101 2.1 Running in a fixed place. Lift up each foot about 8 inches; this type of running will limit the movement of the joints and stretch ability and contraction of the muscles. This is the disadvantage of exercise compared to the others. 2.2 Running on the belts is safer than running outdoor because we do not face with the rain, sunlight, or dust. The variety of the systems are shown on the screen of the electric belts such as showing the speed of running, the distance, the pulse rate. All these are the basic information for us to adjust ourselves for the next time running. The disadvantage of running on the belt is that the running belt machine is expensive and we have to pay a lot of money if we use it at the private fitness center. So the best way is to use the public exercise service such as at the municipalities, provincial administration, provincial sports and recreation developing office, provincial tourisms and sports, and the Sports Authority of Thailand. Everyone can use the services in all these organizations. 2.3 Outdoor running is the running which we can get fresh air especially running in the park or out of town, we also see the scenery helping us feel better without any expense. Only one important thing is the safety in case of running alone. 3. Riding a bike. Riding a bike to places is a useful exercise for body balancing, activeness, and self-tolerant practicing as well. Riding a bike in the park or at the places without any pollutions is not only useful for our body but also beneficial for our health. We also gain happiness from seeing scenery and fresh air, which is different from riding at home or at the fitness center . Easy technics for riding a bike are as follows: 3.1 Adjust the bike seat suitable to waggle ourselves together with the bike. 3.2 Using the tips of the toe for riding a bike. 3.3 If it is a fixed bike, using less stiff for 3 -4 minutes to warm our body first then gradually adjust more stiff until the pulse rates are determined and released the stiffness to relieve when the pulse rate gradually slowdown to normality and then stop. 4. Aerobic exercises are the most famous for people. We can move every part of our body from this kind of exercise. The usefulness of the aerobic exercise is to create the rigidity and the tolerance of our muscles especially the cardiac muscles. Technics of the aerobic exercises are as follows: 4.1 Move our body all the time to make the pulse rates at the level needed. 4.2 Spend about 20 -30 minutes for the exercise each time, 3 times a week.
102 4.3 Use the good ventilated place for the aerobic exercise and if it is a hard floor, we have to wear shoes while doing the aerobics because the sole of the shoes are able to support our feet from bumping. 4.4 Avoid jumping because it will make our feet crush to the floor. We can choose either of these exercise activities which are appropriate to time, and places. So finding free time each day for the exercise activities or playing sports to strengthen our physical fitness in order to be healthy both physically and mentally. In addition, there are also other forms of exercises which we can choose from our interest and the body readiness, time, places, equipment such as swimming, rhythmic activities, dancing, Thai traditional dancing, a club dance, yoga ,etc. including soccer, volleyball, basketball which can be played in teams. These can make us enhancing our health and the relationship in the community. Exercise for patients The patients of diabetes, heart diseases, high blood pressure, and any congenital disease who can move as usual which if can properly exercise depending on the symptoms and status of the patients, which can make fast recover it. However, there are both pros and cons of having exercise if we do not know the suitable ways , may cause harmfulness especially for the congenital diseases. Therefore, it is advisable to consult the physician to have body checked up. According to Dr. Jaruiporn toranin, an expert of Physical Education. The principles of having exercises for patients are as follows: The patients who are able to move can follow the following instructions. 1. Begin having the exercise little by little then increase time and get exercises harder. 2. Always having exercise at least 3 times a week, 10 -15 minutes a day. 3. Use every part of the body for the movement especially the muscles at the abdomen, arms, legs, back, and trunk. The cardiac muscles and blood tubes must be working hard. 4. For those who have high blood pressure, if the systolic is over 130 millimeters mercury and the diastolic is lower than 90 millimeters mercury, must have physical check by the physician and wait until the systolic is lower than 130 millimeters mercury and the diastolic is lower than 90 millimeters mercury then they can have exercises or have the antihypertensive drug. 5. For the diabetes who have over 200 milligrams mercury of sugar in blood must have it
103 lower than 160 milligrams mercury first then they can have the exercise or have the drugs prescribed by the physicians to decrease starch and sugar and increase vegetables and unsweetened fruits instead. 6. For all types of heart disease patients must consult physicians before having exercises or running race. 7. The elderly who are over 60 years old and overweight, consult the physicians before having the exercise. 8. Every patients or normal people which the age over 30 years old should have physical and mental checked before having the exercise. And after having the permission from the physicians, then gradually having the exercise. For every patients, taking exercises should start from walking which is the safest exercise; the patients should try walking for 2 weeks to adjust themselves for working out harder. If the body get appropriate exercises, the patients will feel refreshing, sleep soundly, joyful and stronger. After slowly walking in the first two weeks, the patients should walk faster with longer steps in weeks 3 -4 if they are not serious ill. In the beginning of week 5, the patients can take turns between slowly walking and trotting unless feeling dizzy, having rapid heartbeat, out of breath, becoming faint. If the above symptoms occur, the patients should stop taking exercises. When starting walking, they should trot slowly 5 – 10 minutes each day and gradually increase afterwards. Another way for a safety exercise is to have body exercise stretching muscles and joints from the following instructions: 1. Taking body exercise for 10 minutes a day. 2. Practicing 6 -7 postures each day. In the first 2 weeks practice 5 -10 times for each posture, and 12 times in week 3 and 4 3. Changing the postures in order not to get bored. Should take exercises for large muscles such as legs, arms, neck, shoulders, etc. 4. Shuffling on a fixed place and jumping on the rope should carefully be done especially for the elderly and the seriously ill person. 5. Although feeling well and freshen, over exercising can be harmful to the body; each posture should be practiced 30 times and not more than 3 postures in a day. 6. Check the progress of taking exercises by weighing themselves. The persons with appropriate body’s proportions should not have a lot of changes in weight. 7. Check the pulse rates at the neck or the wrist; normal males’ pulse rates
104 are 70 -75 times per minute, and those of females are 74 – 76 times per minute. However the patients with a fever have more pulse rates, but they should decrease 5 – 10 times per minute showing that the heart works better. Conclusion Each type of exercises has special characteristics that have to be taken into consideration such as riding a bike can affect the joints of the knees. If they are inflamed, we should avoid riding a bike and wait until the symptom is relived. Therefore, choosing exercise should think about the limitation of the body conditions. Trying to avoid or the least using the organs risking ourselves or until recovering, then start exercise little by little. Those who have congenital diseases should consult the physicians before having the exercises They should notice any unusual symptoms occurring while having or after the exercise every time. Any exercise activities being controlled by physicians are certainly more useful than harmful for the patients. In addition, they should regard that the exercise may suitable for only a person but not for the other one. Activities 1. Always train how to check the pulse rates at the neck and the wrist. 2. Help analyze friends in the group whether they are healthy or not and group them into 2 groups. 3. Setting the exercise programs for the friends in each group depending on the suitable physical conditions suitable and readiness of each group from the groups mentioned above. 4. Demonstrate the exercise to both groups and tell how useful and suitable they are from each type of the exercises.
105 chapter 6 Safety From Taking Medication Essence Having knowledge and understanding about the principles and appropriately taking medication, being able to discriminate the harmfulness from taking medication and analysis and belief and danger from various drugs such as nourishing medicine, herbal liquor, including prevention and assistance in case of getting harmfulness from taking medication. Expected Learning outcomes 1. know and understand the principles and the appropriate ways to take medication. 2. discriminate dangers from taking various drugs. 3. analyze the effects resulted from misbelief in taking medication. 4. First aid for assistance the others who are in danger of taking medication. Scope 1. Principles and appropriately taking medication. 2. Harmfulness caused from taking medication. 3. Belief in taking medication.
106 1. Principle and appropriately taking medication. How to appropriately take medication can follow the instructions below. 1. Read the label thoroughly before taking the medication. Usually, every medicine will have the labels with the names, instructions, prohibition and other details. We should strictly follow the instructions. 2. Take the right types of medicine. If taking the wrong medicine, it will be harmful to the patient and the diseases cannot be cured. Some medicines may have similar colors, shape,or packages, but their effectiveness is different. 3. Take the right dose. If taking less dose of medicine, it cannot effectively cure the diseases and may cause resistance to the medicine. Moreover, if taking overdose, it will be harmful to the body. The patient should take the right dose and type of the medicine such as the medicine to relieve a pain and a fever must be taken 1 – 2 tablets every 4 – 6 hours. 4. Take the medicine at the right time. Since some medicines have to be taken before meals like anti biotic or penicillin because this type of medicine can be absorbed well when the stomach is empty. However, other medicines should be taken after meal, while the medicines which cause drowsiness will be taken before going to bed; they should not be taken while working with the machine or driving because they may cause danger. - before meal medicine should be taken half an hour to one hour before meals. - after meal medicine should be taken immediately after meals or 15 minutes after meals. - medicine before going to bed should be taken before going to bed to make the body relaxed. 5. Take medicine appropriately such as a lozenge we should have it gradually dissolved in the mouth: it will not be effective if we swallow it together with food. And also other medicine like a balm can be used for skin; we cannot eat it because it causes harm to the body. 6. Take the medicine for the right person: the physician will prescribe the medication for each person’s illness with the patient’s names on the sachets; the medicines should not be given to others for any treatment since some medicines are prohibited for children or the elderly or the patients with certain diseases if these types of medicines are used, they might cause dangerous side effects. 7. Do not take expiry or deteriorated medicines: which can be seen from the change of outside appearance such as colors, smells, tastes and shapes; they must be thrown away. Instructions for medicine usages
107 1. Shake well before used if it is a liquid medicine. 2. Some medicines cannot simultaneously be taken with certain food or drinks such as do not take those medicines with milk, tea or coffee since they are resistant to each other resulting in harmfulness or ineffective treatment. 3. Do not buy medicines from the pills, the bottles, the sachets or the tube of used medicines or wrong belief getting from advertisement. 4. Seal the sachets tightly to prevent moisture and do not expose them to light or keep them in hot and damp places, which can deteriorate. 5. Do not take double medications when skipping to take once because it will be overdosed causing harmfulness. 6.If allergic to the medicine or take the wrong dose, the symptoms of which are feeling sick, throwing up, swollenness of the face and the body, rash, stuffiness, breathlessness etc.; stop taking that medication at once and go to the physician bringing that medicine as well. 7. Do not keep each person’s medicine with others’ in the family or with other types used for animals or plants such as insecticide or other medical substances. They may wrongly use. 8. Keep the medicines away from the reach of children because children may unknowingly take them resulting in harmfulness to their health. 9. Household medicines should be bought in order to relieve common symptoms because they can cheap, safe and easy to be used. If taking that medicine and not recovering from the symptoms, they should consult the physician. 2. Harmfulness from Taking Medication. All medicines can cause benefits and harmfulness so to avoid the danger from taking medication, one should carefully take the medicine only when necessary. The harmful resulting from taking medication can be identified as follows: 1. Lacking knowledge can be categorized as: 1.1 Not taking the right medication for the disease, the person, the period of time, the method and the dose, each of which affects incurable treatment and danger. 1.2 Stop taking the medicine immediately. Some medicines can gradually be reduced if the symptoms are relieved. If we quit taking that medicine at once, it may result in another disease, for
108 example, prednisolone, or dexamethasone if continually used and stopped immediately, the patient will have less appetite, feel sick or vomit, have stomach ache , dehydrated and lack salt. 1.3 If taking various medicines simultaneously, sometime, the medicines may resist one another causing overdosing which may cost the patient’s life. On the other hand, some medicines may resist one another, they are not effective to cure the disease and cause ‚ resistance to drugs‛ such as using anti –biotic like penicillin and tetracycline. Besides, some medicines may be less effective if used with alcoholic drinks, cigarettes some food. The patient who regularly take sedative with alcoholic drinks may be unconscious and dead. 2. Drugs’ Quality Although the patient can appropriately take the medicine with the right dose and the suitable period of time, the medicine may cause harmfulness if the medicines are of less quality, which causes from 2.1 appropriate keeping such as vaccine has to be kept in the refrigerator or aspirin has to be kept away from dampness, light and heat, or else it will be changed to salicylic acid which can harm the stomach. 2.2 production: the production of medicines with below the standard may result from several factors such as raw materials mixed up, the inappropriate process of production; for examples, if the medicines are not baked dry, it may makes the medicines become bad and have a fungus. Besides those, in many types of medicines, there may be a mixing up of microorganism , some medicines consist of different substances which make them less effective because each substance cannot be effective if mixed with the other such as kaolin will absorb neomycin resulting in an effectiveness of the medication. 3. The pathology of the drug users and genetic factors. The patients who endure the diseases of the livers or kidneys has less efficiency in excreting waste. Therefore, these groups should be more aware of taking medicine. Genetic factors also help motivate the patients’ reaction to the medicines differently. For instance, the Negro lack the enzyme to destroy the medicine’s group of I ozone acid if taking the same dose as other races do may suffer from neuritis and sleeplessness. It is better to closely consult the physicians or the pharmacist before taking any medication in order to avoid any harmfulness that may occur. The users should realize the harmful of using the medicines which may occur as follows:
109 1. Drug Allergy or Drug Hypersensitivity The condition that the body has to get medication like what it used to get before and has immunity called ‚ Antibody‛ within 7 -14 days. When getting that medication again, there is a chemical compound called ‚Antigen‛ in the body and produces ‚Histamine‛ resulting in allergy. For example, those who used to be allergic to penicillin when taking the penicillin again, it will be changed into penicillanic acid which acts as ‚ Antigen‛ causing allergy. Drug allergy ranges from tiny to severe or losing one’s life depending on the following factors: 1. Type of drugs: penicillin, aspirin, sulfonate, serum for tetanus, anesthetic, procaine, saline solution, and blood. 2. How to take medicine can also cause touching or applying it to the skin causes less allergy. However, injection causes severe allergy and it is hard for treatment. 3. Genetics: allergy is typically personal characteristics. The person who is easily allergic to medication or has the history of allergy like asthma, chronic cold, or rash will have more chance to be allergic than others. 4. Having been activated: the person who used to be activated by some medicine will easily be allergic to that medicine if he takes the medication again. For example, a patient who is allergic to penicillin may or may not know that he used to be allergic to it; he claims that he has never been allergic to penicillin. Prevention and treatment: prevention is better than treatment because it is difficult to cure the person who is allergic to medication. However, what can be done for prevention are as follows: 1. Stop taking the medicine: the patient should notice and remember the medicine he used to be allergic to, and also avoid taking any other medication with similar chemical factors. 2. Being aware of taking medicine which can easily cause allergy like penicillin, sulfonamide, or salicylate especially the person who used to undergo the following diseases: asthma, chronic cold, rash or allergic to any other medication. 3. In the case that the patient has to take the medicine he used to be allergic to, he needs to consult a physician who will gradually give the patient the anti – biotic until the patient himself can adjust with it. The patient with less allergy( having only rash or nose congestion) should stop that medication. The symptom will more allergy, antihistamine should also be used or if it is severe, he should immediately consult a physician, In addition, activated charcoal can be a great help in reducing the
110 absorbing of medicine in order to make the patient can help enlarge bronchial tubes and increase blood pressure. If there is any infection, medication with steroid can be used. 2. Side Effect Any symptom caused by taking the medicine apart from expected result from the medication; for example, antihistamine usually results in drowsiness or children taking tetracycline also have side effect like having yellow teeth. They should stop taking that medicine at once. 3. Drug Resistance Taking antibiotics which is not for the disease, not suitable duration, or not the right dose, can cause drug resistance because the medication is not strong enough to destroy the disease. The example of drug resistance are caused from the medicine like tetracycline, chloramphenicol, etc. 4. Drug Dependence Some medicine if misused or continually used will results in drug dependence such as opium, morphine, barbiturate, amphetamine, sedative etc. 5. Drug Toxicity This is caused by overdosing on medication that is: 1. Some medicine can cause fever, but if we stop taking it, the person will recover from that symptom. 2. Blood disorders and blood composition including some medicine like phenylbutazone, chloramphenicol and medicine for cancer can stop causing the white blood cells and red blood cells diminish in number and making the patient anemia, fatigued, easily and severely infected. Some medicine to cure malaria like quinine, pamaquine, and primaquine can cause blood cells easily broken. Aminopyrine and Dipyrone also affect blood composition. 3. Medication is harmful to the liver even though it is the most efficient organ to get rid of toxin. Some medicine like chlorinated hydrocarbons, pills for birth control, some antibiotics like polymyxin and vitamin A can destroy the liver. 4. Medication is harmful to kidneys; this organ excrete waste from the body. Some medicine causes silts and infection in the kidneys, so when taking this medication, we should drink a lot of water. Some other medicines that directly harm the kidneys are neomycin, phenazidine, boric acid , penicillin or vitamin D. If taking it a lot and a long period of time, it may harm the kidneys and make them inefficient which might cost the patient’s life. 5. Some medication may toxic to the ear neuron which resulting in tinnitus, hard of hearing and deaf such medicine as streptomycin, neomycin, kanamycin, quinine, salicylate, etc.
111 6. Toxic to the brain: some medication may be toxic to the central neural network disturbing the brain. For instance, taking amphetamine activates the brain causing sleeplessness, headaches, anxiety, and cramps. Taking barbiturates for a long period of time may result in drowsiness or depression possibly leading to feelings of suicide. 7. Toxic to heart and vascular systems: taking heart or asthma medication may result in a rapid heartbeat. 8. Toxic to the bladder: some medications such as aspirin, phenylbutazone, prednisolone, and indomethacin if taken often when there is no food in the stomach, may cause the bladder to become inflamed andinjured. 9. Toxic to infants in the womb: pregnant women should not take some medication such as thalidomide for sleeplessness and neurosis, phenobarbital for cramps, diazepam for anxiety, or medicine for nausea because those are harmful to the infant and can result in abnormalities such as hand stub disease, cleft lip, cleft palate or dented head. Pregnant women should be very careful about taking any medication. Drug Abuse and Drug Dependence Drug Abuse refers to taking medicine which is not for a disease, or, not following directions such as dosage. . For example, taking barbiturates to help you sleep under a physician’s prescription is not drug abuse; however if it is used to become intoxicated then that is drug abuse.. Drug Dependence refers to continually taking a medication for a period of time until some organs, especially the neural systems, become used to it and accept it as a necessity. Then, if we stop taking the medication, or lower the dosage, it can cause withdrawal symptoms, which can be both physical and mental in nature. Drug abuse or drug dependence may be caused from: 1. Belief that it is good to take medicine to cure diseases or other problems. 2. being able to easily buy medicine from different sources. 3. being satisfied and happy with the effects from taking medicine. 4. Succumbing to peer pressure. 5. Belief that medicine can help your abilities and intelligence. 6. Feeling dissatisfied with your status or social standing or rebelling against your culture. 7. Misunderstanding medicine advertisements.
112 Drug abuse can be caused from: 1. Misusing: Using various medications improperly. For example some people may use antibiotics instead of Vaseline for skin care. This can cause a resistance to antibiotics which could cause serious health problems later. 2. Continually using:Medicine, in general, is meant to be taken as needed. Only rarely, and under the direction of a physician, should any medication be taken continually. Sleeping pills, tranquillizers, and sedatives as well as recreational drugs such as cigarettes, alcohol, marijuana, cocaine, amphetamines and inhaling glue can all cause drug dependence and have varying degrees of damage to your body. Be cautious about using herbs In case of necessity or need, herbs may be used for whatever purpose, but one thing to remember is that if you want to be in good health and not get sick, whatever you take into the body should be useful and healthful. Do not wrongly believe in anything which may destroy our health. There was a story in the newspaper in the year 2529 of Doctor Noi who was 3 years 7 months old, , and people believed that he could cure many diseases by pointing to branches or leaves. Many people, with strong belief, took and boiled these leaves for drinking. The fact is that we have to know what to choose in order to make use of them. Caution: the following are simple ways to take herbs safety: - Using the right types: beware of similar herbs or similar names. They may be harmful and cannot cure the disease. - Using the right parts: each part of an herbal plant like leaves, roots or flowers has different effects on treatment. Some may be toxic; for example, chewing only one seed of jequirity will kill you while its leaves are not toxic. - Using the right dose: if you take too much of a herb, it can cause harm; however, if too little is taken it will not have any effect on the disease. - Using it for the right disease: each herb has different effects on each disease. If you have severe symptoms, it is best to consult a physician. When taking herbs which you have prepared yourself you should start taking it in small amounts first and then gradually increase the dose. It is not safe to follow others’ dosage because each person has a different reaction to each dose. Medicine bought from a pharmacist’s should be taken carefully as well and followthe directions on the label. Herb expiration dates aresimilar to common drugs. In general, when kept for a long period of time herbs may become decayed, moist, have fungus or be covered by flies, resulting in
113 ineffectiveness to cure diseases. It is difficult to set an expiration date for herbs. Usually, they can’t be kept for more than 2 years unless special measures are taken. . In addition, if fungus is found, or the smell and color have changed from the original condition, it should not be used. Choosing herbs and traditional medicine. Each medicine is differently regulated by the law. If we need to buy some medicine, it is advisable to study the law concerning it in order to know the qualification of each medicine. What we should know about each medicine is as follows: Herbal medicine: refers to medicine produced from plants or minerals without mixing with other ingredients or changing it. Traditional medicine: refers to medicine treated traditionally without scientific processes. For example, herbs may be boiled or dissolved for treatment. Traditional medicine has been developed to be convenient to use such as making pills, pills coated with syrup or capsules. These medications have to be labeled as ‚ Traditional medicine‛.
114 3. Belief in Drug Usage Nowadays, owing to modern technology in medical treatment and people’s ways of life which have been affected by the Western countries, patients prefer to have modern medical treatment rather than traditional treatment or local medicine. This results in the loss of local intelligence and medications. The traditional ways to take care of our health by using local herbs easily found in the jungle is not being passed down to the next generation and may be lost. Knowledge transferred from generation to generation should be analyzed and tested to ensure that it does not do any harm to health. However, some still believe in certain medications which are not certified by modern medical scientists such as herbal liquor, purify blood herbal drug, herbal medicine, medicine made from crops or animals’ corpses including drug combinations. They may hear of these traditional remedies by words of mouth or advertisements. These may be harmful or cause side effects to the users if taken for a long period of time,. All these traditional drugs have been advocated advertised as truth to cause people to believe in the properties of the drugs . The advertisementsclaim such things as: - having great appetite: after taking medications like herb liquor and some herbal medicines people can eat more food. - being energetic: after taking that medication, people can work longer. - having sexual strength: such as herb liquor or pickled animals’ corpses, bear’s paws or galls of cobra’s snakes, etc. - having good blood circulation: causing good sleep, spotless, shining skin like purifying blood medicine, uterine stimulants etc. - feeling younger: or making some organs larger. drugs such as antler, red mirifica help women have larger breasts. - slowing aging or organ deterioration: bird’s nests from swallow’s saliva, shark’s fin or ginseng, most of which cost a lot of money. It is not worth paying the high price for only a little benefit the body may get. - helping decrease muscle pain or chronic inflamed joints such as drug combinations, the medicine to protect the kidneys from damage, usually mixed with arsenic which is harmful to the body because the user becomes addicted to it and increases the dose resulting in the toxic accumulation in the body, which is difficult to remedy. Many people misuse these medications because of wrong beliefs or over advertisement. This is called ‚silent harm‛ results in harm if it is continually used in large amounts. Besides that, these
115 medicines cost a lot of money, but do not relieve the symptoms. It is suggested that before buying medicine or supplementary products, people should study all the properties, ingredients, production place, expiration date and possibly the manufacturers trust worthiness (consider a registration from the Food and Medication Organization) or having any license for production or medical certification for traditional treatment etc. Belief and caution when taking drug combinations, herbal liquor, and herbal infusions 1. Drug combinations set Drug combinations set refers to medicine of different types taken together as a set. A set usually has 3 -5 tablets or more. It may be put in a small plastic bag with a label on it indicating its properties. These will likely be over advertised for commercial purposes. It may be named to attract attention like drug combinations set for spreading tendons, drug combinations set for skin afflictions, drug combinations set for malaria. In this case, it may be very harmful to use because the seller or the person who made this set lack knowledge about medication. Danger from drug combinations set 1. Repeated usage resulting in overdose. For example, a set of drusg for releasing muscle pain is composed of 2 – 3 pills of different colors and sizes but all have properties for killing pain. Hence, the person who takes all of them will get more pain medication than is advised. 2. Overdosing: in a set of medicine for colds, there may be medicine for relieving pain, fever, running nose, or cough and even an antibiotic. The fact is that antibiotics cannot cure a cold. Colds are caused by viruses which antibiotics do not affect. Alsoeach person has different symptoms. If one has a headache without a fever, there is no need to take medicine for both headache and fever. If a person has not got a cough, he should not take medicine for a cough. Therefore, some medicine in the set may not be necessary for that person. 3. Out of date or counterfeit medicine is usually in a set of medicine. Keeping medicine in a plastic bag cannot protect it from moisture, heat, or light unlike the original bottles. Moreover some of the sellers make more profit by selling counterfeit medicine which is very dangerous for users. 4. A drug combinations set may have harmful drugs in order to relieve the symptoms in a short time, which satisfies the consumer, but can result in more illness. The most harmful kind of medicine usually put into a set of medicine are‚steroids‛ such as prednisolone and dexamethasone.These are sometimes called ‚universal medicine‛ because they can relieve several symptoms in a short time. However, they cannot cure diseases and can cause harm to the
116 user such as adema, high blood pressure, rapid heartbeat, swollen face like the moon resulting in fragile bones, injuries to the stomach, a low resistance to disease and evenmental disorders. 5. When taking a set of medicine, problems are found by not taking enough doses. When taking a medicine like antibiotics, you must take it 2 to 4 times a day for at least 3 -5 days depending on the type of medicine. However, the consumer will buy 3 -4 sets of medicine and take it all in one day or one set a day causing an inadequate dose and the disease will not be cured; instead, this may cause drug resistance. 2. Herbal liquor and haemagogue Many people have seen or taken this medication; at first, women used it as a supplement to their blood, or infrequent menstruation. Women after delivery take this medicine instead of lying near an open fire. Ingredients in the medicine consist of hot and spicy herbs such as some part of a plants root, garlic, pepper, white candle, skin of cinnamon, ginger and others things depending on each medication. Some are sold in pieces; others are in the form of a liquid or powder. It is difficult to access the efficacy of most medicines in this groupowing to a lack of knowledge. The results from clinical experiments only partly shows the composition of the medicine, most of which consists of evaporated perfume and various hot and spicy stuff. When this is taken into the body, it will make us feel hot, motivating blood circulation. Many herbs in the medication like garlic can cause contraction of the womb muscles according to experiments with female mice. Therefore, pregnant women should not take this medicine since it may cause an abortion. Some of this medication consists of herb liquor. When it is taken it results in having a great appetite which will make the user become fat. Alcohol in this medication causes fat accumulation in the body. If it is continually used, it may cause a fatty liver. Drinking alcohol may cause infants in the womb to be crippled. Moreover, it is wrongly believed that the herbal haemagogue can be used for abortion, which should not be done especially to a woman with more than one month pregnancy. It is useless to do so; in addition, it can damage parts of the wall of the womb resulting in a crippled baby. 3. Herbal infusions Herbal medicine is popularly used in many countries both in Europe and in Asia. In Thailand, the use of herbal infusions such as safflower infusion, java tea, white flower grass is increasing. The advantage of using herbal infusions is that they are taken separately so when there is any side effect, we know what herbal infusion we took. This differs from medicine mixtures; we do not
117 know what causes the side effect. In foreign countries, there are reports concerning the toxins caused from herbal infusion widely sold in market. In Thailand, not many reports have been released since most of the herbs chosen are safe. But some herbal infusions may cause problems. Senna seed for example is cathartic and can help slim the body. It also has anta quinone which stimulates excretion. However, tepeated use can become habit forming, so when we stop eating it, the body cannot excrete by itself andmedicine is continually needed. It is advisable that we should eat glucomannan instead of senna seed; however, it too should not continually be used because it reduces too much fat in the body. In fact our body needs a certain amount of fat for living. Anta Quinone substances group
118 Chapter 7 Narcotic Effects Essence It is important to have the knowledge, understanding, and ability to analyze problems, concerning the cause and effect of the spread of narcotics including participating in preventing narcotics programs in the community, and helping to publicize knowledge about the laws concerning narcotics. Expected Learning Outcome 1. Be able to analyze the problems, causes and effects of the spread of narcotics. 2. Avoid narcotics and co–operate in preventing narcotics deliveries in the community 3. Publicize knowledge about the laws concerning narcotics to others Content 1. Spreading of narcotics today 2. Preventing the spread of narcotics 3. Laws concerning narcotics
119 1. Problems of the spread of narcotics Nowadays, the problems of the spread of narcotics has become more severe especially among children and teenagers. According to statistics from the Public Health Ministry, the number of narcotics users are increasing, which may cause bad effects to their health, intelligence and concentration in studying resulting in lower quality in the population. This causes a lot of difficulty in developing the country and dealing with others in the world in the future. Therefore, prevention and solving this problem should be an immediate priority in families, schools, communities and the country. There are various narcotics and they can be categorized into three types: 1. Neuroleptic: this type can cause drowsiness. Examples are opium, morphine, heroin, sleeping pills, tranquilizers, and dried alcohol. 2. Neurotic Motivated: this type causes nervousness resulting from taking amphetamines, cocaine, caffeine, Mitragyna speciosa, and dietetic drug. 3. Hallucination effect: this type causes illusions, false hearing, unreasonable fear, which may cause danger themselves or others. Examples are LSD, mushrooms, vapor from gasoline engines, paint thinner, glue etc. These days, narcotics have been widely developed in the form of tablets and liquids mixed in drinks, desserts or different kinds of food, which is difficult to detect, so it causes harm to children and teenagers. 1.1 The causes of drug addiction The problems of drug addiction include the following: 1. Personal causes including - Age: most drug addicts are teenagers; they are eager to try new things - Knowledge, attitude and ideas concerning narcotics and violence. For example, it is believed that violence or cruel words can make others believe and follow them, hitting children can help encourage them, or being a bully who has to fight in order to win etc. - Lacking essential skills in adjusting to others in the group such as communication skills, anger management, appropriate behaviors etc. - Drug usage and alcoholic drinks make people lack the ability to control themselves. - Having experienced violence, having seen violent acts, or having weapons at hand can cause them to harm others when they get angry.
120 2. Family’s nurturing includes: - Lack of love, understanding and support from the family. For example, children without an elders advice may use drugs. - Being raised in a family in which the members commit violence, so they think it is a common behavior. - Having been punished and hurt. - Having parents or relatives committing a crime. 3. Environment includes the following factors. - Different social status, economy, city life with high competition and stress. - Fast economic growth and high unemployment in youngsters. - Effects from media like movies, television, and newspapers showing violence. - Social standards supporting violence; for example, those who commit violence are not punished, which makes people misunderstand that committing an act of violence is tolerated in society. - Weapons are easy to possess. 1.2 Harm, danger and effects of narcotics Harmfulness and danger caused from taking narcotics not only affect directly the user’s body and mind, but they also affect family, society and the nation as mentioned below. 1. The effects on a drug user include destruction of the neural systems and organs of the user. Therefore, a person who takes drugs can have poor health in both his body and mind such as being very thin, pale and dark skin, fatigue, weariness, degenerated brain, poor memory, and easily infected with other diseases such as an inflammable liver and kidneys, respiratory disease, heart disease, cancer, low immunity, mental disorders or deterioration, bad temper, depressed, worried, out of one’s mind etc. The aforementioned effects will cause drug users to be incapable both physically and mentally of living their own lives in society, lacking confidence, losing personality, not paying attention to themselves or work or learning. Some drug users may have an accident making them crippled, such as falling from a high place while working or falling down as a result of the drugs effect on neural systems and the brain. 2. The effects and danger to the family: drug taking can cause a bad reputation to that person and the family. Moreover, a drug user may be irresponsible to the family resulting in losing income since money has to be spent on drugs. Some spend a large amount of money to cure the diseases caused
121 by narcotics, all of those things cause a burden to their family leading to family problems, frequent quarrels, broken families etc. 3. The effects and dangers to society and the economy: those taking drugs feel that they are inferior to others in society, and their behaviors or ideas may lead to social problems such as committing a crime, robbing, attacking others in order to take their property and also cause accidents and spreads disease. These cause a personnel loss, loss of property, and asocial and public burden to manage the personnel, labor and budget to deal with and cure those who are addicted to drugs. 4. The effects and dangers to the country: those who are drug addicted can damage the country’s economy and security because the government has to use a lot of personnel and finances to control and cure drug users leading to a reduction in the country’s stability.
122 2. Prevention of the spread of Narcotics Drug problems result from two factors: someone needs to take it (demand) and there is a drug to satisfy their needs (supply). The demand and supply are mutually supportive. Therefore, to solve this problem, the two aforementioned factors should simultaneously be dealt with: that is to reduce the demand as well as the supply. However, practically, people pay less attention to reducing the demand for drugs than reducing the quantity of drugs in the market. The problems concerning drugs result from wrongly taking drugs in the expectation of getting some benefit from them or depending on them in any situation. Fundamental factors in the problem are drugs and the persons who take them. The most significant factor is ‚motivation‛; if there is not any of the three, the problems about drug addiction do not occur. Therefore, the problem of drug addiction can be prevented by looking into the personal behavior of drug users who depend on drugs. These persons are categorized into the following groups. 1. Those that have not yet taken or just started using it. 2. Those who do take drugs, divided into, the persons who used to take drugs and then stopped, the persons who occasionally take it, the persons who always take it but are not addicted to it and the persons who are already addicted to it. 3. Those who always take drugs or were addicted and underwent treatment and are not addicted to drugs anymore. All three groups are possibly taking drugs and could be addicted to them in the future. The activities to solve these problems should cover all of them. The methods used depend on each target group. Prevention can be divided into three levels: - Primary Prevention - Secondary Prevention - Tertiary Prevention 1. Primary Prevention This may be called basic prevention referring to any procedure to make teenagers immune from taking drugs permanently. Teenagers can make their own decisions about not taking drugs without trying the drugs. It is the best way to prevent most citizens from being involved in drug addiction. Primary Prevention, therefore, is the most important step leading to successful prevention and solving of the drug addiction of the country. However, this is a rather complex process
123 because it involves fundamental management for most of the people of the country, which must be established in youngsters first since they are young. And done before they graduate with the cooperation of many sectors. 2. Secondary Prevention This step has two methods: one is to prevent people from taking drugs, which is different from primary prevention which keeps people from wanting to do drugs.. This step covers the suppression, confiscation, destruction of drugs, inspection for narcotics in urine. Officers are sent to inspect schools, and send drug addicts to get treatment or prevent drug users from spreading narcotics to non drug users. The other method is the process of assistance to the persons who have tried taking drugs, or persons who occasionally or often take drugs but are not addicted to them. Those persons are asked to change their behavior and to not take that drug anymore. This procedure separates addicts from drugs or persuades addicts to get advice and psychological treatment in order to prevent and stop taking drugs. 3. Tertiary Prevention This step of prevention is to prevent relapse, which helps the addicts who underwent treatment to not become addicted to drugs again. This includes medical treatment so that the addicts can live safely away from drugs. Tertiary prevention depends on many procedures to help addicts such as rehabilitation, psychological therapy, social counseling, group therapy and recreational therapy. To prevent addicts from taking drugs again is a part of the prevention program aiming to reduce drug desire, which can prevent them from spreading drugs to others. To sum up, Primary Prevention can prevent people from ever trying drugs ; whereas, Secondary Prevention immediately takes the addict for treatment. In order to make the prevention effective, it is essential to understand the causes and factors of drug addiction. The factors of drug addiction are people, drugs, and other elements. Therefore, the plans to prevent it should be carefully managed in accordance with the root of the problems which are as follows: 1. General Prevention: emphasize to society as a whole the harmfulness of drugs. Reduce the need for drugs, and decrease their attraction to drugs using various procedures such as health development, moral support, law enforcement, social development etc. Three methods of prevention are as follows:
124 1.1 Education: transferring knowledge in order to educate people on how to have a good quality of life without depending on drugs. This emphasizes self and mental development, self confidence, hygiene, and training for careers. 1.2 Giving information and reports: people in the community can analyze, select, and make their own decisions by using the information. 1.3 Preparing special activities: this is to provide suitable basic activities for each person and community in order to switch their attention from inappropriate behavior and also to help develop them both physically and mentally. 2. Specific Prevention: directly prevents some groups of people or some communities that are at risk of addiction. The procedures are as follows: 2.1 Training: group leaders and the population are trained how to prevent addiction and how to take proper medications for the purpose of applying this knowledge in the community and locality. These people then gain knowledge that is directly opposed to taking drugs. 2.2 Publicity campaign: this is too help spread information by using different media in a limited area, which can alert people to the harmfulness of drugs and encourage them to take part in solving the problem. 2.3 Social conduct: this method is used to get rapid changes such as getting rid of unlawful gatherings or drug producing places etc. 3. Special Prevention: this is the most specific way to prevent addiction in persons who are at high risk as well as their families such as persons who are facing personal problems, persons from broken families, or addicts who have undergone treatment. This special prevention includes the following methods. 3.1 Problem analysis: for addicts to recognize their own behaviors and problems. 3.2 Counseling: for addicts to choose practical methods whenever they have problems in order to avoid taking drugs. 3.3 Family counseling: to reduce pressure on the family and give them advice in order to manage their problems 3.4 Health education: to educate people about drugs and health to prevent them from taking drugs improperly. 3.5 Counseling: to encourage addicts while they are facing their problems.
125 3.6 Career training: to help people reduce economic pressures by earning their living with their own ability and talent, so they can spend their free time for their own benefit. All of these methods can be used simultaneously either for prevention on whatever level or for prevention of drug misuse, or for prevention to be addicted to drugs, all of which are most important ways to prevent and solve the problems concerning addiction. Every sector involved should seriously take part in this process. 3. Laws concerning narcotics ‚Narcotics are harmful to life and toxic to society‛ this saying can clearly pictures narcotics. At present, narcotics are an international problem, in which every nation gives priority to prevent and suppress them. It is internationally illegal; every nation can immediately arrest and punish persons committing crimes concerning drugs. Narcotic law defines narcotics as a chemical substance which when taken into the body by means of eating, smelling, smoking, injecting, or any other way it will affect you both physically and mentally. Users have to constantly increase the amount of the drug and sometimes when they do not take drugs, they suffer withdrawal symptoms and can commit crimes in order to get drugs. Their health will deteriorate. Narcotics includes plants or parts of plants or any chemical substance used to produce drugs. Narcotics include opium, heroin which is produced from opium, and morphine which is synthetic heroin and is used medically. Types of narcotics and law punishment According to the law, narcotics can be categorized into 5 types: Type 1 includes the most harmful drugs like heroin or opium No one can produce, distribute, import, export or possess this type of drug except for the authorities with the Minister’s permission. Violations are punishable by imprisonment or death sentence. Type 2 general narcotics like morphine According to the law, nobody can produce, import or export this type of drug, but it can be distributed with permission of the secretary of the ‚Food and Drug Administration‛ or the provincial public health department. Individuals may possess a certain amount only for specific treatment and must have a certified letter from a medical office. Violations are punishable by imprisonment from 5 years to life depending on his or her guilt. Type 3 narcotics are mixtures that contain type 2 narcotics such as cough medicine mixed with codeine
126 According to the law, nobody can produce, import or export type 3 narcotic without getting permission. Manufacturers must have permission to produce, sell or bring into the Kingdom of Thailand conventional medicines containing type 2 narcotics and the medicine must be kept with a pharmacist who is on duty the entire time the store is open. Violations are punishable by imprisonment of one year to three years. Type 4 Chemical substances for processing narcotic types 1 or 2 The law forbids anyone to produce, import, export, or possess narcotic type 4 without getting permission from the minister. Violations are punishable by imprisonment from 1 to 10 years. Type 5 Narcotics which are not in type 1 to type 4 such as marijuana and mitragyna speciosa. The law forbids anybody to produce, import, export, or possess narcotic type 5 without getting a permission from the minister. Violations are punishable by imprisonment from 2 to 15 years. Punishment concerning the possession of volatile substances According to the Royal Ordinance for Prevention of Volatile Substance B.E. 2533, the criteria for controlling improper use of the substances are as follows. 1. The producers, the importers, or the sellers of volatile substances must put pictures or any details on the package to warn users to be aware of taking such substances. Anybody who violates the law will be imprisoned for not more than 2 years or fined not more than 20,000 baht or both imprisoned and fined. 2. No one may sell volatile substances to children who are under 7 years of age except sold by a school for learning purposes. anyone who violates the law will be imprisoned less than 1 year or fined not more than 10,000 baht or both imprisoned and fined. 3. No one may sell, provide, or give substances to others whom he knows or should know that those persons are addicted to the substance. Anybody who violates the law will be imprisoned less than 2 years or fined not more than 20,000 baht or both imprisoned and fined. 4. No one may encourage, enhance, or deceive other people into taking any substance in order to meet their needs. Anybody who violates the law will be imprisoned less than 2 years or fined not more than 20,000 baht or both imprisoned and fined. 5. No one may use any substance to meet the needs of their body or mind either by inhaling or taking it by any other way. Anybody who violates the law will be imprisoned less than 2 years or fined not more than 20,000 baht or both imprisoned and fined. We should keep in mind that being addicted to narcotics is not only harmful to the body but also against the law.
127 At present, the law concerning narcotics consist of various acts which can be categorized as follows: 1. The laws concerning drugs include: 1.1 The Narcotic Act B.E. 2522 1.2 The Narcotic Act B.E. 2545 1.3 The Narcotic Act B.E. 2528 1.4 The Volatile Substance Royal Ordinance B.E.2533 1.5 The Commodity Control Act B.E. 2495 2. The criteria laws include 2.1 The Prevention and Suppression of narcotics Act B.E. 2515 2.2 The Prevention and Suppression of narcotics Act B.E. 2545 (Volume 4) 2.3 The Addict Recovering Act B.E. 2545 People, students, and college students should clearly understand the regulations and punishments concerning narcotics in order to avoid violating the law. Moreover, they should advise or publicize all the aforementioned knowledge to their friends, to family members and to the people in the community, so that everyone can realize the harmfulness of narcotics. In addition, they can cooperate with one another in campaigning for the prevention of spread of narcotics to children and youngsters in the community. The sell or use of narcotics either in or outside the country will be punished in the country. If already punished outside the country, the court of law may appropriately reduce the degree of punishment in the country. As aforementioned, narcotics prevention and suppression are considered to be most crucial, so it is punished more severely than other crimes. For example, if any person violates this law, he will get punished even if he may or may not have intended to break the law. According to criminal law, any person who is trying to commit a crime will get 2 out of 3 punishments. In addition, those who support, help, or facilitate the crime will get the same punishment as the person who commits that crime. Any properties obtained from the crime, will belong to the court unless it is proven thatthe properties are not involved with the crime. Moreover, in investigation, the authorities have a right to call any person concerned to prove himself or give evidence for the trial; the authorities can also search for evidence at the residents homes if they are suspicious of narcotics involvement. After investigating and finding evidence of a crime involving narcotics, the authorities can arrest and send that person to the court of law to undergo his or
128 her trial. If they are found guilty, they will receive severe punishment because in each nation, it is believed to be the most serious crime as aforementioned.
129 Chapter 8 Life skills for Mental Health Essence Having knowledge and understanding of the importance of the 10 life skills and apply it to their daily life, work, problem solving and families as well as others. Learning Expectation 1. Be able to define the importance of life skills. 2. Be able to correctly explain the 3 most essential life skills. Content Area 1. Definition and importance of life skills. 2. Skills on self – realization. 3. Skills to deal with emotions. 4. Skills to deal with stress. 1. Definition and importance of life skills Definition of life skills ‚Skill‛ refers to experience and expertise on something. A person can have skill by learning it such as a skill in your career, in sports, in working with others, reading, teaching, management, mathematics, language, technology etc. All of which can clearly be seen from the outside by doing or practicing. The aforesaid skills are essential to people‘s ways of living, and those skillful persons have a better life than those who lack skills. These skills are called ‚Livelihood Skills‛ or ‚Skills for Living‛, which differs from ‚life skill‛ ‚Life Skill‛ refers to any characteristic or ‚psychosocial competence‛ which is an inner skill helping people efficiently face daily life situations and to be well prepared for the future taking care of their health, aids, drugs, safety, environment, morality, ethics etc. in order to happily live in the society. To make it simple, ‚life skill‛ is the ability to solve the problems people face in daily life and how to live with others and prepare themselves for the future.
130 The importance of life skills Nowadays, due to the complexity of modern society, it is very difficult for people to maintain their traditional way of life because of rapid changes in the economy, society, information and technology which causes conflict and competition. Hence, people have to adjust themselves in order to compete with others and to reasonably handle any crisis and to use new technology to develop themselves and their careers. In addition, they have to be able to control their emotions and manage any conflicts which occur. Being qualified to live with others can help one stay happily in society. Essential Life Skills Elements of life skills A set of life skills differs according to culture and environment. The common essential life skills that everyone should possess, the heart of living itself according to the World Health Organization (WHO) are: 1. Decision making – this is the ability to make life-related decisions systematically. For example, if individuals are skilled at evaluating alternatives, outcomes and consequences related to health and safety, they will be able to make a reasonable decision about their health and safety and thus have good physical and mental health. 2. Problem solving – this is the ability to systematically deal with problems in life without causing stress to the body and mind which can lead to even worse problems. 3. Creative thinking – this is the ability to think creatively and is beneficial to decision making and problem solving through determination of alternative solutions and their outcomes. It also enables individuals to apply gained experience to daily life appropriately. 4. Critical thinking – this is the ability to analyze information and assess problems and circumstances around us that might affect our lives.
131 5. Effective communication – this is the ability to use verbal and non-verbal language to express our opinions, ideas, needs, admiration, requests, negotiations, warnings, help offers, refusals, etc. in a manner which is suitable to the situation and the culture. 6. Interpersonal relationships – this is the ability to build and maintain a good relationship with other people. 7. Self-awareness – this is the ability to know and to understand ourselves in relation, for example, to our own strengths, weaknesses, what we want and what we do not want. Self awareness is important and beneficial for handling stress or difficult situations. It is also the foundation for the development of other skills such as communication, interpersonal relationships, decision making, and empathy. 8. Empathy –this is the ability to understand similarities and differences of people in terms of ability, gender, age, education, religion, belief, skin colour, occupation, etc. This will help us to accept people who are different from us and to be willing to help those who are in need or in trouble such as drug addicts, AIDS victims, etc. 9. Coping with emotion – this is the ability to recognize our own emotions as well as those of others, know how emotions affect behaviors and understand how to appropriately deal with anger and grief that have a negative impact on the body and the mind. 10. Coping with stress – this is the ability to recognize the causes of stress, know how to reduce stress and practical ways to control stress levels in order to direct our behaviors in the right direction and prevent health problems. How to create life skills The above 10 skills can be divided into 2 main groups in order to develop the life skills. 1. General life skills: The basic ability to deal with everyday challenges such as stress, health, friendship, adjustment to changes, a broken family, food consumption, etc.
132 2. Specific life skills: The ability to cope with particular or specific challenges such as drug addiction, AIDS, fire, flood, sexual harassment, etc. 2. Skills on Self realization You may think that knowing oneself is not important, but it is considered to be the most important factor for most people to survive. In fact, the basic knowledge that people should learn first is about themselves and their goals so that they may develop their competency and capabilities. When they know themselves and their goals, they can know what they should focus on, what to study, how to earn their living, and what knowledge to seek. To know their own selves will help them effectively develop other skills. For example, while studying, they know which method to use to study effectively; if they know that they do not have a good memory, they have to take notes from the lesson and regularly review it. If they know their weaknesses, they can correct them; for example, if they know they are impatient, when they are in a situation that may become violent, they can separate themselves from that situation to calm themselves, looking for the best way to solve that problem. To efficiently develop skills in solving everyday problems, if they know the cause of that problem whether it is from their own selves or not, they know how to cope with their emotions. To find true happiness from what they choose to do helps to bring their own happiness and results in learning and understanding others. That can reduce conflict and encourage good relationships. People who do not know themselves may try to adopt social trends, imitating people around them who do not have their own objectives/ For example, trying to find their own happiness they may go around with friends, and become addicted to drugs. When entering a university, they follow the trend of that time or follow their friends. As a result they cannot experience true happiness in their life which causes various problems. These people cannot cope with problems, most of which may or may not be caused by themselves; they usually accuse others, which makes it difficult to completely solve those problems. These skills are, therefore, the most essential ones which everyone must learn and practice since they cannot develop by themselves. People must undergo various experiences such as disappointment, pain, failure etc., which helps us to know ourselves. People around us can also reflect us. The sooner we know ourselves, the more advantage we get, which helps us reach the target of our lives faster resulting in succeeding in life even if you must cope with a lot of pressure.
133 These skills should be studied from an early age and learned from our most important persons, our parents. Parents should help their children find out about themselves by experimenting with various experiences such as doing housework or other activities that interest them. Parents support and facilitate them and select appropriate activities for their age and their interests for the sake of their happiness and safety. For example, if they want to participate in a social development camp or sports camp, parents have to consider how safe the activities are before giving permission. Sometimes, in some situations, parents should let them have freedom in making decisions like choosing what they study or what to do in the future. It is better to give them good suggestions than to force them to do what parents want them to do. Research confirms that it is a parents’ duty to let their children make mistakes, but to foster positive attitudes towards themselves. An example of this is a students who failed a mathematics test and was chastised by the teacher who told the student that he was stupid. The parents knew how hard the student tried, so it would be better to encourage him to see himself as an intelligent person, who just may not be excellent at math. This way he can be confident in his intellect and efforts; otherwise, that student might become obsessed with what the teacher told him. As a result, he cannot succeed in life in the future. Parents can help their children understand themselves by observing their behaviors and emotions in different situations and giving them suggestions. These may encourage them to learn about themselves instead of blaming other people or situations. Another example is when their children receive bad grades. Many students would accuse the teacher of bad teaching or claim that even though bad, their grades are better than their friends. In this case, parents should explain to them that they should not complain or compare with their friends. Instead, have them analyze what their best points and weakest points are. Some weak points might include lacking discipline or inappropriate time management. Parents can point out these weak points and help them plan their studies. Parents can teach and remind them how to behave appropriately in each situation in order to prevent them from misbehaving including finding out the methods to cope with problems. For example if parents know that their children are bad tempered or easily anger, they should tell them the effects of that style of behavior on their lives if they keep doing it. At the same time trying to work this out together in order to help them efficiently cope with their emotions by reacting incorrectly to the situation. One way to avoid situations that stimulates their emotions is to find some place that helps them to calm down and control their anger.
134 Knowing themselves thoroughly is more important than any other learning process. It is a long life process that results in happiness and a foundation for success in life. Parents can be a reflection for their children to make them truly see themselves as they are. 3. Skills to deal with emotion Emotion is powerful for human beings, and may cause wars, crime, race conflicts and other conflicts among human beings. On the other hand, emotion also provides feelings of joy; it can make everything beautiful and lovely. The emotions of love, joy, happiness, pleasure and fun can all make our life worthwhile and meaningful. Emotion may be defined in various ways, one of which is ‚the state of motivation resulting in rapid heart beat a rise in pulse rate, fast and strong breathing, red face, etc.‛ Emotion also is noticeable when some parts of the body become motivated; this may be a pleasant or unpleasant feeling. Emotion is also shown through one’s voice, words, face or manners. How to cope with bad emotions 1. Try to be optimistic when we are depressed in some situation. For example, when we cannot solve a math problem, trying thinking that ‚ if I get some help, I can do it.‛ After that we can go to see a teacher or some friends for extra tutoring. 2. Writing down all the good things in a note book before going to bed every day. At first, it may be difficult, but we may write only the good events of the day. From studies about emotion, people who wanted to commit suicide felt better after doing so for two weeks. 3. Spending time with people who can make you laugh. 4. Paying attention to your own feelings all day. If we know about our emotions, we can manage them with our daily work. When we are in a good mood, we can deal well with difficult
135 situations such as meeting a friend who hurt our feelings, talking to teacher who we think gives us the wrong grade, etc. If we are exhausted in the afternoon, we should do relaxing activities like reading or staying with friends, and avoid stress. 5. Take notice of our own emotions during each month; some women find out that their bad temper is related to having their periods. 6. Exercise can strengthen our bodies and minds; it should be done at least 20 minutes a day. This can help us feel peaceful and happy because exercise will help the body produce endorphins which is a chemical substance in the body which helps us naturally feel good and happy. 7. Being able to think things over and differentiate good from bad. 8. Listening to music; research shows that the rhythm of a song can help us put our thoughts in order and have a stable mind as well as to relax tense muscles. 9. Call friends. Asking for help makes people have good relation with others and reduces feelings of loneliness. 10. Hugging helps the body produce hormones, makes us feel good and able to cope with our emotions. Practical ways to deal with teenagers’ sexual emotions There are two practical ways: one is to control the sexual desire; the other is to lower your sexual desire. Practical ways to control sexual desire includes avoiding increasing sexual desireby: 1. Avoid reading books, watching films or visiting internet sites which have sexually explicit pictures or messages. 2. Avoid any easy going action such as having sexual day dreams. 3. Avoid any situation where certain parts of the body to touch someone of the opposite sex such as hands and arms, hugs, kisses and fondling. These can cause sexual desires. 4. Avoid going out at night since it may result in stimulating sexual desires. In addition, places such as night clubs or anywhere alcoholic drinks are served may stimulate sexual desire.
136 4. Skills to cope with stress Stress refers to a contraction of important muscles on a part or various parts of the body such as balancing or moving. Studies show that every time we think or get in a mood, there will always be a contraction or a movement of muscles in the body. Stress can be both beneficial and harmful. Harmful stress is not essential. When one is under stress, the body will prepare itself to either ‚retaliate‛ or ‚escape‛ from the stimulus by stimulating the heart in order to pump more blood containing oxygen and nutrients through the cells in the body, rapidly removing wastes from bloodstream, breathing faster but more shallow, adrenaline and other hormones are pumped into the bloodstream, the iris of the eye becomes enlarged to let more light enter, muscles contract to prepare to fight or escape, the blood vessels of some organs in the digestive system shrink, and the metabolism rate increases resulting in a higher body temperature and sweating. All these reactions will return to normal after getting past the crisis. However, toxins from excessive harmful stress will remain. The effects of stress towards living The effects of stress on your physical health may include certain conditions such as headaches, pain in the body, abnormalities of the heart, high blood pressure, gastric disorders, constipation or diarrhea, insomnia, asthma, erectile dysfunction, etc.
137 The effects towards mental health include such symptoms as anxiety, depression, unreasonable fear, emotional instability, or certain neurotic disorders. The causes of stress - General environmental factors such as loud noises from machines or mechanical devices, air pollution, wastewater, dust, insecticides, and crowded places. - Poor economic conditions such that income cannot meet expenditures. - Social environments; for example, educational competition, work, worries about promotions, etc. - Unpleasant interpersonal relations which includes disputes with others that occur regularly. - Feelings of inferiority - A desire to dominate others. How to reduce stress as follows: 1. Deal with the consequences of stress by using certain drugs including balms, inhalants, painkillers, antacids, and tranquilizers. Such drugs, however, do not eliminate the causes of stress resulting in the return of the stress, so the best way is: 2. Deal with the causes of stress by adjusting your way of life to reduce stresses; for example, finding a hobby and exercising. 3. Change your habits and attitudes in daily life to reduce competition with others, be more flexible, and less strict. 4. Learn about proper nutrition. Certain foods and beverages can increase or decrease stress. 5. Observe and change your attitudes about yourself and others. Be more optimistic. 6. Observe and improve interpersonal relationships with your family members and others in society. 7. Learn different ways to relax such as breath control, meditation, simple exercising, muscle relaxing, and massage. Try new sitting, lying, standing, and walking positions, and use your imagination to think about pleasant things. When getting stressed out, try to consider what the cause of the stress is and apply any of the methods above to reduce stress. This may partly or totally reduce the stress.
138 Activities Write down the answers for the list of questions below and present them to the class 1. What are the effects of self-actualization towards living? 2. How can we cope with anger? 3. What are the effects of stress on health and how can we deal with stress?
139 Chapter 9 Occupation of Selling Preserved Food In Thailand there are various types of food produced from agricultural products depending on the specific region. Processing such agricultural products into cooked food is another career option for those who are interested. Preserving food today utilizes processing technology to simultaneously process a great number of raw materials into cooked food or convenience food. Today’s food preservation techniques are considerably better than those used in the past in terms of hygiene, smell, appearance, taste, texture, and quality. Agricultural food preservation requires a basic knowledge of science, business, and management as well as knowledge of processing agricultural products. The purpose for such an activity is to completely change the product or to improve the product in terms of color, smell, and texture as well as to improve nutrition. Cooked food refers to food that has been cooked or processed for preservation. Cooked food can be eaten immediately when needed; either heated up or not. Examples of this include canned food and dairy products such as milk. Convenience food means food that is cooked and processed for preservation. Like cooked food, it can be kept for a long period as well. Convenience food needs to be prepared before consuming; for example, concentrated juice should be mixed with water before drinking, and so should curry paste. Processing and preserving food: the primary purpose for such processes is to eliminate microorganisms which cause decomposition. Due to the fact that there are a wide variety of agricultural products, there is a need to study and experiment with preservation technologies in order to learn how to best prolong the product’s quality. For example, using steam to eradicate microorganisms in canned food, utilizing gamma rays to suppress or stop enzyme reactions resulting in a slower chemical transformation as well as to limit the growth of microorganisms. Food preservation methods widely used nowadays are as follows: · Food preservation using high temperatures such as canned food · Food preservation using refrigeration such as frozen food products · Food preservation by drying such as Pla-haeng (dried fish) and ground coffee · Food preservation by pickling such as soy sauce and vinegar · Food preservation by irradiation such as irradiated onions
140 1. Food preservation using high temperature methods Food containers have improved considerably. At first, cans made from tin were widely used; however, due to the fact that tin has become more difficult to find and is now more expensive, a tin coated steel can is used instead which greatly reduces the amount of tin used. A can made from aluminum, which is lightweight but can be easily distorted, is most often used to contain juice, milk, or other beverages. The use of aluminum cans is not as common as that of tin coated steel cans. Apart from the container, the type of food is also an important factor that should be considered, in the sense that what level of temperature is needed to eliminate microorganisms in the preserved food. Heat will basically change the food condition from fresh food to cooked food that is ready to eat, so one might add certain ingredients in the process and doing so is called ‚Food processing‛. Ingredients put in meat dishes may include meat, vegetables, and spices while those that are added to desserts include syrup for fruits. Canned or bottled food processing requires a certain amount of heat both to cook the food and to kill the microorganisms. The level of heat used depends on the type of food. If the temperature is too high, it will overcook the food making it unsavory. However, if the temperature used is too low, there might be some microorganisms remaining leading to the container swelling and exploding. Therefore, food preservation using a high temperature method is a process to eliminate microorganisms in the sealed container in order to prevent any decomposition from both microorganisms and enzyme reactions in the food itself. There are 3 levels of food sanitization which include sterilization, commercial sterilization, and pasteurization. Sterilization refers to a food preservation process which uses high temperature and pressure in order to completely eliminate existing microorganisms. Commercial sterilization is a food preservation method using high temperature to eliminate most of the microorganisms in food so that it may be consumed without harm and kept for a longer period of time at normal temperatures. Pasteurization refers to a food preservation process utilizing a lower than boiling point temperature (below 100 degrees Celsius) to partly eliminate the microorganisms. However, the process should be used together with other methods such as refrigeration, or maintaining pH, sugar, or salt levels. Food and technology scientists classify canned food into 2 categorizes which are: 1. Acid foods refers to the food that has a pH lower than 4.5. Most of these are fruits such as pineapples and oranges, or sour vegetables such as tomatoes and roselles.
141 2. Low acid foods have a 4.5 pH or higher. Most of these are meat and vegetables such as beef, pork, fish, baby corn, and asparagus. Cans used to contain food Canned pineapple factory Process of food canning 1. Buying ingredients 2. Washing and trimming ingredients 3. Picking out and categorizing ingredients
142 4. Boiling them for a short time 5. Canning, bottling 6. Adding water into the can / bottle <----- preparing spices or water 7. Emptying the can / bottle 8. Sealing the container 9. Sanitizing with heat 10. Chilling the can 11. Applying a label on the can / bottle 12. Packing in a box 13. Storing in a room 14. Distributing the product 1.1 Tools used in producing the canned food In general, tools and machines used in producing canned food must not be harmful towards one’s health and must be well-cleaned. A reusable container must not be made from toxic substances. It must be designed so that it is easy to clean in order to prevent left over food material. Preferably it should not be made from an absorptive material except for certain purposes such as a wine cask. Tools and machines used in the factory vary depending on the types and categories of the products but they can generally be classified into 3 categories which are: Tools and instruments necessary to the production processes Machines used according to the production processes Machines used according to the types of product 1.1.1 Tools and instruments necessary to the production process This section includes tools and instruments that are necessary for food processing entrepreneurs particularly for manufacturing canned food; regardless of the business size. 1) Weighing instruments which are generally used to weigh or measure the volume of things such as ingredients and spices. It is necessary to have various sizes of these instruments. 2) Temperature measuring instruments are one of the most essential instruments in the food production process maintain the correct temperature for proper cooking and sterilization. 3) Salt measuring instruments 4) Sugar measuring instruments
143 5) pH meters 6) Heat penetration equipment are instruments used to calculate the length of time needed in the sanitization process after putting the food into a container. Such an instrument is called a Thermocouple. It measures the temperature at which the heat reaches the product in the can. 7) Instruments measuring the size of the can seams. The quality of the cover and body attachment of the can is very important. It must be up to standards otherwise the can will leak. 8) Instruments measuring pressure in a can are utilized in order to determine whether there are any leaks in the can. This is done by pumping air into the can until the required level of pressure is met, then submersing it in water. If there are leaks in the container, air bubbles will come out from the seam in which the can seam machinery will need to be adjusted. 1.1.2 Machines used in the production process Machines used in manufacturing canned food are generally classified according to the production processes which include: Washing, preparing, and trimming ingredients Scalding Cooking Containing Emptying the container Sealing the container Sanitization 1.1.3 Machines used for the types of product: machines used vary depending on the types of the food manufactured; for instance, machines used in producing canned pineapple might be different from those used in manufacturing canned fish. 1.2 Cleaning the place of production In ‚Hygienic‛ terms, the most crucial part to consider is the level of microbes since they could significantly harm the consumer’s health. Therefore, the amount of such microorganisms on both people and machines must be controlled by: 1) Not allowing any contact from animals or insects.
144 2) Providing staff with aprons which prevent any contaminations from those who produce or serve the products and their clothes, and providing staff with a cap or a scarf to prevent their hair from falling into the product. 3) Always keeping all machines, instruments, tables, water bowls, and kitchens clean in order to eliminate food scraps which will foster microbe growth. 4) Dumping all the food scraps every day. 5) Keeping the stock room, storage area, refrigerator, and cold storage clean. 6) Orderly arranging all the machines and instruments in order to be convenient and prevent any damage. 7) Providing sufficient restrooms for staff. 8) Arranging an annual health check program for staff. 9) Coordinating with an ‚Inspector‛ from the government for suggestions and to establish good coordination. 10) Improving processes as suggested by the ‚Inspector‛. 1.3 Eliminating food scraps, garbage, and waste from the factory Releasing wastewater is also important since it may negatively affect two aspects which are: 1) Hygiene and safety in production, impurities may easily contaminate the production processes. 2) Safety towards the environment: releasing water containing food scraps will disturb the neighbors and letting out production wastes into nearby water sources will cause troubles and difficulties for those who live near the river. 2. Food preservation using refrigeration Refrigeration refers to a method to reduce the temperature from certain objects or areas. Refrigeration can be classified into 2 categories which are: Chilling is a process to reduce the temperature of a certain object to just above the freezing point. This allows the food to maintain it’s quality and consistency. Chilling food to 1 degrees Celsius will not make it’s ingredients freeze. Freezing refers to a process to decrease the temperature of certain objects below its freezing point (-1 to -40 degrees Celsius). Freezing will trigger changes in the composition for that particular object; for instance, the water contained in the food will freeze which prevents microbes from. Freezing however, does not eliminate the microbes.
145 Freezing point is the balancing point between a liquid and a solid or the point of temperature when a liquid turns into a solid at a standard pressure of 1 atmosphere. Food preservation by refrigeration can be done as follows: 1) Using ice: cold ice will dramatically reduce the temperature of food and if there is sufficient ice, the food temperature can be decreased to nearly 0 degrees Celsius. 2) Using freezing mixtures: by mixing the ice with salt and other inorganic salts, can result in a freezing mixture with a temperature lower than 0 degrees Celsius. 3) Using dry ice: dry ice is frozen carbon dioxide which is approximately -80 degrees Celsius. It can be used to preserve frozen food products and is suitable for a 2-3 day transportation. 4) Using liquid nitrogen: liquid nitrogen at a standard pressure will evaporate at -196 degrees Celsius which is the lowest temperature that can be used for preserving the product. Moreover, nitrogen is an inert gas which does not harm the consumer. 5) Using freezers: a freezing machine that is commonly used, especially in households, is the refrigerator. 3. Food preservation by drying There are various techniques for drying which are: 1) Using hot air to dry food such as solar drying and hot air drying. 2) Spraying liquid food into hot air. A tool used in such process is a spray dryer.
146 3) Using a heat roller to dry thickened food. Tools used are the drum dryer or the roller dryer. 4) Eliminating the water in food by freezing and then making the water evaporate in a vacuum. This is known as freeze drying. The machine used is a freeze dryer. 5) Reducing food moisture by using a Microwave. The primary principle in drying food is to partly remove the water contained in the product. To what extent the moisture must be removed depends on the type of product. Heat transfer will occur at a place where there are differences in temperature between the tools used and the food. Heat transferring can be classified as: 1) Heat conduction is the transfer of heat energy from one molecule to another nearby molecule. heat conduction is likely to occur with food in a solid state. 2) Heat convection will occur with food in a liquid state. A heat current will be transferred over a gap of air or gas from one liquid to another liquid. 3) Thermal radiation is a heat transfer process in which heat radiation is emittedfrom the food. This process is used for vacuum packing and freeze drying. Water and moisture circulation: water and moisture will circulate to the surface of the food when it is heated and cooked. Drying apparatus Appliances that can be used to dry a large amount of food vary in terms of types and sizes as mentioned below: 1) Solar food dryer: the solar dryer consists of solar cells made from clear materials. When the sun shines on these solar cells, it will pass into a black object in the dryer and turn into heat which will evaporate the water in the food out through an air passage, resulting in drying the food. It is recommended to turn the product 1-2 times each day during the drying process to have all the surfaces of the product heated, dried quicker and dried completely. The solar food dryer is commonly used with vegetables, fruits, and grains. The benefits of the dryer are as follows: (1) The product is attractive. (2) The process is clean since it keeps dust and insects from getting in (3) It takes one-third of the time of a natural drying process. (4) It requires less space to dry the products since multiple layers of tray can be placed.
147 (5) It saves labor because there is no need to pick up the dried food in the evening and take it out in the morning as was done before, thus reducing the cost of producing dried food. A roller dryer A tray dryer using hot air 2) Drying using heat from other sources: drying in this category generally use gas as a fuel to provide heat. Most of these are used at an industrial level and vary in terms of models, sizes, and applications such as: (1) A tray / cabinet dryer using hot air: the cabinet is lined with non conductive materials and contains trays for the food. This type of machine is commonly used to dry a small amount of food, or used in an experimental work. (2) A dryer using continuous hot air: the machine looks like a tunnel. The food will be placed onto a conveyer belt which moves through the tunnel. Fans in the tunnel blow hot air over the food, drying it. Some examples of food suitable for this machine are vegetables or dried fruits. (3) A spray dryer which will spray a liquid that is to be dried into a cabinet containing hot air. Some examples of products in this category include instant coffee, powdered eggs, powdered fruit, and powdered soup. (4) A roller dryer uses a heat convection process. The machine consists of a set of stainless steel rollers. The food used for this process must be condensed and will be put through the roller and made into a thin film. heat is transferred from the roller to the food.
148 (5) A freeze dryer consists of a freezer, a dryer sheet, and a vacuum cabinet. The machine evaporates the water in the food under a vacuum condition. Heat is transferred by heat convection. An example of products in this category is instant coffee. (6) A microwave dryer uses a microwave frequency of 13x106 cycles to reduce moisture in vegetables such as cabbage. The product output will be good quality and has a good appearance. An example of products using microwave driers includes orange powder. 4. Preserving pickled food Advances in microbiology have made preservation techniques more applicable to new products. As a result, certain purified and effective kinds of microbes are utilized in food preservation. Products such as soy sauce and bean paste are often produced at the same time because they both use fungi spores called the Aspergillas Flavus Columnaris as an ingredient, in order to prevent contamination by other fungi and to make soy sauce stay in good quality throughout the year. More importantly, the fungi spores used do not generate aflatoxin which is a carcinogen. 5. Food preservation by radiation Radiation refers to an wave of energy that can have either a long or short wave length. The radiation of most radioactive substances is similar to a wave of particles. This radiation comes from the smallest unit of matter which is called an atom. A particular chemical element commonly consists of various types of atoms which possess identical chemical properties but are different in terms of weight. Such atoms with the same chemical attributes are defined as isotopes. The kinds of radiation used in food preservation may include: 1) Gamma is commonly used in preserving food. The gamma ray is emitted from cobalt 60 or Cesium 137. 2) X-radiation is emitted from a radiation-producing machine operated with the energy level of equal or less than 5 million electron volts. 3) Electron radiation is emitted from a radiation-producing machine operated with the energy level of equal or less than 10 million electron volts.
149 5.1 Principles of food preservation with radiation The radiation emitted into the food will eliminate or slow the growth of microorganisms, or reduce its chemical attributes; as a result, food can be kept longer without becoming spoiled. However, this depends on the type of food and the amount of radiation received. The objectives of radiation can be summarized as follows: 1) To prevent the growth of the plant while being kept. The maximum amount of radiation allowed by the Ministry of Public Health on food is 0.15 Kilograys; however, the common amount used to preserve crops such as garlics, onions, and potatoes is between 0.05 and 0.12 Kilograys. This amount of radiation can control the growth and the loss of weight for more than 6 months. 2) To control insect breeding while the food is being stored, the amount of radiation typically used is around 0.2-0.7 Kilograys which is less than the maximum value allowed (1 Kilogray). This radiation will kill all insect eggs and control the spread of insects on stored food such as rice, peanuts, spices, and dried fish. 3) To keep various types of food longer. Irradiating sea food and meats with of 1-3 Kilograys will greatly reduce the amount of bacteria, allowing them to be stored for longer periods but the food will have to be kept in containers in cold rooms. For fruits such as mangoes and bananas, an irradiation of 0.3-1 Kilograys will slow down their ripening and help control insects while being kept, allowing for a longer storage. Radiation of 3 Kilograys on strawberries will eliminate some microorganisms which cause decomposition and a radiation of 1-2 Kilograys will also slow down the bloom of mushrooms, thus lengthening the selling period. 4) To eliminate bacteria and parasites in food. Products made from meat may contain certain bacteria or parasites; for examples, opisthorchis found in raw fish can be eliminated by irradiating with 0.15 kilograys. Salmonella which is a species of bacteria that causes diarrhea found in fermented pork, a popular pork product among Thai people, can be terminated by irradiating with 2-3 kilograys. 5.2 Radiation process In Thailand food irradiation is controlled and operated by the Office of Atoms for Peace, the Ministry of Science and Technology of Thailand. However, the standards of radiation in use and safety
150 will depend on announcements from the Ministry of Public Health. Food processing with radiation includes agricultural products after harvesting, ready-made food and convenience food, so packaging for these products should be suitable; for instance, fermented pork and Mooyor should be wrapped with banana leaves, while onions and potatoes need no wrapping. The products should first be enclosed in an appropriate package, then processed through the electromagnetic building which is located far away from the emission building which should be well designed in accordance with safety standards.Then this process will neither cause harm nor damage to surrounding communities. 5.3 The amount of radiation used to preserve food A gray is a unit of radiation. 1 kilogram of food that is irradiated by 1 joule of radiation is called 1 gray. Furthermore, there is a unit called a rad. 100 rads are equal to 1 gray and 1,000 grays are equal to 1 kilogray. The World Health Organization and International Atomic Energy Agency conclude that less than 10 kilograys of irradiation on food is harmless and does not alter the nutrients in food. However, the amount of radiation irradiated must comply with the amount announced by the Ministry of Public Health and such amounts will vary depending on the types of food and the purpose of irradiation. 5.4 Labeling the product Irradiated food should have a label indicating certain information important for purchasers. A label should contain: 1) The name and the location of the manufacturer including the company performing irradiation. 2) The purpose of irradiation such as: ‚This food has been irradiated in order to………………‛ (the blank should inform such a purpose). 3) Date and year of irradiation 4) A sign showing that the food has been irradiated. Convenience food refers to a ready-made food that is able to be warmed and eaten immediately. A convenience food in this context also includes food that is ordered and cooked by a consumer. The following factors should be considered when buying convenience food; the cleanliness of the place of production, a container that is protected from insects and dust, and the cleanliness of the seller. Instant food means a ready-made food packed in a container to be sold such as instant chili sauces (Nam Prik Phao, Nam Prik Sawan, Nam Prik Ta Dang, and Jaew Bong), confections (Rang
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