The Syrian Refugee Crisis Is An Outcome Of The Civil War

POLICY MEMORANDUM #1 To: Dr. Ban Ki-moon, United Nations Secretary General From: Dr. Amena Al-Diri, Strategic Advisor to OCHA-Syria Subject: Proposal to solve the Syrian civil war in the UN Security Council Date: 09/22/2015 _____________________________________________________________________________ Executive Summary The Syrian refugee crisis is an outcome of the civil war that has suffered this country over four years. Therefore, a solution to this conflict is urgently needed to stop the humanitarian tragedy and the flood of refugees. In Syria’s civil war, the critical mass participation of local and international actors, with different priorities, perceptions and interests, has dramatically reduced the likelihood of a negotiated or military solution. In this context, the United Nation Security Council is the most suitable and pragmatic space to lead and seek for a multilateral solution, instead of continuing with these failed unilateral or bilateral military interventions that have taken place in Syria. The UN Security Council should promote a converging and problem-solving approach between Russia, the United States and other regional powers involved in Syria’s crisis, like Saudi Arabia and Iran; and then try to negotiate with the Government, rebels and paramilitary groups, as wel l as define an international strategy to defeat Jihadists. Background and Problem Statement â€Å"A political solution to the crisis in Syria needs to be found. Until then, displacementShow MoreRelatedThe Hysteria Of The Salem Witch Trials1366 Words   |  6 Pagesrefused to take responsibility for their actions. The same thing is happening in modern day America due to a 4 year long civil war, in Syria, and a mounting war on terrorism, in the United States. Syrians are fleeing their country because of the impending civil war, of 4 years, between those loyal to President Bashar al-Assad and those who oppose him, the rebels. Accepting refugees from war torn countries has always been something the United States has done, even if it caused some controversy. However,Read MoreRefugee Crisis Is The Country Of Hopes And Dreams1232 Words   |  5 Pagesour country, we should accept Syrian refugees into the United States because the Refugee Crisis is a serious problem, accepting refugees is an act of Congress, and helping refugees is the humane thing to do. The first reason the United States should accept refugees is because the Syrian Refugee Crisis is a major problem. Syria has been in a civil war since March 15, 2011 with the government of their president and his allies against multiple opposing sides. The war is intense and caused a lot ofRead MoreEssay about Teachers in Syria1399 Words   |  6 Pageshalf year long Civil War in Syria has lead to more than one hundred thousand deaths in the region. The continued conflict in Syria has caused the UN to stop updating the death toll in Syria because they have found that information from Syria and the surrounding region is no longer verifiable (UNCHR, 2014). The UN’s Refugee Agency (UNCHR) (2014) has noted that 2.4 million Syrians have registered as refugees, but they estimate that there are, in fact many more unregistered Syrian refugees escapingRead MoreThe Syrian Refugee Crisis Essay1304 Words   |  6 Pagesevent. In the case of the Syrian refugee crisis, my interest stems from my fascination with the glaring hypocrisy of American exceptionalism that bubbles to surface when the international crockpot of geopolitics turns sour with abhorrently violent dictators and the inevitable civil wars that remove them from power. The Syrian government, under the power of Bashar Hafez al-Assad, has resorted to violence against Syrian citizens who are critical of the government. The â€Å"crisis† we hear about developedRead MoreDetermining a Strategy for the Refugee Crisis in Syria1964 Words   |  8 PagesSummary Balancing humanitarian concerns with U.S national interests is essential in determining a strategy for the refugee crisis in Syria. According to the UN Refugee Agency, there are approximately 2.5 million refugees, more than half of which are children. Not only do such atrocities conflict with the moral fiber of democracy, but also present serious risks to the economic well-being and security of the United States. Current research as well as historical reference illustrate that U.S foreignRead MoreSyrian Activists Main Goals1829 Words   |  8 PagesSyrian activists’ main goal from these talks was always about the formation of a transitional government enjoying full executive powers, without Assad in the picture; while, naming the members of this transitional governing body and the immediate start of performing its functions; followed by a ceasefire throughout the nation. These goals were, more or less, achieved through the passing of the France-US document; that included the point of cessation of hostilities among the warring parties and theRead MoreSample Resume : Syrian Refugees Essay2325 Words   |  10 PagesIntroduction: Syrian refugees in Kansas On September of 2015, the image of 3-year-old Aylan Kurdi went viral. â€Å"The toddler’s lifeless body on a Turkish beach had reverberated across the globe† (Parkinson George-Cosh, 2015). Aylan’s family had â€Å"fled the brutal civil war in their native Syria and only attempted the boat crossing after Canada denied their application of admission as refugees. The image led to an astonishing outpouring of support for Syrian refugees† (Hein Niazi, 2016). PresidentRead MoreThe Most Important National Security Threat1656 Words   |  7 Pagescountry is the migration crisis. Middle East’s conflicts, especially Syria’s civil war have created an influx of refuges outflow. Greece is the main point of entry in the Western â€Å"Balkan Route†; migrants’ access trek to desirable northern European â€Å"destination countries†. This humanitarian crisis raises serious security concerns regarding terrorism and nationalism but also economic concerns as Greece is facing an intense financial recession. Moreover, this migration crisis tests the European Union’sRead MoreThe Syrian Crisis And How We May Resolve It?1461 Words   |  6 PagesUlises Navarro-Santibanez Mrs. Gallos English 3 Honors 6 November 2015 What is the Syrian Crisis and how we may resolve it? The crisis in Syria began with two students who began to show defying motifs against the Syrian government, by displaying graffiti, who were later tried and executed by the Syrian government. Citizens responded with protests, which ultimately led to the military confronting them and killing protesters. With these acts of violence, a rebellion occurred in which civilians forcefullyRead MoreImplications Of The Involement Of Neighboring Countries1599 Words   |  7 PagesQ2. IMPLICATIONS OF THE INVOLEMENT OF NEIGHBORING COUNTRIES 1. Regional Implications The continuous conflict and seemingly unending civil war in Syria has made the refugee settlement mission a difficult task. The persistent state of fear has given rise to security controls across the border, and the incessant displacement of people from Syria has increased vulnerability amongst refugees seeking asylum. The number of refugees has grown steadily and has reached a disturbing number of 235,000 according

Is the Life-Span Approach Essential to Human Development

Human development has been a subject of interest among modern researchers. The most prominent theory in human development is the life-span approach which is made up of various concepts. This essay aims to show the importance of the life-span approach by analysing some of the concepts that make up this approach, such as multi-directionality historical location and contexualism among others. This essay will critically analyse some of the assumptions of the life-span approach. It will also examine arguments against the lifespan approach as well as other theories of human development such as Freud’s psychoanalytic theory with the aim of showing that this approach is essential for understanding human development. One of the major assumptions†¦show more content†¦In southafrica research shows that black children who lived during the apatheid era ended up in sqatter camps without any aducation, with poor sanitation no recreation facilities and high health risks, this forced some to join ganges. Removal from their land also caused identity confusion which is a very important developmental task according to Erikson. showng that historcal context brings with it a unique experience that individuals are exposed to and this has a great impact on one’s developmet reafirming the claim tht the life-span approach is important in understanding human development. It has also been brought to attention that the research methods used by life-span researchers are to some extent unreliable and may produce inaccurate information. As critics of this approach have noted life-span researchers mainly use introspection, questioning and obsarvation for example Elder, (1998) on his study of children of the great depression admits that they would ask the subjects on how they thought the great depression influenced their lives, Havighurst also used the same technique in his study of developmental tasks and this is problematic since subjects are most likely unware of their developmental tasks and deficits (Sugarman, 1986). He went on to say researcherShow MoreRelatedErik Erikson s Theory And Theory908 Words   |  4 Pagesidea that early life experiences impact the person across their lifespan. Erikson’s developmental theory discusses the eight stages of life and the forces and values that arise at each stage, which should be developed within this f rame. The attachment theory focuses on the interaction an individual has and the impact it may have on their psychological and social development. Both theories believe that personality begins to develop from a young age and therefore occurrences in early life can have lastingRead MorePsychological Factors That Influence Human Behavior1079 Words   |  5 PagesPsychological Factors That Influence Human Behaviour Throughout The Life course. Introduction; According to Crawford and Walker(2010), the life course is defined in literature as, â€Å"The progression and path an individual takes from conception to death.† (Crawford and walker, 2012, p.3). The study of the life course and human development is extremely complex and could be described as interdisciplinary as it encompasses many fields of study. When examining the life course of individuals it is necessaryRead MoreErikson s Psychosocial Theory Personality924 Words   |  4 PagesLife Span Development involves a process of age-related changes that individuals go through beginning from birth though old age. Individuals can undergo physical, psychological, behavioral, and social changes that can impact the development of personality. According to Erikson’s Psychosocial Theory personality evolves through several stages of development (Zastrow Kirst-Ashman, 2015). One of the benefits of having a cross-cultural perspective in regards to life span development is that it allowsRead MoreThe Theories Of Human Mind And Behavior1138 Words   |  5 PagesPsychology refers to the scientific study of all the aspects of human mind and behavior. Psychology is broadly categorized in various branches that deeply analyze different concepts of human behavior. In Human Growth and Development, full perceptions of the process of human development are covered in detail evaluating various stages of human growth. As such, this aspect provides an overview of the stages of human life from birth through the middle stages to the adult stage. Some various theoriesRead MoreThe Industrial Revolution Sparked Invention1349 Words   |  6 Pagesour future generations and what we are leaving behind for them. It is estimated that by 2050 we will run out of most of the metal resources. Metals are an essential part of us our survival. It can seriously affect the way we on earth. Sustainable development is the key to a brighter future with less waste production. Sustainable development involves three major sectors, social, economical and environmental. When considering these aspects separate, we can see that solution to a problem creatingRead MoreEssay on 20th Century Approaches in Early Childhood Education861 Words   |  4 Pagesthere are many kinds of programs and approaches used in early childhood education? The 20th century was the start of inclusive classrooms and about the idea of education for all. Education in the early preschool years boomed with early childhood development programs. While there are many popular approaches, I find that Maria Montessori and Rudolf Steiner have the reliable strait forward and captivating approaches to early childhood education. Maria Montessori has an educational method that is inRead MoreThe Different Stages Of Human Development1617 Words   |  7 PagesThe different stages of human development can be vast in dimension. The chosen age group was childhood (3-12 years) or also called the juvenile period consist of various features of its age group. Early to middle childhood features such as physical, emotional, cognitive, and social aspects have their growing and specific developments compared to other human developmental stages. Also, different theoretical perspectives will substantiate the selected developmental stage and which is most usefulRead MoreThe Effects Of Family Systems On Healthy Development1512 Words   |  7 PagesThe Affects of Family Systems on Healthy Development Relationship between Family Systems and Development Family systems are essential to the healthy development of a child. Family systems and development go hand in hand. Children who come from a healthy family system are more likely to have a healthy development. Children who come from an unhealthy family system are more likely to have an unhealthy development. According to David V. Papero (2014), â€Å"Murray Bowen developed a family systems theoryRead MoreDoes an Infant’s Temperament Shape His/Her Cognitive and Socio-Emotional Development?1333 Words   |  6 Pagescognitive, socio-emotional development. I will discuss various theories of human development, identify the social and emotional domains development and how they affect temperament. I will discuss the eight stages of socialization according to Eric Erikson, and the cultural perspectives of temperament. A person’s temperament, biology, environment, and even attachment to others can affect how social the individual is. Temperament is an important aspect of emotional development. Temperament is theRead MoreThe Theory Of Education On Children s Brain Development1493 Words   |  6 Pages In life there is always something going on in the background and music surrounds us every day whether we notice it or not. So why not intrigue students by bringing it into the classroom? There is a lot of benefits to having music in the classroom and it helps students expand on their knowledge. However, to bring it into the classroom a teacher needs to acknowledge how children learn. There is a multitude of research on children’s brain development. Therefore let us dive into the findings and beliefs

The direct effects of Johnes disease Free Essays

Introduction Mycobacterium avium races paratuberculosis ( MAP ) is the causative agent of an incurable, infective, chronic, granulomatous enteritis in ruminants, called Johne ‘s disease or paratuberculosis. The direct effects of Johne ‘s disease on animate being public assistance and productiveness may look insignificant and are frequently masked by the mostly subclinical character of the disease in domesticated farm animal ( incubation period prior to the oncoming of clinical marks by and large ranges from 2 to 10 old ages ) { { 1 Lepper, A.W. We will write a custom essay sample on The direct effects of Johnes disease or any similar topic only for you Order Now 1989 } } { { 2 Chiodini, R.J. 1984 } } .The economic impact of JohneA?s on dairy cowss industries is significant. Estimated costs as a consequence of reduced weight addition, milk production loss, premature culling and decreased carcase value add up to an one-year sum of $ 250 million ( USD ) in the United States industry entirely { { 3 Ott, S.L. 1999 } } . More recent in-depth estimations indicate a important relationship being between Johne ‘s disease position and decreased milk production { { 51 Smith, R.L. 2009 } } , increased hazard of being culled { { 40 Smith, R.L. 2010 } } and a reduced calving rate in high sloughing animate beings. The on-going contention refering the possible function of MAP in Crohn ‘s disease ( human inflammatory intestine disease ) suggests that MAP itself might be of great public wellness significance { { 17 Hermon-Taylor, J. 2000 } } . 1.2. Transmission of MAP Cattles are most susceptible to infection as calves from birth to a few months of age { { 27 Taylor, A.W. 1953 ; 55 Windsor, P.A. 2010 } } , but can besides be infected as grownups { { 28 Doyle, T.M. 1951 } } .Transmission of MAP can happen by a assortment of paths in dairy cowss ; horizontally by consumption of MAP from the environment, or vertically from dike to calf. Evidence of intrauterine transmittal and sloughing of MAP in milk and foremilk has been reported by several surveies { { 5 Nielsen, S.S. 2008 ; 25 Seitz, S.E. 1989 ; 24 Sweeney, R.W. 1992 } } . Although calf-to-calf transmittal has besides been demonstrated in several experimental scenes where calves are being housed together { { 52 RANKIN, J.D. 1961 ; 53 new wave Roermund, H.J. 2007 } } horizontal infection from cattles to calves and perpendicular infection from dike to calf are believed to be the most common and most of import infection paths in dairy cowss. Previous surveies besides describe that calves born from positive tested dikes were at a significantly higher hazard of going Map infected than calves without this risk-profile. Besides calves turning up with a future high spiller and calves being born shortly following the freshening of an septic dike were at higher hazard being infected { { 29 Benedictus, A. 2008 } } . 1.3. Treatment A ; control Presently, there is no satisfactory intervention for the disease. No disinfectants are approved for the intervention of Johne ‘s disease because of their deficiency of efficiency and their failure to supply bacteriological remedy. A vaccinum for Johne ‘s disease exists but is non really normally used because it interferes with the reading of the current TB tegument trial and its inability to wholly forestall infection { { 44 Muskens, J. 2002 } } . Consequently JohneA?s disease is presently controlled via control plans that implement a assortment of production patterns. The most cost-efficient option for cut downing the prevalence of MAP infection in herds is application of hazard direction steps to interrupt known transmittal paths { { 6 Groenendaal, H. 2003 ; 16 Kudahl, A.B. 2009 } } . Current MAP control plans are risk-based. Management-wise, animate beings are divided into high and low hazard animate beings, by looking at the consequences of 4 one-year showings that test all lactating cattles for MAP specific antibodies in the milk { { 47 Nielsen, S.S. 2011 } } . Particular production pattern recommendations are provided for pull offing bad animate beings and these recommendations chiefly focus on within-herd MAP transmittal { { 46 Nielsen, S.S. 2007 } } .According to recent surveies, implementing patterns that can minimise the exposure of MAP to newborn calves should take precedence in control plans { { 45 Pillars, R.B. 20 11 } } . However, control steps are really expensive and non cost-effective. Current control steps do non take into history that MAP can be transmitted vertically and ignores the possibility that there is familial fluctuation in cowss associated with differential susceptibleness to Johne ‘s doing girls of septic dikes more likely to be infected even if hygiene steps are implemented absolutely at birth. 1.4. Heritability of susceptibleness Considerable work on linkage between genetic sciences and the opposition, tolerance or susceptibleness to Mycobacterium avium races paratuberculosis. Heritability of susceptibleness to infection with MAP has been estimated from 0.06 to 0.159 { { 18 Koets, A.P. 2000 ; 31 Mortensen, H. 2004 ; 37 Hinger, M. 2008 ; 38 Attalla, S.A. 2010 } } . The broad fluctuation in these extimates can be explained by differences in definition of infection and nosologies ( blood or milk ELISA, faecal civilizations, tissue civilizations ) , sample sizes, survey population ( breed ) and statistical theoretical accounts ( assorted animate being theoretical account, beget theoretical account ) used. Two genome-wide surveies have identified venue for resistence or susceptibleness to infection by MAP utilizing Illumina Bovine SNP50 assay { { 32 Settles, M. 2009 ; 33 Minozzi, G. 2010 } } . A SNP on chromosome 9 ( BTA9 ) is associated with casting ( being faecal civilization positive ) when genuinely infected ( tissue civilization positive { { 32 Settles, M. 2009 } } and being ELISA positive { { 33 Minozzi, G. 2010 } } . Zanella et Al. performed an association survey on the same dataset as Settles et Al. and found BTA6 to be associated with tolerence to paratuberculosis { { 43 Zanella, R. 2011 } } . Several campaigner cistrons identified by these genome-wide surveies have been examined for farther association with infection. Attempts to turn up cistrons associated with susceptibleness or opposition to paratuberculosis hold had limited success. Pinedo et al 2009 identified an association of caspase enlisting sphere 15 ( CARD15 ) with infection { { 34 Pinedo, P.J. 2009 } } , while a separate comparative analysis of bovine, murine, and human CARD15 transcripts suggest no important associations between fluctuation in the CARD15 and disease position { { 41 Taylor, K.H. 2006 } } .Toll-like receptor 4 ( TLR4 ) was associated with infection in recent work by Mucha et Al. 2009 but was non associated with infection in a coincident independent analysis { { 49 Pinedo, P.J. 2009 } } . Tendency towards association between infection and variant allelomorphs of the SLC11A1gene ( once NRAMP1 ) { { 34 Pinedo, P.J. 2009 } } is consistent with a population-based familial association survey carried out by Ruiz-Larranaga et Al. { { 42 Ruiz-Larranaga, O. 2010 } } , but conflicting consequences were presented by a population ba sed association survey by Hinger et Al. 2007 { { 39 Hinger, M. 2007 } } . Hinger et Al. and Minozzi used ELISA-tests as a diagnostic step to sort animate beings as septic whereas Pinedo et Al. used a combination of ELISA and faecal civilization to specify infection and Settles et Al used faecal and tissue civilization. The complexness of the intracellular infective disease Mycobacterium avium races paratuberculosis causes suggests engagement of many different cistrons that perchance interact with one another and with external factors from the environment. In add-on, the different procedures involved in early disease and late disease are yet ill-defined and may besides be reflected in the different venue found to be associated with the categorization of the type of infection. Particularly because pathogenesis of the disease is non to the full understood and sensitiveness of ELISA trials is rather low in latent or low casting animate beings { { 10 McKenna, S.L. 2006 ; 54 Eamens, G.J. 2000 } } { { 50 Nielsen, S.S. 2008 } } , case-control association surveies that use chiefly tissue and fecal nosologies in order to find the true infection position of the cow present the most dependable consequences. 1.5. Vertical transmittal To look into the importance of perpendicular transmittal, old surveies tried to find the prevalence of foetal infection in cowss and estimated the incidence of calves infected via in utero transmittal. On norm, approximately 9 % of foetuss from subclinically infected cattles ( faecal civilization positive ) and 39 % from clinical cattles were infected with MAP prior to deliver { { 4 Whittington, R.J. 2009 } } . Harmonizing to Whittington and Windsor { { 4 Whittington, R.J. 2009 } } existent prevalence of foetal MAP infection would be higher than reported because some of the methods and protocols used in these surveies to handle and prove samples have really low specificity { { 54 Eamens, G.J. 2000 } } . The estimated incidence of calf infection derived via the in utero path depends on within-herd prevalence and the ratio of sub-clinical to clinical instances among septic cattles. The mean perpendicular infection rates mentioned above are derived from the consequence of five independent surveies published between 1980 and 2003. 1.6 Strain typewriting Current developments in molecular genetic sciences make it possible to disciminate Mycobacterium avium paratuberculosis strains with different fingerprinting techniques { { 36 Motiwala, A.S. 2006 } } . These techniques can besides be used as a tool to look into the possibility of perpendicular transmittal by comparing strains carried by the dike with strains carried by the girl. When comparing different MAP fingerprinting techniques, the Multi Locus Short Sequence Repeat technique utilizing all 11 venues selected by Amonsin et Al. 2004 has the highest prejudiced power with a Simpsons diverseness index of 0.967 { { 36 Motiwala, A.S. 2006 } } . Harris et Al. 2006 used four of these identified repetitions ( locus 1, venue 2, locus 8 and locus 9 ) to distinguish MAP strains { { 21 Harris, N.B. 2006 } } . To analyze diverseness of the selected MAP isolates we used these same four venue for MLSSR analysis and added venue 3, venue 5, venue 6, locus 10 and locus 11 in order to observe more diverity among dam and daughter isolates. Strain typing methods to longitudinal datasets can now supply us with extra penetration into within herd infection kineticss, including the transmittal of MAP from dikes to girls. How to cite The direct effects of Johnes disease, Essay examples

Evidence Based Decision Making Administrators and Professionals

Questions: 1. How readily can the concepts of evidence-based decision making be applied in the strategic decision making of health service management executives? Justify your arguments. 2.What leadership style(s) is/are most suitable to manage strategic changes in health care? Justify your answer which includes providing examples of strategic health changes. Answers: 1. Evidence based decision making process can be implemented with the strategic decision making in a health care organisation, with objective of maintaining work continuity and achieving effectiveness in care delivery (Lgar, 2014). Health care executives, administrators and professionals uses the evidence from various researches to implement their opinion, knowledge, and perspectives within their decision-making process of routine care delivery. This concept of clinical services has become an integral part of health care centres all over the world, owing to the fact of proven efficacies in care outcomes, which has been further explained with an example, that can provide clear understanding. Use of evidence-based decision making helps the managers to make strategic planning about how to organise, deliver and operate the health services (Lgar, 2014). For instance, the Australian government uses demographic information, population dynamics, incidence of diseases, and effectiveness of medication (post-marketing surveillance) within the pharmaceutical companies, which allows easy access of the prescribed medicines for community. The measure is also effective in terms that it makes the medication production, cost effective (due to presumed market demand) (Alonso-Coello, 2016). Another example illustrates Australian childhood immunization register which uses the evidence based vaccination policy. According to their earlier statistics, the estimated cost for the vaccination for childhood immunization was supposed to increase from $6 million annually to around $60 million. Here in this case population based observational information was used in determining the increased profit, in conjunction to the expanded vaccination policy (Barry Edgman-Levitan, 2012). The above-mentioned example thus illustrates how the evidence based decision making process renders cost effective solution to manage the health requirement of Australian community, thereby also offering access to medication and immunisation requirements. Similarly, in another case of Australian medical care related to optometrists, the above technique of evidence-based decision making has been used. This clinical practice here includes the diagnosis, analysis, and supervision of dry eye. The Australian optometrists mostly used the phenol red test and tear osmolality test based on the research evidence data of dry eye (Alonso-Coello, 2016). These primary sources of evidence further helped the optometrist practitioners in their routine clinical services that in turn is reflective with optimal standards in managing care delivery of commonwealth. A statistical analysis was done on Australian women suffering from polycystic ovary syndrome (PCOS) based on the evidence based guidelines, which was subsidized by the Government of Australia (Department of health and ageing). According to the evidence, about 21% of the Australian reproductive-age are facing PCOS, and mostly who are weighty. Thus, in the year 2003, a conclusion was made on PCOS by the Rotterdam consensus workshop based on the guideline and according to it, ultrasound of either oligo or anovulation and polycystic ovaries is implemented as an effective diagnostic tool. Similarly, another such instance was seen in the year 2003, where the national health and research council of Australia provided the evidence based guidelines for the acute low back pain (LBP) to every Australian practitioner. According to the evidence the practitioners supported either of the two methods, that is conducting x-ray if fracture is detected and another is providing appropriate treatment. While it should be noted that practitioners should not implement these evidences blindly, rather they should do proper research and study before implementation in routine services (Melnyk, Gallagher?Ford, Long Fineout?Overholt, 2014). Thus, these examples, explain how the evidence-based decision making is helpful in managing the standards of care delivery and managing customer satisfaction. 2. Change is the key to success for every organisation, especially the health care organisation, where strategic changes have potential to manage the effectiveness and brings positive outcomes. The change can be in the form of structure of the health care departments or in the selection of the treatment procedure, or in the treatment instruments. In this regard, it is noteworthy to mention that the implementation of the change or the innovation might not work properly, because of the wrong implementation procedure (Daly, Jackson, Mannix Hutchinson, 2014). Thus, in a health care organisation proper management and implementation of the change is a matter of key concern which needs to be handled effectively by the medical leaders. For a successful strategic health change management, the medical leader has to properly evaluate, plan and implement the necessary actions and strategies needed. Additionally, the proper coordination of medical leaders and other health care staffs is requisit e to implement the change successfully. The various leadership qualities needed for efficient strategic change management are: Charismatic leadership- In a health care management, a medical leader should be charismatic in order to drive transformation among the medical staffs to successfully implement change in the department. They give new strategic view and preview its positive outcomes to gain maximum support from the staffs (Fulop Mark, 2013). They identify their staffs needs, which includes doctors, nurses, technicians, pharmacists and other employees and bring the change accordingly. Notably, in some cases the patients also disagree to implement the change in the health care system to avoid the risk factor. Thus, a charismatic leader can only direct them towards the change with the use of communication, mentor relationship, and visionary for long term benefits. Visionary leadership- A visionary medical leader has the potential to change the vision of implementation into reality. This leadership style helps in proper evaluation, analysis of the outcomes, and manages the results from the change implementation into visionary objective. Notably, the visionary leader has characteristics of making use of evidences in strategic change plans and also have effective communication skills to convince others (Hurley Hutchinson, 2013). Transformational leadership- The transformational medical leader will always try to initiate change in the health care system by virtue of their perspectives, wisdom, evidence, and justified rationale. They motivate the medical staffs, the senior management and the patients to follow and implement the change in the medical procedure, which in turn is always effective in managing the standards of outcomes (Sebastian, 2014). They use challenging steps to get the higher result in course of time, which marks their attitude of strategic decision making distinct from other leaders. Strategic leadership- A strategic leader within health care settings is generally the head of the organisation, who is always willing to provide change in the research, procedures and medicines. The leaders should provide proper medical training to the doctors and nurses to adopt the new procedures. Note that strategic leader always make use of evidence in the process of strategic planning (Hurley Hutchinson, 2013). Likewise, they also put emphasis on the training and education related framework to bring optimal competency level in their employees. Correspondingly, they also make rationalised usage of evaluation and monitoring framework to achieve efficacy in their implemented strategic changes. References: Alonso-Coello, P., Schnemann, H. J., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Morelli, A. (2016). GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 1: Introduction.bmj,353, i2016. Alonso-Coello, P., Oxman, A. D., Moberg, J., Brignardello-Petersen, R., Akl, E. A., Davoli, M., Guyatt, G. H. (2016). GRADE Evidence to Decision (EtD) frameworks: a systematic and transparent approach to making well informed healthcare choices. 2: Clinical practice guidelines.bmj,353, i2089. Barry, M. J., Edgman-Levitan, S. (2012). Shared decision makingthe pinnacle of patient-centered care.New England Journal of Medicine,366(9), 780-781. Daly, J., Jackson, D., Mannix, J., Hutchinson, M. (2014). The importance of clinical leadership in the hospital setting.J Healthc Leadersh,6, 75-83. Fulop, L., Mark, A. (2013). Relational leadership, decision-making and the messiness of context in healthcare.Leadership,9(2), 254-277. Hurley, J., Hutchinson, M. (2013). Setting a course: a critical review of the literature on nurse leadership in Australia.Contemporary nurse,43(2), 178-182. Lgar, F., Stacey, D., Turcotte, S., Cossi, M. J., Kryworuchko, J., Graham, I. D., Donner?Banzhoff, N. (2014). Interventions for improving the adoption of shared decision making by healthcare professionals.The Cochrane Library. DOI: 10.1002/14651858.CD006732.pub3 Melnyk, B. M., Gallagher?Ford, L., Long, L. E., Fineout?Overholt, E. (2014). The establishment of evidence?based practice competencies for practicing registered nurses and advanced practice nurses in real?world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs.Worldviews on Evidence?Based Nursing,11(1), 5-15. Sebastian, A., Fulop, L., Dadich, A., Fitzgerald, A., Kippist, L., Smyth, A. (2014). Health LEADS Australia and implications for medical leadership.Leadership in Health Services,27(4), 355-370.