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PUBH6003 Principles And Practices Of Epidemiology

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PUBH6003 Principles And Practices Of Epidemiology

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Course Code: PUBH6003
University: The George Washington University

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Country: United States


Some challenges that may face systems thinking approach in tobacco control in Nigeria include:

Lack of co-operation among stakeholders. Because different stakeholders may have different interests e.g. politics, public safety etc., lack of co-operation among the stakeholders may stall the progress of the program.
Lack of co-ordination at the federal and state levels. Because these laws are made at the federal level, it may be difficult for state governors to implement them in their respective states as they do not have the instrumentality to enforce policies e.g. federal police is controlled by the federal government.

What happens to people who die without a family?
Who takes care of the last wishes of a homeless individual?
Does the death of a homeless person affect anyone?


Essay 1:
The essay essentially revolves around an interview that was conducted with a close relative as per the requisite to address the question. The subject of the interview was the author’s mother. A mother plays the most vital role in the life of an individual. Right from giving birth till her last breath, a mother is always concerned about the wellbeing of her family members and making sure that all the members in the family are leading a happy and healthy life. The first question that was asked to the subject required her to opine on what would be her reaction if she was a victim of terminal illness or some major complicated ailment that elicited immense pain. The question delved deeper into the emotional aspects concerned with the condition and her wish to struggle for an existence. The answer of the subjected included a negative response towards the question. The subject replied that a life is only worth living when the body is fit for survival and the mind is in a happy and stable state. Terminal illness or being a victim of a complicated disorder would elicit pain and a degenerating body that would not lead to any hopes for survival (Marris,2014). Moreover, terminal sickness would lead to a negative and frustrated outlook towards life that would also lead to a feeling of sadness and discomfort among the family members (Keyes et al.,2014). Hence, the subject does not wish to live any longer if diagnosed with a highly complicated disorder or terminal illness. The second question asked to the subject included the question, what could possibly elicit the feeling of a fulfilling life in such a circumstance and to that the response of the subject included the fact that seeing the members of her family who have remained eternally close to her heart throughout her life together, by her side and leading a prosperous life with their spouse and children would generate an emotion of fulfilment in her. Seeing her children and grandchildren come and spend time with her, pray for her and shower their love and affection towards her would make her feel ethereal and complete. The third question, included her response on the manner in which she would like her dead body to be cremated and the response was extremely opposite to what could have been predicted. The subject wanted her dead body to be donated to a “Medical College” instead of being buried in the graveyard. The subject believes ‘serving’ to be the most noble virtue and said that as soon as the heart stops beating inside a body, arrangements are made for a burial but she believes that if by any possibility the lifeless dead body could serve a purpose of education then she would want her body to be used by medical students for an academic purpose. The subject also wants to donate her organs if they are still of some use so that a person in dire need of it can survive and see a new dawn in their life. In order to fulfil the desires of the subject, it is mandatory that the subject signs a declaration form of organ donation that is collected from a neighbouring healthcare organization and it must be noted that the subject also needs to sign a letter of consent that would declare the fact that she would want her dead body to be donated to the concerned medical hospital on her death in order to be used by the medical students for research work or any other academic purpose related to medicine (Gries et al.,2013). The organ donation form can be filled up online, anytime, free of cost and does not involve any charges (Truog,2013). The forms should be signed by subject before the demise and immediately after the demise the concerned hospital must be informed in order to carry out the further formalities. The author has immense respect and love for the subject and would make sure that the earnest desires of the subject is fulfilled at any cost in order to make the subject happy even after her death. According to the author the interview was not a comfortable experience as it elicited in the interviewer or the author a feeling of anxiousness in combination with sadness and a feeling of despair. The fear of losing a loved one is extremely disturbing and it takes a long time to cope with the sadness associated with the death of a loved one (Goesling et al.,2013). The author at the very thought of losing the subject feels uncomfortable and shivers even at imagining such a dreadful scenario. Death is inevitable and so is the emotional trauma associated with it (Elisma et al.,2013). The subject of the interview also feels a similar emotion of helplessness on absorbing the fact that death is unavoidable and the advent of it would lead to a dead end. The feeling of not being able to see ones loved ones ever again is terrible and the word death elicits a very negative impact on people (Boelen et al.,2016).
Essay 2:
The video deals with the demise of people who do not have an immediate kin. It is really sad and disturbing. The Coronor system in California deals with the investigation of unclaimed dead bodies. In the video, the deceased person Renyolds Tanner is found dead in his apartment and the death is supposed to have taken place three weeks before the actual discovery of the death on the basis of complains about a foul smell from the neighbours. Thorough search of the apartment brings to the notice the death certificates of the father, mother and a brother of the subject. A telephone directory is also found from the department but sadly, that does not provide any lead to the dead body claim. The death has been suspected to occur because of rectal infection and the body could not be considered for tissue donation due to the decomposed state of the body. The Coronor office tries to reach all possible contacts and infer any information available about the asset possessed by the person. However, due to unavailability of any suitable leads, the body is finally buried by the officials and the death record is updated in the database.
The most shocking part of the video is to absorb the fact that the subject had no body to even acknowledge his demise. The video is disturbing and makes me want to make my disposition plans clear to family and my friends so that after my demise I do not remain an unacknowledged dead body, half decomposed and waiting to be cremated by some officials. The three questions that the video raised for me includes,
Essay 3:
The loss of a loved one is extremely hard to accept and come to terms with (Resick,2014). The audio transcript is based on the grief that Christa had to deal with she lost her twin sister Cara. Although, there were differences between them but the moment, Christa lost her sister forever, she faced a never ending emotional turmoil. Grief is the most common outcome of personal loss (Bryant,2014). In order to deal with the depression people resort to the use of antidepressants and tranquilisers prescribed the physicians, however it should be noted that depression because of the loss of a loved one is not similar to a major depression case (Dowrick & Frances,2013). My personal reaction to the loss of a loved one would deal with trying to accept the permanent loss and mourning till the heart is contented. When the heart is finally ready to accept the inevitable, I would like to see a counsellor and devise ways to keep myself busy in various works in order to keep my mind free of the sad thoughts. Any committee trying to work for the cause of promoting mental wellness among people who have lost someone dear to them should be soft with the person who is experiencing the pain and let him mourn his/her way. Prescription of antidepressants should not be entertained and positive thoughts could help people come to terms with practicality faster.
Boelen, P. A., Reijntjes, A., Djelantik, A. M. J., & Smid, G. E. (2016). Prolonged grief and depression after unnatural loss: Latent class analyses and cognitive correlates. Psychiatry research, 240, 358-363.
Bryant, R. A. (2014). Prolonged grief: where to after Diagnostic and Statistical Manual of Mental Disorders. Current opinion in psychiatry, 27(1), 21-26.
Dowrick, C., & Frances, A. (2013). Medicalising unhappiness: new classification of depression risks more patients being put on drug treatment from which they will not benefit. BMJ: British Medical Journal (Online), 347.
Eisma, M. C., Stroebe, M. S., Schut, H. A., Stroebe, W., Boelen, P. A., & van den Bout, J. (2013). Avoidance processes mediate the relationship between rumination and symptoms of complicated grief and depression following loss. Journal of Abnormal Psychology, 122(4), 961.
Goesling, J., Clauw, D. J., & Hassett, A. L. (2013). Pain and depression: an integrative review of neurobiological and psychological factors. Current psychiatry reports, 15(12), 421.
Gries, C. J., White, D. B., Truog, R. D., DuBois, J., Cosio, C. C., Dhanani, S., … & Glazier, A. K. (2013). An official American thoracic society/international society for heart and lung transplantation/society of critical care medicine/association of organ and procurement organizations/united network of organ sharing statement: ethical and policy considerations in organ donation after circulatory determination of death. American journal of respiratory and critical care medicine, 188(1), 103-109.
Keyes, K. M., Pratt, C., Galea, S., McLaughlin, K. A., Koenen, K. C., & Shear, M. K. (2014). The burden of loss: unexpected death of a loved one and psychiatric disorders across the life course in a national study. American Journal of Psychiatry, 171(8), 864-871.
Marris, P. (2014). Loss and change (Psychology revivals): Revised edition. Routledge.
Resick, P. A. (2014). Stress and trauma. Psychology Press.
Truog, R. D., Miller, F. G., & Halpern, S. D. (2013). The dead-donor rule and the future of organ donation. New England Journal of Medicine, 369(14), 1287-1289.

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