HEALTH INSURANCE SECTOR IN INDIA: CURRENT SCENARIO Essay

1.1 Introduction: Health and health care need to be distinguished from each other for no better reason than that the former is often incorrectly seen as a direct function of the latter. Heath is clearly not the mere absence of disease. Good Health confers on a person or groups freedom from illness – and the ability to realize one’s potential. Health is therefore best understood as the indispensable basis for defining a person’s sense of well being. The health of populations is a distinct key issue in public policy discourse in every mature society often determining the deployment of huge society. They include its cultural understanding of ill health and well-being, extent of socio-economic disparities, reach of health services and quality and costs of care. and current bio-mcdical understanding about health and illness. Health care covers not merely medical care but also all aspects pro preventive care too. Nor can it be limited to care rendered by or financed out of public expenditure- within the government sector alone but must  include incentives and disincentives for self care and care paid for by private citizens to get over ill health. Where, as in India, private out-of-pocket expenditure dominates the cost financing health care, the effects are bound t be regressive. Heath care at its essential core is widely recognized to be a public good. Its demand and supply cannot therefore, be left to be regulated solely by the invisible had of the market. Nor can it be established on considerations of utility maximizing conduct alone.1 Health insurance in a narrow sense would be ‘an individual or group purchasing health care coverage in advance by paying a fee called premium.’ In its broader sense, it would be any arrangement that helps to defer, delay, reduce or altogether avoid payment for health care incurred by individuals and households. Given the appropriateness of this definition in the Indian context, this is the definition, we would adopt. The health insurance market in India is very limited covering about 10% of the total population. 1.2 Hypothesis: The Researcher assumes that all projections of health care in India must in the end rest on the overall changes in its political economy – on progress made in poverty mitigation (health care to the poor) in reduction of inequalities (health inequalities affecting access/quality’), in generation of employment /income streams (to facilitate capacity to pay and to accept individual responsibility for one’s health ) in public information and development communication (to promote preventive self care and risk reduction by conducive life styles ) and in personal life style changes. 1.3 Research Methodology: In this endeavour, both primary and secondary sources of data have been used to prepare the present paper. Further, it must be noted that the present paper discusses in detail the Indian position in this regard. 1.4 Object : The purpose of this paper is to study the Situation exists in a scenario where health care is financed through general tax revenue, community financing, out of pocket payment and social and private health insurance schemes. 1.5 Scope : The Scope this Research is limited to the extent of Indian position in this regard, while ignoring the foreign Scope. Chapter-2 Health Insurance: Health insurance in a narrow sense would be ‘an individual or group purchasing health care coverage in advance by paying a fee called premium.’ In its broader sense, it would be any arrangement that helps to defer, delay, reduce or altogether avoid payment for health care incurred by individuals and households. Given the appropriateness of this definition in the Indian context, this is the definition, we would adopt. The health insurance market in India is very limited covering about 10% of the total population2. The existing schemes can be categorized as: (1) Voluntary health insurance schemes or private-for-profit schemes; (2) Employer-based schemes; (3) Insurance offered by NGOs / community based health insurance, and (4) Mandatory health insurance schemes or government run schemes(namely ESIS, CGHS).3 2.1 Voluntary health insurance schemes or private-for-profit schemes: In private insurance, buyers are willing to pay premium to an insurance company that pools people with similar risks and insures them for health expenses. The key distinction is that the premiums are set at a level, which provides a profit to third party and provider institutions. Premiums are based on an assessment of the risk status of the consumer (or of the group of employees) and the level of benefits provided, rather than as a proportion of the consumer’s income. 4 In the public sector, the General Insurance Corporation (GIC) and its four subsidiary companies (National Insurance Corporation, New India Assurance Company, Oriental Insurance Company and United Insurance Company) and the Life Insurance Corporation (LIC) of India provide voluntary insurance  schemes. The Life Insurance Corporation offers Ashadeep Plan II and Jeevan Asha Plan II. The General Insurance Corporation offers Personal Accident policy, Jan Arogya policy, Raj Rajeshwari policy, Mediclaim policy, Overseas Mediclaim policy, Cancer Insurance policy, Bhavishya Arogya policy and Dreaded Disease policy (Srivastava 1999 as quoted in Bhat R & Malvankar D, 2000) Of the various schemes offered, Mediclaim is the main product of the GIC. The Medical Insurance Scheme or Mediclaim was introduced in November 1986 and it covers individuals and groups with persons aged 5 – 80 yrs. Children (3 months – 5 yrs) are covered with their parents. This scheme provides for reimbursement of medical expenses (now offers cashless scheme) by an individual towards hospitalization and domiciliary hospitalization as per the sum insured. There are exclusions and pre-existing disease clauses. Premiums are calculated based on age and the sum insured, which in turn varies from Rs 15 000 to Rs 5 00 000. In 1995/96 about half a million Mediclaim policies were issued with about 1.8 million beneficiaries (Krause Patrick 2000). The coverage for the year 2000-01 was around 7.2 million. Another scheme, namely the Jan Arogya Bima policy specifically targets the poor population groups. It also covers reimbursement of hospitalization costs up to Rs 5 000 annually for an individual premium of Rs 100 a year. The same exclusion mechanisms apply for this scheme as those under the Mediclaim policy. A family discount of 30% is granted, but there is no group discount or agent commission. However, like the Mediclaim, this policy too has had only limited success. The Jan Arogya Bima Scheme had only covered 400 000 individuals by 1997. The year 1999 marked the beginning of a new era for health insurance in the Indian context. With the passing of the Insurance Regulatory Development Authority Bill (IRDA) the insurance sector was opened to private and foreign participation, thereby paving the way for the entry of private health insurance companies. The Bill also facilitated the establishment of an authority to protect the interests of the insurance holders by regulating, promoting and ensuring orderly growth of the insurance industry. The bill allows foreign promoters to hold paid up capital of up to 26 percent in an Indian company and requires them to have a capital of Rs 100 crore along with a business plan to begin its operations.Currently, a few companies such as Bajaj Alliance, ICICI, Royal Sundaram, and Cholamandalam among others are offering health insurance schemes. The nature of schemes offered by these companies is described briefly.5 Bajaj Allianz: Bajaj Allianz offers three health insurance schemes namely, Health Guard, Critical Illness Policy and Hospital Cash Daily Allowance Policy. – The Health Guard scheme is available to those aged 5 to 75 years (not allowing entry for those over 55 years of age), with the sum assured ranging from Rs 100 0000 to 500 000. It offers cashless benefit and medical reimbursement for hospitalization expenses (preand post-hospitalization) at various hospitals across India (subject to exclusions and conditions). In case the member opts for hospitals besides the empanelled ones, the expenses incurred by him are reimbursed within 14 working days from submission of all the documents. While pre-existing diseases are excluded at the time of taking the policy, they are covered from the 5th year onwards if the policy is continuously renewed for four years and the same has been declared while taking the policy for the first time. Other discounts and benefits like tax exemption, health check-up at end of four claims free year, etc. can be availed of by the insured. – The Critical Illness policy pays benefits in case the insured is diagnosed as suffering from any of the listed critical events and survives for minimum of 30 days from the date of diagnosis. The illnesses covered include: first heart attack; Coronary artery disease requiring surgery: stroke; cancer; kidney failure; major organ transplantation; multiple sclerosis; surgery on aorta; primary pulmonary arterial hypertension, and paralysis. While exclusion clauses apply, premium rates are competitive and high-sum insurance can be opted for by the insured. – The Hospital Cash Daily Allowance Policy provides cash benefit for each and every completed day of hospitalization, due to sickness or accident. The amount payable per day is dependant on the selected scheme. Dependant spouse  and children (aged 3 months – 21years) can also be covered under the Policy. The benefits payable to the dependants are linked to that of insured. The Policy pays for a maximum single hospitalization period of 30 days and an overall hospitalization period of 30/60 completed days per policy period per person regardless of the number of confinements to hospital/nursing home per policy period. ICICI Lombard: ICICI Lombard offers Group Health Insurance Policy. This policy is available to those aged 5 – 80 years, (with children being covered with their parents) and is given to corporate bodies, institutions, and associations. The sum insured is minimum Rs 15 000/- and a maximum of Rs 500 000/-. The premium chargeable depends upon the age of the person and the sum insured selected. A slab wise group discount is admissible if the group size exceeds 100. The policy covers reimbursement of hospitalization expenses incurred for diseases contracted or injuries sustained in India. Medical expenses up to 30 days for Pre-hospitalization and up to 60 days for post-hospitalization are also admissible. Exclusion clauses apply. Moreover, favourable claims experience is recognized by discount and conversely, unfavourableclaims experience attracts loading on renewal premium. On payment of additional premium, the policy can be extended to cover maternity benefits, pre-existing diseases, and reimbursement of cost of health check-up after four consecutive claims-free years. Royal Sundaram Group: The Shakthi Health Shield policy offered by the Royal Sundaram group can be availed by members of the women’s group, their spouses and dependent children. No age limits apply. The premium for adults aged up to 45 years is Rs 125 per year, for those aged more than 45 years is Rs 175 per year. Children are covered at Rs 65 per year. Under this policy, hospital benefits up to Rs 7 000 per annum can be availed, with a limit per claim of Rs 5 000. Other benefits include maternity benefit of Rs 3 000 subject to waiting period of nine months after first enrolment and for first two children only. Exclusion clauses apply (Ranson K & Jowett M, 2003) Cholamandalam General Insurance: The benefits offered (in association with the Paramount Health Care, a re-insurer) in case of an illness or accident resulting in hospitalization, are cash-free hospitalization in more than 1  400 hospitals across India, reimbursement of the expenses during pre- hospitalization (60 days prior to hospitalization) and post- hospitalization (90 days after discharge) stages of treatment. Over 130 minor surgeries that require less than 24 hours hospitalization under day care procedure are also covered. Extra health covers like general health and eye examination, local ambulance service, hospital daily allowance, and 24 hours assistance can be availed of. Exclusion clauses apply. Employer-based schemes. Employers in both the public and private sector offers employer-based insurance schemes through their own employer-managed facilities by way of lump sum payments, reimbursement of employee’s health expenditure for outpatient care and hospitalization, fixed medical allowance, monthly or annual irrespective of actual expenses, or covering them under the group health insurance policy. The railways, defence and security forces, plantations sector and mining sector provide medical services and / or benefits to its own employees. The population coverage under these schemes is minimal, about 30-50 million people. 2.2 Insurance offered by NGOs / community-based health insurance: Community-based funds refer to schemes where members prepay a set amount each year for specified services. The premia are usually flat rate (not income-related) and therefore not progressive. Making profit is not the purpose of these funds, but rather improving access to services. Often there is a problem with adverse selection because of a large number of high-risk members, since premiums are not based on assessment of individual risk status. Exemptions may be adopted as a means of assisting the poor, but this will also have adverse effect on the ability of the insurance fund to meet the cost of benefits.6 Community-based schemes are typically targeted at poorer populations living in communities, in which they are involved in defining contribution level and collecting mechanisms, defining the content of the benefit package, and / or allocating the schemes, financial resources (International Labour Office Universities Programme 2002 as quoted in Ranson K & Acharya A, 2003). Such schemes are generally run by trust hospitals or nongovernmental organizations (NGOs). The benefits offered are mainly in terms of preventive care, though ambulatory and in-patient care is also covered. Such schemes tend to be financed through patient collection, government grants and donations. Increasingly in India, CBHI schemes are negotiating with the forprofit insurers for the purchase of custom designed group insurance policies. However, the coverage of such schemes is low, covering about 30-50 million (Bhat, 1999). A review by Bennett, Cresse et al. (as quoted in Ranson K & Acharya A, 2003) indicates that many community-based insurance schemes suffer from poor design and management, fail to include the poorest-of-thepoor, have low membership and require extensive financial support. Other issues relate to sustainability and replication of such schemes. Some examples of community-based health insurance schemes are discussed herein: Self-Employed Women’s Association (SEWA), Gujarat: This scheme established in 1992, provides health, life and assets insurance to women working in the informal sector and their families. The enrolment in the year 2002 was 93 000. This scheme operates in collaboration with the National Insurance Company (NIC). Under SEWA’s most popular policy, a premium of Rs 85 per individual is paid by the woman for life, health and assets insurance. At an additional payment of Rs 55, her husband too can be covered. Rs 20 per member is then paid to the National Insurance Company (NIC) which provides coverage to a maximum of Rs 2 000 per person per year for hospitalization. After being hospitalized at a hospital of one’s choice (public or private), the insurance claim is submitted to SEWA. The responsibility for enrolment of members, for processing and approving of claims rests with SEWA. NIC in turn receives premiums from SEWA annually and pays them a lumpsum on a monthly basis for all claims reimbursed. The Action for Community Organization, Rehabilitation and Development (ACCORD): Nilgiris, Tamil Nadu was established in 1991. Around 13 000 Adivasis (tribals) are covered under a group policy purchased from New India Assurance. Another scheme located in Tamil Nadu is Kadamalai Kalanjia Vattara Sangam (KKVS): Madurai. This was established in 2000 and covers members of women’s self-help groups and their families. Its enrolment in 2002 was around 5 710, with the KKVS functioning as a third party insurer. The Voluntary Health Services (VHS): Chennai, Tamil Nadu was established in 1963. It offers sliding premium with free care to the poorest. The benefits include discounted rates on both outpatient and inpatient care, with the VHS functioning as both insurer and health care provider. In 1995, its membership was 124 715. However, this scheme suffers from low levels of cost recovery due to problems of adverse selection. 2.3 Social Insurance or mandatory health insurance schemes or government run schemes (namely the ESIS, CGHS): Social insurance is an earmarked fund set up by government with explicit benefits in return for payment. It is usually compulsory for certain groups in the population and the premiums are determined by income (and hence ability to pay) rather than related to health risk. The benefit packages are standardized and contributions are earmarked for spending on health services The government-run schemes include the Central Government Health Scheme (CGHS) and the Employees State Insurance Scheme (ESIS). Central Government Health Scheme (CGHS): Since 1954, all employees of the Central Government (present and retired); some autonomous and semi-government organizations, MPs, judges, freedom fighters and journalists are covered under the Central Government Health Scheme (CGHS). This scheme was designed to replace the cumbersome and expensive system of reimbursements (GOI, 1994). It aims at providing comprehensive medical care to the Central Government employees and the benefits offered include all outpatient facilities, and preventive and promotive care in dispensaries. Inpatient facilities in government hospitals and approved private hospitals are also covered. This scheme is mainly funded through Central Government funds, with premiums ranging from Rs 15 to Rs 150 per month based on salary scales. The coverage of this scheme has grown substantially with provision  for the non-allopathic systems of medicine as well as for allopathy. Beneficiaries at this moment are around 432 000, spread across 22 cities. The CGHS has been criticized from the point of view of quality and accessibility. Subscribers have complained of high out-of-pocket expenses due to slow reimbursement and incomplete coverage for private health care (as only 80% of cost is reimbursed if referral is made to private facility when such facilities are not available with the CGHS).7 Employee and State Insurance Scheme (ESIS): The enactment of the Employees State Insurance Act in 1948 led to formulation of the Employees State Insurance Scheme. This scheme provides protection to employees against loss of wages due to inability to work due to sickness, maternity, disability and death due to employment injury. It offers medical and cash benefits, preventive and promotive care and health education. Medical care is also provided to employees and their family members without fee for service. Originally, the ESIS scheme covered all power-using non-seasonal factories employing 10 or more people. Later, it was extended to cover employees working in all non-power using factories with 20 or more persons. While persons working in mines and plantations, or an organization offering health benefits as good as or better than ESIS, are specifically excluded. Service establishments like shops, hotels, restaurants, cinema houses, road transport and news papers printing are now covered. The monthly wage limit for enrolment in the ESIS is Rs. 6 500, with a prepayment contribution in the form of a payroll tax of 1.75% by employees, 4.75% of employees’ wages to be paid by the employers, and 12.5% of the total expenses are borne by the state governments. The number of beneficiaries is over 33 million spread over 620 ESI centres across states. Under the ESIS, there were 125 hospitals, 42 annexes and 1 450 dispensaries with over 23 000 beds facilities. The scheme is managed and financed by the Employees State Insurance Corporation (a public undertaking) through the state governments, with total expenditure of Rs 3 300 million or Rs 400/- per capita insured person. The ESIS programme has attracted considerable criticism. A report based on patient surveys conducted in Gujarat (Shariff, 1994 as quoted in Ellis R et a, 2000) found that over half of those covered did not seek care from ESIS facilities. Unsatisfactory nature of ESIS services, low quality drugs, long waiting periods, impudent behaviour of personnel, lack of interest or low interest  on part of employees and low awareness of ESI procedures, were some of the reasons cited.8 Chapter-3 Conclusion: The challenge for the Indian policy-makers is to find ways to improve upon the existing situation in the health sector and to make equitable, affordable and quality health care accessible to the population, especially the poor and the vulnerable sections of the society. It is in a way inevitable that the state reforms its public health delivery system and explores other social security options like health insurance. Implementing regulations would be one, but by no means the best mechanism to contain provider behaviour and costs. This can only be done by developing mechanisms where government and households can together pool their funds. This could be one way of controlling provider behaviour. There is an urgent need to document global and Indian experiences in social health insurance. Different financing options would need to be developed for different target groups. The wide differentials in the demographic, epidemiological status and the delivery capacity of health systems are a serious constraint to a nationally mandated health insurance system. Given the heterogeneity of different regions in India and the regional specifications, one would need to undertake pilot projects to gather more information about the population to be targeted under an insurance scheme and develop options for different population groups. Health policy-makers and health systems research institutions, in collaboration with economic policy study institutes, need to gather information about the prevailing disease burden at various geographical regions; to develop standard treatment guidelines, to undertake costing of health services for evolving benefit packages to determine the premium to be levied and subsidies to be given; and to map health care facilities available and the institutional mechanisms which need to be in place, for implementing health insurance schemes. Skillbuilding for the personnel involved, and capacity-building of  all the stakeholders involved, would be a critical component for ensuring the success of any health insurance programme. The success of any social insurance scheme would depend on its design, the implementation and monitoring mechanisms which would be set in place and it would also call for restructuring and reforming the health system, and developing the necessary prerequisites to ensure its success.

Debate whether downloading of music through the internet is ethical or not Essay

Music is one of the countless arts that represent the world as it is and sometimes much better- what it should be. Aside from this cliche, the world of music is being torn between legal issues of piracy and what others claim to be the inherent natural rights of individuals who would want to listen to music- free access. The internet provides one of the most free access portals for those who would want to have the music of their choice, but the question remains- is it ethical to get something for free when it is legally established to have a tendering value? In more simple terms- is it ethical to steal music online? Joseph, Francis, Angelo, Kairos, Karina and Angelina have been friends for almost a decade now. They met in their high school years, now they have decided to pursue different paths for their college education. Joseph entered college under a program of business administration; Kairos pursued a similar course under the program of economics. Karina and Angelina who both shared undying passion specialized in two major art subjects. Karina studied arts and letters; while Angelina enrolled in a program of music. Angelo, the techno savvy of the group enrolled to be an information technology specialist someday. And lastly, Francis the most authoritative of them all enlisted in the police academy to become a member of the police force someday. All of them are happy in their pursued lives, but there are things that remain the same –their friendship and their enthusiasm to listen to music. It became a habit for them to meet up during weekends to catch up over dinner, share a couple of laughs and go back to their mishaps and fun times when they are still in high school. In one of their dinner at Kairos’ place, they chose to play a concert video of Alicia Keys; but then something happened to Angelina†¦ (against) Angelina: Kairos, this is a nice DVD where did you get it? I did not know that they have already released this one. (pro) Kairos: They already have that one in Danton’s record bar down the street, but it is pretty expensive. I did not bought it, Angelo got it, (joking) it is no secret†¦our friend has pretty cool tricks in front of a computer. (pro) Angelo: Hey man, stop bragging about it. I might end up downloading whole day for these guys. It is pretty boring man, if it’s not free, I won’t bother at all. (pro) Kairos: Hey Angelina, are you ok? Do you feel something wrong? Or are you just too mesmerized with the glories of downloading? (against) Angelina: You’re unbelievable†¦ (pro) Karina: Hey Kairos, I think you hit a wrong†¦very wrong button. (pro) Kairos: huh? (against) Angelina: You are unbelievable! You are to busy computing how much you can save you became a common thief. (pro) Kairos: Are you serious? What did I do? (against) Angelina: You have practically stolen something and yet you act as if nothing happened. You and Angelo you both favor convenience without its obligations. (pro) Kairos: I did not steal anything; do not put that on me. Angelo is the one who downloaded. But still, I cannot see your point why you are overacting. (against) Angelina: Ok, I will indulge you and downloading accomplice in the implications of what you have done, shall I get started? Downloading is stealing because- (Angelo interrupts). (pro) Angelo: It’s free, get a computer and link it to the internet. You will find there it’s free; you cannot steal something which is free. That’s the glory of it, free downloading it is FREE and logically it will be free even from your so- called obligations . (against) Angelina: That is not the point, the point is just like any other form of art Alicia Keys’ concert is the result of her hard work and even painstaking attempts to create something exemplary beautiful. You stole that from her by not buying the original copy of her concert and opting to download a mere duplicate of her work. (pro) Kairos: Last time I checked recording companies, reap off a lot from the original copies, not the artist. The competition between record labels is too superficial for ordinary citizens, just like me and Angelo to purchase the original copy. Original copies are too expensive; it is like a monopoly of record labels, prices do not compete . And with what I learned, the recording industry without competition is no longer viable as a form of market. (against) Joseph: Excuse me, but I think the likes of you and Angelo are the reason for the increase in the prices of original copies. Companies compensate for their losses from free downloads and other forms of piracies . Kairos, above everyone else in this room you should know that, your studying economics right? (pro) Kairos: Yes I am, what you are saying is profit making. I am standing on the notion of free. (against) Francis: Come one man, what you claim to be free as contested by Angelina is not free at all; I think, you are using the word in a wrong way. (against) Angelina: You cannot financially categorize the works of others for your benefit. It is true that the music industry is highly privatized. And it has a very good reason to do so; music is private in the sense that it is the fruit of the musician and singer. The prices are high simply because music is an innovation in its simplicity . The creation of an innovation is one thing, but guarding and protecting it from the likes of you and Angelo is another thing. (pro) Karina: I don’t know for music which is highly commercialized, I think individuals who want to access into a form of art should be allowed to do so as long as it is permitted by the artist. I doubt that a real artist would deny such privilege. (against) Angelina: Karina, you are an artist yourself or at least someone who is aspiring to be. How can you reach your dreams if your early first steps are being trampled by piracy such as that experienced by starting out musicians in free music downloading? (pro) Karina: Pirated works are usually that of already â€Å"made† stars, free downloading has minimal effects to starting musicians since their works are not there in the first place . Websites do not host unpopular music files. As a matter of fact, only 1% of websites have more than 50% of the general traffic in the internet . In short, starting bands are usually and probably exempted. (pro)Angelo: What Karina told is true in both statistics and even in logic. Angelina, some starting bands even welcome the idea of being pirated simply because it is a good venue to be established in the music industry which is dominated by bigger music labels . (against) Angelina: No matter what statistics you would use, it is unethical because it is stealing in the first place and will forever be stealing. (against) Francis: It is true that it is stealing but only through a different way such as the internet . That difference makes some individuals assume that they are doing nothing wrong, but actually they are. (pro)Kairos: Well, we can look at this issue through multi perspectives and that what makes it problematic. We can argue regarding this issue for a long time, but nonetheless we will never arrive at a common ground. (against) Angelina: So guys, since the topic can be debated indefinitely can we just leave the topic alone and continue to live according to our principles and promise to compromise in the presence of another contradicting principle? (against) Angelo: Hey, what friends are for? All agreed to give up on the debate and just enjoy the rest of the night with stories that would allow them to catch up with each other. Their circle of friendship grew stronger after such a healthy debate; all of them without exemption learned to compromise. Impact Statement: The issue of free downloading music through the internet can be debated on different point of views and starting points. Due to this nature, up to date the debate whether music should be a free enterprise at some levels is still questionable. Issues on it being ethical are not solely debatable in the light of being a free enterprise or a private intellectual property; it can also be debated on the perspectives of economics and profiteering. There are countries that allow free downloading of music such as China, so in terms of citizenship in relation to the issues on ethics behind free downloading of music the countries ruling are still the end of it all. No matter how long debates can be, it can only affect public opinion; nonetheless the law will still hold. After watching this group of friends argued on the topic. It can be said that the main question is wrong and prejudicial. â€Å"Is it ethical to STEAL music online? † should be replaced by â€Å"Is it ethical to DOWNLOAD music online? † Bibliography 123HelpMe. com. â€Å"Copyright Laws, Napster and Personal Ethics. † www. 123HelpMe. com. 30 April 2010 . Albert, Pete. Music Piracy: Is downloading music ethical? 2010. 30 April 2010 . Arrington, Michael. â€Å"Stealing Music: Is It Wrong Or Isn’t It? † 31 March 2009. Techcrunch. com. 30 April 2010 . Easley, Robert. â€Å"Ethical Issues in the Music Industry Response to Innovation and Piracy. † Journal of Business Ethics, Vol. 62, No. 2 (2005): 163-168. Johnson, Eric J. , et al. â€Å"On the Depth and Dynamics of Online Search Behavior. † Management Science, Vol. 50, No. 3 (2004): 299-308. Storey, Michael. Music Piracy: Is downloading music ethical? 2010. 30 April 2010 .

Cause of an individual social emotional and behaviour education essay

2. Please use the headers in the box to depict the impact this course/module has had in your professional scene. i. on you This faculty has affected the manner I view and manage pupils in a mainstream scene who exhibit facets of SEBD ; it has given me new ideas and thoughts to research. It has led me to oppugn current behavioral policies and see what instructors can set in topographic point in the schoolroom to supply more effectual schemes. two. on your students For the students I teach with SEBD it has made me more cognizant of possible issues and intercessions and enabled me to prosecute support for them in a more professional mode. three. on your co-workers Colleagues in my module have been interested in cognizing what I am analyzing ; we have had some interesting treatments associating to facets of SEBD. I feel that I have been able to offer some counsel in specific state of affairss with students or at least to promote co-workers to see alternate positions and schemes. four. on the establishment Whilst my school are non funding me for this class of survey and I do non work straight in the SEN section I have been able to lend more to whole school issues associating to kids with SEBD through a working party and within my module. This is an country I hope to develop over the following 2 old ages. 3. Is at that place any other impact this faculty has had? ( eg. on your publicity chances, on your programs for the hereafter ) I have been diffident as to whether I want to travel into specialist instruction in the Fieldss of SEBD or autism ( I am analyzing autism in twelvemonth 2 ) . At the minute, I am go forthing this determination unfastened. As a female parent of a kid with aspergers who is in an EBD secondary school ( as this is seemingly the most appropriate proviso ) this faculty has fuelled my involvement in working with high working ASD kids who exhibit riotous behavior and emotional troubles as this does non look to be to the full addressed in ASD support and education.. 4. What suggestions do you hold about betterments that might be made to the faculty? Some of the log activities have been hard to finish to the full due to the nature of my professional function ( a concern instructor in a big mainstream school ) . It may be interesting to see ways of opening some activities to pupils in similar state of affairss. Although I was pleased by and large with my feedback for the practise assignment, I disagreed a small with the rubric diction as it stated â€Å" A instructor attack you†¦ † and â€Å" the instructor would wish advice.. † and â€Å" depict your attack†¦ † yet we were non expected to give advice straight to the instructor and besides non to be descriptive. I felt the rubric should be clearer particularly in the bid footings and besides outlooks made more expressed as many of us have non written academically for a really long clip†¦ I think some pupils were unsure of what was expected. Please tick the box in each statement that best depict your positions on the acquisition procedure experienced This faculty hasaˆÂ ¦ Strongly hold Agree Disagree Strongly differ Had a positive impact on my acquisition Yttrium Had a positive impact on my professional pattern Yttrium Engaged positively with the content Yttrium Provided me with appropriate counsel on wider reading. Yttrium Given me entree to good coach counsel Yttrium Provided me with an appropriate assignment Yttrium If you have a specific issue that you would wish to discourse separately so delight include your name and contact inside informations or e-mail Dr Visser straight at j.g.visser @ bham.ac.uk: Name: Contact inside informations Understanding the cause of an person ‘s societal, emotional and behavioral troubles is indispensable before you can do a successful intercession. Critically assess this averment in the visible radiation of an activity you have undertaken as portion of this faculty. Introduction Delinquents, moral idiots and maladjusted kids are merely some of the labels historically attributed to persons showing the troubles subsequently termed as emotional and behavioral troubles ( Ministry of Education 1995 ) . In this essay the importance of understanding the causes of an person ‘s societal, emotional and behavioral troubles ( SEBD ) is explored in relation to whether this apprehension is critical for the execution of successful intercessions. This essay chiefly considers persons within the UK educational system which covers children/young people between the ages of 4 and 16. In the survey and instruction of persons with SEBD at that place seems to be a deficiency of uniformity in how the label is interpreted and applied ; the forms and definitions of SEBD will hence be considered along with current tendencies in the figure of school age persons diagnosed as SEBD in order to give context to this country of treatment. Another cardinal country of disparity is the theoretical position adopted when measuring and handling an person with SEBD. The theoretical positions each present a different attack to aetiology and intercessions, these will be considered in relation to importance of caus e in the footing of each and how they lead to intercessions. The cardinal statement will so concentrate on the importance of understanding cause and examine grounds from published literature, research and policies to back up this followed by treatment of why understanding cause may non be indispensable in order to implement successful intercessions. The overall purpose is to determine whether intercessions are chiefly based on consideration of the aetiology of behavior and whether there is grounds to bespeak their success. Indeed Harden ( 2003 ) concluded that there was deficient grounds for scheme effectivity in behavioral troubles. The topic of cause and intercessions was discussed with fellow professionals in a web based treatment ( Vygotsky, Skinner and Montessori treatment group October 2010 & A ; November 2010 ) and mention will be made to the two fictional instance surveies which formed the footing of these practical treatments. In the first a male child, Ronnie, no information was given on his background so the focal point was on the ascertained riotous behavior in school and the instructor believing he has SEBD. In the 2nd an 11 twelvemonth old miss, Vicki, far more item was given including her recent transportation to secondary school ; above norm reading accomplishments, parents separated and with new spouses, the possibility of epilepsy, refusal to make prep and acquiring into problem at school. These treatments elicited a scope of positions on aetiology, the demand for information perchance associating to do and the nature of appraisal and intercessions. In general the contributing professionals show ed a desire to hold more information about each kid and to construe the impact of background factors on the troubles being observed although there was small recognition of why this information was needed ( Farrugia, 2010 ) . What is understood by societal, emotional and behaviour troubles ( SEBD ) ? One of the overruling issues in the field of SEBD is the ambiguity in apprehension and designation of persons who may hold societal, emotional and behavioral troubles with those who have less terrible subject jobs ( Evan, Harden, Thomas 2004 ) . This introduces the first trouble as the determination to sort an person as holding SEBD is with the individual who identifies some facet of behavior as debatable and is reliant on that individual ‘s concepts. Government publications have provided several descriptions of which two are considered in this essay. In Round 9/94 ( DfE 1994 ) Emotional and Behavioural Difficulty ( EBD ) is described as being between: â€Å" behavior which challenges the instructor but is within normal, albeit unacceptable, bounds and that which is declarative of serious mental unwellness. The differentiation between normal but stressed behaviors, emotional and behavioral troubles originating from mental unwellness is of import because each demands to be treated otherwise. † ( p.4 ) The definition focuses on the behavioral facet instead than emotional and indicates it is a job for the instructors thereby curtailing the troubles to educational scenes. Interpretation of what may be considered unacceptable is hence likely to ensue in inconsistent designation of the types of kids instructors identify as holding EBD ( Soles, Bloom, Heath, Karagiannakis 2008 ) . In The Particular Educational Needs ( SEN ) Code of Practice ( 2001 ) , the definition was amended to integrate societal troubles and so expanded to societal, emotional and behavioral troubles ( SEBD ) , the codification defines those with societal, emotional and behavioral troubles ( SEBD ) as: Children and immature people who demonstrate characteristics of emotional and behavioral troubles, who are withdrawn or isolated, riotous and distressing, overactive and lack concentration ; those with immature societal accomplishments ; and those showing ambitious behaviors originating from other complex particular demands ( Paragraph 7:60 ) This description describes a scope of features associated with this upset and recognises that such behaviors can germinate from other particular educational demands. This presents a broader spectrum of behaviors linked with emotional and societal troubles and remains unfastened to the personal reading of those interacting with such kids. The deficiency of lucidity of the forms could be linked to the increasing figure of kids diagnosed as holding SEBD being recorded in English schools. In 2008 149,040 kids had a demand of EBD on school action plus or statemented at primary, secondary and particular province funded schools, this was an addition of 6.98 % twelvemonth on twelvemonth ( DCSF 2008 ) , EBD represented the 2nd highest demand after moderate acquisition troubles. This could be due to an existent addition in the figure of kids sing troubles or to the wider reading of the definition taking to more kids being recorded with this trouble who might otherwise hold remained at a school action phase. Whichever the ground, it is evident that increasing figure of kids within the UK instruction system are being identified as holding a demand of SEBD and this in bend has led to increasing focal point on intercessions in peculiar for behavioral troubles as seen in the recent white paper ( DfE 2010 ) . The descriptions given in Round 9/94 ( DfE 1994 ) and the SEN Code of Practice ( 2001 ) make no direct mention to aetiology or the necessity to admit this although The SEN Code of Practise ( 2001 ) recognises that SEBD may hold co-morbidity with other biological or medical conditions ( 7.52, 7.53, 7.58 ) and links with mental wellness ( 10.27 ) yet counsel for specific appraisal and intercessions is non detailed. This could be seen as declarative mood of the deficiency of integrity on the apprehension of causes and intercessions for those with SEBD. Which theoretical position of cause of SEBD? In 1829 a 20 twelvemonth poet wrote these lines: From childhood ‘s hr I have non been As others were-I have non seen As others saw-I could non convey My passions from a common spring- From the same beginning I have non taken My sorrow-I could non rouse My bosom to rejoice at the same tone- And all I lov'd-I lov ‘d entirely ( from Entirely by Edgar Allen Poe – 1829 ) The poet was Edgar Allen Poe. Poe was taken into surrogate attention at the age of 3 following the decease of his parents and at the age of 6 his surrogate household moved to London. Poe was said to be talented academically yet a hard character ( Poe Museum n.d. ) ; the verse form â€Å" Alone † suggests a troubled kid who considers himself to be different. In today ‘s educational clime he may good hold been identified as a kid with SEBD. Would an apprehension of his early life have been of import in development of successful intercessions? From a behavioral position it could be suggested that merely his discernible hard behavior was of importance and therefore treatable. The causes could non be speculated upon as they could non be scientifically measured. Bowlby, from a psychodynamic attack might hold disagreed ; Poe ‘s early childhood experiences, most notably the decease of his parents and being taken into surrogate attention, may hold suppressed his inner desir es and thrusts taking to internal struggles. Bowlby might hold been interested in the repression of Poe ‘s feelings following the decease of his parents ( Bowlby 1988 ) . An ecosystemic position may hold considered the effects of the alterations of the household systems and the move to a different society in England as impacting on his interactions with the systems around him. In a same vena, the web based treatments of Ronnie and Vicki ( Vygotsky, Skinner and Montessori treatment group October 2010 & A ; November 2010 ) led to similar inquiries. In the instance of Vicki, fellow professionals largely concurred on the acceptance of an ecosystemic position for appraisal based on the information given refering the dislocation of the systems in her life ; some believed that a psychodynamic attack to set up her unconscious procedures and a biological position to analyze the possible epilepsy should besides be considered. However, the intercession schemes proposed were based on a humanistic attack instead than linked to the diagnostic positions. As celebrated earlier for the Ronnie treatment there appears small recognition of why the information was needed and how information may associate to intercessions. In the instance of Ronnie, treatments indicated that more information on countries such as his household background, his larning troubles, incidences of asce rtained behavior at school and the relationships within his household would be valuable in order to do a more informed recommendation for intercession schemes. This desire for more information showed an merger of positions including societal acquisition, psychodynamic and behavioral. Most interesting is that fellow professionals adopted a behavioral attack to intercessions in the absence of farther information about Ronnie. It could be that this was within the kingdoms of their experience of available schemes in instruction. The inquiry of which theoretical apprehension of cause is the right one can non be to the full answered. Professionals in the field of educational research tend to back up a peculiar position ; there are differences of sentiment between psychological, medical and sociological positions, this is further compounded by newer positions such as eco-systemic and humanist which have evolved from earlier theories. As Visser ( 2000 ) notes most make admit that â€Å" it is a mixture of positions which can supply penetrations into understanding and explicating that behavior. † ( p.33 ) . The tendency for which cause can be seen in the changing forms given for SEBD as noted antecedently ( DfE 1994 & A ; SEN Code of Practice 2001 ) and besides in attacks to behavioral troubles adopted by schools. The tendency towards a behavioral psychological science attack of operant conditioning and behaviour alteration as a scheme for handling kids with SEBD has been seen since 1975 ( Cooper 1999 ) . Children are seen as doing a pick non to act and through usage of behavioral attacks such as effect and wages they can be taught to desire to act so a new behavior is learnt ( Greene 2008 ) . From this position, aetiology is non a considered factor and accent is on implementing a system of wagess and effects which aim to cut down unacceptable behavior and promote a re-learning of acceptable behavior. The cover attack of many behavioral policies, in portion dictated to schools through authorities directives, suggest that policy shapers and educationists do non see there is a demand to understand causes of SEBD. Behaviour is assumed to be within the control of the kid and the school is assumed to be able to act upon and alter the behavior. Recent old ages have seen a alteration in attack with prominence given to systemic attacks taking into history the interaction of systems and environments environing the kid as cardinal factors impacting on their societal, emotional and behavioral troubles ( Evans, Harden and Thomas 2004 ) . From this position there is a demand to understand cause in footings of the environments of the person. This was apparent in the web based treatment on Vicki ( Vygotsky, Skinner and Montessori November 2010 ) where subscribers were largely united in acceptance of an ecosystemic attack and attributed the cause of the troubles to break in Vicki ‘s place a nd school life. Understanding the cause of the SEBD is indispensable before doing a successful intercession. In the old subdivision a figure of theoretical attacks to placing cause were examined and it is concluded that there are troubles in happening consensus on one attack and one apprehension of cause. Despite the difference of sentiments of the likely beginnings of the SEBD, there is widespread support of the demand for understanding the cause. Visser ( 2005 ) is opposed to a normative attack to covering with behavioral troubles and therefore supports the instance for recognizing that each kid with SEBD may hold a different cause of SEBD although he antecedently acknowledged that there are still spreads in apprehension of both causes and of attacks used in kids with EBD ( Visser 2002 ) . Others in this field besides advocate the benefits to instructors holding apprehension of students with SEBD ; Cole, Visser and Daniels ( 1999 ) in a paper analyzing effectual EBD patterns in mainstream schools promote the demand for school staff to understand the complex causing and the varied aetiolog y of EBD in order to be able to fit apt intercessions. Another manner of sing cause is to analyze underlying troubles which may be doing SEBD, non from a theoretical position but from a possible medical or other trouble so the behavior is non straight linked to a psychological or systemic root but instead from some other trouble which leads to the behavior emerging as a symptom. Cross ( 2004 ) believes that a relationship exists between communicating troubles and emotional and behavioral troubles. Communication troubles may originate from biological causes such as Pervasive Development Disorder, Attention Deficit Hyperactivity Disorder or from environmental factors such as kid maltreatment and disregard, or from larning troubles. Cross maintains that whatever the beginning, it is the communicating trouble which must be addressed as a precedence as weak communicating accomplishments can hold a negative impact on a kid ‘s ability to interact and socialize, this can worsen emotional and behavioral troubles. In this sense the ascertain ed behavioral troubles could be dissembling implicit in communicating troubles which, if non treated, will non better the behavior. In the web treatment on Ronnie ( Vygotsky, Skinner and Montessori treatment group October 2010 ) chap professionals concurred that a nexus was likely between his possible acquisition troubles and his behavioral troubles and that this should organize a cardinal portion of any intercessions. In his book, Lost At School, Greene ( 2008 ) maintains that instructors can non cognize what to make with disputing behavior unless the grounds for it are understood, mentioning to these grounds as â€Å" dawdling accomplishments † ; those accomplishments which are missing irrespective of diagnosing. Staff need to place and understand the accomplishment missing as this is polar to implementing a successful intercession. Greene ( 2008 ) lists many dawdling accomplishments, including troubles with maintaining focal point, sing likely results, pull offing emotional responses, which professionals may impute to a scope of upsets such as larning troubles, autistic spectrum upset, cognitive troubles, or anxiousness. It is designation of the specific lagging accomplishments which are of more importance than the existent diagnosing as the diagnostic label does non in itself indicate which accomplishments are missing. Emphasis should hence be on placing the particular facets which are m issing ; the deficiency of a accomplishment alongside an environment which demands these accomplishments is the trigger to there being a job ( Greene 2008 ) . This is in line with an ecological position as the behavior is an result of the lagging accomplishment conflicting with the environment. Support for the importance of understanding aetiology is besides found in educational counsel ; the School Discipline and Pupil – Behaviour Policies ( DCSF 2010 ) advises that it is indispensable to guarantee right appraisal of possible grounds for kids non acting suitably and acknowledges that behavioral troubles may be caused by larning troubles, environmental factors or other cognitive, societal or emotional troubles ( paras 3.9.29 -3.9.33 ) ; yet a subsequent subheading is â€Å" Students who can act but take non to † ( p.58 ) . This takes the school back to the forms of SEBD and topographic points reading back in a subjective model where the school has to separate between the former and the latter. In much the same manner as seen in the SEN Code of Practice ( 2001 ) there is a deficiency of lucidity in how cause should be identified and how this cognition should steer intercessions. A recent study entitled Not Present and Not Correct ( Evans, 2010 ) examined the efficaciousness of fixed term exclusions in bring arounding behavioral jobs. The study concluded this was non an effectual scheme based on the figure of fixed term exclusions holding increased by 5.4 % since 2003-4. Persistent riotous behavior was the ground for the bulk of fixed term exclusions ( 23.3 % ) and lasting exclusions ( 29.6 % ) in 2008-9. These Numberss have non shown important alteration twelvemonth on twelvemonth indicating that current intercessions are non effectual. The study recommends that a trigger is needed to motivate a needs appraisal where fixed-term exclusions are used continually. Yet, in the SEN Code of Practice ( 2001 ) this trigger should be go oning for students who do non react to standard behaviour direction schemes or individualised behaviour direction programme traveling them to a School Action Plus phase. This could propose that either appropriate referrals are non taki ng topographic point or, if they are, the resulting intercessions are non successful. If the latter is the instance so it may bespeak that either causes are non being considered or, if considered, are non taking to successful intercessions. The American based Assertive Discipline attack to pull offing behavior in schools is rooted in a behavioral position. A survey by Jones and Smith ( 2004 ) concluded that the this attack was effectual in bettering minor mis-behaviour and led to overall benefits for learning and larning in the school at the Centre of the survey ; yet, a little but important group did non profit from the attack. This group may hence hold required farther individualized appraisal of the cause of their SEBD with single schemes being put in topographic point. This lends support to the necessity of understanding cause in those specific state of affairss where the criterion schemes employed in mainstream schools are non deciding societal, emotional or behavioral troubles. It besides suggests that the importance of cause is non indispensable at initial phases of designation of behavioral troubles, but may necessitate to be understood if current intercession schemes are non accomplishing the coveted result. A cardinal factor in placing the cause of the SEBD lies in the pick of the position adopted. As seen in the web based treatments for Vicki ( Vygotsky, Skinner and Montessori November 2010 ) causes could be attributed to several facets of the person ‘s life. Depending on the attack taken, the diagnosing and intercession will change which means that successful intercession can non be guaranteed. Overall, whilst there is much argument and research on causality and at the same clip turning accent on the rise in behavioral troubles in the schoolroom, schoolroom based research for kids with SEBD tends non to associate theory to designation, policy and effectual intercessions ( Maras and Kutnick 1999 ) . Understanding the cause of the SEBD is non indispensable before doing a successful intercession. All positions consider cause to some extent although a behavioral attack is founded chiefly on ascertained behavior. There is small research recommending that placing cause is non indispensable or of import in footings of implementing intercessions. The statement against the value of understanding cause is chiefly one of whether cognizing the cause can really take to a particular and effectual intercession. Whilst Visser ( 2002 ) advocates the importance of understanding cause, it has proved hard to happen grounds which gives clear counsel for a nexus between cause and effectual intercession schemes. In discoursing the Individual, Medical or Deficit Model ( IMD ) , Macleod and Munn ( 2004 ) suggest that the deduction of causing should be rejected which is the contrary of the consideration of disablements with a bio-medical root. This position is based on the belief that the biggest trouble in placing cause is the deficiency of understanding in what SEBD really is, as seen in the earl ier treatment on the readings of definitions. It could be argued that focal point should be on schemes and non on cause as readings of the cause are excessively subjective. The web based treatments on Ronnie and Vicki, despite dwelling of differing positions for diagnosing and cause, saw a commonalty in the recommendations for a multi bureau attack. This is besides seen in Diagram 8 theoretical account ( Cole, Visser and Daniels1999 ) in which audience with the Local Education Authority ( LEA ) and relevant bureaus, such as Child and Adolescent Mental Health Services ( CAMHS ) , is seen as an of import factor in schools which are successful in the inclusion of kids with SEBD. Whilst Visser ( 2005 ) has been cited earlier as an advocator of the demand to understand aetiology, in a talk based on a term he encountered in his professional work, â€Å" ageless truths † , he looked at factors which may be cosmopolitan in execution of successful intercessions for SEBD ( Visser, 2002 ) . Understanding cause of the SEBD was non a factor given which lends support to the position that, whilst understanding cause may be desirable and enlightening, there are more of import factors necessary for successful intercession. Merely a 3rd of secondary schools were deemed as effectual in run intoing the demands of students with SEBD ( Ofsted 2004 ) , which suggests that focal point should be on placing effectual schemes. Research carried out by Evans, Harden, Thomas ( 2004 ) concluded that there was a limited grounds base of recommended schemes which were effectual for kids with EBD and they recommended â€Å" a focal point for more strategic commissioning of future primary research†¦ † ( p.8 ) . In the instance of Ronnie ( Vygotsky, Skinner and Montessori treatment group October 2010 ) , there was a quest to cognize more from those measuring the state of affairs. Be it non plenty that his behavior was riotous and so category room based behavioral schemes should be put in topographic point to do Ronnie larn appropriate behaviors? The reply in this instance seems to lie in the apprehension of cause. If Ronnie had a acquisition trouble, there was support for this being addressed first/or in concurrence with the behavior intercessions. If it so emerged that Ronnie was holding jobs at place, such as parental struggle or disregard, this may hold required another signifier of intercession. In the instance of Vicki ( Vygotsky, Skinner and Montessori treatment group November 2010 ) there was more information on her background state of affairs ; this meant some likely causes could be explored which could so take to a scope of possible intercessions. Having more information still led t o a treatment on which position may be more applicable and in fact the intercessions proposed were largely similar to those for Ronnie. Although the participants suggestions for intercessions for Ronnie tended to be school based whereas those discussed for Vicki were both within school and outside with a wider multi bureau attack. Professionals such as instructors, educational psychologists, CAHMS practicians and behaviour support specializers will all convey their ain attacks to the SEBD tabular array. It could be that efforts to understand the cause through a multi-agency scheme may take to confused and confusing intercessions at worst and a drawn-out period of appraisals and interventions at best, neither of which presents an ideal state of affairs for a kid ( Rayner 1999 ) . The scope of readings, societal concepts and positions makes a instance for a scientific attack to developing intercessions for kids with SEBD. The aetiology is acknowledged but it is the present symptomatic forms which are the key to successful intercessions. Conclusion – is it indispensable to understand the cause of an person ‘s societal, emotional and behavioral troubles doing a successful intercession? In seeking an reply to this inquiry, much of the published research advocates the demand to set up the cause of SEBD before implementing intercession thereby presuming the intercession will be more successful. The trouble in this belief is twofold ; foremost the definition of what constitutes societal, emotional and behaviour troubles and in peculiar at what point the badness requires specific intercessions and secondly, which perspectives should be adopted to right place the cause ( s ) and therefore which intercessions are most suited. With the definition of SEBD including a broad scope of features, it seems most likely that there is besides a broad scope of causes and therefore a broad scope of intercessions. Most grounds supports the desire to look into and specify the cause ; this is besides reflected in authorities and SEN policy and guidelines. Yet grounds to back up the importance of this in procuring successful intercession is thin. Overall, whilst the demand to understand the cause seems to be supported in research and advocated in authorities guidelines, the intercessions put in topographic point within educational scenes are preponderantly based on a behavioral attack where it is the discernible behavior which is addressed, measured and evaluated ; this is where an anomaly exists. Over clip, more duty and answerability has been awarded to schools and local governments for kids with SEN including SEBD. This in itself appears to hold reduced the focal point on understanding cause as schools have to pull off this duty alongside authorities directives for bettering behavior in schools. With increasing accent on schools primary answerability being for pupil accomplishment in academic footings and the move to cut down the figure of statements, there is likely to be less accent on aetiology in favor of intercessions based on commanding kids with SEBD – surely in mainstream instruction. The current authorities ‘s support of academies may besides amplify this as the remotion of local authorization engagement means that schools can make up one's mind whether there is economic value in seeking input from bureaus that may hold more concern with aetiology. It may be that there are other factors necessary in implementing successful schemes aside from understanding cause such as the necessity for a positive ethos within the school itself ( Cole, Visser, Daniels 1999 ) . It is concluded that understanding the cause of an person ‘s SEBD is portion of the equation for successful intercession but unless the grownups responsible acknowledge the cause and seek to advance appropriate and differentiated solutions which can be proven to be successful, so understanding on its ain is non sufficient.

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Only Hope comparison - Essay Example On the other hand, Condon authored a book describing his findings from an extensive study that sought to describe how the youth of the Inuit people of the Holman island of Canada Arctic coped with the rigorous changes of adolescence amidst many social, economic, and demographic transformations. Both of these books offer an anthropological description of the Inuit youth and Chinese singletons. This paper will offer a comparison of the research questions addressed, methodologies, roles of the research , the content described in the two books and the conclusions drawn. Fong’s as highlighted in the book ‘only hope’ research question centered on determining what type of attributes were exhibited by singletons. The research was probed by the fact that parents of singletons bestowed a lot of hope in these children. Moreover, the possibility that the parents accorded these children all their attention and offered them multiple material things would have had the potential of spoiling such children. On the other hand, Condon realized that the adolescence stage presented rigorous psychological, emotional, hormonal, and physical changes that define the transition from childhood to adulthood (Fong, 2006). This prompted him to analyze how the adolescents of the Inuit youth in the Holman Island in the Canadian Arctic region coped with the social, economic, and demographic factors. He reasoned that understanding how all these changes shaped the maturation process of the adolescents could offer an advanced understanding of functioning processes of humans. Fong carried a study in the Dalian region, a coastal city that was undergoing transformation from an industrial center to service-oriented town. For 27 months, in the years 1997-2002, Fong worked closely with different schools, students, and parents. Her survey was extensive and included 2273 students in different ranks of schools. She had the privilege of visiting about 107 homes in the region (Fong, 2006) . She identified 31 families as her sample after having an extensive interaction through tutorial classes offered within the home setting. The role of her research was to determine whether the one child policy had any impact on the children born. On the other hand, Condon carried out two extensive field studies of the Inuit youth on the Holman Island. Although his first study sought to address a different objective, it offered an introductory understanding of the community (Condon, 1988). He compiled his findings after seven years of an interactive field study. The role of his research was to analyze how the youth coped with the numerous changes that defined their lives. Condon selected sub-section of the Holman Island as his sample population. Fong’s research revealed that singletons faced a surging pressure to become exemplary children as her findings highlight. The different chapters in her book reveal that parents expected singletons to demonstrate a higher sense of focus in school compared to children who had siblings. This translated into different forms of pressure exerted on the children by the parents so that they would meet the defined expectations (Fong, 2006). It becomes evident from the findings described that parents had viewed singletons in terms of the future. The research

Reading the Text of the Photograph Essay Example | Topics and Well Written Essays - 750 words

Reading the Text of the Photograph - Essay Example The mother’s eyes are directed outside the window where she could be looking at something which caught her attention – or could just be lost in her thoughts. They both appear to be pensive as both their lips are curved downwards. Both are wearing white which glow as the sun shines on them. Two throw pillows neatly covered by a weaved pattern appear beside the mother, with one pillow directly providing cushion to her back. To their back, at the upper left portion of the photograph appears a top thin table containing picture frames which are about nine in number. There are bigger frames, numbering three, which are mounted on the wall above the thin table. Most of the background is obscured in contrast to the bright light focused on the mother and child. It is possible that this picture is taken either late morning (almost near noontime) – or immediately after lunch. The photographer could possibly be a member of the family – the father, or brother, or even a sister who wanted to capture the lazy, reposed mood of the members. It is possible that mother and child did not expect their photos to be taken, as they remain sober and melancholy. This photograph is taken inside an auditorium where two prominently seated men are close to the photographer. A total of seven men are clearly seen in this photo – all smiling. These men could be batch mates or members of an all male organization; maybe a fraternity or a professional civic organization. It is eminent that these men are viewing someone, possible a colleague or a person with great humor. There were not viewing a film as their eyes were not focused on a movie screen – but rather on someone directly in front of them. They could possibly be listening to a guest speaker or a batch mate talking about his previous experiences. The man on the right front seat was holding a snack (possible filled with peanuts) and he was seated in a slouching position

The Tide Rises and the Tide Falls Essay Example for Free

The Tide Rises and the Tide Falls Essay The Tide Rises and The Tide Falls is a poem that is filled with symbolism. I think the tide represents the everyday life of people, which is continuously being repeated over and over. Also, the calling of sea in the darkness symbolizes the upcoming death. The authors tone in this poem is very clear and not emotional, although the overall atmosphere is very sad and lonely. This poem uses mood to show that death in inevitable and it comes to everyone. The author also wishes to show that death is just another part of life and nature. The poem talks about a traveler who walks down the beach towards town but he will never walk on the shore again and the tide washes away his footprints. When the author writes The day returns, but nevermore returns the traveler to the shore, and the tide rises and the tide falls he conveys that the traveler has died but the sun still rises and the tide still goes in and out. The mood of the poem is accepting and calm. Longfellow is accepting that he, along with everyone else, will die and that its just a part of nature. The theme of The Tide Rises and The Tide Falls is that life continues even though we go through many traumatic events. In the last stanza, the traveler does not come back like before, the tide is still rising and falling just like before. It is continuing the action just like yesterday, the day before yesterday, and it will repeat in the future. Although people feel like they are going to die or not able to live like before, but when time passes, they live like they never experienced those painful emotions. I think this poem and this theme is sad because erasing from the memory is sad, even if the erased memory is about a painful thing. In the poem, time passes by as the tide rises and falls. Eventually, the sky gets dark and a traveler goes to town. Darkness comes, the sea washes away the travelers footprints in the sand. The morning comes, and the traveler does not go back to the shore. The daily life of the sea continues even though the traveler will not be returning. The tide is probably showing that life continues as normal even though the traveler is not there; the tide is not going to stop just because someone isnt there. The traveler could possibly represent the life of a person. Although we may leave footprints, over time they are washed

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.