompassed: â€Å"1. intrapersonal and individual factors; 2. interpersonal factors; 3. institutional factors; 4. community factors and 5. public factors†(Curry and Cole, 2001, p. 13).            Educational interventions were developed that addressed each level of influence and behavioral change was predicated on â€Å"modeling, observational learning and vicarious reinforcement†(Curry and Cole, 2001, p. 13). These procedures resulted in a marked decrease of â€Å"VRE surveillance cultures and positive clinical isolates†within six months and this decrease has been consistent over the next two years (Curry and Cole, 2001, p. 13).            Research has shown that the nutritional status of preoperative and perioperative patients can influence their risk for acquiring a HAI (Martindale and Cresci, 2005). This is particularly true for patients who are undergoing surgery for neoplastic disease as this can commonly result in immunosuppression (Martindale and Cresci, 2005). Inadequate nutrition, â€Å"surgical insult, anesthesia, blood transfusions, adjuvant chemotherapy/radiation/ and other metabolic changes†have been identified as contributing to suppression of the immune system (Martindale and Cresci, 2005). Furthermore, studies have also associated infection risk with glycemic control Maintaining blood glucose levels between 80 and 110 mg/dL vs. 180 and 200 mg/dL has been shown to result in fewer instances of â€Å"acute renal failure, fewer transfusions, less polyneuroopathy and decreased ICU length of stay†(Martindale and Cresci, 2005, p. S53).            Citing Ulrich and Zimring, Rollins (2004) states that getting rid of double-occupancy rooms and providing all patients with single rooms that can be adjusted to meet their specific medical needs can improve patient safety by reducing patient transfers and cutting the risk of nosocomial infections. While these researchers admit that the up-front cost of private rooms is significant, this will be offset by the savings accrued through lowers rates of infection and readmission, as well as shorter hospital stays (Rollins, 2004).            A recent study conducted by researchers at Chicago’s Rush University Medical Center found that enforcing environmental cleaning standards on a routine basis resulted in less surface contamination with VRE, â€Å"cleaner healthcare worker hands, and a significant reduction in VRE cross-transmission in an ICU†(Cleaning campaign, 2006, p. 30). These improvement in VRE contamination continued to be experienced even when VRE-colonized patients were continually admitted and healthcare workers compliance with hand hygiene procedures were only moderate (Cleaning campaign, 2006). The strategies that the researchers implemented included that they: held in-services for housekeepers about why cleaning is important–emphasizing thorough cleaning of surfaces likely to be touched by patients or workers. increased monitoring of housekeeper performance. recruited respiratory therapists to clean ventilator control panels daily. educated nurses and other ICU staff on VRE and how they could assist housekeepers by clearing surfaces that need cleaning. conducted a hand hygiene campaign, including: mounting alcohol gel dispensers in common areas, patient rooms and every room entrance (Cleaning campaign, 2006, p. 30).            CDC guidelines indicate that if hands are not visibly soiled, using an alcohol-based hand rub should become habitual between patient contacts. When hands are visibly soiled, use of an anti-microbial soap and water is required. If contact with C difficile or Bacillus anthracis is possible, it is recommended that the healthcare provider wash with anti-microbial soap and water, as other antiseptic agents have poor efficacy against spore-forming bacteria and the physical friction of using soap and water at least decreases the level of contamination (Houghton, 2006). Page (2005) indicates that the CDC has joined with the US Department of Health and Human Services, the National Institutes of Health (NIH and the Food and Drug Administration (FDA) to lead a task force of 10 agencies and departments, which have developed a blueprint outlining federal actions to combat this problem. This template emphasizes the efficacy of hand washing, among other points (Page, 2005).            In 2002, the CDC issued updated hand hygiene guidelines, which address new development and research on this topic, such as â€Å"alcohol-based hand rubs and alternatives to antibacterial soaps and water†(Houghton, 2006, p. 2). However, while the efficacy of hand hygiene is well accepted, it is also well known that healthcare workers â€Å"of all disciplines†frequently fail to abide by adequate hand hygiene practices (Houghton, 2006, p. 2). In fact, research has shown that adherence rates to hand hygiene guidelines are lowest in ICUs, where to the frequency of patient care contact, multiple opportunities for hand hygiene exist on a hourly basis (Houghton, 2006). According to Houghton (2006), any direct patient-care contact, which includes contact with gloves and/or contact with objects in the immediate patient vicinity, constitutes an â€Å"opportunity†for appropriate hand hygiene.            This suggests that the proposed intervention should also include asking healthcare employees at the site of the intervention to participate in a survey that examines, first of all, how closely hand hygiene protocols are followed and, if they are not followed, why not. It may be that the activity level of ICUs is so great that the practitioners feel that they cannot take sufficient time to do adequate hand hygiene. If this is the case, alternative methods of hand hygiene to that institution’s traditional policy may need to be investigated.            Just as this study revealed factors that can be associated with non-compliance, a similar investigative effort may be called for to determine reasons why compliance may not be satisfactory for cleaning/disinfecting environmental surfaces. Again, it may be that non-compliance hinges on factors of time. It may be, therefore, expeditious for hospitals and other healthcare organizations to look into hiring additional personnel to aid with cleaning/disinfecting tasks. It may also prove necessary, to cope with factors of time and efficiency, to train cleaning personnel to take a systematic approach to patient room cleaning that includes all â€Å"high touch†areas. As noted previously, researchers at Chicago’s Rush University Medical Center found that holding in-service training for housekeepers was an effective component of their overall strategy in lowering VRE related infections (Cleaning campaign, 2006). This process could be facilitated by a checklist approach or by periodically reevaluating rooms according to the Carling et al. (2005) methodology.            Given these detailed accounts of healthcare-associated infections in hospitals, it is of significant importance that the sensitivity and response rate of health personnel be identified in order to know if there are any discrepancies and gaps in the standard hospital protocols that foster the expansion of microbials in hospitals. This study aims to determine the level of sensitivity and response rate of healthcare institutions to the growing epidemic of healthcare-associated infections.  SUMMARY            HAIs are an unnecessary tragedy, increasing morbidity and mortality figures and adding to healthcare costs. While there are ways to treat all the various HAIs, the clearest remedy for this insidious drain on healthcare resources and personnel is prevention, which begins with the simplest of acts–washing one’s hands–but also extends to considering all hospital surfaces as having the potential to harbor pathogens. This means rethinking some healthcare institutional procedures. It means habitually and routinely cleaning all surfaces, as well as everywhere and anything that is routinely touched, whether by a bare or gloved hand.            Stopping the spread of HAIs includes multiple factors, such as restrained and appropriate use of antibiotics. However, the first line of defense is cleaning/disinfecting procedures. This constitutes the â€Å"ground zero†foundational line for battling HAIs and this means that all healthcare practitioners should keep the goal of reducing the spread of HAIs foremost in their minds while going about their daily routines, washing hands between each patient contact and paying attention to other sepsis concerns. In other words, the first step in stopping HAIs is simply to keep them in the forefront of practitioner consciousness. References Broadhead, J. M., Parra, D. S., & Skelton, P. A. (2001). Emerging multiresistant organisms in the ICU: Epidemiology, risk factors, surveillance, and prevention. Critical Care Nursing Quarterly, 24(2), 20. Carling, P. C., Briggs, J., Hylander, D., & Perkins, J. (2006). An evaluation of patient area cleaning in 3 hospitals using a novel targeting methodology. American Journal of Infection Control, 34(8), 513-519. Centers for Disease Control and Prevention. (2006). Healthcare-Associated Infections (HAIs).  Retrieved March 17, 2007, from http://www.cdc.gov/ncidod/dhqp/healthDis.html Cleaning campaign targets VRE transmission. (2006). OR Manager, 22(7), 30. Curry, V. J., & Cole, M. (2001). Applying social and behavioral theory as a template in containing and confining VRE. Critical Care Nursing Quarterly, 24(2), 13. Furuno, J. P., Perencevich, E. N., Johnson, J. A., Wright, M.-O., McGregor, J. C., Morris Jr, J. G., et al. (2005). Methicillin-resistant Staphylococcus aureus and Vancomycin-resistant Enterococci co-colonization. Emerging Infectious Diseases, 11(10), 1539-1544. Harrison, S., & Lipley, N. (2006). Wipe It Out infection control initiative extended. Nursing Management – UK, 12(10), 4-4. Houghton, D. (2006). HAI prevention: The power is in your hands. Nursing Management, 37(5), 1-8. Johnson, A.P. Pearson, A. and Duckworth, G. (2005): Surveillance and epidemiology of MRSA bacteraemia in the UK.  J. Antimicrob. Chemo.  56:455–462. Lopman, B.A., Reacher, M.H., Vipond, I/.B., Hill, D., Perry, C., Halladay, T., Brown, D.W., John Edmunds, W. and Sarangi, J. (2004): Epidemiology and Cost of Nosocomial Gastroenteritis, Avon, England, 2002–2003. Emerg. Infect. Dis. 10(10):1827-1834. Martindale, R. G., & Cresci, G. (2005). Preventing Infectious Complications With Nutrition Intervention. JPEN, Journal of Parenteral and Enteral Nutrition, 29(1), S53. Page, S. (2005). MRSA, VRE and CDC’s plan to combat antimicrobial resistance. Vermont Nurse Connection, 8(3), 6-7. Parienti, J. J. M. D. D. T. M., Thibon, P. M. D., Heller, R. P. P., Le Roux, Y. M. D. D., von Theobald, P. M. D. D., Bensadoun, H. M. D. D., et al. (2002). Hand-rubbing with an aqueous alcoholic aolution vs traditional surgical hand-scrubbing and 30-day surgical site infection Rates. JAMA, 288(6), 722-727. Ridwan, B., Mascini, E., Reijden, N. v. d., Verhoef, J., & Bonten, M. (2002). What action should be taken to prevent spread of vancomycin resistant enterococci in European hospitals? British Medical Journal, 324(7338), 666. Rollins, J. A. (2004). Evidence-Based Hospital Design Improves Health Care Outcomes for Patients, Families, and Staff. Pediatric Nursing, 30(4), 338. Sheff, B. (2001). Taking aim at antibiotic-resistant bacteria. Nursing, 31(11), 62. STATA 8.0. College Station (TX): STATA Corporation; 2002. Stevenson, K.B., Searle, K., Stoddard, G.J. and Samore, M.H. (2005): Methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci in rural communities, Western United States. Emerg. Infect. Dis. 11(6):895-903. Tacconelli, E. Venkataraman, L., De Girolami, P.C. and D’Agata, E.M.C. (2004): Methicillin-resistant Staphylococcus aureus bacteraemia diagnosed at hospital admission: distinguishing between community-acquired versus healthcare-associated strains. J. Antimicrob. Chemother. 53:474-479. Wiseman, S. (2006). Prevention and control of healthcare associated infection. Nursing Standard, 20(38), 41-45. Zaoutis, T., Dawid, S., & Kim, J. O. (2002). Multidrug-resistan organisms in general pediatrics. Pediatric Annals, 31(5), 313. Zirakzadeh, A., & Patel, R. (2006). Vancomycin-resistant enterococci: Colonization, infection, detection and treatment. Mayo Clinical Proceedings, 81(4), 529-536. METHODOLOGY            A retrospective non-probability cluster surveillance study will be performed on hospital records of two health institutions, Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006. Such coverage will represent a larger population of similar environmental and socioeconomic settings, which may also influence the frequency of healthcare-associated infections in the area. This type of non-probability cluster sampling will be used because it will benefit the split-level definition that will be followed, distinguishing normal hospital cases and healthcare-associated infections or outbreaks, based on the CDC’s guidelines for healthcare-associated infections. Ethical approval from the respective ethics review committee of each hospital will be obtained before the study will be conducted. Study population. Thà µ study population will includà µ 5,000 patià µnts that have been admitted at the Assir Central Hospital and Khamis Mushait Hospital from January 2002 to December 2006. These hospitals were chosen in order to primarily focus on collection of reliable, high-quality data based of systematic sampling. The hospital’s administrative database will serve as the main source of information for this study. For purposes of anonymity, patient’s names will be kept confidential and will be replaced with a case number instead. A retrospective non-probability sampling using patià µnt cases will be classified according to gender, age, diagnosis upon admission, length of stay and treatment received. The treatment category of the patients will be further characterized as surgical, respiratory, urinary, urological, obstà µtrical, intensive care, cardiac or trauma. Any co-morbidities will be taken note of in every patient included in the study.  Patient records will also be reviewed to determine whether and when a healthcare-associated infection was observed after admission to the hospital or during the patient’s stay in the hospital and will be identified as the time-at-risk, or the time when the infection has been ascertained and may most probably be contagious to the patient’s immediate environment. Among the inclusion subjects are healthcare workers such as nurses, laboratory technicians and other hospital staff members will be included in the study as population at risk. Exclusion subjects are those patients that were not admitted into the hospital because their stay in the hospital was not recommended during their healthcare.           The database of the infection control team of each of the two hospitals will be reviewed to gather information on the study population in the hospitals. Infection control nurses are responsible for monitoring any outbreaks in each hospital during hospital ward rounds, or are identified as the point-of-contact personnel that is alerted as soon as an HAI incident is suspected to occur in the specific ward of the hospital. Cluster sampling will be performed when an infection does happen that fits the clinical definition of an HAI, the healthcare institution is required to report this incident to the area’s or county’s health protection agency. The area or county health protection agency is in charge of ensuring the comprehensiveness of incident reports, monitoring data entry and conducting analyses. The health protection agency also collects reports during months that no infections were reported to verify that no inf ections occurred at that time. Tools to be employed. To determine whether a case patient has contracted a healthcare-associated infection, the system definitions established by the Center for Disease Control and Prevention’s National Nosocomial Infection Surveillance (NNIS) will be followed, with slight modification for usà µ in a rà µtrospà µctivà µ study. Thà µ NNIS dà µfinitions were dà µvà µlopà µd according to a prospà µctivà µ approach to hospital survà µillancà µ and arà µ dà µsignà µd to bà µ quità µ spà µcific. Bà µcausà µ clinical dà µcisions arà µ oftà µn not madà µ on thà µ basis of survà µillancà µ dà µfinitions, wà µ bà µlià µvà µ that somà µ casà µs of clinically suspà µctà µd infà µction would mà µÃ µt most but not all of thà µ NNIS crità µria and thus bà µ classifià µd as non-HAI, à µspà µcially on a rà µtrospà µctivà µ chart rà µvià µw. Wà µ designed a retrospective-based data classification scheme that follows the following criteria: patià µnts who were not infà µctà µd, thosà µ with suspà µctà µd HAI, and thosà µ with confirmà µd HAI. In gà µnà µral, patià µnts with suspà µctà µd HAI will includà µ thosà µ who have received antimicrobial thà µrapy for a condition that appà µarà µd 148 h aftà µr hospital admission and who will mà µÃ µt all but onà µ clinical crità µria for a confirmed infà µction. Dà µfinitions for a confirmed HAI will bà µ the samà µ as thosà µ usà µd by thà µ NNIS, à µxcà µpt that rà µcà µipt of appropriatà µ antimicrobial thà µrapy will bà µ à µxcludà µd as a crità µrion for a confirmà µd infà µction. Thà µsà µ crità µria will bà µ finalizà µd bà µforà µ chart data abstraction bà µgins. Thà µ à µconomic pà µrspà µctivà µ will bà µ usà µd for mà µasuring costs incurred by thà µ hospital, bà µcausà µ thà µ hospital administ ration will bà µ thà µ dà µcision makà µr for instituting and financing infà µction control programs. Data collà µction. Clinical cases of healthcare-associated infection identified by the clinical laboratories of the two participating hospitals will be compiled. Demographic, medical history and other epidemiologically relevant data on each reported case will be collected. The microbiology laboratory of the hospital may also contribute information to the data collection. The patient’s medical record will serve as the primary source of information for this study. The data collected will be recorded in a standardized data collection form. In addition, outbreak or infection summary forms that were previously completed by infection control nurses and reported to health protection agencies as a healthcare-associated infection will be collected and integrated into the study database. The duration of an outbreak will be determined by taking note of the date the first case of the infection was reported and correlating this date to the date when the last case of the infection was reported at the healthcare institution (Lopman et al. 2004). All data will abstracted from patià µnt mà µdical rà µcords of the healthcare facility. Intà µrratà µr rà µliability will not bà µ mà µasurà µd, bà µcausà µ à µach abstractor will bà µ focusà µd on rà µcording a singlà µ à µlà µmà µnt of data for à µach patià µnt, similar to an assà µmbly linà µ. All data gathering will bà µ dirà µctly supà µrvisà µd by a member of the research program. Patià µnts with suspà µctà µd or confirmà µd HAI will bà µ idà µntifià µd on thà µ basis of thà µir vital signs, laboratory and microbiology data, and clinical findings documà µntà µd in the respective physician’s progrà µss and consultation notà µs. To improve the validity of the collected data, the following approaches (Stevenson et al. 2005) will be employed: 1) a data dictionary and operations manual will be created with explicit instructions for completion of the data collection forms; 2) the data collection protocol will be discussed during conference calls along with frequent one-on-one communication; and 3) anomalous data in the data reports will be routinely searched for and corrected. The definitions employed in this study will concentrate on the location of the patient at the time of microbiological testing for infection diagnosis, and the presence or of exposure to the healthcare environment.  The study will emphasize the time of response of any member of the healthcare institution to the definitive diagnosis of the healthcare-associated infection (Johnson et al. 2005). Each identified HAI case will be further analyzed for its causative agent, such as MRSA or VRE. All included in this study were HAI cases with any prior history of hospitalization, out-patient surgery, residence or care in a home/health agency with documented healthcare-associated infections in the last 6 months. Examples would include former out-patient cases with post-operative infections. Other coexisting factors that may be associated with healthcare-associated infections such as diabetes mellitus, immunosuppression, renal failure and other antimicrobial drug treatments, will also be included in the data collection form. The incidence rates of each type of healthcare-associated infection will be calculated for each hospital from January 2002 to December 2006. Any patient cases that could not be ascertained to be completely reported in the medical records will not be included in the analysis. The incidence rates will be expressed as the number of healthcare-associated infections per 10,000 patient-days or number of community cases per 10,000-person-years, based on county population (Taconelli et al. 2004). Instruments including reliability and validity. A data collection form will be designed for use in this investigation. Essential entry data will include case number (patient name is kept confidential), hospital name, date of admission, diagnosis upon admission, treatment regime, date of detection of healthcare-associated infection, treatment of healthcare-associated infection, date of admission of treatment of healthcare-associated infection, identification of HAI etiologic agent, resistance of HAI etiologic agent and date of patient discharge. The healthcare institution personnel that have attended to the patient will also be noted, such as attending physician, consults, nurses, technicians and technologists.          In order to ensure reliability and validity of the data inputted into the application form, only medical records that have been completely filled will be used in this investigation. In addition, there will be questions in the application form that will determine whether the patient has undergone any previous exposure to any hospital for outpatient or inpatient hospital or nursing facility in the last 6 months. This is done to make sure that the source of the HAI is determined, whether it is coming from within the hospital or from another healthcare institution. Data Analysis. The collected data will be entered and stored in an AccessTM relational database (Microsoft, Redmond, WA) for analysis. AccessTM is a database management system that is very useful for handling and manipulation of data that are designed in the query format. It provides the analyst an easier way to extract data from the database according to selected fields or variables, as well as compare or combine two variables at one time. Data analyses will be performed using Microsoft ExcelTM and Stata 8.0 (2002). Proportions of total cases meeting specific epidemiologic criteria will be calculated, and characteristics of each category will be compared by using Fisher exact testing. To compare means, the t-test will be employed, and to compare proportions, the Ç2 test will be used. All continuous data will be analyzed using linear regression. To assess linear correlations between two variables, the Spearman rank test will be used. Census data and ages of patients in each category will be compared using the Kruskal-Wallis equality of populations rank test.  The relationship of healthcare institution response rates to the infection and other covariates will be modeled by using random effects Poisson regression. Each hospital will be taken into account as a unit and treated as a random effect. During thà µ initial phasà µ of data collection, dà µscriptivà µ statistics will be used to dà µscribà µ and summarizà µ thà µ data obtained in thà µ study. Thà µ sà µcond phasà µ of analysis will focus on thà µ usà µ of multivariatà µ analysis to dà µtà µrminà µ thà µ rà µlationship bà µtwà µÃ µn variables such as length of stay and the severity of infection. This will bà µ conductà µd through thà µ usà µ of cross tabulation of nominal data bà µtwà µÃ µn sà µlà µctà µd variablà µs in thà µ study. Statistical significancà µ is to bà µ sà µt at an alpha là µvà µl of 0.05; ANOVA will bà µ usà µd to à µxaminà µ thà µ variation among thà µ data. Along with it, ordinary là µast-squarà µs (OLS) rà µgrà µssion will bà µ usà µd to tà µst for linà µar rà µlationships bà µtwà µÃ µn variables tested. Suspà µctà µd HAI, confirmà µd HA I, and admission to ICU will bà µ codà µd as dummy variablà µs, with thà µ valuà µs of 1 that will bà µ assignà µd for patià µnts with thà µ attributà µ and 0 for thosà µ without it. Whà µn prà µsà µnt, thà µsà µ dichotomous variablà µs act as intà µrcà µpt shiftà µrs but do not changà µ thà µ slopà µ of thà µ à µstimatà µd rà µgrà µssion linà µ. Limitations of the study.  Since the study population is focus only on admissions in two hospitals, this investigation may not fully represent the country’s conditions on healthcare-related infections. However, such initial surveys on reaction rate of hospital administration to healthcare-associated infections may provide a baseline foundation for larger surveys around the country.   Ethical considerations.  There may be some hospital cases that are deemed private or uninvestigable. These will not be included in the investigation. In addition, this study will not consider race or ethnicity differences, because it is not necessary to consider such factors in this type in infectious disease research project.  Feasibility of the scope of this study. This investigation is feasible to conduct given the resources and time available to the investigator because it is a retrospective study that will only deal with medical records. Should the investigator feel that analysis of five years’ worth of patient cases from two hospitals is overwhelming, the duration of survey may be shortened to two years instead of five years. This will decrease the robustness of the data analysis, but it would also serve as a preliminary test to determine whether there are any initial trends that may be observed from the data collected from hospital-case data compiled for a two-year duration. Summary assessment. This study aims to assess the sensitivity and response rate of healthcare institutions to healthcare-associated infections by performing a retrospective analysis of hospital records from two participating hospitals for a duration of five years. Such information may be helpful in the evaluation of current guidelines for detection of nosocomial infections and the standard operating procedures as soon as ascertainment is reached. Recommendation. It is recommended that other hospital administrations collaborate with this investigation in order to generate a more comprehensive analyses of the current status of response rates of healthcare institutions to infections or outbreaks. Such collaborative effort may benefit the healthcare system in the near future and may also provide new measures on how to deal with factors that influence or cause etiologic agent-specific outbreaks.
Saturday, January 11, 2020
Operations Management at Rolls Royce
Automobile sector is one of the most competitive and technological driven sector of the world, taking an advantage edge on Innovation and technology the automobile companies such as Ford, Honda, BMW etc. have successfully implemented these changes into its product as well process and introduced differentiated product in the market. To remain competitive, it is important for the organization to focus on its operations and supply management with which they are able to achieve competitive advantage over the other company. The CEO of Rolls Royce has strongly focused on enhancing the operations management in 2006 so as improve on its production. Facilities: In 2006, the company commenced its operations at Derby, Hucknall, Barnoldswick and Bristol. These facilities are equipped with the modern working facilities along with the old repair and overhaul workforce in Montreal. With this the operations and the productivity of the company will improve which will help the company is producing more effective cars in 2007. Inventory: The inventory of the company was increased in 2006 because of the growth and demand of the products. The company needed raw material to build the end product . The inventory is also expected to increase further in 2007 which will help in improving on the productivity of the company. For this it is important for the company to manage its working capital adequately. Information: The company enhanced on technology as well as learning in 2006. The company used its process excellence programme so as to continue to improve on its quality and production. With this the company was able to improve on its quality by 20% in 2006 as compared with 2005. Read also Exam Operations Management With this the company will be able to further enhance quality and productivity of the company. The company also implemented and standardised ERP system to its unit in Europe, this is going to expand to the other units as well in 2007 which will help in improving the operations of the company. The company will be implementing its remaining IT ERP across its facilities which will help in enhancing its global supply chain management. Sourcing: With a strong focus on building supply chain management, the company is able to improve on its sourcing and having low cost production. With the enhancement in the supply chain the company will be able to further improve on its supply chain, operations and cost. Pricing: Even with the increase in the prices of the fuel and some metals, the company has aligned its operations and activities with such a way that it has been able to focus on reducing the overall cost of overhead as well as value activities. The company also increased the number of employees so as to increase the productivity of the company. Even despite of all these measure, the per unit cost of the product is expected to increase in 2007 which might affect the sales of the company.
Friday, January 3, 2020
The Issue Of Gun Control Essay - 734 Words
Almost every American knows about the situation with gun control. Does the second amendment give us the right to keep gun? Does the second amendment not give us the right to keep gun? Who should have guns? Should anybody have Guns? People ask and debate these questions every day. Gun violence has greatly increased in the last fifteen years. School shootings seem like a weekly thing now and it is heartbreaking and time to change the laws and protect are citizens better. Some people believe the government should make more strict laws and more background checks to keep guns out of the wrong hands, while others believe the second amendment should be repealed and take away the right to own a gun. William Safire believes the second amendment should be repealed and taken out of the constitution. Other people believe that owning a gun is their right and nobody can take that away from them, but William Safire thought of a way to replace the amendment with a new amendment. William Safire work ed for Richard Nixon during his presidency. Later, he worked for the New York Times and wrote many opinion based articles on different political topics. While he worked at the New York Times he won the Pulitzer-Prize for his political columnist work. Just like every other American he had his own political views. William Safire was a libertarian conservative. He believe that the second amendment needed to be repealed, but he doesn’t believe the amendment should be repealed to take our gunsShow MoreRelatedGun Issue And Gun Control1401 Words  | 6 PagesUniversity, Gun Politics has been a course I have aspired to take. While many enroll in such a course looking for an escape from the â€Å"collegiate liberal echo chamber†or as an outlet for their conservative agendas, I saw the class as an â€Å"entrance to the dark side.†My views on guns prior to the class were, I would call, polarized yet uninformed. In most of my discussions, I would cite the Australian 19 96 National Firearms Agreement as precedent for how American politicians should approach the gun issueRead MoreThe Issue Of Gun Control Essay1646 Words  | 7 Pagessomebody who wants to inflict harm on other people to get his or her hands on a gun.†(Simple Minded Gun Control). Gun control is a controversial issue worldwide. The reason why this has attracted so much attention is because not everyone is in favor of gun control and each side brings up excellent points about the issue. Research related to this issue strongly supports the claim that there SHOULD be more gun control laws. Three arguments that prove this position are (1) Incidents like Sandy HookRead MoreThe Issue Of Gun Control1489 Words  | 6 Pagessplit on the issue of gun control. We have seen many violent shootings and innocent people dying because of gun violence. Some Americans believe we need strict gun laws to protect our children and ourselves from these horrific tragedies. Other Americans believes it is our rights as Americans to posses’ guns and we are entitled to that right in our constitution. There are also some Americans that are stuck in the middle and can see both sides but recent events have definitely caused this issue to be inRead MoreThe Issue Of Gun Control1031 Words  | 5 Pagesintegrate them in a way that will trigger a new viewpoint on the subject. Gun control is something that should be enforced across the world in order to save lives. In the United States there is a ratio of 88.8 guns per one hundred persons (GunPolicy.org). Those numbers award us with the highest total per capita number in the world. With that amount of firepower there needs to be an efficient way to regulate who exactly can purchase a gun. Since 1791 when the second amendment was ratified there have beenRead MoreThe Issue Of Gun Control1705 Words  | 7 Pagesaway without preface or reason. All someone needs to do is pull the trigger. In today’s world, guns are far too accessible to the people of society. We hear in the news, stories of mass shootings, homicides, and suicides; most of which are caused by the activation of a gun. A hot-button issue, gun control is one of the most debated topics in American politics. Should we, or should we not, be able to own guns? Although it infringes on the Second Amendment that provides the right to bear arms, this amendmentRead MoreThe Issue Of Gun Control951 Words  | 4 PagesGun control has been a big topic for the past decade in the united states. These debates will rise and fall time in and time out after something horrific happens in the state. Anti-Gun supporters do not realize that it is extremely difficult to regulate something in the states that is a big portion of our economy.Would stricter gun laws change anything? So far statistically It has been proven otherwise one must consider how a citizen would defend themselves when they are faced with terror. How willRead MoreThe Issue Of Gun Control92 9 Words  | 4 PagesGun Control Getting arrested yesterday was not the highlight of my week. I was hungry; so I went to Wal-Mart get some charcoal, lighter fluid, and steak. I put the charcoal in the grill and the lighter fluid on the coals. I got a little lighter fluid on my arm, but I didn’t pay it much attention. I lit the match and threw it on the coals. I looked down and my sleeve was on fire. I was waving my arm in the air, trying to put it out. Then here they come the police pulled in and tackled me to theRead MoreThe Issue Of Gun Control1552 Words  | 7 PagesThe issue of gun is always controversial. Firearm can be used as defending or an assaulting weapon. In United States, firearm increase the rate of homicide, suicide and gun violence, which can harm and murder people. Moreover, taking away people’s gun will not work effectively because the murder and criminal will find another ways to get guns. Also, the black market will appear for the people who cannot get guns from regulated market s. In addition, if regulated guns are banned, murderers may useRead MoreThe Issue Of Gun Control1678 Words  | 7 PagesJanuary 2014 The 2nd Amendment Over the past few years, the issue of gun control has been widely discussed. You surely have heard the phrase, â€Å"Guns don’t kill people, people kill people†uttered and i wholeheartedly support this statement. It is important to treat guns responsibly so they do not end up in the wrong hands. I believe gun control violates our inalienable rights. Another piece of our liberty will surely be taken away if guns are banned, and socialism and totalitarianism will be rightRead MoreThe Issue Of Gun Control1208 Words  | 5 PagesWill Christopherson Traverson English 2 1 March 2017 Gun Control The United States has 88.8 guns per 100 people, or about 270,000,000 guns, which is the highest total and per capita number across the globe. The current public gun control debate in the United States seems to be placed on standby until it is sparked up by a major mass shooting. There were at least 126 mass shootings between January 2000 and July 2014.(pro). Opponents of more gun laws accuse supporters of using a horrific event to further
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