Image Tales for Grownup ESL Well being Literacy

Created by Kate Singleton
Fairfax County (Virginia) Public Colleges

The image tales are:

  • Designed to assist ESOL instructors deal with subjects that have an effect on the well being and well-being of their college students.

  • Helpful for newbie and low-literacy college students. Newcomers to the USA and adults with decrease literacy are inclined to have the least consciousness of and entry to well being care providers, thereby working the chance of extra critical and continual well being outcomes. Phrases are stored to a minimal within the tales to present simply sufficient info to convey an concept with out changing into too distracting for college students with very low literacy.

  • Designed to be protected, impersonal prompts to permit college students to debate tough subjects, ask questions, and acquire info. Because the tales are about cartoon characters, the scholars shouldn’t really feel strain to reveal their very own experiences on the subject if they do not wish to.

  • Adaptable to be used at completely different ranges.

What teams of scholars are the image tales appropriate for?

The tales “Emergency,” “A Doctor’s Appointment,” and “Stressed Out” are appropriate for many courses, because the subjects are frequent and uncontroversial. “What Should She Do?,” nevertheless, needs to be used with discretion, as its matter of home violence could evoke robust reactions and discomfort, particularly if a category member has skilled home violence personally or is aware of somebody who has.

How can the tales be utilized in class?

The Language Expertise Strategy (LEA) is an efficient method to make use of the image tales with inexperienced persons.

Advantages of LEA:

  • Makes use of the scholars’ personal language, experiences and observations to create a product, their very own story.

  • Promotes talking, listening, studying and writing, whereas letting college students resolve on the content material.

  • Life expertise are mentioned, and the scholars negotiate to provide you with a narrative on which all can agree.

Recommended LEA process:

  • The instructor can ask the scholars what is going on in every body of the story. She will be able to ask inquiries to elicit particular particulars or observations, and if college students do not have a transparent concept of what to say, varied eventualities will be mentioned till the category chooses one they like.

  • As soon as the entire story has been elicited orally, the instructor tells the scholars that she is going to write it down as they retell it. Whereas the scholars retell it, the instructor writes, attempting to remain near the scholars’ personal language. She will be able to clean it out for readability’s sake sometimes, however the story needs to be the scholars’ product, primarily based on their concepts.

  • The instructor can ask questions once more to verify vital info or vocabulary is included.

  • After the story has been written, the category can follow studying it chorally and individually.

  • College students can then copy it down (it is best to go away this step till the tip; if college students are writing because the instructor is eliciting the story, they do not take part within the creation of the story.).

  • If studying is a talent focus of the category, varied follow-up actions like sentence or phrase sequencing, or cloze actions will be carried out in a later class. If oral talent improvement is the main target, retelling with out studying might be practiced.

Are there another concerns?

In utilizing image tales, lecturers ought to rigorously contemplate the photographs that they select to make use of. Cartoons or comparable drawings or illustrations that incorporate figures of remoted physique elements will not be recognizable or understandable to all English language learners. This can be very true for learners with restricted literacy of their native languages. Drawings of individuals or physique elements could even be offensive to some teams. Academics want to concentrate on these points and be ready to make use of different sources resembling images, movies, or gestures.

Well being literacy points:

  • entry to care; availability of low or no-cost well being look after low-income uninsured value of care; value comparability of preventive care and emergency care;

  • negotiating a cost plan; credit score data and non-payment of payments

  • medical insurance system, availability, procedures

  • the tradition of preventive care in the USA

The essential story:

A person feels ache signs in June, however ignores them as a result of he would not have insurance coverage and feels he cannot afford medical care with out it. A feminine acquaintance means that he see a physician, however he repeatedly refuses to due to his concern about the price. Six months after his ache begins, he’s taken to the emergency room by ambulance as a result of his situation has worsened. A month later, he’s nonetheless in mattress, confronted with a big hospital invoice which he would not know the way he pays.

Background info:

  • Starting and low literacy college students generally report back to ESOL lecturers that they do not have insurance coverage and do not go to the physician in the USA as a result of it prices an excessive amount of cash.

  • College students are sometimes unaware of native low or no-cost clinics that they’re eligible to make use of, or they worry that utilizing clinics will jeopardize their immigration standing. Low or no-cost clinics exist in lots of city areas and a few rural areas within the U.S. Low value clinics cost charges on a sliding scale primarily based on earnings. New sufferers could must make a preliminary appointment for verifying eligibility earlier than they will have a medical appointment at some clinics. Some clinics periodically shut enrollment as a result of they’re overburdened, so a scholar may must examine again recurrently to see if new sufferers are being accepted.

  • Consequently, circumstances that might be handled at comparatively low value and bodily discomfort to the affected person can turn into very expensive and continual when remedy is delayed.

  • Such conditions can derail a scholar’s efforts to attend faculty or keep employment, amongst different repercussions.

  • When college students do see a U.S. well being care supplier, they might be confused by the expectation of self-care and prevention in our well being care tradition if these will not be the norm of their native tradition.

Recommended questions for prompting dialogue whereas eliciting the story:

  • First body: What is going on within the image? What do you see? What’s the man’s identify? What is the matter with him? What’s he saying? What does “ouch” imply?(What do you say in your language when you find yourself harm?) When is it taking place?

  • Second body: When is it now? How is the person now? What’s he saying? Who’s the girl? What’s she saying? (If college students simply say, “Doctor?,” ask them for an entire query, like “Did you see a doctor?”)

  • Third body: What does he reply? (Once more, attempt to elicit extra phrases than “No doctor. Too much money.” If college students are confused or hesitant, you may suggest “I can’t go to the doctor! It costs too much money!”

  • Fourth body: When is it now? How does he really feel now? (A standard reply is “Double ouch!”) Does he go to the physician in December? Why not?

  • Fifth body: When is it now? What’s taking place? The place is he now? The place is he going? What room will he go to within the hospital? What’s going to occur within the emergency room? (This could convey up vocabulary like surgical procedure, operation, drugs, and so forth.)

  • Sixth body: Now what month is it? The place is he now? What’s he ? How a lot do you assume the invoice is for? How a lot does it value to go to the emergency room? How a lot does surgical procedure value? How a lot does it value to go in an ambulance? What’s he pondering? How is he feeling? What can he do?

With the sixth body the chance arises for notably worthwhile dialogue on college students’ well being care choices and duties:

  • Can he do something completely different in June so he is not going to have a giant drawback in January? (Some college students could convey up worthwhile recommendations for preventive care, resembling exercising, taking nutritional vitamins, lowering stress, and so forth. Some could have expertise with clinics and volunteer info, which is nice!)

  • Can he go someplace to see a physician? (Typically this meets a unfavorable response from college students who’re unaware of native reasonably priced clinics. The instructor can present the telephone quantity, deal with and primary eligibility info for such clinics and clarify that their use is just not reported to Immigration.)

  • How will he pay the invoice? (Some college students could have had the expertise of arranging a cost plan with a hospital. If not, the instructor can convey up the thought. Additionally, particular person medical doctors could comply with cost much less for uninsured sufferers.)

  • What occurs if he would not pay the invoice? (This could result in dialogue of credit score, why it is vital, what it’s wanted for, and the best way to hold in good standing.)

Extra Helpful Data

The next info will be useful on your college students. Language is simplified, however you may resolve the best way to current it, how a lot to current and what particular info fits the curiosity and desires of your college students. The knowledge could also be used for instructor reference, or it might be modified for the extent of your college students to make an informational handout or different exercise.

Paying for well being care if you happen to would not have insurance coverage

  • Is there a low-cost or free clinic close to your property? Discover the telephone quantity and name to see if you happen to qualify for remedy there. Typically you must wait a couple of weeks on your first appointment as a result of the clinics are busy.

  • For those who would not have insurance coverage, typically (not all the time!) common medical doctors cost much less for uninsured individuals’s remedy. It’s good to ask on the physician’s workplace or hospital. Typically nobody tells you if you happen to do not ask.

  • In case you have a giant invoice that you just can not pay at one time, ask if you happen to can have a cost plan. With a cost plan, you pay the identical quantity every month (for instance, $50) till you end paying every thing off.

  • If you don’t pay a medical invoice, normally your invoice will go to a collections company. That is very critical! Collections companies provide you with a bad credit report ranking in pc techniques that banks and lots of different companies can examine. If you don’t pay the collections company, you should have bad credit report. With bad credit report, you can’t purchase a home, automotive, or school training. You can’t hire a brand new condominium. You can’t get a bank card. You can’t obtain a mortgage from a financial institution, and typically you can’t open a checking account. It is extremely tough to repair bad credit report.

Well being literacy points:

  • Talking with a well being care supplier

  • The proper to an interpreter

  • Affected person self-advocacy; affected person’s duty to ask questions in short scientific encounter

  • Clarification of remedy plan

  • Avoiding treatment errors

  • Cultural perceptions of physician/affected person relationship

The essential story:

A person feels a ache and goes to the physician. The physician examines him, asks questions concerning the signs and offers him numerous info. The person pretends he understands, however he would not communicate a lot English and would not know what the physician is saying. The physician provides him an opportunity to ask questions, however the man would not ask any. He will get some new prescriptions however would not perceive the best way to take them. At house one among his relations asks what the physician mentioned, and the person studies that he would not know. He’s pissed off and confused.

Background info:

  • College students report and statistics bear out that they usually do not perceive what well being care suppliers inform them in English, do not feel in a position to ask questions, and do not perceive all of the written directions for medicines and remedy.

  • Concern of getting to speak in English retains some from looking for remedy.

  • Federal legislation (Civil Rights Act of 1964) mandates that any facility receiving federal funds (medicare, medicaid) should present interpreters for sufferers whose English is restricted. Particularly, the legislation prohibits discriminatory remedy on the idea of nationwide origin by companies receiving federal funds. Whereas compliance with the legislation is just not well-monitored, the usage of educated well being care interpreters is rising within the medical discipline. Your native well being division may be capable to present an interpreter for a college students’ medical appointment. Medical doctors typically subscribe to call-in translation banks that may do interpretation for many languages over the telephone.

  • Some cultures imagine that a physician is an professional and subsequently shouldn’t be questioned. College students from such a background may benefit from studying the significance of the affected person’s asking clarifying questions in at present’s usually temporary medical encounter, and their proper to hunt a second opinion.

  • Treatment errors are a rising drawback in the USA. Whereas causes range, proof reveals that many adults lack the literacy expertise to grasp treatment info and directions, which might result in critical errors of their utilization.

Recommended questions for prompting dialogue whereas eliciting the story:

  • First body: What is the matter with the person? What’s his identify? What ought to he do?

  • Second body: The place is he now? Who’s with him? What’s the physician doing? How is the person feeling?

  • Third body: What’s the physician saying? What does the person say? Do you assume the person understands the physician? Why not? Why does he say “OK”?

  • Fourth body: Now what’s the physician saying? What query does he ask the person? What does the person reply? Is that true?

  • Fifth body: Now what does the physician ask him? What does the person reply?

  • Sixth body: Now the person leaves the physician’s workplace. What’s within the image with him? What’s he pondering? What’s the drawback with taking the prescriptions?

  • Seventh body: Now the place is the person? Who’s he talking with? What does she ask him? How is the person feeling now?

  • Eighth body: What does the person reply?

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With the eighth body the chance arises for notably worthwhile dialogue on language boundaries in well being care and what communication is predicted of the affected person within the U.S. well being care system.

  • Has this ever occurred to you? (College students have reported that “This is my story,” or “The man is me!”)

  • What recommendation are you able to give the person?

  • What can somebody do if they do not communicate a lot English and they should see the physician? (At this level the instructor can provide details about the rights of restricted English audio system and any decoding choices accessible locally or by means of a physician’s workplace, e.g. the call-in interpreter banks. Different recommendations college students have provide you with embody taking a pal or member of the family who speaks extra English, or discovering a physician who speaks your language. There isn’t a good reply, however it is very important know the legislation and focus on choices.)

  • What questions can this affected person ask the physician concerning the prescription medicines? (The category might brainstorm a listing. Some examples of potential questions comply with. Questions are simplified, however some should still be tough for decrease ranges and a few vocabulary might have clarification. You may resolve how a lot and what sort of info your college students is suited to your college students’ ranges and desires. You might use these as a reference, or you could modify them on your college students’ stage to make informational handouts or different actions.)

    Inquiries to ask the physician about your drugs

    1. What is that this drugs?
    2. Why am I taking it?
    3. What does this drugs do?
    4. How lengthy do I must take it?
    5. When will I begin feeling higher?
    6. What are okay unwanted effects of the medication?
    7. What are dangerous unwanted effects of the medication?
    8. What unwanted effects do I must name you for?
    9. Is it okay to drink alcohol with this drugs/this situation?
    10. Do I want to return again and have the physician examine my drugs?
      (Sure medicines require that the extent of the medication within the blood is recurrently monitored.)

    11. Listed below are the names and doses of different medicines I am taking now. Is it okay to take the brand new drugs with them? (Embrace over-the-counter medicines, prescriptions, nutritional vitamins, and herbs, from the USA and different international locations.)

Extra Data

Extra recommendation for speaking with medical doctors about your medicines

  • For those who can not learn the physician’s handwriting on the prescription, ask him to put in writing it once more clearly so the pharmacist can learn it, too.

  • Inform the physician your allergy symptoms to medicines, and dangerous unwanted effects you had from medicines up to now.

  • Write a listing to point out the physician or hospital employees what medicines you take and the way a lot you’re taking. For those who can not write it, put your medicines in a bag and take them with you to the physician.

  • Verify earlier than you permit the pharmacy that you just acquired the right drugs and that you just perceive the best way to take it. It’s okay to ask the pharmacist questions.

Common recommendation for sufferers within the physician’s workplace/hospital
(This info refers to what’s anticipated from the affected person in U.S. well being care tradition. It’s simplified, however nonetheless makes use of helpful well being care vocabulary which can have to be launched to your college students. Once more, you may resolve how a lot and what sort of info is suited to your college students’ ranges and desires. You might use these as a reference, or you could modify them on your college students’ stage to make informational handouts or different actions.)

  • SPEAK UP. ASK QUESTIONS! Medical doctors need sufferers to be focused on their remedy. Within the US medical doctors count on you to make selections along with them.

  • If a physician is busy, she or he sees the affected person for less than 10 minutes. Consider some questions earlier than you go to the appointment so that you get the knowledge you want.

  • Take a pal with you who will help you ask questions and perceive the physician. Typically a pal is healthier than somebody in your loved ones, as a result of a member of the family will not be comfy talking about your well being and physique.

  • Make INFORMED DECISIONS. This implies study all you may about your drawback and its potential remedies earlier than you resolve what remedy to have. Ask inquiries to medical doctors, nurses, and different individuals who had your drawback. If potential, learn details about it in books and on the Web.

  • Be prepared to inform the physician what signs you will have and the way lengthy you will have had the signs.

  • Within the US, be prepared to inform the physician your loved ones’s medical historical past. What huge well being issues did your mother and father, grandparents, brothers and sisters have? This helps the physician know what to examine for in you.

  • In case you are within the hospital, discuss with the physician or nurse earlier than you go house about what it’s best to do and what medicines it’s best to take if you depart the hospital. Be sure you perceive every thing. For those who do not perceive, ask extra questions.

  • For those who do not wish to take a drugs or have an operation, you may ask the physician if there’s another remedy. In case you are unsure that surgical procedure is the best factor for you, you may ask a unique physician for a second opinion. (You need to pay each medical doctors!)

  • If you must go to the hospital for an operation, attempt to go to a hospital that does this operation so much.

  • For those who do not hear check leads to the time the physician tells you, name the physician to examine on the outcomes.

Well being literacy points:

  • stress administration
  • self-care
  • prevention

Fundamental Story:

A lady wakes up in the midst of the night time to feed her child. Her household (her husband and a couple of older youngsters) is ready for her to cook dinner them breakfast at 7AM. She arrives late to work, and her supervisor is offended together with her. On her method house from work, she is in a fender bender. Later that night time, she seems at her payments and worries about cash. After that, she feels utterly stressed from all of the stressors of her day.

Background Data:

  • Stress is one thing most grownup ESL college students can relate to. Many juggle the calls for of a number of low-paying jobs whereas going to high school and caring for household.

  • The immigration course of itself generates stress as individuals adapt to the brand new tradition.

  • Intergenerational stress happens as youngsters assimilate to U.S. tradition and utilizing English sooner than their mother and father.

  • Unchecked stress can result in bodily sickness in many individuals and psychological sickness, resembling anxiousness and melancholy, in some.

Recommended questions for prompting dialogue whereas eliciting the story:

  • First body: What time is it? Who’s within the image? What’s the mom doing? What’s the child doing? How does the mom really feel?

  • Second body: What time is it now? Who’re the individuals within the image? (the girl’s husband and two older youngsters) What do they need? Who makes the breakfast for them? The place do you assume the mom is now?

  • Third body: What time is it now? Now the place is the girl? What’s the drawback? Who’s the person within the image? What’s he saying? Is he blissful? Why not? How does the girl really feel?

  • Fourth body: What time is it now? The place is the girl? What occurred? What’s she pondering? How does she really feel?

  • Fifth body: What time is it now? Now the place do you assume the girl is? What’s she holding in her hand? What’s she pondering? Is she blissful? Why not?

  • Sixth body: What time is it now? What’s the lady doing? Why?

With the sixth body the chance arises for notably worthwhile dialogue on stress discount and stress administration.

  • What are the girl’s issues within the story?

  • What can occur if she continues to have an excessive amount of stress in her life? (e.g. make errors at house and on job, bodily diseases, anger, melancholy, anxiousness)

  • What recommendation are you able to give the girl to have much less stress in her life? What do you do if you really feel stress? (College students can create lists of concepts in teams when completed with LEA story. They may make a poster or share concepts orally.)

  • What are some issues that provide you with stress in your life?

  • Can you alter something to really feel much less stress for your self? What are you able to do?

Well being literacy problem:

  • home violence

IMPORTANT: “What Should She Do?” needs to be used with discretion, as its matter of home violence could evoke robust reactions and discomfort, particularly if a category member has skilled home violence personally or is aware of somebody who has.

It’s the creator’s expertise that college students who really feel comfy in a category typically ask their instructor for details about the rights of home violence victims within the U.S. in addition to providers that may present refuge from abuse. Such college students could point out that they know a pal of a pal who’s in an abusive scenario. The image story could be a protected catalyst for dialogue of the legislation and dissemination of correct info on providers for victims.

: Occasions of occasions are proven within the story merely to point the passage of time for a learner to comply with. They don’t point out a typical timeline of a home violence scenario. Every scenario in actual life is completely different, and occasions shouldn’t be discounted as home violence as a result of they’re far aside or intense durations of violence are adopted by fewer episodes.

The essential story:

A lady and man fall in love. They stay peacefully collectively and begin a household. Sooner or later, the person drinks an excessive amount of. He will get offended and hits the girl. The girl has a black eye. The youngsters see what occurs and turn into upset. Later the person apologizes to the girl, tells her he loves her and offers her flowers. She is confused, however she hopes issues can be higher. The person drinks once more, and he beats the girl once more. Now the girl may be very confused. She would not know if she ought to stick with the person, who says he loves her, however retains getting drunk and beating her. She would not know what she ought to do to guard her youngsters. She thinks about calling 911, however she is not certain what is going to occur if she does.

Background info:

  • Proof reveals that “there are large numbers of immigrant women trapped and isolated in violent relationships” in the USA. (Household Violence Prevention Fund web site, http://endabuse.org/programs/immigrant/ , 1999, as cited within the ERIC Digest “Trauma and the English Language Learner” by Janet Isserlis, http://www.cal.org/caela/esl_resources/digests/trauma2.html.)

  • Immigrants are often unaware that victims of abuse have authorized rights within the U.S. They’re additionally usually unaware of the existence of shelters. Academics are inspired to seek out telephone numbers and procedural info for shelters to offer to college students along side image story actions. Victims want a practical concept of what they’ll encounter in the event that they attempt to depart an abuser with the help of public providers.

  • Immigrant and refugee victims of abuse are threatened by abusers with lack of youngster custody and immigration standing.

  • Kids are strongly affected by observing home violence. Some could turn into violent themselves in consequence, whereas others withdraw or act out in different methods. For extra info on this matter, see http://www.ndvh.org/, web site of the Nationwide Home Violence Hotline.

  • October has been designated home violence consciousness month, which gives an impersonal alternative to convey up the problem for academic functions.

Recommended questions for prompting dialogue whereas eliciting the story:

  • First body: Who’re the individuals within the image? How are they feeling? What are they pondering?

  • Second body: When is the image taking place? Who’s within the image now? What’s new within the image? How is the household feeling?

  • Third body: Now what day is it? Who’s within the image? What’s he doing?

  • Fourth body: Now what day is it? Who’s within the image? What’s the man doing? Why do you assume he’s hitting the girl? What’s the lady doing? (Observe: the alcohol is a prop within the story for example a potential development of occasions; nevertheless, you could wish to make clear to college students that home violence happens with out substance abuse as a precursor.)

  • Fifth body: Now what do you see? What are the mom and youngsters doing? Why is the mom crying? Why are the youngsters crying?

  • Sixth body: Now what day is it? What’s the man doing? What do you assume he’s saying? What’s the lady pondering?

  • Seventh body: Now what day is it? What is going on on this image?

  • Eighth body: How is the girl? (upset, confused). She is considering many issues. What’s she eager about? (calling police, impact on youngsters, alcohol drawback, man says he loves her and will not do it once more, and so forth.)

With the eighth body the chance arises for notably worthwhile dialogue on the issues a sufferer of abuse faces and sources of assist accessible locally.

  • What occurs in your nation in this type of scenario? Is it the identical or completely different from the USA?

  • What are the issues for the youngsters? (trauma of seeing their mom attacked, chance of turn into victims themselves, neglect by mother and father, and so forth.)

  • What do you assume the girl will do? Why? In the event that they reply “stay,” perhaps it is for causes of loving husband, wanting to maintain the household collectively, embarrassed that neighborhood will discover out, or worry of getting to help youngsters alone, financially and emotionally.

  • What do you assume the girl ought to do? Why?

  • What can occur if she calls 911? (perhaps constructive consequence of protecting order and placement in shelter; or unfavorable consequence of police do not imagine her, youngsters faraway from house, and so forth. College students could provide you with some bleak outcomes from conditions they’ve heard about. It can be crucial that the instructor is aware of upfront what native police and social service sources can be found to victims in order that college students know what hope and assist there’s for victims. Possibly a neighborhood police officer or a social employee who focuses on home violence circumstances would communicate to your class.)

  • What can she do if she lives in your neighborhood? (This provides you the chance to offer correct info on your neighborhood.)

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To print image as a handout, use the pdf model of the file.

Well being literacy points:

  • Psychological well being consciousness
  • Totally different cultural views on psychological well being points
  • Accessible neighborhood providers for psychological well being care in the USA

The essential story:

In January, a lady is having an energetic, blissful life. She is busy with work, pals, household, faculty, train and events. In February she begins to really feel unhappy. In March she feels worse. She cries so much. In April she remains to be unhappy, and he or she would not wish to eat. In Might she feels very drained and stays in mattress all day whereas different individuals are busy exterior. In June she decides to ask for assist.

Background info:

Despair is a quite common sickness worldwide, affecting an estimated 9.9 million adults within the U.S. alone yearly. It’s believed to be partly attributable to environmental elements and partly attributable to organic elements. Practically twice as many ladies as males expertise main melancholy. Despair can happen at any age to individuals from all ethnic, racial and socioeconomic teams.
Despair is extremely treatable with counseling, antidepressant treatment, or a mixture of the 2. Many individuals from different international locations do not find out about remedy, partly due to a low presence of psychological well being care in lots of elements of the world. The World Well being Group studies that:

  • Over 30% of nations would not have a psychological well being program.

  • Greater than 25% of nations would not have entry to primary psychiatric treatment.

  • 70% of the world’s inhabitants has entry to lower than one psychiatrist per 100,000 individuals. (WHO, 2001)

Many individuals come to the USA to flee conditions of battle and torture, which can have left them traumatized and depressed. Others could expertise socioeconomic hardship or different challenges of cultural adjustment which make them extra weak to melancholy. Typically immigrants do not search care as a result of they’re unaware of psychological well being care choices, really feel stigma across the problem of psychological well being, or really feel they cannot afford care.

Many communities in the USA present sliding scale psychological well being providers. These providers could also be discovered by way of county or municipal well being departments or neighborhood service boards. More and more, providers are being provided in languages aside from English from authorities and different non-profit psychological well being care suppliers.

Main melancholy (typically known as scientific or continual melancholy) is believed to have a organic foundation that may reply to triggers in life. Neurotransmitters within the mind are out of stability. The time period main melancholy is used when an individual has among the following signs for greater than 2 weeks and the signs do not get higher.
Doable signs:

  • You’re very unhappy. Possibly you cry on a regular basis.
  • Sleeping is an issue. Possibly you sleep an excessive amount of, or perhaps you sleep too little.
  • Consuming is tough. Possibly you do not really feel like consuming, or perhaps you eat on a regular basis.
  • Considering, remembering and concentrating are tough.
  • Your bodily power is low, otherwise you really feel like you may’t sit nonetheless.
  • You do not like doing issues that you just all the time favored earlier than.
  • You’ve bodily issues like complications or stomachaches, however they do not get higher from regular remedies.
  • You concentrate on dying or killing your self.

Another vital issues to find out about melancholy:

  • An episode of main melancholy will be triggered by a traumatic life occasion, or it could occur with no triggering occasion.
  • In case you have main melancholy, it doesn’t imply you might be “crazy.” It might be vital to make clear this in school.
  • If different individuals in your loved ones have main melancholy, there’s a stronger likelihood that you would be able to get it.
  • Some individuals get melancholy from taking some sorts of drugs.
  • Some individuals get it if they’ve sure bodily diseases.
  • Typically girls can get melancholy after they’ve a child.

Recommended questions for prompting dialogue whereas eliciting the story:

Go over the title, “Depressed,” with college students. Ask if anybody is aware of what melancholy means. Ask in the event that they know what signs an individual has if they’re depressed. Ask what an individual can do if they’re depressed.

Preteach vocabulary as wanted: signs (issues you will have when you find yourself not wholesome, like sneezing and a runny nostril for a chilly), remedy (one thing that will help you get higher, like drugs; you go to the physician for remedy), power (pantomime the distinction between having power and having no power).

First body: What do you see within the image? What’s the lady’s identify? What month is it within the image? How is she? (busy) Why is she busy? What does she do? (You may emphasize that she is busy and blissful in her life. She does many various issues and he or she has family and friends in her life.)

Second body: When is it now? How is the girl now? Is she very depressed, or just a bit depressed? Have you learnt why she is unhappy? (Inform college students that we do not know why she is unhappy. Typically individuals get depressed as a result of one thing dangerous occurred of their life. Typically individuals get depressed with out one thing dangerous taking place of their life.)

Third body: Now what month is it? How is she in March? Is one month a very long time to be unhappy, or a bit of time?

Fourth body: When is it now? How does she really feel now? Does she wish to eat the meals? Why not? (Clarify that being unhappy for a very long time and having no urge for food are signs of melancholy.)

Fifth body: When is it now? The place is she now? How is she feeling? (You may wish to elicit phrases like very depressed, no power, very drained. You may clarify that having no power and being drained on a regular basis are signs of melancholy.) What’s taking place exterior? (It is sunny. Individuals are busy/taking part in/strolling, and so forth.) What time do you assume it’s? Do you assume she feels lonely? (Clarify that feeling lonely and never desirous to do actions that you just favored earlier than are signs of melancholy.)

Sixth body: Now what month is it? The place is she now?
What’s she doing? Who do you assume she is looking? (Possibly a pal, member of the family, individual from her church, counselor, or physician.) Why do you assume the girl waited till June to get assist? (e.g., stigma, no details about assist, thought she may get higher on her personal.)

  • Do many individuals speak about melancholy in your native international locations?
  • Is it OK to speak about?
  • What do depressed individuals do for assist in your native nation?
  • Do many individuals speak about it in the USA? (You may level out that some individuals do not like to speak about it and others assume it is okay. It’s okay to speak about with social employees and medical doctors as a result of they will help you get the remedy you must get higher. Drugs and counseling are quite common for treating melancholy in the USA.)
  • What do depressed individuals do for assist in the USA?
  • The place are you able to get assist for melancholy on this neighborhood? (Earlier than class, examine native listings of psychological well being service suppliers. Doable sources of psychological well being assist, or referrals for assist, in your neighborhood: neighborhood service board, public well being clinics, the native division of well being and human providers, medical doctors’ workplaces.)

Reference:

World Well being Group (WHO). (2001). Geneva: WHO.

Assets:

Nationwide Alliance for the Mentally Unwell web site at http://www.nami.org. Click on on “Education.”

Nationwide Psychological Well being Affiliation at http://www.nmha.org. Click on on “Mental Health Information.”

To print image as a handout, use the pdf model of the file.

Well being literacy points:

  • Understanding treatment instructions
  • Avoiding treatment errors
  • Youngster and Grownup dosages

The essential story:

One drugs label says that youngsters ought to take 2 teaspoons of the medication each 2 hours. A mom provides the medication to her son. She confuses the teaspoon and tablespoon. She provides her son 2 tablespoons of the medication at 7 AM. It’s an excessive amount of drugs. At 11:30 her son may be very sleepy. The mom shouts, “WAKE UP!!!” She is fearful.

One other drugs label has one dose for adults and one dose for kids. A father reads the label incorrect. At 7:00 AM, he provides his little daughter the grownup dose accidentally. He ought to give her 2 tablets, however he provides her 4. At 12:00 PM his daughter may be very sleepy. The daddy shouts, “WAKE UP!!!” He’s fearful

Background info:

Treatment errors are a giant drawback in the USA. It is very important perceive all the knowledge on the medication label, and to ask your well being care supplier questions on treatment for your self and your youngsters. If studying expertise are restricted, asking questions on treatment instructions is important. Errors can embody taking the incorrect dose, taking the incorrect drugs, or taking a drugs you might be allergic to. Grownup ESL learners usually report back to their lecturers that they’ve problem understanding treatment labels to resolve the right dose to take themselves or to present their youngsters. Individuals make treatment errors of their houses and hospitals additionally make errors. An estimated 7,000 individuals die every year in the USA from treatment errors.

Widespread recommendations for treatment security:

  • Be sure you know the identify of your drugs and what it does.

  • Be sure your physician is aware of all of the drugs you take, even nutritional vitamins.

  • Be sure your physician is aware of your allergy symptoms.

  • Be sure you perceive the physician’s directions. Ask inquiries to the physician or pharmacist. Examples:

    • What is that this drugs?
    • What’s it for?
    • How a lot do I take at one time?
    • What number of instances do I take it in sooner or later?
    • How usually do I take it?
    • Are there meals and drinks I shouldn’t have with this treatment?
    • Can I drink alcohol with this treatment?
    • Are there actions I can not do when I’m taking this treatment?
    • What are unwanted effects of the treatment?
    • What ought to I do if I’ve unwanted effects?
    • I am taking (treatment identify) and (treatment identify). Is it okay to take the brand new treatment with them?
    • If I neglect to take it one time, what ought to I do?
    • If I take an excessive amount of accidentally, what ought to I do?

  • For those who can not learn your physician’s writing on a prescription, ask her or him to put in writing it extra clearly. It may be tough for the pharmacist to learn, additionally.

  • Recommended questions for prompting dialogue whereas eliciting the story:

    Go over the title, “The Right Dose.” What does “dose” imply? (How a lot drugs to take at one time.) What does “the right dose” imply? (Taking the right dose, not an excessive amount of, not too little.)

    Preteach vocabulary, as wanted: Dose (How a lot drugs to take at one time.), label (the writing on the medication that tells you the medication’s identify and dose), teaspoon (the small sized spoon; herald instance), tablespoon (the big sized spoon; herald instance), instructions/directions (the phrases that say how a lot drugs and when to take the medication), adults (older individuals, not youngsters; like mom, father, and so forth.), youngsters (younger individuals, like infants, youngsters, and so forth.), each (as in each 4 hours; give examples), an excessive amount of (make certain college students perceive that “too much” doesn’t equal “a lot.” An excessive amount of means you will have an issue, like “Too much ice cream can make you sick.”)

    First body: What do you see within the image? What are the instructions on the medication label? What’s the identify of the little spoon? What’s the identify of the large spoon? What spoon do you employ for this drugs?

    Second body: What do you see within the image? What time is it? What spoon is the mom utilizing for the kid, a teaspoon or a tablespoon? Is that appropriate? What’s going to occur to the kid?

    Third body: What time is it now? What occurred to the boy? (He fell asleep/He’s sleepy, and so forth.) Why? (He had an excessive amount of drugs.) What’s the mom saying? How does she really feel? (She feels nervous, fearful, and so forth. You may wish to make clear that if she can not wake the boy up, she ought to name 911.)

    Fourth body: Now here’s a completely different drugs. What are the instructions for adults for the medication? What number of tablets can an grownup take at one time? (You may wish to ask college students some questions, like “If I take 4 pills at 6 pm, what time do I take the next 4 pills?, etc.”) What are the instructions for kids? What number of tablets can a toddler take at one time? (Once more, you may wish to quiz college students on what instances they will take the tablets.)

    Fifth body: What’s taking place on this image? What time is it? What number of tablets is the daddy giving his daughter? (4, the grownup dose) Is that appropriate? What’s going to occur to the kid?

    Sixth body: What time is it now? What occurred to the woman? (She fell asleep/She is sleepy, and so forth.) Why? (She had an excessive amount of drugs.) What’s the father saying? How does he really feel? (He feels nervous, fearful, and so forth. You may wish to clarify that if he can not wake the woman up, he ought to name 911.)

    Assets:

    Company for Healthcare Analysis and High quality, “Your Medicine: Play it Safe.” at http://www.ahrq.gov/consumer/safemeds/safemeds.htm.

    American Pharmacists Affiliation Web page at http://www.pharmacyandyou.org/ . Click on on “About your Medicine” for in depth info on treatment security.

    U.S. Meals and Drug Administration, “FDA’s Tips for Taking Medicine” at http://www.fda.gov/fdac/reprints/medtips.html.

    Image Story Seven: What Occurred to My Physique?

    To print image as a handout, use the pdf model of the file.

    Well being literacy points:

    • Dietary values of various meals and diets
    • Dietary and train consciousness
    • Want for stress administration and self-care when altering way of life and adjusting to a brand new tradition.
    • Consciousness of ailments for which poor diet will increase threat, resembling coronary heart illness and diabetes

    The essential story:

    In his native nation, the person was very energetic and ate contemporary, nutritious meals daily. When he got here to the USA he acquired a job as a taxi driver. He did not get a lot train. He ate numerous quick meals. For breakfast, he ate at McDonalds (word golden arches behind taxi cab within the second body). For lunch he ate pizza. For dinner he ate meals he might microwave shortly. After dinner he ate snacks of ice cream and potato chips whereas watching TV. After one yr, he had gained numerous weight. He could not breathe whereas going up some stairs. His physique had modified so much in a single yr! He was not wholesome!

    Background info:

    Learners from completely different international locations usually report back to their lecturers that they’ve gained weight since they got here to the USA, or that they’ve much less power. Typically their diets of their native international locations have been decrease in fats and sugar than the meals they eat right here, and their every day routine contained extra bodily exercise. They might not have had a lot training in diet or preventive well being practices up to now to assist them make higher meals and train decisions of their new house.

    Being obese will increase well being dangers like kind 2 diabetes (also referred to as grownup onset diabetes) and coronary heart illness (heart problems, hypertension, coronary coronary heart illness). Danger for each diabetes and coronary heart illness can normally be decreased with:

    • weight reduction
    • change in weight-reduction plan
    • stress discount
    • elevated train

    Some ethnic teams are at higher threat for diabetes and heart problems than others. Kind 2 diabetes is very frequent amongst sure ethnic teams, together with Hispanics, some Asian and Pacific Islander teams, African People and Native People.
    Signs of diabetes could embody:

    • frequent urination
    • extreme thirst
    • excessive starvation
    • uncommon weight reduction
    • elevated fatigue
    • irritability
    • blurry imaginative and prescient

    Issues from kind 2 diabetes can embody:

    • coronary heart illness
    • hypertension
    • blindness
    • kidney failure
    • foot or leg amputations because of circulatory or nerve harm

    Therapy for kind 2 diabetes usually entails adjustments to weight-reduction plan, common train, and medicine. Eating regimen adjustments usually contain:

    • controlling carbohydrates
    • limiting fats consumption (particularly saturated fats)
    • limiting energy

    Recommended questions for prompting dialogue whereas eliciting the story:

    Go over the title, “What Happened to My Body?” Ask what college students assume it means. What’s going to the story be about?

    Pre-teach vocabulary as wanted. Vocabulary may embody: diet/ nutritious (realizing what meals that’s good on your physique, like meals that do not have an excessive amount of fats, sugar, and salt, or meals which have numerous nutritional vitamins), contemporary (new meals, not outdated), wholesome (good on your physique), quick meals (meals that you would be able to purchase shortly, like McDonalds, Wendy’s, KFC; many instances it has numerous fats, salt and sugar.), junk meals (meals that’s not nutritious, like chips, soda, and french fries; it has numerous fats, salt, or sugar), microwave (a machine for cooking meals quick), train (shifting your physique to make your physique robust and wholesome; e.g., working, swimming, strolling, taking part in sports activities), fats (herald examples of excessive fats meals like butter and oil, or footage of muffins, ice cream, and so forth. Pantomime your abdomen getting larger as you might be consuming them) and achieve weight or get fats (the latter may be simpler for decrease stage learners to recollect; pantomime for college students to grasp), and breathe (pantomime).

    First body: The place is the person? What’s his identify? What do you see within the image? What do you assume the person eats daily in his native nation? Is the meals good for him/ nutritious/ wholesome? (You may draw consideration, if crucial, to the truth that the meals is contemporary and nutritious.)

    Second body: Now the place is the person? (Level out the arches if crucial.) What do you assume he eats for breakfast in the usA.? What’s his job? Do you assume he will get a lot train in his job?

    Third body: Now the place is the person? What does he eat for lunch daily? What does he drink? Are pizza and soda nutritious?

    Fourth body: What does the person eat for dinner daily? Is it nutritious? (You may level out that some meals that you just purchase for microwaving are wholesome, however others have numerous fats and salt. It is vital to have a look at what’s within the meals. You may herald containers and speak about elements in case your learners are as much as it.)

    Fifth body: Now what’s the man doing? What’s he consuming? (ice cream cone and chips.) Are ice cream and chips nutritious? Is he doing any train? (Solely the finger on the distant train!). Does he get a lot train within the day?

    Sixth body: When is that this image? Is the person completely different? What is going on? What’s the issue? Why is it tough for the person to go up the steps? What can the person do to be extra wholesome? (Your college students will in all probability be capable to provide you with particular examples, however usually options embody weight reduction, change in weight-reduction plan [if your students are up to handling the details, this includes controlling carbohydrates, and reducing fat and calories in the diet], stress discount, and elevated train).

    • What are some well being issues you may get if you happen to do not train and also you achieve weight/get fats? (e.g. coronary heart illness, diabetes)
    • Do lots of people have these issues? Are they an issue for individuals out of your nation?
    • What sorts of meals do individuals eat in your native nation?
    • What sorts of meals do you eat in the USA? Do you eat wholesome meals in the USA?
    • Did you get train in your nation?
    • Do you get train in the USA?
    • What are completely different sorts of train? Do you must go to the health club or play sports activities to get train? What different issues are you able to do for train? (Level out that issues like strolling as a substitute of driving or taking the bus and taking the steps as a substitute of the elevator can provide you train. Train would not must value cash or have particular tools. You too can get train taking part in together with your youngsters.)
    • Do you ever ask a physician to examine for diabetes or hypertension?

    Assets::

    American Diabetes Affiliation Web page at http://www.diabetes.org. Data on forms of diabetes, prevention, and administration.

    American Coronary heart Affiliation Web page at http://www.americanheart.org. Data on heart-related ailments, their prevention and remedy.

    U.S. Meals and Diet Data Heart Web page at http://www.nal.usda.gov/fnic/Fpyr/pyramid.html. Has a wide range of Meals Information Pyramids which print out clearly, together with ethnic and culturally-based pyramids.

    Image Story Eight: Snack Assault

    To print image as a handout, use the pdf model of the file.

    Well being literacy points:

    • Childhood weight problems epidemic in the USA
    • Halth dangers crated by childhood weight problems
    • Well being training and modeling by mother and father for his or her youngsters on diet and train

    The essential story:

    In summer season, the boy within the story is energetic and wholesome. He performs soccer, basketball, and baseball, and goes swimming, so he has numerous train. In September he doesn’t train a lot. He eats snacks of chips and soda after faculty whereas he sits in entrance of the T.V. In October, he eats ice cream whereas he sits on the pc. In November, he eats cookies whereas he watches T.V. He weighs a bit of extra. In December, he eats French fries whereas he sits on the pc once more. He has gained numerous weight. He isn’t wholesome anymore like in the summertime.

    Background info:

    Childhood weight problems is taken into account to be a significant well being drawback in the USA at present. The speed of childhood weight problems on this nation is believed to have tripled up to now 15 years. There’s debate over the causes. An excessive amount of TV, Nintendo, and pc time? Working mother and father not round to watch youngsters’ consuming and exercise stage after faculty? An excessive amount of entry to junk and quick meals? Nevertheless, the fundamental information that many youngsters will not be getting sufficient bodily exercise and they’re consuming an excessive amount of fats and sugar to be wholesome are extensively accepted. Extra youngsters are exhibiting indicators of hypertension and sort 2 diabetes (additionally known as diabetes), circumstances that normally present up a lot later in life. (For extra info on coronary heart illness and diabetes, see Background Data for the story “What Happened to My Body?”)

    Recommended questions for prompting dialogue whereas eliciting the story:

    Go over the title, “Snack Attack.” What’s a snack? (consuming meals between meals.) What does “attack” imply? (one thing hurts you or hits you strongly.) Ask what college students assume the title means.

    Pre-teach vocabulary as wanted. Vocabulary may embody: diet/ nutritious (realizing what meals that’s good on your physique, like meals that do not have an excessive amount of fats, sugar, and salt, or meals which have numerous nutritional vitamins), wholesome (good on your physique), quick meals (meals that you would be able to purchase shortly, like McDonalds, Wendy’s, KFC; many instances it has numerous fats, salt and sugar.), junk meals (meals that’s not nutritious, like chips, soda, and french fries; it has numerous fats, salt, or sugar), train (shifting your physique to make your physique robust and wholesome; e.g., working, swimming, strolling, taking part in sports activities), fats (herald examples of excessive fats meals like butter and oil, or footage of muffins, ice cream, and so forth. Pantomime your abdomen getting larger as you might be consuming them) and achieve weight or
    get fats( the latter may be simpler for decrease stage learners to recollect; pantomime for college students to grasp).

    First body: What’s the boy’s identify? When is it? What does the boy do in summer season? How is the boy? Is he wholesome?

    Second body: Now when is it? What’s the boy doing? What’s he consuming? Are chips and soda wholesome (or nutritious)?

    Third body: Now when is it? What’s he doing? (He is utilizing the pc.) What’s he consuming? (An ice cream cone.) Is an ice cream cone wholesome (or nutritious)?

    Fourth body,: Now when is it? What’s he doing? What’s he consuming? (Cookies.) Are cookies wholesome (or nutritious)?

    Fifth body: Now when is it? What’s he doing? (He is utilizing the pc.) What’s he consuming? (French fries.) Are French fries wholesome (or nutritious)?

    Sixth body: . What occurred to the boy? (He gained weight/acquired fats.). Is he very wholesome now? (No.) What can he do to be extra wholesome? (Train extra, eat wholesome meals, not junk meals or quick meals.) What can his mother and father do to assist him?

    See what recommendations for fogeys your college students can provide you with. Listed below are some concepts:

    • Train youngsters about maintaining a healthy diet meals. Train them to watch out about fats, sugar, and salt.
    • Speak about being wholesome, not about how your kid’s physique seems.
    • Present wholesome meals decisions for kids to eat. Scale back the quantity of quick meals, junk meals and soda youngsters get.
    • Present youngsters what a wholesome serving dimension is. Do not supersize! Give smaller servings.
    • Do not give meals as a prize or reward (“If you are good, I will get you an ice cream.”).
    • Give youngsters cut-off dates for TV, Nintendo and pc use.
    • Mannequin wholesome behaviors for kids. If mother and father attempt to educate youngsters wholesome consuming and train habits, however do not do what they educate, the youngsters will not both. Dad and mom have to point out good examples to youngsters.
    • Attempt to make alternatives to get train together with your youngsters by going to a park, taking part in a sport collectively, and so forth.
    • Assist your youngsters discover an afterschool exercise to join which can give them common train. The American Coronary heart Affiliation says that youngsters ought to get at the least half-hour of average bodily exercise daily.
    • Assist youngsters speak about issues that give them stress so they do not flip to meals or zoning out in entrance of the TV or pc to alleviate stress.

    The next questions will help generate dialogue on the long run dangers of weight problems for kids:

    • What are some well being issues you may get if you happen to do not train and also you achieve weight/get fats? (e.g., coronary heart illness, diabetes)
    • Do numerous youngsters have these issues? (Not so much, however many extra have them now than 10 or 15 years in the past. Previously we known as these grownup well being issues.)
    • If a toddler will get these issues, how will their well being be in 20 years? What do you assume? How can we assist make the issue higher?
    • Assets:

      American Diabetes Affiliation Web page at http://www.diabetes.org. Data on forms of diabetes, prevention, and administration.

      American Coronary heart Affiliation Web page at http://www.americanheart.org . Data on heart-related ailments, their prevention and remedy.

      KidsHealth Web page at http://kidshealth.org/ . Has 3 sections, one for fogeys about their youngsters, one for teenagers, and one for youthful youngsters. Every part has articles with vital diet and health info for that group to know.

      U.S. Meals and Diet Data Heart Web page at http://www.nal.usda.gov/fnic/Fpyr/pyramid.html. Has a wide range of Meals Information Pyramids which print out clearly, together with ethnic and culturally-based pyramids and a pyramid for younger youngsters.

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