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RHEUMATOID ARTHRITIS: COPING WITH STRESS

Stress is a universal aspect of life – a predictable reaction to life’s surprises. Our world is constantly changing and presenting us with new situations and environments, and we draw on our resources to make adjustments to these changes. If the magnitude of the changes overwhelms our ability to adjust, we experience stress.
In our daily routines, we are aware of potential demands and know how to approach them, but when that routine is altered – when change occurs – we may stumble. Stress associated with change is generally a result of our anxiety and fear of the unknown: we don’t know what the future holds, and we may be afraid that we don’t have what it takes to meet this unexpected challenge.
Since RA is a life change that has a great deal of unpredictability associated with it, stress is a normal response to it. In fact, the most stressful part of RA is its unpredictability. People with RA do not know what they need to prepare for. The course of the condition varies among different people and varies over time in the same person. This results in people having to make frequent adjustments, which in itself can be stressful. People often say that if they only knew what to expect they might not feel so anxious, they might adjust easier. If they dwell on potential or unexpected future consequences, such as medication toxicity, medical bills, or pain, people will almost always begin to feel afraid. And, as we have seen, anxiety and fear lead to stress.
Stress changes the pain threshold by opening the pain gate. Stress also causes physical and mental fatigue, which interferes with restful sleep, further increasing pain. And stress affects the body in other ways; it can result in increased heart rate and perspiration and in elevated blood pressure.
But stress is not always harmful. Stress occurs with positive changes as well as negative ones. Consider how you felt when you graduated, bought a house, got married, or went on a long-anticipated vacation. We all know, too, that feeling a little stress can motivate us to get tasks accomplished. Everyone has experienced short-lived deadline pressure and responded to it with increased adrenaline and increased activity. When stress becomes a permanent part of your life, however, it can take its toll on you and your RA.
You can use coping skills to approach negative stress. First, you must identify the source of stress (define the problem). This includes identifying situations that cause you stress at work and at home. Determine which of these can be modified and which cannot. Avoid the frustration of trying to change the unchangeable, and start with a set of goals that can be accomplished.
To solve a stress-related dilemma (problem solving), begin by appraising the situation. What are its demands? Are they reasonable at this particular time? If necessary, modify as many of the demands as possible so that they are reasonable for you at this time. Then call on the following problem-solving tactics:
•    Propose a reasonable long-term goal (reasonable expectations).
•    Plan ahead (include short-term, attainable goals).
•       Provide a supportive environment (communication).
•       Promote your identified strengths (use all resources).
•      Put priorities into perspective (does it need to be done now?).
•      Prepare (get organized).
•      Place time slots in your schedule to allow for inevitable interruptions and rest breaks (expect the unexpected).
•      Pace yourself (one step at a time).
•      Positively reappraise the situation and your abilities (modify negative thoughts and behaviors).
•      Prove to yourself that you can do it.
•       Praise yourself for a job well done.
You can see almost any situation through by calling upon your imagination, and each time you overcome a stressful situation successfully you increase your ability to cope with stress. Each such experience will empower you! Remember, “A great part of courage is having done the thing before”.
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BIOLOGICAL CONTROL OF INSECT PESTS OF AGRICULTURAL AND FORESTRY IMPORTANCE

One of the major constraints in increasing the productivity of agricultural crops and timber yielding forest trees, is the damage caused by pests. A pest may be defined as ” any organism detrimental to man or his property in causing damage of economic importance”. It may also be defined as ” A species which because of its high numbers is able to inflict substantial harm to men, domestic animals or cultivated plants”. The pest is a broad term which includes organisms from various distinct groups like insects. Nematodes, Weeds, Rodents, birds and disease causing microbes. Out of them, insects and disease causing microbes, cause enormous damage to eco-momically important plants and plant products.

There are about one million insects, known out of which pests are about 15,000 and only 300 of them are of economic importance. These insect pests damage valuable plants of agriculture and forestry importance. Mention may be made of three insect pests one from agriculture and two from forestry.

Heliothis armigera
* Key-note address

Hubner syn.Helicoverpa armigera Hubner of Lepidop-tera; Noctuidae, is perceived by both farmers and researchers
I to cause serious losses to the crops. It is reported to darri’age 60 cultivated plant species and atleast 67 other species in 39 / families across Asia, Africa and Australia.lt is a polyphagous / pest and is commonly called as gram pod borer, tomato fruit I borer, cotton boll worm, American bollworm and is widely distributed. In India the ICRISAT surveys of farmers field reveal that the annual loss of major pulses like chickpea and pigeon pea exceeds $300 million per year and losses in other legumes, cotton, cereals and other crops add substantially to that total. The damage potential of H. armigera is so great that an average infestation of one larva per plant of pigeon pea can cause a yield loss of 1015 kg/ha. In Jowar, yield loss of 18-26% and in tomato 40-50% loss has been reported. Out break in the incidence of American Bollworm had reached in epidemic proportion in some districts of Andhra Pradesh and Punjab causing huge losses to cotton during 1987-88 as a result of which many farmer committed suicide. Recently, in 1993, winter proved to be worst for cotton growers of Panjab, Haryana and Rajasthan. Against expected 50 lakh bales of desi and American var. of cotton this year the yield is expected to be down by 15 lakh bales, which means a net loss of Rs.1000 crores and also loss in revenue to the state governments.

Teak (Tectona grandis), one of the most important timber yielding plant, is widely grown in the forests of Madhya pradesh, Maharashtra, Tamilnadu, etc. Its cultivation is one of the most important aspect of economy of this state of M.P. Teak suffers heavily from two lepidopteran insect pests which cause serious damage to the foliage, thus reducing the quality and yield considerably. Hyblaeapuera commonly known as teak defoliator, is a serious pest of teak whose larvae eat up whole of the leaf except midrib and thicker veins which is responsible for about 44% of loss of wood increment. Defoliation of teak foliage is followed by infestation by Eutectona machaeralis,
commonly called as teak skeletonizer, whose caterpillar eat
only the mesophyll leaving a network of veins. The growth oi
the plant is completely checked due to loss of photosynthetic
region.    \.

Conventionally, insect pests are being managed by the ( use of chemical insecticides. The indiscriminate use of insecti-  ] cides has done potential harm to the ecosystems. Dr. Ross Hall, a noted chemist and environmentalist of Canada stated   i that to-day we live in a sea of chemicals which are posing many problems.

As a result of serious problems of chemical insecticide 1 application, an awareness has developed not only among environmentalists but also among consumers, Governments and common public and now this method of pest control has not been acceptable. Sophisticated, alternative, non-chemical, pest management systems are being developed to reduce total pesticide load on the environment. One of the most significant non-chemical method of pest control is known as Biological control.

Biological control may be defined as

“The action of parasites, predators and pathogens in maintaining another organisms density at a lower average than would occur in their absence”.

Biological control is a broad term in its true sense and pathogens are a part of such control measure. Pathogens or disease causing microbes occur every where and insects too suffer from them. A number of microbes including fungi, viruses, bacteria, protozoa and nematodes are causing diseases in insects naturally, thus managing their population at a level. Sometimes the insect diseases occur in epidemic form involving a large population of insects.Such microbes can be exploited for control or management of insects pest and the system is called as microbial control. There are many advantages of using microbes for managing insects pests -
They are highly specific, thus safe to nontarget organisms.
Absence of insect resistance.
They can be easily integrated with other control measures.
They can be easily produced in large scale and their application is cheap and easy.
They have no residual activity in environment.
They occur naturally.
HPwever, there are some drawbacks also -
1 Killing time may be more as they require an incubation period.
2. Production of some microbes which are obligate in nature may be expensive as they require living host for multiplication.

It is hoped that in coming years both these limitations may be overcome with the help of biotechnology. Microbial agents may be produced in large scales, formulated and applied in a variety of ways depending upon the characteristics of entomopathogen, the pest and the crop -
(i)    Introduction: An exotic organism, is introduced in to an area where it becomes established and maintains the density of the insect population below the economic threshold.

(ii)    Augmentation: This is the strategy of increasing the density of a native entomopathogen within the insect population to maintain the pest density at an acceptable level.

(iii)    Inundation: This is an insecticidal approach. The microorganisms are propagated in the laboratory and applied in the same manner as an insecticide to pests at critical periods of the lifecycle of the pest for short term suppression of pest numbers.

(iv)    Integrated Pest Management (IPM) This strategy involves the simultaneous or sequential use of several control methods in managing insect populations. This includes use of entomopathogen,low doses of insecticides, cultural methods, other parasites, predators, etc.

Now-a-days, there has been increased emphasis on investigating the use of entomopathogens as a complete or partial alternative to chemical insecticides in the developed countries like USA, USSR and UK etc. Many commercially prodxrced microbial insecticides based on either viruses, or bacteria or fungi are available in these countries under several trade names.

A microbial preparation and formulation for use in insect control programme is called as microbial insecticides.
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THE ENDOMETRIOSIS DIET

The goal of this plan is to structure your dietary intake and relieve or prevent some of the more disabling symptoms of endometriosis. The plan has been designed to work over the long run to decrease your estrogen level and stabilize hormones, increase energy, alleviate extreme menstrual cramping, and work as a calmative for emotional and physical distress. You will need to analyse your own case and judge your own needs, following the Calendar to chart mood changes, bleeding patterns, and pelvic pain.
Tins diet is a basic regimen that stresses low-fat, low-sugar, low-salt, low-cholesterol, low-dairy-product intake, which is especially advisable during the menstrual cycle and for at least ten days preceding it. This is not a weight-loss diet, although you might indeed stabilize your weight or lose a pound or two. If you are unable to stay on the diet for ten days of the month, try to follow the suggestions on alternate days, h will help to work as a “cleansing” or balancing diet.
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CHILD SEXUAL ABUSE: STREET KIDS

The same goes for a child who keeps running away from home. Every city has its share of homeless street kids. Obviously there will be a number of reasons a child would run away from home but things would have to be pretty unbearable for them to find life on the streets more appealing.

A percentage of these children would be escaping from sexual abuse.

Kay is now twenty-three. She was abused by her stepfather from the age of seven until she was fifteen. ‘At first he would turn out my light and get under the covers with me and fondle me. He told me I had to keep it a secret or he would kill my kitten. Later he would tell me that if I said anything to Mum he would kill me or my sister. After a while … I can’t remember exactly how long … he started putting his finger inside my vagina. When I was about ten he started putting his penis inside me. It felt like I was being torn apart. I felt bad and I felt dirty and I can remember this horrible nausea and panic whenever he told my mother he was going to take me up to bed and tell me a story. I used to think it was somehow my fault and I wanted to stop it happening but I didn’t know how. So I ran away and they came to get me. So I ran away again and they came to get me again. I even tried killing myself with pills I found in the bathroom cupboard when I thought there was just no way out. When I was fifteen I ran away and this time I made sure they didn’t find me.’

Kindergarten staff and schoolteachers have a special responsibility to look out for children who are withdrawn or seem depressed, especially if the child’s moods swing obviously from day to day. They also take notice of a child whose grades start to suffer. Now these signs can result from any serious problems at home (like parents in the process of separating) so they need to be seen in perspective.

The other sign that teachers look for is unusual behavior with a sexual theme. Children learn by watching their world and copying what they see. Overt and inappropriate sexual behavior or language doesn’t come naturally to a child, so if that’s the case it’s being copied from someone.

Warning bells need to sound for parents if a child shows an intense dislike for a relative or a family friend. Tina was molested by the family’s nextdoor neighbor for two years from the age of eight. ‘I remember he would ask Mum if I could bring -him over some garden tool or some ingredient he needed in the kitchen. I always knew it was just an excuse to get me over there on my own. I used to try and find any excuse I could think of to get out of it. I would even point blank refuse, go and hide, or cry that it was unfair that I had to run all the errands. Mum would tell me to stop being so naughty and that I had to do what she asked. Of course she had no idea what was happening.’

The reaction a person gets when they reveal the secret makes a big difference to their future. Susie sought counselling for the eating disorder bulimia nervosa. Through her counselling she revealed that she had been abused by her babysitter when she was five. She tried to tell her mother what was happening but she did not believe her, so did nothing to stop it. ‘I don’t trust anyone. Even when I find myself attracted to another person I stop myself getting too close because I don’t want to get hurt.’ Marie told her counsellor what she wanted to achieve. ‘One day I want to be able to put myself first sometimes; to look after myself instead of always satisfying the needs of other people. I find I even put people I don’t particularly like ahead of myself. Mind you, I hate myself. I’d like to be able to like myself.’

Not liking yourself is a serious business because, like Susie, it can mean you don’t care enough to look after yourself. That can mean taking serious risks with your personal safety and not caring about your diet, your general health or your appearance. Sexual abuse has also been linked to substance abuse as a way of numbing the emotional pain or trying to make the bad memories go away. That can mean drinking too much alcohol, doing drugs like cocaine or Ecstasy, or taking tranquilizers that artificially alter your moods for a while. Unfortunately when the drugs wear off the pain is still there. It is just a temporary way of covering up one problem with a different problem. You have a real uphill battle overcoming the drug or alcohol problem until you are able to contend with the feelings you are needing to cover up.
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CHILD SEXUAL ABUSE: SECRETS

Is it possible that this framework of isolated family units creates the environment where child sexual assault is more 1ikely to occur?

The perpetrator is far less likely to be some psychotic stranger than someone in their own family or a person well known to them. Perpetrators of child abuse look just like any other men and women. They may be fathers, stepfathers, grandfathers, babysitters, mothers, uncles, nextdoor neighbors or family friends. They may use bribes, threats or physical force to involve the child in sexual activity and keep it a secret. But no matter how well kept the secret is, like any crime there are clues for those who are prepared to look.

As a community, the first step in protecting children from sexual abuse is to acknowledge that it happens. Sexual abuse is not a phenomenon of the nineties, or the eighties, or even lust of this century. What is relatively new is our awareness of it. But it takes more than just knowing about it. We have to believe that it happens and, most importantly, believe the child who reports or even hints at abuse. When you are dealing with children you realize that they do not always use the same words to describe their bodies or their feelings as an adult would. A child may say something like, ‘When Gary gives me a bath he hurts my bottom’ or ‘I don’t want Joe to come over anymore.’ You may not get very many chances to pick up on these clues because the fear of what might happen if they ‘tell’ means that it takes all the courage they can muster to try to let you know. This fear of what might happen will frequently hold back disclosure of sexual abuse for many years. Even when a child does reveal sexual abuse, they may be so terrified of the repercussions, like parents’ anger or distress, rejection by other family members and the threat of their family disintegrating, that they retract the story.

The clues may be even more subtle than this, particularly if the child is frightened of direct threats of what will happen if they ‘tell’. This fear will not necessarily be in anything the child says. Happy, secure children never consider, and certainly do not attempt, suicide, so any child who talks about killing themselves must be taken seriously. The alarm bells should immediately ring that abuse is a possibility.

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DEADLY EMOTIONS: HOSTILITY AND ITS STAGES

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NUTRITION FOR INFANT: GROWTH AND DEVELOPMENT

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CHILD’S HEALTH CARE/INFECTIOUS DISEASES: ACQUIRED IMMUNE DEFICIENCY SYNDROME (AIDS)

AIDS has received wide publicity in recent years. It is important to remember that it is still a rare disease in children in this community. Infected children have usually acquired AIDS from their mothers, in particular during pregnancy if she is infected. In the past there was a risk of contracting AIDS through transfusions with contaminated blood. All blood is now carefully screened for HIV (Human Immunodeficiency Virus, which causes AIDS). Children infected with HIV are likely to develop AIDS. This causes marked suppression of their immune system, and they are prone to developing life-threatening diseases. There is currently no cure for AIDS, although certain drugs being developed show promise.

The HIV virus is spread by the exchange of human fluids such as blood or semen. It cannot be acquired by direct body contact or by kissing. There is no danger of your child contracting HIV by coming into normal contact with another child or adult who has HIV, unless there is an exchange of bodily fluids.

A family who has a child with AIDS requires expert medical and counselling support. If you need further information, contact your doctor. Each state has organisations which provide both information and support to those with AIDS and their families.

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LEAVING YOUR CHILDREN SOMETHING TO LOVE BY: ONE OF THE RULE OF FAMILY SEX EDUCATION

    Your children know a lot already, but they think they know a lot more than they do, and a lot of what they know just is not so. What they know something about is the mechanics, but much less about values and right and wrong. They wonder about love, about how and what to do with whom sexually. They want to know what love is, what it means, how you know when you are in love. Start talking about that openly and see how much

discussion takes place. Another guideline is that the more they pretend to know, the more mechanical and mythological their knowledge really is. Teens seldom come to you and say, “You know, Mom and Dad, I’m really very vulnerable and immature. Your experience is so much broader than mine. Could you please fill me in?” Such statements may occur only when there is emergency need to use the family car, not when there is real need to know.

There are really four basic areas that need to be addressed. These are what I call the “BARE” facts. Â stands for biology. As I have said, many kids have learned something about the basic biology of sex. You may want to make sure all four, not just the first three perspectives of sexuality, are a part of your children’s biological knowledge. Most formal sex education emphasizes the same genital/energy approach of the early sex perspectives, not the fourth perspective of this twenty-first-century marriage manual.

A stands for attitudes. They need to know yours, you need to know theirs. What is their attitude toward premarital sex and intercourse, abortion, masturbation, various sexual behaviors and preferences?

R stands for reproduction. They need to know about menstruation, conception and contraception, sexually transmitted diseases, responsibility for sex, children, and family.

E stands for emotion. They need to know about your feelings, be able to clarify and express their own feelings. An important warning here! Your feelings, their feelings, change. Sometimes they may shock you and test you. Give it some time. They may try a feeling out for a while. Teenagers particularly use the “feeling for a day” system of trying out for life. They are less moody than they act, and they do tend to “act” moody. Don’t overreact, because overreaction is what they are testing for and afraid of, in you and within themselves. When you overreact, teens go from the more acceptable playacting and testing of parents to acting-out, which almost always signals unexpressed feelings of helplessness.

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YOUR MARITAL HEALTH/WHY WIVES HAVE TOO MANY ORGASMS: “SEXUAL WITCH” FALLACY

He gestured with his hand as if he were erasing a chalkboard. “On and on and on. I work on her until she comes. She has two, maybe even three or four orgasms, then it’s my turn.” The husband described his typical patterned sexual process of pleasing as if it were an indelible code of sexual marital conduct.

“I know, and I feel worked on,” said the wife as she grabbed his hand from its circular path, took it in her own, and held it in her lap. “It’s like I have to come, usually a couple of times, for him to feel that he has done his job. Then he does it. I feel like a prerequisite instead of a partner.”

“Name one time, just one time we have ever had sex when you were not completed,” demanded the husband as he pulled his hand from hers and rested it in his own lap. “You are satisfied every damned time. I make sure of it. I know how it is with women. I know that they, I mean you, can go on and on and need a lot to get going but then you keep going.” His hand returned to its circular motion in the air. “I just use this technique and you know it takes work. I can’t believe after all of these years you don’t appreciate the fact that I take your feelings into account. Some men just don’t care. At least I’m not the T don’t care as long as I’m happy’ type.”

“No, you’re not that type,” answered the wife, again grabbing his hand, this time stopping it in mid-air. “You’re the ‘make ‘em come, then you get some’ type. You seem to think I’m some sexual object that needs preparing for your pleasure, some bagful of orgasms that you withdraw from until you deposit yours, ejaculation, I mean.” She held his hand firmly to her chest as she began to cry. “Why can’t we just make love? I’m sick of orgasm, orgasm, orgasm.”

The first three perspectives freed women^ at least theoretically, to be sexual persons, to respond, to enjoy, to be orgasmic, to be multiply orgasmic, to have sexual choices. Women were viewed as not only the erotic “equals” of men, but as somehow sexually superior, mystical persons with sexual capacities far exceeding those of men. In fact, their sexual-response model was seen not only as different, but as a goal, the standard against which the male sexual capacity fell woefully short. They became ”sexual witches” with almost magical sexual powers.

As many as nine million women were murdered in the 1500s and 1600s, burned, hanged, and tortured as possessed with erotic demons. The Malleus Maleficarum (The Witches’ Hammer) was written in 1486 by Heinrich Kramer and James Sprenger. They wrote mat “all witchcraft comes from carnal lust which is in women insatiable.” Early sex researchers unknowingly gave indirect physiological and alleged psychological credence to the idea that women were much different, much more erotic, much more sexually responsive than men. The evil ascribed to women was related to their mysterious sexual prowess, the “evil woman” syndrome.

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