How would the working class transform society according to Marx Essay

How would the working class transform society according to Marx - Essay Example It was just that which Marx sought to do: end social and economic injustice. Writing at the outset of industrial society, his theories addressed the control of wealth and capital by the few at the expense of the many. Central to his various theses regarding the history (and future) of human social development were the concepts of class and capital. It was Thomas Hobbes who claimed that man exists in a state of nature epitomized by ‘War of every one against every one’1 (Hobbes 2201, p. 100). Marx in his own right approached the history of man in a civilized state as a similarly bellicose one. Only for Marx, the violence was not of one man against another, as was the case with Hobbes, but rather one of whole classes fighting against one another in a struggle which defined human history itself. The history of all hitherto existing society is the history of class struggles...Freeman and slave, patrician and plebeian, lord and serf, guild-master and journeyman, in a word, oppressor and oppressed, stood in constant opposition to one another, carried on an uninterrupted, now hidden, now open fight, a fight that each time ended, either in a revolutionary reconstitution of society at large, or in the common ruin of the contending classes. (Marx 1997, p. 219) Along with class stood Marx’s formulation of capital. According to him, the breakdown of modern society was not terribly complicated. There were those who had capital and those that did not. ‘The circulation of money, as capital is, on the contrary, an end in itself...The circulation of capital has no limits. Thus the conscious representative of this movement, the possessor of money, becomes a capitalist’ (Marx 1952, p. 72). The capitalists controlled the means of production. The working classes were merely ‘cogs in the machine’. The struggle of the capitalists and the proletariat drew all other remaining classes

Oppressed Caribbean Culture Essay Example for Free

Oppressed Caribbean Culture Essay Caribbean culture, in so far as it is conceded to exist, is at once the cause, occasion, and result of evolved and evolving paradoxes. The psychic inheritance of dynamic response to disparate elements interacting to find ideal, form, and purpose within set geographical boundaries over time could not have produced otherwise. The 1990s have witnessed no less of this, precisely because the decade serves to encapsulate contradictions in human development over the past half a millennium. The entire Caribbean, and indeed all of the modern Americas of which the Caribbean, like the United States, is only one part, are the creatures of the awesome process of cross-fertilization following on the encounters between the old civilizations of Europe, Africa, and Asia on foreign soil and they, in turn, with the old Amerindian civilizations developed on American soil long before Christopher Columbus set foot on it. It is a development that has helped to shape the history and modern condition of the world for some half a millennium and one that has resulted in distinctive culture-spheres in the Western hemisphere, each claiming its own inner logic and consistency. The Caribbean, at the core of which are a number of island nations, themselves in sub-regional groupings, is conscious of the dynamics of its development. For it rests firmly on the agonizing and challenging process actualized in simultaneous acts of negating and affirming, demolishing and constructing, rejecting and reshaping. Nowhere is this more evident that in the creative arts, themselves a strong index of a peoples cultural distinctiveness and identity. Admittedly, other indices of culture such as linguistic communication, which underpins the oral and indigenous scribal literatures of the region, religion, and kinship patterns, reveal the texture and internal diversity that are the result of cross-fertilization of differing elements. The result is an emerging lifestyle, worldview, and a nascent ontology and epistemology that all speak to Caribbean historical experience and existential reality, in some cases struggling to gain currency and legitimacy worldwide (and even among some of its own people) for being native-born and nativebred. For this is the original meaning of Creole. Whites born in the American colonies were regarded as creoles by their metropolitan cousins. And the Jamaican-born slaves were similarly differentiated from their salt-water Negro colleagues freshly brought in from West Africa. The term was soon to be hijacked by or attributed to the mulatto (half-caste) who defiantly claimed certified rootedness in the coloniesa status not as easily claimed by the person of African or European descent whose ancestry lay elsewhere, it was felt, other than in the Caribbean or the Americas. An understanding of the shared human thirst for freedom in terms of its cultural significance is critical. For the impulses that drive the Caribbean people (like people anywhere) to freedom within nation states, to the right to choose their own friends and political systems, and to independent paths to development are the same impulses that drive them to the creation of their own music, their own languages and literature, their own gods and religious belief-systems, their own kinship patterns, modes of socialization, and self-perceptions. All plans made for them from outside must take this fact into account, whatever may be the dictates of military and strategic interests or the statistical logic of tabulated growth rates and gross national products. The Caribbean people, faced as they are with the post-colonial imperative of shaping civil society and building nations, expect to be taken seriously in terms of their proven capacities to act creatively in coordinated social interaction over centuries in the Americas. They feel passionately that their history and experience are worthy of theory and explanation and expect others to understand and appreciate this fact. They are unique, paradoxically because they are like everybody else. The Caribbean has been engaged in freedom struggles and its inhabitants have been at the job of creating their own languages, and designing their own appropriate lifestyles for as long as and, in some cases, longer than most parts of what became the United States. Recognition of this and the according of the status due such achievement is a prized wish of all Caribbean peopleBlack, White, Mestizo, Indian (indigenous and transplanted), Chinese, and Lebanese. By general critical consent, the principal women writers in English to emerge, so far, from the Caribbean are the properly varied trio of Jamaica Kincaid (Elaine Potter Richardson) and Jean Rhys. I say properly varied because the immensely mixed political and social history of the Caribbean is reflected by and in its writers. Kincaid, the most experimental of the three, is seen by her admirers as a deliberate subverted of Dead White European Male modes of narrative. Yet any reader deeply immersed in Western literature will recognize that prose poetry, Kincaids medium, always has been one of the staples of literary fantasy or mythological romance, including much of what we call childrens literature. Centering almost always upon the mother-daughter relationship, Kincaid returns us inevitably to perspectives familiar from our experience of the fantasy narratives of childhood. Kincaid genuinely expresses her regard to Caribbean as those that have been creolized into indigenous form and purpose distinctively different from the original elements from which those expressions first sprang. With some of those original elements, especially those from a European source, themselves reinforcing their claims on the region, whether through politics, economic control, or cultural penetration, the Caribbean is becoming even more conscious not only of its own unique expressions but also of the dynamism and nature of the process underlying these expressions. These in turn constitute the basis for the claims made for a Caribbean identity. Jean Rhys, of Creole Dominican descent, is a formidable contrast to Marshall and seems to me the major figure to emerge thus far among Caribbean women writers. Though she lived mostly in Paris and England, the imagination of Rhys came fully alive in her novel of 1966, Wide Sargasso Sea, a remarkable retelling of Charlotte Brontes Jane Eyre from the perspective of Bertha Mason, Rochesters mad first wife. The terrifying predicament of the 19th-century Creole women of the West Indies, regarded as white niggers by colonialists and as European oppressors by blacks, is presented by Rhys with unforgettable poignancy and force. Shrewdly exploiting the modernist formal originalities of her mentor, Ford Maddox Ford, Rhys achieved a near masterpiece in Wide Sargasso Sea. Allusive, parodistic, and intensely wrought, the novel remains the most successful prose fiction in English to emerge from the Caribbean matrix. In Wide Sargasso Sea, the starting point is this placelessness. Although Rhyss novel starts with Antoinettes childhood in Coulibri, its boundaries lie outside the novel in another womans text. In Jane Eyre we have the madwoman Bertha locked up in the attic of Thornfield Hall. The significant title Wide Sargasso Sea refers to the dangers of the sea voyage. Rochester first crosses the Atlantic alone to a place which threatens to destroy him, then once more, bringing his new wife to England. Both Rochester and Antoinette are transformed through this passage. Rochester gives Antoinette a new name, Bertha, and in England she finally is locked up as mad. Rhys finds her own place in Jane Eyre, a prisoner of anothers desire. She sets out to describe that place and, in doing that, she redefines it as her own. In her challenge to Jane Eyre, Rhys draws on the collective experience of black people as sought out, uprooted, and transported across the Middle Passage and finally locked up and brutally exploited for economic gain. She uses this experience and the black forms of resistance as modes through which the madwoman in Jane Eyre is recreated. In the film version Wide Sargasso Sea develops stereotypes of Black West Indians that strongly mirror Bogles discussion of classic film depictions of African Americans. The inner stereotype in the film is that of the tragic mulatto which, the film hints, describes Angelique, the evidently White child who has been raised by Blacks. Although Angelique insists on her Whiteness, a menacing dark skinned stranger claims at diverse points in the film to be her brother through her fathers relationship with a slave. The viewer is left to consider whether the widowed plantation owner seen at the beginning of the film is actually Angeliques mother. While it does not answer this question directly, it obviously shows through Angeliques actions that her culture is far more African than European. These suspicions, actions, and Angeliques reliance on the ex-slave Christophine ultimately destroy her marriage and drive her insane. Christophine, herself, fulfills the mammy role since the film portrays her as a constant presence who fiercely guards Angelique from all dangers. In the West Indian context, though, she is given a twist, as she is not only guardian angel but also a practitioner of the magical art of obeah. This portrayal a staple of films dealing with the West Indies is never completely developed. Nevertheless, the film permits us to witness its potency, as Angelique, despairing of keeping her husbands love, calls on Christophine to develop a magical potion to bind his affections to hers. One opponent for those affections is Emily, a young Black servant who might well be characterized as a female Black buck a sexual predator who seduces a married White man into interracial unfaithfulness. Finally, there is Nelson, the long-suffering head of the household who intimately approximates Bogles Tom. In the film, insults of various sorts that are directed towards him result only in silence and a determination to remain a faithful servant. Though, in Dominican novelist Jean Rhys Wide Sargasso Sea (1966), the islands riotous vegetation and dramatic landscape are depicted with an ominous intensity that prompts the protagonists English husband to equate it with evil. Lally, the narrator of another Dominican classic, Phyllis Shand Allfrey The Orchid House ( 1953), faced with the menacing power the islands nature exerts over Stella and Andrew, ruefully concludes that the island offered nothing but beauty and disease. Rhyss protagonists, most evidently Antoinette in Wide Sargasso Sea, share a view of England as deadening, grey and emotionally destructive. England is a place of hypocrites, and the English have a bloody, bloody sense of humour. With a West Indian accent, she goes on, and stupid, lord, lord (Wide Sargasso Sea: 134). But it remains Rhyss place, the source of those English books which provided an early contribution to her construction of herself as writer. The idea of definitive national origin and affiliation is a source of anxiety for Rhyss protagonists. For Rhys herself nationality was complicated by her exile and her race: also England did not value her Caribbean origins. For Rhyss women, as perhaps for herself, England is also a place where human emotions, especially those associated with sexuality, are outlawed or repressed; she described sex in a letter of 1949 as a strange Anglo-Saxon word (Abalos, David T. 1998, 66). Hemond Brown comments that Rhyss attitude to England remained remarkably consistent over her whole writing career: For those fifty-odd years, England meant to her everything she despised (Bandon, Alexandra. 1995). But despite this, she surely demonstrated in her characterisation of working-class English chorus girls and call girls and Rochester (perhaps informed by her important attachments to Lancelot Grey, Hugh Smith, Leslie Tilden Smith and Max Hamer, all upper- or middle-class Englishmen), that the poor Englishwoman and even the colonizing, socially secure Englishman have their own areas of serious emotional damage. She may have blown off steam sometimes, but in her fiction she took pains to be fair to the country which had both given her sustained literary identity and denied her dignity. In the Caribbean, complex racial narratives are the most powerful signifiers, although class increasingly reverberates now. In England, in Rhyss lifetime, it was the class narrative which primarily constructed identity, though Rhys clearly writes the importance of race as a formative self-construction from her Dominican childhood. She sometimes sees race and class as equally important even in England, as in the case of Selina, who carries Rhyss own outlaw status during an important period of her life. In the two explicitly Caribbean novels, Voyage in the Dark and Wide Sargasso Sea, race is evidently a major source of identity. Jean Rhys had long described the cultural dialectic of his regions historical experience and contemporary reality in the following way: But the tribe in bondage learned to fortify itself by cunning assimilation of the religion of the Old World. What seemed to be surrender was redemption. What seemed the loss of tradition was its renewal. What seemed the death of faith was its rebirth. Caribbean existential reality is here portrayed as a creature of paradox. Surface appearances may well be masks for their opposites. What one sees is not likely to be what one gets. Other similar manuscript was in Goodbye Mother by Reinaldo Arenas, the grief inundated daughters Ofelia, Otilia, Odilia and Onelia kill themselves in front of their dead mum just for their cadavers to occasion a series of triumphant choruses from the legion of rats and maggots who feast on the putrefactory banquet. Neither of these authors, nor the evenly talented Rene Depestre and the former Dominican President Juan Bosch, is Anglophonic. Its usually believed that the most excellent Caribbean literature in English consists of chronological polemics On the other hand Cristina Garcia novel â€Å"Dreaming In Cuban† tells the stories of the women of a Cuban family, scattered by revolution but still connected through a shared past. The narrative is polyphony of several voices who, in turn, describe their world from their viewpoint. Characters include Lourdes, an anti-Castro exile who runs a chain of Yankee Doodle Bakeries, and Felicia, whose perceptions connect and blur the lines between insanity and santeria. Pillar, Lourdess daughter and an aspiring punk artist, is determined to return to Cuba to reconnect with her grandmother and make her present life meaningful. She laments that history does not tell the important stories and longs to recover Cuba for herself: [T]heres only imagination where our history should be (138). In the title of Dreaming in Cuban, Dreaming includes all the diverse dreams of Garcias female protagonists about the nature of being Cuban, what it is to be Cuban, to dream, not in American, but in Cuban. This necessitates Garcias taking into account all the conflicting elements of contemporary Cuban-ness for Cuban and Cuban American women. Amazingly, she never invalidates or disputes the diverse and conflicting perspectives of these different dreamers. She succeeds by giving readers a complexity of experience beyond binaries, where many diverse and conflicting perspectives circle around one another endlessly. These differences are constructed by differences in the various ideologies that the characters embrace communism, capitalism, traditional gender relations, voodoo, and feminismand also by differences in their experiences due to varying historical locations in time and place.

Modern Global Epidemic Of Obesity

Modern Global Epidemic Of Obesity In his Annual report of 2002, the UK Chief Medical Officer has described it as a health time bomb. Overweight and obese children are likely to stay obese into adulthood with increased risk of associated major chronic diseases. Consequently, socioeconomic disparities observed in obesity supplement socioeconomic inequalities in health (Law et al., 2007). Prevention of childhood obesity therefore is critical. In this paper, the author will examine the complex interaction of social, economic, biological and environmental determinants of health that may explain the recent explosion, shifts in demographic trends of this worldwide problem, and briefly explore lifestyle and behavioural factors that may create particular risks. A discussion about causes, complications and treatment options of childhood obesity will follow. The author will review and analyse determinants and health policy initiatives, critically appraise various global, national and local strategies, initiatives and interventions, which aim to prevent obesity in childhood and examine their link to conventional health promotion models and theories. By critically examining the range of interactions and existing initiatives, the author seeks to propose appropriate interventions to tackle the growing challenge of childhood obesity. Key words: childhood obesity, inequalities, policy, strategy, prevention, health promotion DEFINITION Obesity/Adiposity is defined as a condition characterised by excessive body fat. Body fat can either be stored predominantly around the waist or around the hips. Body Mass Index (BMI) is used to measure obesity and defined as: Bodyweight (Kg) (Keys et al., 1972) Height (m) 2 BMI is useful in clinical practice and epidemiologic studies, but has limitations. Freedman et al. (2004) reported that although BMI is a good measure of fat mass in children with high BMIs, it is not a reliable indicator in thinner children. Two international datasets that are widely used to define overweight and obesity in pre-school children are International Obesity Task Force (IOTF) reference and World Health Organisation (WHO) Child Growth Standards (2006). None is superior to the other and both tend to underestimate or overestimate the prevalence when used on the same population (Monasta et al. 2010). Thresholds for obesity in children in UK (and Scotland) are measured by referring to UK National BMI classification system that uses reference curves based on data from several British studies between 1978 and 1990 (Cole et al, 2000). Children are classified as overweight or obese using the 85th and 95th percentiles as cut points. PREVALENCE, trends and costs Obesity has become an epidemic in many parts of the world and surveys over the last decade have documented the rapidly increasing prevalence of obesity and overweight among children along with rising socioeconomic inequalities (Wang and Lobstein, 2006; Lobstein, Baur and Uauy, 2004). The latest WHO report (Mercedes, Monika and Elaine, 2010) based on surveys from 144 countries estimates that globally, 43 million children (including 35 million in developing countries) are overweight and obese and another 92 million are at risk of overweight. This corresponds to a prevalence increase from 4.2% in 1990 to 6.7% in 2010. In England, 2008 figures showed 16.8% of boys aged 2 to 15, and 15.2% of girls were classed as obese, an increase from 11.1% and 12.2% respectively in 1995 (The Health and Social Care Information Centre, 2010). Amongst Organisation for Economic Cooperation and Development (OECD) countries, only USA and Mexico having higher levels of obesity than Scotland and this is expected to get worse even with current intervention practices. Scottish Govt. report (2010) states that in 2008, 15.1% children were obese and 31.7% were overweight. Amidst this doom and gloom scenario are recent reports (Stamatakis, Wardle and Cole, 2010) showing trends in overweight and obesity prevalence have stabilized or reversed in pre-teens and early teenage years in France, Switzerland and Sweden. In the US too, the obesity epidemic may be stabilising (Ogden et al.,2010) but it is too early to know whether the data do reflect a true plateau (Cali and Caprio, 2008). Similarly, in England, trends in overweight and obesity prevalence have levelled off after 2002 (Stamatakis, Wardle and Cole, 2010); however, socioeconomic inequalities have deepened. Healthcare (direct) costs of obesity are only a fraction of overall (indirect) costs to society (McCormick, 2007) which are due to loss of employment, production levels and premature pensions and deaths. Obesity is responsible for 2-8% of total health costs in Europe and other developed countries (WHO, 2007). Direct costs of obesity in Scotland were about  £175 million in 2007/8 and expected to double by 2030. The indirect costs were much higher (about  £457 million) and expected rise to  £0.9 billion- £3 billion by 2030 (Scottish Govt. report, 2010). In England, recent estimate of direct obesity-related costs to NHS is  £4.2 billion and this may double by 2050. Cost to the wider economy is in the region of  £16 billion, and will rise to  £50 billion per year by 2050 if left unchecked (Department of Health (DH) report, 2010). INEQUALITIES Although no clear relationship between socio-economic status (SES) in early life and childhood obesity (but confirmed a strong relationship with increased fatness in adulthood) was reported by Parsons et al.,(1999); a more recent systematic review by Shrewsbury and Wardle (2008) supports the view that overweight and obesity tend to be more prevalent among socio-economically disadvantaged children in developed countries. Similar patterns are shown in data from England (Stamatakis, Wardle and Cole, 2010; Law, 2007) and Scotland (Scottish Govt. report, 2010). However, trends vary within different ethnic populations as highlighted by Wang and Zhang (2006); a review by Caprio et al. (2008) who studied the influence of race, ethnicity and culture on obesity trends concluded higher prevalence in non-Caucasian populations in US. Although earlier reports (Wang, 2001) revealed that the burden of this problem was mainly in wealthier sections of the population in developing nations, recent reports (Lobstein, Baur and Uauy, 2004; Wang and Lobstein, 2006) indicate that prevalence is rising among the urban poor in these countries, possibly due to their exposure to Westernized diets overlapping with a history of undernutrition. The reasons for the differences in prevalence of childhood obesity among population groups are complex, involving race, ethnicity, genetics, physiology, culture, SES including parental education, environment, as well as interactions among these variables (Law et al.,2007; Caprio and Cali, 2008; Townsend and Ridler, 2009). ETIOPATHOGENESIS and COMPLICATIONS Kirk, Penney and McHugh (2010) argue the complexity of the obesogenic environment, which comprises of personal (e.g. diet and physical activity preferences; disability), physiological (e.g. genetics, race and ethnic, psychological, metabolic) and environmental factors (home, school, and community). Other contributory factors are influences in society (e.g., social and peer influences, food advertisements) and availability of and access to optimal health care. Although genetic factors can have an effect on individual predisposition (Wardle et al., 2008), perinatal and maternal factors explain rapidly rising global prevalence rates. Key perinatal factors for childhood obesity (Wojcik and Mayer-Davis (2010), cited in Freemark, 2010) are maternal overweight before, during and after pregnancy, smoking and bottle-feeding. The mothers dietary habits and level of physical activity are also significant. Decreased physical activity levels associated with sedentary recreation (video and computer games), mechanised transportation (less walking), and increasing urbanization (limited opportunity to physical activity) are all associated with increased risk of obesity (Trost et al. 2001; Gordon-Larsen, McMurray and Popkin, 2000). Children with disability are at a greater risk to develop obesity (Reinehr et al.,2010); factors include health concerns and restricted access to physical activity. Epstein et al. (2008) propose that television viewing encourages weight gain not only by decreasing physical activity, but also by increasing energy intake. In addition, television advertising could adversely affect dietary patterns throughout the day (Lewis and Hill, 1998). Psychosocial factors can influence dietary and physical activity behaviours that define energy balance. Children who suffer from neglect and depression are at increased risk for obesity during childhood and later in life (Johnson GJ et al.,2002; Pine DS et al.,2001).In contrast, social support from parents and others increases participation in physical activity of children and adolescents (Sallis, Prochaska, Taylor, 2000). There is evidence that breast milk in infancy may protect against overweight in childhood (Harder et al.,2005) while intake of foods with high glycemic index, sugary soft drinks and fast foods are associated with increased risk and prevalence of childhood obesity (Ludwig et al.,2001; French, 2001); however, long term trials are needed to corroborate this association. Also, eating out (Zoumas-Morse et al.,2001) appears to be an important contributory life style factor. Excessive fat in the diet is believed to cause weight gain (Jequier, 2001); though, this association is not consistently shown in epidemiological studies (Atkin L-M Davies, 2000; Troiano,2000). Lustig (2006) proposes that the relationship between changes in the environment and neuroendocrinology of human energy balance is complex. The author explains that behaviours of increased caloric intake and decreased energy expenditure are secondary to obligate weight gain that is due to associated hyperinsulinemia, leptin antagonism and interference with normal satiety. Childhood obesity is a multisystem disease with potentially serious complications. Several studies suggest that childhood overweight/obesity is associated with increased risk of mortality in adult life (Gunnell,1998; Dietz,1998). Young-Hyman et al. (2001) have documented cardiovascular risk factors along with insulin resistance in children as young as five years old. The rising prevalence of type 2 diabetes in obese children is worrying in view of the vascular complications (heart disease, stroke, limb amputation, kidney failure, blindness) (Ludwig and Ebbeling,2001). These risks appear to be higher in non-Caucasians (Goran, Ball and Cruz,2000). According to Strauss, (2000) adverse psychosocial effects are more severe in white girls. Treatment Effective intervention is essential because obese children are likely to face substantial health risks as they mature (Cali and Caprio, 2008). Further, as healthcare costs of this problem are rising (Wang and Dietz, 2002); intervention is required to prevent morbidity in adulthood while effective tools for primary prevention are developed. Spear et al. (2007) reviewed the evidence about the treatment options in primary care, community, and tertiary care settings and proposed a comprehensive 4-step approach for weight management. Uli, Sundarajan and Cuttler (2008) support a similar strategy. Several reviews of lifestyle (i.e. dietary, physical activity and/or behavioural therapy) interventions for treating childhood obesity (Oude- Luttikhuis et al.,2008; Wilfley et al., 2007) have concluded that family based combined behavioural and lifestyle interventions can produce significant reduction in overweight in children and adolescents. Although Golan and Crow (2004) suggested that targeting exclusively parents for change was superior to targeting only children for change, behavioural approaches involving both parents and children in the framework of a combined lifestyle intervention appear to be more effective (Wilfley et al. 2007; Epstein 1994; Bronwell, Kelman and Stunkard 1983). Moreover, intensive lifestyle intervention (with daily exercise, mandatory caloric restriction, multiple clinic visits and counselling sessions) appears to be more successful (Nemet at al. 2005) than standard lifestyle intervention (Epstein and Wing 1980). There is no consistent evidence to show that decreasing sedentary behaviour by reducing television viewing is effective in weight reduction (Dennison et al. 2004; Gortmaker et al. 1999). However, limiting TV food advertising to children appears to be a useful cost-effective population-based intervention (Magnus et al. 2009). In obese adolescents, treatment with orlistat or sibutramine as adjunct to lifestyle intervention is prescribed sometimes. However, these drugs can have significant side effects and this approach needs close monitoring and follow-up (Freemark, 2007). Morbidly obese adolescents can benefit from sizeable weight loss following bariatric surgery but with potential serious complications (Lawson et al., 2006; Uli et al.,2008). This necessitates close follow-up and dedication to a specialized dietary regimen (Shen, Dugay and Rajaram, 2004) for successful results. Evidence base of school-based interventions: Systematic reviews of random controlled trials (RCT) by Reilly and McDowell (2003) and Bluford, Sherry and Scanlon (2007) did not find sufficient evidence base for interventions to prevent childhood obesity and recommended further research. In contrast, Thomas et al. (2004) put forward a more positive conclusion in their review. Similarly, Flynn et al. (2006) and Doak et al. (2006) reported favourable outcomes in nearly all trials they reviewed. Interestingly, in an analysis of school-based programs, authors from National Institute for Health and Clinical Excellence (NICE), UK (2006) indicated that the evidence does not convincingly support the multidisciplinary whole school approach promoted by UK National Healthy Schools Program. Nonetheless, Connelly, Duaso and Butler (2007) in their review of RCTs have supported a decisive role for obligatory provision of aerobic physical activity in schools coupled with nutritional education and skills training. Finally, Kropski, Keckley and Jensens review (2008) concludes that although evidence is limited, schools play an important role in prevention strategies and directing different techniques at boys and girls may have more impact. HEALTH PROMOTION MODELS RELATED TO PREVENTION OF CHILDHOOD OBESITY Knowledge-Attitude-Behaviour model proposes that as knowledge accumulates, changes in attitude are set off resulting in gradual change in behaviour (Baranowski 1999). The model assumes that a person is logical by instinct. However, evidence shows that generally people in a variety of circumstances do not act logically (Shafir and LeBeouf, 2002). A common application of this model to promote change is providing health and nutritional information within school syllabi. Gaining knowledge may help to set goals and boost self-confidence but has not been shown to cause change in behaviour (Schnoll and Zimmermann, 2001) or to change in physical activity behaviour (Rimal, 2001) except perhaps in specific right people (Wang and Biddle 2001). Besides, there is no evidence that interventions based only on education strategies will change behaviour (Contento et al.,1995). According to Behaviour Learning Theory (BLT), when a specific stimulus elicits a desired behaviour, there is increased likelihood of that behaviour recurring if that behaviour is reinforced (Skinner,1938 as cited in Baranowski et al.,2003). A modern version of BLT, the Behavioural Economics model (Epstein and Salaens,1999) suggests behaviour is the result of benefits and costs where benefits are reinforcers. Obese people find food more reinforcing than others do whereas physical activity has greater reinforcing value among non-obese people. In addition, preference for a specific physical activity declines when the distance to that activity increases which reduces the reinforcing value of that activity (Raynor, Coleman and Epstein, 1998). Thus, obese people are more likely to find behaviours that lead to obesity more reinforcing. Saelens and Epstein (1998) applied the model successfully in obtaining increased physical activity. However, application of reinforcers on controlling behaviour is challenging and can be beyond the ability of many parents. The Health Belief Model explains the utility of health services. It has been widely applied to health-related behaviours (Janz, Champion and Strecher, 2002). The model describes health actions through the interaction of sets of beliefs: perceived susceptibility, perceived seriousness perceived benefits and disadvantages and cues to action. A meta-analysis study by Witte and Allan (2000) of fear-based communications revealed that they could induce behavioural change by affecting individuals perception of threat. However, children and adolescents often tend to perceive themselves as invincible, thus the concept of fear, threat and perceived risk and susceptibility are not useful in this age group. HBM may become more relevant if people perceive obesity as a serious threat waiting to happen to them (Baranowski, 2003). Social Cognitive Theory (SCT) proposes (Bandura 1999) that behaviour is a function of continuous mutual interaction between the environment and the person. The theory assumes that people generally strive for positive outcomes and evade negative ones by changing their behaviours by using self-control. Programs based on SCT have resulted in some changes as reported in a review by Sharma (2006) of school-based interventions for preventing childhood obesity where SCT was the most popular intervention tool. However, the theory lacks predictability for understanding childrens behaviour that is related to food and activityit could be that the concepts are too complex for children (Baranowski, Cullen and Baranowski,1999). Furthermore, children may not be expected to or capable of sufficient self-control over their diet and physical activity. Environmental variables like parenting and availability of food and physical equipment may be more beneficial (Cullen et al.,2003). Theory of Reasoned Action (TRA) and Theory of Planned Behaviour (TPB): To explain the relation between attitudes and behaviour (Ajzen and Fishbein,1975 in Baranowski et al.,2003) proposed TRA and said that people are more prone to perform a specific behaviour when they have the intention to perform it. The theory has many limitations one is that presence or absence of choice can influence behaviour e.g. unable to perform the intention to buy healthy food due to its unavailability in the local store. Ajzen and Madden (1986) modified TRA to TPB, which emphasises that perceived behavioural control influences intention. Goding and Koks review (1996) argued that the efficiency of the theory varies between health-related behaviour categories. TPB model has been applied to childhood obesity prevention programs with results showing both good (Andrews, Silk and Eneli, 2010) and mixed (Fila and Smith, 2006) predictability. The Transtheoretical model (T) proposes that health behaviour change progresses through six stages of change: pre-contemplation, contemplation, preparation, action, maintenance, and termination and describes 10 processes that enable this change (Prochaska et al.,1992). The model has been successfully applied in addictive disorders but has limitations when applied in the treatment of eating and weight disorders (Wilson and Schlam, 2004). T has been applied to obesity with studies reporting both good (Sarkin et al., 2001) and poor predictability (Macqueen, Brynes and Frost, 2002 in Wilson and Schlam, 2004). The complex etio-pathogenesis of childhood obesity suggests that Social Ecological (SE) Models may generate creative and lasting solutions (Huang and Glass, 2008). The SE model initiated by Bronfenbrenner (1977) and subsequently developed for understanding obesity by Davison and Birch (2001) and Story et al., (2008) proposes that individuals contribute their cognitions, skills and behaviours, lifestyle, biology and demographics, while surrounded in other circles representing the social, physical and macro-level environments to which they are exposed. Swinburn, Egger and Raza (1999) have described the ANGELO (analysis grid for environments linked to obesity) framework which is an ecological model for understanding environments that are obesogenic. Figure 1. The IOTF model is a SE model and describes societal policies and processes with direct and indirect influences on body weight (Kumanyika et al.,2002) as shown here in Figure 1(above). An ecological approach is also the basis of the Canadian model, Child Health Ecological Surveillance System (CHESS). As illustrated in Appendix 4, it demonstrates a local approach to tackle childhood obesity and has possible global implications (Plotnikoff, 2010). Global, regional and national prevention strategies As part of the response to fight the childhood obesity epidemic, WHO (2004) developed the Global Strategy for Diet, Physical Activity and Health (DPAS) and produced a range of tools to assist Member States and stakeholders to implement DPAS. It emphasised that National plans should have achievable short-term and intermediate goals. A schematic model developed for WHO by Sacks, Swinburn and Lawrence (2009) for implementation and monitoring of DPAS provides the basis for a framework for action and explains how supportive environments, policies and programmes can influence behaviour change in a population and have lasting environmental, social, health and economic benefits. The monitoring and evaluation component provides the foundation for promotion, policy development and action. Figure 2: Implementation framework for the Global Strategy on Diet, Physical Activity and Health. The model emphasises the need of right mix of upstream (socio-ecological) approaches to shape the economic, social and physical (built and natural) environments, midstream ( lifestyle) approaches to directly influence behaviour (reducing energy intake and increasing physical activity), and downstream (health services) approaches to support health services and clinical interventions (Sacks, Swinburn and Lawrence, 2008 in WHO report, 2009). According to WHO (2009), population-based prevention strategies developed in the context of a social determinants-of-health approach and implemented both at the national level and locally in school and community-based programmes will help to change the social norm by encouraging healthy behaviours. Furthermore, transferring the responsibility of tackling health risks from the individual to decision-makers will help to combat associated socio-economic inequalities. In addition, strategies will need coordinated action by multiple stakeholders and effective leadership for success. Surveillance tools for growth assessment recommended by WHO are Child Growth Standards (WHO Reference, 2007) and the Global School-based Student Health Survey (GSHS) (WHO, 2009). Key challenges of population based strategies identified by WHO are increasing globalization of food systems that have created economic and social drivers of obesity through changes in food supply and peoples diets, worsening socioeconomic inequalities and tackling obesity in children with physical and/ or mental disabilities. Other important hurdles are poorly designed urbanisation and achieving cost-effectiveness. In this regard, combined approaches that address multiple determinants can improve efficiency of intervention programmes according to a model-based analysis by OECD and WHO (Sassi 2009 in WHO report 2009). The Ottawa Charter for Health Promotion (WHO 1986) recommends that global prevention strategies should work at multiple settings (e.g. schools, after-school programmes, homes and communities and clinical settings) and use the correct mix of approaches for a given situation along with concern for country- and community-specific factors, such as availability of resources and/or socioeconomic disparities. It emphasises that such strategies must identify and include at-risk groups, set priorities and realistic targets and engage with all stakeholders in a transparent manner. The public should have access to information on partnerships including potential conflicts of interest. Successful implementation and sustenance of such strategies depends on long-term planning, budgeting and identifying cost-effective interventions such as the ACE-Obesity project (Carter et al., 2009). It is also important to dissociate private sector funding from projects that set direction and techniques of such programs by adopting novel funding strategies. The IOTF (2007) have developed in consultation with WHO a set of (Sydney) principles that define the commercial promotions of foods and beverages to children and guide action on changing marketing practices them. The principles aim to ensure a degree of protection for children against obesogenic foods and beverages. The European Union (EU) Member States have adopted the European Charter on Counteracting Obesity (2006), which defines WHO policies and action areas at the local, regional, national and international levels for all interested parties in government and private sectors (e.g. food manufacturers, advertisers and traders) and also organizations of professionals (providers) and consumers (users). Policy strategies emphasise the need to identify and focus on at-risk population groups, set realistic goals, and use efficiently coordinated multiple settings and approaches. They also stress the need for research into all aspects of treatment and prevention methods and develop creative sustainable funding (WHO Europe, 2007). In UK (England), to encourage individual behavioural change, the strategy Healthy Weight, Healthy Lives: A Cross-Government Strategy (DH, 2008) has been developed with emphasis on healthy growth and development of children, promotion of healthier food choices and bringing physical activity into peoples lives by building healthy towns on the EPODE model ( Borys 2006). It also aims to provide personalised advice and support and create incentives to be healthy. Policy drivers include national policy changes (e.g. increased support for monitoring of growth, promotion of breast feeding, bans on unhealthy food advertisements, social marketing campaigns) and changes to the food supply (e.g. development of a healthy food code, front-of-pack labelling, limits on fast-food restaurants near schools and parks, increased supply of fresh fruit and vegetables to stores in deprived areas). Change4Life is the marketing arm of the Governments strategy to stress on prevention through healthier habits from early life (DH, 2009). Other strategies are development of a national physical activity plan in part tied to the 2012 Olympics with the purpose of improving built environments and support more weight management services. The national Government leads the project and provides resources for local authorities, National Health Service (NHS), and community care partnerships. Government agencies and their partners coordinate to raise funds and integrate projects into existing strategies and programmes for cost-effectiveness. Long-term goals include developing a national dialogue on societys response to the epidemic of obesity, provide more support and guidance for PCTs and local authorities and build up skills and capabilities of staff, set aside extra resources and while demonstrating good governance and clear accountability. In Scotland, the Government and Convention of Scottish Local Authorities (COSLA) have developed a Route Map for decision-makers in government to work with their partners, NHS and businesses to develop and deliver lasting solutions to prevent overweight and obesity (Scottish 2010). The Government has targets to reduce the rate of increase in the proportion of children with unhealthy BMI by 2018 but none yet for obesity or weight management. The aim is to reduce energy consumption, increase physical activity, minimise sedentary behaviour, and create positive health behaviour through early life interventions and building healthier work place environments. Policy drivers to manage obesity include HEAT (health, efficiency, access and access target) which measures achievement rates for intervention programmes, Counterweight which is a second-level program to support people who need management of their weight, and Scottish Enhanced Services that provides childhood obesity services in primary and community care settings. To prevent obesity, the Government has developed several initiatives in a framework Lets Make Scotland More Active which is for promoting increased physical activity. Policies to help build healthier lifestyle are the National Food and Drink Policy Recipe for Success, eight Healthy Weight Communities programmes nation-wide, and Seven Smarter Choices Smarter Places to study travel behaviours of communities and their potential to adopt healthier choices. Take Life On is a national social marketing drive that aims to improve diet and fitness of communities and Beyond the School Gate and Scotlands Healthy Weight Outcomes Framework will provide guidance to help create health-promoting communities. In addition, there are several national programs directed to a Greener, Healthier, Smarter, Safer and Stronger Scotland which are likely to have indirect contribution to tackle overweight and obesity. CONCLUSION: The essay emphasises the rapidly increasing burden of childhood obesity with associated population profile changes and increasing social inequalities. It explains the complex multifaceted and interlinked causal pathways that form the obesogenic environment. The author has described community and school-based obesity intervention and prevention programmes and explored the role of research protocols in gathering evidence for such interventions and their usefulness. Various prevention strategies and interventions (singly and in combination) that are in practice and the settings and conditions in which they may be effective are reviewed and compared. Existing global, regional and national prevention and implementation strategies and their need to tackle upstream influences to fight childhood obesity are explained. The present evidence for effective treatment and prevention of childhood obesity is not consistent. It is very difficult to attain significant weight on a long term basis in spite of strenuous efforts it could be that present prescriptions for diet and exercise are not as effective as they need to be; in addition, the adversities in the environment can overwhelm the beneficial effects of techniques used in current intervention techniques. Further research is required to identify realistic options for treatment and best practice procedures for public health policies that are cost-effective, culturally sensitive, deal with upstream influences and address population inequalities. Although numerous school and community based programs are having an impact, there is a need for evidence to evaluate effective social interventions so that social policies direct healthy lifestyle approaches. From the review of available evidence, the author has learnt that policymakers and professiona

Injury can result from violence Essay -- Social Issues, Domestic Viole

Injury can result form violence Injury Can Result from Violence Injury can result from many different incidents. One specifically important incident resulting in injury is domestic violence. It is approximated statistically that 1.8 million to 3-4 million domestic violence cases occur each year, unfortunately, the number of cases that occur cannot be more accurate due to domestic violence usually occurring in the relative privacy of one’s home. (Kelly, 2003) As disturbing as these numbers may be, we need to acknowledge that domestic violence is not a new problem arising in American homes but what is new is that we are now more aware of how serious the issue of domestic violence is in today’s society. Today, domestic violence, in its broadest definition is being defined as verbal, emotional, threatening, or physical abuse among current or former intimate partners and includes any persons related by blood. (Robert, 2002) They may be living currently within the same household or have been in the past for it to be considered do mestic. Domestic violence has no barriers. It affects any race, religion, culture, or socioeconomic status. In today’s world every nurse knowingly or not is most likely to encounter a situation involving domestic violence. (Nucero & O’Connor, 2002) Therefore, it is important that within this discussion that the following issues is to be identified: the seriousness of domestic violence and what factors contribute to domestic violence, what role the legal system must take on when domestic violence occurs, and lastly what a nurse and the medical world can do in identifying and assessing domestic violence. Domestic violence is a serious problem affecting many people each and every ye... ...ic violence, as we can see from the previous read information, results in injury. It is a very serious issue for the people within a violent home setting and with today’s legal system domestic violence cases are being taken extremely serious. It is important that we as nurses, if we feel someone is in a violent home setting, to identify these patients and assess as needed. By nurses identifying and assessing victims of violent acts we can help these people and contribute to decreasing the number of violent acts that occur. If a nurse or anyone knows or suspects that someone is being abused, we need to let that victim know there are alternative solutions, choices they can make, and that there is hope to solve the problem at hand. We should also let this victim know that without help, this problem may only get worse and could progress in frequency and severity.

Book Review: the Protector Essay

The Protector is about a firefighter named Jack O’Malley, and his ‘family’ of seven people orphaned as teens who basically adopted each other and who all changed there sir name to O’Malley. Jack O’Malley is a firefighter who has seen so many wrecks and fires he has lost count, but the arsonist who is treading on he, and his fellow firefighters lives, he knows his task at hand, to stop the arsonist in its tracks before he ends up killing one of his own. Cole, the arson investigator is worried, but wont admit that to anyone, but with the arson’s escalating, he has an uneasy feeling of what the future holds. The arsonist is leaving signs, murals painted on the walls with the words murderer, and killer, and popcorn at every scene. When Cassie, a firefighter who took a break from her job after being severely burned at a nursing home fire that had been ruled as the first arson fire, witnesses the arsonist in the act, she is put in danger and it’s Jack and Cole’s job to protect her. After Cassie see’s the arsonist, she decides she has to go back to work, and she has to help in anyway she can to catch this arsonist, starting with trying to figure out who she had seen, knowing she had seen him before. I think that the author, Dee Henderson, wrote this book very well. Henderson has an amazing way of showing the emotion f the characters she is portraying on her writings. I feel as though Henderson has a way of writing that warms your heart, making it seem like you are in the book too, or as though you are watching the story unfold around you. â€Å"The new year is eighteen minutes away. â€Å"†Come kiss me awake in seventeen minutes. â€Å"She blinked at that lazy suggestion, gave a quick grin, and dropped Benji on his chest. He opened one eye to look up at her as he settled his hand lightly on the kitten. â€Å"That’s a no? â€Å"She smiled. She was looking forward to dating him, but she was smart enough to know he’d value more what he had to work at. For example when reading the above excerpt from the book, she writes it so hate you can mentally visualize Cassie sitting with Benji, her cat, on her chest and Jack asking her to kiss him awake for new years. You can really feel what Cassie is saying when she says that she was looking forward to dating Jack, but is making him work for it so he will value it more. I feel as though this book is an overall good read, it shows traces of how God is working in each of the main characters lives and how he is present in there hearts, but it is not in your face about God. The book was definitely a page turner, it took me about a day to read the 333 page book, I was hooked from about the third chapter and just could not put it down until I was finished. I think that this book would be a great book for young adults to read, the book is a really interesting book, and I would recommend any christian no matter where in there walk with God, to read this inspiring book about Jack O’Malley, the main character in this book, and his family of seven orphaned and abandoned teens who became a family, and changed there sir to O’Malley .

Divine Command Theory

Divine Command Theory Divine command theory is based on the idea that God is the determinant of right and wrong behavior. Religious groups such as Christians, Muslims and Jews follow laws contained in holy books that guide their worship activities.Advertising We will write a custom essay sample on Divine Command Theory specifically for you for only $16.05 $11/page Learn More Holy books were written by wise people inspired by God and should be followed. God forbids morally wrong actions and encourages people to engage in morally upright activities. Violation of commandments of God is immorality. People will be held responsible for their actions on the final Day of Judgment. Theists disagree with divine command theory because they do not believe in the existence of God. There are also differences within believers. According to Plato, any act is neither good nor bad unless God has categorized it. This raises an issue of dilemma in some cases such as whether people should be truthful because God has commanded them or because it is good (Rachels Rachels, 2011). According to Rachels and Rachels (2011), the criterion used to define wrong and right is not clear. For instance, in a case of child abuse where a child has been slapped, the action could be right if God wants it that way. In such a case, defining morality would be mysterious. The definition of what is moral makes commandments of God Arbitral because judgment depends on God. For instance, lying is not allowed. However, if God commanded it, it would be accepted. Conception of morality differs with moral principals. This is because the theory does not recognize effects of child abuse as long as punishment is based on Gods commandments. Divine command theorists argue that child abuse could be allowed if God was not in existence. The statement is invalid because if God was not there, then He could not be there to make child abuse wrong. Since child abuse is malicious, it would still be wrong. Religious texts give contradicting information that makes even believers have doubts in God’s commands. It is wrong for believers to say that the commandments given by God are arbitrary because He knows what best fits them. People should remain truthful because God requires them to do so. Believers should follow Gods wishes if they are to remain religious. Many theologians have rejected the theory because it is impious and untenable. Other thinkers like Saint Thomas Aquinas have explained the relationship between religion and morality in other ways (Rachels Rachels, 2011).Advertising Looking for essay on philosophy? Let's see if we can help you! Get your first paper with 15% OFF Learn More The Theory of Natural Law According to this theory, laws of nature govern human beings. According to Aristotle who lived between 384 and 322 B.C, everything that exists should serve a certain purpose. He gave the example of a knife that is used for cutting, different body parts th at perform different functions in the body and rainfall that enables proper growth of plants. Many things exist in the world with each serving its own purpose making the world a rational and orderly system. Other scholars who followed later have supported Aristotle’s view. For instance, Christian thinkers accepted the view but added that the aspect of God was missing. They argued that human beings use animals because God made them to serve that purpose (Rachels Rachels, 2011). Rachels and Rachels (2011) point out that the Natural theory describes the nature of things. People live in unity when everything is in place and every individual assumes his/her responsibilities in order to maintain social order. For examples, eyes that cannot see are functionless and this can be explained by the natural law. God created people to help each other. Naturally, human beings are social beings who need the company of other people. People who seem not to care about others (psychopaths) go a gainst the natural law. Deviant sexual activities are condemned in the theory of natural law. Theorists argue that sex is meant for procreation. Practices like gay and masturbation are condemned. The Catholic Church bases its moral values on this theory. Apart from Catholics, the theory has few supporters; reasons being that not all natural things are good. Secondly, it brings about confusion because people must not engage in sex except for purposes of procreation. Lastly, natural law differs with science (Rachels Rachels, 2011). The theory of natural law points out that determining right and wrong depends on one’s reasoning. Right actions should bring about good results. In this case, believers and non-believers follow in the same category of accessing moral truth. People have the ability to listen, think and make sound decisions. Natural theorists argue that morality is not dependent on religion (Rachels Rachels, 2011). Reference Rachels, J. Rachels, S. (2011). The eleme nts of moral philosophy. New York, NY: McGraw-Hill Companies Inc.