Partnership for Lebanon and Cisco Systems Essay Example for Free

Partnership for Lebanon and Cisco Systems Essay The â€Å"Partnership for Lebanon and Cisco Systems† case study discusses a project developed after the war in Lebanon in July of 2006. After the war, President George W. Bush urged 5 U. S. based companies to partner together to help with the reconstruction efforts in Lebanon, including Cisco systems (led by John Chambers), Intel corp. (led by Craig Barrett), Ghafari Inc. (led by Yousif Ghafari), Occidental Petroleum (led by Dr. Ray Irani), and Microsoft (led by Steve Balmer). The partnership of these 5 successful U. S. companies formed the Partnership for Lebanon, or the PFL, for which a woman named Salam Yamout was appointed as project manager (Jimali, 2011). Upon the formation of the PFL in 2006, the leaders met at the Paris III donor conference with Fuad Seniora, the Lebanese prime Minister, to discuss and develop the key goals that would need to be achieved in the Lebanese reconstruction efforts, and to map out the main initiatives of the PFL (Jimali, 2011). With a primary focus on efficient and productive communities and advancement opportunities for the Lebanese people, they developed the following 5 key objectives for which they made significant progress over the next three years: 1. Emergency Relief and Response: The first of the 5 key objectives, emergency relief and response, was essential to establishing a sense of security among the Lebanese people following the war. From 2006 through 2009, the PFL helped more than 1000 families to rebuild their homes, and helped many communities to resettle. This was a first step toward rebuilding the infrastructure and public society needed for economic and workforce growth (Jimali, 2011). The PFL also rebuilt 10 youth and IT centers, complete with computer labs and Internet technology, providing a training center for over 1400 young people in Lebanon and rehabilitated the schools that stood in the areas most affected by the war, focusing on school safety, quality of student life, and Information Communication Technology (ICT) training (Jimali, 2011). Finally, in order to reduce continued casualties, the PFL trained and certified two dogs to detect landmines, a $65,000 effort that likely saved lives and increased the mobility of the Lebanese people. 2. Job Creation/Private Sector renewal: The next key objective of the PFL was to increase the number of available jobs in Lebanon, particularly in the private sector. Much of the focus on this initiative was suggested by Cisco leader John Chambers, who, in a visit to the American University of Beirut, was affected by the number of highly educated, multi-lingual Lebanese young people who would look for employment opportunities outside of Lebanon immediately following graduation. Noting the emigration of the most capable young workers as a significant obstacle to the future prosperity of the Lebanese people, Chambers suggested the job creation be made a top priority. As a top global leader in the Information Communication Technology industry, Cisco took the lead by developing a $1 million grant program called the â€Å"CREDIT† program, which they used to deliver 133 loans to businesses specializing in ICT (Jimali, 2011). Furthermore, in order to provide learning opportunities for Lebanese businesses, the PFL developed the Executive Mentorship Program, which matched successful U. S. businesses with leaders of Lebanese businesses. 3. Developing ICT infrastructure: As part of the PFL’s job creation efforts, Cisco also took the lead in developing a sustainable Information Communication Technology infrastructure. The first step toward this was to expand broadband service to all rural and urban areas. By partnering with the Lebanese Telecommunications Regulatory Agency (TRA), the PFL developed a long-term strategy for expanding broadband service, which began with the development of several new Internet exchange points and an International Internet gateway. 4. Workforce Training ICT education: Finally in workforce development, the PFL set out to create private sector job opportunities for the uneducated Lebanese population. By creating professional training programs and ICT education, a basic infrastructure targeted at building a middle-class could be developed. The PFL made several achievements in this area, including using high-speed broadband connections to connect 50 public schools to the Ministry of Education, providing online learning materials, sponsoring and ICT/life skills youth summer camp program, placing interns in Lebanese businesses, and helping to integrate ICT programs in Lebanese schools (Jimali, 2011). 5. Developing connected communities and connected governments: The final PFL objective sought to develop connected communities throughout Lebanon. A major stride in this objective involved developing ICT centers where people without broadband capabilities could go to stay connected through variety of Medias. In addition to developing 10 of these ICT centers, the PFL also enabled 5 full-service community access points that were affected by the war (Jimali, 2011). CSR Lessons There are several key strategic lessons that the PFL learned throughout their efforts in Lebanon concerning the creation and implementation of development programs, particularly those that would be able to be adopted by any senior manager. Perhaps the most important strategic lesson was that a targeted, overall objective must be developed in order to maintain the highest likelihood of success. Instead of developing a wide spectrum of initiatives to help rebuild Lebanon, Cisco and the other PFL partners focused on ICT as a means for rebuilding infrastructure and developing economic and educational opportunities for the Lebanese people. By developing this focused mission, Cisco avoided wasting time and resources or putting a great deal of input into unrelated initiatives that may or may not have had beneficial results. Furthermore, by developing a single mission that was within their expertise, Cisco was able to make valuable contributions in a vital area and thus maximize their impact. The PFL recognized that it could not solve all of Lebanon’s problems, but by developing a set of initiatives that Cisco and partnering companies felt well equipped to address, they were able to develop a plan within the ICT industry where it could make a measurable impact (Jimali, 2011). Another key strategic lesson learned by the PFL was that a thorough situational analysis is essential to developing an effective restructuring campaign. This is a lesson that is relevant to any rebuilding efforts, whether it is for a nation, a corporation, or a nonprofit organization. By conducting a detailed situational analysis, Cisco as able to analyze which objectives would create opportunities in Lebanon and how Lebanese government organizations, businesses, and communities would utilize various initiatives. Cisco’s thorough analysis allowed them to develop an effective methodology for implementing various programs, as well as to gain government cooperation and support throughout the process. This analysis also provided Cisco with insight regarding which support and resources they would need to ensure success and therefore allowed them to gather the support they needed before beginning the process in order to produce the fastest and more effective results. John Chambers, Cisco CEO, said, â€Å"In September, we visited Lebanon and we saw a country that can achieve many of the goals itself, but with the proper assistance can achieve them at a much faster pace and rebuild the country for the future, not just rebuild back to where they were before. † (Cisco CSR Report, 2009). Lastly, an essential strategic lesson learned by the PFL concerning the implementation and running of development programs was that a change process must be developed in carefully planned incremental steps, beginning with the development of the infrastructure needed to prepare for the next step. This is especially important for ensuring that the strategy can be adopted by any senior manager, because it allows for a step-by-step map of development that allows managers to build upon previous initiatives. Cisco, Corporate Sponsors, and PFL Because of its expertise in this area and its long-time commitment to investing in community sustainability, Cisco was an effective leader in the PFL’s objectives, providing valuable insight on how to encourage job creation that would continue to evolve over time. Cisco is a leading organization in global networking and communications technology, and was the creator of the multi-protocol router, which revolutionized Internet communications. A company worth $550 billion in 2000, Cisco’s success has been attributed to a focus on customer need that was so targeted that they did not commit to any specific technology and were willing to change in whatever way they needed in order to meet their customers need. It was this willingness to adapt as well as Cisco’s commitment to community and economic investments that made Cisco the right leader for the PFL’s goals. Cisco’s CSR initiatives had always been designed in a way that sought to add value to the organization through strategically planned initiatives and to leverage the company’s core competence and sustainability levels in a way that provided clear and measurable outputs. Cisco also took a lead in the PFL’s educational and professional training programs, which provided crucial career opportunities for the Lebanese people. The Challenge of Sustainability Despite the successful implementation of the PFL initiatives from 2006 through 2009, in September of 2009, PLF project manager Salam Yamout expressed concern to her manager, George Akiki regarding the long-term sustainability of the PLF initiatives. She said, â€Å"The PFL has undoubtedly been successful across the 5 work streams, and has infused much needed resources, support and hope in a context of post-war devastation, but the key question haunting me now is how to sustain this impact into the future. † (Jimali, 2011). Akiki agreed, and thus the question of how Lebanon could sustain the development initiated by the PLF without the generous management and resource contributions of Cisco and PLF partners. While the sustainability challenges faced by the PLF may seem daunting, the educational and job training programs developed by the program can be designed to be self-supporting, these programs, if continued and managed by competent leaders, can allow Lebanon’s ICT related programs to continue to prepare Lebanese people for good jobs. The first step to maintaining these programs is to gather investors from both within Lebanon and from the International community, particularly those who benefit from the increased educational and professional opportunities in the Middle East. Moreover, if the Lebanese government is able to recognize the benefit hat a more vibrant ICT community can offer to the economy, a system of public funding can be developed. Furthermore, if individuals who are trained through these programs can be offered incentives to remain within the program as educators, the programs can become self-sustaining through generations. Conclusion Cisco and the partners that formed the PLF provide an example of an efficient program for utilizing the specific expertise and resources of one industry to enact positive change on a community in desperate need of rebuilding. Their thorough analysis, clear-cut mission, and careful planning in an area that they were well resources in, allowed for an extremely effective rebuilding process. Moreover, Cisco provided a valuable framework for how with productive partnerships and effective leadership, successful organizations can help to address societal problems in a way that adds value to both the community involved and the partnering organizations. Too often, today’s conversation regarding CSR presents in if/or debate, as if companies must choose between economic value and ethical value. The economic argument suggests that corporations are obligated only to shareholders, and that investments made in activities that do not directly maximize profits are irresponsible, while the ethical argument suggests that because corporations benefit from the people and infrastructure of communities, they are obligated to make investments in those communities (Bansal, 2005). However, a modern view of CSR suggests that there is a middle ground where economics and ethics can converge to create longer term sustainable value. Cisco’s participation in the PLF program is an example of this middle ground. In its participation in the PLF program, Cisco expanded its influence in a part of the world where they previously had little reach, thus creating added value to their organization while addressing significant societal problems.

Effectiveness of Teaching Program on QoL of Elderly Patients

Effectiveness of Teaching Program on QoL of Elderly Patients CHAPTER – 1 INTRODUCTION â€Å"It’s not how old you are, it’s how you are old Live your life and forget your age† Older adults recognize that they have less time in which to continue achieving their goals, so they face their challenges with resilience and determination. Gerontologists are increasingly recognizing that older adults who are aging successfully possess wisdom, which includes factual knowledge, problem- solving strategies, and the ability to manage uncertainty. Because many of the challenges of older adulthood involve health and functioning, older adults need accurate information, not only about aging, but also about interventions to promote wellness. Nurses are ideally positioned to teach older adults about health and aging and empower them to implement problem-solving strategies directed towards wellness, improved functioning, and quality of life (Blazer, Brugman, 2006). With increases in life expectancy, delayed onset of morbidity, and higher expectations for old age, interest in well-being in later life and how to achieve it has intensified. ‘Successful ageing’ has come to the fore as a goal for the ageing population. While an agreed definition of successful ageing remains elusive, there is broad agreement that core constituents include physical health and functioning, psychological wellbeing, and social functioning and participation. As the older population surges both in absolute and relative numbers, well-being in old age has also become a focus for policy-makers as a key indicator of the physical and psychological health, social integration and economic security of the older community (Bowling A, Dieppe P Dec 24). Despite the adverse changes that occur with increasing age, older people typically report high levels of well-being. Most feel younger than their actual age and maintain a sense of confidence and purpose. In the HeSSOP (Health and Social Services for Older People) surveys of older people in Ireland, conducted in 2000 and 2004, over three-quarters of community-dwelling older people scored high on morale (Garavan R, Winder R, McGee H. ; 2001, O’Hanlon A, McGee M, Barker M 2005). In fact, older people are more likely to report satisfaction with their lives than younger people (Strine TW, Chapman DP 2008). Old age, it appears, brings with it an ability to adapt to age- related changes and stresses. One study found, for example, that physical decline did not have an impact on older people’s satisfaction with life, suggesting that they regard it as a normal and relatively acceptable part of ageing (Steverink N, Westerhof GJ .2001). Moreover, older people recognize benefits in old age, such as increased wisdom and maturity, with opportunities for growth and lessening of demands upon them. Research has come to emphasize that ageing is highly specific to each individual, which implies that the pathway of old age is not predetermined. While growing older unavoidably entails losses, some individuals cope better with these losses than others. With this in mind, it aims to shed some light on the personal, material and social circumstances that influence how well people cope. â€Å"Successful ageing† refers to those cases where ageing people are free of (acute and chronic) diseases, do not suà ¯Ã‚ ¬Ã¢â€š ¬er from disability, are intellectually capable, possess high physical à ¯Ã‚ ¬Ã‚ tness and actively use these capacities to become engaged with others and with the society they live in. Concepts which have been used in gerntological research and which emphasize dià ¯Ã‚ ¬Ã¢â€š ¬erent aspects of the ageing process are healthy ageing (Ryà ¯Ã‚ ¬Ã¢â€š ¬, 2009) Gerontology has seen many dià ¯Ã‚ ¬Ã¢â€š ¬erent conceptions of active ageing. A classic deà ¯Ã‚ ¬Ã‚ nition of active ageing was presented by Rowe and Kahn (1997) who used the term successful ageing: â€Å"We deà ¯Ã‚ ¬Ã‚ ne successful ageing as including three main components: low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life† (Rowe Kahn, 1997, p. 433; Rowe Kahn, 1987). â€Å"Successful ageing† refers to those who are free of (acute and chronic) diseases and do not suffer from any disability, aged who are intellectually capable and those who possess high physical fitness and actively use these capacities and engage with others and the society they live in. Concepts which have been used in gerontological research and which emphasize different aspects of the ageing process are healthy ageing (Ryff, 2009), productive ageing (Morrow-Howell, Hinterlong, Sherraden, 2001), ageing well (Carmel, Morse, Torres-Gil, 2007). There is a strong normative element in the definition of successful ageing. Successful, healthy and productive ageing are evaluated as the more desirable as â€Å"normal† or even â€Å"pathological† ageing processes. Most people want to grow old without being affected by chronic illnesses and functional disabilities. Despite the efforts are to increase the proportion of healthy life expectancy, a substantial part of the old, and the very old population will have to face dependency and frailty. Hence, attention have to be paid to the fact that normative definitions of â€Å"active ageing† should not lead to the degradation and a discrimination against individuals and groups who do not reach the positive goal of â€Å"active ageing†. (Fernà ¡ndez-Ballesteros, 2008). The WHO deà ¯Ã‚ ¬Ã‚ nition of active ageing was more inclusive in respect to dià ¯Ã‚ ¬Ã¢â€š ¬erent ageing trajectories and the diverse groups of older people: â€Å"Active ageing is the process of optimizing opportunities for health and participation and security in order to enhance quality of life of aged people† (WHO, 2002) The Regional Implementation Strategy for the Madrid International Plan of Action on Ageing, the UNECE members express their commitment to enhance the social, economic, political and cultural participation of the older people and also to promote the integration of older people by encouraging their active involvement in the community and by fostering intergenerational relations (UNECE, 2002). Old age often bring decreasing functional capacity and health problems which may affect the individual’s sense of wellbeing.The goal of health for the elderly in the society may not be free from diseases but the possibility of having a good life despite of illness are in decreasing capacities (Lawton, 1991; Nordenfelt, 1991b; Sarvimaki and Stenbock-Hult, 2000). The Quality of life of the people in a developed country with chronic health condition will have a lower impact rather than the patients with the same disease in a low income country where the resources to ameliorate the disability may be scarce. The subjective and the contextual nature of Quality of life inform the World Health Organization’s definition as: â€Å"an individual’s perception of his/her position in life in the context of the culture and value systems in which he/she lives, and in relation to his/her goals, expectations, standards and concerns† (The WHO QUALITY OF LIFE Group, 1995). Thus Quality of life reflects a extended view of subjective wellbeing and life’s satisfaction that encompasses physical and mental health, material wellbeing, interpersonal relationship within and without the family, personal development, work and activities within the communities, and fulfillment and active recreation (Niemi et al., 1988). There is an important consideration in studying the factors associated with the Quality of life of the elder persons is the multi-dimensional nature of the construct and the possibility that determines from one dimension may be different from those of the other dimension. (Patel et al., 2007). NEED OF THE STUDY Little is known about factors that determine the Quality of Life of the elderly persons living in the developing societies and who are undergoing rapid social changes. Quality of life has become increasingly important as an outcome in medical research. The influence of health status is often emphasized, but other dimensions are important. In order to improve quality of life, there is a need to know what people themselves consider important to their perception of quality of life. The studies that are conducted among the groups of elderly persons have shown that Quality of life and the subjective evaluation of the life satisfaction are determined by several factors (Jakobson et al., 2007). Other than the demographic features such as age and financially status, the health, including social support functional disability and networks are often found to be important in the elderly person’s assessment of their Quality of life. (Bowling, 1994;Low and Molzahn, 2007;Richard et al., 2005 ). Other than functional impairments and the health problems to which most of the elderly persons are vulnerable (Clark and Siebens, 1993), old age may also predispose to some social and economic problems. The ccess to health care is severely limited both by manpower and paucity of health facilities and by out-of-pocket payment arrangement. Traditional family support is decreasing and social network is dwindling as migration and urbanization take the young members of the family away. Social changes are also affecting the position of the elderly in the society and leading to a reduction in their social status and influence in the community (Gureje and Oyewole, 2006). All of these factors affect the Quality of life of elderly. (Hickey et al., 2005) Quality of life is the central concepts in the ageing research. Two different traditions can be distinguished in this respect: Concepts which define quality of life in terms of objective living conditions, and concepts which define quality of life in terms of subjective evaluation (Noll, 2010). Similar distinctions have been made in the context of social gerontology. Objective quality of life can be measured by the extent to which the elderly has access and command over the relevant resources like income, health, social networks, and competencies that serve the individuals to pursue their goals and direct their living conditions. Hence, objective quality of life is high in those cases where the health is good, income is high, social networks are reliable and large and the competencies as achieved by the educational status are high. Objective quality of life can be measured by the external observers (Erikson, 1974). Subjective quality of life, in contrast, emphasizes an individual’s perceptions and evaluations. Individuals compare their (objective) living situation according to different internal standards and values. That means the elderly people with different aspiration levels may evaluate the same objective situation differently. Subjective quality of life depends upon the individual person – and lies in the â€Å"eye of the beholder† (Campbell, Converse Rodgers, 1976). Hence, high subjective quality of life can be defined as subjective well-being (high life satisfaction on, strong positive emotions like happiness, and low negative emotions like sadness). Quality of life has become increasingly important as an outcome in medical research. The influence of health status is often emphasized, but other dimensions are important. In order to improve quality of life, there is a need to know what people themselves consider important to their perception of quality of life. The study was of 141 randomly selected people aged from 67 to 99 years that formed a control sample for a study of suicide among older people. They were interviewed in person about their health, socio-demographic background and, using an open-ended question, what they considered to constitute quality of life. Their answers were grouped into eight categories. In addition, they were asked to choose from a ‘show card’ three items that they regarded as important to quality of life. Functional ability was the most frequently selected domain, followed by physical health, social relations and being able to continue to live in ones present home. It was found that socia l relations, functional ability and activities influence the quality of life of elderly people as much as health status. ( Katarina Wilhelmson ,Christina Andersson, et al., 2004) Since 1970s cardiovascular disease is the leading cause of deaths worldwide, cardiovascular mortality rates have been declined in many high-income countries Age is an important risk factor in developing cardiovascular diseases, though it usually affects the older adults. It is estimated that 87 percent of people who die of coronary heart disease are 60 and older. â€Å"It’s important that this vulnerable group of people doesn’t get overlooked so that they are properly assessed and they receive the best treatments to improve their quality of life.† Newcastle University,British Heart Foundation, (Professor Bernard Keavney, July 25, 2012) A study wasrecently carried out376heart scans calledechocardiogramson 87- 89 year olds in their homes. The results revealed that around a quarter hadundiagnosed heart problemsand are missing out on treatments, which could improve their symptoms and theirquality of life. (Newcastle University,British Heart Foundation, Professor Bernard Keavney, July 25, 2012) The purpose of the present study is to identify the effectiveness of structured teaching program on awareness of quality of life among elderly patients with cardiac disorders, at GKNM Hospital, Coimbatore. The researcher strongly believes that, the result of the proposed study can be used to enhance nursing initiatives, and to establish a teaching strategy for elderly patients attending cardiac and cardio thoracic opd’s at GKNM Hospital and thereby improve their quality of life. STATEMENT OF THE PROBLEM A Study to Assess the Effectiveness of Structured Teaching Program on the Awareness of Quality Of Life among Elderly Cardiac Patients at G.K.N.M Hospital, Coimbatore. OBJECTIVES To assess the quality of life of elderly cardiac patients To assess the effectiveness of structured teaching program To find the association between the pre- test level of scores and selected demographic variables OPERATIONAL DEFINITIONS Effectiveness: It refers to the outcome of the planned teaching program in terms of awareness gained Structured Teaching Program: It refers to the systematic information provided to the elderly cardiac patients regarding quality of life. Awareness: It is the state or ability to perceive, to feel, and sense data confirmed by an observer. Quality of life: It is the personal satisfaction with the cultural or intellectual conditions under which a person lives. Elderly cardiac patients: Patients above 60 years of age and having cardiac disorders. HYPOTHESIS H0: There will be no significant difference between the pre-test and the post-test awareness scores of elderly cardiac patients regarding quality of life. H1: There will be significant association between the demographic variables and the pre-test awareness scores of elderly cardiac patients regarding quality of life. ASSUMPTIONS The elderly patients will not have adequate awareness regarding Quality Of Life. The structured teaching program will enhance the quality of life of elderly cardiac patients.

Mathematics in the Primary School

Mathematics in the Primary School Innumerate school children cost the taxpayer up to  £2.4bn a year. In 2007, Sir Peter Williams the then chair of the Advisory Committee on Mathematics Education (ACME), was commissioned to consider and make his recommendations in response to the teaching of mathematics in early years settings and primary schools, with a view to assessing and improving upon the current practices of mathematics teaching in early years settings (EYS) and primary schools (Adonis 2007). By examining the available evidence, drawing from the best practice nationally and internationally and by working closely with the teaching profession, the Williams final report was published in June 2008. By means of 10 recommendations the report identifies methods by which children in primary schools and early years settings can acquire a greater understanding of mathematics, and a greater appreciation of its importantance with relation to a successful progression through life during and after their school career is over. Through a high-quality curriculum and excellent teaching (Williams, 2008, p61), children should have confidence and feel comfortable with the concept of Mathematics within their day to day lives. In the following, I will explore the implications of the ten recommendations outlined in the Williams Report and will conclude with some reflection on the value of the report and the likely impact it will have on me as a trainee teacher. Recommendation 1 Considers the entry requirements necessary for Initial Teacher Training (ITT). GCSE Grade C mathematics continues to be the mandatory minimum requirement level. However the report argues that grade B in GCSE maths is desirable with the long-term ambition of the government initiative the Training and Development Agency for Schools(TDA), being for all Qualified Teacher Status (QTS) graduates to have reached Masters-level accreditation. However, this is currently deemed inadvisable given the possible risk of falling enrolment of trainee teachers A higher priority is given to teaching experience through teaching placements to increase the students pedagogical knowledge, Williams (2008, p7) states that, a combination of deep subject knowledge and pedagogical skill is required to promote effective learning, a view supported by the research body Mathematical Knowledge in Teaching (2007/2008). The evidence of good grounding in these two fundamental attributes shows; taken together they constitute a necessary condition to progress learning for all children up to the end of Key Stage 2, which prepares them well for Key Stage 3 ((Williams, 2008, p10). The only currently acceptable route to raising mathematical understanding is through properly funded and rewarded continuing professional development (ibid p 12) Q14, Q15, Q19, Q25a,b,c,d Recommendation 2 Local Authorities (LAs) are to continue to up-skill and increase the numbers of their Mathematic Consultants. A continued extensive budget is to be set aside by the Government for local LAs to implement this following the recommendations made by the Primary National Strategy (PNS) (via the National Numeracy Strategy (NNS)), and in partnership with the National Centre for Excellence in the Teaching of Mathematics (NCETM). This funding to be used to develop and track refresher Continued Professional Development (CPD) courses for all LA consultants, evidence being that since the introduction of the NNS, a transformation in the way mathematics is taught can be strongly correlated with the increase in the attainment levels of primary school children (ibid p 16). Q14, Q15, Q18, Q19, Q20, Q25a,b,c,d Recommendation 3 Every school should have at least one mathematics specialist present (or have access to one), whose initial objective is to raise standards and narrow attainment gaps. By utilising the highly-trained (circa) 400 LA Mathematic Consultants to their fullest, a phased proposal is given to have a Mathematical Specialist present in every school which will re-enforce the importance of mathematics within schools and enhance and allow flexibility for CPD provisions available to all teaching and support staff. Small and rural schools benefitting from pooled resources wherever possible. Many of these specialists could be sourced from Newly Qualified Teachers (NQTs) trained to a higher mathematical level through their ITT providers, and all specialists to be monitored by their respective head teacher. Q14, Q15, Q19, Q20, Q25a,b,c,d Recommendation 4 The Department for Children, Schools and Families (DCSF) is to commission a set of materials which will help early years practitioners understand the effect of childrens development as shown through their mathematical mark-making. The resulting report supports the introduction of childrens mathematical graphics (Worthington, M/ Carruthers, E, 2003), at the Early Years Foundation Stage (EYFS). The EYFS adheres to the principles of the central importance of creativity and critical thinking in early learning and development (Mark Making Matters, 2008, p2). By giving practitioners the tools to support and challenge a childs thought process through encouragement and understanding of the young childs mark-making, along-side open ended discussion (sustained shared thinking (Williams, 2008, p34)), the children will become confident and competent communicators, both orally and on paper, in all six areas of learning and development. (Mark Making Matters, 2008, p2) In relationship to mathematics, by encouraging a child to mark-make from a very early age, when children realise that marks can be used symbolically to carry meaning [] they begin to make marks as tools to make their thinking visible (ibid p3). Through drawing the child may develop their concepts in relationship to problem solving, reasoning and numeracy. The importance of the Early Years Practitioners taking the time to observe, listen and analyse childrens mark making in order to understand, praise and enrich the childs achievements (ibid p3), is affirmed. However, I must agree with the importance of a young childs mathematical understanding being developed through imaginative play and effective mathematical learning for children in this age group needs to be predominantly social in nature (Williams, 2008, p36). Q15, Q18, Q19, Q20 Recommendation 5 The forthcoming review of the EYSF in 2010 is to consider the inclusion of time and capacity which Williams feel were omitted when the statutory early learning goals set out in the Statutory Framework for EYFS: Learning and Development Requirements (DCSF 2006) were first developed. By using these two extra concepts along with those already required i.e., shape, space, measures along with the use of correct mathematical language, it would enable the child to apply their mathematical knowledge in practical and active ways (Williams, 2008, p36), whilst also enhancing the childs understanding of problem solving. The responsibilities of effective pedagogy for this remit falling to local authorities, leaders, managers and head-teachers. Q14, Q15, Q19, Q20, Q25a,b,c,d Recommendation 6 The DCSF is to continue to increase the amount of graduate practitioners going into Early Years Settings (EYS). The Childrens Workforce Development Council (CWDC) (2010), states High quality early years provision can have a significant impact on childrens development, performance at school and their future life chances (CWDC, 2010, Areas of Work- Early Years) and the early years workforce must be well qualified. (ibid) With reference to the Effective Provision of Pre-School Education (EPPE, 2004), the Millennium Cohort Study (MCS, 2005) and the evaluation of the Neighbourhood Nursery Initiative (NNI, 2000), it recognises the importance of having a good proportion of trained teachers on the staff. The recommendation being for one graduate early years professional per setting by 2010 and with provision for two graduates per setting in disadvantaged areas. A member of staff having Qualified Teacher Status (QTS) and a Graduate Early Years Practitioner who has a specialism in working with early years children could have the most benefit to most childrens development and learning. Standards could also be raised with additional funding given to implementing CPD within the Early Years Workforce where mathematics is given essential priority. It should however be noted that EYFS provisions are currently very erratic throughout the UK. Q14, Q15, Q18, Q19, Q20, Q25a,b,c,d Recommendation 7 Engaging the full understanding and commitment of participating children and their parents/carers before the onset of intervention, paying special attention to the integration of intervention in the class room and in a home-school partnership through official home-learning activities. Where research is undertaken, it is proven that the inclusion and understanding of parents/carers before the onset of intervention is paramount in guaranteeing programme success, and parents/carers could support their childs learning progress through official home-learning activities. Equally, children who understand exactly the nature of the programme show genuine delight in their progress and the importance of this factor should not be under estimated for a successful programme (Williams, 2008, p55). In terms of the integration of intervention, the DCSF National Strategy Standards (PNS) (1998) cites; Intervention is not just about additional out-of-class provision. It also includes reviewing what happens in class to make sure it is appropriately tailored to the needs of the children. Q14, Q15, Q18, Q19, Q20 Recommendation 8 The Wave 3 Intervention programme from The Every Child Counts (2008) initiative; a partnership between government, businesses and the charity Every Child a Chance (2007) aims to enhance achievement for approximately 5%-10% of children nationally who are failing to master the basics of numeracy (Adonis, 2007). Adonis (2007) states; there is no single cause of under-attainment and therefore no single answer'(ibid) It is best to summarise the implications, logistics and recommendations of wave 3 intervention in Year 2 as follows:- Intervention should be led by a qualified teacher on a 1: 1 teacher pupil ratio. The benefits of working in pairs or small groups should also be explored. The childs class teacher should be given responsibility to decide whether intervention is necessary. Investigation into of the efficacy of using video tapes for assessment and training should be undertaken. Diagnostic tools should be developed to aid teachers with assessment before intervention and monitor progress after leaving the programme, using for example, Assessing Pupils Progress (APP) and the Early Years Foundation Stage Profile (EYFSP). Intervention should ideally last for one term and be completed by the end of Key Stage 1. Where it is deemed that a child is in need of intervention for both literacy and mathematics, it is imperative that mathematics be given equal standing to literacy. A wide range of (potentially costly) multi-sensory resources should be made available, for example, Numicom and the interactive whiteboard, to enable the teacher and child to select the appropriate aid to their specific issue. CCD programmes should be developed for the teacher as intervention specialist and for LA intervention specialists. Currently there is only a small cohort of intervention specialists available. Combining the roles of intervention specialist and mathematics specialist should be considered through the pooling of resources wherever possible to limit cost implications. Teaching Assistants could be further trained to lead less intensive wave 2 and 3 interventions. A longitudinal study is to be carried out over the next 10-15 years to assess the success of the programme. Q14, Q15, Q18, Q19, Q20, Q25a,b,c,d Recommendation 9 and 10 Refer to the importance of continued building on the currently solid curriculum, with more prominence being given to use and application (Williams, 2008, p60) of Mathematics across all subjects and to give renewed focus to oral and mental mathematics. Q14, Q15, Q18, Q19, Q20, Q25a,b,c,d Conclusion In conclusion, the above discussion has demonstrated the key features of the Williams Report and has reflected on the implications of the report for EYP, strategies for intervention and the roles of the curriculum, training, accreditation, head-teachers and the family. I have demonstrated how the Williams Report has both drawn on existing regulations, recommendations, policies and practice but crucially, identified the weaknesses in existing legislation. For me the key strengths of the report lie in its emphasis on the role of teacher pedagogy and practice and the shared responsibility of the LAs with schools, in particular the head-teacher, and with the parent/carer. A key recommendation is being pro-active and understanding that every child matters. I feel the weaknesses of the report relate to its over-emphasis on high-levels of formal accreditation, which do not reflect an individuals natural gift to teach and which may jeopardise future recruitment. Of course, the question remains what the effect of recent government changes and the very real and imminent threat of public sector cuts will mean for the practical implementation of the Williams report recommendations.

The Depths of Fear: Peter Benchley Essays -- Authors

The world’s oceans, they cover a great majority of our planet. According to scientists, we know more about the surface of the moon than we do about what’s in the waters of our own planet. Even with advancing science we still don’t know very much about them. So imagine what it was like back around the 1970’s, it was already a time of great fear, and to some extent, paranoia in the United States with the threat of nuclear war and multiple other new threats emerging. Surprisingly, although it was known that there were dangerous things in the sea, nobody seemed to pay that much mind to it. All that changed when a man named Peter Benchley wrote a book called Jaws. This book, the resulting movie, and his literary works to follow opened up a new aspect that no one had ever thought of. It was a new breed of terror that came from the last place anyone ever had expected, the ocean itself. It is because of this book that Peter Benchley really became a household name. Born May 8th, 1940 in New York, NY he was raised in a family of writers. His father Nathaniel Benchley was a known writer of children’s books and his grandfather was a well-known humorist named Robert Benchley. He spent his childhood writing and even got paid in his teens to write during his vacations. He got a very formal writer’s education studying at Phillips Exeter Academy in New Hampshire and attaining his major in English from Harvard. He wrote a sort of autobiography of himself as his very first published book entitled Time and a Ticket in 1964. Before he even got to the ideas for the books he’s now famous for, he spent time in several other writing positions including some for the Washington Post, Newsweek, and he even served as a speech writer for President Lyndon B. ... ... over the course of his life, Peter Benchley passed away in February 2006, the legacy ending of the man who made generations afraid to get in the water. Works Cited Swann, Christopher. "Peter Benchley: Overview." Contemporary Popular Writers. Ed. Dave Mote. Detroit: St. James Press, 1997. Literature Resource Center. Web. 29 Mar. 2012 The Wilson Quarterly. 30.2 (Spring 2006) p120. Word Count: 155. From Literature Resource Center. "Peter Benchley." (2007): n. page. Web. 4 Apr. 2012. http://www.notablebiographies.com/newsmakers2/2007-A-Co/Benchley-Peter.html Benchley, Peter. The Beast. Random House, 1991. Print. Benchley, Peter. Shark Trouble. Random House Trade Paperbacks, 2003. Print. Benchley, Peter. White Shark. Random House, 1994. Print. "Biography for Peter Benchley." n.pag. Web. 5 Apr 2012. . The Depths of Fear: Peter Benchley Essays -- Authors The world’s oceans, they cover a great majority of our planet. According to scientists, we know more about the surface of the moon than we do about what’s in the waters of our own planet. Even with advancing science we still don’t know very much about them. So imagine what it was like back around the 1970’s, it was already a time of great fear, and to some extent, paranoia in the United States with the threat of nuclear war and multiple other new threats emerging. Surprisingly, although it was known that there were dangerous things in the sea, nobody seemed to pay that much mind to it. All that changed when a man named Peter Benchley wrote a book called Jaws. This book, the resulting movie, and his literary works to follow opened up a new aspect that no one had ever thought of. It was a new breed of terror that came from the last place anyone ever had expected, the ocean itself. It is because of this book that Peter Benchley really became a household name. Born May 8th, 1940 in New York, NY he was raised in a family of writers. His father Nathaniel Benchley was a known writer of children’s books and his grandfather was a well-known humorist named Robert Benchley. He spent his childhood writing and even got paid in his teens to write during his vacations. He got a very formal writer’s education studying at Phillips Exeter Academy in New Hampshire and attaining his major in English from Harvard. He wrote a sort of autobiography of himself as his very first published book entitled Time and a Ticket in 1964. Before he even got to the ideas for the books he’s now famous for, he spent time in several other writing positions including some for the Washington Post, Newsweek, and he even served as a speech writer for President Lyndon B. ... ... over the course of his life, Peter Benchley passed away in February 2006, the legacy ending of the man who made generations afraid to get in the water. Works Cited Swann, Christopher. "Peter Benchley: Overview." Contemporary Popular Writers. Ed. Dave Mote. Detroit: St. James Press, 1997. Literature Resource Center. Web. 29 Mar. 2012 The Wilson Quarterly. 30.2 (Spring 2006) p120. Word Count: 155. From Literature Resource Center. "Peter Benchley." (2007): n. page. Web. 4 Apr. 2012. http://www.notablebiographies.com/newsmakers2/2007-A-Co/Benchley-Peter.html Benchley, Peter. The Beast. Random House, 1991. Print. Benchley, Peter. Shark Trouble. Random House Trade Paperbacks, 2003. Print. Benchley, Peter. White Shark. Random House, 1994. Print. "Biography for Peter Benchley." n.pag. Web. 5 Apr 2012. .

The Empiricist Journey of Young Goodman Brown Essays -- Young Goodman

The Empiricist Journey of Young Goodman Brown  Ã‚     Ã‚  Ã‚   In the late 17th century, John Locke was one of the most influential people of his age. He was a renowned philosopher who established radical ideas about the political, social, and psychological ideals of mankind. One of his philosophical ideas, which he is said to be the founder of, is British Empiricism. This idea holds that "all knowledge is derived from experience whether of the mind or the senses" ("Empiricism" 480). In any man’s life, there arises such a point in time where he comes to the realization that there is a sense of evil in the world. Whether it is by something as subtle as locking the door at night before going to bed or being directly confronted at gun point as a man demands your tennis shoes, at some point man will realize that the innocence of his childhood does not last forever. Locke believed that people gain knowledge from their own personal experience. For Young Goodman Brown, this experience comes with his journey into the forest with the fellow traveler as chronicled in Nathaniel Hawthorne’s short story. Initially, Brown was, as his namesake foretells, a "young, good man" who believes in man’s basic goodness, yet within the inner desires of his heart wishes to see what all the world had to offer. Therefore, he set off on a "journey" into the forest to explore the world of this unknown evil. The story of "Young Goodman Brown" is a classic example of the empiricist ideas of Locke in how the intrigues of the unknown beckoned Young Brown as he experienced the transition between his initial idea of man’s basic goodness to the reality that evil exists in the heart of every man. However, before we can analyze Young Goodman Brown’s journey in the for... ...h he knows little about. Works Cited Brown, Vivenne. "The ‘Figure’ of God and the Limits to Liberalism: A Rereading of Locke’s ‘Essay’ and ‘Two Treatises’". Journal of the History of Ideas 60.1 (1999): 85. "Empiricism." New Encyclopaedia Brittanica. 1998 ed. Volume 4, 480. Hawthorne, Nathaniel. "Young Goodman Brown." The Compact Bedford Introduction to Literature. Ed. Michael Meyer. 5th ed. Boston: Bedford/St. Martin’s, 2000. 268-276. Locke, John. An Essay Concerning Human Understanding. New York: Penguin, 1974. Meyer, Michael, ed. "A Study of Three Authors: Nathaniel Hawthorne, Flannery O’Connor, and Alice Munro." The Compact Bedford Introduction to Literature. 5th ed. Boston: Bedford/St. Martin’s, 2000. 267. Tritt, Michael. "‘Young Goodman Brown’ and the Psychology of Projection". Studies in Short Fiction. 23 (1996): 113-117.    The Empiricist Journey of Young Goodman Brown Essays -- Young Goodman The Empiricist Journey of Young Goodman Brown  Ã‚     Ã‚  Ã‚   In the late 17th century, John Locke was one of the most influential people of his age. He was a renowned philosopher who established radical ideas about the political, social, and psychological ideals of mankind. One of his philosophical ideas, which he is said to be the founder of, is British Empiricism. This idea holds that "all knowledge is derived from experience whether of the mind or the senses" ("Empiricism" 480). In any man’s life, there arises such a point in time where he comes to the realization that there is a sense of evil in the world. Whether it is by something as subtle as locking the door at night before going to bed or being directly confronted at gun point as a man demands your tennis shoes, at some point man will realize that the innocence of his childhood does not last forever. Locke believed that people gain knowledge from their own personal experience. For Young Goodman Brown, this experience comes with his journey into the forest with the fellow traveler as chronicled in Nathaniel Hawthorne’s short story. Initially, Brown was, as his namesake foretells, a "young, good man" who believes in man’s basic goodness, yet within the inner desires of his heart wishes to see what all the world had to offer. Therefore, he set off on a "journey" into the forest to explore the world of this unknown evil. The story of "Young Goodman Brown" is a classic example of the empiricist ideas of Locke in how the intrigues of the unknown beckoned Young Brown as he experienced the transition between his initial idea of man’s basic goodness to the reality that evil exists in the heart of every man. However, before we can analyze Young Goodman Brown’s journey in the for... ...h he knows little about. Works Cited Brown, Vivenne. "The ‘Figure’ of God and the Limits to Liberalism: A Rereading of Locke’s ‘Essay’ and ‘Two Treatises’". Journal of the History of Ideas 60.1 (1999): 85. "Empiricism." New Encyclopaedia Brittanica. 1998 ed. Volume 4, 480. Hawthorne, Nathaniel. "Young Goodman Brown." The Compact Bedford Introduction to Literature. Ed. Michael Meyer. 5th ed. Boston: Bedford/St. Martin’s, 2000. 268-276. Locke, John. An Essay Concerning Human Understanding. New York: Penguin, 1974. Meyer, Michael, ed. "A Study of Three Authors: Nathaniel Hawthorne, Flannery O’Connor, and Alice Munro." The Compact Bedford Introduction to Literature. 5th ed. Boston: Bedford/St. Martin’s, 2000. 267. Tritt, Michael. "‘Young Goodman Brown’ and the Psychology of Projection". Studies in Short Fiction. 23 (1996): 113-117.   

Foreign Aid Speech

Australia's foreign aid should be reduced Today I'm bringing a serious subject that has Influenced the world and the development of countries around us into perspective. Foreign aid, and how the government should Increase It, but first we have to ask the question, â€Å"What Is foreign aid? ‘ Simply, It Is the economic, or military lad given by one nation to another for purposes of relief and rehabilitation, for economic stabilization, or for mutual defense. The 620 or group of 20 is the premier forum for its members' international economic cooperation and decision making.And their existence is more important than ever because the world's economy is in such a precarious state and so the decisions they make will be vital in the development of poorer countries. A part of this that people may not recognize is that when the economy is weak, the poorest countries suffer the most. $1 dollar can help a hundred people in a poor country more than it can help someone in a rich or develo ped country. Although we have stronger affinity towards our citizens and if money was equally effective we would whose our own citizens first, when it's 100 times more effective in impacting lives, then we think we're all human beings.The suffering of a mother whose child Is sick and might die Is a universal value. And If a dollar has so much Impact then I must ask you, not as a student, but as a fellow human: why are we all still so greedy? If I were to ask you what percentage of the federal budget is spent on foreign aid, would you be surprised that it is 0. 35%? That equates to $5. 44 billion dollars of our IN (gross national income) in 2012. The government expects to reach 0. 5% by 2017, but in recent media, Julie Bishop, the Minister of foreign affairs has implemented a cap of 5 billion dollars over the next two financial years.The promise Australia made with the UN along with many other developed countries, was an agreed 0. 7% of our countries IN. The 2014 Australian budget IS a broken election promise to the world's poorest people. The Abbott Government has torn up its promise to Increase aid. This year's budget, announced two days ago, shows that the Australian government Is cutting rut the most vulnerable members of the communities around the world. Every second we breathe, 30, 000 children under the age of five die from preventable diseases.It is made evident that Australia's contribution to alleviate poverty through overseas aid is successful. The average life expectancy of individuals living in developing countries has increased by approximately twenty years in the last decade, which is substantial in contrast to the figures fifty years ago. Vaunt has reduced the incidence of malaria by 80% with the support of Australian aid. It is a myth that reign aid doesn't work. 79% of Australians, according to the essential report, agree that the Government should reduce spending in foreign aid when 41% don't know what it Is.The ignorance surrounding foreign aid Is what potentates suffering of individuals living In developing countries. Australia Is already providing less foreign aid compared to other developed countries. We are ranked 1 13th. The Abbott Government's abolition of Causal, which manages our tax dollars for overseas aid, Is because they want to see a better alignment between aid, trade and diplomatic erection and aid programs going in another direction† yet there is no evidence for this. Aid vs.. Diplomacy is a false dichotomy.Helping neighboring countries develop strong economies means a better market for our own goods. Helping our neighbors improve their health systems means fewer health threats. Increasing the number of children in our region going to school reduces the opportunity for indoctrination in place of education. The success of our neighbors are good for us. In 2006 and 2007, Australia gave 2. 9 billion dollars through Said and in 2013, 2014, it grew to 5. 44 lion dollars, almost doubling the overseas as sistance.Now, the proportion of aid to IN is back to 2000, 2001 levels under Abbot's government, especially now that foreign aid will grow in line with the Consumer Price Index or inflation rate. With the help of global initiatives, the number of people living in poverty has fallen by 200 million people since 1980 and increasing. Australia shouldn't turn their back on the less fortunate as an affluent country. The children suffering every single day rely on our international aid. The government has slashed the foreign aid budget which asses many problems and places a strain on our relationship with other countries.If Australia works with the countries we're aiding, to redirect foreign aid funds to priorities assets, deregulate their economy and opened up their economy to global trade for economic growth, then the output of foreign aid would be effective in forming a sustainable economy and alleviating poverty. We should raise our Foreign aid budget to the agreed 0. 7% IN. Australia is a generous country, we can afford to provide aid to those in need and grow, not only as a country, but as humans of this earth.

Postpartum Stress Disorder Essay

The postpartum period has been defined as â€Å"a bringing forth of the period following childbirth† (Webster, 1988, p. 1055) or â€Å"occurring after childbirth or after delivery, with reference to the mother† (Doriand, 1988, p. 1343). In nursing or medical textbooks, the postpartum period is defined as â€Å"the 6-week interval between the birth of the newborn and the return of the reproductive organs to their normal non-pregnant state† (Wong & Perry, 1998, p. 480). However, Tulman and Fawcett’s (1991) found that the recovery of postpartum women’s functional status from childbirth takes at least 3 to 6 months. Webster’s Dictionary defines stress concretely as a â€Å"physical, mental, or emotional strain that disturbs one’s normal bodily functions† (Webster, 1997, p. 735). Stress is produced by stressors. Wheaton (1996) defines stressors as â€Å"conditions of threat, demands, or structural constraints that, by the very fact of their occurrence or existence, call into question the operating integrity of the organism† (p. 2). In addition, four characteristics of stressors are described: (1) threats, demands, or structural constraints; (2) a force challenging the integrity of the organism; (3) a â€Å"problem† that requires resolution; and, (4) â€Å"identity relevant† in threats in which the pressure exerted by the stressor, in part, derives its power from its potential to threaten or alter identities. Further, awareness of the damage potential of a stressor is not a necessary condition for that stressor having negative consequences; and a stressor can be defined bidirectional ly with respect to demand characteristics. That is, it is possible for both over-demand and under-demand to be stress problems (Wheaton, 1996). Accordingly, based on the above definitions of the postpartum period, stress, and stressors, postpartum stress is defined as a constraining force produced by postpartum stressors. Postpartum stressors are defined as conditions of change, demand, or structural constraint that, by the very fact of their occurrence or existence within six weeks after delivery, call into question the operating integrity of body changes, maternal role attainment, and social support. Due to its many adjustments, the postpartum period has been conceptualized as a time of vulnerability to stress for childbearing women (Too, 1997). Postpartum Period The postpartum period has been conceptualized by a variety of cultures as a time of vulnerability to stress for women (Hung and Chung, 2001). It is characterized by dramatic changes and requires mandatory adjustments that involve many difficulties and concerns, possibly leading to new demands, or structural constraints and, therefore, stress. All mothers face the multiple demands of adjusting to changes in the body, learning about the new infant, and getting support from significant others. For women going through this transition, it may be a uniquely stressful life experience. Several stressors specific to the puerperium as it exists in the literature have been identified. Those pertaining to body changes include: pain/discomfort, rest/sleep disturbances, diet, nutrition, physical restrictions, weight gain, return to prepregnancy physical shape, care of wounds, contraception, resuming sexual intercourse, discomfort of stitches, breast care, breast soreness, hemorrhoids, flabby subcutaneous tissue, and striae. Stressors pertaining to maternal role attainment include: concerns about infant crying, health, development, bathing, clothing, handling, diapering, night-time feeding, breastfeeding, conflicting expert advice, keeping the baby in an environment with a comfortable temperature, bottle feeding, appearance, safety, elimination, body weight, skin, baby’s sex, breathing, spitting up, sleeping, and cord care (Moran et al. , 1997; Too, 1997). Finally, those stressors pertaining to social support include: running the household, finances, perception of received emotional support, giving up work, finding time for personal interests and hobbies, father’s role with the baby, relationship with the husband, restriction of social life, relationship with children, and coordinating the demands of husband, housework, and children (Moran et al. , 1997). In addition, Hung and Chung (2001) shows that after childbirth women will encounter another type of stress during the postpartum period, which is characterized by dramatic changes and requires adjustment. Conditions of change, demand, or structural constraint may occur during these dramatic changes, creating many difficulties or concerns. Therefore, in addition to general stress, postpartum stress is induced after delivery during the postpartum period. Postpartum Stress Disorder Postpartum Stress Disorder (PSD) is the most serious, least common, and most highly publicized of the postpartum mood disorders: mothers with PSD have killed their infants and themselves. It is on the extreme end of the postpartum continuum of mood disorders (Nonacs, 2005) and attention to symptoms is vital for any postpartum support program. The treatment issues will not be fully discussed here because of their specialty and complexity. However, it remains a primary function of the service delivery to recognize symptoms and refer appropriately for specialized psychiatric care and management. A sensitive, direct question such as, â€Å"Some women who have a new baby have thoughts such as wishing the baby were dead or about harming the baby; has this happened to you? (Wisner, et al. , 2003, p. 44), is an essential element of postpartum evaluation and Wisner and colleagues (2003) have suggested that this question be asked of all postpartum women. PSD is a rare, severe disorder with a prevalence of one to two cases per one thousand births (Seyfried & Marcus, 2003). Symptoms are abrupt and often occur within 48 hours of delivery but can be delayed as long as two years (Rosenberg, et al, 2003). Typically, however, symptoms occur within the first three weeks, and two thirds appear within the first two weeks postpartum (Chaudron & Pies, 2003). Symptoms include mood lability, distractibility, insomnia, abnormal or obsessive thoughts, impairment in functioning, delusions, hallucinations, feelings of guilt, bizarre behavior, feelings of persecution, jealousy, grandiosity, suicidal and homicidal ideation, self-neglect, and cognitive disorganization (Wisner et al. , 2003). Women with PSD who harbor thoughts of harming their infant are more likely to act on those thoughts (Wisner et al. , 2003). Because of the severity of the illness and significant concern for the safety of both the infant and the mother, PSD is considered a psychiatric emergency and hospitalization is necessary. Etiology of PSD There has been some debate about the etiology of PSD. As noted previously, the incidence is approximately one or two women per one thousand births. This rate has remained unchanged for that last 150 years (Wisner et al. , 2003). In cross-cultural studies the rates for PSD are similar to those reported in the United States and the United Kingdom. These findings suggest a primary etiologic relationship between PSD and childbirth, rather than psychosocial factors (Wisner et al. , 2003). O’Hara (1997) has noted that women are 20 to 30 times more likely to be hospitalized for PSD within thirty days after childbirth than at any other time during the life span, leading him to speculate, with little doubt, that for women there is a specific association between childbirth and PSD. There are subgroups of women who may be more likely to develop stressful symptoms after delivery. Primaparas appear to have a higher risk for c than multiparous women (Wisner et al. , 2003). This may be the result of an undiagnosed bipolar disorder. Women with a history of bipolar disorder or PSD have a 1 in 5 risk of hospitalization following childbirth (Seyfried & Marcus, 2003). The overall pattern of symptoms described as PSD suggests the illness is on a continuum of bipolar mood disorders (Wisner et al. , 2003). The clinical presentation of PSD is often very similar to a manic episode (Seyfried & Marcus, 2003). Affective disturbances may be depressive, manic, or mixed (Chaudron & Pies, 2003). While there is no typical presentation, women often display delusions, hallucinations, and/or disorganized behavior. Delusional behavior often revolves around infants and children, and these women must be carefully assessed because thoughts of harming their children are sometimes acted upon (Chaudron & Pies, 2003). The predominant affective symptom in those postpartum women who commit infanticide, filicide, or suicide is depression rather than mania (Chaudron & Pies, 2003). In reviewing the connection between bipolarity and PSD several studies have shown evidence for a link in four areas: symptom presentation, diagnostic outcomes, family history, and recurrences in women with bipolar disorder (Chaudron & Pies, 2003). The relationship to bipolar disorder is considered quite persuasive and it has been suggested that acute onset PPP be considered bipolar disorder until proven otherwise (Wisner et al. , 2003). However bipolarity does not account for all cases of PSD and a meticulous differential diagnosis is mandatory for those women with presenting stress symptoms. A careful checking of the patient’s history for previous manic or hypomanic episodes as well as any family history of bipolar disorder is important in order to rule out bipolar disorder. Organic causes contributing to first onset PSD need to be examined and ruled out. These include: tumors, sequelae to head injury, central nervous system infections, cerebral embolism, psychomotor seizures, hepatic disturbance, electrolyte imbalances, diabetic conditions, anoxia, and toxic exposures (Seyfried & Marcus, 2003). Of special consideration in postpartum women is thyroiditis. This is relatively common in postpartum women and usually begins with a hyperthyroid phase progressing to hypothyroidism. In either phase PSD can occur (Wisner et al. , 2003). Obtaining serum calcium levels is important to rule out hypercalcemia for patients displaying PSD symptoms (Wisner et al. , 2003). Sleep loss resulting from the interaction of various causes may be a pathway to the development of PSD in susceptible women (Wisner et al. , 2003). The later stages of pregnancy and the early postpartum period are associated with high levels of sleep disturbance. This seems to be more prevalent in primiparous women than in multiparae. Historical and contemporary studies have noted that insomnia and sleep loss are significant and early symptoms of PSD. The rapid and abrupt changes of gonadal steroids after delivery and the evidence that estrogen has an effect on mood and the sleep-wake cycle (Wisner et al. , 2003) suggest an interaction between hormonal fluctuations, sleep loss, and the onset of PSD. Treatment of PSD PSD is a severe illness and should be considered a psychiatric emergency requiring hospitalization (Rosenberg et al. , 2003). The stigma attached to mental illness and especially to mothers who may harm their infants and themselves, often prevents women and their families from seeking help. PSD is often marked with periods of lucidity that can fool those close to the mother and health care professionals. Because of the complexity of the diagnosis and treatment, referral to a psychiatric specialist is required and formal treatment is beyond the scope of this program. However, it will be necessary to recognize symptoms and be cognizant of risk factors, such as history of bipolar disorder or previous PSD. Such awareness is essential, as is the readiness to offer support until adequate services can be implemented (Wisner et al. , 2003). Prevention of PSD is unclear, but early identification of a history of bipolar disorder and/or previous PSD would be an element of a comprehensive postpartum program. Prenatal education describing symptoms is an important aspect of a proactive approach to postpartum care. Part of the prenatal and postpartum educational effort will include urging women to share any bizarre thoughts and fears with their health care professionals and families. New mothers experiencing insomnia will be encouraged to seek assistance from their physicians and to engage other family members to care for the infant during nighttime feedings (Wisner et al. , 2003). As noted earlier, specific treatment is beyond the scope of this program, but a proactive approach to early identification and recognition of unusual thoughts, feelings, and experiences may help to initiate treatment and avoidance of tragic results. Conclusion During the postpartum period, women are immersed in the realities of parenting and coping with balancing their multiple roles (e. g. , wife, mother, and career woman). However, women frequently report difficulty in adjusting to the needs of the baby and other children, difficulty with housework and routines, concerns over support to cope with family needs, and concerns over weight gain and body changes. Accordingly, postpartum stress has an important role in a woman’s life and influences her health status, both physical and mental.