Research paper on rwanda Example | Topics and Well Written Essays - 1500 words

On rwanda - Research Paper Example The earliest ‘residents’ are thought to be a group of Pygmy hunters and gatherers, labeled the Twa. After the Twa settled, it is believed that the Hutus, agriculturists, and the Tutsis also settled in. By the 15th century, evidence shows that the Hutu and Tutsi, both of the Bantu tribe, had organized themselves into states (Melvern, 2006), and thus the Rwandan civilization came into being. One of these states, the Rwabuguri, was the most powerful and maintained control until well into the 19th century. It expanded both geographically and demographically, spreading agricultural techniques and political control. While the military was never a strong means of achieving control, it was used at times against other well-developed states such as Gisaka and Burundi. Soon, economic disparity between the Hutus and the Tutsis became apparent leading to divisions. The Tutsi population emerged with a Mwami (king), who the Rwandans were made to pay tribute to and who controlled much o f the Rwandan land (Melvern, 2006). Moreover, the Tutsis were given many of the important positions in the government. Despite the disparity in control and power, Rwanda did not see any ethnic strife in its pre-colonial administration. It was only when it became a colonial administration that relations between these two tribes, the Hutus and the Tutsis became contentious (Melvern, 2006). Colonial History Early 20th century saw Germany and Belgian colonialism in Rwanda (Cooper, 2002). Unfortunately, this was also an epoch where Germany, like much of Europe, had become fixated on racial differences and soon, they seemed to be favoring the Tutsis against the Hutus since the former were more European in appearance and more inclined to take on the Catholic faith. Therefore, the Tutsis were elevated to higher statuses in the administration and Hutus were routinely oppressed. Soon, many Rwandans started resenting Belgian occupation and formed secret organizations to throw out the Belgians and gain liberation. They resisted reforms by the Belgian administration and in the second half of the 20th century, Pan-Africanism culture spread through Africa and demands of anti-colonialism were made. The final straw came when, in 1962, the last Mwami died and it was believed to have been killed by Belgians. In anger, the Hutus drove out the Belgians soon, the Hutu Emancipation Movement gained power and drove out the Tutsis and killed many of them in revenge for the oppression they had been dealt with (Mamdani, 2002). Post-Independence History to Present The Tutsi refugees started their own party, the Rwandese Patriotic Front (RPF) and in 1990, the RPF invaded and forced the president to sign a treaty that stated that Hutus and Tutsis would share power (Broch-Due, 2005). After a mass genocide in which 800,000 Tutsis were killed and one-tenth of the population was wiped out (Cohen, 2007) relative peace was seen in Rwanda. The RPF invaded the country and put in place a government with representation from both Hutu and Tutsi fronts. The President was Hutu, and the Vice-President was a Tutsi. Moreover, over 900,000 people had fled Rwanda to

Development of Postoperative Infection in Women between the age of 30 Research Paper

Development of Postoperative Infection in Women between the age of 30 to 50 - Research Paper Example Due to some violation of safety precautions before, during, and after surgery, these or other freshly colonized bacteria in the hospital environment may enter the wound and cause infection, where bacteria now easily penetrate the wounded skin. As mentioned earlier, injury and inflammation caused by surgical manipulation may also help the nosocomial bacteria enter into the wound after being transmitted from somewhere else from within the hospital environment. In effect such infections in the surgical wound would slow down the approximation of the wound edges, delay wound healing, lead to morbidity, and cause increased economic burden, increased hospital stay, and increased incidence of other infections. Usually the patients present with increased pain in the surgical wound as a result of inflammatory process early in the infection, redness at the wound margins that spreads unless treated, drainage from the wound margin, fever due to infection, and ultimately breakage of the wound (Pry or et al., 2004). Such cases are often encountered in clinical surgical nursing practice, and the nursing assessment usually yields the following diagnoses, risk for infection, impaired skin integrity, impaired tissue integrity, and delayed surgical recovery. Thus this is a recognised surgical nursing care problem the evidence-based knowledge about which would be helpful in clinical practice nursing. While the problem is evident and common one, in this author's clinical practice as a surgical nurse in the Jacobi Medical Center, despite an uniform age distribution in the surgical cases, it is a common finding that female patients develop postoperative infections more frequently, and as a result they on an average have a longer postoperative stay, and in some cases, following discharge from the hospital, they return to the hospital with wound discharge, breakdown, or infections. This leads to a focus question, why these female patients have an increased preponderance of wound infection. To find out the answers, this author has chosen the age group of 30 to 50-year-old female surgical patients, so the answers to this question in the context of these patients are found out from the literature. The findings may prove to serve as evidence base where change in practice in such cases may be mandated. Focus Question Why so many women between the ages of 30 to 50 develop postoperative infection Literature Review To this end, a literature search was conducted with key words postoperative infection, females, women, nursing care, surgical nursing, wound infection, and wound care. Out of the available literature which included studies, research articles, and reviews, including both quantitative and qualitative literature, six recent articles were selected for critical review in order to point out the evidence available. It is to be mentioned that although the assignment requirement only mentions nursing literature, it would not be prudent to include only nursing literature since the cause of surgical site infection may also lie in the operating room management and handling of the skin, the magnitude of the operative procedure, the technical dexterity of the surgical team, and safety protocol

Outline macro journal Essay Example | Topics and Well Written Essays - 500 words

Outline macro journal - Essay Example They obtained more than five hundred information pieces in relation to the background of students, as well as the facilities and resources available in their schools (Heyneman & Loxley 1163). Data was collected from Uganda from sixty-one primary schools spread across five districts and three urban areas of Kampala, Mbale, and Jinja through primary leaving examination performances, inventories of facilities by the principals, and questionnaires (Heyneman & Loxley 1166). In El Salvador, they selected 595 schools based on their location and number of students after which they tested 50% of the students in these schools in social studies, math, and science. They also collected data from Bolivia, Argentina, Colombia, Peru, Mexico, Paraguay, and Brazil under the ECIEL auspices, obtaining information on attitudinal characteristics and background. Data from Egypt included school quality and achievement information and was collected from 1.250 students in 5th and 6th grade attending sixty schools picked at random. Finally, they also collected data from Botswana with regards to reading and math comprehension for 3rd, 5th, and 7th grade students, as well as inventories on facilitie s, principals, and teachers (Heyneman & Loxley 1168). Due to the similarity of each study’s design, the authors examined societal differences at varying economic development levels. Comparing the studies that they got their data from raised several concerns regarding the achievement tests’ intent, the test questions’ content, the sample populations, administration of the studies, and the sample representation (Heyneman & Loxley 1169). In their own methodological procedures, their country samples involved some five hundred independent measures of education. 300 experts in 18 countries using 14 languages in 10,000 institutions with 260,000 students and 50, 000 teachers, carried out the data they used. 45 items in the questionnaire referred to the opportunity for students

Writing the Winning Thesis or Dissertation Essay

Writing the Winning Thesis or Dissertation - Essay Example The reviser must restate the problem precisely how it comes out in chapter one of the book. The researcher must also have a detailed and precise review of the methodology without exaggeration in repetition. A detailed and precise review helps readers who have not read the chapter containing the methodology part to understand it.However, your chair may approve another organization in a way that pleases the reader. General-to-specific can be sufficient by giving a result first then evidence later, but the writer does not have to represent the details mentioned in the previous chapter. The writer should avoid partisan interpretation at this stage. Writer should also observe great clarity when stating the findings by using word sequence or bullets.Discussing the hypotheses of the study is the most crucial section in the final chapter. Reflection of the findings provides a quick answer to the researcher question that aims at finding the meaning of the study other than the details. Tentati ve answers to study questions provide a solution in determining the content of the chapter.The writer should develop an outline for the chapter. The section contains the researcher insights. Research ideas allow the researcher to conceptualize the study without being assertive. The other components include Relationship of the current study ahead of research, theoretical impacts explanation on expectation and Amplification for practice. Final in the list are recommendations for further research.

Utilitarianism Notes Essay Example for Free

Utilitarianism Notes Essay – – – – – – – No Absolutes Morality Depends on individual circumstances Happiness is the most important thing Quality and Quantity of Happiness need to be taken into account The Measure of Usefulness or Fittingness for purpose an action may have Teleological Ethical theories such as Utilitarianism tend to rely on the principle of utility It is the way of measuring how useful an action is in bringing about the consequences that we desire Equality The Happiness of each individual person is equally important No Persons happiness is more important than anothers You can work out the right action mathematically. Not absolute rules but we would all make the same decision under the circumstances. No rules. Principles are used to govern right and wrong rather than rules in Act Utilitarianism In Rule Utilitarianism, J. S. Mill introduced some beneficial rules, which acted as guidelines Hedonistic Principle of Utility †¢ Egalitarian – – – †¢ †¢ †¢ Hedonistic Calculus – – – – Anti-Legalistic Harm Principle – – Put forward by Mill to avoid restricting the freedom of the minority. It states that each person can do whatever they want, as long as it does not negatively impact on the freedom of other people Teleological Ethics. †¢ In order to understand Utilitarianism, you must first study Teleological Ethics, which share many principles with Utilitarianism. †¢ Teleological Ethics is to judge whether or not an action is moral by purely looking at the result or consequence of the action. †¢ This is also known as Consequentialism. Teleological Ethics †¢ In Teleological Ethics, there are no moral absolutes. †¢ Teleological Ethics only consider the consequence of an action, and disregard the motive or circumstances. †¢ Teleological Theories are consequentialist (based on consequences) †¢ Actions only have Instrumental Value, not intrinsic value. (see table below to see definitions) Problems with Teleological Ethics †¢ How do you decide what a morally good or bad consequence is? †¢ There are many conflicting factors †¢ We cant tell the future, we have no way of knowing what the consequences will be! The Principle of Utility †¢ Teleological Ethical theories tend to rely on the Principle of Utility †¢ This is defined as the measure of usefulness or fittingness for purpose an action may have †¢ A Principle of Utility is a way of measuring how useful an action is in bringing about the consequences that we desire †¢ The Principle of Utility of Utilitarianism is Happiness. This is for the following reasons: – It is universally valued and desirable – Subjective (opinion matters) – However, it is also open to abuse as it cannot be easily defined. †¢ This links to Hedonism Hedonism †¢ Hedonism is the belief that happiness is more important than anything else †¢ Pleasure or happiness are often interchangeable and used to mean the same thing â€Å"Nature has placed mankind under the governance of two masters, pain and pleasure. It is for them alone to point out what we ought to do as well as what we shall do. † -David Hume Before Utilitarianism. †¢ Hume linked Utility with Happiness †¢ It is difficult to define Happiness †¢ Aristotle saw no difference between living well (flourishing) and living normally. Well being is part of the good life. This can include comfort and enjoyment Act Utilitarianism Act Utilitarianism is the earliest form of Utilitarianism. It was first put forward by scholar Jeremy Bentham †¢ Act Utilitarianism is a Relativist theory, which means that nothing is always right or wrong and the choice of actions depend on circumstances, which allows flexibility and is intuitive. †¢ It also rejects God, as there is no proof as to whether or not God exists. It also rejects the Bible and religion in general. This removes the need for faith which makes it a theory that can be supported by both religious and secular people. †¢ There are no absolute rules in Act Utilitarianism, which means that there is no unfairness and is a more flexible theory. This makes the people more important than the rules. †¢ Act Utilitarianism uses a Hedonic Calculus to work out the right action for people to do. This creates a simple, objective, mathematical, tangible and logical way of working out what is right and wrong. †¢ It is also a Hedonistic theory, this means that happiness is more important than anything else. This is good because we all agree that happiness is good, and an objective base for morality (meaning of life) which fits in well with modern society. â€Å"The good is that which will bring about the greatest sum of pleasure and the least sum of pain for the greatest number† -Jeremy Bentham Hedonic Calculus. †¢ The Hedonic Calculus is a formula that can be used to work out the right action mathematically †¢ It is simple, objective, mathematical, logical and tangible. †¢ The Hedonic Calculus uses the following factors to establish the presence of happiness: Rule Utilitarianism Rule Utilitarianism superseded Benthams Act Utilitarianism. It was put forward by scholar John Stuart Mill, who had learned about Utilitarianism for most of his life, as his father James Mill was a colleague of Jeremy Bentham. Rule Utilitarianism. †¢ Mill argued that not all forms of happiness or pleasure were of equal value, which was seemingly what Bentham was implying †¢ He also recognised that, in life, it is easy to settle for the more immediate and sensual pleasures, rather than the nobler and more refined ones. †¢ Mill goes beyond the Hedonic Calculus of Act Utilitarianism by recognising that there are many different ways of assessing its value †¢ Mill was concerned to link his utilitarian theory with Jesus teachings by claiming that to love your neighbour as yourself constitutes the ideal perfection of utilitarian morality. †¢ Mill also suggested a positive place for rules within an overall utilitarian approach. His one rule that he introduced was known as the Harm Principle it stated that everyone should be able to do what would make them happy, unless the majority of people affected, are negatively affected. †¢ Mill stated that general rules such as the Harm Principle should be obeyed as they give overall benefit to society, but they can be broken in exceptional circumstances. â€Å"It is better to be a human being dissatisfied than a pig satisfied† -John Stuart Mill. Strong and Weak Rule Utilitarianism †¢ Strong Rule Utilitarianism holds that one should never break a rule that is established on utilitarian principles †¢ Weak Rule Utilitarianism holds that there may be situations where breaking the rules is acceptable, in order to bring about the greatest good for the greatest number, but generally keeping the rules (eg. Telling a lie is generally wrong, but there may be circumstances where it acceptable in order to bring about the greatest good for the greatest number). Rule Utilitarianism Preference Utilitarianism †¢ Preference Utilitarianism superseded Mills Rule Utilitarianism. It was put forward by several scholars, who advocated it over a period of time. †¢ They are: – Henry Sidgwick (1838-1900) – R. M. Hare (1919-2002) – Peter Singer (1946-present) †¢ Preference Utilitarianism uses Preference over Happiness or Pleasure as the Principle of Utility. †¢ Preference Utilitarianism also takes other factors into account, such as duty †¢ This means that most people would get what they wanted. Prima Facie Obligations †¢ â€Å"Prima Facie† – At First Sight †¢ This is the idea that we do not value strangers as highly as friends or family †¢ Most of us judge morality as ‘agent relatve’, we will favour some people above others. †¢ Utilitarianism requires us to judge all people equally and not consider Prima Facie obligations †¢ This is a criticism of Utilitarianism as to abandon prima facie duties seems to go against all instinct †¢ Some people argue that people should be treated as ends in themselves and not means to an end. †¢ It is necessary for a utilitarian to defend against this position. Motive Utilitarianism †¢ Henry Sidgwick put forward a theory of Utilitarianism which became known as ‘Motive Utilitarianism’ †¢ It states an action can be considered to be good if its motive was to bring about the greatest happiness for the greatest number, regardless of the actual outcome (which links to Situation Ethics).

Health Promotion: Post Natal Depression

Health Promotion: Post Natal Depression The issues of health and health promotion initiatives have gained much significance in the recent past. Stephens (2008:5) comments that from a social perspective health are understood as much more than a matter for individual experience and responsibility; health behaviour is seen in terms of relationship with others and health is structured by society. World HealthOrganisation(WHO) constitution of 1948, defines health as a state of complete, physical, social and mental well-being, and not merely the absence of disease or infirmity. It also adds that health has been considered less as an abstract state and more as a means to an end which can be expressed in functional terms as a resource which permits people to lead an individually, socially and economically productive life, with respect to health promotion. (WHO, Geneva, 1986). WHO recognizes the spiritual dimension of health and regards health as a fundamental human right and states that the basic resources for health should be acc essible for all people. According to WHO, health promotion represents a comprehensive social and political process, which not only embraces actions aimed at strengthening the skills and capabilities of individuals, but also acts toward changing social, environmental and economic conditions so as to alleviate their impact on public and individual health. Its also the process of enabling people to increase control over the determinants of health and thereby improve their health (WHO official website) The concept of social determinants of health needs to be considered while discussing health and health promotion initiatives. According to a study conducted by Bambra et.al(2008), the wider social determinants of health were listed out as water and sanitation, agriculture and food, health and social care services, unemployment and welfare, working conditions, housing and community, education and transport. The term health promotion has variously been used to refer to a social movement, an ideology, a discipline, a strategy, a profession, and a strategy or field of practice delineated by commitment to key values(Keith and Tones, 2010).According to ODonnell (2009), health promotion is the art and science of discovering the synergies between their core passions and optimal health enhancing their motivation to strive for optimal health and supporting them in changing their life style to move toward a state of optimal health, which is a dynamic balance of emotional, social, spiritual and intellectual health. Tones and Tilford (2009) is of the opinion that health promotion as a quasi-political movement and professional activity can be described as militant wing of public health. At a general level health promotion has come to represent a unifying concept for those who recognize the need for change in the ways and conditions of living to promote health (Fleming and Parker, 2006). Post natal depression Postnatal depression is one of the most discussed topics in health today. This assignment discusses postnatal depression in detail, considering the significance it has and the risks associated with Postnatal depression, among the women in the United Kingdom. There has been a growing international recognition of postnatal depression as a major public health concern (Oates et.al, 2004). The government policy (Department of Health, 2004) recognises that the mental disorders during pregnancy and the post natal period can have serious consequences for individual women, their partners, babies and other children. Perinatal psychiatric disorder is one of the leading causes of maternal morbidity and is the leading cause of maternal mortality in the UK (Confidential Enquiries into Maternal Deaths, 2001).NICE (2007) observes that the mental disorders which occur during pregnancy and the postnatal period can seriously affect the health and wellbeing of a mother and her baby, as well as for her p artner and other family members. This condition is a form of maternal morbidity that affects about one in eight women from diverse cultures and is a leading cause of maternal mortality(Dennis, 2009).Dennis(2009) also comments that postnatal depression can also have serious consequences for the health and well being of the family as the infants and children are particularly vulnerable to it impaired maternal-infant interactions can have an impact on the cognitive, social ,emotional and behavioural development of the children. According to the latest reports it is estimated that approximately 75000 women within the United Kingdom are affected by postnatal depression (Hanley and Hanley, 2009).Craig (2008) comments that postnatal depression has been various defined as non-psychotic depression occurring during the first six months, the first four weeks and the first three months post partum; but recently three months postpartum was suggested in the United Kingdom. There have been many views by various authors about postnatal depression. Wheatley (2006) comments that postnatal depression affects between 10 and 20 percent of women who have had babies, and it causes distress at a time when there is every reason for happiness. Wheatley (2006) adds that the symptoms vary from person to person as for some symptoms can be mild and for other women, it can lead to serious consequences including bouts of depression. However, the case of postnatal depression which is serious enough to warrant treatment percentage is bet ween 7% and 35%. Dalton and Holton (2001) defines that postnatal depression is one of the symptoms of a serious mental condition known as postnatal illness. They opine that postnatal illness covers a range of afflictions which range from sadness to infanticide which start after child birth. The disorders associated with postnatal illness are blues, postnatal depression, puerperal psychosis and infanticide or homicide. Dalton and Holton (2001, p.3) defines postnatal depression as the first occurrence of psychiatric symptoms severe enough to require medical help occurring after childbirth and before the return of menstruation. They add that it does not include the blues, and excludes the condition of those who have previously sought psychiatric help because of other psychiatric illnesses such as schizophrenia, manic depression, depression or drug abuse. Feeney (2001) is of the view that although the symptom of postnatal depression is dysphoric (depressed) mood, this state is also acco mpanied by other symptoms like extreme fatigue, strong feelings of guilt, disturbance of sleep and loss of appetite. Hanzak (2005) attributes the occurrence of postnatal depression to three factors; biological, psychological and social causes. She lists out some of the possible reasons for postnatal depression as history of disturbed early life, loss of own mother, current marital or family conflicts, infertility and investigations for four or more years , loss of a previous pregnancy, adoption or fostering, high medical anxieties over the pregnancy, admission to hospital for longer than one week over the last three months of pregnancy ,major upheavals or stress over the last three months, emergency Caesarean section, neonatal illnesses, hormonal changes and personal or family history of depression Walsh (2009) comments that the occurrence of postnatal depression is linked with birth experience. Parker (2009) had earlier opined that if the birth was traumatic, there are high chances for postnatal depression. Epidemiological factors of poverty, social class and low income influence the chances of postnatal depression (Gale and Harlow, 2003). Walsh (2009) puts forward a view that postnatal depression can affect fathers and children and hence its important to maintain communication and interaction between family members. Cox and Holden (2001) are of the opinion that the consequences of maternal depression are costly not only on a personal level, but also in terms of money and personnel level as well. They put forward an interesting point that when there is contact between professionals and mothers is high detection of postnatal depression is very low and that the failure to diagnose depression may be attributed to short appointments, a physical orientation of care and an emphasis on the babys rather than the mothers well being. Most cases of postnatal depression can be dealt with at primary care level with monitoring by the family doctor and interventions by primary care staff (Cox and Holden, 2001). Health promotion models and approaches Dahlgren and Whitehead (1991) had proposed that the factors which influence health are multidimensional and suggests a model which illustrates the wider determinants of health. The main factors according to them are general socioeconomic, cultural and environmental conditions, living and working conditions, social and community influences, individual lifestyle factors, age, sex and hereditary factors. The model depicts individuals as central characters, who are influenced by various other determinants, which play a major role in influencing their health factors. Source: Dahlgren and Whitehead (1991) Another model which is widely discussed with relation to health promotion is the stages of change model. Bunton et.al(2000) proposes that the transtheoretical or stages of change model has greatly influenced health promotion practices in the United States of America, Australia and the United Kingdom since the late 1980s.The stages of change model was focused on encouraging change for people with addictive behaviour. People go through several stages when trying to change behaviour (Naidoo and Wills, 2000). Fertman (2010) asserts that behaviour change occurs in stages and that a person moving through these stages in a very specific sequence constitutes the change. According to this model, there are five stages of change, which are listed as pre contemplation, contemplation, preparing for change, making the change and maintenance. The health belief important model is a well known theoretical model, which emphasises the role of beliefs in decision making. This model which was proposed by Rosenstock(1966) and modified by Brecker(1974) proposes that whether or not people change their behaviour will be influenced by an evaluation of its feasibilities and the comparisons of its benefits weighted against the costs. Evans et.al (2005) comments that the major three health promotion approaches are the behaviour change approach, the self-empowerment approach and the collective action or community development approach. They add that these approaches have different goals and adopt different ways to achieve their goals and propose different criteria for their evaluation, though they have a common aim to promote good health and to prevent the effects of ill health. Each of these approaches has a unique understanding of the origins of health and health behaviour and subsequently of their objectives in health promotion and these three approaches are mutually complimentary. (Victorian Health Promotion Foundation, 2004). NICE (2007) defines behaviour change as the product of individual or collective human actions, seen within and influenced by their structural, social and economic context. Resnicow and Waughan (2006) comment that the study of health behaviour change has historically been rooted in a cognitive-rational paradigm. The models such as social cognitive theory, the health belief model, the transtheoretical model have viewed behavioral change as an interaction of factors such as knowledge, attitude, belief etc (Rimer and Lewis, 2002; Baranowski et.al, 2003).It has been suggested by the evidences that behavior change occurs in stages or steps and that movement through these stages is cyclical involving a pattern of adoption, maintenance, relapse and readoption over time. It has been suggested by the evidences that behavior change occurs in stages or steps and that movement through these stages is cyclical involving a pattern of adoption, maintenance, relapse and re adoption over time(Di paitro and Hughes, 2003).. According to NICE (2007) the attempts to promote or support behaviour change take a number of forms, which are activities which can be delivered at a number of levels, ranging from local, one to one interactions with individuals to national campaigns. NICE(2007) divides interventions into four main categories as policy-such as legislation ,education or communication-such as one to one advice, group teaching or media campaigns, technologies-such as the use of seat belts, breathalyses , resources-such as leisure centre entry, free condoms or free nicotine replacement therapy. According to the Victorian Health foundation (2004) the behavioural approach focuses on implementing interventions to change or remove behavioural health risk factors. Interventions from this perspective are targeted at a particular behavioural risk factor associated with a particular negative health outcome, and they target a population performing the behavioural risk factor and endeavour to promote health through various strategies. However, Craig et.al (2008) adds that behaviour change interventions are generally complex to design, deliver and evaluate.Michie (2008) states that more investment in developing the scientific methods for behavioural change studies is essential. Behavioural science is relevant to all phases of the process of implementing evidence-based health care; development of evidence through the primary studies, synthesizing the findings in systematic reviews, translation of evidence into guidelines and practice recommendations and implementing these recommendatio ns in practice(Michie,2008). Dunn et.al (2006) proposes that Item Response modeling (IRM) can be used to improve the psychometric methods in health education and health behaviour research and practice. They add that IRM is already being adopted to improve and revise quality of life questionnaires. However Masse et.al (2006) comments that a number of issues seem to stunt the application of IRM methods, as they list out the following issues (i) Lack of IRM applications in the context of health education and health behavior research; (ii) lack of awareness as to what IRM can do beyond assessing the psychometric properties of a scale; (iii) lack of trained psychometricians trained in our field. It is to be noted that the behaviour change approach came under criticism from various quarters. The major criticisms pointed out by Marks et.al(2005) were the inabilities to target the major socio-economic causes of ill health, possible incompatibilities of the top-down recommendations with community norms, values and practices, the assumption of a direct link between knowledge attitudes and behaviour and the assumption of homogeneity among the receivers of health promotion messages. Post natal depression-Current significance and ethical considerations Post natal depression is a matter of serious concern in the current age, as many women are being affected by it. Almond (2010) comment that post natal depression can be deemed a public health problem as the effects of it are known to go beyond the mother and it also affects the partner and the child. He adds that it can lead to infanticide as well as maternal death by suicide and according to evidences, all countries are faced with the challenge of postnatal depression, and the most affected countries are the low and middle income countries. The NICE guidelines for the clinical management of antenatal and postnatal mental health (2007) have observed the risks associated with postnatal depression. Ramchandani (2005) concurs to it and observes that the postnatal depression in fathers can have long-term consequences for the development of their child, on behavioural and emotional aspects. A study entitled The children of the 90s by Bristol University in 2008, had found that post natal d epression in fathers can have long lasting psychological effects on their children. A notable observation in this study was that the boys born to depressed fathers are twice as likely as other boys to have chances of developing behavioural problems by the age of three and a half. It is essential to look into the long term consequences posed by the problem. Ramchandani (2008) points out that the conduct problems at the age of three to four years are strongly predictive of serious conduct problems in the future, increased criminality and significantly increased societal costs. The quotes by Ramchandani points out the threats posed by the depression among the fathers of new born babies. The impact of postnatal depression can be highly detrimental to a society, as proved by the recent unfortunate happening of a depressed teacher killing her baby in Exeter, as a result of the depression. Policy drivers There have been lots of developments over the last few years in policy on the mental health and womens services (NICE, 2007). NSF for Child Health and Maternity was published in 2004 and is a 10 year programme that is aimed at the long term and sustained improvement in childrens health. Setting standards for health and social services for children, young people and pregnant women, the NSF aims to ensure fair, high quality and integrated health and social care from pregnancy to adulthood (NHS, 2007). NICE(2007) lists out the four main strands of policy relevant to antenatal and postnatal mental health as National service frameworks(NSFs), (particularly the mental health NSF,NSF for children young people and maternity services),policy to ensure equal access to responsive mental health services( especially services that meet needs of women, people from minority ethnic groups), public health policy and policy on commissioning and delivering health care and social care services in the com munity and the policy concerned with strategies for improving mental health services. The screening for postnatal depression is highly talked about in the field of psychology and medicine today. Currie and Radematcher (2004) argues that pediatric providers are aware of the prevalence of postnatal depression and its effect on new born babies. However, there have been arguments for and against screening for postnatal depression and hence the practitioners should consider them carefully (Coyne et.al, 2000). The view proposed by Chauldron et.al (2007) is that from the legal and ethical standpoints and the perspective of feasibility, the benefits of screening outweigh the risks. However, they add that, the implementation must be seen as an iterative process, and implementing the screening for post natal depression in a systematic and comprehensive approach is critical to the ultimate well-being of children and families.Basten (2009) proposes that more studies in the field of psychotherapeutic research and psychological areas are required. This is in conformance with the ob servation by De Tychey ,Briancon et.al, 2008) that the diagnostic techniques need to be improved for both caregivers and sufferers through education and the communication should be promoted, focusing on the fostering of parenting skills as a preventive measure against Post Natal Depression.(de Tychey, Brianà §on et al. 2008). One of the recent studies by Norman et.al (2010) has found out that exercise can help women in combating postnatal depression and that the specialised routines could help new mothers decrease the chances of depression by upto 50 percent. Partnership working Partnership working is a very important term in the current health and social care system in the United Kingdom. Partnership working can be defined as a system where two or more disciples work collaboratively to deliver optimal care to an individual (NHS, 2007). In the context of post natal depression partnership working refers to working in partnership with the team involved in the mother and the newborn baby, which includes pediatricians and obstetricians(Byrom et.al,2009) .Douglas(2008) points out that partnership working is recognised as the most effective way of improving social care services. Department of Health (2006) had stressed that the action to improve health and care services will be underpinned through working in partnerships between individuals, communities, business, voluntary organizations, public services and government.Butt(2008) argues that partnerships have international appeal as a means to integrate health and social services in response to the realisation tha t both sectors serve populations whose complex needs cannot be met adequately through segmented approaches. Partnership working with women having mental health problems can be a challenging task (Department of health, 2008). According to NICE (2007) the impact of partnership working is a function of a number of features of joint working and it is possible to categorise partnerships along a number of descriptive variables such as membership, structures, leadership, agendas and organisational cultures. Previous studies have shown that the working of people involved in the care of women with post natal depression, a trusting partnership can be developed between carers, patients and professionals, which will be beneficial to all. Feeney et.al (2001) had proposed that working in partnerships with families is an essential component of effective programming in the early developmental stages of children. Hence partnership working holds a very important role in the post natal period as, it would be able to relieve the emotional stress which many women go through. It was observed by NICE (2007) that developing trust and accommodating relationships within facilitating partnerships is imperative to the attainment of partnership goals, and issues of process are highly important building blocks to success.Sorin (2002) comments that there are many reasons to establish partnerships and asserts that the family is the most significant influence on the mothers post natal health as well as the childs development and well being. Sorin( 2002) adds that partnerships that develop to address fear and other emotions can work towards understanding appropriate expression of these emotions, which include learning words to describe the emotion using forms like music ,talking to others . A report on safety in maternity services published by Kings fund (2008) emphasises the significance of team work and collaboration in ensuring the safety of mothers and babies and points out that effective team work can increase safety, whereas poor teamwork can be detrimental to the safety. The report proposes several solutions to resolve the difficulties in team work. The main suggestions include ensuring clarity about the objectives of the team and roles and that there is effective leadership among the group and clarity in procedures for communication is present (Byrom et.al, 2009). It is important to look into the barriers which affect the concept of partnership working. Lester et.al(2008) comments that there are barriers to closer working in partnerships, which include cultural differences, the time factor which is required to create and maintain relationships and recognition of the advantages of remaining a small and autonomous organisation. Conclusion This essay has critically analysed the effect of the behavioural change approach intervention of postnatal depression to address the needs of women who are more at risk in the United Kingdom. Various factors which lead to postnatal depression have been explained in the essay. It can be concluded that postnatal depression is to be seriously taken care of, and that the impact of postnatal depression can have serious consequences for society. The various health promotion models have portrayed the linkages between beliefs and behavioral changes. The essay has pointed out the importance of partnership working in improving the conditions of mothers and newborn babies. Effective working in partnerships can go a long way in alleviating the concerns of the mothers and improving the mental health of the new born babies, as they play a very important role in framing the future characteristics of the new born babies. A recent study by the University of Leicester has found out that women are less likely to become depressed in the year after childbirth if they have an NHS health visitor who has undergone additional mental health training. These findings point out the fact that postnatal depression can be effectively tackled with external help. The studies about postnatal depression and the concept of partnership working have been very effective in improving the health care system in the United Kingdom and hence serve as an interesting topic for future researches in the field.

Hitler In germany :: essays research papers

The point of this essay is to prove that although Hitler came to power within the 'letter of the law" he did not come to power within the 'spirit of the law.' Hitler was appointed Chancellor on the 30th of January 1933, with only two other Nazis in the Cabinet, this was though to be enough to control him, by Van Papen and the conservatives. Hitler persuaded President Hindenburg to hold new elections in March 1933, in the hope he would gain an over all majority. However in the new elections Hitler controlled Prussia through GÃ ¶ring (Cabinet Minister) and the other two fifths of Germany through Frick (the other Cabinet Minister). With Nazi appointed police chiefs and local government heads, the Nazis had the legal power to intimidate the electorate. By the end of February 1933 Hitler was Chancellor and in control of police and local government, all legally and not within the spirit of the constitution. On the 27th of February 1933 a half-mad Dutch Communist called Van der Lubbe was found wondering in the ashes of the burning Reichstag. This provided the Nazis with the opportunity to persuade Hindenburg to sign an emergency decree (composed by Frick) on February the 28th, suspending civil liberties and allowing the central Government to run regional governments deemed unable to run them selves. By the end of April, twenty five thousand people had been taken into 'protective custody' in Prussia alone. Under the decree Frick was able to 'take over' areas not already controlled by GÃ ¶ring. Because of the 'suicide clause' these actions were legal however they were definitely not within the democratic spirit of the constitution. In the Reichstag elections of March 1933 the Nazis increased their control from 33.1% in December 1932 to 43.9%. This increase can be attributed to the Nazis strong stance on Communism. The Nazis were known for their hatred of Communism, the middle class voted Nazi because of that policy. Joseph Goebbels' propaganda machine was also very good at 'acquiring' votes. Nazi intimation by the now auxiliary policeman (in Prussia), the S.A. and S.S. plus the threat of unemployment by Nazi run organisations also helped increase Nazi votes. With their rightwing and Catholic allies the Nazis were now in a position to obtain power legally. Hitler clearly gained power legally as regards election results but as to how he got the results it is clear he acted both illegally and against the constitution.