Giving Up Smoking in Pregnancy

Giving Up Smoking in Pregnancy Health Promotion:SMOKING Giving up Smoking in Pregnancy Introduction The object of this assignment is to critically appraise a health promotion initiative related to midwifery practice. The initiative chosen Introduction The object of this assignment is to critically appraise a health promotion initiative related to midwifery practice. The initiative chosen is a NHS Health Scotland leaflet entitled Smoking: giving up during pregnancy: a guide for pregnant women who want to stop smoking (NHS Health Scotland 2003). It will be referred to as the initiative or the leaflet throughout this assignment. The World Health Organisation (WHO) identified that health promotion was a way of equipping people to have more power enabling them to make choices in regard to improving their well-being (WHO 1986). Ewles and Simnett (2003) determine from this, that the fundamental elements of health promotion are improving health and empowerment. The Scottish Office paper Towards a Healthier Scotland (1999) recommended making more health promotion available for pregnant smokers. This appraisal will systematically review the literature relating it to the health promotion initiative chosen using Ewles and Simnett (2003) Five Approaches to Health Promotion model. It will furthermore evaluate the midwifes role in promoting the issue highlighted and conclude with a summary and any proposals to improve future practice. Critical Appraisal The Scottish Office paper Towards a Healthier Scotland (Scottish Office 1999) recommends reducing the numbers of women smoking during pregnancy from 29% to 20% in the next 5 years. According to the Health Education Authority (1999) the rate for smoking in pregnancy in the UK was 30% however nearly 90% classified smoking as dangerous to their unborn child. Johnston et al (2003) point out that smoking is the main preventable cause of disease and disability in the fetus and newborn. Around 13 000 individuals die from smoking in Scotland each year (NHS Health Scotland and ASH Scotland 2004a). This initiative is based on the normative needs concept as it is influenced by expert opinion and government policies (Ewles and Simnett 2003). Epidemiological evidence in its favour allows the initiative to be evaluated by reduction in the mortality and morbidity (Naidoo and Wills 2000). This is cost effective because the initial resources for implementing the smoking cessation will be significantl y less than the cost of hospitalisation later in life (NHS Health Scotland and ASH Scotland 2003). The leaflet that will be critiqued (appendix 1) is aimed at pregnant women who currently smoke but who want to give up. It is split into five sections titled: pregnancy and smoking; stopping smoking; tips for stopping; stopping smoking is worth it and thinking about your smoking. The Ewles and Simnett (2003) model comprises of five approaches to health promotion; medical approach; behaviour change approach; educational approach; client-centred approach and societal change approach. The behaviour change approach is the main focus for this initiative, although it does utilise aspects of all approaches. The behaviour change approach as described by Ewles and Simnett (2003) is a way of encouraging changes in an individuals attitudes and beliefs to take up a healthier lifestyle. It is, however considered by some, to be more forceful depending on the degree of encouragement and persuasion utilised (Crafter 1997, Norton 1998). The behaviour change approach uses a number of models to guide health promoters to facilitate clients to achieve a positive outcome. The Stages of Change Model (Prochaska and DiClemente 1984 as cited by Ewles and Simnett 2003) is a five stage cyclical model that has been found to be particularly useful in work with addictive behaviours (Naidoo and Wills 2000). This cycle incorporates a pre-contemplation stage where the individual is unaware of any need for change or has no interest in changing (Ewles and Simnett 2003). At this stage the midwife would assess whether the woman is genuinely not interested in stopping smoking at present and respect this decision but inform her she will be asked throughout her pregnancy about her smoking status (Crafter 1997, Dunkley 2000). The leaflet may still be issued as having the information readily at hand may prompt the individual to think about stopping smoking. The advantages of leaflets mean they allow individuals to read through them at their own pace (Ewles and Simnett 2003). The second stage is the contemplation stage where the individual is motivated to consider changing their behaviour, maybe she reads the leaflet and attempts to seek information (Naidoo and Wills 2000). The role of the midwife at this stage would be to determine why the woman smokes and what barriers she may face in stopping smoking (Dunkley 2000). The leaflet facilitates this by allowing the woman to question why she smokes and how she feels about it. It also seeks to establish what the woman feels is good and bad about smoking and how she anticipates changing her behaviour towards smoking. It has been suggested (McLeod et al 2003) that some midwives find it difficult to broach the subject of smoking particularly with women who have no desire to stop and those who are still considering stopping. However McLeod et al (2003) found from their qualitative study that women expected to be asked about smoking during routine antenatal care and indeed they felt it was part of the midwives rol e to ask. The preparation stage is where the woman is committed to giving up smoking. She may seek extra help and is likely to attempt change soon (Dunkley 2000). If the woman is in this planning stage she may benefit from smoking cessation services, which the midwife can offer such as Smokeline, or other local services. Within the leaflet is a free phone number for Smokeline (HEBS 2003) who offer advice and issue the booklet Aspire to Stop Smoking (HEBS and Action on Smoking and Health Scotland 2001). This supporting information helps the woman to discover what she can do to help herself to stop smoking. NHS Health Scotland and ASH Scotland (2004b) challenge the reliability of answers to questions Midwives and other health promoters may be asking individuals with regard to their interest in stopping smoking as that individual may feel that agreeing is what is expected. Hesitancy in answering may be indicative of reluctance to commit to stopping at present, so ensuring they understand that the re are many options available in the future can enhance the chance of them stopping (NHS Health Scotland and ASH Scotland 2004b). The midwife would continue to support the individual during this time offering advice and encouragement (Crafter 1997) and also would remind the patient of the importance of social support from partners and friends (NHS Health Scotland and ASH Scotland 2004b). The findings from a study by McLeod et al (2003) concur with the need to have partner involvement. They found that although the women were supported by the midwives there was a failing in educating the partners to the womens needs while trying to stop smoking (McLeod et al 2003). Moreover Thompson et al (2004) would like to see this expanded out with the antenatal setting. This issue has been addressed in part by the initiative, which encourages the woman to seek partner involvement to support her at this time (HEBS 2003). The penultimate stage is the making the change stage this is when the woman is taking action (Naidoo and Wills 2000). NHS Lothian (2002) supports making a date to stop and sticking to it. One of the options is nicotine replacement therapy (NRT), which has caused debates over its place in smoking cessation during pregnancy (Dunkley 2000, McNeill et al 2001). McNeill et al (2001) found that using NRT, although not recommended in pregnancy, could be beneficial, as all the pollutants from actual cigarettes would not be delivered to the mother or the fetus. The final stage is the maintenance stage. It is vital that the midwife maintains good support through the postnatal period as Pollock (2003) found that 60% of women who give up during pregnancy restart smoking within 1 month of birth. Encouragement from the midwife to eat a sensible a diet (Crafter 1997) and use diversionary tactics like regular brushing of teeth and saving cigarette money up for treats (NHS Lothian) helps the woman to stay stopped. The leaflet in its favour mentions how other smokers managed to stop and what they have done to help themselves. In this final stage there is room for relapse or slipping. The leaflet lets individuals know it is ok to relapse but encourages them to learn from this. It also mentions some of the side effects that women may experience from nicotine withdrawal. The medical approach to health promotion aims to ensure individuals are disease and disability free (Ewles and Simnett 2003). This approach could be viewed as paternalistic, where professionals decide what is best for an individual (Crafter 1997) and as pregnancy is not a state of ill health (Dunkley 2000) it brings into question its validity in midwifery care. However women could jeopardise the health of themselves and their unborn child if they are involved in risk taking behaviour such as smoking during pregnancy. The initiative mentions some of the health risks involved such as miscarriage and low birth weight babies (HEBS 2003) but favourably does not go into detail to avoid victim-blaming. Within the medical approach such initiatives as General Practitioners or other health professionals advocating smoking cessation during consultations is found to be more useful than no mention at all (HEBS 1998) resulting in approximately 2% of smokers stopping long term. Recommendation 1.2 o f the Smoking Cessation Guidelines for Scotland (NHS Health Scotland and ASH Scotland 2004a) states that a midwife should ascertain a patients smoking status and discourage them from smoking at the earliest opportunity. The midwife should also offer support and treatment to aid cessation (NHS Health Scotland and ASH Scotland 2004a). Crafter (1997) identifies the need for midwives to give unbiased information, however justifies the obligation to educate women about damaging behaviour such as smoking during pregnancy. Facts specific to smoking in pregnancy are not included in the leaflet such as smoking in the first 3 months of pregnancy accounts for a quarter of low birth weight babies (Scottish Executive 2001). An educational approach to health promotion is giving individuals information to discover the health benefits or detriments for themselves (Ewles and Simnett 2003). Crafter (1997) argues that there can be no true educational approach when it comes to smoking in pregnancy because midwives would be unable to remain neutral due to the fact that evidence is available that clearly shows smoking is detrimental. Naidoo and Wills (2000) explain that the educational approach differs from the behaviour change model, as the educational model does not use encouragement to achieve its aims. NHS Health Scotland and ASH Scotland (2004b) concur with this view advocating that it is not the role of the midwife to persuade but to inform. They go on to defend the use of facts in conjunction with the leaflet. The National Institute for Clinical Excellence (2003) also emphasise the need for women to be informed of the risks, which can make a purely educational approach unattainable in relation to smoking cessation. The information could be available to patient who enquire about if for them to discover the advantages and disadvantages for themselves with the midwife advising them of where to find resources. In a study by Pullon et al (2003) it showed how suitable resources helped educate women to stop smoking. Critically however it appeared that the midwives concerned were involved in a more behavioural change role as then conclusion commented on the midwives powerful influence (Pullon et al 2003). The client-centred approach facilitates health promotion of things that the client feels will be of benefit (Ewles and Simnett 2003), this could mean that an individual may not consider that smoking cessation is an issue they want to address and as such the topic may never be discussed. This model is said to facilitate autonomy (Dunkley 2000) but as such the leaflet may never be looked. If however the client felt that smoking cessation was something she was interested in, the midwife would be able to offer any help that was available to her to empower the woman to achieve her objective (Crafter 1997). The societal change approach focuses on changing the whole society not just individuals within it (Ewles and Simnett 2003). Implementation of changes at community level or above looks to bring about changes to the attitudes and beliefs about smoking during pregnancy to the population. This would include laws such as that to be introduced in spring 2006 banning anybody smoking in enclosed public spaces in Scotland (Scottish Executive 2004). The majority of pregnant smokers are age 16-24 and low socio-economic groups highlighting the important fact that deprivation and inequality increase the incidences of smoking and of teen pregnancy (Lazenbatt et al 2000, NHS Health Scotland and ASH Scotland 2003). Conclusion Midwives play an important role in promoting the health and wellbeing of individuals and their families and delivery of health education (Scottish Executive 2001). The initiative appeared to have some weaknesses as a stand-alone leaflet, however as part of a multi-dimensional approach it emerged favourably. The midwife must endeavour to gain trust and support to deliver the required service and promote empowerment (Dunkley 2000). She must take care not to alienate the women that require her help. There must be a trusting relationship built up between the midwife and the woman to achieve a positive outcome. Approximately 20% of smoking mums give up during pregnancy and of them over 50% who gave up attributed it to being pregnant (HEA 1999) this indicates further that women want to stop and indeed manage successfully to stop smoking.

Future Of Army Aviation History Essay

Army air power is an of import combat plus for land commanding officers and it is apparent that it will go on to be in high demand into the foreseeable hereafter. From a wide position, they are charged with overarching missions of continued support for the land forces, and at the same clip position itself for the hereafter. The demands will merely go more complex in the modern battleground and we merely can non afford to retain bequest systems, processs and constructions simply because they have existed for decennaries and are familiar. However, integrating of lessons learned will emphasize beyond current capablenesss and beat up the cardinal capablenesss needed to back up land commanding officers without break or debasement to mission capableness.Pasts to Show DevelopmentsThe Gallic were the first to utilize balloons for aerial reconnaissance during conflict in 1794[ 1 ]and so by the Austrian ground forces in 1849.[ 2 ]The roots of Army Aviation can be traced back to 1861 and the fo rmation of the Civil War-era Balloon Corps which pioneered the missions of reconnaissance and heavy weapon staining. The coming of Airpower in the twentieth century revolutionised warfare and it was realised by the land forces that there were excessively many undertakings to be performed in a battleground. British Royal Air force had taken an approximate of 14,678 exposures and helped run heavy weapon on to another 9,539 marks[ 3 ]during World War I itself. Between World War I and World War II, while the Air Forces of the universe were concentrating on increasing capablenesss for what had become their primary missions – strategic bombardment, air-to-air combat and near air support[ 4 ]– the Artillery was experimenting with utilizing smaller, unworldly aircraft for accommodation of heavy weapon fire. These aircraft were flown and maintained by heavy weapon forces to make the same mission as the Balloon Corps of the Civil War.[ 5 ]They were basically light roadster aircraft which could run from short semi-prepared strips and therefore non dependent on prepared tracks. Artillery ranges were relatively limited and hence it was possible to set about heavy weapon staining and fire rectification from an aerial platform winging over enemy district. Anti- aircraft arms and air defense mechanism system were crude. Such aircraft could so of course execute communicating responsibilities and be at the disposal of field commanding officers. Fixed-wing aircraft started to alter with promotion in engineering. Artillery ranges increased and it became apparent that observation even with optical AIDSs was falling out of the scope and outlook, and so did the gait of operations where the majority of heavy weapon pieces could non fit the tally of armored formations.[ 6 ]Besides, indirect fire against conflict armored combat vehicles had proven to be uneffective. In fact, coming of low degree radio detection and ranging coverage besides narrowed the operational envelope of such aircraft. Operationalisation of the rotary wing aircraft brought in the advantage of close contact operations even in confined infinites. For the most portion, United Nations Command during the Korean War fought with World War II arms with one noteworthy exclusion. Helicopters were used non merely for battlefield observation but besides for conveyance of work forces and supplies and emptying of the hurt. There was no more abiding image of the Korean War than a chopper evacuating the hurt and set downing at Mobile Army Surgical Hospital ( MASH ) ) . In crisp contrast, the Chinese and North Korean medical emptying system about collapsed by early 1951 because they relied on route and rail which was delay- prone and immensely clip intensive.[ 7 ] Army choppers were sent to Vietnam to increase mobility and local fire, and better over the construct of keeping inactive defensive places.[ 8 ]The construct of air mobility has, of all time since, remained attractive to ground forcess ‘ universe over. Developments in guided missiles led to the combat function of ground forces from the air including the aspect of air-to-air combat. This was concurrent with supplying foot a platform to run from the 3rd dimension. The kernel in application of force during the 1980s in Afghanistan was heavy trust on aerial warfare, airborne military personnels and extended usage of armed choppers. However, dark and adverse-weather operations were about ne'er attempted, even when air support was severely needed by military personnels in trouble.[ 9 ]They were besides used in concurrence with conventional arms dwelling of armored combat vehicles ( T-72 ) and artillery guns ( 152mm automotive Mortars ) . The experience in Chechnya was slightly different from the erstwhile construct. Helicopters were now progressively being utilised chiefly for non-combat missions[ 10 ]and about 90 per cent of the wounded were evacuated by choppers.[ 11 ]This gave adequate grounds of the built-in potency to put to death combat support operations including medical emptying responsibilities, and combat hunt and deliverance.The Future: Particular Focus and Relevant IssuesWhat has now become Army Aviation was born and derived from an incontrovertible demand in the tactical sphere necessitating built-in intimate support from the air. With the addition in denseness of air vehicles and those envisaged to busy air space, which includes missiles and remote-controlled flights, the public-service corporation and keeping of ground forces air power equipped chiefly with rotary winged aircraft could good be contended. The relevant issue of aiming is an of import aspect in warfare. Ability to execute on nap-of-the-earth ( NOE ) winging which is virtually a proprietary claim, ability to vertically emerge from behind screen or obstruction, reconnoitre and even fire to destruct are inevitable chases and demand to retain the film editing border on a front line. When pitted against armor, and little and traveling marks the quandary of pin-point aiming from a fixed-wing tends to be aggravated. An appraisal of what is likely to act upon the battle-space in hereafter will acquire us to an understanding sing the figure of battling elements in struggle. This raises an issue of vulnearbility. High denseness of guided and unguided missiles with land forces create greater challenges of placing unexposed enemy and increased hazard of ain exposure to hostile fire. While defensive warning systems will help in countering air defense mechanism steps of the enemy, exposure to innocuous little weaponries fire can turn out to be deadly to low-flying aircraft. However, an nonsubjective appraisal would put the ground forces chopper in a better place to maneuver in and out of unsure missions in enemy district. The Forward Air Controller ( FAC ) takes charge of placing, turn uping and bespeaking the mark to the pilot in the combatant land onslaught aircraft, when considered indispensable. Immediate work stoppages are basically the same except that call for fire is handled by wireless and expedited through the system of field force as an immediate response. Army aeronauts executing the undertakings of FAC in such scenario will necessarily be capable to the clash expected from ‘unseen ‘ marks from a combatant aircraft winging at far greater velocity and at a different tallness set. There will be an increasing diffusion of the conflict infinite non depicted on the operational map. It will be an inevitable characteristic for the FAC to be besides considered a relevant mark to be ambushed at the earliest.[ 12 ] The dimensional enlargement with regard to use of air space would convey about the complex job of control and co-ordination of the air and land operations. While battlefield radio detection and rangings assist in air infinite direction the ability to widen their full spectrum of maps to moo winging aircraft at 30 meters above land degree ( AGL ) and beyond 50 kilometers from base will stay a primary concern. While the bid and control of land operations by the ‘war-managers ‘ can be effected by commanding officers being close to the military personnels, control of the air space assumes a complex and gigantic challenge. Operationalisation of Integrated Air Command and Control System ( IACCS ) with automated response may non be able to supply an full control over all air vehicles runing beyond ocular scope. The radio detection and rangings and bid Centres besides would be primary marks for hostile air power and enemy counter steps wanting suppression, hence the effectual bou nd of clip critical aid to army air power missions over significantly more strategic enterprise, will name for witting rating. Airspace direction and early warning are of import facets of support in combat. The flight profile of choppers by and large makes it hard for land radio detection and ranging to observe and prosecute them with anti-craft guns in good clip[ 13 ]but with Aerostats[ 14 ]and AWACS[ 15 ]in operational usage, sensing may non be the issue but designation will still stay a contention in a dense winging environment. It was by and large expected that in instance of war between NATO and Warsaw Pact forces, every bit many as 33 per cent aircraft losingss would be accounted for by friendly fire within the first 24 hours.[ 16 ]In the 1982 Lebanon War abrasion rate was imposed at an equal rate by friendly forces as compared to hostile action.[ 17 ] Dichotomies will ever be in the use of this elect corps equipped with various winging machines. A study was submitted during the Vietnam intercession sing task public presentation of UH-1E enlisted for public-service corporation missions during the period July 1966 to June 1967: – Administration/Liaison 5579 Tactical Air Controller ( Airborne ) 1086 Casualty emptying 1109 Command and Control 1099 Search and Rescue 116 Reconnaissance 1756 Entire 10745 The startling information was so announced. In add-on, to the flights listed another 19597 missions had been flown as armed choppers.[ 18 ]This gets interpreted as a listed vision runing from combat, combat support and combat service support operations the in use spectrum exposed to excessively accent on subjective readings of use. Similar illustrations are by far and many, and tendencies have non changed well. Army gunships besides tend to be overused and misused. In a survey conducted by BDM Corporation it was analysed that the land forces become quite fond of them and at critical times on occasion employed them in stead of tactical air and heavy weapon.[ 19 ] Technological progresss, nanotechnology and growing of digitization are altering constructs in modern warfare. While it may be hard to foretell the gait at which hereafter warfare will be contested, the common factor will be the functions that army air power will be required to execute. These will non be really diverse from what they are expected to and presenting today but will acquire combined with other platforms of the present and future coevals. This brings about the integrating of UAVs ( Unmanned Air Vehicles ) with functions and capablenesss of ground forces air power. It besides brings about the issue of sharing air infinite with these remote-controlled platforms without cut downing denominators to built-in undertakings. Tube launched and catapulted UAVs and micro aerial vehicles ( MAVs ) underscore the demand of a greater degree of planning and co-ordination for the land forces in the direction of their portion of ‘near-space ‘ 30-100 meters from land. At the sam e clip, ability to aim with remote-controlled aid and precise striking with human capacity for real-time analysis and prioritisation would further distinguishable possibilities of a higher grade of truth and efficaciousness. The ground forces believes combat as cardinal to war, and shutting with and destructing the enemy as cardinal to battle with all other elements in support, and air power being the manoevre component in such support. It is besides accepted that ground forces air power is really limited in its ability to execute interdiction missions and close air support which should be the duty of the Air Force. Therefore, doctrinally and besides practically the fixed flying assets of the ground forces would hold really limited public-service corporation except for possibly limited transit and communicating undertakings. However, we may see an addition in their Numberss alternatively when the issue of ‘hearing ‘ a chopper winging in a vale or in cragged terrain from stat mis, is evaluated. Besides, with comparative lower operating costs, initiation and use of fixed wing aircraft besides proves good in reconnaissance, current situational air exposure including transit where frontward set downing strips license. The reappraisal of tilt rotor V-22 Osprey aircraft were encouraging boulder clay weighed against a measure of $ 100 million per unit, missing manoevreability, slow descent and limited protection.[ 20 ]Operating such aircraft from the field and holding to be concerned with tactical scattering, disguise, enemy state of affairs, assembly country security, land to land every bit good as land to air communications jobs, and keeping aircraft from a field environment should, nevertheless, non be overlooked. Factors that contribute to the operational attraction of these aircraft are by and large associated with an airbase substructure and possible menaces near the landing evidences require active consideration. Military attempt is frequently directed at the high ranges of mountains. Whether it be contending in Afghanistan or keeping land in the Himalayas, a major part of struggle is witnessed in higher heights and therefore the operational bounds of public presentation demands critical rating both in footings of systems in usage and bounds of human endurance. Any troop carrying attempt or heavy armory would connote sulky manoevreability at that height. Army air power assets would however supply first-class properties in helping logistical and support steps including manned surveillance and reconnaissance. Tacticss and equipment will necessitate to be tailored to the different demands of mountain warfare.[ 21 ]This aspect requires more focal point as conditions in the higher ranges of the Himalayas are alone to us. Success or failure of a military operation will frequently be determined by the velocity with which the needed forces can be manoervred and moved into place at such high heights. Planing would besides necessitate to take history of the predominating air state of affairs ; due to their increasing function there will be marked exposure of ground forces air power aircraft from enemy air action. A favorable air state of affairs may good go an indispensable requirement for the employment of such assets in most operational scenarios. Military work stoppage for immediate success and consequence may ensue on a measured usage of Particular Forces ( SF ) . This would intend interdiction behind enemy lines fleetly and exactly at the same time with application of airpower for strategic surgical consequence and SF units for operational degree ends. This would ask the expedience of ground forces air power for rapid troop interpolation and unsnarling on completion of mission. At the conventional degree it would necessitate the enemy commanding officer to deploy military personnels in larger step for protection of their rear countries. Nuclear arsenal with states in struggle influences responses. Rise to the atomic threshold is an implied and immediate response, whether or non existent struggle takes topographic point.[ 22 ]Troop motion and application in a atomic battleground has been thought through the old ages, to be better feasible with choppers when clip is a premium, than any other manner.[ 23 ]Armored bearers with NBC protection have been evaluated as utile but ability to transport both military personnels and arms in a atomic battleground with just velocity and able to concentrate from spread landings is a characteristic acknowledged while sing tactical mobility in affected countries.[ 24 ]Survey and inert reconnaissance squads can be transported and commence operation within 15 proceedingss in the contaminated countries[ 25 ]provided the environment remains contributing for winging.[ 26 ]The bounds of survivability of aircraft and equipment in the presence or deficiency of field munitions when runing off from lasting air bases, and that of air power crew will necessitate rating exercisings. Army air power has found increased applications through the old ages and have become indispensable to many types of military operations. Helicopter support can be decisive when used rapidly to counter an enemy ‘s motion or when used to work success. Responsiveness means control, and control demands to be shifted to a lower degree for the chopper assets to do their full impact.Closing IdeasGiven myriad ongoing attempts across the air power community, it is critical that we maintain a long scope planning window that will let us to better place ourselves for upcoming challenges in a co-ordinated mode. In showing Army Aviation as an built-in portion of the hereafter force, we are obliged to hold clear vision of aims, functions and duties in order to efficaciously vie for the necessary capablenesss to take this arm into the following 25 old ages. The development of new schemes and procedures implementing them sagely and efficaciously while continuing indispensable bequest will keep high criterions of sustenance and operational support achieved by Army Aviation have achieved in recent old ages.

Examining Current Issues in Child Mental Health Essay

In today’s society, a major concern that ought to ensure success in a country’s future is the positive development, growth and health of children. According to the World Health Organization, children are susceptible to acquiring malnutrition, along with having a higher prevalence rate of diseases compared to any other age group (WHO, 2012). Likewise, these susceptibilities in children are determined by the social determinants of health; known as conditions set in place in order to combat illness and are dependent on the country’s power, wealth and economy (WHO, 2012). In this critical review, the social gradient and social determinants of health are used in order to analyze the impact of society on child mental health and development. From a Canadian perspective of the social the determinants of health, the following topics that are addressed in the critical analysis of child mental health include three social determinants. These determinants consist of the early child hood development vs. race/ethnicity, early child hood development vs. ealth services, and early child hood development vs. social exclusion. While the article, â€Å"Call for Help (HL)† By Suzanna Pillay, reports the significant view that the children’s help line service is known to be the number one coping method for children with negative psychological issues; however, this is not the case since the primary solution to avoiding child mental health issues is with the main help of the primary care giver, general public and global organizations. Summary of â€Å"Call for Help† By Suzanna Pillay The article’s overall message describes children being a susceptible being to mental health issues that occur due to many factors, however, those issues can be reduced and prevented during the first three years of development with the help of several caregivers. Suzanne mentions that the children’s helpline is the main route to determining what’s wrong with the children who call because many tend to seek help there rather than to their primary caregivers, their parents. In addition, research and statistics from the child helpline shows that some of the mental disorders that the children acquire are a lack of confidence, eating disorders, phobias, obsessions, anxiety, suicidal, loneliness and depression. According to the article, the central solution to fight against the odds of children developing mental health problems in their later years is to provide a positive environment both external and internal that will lead them to a stable life. Overall, although the article layout many viewpoints, issues and solutions toward child mental health, in the end it comes down to the fact that the early years of a child’s development is critical and consists of many components such as brain development, emotions, stability and perception in life, coping, and health. Critical Analysis To begin with, from a Canadian perspective they believe that early childhood development (ECD) is one of the important social determinants of health to draw upon on when analyzing child mental health. As mentioned in the article, the first three years are vital for a child’s emotional and development and control; whereas increasing stress hormones can affect the development of the brain. However, on the social gradient scale the early years of development can vary between different races and ethnicities. For instance, according to an article by Christina Gamache Martin and her colleges, research has shown to indicate that there are racial and ethnic disparities; where African Americans are more prone to higher cortisol levels than Caucasians and Latinos had lower levels of cortisol than Caucasians (Evidence 1). Critsol is a glucocorticide hormone derived from the hypothalamic–pituitary–adrenal axis, where both work together to mediate between persistent stress and appalling health (Evidence 1). As a result, since the African American group has shown to have had higher levels of crotisol, they tend have a lack of parental monitoring and higher risk of acquiring mental health issues (eVdence 1). Therefore, it is clear that some children may have a higher tendency of acquiring mental health illnesses due to race and ethnicity. In conclusion, it would be logical to rovide public services as mentioned in the article by Suzanne Pillay to specific race and ethnic youth groups who are more likely experience negative early child hood development. Moreover, health services provide to a society in Canada is also known to have a significant impact on children and their development. One issue outlined in the article was that 60 % and higher of child care and nursery centers were overpopulated with children with mental disabilities and on top of that they did not follow up on child’s needs presented in an Act in 2001 for children. This statement essentially indicates that health services such as foster care services and child care centers with mental health ill children will need to be addressed in a manner that will benefit the children. A research study acknowledged by Georgina, Hibbert, makes note of the worthiness of health services in relation to child mental illnesses. The study was a consultation called the â€Å"Psychology Consultation Service† which was set up by Brent CAMHS in 1005 that provided consent to improve foster care services. It was in support of limitations in other studies and issues revolving around mental health and children. They found this consultation to show great improvement in the skills and understanding of children with mental illness in foster care, while also making the foster care givers more self-reliance and assurance to perform their job well. (evidence 2). Other workers, such as social workers found the model consultation to also be beneficial in terms of skills advancement, planning, and increase knowledge. In regards to the article, the consultation is a fine example of presenting methods in which health services can perform in order to improve their quality of services to help child mental health patients in the future. Lastly, to draw upon the viewpoints made in the article it quite apparent that social exclusion are viable key determinants factors that can both hinder and impact child development in a negative way. As stated in the article, it important to acknowledge the fact that children who are cared for, not neglected and grow up in a warm environment are more likely to do better in life compared to those who are neglected and experience some type of violence or abuse at a young age. Wren, Frances J, expresses this logic strongly in his article insisting that primary care givers, such as the parents and clinician, of a child play a significantly important role decreasing the chances of mental health illness such as depression in the future (Evidence 3). The close relationship between the care givers and the child will help to determine any early symptoms of mental health illness that can be prevented in the future (Evidence 3). In connection to the article, if parents sought to provide their child with the care and positive environment they need, children would be less likely to perform such acts like calling the children helpline to ask for help and advice when facing psychological symptoms’ or disorders. Moreover, they would feel more comfortable to talk to their parents and could mean a way of closing the mental illness treatment gap in medical care. Conclusion In conclusion, it is apparent that there are various social determinants of health that create inequalities in health, usually leading to problems like affecting the care of children with mental health illnesses. As for limitations, this analysis only focuses on three of many of Canada’s standpoints in social inequalities in health. Moreover, despite the research and enhancement of services provided there will always be limitations due to the fact that every child differs from one another. The analysis makes a clear distinction between the social determinant of health and inequalities in health towards child mental health and development, such that there are inequalities in the child mental health spectrum that need to be evaluated and improved. As a result, the general conception is that in order to reduce limitations in child mental health the help of primary care givers, society and organizations are needed and without them it would be impossible to reduce the effects of negatively impacting environments and early child hood development on children in the future.

Personal Narrative My Favorite Teacher - 853 Words

1. Parents— The child’s mom go on some of the field trips that they have at the center and she also comes in to help out sometimes when they have parties. When he mom is around she seem to like to be around or stay lose to her. One example being during one of the classroom parties the mom sat in the back of the room on the carpet while the teacher finished up the circle time and â€Å"Mia† was sitting really close to her mom and when she went to get up she started to look where she was going. She is fine without her mom being in the classroom all the time it is just when she does come she seem to be really close to her. 2. Teachers--- In the parent interview the mom said â€Å" I think her favorite teacher is â€Å"Staci† when we are at home she always can’t wait to tell her things that she s done†. I would say her favorite teacher is â€Å"Staci† the lead teacher in the classroom because just the other day she got new shoes and the first person she showed her shoe to was the lead teacher and sometime after nap time when it s time for her to leave she will go up to her and hug her goodbye. She talks and interacts with the other teacher, but just not like with the lead teacher will some time she just goes up and start talking to her. She seem a little shy and timid around visitors when I first started observing their she really didn’t talk to me, but then the more she started talking to me she was playing pet shop next to me and telling me about the cats she had and how she set up herShow MoreRelatedPersonal Narrative For The Nebraska State Writing Test761 Words   |  4 PagesI teach fourth grade language arts where my main focus is to prepare my students to write a personal narrative for the Nebraska State Writing Test in January. 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