Disaster Relief

Preparing for Disaster Materialization of Disaster Disasters can strike at anytime, and for the most part, happen without warning. That is why is has become vital for health care organizations to prepare in advance for disasters. The most common type of disasters are natural (tornadoes, hurricanes, earthquakes, etc. ). Since natural disasters have always been around, health care professionals have been aware of their capabilities and possible damage they can wreck upon society. For example, Hurricane Katrina completely wiped out the city of New Orleans on August 29, 2005, leaving the city helpless.Not only did the tragedy claim the lives of thousands of Americans, it also led to power failures, water and fuel shortages, flooding, and communication breakdowns. While American health care organizations have had emergency plans for natural disasters, they could not fathom a hurricane of that magnitude. Another type of disaster that has become more of a focal point over the past decade is chemical or hazardous materials disaster. Whether these disasters are intentional (terrorist attacks) or unintentional (chemical spills or nuclear meltdowns), they are just as serious and need to be prepared for just like natural disasters.The terrorist attacks on September 11, 2001, and the more recent tsunami that stuck Japan on March 11, 2011 and destroyed nuclear plants releasing radiation into the environment, are two examples of intentional and unintentional disasters, respectively. Nature and Scope Large scale emergencies are a threat to any health care entity, regardless of location, size, or scope. No health care organization can predict the nature of a future emergency, nor can it predict the date of its arrival. However, health care providers can plan by following six major areas of emergency response.These six areas of emergency preparedness were set forth by The Joint Commission (TJC), formerly the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an United States-based not-for-profit organization that accredits over 19,000 health care organizations and programs in the United States. The six areas of emergency management are as follows: open lines of communication, availability of resources and assets, safety and security of the patients, staff responsibilities, uninterrupted function of its utilities, and patient clinical and support activities.All of these areas must be taken into consideration when preparing for disaster. Disasters can happen at any time and place. Not all disasters happen outside of a health care organization. â€Å"The hazards to which a hospital is susceptible include fire, utility failure, armed intruder, and hazmat release (occurring within the facility); and hurricane, earthquake, landslide, external fire, flood, tornado, other severe storm, external hazmat release, and civil disturbance† (Sternberg, 2003).These type of disasters are termed â€Å"internal disasters†, and are just as dif ficult for health care organizations to prepare for as off-site (external) disasters. Impact and Importance on American Health Care It is absolutely crucial for healthcare organizations to have emergency plans put in place and ensures that its employees know what their role is in case of a full scale disaster. Emergency plans have to be continually changed and updated to meet Federal, state, and local laws and statutes.Along with developing a emergency plan, health care organizations must routinely practice and execute their emergency plan to help better prepare its employees for a disaster. The better prepared the organizations employees are, the potential for higher survival rate of the disaster’s victims. In the event that a disaster strikes, health care organizations must run post-emergency assessments of the facility’s performance during the crisis and make the necessary improvements to help better serve its patients in the case of a similar disaster.Continual str ides must be made with regards to preparing for disaster for health care providers, because disaster can strike at any moment. It is so important for government agencies, emergency personnel, and heath care organizations to band together to help create plans that will save lives and produce the best possible outcome. The most difficult aspect of disasters is that they are completely unpredictable, but with health care organizations continual persistence of staying ahead of the curve and developing emergency plans, American lives will be saved.Bibliography Ford, Lauren. (2008). Preparing a hospital and community for disaster. Retrieved September 17, 2011 from http://bama. ua. edu/~joshua/archive/may08/Hospital%20Preparedness%20-%20Lauren%20Ford. doc. Graham, Jaclyn. (2007, June). Approved: revisions to emergency management standards for critical access hospitals, hospitals, and long term care. The Joint Commission Perspectives, 27, 1-10. Sternberg, E. (2003). Planning for resilience in hospital internal disaster. Prehospital Disaster Medicine, 18(4):291–300.

Bullying In Schools Essay

A huge problem seems to be taking over our schools these days. Bullying has become a major issue in our schools and should be a problem taken very seriously. Parents need to take action in putting a stop to their children harming others. Teachers also should be aware of what is going on in their schools and take immediate action before something terrible occurs. Bullying is when someone intentionally brings harm to someone else. It comes in forms of physically harming another person or mentally harming them. Bullying is not based on one single incident but reoccurring incidents. It can be brought on by one single person or even a group of people targeting an individual . Bullying is usually an unfair fight where the person doing the bullying has an advantage over the one being bullied. Teaching our children empathy at an early age is a vital piece to their lives. â€Å"Without empathy; we would have no cohesive society, no trust and no reason not to murder, cheat, steal or lie. At best we would only act out of self-interest; at worst, we would be a collection of sociopaths†(Szalavitz). This advice is so true because the way we teach and treat our children will ultimately be the way they treat others as they get older. Spending quality time and giving lots of positive attention to our children will help them grow and develop positive social skills. It is very sad to sit and watch the news or read the paper and see that there are young people committing suicide over being bullied at school. These children should not see ending their life as a solution to any problem. Teachers and parents should be doing everything in their power to put a stop to bullying in schools. If a child is bringing that much harm to another child they should be expelled. Maybe then their parents will realize how serious the problem is and do something to help their child before it’s too late. School is a place to learn and develop as people in society. Children should not have to feel threatened but feel safe in school. Teachers, school staff, and parents definitely need to be aware of everything that goes on with  these children in order to teach them the right ways to deal with problems. After all they are going to be harder to control the older they get.

Corrections Current Trends

When it comes to prison sentencing there are a lot of trends to go from, probably the main outline you could say is the sentencing models these models are a basic outline of what’s going to happen to an offender while being sentenced.These are the six options which include: capital punishment- for like murder offenders which includes the death penalty only in some states though, imprisonment -for those who commit violent crime and so forth usually sent to state or federal prison longer that one year, short term confinement -for minor offenders those petty crimes such as petty theft and so on normally less than a year served in county, intermediate sanctions- falls between probation and imprisonment which I would say is on the fence could go either way prison or probation which includes house arrest and electronic monitoring, then theirs probation which is a alternative of prison in which the offender is monitored within the community, and then theirs economic sanctions- which I would say an offender like this would be due to vandalism or something in that nature, in economic sanctions the offender is ordered to pay restitution or a fine for their crime.Pretrial diversion is a good system for offenders who are not constant offenders, for instance here in Odessa TX they have what I would call a pretrial diversion program which is called teen court and in teen court offenders for let’s say theft well instead of it going down in the records they chose to do some community service and avoid trial and a criminal record but this type of program is only offered to teens. For those who have the option of pretrial diversion it is a pretty good system which allows first time offenders in most cases to stay out of the system. Plea bargaining is a really good trend in sentencing, because plea bargaining is an agreement in which the defendant decides to plea guilty to the offense in return the defendant gets a lesser sentencing.Plea bargaining is a good system why because if the defendant pleads guilty to a lesser offense not only does it save time without having to go to court and the expenses they would have to put out their but most times if the defendant know that he or she did it and them pleading guilty to a lesser offense to cut back time in prison or probation most times they will take the bargain. Another great trend in sentencing is the three strikes laws which basically states that felons who commit three felonies are incarcerated for a very long time sometimes even life in prison this trend is good because most times it will keep repeat offenders from committing crimes I guess the thought of getting that third strike and going to prison for possibly life would be a really strong motivation to stay out of trouble and keep doing good.Then again this three strikes law could not be a good thing for instance in the text it talks about jerry Williams who had a record of two prior felony convictions involving violence when he stole p iece of pizza without a weapon from four children, then the judge under mandatory California law, had to sentence Williams to twenty five years in prison. I understand this man had a record and was on the verge of the third strike but I don’t think that sentencing Mr. Williams to twenty five years in prison for a pizza was really necessary that five dollar pizza now has cost the state an estimated 500,000 for the time that Williams is going to be incarcerated a simply being locked up for even a year in county would I think be more suitable and cost friendly in which saves the state a lot of money.Drug courts is also another great trend in sentencing because in drug court offenders who have had or have a problem with run in with the law due to drugs can choose to get help and drug court main goal you could say is to get the offender help and back into the community clean and on their way unlike traditional courts, drug court is not so much to punish the offender but to change the offender according to the text drug courts have proved very promising, and I would say a very good solution on handling a different kind of offender so that they wouldn’t have to go into a regular court and maybe receive six months or maybe even a worse sentence but trying to rehabilitate the offenders who need help and get them back into the community and on the right track. These trends that I listed are only a few that help the sentencing progress move along there are a lot more trends but these are only a few with a slight overview of how they operate and what goes on in the few trends that were listed.

Strategic Audit Essay Example | Topics and Well Written Essays - 2750 words - 2

Strategic Audit - Essay Example Worldcom was regarded as world’s second-largest long-distance telecommunications company (Lyke, 2002). It was established in 1983 by Bernard Ebbers as a long distance discount service (LDS) provider. It initially sold AT&T WATS lines to small businesses. WorldCom was successful in selling LDDS and thus, the business grew rapidly (Lyke, 2002). The company acquired about 70 small and medium-sized companies. The acquired companies included IDB WorldCom, largest international carrier; WilTel, telecom carrier; and lastly, international phone company and parent of UUNET, MFS Communications (Lyke, 2002).  During the period 1997, the operational networks of CompuServe and America Online formed part of the giant company, WorldCom. The company also merged with Brooks Fiber and thereafter, it had acquired MCI. The merger and acquisition had rendered the company the second largest long distance carrier in the United States. However, prosperous position in the market of United States had not sustained as the company had to file bankruptcy in 2002 (Lyke, 2002). WorldCom filed for bankruptcy since it had encountered huge financial deficit. The company disclosed to have earned the inflated profit of $ 3.8 billion for the previous two years. Nevertheless, the amount was observed to rise beyond $ 10 billion, rendering it the â€Å"largest accounting fraud in U.S. corporate history† (Yahoo! Inc., 2007; Lyke, 2002).  The external auditor of WorldCom was Arther Anderson LLP and later, KPMG.

San Francisco Prescott Hotel Essay Example | Topics and Well Written Essays - 1000 words

San Francisco Prescott Hotel - Essay Example The hotel offers some of the best services to its customers. From celebrities to business executives, from families to groups of friends, the hotel fits the needs of all its guests. The experience is unmatchable and the hotel is marked as one of the bests mainly because of the front desk staff here at Prescott. The front desk staff plays a major role in any hotel’s success and progress. They tend to carry out some of the major activities related to the customers including welcoming customers, listening and responding to customer complaints and needs, allocated check ins and check outs, ensuring security arrangements, settling customers’ accounts, and giving them important information or messages (Sterling, 2010). The hotel pampers its guests and provides them with a number of facilities that would add up to their amazing experience. It gives club level accommodations to the guests including complimentary breakfast and a free hosted bar night for two hours. The wine receptions in the evening for business executives and friends are hosted in the lobby lounge near the fireside. This is completely arranged and handled by the employees of Prescott. The front desk department has the duty to ensure all the events and services are given to the customers and there are no complaints. The staff at Prescott is friendly, highly professional, and trained in providing guests a remarkable experience. As we know that the biggest attraction that the hotel has is its location. The building of the hotel was originally built in early 1900s giving it old world elegance and adding to the historic importance of the location. The hotel lobby lounge adds to the historic importance as it includes paintings and interior which reflects the historical details related to the city. Prescott has trained its front desk department with all the necessary details about the paintings and the building. The employees seem to

Organ sale Essay Example | Topics and Well Written Essays - 750 words

Organ sale - Essay Example It is time the government legalized the sale of organs. Legalization of organ sales will lower vital organs-related deaths boosting the supply of such organs, eliminating illicit organ markets, allowing access to cheaper organ transplant, and compensate donors, as revealed from the Iranian system of organ transplantation. The demand for organs is overwhelming, and yet the supply is far more muted. Right now, over 85,000 people in U.S. alone are on the list of those waiting for organs (Calandrillo 72). Out of these, a majority (about 60,000) requires a kidney, 17,000 are in desperate need of a liver, 4,000 are hoping for a lung while 3,500 are desperate for a heart. The organs are the most important for the survival of any human being. Any defect in them can shorten a person’s life within a short period. The patients on the waitlist thus urgently need them as they are living on borrowed time. However, the supply of these organs is shockingly far much less. Calandrillo says that the year 2003 saw organs harvest from only 13,000 individuals to facilitate the mere 25,000 transplants in the U.S. (72). It means that the many patients who were not successful to get a required organ sadly died. Ironically, the painful shortage is because a majority of the organs goes to the grave when the owners die. A lack of donation-appropriate organs is not a primary cause. A bumper sticker once read, â€Å"Please do not take your organs with you to heaven. Heaven understands that we are desperate for them here on the earth† (The Economist). Each year witnesses many Americans die in ways that would make it possible for an organ harvest. For example, some die in road accidents, others due to heart attacks and strokes, but organs come from only a few of the possible donors. In fact, about 75% of the Americans are not ready to donate organ upon their death. Hence, the remaining percentage that have opted to offer an

The Holocaust Museam Report Essay Example | Topics and Well Written Essays - 1000 words

The Holocaust Museam Report - Essay Example The Museum, through static displays, brings history alive by explaining how the Nazi Party inflicted mayhem and cruelty out of sheer feelings of hatred and abhorrence for the Jews. The museum also takes great care to explain that women, elderly, and over one million children were killed in cold blood, in order to take revenge for the alleged support rendered by some European Jews to the enemies of Germany during WWI. It is believed that nearly six million Jews were massacred by different means during these twelve years, and that other cruelties were inflicted upon other racial communities. Between 1941 and 1945, five to six million Jews were systematically murdered by the Nazi regime, its allies, and its surrogates in Nazi-occupied territories. Yet, despite the extraordinary scale and intensity of this genocide, its prominence in recent decades was far from preordained. Hatred can be overcome only if an honest, non-political approach is used towards those who may be affected or who m ay instigate the violence. Hatred, undeclared violence towards others left unchecked, can lead others to disregard their understanding of their own humanity. To dislike somebody or something is understandable; however, to do so in such an intense manner to somebody or something that evokes feelings of anger, hostility, or animosity, is wrong. To know hatred, there first must be an understanding of what forms of hate can influence our actions and theits effects on history. Once hatred is identified, hopefully through education, solutions can be implemented in ways to intervene and negate such actions. The Jewish Holocaust, a depressing subject, helps to shed light on the darkness of humanity in the modern age. Although other holocausts have occurred throughout history, it is often the victor of such tragedies who writes history. Thus, such tragedies are often relegated through time, and their long-term impact can be eroded. The museum helps to educate and serve as a venue of historie s past. Most individuals have never seen a dead body in person in a non-clinical setting. Imagine witnessing such an atrocity as someone being murdered. Try to comprehend this tragedy and multiply it by six million. This idea, with the use of pictures and the personal accounts displayed in the museum, illustrates this dark chapter of humanity with the use of personal details and artifacts of the Jewish-American immigrants who survived. The efforts by the museum can only help to teach, in a non-partisan way, what has happened and could continue to happen if efforts to stop such tragedies are not undertaken. As the WWII generation can no longer tell their story due to old-age, the Holocaust Museum will speak on their behalf for many years after their voices fall silent. The Holocaust Museum demonstrates the overall history of the solution through the logical sequence of Jewish migration. The museum displays explain that it is not easy to order a fighting soldier to take 25 innocent pr isoners and kill them. Social, political, and religious ideological understandings must be in place to activate such atrocities. Throughout history, evil persuasion has influenced others to act inhumanely. Although such instances are rare and difficult, history has proved that genocide has occurred

Power point presentation about Firewall Technologies Essay

Power point presentation about Firewall Technologies - Essay Example These threats lead to the creation of the firewall technology in order to protect a computer or network of computer which is connecting to the internet. A firewall is defined as a "computer, router, or other communication device that filters access to the protected network" (Abie 2000). Thus, it gives the implication about the main tasks of a firewall. Accordingly, a firewall inspects traffic network passing through it and is responsible for permitting or denying access. In addition, Cheswick and Bellovin specifies certain processes which characterizes a firewall which include: "all traffic from inside to outside, and vice-versa, must past through it; only authorized traffic, as defined by the local security policy, is allowed to pass through it; and the firewall itself is immune to penetration" (Abie 2000). In summary, a firewall serves as a filter allowing the access of a trusted network and rejecting "untrusted" ones. The emergence of firewall technology occurs during 1980s far before the internet has gained popularity in global users. Traditionally, a firewall is a term used to denote a "wall to confine a fire or potential fire within a building (Firewall 2008)." The use of firewall in internet has been triggered by the attack of Morris Worm making internet connection vulnerable to its adverse effects. Because of what happened, the whole community becomes aware of the realities of such attack which can threaten the computers accessing the internet (Firewall 2008). Thus, the online community sought for a protection in order to ward off the threat of viruses, worms, and other which can be very harmful and disruptive to the internet users. This is when firewall technology came into being (Firewall 2008). The beginnings of first generation firewall technology can be traced to the paper released by engineers of Digital Equipment Corporation in 1988 (Firewall 2008). This is referred to as packet filter firewalls which lays down the foundation of a technology that will further be improved and developed. Thus, after the work of these engineers, companies like AT&T Bell Labs and scientists Bill Cheswick and Steve Bellovin continued the long process of research and released a more efficient and complicated versions (Firewall 2008). Packet filtering is a firewall technology which acts by "inspecting the packets which represent the basic unit of data transfers between computers on the internet" (Firewall 2008). A packet filtering router typically filter packets based on four fields namely, source IP address, destination IP address, TCP/UDP source port, and TCP/UDO destination port (Chadwick 2004). These functions of packet filter are used to block connection from specific hosts or networks, to specific hosts or networks, from specific ports, and to specific ports. Because of their relative simplicity, this type of firewall perform only basic operations including "examining the packet header, verifying the IP address, the port or both, and granting and denying access without any changes" (Abie 2000). Packet filters are regarded for their speed and

Business ethic Essay Example | Topics and Well Written Essays - 500 words - 1

Business ethic - Essay Example In conclusion, the challenge was on both AWB and oil protocol. The main stakeholders in the case study are Iraq government and the international community including the US and Australia. Likewise, the primary interest of Australia was to obtain oil while offering food support to help in the recovery of the war torn Iraq after the desert storm. The primary interest of the Iraq government led by Saddam Hussein focused on protection of personal interest and development of the weapons of mass destruction. The ethical framework theories such as the teleological ethics can apply to the situation because it is based on the end result of the action. For instance, the food for oil, programs main aim was to ensure the Iraqis do not die of hunger after the operation desert storm which leads to loss of food reserves. However, the end result of the program was massive corruption making the idea wrong based on the teleological ethics theory. The consequence of the approach of the makes it a wrong approach in Iraq because of massive corruption and strengthening of the incumbent government which latter stocked itself with banned weapons including biological weapons of mass destruction. Utilitarianism ethical theory focuses on the greatest benefit to the greatest number of people. For instance, the attack of Iraq because of the existence of the biological weapons was considered a best option because it would benefit the whole world. Therefore, the theory supports the invasion of Iraq by the inter national community. The decision to open case against the eleven executive members of the AWB board is end product of unethical approach in problem solving for the Iraq case. The best approach was to ensure that the Iraq government pays for the goods and service provided instead of working on the Oil for Food strategy which failed miserable and led to empowerment of the incumbent government. In a good strategy in solving strategy ensures that

Post-16 option Essay Example for Free

Post-16 option Essay POST 16 – OPTIONS Post 16 options are given to young people and adults after they finish year 11 from school. Each post-16 option offers you different qualification opportunities and a different mix of teaching methods and assessment. Post 16 options comprises on: STUDY FULLL TIME 6th form or college Take up an Apprenticeship, Traineeship or Supported internship Take a part-time education or training course if you are employed or volunteer for more than 20 hours per week STUDY FULL TIME Schools, colleges and training providers offer a range of subjects and courses in which a student can study full-time. It normally requires to have at least five GCSEs at grades A* to C and at least grade B in any specific subjects one chooses. 6TH FORM COLLEGES A sixth form college is an educational institution in England, Wales and Northern Ireland, where students aged 16 to 19 typically study for advanced school-level qualifications, such as A-levels, BTEC and the International Baccalaureate Diploma, or school-level qualifications such as GCSEs. In England and Wales, education is only compulsory until the end of year 11, the school year in which the pupil turns 16 (although this is changing in August 2013 to compulsory education until year 12 and by 2015, education will be compulsory until year 13) In the English and Welsh state educational systems, those wishing to continue may either stay on at a secondary school with an attached sixth form, transfer to a local sixth form college, or go to a more vocational further education college, although, depending on geographical location, there may be little choice as to which of these options can be taken. In the independent sector, sixth forms are an integral part of secondary schools (public s chools), and there is also a number of smaller-scale independent sixth form colleges. Students at Sixth Form College typically study for two years. Some students sit AS examinations at the end of the first year, and A-level examinations at the end of the  second. In addition, in recent years a variety of vocational courses have been added to the curriculum. There are currently over 90 sixth form colleges in operation in England and Wales. Most perform extremely well in national examination league tables. In addition, they offer a broader range of courses at a lower cost per student than most school sixth forms. In a few areas, authorities run sixth form schools which function like sixth form colleges but are completely under the control of the local education authorities. Unlike further education colleges, sixth form colleges rarely accept part-time students or run evening classes[citation needed], although one boarding sixth form college exists. Take up an Traineeship, Apprenticeship or Supported internship Traineeship It makes one get ready for work or for doing an Apprenticeship. They last from six weeks to six months and provide essential work preparation training, literacy and numeracy skills and work experience to get an Apprenticeship or other job. Apprenticeship In an apprentice ship one has to work for an employer and train to do a specific job at the s Apprenticeships at three levels: a, Apprenticeship b, Advanced Apprenticeship c, Higher Apprenticeships Entry requirements for these apprenticeships is one must be 16 or over, living in England and not in full-time education. There are now nearly 200 types of Apprenticeship from engineering to boat building, veterinary nursing to accountancy. Options depend on experience and what is available locally. There is no set time for completing an apprenticeship. Most take between one and four years, depending on the level of learning capabilities. As well as working alongside and learning from experienced staff, there will be off-the-job training, usually on a day-release basis at a local college or specialist training facility. The qualifications will be a study for a work-based qualification at level 2, 3 or 4, a technical certificate relevant to to the subject chosen occupation, such as BTEC or City Guilds award and Functional Skills qualifications. More studies included for certificates or other qualifications that are required in chosen occupation. Assessment includes a mix of observation by an assessor, the assessment of a  portfolio of evidence and examinations. Supported internship Just for students with learning difficulties or learning disabilities who want to get a job and need extra support to do this. They last for at least six months and are unpaid. Work experience and an employer trains students to do a job role. Students also get to study for qualifications or other courses to get ready to take up a job. Work or volunteer while studying or training part-time It is a combined training or studying for a qualification and work at the same time. It doesn’t have to be a paid job, student can volunteer on a project or with a charity, or get a work-experience placement in a career or job area that interests them. Colleges and training providers offer a wide range of training courses which are part-time including A levels and work-related qualifications like BTECs or NVQs. BTEC’s- are usually studied at school or college they are work based qualifications that are a mix between practical and theory and some work experience. NVQ’s- these can be taken either at school/college, through a placement or in the work place.

Effect of Tetanus Toxoid Vaccine on Neonatal Tetanus

Effect of Tetanus Toxoid Vaccine on Neonatal Tetanus Evaluation of the effect of Tetanus Toxoid vaccine on neonatal tetanus Clinical scenario Tetanus is a vaccine preventable disease caused by a ubiquitous spore-forming bacteria called Clostridium tetani (reference need). Due to its ubiquity, the disease cannot be eradicated (Roper et al. 2007). Tetanus that occurs in neonates between 3-28 days of life is termed neonatal tetanus (CDC, 1997) and the most common nidus of infection in neonates is through the freshly cut umbilical cord (Bennett et al. 1996; Roper et al. 2007). Substantial progress has been made towards the elimination of maternal and neonatal tetanus (MNT) by the WHO initiative, although it still remains a major problem in more than 30 developing countries (figure 1) (WHO, 2015). Figure 1. The global map sowing the advancement towards the elimination of maternal and neonatal tetanus. Source: WHO. (2015). [Online]. http://www.who.int/immunization/diseases/MNTE_initiative/en/index4.html Developed countries such as the United States of America, England and Denmark, have long ago eliminated tetanus linked neonatal deaths compared to developing countries (Pascual et al. 2003; Simonsen et al. 1987; Rushdy et al. 2003). Haws et al. (2007) mentioned that in areas where the prevalence of neonatal tetanus is common, vaccinating women against tetanus during pregnancy is likely to prevent the disease. Neonatal tetanus still remains one of the leading causes of infant mortality in many developing countries despite the fact that tetanus vaccine has been available for years (Stanfield et al. 1984). Hence, the aim of this critical appraisal is to evaluate the effect of tetanus toxoid vaccine given to pregnant women to provide effective protection and reduce deaths from neonatal tetanus in comparison to no vaccine. Focused Clinical Question Table 1: Search Strategy Inclusion and Exclusion Criteria Table 2: search and screening results Total number of studies = 3 (Blencowe et al., 2010; Maral et al., 2001 and Demicheli et al., 2013). Table 3: CASP screening tool for the appraisal of two Systematic Reviews and one Cross-sectional Study *A cross-sectional appraisal tool does not exist, therefore Maral et al., 2001 was appraised using the systematic review appraisal tool. Exclusions Summary of best evidence Blencowe et al., 2010 Systematic review Aim/Objective of the Systematic review: To evaluate the effect of Tetanus Toxoid vaccination of pregnant women or women of child bearing age on neonatal tetanus mortality. Study Design Search Strategy A range of appropriate databases were used such as PubMed, EMASE, Cochrane Libraries and World Health Organisation Regional Databases. Suitable search terms were used such as ‘Neonatal Tetanus, Tetanus Toxoid, Neonatal Mortality and Women’. Publications in any language were also included. Selection Criteria for inclusion of studies The PICO format (Patient, Intervention, Comparison and Outcome) was used in this review to identify the studies to be included as follows: Population – Neonates Intervention – At least two Tetanus Toxoid vaccine doses Comparison – Neonates born without Tetanus Toxoid vaccination Outcome – Mortality from Neonatal Tetanus Randomised trails and observational studies meeting the above criteria’s were considered in this review. Methods A systematic review of various databases was carried out to identify suitable studies meeting inclusion criteria Standardised abstraction forms were used for each outcome of interest for studies meeting the inclusion criteria Studies not meeting the inclusion criteria, studies which only reported serological outcomes and duplicate reports of studies or trails were all excluded Quality of individual studies and evidence were evaluated according to the CHERG version of the GRADE method to generate an approximate calculation of the effects in reducing neonatal mortality A meta-analysis was carried out using STATA version 10.0 statistic software and stated the mantel-haenszel pooled relative risk and corresponding 95% confidence intervals (CI) Findings Two studies which had no heterogeneity between them (p=0.16) i.e. a high-quality randomised controlled trial and a well-designed cohort study with adjustment for publication bias in its analysis, were joined into one meta-analysis to give an estimate of relative risk (RR)= 0.06 (95% CI 0.02-0.2) (Fig. 1). While, three case-control studies each with adjustment for publication bias showed a protective effect of two tetanus toxoid injections during pregnancy (odd ratio (OR) = 0.05 (0.005-0.4); OR=0.1 (0.03_0.4); OR=0.2 (0.03-0.7). Overall result A 94% reduction in neonatal tetanus mortality (95% CI 80-98%). The confidence interval of 95% for these results appear to be accurate.