LEONARD OTIENO FOUNDATION IN SUPPORT OF WESTERN KENYA YOUTH

LEONARD OTIENO FOUNDATION IN SUPPORT OF WESTERN KENYA  YOUTH .
After conducting formative research (see our learning brief on the research findings) on the factors that aid young people in transitioning away from the care-system to independence, we developed our innovative long-term approach. Our strategy focuses on preparing the youngsters for independent living before, during, and after the transition process.

Based on the research findings and the pilot rollout of this program we have the following lessons to share:

1. Provide the space and infrastructure to develop independent living skills while in the care-system, as well as the other skills needed to cope beyond care. It is important to transfer practical independent living skills, and equally vital to develop healthy inter-dependent living skills necessary for coping beyond care. Leonard Otieno  Foundation  provides young people with practical opportunities to gain these skills and to experiment with them in real life situations. For example, we give young person a chance to learn budgeting skills by managing money within our programme.

2. Provide the space to acquire skills and competencies (to learn by doing). Young people need to acquire skills in a real life space, to experiment with these skills, and to learn from mistakes. Transitioning from care is a big change in a young person’s life. This is the time when a child becomes a young adult and needs to negotiate and find their place in the world. It is a period that also provides unique opportunities for the young adult to rediscover and redefine who they are. We believe that each challenging experience can be used as a potential learning opportunity and if the youngsters are supported with information and skills, they will be able to learn form the experience and build a sense of mastery and self-determination. Thus it is imperative that when mistakes are made (and they will be) that the individual is encouraged to learn from these setbacks and keep moving forward. Affirmation, support, authentic mentor relationships, and celebrating each significant victory along the journey are central to creating positive change.

3. Provide access to developmental and therapeutic support. Leonard Otieno Foundation  promotes the personal development of each young person by helping him or her develop an identity, strengthen relationships, and build resilience. We provide individual one on one support, experiential group work, and wilderness-based rites of passage processes. We provide psychosocial assessments and referral to professional counselling if needed. We use an Independent Living Skills Assessment Tool to assesses each youngster’s current capacity of practical skills, and then conduct on-going psychosocial assessments to explore their emotional and social capital – this becomes the tool that tracks their growth in terms of identity, resilience and relationships.

4. Provide access to a collaborative mentor/ positive adult relationship. Leonard Otieno  Foundation believes that youth transitioning into adulthood need positive and collaborative one-on-one adult relationships that are free of judgement and that allow the youngster to work and grow at his/her own pace. We facilitate the development of such mentoring relationships. Each young person develops an Individual Development Plan and sets goals for exiting the youth-care-system. The assigned adult mentor then works alongside them to reach these self-defined goals and to provide advice and assistance along the way.

5. Provide support in navigating the broader communities and developing resource networks. Young people leaving the care-system need to be resourceful and need to know how, and where to access vital resources from a wide community network. Leonard Otieno Foundation programme encourages these youth to network and build wide-ranging relationships by participating in community service activities. Each young person conducts a community resource mapping exercise where they identify and list different types of resources in their community. We also get them to visit new locations in their community/city such as banks, the clinic, and home affairs offices.

6. Provide access to on-going support and development once the young person has transitioned out of the care-system. Our research findings show that 40% of CYCCs believed youth needed at least 2 of support after leaving the formal care-system in order to successfully establish themselves, financially and relationally. On-going support is critical to ensure that these young people continue to feel they have somewhere to turn if needed, and that they have a safety net if things go wrong. Thus, Leonard Otieno Foundation  transitional support programme focuses on a continuum of care that starts before the young person leaves the care-system and remains once they have left care for up to period of two years.

7. Provide access to material support after leaving the care-system. One of the major obstacles facing young people once they “age out” of the formal state care system is limited access to basic material resources such as money, accommodation, transport, and food. Many of these youth seek refuge with extended family or friends who cannot adequately meet their basic material and emotional needs. Leonard Otieno Foundation's programme therefore supports young people in meeting these needs for the duration of their participation in the programme. We encouraged each youngster to identify ways in which they can begin to meet their own needs and become self-reliant. They learn where they can help themselves and where they can’t, and then they learn how to ask for help. We emphasise responsibility and resourcefulness by giving them an opportunity to work for, and take care of some small resources. This nurtures an identity of self-reliance, and a belief that they can do things for themselves.

8. Continually advocate for structural change. At Leonard Otieno Foundation  we believe that children who have grown up under state care should have access to adequate transitional support, and should not be further marginalized as they disengage from the care-system. To this end, the legislation relating to transitional support should be further developed, outlining more specifically the components that should form the basis of transitional support. We continually advocate for more research quantifying and exploring the meaning of “after care” services described in the Children’s Act, particularly with regard to what this means for Independent Living Programmes. We also want to prioritise increased collaboration between the Departments of Social Development, Children and Families, and Youth Development. This will serve to close the gap between the services provided to children and youth.

THE WAY FORWARD – Anticipated challenges of implementing an integrated approach

Over the next 3 years, Leonard Otieno Foundation  and its partnering CYCCs  will need to address the following questions as it implements this novel approach:

How do we support the CYCCs in creating enabling spaces where the transitional young people can acquire the skills necessary for coping as independent adults?
How do help young people who have experienced long-term institutionalisation to shift from an institutionalised to an independent mindset? Furthermore, how can we help carers and social workers shift from a mindset of ‘doing for’ to one of ‘doing with’ young people?
How can we successfully lobby government and municipalities for adequate post-care support and resources to ensure that young people do not fall through the gaps once they leave?
In order to remain youth-centred and relevant, how we do ensure that we continually reflect and engage with the young participants in the process?
How do we support our team, not only with delivery, but also with the strengthening of our practice? How can we incorporate adequate debriefing and developmental supervision?
How can we as an organisation build the knowledge base and practice for better equipping those working with young people in providing transitional support so that this area of work becomes more established and based on evidence and shared practice principles as Independent Living Programmes have not been adequately outlined in the Children’s Act.

CONCLUSION

This learning brief has listed 8 action points that the Leonard Otieno Foundation  Project takes to help prepare young adults in the state care-system transition into independent, adult living. Other agencies interested in youth care can adopt these action points for their own purposes. In addition to listing some of the challenges of adopting this type of strategy, this learning brief has highlighted the benefits of inter-organizational partnerships and a long term commitments that best serve young people in formal state care to aid them in becoming self-sufficient adults.

5 TIPS OF FINISHING WELL

tips for finishing well

I’m a geek about goals. I love to help people set and achieve goals and finish well. I personally don’t want to quit this race before the whistle blows. Here are 5 of my best tips for finishing well.

Many people set goals. But not so many people actually accomplish what they planned to do. Accomplishing goals requires hard work, but with a bit of encouragement and some logical equipping, I believe anyone can finish well.

1. CAST OUT FEAR

God’s number One on our bucket list is “Love the Lord your God with all your heart, soul, mind and strength” (Mark 12:30). God’s objective for our lives is not who we are, but whose we are.

When our lives are fully his, love becomes our way of life. There is no judgment, pride, comparison or ego involved in God’s success plan.

“There is no fear in love. But perfect love drives out fear, because fear has to do with punishment. The one who fears is not made perfect in love.” 1 John 4:18

2. WRITE DOWN YOUR GOALS EVERY DAY

This is not just busy work. Many people resist writing down a goal every day. But there is a real, scientific reason for doing this.

In our subconscious brain there is a part called the Reticular Activating System, or RAS. The RAS acts to filter out the billions of bits of information it deems unnecessary for our attention every day. We would literally go crazy if we didn’t have a RAS.

One of the criteria the RAS uses to filter is – what’s been on your mind lately. If you’ve set a goal to write a book about moles, and you write that down every day, and you think about moles, and you read about moles, you will be informing your RAS that moles are very important to you.

All of a sudden you will notice stories, articles, and other bits of information having to do with moles.

Try it, it works!

3. PRAY CIRCLES AROUND YOUR GOALS

God gives us the desires in our hearts. He set us up to want what He wants for us. And He loves to see us realize our desires. If He is in the desire, He also wants to be in the accomplishment.

Pray circles around your goals. Read The Circle Maker: Praying Circles Around Your Biggest Dreams and Greatest Fears by Mark Batterson. It’s an awesome book about goals from a Christian perspective.

God’s number One on our bucket list is “Love the Lord your God with all your heart, soul, mind…

4. KEEP YOUR VISION CLEAR

Before you set detailed goals, spend some time thinking about your vision. My next blog post will give more details on this. Is there a word or phrase that represents the overall picture of where you would like to see your life going this year?

If so, consider creating a vision board using the app Success Vision Board by Jack Canfield. Keep this electronic vision board on your computer as the screen saver, as the wall paper on your smart phone or tablet. And print it out and post it somewhere where you will be reminded of the vision God gave you.

5. USE TOOLS

When we have weak eyes, we wear glasses. When we have a weakness with regard to organization or discipline we should use tools to help us. I am not naturally organized and disciplined. That’s why I love helping other people achieve their goals. I know how it feels to be unsuccessful. I know how it feels to have a spaghetti brain!

A calendar to schedule time to work on goals. Make appointments with yourself, and keep them!
Toggl to keep track of how much time was spent on each of your projects.
Evernote to keep track of benchmarks and information as it comes to you.
A timer to keep track of the time you invest in a project. The time can easily get away from me. Sit down, set the timer and don’t get up until the timer goes off.
I hope these tips help you to actually accomplish your desires and finish well.

WHAT IS BREAST CANCER IN MEN?

A breast cancer is a malignant tumor that starts from cells of the breast. A malignant tumor is a group of cancer cells that may grow into (invade) surrounding tissues or spread (metastasize) to distant areas of the body. Breast cancer occurs mainly in women, but men can get it, too. Many people do not realize that men have breast tissue and that they can develop breast cancer.

Normal breast structure

To understand breast cancer, it helps to have some basic knowledge about the normal structure of the breasts.

The breast is made up mainly of lobules (glands that can produce milk if the right hormones are present), ducts (tiny tubes that carry the milk from the lobules to the nipple), and stroma (fatty tissue and connective tissue surrounding the ducts and lobules, blood vessels, and lymphatic vessels).

Until puberty (on average around age 9 or 10), young boys and girls have a small amount of breast tissue consisting of a few ducts located under the nipple and areola (area around the nipple). At puberty, a girl's ovaries make female hormones, causing breast ducts to grow, lobules to form at the ends of ducts, and the amount of stroma to increase. Even after puberty, men and boys normally have low levels of female hormones, and breast tissue doesn’t grow much. Men's breast tissue has ducts, but only a few if any lobules.

Like all cells of the body, a man's breast duct cells can undergo cancerous changes. But breast cancer is less common in men because their breast duct cells are less developed than those of women and because they normally have lower levels of female hormones that affect the growth of breast cells.

The lymph (lymphatic) system of the breast

The lymph system is important to understand because it is one of the ways that breast cancers can spread. This system has several parts.

Lymph nodes are small, bean-shaped collections of immune system cells (cells that are important in fighting infections) that are connected by lymphatic vessels. Lymphatic vessels are like small veins, except that they carry a clear fluid called lymph (instead of blood) away from the breast. Lymph contains tissue fluid and waste products, as well as immune system cells. Breast cancer cells can enter lymphatic vessels and begin to grow in lymph nodes.

Most lymphatic vessels in the breast connect to lymph nodes under the arm (axillary nodes). Some lymphatic vessels connect to lymph nodes under the breast bone (internal mammary nodes) and either above or below the collarbone (supraclavicular or infraclavicular nodes).

If the cancer cells have spread to these lymph nodes, there is a higher chance that the cells could have also gotten into the bloodstream and spread (metastasized) to other sites in the body. The more lymph nodes with breast cancer cells, the more likely it is that the cancer may be found in other organs as well. Because of this, finding cancer in one or more lymph nodes often affects the treatment plan. Still, not all men with cancer cells in their lymph nodes develop metastases to other areas, and some men can have no cancer cells in their lymph nodes and later develop metastases.

Benign breast conditions

Men can also have some benign (not cancerous) breast disorders.

Gynecomastia

Gynecomastia is the most common male breast disorder. It is not a tumor but rather an increase in the amount of a man's breast tissue. Usually, men have too little breast tissue to be felt or noticed. Gynecomastia can appear as a button-like or disk-like growth under the nipple and areola (the dark circle around the nipple), which can be felt and sometimes seen. Some men have more severe gynecomastia and they may appear to have small breasts. Although gynecomastia is much more common than breast cancer in men, both can be felt as a growth under the nipple, which is why it's important to have any such lumps checked by your doctor.

Gynecomastia is common among teenage boys because the balance of hormones in the body changes during adolescence. It is also common in older men due to changes in their hormone balance.

In rare cases, gynecomastia occurs because tumors or diseases of certain endocrine (hormone-producing) glands cause a man's body to make more estrogen (the main female hormone). Men's glands normally make some estrogen, but not enough to cause breast growth. Diseases of the liver, which is an important organ in male and female hormone metabolism, can change a man's hormone balance and lead to gynecomastia. Obesity (being extremely overweight) can also cause higher levels of estrogens in men.

Some medicines can cause gynecomastia. These include some drugs used to treat ulcers and heartburn, high blood pressure, heart failure, and psychiatric conditions. Men with gynecomastia should ask their doctors if any medicines they are taking might be causing this condition.

Klinefelter syndrome, a rare genetic condition, can lead to gynecomastia as well as increase a man's risk of developing breast cancer. This condition is discussed further in the section "What are the risk factors for breast cancer in men?"

Benign breast tumors

There are many types of benign breast tumors (abnormal lumps or masses of tissue), such as papillomas and fibroadenomas. Benign tumors do not spread outside the breast and are not life threatening. Benign breast tumors are common in women but are very rare in men.

General breast cancer terms

Here are some of the key words used to describe breast cancer.

Carcinoma

This term describes a cancer that begins in the lining layer (epithelial cells) of organs such as the breast. Nearly all breast cancers are carcinomas (either ductal carcinomas or lobular carcinomas).

Adenocarcinoma

An adenocarcinoma is a type of carcinoma that starts in glandular tissue (tissue that makes and secretes a substance). The ducts and lobules of the breast are glandular tissue (they make breast milk in women), so cancers starting in these areas are sometimes called adenocarcinomas.

Carcinoma in situ

This is an early stage of cancer, when it is confined to the layer of cells where it began. In breast cancer, in situ means that the abnormal cells remain confined to ducts (ductal carcinoma in situ, or DCIS). These cells have not grown into (invaded) deeper tissues in the breast or spread to other organs in the body. Ductal carcinoma in situ of the breast is sometimes referred to as non-invasive or pre-invasive breast cancer because it might develop into an invasive breast cancer if left untreated.

When cancer cells are confined to the lobules it is called lobular carcinoma in situ (LCIS). This is not actually a true pre-invasive cancer because it does not turn into an invasive cancer if left untreated. It is linked to an increased risk of invasive cancer in both breasts. LCIS is rarely, if ever seen in men.

Invasive (or infiltrating) carcinoma

An invasive cancer is one that has already grown beyond the layer of cells where it started (as opposed to carcinoma in situ). Most breast cancers are invasive carcinomas, either invasive ductal carcinoma or invasive lobular carcinoma.

Sarcoma

Sarcomas are cancers that start in connective tissues such as muscle tissue, fat tissue, or blood vessels. Sarcomas of the breast are rare.

Types of breast cancer in men

Breast cancer can be separated into several types based on the way the cancer cells look under the microscope. In some cases a single breast tumor can be a combination of these types or be a mixture of invasive and in situ cancer. And in some rarer types of breast cancer, the cancer cells may not form a tumor at all.

Breast cancer can also be classified based on proteins on or in the cancer cells, into groups like hormone receptor-positive and triple-negative. These are discussed in the section “How is breast cancer in men classified?”

Ductal carcinoma in situ (DCIS)

Ductal carcinoma in situ (DCIS; also known asintraductal carcinoma) is considered non-invasive or pre-invasive breast cancer. In DCIS (also known as intraductal carcinoma), cells that lined the ducts have changed to look like cancer cells. The difference between DCIS and invasive cancer is that the cells have not spread (invaded) through the walls of the ducts into the surrounding tissue of the breast (or spread outside the breast). DCIS is considered a pre-cancer because some cases can go on to become invasive cancers. Right now, though, there is no good way to know for certain which cases will go on to become invasive cancers and which ones won’t. DCIS accounts for about 1 in 10 cases of breast cancer in men. It is almost always curable with surgery.

Infiltrating (or invasive) ductal carcinoma (IDC)

Invasive (or infiltrating) ductal carcinoma (IDC) starts in a milk duct of the breast, breaks through the wall of the duct, and grows into the fatty tissue of the breast. At this point, it may be able to spread (metastasize) to other parts of the body through the lymphatic system and bloodstream. At least 8 out of 10 male breast cancers are IDCs (alone or mixed with other types of invasive or in situ breast cancer). Because the male breast is much smaller than the female breast, all male breast cancers start relatively close to the nipple, so they are more likely to spread to the nipple. This is different from Paget disease as described below.

Infiltrating (or invasive) lobular carcinoma (ILC)

This type of breast cancer starts in the breast lobules (collections of cells that, in women, produce breast milk) and grows into the fatty tissue of the breast. ILC is very rare in men, accounting for only about 2% of male breast cancers. This is because men do not usually have much lobular tissue.

Paget disease of the nipple

This type of breast cancer starts in the breast ducts and spreads to the nipple. It may also spread to the areola (the dark circle around the nipple). The skin of the nipple usually appears crusted, scaly, and red, with areas of itching, oozing, burning, or bleeding. There may also be an underlying lump in the breast.

Paget disease may be associated with DCIS or with infiltrating ductal carcinoma. It accounts for about 1% of female breast cancers and a higher percentage of male breast cancers.

Inflammatory breast cancer

Inflammatory breast cancer is an aggressive, but rare type of breast cancer. It makes the breast swollen, red, warm and tender rather than forming a lump. It can be mistaken for an infection of the breast. This is very rare in men.

RISK FACTORS FOR INCREASE OF GETTING CERVICAL CANCER

Lets discuss the risk factors that increase the risk of
getting cervical cancer.
1. Infection with HPV is the most common cause
especially the high risk types.A routine pap smear is
the best way to detect abnormal changes before they
develop into cancer.
2. Having multiple sexual partners and early age of
sexual debut(earlier than 16 years)
3.women who have had too many or too frequent births
4.smoking. A woman who smokes doubles her risk of
getting cervical cancer.
5.having other sexuall transmitted infections such as
chlamydia
6.immunosuppression. in most people with healthy
immune systems the HPV virus clears itself from the
body. However HIV infected patients or people who
take medication that weaken their immunity have low
ability to fight off infection.
7.oral contraceptive use.Women who take oral
contraceptive for more than 5 years have increased
risk of cervical cancer. However,the risk returns to
normal within a few years after the pills are stopped.

NAUSEA & VOMITING IN PREGNANCY

Nausea and Vomiting During Pregnancy

Nausea and vomiting is a normal part of pregnancy, but there are steps you can take to feel better.

If you are pregnant and have nausea and vomiting, you’re not alone. Over half of all pregnant women suffer from this common ailment, sometimes called ‘NVP’.

The symptoms can be very unpleasant and can interfere with your daily routine. The good news is that nausea and vomiting isn’t usually harmful to you or your unborn child.

And, there are many ways of easing your nausea and vomiting. Your doctor, nurse or midwife can help you find the right solution for a comfortable and healthy pregnancy.

‘Nausea and vomiting of pregnancy’ is also called ‘morning sickness’ — even though it can happen at any time of the day.

What causes nausea and vomiting?

No one knows exactly why women have nausea and vomiting when they are pregnant. It’s probably due to all of the changes taking place in your body, such as high levels of hormones in your blood.

However, it could be due to an illness or other medical problem. Not all nausea and vomiting is related to pregnancy.

How long will these symptoms last?

Nausea and vomiting usually starts around the sixth week of pregnancy and stops around the 12th week. However, you may still have queasiness after that, often up until your 20th week. Some women will have nausea and vomiting for longer, maybe even until the end of pregnancy.

Should I be worried?

Nausea and vomiting isn’t usually harmful for pregnant women and their babies. For most women, nausea and vomiting doesn’t last all day and there are times when they feel hungry and can keep food down.

However, in severe cases you may not be getting the nutrients and fluids that you and your baby need. Speak with your health-care provider if you are so sick that you miss meals day after day.

What if I just can’t keep anything down?

About one per cent of pregnant women in Canada have ‘hyperemesis gravidarum’. This is when you are so sick that the lack of fluids and nutrients being taken in may be dangerous for you and your baby.

The biggest worry is dehydration. If you don’t have to go pee very often or have dark yellow urine, and you cannot drink enough liquid to correct this condition, call your health-care provider. You should also get help if you are so sick that you are losing weight rapidly.

Nausea and vomiting can be difficult to control; the sooner you are diagnosed and get treatment, the more likely you will be to avoid severe symptoms.

Helpful tips to control nausea and vomiting:

What you eat, and when

In the morning, eat a few crackers and rest for 15 minutes before getting up.
Get up slowly and do not lie down right after eating.
Eat small meals or snacks often so your stomach does not become empty (for example, every two hours). Try not to skip meals.
Eat what you feel like and eat when you are hungry, though you may want to avoid cooking or eating spicy, fatty or fried foods because of the smell.
If cooking smells bother you, open windows and turn on the stove fan. If possible, ask someone else to cook. Eat cold food instead of hot, as it may not smell as strongly.
Sniffing lemons or ginger can sometimes help an upset stomach.
Eating salty potato chips can help settle the stomach enough to eat a meal.
Tips to get enough fluids

Sip small amounts of fluid often during the day.
Avoid drinking fluids during, just before or immediately after a meal.
Food ideas to help relieve nausea

Salty: Chips, pretzels
Tart/sweet: Pickles, lemonade
Earthy: Brown rice, mushroom soup, peanut butter
Crunchy: Celery sticks, apple slices, nuts
Bland: Mashed potatoes, gelatin, broth
Soft: Bread, noodles
Sweet: Cake, sugary cereals
Fruity: Watermelon, fruity popsicles
Liquid: Juice, seltzer, sparkling water, ginger ale
Dry: Crackers
Getting enough rest

Get plenty of rest, and try napping during the day; nausea tends to worsen when you are tired. Many women find they need more sleep in the first three months of pregnancy