Saturday, January 25, 2020

Accidents Have Caused Major Explosion

Accidents Have Caused Major Explosion In the past few years there had been a steady increment in the usage of the risk assessment in the offshore production facilities. This is especially after the Piper Alpha disaster in 1988 and many other major accidents that killed many lives. Operators are showing an increasing awareness by reviewing the safety of their existing topside production facilities. The Piper Alpha accident provided adverse confirmation that the predictions of risk analyses regarding major accidents were certainly prudent. Quantitative Risk Assessment (QRA) is very useful in order to reduce the risks especially on the hydrocarbon releases from offshore topsides facilities. (Harmony, 1998) The accidents have caused major explosion and followed by some other minor explosions that release huge amount of hydrocarbons such as gas, liquid and 2-phase liquid. According to the investigation report that had been made after the accident, the main reason that causes the accident is the handover work made by two different shift personnel. Communication problem is one of the reasons of the tragedy. Initially the platform only produced crude oil. However, after a few years natural gas is also being produced. During the installation of the gas conversion equipment, the fire walls were not upgraded to the blast wall that causes a severe explosion throughout the disaster. Moreover, the pumping operation of oil and gas was continued even though the fire started to spread on the platform due to lack of professed authority that just witness the burning of the Piper (Taylor, Wallace, Ward, 1991). It was started from the two condensate injection pumps which are A and B. The day shift engineer forgot to inform the condition of pump A to the night shift engineer in which the pressure valve was removed for recalibration and recertification. There are about 106 recommendation has made for the future of safety offshore by the Cullen Report. All of the recommendations had been accepted and implemented by the offshore operators later then (Simon, 2012a). Petrobras Enchova Central Platform was listed in the major offshore accidents. This platform also listed as one of the worst and notable blowouts in the history of offshore oil platform. It is located in the Enchova Field, Brazil and operated by Petrobras. Two major incidents recorded in these fields which were on 16 August 1984 and 24 April 1988. The first accidents caused by blowout followed by explosion and fire. Most of the personnel were evacuated safely by chopper and lifeboat. Unfortunately, 42 workers died during the evacuation processed. The main reason that killed many lives during evacuation is because the failure of lowering mechanism of a lifeboat. The lifeboat was suspended and eventually fell 10-20m to the sea which killed 36 personnel. The other six workers were killed when they jumped from the platform to the sea at 30-40m height. (Simon, 2012b) The second accident occurred on 24 April 1988 which is four years later during the workover operations on the platform. One of the well that operated by the platform blew out and finally ignited that resulted in the destruction of the platform. Petrobras decided to drill two relief wells in 30 days time and eventually succeed in controlling the blowout (Maduro Reynolds, 1989). The workover well was performed in order to convert oil well to gas well. Then the blowout occurred during that converting process. The fire resulted from gas ignition last for 31 days. There was no loss of life recorded because the floating living quarters were separated from the platform during the blowout. The operator incurred a total loss because the extensive damage to the topside structure (Simon, 2012b). Ekofisk Bravo Platform is another type of platform that was listed in the top five worst blowout accidents in the oil and gas industry in which the volume of hydrocarbon released is about 202,381 barrels. This platform is operated by Philips Petroleum Company located at Ekofisk field in Norwegian continental shelf. The event of blowout was recorded on 22 April 1977, a few years after the discovery of this field in 1969. It was declared that the blowout cause the biggest oil spill in the North Sea. The blowout occurred during the workover of the production well. It was started when the production tubing was pulled out at 10000 feet depth. Then the blowout preventer (BOP) is not yet installed after removing Christmas tree prior to the production tubing pulling process. The downhole safety valve was malfunctioned because of improperly installed that cause well kick then resulted in well blowout that release large amount of hydrocarbon to the environment. There was no loss of life recorded as the evacuation job carried properly. Initially the total release calculated was 202,381 bbls by the Norwegian Petroleum Directorate. Then the oil was evaporated up to 40% of the initial release and a total spill estimated is lower than the initial amount. It was reported that there was no significant effect to the environment. The investigation to determine the root cause of the accident had been carried out. They found that the main reason of the blowout was caused by human errors. The human errors include inappropriate planning and well control, misjudgment on the job scope difficulty for instance ignores the proper installation documentation and equipment identification (Simon, 2012c). Bekok C platform that is operated by PETRONAS Carigali Sdn. Bhd. is one of the listed platform accidents in Malaysia that cause severe injuries to the workers. This platform is located 200km from the coast of Peninsular Malaysia. The major factor of the tragedy is because of the gas leaked that cause fire on the platform. Basically, the platform went through scheduled shutdown in order to plan maintenance activities during the accident (Bernama, 2010). There were about 108 personnel on the platform at that moment of incident and six of them were injured because of the fire. The fire just started after midnight and brought under control by the emergency response teams (ERT). The injured personnel were the one that on duty at that time and in the process to complete their shift. The six injured personnel suffered several burns on parts of their body including the face. The fire might be resulted from sparks that produced from one of the maintenance valves. The remaining 102 workers have been evacuated safely to the nearby platform (Chris, 2010). Another offshore accident in Malaysia is Tukau B platform located in Miris offshore. This platform is operated by PETRONAS Carigali Sdn Bhd which is Malaysias National Oil Company. The fire occurred on 11 June 2012 which is the latest accident at an oil and gas facility recorded on offshore platform. It was reported that 16 workers were on the platform at that time of fire. Five of them (two PETRONAS employees and other three contractor staff were suffered first and second degree burn. There was no loss of life reported as other remaining workers were evacuated safely to the nearby platform, Tukau A living quarters. (Mohamad Abdullah, 2012) The fire resulted from the explosion at Tukau B oil drilling platform started to spread on the structure at 9.20am at the compressor skid. Fortunately they managed to put the fire under control within an hour that prevents the fire to spread over the platform. The personnel were doing some maintenance works on the platform at the time of fire. The human errors could be the reason of the explosion that cause fire and injured some of the workers. Most of the accidents occur were mainly cause by the engineering workers that do not have good understanding on the safety elements. Misjudgment on the job difficulty has been normal situation on the event of fire and explosion. Improper use of standard operating procedure for equipment always becomes major factor in platform accident. This is mainly occurring during the maintenance works that involve the operator and contractor staffs (Luin, 2012). The most recent incident that involves oil and gas industry in Malaysia is the fire and explosion of the oil tanker named Bunga Alpinia own by Malaysian International Shipping Company, MISC which occurred at 26 July 2012. This event of fire and explosion take place at Rancha-Rancha industrial zone, Pulau Enoe near Labuan. It was reported that the oil tanker was loading six tons of methanol at the PETRONAS Chemicals Methanol Sdn Bhd jetty when a small fire ignited during a thunderstorm. The fire started at 2.30am and resulted in at least three major explosions that shake the Labuan Island. Bunga Alpinia had 29 crews on board consisting 23 Malaysians and six Filipinos. The accident killed five workers; four of them were Malaysian and one Filipino as mentioned by MISC Company which is a subsidiary of PETRONAS. Another 24 workers were evacuated safely to onshore (Almeida, 2012). The fire and explosion just occurred nearby the PETRONAS Chemical Methanol plant that arise another concern if the flames from the tanker ignite the methanol silo. The effect might be severe which can cause enormous destruction to the surrounding area. Problem Statement According to Oil Gas UK Knowledge Centre, hydrocarbon release may contribute to major accidents as well as determine a key performance indicator of asset integrity management of offshore installations. A hydrocarbon can potentially release to atmosphere due to leakage from equipment, flanges, valves, pipe works and etc. Each of this equipment has their own release frequency. QRA study is very important in order to identify the most cost effective ways to reduce risks to people and to the production asset. It is also important for company to improve their understanding on the risks and hazard involved in its offshore operations (Hanson, Lewis, Walters, 1995). For Quantitative Risk Assessment study, the release frequency of each Isolatable Section needs to be calculated. The QRA is employed in order to size hazards and advantages gained from their concession. The QRA particularly calculates the overall risk and potential loss of life and the average individual risk of fatality. In order to determine the release frequency the installation type and location are the important parameters that should be considered. Objective The overall objective of these studies is to calculate the hydrocarbon release frequency for each isolatable section of offshore production facilities. In order to determine the release frequency, the isolatable section of the topsides production facilities needs to be identified at the early period of the research. The quantity of each of the process equipment needs to be determined in order to get the release frequency. The other objective is to utilize the raw and modify data of release frequencies from the risk assessment data directory (OGP Publications) in order to classify the release criteria by using the inventory released. Scope of the Research In this research, a typical unmanned platform is used as a subject of study. A complete offshore production facility will be divided into several sections in QRA study. The sections are known as Isolatable Section. The Isolatable Section consists of different type and sizes of equipment, flanges, valves, pipe works and etc. The research will identify method to calculate the release frequency of a given Isolatable Section of Offshore Production Facilities. All of the possible process equipment with various sizes is listed down to make the parts count easier. There are three types of release which are full releases, limited releases and zero pressure releases but in these studies full releases type will be used in order to determine the release frequency for each isolatable section. The parts count of process equipment with its specific sizes can be done by using the data that is provided in the Process and Instrumentation Diagram PID. Other than that, the volume of equipment on the topsides of offshore facilities also needs to be calculated by using the volume equation. Process Flow Diagram (PFD) is used in order to determine the volume of each of the process equipment. CHAPTER 2 LITERATURE REVIEW 2.1 Quantitative Risk Assessment 2.1.1 Definition According to C.M. Pietersen et al. (1991), Quantitative Risk Assessment (QRA) can be defined as a method to determine the risk in major offshore platform accidents. It is crucial to determine the release frequencies from process equipment in the event of failure so that the risk can be identified. P.J Corner et al. (1991) state that QRA can use many type of methods or model ranging from simple correlation to complex computer codes. The method of assessment includes the effect of releases such as fire and explosion models, the model for assessing the impact resulting from the fire and explosion and the probability of failures of the process equipment on the topsides platform. Based on R J Hanson et al. (1995), the QRA (computer based model) was implemented in order to evaluate the risk reduction measures. 2.1.2 History In order to improve safety on offshore platform, QRA was introduced after the tragic accident that killed many lives in the event of fire and explosion at Piper Alpha platform. Lord Cullen in his report of The Inquiry based on Piper Alpha Disaster had identified that QRA as a technique that provides a structured, objective and quantitative approach in order to have better understanding on the risks and ways to overcome or control them (Hanson et al., 1995). 2.2 Hydrocarbon Release Frequency 2.2.1 Type of Offshore Topsides Production Facility Offshore topsides production facilities investment is substantial in order to maximize the production. The main production facilities can encompass half of an offshore topsides platform area and half of the capital or installation cost. There are approximately 16 types of process equipment on the topsides of offshore installation facilities handling hydrocarbon that have potential to release hydrocarbon in the event of equipment failures based on the Risk Assessment OGP (2010). The process equipment include steel process pipe, flanges, manual and actuated valves, instrument connections, process (pressure) valves, centrifugal and reciprocating pumps, centrifugal and reciprocating compressors, heat exchangers (four different types), filters and pig traps (launchers/receivers). 2.2.2 Type of Releases According to the analysis of historic process release frequency data (Producers, 2010), releases can be divided into three different types which are full releases, limited releases and zero pressure releases. Full releases can be described as flow through the defined hole is consistent, starting at the normal operating pressure then continuing until controlled by emergency shutdown and blowdown. Limited releases can be classified as cases in which pressure is not zero but the quantity of releases are much less than from a full release. The main reason of these releases is because of the human intervention such as closing an inadvertently opened valve. Then it may cause by the failure from the system itself. Zero pressure releases can be defined as the cases where pressure inside the leaking equipment is virtually zero. This is because of the equipment has a normal operating pressure of zero. Releases can be classified as major, significant and minor based on the (Pratt, 2002) statement. Significant releases are those lying between major and minor releases. Release frequency of the major hydrocarbon release is higher compared to the significant and minor releases (Edmondson Hide, 1996). 2.2.3 Type of Hydrocarbon Releases Hydrocarbon releases have the highest risk on offshore platform that potentially cause loss of life (Hanson et al., 1995). According to Derek B Pratt (2002), the hydrocarbon release type can be classified into three which are gas, liquid and two phase hydrocarbon. Hydrocarbon such as diesel, methanol, hydraulic oil, lubricating oil and helicopter fuel were included. These types of hydrocarbon are termed as non-product hydrocarbon. (Hare, 2008) states that there are five types of hydrocarbon release which are gas, oil, non-process hydrocarbon, 2-phase hydrocarbon type and lastly condensate. 2.3 Inventory of Basic Data 2.3.1 Number of Decks on the Platform Basically there are three types of decks found in offshore platform which are cellar deck, main deck and helideck. Cellar deck is the lower part of the platform while main deck is the upper part of the platform. Helideck is installed on this main deck which commonly above the living quarters. In some platforms, there are four types of decks existed which are spider deck, cellar deck, main deck and helideck. Most of the time, all of the drilling or production facilities are placed or installed on the main deck such as power generator and water treatment while all of the manifolds and Christmas trees will be installed on the cellar deck. One of the significant issues in order to reassessment and requalification of an old platform is the wave-induced force on offshore platform decks. Platform may be subject to partial or even fully submerge in the event of severe storms due to seafloor sinking the cellar deck. The structural integrity of the platform will be obviously affected and is thus a very crucial issue of concern (Grà ¸nbech, Sterndorff, Grigorian, Jacobsen, 2001). 2.3.2 Accommodation Arrangement Living quarters are the crucial requirement for the safe operational and life support requirements for personnel in the offshore Oil and Gas Industry. The other key requirement in the design and build of offshore facilities is to provide functional spaces for optimum comfort of personnel. Providing a safe environment offshore is mandatory in this industry. The location of the living quarters on the platform is one of important parameters in personnel safety requirement. The findings presented to the Cullen report based on the past Piper Alpha disaster regarding on the risk reduction would be achieved whether by accommodating personnel on a nearby flotel (floating hotel) or on PDQ (production, drilling, quarters) platform. The advantage is that personnel are separated from fire and explosion hazards if there are accommodated on a nearby flotel but the disadvantage of exposing them to other hazards such as transportation and flotel capsize (E.F, 1993). According to the QRA made based on the Piper Alpha disaster, it can be concluded that safety can be improved by decreasing the number of personnel offshore or separating production and accommodation platforms linked by bridges. (Lewis Spouge, 1994) in their study also claimed that the risks depend mostly on the separation between the accommodation and the hydrocarbon inventories. 2.3.3 Location of Helideck Location of helideck also one of the important parameters in the offshore platform and should be taken into consideration in order to reduce the risks. The scope of study carried out by K.H Von Blohn et al. (1979) included different locations of helideck on platform, effect of a seaway on the wind velocity profile, effect of varying wind velocity on the turbulence level and air flow around modules without the helideck. Most of the helideck are located directly on top of the crew quarters structure (Blohn, Peterka, Cermak, Barnard, Ewald, 1979). Based on the wind tunnel tests made on the Maui B platform, the flow conditions over the helideck for all approach wind directions tested are improved if the original helideck shape is raised 2.5 m above the crew quarters. Different types of drilling rig or platform have different location of helideck for instance jack-up rig, submersible platform and drillship because they are different in sizes and water depth. The location of helideck also differs between fixed and unfixed structure (BOMEL Limited Burt, 2012). 2.3.4 Location of Process Equipment In order to ensure the safety of personnel working on the offshore platform the process equipment should be placed or installed at the right position where there is less tendency of injury during the event of emergency. In other words, accident can be prevented if the equipment had been engineered properly (Johnstone Curfew, 2011). Properly layout the facility on the platform is the first job in building a new facility. The equipment that needs to be installed should be listed out and a plot plan of the site must be obtained in order to plan equipment layout. It is started by placing the most hazardous items of equipment on the site. Some examples of hazardous items are venting system, flaring system, fire process equipment, engines and rotating equipment, separators, tanks and unfired vessels. According to J.E Johnstone et al. (2011), venting system should be positioned downwind of the facility in which the released gases will not risk the personnel life and platform area. Venting system must be placed where there are no or far from the source of ignition. The same goes to the flaring system. Fired process equipment such as heater treaters, heater or separator, glycol and amine reboiler should be placed away from the equipment that process or store flammable hydrocarbons. It is also should be located away from the potentially released type equipment such as vents and pig receivers. Pumps and compressors which are categories as engines and rotating equipment must be placed on the site to avoid damage from any possible hydrocarbon releases, ignition and noise. Liquid hydrocarbons may be released to the environment resulted from losing seals of pumps while compressors normally leak small amount of oil which might cause fire if there are source of ignition (Johnstone Curfew, 2011). 2.3.5 Location of Risers and Pipelines Risers and pipelines are frequently become one of the main risk contributor on an offshore platform. The most crucial safety goal is to minimize the potential leakage from a riser or pipeline. The impact and corrosion are the significant failure causes by risers and pipelines (Edmondson Hide, 1996). The location of riser and pipeline should be planned properly because of a limited space on platform in order to operate in a safe condition (Sarica Tengesdal, 2000). Moreover the congestion on the platform should be reduce in order to lower the risks (Majumder, Markanday, Anand, 1991). According to P.J Corner et al. (1996), the most important approach in QRA is the failure that will cause different in the holes sizes and leaks rate to the marine environment. The impact may result in rupture or destruction of the platform while corrosion may cause small holes on the riser or platform which can be repaired and not hazardous. It is also essential to anticipate the release duration in order to determine the significant effects. It might be the long duration release of medium size cause destruction compare to enormous release of very short duration. Some risers are installed outside of the shafts, leakage and explosion will occur if hit by ships (Larsen Engseth, 1978). 2.3.6 Location of Wellheads Wellhead is the equipment that installed on the surface of an oil and gas well that acts as a pressure seals and suspension point for casing string. Wellhead that is located at the production platform is called surface wellhead while if the wellhead is located below the water it is termed as subsea wellhead or mudline wellhead. Wellhead should be located properly on the platform because wellhead load includes all casing strings with cement weight, tubing strings weight, weight of wellhead itself and BOP equipment (Anderson, 1984). Meaning that wellhead carries massive loads and part of the platform weight. 2.3.7 Location of Any Drilling Activities Drilling operation is one of the most hazardous activities on the offshore platform. Many personnel are at risk because of the intensive labor work. This is because this operation involves in heavy lifts of many components, BOP stacks, collars and precisely miles of drill pipe. Additional risk will be encountered during exploration drilling especially on the shallow gas hazards and the ultra deepwater operations that potentially have high pressure and temperature (HPHT) wells. Harsh environment condition also need to be considered (E.F, 1993). The best location of any drilling activities is away from the living quarters in order to reduce the risks on personnel. This is for instance in the event of blowout, the personnel can be evacuated safely from the platform. The drilling operations should be separated from production in order to reduce the release frequency of reservoir fluids on the platform as well as reduce the population at risk. Blowout that can claim many lives also can be prevented if drilling and production carried out separately (E.F, 1993). 2.3.8 Transportation According to E.F et al. (1993), the risk to people working offshore start when they leave the shore and stop when they return onshore. The main transportation of the personnel (crew change) is by helicopter or boat. The use of QRA technique had made the risk become apparent because the future risk can be predicted, accidents to be anticipated and ways to overcome or prevent is considered by interpreting the past accident experiences (Lewis Spouge, 1994). The helicopter accident can be categorized into three major sections which are accidents in flight, accidents on take-off and accidents on landing while crew boat accident can be described in two categories which are fatalities in transit and fatalities in transfer. Helicopter crash is on the second ranking for causing of fatalities on UK Continental Shelf (UKCS) after hydrocarbon fire and explosion (Lewis Spouge, 1994). Based on transport risk study carried by JR Spouge et al. (1994), it can be concluded that transport risks are important. Transportation by using helicopter has higher risk if compared with crew boat. This is because the usage of helicopter is higher for crew change operation since the distant of onshore and platform is considered while crew boats indicate dissimilar problems in evaluating risk due to their great safety record. 2.4 Inventory of Materials That May Cause a Fire or Explosion 2.4.1 Inflammable, Combustible and Explosive Materials Inflammable, combustible and explosive materials are materials that are capable to cause fire and explosion. These types of materials should be placed or stored away from the fired process equipment, venting and flaring system in order to prevent any ignition from occurring. These materials must be located away from the living quarters to prevent severe injury to personnel on board in the event of fire and explosion. The blast or firewall has to be installed around these storage materials to reduce the impact of explosion. Properly handling method has to be done on these materials. 2.4.2 Medium of Materials Released There are many ways for materials release to the surrounding environment. One of medium of materials release is through cracks, splits or holes in the containment envelope. This medium is created from the degradation of the equipment such as corrosion, erosion and wears out. The releases of material to the atmosphere may be resulted from opening pathway that is provided by the opening of equipment that still containing hydrocarbon by personnel with intention (Pratt, 2002). 2.4.3 Types of Fire The event of fire and explosion are common in the oil and gas industry especially on the offshore oil and gas platform and drilling rigs (Heaviside, 1980). Every year many injuries and loss of life are recorded because of fire and explosion itself. Personnel are suffered from first to third degree burn which can cause severe injury as well as loss of life. Fire can be classified into four categories which are jet fire, flash fire, pool fire and fireball. 2.4.3.1 Jet Fire Jet fire can be classified into two categories which are the fire that colliding against wall resulting in a diffuse flame and without collision. Immediate ignition will cause jet fire (Pietersen Engelhard, 1991). Jet fire also termed as spray fire. Diffusion flame is resulted from the combustion of a fuel that unceasingly released with significant momentum in a particular direction or direction. The releases of gaseous, flashing liquid and pure liquid inventories can cause jet fires (Executive, 2012). 2.4.3.2 Flash Fire According to C.M Pietersen et al. (1991), in case of gases, delayed ignitions in open spaces will result in flash fire. A flash fire is a sudden, intense fire caused by ignition of a mixture of air and a dispersed flammable substance such as solid, flammable or combustible liquid or a flammable gas. It is described as high temperature, short duration and a rapidly moving flame front. 2.4.3.3 Fireball Fireball can arises from the delayed ignition in enclosed containment that resulting in gas cloud explosion (Pietersen Engelhard, 1991). The gas cloud explosion together with fire will gives tremendous effect on the offshore platform such as destruction of platform. Fireball can cause severe injuries as well as loss of life to the personnel on board. 2.4.3.4 Pool Fire Pool fire can be defined as the turbulent diffusion fire burning above a horizontal pool vaporizing hydrocarbon fuel where the fuel has zero or low momentum. Pool fires could be static which depends on where the pool is contained. Large amount of hydrocarbon inventories have the highest risk and likelihood for the arising of pool fire (Executive, 2012). 2.5 Identification of Initial Accidental Events 2.5.1 Release and Leakage of Hydrocarbon from Process Equipment Hydrocarbon releases is one of the main reasons that result in accident. The release of hydrocarbon from the process equipment may cause ignition followed by fire. Each of the process equipment has its own release rate and frequency. The release rate may be depends on the size and diameter of the equipment. The leakage of hydrocarbon from process equipment can lead to fire and explosion. Oil and gas can migrate to other areas of the platform in a split second and cause ignition that may destruct the platform as well as kill many lives. It is important to minimize the number of equipment and piping installation in order to reduce the failure rate. It is better to operate at low pressure if possible to lessen the leak. The equipment with high leak potential such as compressor is place in open ventilated area. Separation between process system from drilling systems, utilities and accommodation is made by using blast and firewalls (Comer Eades, 1991). 2.5.2 Failure of Utilities The failure of utilities such as electric power shutting down pumps, compressors or motor operated valves can result in overpressure. Overpressure can be defined as pressure build up over the set pressure of the primary relieving device. Overpressure can cause sudden rupture or leak of utilities. Loss of cooling system such as water and refrigeration can form hazardous situations (Johnstone Curfew, 2011). 2.5.3 Falling Loads According to E.F. Brandie (1993), falling loads or dropped objects will create an immediate hazard to offshore workers. It also has high potential to cause major accidents if falling on the process equipment. The object may be dr

Friday, January 17, 2020

Importance of Literature

ENG 101 7 February 2012 Importance of Literacy Literature is a creative and imaginative type of writing. It is a source of information that leads to the guiding principles of life. Having the knowledge to read literature attentively and understand it is extremely important. Literacy is not optional, it is necessary. Literature is not just reading a text but being able to reflect upon it. There are many different types and forms of literacy. Some come in forms of poems and others as dramas or films. Literacy expands towards many varieties.There are children literatures such as â€Å"Winnie the Pooh† and there are also more sacred types of literature such as the scripter’s or Holy Bible. Reading or watching literature gives a person a chance to experience different thoughts towards different situations, it opens a persons mind to imagination. Understanding literature is a sign of intelligence and knowledge. It is not always simple to understand and reflect on literacy. It is important to be open-minded when reading or watching literature.Philosopher Edmund Burke once said, â€Å"Reading without reflecting, is like eating without digesting. † For all means philosopher Burke is one hundred percent correct. The ability to reflect on what is being told shows intelligence, it shows that you have not only read word by word, but you have read the whole piece as one. There are many mistakes that are caused by illiterate people. A perfect example of this concept is the story of a man who was responsible for the death of his son.In the essay â€Å"Hunger in America†, written by Richard Mitchell, Bill Barnhart was charged for certain criminal acts towards his sons death. Barnhart used a passage from the bible for his defense in the case. He believed that in the bible God said that no one should use any medication whatsoever. His son was sick and Barnhart refused to treat his son. His misunderstanding of what was being said cost his sons life. Bei ng literate is extremely important. It can affect everyone around you. Learning literacy is a task that can take a while, but it is not impossible.Reading is extremely important; it is the basics in life. Sense everything requires reading words, the only thing that remains is the reflecting part. Reflecting what you have read shows that you have a clear understanding of what is being said. To be literate does not mean that a person has to read novels and books. It could be simply by reading the news paper, and article, or even a magazine or watching a film. As long as you take time to reflect on the information given and understand what is given, you can read whatever you wish to.Reading or watching literacy gives a person a chance to experience different thoughts towards different situations, it opens a persons mind to imagination. The understanding of literature brings many good things to us, either in science or entertainment. Everything that our world is built on has been based on literacy and continues to do so. Being literate is required to humankind, it is important that we all understand obstacles and situations in life. Literacy allows us to have an idea on how different people live their lives, and it also helps us to understand the purpose in our own life.

Thursday, January 9, 2020

Bending The Cost Curve Of The United States - 1696 Words

Bending the cost curve. The Triple Aim is part of health care delivery reform, as part of the ACA, all derived with the ultimate goal of reducing healthcare spending in the United States. The government and organizations are still waiting for evidence on the effectiveness of Triple Aim models in improving population health, controlling costs, and improving patients’ experience of care. As of 2010, concerns regarding balanced attention to the three overarching aims, indicate that healthcare organizations may increase quality at the expense of cost, or alternatively, they may decrease cost while creating a dissatisfying experience for patients (McCarthy and Klein, 2010, p. 1). All the while, healthcare spending costs in the United States†¦show more content†¦Ã¢â‚¬Å"Attention should be given to assessing the impact of new methods of organizing the delivery of health care services, adoption of electronic information systems, and health reform provisions that will test and reward health care organizations that are accountable for achieving better outcomes, higher quality, and lower costs† (Davis, 2012). Only collaboration between payers and physicians, with a focus on improving the health outcomes of patients will bend the projected cost curve set forth. Organization success. The IHI’s Triple Aim initiative has been deployed internationally, and began yielding successful results soon after its’ initiation in 2010. McCarthy and Klein (2010) indicate: Exemplary results at the study sites have included enhanced access to care, high or improving satisfaction with care, and increases in preventive care, chronic disease management, and healthy behaviors. These improvements have contributed to lower use of resources such as the hospital and emergency department, and to lower overall costs of care for defined populations (p. 7). After 7 years of various organizations attempting, and in most cases successfully implementing the Triple Aim, it has become evident to the IHI that there are particular components that must be closely adhered to in order to reach the desired results. These components, which enhance the program theory for achieving the Triple Aim and form a basis for future testing,

Wednesday, January 1, 2020

Mandatory Vaccination For Children A Health Policy Debate

Mandatory Vaccinations for Children: A Health Policy Debate Holly Milligan University of New Hampshire Mandatory Vaccinations for Children: A Health Policy Debate Vaccines change over time as science makes advancements and diseases processes evolve and emerge. Around 400 BC, Hippocrates recognized the now preventable diseases, such as diphtheria and mumps (Immunization Act Coalition, 2015). The first effort to immunize dates back to the 1100’s when children were inoculated with scabs from individuals who recently had small pox, with a technique coined as variolation. Then in 1796, Edward Jenner successfully created the first small pox vaccine (Immunization Act Coalition, 2015). According to the Center’s of Disease Control and Prevention (2012), there are no federal requirements for childhood immunizations. While the CDC (2012) provides recommendations, each state sets their own rules and exemptions for schools and childcare attendance. On June 30, 2015, Governor Jerry Brown of California made history by eliminating the exemption from immunizations due to personal beliefs for children in public or private schools; however, medical exemptions initiated by a DO or MD will still be allowed (Royce, 2015; California Department of Public Health, 2015a). In 2013-2014, there were nearly 17000 personal belief vaccination exemptions in California (Almasy, 2015). Throughout the history of vaccinations very strong opinions for or against immunizations have existed,Show MoreRelatedImmunizations And Vaccinations : A Hot Topic1426 Words   |  6 Pages Immunizations and Vaccinations: A Hot Topic Crystal L. Clauser Frostburg State University Immunizations and Vaccinations: A Hot Topic In the United States, the childhood immunization schedule recommends that children receive approximately 15 vaccinations by 19 months of age, and it specifies ages for administration of each vaccination dose (Luman, Barker, McCauley, Drews-Botsch, 2005, p. 1367). According to the Centers for Disease Control and Prevention, a vaccine is a product thatRead MoreThe Importance Of Mandatory Vaccination879 Words   |  4 Pagessurrounding the mandatory vaccination of healthcare workers with the Influenza vaccine. The Center for Disease control advises all health care workers to get vaccinated annually against influenza (Center for Disease Control, 2017). Mandatory vaccination policies have always been debated, and in this policy there is not much difference. The continued efforts by many healthcare officials to implement policies to avoid the effects caused by unvaccinated staff have promulgated controversial debates among manyRead MoreThe Importance Of Mandatory Vaccination791 Words   |  4 PagesMandatory vaccination of health care workers raises important questions about compelling individuals to engage activities to protect the public. Many health care workers believe that mandatory vaccination violates fundamental individual rights and public health policy, and some have filed court actions. The workers argument states, first, that compulsory vaccination violates the Fourteenth Amendment in depriving them of liberty without due process. The health care workers also argue that mandatoryRead MorePreventing Cervical Cancer with the HPV Vaccination652 Words   |  3 PagesHPV vaccination is the most common used method for preventing cervical cancer in young girls ranging from age nine to eleven years old. The overall perception of the vaccine is positive by the public because of its wide use and support by state laws, school systems and medical associations. According to the American Pediatric Association the vaccine has an excellent safety record. (Nirvi,1) A reasonable amount of parents still feel skeptical about mandatory HPV vaccination on their kids and lackRead MoreJohn Stuart Mills Case Study On Vaccinations999 Words   |  4 Pagesliterature. This hallmark principle of his liberalist philosophy continues to be the centre of contemporary ideological political debates, almost 160 years on. Yet, there are evident discrepancies that can result in dutifully applying the principles of a long-dead philosophe to contemporary issues. Of reference here is its application to the case study on vaccinations. In 2015, the Australian government announced the ‘no-jab-no-pay’ scheme, which closed off non-medical exemptions from the immunisationRead MoreBenefits Of Vaccination1438 Words   |  6 PagesWhy should we get vaccinated? What are the benefits? Do vaccinations even work? Many people in America are/have been questioning if they even need to get vaccinated. In fact, Between 2006 and 2013, the percentage of pediatricians who had encountered a parent refusing a vaccine went from about 75 percent to 87 percent. (Greenberg) There are many reasons why people refuse to get vaccinated, three of the major reasons is for religious purposes, they are unnecessary and that they have a negative effectRead MoreEthical Concerns Regarding Pediatric Vaccinations1623 Words   |  7 PagesAbstract Ethical concerns regarding pediatric vaccinations span several viewpoints including clinicians, policymakers and parents. A parent’s concern is to protect their children. Parents want to know more about how vaccines work - the risks and side effects, vaccine ingredients, and vaccine safety - before deciding to vaccinate a child. The responsibility of the medical professional is to protect the public while preserving the rights of the patient. The ethical issues concerning childhood immunizationRead MoreThe Importance Of Vaccinations1372 Words   |  6 PagesVaccinations have proven time and time again to be an effective form of preventive medicine, but in recent research it has been associated with serious developmental problems. The controversy over whether childhood vaccines are actually the cause of these development issues has been an ongoing debate for 2 centuries and is even more prominent in society now as more research is becoming available to the public, even if s ome of it says there is no link between the two. Parents and guardians now alsoRead MoreCompulsory Vaccinations : Should It Be Mandatory Out Of Vaccinations?1805 Words   |  8 Pages Heather Slack Compulsory Vaccinations: Should States Eliminate Non-Medical Exemptions to Opt Out of Vaccinations? MGH Institute of Health Professions Introduction It is estimated that vaccinations have prevented more than 100 million cases of serious diseases (Gostin, 2015). Presently, all 50 states mandate that children age 5 and older be vaccinated prior to enrolling in school, however many states have exemptions to those laws. These include exemptions for medical contraindicationsRead MorePolicy Analysis : Vaccination Policy2664 Words   |  11 PagesVaccination policy Analysis Adriana Ortega Benjamin Tetteh Ramona Abou Habib Saera Sultana PUAD 6260-01 Healthcare Policy Analysis Professor Farida Sultana July 27, 2015 Table of Contents I. Executive Summary 3 II. Introduction 4 III. Examination and Analysis of the Policy 5 A. Background 5 B. Involvement and Work of Lobbying Groups 5 C. Analysis: Pros and Cons 6 D. Analysis: Evaluation Methods 10 E. Outcomes 11 IV. Conclusion 12 References 13 I. Executive Summary Vaccination policy