Community Health Needs Assessment Tools Health And Social Care Essay

Community Health Needs Assessment Tools Health And Social Care Essay The research need to generate qualitative and quantitative data regarding a particular community health need is directly proportionate to the impact that the particular health need has on the community and sometimes even the mortality/morbidity generated by the particular health problem. In this regard, in this current assessment we review the health needs of coal mining workers in West Virginia, USA to identify hazards and risk factors pertaining to their health, by virtue of their designated profession. Community health needs assessment is a rigorous project that serves the population under study by elucidating the current needs, reflecting the situation which is often not balanced between health providers, insurance schemes, health administration and/or community leaders. It also serves at identifying particular needs that are overlooked by healthcare officials that are either novel or problematical by elucidating perceived and expressed health and wellbeing needs. In other words, it can be a useful means to depict the selected communitys horizon in respect to health needs, healthcare shortfalls and aetiology, all useful areas for the facilitation of better public health management. In order to perform an accurate community health needs assessment, research should be grounded on an up to date background study of the selected populations demographics and census (socioeconomic, workforce and other) data, where available. Moreover, particular health factors should be taken into account by managing information currently disseminated through healthcare officials (such as mortality, disease prevalence, risk factors analysis). This research would also benefit from an on-site review of environmental and work related conditions, if possible. The most useful and widely used instrument to conduct a community health needs assessment and subsequent analysis is by means of a structured questionnaire based survey that will employ cross sectional and population specific items targeted at the current health need. Moreover, the instrument should be designed with attention to environment and state specific conditions, such as regulations and laws, insurance coverage and even so, local traditions and unwritten codes of conduct. For the above reasons, in this essay we will conduct a review of available information on the community of Coal Mining Workers in West Virginia, USA. After the acquisition and analysis of the pertaining data, we will present a structured survey instrument, aiming to identify health needs with respect to existing health problems and patient satisfaction. BACKGROUND-RESEARCH We searched a wide array of online databases and organisations providing demographic and other information for the population in question. We also conducted a MEDLINE search, to draw the picture of already identified health needs and/or needs assessments already conducted in this population. Search terms employed were coal workers, west Virginia, health needs, pneumoconiosis, interstitial lung disease, occupational hazard alone or in combination. West Virginia is a state in the Mid-Atlantic section of the USA, capital Charleston. The state is notorious for its mountain composition and significant coal mining industries. The mineral and coal resources in the area are vast, and West Virginia has been considered to have fuelled a great part of the industrial revolution of the developed world. Moreover, coal mining and related work constituted major part of the employment activities of the state, while still in the 21st century, it is believed that mining safety and environmental concerns are amongst the most challenging issues facing the state. In 2009, West Virginia was inhabited by 1,819,777 people. 5.6% of West Virginias population were reported as under 5, 22.3% under 18, and 15.3% were 65 or older. Females made up approximately 51.4% of the population (United States Census Bureau, 2010). Moreover, according to US Census Bureau Data, West Virginia is the third lowest in per capita income state. It also ranks last at median household income. Virginias adult population with a bachelors degree is the lowest in the U.S. At 17.3%. The main economy is coal, and the state is the lead in coal production, second only to Wyoming.From the West Virginia Office of Miners Health, Safety and Training we find that the West Virginia Coal Industry provides about 30,000 direct jobs in WV, including miners, mine contractors, coal preparation plant employees and mine supply companies. In particular 20,715 are registered as employees in the 188 active coal mines in WV, while an additional 4,842 work as an independent contractor. From the same source we read that for 2009, fatal accidents were 3, non fatal accidents 1,164 and the accident frequency was estimated to be   2.79%. Involved in accidents are mainly high voltage equipment, and areas in and around river load outs. But apart from fatalities, a major health problem for VW coal mining workers is pneumoconiosis, or black lung. The CDC has implemented a safety and health chapter regarding occupational Respiratory Disease Surveillance, and especially for coal miners, the Enhanced Coal Workers Health Surveillance Program (ECWHSP). The ECWHSP includes surveys that include specifically designed standardized health questionnaires, work histories, spirometry testing, radiographic examinations, and collection of other relevant health information, which are gathered in a specially designed mobile examination unit by trained personnel on site.Results of the ECWHSP 2009 survey on mine workers in West Virginia are shown on table 1: Finding Examined Rate Total Participation 1,884 20% 9,593 pneumoconiosis (>=1/0 or PMF). 93 5% 1,884 pneumoconiosis (>=2/1 or PMF). 43 2% PMF 24 1% advanced pneumoconiosis 35 2% have a chronic cough. 624 34% bring up phlegm from their chest. 690 38% have chest sounds of wheezing. 613 34% have had an attack of wheezing 738 41% have experienced dyspnea on level 741 41% have experienced dyspnea on a hill 1,119 62% have chest tightness 672 37% have chronic bronchitis. 142 8% have emphysema. 79 4% have had pneumonia 337 19% have asthma 132 7% have tuberculosis. 4 0% never smoked. 954 53% former smokers 455 25% current smokers 393 22% Although under a lot of argumentation, coal and in general volatiles (dust) have been proven by sufficient evident as causes of respiratory damage. In detail, in coal miners a significant association between the level of FEV1 and dust was found, even after adjustment for age, physique and smoking (Cowie ,1999; Soutar 1989). Some more interesting figures arise from the State Health Facts website, shown in Table 2: Measured index WEST VIRGINIA USA Age-Adjusted Invasive Cancer Incidence Rate per 100,000 Population, 2005 484.2 458.4 Births of Low Birth weight as a Percent of All Births, 2006 9.7 8.3 Number of Deaths per 100,000 Population, 2007 951.7 760.31 Life Expectancy at Birth (in years), 2005 75.3 78.0 Percent of Adults Who Have Ever Been Told by a Doctor that They Have Diabetes, 2008 11,9 8,2 Number of Deaths Due to Diseases of the Heart per 100,000 Population, 2006 236,9 200,2 Asthma prevalence among adults 9.0 8,2 Percentage of Adult Population Aged 21-64 Years Who Reported a Disability, 2007 22,4 12,8 The above figures need to be assessed in caution regarding the high prevalence of occupation of coal worker in West Virginia. Apart from the apparent pathophysiology of dust entering the lungs and rendering them chronically inflammatory, with signs of fibrosis and atelectasia or other interstitial pneumonic disease or pneumonoconiasis, health needs of coal mining workers are extended to a variety of diseases that are not as commonly identifiable at the first look. Although current screening methods and occupational policies do exist for these workers, they tend to be centred on respiratory diseases. Coal Mining however, is a demanding, time consuming manual labour that is often exigent and causes a variety of clinical manifestations. As such we can consider lower back pain, physical limitations (Galagher,2005) cervical spine degenerative changes, vibration-hazard related body changes, sudden coronary death (Kopytina et al, 1993), skin lesions (Begraca et al, 1991)and mental health changes (Lagunov,1991). Moreover, the coal mining community often has unmet needs on the level of healthcare access and utilization, that different stakeholders are usually unaware. In a study by Smith et al,2005 a community health needs assessment was the means to the provision of a community nurse and a revision in healthcare provision among former miners in Kent. Having reviewed the major components of community health needs assessment for mine workers in West Virginia and having conducted the appropriate background review, we propose the following questionnaire as a tool to conducting an effective and fruitful evaluation of perceived and actual health needs, in a community of mine workers. This tool comprises of a health needs assessment part, where the answers are left open and views are encouraged for propositions in order to facilitate the analysis of expected health and participation to health concerns. The second part is a standardized demographics and health questionnaire that is used widely in this form, with minor alterations in assessing the perceived health and demographic information of the study population in question. Emphasis is given on other diseases that might affect the coal mining community ( participants are requested to count five-5 major health concerns) and on perceived level of attention and care this community is receiving or should be receiving according to its needs. A question regarding their siblings health is put in the end to elucidate concerns that are also documented in the literature regarding out of site contamination with dust by coal workers that bring their occupational hazard in the family home or by dispersion in neighbourly areas (Pless-Mulloli et al, 2001). QUESTIONNAIRE: We are conducting a review of the Health Needs within the WV coal mining community. Along with statistical data and analysis we are also interested in your viewpoints. Instructions Part One: Health Problems There are several factors that influence or determine whether the people in your coal miners community are healthy. From the following list, please rank from 1-5 (1 being the highest priority) what you think are the top five health and disability issues affecting your community? Health Issue Your Ranking (1-5) Asthma / Respiratory Disease / Pneumoconiasis Cancer Cardiovascular Disease Depression / Psychiatric Disorders Diabetes Disability Drug and Alcohol use Nutrition Obesity Oral Health Physical Injury (including violence and accidents) Self harm / Suicide Sexual Health Smoking Other (please specify below) What do you think is needed to address the top three priority issues identified above and what difference will this make? Issue 1: Issue 2: Issue 3: What is needed? What is needed? What is needed? What difference will this make? What difference will this make? What difference will this make? How much influence do you think the following have as to whether people in your coal mining community are healthy? Please mark each factor with an X, ranking influence from 1-5 following with an X Influence (1 is most, 5 is least) Factors 1 2 3 4 5 Cost of services Ease of access to health services Education Employment Family support Housing Income Social Isolation Transport Community support Insurance status Other (please specify below) Your details Please provide us with some information about yourself. This will assist us with the analysis of the questionnaire results. Please mark the following that applies to you with an X Name (optional) Ethnic Group American German decent Hispanic Other Gender Male Female Age Range Children (aged 0 14) Adults (aged 25 64) Youth (aged 15 24) Older People (aged 65+) Where do you live? metropolitan area county How many years have you worked in the coal mining sector? ( number of years) Do you consider your self healthy? Yes No What is your principal concern? How often do you visit a doctor? List one preventive diagnostic test that you had the previous 6 months: ( colorectal screening, pap test, ECG, CXR, ultrasonogram etc): Does your employer offer health promotion/wellness programs? Yes No Type of health insurance( state) : In the following section, select which answer describes you. *Note that N/A stands for not applicable Always Sometimes Never N/A You wear a seat belt: You wear a helmet when riding a bicycle, rollerblading or skateboarding: You drive the posted speed limit: You eat at least 5 servings of fruits and vegetables each day: You eat fast food more than once a week: You exercise at a moderate pace at least 30 minutes per day, 5 days per week: You consume more than 3 alcoholic drinks per day (female) or more than 5 per day (male): You smoke cigarettes: You chew tobacco: You are exposed to secondhand smoke in your home or at work: You use illegal drugs (marijuana, cocaine, methamphetamine, etc.): You perform self-exams for cancer (breast or testicular): You wash your hands with soap and water after using the restroom: You undergo physiotherapy for lower back pain You apply sunscreen before planned time outside: You get a flu shot each year: You practice safe sex (condom or other barrier method, etc.): You take vitamin pills or supplements daily: You spend money on gambling more than once a month: You attend religious services regularly: You volunteer in your community (church, schools, civic organizations, etc.): You donate money to community based organizations (churches, non profit organizations, etc.): You get enough sleep each night (7-9 hours): You feel stressed out: You feel happy about your life: You feel lonely: You worry about losing your job: You feel safe in your community: You are afraid for your childrens health You feel that the government is liable for your health You feel that the government is liable for your childrens health

Mckinsey Accounting and Engineering Advisors Essay

The firm was founded in 1926 by university of Chicago professor, James (â€Å"Mac†) McKinsey, it was called â€Å"accounting and engineering advisors†. Mac started recruiting experienced executives and training them in the integrated approach he called his General Survey outline. In Saturday morning sessions he would lead consultants through an undeviating sequence of analysis – goals, strategy, policies, organisation, facilities, procedures and personnel – while still encouraging them to synthesize data and think for themselves. McKinsey’s mission was to help clients make positive, lasting, and substantial improvements in their performance and to build a great firm that is able to attract, develop, excite, and retain exceptional people. Bower’s vision of the firm was: â€Å"one focused on issues of importance and top-level management, adhering to the highest standards of integrity, professional ethics, and technical excellence, able to attract and develop young men of outstanding qualifications, and committed to continually raising its stature and influence. Above all, it was to be a firm dedicated to the mission of serving its clients superbly well. Bower also articulated a policy that every assignment should bring the firm something more than revenue – experience or prestige for example. Bower and his colleagues believed that well-trained, highly intelligent generalists could quickly grasp the issue, and through disciplined analysis find its solution. The firm grew extraordinarily domestically in the 1950’s which provided a basis for international expansion that accelerated the rate of growth in the 1960’s. Offices opened in London, Geneva, Amsterdam, Dà ¼sseldorf and Paris. McKinsey was now a well established and highly respected presence in Europe and North America. To Gupta the task of knowledge development had become much more complex over the past decade or so due to three intersecting forces: †¢ In an increasingly information and knowledge driven age, the sheer volume and rate of change of new knowledge made the task much more complex †¢ Clients expectations of and need for leading edge expertise were constantly increasing †¢ The firm’s own success had made it much more difficult to link and leverage the knowledge and expertise represented by 3800 consultants in 69 offices worldwide. Gupta believed that knowledge is the lifeblood of McKinsey. How does knowledge create value for McKinsey and Company? Creating value for a firm means performing activities that increase the value of goods or services to consumers. McKinsey does this by trying not only to ‘serve its clients but also to develop its consultants’. Bower and his colleagues believed that well-trained, highly intelligent generalists could quickly grasp the issue, and through disciplined analysis find its solution. Because of the use of knowledge management one of McKinsey’s clients managing director reflected on a certain outcome that â€Å"their value added was in their access to knowledge, the intellectual rigor they bring, and their ability to build understanding and consensus among a diverse management group.† In 1980 when Gluck joined the central small group that comprised the firm office he proposed that â€Å"knowledge development had to be central, not a peripheral firm activity; that it needed to be ongoing and institutionalised, not temporary and project based; and that it had to be the responsibility of everyone, not just a few†. Gluck was trying to build a shared body of knowledge throughout the firm. Even though doing this may be costly Gluck was hoping the benefits would outweigh the expenses. Knowledge had created value for McKinsey and Company through that its client’s impact studies indicated that the new knowledge structure led to a longer-term focus on deeper understanding of issues. McKinsey and Company’s use of knowledge throughout the firm helped build long lasting client relationships. Gupta believed that knowledge was the core factor in being successful in the long run. Knowledge is a fundamental value for the McKinsey and Company. Even though focusing on developing knowledge throughout the firm may lead to less client work Gupta argued that it was still worth it and would increase value for the firm in the long term. Critically evaluate the company’s soft knowledge management strategy. I.e people. Soft knowledge management is â€Å"less quantifiable and cannot be captured codified and stored easily† (Kidd, 1994; Skyrme, 1998) Tacit knowledge is an example of soft knowledge. Tacit knowledge â€Å"cannot be easily communicated and shared, is highly personal, deep rooted in action and in an individual’s involvement within a specific context. It is commonly referred to as ‘the knowledge in people’s heads†. â€Å"Soft knowledge becomes accepted by virtue of informal authority and consensus within the group.†(Hildreth, Wright and Kimble, 2005). Gluck felt that there was a need to adjust the firm’s knowledge development focus. He believed that â€Å"knowledge is only valuable when it is between the ears of consultants and applied to clients problems.† Knowledge is less effectively developed through the disciplined work a few than through the spontaneous interaction of many. He changed the more structured â€Å"discover-codify-disseminate† model to an â€Å"engage-explore-apply-share† approach. Which is, a more loose approach. Even though McKinsey had adopted hard knowledge approaches, it still relied heavily on soft knowledge components, such as personal networks, old practices like cross-office transfers and strong ‘one firm’ norms like helping other consultants when they called. Unlike the hard knowledge approach the transfer of knowledge with the soft approach is not through databases and ‘Knowledge Resource Directory’s† it is a more informal method. It is when the older staff of the firm helps and teaches the new comers by sharing their experience an d knowledge.

The Conception of Substance Dualism

The Conception of Substance Dualism Rene Descartes, a 17th century French philosopher, created the idea of Substance dualism. Descartes states that the mind and the body are two separate entities that possess different characteristics. The mind, a theoretical substance, cannot be viewed in space as a material substance using tradition measuments such as height or weight. Because of this, only the physical body can be extended, not the mind, separating the two into the theory of substance dualism. Throughout the many Meditations, multiple concepts are introduced in order to prove this seemingly complex notion.A principle that Descartes often employed and of great interest to me is that nothing can come from nothing and provides an excellent basis for the many ideas surrounding substance dualism. Descartes concluded that because no perfect idea can be created by something imperfect, the idea that an indefinitely perfect God exists must have been place in us by a perfect God. Descartes uses very complex and convincing arguments to prove the existence of God and the separation of mind and body. Cartesian theory essentially proves each sub-idea until the main idea is reached.By using a step-by-step methodology for proving God’s existence and substance dualism, it is very difficult to find a flaw in his theories. Because nonexistence is an imperfection, God must exist because he has placed a perfect thought of him into us. This is Descartes first reasoning as to why God exists. Next Descartes says that because deception is an imperfection, God cannot be a deceiver, loosely disproving doubt of objects and surroundings. Descartes reasoning for separating mind and body is as follows.He states that because I have a clear and distinct conception of myself as a thinking thing without extension, the mind cannot exist in space. Because he also recognizes the body however as having extension, It cannot be a res-cogitans. Despite his methodology, it is difficult to agre e with Descartes on his theory of substance dualism. He connects each idea in a logical way, but the main picture seems too irrational. If the mind and the body are separate as he states using the theory of doubt, what is the agent of movement and extendibility for the body?If the mind is not extendible, it seemingly cannot control the function of a body. Descartes states later on that the mind connects to the body through the Pineal gland. Most Cartesian theorists, refuse to accept this theory because it contradicts Descartes original theory of substance dualism. A non-extendable object cannot connect to an extendable one because Descartes argues that the mind is immeasurable in space. In addition, Descartes has no grounds to question the existence of his own body. According to him, Gods very existence proves his perfection.A perfect God is incapable of deception meaning that all objects on earth exist, including our bodies. In conclusion, Descartes does an admirable job in creatin g a logical format that shows how God can exist. Furthermore, his belief that the mind and body are separate entities based on extension and thought makes sense until he questions the existence of our bodies. In doing this, Descartes is contradicting his original theory about deception and raises new questions. Descartes makes good arguments but is missing key concepts that cause his theory to ultimately fail.

Should Athletes Use Performance Enhancing Drugs - 935 Words

Roy Shurn Jr English 12 Ms. Terry 11/20/14 PED users in sports Everyone wants to win and everyone loves a winner. Athletes are a competitive group and if you are good enough to get into professional sports, you can achieve fame and fortune would you cheat to accomplish? This is the question that many athletes have to answer? What do I mean by cheating? I mean the use of performance enhancing drugs. How many records were made and broken by athletes that used these enhancements. â€Å"According to Marvin Olasky â€Å"Baseball needs to put the steroids era behind if by having and enforcing tough rules against all kinds of arterial advantages so that spring can return Just what are performance enhancing drugs†? What is the history of†¦show more content†¦Anabolic steroids abuse side effects in men and women different. Men can develop breasts and woman may stop menstruating which can cause major damage to the human body. These side effects are permanent even when the steroid use is discontinued. All parts of the body can be affecte d including your behavior studies on steroids abuse reported that anabolic steroids taken in high doses increase irritability and aggression. Many former abusers have reported that they are more aggressive and physical then before the use of anabolic steroids. The most toxic drugs of all steroids that’s athletes are using man made drugs are very sneaky and can’t not be traced by present day drug test also these designer steroids have not being approve by FDA (Food and Drugs Administration). According to Jim Sensenbrenner Several professional athletes have wrongly taught many young Americans by example that the only way to succeed in sports is to take steroids. Designer steroids are anabolic steroids or other steroid-like performance-enhancing drugs designed to be undetectable in drug testing. So when you take a drug test you might get away with it. Banned in most athletic organizations and contests worldwide, some athletes have nevertheless sought ways around the bans just like any other steroids. There are so many thing you can get away with using this drug I think there are some players that got away and never got caught like Alex Rodriguez. Lance Armstrong he has won medals in the