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Clinical Recommendations for the Medical Respite Setting

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The National HCH Council highlights the unique clinical work being offered in medical respite settings in this new publication. The recommendations focus on common admitting diagnoses from nine medical respite programs across the United States. Each diagnosis includes recommendations for assessment, management, prevention, and outcomes that can be used to determine discharge from the medical respite setting. Although this document is intended to be used primarily by clinicians working in the medical respite setting, it also acts as a compelling tool for describing to policy makers the recuperative care needs of people experiencing homelessness, which are often beyond the scope of acute care hospitals and homeless shelters.

Read the Clinical Recommendations for the Medical Respite Setting.

Sunrise of the Virgina Military Institute as a School of Arms, Woodrow Wilson,


The Acadians (French: Acadiens, IPA: [akadjɛ̃]) are the descendants of the 17th-century French colonists who settled in Acadia (located in the Canadian Maritime provinces – Nova Scotia, New Brunswick, and Prince Edward Island – as well as part of Quebec, and in the U.S. state of Maine).


Acadia was a colony of New France. Although today most of the Acadians and Québécois are French speaking (francophone) Canadians, Acadia was a distinct colony of New France, and was geographically and administratively separate from the French colony of Canada (modern day Quebec), which led to Acadians and Québécois developing two rather distinct histories and cultures.[3]


The settlers whose descendants became Acadians came from "all the regions of France but coming predominantly directly from the cities".[4]

Prior to the British Conquest of Acadia in 1710, the Acadians lived for almost 80 years in Acadia. After the Conquest, they lived under British rule for the next forty-five years.


During the French and Indian War, British colonial officers and New England legislators and militia carried out the Great Expulsion of 1755–1763.


They deported approximately 11,500 Acadians from the maritime region. Approximately one-third perished from disease and drowning.


One historian compared this event to a contemporary ethnic cleansing, while other historians suggested that the event is comparable with other deportations in history.[5]

Many later settled in Louisiana, where they became known as Cajuns. Others were transported to France[6] (but note the subsequent policies by Henri Peyroux de la Coudreniere).


Later on many Acadians returned to the Maritime provinces of Canada, most specifically New Brunswick.


Most who returned ended up in New Brunswick because they were barred by the British from resettling their lands and villages in the land that became Nova Scotia.


This was a British policy to assimilate them with the local populations where they resettled.

Acadians speak a dialect of French called Acadian French. Many of those in the Moncton, New Brunswick area speak Chiac and English.


The Louisiana Cajun descendants mostly speak English, with a distinct local dialect known as Cajun English being prominent, but some still speak Cajun French, a French dialect developed in Louisiana.

Saturday, May 12, 2012

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Republic of the Marshall Islands
Aolepān Aorōkin M̧ajeļ[1][2]
Flag Seal
Motto: "Jepilpilin ke ejukaan"
("Accomplishment through Joint Effort")
Anthem: Forever Marshall Islands
Capital Majuro (Delap)
7°7′N 171°4′E
Largest city Majuro[3]
Official language(s) English
Marshallese
Ethnic groups (2006) Marshallese 92.1%
mixed Marshallese 5.9%
other 2%
Demonym Marshallese
Government Unitary presidential Democratic republic
 -  President Christopher Loeak
Independence
 -  from the United States October 21, 1986 
Area
 -  Total 181 km2 (213th)
70 sq mi 
 -  Water (%) negligible
Population
 -  2009 estimate 68,000[4] (205th)
 -  2003 census 56,429 
 -  Density 342.5/km2 (28th)
885.7/sq mi
GDP (PPP) 2001 estimate
 -  Total $115 million (220th)
 -  Per capita $2,900 (2005 est.) (195th)
HDI (n/a) n/a (unranked) (n/a)
Currency United States dollar (USD)
Time zone (UTC+12)
Drives on the right
ISO 3166 code MH
Internet TLD .mh
Calling code 692
The Marshall Islands, officially the Republic of the Marshall Islands (RMI) (Listeni/ˈmɑrʃəl ˈaɪləndz/; Marshallese: Aolepān Aorōkin M̧ajeļ, /ɦˠaɦˠʷɜlʲɜpʲanʲ ɦˠaɦˠʷɘrˠɘkɨnʲ mˠaɦˠtʲɜlˠ/ or [ʕɑ͡ɒɔ̯ɔ͡ɛlɛbæn ʕɑ͡ɒo̯o͡ɤr̴ɤɡɯ͡in m̴ɑʕʑɛ͡ʌɫ]), is a Micronesian nation of atolls and islands in the middle of the Pacific Ocean, just west of the International Date Line and just north of the Equator. As of July 2011 the population was 67,182.[5] In 1986, RMI achieved independence under the Compact of Free Association with the United States.

Contents

History

Main article: History of the Marshall Islands
The Marshall Islands were settled by Micronesians in the 2nd millennium BC. Little is known of this early history. People traveled by canoe between islands using traditional stick charts.[6]

Spanish exploration

Spanish explorer Alonso de Salazar was the first European to see the islands in 1526, commanding the ship Santa Maria de la Victoria, the only surviving vessel of the Loaísa Expedition. On August 21, he sighted an island at 14°N that they named "San Bartolome" (probably Taongi).[7]
On September 21, 1529, Álvaro de Saavedra Cerón commanded the Spanish ship Florida, on his second attempt to recross the Pacific from the Moluccas. He stood off a group of islands from which several natives came off and hurled stones at his ship. These islands, named by him "Los Pintados," may have been Ujelang. On October 1, he found another group of islands where he went ashore for eight days, exchanged gifts with natives and took on water. These islands, "Los Jardines," could be Eniwetok or Bikini Atoll.[8]
The Spanish ship San Pedro and two other vessels in expedition commanded by Miguel Lopez de Legazpi on January 9, discovered an island at 10°N where they went ashore and traded with natives and named it "Los Barbudos" (possibly Mejit). On January 10, they sighted another island that they named "Placeres" (perhaps Ailuk), ten leagues away, they sighted another island that they called "Pajares" (perhaps Jemo). On January 12, they sighted another island at 10°N which they called "Corrales" (possibly Wotho). On January 15, another low island was sighted at 10°N (perhaps Ujelang) where they made a good description of the people on "Barbudos."[9] After that, ships like San Jeronimo, Los Reyes, Todos los Santos also visited the islands in different years.

Other European expeditions

See also: German New Guinea
Captain John Charles Marshall together with Thomas Gilbert came to the islands in 1788. The islands were named after the first in the Russian (Krusenstern) and French (Duperrey) maps (1820), later in the English maps. However, they were claimed under the Spanish sovereignty as part of the Spanish East Indies. In 1874, the Spanish sovereignty was recognized by the international community. They were sold to Germany in 1884 through papal mediation.
A German trading company settled on the islands in 1885. They became part of the protectorate of German New Guinea some years later.

World War I

See also: South Pacific Mandate
Under German Imperial control, and even before then, Japanese traders and fishermen from time to time visited the Marshall Islands, although contact with the islanders was irregular. After the Meiji Restoration (1868), the Japanese government adopted a policy of turning Japan into a great economic and military power in East Asia.
In 1914, Japan joined the Entente powers during World War I, and found it possible to capture German colonies in China and Micronesia. On September 29, 1914, Japanese troops occupied the atoll of Enewetak, and on September 30, 1914 the atoll of Jaluit the administrative center of the Marshall Islands.[10] After the war, on June 28, 1919, Germany renounced all of its Pacific possessions, including the Marshall Islands. On December 17, 1920, the Council of the League of Nations approved the mandate for Japan to take over all former German colonies in the Pacific Ocean located north of the equator.[10] The Administrative Center of the Marshall Islands atoll remained Jaluit.
The Japanese were unlike the German Empire, which had primarily economic interests in Micronesia. Despite its small area and few resources, the absorption of the territory by Japan would to some extent alleviate Japan's problem of an increasing population but an ever decreasing amount of available land to house it.[11] During its years of colonial rule, Japan moved more than 1,000 Japanese to the Marshall Islands although they never outnumbered the indigenous peoples as they did in the Mariana Islands and Palau.
The Japanese enlarged administration and appointed local leaders, which weakened the authority of local traditional leaders. Japan also tried to change the social organization in the islands from Matrilineality to the Japanese Patriarchal system, but with no success.[11] Moreover, during the 1930s, one third of all land up to the high water level was declared the property of the Japanese government. On the archipelago, before it banned foreign traders, the activities of Catholic and Protestant missionaries were allowed.[11] Indigenous people were educated in Japanese schools, and studied Japanese language and Japanese culture. This policy was the government strategy not only in the Marshall Islands, but on all the other mandated territories in Micronesia. On March 27, 1933, Japan left the League of Nations, but nevertheless continued to manage the islands in the region and in the late 1930s, and started constructing air bases on several atolls. The Marshall Islands were in an important geographical position, being the easternmost point in Japan's defensive ring at the beginning of World War II.[11][12]

World War II

US troops inspecting an enemy bunker, Kwajalein Atoll. 1944.
In the months before the attack on Pearl Harbor, Kwajalein Atoll was the administrative center of the Japanese 6th Fleet Forces Service, whose task was the defense of the Marshall Islands.[13]
In World War II, the United States, during the Gilbert and Marshall Islands campaign, invaded and occupied the islands in 1944, destroying or isolating the Japanese garrisons. The US government added the archipelago to the U.S. Trust Territory of the Pacific Islands, along with several other island groups in the South Sea.
The battle in the Marshall Islands caused irreparable damage, especially on Japanese bases. During the American bombing, the islands' population suffered from lack of food and various injuries.
U.S. attacks started in mid-1943, and caused half the Japanese garrison of 5,100 people in the atoll Mili to die from hunger by August 1945.[14] In just one month in 1944, Americans captured Kwajalein Atoll, Majuro and Enewetak, and in the next two months the rest of the Marshall Islands except Wotje, Mili, Maloelap and Jaluit.
Shipping Lane Patrol Kwajalein Island (Marshall Islands-April 1945)

Nuclear tests after World War II

See also: Trust Territory of the Pacific Islands
Mushroom cloud from the largest nuclear test the United States ever conducted, Castle Bravo.
From 1946 to 1958, as the site of the Pacific Proving Grounds, the U.S. tested 67 nuclear weapons in the Marshall Islands,[15] including the largest nuclear test the U.S. ever conducted, Castle Bravo.[16] In 1956, the Atomic Energy Commission regarded the Marshall Islands as "by far the most contaminated place in the world".[17]
Nuclear claims between the U.S. and the Marshall Islands are ongoing, and health effects from these nuclear tests linger.[16] Project 4.1 was a medical study conducted by the United States of those residents of the Bikini Atoll exposed to radioactive fallout. From 1956 to August 1998, at least $759 million was paid to the Marshallese Islanders in compensation for their exposure to U.S. nuclear testing.[18]
With the 1952 test of the first U.S. hydrogen bomb, code named "Ivy Mike", the island of Elugelab in the Enewetak atoll was destroyed.

Independence

In 1979, the Government of the Marshall Islands was officially established and the country became self-governing.
In 1986, the Compact of Free Association with the United States entered into force, granting the Republic of the Marshall Islands (RMI) its sovereignty. The Compact provided for aid and U.S. defense of the islands in exchange for continued U.S. military use of the missile testing range at Kwajalein Atoll. The independence procedure was formally completed under international law in 1990, when the UN officially ended the Trusteeship status.

Government

Main article: Politics of the Marshall Islands
The Marshall Islands Capitol building
The government of the Marshall Islands operates under a mixed parliamentary-presidential system as set forth in its Constitution.[19] Elections are held every four years in universal suffrage (for all citizens above 18), with each of the twenty-four constituencies (see below) electing one or more representatives (senators) to the lower house of RMI’s bicameral legislature, the Nitijela. (Majuro, the capital atoll, elects five senators.) The President, who is head of state as well as head of government, is elected by the 33 senators of the Nitijela. Four of the five Marshallese presidents who have been elected since the Constitution was adopted in 1979 have been traditional paramount chiefs.[20]
Legislative power lies with the Nitijela. The upper house of Parliament, called the Council of Iroij, is an advisory body comprising twelve tribal chiefs. The executive branch consists of the President and the Presidential Cabinet, which consists of ten ministers appointed by the President with the approval of the Nitijela. The twenty-four electoral districts into which the country is divided correspond to the inhabited islands and atolls. There are currently three political parties in the Marshall Islands: Aelon Kein Ad (AKA), United People's Party (UPP), and United Democratic Party (UDP). Rule is shared by the UDP and the UPP. The following senators are in the legislative body:

Foreign affairs and defense

Further information: Compact of Free Association
The Compact of Free Association with the United States gives the U.S. sole responsibility for international defense of the Marshall Islands. It allows islanders to live and work in the United States, and establishes economic and technical aid programs.

Geography

Main articles: Geography of the Marshall Islands and Administrative divisions of the Marshall Islands
Map of the Marshall Islands
Beach scenery at Laura, Majuro.
The islands are located north of Nauru and Kiribati, east of the Federated States of Micronesia, and south of the U.S. territory of Wake Island, to which it lays claim.
The country consists of 29 atolls and 5 isolated islands. The atolls and islands form two groups: the Ratak Chain and the Ralik Chain (meaning "sunrise" and "sunset" chains). 24 of them are inhabited (see above section). The uninhabited atolls are:
A majority of the islands' land mass is at sea level.

Shark sanctuary

In October 2011, the government declared that an area covering nearly 2,000,000 square kilometres (772,000 sq mi) of ocean shall be reserved as a shark sanctuary. This is the world's largest shark sanctuary, extending the worldwide ocean area in which sharks are protected from 2,700,000 square kilometres (1,042,000 sq mi) to 4,600,000 square kilometres (1,776,000 sq mi). In protected waters all shark fishing is banned and all by-catch must be released. However, the ability of the Marshall Islands to enforce this zone has been questioned.[21]

Territorial claim on Wake Island

The Marshall Islands also lays claim to Wake Island. While Wake has been administered by the United States since 1899, the Marshallese government refers to it by the name Enen-kio.

Climate

Average monthly temperatures (red) and precipitation (blue) on Majuro.
The climate is hot and humid, with a wet season from May to November. The islands occasionally suffer from typhoons. Many Pacific typhoons start in the Marshall Islands region and grow stronger as they move west toward the Mariana Islands and the Philippines.

Climate-related emergencies

In 2008, extreme waves and high tides caused widespread flooding in the capital city of Majuro and other urban centres, located at 1 metre (3 ft 3 in) above sea level. On Christmas morning in 2008, the government declared a state of emergency.[22]
The Marshall Islands are ranked nation the most endangered due to flooding from global warming.[23]

Economy

Main article: Economy of the Marshall Islands
Graphical depiction of Marshall Islands's product exports in 28 color coded categories.
The islands have few natural resources, and imports far exceed exports.

Labor

In 2007, the Marshall Islands joined the International Labor Organization, which means its labor laws will comply with international benchmarks. This will impact business conditions in the islands.[24]

Taxation

The income tax has two brackets, with rates of 8% and 14%. The corporate tax is 11.5%. The general sales tax is 6%. There are no property taxes.

Foreign assistance

United States government assistance is the mainstay of the economy.
Under the terms of the Amended Compact of Free Association, the U.S. will provide US$57.7 million per year to the Marshall Islands (RMI) through 2013, and then US$62.7 million through 2023, at which time a trust fund, made up of U.S. and RMI contributions, will begin perpetual annual payouts.[25]
The United States Army maintains its Ronald Reagan Ballistic Missile Defense Test Site on Kwajalein Atoll. Marshallese land owners receive rent for the base, and a large number[quantify] of Marshallese work there. The main airport was built by the Japanese during World War II, and the only tarmac road of the capital was built partly by the Taiwanese and partly by the Americans.

Agriculture

Agricultural production is concentrated on small farms. The most-important commercial crops are coconuts, tomatoes, melons, and breadfruit.

Industry

Small-scale industry is limited to handicrafts, fish processing, and copra.

Fishing

Fishing has been critical to the economy of this island nation since its settlement.
In 1999, a private company built a tuna loining plant with more than 400 employees, mostly women. But the plant closed in 2005, after a failed attempt to convert it to produce tuna steaks, a process that requires half as many employees. Operating costs exceeded revenue, and the plant's owners tried to partner with the government to prevent closure. But government officials personally interested in an economic stake in the plant refused to help. After the plant closed, it was taken over by the government, which had been the guarantor of a $2 million loan to the business.

Energy

On September 15, 2007, Witon Barry (of the Tobolar Copra processing plant in the Marshall Islands capital of Majuro) said power authorities, private companies, and entrepreneurs had been experimenting with coconut oil as alternative to diesel fuel for vehicles, power generators, and ships. Coconut trees abound in the Pacific's tropical islands. Copra, the meat of the coconut, yields coconut oil (1 liter for every 6 to 10 coconuts).[26]

Demographics

Main article: Demographics of the Marshall Islands
There are 68,000 people living in the Marshall Islands. Most of these are Marshallese. The Marshallese are of Micronesian origin and migrated from Asia several thousand years ago. A minority of Marshallese have some recent Asian ancestry, mainly Japanese. Two-thirds of the nation's population lives on Majuro, the capital, and Ebeye. The outer islands are sparsely populated due to lack of employment opportunities and economic development. Life on the outer atolls is generally traditional.
The official language of the Marshall Islands is Marshallese, but it is common to speak the English language.[27]

Religion

Main article: Religion in the Marshall Islands
Major religious groups in the Republic of the Marshall Islands include the United Church of Christ (formerly Congregational), with 51.5 percent of the population; the Assemblies of God, 24.2 percent; and the Roman Catholic Church, 8.4 percent. The Church of Jesus Christ of Latter-day Saints (Mormons), 8.3 percent;[28] Also represented are Bukot Nan Jesus (also known as Assembly of God Part Two), 2.2 percent; Baptist, 1.0 percent; Seventh-day Adventists, 0.9 percent; Full Gospel, 0.7 percent; and the Baha'i Faith, 0.6 percent.[28] Persons without any religious affiliation account for a small percentage of the population.[28] The Jehovah's Witnesses were believed to have a few hundred practitioners, Jews fewer than 20, and the Ahmadiyya Muslim Community fewer than 10.[28]

Education

The Marshall Islands Ministry of Education operates the state schools in the Marshall Islands.[29]
There are 2 colleges operating in the Marshall Islands. The College of the Marshall Islands (CMI) and The University of the South Pacific.

Transportation

Main article: Transportation in the Marshall Islands
The Marshall Islands are served by the Marshall Islands International Airport in Majuro, the Bucholz Army Airfield in Kwajalein, and other small airports and airstrips.
In 2005, Aloha Airlines canceled its flight services to the Marshall Islands.

Media

The Marshall Islands have several AM and FM radio stations.
AM: V7AD 1098 • 1557
FM: V7AD 97.9 • V7AA 104.1 (formerly 96.3)
AFRTS: AM 1224 (NPR) • 99.9 (Country) • 101.1 (Active Rock) • 102.1 (Hot AC)

Health

Nuclear tests at Enewatak have left islanders there suffering from Cancer and birth defects.[30]

Culture

Marshallese fans
Main article: Culture of the Marshall Islands
Marshallese is used by the government. Although the ancient skills are now in decline, the Marshallese were once able navigators, using the stars and stick-and-shell charts.

Gallery

See also

Portal icon Geography portal
Portal icon Oceania portal
Portal icon Micronesia portal

References

  1. ^ Names of the countries of Oceania in local languages, Omniglot. Retrieved 5 March 2011.
  2. ^ "Marshall Islands". geonames.de. Retrieved March 5, 2011.
  3. ^ population.mongabay.com
  4. ^ Department of Economic and Social Affairs Population Division (2009) (PDF). World Population Prospects, Table A.1. 2008 revision. United Nations. Retrieved 2009-03-12.
  5. ^ http://www.indexmundi.com/marshall_islands/demographics_profile.html
  6. ^ The History of Mankind by Professor Friedrich Ratzel, Book II, Section A, The Races of Oceania page 165, picture of a stick chart from the Marshall Islands. MacMillan and Co., published 1896.
  7. ^ Andrew Sharp (1960)Early Spanish Discoveries in the Pacific 11-3
  8. ^ Wright 1951: 109-10; Sharp 1960: 19-23.
  9. ^ Filipiniana Book Guild 1965: 46-8, 91, 240; Sharp 1960: 36-9.
  10. ^ a b "Geography of the Marshall Islands". Retrieved 11 June 2010.
  11. ^ a b c d "Marshall Islands". Pacific Institute of Advanced Studies in Development and Governance (PIAS-DG), University of the South Pacific, Suva, Fiji. Retrieved 11 June 2010.
  12. ^ "History of the Marshall Islands". Marshall Islands Visitors Authority. Retrieved 11 June 2010.
  13. ^ "Marshall Islands". World Statesmen. Retrieved 11 June 2010.
  14. ^ Dirk H.R. Spennemann. "Mili Island, Mili Atoll: a brief overview of its WWII sites". Retrieved 11 June 2010.
  15. ^ "Nuclear Weapons Test Map", Public Broadcasting Service
  16. ^ a b "Islanders Want The Truth About Bikini Nuclear Test". Japanfocus.org. Retrieved 2010-07-04.
  17. ^ Stephanie Cooke (2009). In Mortal Hands: A Cautionary History of the Nuclear Age, Black Inc., p. 168.
  18. ^ "50 Facts About Nuclear Weapons". Brookings Institution.
  19. ^ "Constitution of the Marshall Islands". Paclii.org. Retrieved 2010-07-04.
  20. ^ Johnson, Giff (2010-11-25). "Huge funeral recognizes late Majuro chief". Marianas Variety News & Views. Retrieved 2010-11-28.
  21. ^ "Vast shark sanctuary created in Pacific". BBC News. October 3, 2011. Retrieved November 25, 2011.
  22. ^ "Marshall atolls declare emergency ", BBC News, 25 December 2008.
  23. ^ http://findarticles.com/p/articles/mi_m0BUE/is_5-6_144/ai_n58473630
  24. ^ "Republic of the Marshall Islands becomes 181st ILO member State [Press releases]". Ilo.org. Retrieved 2010-07-04.
  25. ^ "COMPACT OF FREE ASSOCIATION AMENDMENTS ACT OF 2003" (PDF). Retrieved 2010-07-04.
  26. ^ "Pacific Islands look to coconut power to fuel future growth". afp.google.com. 2007-09-13. Retrieved 2010-07-04.
  27. ^ "Marshall Islands Travel". Wwp.greenwichmeantime.com. 2010-03-11. Retrieved 2010-07-04.
  28. ^ a b c d International Religious Freedom Report 2009: Marshall Islands. United States Bureau of Democracy, Human Rights and Labor (September 14, 2007). This article incorporates text from this source, which is in the public domain.
  29. ^ rmigovernment.org
  30. ^ "Marshall Islands – Economic Policy, Planning and Statistics Office – Home page". Spc.int. Retrieved 2010-07-04.

Further reading

  • Barker, H. M. (2004). Bravo for the Marshallese: Regaining Control in a Post-nuclear, Post-colonial World. Belmont, California: Thomson/Wadsworth.
  • Rudiak-Gould, P. (2009). Surviving Paradise: One Year on a Disappearing Island. New York: Union Square Press.
  • Niedenthal, J. (2001). For the Good of Mankind: A History of the People of Bikini and Their Islands. Majuro, Marshall Islands: Bravo Publishers.
  • Carucci, L. M. (1997). Nuclear Nativity: Rituals of Renewal and Empowerment in the Marshall Islands. DeKalb: Northern Illinois University Press.
  • Hein, J. R., F. L. Wong, and D. L. Mosier (2007). Bathymetry of the Republic of the Marshall Islands and Vicinity [Miscellaneous Field Studies; Map-MF-2324]. Reston, VA: U.S. Department of the Interior, U.S. Geological Survey.
  • Woodard, Colin (2000). Ocean's End: Travels Through Endangered Seas. New York: Basic Books. (Contains extended account of sea-level rise threat and the legacy of U.S. Atomic testing.)

External links

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