Dispersal Policy Of Asylum Seekers And Refugees

Dispersal Policy Of Asylum Seekers And Refugees The essay will look at dispersal policy; a brief background and description of the dispersal policy. Critically analysing the policy in relation to asylum seekers, elaborate the role of NASS and arguments on welfare and asylum seekers in relation to Britains changing laws of seeking asylum. Outline how ideologies have used those policies and the impact they have caused. Critique the policy; explain the Implications and challenges for social work practice in relation to the policy. A policy is a concept developed by government or political party to put down decisions 0r performance and matters that will prove advantageous to society in general. Dispersal is the process of moving asylum seekers to different areas of residence, to share the call on resources and public services amongst a wider range of local authorities across the UK instead of one particular area of the country. Under the immigration and Asylum Act 1999, any asylum seeker requiring support and accommodation may be dispersed anywhere in the UK while their applications are being considered (www.ind.homeoffice.gov.uk). Asylum is protection given by a country to someone who is fleeing persecution in their own country. It is given under the 1951 United Nations Convention Relating to the Status of Refugees. To be recognised as a refugee, you must have left your country and be unable to go back because you have a well-founded fear of persecution. The person claiming for protection is an asylum seeker. If the claim go through the person becomes a refugee (ww.homeoffice.gov.uk). In Britain, legislation and social policy in relation to asylum and refugees has been a priority for long. Britain gave attention to the refugees they had drafted in the1951 UN convention to provide protection to people who are at risk of persecution in their own countries. People from common wealth countries were invited to fill in gaps in the labour market following the economic boom in 1960sand thus settled in the Greater London. Dispersal has a history in UK, though it is only in recent years that it has come to be used routinely for asylum seekers. Before the 1990s, it was used to distribute specific groups of refugees such as the polish resettlement in 1950s, the Ugandan Asians in 1972, the Chileans in 1974-1979, the Vietnamese as an attempt to de-concentrate ethnic minority families whose numbers had had been considered too high in relation to resources such as housing and schools. (Griffiths, Sigona and Zetter, 2005). The concentration of asylum seekers in London and south east generated localised social and economic costs that those areas were not willing to accept. As a result of local tensions, the practical problems of housing, and supporting large and unexpected numbers of additional residents, some LA started to disperse asylum seekers. From 1996 on wards, London boroughs such as Harrow sent asylum seeker to Teignmouth in Devon (Robinson et al 2003 p: 122). This inspired dispersal and more local authorities were encouraged to do so voluntarily. More so, the policy was also inspired by dispersal of Bosnians in 1993, which was hailed as an example of effective settlement based up cluster areas and the principle of ethnic community formation (Griffiths et al 2005). Initially the policy applied to asylum seekers who are destitute. If they asked for accommodation, they could only refuse to go if they have a medical support in London, risk of domestic violence and have relatives around. The main aims of the dispersal are to relieve pressure on councils in key areas of South East and London which have been over burdened with asylum seekers and to distribute the load more evenly around the count. Those requiring accommodation would be dispersed to areas with housing to spare (www.bbc.co.uk/news). Dispersal was also seen as a means of improving the access of minority ethnic groups to improving life chances and a way of reducing prejudice through the deconstruction of stereotypes that these groups with areas characterised by overcrowding, poverty. The dispersal would encourage informal connection between neighbours of different races who might then begin to see each other as individuals rather than as stereotypes. The objectives of the policy were to control asylum seekers to enter the UK, increasing speed of the decision making for asylum seekers, refurbishing the financial support method of welfare benefits (Griffiths et al 2005). However, to supporters of dispersal policy, the issue is one of costs and equity: if society has made the democratic decision admit migrants, then the whole of society should bear the costs (Robinson 2003, P: 163). When you look at dispersal, it is not about cutting costs, sharing the burden or addressing racism, but about soothing the fears of some voters who want to believe that immigration, and who is allowed to stay in their cities is under control. The government needs to embrace asylum seeking, shift in the tone of public debate away from illegal immigration and deterrence, using the educational system to change public perceptions, and promoting community involvement, active engagement and sponsorship (www.migrationyorkshire.org.uk). Dispersal as a form of enforced population control is primarily a means of reducing the social visibility of asylum seekers and their potential pollution of social space. If the concentration of asylum seekers in the community is constructed as a problem for race relations, then their social dispersal is both a valid and desirable outcome (Griffiths et al 2005). By 1990s the number of asylum seekers had increased sharply and public opinion had turned against them, racialising the issue and labelling them as bogus and undeserving (Robinson et al 2003 P: 122). They are perceived to be economically motivated. Today immigration is perceived by many in Britain as a problem for our society which stems from a fear of unknown. Refugees and asylum seekers create an unwanted entity of the otherness in the margins of UK. From the moment they arrive they face an unpredictable and often aggressively hostile local public with racist political sentiment openly engaging in intimidation and local press making accusations of bogus claims and a drain on national resources (Pierson, 2002,p: 203, Dobrowolsky and Lister 2005). This othering resulted in discriminatory policies, which lead to the social exclusion, and discrimination of the asylum seekers, and refugee communities to the extent that their basic human rights have been challenged and their very existence has been criminalized (Dominelli 2002). I think devising strategies to prevent refugees coming to the country are a threat to the civilisation as it violates the basic human rights. The media could be partly to blame for this concept as they often wrongly imply that all asylum seekers for example, are criminals. Glasgow suspended its participation in the scheme in the wave of press hysteria. Media portrayals are often confusing and unreliable as they represent a gloomy impression about asylum seekers. The media blow up the insecurities of the public to sale more papers, as they are the only visible group in the local communities to blame for the ill health of the welfare system in the country. They have been an easy target for all as they are po werless, dislocated, silent, and do not even having the right to be here (Robinson et al 2003). Before 1996, asylum seekers were entitled to use the same social services as the rest of the population for example, if they had had been homeless, they would go to a homeless person unit, for support. The conservative Government introduced the asylum and immigration Act 1996, which meant that asylum seekers were cut off from mainstream welfare benefits. This left asylum seekers with no access to services. However, this was against the 1948 National Assistance Act which requires local authorities to provide welfare support to those destitute asylum seekers. Some local authorities started providing support to asylum seekers and their dependants if they appeared to be destitute. But, this was done on ad hoc basis and there were no clear guidelines of the local authorities responsibilities. In 1999, a new policy had been formulated for asylum seekers and refugees, which is called immigration and asylum Act 1999. The immigration and asylum Act 1999 gave the National Asylum support service (NASS) the responsibility to provide services and meet needs of asylum seekers. This was due to the problems encountered by the social policy of UK regarding asylum and refugees, the policymakers have decided to establish the NASS in April 2000. NASS was set up to alleviate the pressure on the LA, and also to meet the government view that access to social security benefits creates a pull factor on economic migration. The major role of NASS was to provide support and accommodation for those asylum seekers who are poor while their claim is still being considered. Individual will be given accommodation in the UK, which is usually located and on a no choice basis. This meant that NASS has the sole right to decide for the asylum seekers will be moved (Griffiths et al 2005). In 1999 the dispersal policy marked a fundamental change in British asylum approach by Introducing new procedures for the reception and accommodation of asylum seekers pending their claim for status determination in the UK (www.fmreview.org). Failed asylum seekers are often destitute when support is cut off 21 days after a final claim for asylum is refused (Refugee Action 2006). The Red Cross estimate some 26,000 are living off food parcels although the figure could be far higher (www.rcn.org.uk/). Dispersal failed to relieve pressure on London. It is possible that up to 2/3 of asylum seekers decided to remain in London and stay with friends and relatives rather than take up accommodation in other parts of UK while this does not add pressure to housing, it creates problems a with health and education www.school.gov.uk/policyhub/asylum_dispersal). There were many draw backs, in the dispersal, as there was miscommunication between NASS and agencies concerned. There was no sufficient accommodation in the dispersal areas and the whole situation was in shambles as reported by the for example, councils did not know how many people were sent to them and what language they spoke so that they arrange translating services. In general, principles of the policy were not effectively adhered to. NASS should work closely with other agencies to coordinate action to ensure the presence of asylum seekers do not harm community relations. NASS has been criticised by Fekete as being oppressive and institutionalised racism in her report Crimes of NASS: What is so alarming about the approach of NASS is that they do not consider it their duty to protect asylum seekers from racial violence, or ensure racial harmony, NASS is probably the only body in the country with no coherent policies against racial harassment and no apparent overall strategy to promote good race relations (Fekete, 2001). Since the year 2000, the NASS took the responsibility of asylum seekers to disperse them, wherever there is accommodation without considering their culture, language or any individual needs. Those who are vulnerable were left without support or information (Cohen, 2002, p: 119). Ethnic minority people suffer from linguistic deprivation in areas they are dispersed to. Initially, the idea was to send asylum seekers to established communities who shared a common language and provided comfort and support. However, due to limited resources and scarcity of accommodation in some places, most asylum seekers were sent to places away from the communities. Breaking up families and then dumping asylum seekers in sub-standard accommodation in some of our poorest communities was always bound to backfire. It is a policy that was neither human nor practical (www.independent.co.uk/news). From 1996 onwards, the responsibility of asylum seekers was given to voluntary organisations, for instance, NASS who dispersed refugees away from their countrymen and families. In so doing, their networks are sabotaged and left in isolation where they do not share any ownership or sense of belonging. They are unable to convey information or attain financial assistance from their communities, and that keeps them in a state of tension. There are questions about the long-term impacts on social cohesion, because clustering can deprive these groups of people of integrating in the community. Also, clustering led to emergency of Ghettos in deprived areas of asylum seekers. This may in turn hinder refugees future integration into communities (The Guardian 2005). In addition to that, dispersal has led asylum seekers being sent to live in the very poorest areas where there were large numbers of people living on either benefits or in the lowest-paid jobs where they were not only more likely to face assaults but were also twice as likely to face racial harassment. More so, the accommodation of these dispersed people is made with no choice as to the location and anyone leaving the accommodation offered to them will lose the right to support. As a result, they are will be impoverishment, poverty, exploitation, ill health and sometimes death. Secondly; some of them whose claims are still pending are sometimes taken to detention centres where they are dealt with brutally with discrimination and abuse (Cohen, Humphries Mynott, 2002). In relation to housing some private landlords force asylum seekers to live as a family with people they do not even know. Overcrowding has become an issue for larger families, which are given smaller accommodation. Others return to their homeless charities after failing to cope with the situation (Audit Commission 2000, p: 3). NASS housed accommodation has no legal protection from eviction and the legislation of 1999 deteriorated in relation to housing conditions for asylum seekers and where by landlords growing richer on contracts in order to accommodate asylum seekers (Cohen et al, 2002). One of the worst impacts of the Asylum and Immigration Act is the extension of immigration checks to housing and to all homeless applications. If the Home Office learns that a refuge has received public funds, he might lose the right to stay in the country or fail to renew their permission to stay (Cohen et al 2002). Again, the vouchers are stigmatising, as they are used in fewer shops and less on public transport. Asylum seekers and Refugees who are skilled, experience high unemployment and low pay as there are not as many jobs in rural areas as the cities, and the policy sabotage them from their networks that would help them. As a result of this, asylum seekers are discriminated against instead of being offered opportunities and strategies for help (Ibid). The government initiative towards asylum seekers preserved within the 2004 Asylum Act did not include the children welfare or to ensure that their human rights were thought of. On the contrary, children of asylum seekers whose claims failed are threatened to be removed from their families due to the powers of this act. A government which sets out to make the children of failed asylum seekers destitute cannot seriously argue, Every child matters (Lavalette and Pratt, 2006, p. 200). It destabilizes the domestic and international human rights commitment and undermines the Third Way ambition of every child matters. The detention centres, prisons and enforcement of dispersal programmes together with the 2002 Nationality Immigration and Asylum Seekers Act are all stereotyping asylum seekers as criminals, agree to be dispersed anywhere to get support, accommodation taken off them if they try to choose, taken in to isolation with high levels of crime directed to them, lack of legal representation. According to the Joint Council for the Welfare of Immigration: These policies are not only discriminatory against one of the most vulnerable sections of our community but also, of the worst kinds of social engineering which is destined to fail (www.lga.gov.uk). More so, the Audit Commission has reported that asylum seekers and refugees get poor health care though they are entitled to free healthcare. Some of the GPs have taken their names off the lists as there is a tendency that it might impact on their surgeries. On the other hand, the examinations refugees take at ports of entry, have no follow ups due to poor health check ups. They are again registered temporary which does not allow keeping frequent medical records and cannot put their needs into account due to the rights and responsibilities of healthcare. For instance, most refugees experience post-traumatic stress disorder as they escape. (Audit commission 2000a). The dispersal is reported to have improved recently, but this is down to the NASS working closely with other agencies like police, landlords, and local councils. They had all been included in the deciding in the area that was to be used, monitored the impact of the arrival of the asylum seekers on schools and other services and monitored community tension (guardian 2005). The policy has some success; this is evidenced by the larger number of refugees and asylum seekers in Birmingham, Liverpool and Manchester areas, and Birmingham hosts a sizeable refugee population in Wet midlands. There has been a corresponding growth of refugee community organisations (RCO) in these areas compared to before the dispersal policy of 1999 (Griffiths et al 2005). In this section the will look at implications and challenges of social workers face in their work with asylum seekers and refugees in the context of dispersal policy in the UK are: Social workers tasks include giving assistance and proper attention to these individuals and ensuring that they receive the services which are included in the immigration and asylum Act. NASS is responsible for identifying who among the asylum seekers have the right to be given the services offered by such agency. The NASS should coordinate with the social workers, and the members of the enquiry lines to know if there are asylum seekers who need assistance of the government (Dominelli, 2008). Hayes and Humphries (2006, p: 44) argue that it is often the most vulnerable who suffer from lack of additional support; parents worry for the health and well-being of their children. For example, a mother who can not breastfed her child because she is HIV positive and cannot afford to buy formula milk for her child. This puts social workers in a dilemma as they are forced to decide on eligibility based on immigration status, and the tension between social work values of providing for those in need and the requirement to exclude people from services. Social workers are forced to negotiate between this role of controlling access to support and that of providing care. In addition to that, social workers working with asylum seekers experience a growing demand for the services as a result of new arrivals in a period of the budget constraint and their work tended to be dominated by assessing eligibility and providing for immediate needs rather than a broad social work role. Social workers need to understand the impact of negative stereotyping on asylum seekers. Thompson (2009, P: 158) the need to recognise the significance of discrimination and oppression in clients lives and circumstances has been emphasised. As we have seen that asylum seekers will be subject to racist media portrayals and hostile views from members of the public, these factors will not help to integrate them into the community once an application has been successful. Thompson (2009, p: 18) argues that the role of social work is to contribute to social stability, to ensure that the level of social discontent does not reach a point where the social order may be threatened. Therefore, it is the role of social workers to help asylum seekers to integrate into local communities and adjust to a new culture. They will need to help asylum seekers to become more empowered as individuals and groups so that they can better represent themselves in the wider community. Empower involves practitione rs having to reinvent their practice and their perceptions of particular problems and solutions (Trevithick, 2005, p: 219). Social workers were under pressure as Social Services are using their already over stretched budgets to provide for asylum seekers. Following the negative media portrayals; the local populations made the assumption that the social services budgets were drained, not as a result of government not providing enough money, but because of the asylum seekers. A discussion about who pays the taxes for public welfare and costs of migration devalues immigrants contributions to economic growth (Dominelli, 2008). In some cases social workers were seen as supporting asylum seekers and neglecting the rest of the population. The role of a social worker is to address issues of oppression and discrimination on a daily basis yet their involvement is too little. Emphasis on the health and welfare of children allow social workers to become focused on specific issues such as safe case transfer of unaccompanied asylum seeking children, while not focusing on the needs of the vulnerable adult. (Hayes et al, 2006). Instead of the centralised NASS service provision, it would be better if asylum seekers could use local Social Services teams and benefits offices as these are more accessible. However, limited resources and staffing, the government should provide more support within the existing mainstream structures. Instead of training more social workers and community workers to support the asylum seekers, the government set up NASS, whose staff are not trained in anti-discriminatory principles, and had not got enough experience in housing and settlement issues. NASS work practices lead to more discrimination and social exclusion of the asylum seekers. Social workers must seek clarification within their services concerning the issues related to asylum seekers. As the most asylum seekers do not speak English or cannot command the language well, social workers should make good use of interpretation services and make sure that these services are available for the asylum seekers and able to communicate appropriately. Patel and Kelly (2006, p:5) suggest that ensuring access to interpreting services, and more equitable access to language learning opportunities, is essential for the appropriate provision of social care to Asylum seekers. It is my belief that all human beings deserve respect and dignity and should be treated will equal concern; however, looking at the media it is evident that the UK is struggling to sustain the support required for asylum seekers, which is becoming a growing problem within the UK today. The Human Rights Act 1998 applies to anyone living within the UKs borders regardless of circumstances or nationality; until an asylum seeker receives refugee status they are often in a state of limbo and regularly their equal rights are denied. Therefore, anti discriminatory practice and humanitarianism is vital within Social Work practice. Social workers should be involved in campaigning for the rights and ensure that they are observed (Dominelli 2008). The role of a social worker is to adhere to enhancing an atmosphere of acceptance, tolerance and equality for all individuals no matter what their background is. It is essential that Social Workers and those accountable for providing services and support to the most vulnerable in our society do not lose sight of the fact that asylum seekers, regardless of their immigration status, are human beings, with fundamental and basic human rights, needs and aspirations. In conclusion, although dispersal policies are always understood as ways of temporarily accommodating asylum seekers as they wait for their decision on their asylum claims, the government needs to look at things on a long-term basis so that they are dispersed where they are able to integrate. Therefore, policy makers should also think of the future employment probability and service as they are most of the requirements for the future. NASS should work together with agencies concerned to make sure that asylum seekers are not put at risk. I have critically describe the policy, explained the implications of the policy into social work practice.

Essay on Human Nature and The Canterbury Tales -- Canterbury Tales Ess

Human Nature and The Canterbury Tales  Ã‚     Ã‚  Ã‚   When Geoffrey Chaucer undertook the writing of The Canterbury Tales, he had a long road ahead of him. He intended to tell two stories from each of thirty pilgrims on the way to Canterbury, and then two more from each pilgrim on the way back from Canterbury. Of these, he completed only twenty-four. However, in these tales, Chaucer depicts both the pilgrims and their stories with striking realism. In "The Nun's Priest's Tale," "The Canon's Yeoman's Tale," "The Friar's Tale," "The Reeve's Tale," and "The Cleric's Tale," Chaucer demonstrates his remarkable insight into human nature. By comparing and contrasting these tales, one can see the universality of human nature as shown by Chaucer. One human trait apparent in these selections is greed. Avarice drives the hearts of many men, whether they may be a common miller or a summoner or a supposedly religious canon, and Chaucer was aware of this. In the tales which contain these three characters, Chaucer depicts the greed of these characters. The Reeve tells his fellow pilgrims in his tale of a miller who "was a thief ... of corn and meal, and sly at that; his habit was to steal" (Chaucer 125). The summoner in "The Friar's Tale" "drew large profits to himself thereby," and as the devil observes of him in this tale, "You're out for wealth, acquired no matter how" (Chaucer 312, 315). The canon in Part 1 of "The Canon's Yeoman's Tale," as well as the Yeoman himself, had been driven by the goal of converting base metals into gold, and "though we never realized the wished conclusion we still went on raving in our illusion" (Chaucer 478). The second canon of which the Yeoman speaks is many times worse than his own canon and mas ter, using h... .... Works Cited Balliet, Gay L. "The Wife in Chaucer's Reeves's Tale: Siren of Sweet Vengeance." English Language Notes 28.1 (1990): 1-5. Baylor, Jeffrey. "The Failure of the Intellect in Chaucer's Reeve's Tale." English Language Notes 28.1 (1990): 17-19. Chaucer, Geoffrey. The Canterbury Tales. Trans. Nevill Coghill. Baltimore: Penguin Books, 1960. Dictionary of Literary Biography: Old and Middle English. Ed. Jeffrey Helteman and Jerome Mitchell. Detroit: Sale Research, Inc., 1994. Edden, Valerie. "Sacred and Secular in the Clerk's Tale." The Chaucer Review 26.4 (1992): 369-376. Fehrenbacher, Richard W. "'A Yeerd Enclosed Al About': Literature and History in the Nun's Priest's Tale." The Chaucer Review 29.2 (1994): 134-148. Whittock, Trevor. A Reading of The Canterbury Tales. Cambridge: University of Cambridge Press, 1970.      

Wound Care

Program Evaluation: Wound Care Center The Methodist Hospital offers a Wound Care & Hyperbaric Medicine Program which works closely with patients and specially trained physicians (2010). The program focuses on monitoring, management, and treatment of chronic and non-healing wounds (TMHS, 2010). Non healing wounds affect a large number of the populace and prevent people from leading an active life. Researchers report new technologies are altering the process in which chronic wounds are treated. More options for wound treatment are available today than previously available. Bio-engineered skin substitutes, specialized dressings and the latest compression wraps are a few of the more recent methods for wound treatment. The Methodist Hospital's Wound Care & Hyperbaric Medicine Program offers state-of-the-art technologies and advanced wound care techniques to effectively care for non-healing wounds. Evidence depicts that a wound that has not healed in over a month should not be overlooked (CDC, 2009). The TMHWC program uses a team approach to promote advanced wound healing. The first step of healing for patients enrolled in the wound care program is a methodical evaluation by a wound care physician. There is a huge need for quality wound centers. Non healing wounds and excessive management cost health care centers a substantial amount of money each year. According to Pompeo (2010) health care organizations want well-organized and precise figures to decide which cost effective wound care services to propose. The difficulty with chronic wounds is that it is very demanding on staff within a hospital’s organization (Shai & Halevy, 2005). The burden of chronic wound management is constant and an evaluation is necessary in an effort to prove the importance of maintaining The Methodist Hospital Wound Center. The purpose of this evaluation is to examine the wound care program at The Methodist Hospital in Houston Texas. This evaluation will provide the history and overview of the root source for chronic wounds and the effectiveness of treatment of those wounds. This evaluation will also comprise a review of the programs patient population, chronic wound diagnoses, primary diseases, treatment devices, as well as costs associated with the health care organization. The assessment will expand the findings of the previously submitted needs analysis for the healthcare organization expansion of services. The components of the proposal are consistent with the organizational mission, values and vision. Background The Methodist Hospital's wound care Treatment Center came to exist from a meeting between several surgeons at a wound care clinic in Southeast Texas. The physicians were discussing a patient who had suffered with wounds for a number of years. The physicians were interested in increasing improving the credentialing and recognition of wound care services. The Wound Care Center was founded and incorporated in 1990 as an extension of The Methodist Hospital. The Methodist Wound Care Center is dedicated to the multidisciplinary team approach in promoting the science of prevention, care, and treatment of acute and chronic wounds. Today the Methodist Wound Center continues to offer treatment and intervention for chronic wounds. The Methodist Wound Center is an independent center staffed and funded by The Methodist Hospital. A chronic wound has an appearance of one or more underlying conditions which become evident on the skin. Chronic wounds are reported to have the following etiologies (Krasner, 2001): pressure, venous, arterial, diabetic, ischemic, cancer, and end-of-life. A chronic wound entails intervention by numerous health care authorities to address the many conditions and co-morbidities that impact future prognosis and healing. Mission The mission of The Methodist Hospital's Wound Care Center is to provide a full range of the highest quality, outcome oriented physical therapy services for a variety of patients with wounds. The Methodist Hospital Wound Care Clinic team of specialists works together for improved healing rates and fewer amputations in chronic wound cases. In the course of treatment, the clinics aim is to prevent prolonged or permanent disability and reduce hospitalizations. Vision Statement Where people want to work, where physicians want to practice, and most important, where registered patients want to go when they need healthcare services. The vision statement sets specific goals in objective terms, and a time frame for the goals to be met (Pelland, 2009). Literature Review Webster's New Riverside University Dictionary (2010) defines an ulcer as an inflammatory, often suppurating lesion on the skin or an internal mucosal surface of the body, as in the duodenum, resulting in necrosis of the tissue. Dorland's Medical Dictionary (2010) describes an ulcer as a local defect or excavation on the surface of an organ or tissue which is produced by sloughing of inflammatory necrotic tissue. Wounds that do not respond within the expected time frame are defined as chronic wounds or ulcers (Wollina, Hansel, Kronert, & Heinig, 2010). Chronic wounds are contributed to primary diagnoses which slow down the healing process and may sometimes result in death (CDC, 2007). The first step in conducting a needs analysis for the Wound Care Center is to identify the services most in need of support. A review of the number of referrals for different services could direct an initial effort. Networking with practices that have already implemented similar services may be of assistance. Performance measures must be in place for monitoring program success. Performance measures should assess for method reimbursement and sustainability, patient and provider satisfaction, treatment outcomes, and areas for improvement (Lockamy & Smith, 2009). Development of standards makes ease of operation with other systems a reality and are necessary for efficient operations (Spivack, 2005). Principles to be considered in selection, implementation, and evaluation are patient satisfaction, strategic alignments, process management, performance measurement, and project management (Lockamy & Smith). Developing community and governing commission liaisons will strengthen the chance of program implementation success (Dick, Manson, Hansen, Huggins, & Trullinger, 2007). The CDC (2009) reported that over 25 billion dollars is spent annually to govern the management of non-healing wounds. Each year seven million Americans are diagnosed with at least one type of chronic wound. The incidence rate of chronic wounds ranges about ten percent annually and is contributed to the current increase in age of the populace. Stages of Wound Healing There are three phases of wound healing (Fishman, 2008). First, there's phase one-the inflammatory phase, which immediately begins and is active for the first five days of injury. The inflammatory phase generates coagulate from vaso-constriction, platelet aggregation, and thromboplastin formation. The proliferative phase is the second stage of wound healing. This phase transpires up to three weeks after injury. Granulation, contraction and epithelialization draw the ulcerated edges together in an effort to reduce the deficiency (Fishman, 2008). Stage three of wound healing is sometimes defined as the remodeling phase. The modification stage last up to two years. Collagen is formed, which increases the overall vigor of the wound (Fishman, 2008). There are three types of cost analyses. They are cost-effective analysis, cost-benefit analysis, cost-utility analysis and cost-utility analysis. They are aimed at reducing the wastage of resources in invalid methods by getting the advantages of use of a particular activity with the value in terms of cost. People with diabetes are more prone to developing ulcers on their feet. Decreased sensation and a lack of circulation lead to this problem. The best way to prevent ulcers from forming is by performing a daily foot inspection. The three are not mutually exclusive in their use and can be used in any one particular situation though in different stages of the pyramid. An example is the use of exercise as a cost-effective means of tackling diabetes. In one of its many advantages, the exercise does not only help manage the diabetes but other conditions are catered for in the primary stage. This includes, stress reduction and hypertension which may be additions to the disease. There are many benefits of using exercise to various diseases like the cardiovascular types. The use of exercise is implemented in the third stage, tertiary stage that will include the treatment or management of the disease. It helps in burning down the excess calories in the body. (Hatziandreu, E. , 2003) Wound Center Protocol Patients undergo an inclusive physical upon admission to the wound care center. The work up plan for wound care consists of physical evaluations, blood work, Xrays and wound assessments. Medical staff meets daily to discuss the best plan of care for the patients. The treatment protocol Centers which practice systematic ways to develop wound treatment provide excellent care, including evidence based treatment protocols which lead to superior clinical outcomes (Fishman, 2008). The Methodist Hospital's Wound Care Center treats and takes care of the wounds at any part of the body including sacral, abdominal and even in the lower extremities. The center treats all types of wounds caused by burns and pressure, diabetes, radiation and vascular diseases. The centers protocol is to treat all chronic wounds until they heal as well as prevents recurrence and preserve limbs. The center’s staff does not only treat but also monitors wounds teaches prevention ways such as eating proper nutrition among other specialties. Program Objectives The American Physiological Society (2010) website indicated the evaluation provides formative feedback that helps guide a program as it is being implemented. It also provides summative data that clearly demonstrates that the program is accomplishing its stated goals and objectives. Without an efficient evaluation, the program personnel may be unsuccessful with regard to documentation of impactful program issues. The Wound Care Center employs five full time registered nurses, certified in wound care. The center also employs three administrative personnel, including the clinic administrator. The wound care center employees several medical staff physicians, including a podiatrist, 2 general surgeons and one plastic and internal medicine. The treatment of chronic wounds and research on the pathogen has been going on for many years now. Despite the effort, a large number of people still face the problem when it comes to wound care. A number of people have named lack of integrative perspective in research methodology as a critical issue facing wound care centers (Singhal, Reis, and Kerstein, 2001). Researchers do not view treatment of wounds holistically but have focused on efficacy and safety of specific therapies. The Methodist Hospital's Wound Care Center objectives are to continue with single treatment investigation in addition to pursuing an integrated approach to the mechanisms of wound healing. Integrated approach deals with the physiological activities that make a wound heal or not heal based on the fundamental activities. Study design This study design is pertinent to an evaluation of the wound care center and the subsequent hospital visits from patients subsequent to discharge. The study design for this research is quantitative and the population will be those patients who required treatment at the Wound Center within the last 24 months. The study will use data from Method admissions data base to calculate the number of patients. The system will also track the number of patients returned to the center. Quantitative designs require a prearranged selection of variables. Quantitative designs clarify the result of an experiment, a correlation testing, and often involve the acceptance or the failure to rejection the null hypothesis (Sproull, 2004) using statistical formulas and hypothesis testing with a significant randomly selected sample that represents the population (Creswell, 2004). Sample Patients who are currently admitted in the wound care center and scheduled for discharge within the next 30 days will be the population for this study. The population will be reviewed and counted from the Method’s computer system. We will aggregate the data of all patients admitted and discharged from the last 24 months. The selection process can be described as systematic sampling. The specificity of the items in the database is controlled by change. The series of items is compiled from the medical record number and is tracked over the last 24 months. The advantage of systematic sampling is that, unlike simple random sampling, a designated number does not need to be assigned to every item. Most patients have been discharged from the program because the wounds have healed or they have transferred to other wound care facilities. Recruitment of Participants. This evaluation will not require an excessive amount of contact with participants. There will be no questions or surveys provided to the participants. An option for this evaluation is to review the data in Method and analyze the discharge and monitoring of each wound care patient. MethoD is the computer admitting database which reports on all admitted patients to any program within the institution. Methods The research study objectives is to identify chronic wound services that need most support, to review the number of referrals and to determine the favorable ways of treating, preventing and controlling chronic wounds. The study uses quantitative data from The Methodist Hospital's Wound Care Center computer records. The study will use a systematic sampling of all the patients that have been treated for wound in the last 24 months. The study will record all the patients who have visited the hospital with wounds, it will determine their age, sex and the type of wound they were treated on. The study will also record how many times the patient has been treated and when the wound healed and if it did not heal the preventive advice given to the patient. The methods of data collection will be observation and investigations of medical records. The prearranged selection of variables includes age, sex, type of the wound and the duration it takes for the wound to heal. The correlation testing will be used to find out if there is a relationship between persons age and time the wound takes to heal or the type of the wound and the sex of a person. The study will apply statistical model of wound healing rates because it predicts the actual healing of the wound. The statistical model does not impose a fixed methodological structure on the healing structure such as time but monitors the progress and actual behavior of the wound (Kumar, 2007). Data Analysis The results obtained from the centers medical records and analyzed by Method’s computer system showed that the center had received quite a number of wounded patients. The computer software showed that 3-4 people out of a hundred people who visited the hospital were wounded. An estimate of 20-30% of the hospital beds were occupied by patients with wounds a big percentage being patients whom had acquired wounds during hospitalization. Pressure ulcers obtained during the period of medication is the major cause of chronic wound affecting an estimate of five inpatients. The results also showed that 5% of patients died after contracting surgical wound infection during the period. The result statistics indicated through tables and graphs drawn using method computer programs showed that chronic wound were caused by a number of factors such as immobility which usually affected patients on hospital bed causing bed sores and pressure ulcers. The other factors included diabetes, trauma, poor circulation and vascular disease (Stillman, 2010). Diabetes was the major cause of developing a chronic would as statistics showed as 20-50% of people with diabetes had the risk of contracting . Wounds can also be caused by other causes namely unhealthy nutrition, ill-fitting shoes, hygiene and lack of exercises. A big number of people obtained wounds after falling. The research study used a new statistical model that combines both the wound’s size wand the time of closure. This was because it was not easy to determine the actual time that most patients would heal after they were released from the hospital. Methodist Wound Care Center just like other hospital and clinical centers released their patients after their wounds closed after giving them advice on proper preventive measures. The model analyzed the wound size against time. A graph drawn should exhibit negative correlation, that is, as time goes the size of the wound reduces in order to indicate healing. Implications Meta-analytic review of wound healing processes showed that the duration a wound took to heal depended on the type of treatment given and the size of the wound. A large number of wounds do not heal completely but only undergo a process called closure. It is therefore not easy to calculate the correlation between the size of the wound and the duration it takes to heal completely. The statistical approach therefore calculated the time of closure as the healing of the wound. Studies have shown that there are four major stages of healing. A normal would heal even before stage IV but a chronic wound that progresses to stage IV may have serious implication that may lead to amputation (Columbia University Medical Center, 2007). Stage IV is usual the wound closure as it involves formation of a new skin and scarring but it does not mean the wound is completely healed. The data analyzed showed there was a negative correlation between the time of closure and the size of the wound. The size of the wound decreased as time the patient undertook treatment increased. This was a measure that healing process was taking place. While 45% of the patients admitted in the hospital for the given period showed a healing trend, some patient’s wounds did not heal regardless of the time frame. In fact some small wounds grew in size as time progressed. The study results did not indicate a linear relationship since some wounds grew in size as time progressed while others became smaller as time increased. The study results showed a non-exponential Gompertz-type model that shows specific differences and variations in individual wound behavior. Monitoring The modified Gompertz-type model was the best for monitoring and evaluating the healing process of the wound as it applied to all types of wound (both the ones that healed and the ones that did not heal). The model has advantage over other models as it could predict the rate of healing based on the treatment and similarity of wound type. Healing involves tissue healing and wound closure. The study model monitored all the patients that had visited the hospital in the last 30 days to determine which stage of healing process they were in. Generally the healing process involved four phases namely inflammatory phase, proliferative phase, remodeling phase and epithelialization(Hess, 2005). All the wounded patients for the last 30 days were monitored and the phase they were in recorded. The wounded patients that had already visited the hospital in last 24 months were expected to be at various phases depending on the size and type of the wound. A table was thereafter recorded and graphs drawn to analyze the data in order to gain conclusive results of the study. A normal wound requires 3-4 days to be at the epithelialization phase where another layer of skin form leading to scarring (Sussman and Bates-Jensen, 2007). Some wounds take more than that depending on the size of the wound. The research study was given 30 days period in which to monitor the phases of patients wound in order to get conclusive results. A table was set up for all the wounded patients, the time they were admitted and the time they underwent all the four phases. At the end of the one month period a time table was prepared that showed the time period and the number of patients at a particular phase.

Stopping Teen Pregnancy and STDs - 595 Words

What does it take to stop teen pregnancies and the spread of STD’s? Sex education in school is a major controversial idea around the world. Tolerance is when people deal with or accept something even though they may not agree with it. Sexual education in school is based on what students need to know to be protected. The schools that do not teach sexual education, teach the idea of abstinence. Abstinence is the idea of retaining from any sexual activity to stay â€Å"pure† until marriage. Schools focus on teen pregnancies, STD and HIV prevention, dating violence,body image, and healthy relationships. Sexual education in schools is a occurring problem in society over the years. The early part of the 1912 teachers were being trained to teach sexual education in schools. In 1940 the health and safety department highly advocated sex ed in schools but by the 1960’s the controversy sexual education in had started (Pardini). Sex education slowly started to stop being sex education it was being turned into abstinence only programs. 1998, twenty percent of states retained to teaching abstinence and fifty-one bills were being considered by state legislatures. Congress committed 250 million dollars from federal funds over five years to promote abstinence until marriage in 1996. â€Å"By the 1970’s, legislatures in the 20 states had voted to restrict or abolish sexuality education.† (Donovan). Sex education has slowly progressed to being a problem in society. Sexual education in societyShow MoreRelatedEssay about The Issue of Sexually Active Young Teens713 Words   |  3 Pagesregarding sexually active young teens. It seems that almost every teen is sexually active. They are having sex at such a early age. A question that rings in our minds, is do they truly even know what sex is? Growing up, Catholic teachings instructed myself to wait until marriage. They say premarital sex is a sin. Now, not only are churches teaching abstinence, but, schools as well. Premarital sex is a important growing problem: that usually results in a unwanted pregnancy, in some cases; forced abortionRead MoreSex, Drugs, And Pressure1065 Words   |  5 PagesRelationships are different than they used to be. There not caused by love at first sight at the homecoming game, there caused by getting drunk at a party and ending up making out or worse. Relationships these days are determined by how much they do. If teens are having sex they must be in love. People donà ¢â‚¬â„¢t realize that you don’t have to have sex to be in love. You should love the person to have sex but you don’t need to have sex unless you are married to that person and are dedicated to spend the restRead More Comprehensive Sex Ed. Programs vs. Abstinence Only Programs Essay2818 Words   |  12 Pagesrealized by abstaining from sexual activity; teaches abstinence from sexual activity outside marriage as the expected standard for all school age children; teaches that abstinence from sexual activity is the only certain way to avoid out-of-wedlock pregnancy, sexually transmitted diseases, and other associated health problems, teaches that sexual activity outside of the context of marriage is likely to have harmful psychological and physical effects; teaches that bearing children out-of-wedlock is likelyRead MoreEssay on The Effects Alcohol Has On Teens1431 Words   |  6 Pages Nearly 25 percent of teens drink alcohol because they think it is fun; however the problems it may bring are not so fun (Hyde 22). There over six times more teen deaths per year from alcohol than any other drug (O’Malley 30). Alcohol affects the body of teens as well as all of the developmental processes. A major issue of teens drinking is that it increases the chance of becoming an alcoholic in the future; which leads to lowered self-control, impaired judgment, and lowered inhibition (Heath 12)Read MoreThe Oldest Profession in the World Essay2135 Words   |  9 Pagesto society in the spreading of sexually transmitted diseases (STD’s). Sexually transmitted diseases are various infectious diseases that are transmitted through sexual intercourse or other intimate sexual contact. Although society has a variety of viewpoints on the practice of prostitution, it an increasing trend that is detrimental to society. Prostitution has issues regarding legal standpoints on the bu siness, the rapid spread of STD’s throughout the human environment, and the morality issues of