Category: Population

Planning in an organization is very critical as it gives direction on what should be done and procedures to be followed. The CDC evaluation model is used in the obtaining of the program policies in healthcare and sickness arresting. The model possesses six steps which are based on feasibility, utility, accuracy, and propriety (CDC, 2021). These steps are involving stakeholders, outlining the program, concentrating on the evaluation perspective, collecting dependable confirmation, supporting conclusions, guaranteeing use, and sharing lessons (CDC, 2021). The Palm Island Indigenous population is the subject study in which the report shows the need for evaluation to help society and its strategy. Additionally, another objective is to raise the number of people who have received the barge of COVID-19 vaccines.

The CDC evaluation design utilizes the six steps to come up with better implementation and revision of the program strategy. The engagement of stakeholders is the first step where the Australian Government Department of Health and the Queensland Government are mainly involved. The framework gives a comprehensive tool in the vaccination and immunization program. The objectives and goals of the program are discussed in conjunction with its target groups and strategies.

The different stakeholders play unique roles to make the plan a success. The evaluator is responsible for overseeing the future and present outcomes. The evaluation includes the target population involving individuals receiving the vaccine to determine its efficiency. They should maintain their lifestyle and provide relevant feedback and report any issues related to COVID-19. The Queens Health department supports the vaccination and provides a disease-free community. Australia Immunization offers vaccination delivery services, the register monitors coverage, digital health maintains the record and the pharmacovigilance monitors adverse effects after the immunization process.

The description of the program indicates the challenges faced by the target population during the alarming pandemic. The group was underestimated in receiving medical attention during the corona period hence facing high health risks. The aged and people with pre-existing conditions like diabetes, pressure, and obesity were the most affected. A lifestyle that is diverse between the indigenous people and Australians posed a difference in the risk factors faced. False beliefs, lack of knowledge, and unhealthy lifestyles were the most contributing factors.

Links to Current Policies and Framework

The Queensland Government and the Australian Government Department of Health have a framework for the vaccination of COVID-19 for the indigenous population in Queensland.it caters to the population with varying ages as from 12,18, and 60 with the Astra Zeneca and Pfizer vaccines (Melbourne Vaccine Education Centre, 2021). The Australian Government Department of Health has two immunization and vaccination for its people. The table below shows the current policies and frameworks for the program.

Table1: Current Policies and Frameworks

Focus the Evaluation Design and Gathering and Analyzing Evidence

An impact evaluation framework is composed of three elements which include the available resources and constraints, the nature of what is being evaluated, and the nature of evaluation itself. Resources include time, staff, money, volunteers, and materials. Illiteracy can impact people’s lives negatively where most may be unaware of simple practices like keeping social distance. Intermediate outcomes such as changes in policies and behavior also have a great impact. Different evaluation designs and methods used include single group (posttest only), single group (pre and posttest), nonequivalent control (pre and post), and single group (time series).

Single group (posttest) involves taking only one measurement at the end of an intervention and its only targets the participants. A single group (pre and post) is where two measurements are taken one before the intervention and another one after (Adeoye et al., 2020). This design is suitable as it gives room for change to be observed appropriately. In a non-equivalent group, two tests are done before and after for two groups (Chesney et al., 2020). Single group time series involves multiple measures over some time only for the participants. The natural changes are being observed and the external influences. Limitations to the evaluation differ depending on the nature and size of the population. The generalization of data can sometimes give false implications of the trends involved. Age difference, inadequate timing, difficulty in locating documents, and writing reports.

Table 2: Threats to Internal Validity

Table 3: Threats to External Validity

Sampling Plans

Sampling plans provide a basis on which research is to be conducted. It has five steps that must be followed beginning with the identifying of the parameters to be measured, range of possible values, and needed resolutions (Wu et al., 2018). A sampling scheme should be designed to determine how and when the data will be collected. Selection of the sample sizes by grouping them if possible by considering similarities and differences. Design of data storage formats if in tables, graphs, or chat formats and finally assigning roles and responsibilities to each stakeholder. The participants were recruited using methods targeting the right audience, screening, incentivizing, and sustaining.

Sampling Methods

Sampling methods like simple random, systematic, and stratified, and cluster were embraced. Simple random sampling provides an equal chance for every member of a population. Tools like random number generators and techniques entirely based on chance are applied. Systematic sampling has similar characteristics to simple but it’s easier to conduct (Li et al., 2018). Every individual involved in the exercise is listed with a number but they are chosen randomly. Stratified sampling involves small subdivisions of populations into groups and conclusions are drawn (Varshney et al., 2017). Cluster sampling also involves the division of the populations but each group has similar characteristics.

Table 4: Developing an Evaluation Plan

Developing an evaluation plan involves the need to achieve the desired objectives. The various methods applied include interviews, observation, single group tests, using test kits and questionnaires (Quek et al., 2017). Personal interviews cover the interrogation on how people been affected by the virus have been coping with the changing lifestyle and how their relationships have changed (Callwood et al., 2018). Observations were made on the general behavior of people, social interaction, and their day-to-day activities. COVID-19 test kits are also used to give quick and accurate tests for treatment and prevention of the spread. The duration of doing the research varies from weekly, monthly, and even daily for observations.

Tools used in data collection were conducting questionnaires and interviews. The questionnaire method is very reliable and cheap to use. It involves making a photocopy of papers consisting of the questions and administering them to the target group. It can be used to collect data from a large audience over a short period (Cumpston et al., 2019). Both open and closed questions can be used to provide information that can be converted easily into quantitative data (de Block & Vis, 2018). The questions are standardized and can be suitable for all ages as they are easy to respond to. An estimate of 2000 questionnaires can be filled in a day targeting different groups in various locations like churches, schools, and hospitals.

The interview method involves one-to-one interaction where questions are asked and answers were given. It is suitable for obtaining data from a small group of people. It’s very private since the information given is kept confidential (Falissard, 2021). Reliability is seen where similar groups are kept together and the others isolated and them comparison of data is made. An estimate of 500 participants can be interviewed during a day making it very reliable. It is highly flexible and can investigate different issues in a period.

The method is suitable for the target population since they have different preferences. Patients with pre-existing conditions also need privacy for to reveal their statuses (Hampton and Lenhart, 2019). Both quantitative and qualitative measures were taken during the research. Qualitative measurements tend to have a deeper understanding of why something happens (Alam, 2020). Quantitative measures involve data that can be put in numbers. The mortality rate among sick adults was very high due to emaciated immunity (Lederer et al., 2018). Conducting it privately without the knowledge of the participants showed deviation as to when conducted publicly (Kizlari & Fouseki, 2021). People tend to vary their behavior and they can pretend in some cases or give false implications.

Table 5: Evaluation Plan for the Process Evaluation

The various question asked are important in determining the components of the program. Since most people prefer privacy, administering personal questionnaires can give them the confidence to give out relevant information (Nguyen et al., 2020). Making a general observation on how persons conduct themselves in society can give a general view of the new infection. Some responses need to be noted immediately as they occur. Correspondingly, some cases involve the synthesis of raw data to come up with better assumptions.

Table 6: Justifying Conclusions

Accuracy calls upon the nature of the problems and behaviors to be observed. Distinct variables are preferred since they give researchers easy time. Awareness should be made on why such an activity is taking place, its importance, and its relevance in the general wellbeing of all the individuals (Pennycook et al., 2020). Honesty value should be emphasized since wrong data can lead to delicate decisions in the final state. The culture of a community is sensitive and must be respected (Mariani et al., 2018). One must learn to be compatible with other cultures despite of their uniqueness. Ethical issues must be adhered to by all and equal treatment of persons must be adopted Feasibility issues refer to the inadequate resources, time, and background knowledge on how to conduct the research. To accomplish the tasks in demand, enough resources must be available and be easy to access (Southwood, 2018). Tools used in data collection must be available and valid to minimize on errors. Having prior information in theoretical form enables its application easily.

Table 7: Use and Share of Lessons Learnt

To ensure that the information gathered is effectively used and analyzed, all the stakeholders must be involved. Monitoring on the use of data by creating online portals for patients to interact with doctors. They can get appropriate guidance on what to do when faced with any emergencies and possible first aids. Members of the public can go for the vaccines to protect themselves from exposure.

Timeline

The procedure shown above was relevant in providing a guideline on the evaluation. The first thing was to select a research area (Palm Island Indigenous Population). Research questions gave direction on what to identify and the unique features. methodologies applied were conducting interviews and conducting of questionnaires. Common open and closed questions were asked to determine the wave nature of the virus (Yassouridis et al., 2018). Various groups of participants included people of all ages with their diversity. Data analysis was done using regression mean to determine variance. after all this was done, the first, second, and final drafts were written to sum up the evaluation.

In conclusion, the CDC framework must follow all the six steps for it to be complete. The plan to vaccinate the Palm Island Indigenous Population followed the procedure as it was the most appropriate. The engagement of stakeholders solved the gap of low income and other economic factors hindering them from receiving better services. Majorly, the government of Australians response was critical. Describing the plan by considering possible risk factors and poor communication created a strong foundation and path to be followed. Goals and objectives set created better pathways to the achievement. Educating the target group and creating governing policies such as wearing masks and keeping social distance.

Evaluation designs and methods used include single group (posttest only), single group (pre and posttest), non-equivalent control (pre and post), and single group (time series). They were able to show the trends of data and variations whenever possible. Threats to both internal and external validity were also examined deeply. Program components like knowledge, attitude, behavior, self-efficacy, and health status, social and environmental support. Ensuring use and share of lessons learned by recalling the stakeholders involved and looking for ways to ensure the finding are used.

References

Adeoye, J., Wan, C., & Thomson, P. (2020). An appraisal of pivotal evaluation designs in validating noninvasive biomarkers for head and neck cancer detection. Acta Oncologica, 59(12), 1500-1502.

Alam, M. (2020). A systematic qualitative case study: Questions, data collection, NVivo analysis, and saturation.Qualitative Research in Organizations and Management: An International Journal, 16(1), 1-31.

Australian Government Department of Health. (2021). Immunization for Aboriginal and Torres Strait Islander people. Australian Government Department of Health.

Belk, R. (2020). Ethical issues in service robotics and artificial intelligence. The Service Industries Journal, 1-17.

Callwood, A., Jeevaratnam, K., Kotronoulas, G., Schneider, A., Lewis, L., & Nadarajah, V. (2018). Personal domains assessed in multiple mini interviews (MMIs) for healthcare student selection: A narrative synthesis systematic review. Nurse Education Today, 64, 56-64.

CDC. (2021).Framework for Program Evaluation – CDC. Cdc.gov.

Chesney, T., Bogach, J., Devaud, N., Govindarajan, A., & Wright, F. (2020). How we did it: creating virtual interviews for postgraduate medical trainee recruitment and keeping it personal. Annals of Surgery, 273(2), e60-e62.

Cumpston, M., Li, T., Page, M., Chandler, J., Welch, V., Higgins, J., & Thomas, J. (2019). Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database of Systematic Reviews. Web.

de Block, D., & Vis, B. (2018). Addressing the challenges related to transforming qualitative into quantitative data in qualitative comparative analysis. Journal of Mixed Methods Research, 13(4), 503-535.

Falissard, B. (2021). The future of evaluation of the child and adolescent psychiatric treatments. IACAPAP Arxiv. Web.

Gefen, R., Bruno, M., & Abujudeh, H. (2017). Online portals: Gateway to patient-centered radiology. American Journal of Roentgenology, 209(5), 987-991.

Hampton, M., & Lenhart, O. (2019). The effect of the Affordable Care Act preexisting conditions provision on marriage. Health Economics, 28(11), 1345-1355.

Immunization for Aboriginal and Torres Strait Islander people. (2020). Australian Government Department of Health.

Kizlyar, D., & Fouseki, K. (2018). Treating resistance as data in qualitative interviews. The Qualitative Report. Web.

Lederer, J., Fellner, J., Gassner, A., Gruhler, K., & Schiller, G. (2021). Determining the material intensities of buildings selected by random sampling: A case study from Vienna.Journal of Industrial Ecology, 25(4), 848-863.

Li, L., Yao, Y., Yao, M., & Goodman, E. (2018). Detecting frequency from randomly sampled data implementation of random sampling in Bratumass. SPG Biomed.

Mariani, M., Borghi, M., & Okumus, F. (2020). Unraveling the effects of cultural differences in the online appraisal of hospitality and tourism services.International Journal of Hospitality Management, 90, 102606.

Nguyen, T., Karney, B., & Bradbury, T. (2020). When poor communication does and does not matter: The moderating role of stress. Journal of Family Psychology, 34(6), 676-686.

Pennycook, G., McPhetres, J., Zhang, Y., Lu, J., & Rand, D. (2020). Fighting COVID-19 misinformation on social media: Experimental evidence for a scalable accuracy-nudge intervention.Psychological Science, 31(7), 770-780.

Quek, J., Brauer, S., Treleaven, J., & Clark, R. (2017).The concurrent validity and interrater reliability of the Microsoft Kinect to measure thoracic kyphosis.International Journal of Rehabilitation Research, 40(3), 279-284.

Queensland COVID-19 vaccination information resource. (2021). Queensland Government. Web.

Southwood, N. (2018). The feasibility issue.Philosophy Compass, 13(8).

Vaccination for Aboriginal and Torres Strait Islander people. (2018). Australian Government Department of Health. Web.

Wu, C., Shu, M., & Chang, Y. (2018). Variable-sampling plans based on lifetime-performance index under exponential distribution with censoring and its extensions.Applied Mathematical Modelling, 55, 81-93.

Yassouridis, C., Ernst, D., & Leisch, F. (2018). Generalization, combination, and extension of functional clustering algorithms: The R package fancy. Journal of Statistical Software, 85(9).

Varshney, R., Gupta, S., & Ali, I. (2017). An optimum multivariate-multiobjective stratified sampling design: Fuzzy programming Approach.Pakistan Journal of Statistics and Operation Research, 13(4), 829. Zucker, N., Schmitt, C., DeJonckheere, M., Nichols, L., Plegue, M., & Chang, T. (2019). Confidentiality in the doctor-patient relationship: perspectives of youth ages 14-24 Years. The Journal of Pediatrics, 213, 196-202.

In the present day, coronavirus disease (COVID-19) may be regarded as a health problem of a global scale. Identified in Wuhan, China at the end of 2019, this severe acute respiratory syndrome has spread across the globe and affected more than 180 countries (Sanyaolu et al. 2020). It infects humans at a highly alarming rate regardless of their age, ethnicity, and sex. The confirmed cases of COVID-19 have a considerably wide range of symptoms “from mild complaints, such as fever and cough, to more critical cases associated with difficulty in breathing” (Sanyaolu et al. 2020, 1070). The major symptoms of this disease include fever, cough, shortness of breath, chills, sore throat, muscle aches, unexplained loss of smell and taste, headache, and diarrhea. In general, clinical manifestations of COVID-19 range from a typical cold to considerably more severe illnesses such as pneumonia, bronchitis, multi-organ failure, severe acute respiratory distress syndrome, and death (Sanyaolu et al. 2020). As a matter of fact, there are still multiple limitations to knowledge related to this virus as it continues to evolve.

At the same time, there is evidence of the ability of COVID-19 to cause lasting damage to health. According to Chalmers (2020), even after being diagnosed with and recovering from the disease several months ago, coronavirus survivors currently report that they still suffer from breathlessness, fatigue, and problems. In general, the majority of coronavirus patients recover within fourteen days suffering cough, losing the sense of taste and smell, and fever for several days (Chalmers 2020). However, by some estimates, one in three coronavirus survivors, even young and relatively healthy individuals, develops particular symptoms that linger for weeks (Mervosh 2020). These symptoms traditionally include a racing heart, deep exhaustion, and piercing chest pain. People who suffer from the comorbidities of COVID-19 call themselves “long haulers” (Chalmers 2020). Despite the fact that these people are not contagious as they have already recovered, the disease’s lasting complications considerably affect their everyday life. These patients frequently struggle to complete simple tasks without a racing heart and extreme tiredness.

In the present day, despite particular attention to racial issues in the United States, the inequalities in the health care system still exist. Due to general inequities in the public health system of the United States, such as a lack of health insurance caused by low income and unemployment, limited access to health care services, and the underrepresentation of Black specialists in medical settings, morbidity and mortality rates within the Black community, including all Black citizens regardless of their place of birth or origin, are considerably high (Gilbert et al. 2016). It goes without saying that social and economic factors currently affect Black people as well, and they are more vulnerable to the infection of COVID-19 and its negative consequences. According to recent data released by public health researchers, the coronavirus is killing Black people at disproportionally high rates (Eligon et al. 2020). In addition, across the country, they generally account for more than half of those people who have positive tests (Eligon et al. 2020).

For the majority of public health experts, the reasons behind high and disproportionate mortality rates from COVID-19 among the Black population are easily explicable (Eligon et al. 2020). Black citizens frequently do not have an opportunity to work from home as they hold “a disproportionate share of retail, municipal, first responder and other jobs that interact directly with the public and have been deemed essential throughout the pandemic” (Higgins-Dunn et al. 2020). In addition, Black health care providers are overrepresented in hospitals (Green & Moore, 2020). That is why they are exposed to a greater risk of coronavirus infection in comparison with White employees who work remotely in the spheres of economics, finance, and information technologies.

As previously mentioned, a substantial number of patients have additional symptoms of COVID-19 that may linger for several months after recovery. Taking into consideration the fact that the virus disproportionately affects Black communities in the United States, it is possible to conclude that the majority of “long haulers” will be Black people who will suffer from the long-term effects of the coronavirus at disproportional rates as well. In addition, the access Black people have to medical services is frequently limited due to their financial state and a lack of nurses and doctors in the Black community (Wingfield 2020). That is why, without appropriate and time-sensitive treatment, they are exposed to a greater risk of diabetes, hypertension, and chronic respiratory illnesses in comparison with the White population. According to recent researches, these comorbidities “increase the chances of infection” (Sanyaolu et al. 2020, 1071). Consequently, Black people suffer from both severe symptoms of COVID-19 and illnesses that may develop on the background of the virus.

In general, COVID-19 and its long-lasting negative health conditions disproportionally affect Black patients and their jobs as their reports concerning their general state are not well-regarded. According to Green and Moore (2020), 39% of positions held by black workers are at considerable risk, opposite to 34% for white employees. Moreover, Black coronavirus survivors have admitted that they have not been paid for several months despite their inability to work that should presuppose their need in paid leave (Mervosh 2020). Physicians and employees frequently regard patients’ chronic pain conditions and inability to breath as ordinary anxiety or stress (Mervosh 2020). At the same time, if the changes of policy in order to reduce racial disparities in the public health system are not initiated on the federal level, Black citizens will be more vulnerable to severe illnesses from the coronavirus in comparison with white citizens.

References

Chalmers, Vanessa. 2020. “How Covid-19 causes lasting damage: Three survivors in their 20s reveal they STILL suffer fatigue, racing hearts and breathlessness MONTHS after they were first sick.” Mail Online, Web.

Eligon, John, Audra D. S. Burch, Dionne Searcey, and Richard A. Oppel Jr. 2020. “Black Americans Face Alarming Rates of Coronavirus Infection in Some States.” The New York Times, Web.

Gilbert, Keon L., Rashawn Ray, Arjumand Siddiqi, Shivan Shetty, Elizabeth A. Baker, Keith Elder, and Derek M. Griffith. 2016. “Visible and Invisible Trends in Black Men’s Health: Pitfalls and Promises for Addressing Racial, Ethnic, and Gender Inequities in Health.” Annual Review of Public Health 37: 295–311.

Green, Jeff, and Donald Moore. 2020. “Covid-19 Is Hurting Black Americans More in Almost Every Way.” Bloomberg, Web.

Higgins-Dunn, Noah, Will Feuer, Berkeley Lovelace Jr., and Jasmine Kim. 2020. “Coronavirus Pandemic and George Floyd Protests Highlight Health Disparities for Black People.” CNBC, Web.

Mervosh, Sarah. 2020. “‘It’s Not in My Head’: They Survived the Coronavirus, but They Never Got Well.” The New York Times, Web.

Sanyaolu Adekunle, Chuku Okorie, Aleksandra Marinkovic, Risha Patidar, Kokab Younis, Priyank Desai, Zaheeda Hosein, Inderbir Padda et al. 2020. “Comorbidity and its Impact on Patients with COVID-19.” SN Comprehensive Clinical Medicine 2: 1069–1076.

Wingfield, Adia Harvey. 2020. “The Disproportionate Impact of Covid-19 on Black Health Care Workers in the U.S.” Harvard Business Review. Web.

Population health promotion entails improving the community’s quality of life by providing primary, secondary, and additional healthcare services. As a result, the community health nurse must supervise the community members in order to manage and control their health medical condition. The essential duty of the nurse in collaboration with community stakeholders is to lead and advise them on healthy practices that can promote community health (Schildmeijer, 2019). For example, the public health nurse may encourage community stakeholders to advocate for the renovation of toilets in each community household. Hence, the nurses would supply primary care through local stakeholders who can help prevent disease development in the community. The nurses can also use community stakeholders to arrange a community meeting at which they can consult and teach the community about health-seeking behavior and wellness promotion activities.

Appraising community resources such as religious and charitable organizations is critical to increasing community awareness about health promotion. Religious institutions, for example, are opposed to particular social acts that can aid in the spread of diseases, such as premarital sex. Appraising such principles in such institutions contributes to a better understanding and participation of the community in disease control and prevention. Moreover, spiritual organizations, such as Catholic Charities, play a crucial role in delivering resources and facilities to those in needs. Through collaborations between communities and research institutions, non-profit community resources promote human welfare and social justice. They generally define health as physiological, mental, affective, social, and spiritual well-being. They value collaborative methods to health that focus on improving the conditions and surroundings in which people reside. To sum up, all the functions mentioned above that different community resources carry become an essential factor in population health promotion.

Reference

Schildmeijer, K. (2019). A Day in the Life of a Community Health Nurse in Sweden. Home Healthcare Now, 37(6), 362.

Major themes in current population health outcomes and healthcare service delivery are post-pandemic recovery, equalization of access to consumers and workers, and expansion while optimizing. Both health areas are slowly returning to pre-COVID-19 performance and operation levels. In terms of population health outcomes, changes in indicators like general and infant mortality and life expectancy “show that the health status in the U.S. population is improving over time, although racial and ethnic disparities persist” (Health status, 2022, para. 12). The equalization of access to healthcare resources and services occurs via constantly improving communication with communities, offering more affordable medical coverage, and bettering infrastructural and socioeconomic accessibility to specialists (Health care access and quality, n.d.). Expansion while optimizing refers to the ongoing virtualization of health data and methods for conducting interventions and trials (Clinical research trends & insights for 2022, 2022). It also implies an overall improvement in IT-related health service delivery approaches, such as telehealth. Some significant milestones have been reached, but most goals are yet to be achieved, and recovery is still in progress.

On Top Priorities for Population Health Researchers

Population health researchers’ top priorities should be treating and preventing widespread, complex, and severe diseases. Namely, cardiovascular, respiratory, and pulmonary conditions and oncology. These are the most influential causes of death in America and globally in terms of diseases (Health status, 2022). Focusing on them requires medical workers to take an interdisciplinary, comprehensive approach with constant revision and modernization of techniques, methods, and technologies for research, diagnosis, and treatment. The choice of this direction in priorities will reduce morbidity and mortality from the conditions mentioned above among all ages and better the overall well-being of the population.

On Top Priorities for Clinical Researchers

Looking at the ongoing trends in clinical research, I think this healthcare sector is on the right path. Experts say that it is “moving towards more agile approaches and a next-generation clinical trial execution model” (Clinical research trends & insights for 2022, 2022, para. 48). It is a wisely chosen priority, as healthcare is a field of intense international academic dialogue now. Such a climate allows for the rapid and efficient upgrading of conventional study approaches and the exchange of novel, revolutionary ideas. I think that clinical researchers should focus on building stronger inter-professional relationships, especially with hospital workers and policymakers. It will make goal setting and planning clearer, more realistic, and more objective and optimize resource allocation across all three health sectors.

On Important Trends for Healthcare Administrators

Being a health care administrator is demanding, and knowing internal field trends dramatically helps those who work there. As communities grow and become more diverse, their needs transform into more complex and nuanced ones. The impact of information and big data management is becoming increasingly significant (Emerging trends in health care administration for 2022, 2022). Nowadays, it is a critical area that all healthcare administrators should pay attention to. Efficient handling of it saves material resources, money, and time for medical organizations and providers working in those. Increasing the capacity for medicines and medical consumables in hospitals is another topic they should consider. Fortunately, the pandemic has not stopped globalization, and talented people from different ethnic, cultural, and religious backgrounds continue to enter the health industry. Therefore, health administrators should also begin to develop programs that better workplace diversity and promote ideas related to inclusion in the workforce.

References

Clinical research trends & insights for 2022. CenterWatch. Web.

Emerging trends in health care administration for 2022. Columbia Southern University. Web.

Health care access and quality. (n.d.). Office of Disease Prevention and Health Promotion. Web.

Health status. (2022). United States Environmental Protection Agency. Web.

Background

The author of this paper is currently working with their course faculty on developing a practice question based on the needs assessment. As the number of African-American population with prediabetes grows, new types of intervention are required.

PICOT

• Population: African-Americans are an endangered category, as in 2016, they suffered kidney disease caused by diabetes 2.0–2.5 times more often than whites (Burrows et al., 2020). In the earlier years, African-Americans had a high percent of those with diabetes compared to those without it (Eberhardt et al., 2018). Racial minorities suffer undiagnosed diabetes more often as well (Mercado et al., 2021).
• Intervention: the author already has the idea on self-evidence based intervention, and research shows that the Centers for Disease Control (CDC) practice evidence-based diabetes management interventions available to high-burden communities (Burrows et al., 2020).
• Comparison: the author knows that there is an insufficient care for African-Americans with prediabetes. The author’s work with DSMES proves that an evidence-based self-intervention may be applied via lowering blood sugar as high blood sugar (hyperglycemia) is a characteristic of diabetes.
• Outcome: As the author develops the PICOT format, they assume that lowering blood sugar will assist the patients. As psychological distress is related to impaired blood sugar control in people with diabetes, treating psychological issues can improve their health (Tavakoli & Kazemi-Zahrani, 2018). Mindfulness Based Stress Reduction (MBSR) has methods for it, which include yoga, exercises, and reevaluating the negative experiences from a different angle.
• Timeline: the plan is to decrease blood sugar in 8-10 weeks.

PICOT Results & Practice Question

• P: African-American population with prediabetes.
• I: Self-evidence based intervention.
• C: DSMES: Lower blood sugar.
• O: Outcome: Decrease blood sugar by MBSR methods.
• T: 8-10 weeks.

Practice Question

What evidence-based interventions included in Mindfulness Based Stress Reduction are the most optimal to lower blood sugar for an African American person in 8–10 weeks? What interventions are more effective when applied for longer or shorter periods?

The author’s PICOT question addresses the problem in that it deals with one of the measures which can be applied to prevent diabetes by lowering blood sugar levels. As African-Americans are an endangered category, they can benefit from these measures. The outcome, which is the lowered blood sugar level, has the direct connection to the evidence-based intervention as the evidence is the heightened blood sugar level measured by a professional via a test.

References

Burrows, N. R., Zhang, Y., Hora, I., Pavkov, M. E., Sheff, K., Imperatore, G., Bullock, A. K., & Albright, A. L. (2020). Sustained lower incidence of diabetes-related end-stage kidney disease among American Indians and Alaska Natives, Blacks, and Hispanics in the U.S., 2000–2016. Diabetes Care, 43(9), 2090–2097.

Eberhardt, M. S., Casagrande, S. S., & Cowie, C. C. (2018). Sociodemographic characteristics of persons with diabetes. In C. C. Cowie, S. S. Casagrande, A. Menke, M. A. Cissell, M. S. Eberhardt, J. B. Meigs, E. W. Gregg, W. C. Knowler, E. Barrett-Connor, D. J. Becker, F. L. Brancati, E. J. Boyko, W. H. Herman, B. V. Howard, K. M. Venkat Narayan, M. Rewers, & J. E. Fradkin (Eds.), Diabetes in America, 3rd Edition (pp. 8-1–8-67). National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases.

Mercado, C., Beckles, G., Cheng, Y., Bullard, K. M., Saydah, S., Gregg, E., & Imperatore, G. (2021). Trends and socioeconomic disparities in all-cause mortality among adults with diagnosed diabetes by race/ethnicity: A population-based cohort study – USA, 1997–2015. BMJ Open, 11(5), e044158.

Tavakoli, Z., & Kazemi-Zahrani, H. (2018). The effectiveness of mindfulness based stress reduction intervention on emotion regulation problems and blood sugar control in patients with diabetes type II. Global Journal of Health Science, 10(3), 111.

Aging is an unstoppable process in all human lives, which can be perceived in biological, psychological, or sociological dimensions. However, the term “old age” is related not as much to biological reasons but to the sociological concept. Various social theories explain the complex relationships between elderly people and the societies they live in. It was insightful to learn that older adults are the largest social group in the United States, with more than 54 million people in 2019 (Barreto & Lin, 2020). Therefore, nursing has to adhere to and develop new strategies to provide high-quality healthcare to the growing population of older adults. Some of the most important issues that have to be addressed are listed in this response.

Among the social, economic, and financial challenges that elderly patients face, the healthcare demand in this group is higher. Numerous health complications are specifically associated with aging. For instance, falls, limited or complete immobilization, hindered hearing or vision, and mental health diseases such as dementia, make elderly people especially vulnerable (Hinberg, 2019). Therefore, special ethical guidelines and training are being developed to target geriatric departments in healthcare facilities.

As experts in the field, it is crucial to be aware of potential ethical dilemmas when working with the aging population. Complex family relationships, end-of-life requests, upholding respect and dignity, encouraging independence, and ensuring the person’s safety are just a few examples of the many contexts in which ethical dilemmas could arise. Age-related vulnerabilities to maltreatment, neglect and malicious intent can result from various circumstances. Knowing about these factors can help nurses better understand how to prevent damage, support older adults, and report problems to the appropriate authorities when they arise.

References

Barreto, T., & Lin, S. (2020). Access to prenatal care among vulnerable populations in the United States. In APHA’s 2020 VIRTUAL Annual Meeting and Expo. APHA. Web.

Hinberg, B. (2019). Caring for Older Patients. Radiologic Technology, 90(3), 278-278.

A Proposal

Problem Description

This project proposal focuses on the problem of the opioid epidemic in the United States. As reported by the U.S. Department of Health and Human Services (2021), “an estimated 10.1 million people aged 12 or older misused opioids” in 2019 (para. 7). Specifically, over 96% of these individuals abused prescription pain relievers (U.S. Department of Health and Human Services, 2021, para. 8). Different social groups seem to be disproportionally affected by this issue. Research shows that veterans are at an increased risk of mortality due to opioid overdose compared to the general population (Midboe et al., 2019). In addition, according to the Substance Abuse and Mental Health Services Administration (2018), survey findings demonstrate that 3.7 million retired soldiers have a mental health problem, a substance use disorder, or both (p. 7). At the same time, veterans are willing to receive treatment, which indicates the importance of implementing an effective policy to resolve the problem.

The existing policies provide a foundation for addressing the opioid mortality problem in veterans. For instance, one of the measures is the implementation of the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act (2018). Such a policy aims to reduce opioid prescriptions, improve care for female veterans, and support research to prevent drug misuse among retired soldiers. Another alternative is the Veterans Affair’s opioid safety initiative, which is expected to reduce the percentage of veterans dependent on opioid medication use (U.S. Department of Veterans Affairs, 2019). Finally, the Hawaii Opioid Initiative focuses on decreasing the number of retired soldiers with substance use disorders who require professional help (“The Hawaii opioid initiative,” 2017). Overall, current policies need to be supported by effective alternatives for a comprehensive approach to the problem. This proposal aims to outline three policy alternatives to be implemented at the state level to supplement the existing federal initiatives.

Stated Alternatives

The first alternative is to reduce the frequency of opioid prescriptions by providing relevant education and training for Hawaii clinicians to encourage them to utilize alternative treatment methods for veterans in need of pain management. This strategy can help decrease the morbidity rate resulting from opium-based medicine overdose. According to Sandbrink et al. (2020), “opioid prescribing was recognized as an important contributor to the U.S. opioid crisis” (p. 927). At the same time, different pain management options can be used, such as acupuncture, yoga, non-addictive medications, and art or cognitive behavioral therapy (Sandbrink et al., 2020). Reducing the number of opioid prescriptions would mitigate the leading cause of higher morbidity rates among retired soldiers. Therefore, this initiative should focus on organizing and providing training for clinicians at the state level regarding opioid safety and overdose in veterans and explaining other treatment options available for such populations. For instance, the education plan can include lectures or webinars by experts on this subject, access to evidence-based resources on opioid and nonopioid medications, and regular meetings of clinicians to exchange knowledge and discuss relevant issues.

The second policy alternative is to introduce a Hawaii program for identifying and monitoring veterans at an exceptionally high risk of opioid overdose. For instance, a risk assessment tool can be developed to collect and analyze veterans’ data and identify patterns of problematic behavior. Such a measure can include a survey measuring one’s symptoms that might indicate an increased risk of depression, overdose, or suicide. This initiative would allow for early intervention and effective management of the opioid crisis. Associated risk factors that can increase the probability of overdose in veterans include mental health problems, suicidal thoughts and behavior, severe chronic pain, drug or alcohol issues, and others (Sandbrink et al., 2020). Therefore, individuals that fall under these categories should be monitored closely. Based on the risk assessment findings for specific individuals, measures can be suggested to reduce the probability of overdose and suicide events. Implementing this policy alternative would focus on identifying individuals needing close monitoring and additional support to prevent overdose.

The third policy option involves providing veterans with access to self-care programs at a state level that help improve mental health and manage pain through nonpharmacological methods. As noted by Meerwijk et al. (2020), such initiatives can decrease the “risk of long-term adverse outcomes” in veterans with chronic pain (p. 775). Self-care programs should educate patients on the importance of nutrition, exercise, massage, yoga, and psychotherapy and explain self-care strategies to reduce pain and stress in retired soldiers. This initiative can be implemented in healthcare and rehabilitation facilities to raise patients’ awareness about the importance of nonpharmacological treatment for one’s well-being and pain management. Healthcare personnel should be involved in providing access to relevant resources and additional information for veterans. Overall, this policy alternative can help address the problem of opioid overdose by providing the population with knowledge and methods to improve mental and physical health without using medication.

Criteria

The criteria for measuring policy outcomes include political acceptability, cost, and effectiveness, namely, reduced veteran mortality rates and the number of people taking opioids. In this regard, political acceptability will be evaluated based on a favorable perception of the policy among the public in the U.S. political context (Shahab et al., 2019). The cost will be measured by evaluating the total cost of each policy option. Finally, the effectiveness criterion will be assessed with regard to the reduction of opioid overdose deaths in veterans and the number of people taking opioids.

References

Meerwijk, E. L., Larson, M. J., Schmidt, E. M., Adams, R. S., Bauer, M. R., Ritter, G. A., Buckenmaier, C., & Harris, A. H. (2020). Nonpharmacological treatment of army service members with chronic pain is associated with fewer adverse outcomes after transition to the veterans health administration.Journal of General Internal Medicine, 35(3), 775–783. Web.

Midboe, A. M., Byrne, T., Smelson, D., Jasuja, G., McInnes, K., & Troszak, L. K. (2019). The opioid epidemic in veterans who were homeless or unstably housed.Health Affairs, 38(8), 1289–1297. Web.

Sandbrink, F., Oliva, E. M., McMullen, T. L., Aylor, A. R., Harvey, M. A., Christopher, M. L., Cunningham, F., Minegishi, T., Emmendorfer, T., & Perry, J. M. (2020). Opioid prescribing and opioid risk mitigation strategies in the veterans health administration.Journal of General Internal Medicine, 35(3), 927–934. Web.

Shahab, S., Clinch, J. P., & O’Neill, E. (2019). Impact-based planning evaluation: Advancing normative criteria for policy analysis.Environment and Planning B: Urban Analytics and City Science, 46(3), 534–550. Web.

Substance Abuse and Mental Health Services Administration. (2018). 2018 National survey on drug use and health: Veterans. Web.

Substance Use-Disorder Prevention That Promotes Opioid Recovery and Treatment (SUPPORT) for Patients And Communities Act, Publ. L. No. 115–271 (2018). Web.

The Hawaii opioid initiative: A statewide response. (2017). Web.

U.S. Department of Health and Human Services. (2021). Opioid crisis statistics. Web.

U.S. Department of Veterans Affairs. (2019). Opioid safety initiative. Web.

Health Science is a commitment to improve the health of the population through the necessary science research. The current environmental situation requires careful monitoring of people’s life and this profession is a high chance to contribute to the future of mankind. A career as a specialist in this field has a great impact on society and is seen as essential. Thus, specialists make a great contribution to the development of the planet through their knowledge and skills. Thus, in the field of work at the Institute of Health, it is important to have high communication skills, work with high technologies and to think critically.

Within this profession, a specialist covers a wide range of knowledge and standards. In this regard, one can find a job in a specific scientific field where a person will be engaged in health research in the health care system. In addition, many healthcare institutions are constantly looking for a highly qualified specialist. It is important that they not only have knowledge in the field of medicine, but demonstrate broad skills regarding the latest approaches to public health (Daniel & Cross, 2018). Associate degree in Health Science assumes that the employee has a proper understanding of innovative technologies that are constantly being introduced into the medical sphere.

Moreover, the range of specialist standards includes the analysis of the physical and psychological health of both an individual patient and a certain group of people or population of a given geographical space (Kim et al., 2019). An employee in this field takes on the task of spreading knowledge about a healthy lifestyle, environmental protection (Shorey et al., 2019). Furthermore, within the framework of their specialization, research is conducted on the environmental situation in the world and the problems in this area facing the medical community.

The Health Science worker takes responsibility for promoting among the population respect for the environment, as one of the main factors affecting the health of the nation. At the same time, an important role is played by the development of communication skills and the ability to systematize and analyze a large amount of information (Peat et al., 2020). In addition, the capacity to understand diseases, to distinguish their symptoms, to successfully and stressfully stand up and act in emergency situations, define a good health specialist.

As for other responsibilities and development in the profession, the possibilities are quite extensive. First of all, the employee must understand the range of his knowledge and those areas that need to be studied more information. The specialist is obliged to think critically, since the main occupation in their field is not only research, but the development of methods and measures of public health in the country (Dos Santos, 2019). These methods are aimed at improving the average level of health of the population and their lifestyle, so that people lead a longer and pain-free life. Moreover, in matters of protecting the health of individuals, the employee can help with legal support or advice.

In conclusion, it should be said that the field of work of a specialist in Health Science is extremely diverse and requires constant updating of knowledge. Moreover, the employee must understand the full responsibility that lies with them in the framework of protecting the environment and improving public health. On the one hand, you need to be prepared to conduct research and the ability to critically process information. On the other hand, working with people requires high communication skills, which requires the employee to constantly improve.

References

Daniel, W. W., & Cross, C. L. (2018). Biostatistics: a foundation for analysis in the health sciences. Wiley.

Dos Santos, L. M. (2019). Evaluation checklist for English language teaching and learning for health science professionals. World Trans. Eng. Technol. Educ, 17(4), 431-436.

Kim, Y. J., Radloff, J. C., Stokes, C. K., & Lysaght, C. R. (2019). Interprofessional education for health science students’ attitudes and readiness to work interprofessionally: a prospective cohort study. Brazilian Journal of Physical Therapy, 23(4), 337-345.

Peat, J. K., Mellis, C., Williams, K., & Xuan, W. (2020). Health science research: A handbook of quantitative methods. Routledge.

Shorey, S., Ang, E., Yap, J., Ng, E. D., Lau, S. T., & Chui, C. K. (2019). A virtual counseling application using artificial intelligence for communication skills training in nursing education: development study. Journal of Medical Internet Research, 21(10), 14-27.

Introduction

The building of dams in the Pacific Northwest started later in the 19^th century. These early dams were mainly constructed on small rivers or tributaries for the purpose of irrigation. In the first years of the twentieth century, the first hydropower dams were constructed on the tributaries of the Columbia River (National Research Council 231 ). As the century progressed on, dam building activities were stepped up due to the increase in the demand for hydropower.

The construction of the Bonneville and the Grand Coulee were initiated in late in the 1930s and this was followed by a marked increase in the number of dams and their storage volumes in Oregon, Washington and Idaho (Bonneville Power Adminstration 3).

“Forty five years after the authorization of the Bonneville (1933), 14 dams on the Columbia River and 13 on the Snake River had been constructed” (National Research Council 131). By early 1980s, there were no more sites for large dam construction. Furthermore, public approval for such projects had significantly diminished and thus signaling the end of the growth phase.

At the completion of the rapid growth phase it was now obvious that the dams were posing a major threat to ecological sustainability. Most of the “dams were built on the migratory routes of the most west Pacific Northwest salmon runs” (Stewart 45). Various mitigation measures have been taken to address this issue but not much has been achieved.

This paper therefore seeks to identify the effects of the Columbia River dams on salmon runs. Though the effects are mostly negative, the paper will go further to identify if there is any benefits that have been created by the dams to the salmon population.

Negative effects

Many species of salmon breed and grow in the riffles of cold-flowing rivers far from the sea (Stewart 57). The young salmons often migrate to the sea where they live for several years before returning home to breed. The man made dams have prevented the fish from travelling up and down the river ways, despite mitigating measures such as the construction of fish ladders (Dube 13).

The insufficiency or lack of fish passage facilities have led to the loss of the upstream habitat. The dams constructed across the Columbia River blocks close to one third of the watershed from being accessed by anadromous fishes. The barriers are mainly associated with the Grand Coulee Dam which accounts for a third of the passage barriers (National Research Council 132 ).

The “impassable dams have lead to a significant reduction in the rearing and spawning habitat. However, it is difficult to estimate the magnitude of the loss as record keeping was nonexistent before the dams were constructed” (Pitzer 10). The following are the specific effects of the dams on salmon populations:

Dam-linked deaths

There dams have been found to account for a considerable number of salmon deaths. Even when the dams are built with fish ladders for upstream passage of salmon, “the fish can still be delayed” (Bonneville Power Adminstration 4, par. 2). The rapid flow of water originating from the turbines usually makes it difficult for the salmon fish to locate the tiny attraction flows that guide them to the ladders. There has been a significant improvement in the ladder design and quality of materials used since the 1900s.

However, not much has been achieved in preventing adult and juvenile salmon deaths that can be attributed to difficulties in locating or using the ladder. Some ladders tend to have high flow rates that often and thus are avoided by the salmons causing delays in upstream migration.

The ladder delays may not directly result in the death of the salmons but may interfere with other processes that increase the chances of death. For instance, “salmons do not feed on upstream migration and must use stored energy as efficiently as possible to migrate upstream, mature sexually and spawn successfully” (National Research Council 234, par. 3 ).

Adult salmons usually get killed if they are pulled back into the turbine intakes, although it is difficult to estimate the deaths that result this way. Counting of the salmons between successive dams shows declining numbers that are thought to result from deaths. However, “poaching might account for some salmon losses” (Dube 45). The losses between dams have been approximated to be as high as 25% between Bonneville Dam to John Day Dam.

The dams also pose a significant risk to the downstream passage of juveniles. The juveniles which are often referred to as the guided fish, “can make contact with deflection screen surfaces, gate well walls, the vertical barrier screens in the gate wells, the orifice entrance or portions of the bypass channel or down well” (Stewart 60, par. 4). Such encounters cause a considerable damage to the scale surface and thus significantly reduce the viability of the salmon fish.

The fish undergoes stress when passing through the bypasses. Sometimes the fish is made to “hold in the currents to resist passing downstream” (Dube 46, par. 1). This experience results into physiological stress and can recover if they are held for 48 hours. However, when the fish is under stressful conditions and directly goes through the bypass it often ends up in the outfall, where it may be preyed upon by birds and other fish.

The bypass systems may also result in the concentration of smolts in a relatively small area. Smolts from the large width of the Columbia River usually gather in the narrow bypass channel. “Sometimes thousands of smolts per hour are delivered in a small volume of water to the dam tailrace, which provides a concentrated stream of prey for predators” (National Research Council 236, par. 5 ). Studies conducted previously indicate that there is a high concentration of predators at the areas between the bypass and the outfall.

It is not easy to identify the total bypass mortality due to absence of carcasses. Some researchers investigators consider bypass-caused deaths to include only those which can be observe in the raceways and sampling facilities incorporated in the bypass systems (Dube 56).

But this does not give information on impingement on deflection screens, predation within the gate-well and bypass system, predation caused by bypass concentrated stream of prey, stress-related deaths that occur after smolts leave the outfall are or predation on stressed fish long after they leave the outfall pipe (Pitzer 105).

Time of travel

The time of travel effect is less clear as compared to the effect of passing through the dams. “Ocean type chinook passes their first winter of life at sea while the stream type spend their first winter of life in the stream before going to sea” (O’Laughlin 3, par. 1).

Data revealed by some studies show that sub-yearlings travel downstream faster when the flow rate is high. Sub-yearling Chinook usually grow as they gradually travel downstream in what can be regarded as a “rearing migration” (Bonneville Power Adminstration 4, par. 3).

The yearling Chinook and the steelhead travel faster with an average downstream passage of up to 20 miles or more a day (Stewart 78). The fish passage Center and the Columbia Basin Fish and Wildlife Authority show that dams can result into faster rates with associated implications (O’Laughlin 56).

Studies have been done to identify the survival of the salmons during the downstream passage. A study conducted in 1999 with using a passive integrated transporter (PIT) tags indicate survival near 100% through lower granite pool. However, the estimated mortality across the concrete was higher than expected (Bonneville Power Adminstration 3).

Loss of migratory path

When a diversion is made from a river so that the water is to be utilized for agricultural or domestic needs, there is a high possibility that the downstream migrating salmon and other fish will be drawn into the diversion channel or pipe (Stewart 107). The Columbia River has several channels adjacent to dams and that are not screened adequately.

These unscreened diversions have been present for years despite efforts by the authorities to add new screens and revive the old ones. No study has adequately established the overall benefit provided by the screens in comparison to the lost rearing habitat in irrigation canals and ditches downstream from the screens (Dube 63).

Estuarine dynamics

The estuaries of the dammed Columbia River are thought to have changed and thus affecting the salmon in one way or another. The reservoir storage in the “upper Columbia and Snake rivers have altered both the seasonal pattern and the characteristics of the extremes of fresh water entering the estuary” (National Research Council 236, par. 5 ). The average sediment supply to the estuary has greatly declined and thus affecting the natural salmon habitat.

Effects on spawning habitats

The “anadromous salmon normally bury their eggs in redds in the gravel substrate at varying depths depending on the species” (National Research Council 237, par.4). The presence of large dams prevents the downstream flow of the sediments and this inevitably leads to the destruction of salmon spawning habitats that are located downstream (Bonneville Power Adminstration 5).

The usual practice of regulating the water level in the dams to prevent power surges or increase the provision of electricity often leads to erosion downstream habitats. The resulting “cyclic floods contribute to the extinction of the salmons by flushing away their spawning gravels” (O’Laughlin 3, par. 3).

Urbanization effects

The development of the dams inevitably led to the urbanization of the areas surrounding the Columbia River. The “primary impact of urbanization is the degradation of the downstream water quality through pollution and reduced water flow through removal of irrigation” (O’Laughlin 3, par. 3). Urbanization has led to the loss of forests and thus significantly contributing to the alteration of the temperatures and sedimentation patterns.

Changing temperatures

Temperatures are observed to change significantly when a river is dammed. Normal rivers often have homogenous temperatures due to the constant flow of water. Reservoirs are layered and are worm at the top and cold at the bottom (Stewart 80). When the water is released from the dam it results into unusual cold temperatures which may compromise the survival of the salmon.

Mitigation efforts

The development of dams along the Columbia River was basically for irrigation, protection against floods, production of hydropower, recreation and for navigation purposes. Hydropower production was the main consideration until 1980 when the Northwest power Act was enacted (National Research Council 239).

One of the key areas agreed upon and captured in the act was the protection and enhancement of fishery. Thus profound changes in the operating strategies were to be planned and implemented. This section discusses the mitigation measures that have been taken so far to improve the conditions. This measures “include; fish-passage facilities, predator control, transportation, spill, flow augmentation, reservoir drawdown and dam removal” (National Research Council 239, par. 2 ).

Fish passage facilities

Initially, there were no fish ladders to enable the salmon to swim upstream past the dams. The ones that were constructed in the early 1900s were also found to be inadequate for that purpose. Intensive studies about fish behavior, response to attraction flows, and in ladder hydraulics led to marked improvement in ladder designs (Dube 67). However, the improved designs have not been able to offer a total solution as there are still instances of fishes being delayed by hydropower dams and falling after passage (Dube 68).

The early mainstem dams (rock island dam and the Bonneville Dam) that were constructed on the Columbia River had fish ways that only permitted the passage of adult salmons. All the other mainstem dams that were constructed later also have fish ways. The juvenile passage facilities on most mainstem dams in the Columbia River system use deflection screens that project downward into the intakes of turbines and deflect fish upward from the turbine intake into the gatewell (National Research Council 56 ).

The design of the deflection screen is founded on the fact that downstream migrating juvenile salmon tend to pass through the turbine intake high in the water column (Stewart 83). The screens often guide intercepted fish upward into the gatewell.

Predator control

The major threat downstream migrating juveniles are the squawfish that is alleged to kill millions of juveniles annually (Pitzer 34). A study conducted using the John Day pool revealed that up to 12% of the salmons that entered the pool were killed every month by the squawfish. As a result initiatives were taken to reduce squawfish related salmon deaths. The “programs include bounties and intensive efforts to reduce predator densities” (Stewart 84). It was particularly designed to down size the population of the larger squawfish.

Transportation

Transport systems have been developed to deliver juveniles downstream. Raceways are normally used to hold downstream migrants for delivery by barges or trucks (Dube 35). The concept is based on “leap frogging” in which the juveniles are delivered at some point downstream from the power projects (Pitzer 87). In the Columbia River system, raceways are used to transport juveniles to the Bonneville Dam tailrace.

This transportation relies on barges which are further used to maintain water quality, for instance, by inhibiting gas super-saturation (National Research Council 243). However, a study conducted on the Snake River showed a reduction of salmon runs when barging was applied which has caused the efficiency of barging to be questioned (O’Laughlin 4).

Flow augmentation

The hydropower dams result in faster passage of the juvenile salmons downstream and therefore significantly reducing their survival rates. This more observed on the middle Columbia and the Snake rivers during spring. An attempt was made to reduce passage through the use of “water budget” which provided some upstream storage in the snake and mainstem Columbia to increase spring flows (Dube 43).

Spill

Spill is water that is deliberately passed over the dam to aid fish passage. The river is often spilled for a short time to prevent the accumulation of water bubbles. Spilling is often done in spring and summer during juvenile migration (Dube 53).

Designing of fish friendly turbines

In real sense a negligible amount of fish pass through the turbines as compared to other passages (Pitzer 45). However, dam operators are slowly removing the old turbines and installing new ones that are designed for fish safety.

Conclusion

This paper sought to identify the effects imparted by dams on Columbia River Salmon populations. The investigation was supposed to identify both the positive and negative effects.

Several negative effects have been identified and they include; increase in mortality rates, loss of habitat, increased time of travel, change in estuarine dynamics, loss of migratory path and finally effects associated with industrialization.

All the literature reviewed had no data on the positive effects of dams on salmon populations. It remains to be investigated whether there are any positive effects impacted by the dams on the salmon populations.

The paper has also identified the mitigation measures that have been taken to improve the viability of the salmon population in the Columbia River. The following measures are currently being undertaken; Predator control, transportation, flow augmentation, spill, designing of fish friendly turbines, fish passage facilities (National Research Council 142).

Works Cited

Bonneville Power Adminstration. “Managing the Columbia River System helps fish .” Govtcorp.com. 4 September 2010. Web.

Dube, Kathy. The effects of large dams on salmon spawning habitat in the pacific northwest . Seattle: Waterdhed Geodynamics, 2003. Print.

National Research Council . Upstream: salmon and society in the Pacific Northwest. New York : National Academies press, 1996. Print.

O’Laughlin, Jay. The varriable impacts of dams on Columbia and Snake river salmon populations. Moscow: University of Idaho, 2001. Print.

Pitzer, Paul. Grand Coulee: Harnessing a Dream. Washington: Washington state University , 1994. Print.

Stewart, Holbrook. The Columbia: The Classic Portrait of the Great River of the Northwest. New york: Comstock Editions, 1986. Print.

Summary

Roberts (2011) article highlights on the increased world population, which currently stands at about seven billion people. To estimate the world’s population, UN and USCB use statistics and censuses from over 228 political entities and countries. The censuses and statistics not only help to project deaths inclusive of those caused by epidemics but also to project births inclusive of those conceived by the refugees.

Approximately, 367,000 people are born each day while 153,000 people die each day hence resulting into an increase of 78.5 million people annually. As revealed, the increased population results from the gradual decline of deaths and gradual increase of births in a rapid manner. As a result, more people are born whilst fewer people succumb to death thus leading to population increment “attainment of billion-person milestones every 12 or 13 years” (Roberts, 2011, para. 11).

Analysis

However, one cannot help but note the statistical discrepancies that exist between the United Nations and USCB. USCB notes that the population will not reach 7 billion until four months are over. This implies that the United Nations ‘miss’ the population estimation “of 28 million, which is more that all people in Saudi Arabia” (Roberts, 2011, para. 2).

The justification behind the outcome is the “margin of error of at least 1 percent” (Roberts, 2011, para. 4) which is said to give room for errors. Considering that UN and USCB collected information from similar sources, the estimation should be approximately the same and therefore, the error margin is not justifiable.

A close look reveals that the disparity results from interpretation of figures. USCB use ‘silly’ or impractical population interpreters ‘population clock’ that projects the number of persons who die or are given birth to every minute. As indicated, UN “don’t use a population clock” (Roberts, 2011, para. 6).

Unfortunately, USCB dismisses these claims when they state that their estimates are precise ‘remarkably close’ (Roberts, 2011, para. 10). This shows that they are not willing to solve the population’s statistical differences between them and UN.

Interpretation

The more people the world has, the more resources are used. Therefore, if there is an increased population that the world can barely support, people will competed for the available resources including land, water and the available economic opportunities. This implies that there are people who will be destitute.

In addition, increased competition for the available resources implies that people will have to fight for the resources thus resulting to conflicts, which can lead to wars. This explains why there is a need to have proper population estimates. They form the basis of addressing the needs and problems that the world’s population is facing such as mitigating overpopulation.

Opinion/insight

Changes in population could affect all people including me. If the world becomes overpopulated, I would likely succumb to poverty or live in a war-stricken society. For this reason, I think that the USCB and the UN should collaboratively evaluate the population estimates.

This will help them come up with the most appropriate method that they can use to interpret the statistics and the censuses collected. In addition, this will help them come up with a more precise estimate for the world’s population and project how the population growth will be in future. This way, all members of the society including the government and the international bodies can come up with precise solutions that could help mitigate overpopulation.

References

Roberts, S. (2011). U.N. says 7 billion now share the world. Web.