Health Care Associated Infections Essay Example for Free

Health Care Associated Infections Essay Did you know that healthcare associated infections are in the top ten leading causes of death in the United States? According to Agency for Healthcare Research and Quality (2010), â€Å"Healthcare-associated infections, also known as HAI’s are the most common complication of hospital care, resulting in 1.7 million infections and ninety-nine thousand deaths each year.† It is unfortunate that so many people suffer each year from infections that could be easily prevented. Slide2 Today my goal is to share some information with you about Healthcare associated infections and hopefully together we can all make a difference by reducing these alarming statistics. To start off I’m going to explain what Healthcare Associated Infections are and then I will go over the different types. Next I am going to go over a couple of the more common pathogens in healthcare associated infections. Following that I would like to talk about the preventive measure that all health care workers should be following to prevent future Healthcare associated infections. (Slide 3) According to Wilkinson and Treas (2011), A Healthcare Associated Infection is an infection related to healthcare given in any setting such as a hospital, during home-care, long-term care, and ambulatory settings. Infections may be spread from one patient to another simply because the healthcare provider failed to wash their hands or wear the proper personal protective equipment. Infections are also commonly spread by devises used during a medical procedure and anything else the patient may come in contact with that has not been properly cleaned such as a call bell or side rail. For instance say you have a patient with MRSA and one of their family members leave the room failing to wash their hands, goes to the front desk to ask for a glass of water for the patient in the mean time she placed her contaminated hands on the desk. Following that a nurse stops by the front desk also placing her hands on the desk then goes in to see a patient and fails to wash her hands prior to patient contact. Now we have just spread the infection and sadly another patient has acquired a healthcare associated infections. Patients whom acquire healthcare associated infections typically have longer duration of recovery time and medical cost are increased drastically. There are many different types of Healthcare Associated Infections, there is Surgical Site Infection (SSI), Central Line Associated Bloodstream Infections (CLABSI), catheter associated infection (UTI), and ventilator associated phenomena (VAP). (Slide 4) Surgical Site Infection A surgical site infection, also known as SSI, is an infection that occurs after surgery in whatever part of a person’s body that the surgery took place. There are three main types of SSI’s. There is superficial incision SSI, which transpires between the integument and subcutaneous tissue. Next is deep incision SSI, taking place at deep tissues such as muscles. The third type is called organ/space SSI, which occurs inside the body at an organ or the open space inside the body around the surgical site. All Surgical infections typically occur within thirty days of the surgical procedure expect in cases of implants, which then surgical site infections can take place with in one year. According to the Center of Disease Control (2012), infections develop in about 1 to 3 out of every 100 patients who have surgery. These infections are not only lengthening hospital stays, but adding unnecessary medical expenses, and are also responsible for unnecessary deaths and long-term disa bilities. (Slide 5) CLABSI Another type of Healthcare associated infection occurs at a central line also known as a catheter line, which is a tube used to draw blood, give medication or fluids through a large vein such as the jugular vein or subcalavian vein. A central line associated blood stream infection is caused when bacteria, or any type of germ enters the blood from the central line, which then causes an infection in the blood stream. –Slide 6- According to The American Surgeon (2011) Nosocomial blood stream infections are one of the leading causes of death in United States hospitals. As stated in the U.S. Department of Health and Human Services (2012), In 2011 there were thirty-seven central line associated blood stream infections reported at Halifax Health Medical Center. (Slide 7) CA-UTI A different type of Healthcare related infection is a catheter associated urinary track infection. This type of infection occurs when the patient has a urinary catheter in place and bacteria or fungus travel up the tubing. The infection can take place any where in the urinary system from the urethra to the kidneys. The longer the patient has the catheter in place the more they are at risk for getting a UTI. The U.S. Department of Health and Human Services reported that one in ever two thousand patients who were cared for at Bert Fish Memorial in New Smyrna Beach acquired a catheter associated infection. (Slide 8) VAP Then there are the ventilator-associated phenomena’s, which is an infection that occurs in the lungs due to contaminated ventilation equipment. Patients who are on ventilators are already weakened due to another form of illness and their immune systems are typically compromised making it difficult for their bodies to cope with trying to fight yet another issue. According to Wilkinson and Treas (2011), ventilator associated infection are associated with high mortality rate. Last year alone there were approximately thirty-six thousand reported cases of ventilator-associated infections. (Slide 9) Pathogens Two of the more common types of pathogens in nosocomial infections are Coagulase-negative staphylococci also known as CoNS and methicillin-resistant Staphylococcus aureus also known at MRSA. CoNS typically causes catheter related ifections since catheters are not easly removed and cleaned it often makes it complicated to treat. CoNS are also known to be resistant to most forms of antibiotics. According to the European Journal Of Clinical Microbiology Infectious Diseases (2011), CoNS infection prolongs treatment with antibiotics and hospital stay by approximately twelve days or up to two and a half weeks. MRSA is a staph germ that is difficult to cure. If MRSA enters the blood stream it can spread any where through out the body, including bones, and organs. According to Clinical Infectious Disease (2012) MRSA infections kill nineteen thousand hospitalized American patients annually. Out of all the MRSA cases, 86% of them are healthcare aquired. (Slide 10) Preventive measures All of these infections could be prevented if we take initiative to follow the proper protocol. One the simplest and most important preventive measures is washing your hands before and after entering a client’s room. Sadly many health providers fail to do this. These infections could be prevented as long as the healthcare team uses proper aseptic techniques. In 2010 Florida’s Department of Health started up a program called the HAI prevention program. One of their main goals is to prevent and decrease the healthcare related infection rates in Florida’s hospitals and long-term care facilities. With in a five-year period the US Department of Health and Human Services plans on reducing Blood stream infections in Florida by 50-70%. That’s a good start, but I believe we should all strive to eliminate all healthcare related infections. A few preventive measures are, if a medical supply accidentally becomes contaminated through it out and start fresh, as soon as our patients are well enough to have catheters removed notify the doctor so that they can be removed promptly, and always wash your hands before and after patient contact and remind others to wash their hands as well. (Slide 11) Conclusion In closing I am sad to say it, but many healthcare providers are in violation of the first rule of health care, Do No Harm. Our patients are coming to us to be relieved of their illnesses not to acquire new ones. So if we could all just follow the simple preventive measures such as washing our hands before and after assisting our patients we all can make a difference. Just think that fifteen seconds it took you to wash your hands may have just saved a life. References Agency for Healthcare Research and Quality. (2010) Ending healthcare-associated infections. Retrieved from http://www.ahrq.gov/qual/haicusp.htm Boucher, H. Corey, R. (2008). Epidemiology of Methicillin-Resistant Staphylococcus aureus. Oxford Journals. 46(5), 344-349. Retrieved from http://cid.oxfordjournals.org Florida state plan to address healthcare-associated infections. (n.d.). Retrieved from http://www.cdc.gov/HAI/pdfs/stateplans/fl.pdf Kordek, A. (2011). Concentrations of procalcitonin and C-reactive protein, white blood cell count, and the immature-to-total neutrophil ratio in the blood of neonates with nosocomial infections: Gram-negative bacilli vs coagulase-negative staphylococci. European Journal Of Clinical Microbiology Infectious Diseases: Official Publication Of The European Society Of Clinical Microbiology, 30(3), 455-457. Retrieved from http://web.ebscohost.com/ehost/ Smith, J., Egger, M., Franklin, G., Harbrecht, B., Richardson, J. (2011). Central line- associated blood stream infection in the critically ill trauma patient. The American Surgeon, 77(8), 1038-1042. Retrieved from http://web.ebscohost.com/ehost Wilkinson. Treas. (2011). Fundamentals Of Nursing. Philadelphia, PA: F.A. Davis.

Observational and Motor Learning Development

Observational and Motor Learning Development Human development is astonishing from embryo, to infant, to kid, and so on till the fullu grown-up person. There are a number of things that kids require to learn and developmental objectives that require to be achieved. The rationale of this paper is to examine learning of motor-skill in a three to four year old child, its connection with observational learning, and strategy to assist a three to four year old child with delayed fine motor skills. Consecutively to completely recognize the issue an examination of milestones of fine motor skills is needed. Milestones of Fine Motor Skills Infants and kids as they develop build up 2 kinds of motor skills: fine and gross. The fine motor skills are individual’s skills that entail movements of small scale e.g. holding a toy(David Grissmer). Gross motor skills are perceived as individual’s skills that engage movements of large scale e.g. the moving of the limbs up and down (David Grissmer). The described ages in this case are three and four years. Three year old Kids must have the capability to: wear their own shoes, solve easy riddles, play with another kid in an activity group (David Grissmer). Four year old Kids must have the capability to: dress by themselves, exhibit a hand preference, emulate a square, open and close buttons of dresses, and consoles buddies in misery (David Grissmer). Kids are supposed to incident milestones of developmental in addition. Milestones of Child Development Children Developmental milestones attain more than merely the range at which they control objects (fine /gross motor skills). Kids attain milestones during learning, playing, speaking, behaving, and moving â€Å"(CHATS , R. (N.D.) ). Once more the spotlight for milestones of developmental will be three and four year’s old kids. A three year old in expressions of milestones of emotional and social must obtain rolls in games, recognize the notion of theirs, and might get disturb with foremost regular changes (CHATS , R. (N.D.). ). Communication and Language engages recognizing and naming the majority of things, being able to recognize and names of friends, and being able to converse with them (CHATS , R. (N.D.). ). In expressions of cognitive movement: can runs easily, playing with toys that have buttons, levers etc, being able to turn pages of book, , and walking up and down on stairs (CHATS , R. (N.D.). ). A four year old in expressions of emotional and social milestones must collaborate with other kids, and recognize the distinction amid imagination and reality (CHATS , R. (N.D.). ). Communication and Language engages speaking their first and last name, telling stories, and (CHATS , R. (N.D.). ). In expressions of cognitive and movement: names some colors together with a few numbers, uses scissors, initiates to recognize time, and being able to catch a thrown ball the majority the time (CHATS , R. (N.D.). ). Piaget and Fine Motor Skills The brain is a vital component of the fine motor skills process of learning. There are 4 segments of the brain that add to this process of learning: premotor cortex, supplementary motor cortex, dorsolateral frontal cortex, and posterior parietal cortex. The premotor cortex is connected with perceptual motor integration by recognizing spatial target discovering a new relationship amid environmental and selfish space (DP,Butters,N.(1995)). The dorsolateral frontal cortex is connected with the strategic course by choosing the objective for the movement and the majority suitable surroundings for that movement (DP,Butters,N.(1995)). The supplementary motor cortex is connected with succession: arranges spatial targets in the accurate sequence and replicates the succession with the similar movement (DP,Butters,N.(1995)). Finally, is the spinal interneuron connected with active which interprets targets og egocentric spatial into patterns of muscle and creates novel relationships amid the target and the patterns of muscle (DP,Butters,N.(1995)). An additional means that fine motor skills can be learned is through the theory of social learning or art of imitating. Theory of Social learning is deemed learning by observation since the viewer habitually a kid is observing a further child, an adolescent, or also an adult. The actions that are exhibited by the observed person have the prospective to be imitated by the observer if and merely if definite criterion is in place. The criterion is concentration, maintenance, imitation, and motivation (Patricia H. Miller). Consequences as well bear burden in this area of learning by observation. The observer will simply replicate the behavior studied if the advantages of that actions overshadow a likely outcomes or reprimands that are connected with that actions (Patricia H. Miller). In expressions of studying fine motor skills a kid who can recognize the series of theory of social learning can automatically start to imitate those about them. The period of the copying behavior is difficult to determine. A kid that observes their parent using a mobile phone will imitate that behavior. The similar goes for eating and dressing. As magnificent as developing of fine motor skills are, there are a few kids who are delayed in incidence this particular time. Strategies for Delay in fine Motor Skill Kids whose development of Motor Skill is delayed there are more than a few diverse strategies that can be utilized consecutively to fix this predicament. Primarily generate daily activities that need the kid to use handheld toys and things (CDC,). Next, make use of songs with finger play to build up fine motor skills (). Thirdly, let the kid to seize and sense objects (CDC). Squeezing objects would be in actuality be helpful. Fourth, provide the kid manipulatives to play for instance blocks or clay (CDC). Conclusion Milestones are extremely significant to welfare and efficient growth on the course to adulthood. Fine motor skills are incorporated in that listing of milestones development. For instance when kid is able to pick up a ball and throw it to others. There are as well additional milestones to be taken into deliberation for instance developmental for kids. Social learning prepared its access with the association of fine motor skills learning with observational learning. The kid merely requires being continued drawn by the actions of the person by observation and then impersonating the behavior observed. There are instances when the milestones are not being able to attain and as a result a delay of motor skills is created. The key spotlight for the person is to use fine motor skills to complete definite actions for instance using manipulative. References Chats , R. (n.d.). Developmental milestones. Retrieved from http://www.childhealth- explanation.com/milestones.html http://www.cdc.gov/NCBDDD/actearly/milestones/index.html CDC: Developmental Screening, â€Å"Facts About Developmental Disabilities,† Important Milestones. David Grissmer, et al. Fine Motor Skills And Early Comprehension Of The World: Two New School Readiness Indicators. Developmental Psychology 46.5 (2010): 1008-1017. PsycARTICLES. Miller, Patricia H. (2011). Theories of developmental psychology. New York: Worth Publishers. Salmon DP, Butters, N. (1995). Neurobiology of skill and habit learning Current Opinion in Neurobiology, 5, 18

Diabetes an Epidemic in the African American Community Essay -- Biolog

Diabetes an Epidemic in the African American Community "The facts are clear: The diabetes epidemic sweeping the U.S. is hitting the African American community particularly hard, according to doctors." (2) Diabetes is defined as, "A disease that affects the body's ability to produce or respond to insulin, a hormone that allows blood glucose (blood sugar) to enter the cells of the body and be used for energy." (1) There are two types of diabetes: type 1 diabetes and type 2 diabetes. Type 1 diabetes, which usually begins during childhood or adolescence, "Is a condition characterized by high blood glucose levels caused by total lack of insulin. This occurs when the body's immune system attacks the insulin producing beta cells in the pancreas and destroys them.." (2) Type 2 Diabetes, most common form of the disease, "Usually occurring in middle age adults after the age of forty-five, is a condition characterized by high blood glucose levels caused by either lack of insulin or the body's inability to use insulin efficiently." (2) National heal th surveys over the past 35 years show that the number of African American's that have been diagnosed with diabetes is drastically increasing. In fact, it has been reported, "Out of 16 million Americans with diabetes, twenty-three million are African Americans." (3) There are clearly many implications on why diabetes is so rampant in the African American community, those of which will be discussed in this report. In this report, I will exam aspects of the "African American Culture," in order to determine whether those aspects have anything to do with the reasons why diabetes is higher in the African American community, more so than others. "Have you ever heard in the Black culture someone say t... ... amounts of oils and sugars in food, improper dieting and apathy towards treating the disease. Diabetes is a major disease in all ethnicities, particularly in African Americans and can be deadly if not treated properly. If the cycle of diabetes is to lessen, in the African American community, people have to take the approach to eat right and exercise, or else the diabetes will continue to run rampant throughout the community. Internet Sources: 1) http://www.diabetes.org/community/outreach/african_americans/diabetesin.jsp , a rich resource from the diabetes community outreach project 2) http://www.ndep.nih.gov/diabetes/control/4Steps.htm , a rich resource from the department of health and diabetes. 3 http://diabetes.niddk.nih.gov/dm/pubs/africanamerican/index.htm, a rich resource on diabetes 4) http://66.102.126.72?Diabetes.htm, a rich resource on diabetes

Essay --

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Who Killed Eddie Carbone and Why :: A View from the Bridge Arthur Miller

Who Killed Eddie Carbone and Why Introduction: In a poor Italian community of Brooklyn, the Carbone family consists of three members. Eddie Carbone, the man of the house. Beatrice Carbone, wife of Eddie Carbone and Catherine, their niece. But, they didn’t consider that their little world would be turning upside down with the arrival of Beatrice cousin’s Marco and Rodolpho. Reading and watching the story, I will base my ‘evidence’ on who killed Eddie Carbone and why. Eddie Carbone: Eddie Carbone was a 40 year old man, who was husky, slighty overweight longshoreman. He’s an ordinary man who lives in a poor Italian community of Brooklyn with his family. He is master of the house or the man of the house - both Beatrice and Catherine are obviously used to him laying down the rules. He sees this as a 'manly' thing to do and he expects all men to do the same - which is why he cannot accept Rodolpho's more gentle talents. He showed his generosity to his wife’s cousins, Marco and Rodolpho, by letting them stay around his house. Even living in Brooklyn most of his life, he still doesn’t have enough trust for people. His Honour and Pride meant a lot to him. He would do anything to protect his good name, especially in later stages. He was very protective of his niece, Catherine. He considered her his own little daughter. He paid for her typing lessons and had ambitions for her to rise to a different class. He is proud of her looks, yet concerned that she will attract the attention of men and is concerned about her new job. He finds it hard to admit that she has become a woman. "I guess I just never figured... that you would ever grow up." However, it soon becomes apparent that Eddie is in love with Catherine. He has not made love to his wife for three months. He quickly becomes jealous of Rodolpho because of the immediate impression Rodolpho makes on Catherine. The stage directions tell us, "He looks at (Catherine) like a lost boy" when she tells him she loves Rodolpho. He is unable to admit this shameful emotion to himself and is angry when Beatrice and Alfieri dare to mention it. His feelings for Catherine become more obsessive and he does everything in his power to prevent their marriage. He tries to prove that Rodolpho is more of a ‘sissy’ then a real ‘man’. He says that Rodolpho is more into ‘sewing’, ‘cooking’ and ‘singing’ then into any ‘manly stuff’.

CIPD Notes Essay

Terms of Reference To investigate how an HR practitioner within East Surrey College (ESC) should ensure that they deliver timely and effective HR services to meet user’s needs. The report was requested by Charles Sleet, HR Director, on 11/11/2013 to be presented on 14/01/2014. Procedure 1. Understanding different customer needs in HR. 2. Communicating effectively in HR. 3. Building and maintaining effective service in HR. 1. Two HR colleagues were interviewed in order to determine who the 3 main customers of the HR department were. Furthermore, requests and enquiries that came through to HR were recorded via the same HR colleagues to identify the main needs of the customers during a period of three weeks from 13th November to 4th December. The way in which these needs are prioritised was recorded. 2. A questionnaire was issued to 20 members of staff to discover the most effective communication method. Staff members were chosen through random sampling. 3. An interview was held with the HR Business Partner to gain insight into the main areas of effective service delivery and how it is constructed. Findings 1. Understanding Customers needs After interviews with the two HR Practitioners, the three main customers of the HR Department were identified as follows: Type of customer Key needs Candidates for interview Gaining information on the outcome of their interview A swift pre-employment check process, ensuring a quick start into a new job Heads of Department (HoD) Absence levels of employees Monitoring online training completion Employees Requesting a copy of their own CPD log – these are updated and kept on HR records Enquiring about upcoming training events The HR practitioners highlighted that the needs of different customers may conflict. An example could be a HoD enquiring about the completion of a member of staffs online training courses conflicting with an enquiry coming in at the same time of a staff member urgently trying to find out when the next ‘Teaching and Learning’ forum is due to take place. Maximum service delivery has to be initiated with regards to these needs – therefore the HR practitioners advised on the ways these needs are prioritised. These prioritise are; Timescales – some requests may have longer timescales than others. These timescales therefore contribute to the importance of the arisen needs. Consequence and risk to the company – discovering the consequences and risks to the company helps prioritise incoming needs and enquiries. For example, it would be seen as more important to provide a HoD with an absence level report for their department than it would to advise a member of staff on their current CPD record. 2. Methods of communication After analysing feedback from the completed questionnaires, highlighted below are 3 methods of communication appropriate to employees at ESC at different levels: Communication method Advantages Disadvantages Face-to-face Immediate feedback Gives a personal touch, body language can be read Can use facial expressions to enhance communication Can be lengthy if certain attendees are unavailable to meet No chance to go away and think about an answer No privacy as someone could overhear Email Can take time over response Large amounts of information can be sent e.g. attachments Able to pass on information without interrupting someone Lack of body language and tone Impersonal Emails can be misinterpreted Phone Immediate interaction with someone far away More personal than an email Ability to transfer calls across locations/conference calls Can be disrupted by hindrance of poor signal Lots of details over the phone can be hard to record 3. The key components of effective HR Service Delivery Delivering service on time – SLAs need to be SMART, in particular they should be realistic and achievable. For example, in the HR Department at ESC HR practitioners aim employ a new member of staff in, at most, 4 weeks from the  date they were verbally offered the role. This is important as it earns the department respect and often means customers will look to reply in the same, efficient way. Delivering service on budget – It is important to ensure that you keep within budget but still deliver a high level of service as going over budget can incur costs financially. Costs that need rectifying mean that other areas would then be restricted to an even lower budget. Dealing with difficult customers – Identify the problem, stay calm, and understand how it can be resolved. Handing and resolving complaints – With the secure SLA in place, the query should be met in a timely way to elude complaints. Any complaints that do arise should be dealt with in an equally timely and professional way . Keeping customers in the loop with updates on progress is key. Conclusions 1. ESC use all 3 methods identified (phone, email, face-to-face) to communicate to employees at all levels, making sure the correct method is used 2. Consequences and timescales were key as methods used to prioritise conflicting needs in the workplace. 3. the HR Business Partner delivers and expresses a high level of service that fits with the four outlined objectives.

Behavioral Issues Essay

On April 16th, 2007, the world was shocked by the senseless killing of 32 students and staff of Virginia Polytechnic Institute (VPI) by a fellow student named Seung-Hui Cho. His actions and subsequent suicide reignited questions on gun control measures countrywide and the ban of weapons on campuses. Public anger was targeted against the campus police and administration for what the public believed were security lapses on their part. The governor of Virginia State appointed a panel to investigate all aspects of the shooting. VPI came under censure for not doing enough to keep Cho away from other students in light of his mental condition. However the blame for the incident was placed squarely on Cho as he failed to abide with the recommendation of the court which would have helped him recover from his condition. Profile of Seung – Hui Cho As a child, Cho was shy and withdrawn. He kept his emotions very much under control and to most people he was considered antisocial. Cho had been diagnosed as suffering from severe anxiety from an early age. His condition was further complicated by selective mutism which caused him speaking difficulties. As a consequence of his speech challenges, the other students derided and bullied him thus contributing to his withdrawal from social activities (Golden, 2007-08-20). He operated as a loner and not much information was known about him or his friends. He received therapy for his condition in junior and middle school but opted to discontinue with the treatment later on in life. Early accounts of his childhood behavior reveal him to have been a bright child who did well in class and was popular with the other children. The transformation to an angry man with suicidal tendencies and distorted thoughts occurred some where along his social development (Bartol, 1999). His anger was so extreme that one of his professors asked that he be removed from her class. He refused to attend therapy despite being advised to so on many occasions by his mentors. The shootings that he carried out were premeditated and carefully planned taking into consideration details concerning the thirty day window before buying a second gun. Rejection by the females he was interested in fueled his feelings of unworthiness and caused him more frustration. Why did Cho gravitate towards criminal behavior? The reason for this change in him was brought about by his exclusion from mainstream society because of abnormalities that he had. The frustration he felt because of the response from the in-group towards his condition made him emotionally insecure (Bandura, 1977). Unloved and despised he developed his own coping mechanisms which were to respond with hostility and anger to any body from the in-group. He had no out – group to socialize with as was the case in the Columbine Shootings otherwise he would have had an accomplice on the fateful day. Cho began to hate society in general but in particular those females who spurned his advances and those who ridiculed him for his speech challenges. Unable to develop a meaningful support system, he relied on other social deviants to be his role models (hence his admiration with the Columbine Shooting students). By identifying himself with Jesus Christ and believing that he was a messiah of sorts, Cho developed delusionary thoughts about who he was. His loss of interest in class and antisocial behavior were common signs of some one with suicidal or destructive thoughts. At that point in life he had no cause for living and looked forward to his release from this world through death (Barlow, 2005). The Role of VPI Campus Police Department Campus police are primarily concerned with the safety and security of the student population and the members of staff. They aim to ensure that criminal acts are prevented from occurring and that action is taken to apprehend the perpetrators of a crime when it takes place. Their roles include responding to cries of distress from any body on the campus and to take the necessary action to ensure that the situation returns to normality as soon as possible (PaperClip Communications, 2007). Campus police receive the same training as normal police offices and are thus well versed in matters of disaster response and first aid. Profiling of any sort is something they are exposed to. Cho had been cited twice for stalking females and been cautioned not to repeat the behavior. Police procedure would have demanded a file be opened and any information about him properly documented. This would have required the cooperation of the administration so that private information about Cho could be put in the file. Based on the analysis of his personal profile, the police would have decided whether or not to put him on their watch list. Close supervision of his activities would have revealed his gun practice outings and alarming writings that would have warranted an administrative decision to revoke his admission at VPI. The lack of coordination between the administration and the campus police contributed to the failure of both parties in identifying Cho as a potential threat to the security of the campus. While it may have required more intense observation of the shooter to accurately arrive at his next course of action, a report from the local authorities charged with reporting gun purchases would have alerted the police to what kind of plan Cho may have been contemplating. Consequently, the blame for the shooting lies with the State of Virginia’s poor enforcement of laws that allowed a mentally challenged person to buy a gun. This incident seems to vindicate those who favor tougher laws regulating gun control and ownership. Further the fact that this purchase was not reported to the campus authorities shows that the agency conducting background checks was not performing its duties meticulously. The fact that a professor had complained about Cho’s behavior and requested he be withdrawn from her class was reason enough for the administration to put the campus police on alert. Cho should have been monitored more closely and any additional complaint form staff or students should have earned him an immediate expulsion. The health bodies that were to handle his case should have taken up the task with more vigor so as to have rehabilitated him and prevented the tragedy from occurring. By setting him loose on society the judiciary must share part of the blame. It appears that the judge was not sufficiently apprised of the danger Cho posed to his fellow human beings. An exhaustive analysis of Cho’s mental condition should have been made and further incarceration ordered in the light of his record. Laws surrounding privacy seemed to have frustrated the efforts to have the various stakeholders arrive at an informed decision. A relaxing of such laws or exceptions to them should be introduced so as to avoid a repeat of such cases. Shortcomings of the key players Profiling of individuals helps to place them in certain categories which identify the basic characteristics associated with that profile. Thus racial profiling may suggest that a black man outside a convenience store late at night might be planning a robbery. Despite the discriminatory nature of profiling, it assists the law enforcement officers to make arrests and in some cases prevent crimes. Similarly, profiling based on behavioral traits may identify potential criminals before they commit a crime. By listing the behavioral traits of criminals, one can be able to pick out those individuals with a likelihood of committing a crime based on their behavior. Antisocial acts, being withdrawn, low self esteem, excessive anger and a tendency to associate with violence are some of the traits that criminals have. Poor support systems and delusionary thoughts contribute to an individual taking up destructive actions. The VPI police were more attuned to dealing with the normal cases of petty crime and harassment to have bothered with a potential case of a mass murderer. A campus setting is not the most likely place to find a serial killer or a rapist. VPI police must have concentrated their efforts on maintaining the peace by dealing expeditiously with any cases of deviant behavior aimed at upsetting the student fraternity rather than profiling students with troubled pasts. This oversight is what led to their failure to notice the alarming trends in Cho’s behavior. It appears that the training they received did not include aspects of criminal behavior. Had they been adequately prepared for such eventualities, they would have identified Cho as a potential trouble maker and taken steps to monitor his behavior. Training in criminal behavior would have helped the police to set up a unit to deal with profiling of suspected students in a bid to prevent any tragedy on the scope that occurred that day (Ellis, 2005). After discovering the two dead bodies the police should have advised all students and staff to take precautionary measures as the killer would still have been at large. As a further measure they should have insisted on checking the bags of any student entering any building to establish if they were carrying any dangerous weapons. The administration on its part should take the concerns of its teaching staff very seriously. From the moment Cho was declared persona non grata in the professor’s class, urgent steps should have been taken to establish the nature of the complaint and whether it would have constituted a major threat to the security of the others members of staff and students. A hotline should be established through which students can report abnormal behavior by their colleagues and have the authorities investigate the claims with a view to taking the necessary action. This will help to identify those students with a potential for criminal behavior. The administration needs to develop emergency measures to be taken in the event that such an incident occurs again. Armed police guards should patrol the grounds and each building should have an armed officer who will deal with such cases. If the police had been in place and armed, they would have confronted the killer and engaged him, thus reducing the collateral damage caused. Behavioral Studies in Campuses Profiling is one of the tools that the VPI police would have used to help them identify Cho as a problem student (Bartol, 1999). By identifying his characteristics, they would have placed him in category that fits his profile correctly. Consequently they would have taken steps to contain any carnage that he would have planned by setting up surveillance around him. Further measures would include accessing the medical records of all students with mental challenges and determining the extent of the disorder ands the potential damage the student would inflict on their colleagues should the worst case scenario be taken. Such students should be closely observed and if there is any conviction that the person presents a threat to the society, their studies should be terminated forthwith. Looking for clue in the student’s essays is another avenue for picking out potential threats to the campus fraternity. By advising teaching staff to forward all essays that contain an alarming reference to violence and death, the police will be able to analyze the thought pattern of the students in a bid to establish the severity of the threat. Recurring violence themes running through a student’s essays are a likely indicator that the student is planning to carry out a violent act (Rogers, 1957). This will inform the police on the need to carry out searches of the student’s room and bags to determine if they are bringing any dangerous weapons to the campus. The police should also liaise with the local authorities to establish if the student has bought any weapons in the recent past and insist that he be blacklisted in the data bases so as to prevent him from accessing any guns. Questioning roommates of suspected trouble makers will help the police get more information concerning the behavior of the person under suspicion. This exercise should be extended to the family members where important records concerning their child can be obtained. It will also help in that the police can raise their concerns with the parents and devise methods to deal with the crisis at hand. Some of the solutions may involve a temporary withdrawal of their child from the campus for treatment. Upon successful completion of the treatment the child can be readmitted to the campus without prejudice. In instances where the treatment is ineffective the student should be permanently removed from the campus to avoid problems arising in the future. Counseling is another option open to the police. Having identified the student’s problem, the rest of the student population can be counseled on how they can assist their colleague deal with his condition. By being more sympathetic and caring, the student fraternity at VPI may have saved Cho’s life. If he had developed a good support system and had understanding friends that did not makes fun of him he may have become happier and more social. Thus as an intervention method, it is important for the staff and students to appreciate the disabilities of their colleagues and work towards making their lives more bearable rather than difficult. Postmortem Had the VPI police identified Cho as a potential threat they should have placed him under close supervision. They may have insisted that he attends therapy for his condition as a prerequisite for continued attendance at the polytechnic. Cho should have been housed in special quarters where he could receive the necessary care and medication for his condition (Prochaska, 2007). If the situation was extreme then he should have been discontinued until a marked improvement in his condition was observed. Close circuit TV should have been installed in all the buildings so that the police could monitor the activities taking place everywhere. This would have made it more difficult for anybody to perpetrate a crime and get away unnoticed. As a deterrent, this measure would have assisted greatly. Metal detectors ands physical searches should have been conducted on anybody leaving or entering a building. All exits and entrances should be monitored and the fewer the better. Police manning the checkpoints should be armed and trained to deal effectively with any threat to themselves or the campus population. As a preventive measure the police should conduct training drills for polytechnic to prepare them for any eventuality. By simulating shooting sprees, grenade attacks and bomb explosions, they can prepare the students and staff about the best action to take when faced with such a crisis. In addition the police should partner with the administration and students to foster close relationships so that concerns like those of Cho’s roommates are reported to the police for necessary action. This will entail the police educating the students for what signs to look for in their colleagues and how to handle them if caught up in a precarious situation. Once Cho began shooting the police should have created a distraction so that his attention was diverted. Such interventions can include the negotiations that take place in hostage situations. VPI police will need a trained negotiator who can talk people out of doing things they had planned to do. If the police knew Cho’s medical history a negotiator would have got to the scene quickly and began to convince him that the carnage was not right and that better alternatives could be found for his concerns. To deal with such case of student violence, more stringent security measures must be put in place (Vossekuil et al. 2002). CCTV should be installed in all buildings and be security centre be manned 24/7. Strict rules on being inn possession of a weapon concealed or otherwise should lead to automatic expulsion of the offender. The administration should share student information with the police so that they can establish profiles for all the students based on criminal, medical or personal information. The profile database will enable the police to narrow down the potential trouble makers and monitor them closely for any disturbing developments. The federal and state government’s should pass laws that make disclosure requirements more explicit and background checks more thorough before a gun can be sold to an individual. A waiting period of not less than one week should be imposed before a license can be issued to own a gun. This will allow for ample time for cross checking of an individual’s background before issuing a gun to him. Restrictions on the sale of guns should extend to students currently enrolled in learning institutions and heavy penalties imposed on gun dealers who break the law. Teaching staff should also be trained on criminal behavior theory so they can identify students who fit the profile of a criminal (Turvey, 1999). This will help the police in their work as the teaching staff are closer to the students and interact with them more often. Further, nationwide campaigns should be held discouraging the use of violence and therapists employed by all institutions to deal with individuals that need counseling. The institutions should be mandated to commit a student to therapy where a professional view demands so. In the event that the student refuses to comply, automatic expulsion should be enforced.