History Of Mental Illness Health And Social Care Essay

History Of Mental Illness Health And Social Care Essay Mental illness is a general term for a group of illnesses. Mental disorders result from biological, developmental and/or psychosocial factors. A mental illness can be mild or severe, temporary or prolonged. Mental illness can come and go throughout a persons life. Some people experience their illness only once and fully recover. For others, it is prolonged and recurs over time. Mental illness can make it difficult for someone to cope with work, relationships and other aspects of their life. Definition of mental illness Mental illnesses are medical conditions that disrupt a persons thinking, feeling, mood, ability to relate to others and daily functioning. Just as diabetes is a disorder of the pancreas, mental illnesses are medical conditions that often result in a diminished capacity for coping with the ordinary demands of life. Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, post traumatic stress disorder (PTSD) and borderline personality disorder. The good news about mental illness is that recovery is possible. Mental illnesses can affect persons of any age, race, religion, or income. Mental illnesses are not the result of personal weakness, lack of character or poor upbringing. Mental illnesses are treatable. Most people diagnosed with a serious mental illness can experience relief from their symptoms by actively participating in an individual treatment plan. In addition to medication treatment, psychosocial treatment such as cognitive behavioral therapy, interpersonal therapy, peer support groups and other community services can also be components of a treatment plan and that assist with recovery. The availability of transportation, diet, exercise, sleep, friends and meaningful paid or volunteer activities contribute to overall health and wellness, including mental illness recovery. History of Mental illness Timeline 1247: Bethlehem Hospital (more frequently known as Bedlam) opens in London to house distraught and lunatik people. 1566: The New Worlds first mental hospital is established in Mexico City. 1774: The Act for Regulating Madhouses, Licensing, and Inspection is passed in England. The law forbade a persons commitment to a madhouse without a physicians certification of that individuals insanity. 1790s: A Quaker called William Turke opens the York Retreat near York, England, an asylum for the mentally ill. The Retreat favored humane treatment; physical restraints were not used and patients were comfortably housed. 1790s: French physician Phillipe Pinel begins working at the Bicentre and Salpetriere asylums where he develops traitement morale, a form of treatment that focused on the mental origins of madness. His kind treatment of his patients brought about recovery for many 1817: Quakers in Philadelphia open the first asylum in America based on the principles of moral treatment. 1841: Dorothea Dix, a schoolteacher from Cambridge Massachusetts, becomes inspired to take up the cause of the mentally ill. She travels to several states where she lobbies state legislatures to better their treatment of the mentally ill. Over thirty state mental hospitals were opened as a result of her efforts. 1867: The Packard Law passes in Illinois. Named for Eliza Packard, a woman committed against her will by her husband after a property dispute, the law required that a patients insanity be determined by a jury before he or she could be sent to an institution. 1927: The US Supreme Court rules in Buck v. Bell that the forced sterilization of defectives, including the mentally ill, is constitutional. 1954: The Durham Rule is established by the US Court of Appeals for the District of Columbia. It states that a person accused of a crime is not responsible if the criminal act was the product of a mental disease or a mental defect. It was later rejected due to problems defining mental disease and product. 1963: Congress passes the Community Mental Health Centers Act. This leads to the closure of many large state psychiatric hospitals. 1966: Lake v. Cameron, a case of the US Court of Appeals for the District of Columbia Circuit , declares that patients in psychiatric hospitals have the right to receive treatment in the setting that is least restrictive. 1975: US Senate holds hearings about the use of neuroleptics (antipsychotic drugs such as Thorazine) in juvenile jails and homes for the developmentally disabled. 1979: NAMI is founded. 1988: The Fair Housing Amendments Act prohibits housing discrimination against people with disabilities, including mental disabilities. 1990: The Americans with Disabilities Act is passed. It prohibits discrimination against people with physical or mental disabilities. 2004: DuPage County begins the Mental Illness Court Alternative Program (MICAP.) 2008: Congress passes the Mental Health Parity and Addictions Equity Act. It requires that any limits to insurance coverage for mental illness be no more restrictive than those for physical health issues. 2010: Williams v. Quinn, a case heard by U.S. District Court for the Northern District of Illinois, rules that Illinois residents with mental illnesses living in nursing homes and other institutions for mental diseases (IMDs) have the right to live in integrated settings in the community Types of Mental Illness There are many different conditions that are recognized as mental illnesses. The more common types include: Anxiety disorders: People with anxiety disorders respond to certain objects or situations with fear and dread, as well as with physical signs of anxiety or nervousness, such as a rapid heartbeat and sweating. An anxiety disorder is diagnosed if the persons response is not appropriate for the situation, if the person cannot control the response, or if the anxiety interferes with normal functioning. Anxiety disorders include generalized anxiety disorder, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), panic disorder, social anxiety disorder, and specific phobias. Mood disorders: These disorders, also called affective disorders, involve persistent feelings of sadness or periods of feeling overly happy, or fluctuations from extreme happiness to extreme sadness. The most common mood disorders are depression, mania, and bipolar disorder. Psychotic disorders: Psychotic disorders involve distorted awareness and thinking. Two of the most common symptoms of psychotic disorders are hallucinations the experience of images or sounds that are not real, such as hearing voices and delusions, which are false beliefs that the ill person accepts as true, despite evidence to the contrary. Schizophrenia is an example of a psychotic disorder. Eating disorders: Eating disorders involve extreme emotions, attitudes, and behaviors involving weight and food. Anorexia nervosa, bulimia nervosa and binge eating disorder are the most common eating disorders. Impulse control and addiction disorders: People with impulse control disorders are unable to resist urges, or impulses, to perform acts that could be harmful to themselves or others. Pyromania (starting fires), kleptomania (stealing), and compulsive gambling are examples of impulse control disorders. Alcohol and drugs are common objects of addictions. Often, people with these disorders become so involved with the objects of their addiction that they begin to ignore responsibilities and relationships. Personality disorders: People with personality disorders have extreme and inflexible personality traits that are distressing to the person and/or cause problems in work, school, or social relationships. In addition, the persons patterns of thinking and behavior significantly differ from the expectations of society and are so rigid that they interfere with the persons normal functioning. Examples include antisocial personality disorder, obsessive-compulsive personality disorder, and paranoid personality disorder. Other, less common types of mental illnesses include: Recommended Related to Mental Health Adjustment disorder: Adjustment disorder occurs when a person develops emotional or behavioral symptoms in response to a stressful event or situation. The stressors may include natural disasters, such as an earthquake or tornado; events or crises, such as a car accident or the diagnosis of a major illness; or interpersonal problems, such as a divorce, death of a loved one, loss of a job, or a problem with substance abuse. Adjustment disorder usually begins within three months of the event or situation and ends within six months after the stressor stops or is eliminated. Dissociative disorders: People with these disorders suffer severe disturbances or changes in memory, consciousness, identity, and general awareness of themselves and their surroundings. These disorders usually are associated with overwhelming stress, which may be the result of traumatic events, accidents, or disasters that may be experienced or witnessed by the individual. Dissociative identity disorder, formerly called multiple personality disorder, or split personality, and depersonalization disorder are examples of dissociative disorders. Factitious disorders: Factitious disorders are conditions in which physical and/or emotional symptoms are created in order to place the individual in the role of a patient or a person in need of help. Sexual and gender disorders: These include disorders that affect sexual desire, performance, and behavior. Sexual dysfunction, gender identity disorder, and the paraphilias are examples of sexual and gender disorders. Somatoform disorders: A person with a somatoform disorder, formerly known as psychosomatic disorder, experiences physical symptoms of an illness, even though a doctor can find no medical cause for the symptoms. Tic disorders: People with tic disorders make sounds or display body movements that are repeated, quick, sudden, and/or uncontrollable. (Sounds that are made involuntarily are called vocal tics.) Tourettes syndrome is an example of a tic disorder. Other diseases or conditions, including various sleep-related problems and many forms of dementia, including Alzheimers disease, are sometimes classified as mental illnesses, because they involve the brain. Causes of Mental Illness Were aware of several different forms of mental illnesses, right from bipolar disorder to schizophrenia to compulsive disorders. How often we come across murders carried out by mentally unstable people! In fact, there are scores of famous people with bipolar disorders. Mental illnesses are especially common in the United States. Approximately 26.2 % Americans above 18 years of age are believed to suffer from mental disorders every year, thereby conducing to one of the leading causes of disabilities in the US and Canada. But what causes mental illness? Mental illness is a condition affecting the brain, that influences the way a person thinks, feels, behaves and relates to others around him or her. The symptoms of mental illness may range from mild depressive symptoms to severe behavioral problems. Genetic Factors Depression and mental illnesses are often passed on from one generation to another through the genes. This means, a person with a family history of mental illness is more vulnerable to develop a mental illness. It is believed that mental illness is associated to various abnormalities in not just one, but several genes. This is the reason why the person inherits the vulnerability to develop this illness, but does not inherit the illness itself. When such people go through horrendous situations the balance of their mind tips and they get engulfed by mental illnesses. . Physical Factors People who have landed up injuring their head several times in accidents, are seen to damage certain areas of their brain and central nervous system, that lead to mental illnesses. Trauma occurring at the time of birth can also cause damage to the brain. Moreover, disruption of early fetal brain development can also lead to conditions like autism, etc. Some biological factors such as chemical imbalance in the brain, are also associated to mental illnesses. The chemicals called neurotransmitters help nerve cells in the brain to transfer impulses, thereby facilitating communication. However, when this balance tips, messages are not transferred correctly, leading to mental illness. Diseases affecting the brain such as Huntingtons chorea, multiple sclerosis and infections like Tuberculous meningitis, Encephalitis lethargica, etc. also result in mental illnesses. Psychological Factors People who have gone through harrowing experiences in their lives like emotional, physical, sexual abuse, domestic violence or bullying are often unable to cope with their traumatic past. Sometimes, the death of a loved one, betrayal or neglect during childhood years, also mars the persons emotional state of mind. This sometimes can be the reason of mental illness of a person. Social and Environmental Factors Poverty, living in a difficult and unsafe environment like in war zones, residing in earthquake prone and other natural disaster-prone areas, living in neighborhoods plagued by gangsters, etc. can lead to mental illnesses. These people develop a constant fear that conduces to mental illness. Moreover, unhealthy environment factors at home, such as growing up in a dysfunctional family, with narcissistic parents or neglecting parents can cause the balance of the childs brain to tip. The persons appearance regarding height and weight also causes depression in certain people. Mental illnesses should be not confused with mental retardation. People with mental illnesses do not exhibit limitations in mental, cognitive and social functions. Thus, causes of mental retardation and causes of mental illnesses are obviously different. The above mentioned causes cannot be viewed in isolation. Its when two or three different factors come together, such as past abuse and present horrendous situation come together, that it often causes the mental illness. It is important to not look upon people with mental illnesses with disdain and ostracize them. What they need is unconditional love. Espouse them and help them out of their pits of depression. The symptoms of mental illness A person with a mental illness can experience problems with their thinking, emotions and/or behaviour. These changes may happen quickly, or they may be gradual and subtle. It may take time to understand and identify what is happening. Psychotic symptoms These symptoms can include: Thoughts and feelings that are out of the ordinary or difficult to understand, such as thought of being persecuted or under surveillance for which there is no proof Experiencing sensations (seeing, hearing, smelling, tasting something when there is nothing there that others can identify) Odd behaviour. Schizophrenia is a psychotic illness. Mood symptoms Some of the symptoms of a changed mood may include: Persistent and pervasive feelings of sadness, elation, anxiety, fear or irritability Changes in sleep patterns Changes in appetite Loss of interest in things that were previously enjoyable Periods of increased or decreased activity, where things may be started and not finished Difficulty thinking and concentrating Excessive worries Changes in use of alcohol and other drugs. Exact causes are unknown Many mental illnesses are thought to have a biological cause. What are the exact causes , its unknown. The relationship between stress and mental illness is complex, but it is known that stress can worsen an episode of mental illness. Treatment: Extraordinary advances have been made in the treatment of mental illness. Understanding what causes some mental health disorders helps doctors tailor treatment to those disorders. As a result, many mental health disorders can now be treated nearly as successfully as physical disorders. Psychological treatment Psychological treatments are based on the idea that some problems relating to mental illness occur because of the way people react to, think about and perceive things. They are particularly relevant to many people with anxiety disorders and depression. Psychological treatments can reduce the distress associated with symptoms and can even help reduce the symptoms themselves. These therapies may take several weeks or months to show benefits. Different psychological therapies used in the treatment of mental illness include: Cognitive behaviour therapy (CBT) examines how a persons thoughts, feelings and behaviour can get stuck in unhelpful patterns. The person and therapist work together to develop new ways of thinking and acting. Therapy usually includes tasks to perform outside the therapy sessions. CBT may be useful in the treatment of depression, anxiety disorders and psychotic disorders such as bipolar and schizophrenia. Interpersonal psychotherapy examines how a persons relationships and interactions with others affect their own thoughts and behaviours. Difficult relationships may cause stress for a person with a mental illness and improving these relationships may improve a persons quality of life. This therapy may be useful in the treatment of depression. Dialectical behaviour therapy is a treatment for people with borderline personality disorder (BPD). A key problem for people with BPD is handling emotions. This therapy helps people to better manage their emotions and responses. Treatment with medication Medications are mainly helpful for people who are more seriously affected by mental illness. Different types of medication treat different types of mental illness: Antidepressant medications about 60 to 70 per cent of people with depression respond to initial antidepressant treatment. These medications are now also used (in combination with psychological therapies) to treat phobias, panic disorder, obsessive compulsive disorder and eating disorders. Antipsychotic medications are used to treat psychotic illnesses, for example schizophrenia and bipolar disorder. Newer antipsychotic medications may have some side effects, but tend to have fewer of the effects that were associated with the older medications, for example stiffening and weakening of the muscles and muscle spasms. Mood stabilising medications are helpful for people who have bipolar disorder (previously known as manic depression). These medications, such as lithium carbonate, can help reduce the recurrence of major depression and can help reduce the manic or high episodes. Other forms of treatment Effective treatment involves more than medications. Treatment may also involve: Community support including information, accommodation, help with finding suitable work, training and education, psychosocial rehabilitation and mutual support groups. Understanding and acceptance by the community is very important. Electroconvulsive therapy (ECT) this treatment can be a highly effective treatment for severe depression and, sometimes, for other diagnoses when other treatments have not been effective. After the person is given a general anaesthetic and muscle relaxant, an electrical current is passed through their brain. Hospitalisation this only occurs when a person is acutely ill and needs intensive treatment for a short time. It is considered better for a persons mental health to treat them in the community, in their familiar surroundings. Involuntary treatment this can occur when the psychiatrist recommends someone needs treatment but the person doesnt agree. In general, people receive involuntary treatment to ensure their own safety or that of others. Mental illness in Pakistan: Mental health in Pakistan has remained a subject of debate since the last few years. The incidence and prevalence have both increased tremendously in the background of growing insecurity, terrorism, economical problems, political uncertainty, unemployment and disruption of the social fabric. 1 Sinking below poverty line by almost 39% of the individuals is an alarming factor worth noting. Many people are now presenting to psychiatrists probably because of the growing awareness through the good work of media. Though there are many things which can be done to improve the mental health of the people in the areas of social environment, economic improvement and political harmony etc. but the important subject for debate is that, how far we are in the areas of education, service and research related to mental health having direct impact on the patient population. From 1947 to 2005, almost 58 years have passed since the independence of the country and many countries with this age have done w onders in overall upkeep of health care and specially the mental health. The scenario though is improving, but is it at the required pace? If we first take the area of education by virtue of which we train our future doctors who in turn can become navigators helping us in sailing smoothly through the heavy storm of up surging mental illnesses, we find lacunas which are evident when it comes to ultimate care of patients. With the exception of very few institutions, the subject of behavioral sciences which has been introduced by the PMDC in the early years of medical teaching is not being taken serious enough, low number of behavioral scientists cannot alone be blamed for this, there are no structured rotation programmes for senior medical students which means a calendar indicating topics, patient sessions, log book and evaluation strategy with weightage in the final year marking system. Low interest by students in the subject of psychiatry despite few institutions model teaching/trai ning programme is understandable in view of no separate paper in psychiatry and very low representation in the paper and clinico-orals of the subject of General Medicine. Regarding the departments, are we fulfilling the international requirements of a good department of psychiatry with full-fledged faculty in all hierarchies? The answer is simply no. Regarding the postgraduate education, how many recognized centers follow structured programmes emphasizing adequate patient exposure, ongoing continuing medical education programmes, research, exposure to subspecialties like, child, geriatric, forensic and rehabilitation psychiatry etc., is there a rural exposure, is there training in cultural issues, is there emphasis on liaison service and multidisciplinary team approach, is there a standard methodology for continuous monitoring and evaluation with resultant weightage in postgraduate exit examinations, is there training in audit and psychiatric administration, the answers to most of t hese questions will remain unanswered nationally. It is precautionary not to say a word about the selection criteria of evaluators and examiners lest it is not politically biased and motivated. It is also worth noting that during postgraduate training how many of the prospective specialists are monitored and assessed for culturally relevant mental state examination, adequate case note management, observation of prescribing practices and its justification, communication skills etc. Once certified, there is no provision of higher specialist training for a period of at least three years on the pattern of UK with evaluation of practice-based efficiency, infact, the UK model is worth adopting. 2 There is no trend for CME credit maintenance and hence no programme specifically designed for psychiatrists though there are many such programmes for the general practitioners of course with no condition of maintaining credit certification, this is mostly prompted by the pharmaceutical companies with a view of improving sale as evidence has shown that the knowledge of even most common disorder depression was not adequate among general practitioners. When we come to service, though the major teaching hospitals have established separate departments of psychiatry but in most of the cases they are not well equipped specially in terms of psychiatric manpower both skill and number wise. Still Pakistan has very low number of psychiatrists and these too are continuously being drained by the developed countries especially by the western world where they are being offered an attractive package and lifestyle that the question remains as to who comes back and serves the nation. 4 It is not surprising that there are a large number of Pakistani psychiatrists in United Kingdom, United States, Canada, Australia and New Zealand apart from those in Middle East, Africa and South East Asia. It seems that soon we shall become a psychiatrists exporting region like our neighbour India thus causing further deepening of the problem related to the already existing scarcity of psychiatrists. 5 Also, at the same time it is vitally important to abolish the feudal psychiatry which fortunately is being eroded by young generation of psychiatrists. There is also acute shortage of allied mental health professionals. In view of poverty, low health budget, high cost of medicines there is huge economic burden on the patients. 6 The hospitals also dont follow the intake/admission criteria, no separate unit for subspecialties, no appropriate long stay units, no exit/discharge criteria, no rehabilitation services, no exchange of information between psychiatrists and family practitioners, no proper advertisement of available services, no concept of day centers, day hospitals, ill developed community services, no central registry of patients and set policy for management systems in the psychiatric set ups and finally no internal referral system. As far as research is conc erned, there is still low representation in local accredited journals and very low in international journals. 7 Though there has been an increase in lay and scientific write-ups recently but it is still far from satisfactory state. Papers are produced for promotions and that too are for the sake of papers, matter of keeping up standards are ignored. The Journal of Clinical Psychiatry published regularly from Lahore once upon a time disappeared eventually. The first journal of Pakistan Psychiatric Society called JPPS was published in the year 2003, which was blocked politically and was not reproduced again. . It appears that still we are far behind in achieving the standards and in order to improve the existing scenario some steps are essential. In order to bring improvement in psychiatric education, it is important to pay emphasis on the subject of behavioral sciences, design an appropriate undergraduate training program in line with one of the international modules, inculcation of research interest among medical students, either introduction of a separate paper of psychiatry or at least 25% of weightage in the paper of medicine, at postgraduate level more structured training program with exposure to subspecialties, designing a postgraduate curriculum and module, introduction of audit of training and performance, provision of higher specialist training at the level of specialist registrar, private-public partnership in provision of services, mobilization of more resources for mental health and maintaining of records. There is a need for development of research culture especially in the a reas of need assessment is also necessary. Along with these efforts the medical fraternity can force the government to allocate a higher budget, reduce poverty, bring social justice and harmony, improving political scenario. It is also advisable to create better incentives for the mental health professionals in order to avert brain drain. Efforts for providing a conducive environment to the public to help in promoting sound mental as well as physical health are imperative. Literature Review Anxiety and depressive disorders are common in all regions of the world. 1 They constitute a substantial proportion of the global burden of disease, and are projected to form the second most common cause of disability by 2020.2 This increased importance of non-communicable diseases such as anxiety and depressive disorders presents a particular challenge for low income countries, where infectious diseases and malnutrition are still rife and where only a low percentage of gross domestic product is allocated to health services.3 These disorders are also important because of their economic consequences. 4 With an estimated population of 152 million, Pakistan is the sixth most populous country in the world. It is projected that, by 2050, the population will have increased to make it the fourth most populous country.5 There is a need to develop an evidence base to aid policy development on tackling anxiety and depressive disorders. We therefore conducted a systematic review as no such work existed to our knowledge. Our main questions were (a) what the estimated prevalence of anxiety and depressive disorders is in Pakistan and how this compares with estimates from other low income countries; (b) what the associated social, psychological, and biological factors are; and (c) what evidence exists for effectiveness of treatment or prevention in this population. Prevalence of anxiety and depressive disorders the prevalence of anxiety and depressive disorders estimated in the studies. The overall mean prevalence in men and women in the six studies of random community samples (n = 2658) was 33.62%, with the point prevalence varying from 28.8% to 66% for women (overall mean 45.5%) and from 10% to 33% for men (overall mean 21.7%). Women aged 15-49 were studied in a paper with 28.8% prevalence, while young men with a mean age of 18 participated in a study reporting 33% prevalence. Only one study reported adjusted prevalence with 95% confidence intervals. For those presenting to traditional or faith healers (n = 511), the prevalence of anxiety and depressive disorders among men varied from 2.65% to 27%, and among women from 11.5 % to 52%. Three studies looked at total psychiatric morbidity in primary care (n = 774). One described women in a rural area, with a prevalence of 50%, while another described 18% prevalence for men and 42.2% for women in an urban area. The third study, with a prevalence of 38.4%, did not specify participants sex. Of those presenting to psychiatric outpatients (n = 2430), the prevalence varied between 32% and 66.3%. There were two studies on psychiatric inpatients, one reported a prevalence of depressive illness of 37% (n = 2620), while the other reported 19.1% (n = 177). Comparison with other low income countries Using stringent criteria, Harding et al reported an overall frequency of anxiety and depression of 13.9% in four developing countries.9 Community studies from Africa have reported prevalences of 24% in rural Uganda and 20%-24% in rural South Africa. Among patients attending primary care, the prevalence varied from 8% to 29%. Patients attending primary care in India showed prevalences between 21% and 57%. In relation to risk factors, Abas and Broadhead found a significant association with formal employment, below average income, overcrowding, and certificate of secondary education in urban Zimbabwe.In the same study, they also found a significant association with humiliation or entrapment and with death or other l

Nagorno-Karabakh Conflict

Introduction From the beginning of the 1988 a conflict lasts between the South Caucasian nations of Azerbaijan and Armenia over the ownership area of Nagorno-Karabakh. The conflict has resulted in a considerable crisis especially in Azerbaijan, with the number of dislocated refugees close to approximately one million. As a result of the war over the NK region with Armenia, Azerbaijan has lost the entire NK region and 7 more surrounding districts of Lachin, Kelbajar, Agdam, Gabrail, Fizuli, Khubadly and Zangilan to Armenia. So Azerbaijan’s territories are occupied and lost fourteen percent of the territory. The conflict is considered as an internal conflict by the major powers and international organizations. As known, from the beginning of 1988 the conflict over Nagorno-Karabakh had an intra-state dimension which means the struggle for independence of Nagorno-Karabakh where are populated Armenian population. But since the beginning of 1922 the conflict possesses an inter-state dimension between two sovereign states: Azerbaijan and Armenia. So the conflict has become one of the most intractable disputes in the international arena and it is also the conflict of the region which has the largest geopolitical significance. So Azerbaijan and Armenia, as the two former Soviet Republics fought over the NK region from 1987 to 1994 in the forms of first communal clashes. Despite the fact that both states agreed on a cease-fire on the conflict in May 1994, the outcomes of the war are political turmoil, territorial losses and mass displacements. Though two sides recognized and ceased-fire armed force, but nevertheless conflict or confrontations existing in the form of diplomatic relations and by other ties relations. Problem and Significance The problem of this conflict lies under the disagreement of belligerents: Armenia and Azerbaijan. Especially, on the side of Armenian which occupied over the enclave land and doesn’t want recognize any resolution are contested and suggested by organizations. Here, one of the problems is influence of external powers which can support its side and made financial and military aid. Also here another problem is the refugees’ problem from both sides to the conflict and their integration into society. To this day, discussion of the problem of refugees has focused exclusively on Azeris from Karabakh or Armenia, with no serious mention of Armenian refugees from Azerbaijan. A comprehensive and fair solution to the refugee problem, consistent with the most basic international human rights standards, will treat all individuals that qualify as refugees independent of their national identity or current location of residence. But in case of significance, the main issue is the security issue which is so fragile. Because Caucasus states are located nearby Europe, Central Asia, Russia and Islamic states in which there are sufficient problems. It is so fragile because the conflict can effect to the neighbor states. This long-lasting problem must be provided by international organizations which peace-making process is going now and for future keeping safeness or security to the neighbors and for their sovereignty status. And this status must be resolve or guaranteed. Literature Review. The Armenia-Azerbaijan conflict over the Nagorno-Karabakh (NK) region of Azerbaijan, which in its modern form has continued for 20 years, is a complicated case study of multi-vector and multi-layered claims, mostly from the Soviet times, ranging from history, economy, and legal status, used to justify the military occupation (along with seven adjacent regions). The article illustrates that some of the weaker claims were dropped altogether, whilst others were continually mixed with additional charges to make them â€Å"stick†. Despite solid legal, historic and moral grounds, Azerbaijan has been lagging in clarifying and explaining the fictitious charges of NK’s supposed transfer to Azerbaijan’s suzerainty in 1920s, the legal status of NK itself, its economic and financial well-being, and the impossibility to apply the 3 April 1990 Soviet Law on Succession to the NK case whether for the purposes of justifying its independence or attachment to Armenia. Despite all the challenges and blame shared by all sides, NK and adjacent currently occupied territories are recognized as part of Azerbaijan, with the latter retaining all rights, including military, to return it under its full sovereignty. So, there are many scholars that wrote articles about Nagorno-Karabakh conflict. I want to mention some famous scholars’ articles. Philip Gamaghelyan wrote article about â€Å"Intractability of the Nagorno-Karabakh conflict: A myth or a reality? He provides a stakeholder analysis and examines political, economic, security and socio-cultural dynamics of the conflict. Distinguishing between the positions and the interests of the main actors, the paper evaluates the peace process, reveals the factors accounting for its continuing failure and develops recommendations on how the conflict can be resolved. This article is intended to call in question the myth of the intractability of the Nagorno-Karabakh conflict. Philip Gamaghelyan: â€Å"The ‘intractability’ of the Nagorno-Karabakh conflict is not attributable to the lack of vitality of a particular solution†. He also argues that any agreement that establishes a definite solution would require some concessions would dissatisfy one or both parties and would produce powerful ‘spoilers’ that could sabotage the peace process. Therefore it is necessary not to look for a fast solution, but to develop a long-term strategy of addressing underlying issues of the conflict such as mutual perceptions, security issues and democracy. In our opinion, the ‘intractability’ of the conflict in this article largely originates from the desire of parties to have a sense of the final status of the region, before addressing the underlying problems. I suggest that if this approach is reversed, all other issues are resolved, and an acceptable level of stability and cooperation in the region is achieved, the final status of Nagorno-Karabakh will become less significant, which will make it easier for parties to come to a compromise. Next article â€Å"Democratization as the key to Nagorno-Karabakh conflict resolution† was written by Tigran Mkrtchyan. Tigran Mkrtchyan: â€Å"Theoretically the risks of war or re-emergence of war are reduced by democratization and exacerbated by reversals in the democratization process, but rapid democratization which was the case after the collapse of the Soviet Union may bring weak regimes unable to establish effective control and political order† He mention these questions in his article â€Å"What can democratization give? Can it reach the peace? †. And also he mention â€Å"Political change or democratization can take many different forms and need not proceed in a unidirectional or linear fashion. The significance is that there be steady movement towards democracy in a given state. Changes toward autocracy and reversals of democratization are accompanied by increased risks of war involvement. Reversals are riskier than progress†. At issue therefore is not the rapidity of change toward democracy but the linearity of the process. Also the elections are indeed the first test of democratization, but by fair and transparent elections only one does not build a democratic society. So the ‘dangerous democratization hypothesis’ has suggested that emergent democracies may be quite prone to international violence, largely because of â€Å"deformed† institutional forces. The conflict is an obstacle to democratization, the solution of the war in the long run also rests with democratization. Democratization or â€Å"mature democracies† do not wage wars against each other. The democratization tendencies in the Soviet Union made many ethnic-nationalist conflicts within its space because the democratization was incomplete and political institutions weak. So, he think in order to have complete democratization they need to consolidate their internal institutions and elect or choose a good leader. Last article that I want to mention is â€Å"Nagorno-Karabakh: basis and reality of Soviet-era legal and economic claims used to justify the Armenia-Azerbaijan war† written by Adil Baguirov. In his article he maintain that regarding the early claims that the economy of NK region was supposedly deliberately neglected by Soviet Azerbaijani authorities, to both â€Å"punish† and â€Å"root out† Armenians, and this, allegedly, left no choice than for Armenian separatism and military action. Ironically, this argument did not stand the test of time and has been disproved by the fact, that the economic situation of the remaining Armenians in the occupied territories today is hardly better than it was before the war. This is not only the consensus of foreign journalists visiting the occupied territories, but also of the OSCE fact-finding mission in February 2005 – he argues such like this in his article. Hypothesis. Russian’s support to Armenia led to occupation 20% of territories of Azerbaijan. Hence we understand that Russia totally support Armenian Governments and it is a one of the cause unresolved long – lasting conflict. Russia behind of this conflict as known obviously wants to keep influence to Caucasus states especially to Armenia, despite of other major powers in international arena. Subjects of study. In our work we are studying – Russian role in the conflict and its support for Armenia, consequences of the war, possible ways of resolving. To find out the ways of resolving and to determine the right side we also use UN Charter and International Law. Exactly we will look at the International Laws branches – sovereignty of the state, self-defense right and self-determination right. Measurement. As â€Å"Russian support† we mean military, economic and political support of Russia to Armenia and its pressure for the Azerbaijan government. Another term is â€Å"Self-determination right† – means right for determining of their future, political system, sovereignty and etc by groups, nations, and autonomies. â€Å"Self-defense right† – the right for declaring a war for the other state in situation when it attacked first or preparing to attack. References: †¢ Philip Gamaghelyan: â€Å"Intractability of the Nagorno-Karabakh Conflict: a myth or reality? † †¢ Shahen Avakian: â€Å"Nagono-Karabakh, Legal Aspects†. †¢ www. flashpoints. info Nagorno-Karabakh: Azebaijani and Armenian perspectives. †¢ Tigran Mkrtchyan: â€Å"Democratization as the key to Nagorno-Karabakh conflict resolution† †¢ www. wikipedia. org Nagorno-Karabakh Conflict †¢ Nora Dudwick, â€Å"Armenia: Paradise Regained or Lost? † in Ian Bremmer & Ray Taras (Ed. ), New States, New Politics: Building the Post-Soviet Nations, (Cambridge: Cambridge University Press, 1997), p. 84; †¢ George Joffe, â€Å"Nationalities and Borders in Transcaucasia and the North Caucasus,† in John F. R. Wright, Suzanne Goldenberg and Richard Schofield (Ed. ), Transcaucasian Boundaries, (London: UCL Press, 1996), p. 25 †¢ Adil Baguirov: â€Å"Nagorno-Karabakh: basis and reality of Soviet-era legal and economic cl aims used to justify the Armenia-Azerbaijan war† †¢ Turkish Weekly Journal:† Nagorno-Karabakh Problem: Claims, Counter Claims and Impasse† by Guner Ozkan

The Indisputable Reality About 5th Grade Essay Samples with Green, Yellow and Red That Nobody Is Telling You

The Indisputable Reality About 5th Grade Essay Samples with Green, Yellow and Red That Nobody Is Telling You The very first step a family must take to control their weight is to immediately begin keeping track of what it is that they eat and drink daily. In the event you were at our home, you would. This room has the most coveted table in the area. The very first room, through the door, is the major portion of the restaurant. Peppers are susceptible to a variety of viruses that could limit fruit size. You cannot differentiate the sweet bell peppers varieties when they're still young because they're all green. For that reason, it's important to remember that all the bell peppers come from the very same species of plant, and their different colors are achieved by abiding by a pure procedure, not by any artificial method. Yellow peppers are just in the center of the spectrum in regards to ripeness (though some varieties stay yellow when fully mature). At harvest the majority of the damaged fruit are left in the area. In general there's no distinctive number of bell pepper that could be recognized in the market place. These foods and beverages ought to be considered a treat and ought to be limited to just a couple daily. The very first fruit set is generally the crown set at the very first branch of the stem. Ideas, Formulas and Shortcuts for 5th Grade Essay Samples with Green, Yellow and Red Essay plans instantly offer an essay structure, they stop you from forgetting to incorporate any critical points, and they keep you from losing your way as you write. This calendar year, your youngster's informative writing gets more organized think formatting (such as headers) and illustrations and possibly even multimedia components to support certain points all in an effort to produce your kid's writing more clear. Before your teen starts writing an essay they need to make a fast plan of what it is that they're likely to write about. Discuss why those paragraphs appear to do the job. The second sentence gives vivid details to produce the reader feel like he's there. Then now is the time to read the whole paragraph. At length, spend some time speaking about a superior means to close, or end, this paragraph. Finding a hold of previous exams and using them to practise is a remarkable idea. Several pages, printed on only 1 side, should be taken out of the book and used for activities. Cannot be utilized in conjunction with other promotional codes. Click the image to look at this self assessment example. Bad foliage cover permits the defect to occur. Now you are aware that temperature can impact the density of water. You may know about the cone of uncertainty. The cone of uncertainty tells us that you cannot completely understand each of the tasks and possible issues within a project, at the start of a project. Starting now, taking notes are going to be a mainstay of your youngster's education. Everybo dy is making better food choices and the kids finally have an effortless approach to think and speak about nutrition. If you wish to assess, start looking for full and fair responses. Be certain that it will supply you with nice and fresh mood every single day. The usage of color in that movie, together with literature, is a means to add symbolism to any work. It is a terrific concept for kids, since they love it when they have a choice,'' she states. You will also have to purchase or borrow novels that are used for the majority of the courses. It's a good idea to consider characters who play a dynamic part in the story. Assessment You might introduce a rubric that students may utilize to verify they did the work. It's wonderful to understand that giving feedback and grading your students isn't the only approach to assess students. If you tell your students it does not count for a grade, explain that they need to choose the assessment seriously. Students could possibly b e attempting to write about something they do not actually know very well. The second characteristic of writing that might cause trouble for student writers is language. For those who have test taking strategies that help your students to be successful, please don't hesitate to share them below. If students do very well on the pre-assessment, it's important to stress there are many different words that they'll still learn, and they will have the chance to become experts on the words they already know. When they are learning to write, there are several aspects of the process that may present difficulty. The fruit may appear unattractive once the color change takes a very long moment. If you look at the image above, you are going to get what I mean. Utilize Adobe's color wheel to discover the complementary color just spin the wheel till you find the color you're looking for, and its complement is going to be on the opposing side. Green could be utilised to describe somebody who is young and inexperienced.

Manifest Destiny and Race - 4652 Words

Laurence Mandin Professor Charles Turner M.A. J.D. History 18 25 March 2011 Midterm Question #1 part 2: What impact did the English view of race have on American society? (Worth 50 points) note: I felt it was more logical for my purposes to place part 2 first. The English view of race developed directly from their perceptions of themselves, from the ideas of their own racial origins, their own ethnocentricity. This perception became a concept that had its roots in 16th and 17th Century England. It involved their ancestry to the peoples of England prior to the Norman Conquest of 1066, and further back to the Nordic and Germanic peoples of ancient, continental Europe. It didn’t start here; their Caucasian ancestry was believed to have†¦show more content†¦This vanguard of â€Å"chosen people† would see their noble sentiments of self-government tainted by a legacy of racial superiority that would contribute to the near extinction of Native Americans, the brutal subjugation of African peoples, and a history of racial bigotry and strife. These entrenched racial attitudes would reach a pinnacle in the first half of 19th Century America (Horsman intro), culminating in the Civil War of 1861: one of the bloodiest wars in worl d history—it left 600,000 Americans dead, white and black. That catastrophic conflict ended 150 years ago—and we still have not seen the end of the terrible manifestation of Anglo-American racism. Midterm Question #1 part 1: Race and ethnicity have played major roles in American social history. How do these constructs relate to an explanation of what it means to be an American? The description of Africa as the dark mysterious continent is a description that can also be applied to her continental sisters sharing similar latitudes in the Western Hemisphere, the areas now known as Latin America. These continents, as well as large parts of vast Asia, seem to be areas of the earth where many dark complected peoples reside. Ironically these areas of â€Å"mystery and darkness† receive the most light from our sun, causing the evolution of a protective coloring in the outer covering of the human body. WithoutShow MoreRelatedReginald Horsman’s Race and Manifest Destiny Essay1958 Words   |  8 Pages Reginald Horsman’s Race and Manifest Destiny: The Orgins of American Racial Anglo-Saxonism explores the evidence and reasons of racial prejudices in America and discusses one of the most controversial topics in American history. The book also navigates the subjects of white superiority, and the creation of Anglo-Saxonism. Manifest Destiny was the belief that the UnitedRead MoreManifest Destiny Research Paper :1382 Words   |  6 Pages2014 Manifest Destiny Research Paper: The 1840’S were years of unprecedented growth for United States; in a mere four years, the national domain more than doubled with an additional 1.2 million miles being added to the country. (PBS) This was due to a movement called Manifest Destiny that suggested that the United States was â€Å"destined† to stretch from coast, sea to shining sea, uninterrupted by anything or anyone. (History.com) However, complex and underlying motives guided Manifest Destiny advocatesRead MoreJohn O Sullivan s Manifest Destiny938 Words   |  4 Pagesname to this belief in 1839: Manifest destiny. Manifest Destiny resulted through misguided beliefs of predestination and white superiority, in which white men, despite opposition, forced their way to the west coast of America. Motives of religion, economic, race, and nationalism contributed to the justification of their ambitious goals and the repercussions. As Catherine Denial states in her article, â€Å"Manifest Destiny: Creating an American Identity,† Manifest Destiny was â€Å"the idea that AmericansRead MoreManifest Destiny, By John L. Sullivan1491 Words   |  6 PagesIt is hard to read anything about the history of the United States without coming across the term â€Å"Manifest Destiny†. Manifest Destiny is a term, which was first coined by John L. Sullivan in the summer 1845 issue of the Democratic Review. â€Å"Hence it was carried into the debate on the Oregon question in the House of Representatives and proved to be such a convenient summing up of the self-confident nationalist and expansionist sentiment of the time that it passed into the permanent national vocabularyRead MoreManifest Destiny, By John L. O Sullivan925 Words   |  4 PagesCity, coined the phrase manifest destiny. O Sullivan claimed that it was the God-given destiny of the United States of America to spread over North America. O Sullivan s ummarized his view this way: And that claim is by the right of our manifest destiny to overspread and to possess the whole of the continent which Providence has given us for the development of the great experiment of liberty and federated self-government entrusted to us.†(OHC) The Idea of Manifest destiny may have created a nationRead MoreJohn O Sulliv Manifest Destiny1164 Words   |  5 PagesAmericans wanted to head west, this mindset was given the name of â€Å"Manifest Destiny† by John O’Sullivan. Manifest Destiny was a term that was prevalent during the 19th century. It expressed the belief that America’s mission was to expand their civilization across North America; this expansion would create liberty and economic progress through territorial gain. President Jefferson, Madison and Monroe, all collectively believed in the Jeffersonian’s mindset, these presidents encouraged such movement;Read MoreManifest Destiny Of The United States1202 Words   |  5 PagesManifest destiny is one of the beliefs that existed in the United States. The latter stated belief claimed that, the settlers based in America were allowed to spread all over the continent. However, historians came into an agreement that three themes exist in relation to manifest destiny, and this include: the America’s special virtue and their institutions; America’s mission that aimed at redeeming and rebuilding the western part as per the agrarian America, and a destiny that will enhance theRead MoreA Different Mirror By Takaki Essay1404 Words   |  6 Pagesthis time, America demonstrated manifest destiny and the Master Narrative. They were led by the belief of â€Å"white purity,† which these ethnic groups threatened. America exhibited supremacy over all of these ethnic groups. Takaki’s work allows me to become aware of the history and the outcomes of manifest destiny and the Master Narrative. Some of the behavior, perspectives, and experiences present in the multicultural history of the United States are: manifest destiny, master narrative, education, laborRead MoreThere Were Different Researches Done To Show What Caused1059 Words   |  5 Pagescaused the Mexican War. Some say America and others say Mexico themselves. There has been some insight by Ramà ³n Eduardo Ruiz, David J. Weber, Rodolfo Acuà ±a, and Walter Nugent. From Ramà ³n Eduardo Ruiz’s article, there are mentions of the Manifest Destiny. Manifest Destiny played a role in the New World and in Mexico. In â€Å"’From Hell Itself’ The Americanization of Mexico’s Frontier† by David J. Weber, talks about the issues within Mexico that caused them to lose so much of their territory. From RodolfoRead MoreManifest Destiny : Ugly Truth Behind Pretty Lies887 Words   |  4 Pages Manifest Destiny: Ugly Truth Behind Pretty Lies? The point of view upon Manifest Destiny that I found most convincing and close to my own interpretation was â€Å"Manifest Destiny as an expression of white superiority is but one explanation for what became a clear rise of anti-Mexican sentiments in the 1850s†. This perspective to me seemed to be the only one that did not skirt around what seemed to be the logical truth and explanations for why Manifest Destiny took place: for the prospects they were