Macro Level Services

September 21, 2017

Macro Level Services

Macro-level services in the society entail the establishment of the social interventions with positive implications in the community, federal State as well as at the national level vital in solving co-occurring disorders (Netting et al., 2016). These services are essential in treating clients diagnosed co-occurring disorders based on political landscape, norms, expectations policies, legislation amongst other service offerings.

In a political landscape, the federal government has invested much to address co-occurring disorders by allocating funds and facilitating training of officers at the Justice Criminal levels. This is not only done in one State, as it covers every region making it a global practice. In this context, a client must be examined by the trained staff to verify their release warranty. Nonetheless, the society dominated by residents has established norms and expectations which a client released have to adhere to for survival. For instance, ethical decision-making process on drug abuse helps rehabilitate the client in their attempt to meet the societal expectations. The federal government has policies and legislation on co-occurring disorders that are used to coordinate activities in bodies such as Center for Substance Abuse Treatment to assist the affected individuals in the society. These features are critical in addressing the client’s health as well as a mental state upon release.

Inadequate collaboration and lack of relevant resources are amongst the main factors that might negatively affect the service offerings necessary to support the client. Therefore, treating this client in a macro level service perspective entails the integration of several policies that demand resources due to co-occurring disorders. For instance, the demographics medical as well as health educative approaches are critical in finding appropriate ways of solving the mental incapabilities affecting this client (Netting et al., 2016).

Some of the examples of local, national and global level policies for a client with the co-occurring disorder as well as criminal background include ensuring such individual does a routine screening in a criminal justice setting. Locally, there are standards set as well as facilities used to ensure the relevant course of action regarding the incarcerated criminals. Heath records are maintained at national levels for effectiveness in screening by the agencies involved in the assessment process. Globally, staffs responsible for co-occurring disorders are trained on specific issues to investigate when faced with such clients.


















Netting, F. E., Kettner, P. M., McMurtry, S. L., & Thomas, M. L. (2016). Social work macro practice. Pearson.








Total Compensation Package

September 21, 2017









Total Compensation Package






Total Compensation Package

After conducting the hiring and recruiting process, organizations often come up with an employee compensation and benefits package. The same case applies here at Tesla Motors where we provide comprehensive employee benefits package with an aim of attracting and retaining employees. Moreover, we develop an employee compensation and benefits package, which is a separate entity from the salary package as a standard measure because it is an expected part of the total compensation package and the employees are usually aware of it once they get hired by the organization.

As an organization that engages highly in production and assembly of cars, motor products and spare parts, employees enjoy the economies of scale due to the large size of the firm. The organization gives extensive benefits package to both the junior and the senior employees. The employee compensation and benefits package was developed at the time the organization was growing and is adjusted as the labor market changes as well as the prevailing market production conditions. The aim is to create an equilibrium where Tesla Motors benefits from the employees and in offering the packages as well the employees enjoy by getting the benefits. Therefore, as a human resource department secretary, the employee compensation and benefits package has to be in line with the budget of the organization, its goals and objectives as well as the employees agreement in the work contracts (Sims, 2016).

Health insurance package

This is the most fundamental benefits package that employees want and at the same time need. Due to the nature of physical work that most employees engage in while in Tesla Motors, health insurance packages offer a selection of choice in which the employee can choose an individual health insurance, which is free or a family health insurance, which comes at a subsidized cost.

Paid time off from work

We understand the intensity and demand of work input at Tesla Motors, which is why we allow employees to go for holiday or vacation twice a year. Additionally, there is no comprehensive employee package that would be complete without the employee getting paid time off from work (Harrison, 2012). The days are varied and account up to 60 fays. It is the choice of the employee to select on how to utilize the off days as they are paid for.

Other benefits under this package include paid sick days, paid holidays, bereavement leave, paid vacation days as well as paid personal days.

Short-term disability insurance benefits

The nature of work at the assembly and production plants at Tesla Motors is understood to be risky despite the fact that organization has worked to surpass the labor requirements in ensuring a safe working environment for the employees. However, upon the occurrence of an accident that leads to a short-term disability, the organization ensures there is insurance that provides the employee with a percentage of income even if they are unable to work, due to a disabling injury or a form of sickness (Williams, 2014).

Long-term disability insurance benefits

The long-term disability insurance (LTD) plan and policy under Tesla Motors ensures that an employee who get sick or injured in the line of duty gets compensation for a period of up to two and a half years. Additionally, the organization approximates that due to the nature of work, one out ten employees is bound to get long-term injuries in a period of three years.




Harrison, R. (2012). Employee Development. New York : Orient BlackSwan Publishers .

Sims, R. (2016). Human Resource Management: Contemporary Issues, Challenges, and Opportunities. New York : Information Age Publishers.

Williams, R. (2014). Managing Employee Performance: Design and Implementation in Organizations. New York : Cengage Learning.


Descriptive essay (memory)

September 20, 2017








Descriptive essay (memory)












Descriptive essay (memory)

Memories in life primary serve the role to entertain, teach and reflect our past. Not very often do people have memories to talk about their day-by-day encounters, unless something unusual or an extraordinary event occurs. I can be deemed memorable and one of the remarkable events in an individual’s life. This occurrence I do term as the most important life event I have ever experienced in my life, did not even happen to myself. Instead, this event happened to my little brother, Elijah. The primary reasons as to why I have to write about his life is because of some of the things he has experienced as well as the actions he has done in the past that did have tremendous effect on my life and the entire family. Elijah’s life use to be filed with drugs, lies, laziness and stealing. My family had never enjoyed any single moment with Elijah present in the compound.

The entire story begun at one point with my younger brother, innocent, self-conscious, and very shy boy did not could not find it very comfortable to fit well in our family. He was 16 of age, chubby with very limited number of friends from within out locality of residence. At one point, Elijah’s real friend and classmate John introduced him to a 20 year old boy by the name Clara. Elijah and Clara did hit it quite very well from the beginning and started making visits on a regular basis. The two went out on a day, had fun without anybody in the family knowing about where Elijah had gone.

My mother then later developed a subconscious felling that John knew where Elijah had gone. She tried to inquire about it but with no productive response which in reality was not the true story at all. During that time, I had gone to visit my aunt Jane. A week went by, still enjoying the stay with my aunt as I was free from the daily duties and instruction that I did routinely get from my parents. Since that day I fought my brother Elijah, it had not taken that long and so took a day extra for things to cool down at home. Upon my return, I expected a warm welcome with a lot of greeting from dining door, instead, to realize that my parents and younger sister Mitchel were headed to the car.  Full of curiosity, I proceeded directly to inquire from my mother what the whole story was all about and she immediately replied “Three hours ago Elijah confessed that for the past year, he has been doing heroin.” In deed my heart sunk. At first, I never took the sentence serious. He was taken to a rehab under monitor of my parents. On the same note, I went to my room, cried the rest of the day, just wondering that Elijah my beloved brother was under serious drug influence.

To my surprise, it did not take long before Elijah and my parents were back into the compound. The surprising report was that psychologists at the rehab has actually turned down my parents’ option to take Elijah into a rehab, claiming that he was aged above 18 and would easily sign himself off as a legal adult whenever he felt like. This arguments by the rehab therefore demanded that Elijah would face his withdrawal from home where he could develop focus on eliminating addiction to heroin (Miller, 2017). Now, I never had any idea or had any encounter with an individual facing drug withdrawal. Despite having not experienced it, I knew it was one of the most painful and frightening experiences one could ever boast off. The instruction was that Elijah had to be kept under custody in my parents’ room and be given at any point no chance to leave sight. The entire experience was devastating, I happened to be one who empathized with Elijah however. Despite the fact that he was at one point my enemy, my opinion was that he should have had a better treatment even though.  The events occurred in a chain series that would think everything was under plan. All the occurrences within that very day still remain fresh in my memory that one could think the event happened yesterday.

This day’s events and all activities remain fresh in my mind as if they did happen yesterday. It appears to remain one of the fresh memories following the fact that a good day full expectation, a day termed as “Mothers’ Day” turned out from what was expected to shower happiness, everything turns directly in the contrary.  Based on my experience with a home family as a case study of what and how drug withdrawal is conducted, I would recommend to those who have never witnessed what happens in rehabs to forget about imagining being taken into a rehab. It is embarrassing, painful and with no glory a place of thugs.













Miller Leah (2017). Long Term Rehab programs. Retrieved on 16th Sept, 2017 from




September 20, 2017

Human behavior turns out to be an essential concept continuously under studies by various academic disciplines such as Anthropology, Economics, Psychiatry, Psychology, Social work, and Sociology. Behavior in the context of studies describes the manner in which an individual interacts and responds to stimuli from the external environment. Behavior, on the other hand, defines continuous systems of actions about every day and new things. different individuals pose different behavioral characteristics based on the surrounding environment and reacting factors. Additionally, human studies reveal that the behavior of an individual mainly gets affected by presences alongside perceptions of ideas and thoughts. Thinking in literal terms defines the processes of generating ideas and solutions mentally by reasoning. According to studies and researches on human conduct, the thoughts of a person widely affect the behavior in the form of behavior (Tripathi, 2014).

Similarly, the aspect of input equals output connects substantially to the human dimension of thoughts and behavior. For instance, the thoughts of a person directly affect his or her behavior. Therefore, weird ideas result in bizarre conduct in an individual following research results based on human studies. About thoughts, perception equally adds to the general behavior of a person based on the fact that visual perception stimulates different responses in a person that in turn changes a particular channel of conduct (Tripathi, 2014). Obsession relates more to the idea of thoughts based on a universal concept that both involve mental operations. Nevertheless, obsession refers to the state of mind involved in thoughts in ways not typical. Obsession in an individual result from increased thoughts about something or somebody in a way out of the ordinary. The concept of obsession determines the general conduct of an individual based on a different perception of ideas and thoughts. Obsessive-Compulsive Disorder (OCD) defines a longer-lasting condition in which an individual experiences repetitive thoughts and behavior like obsession with an exception that the individual feels the urge to repeat continuously.

The idea of Obsessives-Compulsive Disorder points to the fact that uncontrollably recurring thoughts and behavior experienced result primarily from thoughts and perception of different ideas. However, Obsessive-Compulsive Disorder in many cases it controlled and ultimately put to a stop under special conditions of medication and therapy operations designed to relax and ease tension. Following research reports the obsessive results of thoughts and conduct occur under stress and tension (Hyman & Pedrick, 2012). Several drugs have been prescribed with attempts to control different cases of independent thoughts and behavior. The drug Topiramate turns out to be an anti-epilepsy medicine that was initially taken for approval by the United States Food and Drug Administration for use with phentermine for weight control purposes. Nevertheless, the drug was used for the treatment of headaches and Seizers.

Bupropion equally turns out to be a particular drug for the treatment of depression and similar seasonal disorders with depression features. The drug in many cases gets prescribed to patients with depression and in need of attention to restoring healthy thinking and behavior. Buspirone is a drug specially designed for anxiety purposes. The drug targets chemicals in the brain imbalanced in people with anxiety. The drug, therefore, aids patients reduce anxiety and resume normal conditions of conduct and thoughts. Paroxetine is a drug with identical properties as Bupropion in the essence that both are designed for treatment of depression. The drug appears in a group of drugs known as Selective Serotonin Reuptake Inhibitors (SSRIs). Paroxetine aids in the restoration of unbalanced chemicals in the brains of people with depression and anxiety as well as similar disorders. Aripiprazole is a drug sold in many cases under brand name Abilify; the drug specializes in the treatment of atypical antipsychotic. Additionally, it is a recommendation and is primarily used in the treatment of schizophrenia and bipolar disorder.

Also, the drug is used for the treatment of strange ailments such as anxiety and depressions. Risperidone turns out to be an antipsychotic drug. The drug specializes in changing the effect of chemicals in the brain that would otherwise cause odd conducts and thoughts. Risperidone is often used in the treatment of schizophrenia in older people and children at least 13 years. Additionally, the drug is used to treat symptoms of manic depression in older people and children of at least ten years (Kemp et al., 2014). Based on the medication and drug administration outline the appropriate diagnosis would be Depression and anxiety as well as thoughts of paranoid. The diagnosis, however, rules out OCD Paranoid schizophrenia based on the fact that Obsessive Compulsive Disorder is a known psychiatric condition that primarily make changes in the behaviors of the affected patients.

The diagnosis, on the other hand, gets closer to Schizoaffective disorder whereby Schizoaffective disorder turns out to be a mental disorder in which an individual experiences a combination of schizophrenia symptoms based on hallucinations, delusions, and symptoms such as mania. Nevertheless, given the symptoms of the parent who is 38 years old, the best recommendations for mental and behavior restoration would be therapy services and proper medical administration based on symptoms shown. Therapy refers to a remediation solution to a physical problem especially illness or mental and other disorders. Therapy takes place under health recommendations following diagnosis operations. There are many strategies put into place to restore different physical health problems. Following the ailment of the 38-year-old parent, relaxations programs such as yoga and counseling would be appropriate based on the fact that the client needs to relax the mind and let free corrupt thoughts that induce anxiety and depression as having been diagnosed.



















Hyman, B. M., & Pedrick, C. (2012). Anxiety disorders. Minneapolis: Twenty-First Century Books.

Kemp, A. H., Brunoni, A. R., Santos, I. S., Nunes, M. A., Dantas, E. M., Carvalho de Figueiredo, R., … & Thayer, J. F. (2014). Effects of depression, anxiety, comorbidity, and antidepressants on resting-state heart rate and its variability: an ELSA-Brasil cohort baseline study. American Journal of Psychiatry, 171(12), 1328-1334.

Tripathi, K. D. (2013). Essentials of medical pharmacology. New Delhi:  J


September 19, 2017





Objectives/ Learning Targets



Lesson Summary: The use of utensils in eating


Primary learning target: The lesson aims to teach the importance of using utensils in dining and how to go about this process.


Secondary learning target: The lesson also aims to teach the corresponding tools for every step in dining/eating.




Instructional Strategies 1.      Visual Aids (Video clips that demonstrate etiquettes in eating

2.      Live demonstration

3.      Student Performance and Role-playing


Skills and/or


List all standards and/or competencies used for this lesson here.  Use Extended Learning Standards if appropriate or Early Learning Standards if apporpriate  Links to Bloom’s Taxonomy and Adapted Bloom’s Taxonomy if appropriate


At the end of the lesson, the student must be able to:

1.      Identify the different utensils used in dining (cognitive objective);

2.      Show appreciation in using these utensils in exercises to be given (Affective objective) and

3.      Demonstrate the use of these utensils (psycho-motor objective).


Academic Language & Vocabulary

 Basic words like the following:

1.      Spoon

2.      Fork

3.      Plates

4.      Breakfast

5.      Lunch

6.      Dinner


Tools and Resources


1.      Samples Plates

2.      Sample Food

3.      Spoon

4.      Fork

5.      Cups

Prior Student Knowledge and Interests Sharing of Personal and Culturally Diverse Eating Habits and Practices

Sharing of Each One’s Favorite Food and Unique Ways of Eating them



How will you assess student learning for this specific lesson?

(Pre- Assessment Formative assessing and Post Assessment)

Data collection and documentation of data collection.




For the pre-assessment, the question and answer portion could suffice. The coach will see if the students already have a prior knowledge of the utensils, i.e. if she knows how they are called and what their uses are. For the purpose of identifying the students’ prior knowledge and also gauging student profile, the following questions can be asked:

1.      What do you usually prior to eating?

2.      How the utensils are usually arranged in the table for eating?

3.      What is usually done after eating?




Rationale Including Knowledge of Students and

Before & After the Lesson




Following the assessment of students profile and identifying learning objectives that need to be met, more specific objectives need to be outlines. Here are suggested objectives, but to which teacher can add more:


1.      There is the need to improve the students’ motor skills, particularly their ability to control and manipulate utensils so as to help themselves while eating.

(This is significant simply because eating is one of the more fundamental activities essential to human life, i.e. in sustaining human functions.)

2.       Preliminary social skills should be done between teacher and students.

(This can facilitate the conduct of the lessons and the students’ learning. Since there is a long-term goal appended to this initial lesson, the activities of demonstrating ability to use utensils will be done repeatedly until the students are able to show mastery in doing such and until the goals are met.




In this assessment plan, a general outline of learning objectives and the corresponding activities designed to achieve them is sketched. All of the types of learning objectives (cognitive, affective and psycho-motor) are included in this plan. This is done to align with principles of holistic learning which is the intended type of classroom and learning setting for the students. Activities are also specified to target such objectives. For instance, the cognitive and affective dimensions can be answered for by the sharing part of the lesson. Cognitive capacities will also be touched upon the short quiz that will kick off the lesson. Meanwhile, the students’ demonstration of techniques will correspond to their psych-motor skills. Feedback can be gathered by observing the students’ practicum and making them reflect on their own engagement with the activities and participation in the lessons. Aside from this, the class profile can be organized by reviewing students’ data and designing activities (in this case, the personal sharing of cultural expectations and backgrounds) in order to collect further information. This information is vital in ensuring that the plan for the lesson squares with the composition of the students.





Necrotizing Enter colitis in Neonates

September 19, 2017

Necrotizing enterocolitis is a serious disease which occurs after the death of intestinal tissue after damage. When the intestinal tissue is damaged, the intestines become inflamed. Only the inner lining of the intestines is affected but eventually the impact is felt throughout the entire thickness of the intestines.

Necrotizing enterocolitis is mostly common in premature infants. It is important to note the common symptoms experienced on the onset of necrotizing enterocolitis. Some of the symptoms include bloating, blood stained stools, swollen abdomen and loose stools.  If these symptoms are noted, it is very vital to call a pediatrician right away. Necrotizing enterocolitis can be life threatening if it remains untreated in neonates.

In many cases, necrotizing enterocolitis forms a hole in the intestinal walls. When the hole is formed, the bacteria found inside the intestines leaks out to the abdomen causing a spread out infection. In such a scenario, it is considered an emergency.

As indicated earlier, necrotizing enterocolitis can develop in neonates mostly two weeks from birth. Premature infants are more prone to necrotizing enterocolitis and most of them weigh three pounds five ounces. Necrotizing enterocolitis progresses very fast and treatment is very key if a neonate shows any symptoms. Treating necrotizing enterocolitis can be done using antibiotics, surgery or intravenous fluids and once treated, neonates respond quite well without any complications.

While the major symptoms of necrotizing enterocolitis include swollen or bloated abdomen, blood in stools, poor feeding, diarrhea and vomiting, a neonate might experience disrupted breathing, lethargy and fever.

The cause of necrotizing enterocolitis is unknown. It is however believed that during delivery, there might be lack of oxygen which is a contributing factor. When the oxygen supply or blood flow is reduced to the intestine, it might be weakened. When the intestines are weakened, they become vulnerable to invasion by bacteria from food that enters the intestines. Invasion of bacteria causes damage to the tissues of the intestines hence developing an infection or necrotizing enterocolitis.

If a neonate has too many red blood cells or any other gastrointestinal condition, they are more likely to have necrotizing enterocolitis. Neonates born prematurely are prone to infection because their organs are underdeveloped hence have difficulties with digestion, immunity and blood as well as oxygen circulation. The one of the risk factors of the disease in infants is the difference between the times when they are born. If a baby is born after thirty five of gestation, their chances of getting NEC is lower than those born before thirty five weeks. Prenatal factors such as reperfusion injury can result to a cascade of inflammation which can damage the vasculate and intestinal mucosa in the intestines. Drug use and problems related to placental flow of blood may cause growth restricted newborn. If the placenta is unhealthy, the quality and quantity of nutrition supplied to the fetus leading to a compromise in metabolism. Intrapartum risk factors like cardiac arrest and prolapsed of the umbilical cord can lead to NEC in neonates. Maternal infections during the Intrapartum period are a major risk factor.

Necrotizing enterocolitis is usually suspected but needs imaging for diagnosis. The disease is mostly diagnosed by radiography and the signs tell which stage the disease is at. At the third stage, that is when metabolic and respiratory acidosis is noted.

Treatment of necrotizing enterocolitis is mainly supportive care. The pediatrician can recommend stopping of breast feeding. The neonate can then be administered intravenously. Antibiotics help fight the infection. In case of a swollen abdomen or if the neonate is experiencing difficulties in breathing, it can be given breathing assistance by receiving extra oxygen. The neonate can be provided with bowel rest by terminating feeding. Also, gastric decompression with intermittent suction and correcting electrolyte abnormalities acts as treatment to necrotizing enterocolitis. Parental nutrition and antibiotic therapy treats the disease.  Monitoring of the progress is done using x-rays of the abdomen which should take place every six hours. Surgery is the only option when all medical treatments fail. The surgery resects the part of the intestine that is dead.

It is good to give thought to controlling or preventing necrotizing enterocolitis when a child is born prematurely. Feeding a neonate or preterm babies using human milk is a prevention measure with very many short term and long term benefits.

To sum up, necrotizing enterocolitis is a serious disease and can claim the life of an infant. However, if the disease is treated, most babies recover fully. In few cases, the bowel of an infant become damaged and narrow leading to blockage of the intestines. If this scenario occurs, absorption of nutrients becomes difficult.  Poor absorption is more likely to happen in babies whose intestines or rather part of their intestines has been removed.





AlFaleh, K., & Anabrees, J. (2014). Probiotics for prevention of necrotizing enterocolitis in preterm infants. EvidenceBased Child Health: A Cochrane Review Journal, 9(3), 584-671.

Bizzarro, M. J., Ehrenkranz, R. A., & Gallagher, P. G. (2014). Concurrent bloodstream infections in infants with necrotizing enterocolitis. The Journal of pediatrics, 164(1), 61-66.

Pammi, M., & Haque, K. N. (2015). Pentoxifylline for treatment of sepsis and necrotizing enterocolitis in neonates. The Cochrane Library.



Case Analysis-Hiperbaric

September 17, 2017








Case Analysis-Hiperbaric















Case Analysis-Hiperbaric

  1. Customer Analysis

Hiperbaric is a high-pressure processing (HPP) equipment maker based in Spain. The company is the world’s leading manufacturer of the HPP equipment, which it has sold across six continents. Since its formation in 1999, the company has been a leader in high-pressure processing technology and has so far sold more HPP equipment that all other suppliers combined (Hiperbaric, n.d.). HPP technology provides an alternative process of food preservation that allows the elimination of the need for the use of preservatives.

The company operates in the B2B segment where it sells its products and services to other businesses. In its category of customers, the company offers its products to small food processes and large corporate food processors. The products for small food processors are those with the throughput of less 1000 Kg per hour while the HPP equipment with more than 1000 Kg per hour processing capacity is directed towards large food processors.

Currently, its existing customers are concentrated in the United States, which accounts for 55%. Europe and the rest of the world account for 25% and 20% respectively (Hiperbaric, 2016). However, the adoption of HPP is still in its infancy, and there is a large potential for growth for Hiperbaric. The organization views Asia as the market with the highest potential for growth, and the segment will be of great interest to the company in its future growth strategy.

The company’s current customer characteristics differ regarding their size and the equipment that they serve. The small size customers purchase low capacity HPP equipment to reflect their production and financial positions (Hiperbaric, 2016). Most of the products of range from almost $1 million and above and this limits the number of companies that can afford such products. The small-size customers use the HPP equipment for processing their products in niche markets or small-scale products that can be fully covered by the small capacity HPP machines. On the other hand, large-scale customers have a high capacity, which requires more than 1000kg/hr processing capacity machines (Hiperbaric, 2016). Additionally, some of the companies that purchase large-scale HPP machines also often provide tolling services, where they offer HPP services to other enterprises that do not have the financial strength to buy their machines.

  • Buyer Behavior Analysis

Buyer behavior analysis is a valuable tool that allows a business to understand its customer’s purchasing process and consequently find ways through which it can tailor its business to align its sales strategy to attract as many customers as possible. The Buyer Behavior Analysis table below will represent the buying process of the clients of Hiperbaric.













  Actions DMU Criteria Influences
Problem Recognition Customers will realize the need for new (cold) pasteurization technology that avoids the use of heat to meet client needs for natural foods without preservatives Initiators

-R&D team

Desire for better technology to serve customers with more natural foods
General Needs Description -Introduce machines that can pasteurize products without requiring heat Influences

– Quality assurance team

Decision makers

-The management

-Impact on the company bottom-line


Specification -Processing capacity


Decision makers

-Quality Assurance team

The processing capacity, the ease of managing regarding repairs, and the prices Impact on the company bottom-line
Supplier Search -Referrals

-Other industry players

-Online Search



-Industry allies

-HPP reviews online

-Newest and the industry standard trends
Proposals Submission -Price and Capacity quotation Influencers

-Various brands that can supply HPP Machines

The proposal must include the specifications of the equipment and the price To get the best offers
Supplier Selection -Credibility

-Supplier after-sales care



-Quality assurance department

-Technical team

A supplier with credibility and good customer care To get the best offers
Order Process Specification -Customer care

-After sales customer care/services


Decision makers

-Finance team

-Technical department

A deal that involves cooperation between the supplier and the business during and after the purchase To get equipment that is effective and easy to use and maintain
Performance Review -Engagement of the provider throughout the buying and after sales stages Gate Keepers


-Quality assurance team

The response time, other client reviews, and post purchase support To ensure the best service for a long time

Table 1: The Buyer Behavior Analysis table

The findings of the above behavioral analysis show the buying process of the customers of Hiperbaric. By identifying the decision makers and influencers at each stage, it is possible for the company to put strategies to ensure it meets the needs of the decision makers and influencers and each stage.




The Gridbuy Framework

New Task

-In this stage, potential customers of Hiperbaric recognize the need to purchase an HPP equipment to meet their needs

Modified Rebuy

-This relates to those companies that may have bought HPP product but feel that their needs are still not being met and thus seek new and better products from Hiperbaric

Straight Rebuy

-These are majorly the companies that majorly seek to upgrade their equipment capacity and thus come to buy bigger and better equipment from Hiperbaric












  • Relationship Analysis

The relationship analysis is a critical approach towards ensuring that business to understand the relational needs of its customers. Through the process, a company can put in place strategies to ensure its customer services meet the needs of the clients and thus better outcomes. The table below highlights the relationship analysis for the customers of Hiperbaric.

Components of the Relationship Small Purchasers Large Purchasers Large and Small Purchasers Differences in Relational Needs
Trust-Both customer segments demand trustworthy and ethical interactions

Mutual benefits-Both market segments seek to benefit from interacting or purchasing the products from HPP

Long-term Perspective-As an essential product for business services, all the customers of HPP want supplier who will work with them for a long time

Commitment-The customers seek a supplier who is committed to ensuring their needs are met at all times

Communication-Effective communication is needed all times

Customer Services-Responsive customer services are demanded by the customers

The two customer segments have similar relationship needs that involve trust, long-term perspective, mutual benefits, commitment, communication, and customer services

-The larger purchases, however, require more communication as any problem may have a significant influence on the services

Preferred Relationship Type



-Close and Trust Worthy Relationship

The customers of Hiperbaric vary significantly in terms of the Ladder of Loyalty. The company has many prospects, customers, clients, supporters, advocates, members, and partners. In this case, a ladder of loyalty can only be effective in analyzing specific and select customers.

There are not major differences in the relational needs between the two business segments of the company

Table 2: Relationship Analysis-The analysis shows that the two business segments of Hiperbaric do not have a major difference. This can be attributed to the fact that the company does not operate the two segments separately and that it views its market segments similarly


  1. Company Analysis

The company analysis will offer an important opportunity to analyze the company’s performance and its ability to build a relationship with their customers and their current network performance. This is an important process that will be considered in determining the SWOT summary of the company and thus guides future strategies of strengthening its performance.

Supporting Conditions
Leadership & Culture The organization’s leadership can be viewed as highly transformational and engaged throughout the company’s activities. The culture of the organization is based on high degree of teamwork and quality standards
Data Information & Technology The company has invested heavily in its research and development to ensure it comes up with the best products that meet the needs of the customers. Additionally, it is very open to the customers to ensure a sense of trust and ability to meeting all their needs
People The company has more than 100 employees drawn from different nationalities and for various roles. The diversity ensures that the company can meet the needs of the consumers, wherever they come from
Processes The company has been in operation for more than 15 years and has established processes from the product manufacturing to customer services which ensure that clients are satisfied
Customer Portfolio Analysis Hiperbaric has customers drawn from all over the world and majorly focused on medium and large scale food processors

The customers purchase small and large capacity HPP equipment to meet their demands

Customer Intimacy Hiperbaric works closely with its consumers before, during, and after the acquisition to ensure that all the needs of the customers are met.
Network Development Hiperbaric has established a strong customer care system that ensures that the organizations can efficiently respond to customer concerns and interests at all times
Value Proposition Development The value proposition for the company is achieved throughout the purchase process, which ensures that the needs of customers are met at all times. Additionally, the company has out in place an elaborate post purchase support for the consumers.
Manage the Lifecycle The process is repeated for all the customers.

Table 3: CRM Value Chain-The value chain analysis has highlights the company’s ability to form relationships. Evidently, the company works closely with all its customers to meet their needs






Plastic Manufacturers
Iron Ore Miners

The Network Map Analysis ARA model is an important tool that allows an organization to determine its current network capabilities based on its actors, resources, and activities in its industry. The Map below highlights the network capabilities of Hiperbaric based on the ARA Model.


















Diagram 1: Network Map Analysis-As a B2B company operating in a niche industry, Hiperbaric Network is still very small






Hiperbaric. (2016). Industrial High Pressure Processing Equipment. Miami, FL: Hiperbaric.

Hiperbaric. (n.d.). Who we are. Retrieved August 23, 2017, from Hiperbaric-High Pressure Processing:





September 17, 2017

ECO201 Macroeconomics!

September 17, 2017








Team Chang:

Evaluating the Effectiveness of Quality Improvement Strategies on the Management of Diabetes, Systematic Review and Meta – Analysis


Institutional Affiliation


Majority of people who access hospital services represent a fraction of patients who utilize unduly large amounts of health management use, including emergency cases, admissions to hospital and treatment visits. They are of low socioeconomic status and suffer from chronic illnesses like diabetes, and have a high mortality rate. Several visits to the hospital lead to protracted waiting times and affect the quality of health services. The utilization of these services by the population fragment is disputed in various countries, hence the implementation of efforts to encourage incapable intensive therapy for frequent people. One common approach is the use of community-based clinics, which are a changeover of hospital care utilization away from the hospital and closer to the needy people. Much of this literature focuses on common emergency patients, for example, the diabetic patient who requires close monitoring and assessment. One methodological review noted several studies that evaluated the consequence of several mediations, including coordination of care, and the authors deduced that management of a case and interdisciplinary teams were preferably appropriate interventions to decrease visits in the emergency department (Tricco, et al. 2012). The visits are a portion of the burden of cost faced by hospitals. There is urgency in understanding the impact of these interventions whose goal is lowering the entire utilization of health care services, and admissions to hospital. We carried out a precise meta-analysis and review of the potency of quality enhancement strategies for coordination of care for the diabetic patients who frequent the system.


According to Tricco, et al. 2012, the existing strategies on potency of quality improvement of diabetes care stays unclear. Our goal during this research was to assess the adversity of these strategies on management of vascular risks, smoking arrest and monitoring of microvascular complications in diabetic patients. To improve diabetes management, measures to implement appropriate interventions with patient-mediated strategies of quality improvement should be practiced. Many trials of these strategies showed advancements in the care of diabetic patients.

Description of strategies of quality improvement

Coordination of care

As stated by Moher, et al. 2007, it is the purpose of the organization to deliver care activities to a patient and other participant(s) involved in the care of the patient to facilitate delivery of appropriate health care services. The activities include marshalling persons and the resources required to perform all patient care tasks; mostly managed through communication between participants in charge of the different aspects in care delivery. It entails, case management, which is the coordination of care to a patient, including diagnosis, medication and continuous management by someone else other than the in charge clinician; changes to the main health team functions, including often patient visits, use of integrative teams and the development of their professional roles; provision of equipment, for example, a glucometer and establishment of joint goals that empower patients in management of their ailment. It also involves the implementation of a system that generates feedback regularly, from registries, to the hospital teams on compliance guidelines and facilitation of other means for care coordination; and an information system in the clinics for the staff to enter patient data or retrieval at the time of care.

Two more components, patient navigator and outreach activities, are part of the health system. They offer guidance to people, linking them with the significant doctor, assists patient to access available therapies and assessment or follow-up carried out in the nearest clinic. Other strategies include: patient education on their ailment; reminding patients on upcoming appointments; educating clinicians on conditions that their patients might encounter, generating summaries of a patient’s or the clinic’s accomplishment which are submitted to the physician; provision of financial encitement for attaining pre-developed achievements; use of specific processes to note quality problems, formulating solutions, deploying and evaluating changes; and conveying clinical information to clinicians from patients through other means other than medical records.

Research Methods

We established researches through medicine, and referenced the included haphazard clinical trials. We had trials appraising eleven predefined strategies of quality improvement or financial inducement aiming at the health systems, medical professionals, or the patients to advance management of adults suffering from diabetes. Two of the reviewers abstracted the data independently and estimated risk of prejudice (Moher, et al. 2007). We formulated our protocol based on the Preferred Reporting Items for Systematic review and Meta-Analysis Protocols statement which is accessible from authors.

Literature search

An experienced librarian developed the search methods which were then reviewed by another librarian using the Peer Review of Electronic Search Strategies checklist from inception till May, and was restricted to adults. The Medline strategy was changed for the Cochrane and Embase library searches using the required medical subject titles as indicated by Cadilhac, et al. 2017. We also considered trial registries and abstracts of conferences, browsed the references of included researches and reviews relevant to us, searched the ten most relevant and related citations and explored studies that were used to reference.

Study selection

Before screening started, we performed an analysis to ensure accuracy in choosing articles correctly. This activity included screening random titles and 75 samples of abstracts using SR synthesis and the agreement of these critics was determined. Once they came to an agreement, the two authors screened citations using the prettified applicable criteria form. In our discussion group, we resolved the discrepancies and a similar process was used to review full-text of potentially important articles analyzed through screening of citations. In case we were not sure about the content in an author’s study we contacted them (Bates, 2015). Randomized clinical trials of suitable studies gauged at least one of five predefined strategies of quality enhancement targeting adult casualties who were eighteen years and above and users of the hospital system.

Based on Tricco, et al. 2012, interventions of quality improvement preferred to fill the gap in the extended chronic care design, are interrelated with care coordination: team changes, decision support, information systems, self-management promotion and case management. We also contemplated on the two additional components effects: outreach activities and victim navigators and the QI strategies compared with ordinary care. If there were more control arms in the researches, we settled on the common-care arm for incorporation in the study. Studies included during our discussion were to report on the eligibility of health utilization consequences, specifically emergency clinic visits or admissions; the percentage of patients was the main outcome of interest. Any published or unpublished studies documented in any language and conducted at any time were also considered in our research.

Data collection

As a group, we designed a data abstraction sheet that was pilot tested by every member working on random samples of five articles independently. We recorded data items on characteristics of the study, for example, the type of study design, patient characteristics, for example, mean age, strategies of quality improvement and utilization of outcomes examined. Two members reviewed and abstracted relevant data independently and the differences in the outcome were resolved through further group discussion (Tricco, et al. 2012). Since it is challenging to classify QI strategies, it was carried out independently by a clinician and an organized review methodologist, as we resolved conflicts through discussion.

Appraisal of risk of bias

We used two tools to perform this assessment: Organization of Care Risk-of-Bias and Cochrane effective practice which are outlined by Cadilhac, et al. 2017. Each article included in our research was appraised independently by two reviewers from the group and conflicts resolved through discussion or another reviewer.

Data synthesis

We implemented Meta-analysis random-effects to combine the outcome data reported in two randomized clinical trials. The mean difference was computed for studies that reported the average visits of each patient every month, continuous outcomes, and calculation of relative risks for those studies that reported a proportion of patients with visits, dichotomous outcomes (Tricco, et al. 2012). Before meta-analysis, we examined three heterogeneity types: statistical, clinical, and methodologic through an approach that conducted relevant subgroup analyses to find out the influence of the patient type, and the frequent user type based on RCT qualification criteria

Search results and study characteristics

We reviewed forty-eight randomized cluster controlled trials, including 84 865 patients and 2538 clusters, and 94 patient controlled randomized trials, with 38 664 patients. In meta-analysis random effects, the quality improvement strategies lowered HbA1c by 0.37% difference, LDL cholesterol by 0.10 mmol/L (0.05–0.14; 47 trials), systolic blood pressure by 3.13 mm Hg (2.19–4.06, 65 trials), and diastolic blood pressure by 1.55 mm Hg (0.95–2.15, 61 trials) versus usual care. We confirmed diverse effects when basic standard concentrations were higher than 140 mm Hg systolic blood pressure, 80 mm Hg diastolic and 8·0% LDL cholesterol (Tricco, et al. 2014). The effectiveness of these strategies varied based on baseline HbA1c control, they increased the chances of patients who received aspirin (11 trials; relative risk [RR] 1.33, 95% CI 1.21–1.45), antihypertensive medications (ten trials; RR 1.17, 1.01–1.37), and retinopathy screening (23 trials; RR 1.22, 1.13–1.32), renal function (14 trials; RR 128, 1.13–1.44), and foot abnormalities (22 trials; RR 1.27, 1.16–1.39). However, statin use (ten trials; RR 1.12, 0.99–1.28), hypertension control (18 trials; RR 1.01, 0.96–1.07), and smoking cessation (13 trials; RR 1.13, 0.99–1.29) were not significantly increased.

Out of the eleven 107 citations were identified through review of literature, 663 exhaustive-text pieces were reviewed. Upon omission of 613 pieces for several reasons, we combined thirty-six RCTs and an extra fourteen companion reports. The conclusions were published in the year 1987-2014 by North American, European, Australian, South African, and Israel researchers (Tricco, et al. 2012). Time taken for follow-up varied from one to thirty-six months and one of the studies was an RCT cluster.

Figure 1: RCT meta-analysis articles selection = irregular clinical trial.

Table 1: Characteristics of patients and study

According to Tricco, et al. 2014, many definitions of a regular user of clinic services arose. Studies carried out included those patients who are vulnerable of being regular users (n = 11 studies), while others included those who visit less often (n = 8 studies), ordinary users (n = 2 studies) or heavy utilization (n= 15 studies. A larger part of the study included patients already suffering from mental illness; fourteen suffered from lifelong medical condition besides mental illness. Twelve studies considered patients who suffered severe mental illness, such as mania and disorders of substance abuse, and another twelve included homeless patients. The participants had a mean age that ranged between 28.1-81.6 years, and 25-77 percent of women participated.

Strategies of care coordination

Strategies that improved coordination include: hospital information systems (n = 1), team changes (n = 21), clinical, case management (n = 29 studies), and self-management (n = 19). This numbers examined per research varied from one to five (median 2.5), included outreach exercises in twenty-three studies, and victim navigators in six studies (Tricco, et al. 2012). The group comparing deduced victim education in one study or low-force case governance in eleven studies comprising mentally ill patients.

Result of risk of bias

The risk resulted varied largely across the research studies carried out. One study, based on Bates, 2015, explained a high bias risk on four criteria, another on three criteria, three studies on two criteria, eighteen studies on a one criterion, and the rest lacked a high bias risk on either of the criteria.

Effects on emergency hospital visits

After nine months median duration of follow-up of patients, the percentage of patients who went to the emergency departments was not different between control groups and intervention. It was significant among the elderly, with some in the mediation lot than in controlled groups calling emergency hospitals. RRs which are less than 1.0 imply a reduced risk of visiting an emergency department (Bates, 2015). The studies that indicate a mean number of emergency visits of every patient each month, lacked a difference between the control groups and the intervention after a median of twelve months of follow-up.

Figure 2: Effect of QI strategies

Effects on hospital admissions

After a twelve-month median period of follow-up, there were fewer patients in the intervening group, to hospital, than the control group admitted. Specific strategies of quality improvement that notably lowered the number of admittances were patient education, team changes, case management and development of self-management. No difference was found between the control and intervention groups in patients who suffered mental illness, for example, schizophrenia. The important interventions had an outreach aspect, and aimed at those patients with severe utilization percentage and those vulnerable to frequent use (Tricco, et al. 2014). They did not notice relevant results with mediations that used navigators or those targeting patients with decreased utilization rates.

Figure 3: Effect of QI strategies on hospital admissions

Effects on clinic visits and length of stay

After a twelve-month median period, the percentage of patients who visited the clinic was not different between control and intervention groups, and the mean of hospital visits for every patient each month amidst the two groups (Tricco, et al. 2014). The number of days a patient visited the hospital per month varied insignificantly between the control and intervention groups.


We deduced that the strategies for quality improvement concentrated on reduced admissions to hospital among the chronically ill patients despite psychological illness and emergency hospital visits among the elderly. According to Tricco, et al. 2014, the strategies ineffectively lowered the use of health services among the mentally ill patients. It may be because seven of the eleven studies involving mentally ill patients had a strategy on care coordination as a control intervention. The examined interventions as stated earlier had momentous effects on lowering hospital admissions. The patient education is also vital but is missing in the model, together with promotion of patient management, because they require less resources than interventions for case management. It suggests that strategies of quality management targeting patients, other than clinicians, could lead to efficiency use of resources. On the other hand, other systematic analyses stated that boost of self-authority and patient education were effective in developing diabetes care. A previous precise review examined the effects of several mediations on regular users and established that multidisciplinary and case managing groups were effective in lowering emergency hospital visits. The authors failed to conduct an examination of utilization or meta-analysis outside the emergency room. We observed linguistically relevant reductions in the emergency room visits among the elderly patients, but not specific to the interventions used for case management.


Based on previous studies

Similar studies in the meta-analysis have disclosed information about the amount and intensity of strategies of QI, and further details on delivery. The Standards for Quality Improvement Reporting Excellence (SQUIRE) guidelines aim at improving reporting of strategies of quality improvement which will benefit prospective meta-analyses. In other studies, the span of intervention was too limited to signify any impact. The duration of follow-up was also to low, as low as three months, in other studies (Tricco, et al. 2014). The meaning of a regular user was conflicting across the researches.

Based on our studies

First, the meta-analyses plots assembled of more than ten RCTs proved lack of evidence of bias publication. Second, this area of research was challenging and most of the existing studies lacked adequate search terms for identification. We handled auxiliary searches to overcome this issue, but we might have left out relevant information. Third, our analyses were narrow because the strategies of quality development were complicated and hard to group consistently, for instance, some approaches were intertwined. However, we operated a sensitivity examination and determination of our designation of the QI strategies and our findings remained the same. Fourth, we were unable to control all potential effect modifiers and perform a sophisticated regression analysis because of the paucity of data. Some outcomes had limited information on sensitive matters such as clinic visits and the need for caution when interpreting the results of subgroup analyses owing to the limited sources. Fifth, substantial heterogeneity was evident in most meta-analyses which was expected with the number of strategies of QI, the varieties of patient inhabitants examined and the contradicting definitions. Heterogeneity was substantially lower in most subgroups but we interpreted the results with caution. Sixth, we did not manage to determine contextual factors which were relevant to our topic of research, such as access to a clinician, because its information was not measured consistently, according to Wagner, 2011.


We found out that quality improvement methods concentrated on the control of hospital reduced admissions among patients who are chronically ill despite mental illness and reduced emergency visits among the elderly patients. Novel strategies are needed by mentally ill patients. Interventions that are being developed and implemented by researchers aim at frequent users and ought to realize specific strategies, such as, case management, self-management promotion and team changes, because they seem to be more practical than other strategies of quality advances in contracting health care use. Many trials of these strategies showed advancements in the care of diabetic patients. Much of this literature focuses on common emergency patients, for example, the diabetic patient who requires close monitoring and assessment. One methodological review noted several studies that evaluated the consequence of several mediations, including coordination of care, and the authors deduced that management of a case and interdisciplinary teams were preferably appropriate interventions to decrease visits in the emergency department. To improve diabetes management, measures to implement appropriate interventions with patient-mediated strategies of quality improvement should be practiced. We noted those interventions targeting professionals in the health care industry seem to be helpful only if, HbA1c, the baseline control, is poor. While the average results of the QIs seem modest, collectively they should result in a robust reduction in cardiovascular event and microvascular complications in diabetes. Research is required to note which mediations and sequences of these strategies will ultimately enhance important outcomes at a reasonable cost to aid the third-party payers and health-system in diabetes and other costly diseases including coronary disease/acute coronary syndrome, depression, asthma, and chronic back and the other pain syndromes.


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Gram Positive Rods and Gram Negative Cocci

September 17, 2017

Bacillus anthracis

Mary had been working in the farm. Four days later she visited the doctor and complained that she was experiencing severe headache, vomiting and had lost her appetite. She complained of having difficulties when swallowing food. The gram stain results showed that the bacterium was gram positive rod.


  1. What is the disease and etiological agent is based on the test? Anthrax caused by Bacillus anthracis
  2. How did the bacterium cause the infections? The bacterium produces toxins that infect the body cells
  3. How did the bacterium infect Mary? Mary could have inhaled the spores of the bacterium while working in the farm or the bacterium break the skin.
  4. Where do the bacterium live? In the soil in inactive form
  5. Is the disease zoonotic or not? Anthrax is a zoonotic disease.



Jude was admitted in the hospital and the symptoms were phlegm, difficulty in breathing, coughing up blood, chest pain and fever. He experienced rapid and shallow breaths.

  1. What was Jude suffering from? Norcadiasis
  2. What was the pathogenic organism? Norcadia
  3. How did he get the infection? He handled contaminated water or soil.
  4. Is the pathogen a fungi or bacteria? Norcadia is a bacterium whose features are like those of a fungi
  5. How is the infection treated? By administering antibiotics


Bacillus cereus

James bought some take away food from a restaurant on Monday. The following day he was complaining of abdominal pain. Was experiencing watery diarrhea. A lab test showed that he had been infected with rod shaped gram positive bacterium.

  1. What illness could James be suffering from? Food poisoning
  2. Which bacterium had caused the infection? Bacillus cereus
  3. State three characteristics of the bacterium: it is facultatively anaerobic, motile and is beta haemolytic.
  4. After how long do the symptoms of infections manifest? 24 hours
  5. Where does the bacterium live? In food especially left overs



Neisseria gonorrhoeae

Kelly is 22 years old patient whose has been diagnosed with infection whose symptoms foul smelling discharge from genitals, redness and swelling around the genitals.

  1. What infection could Kelly be suffering from? Gonorrhea
  2. What is the bacterium that caused the infections? Neisseria gonorrhoeae
  3. How is the bacterium spread from one person to another? Its sexually transmitted
  4. State three characteristic of the bacterium: it is gram negative, bean shaped, resistant to antibiotics
  5. How is the infection treated? Ceftriaxone is used in the treatment therapy.


Moraxella catarrhalis

Maxwell is a 56 years old patient and a heavy smoker who has been admitted in hospital and from the diagnosis a fluid around lungs, he was losing his ability to hear. The gram stain results showed that the bacterium was gram negative diplococci.


  1. What was the bacterium? Moraxellacatarrhalis
  2. What infection was he suffering from? Chronic pulmonary disease
  3. What are the risk factors with the infections? Old age and smoking
  4. How is the infection treated? By use of antibiotics other than penicillin, ampicillin and amoxicillin
  5. State three characteristics of the bacterium: they are aerobic, diplococci, gram negative and oxidase positive





Listeria monocytogenes

Marie is aged 72 years. She took some raw milk. After 3 days she visited the doctor and complained of muscle aches, fever and diarrhea. A laboratory test was conducted on her blood and a gram positive bacterium was observed.

  1. What was in infection and pathogenic agent? Listeriosis caused by Listeria monocytogenes
  2. Where are the bacterium found? In soil and raw daily products
  3. State three characteristics of the bacterium? Its non-spore forming, facultatively anaerobic and rod shaped
  4. How the bacterium killed? By pasteurizing milk and cooking food well
  5. Which is the vulnerable group to the infection by the bacterium? Elderly, pregnant woman, those with low immunity.



Corynebacterium jeikeium

Jack is 72 years patient and has been admitted several times this year. The symptoms of infection are severe fever, fatigue, malaise and general body weakness. A gram stain results show that he is infected with rod shaped ram positive pathogen.

  1. Name the pathogenic organism: Corynebacterium jeikeium
  2. Where does the pathogen live? On the skin flora
  3. Who are more susceptible to infections? People with low body immunity
  4. Can the infection be treated with antibiotics? The pathogen is resistant to antibiotics
  5. State three characteristics of the Corynebacterium jeikeium: it is catalase positive, non-motile and aerobic.


Neisseria meningitidis

On Tuesday evening Janet’s baby who is 2 months’ old developed sudden fever and stiff neck. The baby was crying uncontrollably.  On rushing her to the hospital she was placed on an intensive care unit and passed away after few hours.

  1. What was the baby suffering from and the pathogen? Meningitis caused by Neisseria meningitidis
  2. How did it contract the infection? She go into contact with infected saliva maybe her mother kissed her or touched her with infected hands
  3. What is the gram stain of the pathogen? Gram negative diplococci
  4. How can the infection be prevented? Though vaccination and observing high level of hygiene
  5. State the characteristics of Neisseria meningitidis: they are aerobic and gram negative.

Corynebacterium diphtheriae

Nelson was diagnosed with a disease whose symptoms were sore throat, painful swallowing, foul-smelling and bloodstained nasal discharge. His lymph nodes were swollen.

  1. Name the disease and the pathogen. Diphtheria caused by Corynebacterium diphtheriae
  2. State the gram stain. Gram negative diplococci
  3. How is the pathogen spread from one person to another? By inhaling air infected with the pathogen
  4. How does the bacterium cause infection? By producing toxins that infect the body
  5. How are the infections prevented? Vaccine should be administered
















Rogers, K. (2015). Bacteria and Virus. New York: Britannica Educational Pub.