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Adolecents and Drug Use
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

It’s hard to fight drug use among teens, but it can be done. Young people are more intelligent than we often give them credit for being. If we talk with them about specific drugs and their negative effects, it will go a long way towards winning the battle against teen drug use
It’s also interesting and important to note that parental involvement plays a vital role. The strongest declines in drug use occurred during years when more parents and guardians were talking to their kids about the risks of drug use, and the kids were exposed to anti-drug messages in the media. Some statistics actually show an increase of drug use during years when parental involvement was down, even if anti-drug media exposure was up.

Factors associated with increased risk for any type of illicit drug use include at least one or more of the following:

Poor parent-child relations. Studies show that living in a stressful home environment with relatively little parental support and monitoring places adolescents at greater risk for drug use.
Family environments that model drug use. Adolescents are more likely to use drugs if someone in their home uses drugs. For example, parents who use drugs may practice poor parenting which may increase the risk of drug abuse for adolescents. Also, parental or sibling drug use sets a model of acceptable inappropriate behavior for teens, makes it seem like a normal part of life, and may encourage its acceptance by youth.
Peer drug use. During adolescence, peers become a major influence because of the increased time spent with them outside of the home. Some teens feel pressured to fit in and do what their friends are doing. Consequently, teens that have friends who use drugs are more likely to use drugs themselves.

High risk communities. Living in communities where drug use is widespread not only makes drug accessibility easier, but also normalizes the act of using drugs.
Low self-esteem. Adolescents who do not have positive views of themselves, or who lack support and encouragement from others are more likely to use drugs.
Poor school achievement. Teens who have negative attitudes toward school and low expectations of academic success are at increased risk of drug use. Also, teens who use drugs typically exhibit declines in grades, and inconsistent attendance at school.
What Are the Consequences
The effects of drug use vary by type of drug and frequency of use, however, some

consequences may include the following:

Mental and physical health problems. Teens who use drugs are at greater risk for developing a number of health problems including attention deficit disorder, anxiety disorders, phobias, and depression.

Increased likelihood of drug use later in life. Early drug use has been linked to positive attitudes toward drug use. Consequently, teens who begin drug use early are at risk for continued drug habits into and through adulthood.
Involvement in other illegal activities. Drug use has been linked to higher tolerance of deviant behavior among adolescents. This results in increased criminal activity for drug users compared to non-drug using peers.
Increased likelihood of death. Drug use increases the odds of death from accidental or intentional drug overdoses as well as engagement in other unsafe behaviors (e.g., driving under the influence).

What Can Parents Do

Communication is key in dealing with any type of risk taking behavior during the teen years. The hectic pace of work and school can sometimes estrange family members, especially parents and teens. But make the effort to keep in touch with your teen. Find out what's going on in his or her life. The best way to find out if your teen is using drugs is to just ask. During adolescence, parents may feel that their influence over their teen's life is waning, but in fact, you have more power than anyone to prevent your child from using drugs. Here are some things that you can do to encourage your child to "Just Say No."

Stay connected with your teen. Keeping up to date with your teen's interests and friends is an important step in creating a warm, communicative, and open environment. If your teen feels that you are available and easy to talk to, then he or she will be more likely to share concerns that might lead to risk taking behavior.

Begin an ongoing conversation with your teen (vs. giving a one time speech). Make it clear that drug use is not an acceptable behavior in your family and be sure to talk about the reasons why. Talk about the consequences of drug use. Help your teen visualize two futures, one that includes drug use and one that remains drug free. Where do these paths lead? Discuss your teen's life goals and how drug use can hinder them from reaching them.
Empower your teen. Teens tend to want to rebel against their parents' standards or advice. Rather than dictate what your child should or should not do, remind him or her that they have the power of choice and that you trust that they can and will make good decisions.
Teens sometimes abuse substances as a way of alleviating stress. Some experiences in life (e.g., not making the basketball team, breaking up with a girlfriend or boyfriend) are both stressful and painful. Drugs are often sought as a means of temporarily easing pain or stress. Talk to your teen about any stressful events that are going on in his or her life and ways they can effectively handle them.

Know your teen's friends. You can influence your teen's choice of peers by talking with them about the qualities that make a good friend.

Encourage your teen's self-esteem by praising their efforts and achievements. Help them to master the things that they are good at. Show them you care through your involvement in their lives/activities.
Take advantage of teachable moments. These include talking about scenes in movies or news headlines that deal with drug associated topics. Explain your position on these topics and ask your teen how they feel about what they are viewing.
Encourage healthy activities that promote the use of your teen's interests and talents. Most teens are curious and are eager to try something new and challenging. High school is the peak time for both beginning substance use and beginning lifetime habits that include using illegal substances. Your parental example, support, and monitoring has a great influence on your teen's behavior. Talk early and often about the consequences of and alternatives to using illicit drugs.

February 23, 2008 | 2:49 AM Comments  0 comments

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Health care workers & HIV Prevention
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Occupational exposure to HIV
In many countries for many years health care workers have become infected with HIV as a result of their work. The main cause of infection in occupational settings is exposure to HIV-infected blood via a percutaneous injury (i.e. from needles, instruments, bites which break the skin, etc.). The average risk for HIV transmission after such exposure to infected blood is low - about 3 per 1,000 injuries. Nevertheless, this is still understandably an area of considerable concern for many health care workers.

Certain specific factors may mean a percutaneous injury carries a higher risk, for example:

A deep injury
Terminal HIV-related illness in the source patient
Visible blood on the device which caused the injury
Injury with a needle which had been placed in a source patient's artery or vein
If percutaneous exposure occurs then the site of exposure should be washed liberally with soap and water but without scrubbing. Bleeding should be encouraged by pressing gently around the site of the injury (but taking care not to press immediately on the injury site). It is best to do this under a running water tap.

There are a small number of instances when HIV has been acquired through contact with non-intact skin or mucous membranes. Research suggests that the risk of HIV infection after mucous membrane exposure e.g. splashes of infected blood in the eye, is less than 1 in 1000. If mucocutaneous exposure occurs then the affected area should be washed thoroughly with soap and water. If the eye is affected, it should be irrigated thoroughly.

If intact skin is exposed to HIV infected blood then there is no risk of HIV transmission.

Post Exposure Prophylaxis
Research evidence seems to suggest that the use of anti-HIV drugs in combination with other anti-HIV drugs if given soon after an injury can reduce the rate of transmission. Such treatment is referred to as Post Exposure Prophylaxis (PEP). PEP is recommended for health care workers if they have had a significant occupational exposure to blood or another high risk body fluid which is likely to be infected with HIV. It is recommended that PEP should be commenced as soon as possible after exposure and ideally within the hour.

Although exposure through needle stick injuries can usually be avoided by following good working practices, health care workers should consider the implications of taking PEP. This will help them to make a swift decision in the event of an accident where an injury occurs.

What are Universal Precautions
Employing universal precautions means taking precautions with everybody. If precautions are taken with everyone, health care workers do not have to make assumptions about people's lifestyles and risk of infection. Health care workers should have the right to be able to protect them against infection, whether it is HIV, Hepatitis or anything else.

The following universal infection control precautions are advised by the World Health Organization3 to help protect health care workers from blood-borne infections including HIV:

Wash hands with soap and water before and after procedures.
Use protective barriers such as gloves, gowns aprons, masks, goggles for direct contact with blood and other body fluids.
Disinfect instruments and other contaminated equipment.
Handle properly soiled linen. (Soiled linen should be handled as little as possible. Gloves and leak proof bags should be used if necessary. Cleaning should occur outside patient areas, using detergent and hot water.)
Use of new, single-use disposable injection equipment for all injections is highly recommended. Sterilizable injection should only be considered if single use equipment is not available and if the sterility can be documented with Time, Steam and Temperature indicators.
Discard contaminated sharps immediately and without recapping in puncture and liquid proof containers that are closed, sealed and destroyed before completely full.
Document the quality of the sterilization for all medical equipment used for percutaneous procedures.

January 28, 2008 | 12:15 AM Comments  2 comments

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Stress
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Stress is the “wear and tear" our bodies experience as we adjust to our continually changing environment; it has physical and emotional effects on us and can create positive or negative feelings. As a positive influence, stress can help compel us to action; it can result in a new awareness and an exciting new perspective. As a negative influence, it can result in feelings of distrust, rejection, anger, and depression, which in turn can lead to health problems such as headaches, upset stomach, rashes, insomnia, ulcers, high blood pressure, heart disease, and stroke. With the death of a loved one, the birth of a child, a job promotion, or a new relationship, we experience stress as we re-adjust our lives. In so adjusting to different circumstances, stress will help or hinder us depending on how we react to it. How Can I Eliminate Stress from My Life? As we have seen, positive stress adds anticipation and excitement to life, and we all thrive under a certain amount of stress. Deadlines, competitions, confrontations, and even our frustrations and sorrows add depth and enrichment to our lives. Our goal is not to eliminate stress but to learn how to manage it and how to use it to help us.



Insufficient stress acts as a depressant and may leave us feeling bored or dejected; on the other hand, excessive stress may leave us feeling “tied up in knots." What we need to do is find the optimal level of stress, which will individually motivate but not overwhelm each of us. How Can I Tell What is Optimal Stress for Me There is no single level of stress that is optimal for all people. We are all individual creatures with unique requirements. As such, what is distressing to one may be a joy to another. And even when we agree that a particular event is distressing, we are likely to differ in our physiological and psychological responses to it. The person who loves to arbitrate disputes and moves from job site to job site would be stressed in a job, which was stable and routine, whereas the person who thrives under stable conditions would very likely be stressed on a job where duties were highly varied. Also, our personal stress requirements and the amount which we can tolerate before we become distressed changes with our ages. It has been found that most illness is related to unrelieved stress. If you are experiencing stress symptoms, you have gone beyond your optimal stress level; you need to reduce the stress in your life and/or improve your ability to manage it.

How Can I Manage Stress Better Identifying unrelieved stress and being aware of its effect on our lives is not sufficient for reducing its harmful effects. Just as there are many sources of stress, there are many possibilities for its management. However, all require effort toward change: changing the source of stress and/or changing your reaction to it. How do you proceed?



1. Become aware of your stressors and your emotional and Notice your distress. Don't ignore it. Don't gloss over physical reactions. Determine what events distress you. What are you telling your problems. Determine how your body responds to yourself about meaning of these events The stress. Do you become nervous or physically upset? If so, in what specific Can you change your stressors byways



2. Recognize what you can change. Can you reduce their intensity avoiding or eliminating them completely Can(manage them over a period of time instead of on a daily or weekly basis) you shorten your exposure to stress (take a break, leave the physical premises) Can you devote the time and energy necessary to making a change (goal setting, time management techniques, and delayed gratification strategies may be helpful The here)



3. Reduce the intensity of your emotional reactions to stress. Stress reaction is triggered by your perception of danger...physical danger and/or emotional danger. Are you viewing your stressors in exaggerated terms Are you and/or taking a difficult situation and making it a disaster? Are you overreacting and viewing things as expecting to please everyone? Do you feel you must always prevail in every absolutely critical and urgent? Work at adopting more moderate views; try to see the stress as situation? Try to something you can cope with rather than something that overpowers you. Temper your excess emotions. Put the situation in perspective. Do not labour on the negative aspects and the “what if's.

"

4. Learn to moderate your physical Slow, deep breathing will bring your heart rate and reactions to stress. Relaxation techniques can reduce muscle tension. respiration back to normal. Electronic biofeedback can help you gain voluntary control over such things as Medications, when prescribed muscle tension, heart rate, and blood pressure. by a physician, can help in the short term in moderating your physical reactions. However, they alone are not the answer. Learning to moderate these reactions on your own is a preferable long-term solution

.

5. Build your physical Exercise for cardiovascular fitness three to four times a week reserves. (Moderate, prolonged rhythmic exercise is best, such as walking, swimming, Maintain your• Eat well-balanced, nutritious meals. •cycling, or jogging). Mix• Avoid nicotine, excessive caffeine, and other stimulants. •ideal weight. Get enough sleep. Be leisure with work. Take breaks and get away when you can. as consistent with your sleep schedule as possible.

6. Maintain your emotional • Develop some mutually supportive friendships/ relationships. •Reserves. Pursue realistic goals, which are meaningful to you, rather than goals others expect some frustrations, failures, and have for you that you do not share. Always be kind and gentle with yourself--be a friend to yourself sorrows.

January 28, 2008 | 12:12 AM Comments  0 comments

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Avoiding Your Abuser (The Conflictive Posture)
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Contrary to its name, the conflictive posture is actually about avoiding conflict by minimizing contact and insisting on boundaries. It is about refusal to accept abusive behavior by demanding reasonably predictable and rational actions and reactions. It is about respect for you and for your predilections, preferences, emotions, needs, and priorities.

A healthy relationship requires justice and proportionality. Reject or ignore unjust and capricious behavior. Conflicts are inevitable even in the most loving and mature bonds – but the rules of engagement are different in an abusive liaison. There, you must react in kind and let him taste some of his own medicine.

Abusers are predators, attuned to the subtlest emotional cues of their prey. Never show your abuser that you are afraid or that you are less than resolute. The willingness to negotiate is perceived as a weakness by bullies. Violent offenders are insatiable. Do not succumb to blackmail or emotional extortion – once you start compromising, you won't see the end of it.

The abuser creates a "shared psychosis" (folie a deux) with his victim, an overwhelming feeling of "the two of us against the whole world". Don't buy into it. Feel free to threaten him (with legal measures), to disengage if things get rough- or to involve law enforcement officers, friends, neighbors, and colleagues.

Here are a few counterintuitive guidelines:

The abused feel ashamed, somehow responsible, guilty, and blameworthy for their maltreatment. The abuser is adept at instilling these erroneous notions in his victims ("Look what you made me do!"). So, above all, do not keep your abuse a secret. Secrecy is the abuser's weapon. Share your story with friends, colleagues, neighbors, social workers, the police, the media, your minister, and anyone else who will listen.

Don't make excuses for him. Don't try to understand him. Do not empathize with him - he, surely, does not empathize with you. He has no mercy on you – you, in return, do not harbor misplaced pity for him. Never give him a second chance. React with your full arsenal to the first transgression. Teach him a lesson he is unlikely to forget. Make him go elsewhere for his sadistic pursuits or to offload his frustrations.

Often the abuser's proxies are unaware of their role. Expose him. Inform them. Demonstrate to them how they are being abused, misused, and plain used by the abuser. Trap your abuser. Treat him as he treats you. Involve others. Bring it into the open. Nothing like sunshine to disinfest abuse.

There are a few techniques which work wonders with abusers. Some psychologists recommend treating repeat offenders as one would toddlers. The abuser is, indeed, an immature brat – though a dangerous one, endowed as he is with the privileges and capabilities of an adult. Sometimes ignoring his temper tantrums until it is over is a wise policy. But not very often – and, definitely not as a rule


January 21, 2008 | 12:34 AM Comments  0 comments

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Service Delivery (Some additional Strategies and Activities)
Related to country: Pakistan

Translations available in: English (original) | French | Spanish | Italian | German | Portuguese | Swedish | Russian | Dutch | Arabic

Adopt a Participatory Approach:



Create a Steering Committee that includes representation from key stakeholders, beneficiaries and relevant Programme staff. The Steering Committee can act as the main decision-making body during Programme planning, design and evaluation



Conduct regular focus group sessions with beneficiaries throughout various phases of Programme implementation and evaluation. The findings from the discussions can be used to review and adapt Programme interventions and activities


Implement peer education programmes with vulnerable groups


Enhance the Scope of Outreach
Implement peer education programmes with vulnerable groups

Conduct awareness raising programmes on HIV&AIDS and human rights with individuals connected with people living with HIV/AIDS and vulnerable groups. For example, programmes targeting injecting drug users can conduct interventions with their families, peers and partners as well as with law enforcement authorities


Ensure Universality of Healthcare and Reduce Stigma


Facilities providing HIV&AIDS-related services to vulnerable groups can also offer general health care services to the surrounding community. This strategy improves the accessibility of services by reducing stigma associated with approaching the facility


Ensure Sustainability

Implement income generation programmes with targeted communities and help them develop partnerships with micro-finance institutions. Since individuals most vulnerable to HIV infection tend to be those with the least social and economic power, this strategy can help vulnerable communities increase their resources and build their capacity to mobilize

Identify Vulnerable Groups

When conducting a situational analysis of community needs, disaggregate data according to gender, ethnicity, religion, social status, etc. in order to determine which categories of people are able or unable to enjoy their human rights. Disaggregated data helps Programme designers and other staffs identify the vulnerable groups within a particular community and to reveal HIV&AIDS-related discrimination


January 15, 2008 | 12:15 AM Comments  0 comments

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