Actin Expression in Hela Cells by APAAP Immunocytochemistry

Actin Expression in Hela Cells by APAAP Immunocytochemistry Kunthavai Jeevananthan Isolation of mononuclear cells, cell counts, cell staining and immunochemistry Aims: to test the morphology of sheep’s blood smear and to calculate the number of viable cells and the percentage viability of live and dead mononuclear cells. To investigate and analyse actin expression in Hela cells by APAAP immunocytochemistry. There are three main components of blood these include erythrocytes (red blood cells), leukocytes (white blood cells) and thrombocytes (platelets). Leukocytes are produced and store in a number of locations called lymphoid organs inside the body such as the spleen, thymus and the bone marrow through a process known as haematopoiesis. They are part of the bodies primary defence mechanism against infections caused by disease causing microorganisms entering the body. Leukocytes are constantly produced and released into the bloodstream where they circulate the body travelling from organs to lymph nodes where they are stored via the lymph and blood vessels. There are three different types of leukocytes known as granulocytes, lymphocytes and monocytes (Kara, 2011). The granulocytes include eosinophils and basophils which are involved in immune responses and also neutrophils ingest and kill any foreign body that enter the body such as bacteria and fungi. Lymphocytes help to protect against viral infections whereas others develop into antibodies against foreign invasions. Blood smears and differential staining techniques such as the Giemsa and Grunwald staining can be conducted to analyse the morphology of blood cells to help diagnose blood disorders. Mononuclear cells also known as agranulocytes are white blood cells containing one lobed nucleus. These include monocytes and immunocytes such as B-lymphocytes, T-lymphocytes, natural killer (NK) cells and macrophages. Normal blood values vary from around 50, 00 to 10, 000 leukocytes per cubic millimetre. High values of leukocytes are known as leucocytosis and it is most commonly due to inflammations as a result of an immune response or blood diseases such as leukaemia (Marshall, 2008). Low values of leukocytes are known as leukopenia this occurs when the bone marrow is unable to produce sufficient RBC like for example neutrophils which leads to neutropenia, this can make the body more prone to diseases and infections therefore mononuclear cell counts are widely used in immunology, haematological malignancy, oncology and vaccine development to monitor immunological functions and to identify and diagnose blood related conditions. This can be achieved by the Ficoll-Hypaque technique; a density gradient method that separates lymphocytes from other formed elements in blood which can be removed and stained with trypan blue in order to be viewed on a haemocytometer under the microscope. Live cells have an intact cell membrane that is impermeable to certain dyes such as trypan whereas dead cells do not therefore viable cells with a clear cytoplasm and nonviable cells with a blue cytoplasm can be identified and calculated (Harlad and Heinz et al, 2004). Immunocytochemistry is the identification of a tissue by specific antigen-antibody interaction where the antibodies are marked with a visible label for examination under the microscope which was first described by Albert H. Coons in 1941. This technique was further developed in different ways by using different indicator molecules such as fluorescein molecules, biotin and enzymes i.e. peroxidase. APAAP (alkaline phosphatase anti-alkaline phosphatase) is an alkaline phosphatase method first described by Cordell et al in 1984 (John, 2008). Antibodies are proteins known as immunoglobulins (Igs) which are further categorised in to different isotypes. The IgG isotype is most commonly used in immunocytochemistry as its biding is more consistent. Actin is a highly conserved and abundant cytoskeletal protein which exists in six different known isofroms in mammals therefore it can be used to detect cancer cells like Hela cells, a continuously cultured strain isolated from human cervical cance r cells, as they are rapidly multiplying and are rich in Actin. Beta and gamma actin are known as cytoplasmic actin as they are expressed in non-muscle cells. Mouse anti-actin antibody is used in this technique as they are a form of highly conserved globular proteins which are found in cell mortality, structure and integrity of all eukaryotic cells hence are often found around the nucleus in the cytoplasm (Richard, 2010). Results Figure 1 Figure 1.1 Red blood cell Platelets Figure 2Figure 2.1 Figure 3: Hela cells only Figure 4: No Primary control Figure 5: Isotype control Figure 6: Actin Discussion The Giemsa and Grunwald staining of the sheep’s blood smear show the all the red blood cells are approximately the same shape and size however the number of red blood cells present appears to be fairly lower than expected. There are a number of reasons as to why this could have occurred such as lack of iron lead to failure of haemoglobin production therefore the number of red blood cells lost cannot be replaced efficiently. Other causes that may result in decreased numbers of erythrocytes may be due to bone marrow damage or disorders, internal or external bleeding and kidney failure. The red blood cells were all however the same shape and size which shows that there is no cause of concern for diseases related to abnormal shapes of RBCs such as sickle cell anaemia. Although the cells appear spherical in figure 1 this may be due to the low magnification and resolution therefore in order to confirm spherocytosis further analysis in higher resolution and tests need to be carried o ut. The light pink staining in the centre of the RBC shows that the area is less dense indicating the absence of a nucleus and the biconcave structure. The mononuclear cell count shown in figure 2 does not show any live mononuclear cells. There are a number of reasons as to why this may have occurred like for example when pipetting the separated white blood cells layer on top of the ficoll layer may have been taken from the wrong layer of cells. Another point to taken into consideration is that when removing the supernatant the live cells may have also been accidentally removed with it. As sheep’s blood cells were used instead of human blood the layering in ficoll is likely to be slightly different therefore in order to obtain a better sample of live and dead mononuclear cells the white blood cells should be removed closer to the bottom of the tube just above the red blood cell pallet at the bottom. In figure 2 there were no dead cells present in the centre square therefore the percentage viability cannot be calculated by dividing the number of live cells by the number of dead cells. The red blood cell count varies from perso n to person as factors such as the altitude and gender. The normal value of male blood count is 4.5 to 6.0 x106 and in females it is 4.0 and 4.5 x 106 therefore when comparing the sheep’s RBC count of 9.3 x 106 calculated from figure 2 is high. A high number of red cell counts may be due to lung diseases, kidney tumours and polycythaemia vera (PVC). The APAAP immunocytochemistry method conducted shows that the Hela cells are a single lineage as all cells in figure 6 were stained brown when incubated with primary anti-actin antibody and secondary polyclonal Goat anti-mouse antibody which are complimentary to each other hence they will only bind to the same cell lineage with the specific antigen. Figure 5 shows a positive isotype control of hela cells incubated with purified mouse monoclonal. This confirms that the actin antibody specific background staining shown in figure 5 were not due to non-specific interactions of antibody molecules with the HeLa cell sample. Figure 4 also shows that hela cells without the secondary antibody alone without the primary antibody convey no significant background staining caused by DAB hence also supporting the fact the background staining is highly antigen specific (Stross and Jones et al, 1989). This method can be used to analyse the cellular contents, localisation and the distribution of cells in their surroundings and their relationship with other cells in peripheral blood smears, swabs, cell cultures, histological biopsy and bone marrow aspirates hereby giving definitive diagnosis to tumour and cancer diagnosis. An alternative immunocytochemistry method is Avidin-Biotin complex (ABC). Similarly like the APAAP method it involves the application of a primary antibody, secondary antibody however APAAP complex is replaced with Avidin-Biotin peroxidase complex (Buchwalow and Bocker, 2010). Reference Buchwalow, I. B, Bocker. W. (2010). Immunocytochemistry: Basics and method: Immunostaning enchantment. 48-52. Germany. Springer-Verlag. Harald, T., Heinz, D., Trosten, H. (2004). Colour Atlas of haematology: practical microscopic and clinical diagnosis. 63-66. German. Georg Thieme Verlag. John, B. D. (2008). Theory and practice of histological techniques: 433-438. United States of America. Elsevier Limited. Kara, R. (2011). Blood: Physiology and circulation. 16-22. New York. Britannia educational publishing. Marshall, C. C. (2008). Diseases and Disorders: Blood diseases. 103-106. Malaysia. Library congress Catalkukuoging-in-publication-data. Richard, B. W. (2010). Immunocytochemistry: A practical guide to biomedical research. 1-10. United States of America. Springer science and business media. Stross, P. W., Jones, M., Manson, D. Y. (1989). Automation of APAAP immunocytochemical techniques J. clin Pathol. 42(1), 106-112.

Health Promotion in the UK

Health Promotion in the UK Introduction Health promotion is a vast and complex subject, encompassing aspects of definitions of health, practical and political approaches to promoting health, education, social policy and particular notions related to preventative approaches to lifestyle management. As such, it requires careful examination and consideration in terms of the current UK socio-political culture and in terms of the evolution of health promotion into its current state (Scriven and Orme, 2001). Health promotion involves a great variety of people, professions and players, including politicians, doctors, nurses, social care professionals, teachers and educators, the legal profession, and of course, the general public. It touches everyone in our society in one form or another, from the advertising on cigarette packets to the nutritional information displayed on supermarket foods. Therefore, it is of concern to everyone in society, because it considers health, however it is defined, as being to a certain degree manageable, in that the manipulation of lifestyle and environmental factors can support people in achieving optimum health and wellbeing. However, its very complexity, partly due to its historical evolution, partly due to the complex social and political interactions which define the sphere of health in society, can mean that simplistic notions of health, health promotion and associated concepts are difficult to define and to achieve. This essay will address some of the complexities of the issues of health promotion. It will attempt to define what health promotion is, what ideas, ideals and concepts it includes, and how health promotion is realised in a practical sense. It will also address the need for exploration of the outcomes and interactions of health promotion activities, and their social and institutional context. It will, of necessity, discuss aspects of the healthcare systems within the United Kingdom which pertain to the subject, and of the socio-political systems and histories which underpin the current climate. It will then examine vital aspects of health promotion, such as health education and communication, participative approaches to health promotion, and evaluation of health promotion initiatives. The author will also attempt to debate ethical, political and professional dilemmas that arise in new practices and policies for promoting health and explore the development of ways of promoting health t hat tackle social and economic inequalities and that are holistic and culturally sensitive. What is Health Promotion? Tones (2001) describes health promotion as a contested concept, raising immediately the notion of differing definitions of health promotion, perhaps based on different conceptualisations of health or different social or political imperatives. Health promotion has often been viewed as synonymous with health education, while health education conversely is often believed to be a fundamental component of health promotion (Tones, 2001). It is also linked with and perhaps interchangeable with definitions of public health (Tones, 2001). This relationship with public health immediately takes the notion of health promotion away from the individual sphere and places it firmly in the public sphere, within the context of the social and political systems of the nation in question, or within a global perspective, both of which are applicable to this essay and discussion. Tones (2001) suggests a formula for health promotion where healthy public policy is multiplied with health education, establishi ng their relationship as the basis for our definitions of the concept. The World Health Organisation defines health promotion as the process of enabling people to increase control over, and to improve, their health. This generic definition suggests that health itself is an individual state over which individuals can have some measure of control. Jones et al (2002, p.xi) also suggest that for many people, health promotion means targeting behaviour, but view it as something imposed upon them which does not necessarily work for them. However, given that promoting heath is a diverse, complex and multi-faceted activity (Jones et al, 2002, p5), these definitions do not address the range of activities and ideologies associated with the process. Health promotion policy appears to combine diverse approaches which include legislation, financial measures, taxation and organizational change. Tones (2001) simplistic suggestion of a formula of the interdependence of health education and healthy public policy as a definition of health promotion does not focus on the role of the individual. Both are equally important in our understanding of this issue. Tones (2001 p4) however further goes on to discuss a model of health promotion which focuses on the purpose of healthy public policy and health education, which is argued to be the empowerment of individuals and communities to reduce or remove the various barrier spreventing the attainnment of health for all. This is a more useful definition, but rather idealistic, as it sugges ts that such a goal is achievable, and there may be vast differences in individuals’ notions of ‘health’ and their abilities to achieve this. Health promotion and health education are often also seen as synonymous. Health education can be as complex an issue as health promotion to define. Education implies somebody ‘teaching’ or educating, and somebody learning new information. Tones (2001) p 15) describes emancipatory education, a dialectical process which involves critical consciousness raising which leads to the translation of critical thinking about social issues into action. Health education involves communication and the transmission or sharing of information, but also implies that such information must be assimilated by the recipient and then utilised in order to bring about change in the self or in aspects of behaviour, lifestyle or environment. There are great benefits in adopting the curent collective approach to promoting health, which aims to involve people not only in their own health and well-being but in acting together upon theirf physical, social, political and economic environment for the sake of health (Sidell et al, 2002, p 1). Such approaches allow for the incorporation, validation and promotion of individual and group needs based on diversity in race, ethnic or religious identity, social or lifestyle identity, social status and social and geographical inequality. Historical Milestones in Health Promotion Webster and French (2003 p9) suggest that while the immediate sources of health promotion and current approaches to public health lie in the political history of the 1970s, there are roots which go much further back, arguing that all communities have had some interest in co-ordinated community action to ensure a better life. The historical link between health promotion and public health is well established, with one of the most significant milestones being the formation of the National Health Service in 1948, whose medicalised approach initially hindered public health and health promotion initiatives as we see them today in favour of a treatment-oriented approach to illness (Webster and French 2003 p 10). Webster and French (2003 p11) suggest that the three seminal documents which launched what we know perceive as the health promotion movement were: the Lalonde Report New Perspectives on the Health of Canadians (1974); the World Health Organisation’s Global Strategy for Health for All by the Year 2000 (1981) and the Ottawa Charter for Health Promotion 1986). It was these documents which, collectively, set out a vision for health improvement which exceeded the traditional approaches of sanitation engineering, lifestyle health education and preventing and caring health services which characterised health promotion to that point. Instead, health promotion became concerned principally with empowering citizens that that they could take control of their health an in so doing attain the best possible chance of a full and enjoyable life (Webster and French, 2003, p 15). This notion of empowerment appears fundamental to current perspectives on health promotion and to its influences on the National Health Service, including on such concepts as patient participation and collaboration, service user involvement and patient rights. This heralds a move away from the medicalisation of health towards a more social definition of health where power is apparently distributed more equally among those who experience and those who purport to affect health, illness and wellness. This is something that the World Health Organisation appears to have consistently advocated, a positive and holistic view of health which comprises mental, physical and social elements (Tones, 2001 p6). The Ottawa treaty, which encompasses the key principles of equity, empowerment and the reorientation of the health services, reflects this notion of demedicalisation, where collaborative working by the many agencies concerned with health promotion is believed to maximise the potential of any strategy or policy in this arena (Tones, 2001, p7). Within the UK, policy drivers which have driven health promotion initiatives are too numerous and complex to fully explore within the context of this essay. However, governmental initiatives, changes in health and social services, changes in approaches to public health and changes in statutory control and responsibility for public services have all formed part of the UK health promotion focus (Jones et al, 2002 p 9-13). However, there appears to be a counter culture of bottom up drivers as well, with empowerment leading to the enabling of the activities of community and voluntary groups to bring about change at local and even national levels. This reflects the overall picture of holistic health promotion as a community development activity rather than a policy founded in political rhetoric. Contextual and Practical Issues in Health Promotion The setting of health promotion is also of some concern, with the role of the media, community development and critical consciousness raising (Tones, 2001, p14-15) still areas of some debate. This author would argue that the media may have some merit in health promotion, but that there are likely to be many who do not trust the ‘messages’ given out given that so much advertising is false, suggestive and manipulative, and based on the need to sell products rather than truly promote health. Health and community services appear to be the most impactful arenas for health promotion to take place within. The National Health Service has already established a policy context for the promotion of health within public services (Adams, 2001 p35). Therefore, a primary and important leader for health promotion is the health authority, with its twin roles of service improvement and strategic leadership for improving health and tackling health inequalities (Adams, 2001, p38). Activities such as health needs assessments and community planning can be carried out in a collaborative and participative way with local organisations and community groups in order to target and focus health promotion activities at a policy level (Adams, 2001, p 39). Primary healthcare services and Primary Care Groups can also be a vehicle for health promotion (Velleman and Williams, 2001, p43), and given their location within communities should be ideally suited to this role. Such groups can focus on practical initiatives to reduce inequalities in health and to target issues such as heart disease, cancer, teenage pregnancies and accidents, on the back of governmental initiatives, alongside emergent and self-defined local issues (Velleman and Williams, 2001, p43). An example of an activity by a primary care group is of a stop smoking initiative, whereby health professionals were trained and located in GP practices to provide one to one support to smokers who want to quit, and practices were supported in developing systems that deliver stop smoking interventions effectively (Velleman and Williams, 2001 p 44). Such practices can have multiple benefits, both to the individuals whose health is improved by the intervention, and to their communities. The wider impact is also that such practices can serve as examples and provide evidence for other groups wishing to develop similar interventions. So it would seem that local initiatives can be of much wider importance. GPs have, following changes in contracts, been charged with the responsibility of improving the public’s health (Jones et al, 2002). But the limitations of their services, their training and their scope are still apparent (Jones et al, 2002). The National Health Service also has an already established professional context which is ideally suited to taking forward notions of true, holistic health promotion whereby communities and individuals become empowered as agents of their own wellbeing. Community nursing services, again on the frontline of NHS care and which function fully within the communities they serve, can be a vehicle for such activities (Wright, 2001, p58). These work alongside specialist health promotion services who act as catalysts and facilitators at local levels (Learmonth, 2001 p 66). Such professionals and services can be active in organisation development, through leadership, partnership, development, training, education and support and policy and strategy development (Learmonth, 2001, p66). They can also engage in evidence based practice, market research, communication and publicity, and programme management (Learmonth, 2001, p67). The benefits of having such professionals are obvious, particularly wit hin the already overstretched and under-funded health and social services sector. Such activities appear vitally important to achieving health promotion goals, and in particular to ensuring collaborative working and full community engagement. Therefore, specialist services can also support community development through advocacy, needs assessment, community participation, information for health, and evaluation of services (Learmonth, 2001, p 67). However, there are challenges, particularly in the capacity and recognition of such services and their location, which may fall between traditional services and serve to hinder their function (Learmonth, 2001, p75). Hospital nursing practice also provides vast scope for health promotion (Latter, 2001, p77). Among other potentialities, the role of the hospital nurse as the primary caregiver for individual patients equates to a significant scope for health education (Latter, 2001, p78). However, there is also the need to further develop this role, and support its expression in the beleaguered health service (Latter, 2001, p 79). Despite the challenges of this, it could be argued that nurses have a strong role to play in creating environments that are supportive of health, encouraging community participation in health and helping to generate healthy policies (Latter, 2001). It should be remembered, however, that nurses are themselves individuals, whose own health needs support and input, and so any drive towards increasing their functions within health promotion may also need to address their working conditions, and the demands which place a strain on their own health. Environment is another contextual issue in health promotion. The role of Local Authorities in supporting healthier environments and communities is described by Allen (2001, p 91), who argues that such authorities can act as role models, and through the work of environmental health services, can promote the health of communities through: food inspection and maintenance of food safety; housing standards; health and safety at work and during recreation; environmental protection; communicable disease prevention and control; licensing; drinking water surveillance; refuse collection and street cleaning; and pest control. These are statutory functions, but if effective and efficient, have obvious public health benefits and therefore health promotion benefits. In addition, the discretionary powers of local authorities can affect issues of HIV and AIDS, alcohol and drug addiction, nutrition, women and men’s health, heating and energy advice, occupational health, environmental enhanceme nt and poverty issues (Allen, 2001 p 91). Their limitations are apparent, but this is where the voluntary sector comes in, and often voluntary groups and agencies fill some of the gaps where statutory services cannot stretch to cover all areas. Social services address the social aspects of health, by engaging in preventive work with children and families, by involvement in the care of older people, and by engagement with the health and wellbeing of people with special needs (Jones and Rose, 2001 p 95-102.) Diversity issues can be addressed by some aspects of social services (Jones and Rose, 2001 p 95-102), but again, there are gaps, where in some areas voluntary agencies can fulfil identified needs that cannot be met by health and social care services. Another arena for health promotion is that of health education in schools (Scriven, 2001 p 115). This is another growth area, supported by a range of policy drivers (Scriven, 2001, p121; Beattie 2001 p 133). School nurses have always had a role in health promotion for specific age groups, and this is another area where health promotion opportunities can be maximised (Farrow, 2001 p 151). Similarly, there is some evidence that Universities can be effective loci of health promo tion activities, with the integration of visions of health within plans and policies and promotion of sustainable health within the wider community (Dooris and Thompson, 2001 p 160). For those who perhaps cannot be reached through these contexts, there is also the Youth Work setting, which also provides considerable scope for health information and advice, though this too is not without its challenges (Robertson, 2001 p 173-176). Where services fail to meet need, as already suggested, the voluntary sector may cover the shortfall. The greatest value of the voluntary sector lies in its diversity and its motivation, which stems from free will, moral purpose and individual personal engagement (Anderson, 2001 p 181). Voluntary agencies are non-profit-making and occupy a singular position within society. Conversely, profit-making agencies can also contribute to health promotion through health working policies and health promotion in the workplace (Daykin, 2001 p 204). Good occupational he alth services, for example, can also play a vital role in health promotion, both generally and in specific issues related to the type of employment and activities concerned (Lisle, 2001). What all of these point to is this notion of collaborative, interagency working, where health promotion becomes the common goal of diverse populations, agencies, services, professions and of course individuals. Some believe that effective interagency working lies at the heart of improving health outcomes for vulnerable populations (Jones and Rose, 2001, p 95). However, such a standard of working is difficult to achieve (Jones and Rose, 2001, p 95), perhaps because of the boundaries and restrictions within which such groups work, and the historical context which makes them protective of their own ‘territory’. It is obvious that such limitations must be overcome if health promotion goals are to be met. It we are to achieve the goal of a holistic, socio-ecological model of health fully applied to our societies, then new ways of working and communicating must be developed, building on current evidence from innovations and practice. Debates and Dilemmas in Health Promotion It would be reasonable to raise the question, in the light of all these services, policies and drivers which promote health in our arguably well-endowed nation, why indeed is health promotion still such a challenge? Why are so many still suffering from ill health, social injustice, health inequalities and supposedly eminently preventable diseases? There may be many possible answers to this. Health is believed to be ultimately determined by the existence of equity and social justice, which is in turn rooted in people’s material, social, economic and cultural circumstances (Tones, 2001 p7). It is also believed that community action for health is based on the premise that health chances and health choices are shaped, to a great extent, by the social, political and economic conditions in which people live, and that ability of individuals to shape and control these structures is limited (Jones et al, 2002 p 25). It has been argued that the creation of healthy public policy is the prerequisite for changing adverse environments in order to facilitate the development of health (Tones, 2001 p8), but this author would also argue that adverse environments must be ‘ owned’ by those who live within them, and no amount of policy, imposed ‘top-down’ will improve environments if those who live within them do not equally invest in their amelioration and long-term development. Tones (2001 p 9) does argue that individual empowerment and community empowerment are linked, and that these are partly dependant on a sense of community where individuals have some notion of membership of some kind of community or group. The term community implies a common bond between individuals (Jones et al, 2002 p 25). Therefore we see the individual in a different context, a context comprised of various relationships and connections with other individuals. These must surely affect health and health p romotion behaviours, positively and negatively. But what of the individuals who fall outside such communities? Is it the remit of government, at any level, to force or coerce individuals into a state of ‘belonging’? Definitions of communities and group identities may serve to alienate those who do not feel associated with them, but in this case it might be necessary to focus on the good of the many, and to address the larger issues before addressing individual differences of this kind. If self-empowerment is attainable (Tones, 2001 p 11) then such individuals may take control of their own health. Activities such as community campaign groups, self-help groups and even more politicised groups related to notions of women’s or men’s health may all engage in action for health (Jones et al, 2002), and therefore it could be argued that any one individual should find a group or action which ‘concerns’ them or some aspect of their life or lifestyle. This may be particularly important in terms of dive rsity, where so-called ‘minority’ groups can both campaign for issues pertaining to their own identities and needs, and develop services which meet those needs. This returns us to the work of the voluntary sector, which is where such activities tend to find expression. But surely it is the role of government, and the services provided, at a locally devolved level, through central funding, to provide such sensitivity in the services and policies it underwrites? Some would argue that such sensitivity exists, but we have yet to see it fully realised in action, and have yet to see evidence of the efficacy of these great policy drivers in real practical terms. Jones et al (2002 p 47) suggest that community groups may find it useful to develop partnerships with local authorities, the education sector, other groups, NHS services, employers and even the media in order to ensure a fully participative, collaborative and comprehensive approach to locally-suited health promotion activities. This author would argue that with the best will in the world, there will always be a divergence between the goals of different groups, and an imbalance of power betw een these different agencies. The agendas of central government may end up dominating those of the community, and while such collaborative working is the ideal, it may need to be undertaken with awareness and caution. Farrant (2003 p 230) argues that the recent moves towards community development may simply mirror or reinforce the existing power inequalities within social systems, and such activities simply serve as another vehicle for governmental control. It is therefore important to be aware of the policy context within social action on health promotion, and to engage in true community or communal activities rather than those made possible by the current political and funding context. The paternalism of our current political system is evident in the media and the governmental policy drivers which shape public services. Such paternalism may be of some benefit in highlighting health promotion issues which need to be addressed, but the media reports demonstrate an over-generalisation of the issues. It is at the community level that the real needs can be identified (Jones et al, 2002 p 100). Part of this process is the evaluation of health promotion initiatives and actions, particularly participatory evaluation of community action with dissemination of findings (Jones et al, 2002 p 100). This serves two purposes. It allows communities themselves to build on evidence and continue to grow and develop such initiatives in a reflexive manner, and it establishes their work within the fields of health and social care on a more critical, intellectual level as an evidence-base which can educate and empower others. This essay has touched on the notion of public health and policy drivers, and has equated health promotion, to a certain degree, with the notion of public health. It is important, therefore, to consider the public health debate and the politics of health promotion. The context of public health within the UK is very much concerned with the notion of health inequalities, again, as mentioned in the above discussion. The evidence from the UK still points to considerable inequalities in health depending on region, and on individual occupation, and suggests that these inequalities are widening, despite significant improvements in aspects of social and economic wellbeing (Graham, 2003 p 20). Changing distributions of work and income, changing access to housing (such as increases in owner-occupation), changing patterns of working and domestic lives are all affecting social determinants of health (Graham, 2003 p 24-25). It has long been believed that income inequality is an important determin ant of health in richer societies, but research suggests that population health is related less to how wealthy a society is, and more to how equally or unequally this wealth is distributed (Graham, 2003 p 25). But individual factors must be taken into consideration, particularly in terms of health and illness. It is no surprise that an individual’s health is a determinant a well as an outcome of socio-economic circumstances, where those in better health are more likely to move up the occupational and economic ladder, while those in poorer health will not (Graham, 2003 p 26-27). Factors on the individual level include material factors, such and the physical environment of the home, the neighbourhood and workplace, and living standards; behavioural factors, such as health-related routines and habits, leisure activities and diet; and psychosocial factors in particular increased stress and risk-taking behaviours (Graham, 2003 p 27-28). Public health therefore has a dual remit – to address the socio-economic factors which affect health, and to address the individual factors which influence health. There is evidence of addressing individual lifestyle factors in governmental paternalism in such campaigns as the no-smoking campaigns and legislation, and the current debate on obesity. However, the notion of the evidence which underpins these drivers is debatable. There has been in recent years, a strong trend towards evidence-based practice in all aspects of health care, and this includes health promotion and public health (McQueen and Anderson, 2003 p 165). Ideally the theory informing practice should arise from multiple disciplines and represent diverse research (McQueen and Anderson, 2003 p 167). However, there is a divergence between empirical evidence and so called qualitative evidence, the latter of which does not enjoy the validity or acceptance of the former in terms of evidence. While health promotion is widely assumed to be based on science and a scientific basis for human behaviour, a scientific paradigm does not underlie our notions of health, public health and health promotion (McQueen and Anderson, 2003 p 168). The whole concept of public health and health promotion stems from an holistic and almost communalist paradigm, rejecting the view that human behaviour is simply a response to physiological and neural processes (MqQueen and Anderson, 2003 p 168). Therefore, simplistic, reductionist and scientific principles of evidence derived from statistics and experimental research will of necessity be woefully inadequate in addressing the very real complexities of health promotion in the practical and real community context. Therefore there is a need to identify news way s of seeking and defining appropriate evidence, in a developmental process which mirrors that of the health promotion activities themselves. Conclusion It is evident that health promotion, particularly within the UK context, is a complex concept with a wealth of diverse yet oddly inter-related issues and problems. This essay has attempted to discuss some of the issues raised in the set books for the K301 course, with an exploration of key issues and some debate of current provision. Health promotion is a governmental initiative, but remains also an ideogical and idealistic goal. It is best viewed as an holistic concept with contextual characteristics which must be taken into consideration. Some of these contextual characteristics are national, some are local or locational, and some are individual. It is the relationship between these three that defines both the need and the processes required to meet that need, fundamentally at a local level. The very complexity of the context requires that health promotion activities occur through collaborative, communal and partnership working, which means a change from traditional methods of organising health and social services. If we accept the principle that coordinated action leads to improved health, income and social policies that foster greater equity, then we understand the fact that collaborative action contributes to ensuring safer and healthier goods and services, better and more locally suitable public services, and cleaner, more healthful environments. It also requires that policy-makers, groups and individuals identify barriers and challenges to the adoption of healthier policies and behaviours, throughout society, and develop collaborative approaches to addressing these. However, avoiding paternalism and the mimicking of governmental agendas is also vital. What is most apparent from this discussion is that despite the debates, and there are many, the systems and resources are already in place to foster improved public health and health promotion activties and to engage all sectors of the community in these actions. Such resources include primary healthcare services and groups, nurses working in acute hospitals and within the community, specialist health promotion professionals, social services, schools, voluntary agencies, statutory agencies, youth groups, social and self-help groups, and many more. The potential of these groups in and of themsleves to engage in health promotion, and to evaluate and communicate these activties to others as a form of evidence, is already apparent from the literature. In particular, the literature also suggests that the notion of evidence in this arena should move away from reductionist, scientific principles to mirror the holistic nature of the health promotion context. But the efficacy of these diverse players in the arena is limited until such time as full collaboration, partnership and inter-agency working is realised.

Essay --

Imagine having to work a 100 hour work week as a slave, being so desperate for food that you eat snakes, rats, and human corpses to stay alive, and being forced to witness public executions of your closest family members. This is the reality for the 176,000 political and associative prisoners living in North Korean prisons with no rights, no trial, and no reason. The world will have to regard the human rights abuses in North Korean as an important issue if we wish to stop the torture, murder, and starvation that it enforces on its people. Recognition for our need for basic human rights is required to understand how North Korea deprives its people from the choices we as citizens of the USA take for granted. The United Nation’s office of the High Commissioner of Human Rights says that â€Å"human rights are rights inherent to all human beings†. These rights include the rights to life, liberty, property, movement, expression, and security. The United States has different rights engrained in its Bill of Rights, like the right to a speedy trial, freedom from harboring soldiers, and the freedom to a militia. North Korea has had its prisons for more than 5 decades, and its background goes back to the Korean War, when they stored their Prisoners of War and the members of the opposition in the camps. They have continued to today, despite the fact that the North Korean government denies their existence. Those on the outside mainly get their information from prison escapees and satellite imagery, and by these testimonies we can only make educated guesses on the population, location, and size of the camps. Shin Dong-hyuk has helped the rest of the world understand what prison life was like, for his story is haunting. He was born in a prison camp... ...t? Indeed, one of the biggest pitfalls that we as people have subsided from is publicizing the rejection of rights from the North Korean peoples, and we have forgotten that we can get out the word to top diplomatic officials on how and when we wish to combat the violations. Spreading the word is one of the most helpful things you can currently do to, as you, as an American, have the right to democracy and the people’s choice in matters, a right that North Korean citizens have been blatantly denied. Get educated on these matters through books, websites and documentaries, then go spread the information you have been given. As support for the prisoners grows, so will support for the human race as a whole, it will be only then that the issue of North Korea’s concentration camps will be brought to the diplomatic table for and by the people wherever they shall reside.

The Stages of the Haulocost Essay -- Hitler, Genocide, Jewish, human ri

Just before the second Great War, 6 million Jews were killed along with 5 million non-Jews (Miss Belevski, 2008, The Holocaust, slide #2). This atrocity and genocide of Jewish population was widely known as The Holocaust. The man who led genocide was Adolph Hitler, the leader of the Nazis, a fascist party that took control during the German Depression in the 1920s. When Hitler came in power, one of his promises was to end the â€Å"Question of the Jews†. A series of steps of the Holocaust was the â€Å"Stages of Isolation† (Miss Belevski, 2008, Stages of Isolation: Holocaust, p.1). This plan which was created by Hitler made millions die in vain. ‘In 1935, the law of Nuremberg Race was decreed’ (Miss Belevski, 2008, Stages of Isolation: Holocaust, p.2); this was the first step of the â€Å"Stages of Isolation†. With this new policy, Jewish people were stripped out of their rights; they were pulled out of schools, fired from work, and no longer held th e title â€Å"persons† or a citizen of Germany. Step two was segregation. Jews were transported to â€Å"ghettos† and many died of starvation or disease. Step 3 and 4 were concentration camps and extermination, where the mass killings began. Jews were forced into concentration camps where they would work till they die. In order to take away their identity and treat them as animals, they were not allowed to have hair or wear clothes. Many inhumane practices and terrifying stories happened in these deadly camps, such as laboratory experiments, human flesh purses, and the lady who swallowed her diamonds because that was all she had. Extermination killed millions of Jews, people who did not die from the concentration camps would be gassed in gas chambers, and mobile killing units were established to eliminate J... ...soners’ (Miss Belevski, 2008, The Holocaust, slide â€Å"Cold heart Facts†). We learnt an important lesson from the Holocaust and now we must stand up and protest for what is justice and what we believe in. To ensure peace and humanity in our world we must take action and be part of the solution. Problems in our world today, such as global warming, poverty cycle in Africa and the war in Iraq all relate to us and we must use our powers and strengths to help in anyway we can. We must not think like the countries during the 30s, these problems are not far away and they do concern us indirectly and directly. We must not blame God for what have happened. God was simply testing our abilities to protect and stand up for what is justice and humanity. We must learn from our lesson and stay united to ensure mistakes such as the Holocaust and other genocides will never occur again.

Human Development Index

What is HDI? HDI (Human Development index) is a way of measuring development by combining indicators of life expectancy, educational attainment and income. The breakthrough for the HDI was the creation of a single statistic which was to serve as a frame of reference for both social and economic development. The HDI sets a minimum and a maximum for each dimension, called goalposts, and then shows where each country stands in relation to these goalposts, expressed as a value between 0 and 1.It is also used to distinguish to a large extent, whether the country is a developed, a developing or an underdeveloped country, and also to measure the impact of economic policies on quality of life. NEED FOR HDI ————————————————- The HDI was created to emphasize that people and their capabilities should be the ultimate criteria for assessing the development of a country, not economic gro wth alone. The HDI can also be used to question national policy choices, asking how two countries with the same level of GNI per capita can end up with such different human development outcomes.For example, the Bahamas and New Zealand have similar levels of income per person, but life expectancy and expected years of schooling differ greatly between the two countries, resulting in New Zealand having a much higher HDI value than the Bahamas. These striking contrasts can stimulate debate about government policy priorities. ————————————————- CALCULATION OF HDI 1) Life expectancy index (LEI) = (LE-20)/(83. 4-20) 2) Education index (EI) = v(MYSI*EYSI)/ 0. 951 3) Income Index (II) Log (GNIpc)-log(100)]/ [Log (107721) – log (100)] LE: Life expectancy at birth MYS: Mean years of schooling (Years that a 25-year-old person or older has spent in schools) EYS: Expected years of schooling (Years that a 5-year-old child will spend with his education in his whole life) ————————————————- GNIpc: Gross national income at purchasing power parity per capita COUNTRY| GDP RANK| HDI RANK| HDI| India| 4| 134| 0. 571| U. S| 1| 4| 0. 910| U. K| 8| 28| 0. 863| China| 2| 101| 0. 87| Pakistan | 29| 145| 0. 50| Oman| 77| 89| 0. 705| India ranks a low 134 among 187 countries in terms of the human development index (HDI), which assesses long-term progress in health, education and income indicators, said a UN report released on Wednesday. Although placed in the â€Å"medium† category, India's standing is way behind scores of economically less developed countries, including war-torn Iraq as well as Philippines. India’s ranking in 2010 was 119 out of 169 countries Sri Lanka has been ranked 97, China 101 and the Maldives 109.Bhutan, otherwise respected fo r its quality of life, has been placed at 141, behind India Pakistan and Bangladesh are ranked 145 and 146 in the list of countries that is headed by Norway and in which the Democratic Republic of Congress is at the bottom. The other two countries in South Asia, Nepal and Afghanistan, occupy ranks 157 and 172. According to the â€Å"UN Human Development Report, 2011: Sustainability and Inequality†, India’s HDI is 0. 5 compared to 0. 3 in 2010. COMPONENTS OF THE HUMAN DEVELOPMENT INDEXThe education component of the HDI is now measured by mean of years of schooling for adults aged 25 years and expected years of schooling for children of school entering age. Mean years of schooling are estimated based on educational attainment data from censuses and surveys available in the UNESCO Institute for Statistics database and Barro and Lee (2010) methodology). Expected years of schooling estimates are based on enrolment by age at all levels of education and population of official school age for each level of education.Expected years of schooling are capped at 18 years. The indicators are normalized using a minimum value of zero and maximum values are set to the actual observed maximum value of mean years of schooling from the countries in the time series, 1980–2010, that is 13. 1 years estimated for Czech Republic in 2005. Expected years of schooling are maximized by its cap at 18 years. The education index is the geometric mean of two indices. The life expectancy at birth component of the HDI is calculated using a minimum value of 20 years and maximum value of 83. 4 years.This is the observed maximum value of the indicators from the countries in the time series, 1980–2010. Thus, the longevity component for a country where life expectancy birth is 55 years would be 0. 552. For the wealth component, the goalpost for minimum income is $100 (PPP) and the maximum is $107,721 (PPP), both estimated during the same period, 1980-2011. The decent stand ard of living component is measured by GNI per capita (PPP$) instead of GDP per capita (PPP$) The HDI uses the logarithm of income, to reflect the diminishing importance of income with increasing GNI.The scores for the three HDI dimension indices are then aggregated into a composite index using geometric mean. The HDI facilitates instructive comparisons of the experiences within and between different countries. FACTORS AFFECTING HDI There are various factors that affect the economic development of any economy like health, education, per capita income, gender inequality, deforestation, population, pollution levels, literacy rate, infant mortality rate etc. Let us see a few of them one by one and try to find where India lags behind majority of the economies and why there is a mismatch in India’s growth and evelopment. A) Education index Education is an important indicator of a nation’s wellbeing, standard of living and is a measure of the economic development and quality of life which further helps in determining whether an economy is developed, developing or underdeveloped. India’s Shortfalls The Indian government has been lethargic in this aspect and has failed in ensuring a better education framework. Here, the government alone is not to be blamed. A majority of Indian population tend to neglect primary education. Poverty has been a major cause leading to lower literacy rates in India.Poor parents in underdeveloped states and backward regions make their children work to support the family financially. Girls in rural areas are forced to stay back at home and do daily chores. Also, education funding in rural areas is quite low. Uneducated parents don’t find it important to educate their children and this vicious cycle continues leaving the whole community uneducated. The government is not spending enough in education. Currently around 4% of GDP is being spent on education much lower than the target of 6% of GDP.Lower enrolment, high dropout rates, teacher absenteeism, poor instruction qualities, poor infrastructural facilities like classrooms, libraries, low encouragement and gender inequality are the root causes of low education index in India. About 30% of the world’s illiterate population belongs to India. COUNTRY| EDUCATION INDEX| India| 0. 450| The U. S| 0. 939| The U. K| 0. 815| Pakistan| 0. 386| China| 0. 623| Oman| 0. 539| SCALE| EDUCATION INDEX| Very High| 0. 894| High| 0. 715| Medium| 0. 561| Low| 0. 392| B) Health Index 2% of India’s children below the age of three are malnourished, almost twice the statistics of sub-Saharan African region of 28%. Although India’s economy grew 50% from 2001–2006, and its child-malnutrition rate only dropped 1%, lagging behind countries of similar growth rate. Malnutrition impedes the social and cognitive development of a child, reducing his educational attainment and income as an adult. These irreversible damages result in lower productivi ty. Infant mortality rate Approximately 1. 72 million children die each year before turning one.The under five mortality and infant mortality rates have been declining, from 202 and 190 deaths per thousand live births respectively in 1970 to 64 and 50 deaths per thousand live births in 2009. However, this rate of decline is slowing. Reduced funding for immunization leaves only 43. 5% of the young fully immunized. Infrastructure like hospitals, roads, water and sanitation are lacking in rural areas. Shortages of healthcare providers, poor intra-partum and newborn care, diarrheal diseases and acute respiratory infections also contribute to the high infant mortality rate.Inadequate safe drinking water Access to protected sources of drinking water has improved from 68% of the population in 1990 to 88% in 2008. However, only 26% of the slum population has access to safe drinking water,  and 25% of the total population has drinking water on their premises. This problem is exacerbated by falling levels of groundwater caused mainly by increasing extraction for irrigation. Insufficient maintenance of the environment around water sources, groundwater pollution, excessive arsenic and fluoride in drinking water pose a major threat to India's health. Rural healthRural India contains over 68% of India's total population with half of it living below  struggling for better and easy access to health care and services. Health issues confronted by rural people are diverse and many – from severe malaria to uncontrolled diabetes, from a badly infected wound to cancer. Postpartum maternal morbidity is a serious problem in resource-poor settings and contributes to maternal mortality, particularly in rural India; however, Misoprostal has been identified as a cost-effective maternal mortality intervention for home births. A study conducted in 2009, using multinomial logistic regression methods, found that 43. % of mothers reported to have experienced postpartum morbidities six weeks after delivery. Rural medical practitioners are highly sought after by people living in rural India as they more financially affordable and geographically accessible than practitioners working in the formal public health care sector. The  National Rural Health Mission  (NRHM) was launched in April 2005 by the Government of India. The goal of the NRHM is to provide effective healthcare to rural people with a focus on 18 states which have poor public health indicators and/or weak infrastructure. COUNTRY| HEALTH INDEX| India| 0. 717| The U. S| 0. 923| The U.K| 0. 949| Pakistan| 0. 717| China| 0. 843| Oman| 0. 836| SCALE| HEALTH INDEX| Very High| 0. 946| High| 0. 838| Medium| 0. 784| Low| 0. 611| C) GDP per capita (PPP) It is defined as GDP divided by the total population of a country. Per capita income is often used as a measure of the wealth of the population of a nation, particularly in comparison to other nations. The very fact that India in spite of being the 4th larg est economy stands 140th in terms of per capita income indicates that the income is distributed unevenly where a very percentage of the population is rich while majority is poor. COUNTRY| GDP per capita($)|India| 2933| The U. S| 41761| The U. K| 32147| Pakistan| 2369| China| 6200| Oman| 23333| COUNTRY| INCOME INDEX| India| 0. 508| The U. S| 0. 869| The U. K| 0. 832| Pakistan| 0. 464| China| 0. 618| Oman| 0. 778| Poverty in India  is widespread, with the nation estimated to have a third of the world's poor. In 2011,  World Bank  stated, 32. 7% of the total Indian people falls below the  international poverty line  of  US$  1. 25 per day (PPP) while 68. 7% live on less than  US$  2 per day. Lack of a market economy & over government regulation and red tape, known as License Raj is the main cause of poverty in India.While other Asian countries like China, Singapore and South Korea started with the same poverty level as India after independence, India adopted a soc ialist centrally planned, closed economy. Another cause is a high population growth rate, although demographers generally agree that this is a symptom rather than cause of poverty. While services and industry have grown at double digit figures, agriculture growth rate has dropped from 4. 8% to 2%. About sixty percent of the population depends on agriculture whereas the contribution of agriculture to the GDP is about eighteen percent.The surplus of labor in agriculture has caused many people to not have jobs. Farmers are a large vote bank and use their votes to resist reallocation of land for higher-income industrial projects. D) Gender Inequality Index There is strong evidence to suggest that India is a country of high concern in relation to missing women. The 2011 Census found a worrying trend in child sex ratios with only 914 females for 1,000 males, a drop from 927 in 2001. Using data from the 2011 Census in India, after adjusting for excess mortality rates in girls, the estimate s of number of selective abortions of girls rose from 0 to 2 million in the 1980s, to 1. to 4. 1 million in the 1990s, to 3. 1 to 6. 0 million in the 2000s. The study shows that the problem is in fact growing amongst the middle class which suggests that missing women cannot be attributed to poor socio-economic status. The male/female sex ratio for the total population in 2012 is 1. 08. According to data from the 2006-2007 Demographic and Health Survey for India, 41. 5% of girls and 45. 3% of boys under the age of two had received all their vaccinations. Under-five mortality rates were higher for girls than for boys (79. 2 per 1000 live births for girls, 69. % for boys), while malnutrition rates were equal or slightly higher for girls. Given that in most contexts, rates of under-five mortality and malnutrition are higher for boys than for girls, this would indicate bias towards sons in regard to early childhood care. Gender-disaggregated data in regard to child labor was unavailable. Primary and secondary school enrolment and attendance rates are lower for girls than for boys indicating some son preference in regard to access to education. COUNTRY| GENDER INEQUALITY INDEX| India| 0. 646| The U. S| 0. 311| The U. K| 0. 216| Pakistan| 0. 611| China| 0. 224| Oman| 0. 09| Conclusion â€Å"Economic growth† and â€Å"development† of any economy should go hand in hand unlike Indian economy where there is a huge contrast in this regard. India should focus on primary education, basic healthcare, gender equality and other social, environmental and economic aspects to ensure sustainable development. India has been very slow in reacting to the transformation of economy restructuring. Masses need to be educated about family planning, importance of education, gender inequality especially in rural areas so that they don’t take much time to adapt to an environment which is essential for development.Educational institutes should be set up on a large scale f ocusing more on basic education. Healthcare sector needs to be given prime importance. We need to take advantage of the technology available to us. Corruption is the biggest hindrance coming in the way of development and thus should be kept in check. India has till date come up with many schemes and programs for the poor section but has repeatedly failed to implement them effectively. So, while economic growth is vital to the economy, human development is to be given equal importance which decides or shows the true picture of the economy. Human Development Index What is HDI? The Human Development Index (HDI) is a composite statistic used to rank countries by level of â€Å"human development†, taken as a synonym of the older terms â€Å"standard of living† and/or â€Å"quality of life†, and distinguishing â€Å"very high human development†, â€Å"high human development†, â€Å"medium human development†, and â€Å"low human development† countries. HDI was devised and launched by Pakistani economist Mahbub ul Haq, followed by Indian economist Amartya Sen in 1990. The HDI is a comparative measure of life expectancy, literacy, education, and standards of living of a country.It is a standard means of measuring well-being, especially child welfare. It is also used to distinguish whether the country is a developed, a developing or an underdeveloped country, and also to measure the impact of economic policies on quality of life. There are also HDI for states, cities, villages, etc. by local organizatio ns or companies which have interest in the matter. The HDI formula result is a number from 0 to 1, 1 being the best outcome possible. Components of HDI What does HDI tell us?The HDI was created to emphasize that people and their capabilities should be the ultimate criteria for assessing the development of a country, not economic growth alone. The HDI can also be used to question national policy choices, asking how two countries with the same level of GNI per capita can end up with such different human development outcomes. For example, the Bahamas and New Zealand have similar levels of income per person, but life expectancy and expected years of schooling differ greatly between the two countries, resulting in New Zealand having a much higher HDI value than the Bahamas.These striking contrasts can stimulate debate about government policy priorities. What are the criteria for a country to be included in the HDI? The Human Development Report Office strives to include as many UN member countries as possible in the HDI. To include a country in the HDI we need recent, reliable and comparable data for all three dimensions of the Index. For a country to be included, statistics should ideally be available from the relevant international data agencies. India’s position in the worldIndia ranks a low 134 among 187 countries in the list that is headed by Norway and in which the Democratic Republic of Congo is at the very bottom in terms of the human development index (HDI). India's ranking in 2010 was 119 out of 169 countries. According to the â€Å"UN Human Development Report 2011: Sustainability and Inequality†, India's HDI is 0. 5 compared to 0. 3 in 2010. Comparison of India with few other countries Countries| Per Capita income in US $| Literacy Rate| Life Expectancy in years| HDI Rank| India| 1600| 74%| 67. 1| 134|US| 48,147| 99%| 79| 4| Canada| 51,147| 99%| 80. 7| 6| Germany| 40,631| 99%| 79. 4| 9| Nepal| 650| 68. 2%| 66. 5| 157| Pakistan| 1250| 70%| 66 . 3| 145| Growth Pattern of India Factors responsible for growth of India The then Prime Minister Narasimha Rao, along with his finance minister Manmohan Singh, initiated the economic liberalization of 1991. The reforms did away with the Licence Raj, reduced tariffs and interest rates and ended many public monopolies, allowing automatic approval of foreign direct investment in many sectors.Since then, the overall thrust of liberalization has remained the same, although no government has tried to take on powerful lobbies such as trade unions and farmers, on contentious issues such as reforming labour laws and reducing agricultural subsidies. By the turn of the 20th century, India had progressed towards a free-market economy, with a substantial reduction in state control of the economy and increased financial liberalization. This has been accompanied by increases in life expectancy, literacy rates and food security, although urban residents have benefited more than agricultural reside nts.Also the boom in IT and other industries in services sector helped India to achieve economic strength whereby foreign currency started pouring in into the market. This was supported by the availability of skilled labours, talented brains and large young population. Growth Pattern of Nepal Nepal’s economic growth continues to be adversely affected by the political uncertainty. Nevertheless, real GDP growth is estimated to increase to almost 5 percent for 2011/2012. This is a considerable improvement from the 3. 5 percent GDP growth in 2010/2011 and would be the second highest growth rate in the post-conflict era.Sources of growth include agriculture, construction, financial and other services. The contribution of growth by consumption fueled by remittances has declined since 2010/2011. While remittance growth slowed to 11 percent (in Nepali Rupee terms) in 2010/2011 it has since increased to 37 percent. Remittances are estimated to be equivalent to 25-30 percent of GDP. In flation has been reduced to a three-year low to 7 percent. The proportion of poor people has declined substantially in recent years. The percentage of people living below the international poverty line (people earning less than US$1. 5 per day) has halved in only seven years. At this measure of poverty the percentage of poor people declined from 53. 1% in 2003/2004 to 24. 8% in 2010/2011. With a higher poverty line of US$2 dollars per-capita per day, poverty declined by one quarter to 57. 3%. However, the income distribution remains grossly uneven. Growth Pattern of Canada Factors responsible for growth in Canada The Canadian economy improved dramatically after 1896, and from that year until 1914, Canada had the world's fastest growing economy. The west was settled, the population grew quickly.The cause of this boom is debated. Whether the settlement of the west was a cause or effect of the boom is one of the most important issues. Globally the economy was improving with the end of the Long Depression. The last semi-humid farmland in the United States was exhausted, leaving Canada with the best unexploited farm land in North America. Technological changes from the steel plow to combine harvesters played an important role, but perhaps the most important development was the practice of dry farming that allowed farmers to profitably grow wheat on the semi-arid southern prairies.The most noted expansion was in western Canada, but at the same time Central Canada was undergoing a period of significant industrialization. While western and central Canada boomed during the pre-World War I years the economies of the three Maritime Provinces grew far more slowly. Investors from US and UK helped fuel country’s economic growth. Growth pattern of USA Factors responsible for growth in USA In the early years of American history, most political leaders were reluctant to involve the federal government too heavily in the private sector, except in the area of transportatio n.In general, they accepted the concept of laissez-faire, a doctrine opposing government interference in the economy except to maintain law and order. This attitude started to change during the latter part of the 19th century, when small business, farm, and labor movements began asking the government to intercede on their behalf. By the turn of the century, a middle class had developed that was leery of both the business elite and the somewhat radical political movements of farmers and laborers in the Midwest and West.Known as Progressives, these people favored government regulation of business practices to, in their minds, ensure competition and free enterprise. Congress enacted a law regulating railroads in 1887 (the Interstate Commerce Act), and one preventing large firms from controlling a single industry in 1890 (the Sherman Antitrust Act). Many of today's U. S. regulatory agencies were created during these years, including the Interstate Commerce Commission and the Federal Tra de Commission. Electrification in the U. S. started in industry ca. 1900 and by 1930 about 80% of power used in industry was electric.Tractors began being mass-produced. In the 1980s, Japan was accelerating its speed and catching up to the USA. In the face of competition from Japan, Americans did not give up hope, but acted with a great sense of urgency. Ronald Reagan called on the industrial association and think-tanks to discuss countermeasures. Through investigation and analysis, they found that the computer and communications industries were beginning to show vitality and had large market potential. In the future, it was possible that they would develop into the world's largest industries.Therefore, the Reagan administration declined to adopt a short-term, profit-oriented competition strategy; rather, it adopted methods that allowed universities to work collaboratively with enterprises to co-develop the computer and communications industries. During the Clinton administration, a large investment was made in building up the world’s internet highway. Growth Pattern of Pakistan Growth Pattern of Germany Factors responsible for growth of Germany Germany's economic growth stemmed from a number of causes. One of the main physical reasons behind economic growth was the sophistication of infrastructure.Between 1845 and 1870 5000 more miles of rail had beenbuilt and in 1850 Germany was building her own locomotives. This increase of rail transport created a huge demand for coal, iron and buildings, therefore industry began on a plant style level. All of this increased the amount of labour needed. The labour need was fuelled by a population growth. From 35 million people in 1840 Germanygrew to 49 million people in 1875 creating a young dynamic workforce,full of innovated ideas for the new industry. Not only was the workforce gained from a population increase, urbanisation also added to the need.People working in factories grew from 4% to 10%. Banks, particular ly investment banks gave a great stimulus to industrialization. It was a combination of commercial enterprise, investment, and investment trusts backed by large central banks. The second industrial revolution was promoted by a number of important factors. Most important of these was probably the scientific-technological developments at the end of the century. Another factor which propelled German industry forward was the unification of the monetary system, made possible in part by political unification.Another economic factor was the increased markets,domestic and overseas. Comparison of growth patterns Why HDI of India is low? While we are steadily increasing our investments in health and education, we have been let down at the most basic level: female mortality rates. Our maternal mortality figures are 450 deaths per 100,000, which is the worst in south Asia. Our adolescent fertility rates also let us down, as do figures for female education. Yet, a quick stroll through the HDI fi gures does show some improvement across sectors in most parts of the country.The stumbling blocks are Uttar Pradesh, Bihar, Madhya Pradesh, Jharkhand, Chhattisgarh, parts of West Bengal and even Maharashtra. Quite obviously, in our race to get ahead, we have forgotten the basics. It has taken us over 60 years since the Constitution was adopted to pass the Right to Education Act for free and compulsory secondary education to all, even though it has long been a part of our Directive Principles. Our dropout rate is high and the girl child is the first to lose the race to school. More painful is the rich-poor divide.Our cities may be full of state-of-the-art hospitals, ready to cater to medical tourists, but village after village in India does not even have access to primary health care. We supply doctors all over the world but are unable to service our own needy. It is almost as if we have got so used to being a poor country that we hardly notice it any more. But as the Sensex and the economy show, India is no longer an ultra-poor country in the aggregate. But we still have a shockingly large proportion of poor people who are being deprived of just about everything.This HDI report is just one more reminder of how far we have to go. It tells us where our priorities should be. India has made huge strides in the field of education and water supply system but the biggest block in the human development indices for India is in the field of sanitation where 58 per cent of open defecation in the world takes place in India. A mere expenditure of Rs 2000 crore (Rs 20 billion) in the field of sanitation is being made while the budget for water supply was Rs 20,000 crore (Rs 200 billion). AgricultureSlow agricultural growth is a concern for policymakers as some two-thirds of India’s people depend on rural employment for a living. Current agricultural practices are neither economically nor environmentally sustainable and India's yields for many agricultural commodities are low. Poorly maintained irrigation systems and almost universal lack of good extension services are among the factors responsible. Farmers' access to markets is hampered by poor roads, rudimentary market infrastructure, and excessive regulation. Agricultural output of India lags far behind its potential.The low productivity in India is a result of several factors. According to the World Bank, India's large agricultural subsidies are hampering productivity-enhancing investment. While overregulation of agriculture has increased costs, price risks and uncertainty, governmental intervention in labour, land, and credit markets are hurting the market. Infrastructure such as rural roads, electricity, ports, food storage, retail markets and services are inadequate. Further, the average size of land holdings is very small, with 70% of holdings being less than one hectare in size.The partial failure of land reforms in many states, exacerbated by poorly maintained or non-existent land reco rds, has resulted in sharecropping with cultivators lacking ownership rights, and consequently low productivity of labour. Adoption of modern agricultural practices and use of technology is inadequate, hampered by ignorance of such practices, high costs, illiteracy, slow progress in implementing land reforms, inadequate or inefficient finance and marketing services for farm produce and impracticality in the case of small land holdings. The allocation of water is inefficient, unsustainable and inequitable.The irrigation infrastructure is deteriorating. Irrigation facilities are inadequate, as revealed by the fact that only 39% of the total cultivable land was irrigated as of 2010, resulting in farmers still being dependent on rainfall, specifically the monsoon season, which is often inconsistent and unevenly distributed across the country. Corruption Corruption has been one of the pervasive problems affecting India. A 2005 study by Transparency International (TI) found that more than half of those surveyed had firsthand experience of paying bribe or peddling influence to get a job done in a public office in the previous year.A follow-on 2008 TI study found this rate to be 40 percent. In 2011, Transparency International ranked India at 95th place amongst 183 countries in perceived levels of public sector corruption. In 1996, red tape, bureaucracy and the Licence Raj were suggested as a cause for the institutionalised corruption and inefficiency. More recent reports suggest the causes of corruption in India include excessive regulations and approval requirements, mandated spending programs, monopoly of certain goods and service providers by government controlled institutions, bureaucracy with discretionary powers, and lack of transparent laws and processes.The Right to Information Act (2005) which requires government officials to furnish information requested by citizens or face punitive action, computerisation of services, and various central and state governmen t acts that established vigilance commissions, have considerably reduced corruption and opened up avenues to redress grievances. The number of people employed in non-agricultural occupations in the public and private sectors. Totals are rounded. Private sector data relates to non-agriculture establishments with 10 or more employees. The current government has concluded that most spending fails to reach its intended recipients.A large, cumbersome and tumor-like bureaucracy sponges up or siphons off spending budgets. India's absence rates are one of the worst in the world; one study found that 25% of public sector teachers and 40% of public sector medical workers could not be found at the workplace. The Indian economy has an underground economy, with an alleged 2006 report by the Swiss Bankers Association suggesting India topped the worldwide list for black money with almost $1,456 billion stashed in Swiss banks. This amounts to 13 times the country's total external debt. EducationInd ia has made huge progress in terms of increasing primary education attendance rate and expanding literacy to approximately three-fourth of the population. India's literacy rate had grown from 52. 2% in 1991 to 74. 04% in 2011. The right to education at elementary level has been made one of the fundamental rights under the eighty-sixth Amendment of 2002, and legislation has been enacted to further the objective of providing free education to all children. However, the literacy rate of 74% is still lower than the worldwide average and the country suffers from a high dropout rate.Further, there exists a severe disparity in literacy rates and educational opportunities between males and females, urban and rural areas, and among different social groups. Infrastructure In the past, development of infrastructure was completely in the hands of the public sector and was plagued by slow progress, poor quality and inefficiency. India's low spending on power, construction, transportation, teleco mmunications and real estate, at $31 billion or 6% of GDP in 2002 had prevented India from sustaining higher growth rates.This has prompted the government to partially open up infrastructure to the private sector allowing foreign investment, and most public infrastructure, barring railways, is today constructed and maintained by private contractors, in exchange for tax and other concessions from the government. While 80% of Indian villages have at least an electricity line, just 44% of rural households have access to electricity. Some half of the electricity is stolen, compared with 3% in China. The stolen electricity amounts to 1. 5% of GDP.Transmission and distribution losses amount to around 20%, as a result of an inefficient distribution system, handled mostly by cash-strapped state-run enterprises. Almost all of the electricity in India is produced by the public sector. Power outages are common, and many buy their own power generators to ensure electricity supply. 6] Substantia l improvements in water supply infrastructure, both in urban and rural areas, have taken place over the past decade, with the proportion of the population having access to safe drinking water rising from 66% in 1991 to 92% in 2001 in rural areas, and from 82% to 98% in urban areas.However, quality and availability of water supply remains a major problem even in urban India, with most cities getting water for only a few hours during the day. Economic disparities A critical problem facing India's economy is the sharp and growing regional variations among India's different states and territories in terms of poverty, availability of infrastructure and socio-economic development. Six low-income states – Bihar, Chhattisgarh, Jharkhand, Madhya Pradesh, Orissa and Uttar Pradesh – are home to more than one third of India's population.Severe disparities exist among states in terms of income, literacy rates, life expectancy and living conditions. The five-year plans, especially i n the pre-liberalization era, attempted to reduce regional disparities by encouraging industrial development in the interior regions and distributing industries across states, but the results have not been very encouraging since these measures in fact increased inefficiency and hampered effective industrial growth.After liberalization, the more advanced states have been better placed to benefit from them, with well-developed infrastructure and an educated and skilled workforce, which attract the manufacturing and service sectors. The governments of backward regions are trying to reduce disparities by offering tax holidays and cheap land, and focusing more on sectors like tourism which, although being geographically and historically determined, can become a source of growth and develops faster than other sectors.In fact, the economists fail to realize that ultimately the problem of equitable growth or inclusive growth is intricately related to the problems of good governance and tran sparency. HDI for Indian states State| HDI| Rank| Maharashtra| 0. 689| 12| Madhya Pradesh| 0. 375| 33| Kerala| 0. 921| 1| Reasons for low HDI in Madhya Pradesh and Maharashtra as compared to Kerala: Life Expectancy: The life expectancy in MP is 56. 5 years for male and 56. 2 years for females averaging around 56. 4. The life expectancy in Maharashtra is 64. 5 for males and 67 for females averaging to 65. 8 years for the total population.The life expectancy in Kerala is 73. 5 years. As an important component of HDI life expectancy should be higher, but here it is low as compared to Kerala. Literacy rate: The literacy rate in MP is only 64. 11% which is very low. More than that literacy rate of women is very low. The literacy rate in Maharashtra is 77. 21 % whereas in Kerala it is 90. 92 %. Literacy is reasonably a good indicator of development in a society. Spread and diffusion f literacy is generally associated with essential trait of today’s civilization such as urbanization , modernization, industrialization, communication and commerce.Standard of living: The main factors influencing standard of living are poverty, physical infrastructure, regional imbalance. Poverty is very high in MP. Also the physical infrastructure is very poor. Poverty is high I Maharashtra because of high population. The physical infrastructure varies from region to region. In cities like Mumbai and Pune the infrastructure is world class, but in other regions of the state the infrastructure is not so good which shows regional imbalance Poverty in Kerala is very low. All over Kerala the physical infrastructure is good, there is no regional imbalance. Human Development Index Introduction: The Human Development Index (HDI) is a composite statistic used to rank countries by level of â€Å"human development† and separate â€Å"very high human development†, â€Å"high human development†, â€Å"medium human development†, and â€Å"low human development† countries. The Human Development Index (HDI) is a comparative measure of life expectancy, literacy, education and standards of living for countries worldwide. It is a standard means of measuring well-being, especially child welfare. It is used to distinguish whether the country is a developed, a developing or an under-developed country, and also to measure the impact of economic policies on quality of life. There are also HDI for states, cities, villages, etc. by local organizations or companies. Background: The origins of the HDI are found in the annual Human Development Reports of the United Nations Development Programme (UNDP). These were devised and launched by Pakistani economist Mahbub ul Haq in 1990 and had the explicit purpose ‘‘to shift the focus of development economics from national income accounting to people centered policies’’. To produce the Human Development Reports, Mahbub ul Haq brought together a group of well-known development economists including: Paul Streeten, Frances Stewart, Gustav Ranis, Keith Griffin, Sudhir Anand and Meghnad Desai. But it was Nobel laureate Amartya Sen’s work on capabilities and functionings that provided the underlying conceptual framework. Haq was sure that a simple composite measure of human development was needed in order to convince the public, academics, and policy-makers that they can and should evaluate development not only by economic advances but also improvements in human well-being. Sen initially opposed this idea, but he went on to help Haq develop the Human Development Index (HDI). Sen was worried that it was difficult to capture the full complexity of human capabilities in a single index but Haq persuaded him that only a single number would shift the attention of policy-makers from concentration on economic to human well-being. Data collection: Life expectancy at birth is provided by the UN Department of Economic and Social Affairs; mean years of schooling by Barro and Lee (2010); expected years of schooling by the UNESCO Institute for Statistics; and GNI per capita by the World Bank and the International Monetary Fund. For few countries, mean years of schooling are estimated from nationally representative household surveys. Many data gaps still exist in even some very basic areas of human development indicators. While actively advocating for the improvement of human development data, as a principle and for practical reasons, the Human Development Report Office does not collect data directly from countries or make estimates to fill these data gaps in the Report. Dimensions and calculation: Published on 4 November 2010, starting with the 2010 Human Development Report the HDI combines three dimensions: 1. A long and healthy life: Life expectancy at birth 2. Access to knowledge: Mean years of schooling and Expected years of schooling 3. A decent standard of living: GNI per capita (PPP US$) The HDI combined three dimensions up until its 2010 report: 1. Life expectancy at birth, as an index of population health and longevity 2. Knowledge and education, as measured by the adult literacy rate (with two-thirds weighting) and the combined primary, secondary, and tertiary gross enrollment ratio (with one-third weighting). 3. Standard of living, as indicated by the natural logarithm of gross domestic product per capita at purchasing power parity. New methodology for 2010 data onwards: In its 2010 Human Development Report the UNDP began using a new method of calculating the HDI. The following three indices are used: LE ¬-20 1. Life Expectancy Index (LEI) = 63. 2 vMYSI . EYSI 2. Education Index (EI) = 0. 951 ln (GNIpc) – ln (163) 3. Income Index (II) = ln(108,211) – ln (163) Finally, the HDI is the geometric mean of the previous three normalized indices: HDI = v LEI . EI . II 2010 report: The 2010 Human Development Report by the United Nations Development Program was released on November 4, 2010, and calculates HDI values based on estimates for 2010. Criticisms: The Human Development Index has been criticised on a number of grounds, including failure to include any ecological considerations, focusing exclusively on national performance and ranking (although many national Human Development Reports, looking at subnational performance, have been published by UNDP and others—so this last claim is untrue), not paying much attention to development from a global perspective and based on grounds of measurement error of the underlying statistics and formula changes by the UNDP which can lead to severe misclassifications of countries in the categories of being a ‘low', ‘medium', ‘high' or ‘very high' human evelopment country. Other authors claimed that the Human Development Reports â€Å"have lost touch with their original vision and the index fails to capture the essence of the world it seeks to portray†. The index has also been criticized as â€Å"redundant† and a â€Å"reinvention of the wheel†, m easuring aspects of development that have already been exhaustively studied. The index has further been criticised for having an inappropriate treatment of income, lacking year-to-year comparability, and assessing development differently in different groups of countries. Economist Bryan Caplan has criticised the way HDI scores are produced; each of the three components are bounded between zero and one. As a result of that, rich countries effectively cannot improve their rating (and thus their ranking relative to other countries) in certain categories, even though there is a lot of scope for economic growth and longevity left. â€Å"This effectively means that a country of immortals with infinite per-capita GDP would get a score of . 66 (lower than South Africa and Tajikistan) if its population were illiterate and never went to school. † He argues, â€Å"Scandinavia comes out on top according to the HDI because the HDI is basically a measure of how Scandinavian your country is. † Economists Hendrik Wolff, Howard Chong and Maximilian Auffhammer discuss the HDI from the perspective of data error in the underlying health, education and income statistics used to construct the HDI. 18] They identify three sources of data error which are due t o (i) data updating, (ii) formula revisions and (iii) thresholds to classify a country’s development status and find that 11%, 21% and 34% of all countries can be interpreted as currently misclassified in the development bins due to the three sources of data error, respectively. The authors suggest that the United Nations should discontinue the practice of classifying countries into development bins because the cut-off values seem arbitrary, can provide incentives for strategic behavior in reporting official statistics, and have the potential to misguide politicians, investors, charity donators and the public at large which use the HDI. In 2010 the UNDP reacted to the criticism and updated the thresholds to classify nations as low, medium and high human development countries. In a comment to The Economist in early January 2011, the Human Development Report Office responded[24] to a January 6, 2011 article in The Economist which discusses the Wolff et al. paper. The Human Development Report Office states that they undertook a systematic revision of the methods used for the calculation of the HDI and that the new methodology directly addresses the critique by Wolff et al. in that it generates a system for continuous updating of the human development categories whenever formula or data revisions take place. The following are common criticisms directed at the HDI: that it is a redundant measure that adds little to the value of the individual measures composing it; that it is a means to provide legitimacy to arbitrary weightings of a few aspects of social development; that it is a number producing a relative ranking which is useless for inter-temporal comparisons, and difficult to compare a country's progress or regression since the HDI for a country in a given year depends on the levels of, say, life expectancy or GDP per capita of other countries in that year. However, each year, UN member states are listed and ranked according to the computed HDI. If high, the rank in the list can be easily used as a means of national aggrandizement; alternatively, if low, it can be used to highlight national insufficiencies. Using the HDI as an absolute index of social welfare, some authors have used panel HDI data to measure the impact of economic policies on quality of life. Ratan Lal Basu criticises the HDI concept from a completely different angle. According to him the Amartya Sen-Mahbub ul Haq concept of HDI considers that provision of material amenities alone would bring about Human Development, but Basu opines that Human Development in the true sense should embrace both material and moral development. According to him human development based on HDI alone, is similar to dairy farm economics to improve dairy farm output. To quote: ‘So human development effort should not end up in amelioration of material deprivations alone: it must undertake to bring about spiritual and moral development to assist the biped to become truly human. [31] For example, a high suicide rate would bring the index down. A few authors have proposed alternative indices to address some of the index's shortcomings. However, of those proposed alternatives to the HDI, few have produced alternatives covering so many countries, and that no development index (other than, perhaps, Gross Domestic Product per capita) has been used so extensively—or ef fectively, in discussions and developmental planning as the HDI. However, there has been one lament about the HDI that has resulted in an alternative index: David Hastings, of the United Nations Economic and Social Commission for Asia and the Pacific published a report geographically extending the HDI to 230+ economies, whereas the UNDP HDI for 2009 enumerates 182 economies and coverage for the 2010 HDI dropped to 169 countries

Belonging Essay Essay

Text One: The China Coin. The China Coin is a short fiction novel for adolescents composed by Allan Baillie, released in 1991. The text explores the instinctive human need we feel to belong culturally, within our family and to belong to a peer group. Following the life of an Eurasian teenager named Leah and her mother, Joan, as they journey to China in search of the missing half of a broken coin, which Joan’s father sent her before he passed away. The coin is the only connection the women have left with their lost family in China. Upon searching for the coin, the characters are not only discovering their extensive family, but the history behind it, giving them an ultimate sense of identity and belonging, bringing a positive change in both characters’’ mindsets. A relevant concept is that belonging may emerge through a person, object or place to enrich a community or group. A massive element of belonging within the text is the symbolism of the half-coin. A quote from page 35 states: â€Å"This broken coin has been in our family for a long time. The other half of the coin is kept by the family in our ancestral village. Perhaps the coin should become one again.† Outlining the coin acting as a connecting passageway between the members of the family, and showing the enrichment stowed upon the group. Baillie has used symbolism to portray self identity and cultural identity, much like the Simple Gift. â€Å"†¦and I looked up into the sky, the deep blue sky that Old Bill and I shared.’ (page.205) also indicates this connecting passageway through an object shared between individuals like Baillie. Another connection item in ‘The Simple Gift’ is the key Old Bill gives to Billy, symbolizing the key to all of Billyâ€⠄¢s problems, and also metaphorically unlocking the door to his future. Metaphors are also used in ‘The China Coin’. Metaphors are used to paint visual images, page 16 is a good example of this. â€Å"I am a giant, she thought.† This quote explains the self belonging issues Leah is experiencing. The idea that appearance effects how you belong is a strong and relatable one to the target audience of adolescents, giving insight that for a lot of young people, this is a firm and struggling issue.  This particular metaphoric example, is also a useful personal insight to how the character is feeling. Another successful way to directly express personal insight is through inner monologues. Baillie has used this particularly strongly on page 158. Quoting: â€Å"How long have you been here?†¦six weeks from that neurotic kid that feared her mother was going to throw some sort of spell to make her Chinese, but you’re not not Chinese either. It doesn’t matter anymore.† This extract reflects Leah’s feelings about her growing acceptance of her Chinese heritage in Red Star Village. The readers watch Leah progress from feeling as though she doesn’t belong in China but identified strongly with her Australian and European links. Leah was ‘not Chinese’, but the viewers watch as the experiences and contacts with friends and family in China change her outer appearance and she realizes it no longer matters. Inner monologues our personal thoughts emphasise the personal view of the character, ‘The Simple Gift’ displays numerous of th ese as the text is written in first person from alternating characters point of views. ‘The China Coin’ by Allan Baillie really exemplifies the ambition to belong, particularly in family and cultural groups, but also within a peer group, through symbolism, metaphors and personal statements, much like the prescribed texts, and selected other related texts.