Sexual Health and Safety

People commonly equate sexual health with reproductive health. However, sexual health is much broader. According to WHO definition of health has therefore been adapted to define sexual health as:

A state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence (World Association for Sexual Health, 2007)

Sexual safety is important it protects against unwanted pregnancy and STIs. Sexual health is broader than reproductive health and includes sexual freedom, sexual pleasure, and sexual safety. Sexual problems are remarkably common, with the majority of adult women and men reporting at least one sexual problem in the previous year. A substantial minority of women and men have experienced sexual coercion or abuse. This is associated with poor psychological and physical wellbeing, increased health anxiety, increased health service use, and more health-compromising behaviors.

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Six-step Approach in Giving Bad News

One of the hardest task in medicine is to give bad news to patients or relatives. This can range from diagnosing a chronic illness to giving news about a death or disability. However, any news that brings with it some restriction or potential loss can be sad or bad news.

Reviews of research in this area have identified three important factors.

1. People appreciate it if the clinician is kind, confident, sensitive, and caring. People also prefer clinicians to show concern and distress rather than being aloof and detached.
2. People appreciate it more if the news is given clearly, using simple terms, and if they have time to talk about it with the clinician and ask questions.
3. People appreciate a quiet and private setting.

Here are the six-step approach whose principle guidelines overlap a good deal.

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How to deal with anxious and fearful patient

Anxiety and fear are a normal response to the perceived threat of illness or injury and thus are common in health-care settings. Anxiety makes people hyper-vigilant for signs of threat. Consequently, they are likely to react strongly to unexpected events, symptoms, or negative news. Anxiety also makes people less flexible in their coping strategies, so specific strategies become more rigidly applied. Anxious people may need to know exactly what will happen next so that the additional threat of unexpected events is reduced. Mere reassurance does not often work with anxious people - in fact it can backfire because they may feel that you do not understand. In dealing with an anxious patient the following may help.

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Chapati pie.

Chapati pie recipe

Ingredients:

• Flour
• Salt
• Water
• Cooking oil/fat,
• Tomatoes
• Onions
• Minced meat
• Blanched carrots
• Peas
• Spices of your choice.

Method of preparation

Fry onions after drying your minced meat and throw in your tomatoes and salt to taste. Put in your desired spices then the carrots and peas. Let it cook for about 7 minutes and remove it. Let it cool off as you prepare your chapati dough. When you are done making your dough roll them thin put your meat on one side, fold and press it closed with a fork and cook it on medium heat.

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Using Motivation as the Key to Good Health

Motivation is essentially a drive to act. People are motivated to do (or, indeed, not do) things in their life by a wide range of factors. Motivational interviewing rests on the principle of not judging or imposing our own views.

Clearly, motivation is relevant to health and health-care at large. Understanding social motivation can help us comprehend our own behavior and what motivates us to work as health-care professionals. It can also help us deal with other people’s behavior that we might not understand. Knowing more about another person’s motives means we can address the situation more constructively. Interventions such as motivational interviewing have been developed to treat disorders with a strong motivational component, such as addiction. Changing a habitual behavior such as alcohol consumption is difficult, particularly when it is longstanding and associated with social functioning. This is also used to encourage changes such as smoking cessation, exercise, and diet.

Understanding motivation can help us treat abnormal extremes of biological drives such as obesity, eating disorders, smoking, addiction, risky sexual behavior, and insomnia. If you ask people about perceived negative behaviors like smoking or alcohol intake they will often report them as less than they are. Educating people about the negative effects of these behaviors can trigger them to try to change. However, imposing our views and making people feel judged will not help them as much as assisting them to harness their own motivation. Try to understand why they behave in this way and empathize with their situation. Then support them to change their behavior. Help them believe that they can change.

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Emotions and Health - Emotions disorder

Emotion include affect, moods, and impulses. Positive emotions are associated with good health and negative emotions, such as anger and depression, are associated with certain illness. However, the mechanisms or causes underlying this association are not clear. Emotional dispositions of optimism and neuroticism are positively and negatively associated (respectively) with psychological health as well as with some measures of physical health.

Five main personality traits 

Openness to new experience	Intellect and interest in culture, Includes characteristics such as artistic, curious, imaginative, insightful, having wide interests, and being unconventional.
Conscientiousness	Dependable with the will to achieve. Includes characteristics such as self-disciplined, efficient, organized, reliable, responsible, dutiful, and thorough.
Extroversion	Outgoing. Includes characteristics such as talkative, gregarious, enthusiastic, seeking excitement, assertive, and active.
Agreeableness	Loving, friendly, and compliant. Includes characteristics such as sympathetic, appreciative, trusting, kind, forgiving, generous, and a altruistic.
Neuroticism	Tendency to experience negative emotions. Includes characteristics such as anxious, tense, self-pitying, worrying, self-conscious, hostile, and vulnerable.

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How to regulate your emotional reaction to injections.

Focus attention away from the situation or emotion 

You should be encouraged to concentrate on something else while the injection is being done, by distracting the patient with injection problem, ask him/her to focus on another object, or talking about a happy event. Helping him cope is much more effective than empathy, which usually increases distress.

Select situations that make things less negative 

Distraction is useful for dealing with needle anxiety, so it might help for one to have his injections in a situation where he can be distracted by something he really enjoys, such as a film, music, or something else he finds interesting.

Modify the situation 

The situation could be changed in many ways including;

• Finding an alternative mode of delivering insulin.
• Changing the timing of injections so he has less time to get anxious beforehand.
• Having a health-care professional do the injections.
• Bringing a friend who can support him and help him stay calm.

Change the way a situation or emotion is appraised or labeled 

One’s appraisals need to be changed from negative (like; the injection will hurt, he/she won’t cope, the nurse will think he’s or she’s stupid) to positive (like; the injection will be over very quickly, he’s/she managed it before, after the injection he or she will feel better).

Regulate physical, behavioral, and emotional responses 

There are many things one could adopt to help regulate his responses in injections. For example, he or she could do physical exercises before the injection to make him more physically relaxed. Before and during the injection he or she could use relaxation techniques such as focusing on his breathing. He could also use positive self-statement to cope.

Reference

1. Ayers, S. et al. (eds) (2007) Cambridge Handbook of psychology, Health and Medicine.

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Remedy for Sleep Disorder - Chronic Snoring

Sleep disorder occurs when the supply of oxygen needed by the body is restricted due to snoring.

Do you suffer from snoring?

Can the allergy present in the bedroom or in the pillow cause snoring? 

Do you remember when was the last time you removed the dirt on the ceiling fan? 

What about changing the pillows?

Dust on the pillows, can cause allergies which in turn could lead to snoring. Also, animals like pets, sleep in the same bed with you brings a serious allergy that can lead to snoring.

There are many things you can do yourself, so that you can stop snoring, here are some tips:

Tips	Explanation
When sleeping the head should be in a higher position.	The position of your head should be a few inches higher than the body, this can allow you to breathe, and pushing the tongue and lower jaw forward. Thus, the use of a pillow during sleep is very important.
Sleep sideways	Avoid sleeping on your back, because it will make it easier for the mouth to open and the tongue to close the respiratory tract that would impede the flow of incoming air, and finally make you snore.
Make sure the nose is not blocked when you sleep.	Nasal congestion can make the process of inhaling air be more difficult that will force one to breathe through the throat which can cause one to snore. To overcome this the user can inhale the scent of eucalyptus oil or other therapies that can make the nose not to clog.
Keep your bedroom in a moist state.	Keep your bedroom in a moist state, you can use a humidifier (humidifier). Dry air can irritate the membranes in the nose and throat, which will increase your chances of snoring.
Set a regular sleep pattern.	Adjust your bedtime, and make sure you get to sleep well and enough quality sleep. If the quality of your sleep is well, it can reduce the risk of snoring.
Avoid alcohol, sleeping pills if possible and tranquilizers before going to bed.	Alcohol, sleeping pills, and tranquilizers can relax the muscles in the throat, breathing becomes disturbed. Especially for those who really need sleeping pills and tranquilizers, further consult your doctor. This is because there are many types of sleeping pills or tranquilizers can make snoring worse.
Lose weight	Lose weight, although only slightly reduce the fat tissue in the back of the throat so as to reduce snoring and even allows you to stop snoring. You can use a diet or exercise plan to do so.
Exercise daily	In addition to weight loss, exercise will form part of the body, such as arms, legs and stomach to produce positive benefits, but also help tighten the muscles of your throat will eventually overcome your snoring problem.
Quit smoking if possible	If you are a smoker, the higher your chance of snoring. Smoking can cause breathing airways to become narrower, because the membranes in the nose and throat irritation. Therefore, it should immediately quit smoking to eliminate habitual snoring

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9 BENEFITS OF DRINKING WARM WATER EVERY MORNING

Most of us know by now that water is essential to our survival. We've probably also all heard doctors say that drinking roughly eight glasses a day is ideal. Many people start their day with a cup of coffee or tea, but what happens if you change your morning routine and drink warm water? Consumption of warm water in the morning has plenty of advantages and therefore you should start the day with one cup of warm water.

Here are some of the proven few reasons:

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Creamy Fudge

Three minutes and three ingredients is all you need to make this creamy.

Creamy Fudge Recipe

Ingredients

1 cup Sweetened condensed milk

2 cups chocolate chips

1 table spoon vanilla extract or any other flavor you prefer 

Method of Preparation

Place your condensed milk and choc chips in a large bowl (microwave safe)

Heat for 1 min on high in the microwave.

Then stir and stir. If needed heat for additional time at 30 seconds intervals until smooth or chips are completely melted.

Stir in the vanilla extract then pour in a prepared pan (I like lining mine with parchment paper)

Let the fudge cool completely before cutting into 1 inch squares (you can place in the refrigerator for 1 hr. to speed the process)

Store in an airtight container. Fudge does not need to be refrigerated.

It's one of my best comfort foods :-) Enjoy :-)

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What you should know about tuberculosis

• Tuberculosis is an infectious disease which is transmitted from the person to another by coughing.
• The patient may have infected several other people with whom he lives in close contact. The patient should, therefore, encourage such people to have themselves checked for tuberculosis when they become ill.
• Tuberculosis drugs are available, free of charge, at any Government health facility and in most mission hospitals.
• Once treatment with these drugs is begun symptoms of tuberculosis disease will disappear quickly, but the drugs still need to be continued daily until the end of the prescribed treatment period. Failure to comply with this treatment requirement may cause the disease to start again, with great risks for the health of the patient.
• The type of regimen and the exact number and type of tablets that the patients will take.
• How long the intensive phase and the continuation phase will take and where and when the drugs will be administered.
• To stop taking Thiazina and report to the COLS if he notices a generalized itchy rash on his skin. He will then be given other drugs.
• A sputum-smear examination is required at certain intervals to monitor the progress towards cure. Explain to the patient when the examination will be required.

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Care for insensitive feet

• To wear protective footwear throughout the day to avoid injury.
• To avoid too much walking because this is the most common cause of a sole wound in an insensitive foot. So, ride a bicycle when you can; send others in your place; if you must go, stop often, rest your feet, watch where you step.
• To learn from any earlier wounds to his feet so that he does not make similar mistakes again.
• To avoid heat. To sit with his feet protected, when he sits close to a fire.
• To avoid sitting on his lower legs when he sits on the ground because this may cause pressure ulcers.

Daily foot inspection

• To inspect insensitive parts of his feet and legs and also to look for signs of injury, dryness, cracks, and swellings. A small mirror is useful for inspecting the sole of his feet.
• To feel for warm spots which may warn of injury, and to press for tenderness caused by infection in the deeper layers of the sole of the foot.

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The factors that complicate the management of leprosy

Leprosy is a complicated disease even for health staff unless they have received some specialized training in the subject. So it is even more difficult for the lay patient to understand the disease and the possible harmful consequences of ignoring medical advice (non-compliance). These are some of the factors that complicate the management of leprosy:

• People with the disease are still stigmatized.
• The patches in paucibacillary patients only disappear some years after MDT has been stooped and the patient is told that he is cured.
• Leprosy reactions with complications such as paresis, paralysis or blindness disabilities are often irreversible if patients report very late. They may have expected their disabilities to be “cured”, therefore this leads to disappointment and may influence their compliance with treatment.
• Even with MDT the treatment period is still quite long (6 months to 2 years) and this causes problems with the regular intake

In these circumstances, it is clear that education of leprosy patients must be a painstaking task which requires patience and understanding of the patient’s way of thinking and his individual circumstances.

What a diagnosed leprosy patient should know

• Leprosy is an infectious disease caused by bacilli (bacteria) not by a curse, witchcraft, or anything similar.
• The patient may have infected several other people with whom he lives in close contact. He should therefore encourage such people to have themselves checked for leprosy when they develop patches.
• Leprosy bacilli are killed by MDT if the drugs are taken regularly for the recommended period.
• Much of the damage that had been done to nerves and tissues before the patient was started on MDT cannot be reversed.
• During (and after) MDT, patients are no longer infectious and are therefore no danger at all for the family or the community.
• In PB patients patches will still be present when the MDT course is already finished. The patches will disappear slowly over a period of 1-3 years.
• Tablets need to be taken daily, as prescribed, and preferably at the same time each day.
• Drugs have to be collected from the clinic every four weeks. On the clinic day the patient takes rifampicin and clofazimine under supervision, and collects dapsone and clofazimine to be self-administered at home. Keep the drugs out of reach of children.

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Delicious warm pumpkin soup

This spicy pumpkin soup will warm the soul.

Delicious warm pumpkin soup recipe

Ingredients.

One chopped onion.

3 cloves garlic

Pumpkin...

Method

Put all the ingredients in a cooking pot

Add some milk to help cook the pumpkin

Let it cook till a fork goes through. Mash with a cooking stick.

Add some more milk and white pepper. You can use black pepper if you wish and salt to taste. Let it simmer and take it off the heat...you can blend or eat as is...

Final results.

Enjoy

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Spicy sweet mixed rice and beef recipe

The recipe has been passed on to me, so I can still enjoy the sweet-spicy flavors of this stew up to date.

Ingredients:

• 3 cloves garlic
• 2 tomatoes meat
• soy sauce rice
• 1 large onion 
• curry powder
• cayenne pepper
• mixed spices
• tomato sauce

Steps in preparation

Boil the meat together with the mixed spices.

After the meat is cooked add some oil, onions and garlic. Let them cook.

Add tomatoes curry powder, tomato sauce and very little cayenne pepper - it's a very strong pepper - put like a drop, not even a quarter of a teaspoon.

Add soy sauce after the tomatoes cook. Add rice, water and salt. Let it boil.

Final dish

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Rules of successful chemotherapy

The success of tuberculosis chemotherapy depends on the strict application of the following rules:

• Follow NLTP regimens.
• Use the correct drug dosages.
• Ensure that the initial phase of chemotherapy is given under strict supervision.
• Ensure regular patient attendance for the full duration of the continuation phase.
• Trace defaulters promptly.
• Keep accurate records of patients’ information and clinic attendance.
• Ensure an adequate supply of drugs.

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How to collect a sputum specimen

• Ask the patient to cough deeply (demonstration is usually more effective than words).
• Ensure that no one is standing in front of a patient producing sputum.
• Avoid contaminating the outside of the sputum containers with sputum. If the outside is contaminated, discard the container and repeat the collection with a fresh one.
• If the specimen is not suitable (e.g. if the quantity is insufficient or if it contains saliva), ask the patient to repeat the coughing until a sufficient amount of sputum has been obtained (3 to 5 ml). 

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Complications of tuberculosis

Pulmonary tuberculosis

Hemoptysis (Coughing up of blood)

In all severe cases, i.e. coughing up a small cup of blood or more, the patient should rest, be sedated and be referred to the nearest hospital.

Spontaneous pneumothorax (Collapse of the lung through damage caused by tuberculosis).

The patient has dyspnea and must be referred to a Medical Officer for further management (expansion of the lung with underwater seal drainage tube).

Pleural effusion.

If the amount of fluid is not too great, the clinical condition will improve after treatment with streptomycin and Thiazine. If there is too much fluid in the thorax (as judged on a chest X-rays) or pus, drainage or aspiration may be necessary.

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Tuberculosis in children

The diagnosis of tuberculosis in children is difficult, because children seldom produce sputum. Diagnosis should be made primarily on history, clinical signs and symptoms, and the result of a tuberculin test. A score chart may help in making the diagnosis.

Pediatric tuberculosis score chart

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Wound Healing

Wound healing is a dynamic process initiated at the time of the insult to the skin. It does not complete itself for many months. It is a natural, predictable process, but it can be affected by a number of outside factors. All wounds are contaminated no matter how clean they may appear. The most important negative influence on wound healing is wound infection. The phases of wound healing are overlapping and they include:

• Immediate response phase (occurs seconds to hours).
• Inflammatory phase (occurs hours to days).
• Epithelialization phase (occurs hours to weeks).
• Neovascularization phase (occurs days to weeks).
• Collagen synthesis phase (occurs days to months).

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Crazy Meal: Omena With Chapati

-Boil water and soak them for 5 minutes then drain.
- on a heated pan add oil enough to just cover the base and let it heat up. Add the omenas and expect a sizzle. Cook stirring until they dry up completely then transfer to a plate.
-on the same pan add oil and onions, cook till they turn translucent then add garlic. Cook stirring for about 2 minutes then add your chopped bell peppers (I used red, yellow and green bell peppers chopped julienne style).
- fry these for a minute then add your preferred spices and chilly powder for some heat. Add a tablespoon of tomato paste and mix.
- Now add your omenas and combine well then add a cup of natural yogurt (you can use less or more). Lower the heat and let this simmer for about 4 minutes. Stir and taste. Adjust the seasoning if need be then add your chopped coriander. Add a dash of lime juice ,mix and serve. Enjoy!

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What Must Be Done To Stabilize the Patient?

Stabilizing a patient may require the direct intervention in a life-threatening process or an intervention that anticipates a critical problem developing. In a patient with chest pain, a cardiac monitor and an intravenous line are placed in anticipation of a dysrhythmia and the need for medications or volume repletion. These steps demonstrate the emergency physician’s awareness of the potential hazards of the pathologic processes associated with the presenting symptoms, not the diagnosis. They represent actions performed to monitor the course of the process while preparations are made to intervene quickly if necessary.

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BAKED MASHED POTATOES WITH MINCED MEAT AND PINE NUTS

BAKED MASHED POTATOES WITH MINCED MEAT AND PINE NUTS

Ingredients;

Minced meat 

Pine nuts(optional) 

Onions 

Pepper 

Salt to taste. 

Potatoes 

Margarine/butter 

Milk(optional) 

Eggs 

Bread crumbs 

Steps of preparation.

Cook the minced meat,add pine nuts(optional),lots of onion ,white pepper and salt (set aside 2 cool).

Peel and boil potatoes in salty water until it's soft.

Mash the potatoes and add some butter/margarine and powder milk(optional)

Spread some butter as shown in the plate like you do while baking and put 1/2 of the potatoes and spread nicely.

Add pre-cooked minced meat on your layer.

Make the 2nd layer from your other half of potatoes(you can dip your hands in filtered water to avoid stickiness).

Beat an egg and spread generously.

Inventing bread crumbs😜

Spread bread crumbs evenly.

How the layers should look like from the side.

Ready for baking/freezing. Put some butter on top at least in the corners and middle(solid not melted).

Bake in a preheated oven until ready(check if it resembles cake design). Should have a nice golden color. Serve with salad. My choice is( cucumber yogurt salad😊). Mine was for freezing.

Enjoy!

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Health Instant Coffee Preparation Guide

The majority of people drink ‘instant’ coffee. Instant coffee is convenient because it can be made into individual cups by adding water to the coffee and stirring. After the seal is broken on the container of instant, or soluble, coffee it should be stored in an airtight container and kept in a cool place. The flavor of instant coffee is improved if it is made in a pot using approximately one heaped teaspoon for each cup, and according to taste. Fresh water that is below boiling point should be added.

Rules for making coffee
Use good coffee that is freshly roasted and ground.
Use ground or vacuum-packed coffee within ten days or the quality will deteriorate. Sure in airtight containers in a cool place.
Use freshly drawn, freshly boiled water cooled to 92-96°C (198-205°F) (to preserve the flavor and aroma of the coffee). Do not use boiling water.
Measure the quantity of coffee carefully: 300-360g per 5 litres.
After the coffee has been made it should be strained off, otherwise it will acquire a bitter taste if kept hot for more than 30 minutes. Do not reheat brewed coffee.
Milk, if served with coffee, should be hot but not boiled.
All coffee-making equipment must be kept scrupulously clean, washed thoroughly after each use and rinsed with clean hot water (never use soda).
Making coffee in pots that have been thoroughly dried and warned.

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Home Safety

We like to think our homes are places where we can be safe. However, within the confines of the home, dormitory, or apartment many potential hazards exist. By conducting a personal survey and remaining alert to these dangers, you can minimize many risks. Discuss the rules for safe living with your house-mates to help ensure each person’s safety. Here are some suggestions for safe living in one’s home. This list is not all-inclusive, but it includes items for which you need to take responsibility.

Home Safety Measures
Install smoke detectors and make sure they are in working order.
If you are going to live above the fifth floor, make sure your fire department has the equipment necessary to reach above that level.
Properly maintain all electrical and heating equipment.
Plan and practice escape in case of an emergency.
Plan alternative methods of escape in case your first-choice plan fails.
Know how to get emergency help. Most areas of the country have 911 service, but many universities have special telephone numbers other than 911. Know your number.
Never smoke in bed or leave lighted cigarettes unattended.
Inspect living areas for surfaces, objects, or room design that can lead to slipping or tripping.
Make sure all rugs have skid-proof backing.
Never overload electrical outlets.
Do not place extensions cords under rugs or where people walk.
Never use a portable heater in an unvented area or near flammable materials.
Keep outside doors locked at all times. Install chain locks on all doors.
Check carefully before allowing anyone to enter.
Look through the peephole or ask who is there before opening the door.
Require people who claim to be maintenance workers to show identification before you allow them to enter.
Place metal poles in the tracks of sliding doors so that they cannot be opened unless you remove the poles.
Be especially careful in parking garages, laundry rooms, and hallways, and when entering and leaving living quarters.
Always tell someone where you are going, and whenever possible have a friend accompany you.

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Responsible Drinking Guidelines for College Students

Many colleges and universities have begun programs that emphasize responsible, rather than total, abstinence. Guidelines for reducing the risk associated with heavy drinking are:

• Pace your drinking - Allow time between drinks and sip the drink.
• Do not drink every day - Tolerance is developed and a person must increase the amount of alcohol consumed before effects are noticed. BAC is still rising even though effects are unnoticed.
• You decide when to drink - Do not allow others or situations to determine your drinking. Drink on your terms.
• Consider alternating nonalcoholic drinks with containing alcohol - Drink a soft drink without alcohol every other drink or drink plain orange juice every other drink.
• Don’t drink on an empty stomach - Food with fats and/or protein slow the absorption of the alcohol.
• Measure the alcohol - Pay attention to the size of containers. Do not provide kegs of beer or use larger sized wine, beer, or shot glasses. No contests or other drinking games.
• Don’t drink for more than one hour - Decide what nonalcoholic drink you are going to drink after the hour.
• Learn how to calculate your BAC - Know how many drinks are allowed within your hour period.
• If you are a female, drink less - Women become more intoxicated than men after drinking the same amount of alcohol even when differences in body weight are take into account. Women have proportionately less water in their bodies than men, thus they become more highly concentrated in BAC.
• Avoid taking over-the-counter or prescription medications - More than 100 medications interact with alcohol. If you are taking any over-the-counter or prescribed drugs, ask your doctor or pharmacist whether you can safely drink alcoholic beverages.

Fortunately, most college students moderate their drinking after their college years. However, about 12 percent are unable to control their drinking and continue to abuse alcohol. You should weigh carefully the potential harmful consequences of alcohol use and abuse before partaking in heavy drinking. Is it worth the price?

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Foods with Unique Health Benefits

Foods that provide a specific health benefits above and beyond their inherent nutritional value are termed as functional foods. Functional food as a term in new but in the strict sense of its definition has been around a long time.

Decades ago the food industry recognized the potential value (and profits) in adding nutrients to various foods. Milk is fortified with vitamin D, cereals are enriched with vitamins and minerals, salt is fortified with iodine, and iron is added to many breads. In a technical sense these foods meet the definition of functional foods. More recent additions to the supermarket shelves include orange juice with added calcium, grain products fortified with folate, pasta enriched with soluble fiber, eggs fortified with omega - 3 fatty acids, and juices with added antioxidants.

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Progressive Muscle Relaxation

There are numerous progressive muscle relaxation activities. The exercises are frequently structured by a facilitator. Some exercise begin with the feet, hands, or face, but because of space constraints, only the relaxing of the face will be described here. You can add the other parts of the body by recording the entire process on audiotape and listening to the tape as often as desired-usually once a day or two to three times a week. Take your time (3 to 4 minutes) for each area of the body.

Assume a comfortable position and concentrate on the instructions. You may find it beneficial to lie down or sit in a comfortable chair.

Close your eyes.

Allow all your muscles to relax and feel loose and heavy. Take several deep breaths.

Wrinkle your forehead and hold for seconds.

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Dealing with stress

All events in life precipitate a reaction. How people react or respond to situations differs. Coping is the attempt to manage or deal with stress. Coping is independent of outcome - it does not necessarily result in success.

Dealing successfully with stress may require using a variety of techniques. Because stress-related responses are based primarily on mental perceptions, coping strategies that achieve desirable results may need to originate in a change in attitude or outlook.

The following are guidelines for effectively dealing with potential harmful stress:

Schedule time effectively. Practice good time management techniques by using time wisely. This means taking out for yourself every day and scheduling work when you are usually at your peak ability.

Set priorities. Know what is important to you. Do not attempt to work on four or five projects simultaneously. Keep your effort focused on one or two major items.

Establish realistic goals. Goals must be achievable. Do not establish impossible expectations and then become frustrated when they are not accomplished as quickly as you would like. Write down long-range goals then establish checks for keeping yourself on track and monitoring progress. Short-term goals help you see how you are moving towards your goal and provide rewards as you advance towards success.

See yourself as achieving the goals. Visualize yourself as being successful. Go over in your mind what it will look and feel like to accomplish a goal.

Give yourself a break. Take time every day to exercise and relax.

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Complications resulting from diabetes

Several serious complications can result from diabetes. Most of the following complications are caused by blood vessel damage.

Coronary heart disease: People with diabetes have two to four more risk of dying from coronary heart disease than do people without diabetes.

Nerve damage: Between 60 and 70 percent of people with diabetes have some form of nerve damage.

Foot problems: Because of peripheral nerve damage, foot problems can go unnoticed. Proper treatment for conditions such as athlete’s foot, blisters, and calluses is extremely important. Any sign of infection should be treated immediately to avert the need for amputation.

Kidney damage: Thirty to 40 percent of people with type 1 diabetes and 20 percent of those with type 2 diabetes eventually develop kidney disease, which can lead to kidney failure.

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Recreational and Outdoor Safety

As you prepare to engage in outdoor or recreational activities, be familiar with the safety rules of your endeavor, have safe and appropriate equipment for the activity, and maintain an attitude of alertness to potentially dangerous situations. Although not all inclusive, the following rules will help keep you safe in a variety of recreational settings:

• Seek training and instruction from certified or respected instructors.
• Purchase appropriate safety equipment for the activity. Make sure your eyes and head are properly protected.
• Make sure all equipment is in proper operating order.
• Obey the laws related to your recreational pursuit.
• Begin any activity slowly and do not attempt advanced skills or actions until you are experienced enough to meet the necessary skill level.
• Stay aware of weather conditions. Always prepare for the worst possible weather.
• Never use alcohol when engaged in a dangerous recreational endeavor or during extremely hot or cold conditions. Alcohol increases the likelihood of emergency situations.
• Take a first-aid course that will prepare you to deal with a variety of unexpected situations

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