Malaria spreads through a mosquito bite (female anopheles) and the common causative organisms in India is plasmodium vivax and p falciparum (malaria parasite). Malaria caused by this parasite does not cause any permanent damage. It is characterized by fever every third day, followed by rigonr or shivering and accompanied by headache and muscle pain. In some cases, there may be enlargement of the liver and spleen. The final diagnosis can be made by examining the blood for the presence of the parasite. Lately a resistant strain of plasmodium vivax and p, falciparum has erupted in some areas of India. This has made the treatment more difficult since it is resistant to usual anti-malarial drugs. How Does the Disease Progress? The malarial parasite gets injected into the bloodstream by the bite of the female anopheles mosquito and reaches the liver where it multiplies. The baby parasites are released from the liver into the bloodstream, where they enter the red blood cells (RBCs) or return to the liver. Those which enter the RBCs, grow and further multiply. This leads to distension and bursting of RBCs and releasing the toxic metabolites of these multiplied parasites, resulting in rigour and fever. The released parasite may re-enter into other RBCs to repeat the cycle of growth and multliplication, causing another attack of rigonr and fever. This new cycle in RBCs takes about 48 hours and account for the occurrence of fever and rigour every third day. Those who enter the liver may be responsible for continuance of the disease; it takes about two weeks’ time to complete the multiplication cycle. The parasites can be attacked in the RBCs or in the liver. Drugs ChloroquineThis is the drug of choice for benign tertian malaria which is usually caused by plasmodium vivax. The oral dose is 600 mg twice of chloroquine (base), followed after 6 hours by 300 mg, then 150mg twise daily, for the next two days. The other drug of this group is amodiaquine. However, some stains of P. falciparum are resistant to chloroquine. In such a situation, quinine is given intravenously. Chloroquine may cause nausea, vomiting and stomach pain. It can be given during pregnancy.MefloquineIt is used for treating an acute attack and curing malaria due to resistant strains of parasites. It should be kept reserved for only these patients of malaria, since its misuse may result in the development of mefloquine-resistant strains of the parasites. It is taken in a single dose of 1.5g. Adverse Effects: Adverse effects of mefloquine are seen in about 1 % patients. These includes irritation in the stomach, fatigue, neurological symptoms in the form of headache, dizziness, visual disturbances, vertigo, tinnitus, insomnia, restlessness, anxiety psychosis, or seizures. It can produce heart-rate irregularities when given along with digoxin, anti-depressants and propranolol.From:http://print.articlesfactory.com/articles/health/drugs-and-medicine-used-in-malaria.html

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Once upon a time progressive activists knew how to campaign on inequality and injustice in a global marketplace. There were clear stances to be taken; there was boycott, resistance and stand off; there were clear hopes for a different international economic order, opposed to one dominated by ‘the’ market. Campaigns were often aligned with national liberation struggles and bubbled with the ideals and potential of new states.

Now there is only the apparent inevitability of a direct engagement in the market and with the few, powerful market-makers. Governments have an ambiguous position: on the one hand we pressure them to regulate transnational companies (TNCs) for the wellbeing of the people; on the other hand they frequently support business in undermining such regulations. The effect of this shift has been a proliferation of policy initiatives for the governance of companies, the financial sector, of overseas development and the environment. Simple commercial and legal mechanisms such as labels have become tools for social and political agendas. Many new private- sector, NGO and trade union think tanks and ‘talking spaces’ such as the UK Ethical Trading Initiative have been launched. Many companies have signed up for working groups on monitoring and verification processes. Specialist ethical company associations, notably the enormous Businesses for Social Responsibility in the USA (which includes companies responsible for 20 per cent of the world’s total turnover, including Monsanto and Coca Cola) have been formed. There is also a new, still-evolving discipline in ethical and responsible business management. There are already graduate courses and degrees, dedicated institutes and academies, and (forthcoming) a government-backed new learning centre all derived from the need to deliver ethics and responsible supply chain management. There is also a growing number of direct agreements between Northern and Southern non-governmental organisations (NGOs) and TNCs. The big accountancy firms and SGS (Surveillance General De Securite) now offer to audit companies’ values and labour standards alongside other more conventional measures of profits and stocks.

As the Maquila Solidarity Network, based in Toronto, recently stated: Five years ago many of us dismissed codes of conduct as nothing more than company attempts to protect their brand image and/or avoid government regulation…In just a few years we have moved from company codes of conduct with no provision for monitoring or verification towards codes with elaborate systems of internal and external monitoring, factory and company certification and mechanisms for NGO and labour participation in monitoring and third party complaints procedures. Intuition and bitter experience are turning more and more people into activists. This has risen from action and argument against the market and its assumption of unassailable rights and an unaccountable sway over people’s lives and the planet’s resources. This new wave does bring to the fore some contradictions. For instance we now find trade unions ‘understanding’ why good companies like Levi’s must lay off thousands of workers; we have NGOs like Oxfam encouraging buycotts (lending their ethical ‘brand’ of approval to specific products or stores like Sainsburys), we have localists anxious to preserve and reinvent their community without heed to notions and benefits of interdependence; and there is a tier of the world’s population who are not currently engaged in the global economy and thus miss out on gains achieved through any negotiations via the formal economy. Further, we have popular alliances which aim to influence the behaviour of powerful companies but are financially and morally entwined with those very companies.

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Don’t be afraid of the dentist. If you avoid the dentist, you may eventually be saying good-bye to your teeth. In fact, dental visits should be a major part of your health regimen. Good habits that start from childhood can easily carry forward through adulthood. Simple habits of brushing and flossing regularly are not enough. You must visit your dentist approximately every six months so that you can be examined. The dentist will be able to catch problems before they become gigantic problems. A simple filling of a cavity can prevent a root canal procedure later on down the road.

With new advanced in dental practices and procedures, the entire experience can be painless. Many dentists are utilizing advances to make the office visit much more comfortable than in years past. For example, there are message chairs, overhead television monitors and radios being played in many offices. The dentist can even let you choose from a variety of movies, musical groups or music stations.

Importantly, the dentist can provide the proper amount of anesthetic so that the patient doesn’t feel pain during the procedure. The dentist can also prescribe the proper after-care medication so that the days following the procedure are not uncomfortable.

In essence, embrace the idea of visiting your dentist. It should not be something that is dreaded. Think of it as a major part of your healthcare package. Learn all you can about your teeth, gums, breath, etc. You have the ultimate control over your mouth and the future of your teeth. It is much easier to take care of your teeth than to have replacement teeth implanted.

Lastly, if you have any concerns or questions regarding a procedure, ask the dentist to explain it to you. Most caring dentists would be happy to describe the type of procedure, the benefits of the procedure and the necessity of the procedure. You should never fear your dentist. You should feel free to ask your dentist any questions that you have related to the work being performed. The dentist is truly there to help patients and will make efforts to demonstrate that desire.

Take action today. Schedule an appointment with your dentist to ensure that your mouth and teeth are in good working order. Failure to take action may result in severe action in the future. If you do not have a dentist, research the dentists on the internet and visit a few that spark your interest.

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With the New Year now upon us, it’s important to give pause and consider making some positive changes regarding the state of your health. As they say, theres no time like the present. People the world over often make resolutions to do something to better themselves in the coming year. In 2006, consider doing something that will benefit your overall health. The following suggestions may just help to ensure that youre able to make New Years resolutions for many years to come.

Get a Check-up – An excellent place to start when considering lifestyle changes is with an honest assessment of your health. At this stage, it wouldn’t hurt to consult with your physician. Why not make an appointment for your annual physical exam? This way, you can begin the year with an accurate assessment of your physical state. Your doctor will be able to focus your attention on areas that are of immediate health concern. This is especially important if youre a smoker, if youre overweight, or if you have any significant health issues that might prevent you from performing simple daily tasks.

Drink More Water – Make another profound difference to your health by consuming more water. Many people make the mistake of assuming that theyve received enough water from the various pop, coffee and other beverages theyve consumed in a day. This is not entirely accurate. Ideally, one should consume upwards of eight, 8-ounce glasses of water per day. Water helps the body metabolize stored fats. It can also help your body cleanse itself of free radicals, which have been linked to cancer and other such ailments.

Get Moving – Exercise is yet another effective way to maintain optimal health. Thats not to say that one has to become entirely committed to working out each and every day, but its in every individuals best interest to perform some form of activity 3 times per week. Physical exercise can be performed in a wide variety of ways to keep it fun and interesting. For instance, the simple act of walking is a highly effective form of exercise. Its one that can be completed without supervision, without props, and without any previous experience working out. Joining a gym has a number of direct benefits as well. Not only will you have access to some excellent equipment, but you will also benefit greatly from the fitness knowledge that most personal trainers possess.

Pay Attention to Nutrition – Diet also plays a significant role is one’s overall health. Everyone should be familiar with the dietary guidelines established by the leading health agencies and authorities. The “food pyramid” is by far the most popular set of published nutritional guidelines. The food pyramid advises people to include all of the major food groups – grains, vegetables, fruits, dairy and meat (or protein) – in their diets. Keep in mind that the food pyramid is merely a nutritional guideline. The dietary needs of each individual will vary drastically, and whats ideal for one person isnt necessarily ideal for the next.

By following these few simple suggestions, you can take control of your health and your life in 2006. Good luck!

From:http://www.articlecity.com/articles/health/article_3920.shtml

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High cholesterol level is probably one of the widely spread complication among Americans. Almost forty to fifty percent Americans have their LDL level higher than the normal. In order to bring down the level, medications are quite frequently in use. But these medications are only sought when dietary measures and exercises are unable to regulate high level of bad cholesterol. Most of the widely prevalent cholesterol medications are likely to result in certain side effects. That’s why great research and development is on in America to come up with effective anti cholesterol medications with least or no side effect.

Although with more side effects or less side effects, old groups of cholesterol medication are widely accepted. However diabetic folks must take these medications with extreme care. They must seek their doctor’s opinion before consuming these medicines.

Folks taking medicines must keep track of their blood cholesterol level so that they may not get indulged in over usage of drugs. These cholesterol lowering drugs work in divergent ways however their purpose remains the same.

Various medications could be listed as follows-

Statin medications

Statin is probably most sought after cholesterol medication. It is very active bad cholesterol reducing agent. Medicines of this group could lower bad cholesterol even up to sixty percent. It enhances liver’s capacity to eliminate LDL or bad cholesterol from blood by increasing level of HDL or good cholesterol. However its usage may result in intestinal and certain other side effects. Simvastatin, Pravachol, Lovastatin and Lipitor are some of the medicines of this group.

Niacin medications

It is also known as Nicotinic acid medicines. Medicines of this group too serve the same purpose. Along with LDL cholesterol it also affects Triglyceride. These vitamin B3 drugs could be even found in natural food products. It also helps in widening blood vessels. Its consumption often results in headache and itching.

Bile Acid sequestrants

These absorbers in intestine help prevent cholesterol from getting into blood circulation for that they get adhered with bile and excess cholesterol comes out through stool. It is an effective cholesterol reducing agent. Colestipol and Cholestyramine are two acids in use to serve the purpose.

Derivatives of fibric acids

It reduces total cholesterol count. It also increases level of good cholesterol. This medicine is particularly meant for lowering Triglyceride. Gemfibrozil and Fenofibrate are two popular medicines of this group. These medicines may give way to certain digestive disorders.

Cholesterol absorption inhibitors

These are relatively new drugs. These facilitates intestinal absorption of Low density cholesterol thus help in preventing excessive deposition of blood cholesterol. Ezetimibe is one of the drugs of this group that is being used frequently.

These are widely prevalent medication groups. None of these medicines come as over the counter drugs. Some new cholesterol drugs have also come on the block. Recently Pennsylvania University has come up with a drug called Torcetrapib that serves the purpose of cholesterol reduction well and inventors also boast off that the medication is free of side effects. ACAT or Acyl co A or Cholesterol acyltransferase is another new drug that is said to be equally efficient to serve the same purpose with probably no side effects.

Let’s hope for many more side effect free medications to curb this menace of bad cholesterol.

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So, just be ready to straighten your hair through our steps. You are just a few steps away from a hair straightening experience. So if you are willing to embrace the latest hair style trends and start straightening your hair, you have a very simple option within your reach.

All what you need to arrange is:

Straightening balm

Wide-toothed comb

Large round bristle brush

Blow-dryer

Flat iron

Non-creasing hair clips (for hair section)

The first step involves you washing your hair and condition it properly so as to enable it absorb the heat better. Precaution advised is, if you get your hair straighten more often, then try to condition them frequently in order to reduce the harmful effects of heating process.
Now, gently apply the straightening balm on your hair, and start brushing your hair by using a round hair brush. This balm is likely to increases the luster and gloss of your hair.

Now, separate hair into sections and arrange them into groups with a non-creasing hair clip. Hold the hair brush with one hand and blow-dryer with the other. Now, start blow drying each section of hair that you have separated and repeat the process twice. Now, use the round hair brush down the hair with the blow dryer gently. If you wish to get a sizeable look, turn your head down at the front and blow-dry your hair following a wide-toothed comb or fingers of your hand. However, you can get a straight and smooth look if you brush and blow dry the hair straight down.

Now, select the sections of your hair, for this you can select around ½ of an inch of your hair. Take the flat iron and execute it on smaller sections. This way, you will get a more uniform and refined look of your hair. So you have achieved the style now!

To get the curled under look, you just rotate the iron inside to get a curled under look. To achieve a pin straight look, hold the iron flat through the end of hair and do not rotate it up or under and the style is here. Give it some rest there, and you have the look you wanted.

Now, you can pack up your instruments. And, you are ready to move out straight with straighter hair style.

Taming your curls is a challenging task. But there are lots of people, who dream of bone straight hair. So, if you also sail in the same boat, try the technique explained here, and who knows that your wonderful dream comes true within few minutes.

From:http://feeds.ezinearticles.com/~r/ezinearticles/health/beauty/~3/276906938/

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There is a piece of equipment available in many gyms and homes that has been shown in tests to be unsurpassed for assisting in your weight loss goals – want to know what it is?

The Treadmill – exercising on Treadmills has helped many people to achieve their weight loss goals – and it can help you too.

Treadmills can be used by virtually any age group, and by individuals of any activity level. Treadmills can help you lose weight, and maintain your weight loss. It really is a numbers game. The more time you spend engaged in physical exercise the more calories you are going to burn and consequently the more pounds you will lose.

If you are searching for fitness equipment that will not only burn fat, but will also raise your metabolism to continue burning fat long after youve stopped exercising, then a treadmill should be at the top of your list.

The treadmill is matchless for cardiovascular exercise. According to a recent study, calories burned on the treadmill for 60 minutes averaged 865 – 705. Compare this figure to the following:

Stair machine 746 – 637 Rowing machine 739 – 606 Stationary cycle 604 – 556 Cross-country ski machine 678 – 595

As you can see the treadmill comes out as the number one cardiovascular machine.

If you would like to develop your own weight loss treadmill program here are some ideas:

Be creative – make your Treadmill session pleasurable, listen to music or audio books on your MP3 player. Some people prefer to just take the opportunity to think or just day dream. The more you enjoy your Treadmill session, the more likely you are to exercise on your treadmill regularly.

Try to exercise daily. Working out on your Treadmill regularly makes your weight loss goals much more likely to happen than if you are only working out only when the mood takes you. Most people that make the switch will tell you that it’s easier to workout every day. You don’t have to think about whether it’s a workout day or not and get prepared for it – just exercise on your treadmill every day – your body will become accustomed to it. It will soon become part of your routine and you will begin to look forward to it.

Try to mix in some interval training into your Treadmill sessions each week. Interval training consists of brief periods (about one minute) of more intense exercise incorporated into your Treadmill workouts. You may do a one minute interval of faster walking about every five minutes throughout your workout.

Start with a three to five minute warm-up and then five minutes into your walk you do your first interval, one minute of faster walking. At the end of that minute you should be out of breath and ready to slow down. Slow down to your regular walking speed for the next four minutes and then your fifth minute is another one minute interval. Repeat this throughout your workout.

By this means you can increase your aerobic fitness level to the limits of your ability. You are in essence crossing the anaerobic threshold into anaerobic metabolism, this forces your body to accept more intense exercise which will in turn make your weight loss gains more achievable.

By increasing your basal metabolic rate, interval training cause you to burn more calories a day, and make your exercise less monotonous. Interval training also helps the time pass more quickly. Try walking on your Treadmill with light hand weights of between one and two pounds weight for two to three days per week. Swing your arms and also use a variety of arm movements while walking. This will increase your basal metabolic rate and tone your upper body muscles.

Try to do your Treadmill workout first thing in the day. Most people who workout regularly, do so first thing in the morning. If YOU want to exercise regularly, you are more likely to succeed by being an “early bird”

In order to add a bit more variety to your routine set one day of the week aside to be your “easy day”. This should be a very leisurely session. Consider how good your walks are starting to feel as you continue to lose weight and tone your body.

You have probably heard the expression “if you can’t measure it, then it doesn’t exist”. With this in mind make sure that you record your progress. Record the date and time-of-day of your workout, and the distance and/or time you walked. Record the total of the miles or minutes you’ve walked. Your thoughts or feelings for that particular workout can also be logged.

All of the above measures will help to ensure that your Treadmill Exercise Session is that one special time of day to take care of yourself. Don’t let anyone or anything keep you from your special time with your Treadmill. Working out on your Treadmill every day will help you achieve your weight loss goals and have a positive impact on all aspects of your life, including physical, mental, and emotional health.

If we only consider the issue of weight loss, the Treadmill is significantly superior to any other exercise machine given its associated energy expenditure. While other fitness equipment “fads” gather dust Treadmills have consistently provided quality results and lasting benefits. Treadmills allow you to work at your own pace, but don’t allow you to slack off. You’ll be able to burn calories efficiently and attain your weight loss targets.

If you’re in the market to seriously educate yourself about Exercise Treadmills, visit http://www.treadmilladviser.com where you can obtain more detailed information.

From:http://www.articlecity.com/articles/health/article_6206.shtml

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A deficiency of vitamins can lead to a variety of health problems, including some forms of arthritis.

These organic nutrients are normal sourced through our intake of fresh fruit and vegetables. Due to the following factors, it is not always possible to get our recommended daily allowance (RDA) of vitamins: Poor soil quality Modern processing methods Popularity of ‘Junk’ foods

As an alternative to getting your RDA through diet, many people now take vitamin supplements.

The following list of vitamins are known to be especially beneficial to arthritis sufferers:

Vitamin B5 When grouped and tanked together, B vitamins work at their peak. They, and B5 specifically, are good for reducing swelling.

Vitamin B3 This vitamin reduces tissue swelling and dilates small arteries, increasing blood flow. Note that Vitamin B3 is NOT advised for persons

with high blood pressure, gout or sliver disorders.

Vitamin B6 Another B that reduces tissue swelling.

Vitamin B12 This vitamin aids in multiple functions. It helps with cell formation, digestion, myelin production, nerve protection.

Vitamin C – This vitamin acts as an anti-inflammatory, relieving pain, and rids the body of free radicals.

Vitamin E This is a strong antioxidant that protects joints from free radicals while increases joint flexibility.

Vitamin K This vitamin assists with mineral deposit into the bone matrix.

Vitamins combine with enzymes involved with tissue repair, cell production and our metabolism.

There are two types of vitamins:

Water Soluable – These vitamins ( B and C complex ) are not not stored in our body organs and usually pass through our bodies very quickly, in the form of urine. It is therefore important to have regular daily intakes of these vitamins.

Fat Soluable – Vitamins A, D, E and K stay in the body as they are stored in the liver.

The information contained in this article is for educational purposes only and is not intended to medically diagnose, treat or cure any disease. Consult a health care practitioner before beginning any health care program.

From:http://www.articlecity.com/articles/health/article_1707.shtml

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Copyright (c) 2007 BrainFit For Life

A new study published in the Archives of Internal Medicine links intake of beta-carotene (a pre-form of vitamin A found in carrots) to improved cognitive performance in later life. We have appreciated the benefits of vitamin A in brain development for a long time. But until now, the beneficial role in the adult brain has been less obvious.

The power of the new study is that it followed participants in a controlled study for 18 years, from about 55 to 73 years old on average. This provides the ability to really look at long-term affect.

Time is Too Short

The difficulty with many nutrition studies, especially those looking at cognitive health, is that they are too short. Many vitamins probably help maintain brain health due to their anti-oxidant properties, allowing them to prevent or slow age-related decline of the brain. These affects may take many years or even decades to be become apparent because your brain doesn’t go belly-up overnight.

Several studies in the past have failed to show the cognitive benefits of vitamin supplements, but most of them were only a few years long. Grodstein et al., who authored the new study, actually looked at groups that participated anywhere from 1 to 18 years.

Although they found no observable cognitive benefit of vitamin A supplementation after 5 years, the benefit was clear by 15 years. Most other controlled studies have been much shorter, with a few making it to the 9-year mark at best. This may be a reason for lack of positive results in the past.

There are many ‘observational’ studies that support the cognitive benefits of taking vitamins, but these are typically plagued with other possible explanations. For example, people who take vitamins also exercise more, smoke and drink less, eat better, and generally limit their vices to a number they can count on one hand.

Control Freaks (make good scientists) The new study by Grodstein et al. is exciting because it presents some of the first data with a controlled study, large groups of people, and a long time course. The researchers looked at about 1,000 people per group for the short-term study (1-3 years) and about 2,000 people per group for the long-term study (up to 18 years).

Although the authors did not directly link vitamin supplementation to reducing Alzheimer’s disease, the cognitive skills they measured are relevant to those that decline in dementia. Also, previous studies in animals have shown that vitamin A may help prevent some of the problems in the brain that are associated with Alzheimer’s disease progression.

Too Much of a Good Thing

There is no magic bullet for preventing disease, but the new study suggests that vitamin A is beneficial for life-long brain health. This doesn’t mean you should dose up on vitamin A, however, because it is toxic at high levels. A safe form found in quality nutritional supplements is beta-carotene, which the body converts to vitamin A as it is needed.

Still, no nutrients work all by themselves. A good quality multi-vitamin that contains optimal levels of beta-carotene along with all the other essential vitamins is a good way to go.

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Ponterotto et al. (1995), p.416

Reasons to suspect that barriers exist

It is known that ethnic minority groups are reticent about seeking mental health assistance, and those who do suffer from premature termination. In a study of 135 African-American outpatients only 25% of those seeing a white therapist returned after the first session, as compared to 43% who were seeing a same race therapist suggesting client-therapist ethnic match to be an important factor. Interestingly, the figures suggest that 57% of the population who were seeing a same race therapist didn’t return and this would indicate that the ethnic match is far from the complete solution. Another study in a similar vein was conducted across 17 community mental health centres across the Seattle area of the USA – over 50% of Asian patients prematurely terminated therapy after just one session, as compared to a 29% rate for Caucasian patients. These observations were explained in terms of a difference in attitudes and beliefs regarding mental illness and psychotherapy, and also that the failure of therapists to consider these attitudes resulted in a failure to develop trust, rapport and a working therapeutic relationship. In a study where 83 black and 66 white university students were recruited by telephone, the white group were 6 times more likely than the black group to have sought help from a psychologist or psychiatrist.

Semi structured interviews were conducted with 48 psychiatric patients recruited from mental health care facilities. The Asian group (consisting of Filipino, Korean, Japanese and Chinese people) had the longest delay between diagnosis of mental health problems and participation in a treatment programme, indicating a degree of reluctance to engage in the help seeking process. In the interim, it was found that this group had more extended, persistent and intensive family involvement than either the Black or Caucasian groups. The authors commented that psychiatric problems in Asian families may be taken as a threat to the homeostasis of the family as a whole. The family participate actively in denying such problems.

Using a random sample of migrants from India to the UK, other researchers have found that they showed less evidence of emotional disturbance when compared to a matched English sample, using a scale which had been validated for both groups in question. This begs the question – do Asians utilise services less because they have less cause to do so, as opposed to there being barriers to obtain such help? Given equal numbers of stressful life events, as social support systems increase, one would expect the likelihood of experiencing psychological distress (and subsequently seeking counselling) to decrease. It is known that Asian communities in Britain tend to have strong links with the extended family, with family homes sometimes consisting of three generations. It may be that this support acts as a buffer during emotionally difficult periods. Other findings refute this suggestion – depression is thought to be diagnosed less commonly among West Indian and Asian patients in Psychiatric hospitals than among the British born, although this does not reflect the actual occurrence of depression in the community.

What are the known barriers?

There may be barriers at an institutional level – the geographic inaccessibility of mental health services to the ethnic community; lack of child care; focus on an intra-psychic model and strict adherence to time schedules. In one study, environmental constraints were ranked second as reasons for leaving therapy prematurely. Equally, there may be financial barriers (such as medical insurance within some countries, or time off work in order to attend); cultural barriers (such as language and attitudes to mental health problems). It is thought language barriers and cultural differences are less of an issue for second or third generation Chinese, who have integrated into the host country. Indeed, the English language has a rich source of adjectives to describe internal experience – such as despondent, despairing, disillusioned, gloomy, unhappy, miserable and so on – there may not be so many direct equivalents in the Asian languages. More probably, Asian clients may struggle to find English equivalents for words that they know perfectly well in their own mother tongue.

Over 2000 adults were interviewed about their perceptions of barriers to help seeking for two specific problems – alcoholism, and severe emotional problems. The Caucasian group perceived less barriers than any of the other Asian groups, and this remained so after controlling for various sociodemographic variables. A sense of shame was rated quite highly across each non-Caucasian ethnic group, and this is discussed in more detail later in the section. The second most popular response across groups was that services were inappropriate, or that they just weren’t aware of them. Interestingly the least most important factor was accessibility of services and ethnic match of the therapist. In one of few studies carried out with Indian participants, a content analysis of the responses given by Tamil women suffering with depression in India has been made. Consistent with earlier findings, treatment seeking behaviour was influenced by the stigma associated with their condition, and another deterring factor was lack of knowledge that treatment was available. The issue of shame seems further emphasised in that the women expressed feelings of wanting to ‘wither away’ rather than seek treatment.

The shame of needing to seek help

Shame has been equated with mental health problems within Asians, for sufferer and family alike – perhaps because it reflects a failing in upbringing, or some inherited component which would affect the families standing in the community. Mental illness seems to be taken by Asians as a weakness of character and the need to seek professional help is seen as a disgrace. In eastern thought there is a strong belief that all events are influenced to some degree by unseen forces, and any personal difficulty is a reflection of the misfortune of the sufferer. Isolation can set in, where people in the community tend to avoid associating with such a person, or the family. It is suggested that ancient codes of India mean psychiatrically ill individuals did not qualify for certain social privileges, and this stigma around mental illness is clearly present in contemporary India. An escape from such stigma may be to conceal the difficulties – perhaps on a conscious level in the avoidance of professional sources of help, and also in the sub-conscious denial of all problems that are not physical. For the Chinese, mental illness seems to be seen as a disgrace and sufferers become family secrets, to the extent that the illness is denied proper care.

It is known that stressful situations that are evaluated as a threat to self esteem provoke a ’self controlling’ coping response (i.e. an inhibition or restraint of ongoing thoughts, feelings and actions). The shame associated with mental health problems is likely to be associated with such a threat to self esteem – and perhaps the reluctance to seek professional help is an extension of this self-controlling response. The avoidance of shame, with the avoidance of help seeking as one mechanism, is one of many withdrawing behaviours. The concept is simply that of withdrawing from situations in which shame could arise. It may be that a failure to live up to spiritual or cultural ideals fits a similar pattern to the other failures discussed in the literature.

The shame of failing to live upto ideals

Within a religious or spiritual framework for Asians, it is often the case that followers aspire towards a surrender to divine will – to accept their lot in life, be thankful for what they have and not to feel downhearted about difficulties or gaps in life. For Indians, religion is often a central part of family life. For Indians residing outside of their country of origin, worship has taken on an additional role – that of maintaining identity and sustaining a social network within their community. It may be suggested that a persons standing within this socio-religious sphere is questioned where mental health problems arise. After all, depression in lay terms is about unhappiness, and this opposes the religious ideal. What trust have you left in God, if you have lost hope ? How can you be a believer, if you do not believe God knows and does best ? Such internal dialogues are likely to influence not only internal judgements about the self (internal shame), but also judgements about the view that others in the community hold (external shame). Internal shame is derived from how the self judges the self, seeing oneself as bad, flawed, worthless and unattractive. Furthermore, shame must include some notion of a place or position that one does not wish to be in, or an image that one does not wish to create – perhaps because this image or position is associated with negative aversive attributes from which one struggles to escape. These ideas provide a helpful context for assertions made about Asian families being more preoccupied with what the neighbours must be thinking when a member of the household has been hospitalised for an overdose.

Shame induced within the professional consultation

A factor not given much attention is the shame that may be induced by professionals. Depressed patients who attend the GP surgery may be struggling with their symptoms, only to feel more distressed at not being able to express their concerns adequately. If there is a case that Asian groups display a different manifestation and expression of psychological symptoms, they may not understand the questions being asked of them in a consultation – this dynamic in itself can be shaming. A vague series of symptoms which do not make sense to a GP may cause the patient to grow more nervous and misunderstood, whilst making the GP increasingly irritated. In despair, the patient may seek help from different doctors, anxiously trying to convince them of something. Unlike mainstream Britain, there are societies in the world where science, medicine, philosophy and religion are not separated into different compartments. For such cultural groups, there may not be the same distinction between the GP’s factual explanation and moral judgement – so that a statement about an illness being bad may imply to the patient that there is something terribly wrong with them as a person!

Service credibility

For a person to approach a practitioner for assistance, and then follow the advice given, it is clearly important for there to be a sense of trust and a feeling that the practitioner understands the difficulties. Practitioners are often trained in a diagnostic method (i.e. asking various questions to narrow down possibilities), and this may undermine the confidence that Asian patients place in their consultations. Patients often arrive at the surgery with their problems, and expect the doctor to know what is wrong with them. If GP’s proceed to ask lots of ‘what’ questions, before looking at ‘why’ and ‘how to help’, this is likely to influence their credibility. Within the conceptual model of Asian immigrants, many questions before solutions may serve to reveal their GP’s ignorance and reinforce the belief that such doctors simply don’t understand.

Furthermore, there may be beliefs within Asian communities that strong feelings should be restrained, that focusing on distress is unhelpful, and that it is better to rise above it and carry on. Such factors impact upon the credibility of a service, since it fails to fit beliefs about what is helpful. Clearly, attitudes to seeking help are a great influence on whether help seeking actually occurs, or not. Credibility may be described as a constellation of characteristics which make a service worthy of belief, entitled to confidence, reliability and trust. The ethnicity of the therapist and perceived ‘cultural competence’ may be an important factor in credibility beliefs. There is a potential for incongruities at various levels, to include problem conceptualisation, means for resolution, and goals for treatment – widely opposing ideas between therapist and client is likely to impact upon how credible the client perceives a service to be.

Tensions between cultural values and the western medical system

There may be a tension between the cultural values of certain ethnic groups and those of the western medical system. Therapy may involve an emphasis on verbal communication of distress and a focus on the individuals personal needs. However, for Asians it is widely believed that individual needs should rightly be subordinate to the needs of the family and collective as a whole. Other research findings contend that for Punjabis, a diagnosis of depression is counterproductive, since it suggests a self-centredness to this community which is associated with negative social and cultural values, and such a diagnosis is likely to meet with denial and a breakdown in communication. The control of personal feelings is important since the ’self’ needs to be relinquished in order to gain proximity to God, and one part of this bargain is to control emotions that are self-willed impulses. In one study, Asian women in distress were found to talk about their difficulties by way of their circumstances, their families, their hopes, prayers and sorrows – they didn’t talk about themselves!

It seems also that such close-knit family ties carry with them a ’sphere of privacy’, where the sharing of certain events and experiences outside this network would be considered as an act of bringing disgrace for the whole family. The notion of sitting with a stranger and discussing personal issues may not rest easily with individuals of Asian background. In a study looking at preferences for help sources, Asian Americans did not indicate a preference to see counsellors.

Alternative sources of help

It seems that Asians prefer alternative health care (e.g. acupuncture, herbalists) as a first line of help for psychiatric symptoms and in India, many people use folk healers before turning to hospitals. Clearly, there are fewer folk healers in the Western world. The Asian healer (e.g a Vaid or Hakim) has been observed to conduct extended consultations with the patients that come to him for assistance. This consultation is akin to a counselling session, where the practitioner gets to know the patient and his concerns. Priests and religious specialists also play an important role in the health care of Asians in Britain. Beliefs in the contribution of cosmic factors to recovery manifest in traditional cultures around Asia and these beliefs are shared by folk practitioners and patients. Some Punjabis are known to prefer Ayurvedic or Unani practitioners over and above more western medical practitioners, primarily because Western medicines are thought to be ‘hot’ and aggravate certain conditions.

In a British review of the literature on primary care presentation and disorders such as anxiety and depression among patients from ethnic minorities, it has been found that the ethnic groups most likely to attend a GP were men and women of Pakistani origin. Male Asians including those born in Britain and those originating from the Indian subcontinent and East Africa were more likely than the general population to consult the GP. This would indicate that people are seeking help, but for various reasons the process of referral to mental health services is not occurring. It has been proposed that Asians who break down are more likely to be tolerated at home without more specialist consultation. Indeed it has been suggested that Asians who suffer with emotional difficulties are less likely to class these difficulties as pathological, and it is perhaps for this reason that such difficulties are not discussed with the GP.

Clearly, a number of other explanations are equally plausible – for example, perhaps the symptoms are seen as pathological, but the GP is not considered an appropriate source of help. Stigmatisation and shame have been addressed as important barriers to help seeking previously. Another issue is that problems affecting physical health may be seen as ‘individual afflictions’ which are amenable to a medical intervention, whereas more emotional or psychological problems are seen in the context of ‘personhood and social roles’. Difficulties in the latter are seen to be within normal parameters – the ability to meet difficulties in life is held in high esteem.

As you will realise from the reading of this article, there are a plethora of barriers that sit between an Asian man or woman, and the help he or she needs with mental health problems. Some of these are barriers within health institutions themselves, although not knowingly created. Some are barriers of a cultural, social and spiritual belief system that are at odds with the western psychiatric approach. Depression, anxiety and stress take their toll – life satisfaction diminishes. Where will these people turn for help ? Perhaps to God, or hope of a better after life. Perhaps to drink, as a means of drowning out sorrows. Perhaps just through numbness, and lack of life energy, as the years limp on. As a British Asian, trained in psychology, I would like to make the plight of ethnic minorities in the UK known. Surely, we can all work together to offer help, compassion and care to one another.

From:http://ezinearticles.com/?Asian-Mental-Health-(Part-3)&id=1203015

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