Why is chewing such an important part of digestion?

By: George Mateljan Foundation.

Chewing is an extremely important, yet oftentimes overlooked, part of healthy digestion. Most people put food in their mouth, chew a few times, and swallow. Yet, in reality it doesn't really take much time and effort to chew your food well. What you get in return is worth the effort in terms of better health and enjoyment of food. How thoroughly to chew While various health professionals advocate distinct numbers of times you should chew food, I recommend more personal guidelines. I feel that this approach will better help you get a sense of your own eating patterns and help you further develop your relationship with your food. My suggestion is that you chew your food completely until it is small enough and dissolved enough to be swallowed with ease. A good rule of thumb is as follows: if you can tell what kind of food you are eating from the texture of the food in your mouth (not the taste), then you haven't chewed it enough. For example, if you are chewing broccoli and you run your tongue over the stalk and can tell that it is still a stalk or over the floret and you can still tell that it is still a floret, don't swallow. You need to keep on chewing until you can't tell the stalk from the floret. The mechanical process of digestion begins with chewing The action of chewing mechanically breaks down very large aggregates of food molecules into smaller particles. This results in the food having increased surface area, an important contributing factor to good digestion. In addition to the obvious benefit of reduced esophageal stress that accompanies swallowing smaller, rather than larger, pieces of food, there is another very important benefit to chewing your food well that comes with its ability to be exposed to saliva for a longer period of time. The chemical process of digestion begins with chewing Food's contact with saliva is important because it helps to lubricate the food, making it easier for foods (notably dry ones) to pass easier through the esophagus. It's also important because saliva contains enzymes that contribute to the chemical process of digestion. Carbohydrate digestion begins with salivary alpha-amylase secreted by glands positioned near the mouth. This alpha-amylase helps break down some of the chemical bonds that connect the simple sugars that comprise starches. Additionally, the first stage of fat digestion also occurs in the mouth with the secretion of the enzyme lingual lipase by glands located at the root of the tongue. Incomplete digestion can lead to bacterial overgrowth When food is not well chewed and the food fragments are too big to be properly broken down, incomplete digestion occurs. Not only do nutrients not get extracted from the food but undigested food also becomes fodder for bacteria in the colon; this can lead to bacterial overgrowth, flatulence, and other symptoms of indigestion. Chewing relaxes the lower stomach muscle Chewing is directly connected with the movement of food through your digestive tract, and, in particular, with the movement of food from your stomach to your small intestine. At the lower end of your stomach, there is a muscle called the pylorus. This muscle must relax in order for food to leave your stomach and pass into your small intestine. Sufficient saliva from optimal chewing helps relax the pylorus, and, in this way, helps your food move through your digestive tract in healthy fashion. Chewing triggers the rest of the digestive process Yet, the contribution of chewing to good digestion does not even stop there. The process of chewing also activates signaling messages to the rest of the gastrointestinal system that trigger it to begin the entire digestive process. This is because when chewing is a well-paced, thorough process, it can actually be said to belong to the "cephalic stage of digestion," the phase in which you first see, smell, and taste your food. The length of time spent chewing the food is related to the length of the cephalic stage of digestion since with more extensive chewing, the longer the food gets to be seen, tasted, and smelled. Cephalic phase responses have been extensively analyzed in the research literature. The release of small messaging molecules that are critical for digestion—such as cholecystokinin, somatostatin, and neurotensin—have been found to increase by over 50% just by the mere sight and smell of food. Additionally, research has shown how chewing, as well as the activation of taste receptors in the mouth, can prompt the nervous system to relay information to the gastrointestinal system to optimize the process of digestion. For example, stimulation of the taste receptors can signal the stomach lining to produce hydrochloric acid that helps in the breakdown of protein. Additionally, chewing signals the pancreas to prepare to secrete enzymes and bicarbonate into the lumen of the small intestines.

Fever – children

Summary- A fever happens when the body's temperature is higher than normal because of an infection or virus. Fever in children is not usually serious, although it can sometimes cause fits or seizures, known as febrile convulsions.

A fever happens when the body’s temperature is higher than normal because of an infection. Normal body temperature is around 37°C. Fever is usually caused by a virus or bacteria. Fever is a way in which the body fights infection. It is not always dangerous and does not always indicate a serious illness.

Signs and symptoms of fever Fever causes an increase in the heart rate, breathing rate and blood circulation to the skin. This is how the body tries to reduce the heat caused by fever. The symptoms of fever can include: Feeling and/or looking unwell Feeling hot to touch Sweating or clammy skin Shivering Chattering teeth Flushed face. Using a thermometer If you suspect that your child has a fever, you can use a thermometer to measure their temperature. Remember, though, that body temperature is better used as a guide than a reliable indicator of illness for babies and young children - a child might have a mild temperature according to the thermometer (slightly over 37°C), but may seem happy and healthy. There are several types of reliable thermometers available, which come with instructions on how to use them. They are available from your chemist. If you are in doubt about which one to choose for your child, or have questions about how to use it, ask your pharmacist to explain. When to see your doctor Trust your own instincts, but seek medical help if your child: Is aged six months or less Has a rash Has a fever of 40°C or more Is still feverish after a day or so, despite four-hourly doses of baby paracetamol Vomits or has persistent diarrhoea Refuses food or drink Cries inconsolably Seems listless, floppy or just looks ill Convulses or twitches Has trouble breathing Is in pain If you feel at all worried or concerned at any stage, consult with your doctor. Treatment for a fever Dress your child in light clothing. Give drinks of clear fluid (like water). Keep your child cool. Give paracetamol in the correct dose for the child’s age (but not more than four doses in a 24-hour period). Do not give regular paracetamol medicine for more than 24 hours without seeking advice from your doctor. See your doctor if your child is three months or younger. Don't give your child a cold bath. Give a lukewarm bath or sponge. Cold water cools the skin but does not lower the body temperature. From Better health Channel.

What Happens When a Mosquito Bites a Person?

contributor , Brandi Laren.

Because of the proteins and anti-coagulants that a mosquito has in its saliva, a bite can affect blood vessel constriction, blood clotting, inflammation and more. More commonly when a mosquito bites a person, however, is an itchy, raised bump that appears within 24 hours of the bite. This bump occurs because the body's immune system is responding to the bite. Some people have more severe reactions to mosquito bites. For example, some people may experience bruises, hives all over the body, extremely large swelling areas or blistering rashes after they've been bitten.

Mosquitoes and Diseases. Mosquitoes suck blood from people and animals and inject their saliva into their blood. In addition to anti-coagulants and proteins, their saliva can also contain parasites or disease-causing viruses. As a result, mosquitoes can pass diseases, like the West Nile Virus, which can quickly lead to permanent neurological damage. The West Nile Virus tends to become an issue in the summer, when mosquitoes are more common. West Nile Virus symptoms include high fever, neck stiffness, paralysis, vomiting, headache and more. How to Treat a Mosquito Bite. Mosquito bites can be treated with antihistamines and hydrocortisone cream. Simply rub the hydrocortisone cream over the bite and take an oral antihistamine as recommended. For severe reactions, go to an emergency room immediately. Try to avoid scratching the mosquito bite, as that can make the bump worse. This can be tough, since mosquito bites are really itchy. A bite can become infected because of bacteria under the fingernails, so it's important to keep nails away from the bite. In addition to hydrocortisone cream and antihistamines, mix together a paste of baking soda and water and put it on the bump. This helps soothe the itch and heal the bite. Ice, water or a cold drink can also soothe the bitten area. The best way to avoid mosquito bites all together is to put on insect repellents and avoid standing water--mosquitoes tend to lay eggs there.

Use mosquito repellent

Humania: Lassa fever, Is It A Nigerian Sickness Or The Worl...

Humania: Lassa fever, Is It A Nigerian Sickness Or The Worl...: Lassa fever is an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two missionary nurses died in N...

Lassa fever, Is It A Nigerian Sickness Or The Worlds'?

Lassa fever is an acute viral illness that occurs in west Africa. The illness was discovered in 1969 when two missionary nurses died in Nigeria. The virus is named after the town in Nigeria where the first cases occurred. The virus, a member of the virus family Arenaviridae, is a single-stranded RNA virus and is zoonotic, or animal-borne. Lassa fever is endemic in parts of west Africa including Sierra Leone, Liberia, Guinea and Nigeria; however, other neighboring countries are also at risk, as the animal vector for Lassa virus, the "multimammate rat" (Mastomys natalensis) is distributed throughout the region. In 2009, the first case from Mali was reported in a traveler living in southern Mali; Ghana reported its first cases in late 2011. Isolated cases have also been reported in Côte d’Ivoire and Burkina Faso and there is serologic evidence of Lassa virus infection in Togo and Benin. The number of Lassa virus infections per year in west Africa is estimated at 100,000 to 300,000, with approximately 5,000 deaths. Unfortunately, such estimates are crude, because surveillance for cases of the disease is not uniformly performed. In some areas of Sierra Leone and Liberia, it is known that 10%-16% of people admitted to hospitals every year have Lassa fever, which indicates the serious impact of the disease on the population of this region.

Signs and Symptoms. Signs and symptoms of Lassa fever typically occur 1-3 weeks after the patient comes into contact with the virus. For the majority of Lassa fever virus infections (approximately 80%), symptoms are mild and are undiagnosed. Mild symptoms include slight fever, general malaise and weakness, and headache. In 20% of infected individuals, however, disease may progress to more serious symptoms including hemorrhaging (in gums, eyes, or nose, as examples), respiratory distress, repeated vomiting, facial swelling, pain in the chest, back, and abdomen, and shock. Neurological problems have also been described, including hearing loss, tremors, and encephalitis. Death may occur within two weeks after symptom onset due to multi-organ failure. The most common complication of Lassa fever is deafness. Various degrees of deafness occur in approximately one-third of infections, and in many cases hearing loss is permanent. As far as is known, severity of the disease does not affect this complication: deafness may develop in mild as well as in severe cases. Approximately 15%-20% of patients hospitalized for Lassa fever die from the illness. However, only 1% of all Lassa virus infections result in death. The death rates for women in the third trimester of pregnancy are particularly high. Spontaneous abortion is a serious complication of infection with an estimated 95% mortality in fetuses of infected pregnant mothers. Because the symptoms of Lassa fever are so varied and nonspecific, clinical diagnosis is often difficult. Lassa fever is also associated with occasional epidemics, during which the case-fatality rate can reach 50% in hospitalized patients.

Prevention Primary transmission of the Lassa virus from its host to humans can be prevented by avoiding contact with Mastomys rodents, especially in the geographic regions where outbreaks occur. Putting food away in rodent-proof containers and keeping the home clean help to discourage rodents from entering homes. Using these rodents as a food source is not recommended. Trapping in and around homes can help reduce rodent populations; however, the wide distribution of Mastomys in Africa makes complete control of this rodent reservoir impractical. When caring for patients with Lassa fever, further transmission of the disease through person-to-person contact or nosocomial routes can be avoided by taking preventive precautions against contact with patient secretions (called VHF isolation precautions or barrier nursing methods). Such precautions include wearing protective clothing, such as masks, gloves, gowns, and goggles; using infection control measures, such as complete equipment sterilization; and isolating infected patients from contact with unprotected persons until the disease has run its course. Further, educating people in high-risk areas about ways to decrease rodent populations in their homes will aid in the control and prevention of Lassa fever. Other challenges include developing more rapid diagnostic tests and increasing the availability of the only known drug treatment, ribavirin. Research is presently under way to develop a vaccine for Lassa fever.

Nigerians, be an advocate in the market place. Garri sellers should be told to cover their Garri to prevent rats defecating/urinating in it in their shops.

How Does Hunger Affect Your Health?

From demand media, sirah Dubois

Hunger. Hunger is a natural physiological process, similar to thirst, that gets your attention and motivates you to seek food. Mild hunger is completely normal and is an effective signal to stop you from working, playing or chatting on the phone so that you can eat something to fuel your brain and body. Hunger is controlled in the hypothalamus -- a relay station in your brain. Incoming hormonal messages from your stomach, intestines and liver tell the lateral part of the hypothalamus that your blood sugar is too low and that it’s time to eat. Interestingly, if this part of the brain is destroyed, even a starving person would have no desire to eat. In contrast, the medial part of your hypothalamus is the satiety center, which signals you to stop eating. When this part is damaged due to cancer or head injury, a person will eat uncontrollably and rapidly gain weight. Side Effects. No one ever said that hunger is enjoyable, which makes sense because it’s meant to be a bit of a “wake-up call” to the conscious part of your brain to gain your full attention. In essence, it’s a powerful survival mechanism inherited through evolution. The most common initial feeling associated with hunger is a rumbling stomach and intestinal pains. Not everyone experiences these, and it’s a bit of a mystery as to why they occur, but it’s often explained as autonomic muscle contractions in the stomach and intestines due to the anticipation of food. Hunger is also associated with low blood sugar levels, which affect the brain because glucose is its only fuel. Symptoms of low blood glucose include fatigue, weakness, irritability, moodiness and reduced ability to concentrate. Potential Health Issues. Any health issues associated with hunger are directly related to the amount of time you go without food as well as your health status. As long as you’re at a healthy weight and have a strong heart, experiencing hunger pains due to a restricted-calorie but otherwise nutritious diet is not risky or harmful. Some people fast for a few days or a week for the health benefit without suffering any ill effects as long as they stay well-hydrated. About the only group that should be cautious of hunger pains are diabetics because of the association with low blood sugar. For diabetics who take insulin injections, the sensation of hunger following meals may indicate that they injected a little too much medicine. Mental Health. Many Americans don’t eat because of physical hunger; they eat due to habit, addiction and/or psychological attachment. If a situation arises that deprives people of food for longer than they are used to, the resulting hunger pains may be more in their heads than their bellies. However, it’s no laughing matter because withdrawal symptoms from certain compounds in food can include intense cravings, anxiety, depression and insomnia, which can negatively impact your health.

what is Mononucleosis?

Mononucleosis, or “mono”, is a common infection among young adults and teenagers. This viral infection is spread through saliva, hence the nickname, the “kissing disease”. Type of Microbe: Epstein-Barr virus (or EBV), belonging to the family of herpes viruses. How it spreads: The virus is spread primarily through the saliva and is not normally spread through the air or blood. There have been some links to sexual transmission, as well. Fever Symptoms. Who’s at risk? The highest rates of mono are in teenagers who haven't been exposed already in childhood, between the ages of 10 and 19 years. In children younger than 10 years, the risk is lower, but mild infections may be under-diagnosed. Mono is most common in places where there are a lot of young adults, such as in the military and in colleges. Because the virus is so common, most people get infected by the time they reach adulthood. In fact, up to 95% of adults (ages 35 to 40) have been infected at some time in their lives. Symptoms: Fever, sore throat, fatigue, and swollen lymph nodes are common symptoms in teenagers. In younger children, these symptoms are either absent or very mild. Older adults are less likely to get infectious mononucleosis (since 95% of adults were already exposed) but when they the infection they are more likely to have more severe presentations, including enlarged livers and jaundice -- possibly requiring hospitalization, but not as likely to have sore throats or swollen lymph nodes. People who have been infected don’t show symptoms for 4 to 8 weeks after being exposed.

Can You Get Any Disease From Kissing?

Yes, you can catch herpes just from kissing someone on the mouth. And while experts believe the risk of catching HIV (the virus that causes AIDS) from kissing is low, someone who has a cut or sore in the mouth has a chance of infection during open-mouthed kissing. We know that kisses of passion can lead to one thing or another. But did you know that kissing can also lead to an infectious disease? Mononucleosis , or mono, is the prototypical “kissing disease,” and sexually-transmitted diseases are infamous following some romantic interludes. But did you know that there are many infections that can be spread through mere kissing alone? Infectious Diseases in Saliva Infectious diseases are spread through several routes of transmission. “Oral transmission” refers to spreading of microbes through saliva, foods or drinks. When a person accidentally consumes microbe-contaminated items, such as saliva during kissing, the swallowing action of the tongue wipes the microbes against the back of the throat, allowing the microbe to enter the body. Infections, such as mononucleosis (the kissing disease), caused by Epstein-Barr virus (EBV), and cytomegalovirus (CMV) are spread via oral transmission from virus-containing saliva.

Could you have a heart attack -- and not know it?

Silent Heart Attack. i Got this from Charles W.Bryant

Sometimes people have heart attacks and never know it. It's called the silent heart attack, when someone either shows no symptoms at all or ignores or misinterprets the symptoms until the pain goes away. Because the key to recovering from a heart attack is by restoring the blood flow to the heart as quickly as possible, silent heart attacks are even more deadly. In fact, twice as many people die from the silent type of heart attack as those who experience the typical variety. What's going on here in most cases is something called ischemia -- when blood that normally flows to a part of the body is temporarily restricted. When this happens to the heart it's called cardiac ischemia. A temporary loss of blood flow to the heart causes chest pain, or angina, which is basically a warning sign that something bad could happen shortly. This is where things get a little tricky. Sometimes there's no angina. This is called silent ischemia and it leads to the silent heart attack. That's the trouble with silent ischemia -- there are no symptoms. In other cases, the heart attack isn't completely pain free, but the symptoms are overlooked or misinterpreted as heartburn, standard angina that goes away, a pulled muscle or even overall fatigue. This is largely explained away by the fact that some people have higher pain thresholds, and others are embarrassed by the fact that they may be in trouble and just want to wait until the pain subsides. One odd symptom that's never been fully explained in regular and silent heart attacks is a feeling of impending doom. In silent attacks, this is often misinterpreted as stress or anxiety. It may be hard to comprehend, but about 25 percent of all heart attacks are silent. This is probably due in part to how heart attacks are portrayed in movies and on television. A study by the British Heart Association shows that one in four people in England get their information on heart attacks from what they see on the big and small screen [source: The Guardian]. Besides the fact that they can kill you, silent heart attacks also increase the risk of dementia for men. A Dutch study reports that men who experienced silent attacks are more than twice as likely to suffer from dementia as those who have never had an attack at all. If it doesn't kill you, you may not even realize you had an attack until your doctor discovers the damage at your next physical. If you're at risk for a heart attack, you should get checked out for silent ischemia. Your doctor will ask you questions about your own and your family's medical history and put you on a treadmill to jog while your heart function is monitored by an electrocardiogram (ECG) machine. In this test, doctors are looking at how your heart rate and blood pressure increase during exercise, a good indicator of how your blood is flowing. You'll also likely get a blood test for cardia­c enzymes. These are proteins that are released when the heart is damaged. Aside from this preventive screening, your best course of action is to know the symptoms of a heart attack and pay attention if you experience any of them. Call paramedics immediately if you feel chest pain, have shortness of breath or are unusually fatigued and they'll walk you through the proper course of action. Ignoring these signs because of embarrassment or shame can kill you.

How Salt Water Gargling Helps Your Throat + Fair Warning

HROSSI EXPERIENCE AND MEDICAL IMPLICATIONS

As home remedies go, this might be the most widely known/practiced/recommended. But why does gargling with warm, salty water help soothe a sore throat? Since I’m doing this multiple times a day–and since I feel like it helps–I decided to Google the gargle and attempt a better explanation than “because it does.” First of all, gargling of any kind is helpful when you have a throat infection because it flushes the area and can encourage any lingering bits of phlegm to ride the wave and leave the premises. For those who still have your tonsils (or who, like me, have big ones), flushing the throat with fluid helps loosen anything that gets stuck in there as well. Alternatives to salt water gargling: cider vinegar, lemon juice, natural mint or cinnamon mouthwash, or just plain warm water. But here are the main two reasons why salt water in particular are helpful for sore throats (information I learned here and here and here): Salt sucks. This is a phrase that I learned in 12th grade biology class, and I’ve come back to it again and again. Salt draws moisture and promotes osmosis. This is why salting eggplant or tomatoes makes them give up their liquid so they’re easier to cook with. In your throat, salt water “sucks” in two ways: it draws moisture out of any bacteria who have set up shop there, and it draws moisture out of your own swollen tissues, relieving inflammation. Salt cleanses. Not only does salt water flush out post-nasal drip and other bacterial material (just like any fluid would), a salty environment prevents bacteria from growing. Just ask any medieval meat-eater how they kept their meat from going rancid, and you’ll recall that salt is a bacteria-fighter. Fair warning, though – you can have too much of a good thing when it comes to salt water gargling. First, do not swallow the salt – your body does not need the extra sodium, it needs to be well-hydrated in order to fight your infection. Second, if the concentration of salt in your gargle is too high, it will dry out your throat membranes, causing them to inflame further. A good rule of thumb is to use only enough salt so that the water tastes just salty, not WHOA, SALTY! I usually do 3 10-second gargles in a row, 3-4 times a day when I have a cold. And for whatever reason, I usually feel better afterward. Do you gargle? Does it help?

Your oral hygiene chocks

Inadequate oral hygiene, which Dr. Weiser defines as those who don’t brush and floss daily, results in visible plaque on teeth and red swollen gums. And it doesn't take long to happen: Research shows that healthy gums can become diseased gums within 24 to 36 hours of not brushing and caring for oral tissues properly. Your best bet? Taking care of your teeth. A commitment to regular professional cleanings as well as home care is essential, says Dr. Weiser. These tools can help make your job easier: An electric toothbrush Automatic brushers massage the gums to stimulate blood flow, bring nutrients to the tissue, and release toxins, says Dr. Samaha. Opt for anti-bacterial mouth rinse and toothpaste to cut down on the bacteria in your mouth. Consider a water pick for flossing, or be vigilant about flossing daily the old-school way (you want to reach the spaces between your teeth, where the disease really takes hold). Oral probiotic mints, which are dissolved in the mouth, are also a helpful means to prevent tooth decay and whiten teeth along the way. A diet with at least six to eight fist-sized servings of fruits and vegetables.

A diet with at least six to eight fist-sized servings of fruits and vegetables, along with nutritional supplements of calcium, vitamin D, vitamin C, magnesium, and anti-inflammatories such as fish oil, are all critical building blocks of oral health,” says Dr. Samaha. Eating well boosts the integrity of the entire immune system and nourishes the oral soft tissues, which are the most vulnerable in the body, she says.

Why that bit of blood in the sink isn’t something you should ignore

Even if you’re a die-hard daily flosser (which, let’s be honest, most of us aren’t even close to being), chances are, you see an occasional drop or two of blood post string-session. No big deal, right? Not so fast. “Bleeding gums are never normal, not even when you have your teeth professionally cleaned,” says Lisa Marie Samaha, DDS, founder and director of the Perio Arts Institute, in Newport News, VA. “Imagine your scalp bleeding when you brush your hair.” In other words, if your gums are bleeding when you floss or brush your teeth, you have periodontal disease, commonly known as gum disease. What exactly is gum disease? Simply put, it’s a contagious bacterial infection that can wreak havoc on your health. In your mouth, it can destroy your gums, erode your jawbone, and lead to tooth loss (gum disease is actually the number one reason teeth fall out). The picture's not any better when it comes to the rest of the body. Here’s what happens: “There are two fronts to bleeding gums,” says Mark Weiser, DDS, a dentist practicing in Santa Barbara, Calif. “The plaque—which is a biofilm of bacteria and its waste products—first create the irritation to the gum tissue. Then there’s the body's reaction to that wounding, the inflammatory response.” Put those two factors together and you’ve got inflamed, bleeding gums. The longer you have inflammation, the more at risk you are for all kinds of systemic illnesses, everything from allergies to cancer. And gum disease is common. Really common. According to the American Academy of Periodontology, up to 80% of the adult population has some level of periodontal disease, while only about 10% are aware of it, as telltale signs of the disease—bleeding gums, for one—don’t typically show up until the middle-to-late stages.

Humania: STOMACH CANCER FACTS

Humania: STOMACH CANCER FACTS: *Stomach cancer facts Medical author: Charles P. Davis, MD, PhD. The stomach is a hollow organ that liquefies food and is part of the...

STOMACH CANCER FACTS

*Stomach cancer facts Medical author: Charles P. Davis, MD, PhD. The stomach is a hollow organ that liquefies food and is part of the digestive system. Cancer is the growth of abnormal (malignant) body cells: stomach cancer cells spread by breaking away from other cancer cells and go into the bloodstream or lymphatics while others penetrate into organs near the stomach. Although the cause of stomach cancer development is not known, risk factors include inflammation of the stomach, Helicobacter Pylori infection, smoking, poor diet, obesity, lack of physical activity, and the history of stomach cancer in the family. The symptoms of stomach cancer may include discomfort and/or pain in the stomach, nausea and vomiting, weight loss, difficulty swallowing, vomiting blood, blood in the stool, and feeling full or bloated after a small meal. Stomach cancer is diagnosed by a physical exam, medical history, endoscopy, and biopsy of the tissue. Stomach cancer is staged according to where the cancers found and how far it has invaded the stomach tissue, or if it has spread beyond the stomach and into other organs (stages 0 to IV). The treatment of stomach cancer depends on the size and location of the tumor, the stage of the disease and the patient's general health. Surgery is done to remove cancer tissue; in general, two procedures are common: partial (subtotal) gastrectomy and total gastrectomy. Chemotherapy is the use of drugs to kill cancer cells: it may be used before or after surgery. Radiation therapy uses high-energy rays to kill cancer cells: it is used frequently along with chemotherapy. Many doctors recommend getting a second opinion before starting treatment: this article provides contact phone numbers to several institutions that can help find a doctor to give a second opinion. Good nutrition after stomach surgery may require supplements like vitamins and minerals, plus changing your eating habits. Surgery, a stent placement, radiation therapy, and laser therapy are treatment options for cancers that block the gastrointestinal (GI) tract. Tests to rule out recurrence of cancer; complementary and alternative medicine should be discussed with your doctor.

What Causes Hyperactivity?

Written by Shawn Goodwin. Medically Reviewed by George Krucik, MD. What Is Hyperactivity? Hyperactivity means being more active than is usual or desirable. Depending on the cause, hyperactivity has many different characteristics. The most common of these are: constant movement aggressive behavior impulsive behavior being easily distracted. Many different mental diseases and medical conditions have hyperactivity as a symptom. People who are hyperactive may develop other problems due to the inability to stay still or concentrate. For example, hyperactivity may lead to difficulties at school or work. It may strain relationships with friends and family. It may lead to accidents and injuries. And it increases the risk for alcohol and drug abuse, and other delinquent behaviors. Hyperactivity is often considered more difficult for those around the hyperactive person—such as teachers, employers, and parents—than it is for the person who is hyperactive. However, hyperactive people often become anxious or depressed because of their condition and the way people respond to them. One of the main disorders that displays hyperactivity as a marker is attention deficit hyperactivity disorder (ADHD). ADHD is a disorder that causes the person to become overactive, inattentive, and impulsive. This condition is usually diagnosed at a young age. Some people, however, suffer from ADHD as adults. Hyperactivity is treatable. For the best results, early treatment is usually required. What Causes Hyperactivity? Hyperactivity can be caused by mental and physical disorders. The most common causes for hyperactivity are: ADHD hyperthyroidism (too much thyroid hormone) brain disorders nervous system disorders psychological disorders Recognizing the Signs of Hyperactivity. One or several signs may be present. These depend on the cause of the disorder. Hyperactive children may have difficulty concentrating in school. They may also display impulsive behaviors such as: talking out of turn blurting things out (this is a typical symptom of Tourette’s syndrome) hitting other students being overactive. Adults who display hyperactivity may also display the following: difficulty concentrating at work short attention span difficulty remembering names, numbers, or bits of information. Anxiety or depression may occur if the person is distressed about the condition. Adults who have hyperactivity probably displayed these symptoms as children. How Is Hyperactivity Diagnosed? If you or your child is displaying signs of hyperactivity, speak to your doctor. Your doctor will ask questions about your symptoms. Questions will focus on when the symptoms began, and will also look at recent changes in your overall health. Your physician will ask if you are taking any medications to treat a medical or mental health condition. The answers to these questions will help your doctor determine what type of hyperactivity you are displaying. They will also help to gauge if it is a new or worsening condition. Your answers will also help your doctor determine if the cause is simply a medication side effect. In addition, your doctor may take a blood or urine sample to check your hormone levels. An imbalance of thyroid hormone or other hormones may result in hyperactivity. if your doctor feels this is a mental condition, he or she will refer you to a mental health specialist for treatment. How Is Hyperactivity Treated? If a condition affecting your thyroid, brain, or nervous system is causing your hyperactivity, your doctor may prescribe medications to treat the underlying problem. Hyperactivity can also be caused by an emotional disorder. If this is the case, you will be treated by a mental health specialist. A mental health specialist will review your symptoms to determine what condition you may have. Once a condition is diagnosed, you may be given medications or therapy to help control the hyperactivity. Therapy Common therapies used to treat hyperactivity are: cognitive behavioral therapy. Talk therapy. Cognitive behavioral therapy aims to change yours patterns of thinking and behavior. Talk therapy involves discussing your symptoms with a therapist. The therapist can teach you how to cope with the condition and reduce its effects. Medication When therapy isn’t enough, you may need to take medicine to control symptoms from the brain. These medications have a calming effect. They are often prescribed for children and adults. These drugs include: dexmethylphenidate (Focalin) dextroamphetamine and amphetamine (Adderall) dextroamphetamine (Dexedrine, Dextrostat) lisdeamfetamine (Vyvanse) methylphenidate (Ritalin) Some of these medications are habit-forming. Your doctor or mental health care provider will monitor your intake. You may also be advised to avoid stimulants that may trigger symptoms. Commonly used stimulants to be avoided are caffeine and nicotine. Article Sources: Attention Deficit Hyperactivity Disorder (ADHD). (2008). National Institute of Mental Health. Attention-deficit/hyperactivity disorder (ADHD) in children. (February 10, 2011).Mayo Clinic. Hyperthyroidism (overactive thyroid). (2010, December 4).Mayo Clinic. What is hyperactivity. (n.d.).Kids Health.

Health Benefits of Onions

Onions are a very good source of vitamin C, B6, biotin, chromium, calcium and dietary fibre. In addition, they contain good amounts of folic acid and vitamin B1 and K. A 100 gram serving provides 44 calories, mostly as complex carbohydrate, with 1.4 grams of fibre. Like garlic, onions also have the enzyme alliinase, which is released when an onion is cut or crushed and it causes your eyes to water. They also contain flavonoids, which are pigments that give vegetables their colour. These compounds act as antioxidants, have a direct antitumor effect and have immune-enhancing properties. Onions contain a large amount of sulfur and are especially good for the liver. As a sulfur food, they mix best with proteins, as they stimulate the action of the amino acids to the brain and nervous system. Onions, Rich Source of Quercitin.

The onion is the richest dietary source of quercitin, a potent antioxidant flavonoid (also in shallots, yellow and red onions only but not in white onions), which is found on and near the skin and is particularly linked to the health benefits of onions. Quercitin has been shown to thin the blood, lower cholesterol, raise good-type HDL cholesterol, ward off blood clots, fight asthma, chronic bronchitis, hay fever, diabetes, atherosclerosis and infections and is specifically linked to inhibiting human stomach cancer. It's also an anti-inflammatory, antibiotic, antiviral, thought to have diverse anti-cancer powers. Quercitin is also a sedative. So far, there is no better food source of quercitin than onion skins. You don't need to eat loads of onions to achieve these effects. In fact, studies show that you can reap the health benefits of onions by eating just one medium onion, raw or cooked, a day.

FIX THE NATIONS

How Does Bananas Affect Blood Sugar?

If you have or are at risk for diabetes it is important to control your blood sugar levels through diet and exercise. Different foods affect blood sugar levels differently and each person with diabetes has unique responses to food. A physician or registered dietitian can help in formulating a healthy eating plan, which should include plenty of fruits and vegetables. However, even healthy foods such as bananas can raise blood sugar levels too much, so it is important to test often. Diabetes. After eating, the body breaks down the food into glucose or blood sugar to provide the body with energy. The hormone insulin must be present in order for the cells to use the glucose. Having diabetes means that the body either does not produce insulin or is unable to use it properly, which means blood sugar levels can get too high. Over time, high blood sugar levels can lead to vision problems, heart disease, damage to the kidneys and damage to the nerves. A large part of preventing diabetes related complications, is eating a healthy diet that keeps blood sugar levels within the range given to you by your doctor. Carbohydrates. Carbohydrates are the main type of food that affects blood glucose levels. Diabetics have to watch not just how many carbohydrates are eaten, but the type as well. Carbohydrates that come in the form of processed or refined grains such as white bread, white rice, potatoes and baked goods, tend to be digested very quickly. They can cause blood sugar levels to spike and drop, making diabetes harder to control. Carbohydrate sources such as fruits, vegetables and whole grains are digested more slowly, which helps to keep blood sugar levels in check. However, even healthy carbohydrates such as bananas need to be eaten in moderation and the best way to tell how a food affects your blood sugar level is to test yourself after eating. The National Diabetes Information Clearinghouse, suggests keeping blood sugar levels at less than 180 one to two hours after a meal. Bananas and Blood Sugar. A general goal for diabetics is to eat no more than 45 grams of carbohydrates at each meal and some may need to go even lower. Bananas are part of an overall healthy diet because they contain fiber, potassium and vitamin C, but they also contain carbohydrates and the amount depends on the size of the banana. According to the American Diabetes Association, a banana that is 6 inches or shorter has about 18.5 grams of carbohydrate; a 7-to-8-inch banana can contain between 27 to 31 grams of carbohydrates and a large banana that is 9 inches or longer, can have up to 35 or more grams of carbohydrates. So eating a banana can cause a rise in blood sugar levels. Glycemic Index and Load. Bananas have a low glycemic index, or GI, at 47, and a moderate glycemic load, or GL, of 11. Glycemic index and load both indicate the effect a food has on your blood sugar. Foods with a high GI and GL have a rapid and pronounced effect on your blood sugar, leading to blood sugar spikes, while foods with moderate or low GI and GL have a sustained effect on your blood sugar. Eating foods with a low or moderate GI and GL help to regulate your blood sugar levels, and also help lower your risk of cardiovascular disease, explains the Linus Pauling Institute.

ARE THERE REMEDIES FOR LOW BLOOD PRESSURE? (HYPOTENSION)

By:Times of India and mayo clinic. COMPILED BY LEONARD NZEREOGU. While high blood pressure is much talked about and people are aware of its symptoms and effects, not many know about low blood pressure. In fact, it affects a large number of people worldwide. Very often people don't realise they are suffering from it and often dismiss it as an one-off case of feeling dizzy or ill. It could be a sign of a serious issue with the heart, endocrine or even signal neurological disorders. Severe low blood pressure can block oxygen and vital nutrients from flowing to the brain and hence shouldn't be taken lightly. Low blood pressure that either doesn't cause signs or symptoms or causes only mild symptoms, such as brief episodes of dizziness when standing, rarely requires treatment. If you have symptoms, the most appropriate treatment depends on the underlying cause, and doctors usually try to address the primary health problem — dehydration, heart failure, diabetes or hypothyroidism, for example — rather than the low blood pressure itself. When low blood pressure is caused by medications, treatment usually involves changing the dose of the medication or stopping it entirely. If it's not clear what's causing low blood pressure or no effective treatment exists, the goal is to raise your blood pressure and reduce signs and symptoms. Depending on your age, health status and the type of low blood pressure you have, you can do this in several ways: Use more salt. Experts usually recommend limiting the amount of salt in your diet because sodium can raise blood pressure, sometimes dramatically. For people with low blood pressure, that can be a good thing. But because excess sodium can lead to heart failure, especially in older adults, it's important to check with your doctor before increasing the salt in your diet. Drink more water. Although nearly everyone can benefit from drinking enough water, this is especially true if you have low blood pressure. Fluids increase blood volume and help prevent dehydration, both of which are important in treating hypotension. Wear compression stockings. The same elastic stockings commonly used to relieve the pain and swelling of varicose veins may help reduce the pooling of blood in your legs. Medications. Several medications, either used alone or together, can be used to treat low blood pressure that occurs when you stand up (orthostatic hypotension). For example, the drug fludrocortisone is often used to treat this form of low blood pressure. This drug helps boost your blood volume, which raises blood pressure. Doctors often use the drug midodrine (Orvaten) to raise standing blood pressure levels in people with chronic orthostatic hypotension. It works by restricting the ability of your blood vessels to expand, which raises blood pressure. Please consult your Doctor:

TOP 3 REASONS WHY YOUR CHILD HAS RUNNY NOSE ALL THE TIME

By Dr.Julie Wei, a Pediatric Otolaryngologist.

Are you constantly running after your child with Kleenex? Does your child seem to have a “cold” that never clears? Does your child have sore nostrils from constant wiping, shirt sleeves that you want to wash on “sanitary cycle”, and crusty material around his/her cute cheeks that is not so “cute”? As an ear, nose, and throat specialist, I am always advocating for what I consider to be the perhaps most underappreciated organ in our body, the nose. No matter how big or small, we all need the nose to work properly to breathe, smell, humidify the air, and smell is responsible for 2/3 of our perceived taste. In addition, our sense of smell let us know if we are exposed to potential dangers such as a fire or exposure to chemicals. Finally, as an Asian woman with a not-so-prominent nasal bridge, I can tell you how useful our noses are to hold up our glasses and sunglasses! For all that it is responsible for, in our children with their small noses, anytime it is runny with snot, many of these functions are impaired.English: A small box of Kleenex. If your young toddler and preschool aged child has chronic runny nose daily or most days, and they are playing, eating, running around, going to daycare, sleeping, and act like mucus is part of their personal charm, then it is very likely that they do not have a “chronic” illness. Any or all of the following are most likely the reasons why they have a runny nose all the time: 1.Young children can’t blow their noses effectively, nor do they sniff snot into the back of their throat effectively like we can. 2. they experience many more colds in the first years of life. 3. they suffer from the Milk and Cookie Disease (MCD) – too much dairy and/or sugar in their diet, and they are drinking milk at bedtime. Preschool aged children are known to experience at least 7-10 upper respiratory tract illnesses (URI) or “colds” per year. The great news is that only 7-13% of these URIs actually go on to result in a true and real “sinus infection” that we associate with bacteria, and therefore would benefit from a course of oral antibiotics. However, the rest of those 93-87% URIs can still result in green and snotty noses with cough even after the initial 7-10 days of cold symptoms, and not represent a true “sinus infection”. The trouble is that for parents and doctors alike, it is extremely difficult to tell when your child may be experiencing that 10% “acute rhinosinusitis” as a complication of the viral illness. As a pediatric ear, nose, and throat specialist, I think a course of antibiotics is reasonable if a child continues to have runny nose, cough, congestion, and fever for over 7 days and the cough is present both daytime and nighttime such that is disturbing their sleep. I am especially concerned if the child has poor appetite, can’t engage in fairly normal play and activities despite the runny noses and cough, and/or seem ill for longer than the week that we would expect it takes for a cold to go away. Research has demonstrated that this is an area of significant challenge. When pediatricians are surveyed, there is significant variation in the age at which pediatricians begin to consider the diagnosis of acute sinus infection with most using duration of symptoms as the most important diagnostic factor. Also found was the likelihood of pediatricians prescribing the use of systemic decongestants and antihistamines in young children, which is now being scrutinized given the recent Food and Drug Administration warnings regarding their safety. By the way, “snot” being green does not mean it’s a “sinus infection”. The discoloration naturally occurs due to an enzyme called “myeloperoxidase” found in neutrophils, a cell that fights infection, and the enzyme contains iron which causes the discoloration. This occurs due to inflammation and should not be interpreted as an indicator of true “acute rhinosinusitis” or need for antibiotics. It is important to understand that children CAN NOT have a sinus infection of a sinus they don’t have! Babies are born with early buds of the maxillary (cheek) and ethmoid (between the eyes) sinuses, while the formation of the frontal (forehead) sinuses and sphenoid (center of the head) sinus do not usually start forming until age 7 or older, for the frontals, and age 5 or older for the sphenoid. Again, the point is, nasty snotty noses can occur without a sinus infection! The understanding of this point by both primary care physicians and parents and caretakers is critical to reduce the overprescription, overconsumption, and inappropriate use of oral antibiotics. Furthermore, we can all reduce unnecessary visits to the emergency department, urgent care facility, and doctor’s visits for these symptoms if we share this information and support one another in how to better handle runny noses in young children. The overprescribing and overuse of antibiotics will continue to threaten our ability to treat resistant strains of organisms responsible for other infections. The overprescribing and overuse of medications in otherwise healthy children will continue to threaten our children experiencing potential side effects that we do not yet know or understand because we have not had research data showing what happens when a child has taken 20-30 years of once daily allergy medications or nasal steroid sprays. While my own research and other clinical trials have shown how effective and safe using saline nasal irrigation is for treating true and chronic rhinosinusitis (congestion, cough, and runny nose) in resolving these symptoms, I find that children younger than 4 simply can’t tolerate the once daily irrigation using a squeeze bottle. Before we get too discouraged, the good news is that based on my clinical experience and research, true chronic rhinosinusitis typically occurs in school aged children (average age around 7) who have underlying skin-test proven allergies to multiple aeroallergens (trees, grass, pollen, mold, dust mites, etc). Therefore, I am even more passionate about making sure that our toddlers and preschool aged children do not have MCD as the cause of their chronic runny nose. I am a strong advocate for making sure that our toddlers and preschool aged children do not receive unnecessary radiation exposure through x-rays of their sinuses and CAT scans to find out if they have “sinus infection”. While both tests definitely have a role in helping primary doctors and ENT specialists to confirm whether a child has sinus inflammation, they are neither recommended nor necessary to make the diagnosis of any suspected acute problems. Based on my own published research findings, I only order CT scan in children who are sent to me for chronic rhinosinusitis AFTER they have used once daily irrigation for 6 weeks, and report no improvement in their chronic symptoms of nasal congestion, cough, and/or runny nose. Thank goodness I find this to be the case in only about 10% or less of all the children I see in my practice. Here is the bottom line, if you have a young child (older than 12 months) with chronic runny nose, try the following and you will likely see an incredible improvement: 1) If your child drinks milk every night right before or at bedtime, STOP immediately. I promise that within 7 days you will notice that he/she will have much less congestion, nighttime cough, waking up with snot and phlegm, and sleep better. A Healthier Wei explains why undigested milk in the stomach lead to reflux and then these nasal symptoms. 2) If your child has a snack every night after dinner and before bed, especially if they contain dairy and/or sugar, STOP that habit. Instead, if he/she must eat again, choose items which do not contain diary and/or sugar. 3)If your child eats a great deal of dairy every day, yogurt, cheese stick, milk, chocolate milk, Mac-n-Cheese, cheese pizza, cheese, ice cream, etc., please consider cutting down on their daily dairy consumption.

Picky Eating and Young Toddlers

Picky eating often surfaces around one year—a time when many children are beginning to feed themselves. They can now choose what and how much to eat, giving them some degree of control over their lives. So some days they may eat a lot of everything. Other days they may not seem to eat much at all. In addition, while children usually grow a lot and quickly in their first year, growth slows down in the second year. Toddlers are also learning lots of new skills, like talking, walking, running, climbing, and more. During a time of great change, children often seek “sameness” as much as possible, including sticking to the same small group of foods. This consistency can help them feel safe and secure during a period of rapid change. Parents also need to be in touch with their own expectations about how much their toddler “should” eat. It is unrealistic to expect a toddler to eat a large amount of food at each meal everyday; after all, a toddler’s stomach is approximately the same size as her clenched fist (Martins, 2002). Ellyn Satter, MS RD LCSW BCD, a researcher and practitioner in the field of pediatric feeding practices, explains that both parents and children have their own “jobs” to do when it comes to eating. Parents are responsible for providing healthy foods at meal- and snack-times. Children are responsible for what and how much they eat. This helps children learn what it feels like to be hungry and then full—and how to make healthy choices based on this awareness, ie., eating when hungry and stopping when full. Back to Top The Role of Parents Research has found that parents’ food preferences are linked to their children's food preferences (Borah-Giddens & Falciglia, 1993). This is probably not a big surprise since we are more likely to prepare the foods that we enjoy, so our children are more familiar with that group of foods than others. Familiarity with foods is key, as a child may need up to be exposed to new foods more than 10 times before they try it. What can you do to help your child enjoy a range of foods? •Eat a range of healthy foods yourself. Make sure that your own choices are in line with the foods you want your child to eat and enjoy. •Prepare meals together. Having a hand in making the meal increases the chances that your child will taste her “creation.” Have your little one assist with measuring, pouring, or stirring. •Avoid showing disgust or disinterest when trying new foods. A study found that mothers who showed (with their facial expressions, body language or words) that they didn’t want to try a new food had children who also tended to refuse new foods (Carruth & Skinner, 2000). In short, your young child will probably be less willing to try something new if you haven’t tasted it. And if you are a “picky eater” yourself, then your young child is likely to imitate you in this behavior, just as she imitates the way you talk on the phone or the way you wave good-bye to her each morning at child care. Back to Top What to Do About Picky Eating There are many reasons why a child may be choosier than usual at mealtime. Listed below are some of the most common causes of picky eating and ideas for how to respond. (Adapted from Lerner & Parlakian, 2007). Some children are sensitive to the taste, smell or texture of food. You can: •Offer several healthy food choices—among the foods your child does like—at each meal. •Gently but frequently offer new kinds of foods. Children need to be offered a new food as many as 10-15 times before they will eat it. •Track your child’s food sensitivities and keep them in mind when preparing meals. Does your child have trouble with “mushy” foods? Then offer apple slices instead of applesauce, or a baked potato instead of mashed. If you’d like your child to try a “mushy” food, combine it with a crunchy food that she does like. Give her an animal cracker to dip in the applesauce. •Talk to your child’s health care provider about any nutritional concerns you may have. Some children are simply less likely to try new things based on their temperament—their individual way of approaching the world. You can: •Put new foods next to foods your child already likes. Encourage him to touch, smell, lick, or taste the new food. •Avoid becoming a short-order cook and preparing special meals for your child. But do make sure that at each meal, there is something he knows and likes on the plate. Also give him what the rest of the family is eating in toddler-sized portions. Over time, these choices will become as liked and familiar as her favorite mac-n-cheese. •Gently but frequently offer new kinds of foods. Children need to be offered a new food as many as 10-15 times before they will eat it. •Use healthy dips such as yogurt, hummus, ketchup or low-fat salad dressings to encourage children to eat fruits, vegetables, and meats. •Involve your child in preparing the meal (like dropping cut-up fruit into a bowl for fruit salad). Handling, smelling and touching the food helps your child get comfortable with the idea of eating it. Some children can seem “picky” because they want to feed themselves. You can: •Offer safe “finger foods” that your child can feed herself. •Offer your child a spoon to hold while you’re feeding her. This lets her feel in control. •Let your child decide where foods go on her plate—the peas there, the turkey there. If you’d like, you can also let your child serve herself (put your hand over hers to help her handle the bigger serving spoons). Some children are very active. They may seem picky because they don’t like sitting for long. You can: Set your child’s meal out before he sits down. •Keep mealtimes short—10 minutes or so. Let your child get up when he indicates he is finished eating. •Put healthy foods, such as a bowl of strawberries or bananas, where your child can reach them so when he gets hungry he can easily get to good foods. Some children have medical issues that make it difficult to swallow or digest certain foods. You can: •Seek an evaluation by a health care provider. Sometimes children need special help with feeding. What NOT to Do About Picky Eating There are two big pitfalls to avoid in order to encourage healthy eating behavior. They include: Forcing your child to eat. The fact is that forcing children to eat usually leads to the child eating less. Forcing also teaches children to rely on others to tell them how much to eat and what they are feeling. This does not lead to healthy eating habits or good self-esteem. In fact, some research has shown that forcing children to eat actually can make picky eating behavior worse (Sanders, Patel, Le Grice, & Shepherd, 1993). When it comes to eating, it can be helpful to see it as you and your child each having your own jobs. Your job is to provide your child with healthy food choices and pleasant meal and snack times. It is your child’s job to decide which of these healthy foods to eat and how much to eat. When you approach feeding this way, your child learns to listen to his body and make healthy food choices. It also leads to fewer power struggles between parent and child around food (Satter, 1990). Nagging or making deals with your child. “Just two more bites, just two more bites!” “If you eat your vegetables, you will get dessert.” Strategies like these don’t work in the long run. Children who learn to make deals about eating quickly learn to make deals and ask for rewards for doing other things—like brushing teeth or getting their shoes on. And soon they won’t do anything unless there is a reward for it! Back to Top What About Dessert? Ah, dessert. Many parents struggle with what to do about sweets. Daniel, father of a toddler and kindergartner, shared his family’s dilemma: I’m fine with letting them choose how much they want to eat. But after they’ve basically eaten nothing, then they want dessert. I feel like I’m getting taken advantage of if I give it to them. If I try to get them to eat more, it’s worse because we end up negotiating the entire meal: “Okay, if you have 3 more bites of meat, you can have a cookie.” It’s gotten to the point that my 6-year-old will ask at the beginning of the meal, “How much do I need to eat in order to have a treat?” How do you handle the “cookie cravings” in your little ones who insist they are done with dinner (after 3 noodles) but still have room for something sweet? The following are some ideas for handling this common dilemma. •Serve a small treat with your child's dinner (for example, one cookie or a small muffin). Yes, he may eat it first or he may eat only that. That’s okay. Over time, your child will come to see that sweets are part of a meal, but not the only part. He will get hungry for other foods. Soon, you might even find that he leaves the sweet on the side opting to eat the healthier foods first. •Serve a small treat at the end of the meal regardless of how much your child has eaten. Again, this teaches your child that sweets, when eaten in moderate servings, have their place.. It also takes away the power of the dessert being a big, special reward that they are constantly pining away for. When you avoid negotiating “if you eat this, you get that”, you also eliminate a big power struggle. You may find that your child eats more on his plate as a result. •Eliminate sweets altogether. Some families believe that cookies, cakes, etc. are not appropriate for their family’s diet. Instead, try offering fresh fruit or cheese to end the meal. Back to Top An Additional Resource: Healthy Eating Strategies for Babies and Toddlers This one-page handout explains how you can help your child develop healthy eating habits from the start. References: Borah-Giddens, J., & Falciglia, G. A. (1993). A meta-analysis of the relationship in food preferences between parents and children. Journal of Nutrition Education, 25, 102-107. Carruth, B.R., & Skinner, J.D. (2000). Revisiting the picky eater phenomenon: Neophobic behaviors of young children. Journal of the American College of Nutrition, 19, 771-780. Gibbs, J. (2006, Jan-Mar). Working with picky eaters: The Toddler years. Family and Consumer Sciences Quarterly Media Packet, Michigan State University Extension, East Lansing, MI. Available online at: http://www.fcs.msue.msu.edu/mediapacket/Jan-Mar06/PickyEaters-theToddlerYrs.doc Lerner, C., & Parlakian, R. (2007). Healthy from the start: How feeding nurtures your young child’s body, heart, and mind. ZERO TO THREE: Washington, DC. Available online at: http://main.zerotothree.org/site/DocServer/healthy_from_start_eng.pdf?docID=1041&AddInterest=1153 Martins, Y. (2002). Try it, you'll like it! Early dietary experiences and food acceptance patterns. The Journal of Pediatric Nutrition and Development, 98, 12-16, 18-20. Sanders, M.R., Patel, R.K., Le Grice, B., & Shepherd, R.W. (1993). Children with persistent feeding difficulties: An observational analysis of the feeding interactions of problem and non-problem eaters. Health Psychology, 12, 64-73. Satter, E. (1990). The feeding relationship: Problems and interventions. Journal of Pediatrics, 117 (Suppl.), 181-190. The article below was also useful background in creating this resource: Cathey, M., & Gaylord, N. (2004). Picky eating: A Toddler’s approach to mealtime. Pediatric Nursing, 30(2), 101-109. Available online at:

Ten Reasons to Respond to a Crying Child

by Jan Hunt and Leonard Nzereogu. Do you stop a child from crying by whipping him/ her? How do you respond to a crying child? See if these reasons makes sense. 1. A baby's first attempts to communicate cannot be in words, but can only be nonverbal. She cannot put happy feelings into words, but she can smile. She cannot put sad or angry feelings into words, but she can cry. If her smiles receive a response, but crying is ignored, she can receive the harmful message that she is loved and cared for only when she is happy. Children who continue to get this message through the years cannot feel truly loved and fully accepted. 2. If a child's attempts to communicate sadness or anger are routinely ignored, he cannot learn how to express those feelings in words. Crying must receive an appropriate and positive response so that the child sees that all of his feelings are accepted. If his feelings are not accepted, and crying is ignored or punished, he receives the message that sadness and anger are unacceptable, no matter how they are expressed. It is impossible for a child to understand that expression of sadness or anger might be accepted in appropriate words once he is older and able to use those words. A child can only communicate in ways available to him at a given time; a child can only accomplish what he has had a chance to learn. Every child is doing his best, according to his age, experience, and present circumstances. It is surely unfair to punish a child for not doing more than he can do! 3. A child who has been given the message that her parents will only respond to her when she is "good" will begin to hide "bad" behavior and "bad" feelings from others, and even from herself. She may become an adult who submerges "bad" emotions and is unable to communicate the full range of human feelings. Indeed, there are many adults who find it difficult to express anger, sadness, or other "bad" feelings in an appropriate way. 4. Anger that cannot be expressed in early childhood does not simply disappear. It becomes repressed and builds up over the years, until the child is unable to contain it any longer, and is old enough to have lost his fear of physical punishment. When this container of anger is finally thrown open, the parents can be shocked and perplexed. They have forgotten the hundreds or thousands of moments of frustration which have been filling this container over the years. The psychological principle that "frustration leads to aggression" is never more clearly seen than in the final rebellion of a teenager. Parents should be helped to understand how frustrating it can be for a child to feel "invisible" when crying is ignored, or to feel helpless and discouraged when his attempts to express his needs and feelings are ignored or punished. 5. We are all born knowing that each and every feeling we have is legitimate. We gradually lose that belief if only our "good" side brings a positive response. This is a tragedy, because it is only when we fully accept ourselves and others, regardless of mistakes, that we can have truly loving relationships. If we are not fully loved and accepted in childhood, we may never learn how that feels or how to communicate that acceptance to others, no matter how much therapy or reading or thinking we may do. How much easier our lives would be if we had simply received unconditional love from birth! 6. Parents wondering whether to respond to crying might give some thought to their own responses in similar situations. Parents may consider it appropriate to ignore a child's cries, yet feel intensely angry if their partner ignores attempts to have a conversation. Many in our society seem to believe that a person must be a certain age before he has the right to be heard. Yet what age would that be? Infants and children are not any less a person just because they are small and helpless. If anything, the more helpless someone is, the more they deserve to have our compassion, attention, and assistance. 7. If children are taught by example that helpless persons deserve to be ignored, they can lose the compassion for others that all humans are born with. If, as helpless infants, their cries are ignored, they begin to believe that this is the appropriate response to those who are weaker than themselves, and that "might makes right". Without compassion, the stage is set for later difficulties or even violence. Those who wonder why a violent criminal had no compassion for his victims need to consider where and when he lost that compassion. Compassion is there at birth, and does not disappear overnight. It is stolen, through unresponsive or punitive treatment, drop by drop, until it is gone. Loss of compassion is the greatest tragedy that can befall a child. 8. When a child learns by her parents' example that it is appropriate to ignore a child's cries, she will naturally treat her own child the same way, unless there is some intervention from others. Inadequate parenting continues through the generations until new experiences come about to change this pattern. How much easier it is for a parent to have learned in childhood how to treat his or her own child! Perhaps the cycle of inadequate parenting can begin to change when bystanders no longer walk past an anguished child without stopping to help. This may be the first time the child has been given the message that her feelings are legitimate and important, and this critical message may be remembered later when she herself has a child. Crying is a signal Provided by nature Crying is a signal provided by nature that is meant to disturb the parents so that the child's needs will be met. Ignoring a child's cries is like ignoring the warning signal of a smoke detector because we find it disturbing. This signal is meant to disturb us so that we can attend to an important matter. Only a deaf person would ignore a smoke detector, yet many parents turn a deaf ear to a child's cries. Crying, like the loud detector sound, is meant to capture our attention so that we can attend to the important needs of the child. It just makes no sense to think that nature would have provided all children with a routinely used signal that serves no good purpose. 10. Parents who respond only to "good" behavior may believe they are training the child to behave "better". Yet they themselves feel most like cooperating with those who treat them with kindness. It is as though children are seen as a different species, operating on different principles of behavior. This makes no sense, because it would be impossible to identify a moment when the child suddenly changes to "adult" operating principles. The truth is much simpler: children are human beings who behave on the same principles as all other human beings. Like the rest of us, they respond best to kindness, patience and understanding. Parents wondering why a child is "misbehaving" might stop and ask themselves this question: "Do I feel like cooperating when someone treats me well, or when someone treats me the way I have just treated my child?"

The Intrapersonal Consequences of Schizophrenia

by Ann Reitan, PsyD. I have proposed before that schizophrenia represents a biopsyhosocial phenomenon. Essentially, it has been stated that schizophrenia originates from chemical imbalances in the brain in the form of auditory hallucinations. The outward appearance of hearing auditory hallucinations is stigmatizing, and the retreat from stigma by assuming a façade of normalcy alienates the schizophrenic in a psychological sense, driving her further into the self-concealed realities and unrealities of her mind. In terms of this, the biopsychosocial process is self-reinforcing. It is important to note that schizophrenia is termed a problem related to “behavioral health”, explicitly. This term may be appropriate in terms of diagnostic considerations using the Diagnostic and Statistical Manual of Mental Disorders (DSM). The DSM utilizes behavioral criteria for the purpose of diagnosing schizophrenia and other mental illnesses. For example, the psychiatrist will note that the mentally ill client displays “negative affect” as opposed to the statement that she “feels badly”. The schizophrenic client may be stated to “report the experience” of hallucinations, as opposed to simply “experiencing” hallucinations. For the purposes of objectivity, the diagnostic criteria for schizophrenia are stated in behavioral terms. The term “behavioral health” can be considered to be particularly damaging in that this term can be construed to mean that there is an appropriate and healthy way to behave – that of concealing one’s mental illness. While it is important to exercise caution in terms of self-revelation of psychotic symptoms, and, in fact, patients are encouraged to reveal to their psychopathological symptoms to their treatment providers, there nevertheless exists an implication that they should behave in a “healthy” way. This is especially true regarding the mentally ill indvidual’s self-conception. In terms of the biopsychosocial model of mental illness, assuming an outward appearance of “behavioral health” relates to concealing one’s symptoms as a retreat from stigmatization. This reinforces the tendency to retreat into one’s subjective mind in an effort the avoid stigma, and the consequences of this retreat is further alienation. As indicated, “behavioral health” implies that there is an appropriate façade that should be assumed by schizophrenics in their efforts to appear psychologically healthy. Note that the biopsychosocial model implicates a synergistic cycle of psychopathology, and it is possible to reinforce this cycle at any point in the cycle: biological, intrapersonal and interpersonal. It is noteworthy that individuals may say that the term “schizophrenic” is stigmatizing. I have heard it suggested that the term “schizophrenic” should be changed to “a person with perceptual differences”. It is much more benign to term an individual “a schizophrenic” than it is to term the fields of psychiatry and psychology those of “behavioral health”. The term “behavioral health” has emerged from the effects and consequences of behaviorism on the fields of psychiatry and psychology. It is obvious that behaviorism is reductionistic. However, behaviorism continues to dominate the mental or “behavioral” health fields due to its emphasis on predicting and controlling behavior, and behaviorism is valued in that it relies on objective results of psychiatric and psychological treatment. Behaviorism itself emphasizes outward appearances as opposed to subjective states, and subjective states can be referred to by the term “subjective well-being.” I have noted that most schizophrenics report that they simply want to feel normal most of the time. While one’s behavior may or may not convey subjective well-being, asking the schizophrenic to describe her subjective feelings may be more therapeutic than it is to emphasize her objective characteristics. While behavioral aspects of mental health treatment, such as hygiene and the observable effects of medication, are important aspects of treatment that emerge from the behavioral perspective, the term “behavioral health” has many negative implications that the lay person or the schizophrenic is unlikely to comprehend. In fact, the schizophrenic may misconstrue the term “behavioral health” to mean that she will be stigmatized if she expresses any symptoms of mental illness. While stigma is real and impactful, creating a wall between oneself and other people as an assumption or presentation of “behavioral health”, the term “behavioral health” will reinforce the psychopathology referred to as the biopsychosocial cycle of psychotic

Pain in Osteoarthritis

by Sara Adaes, PhD. Pain is the arguably the most distressing feature of osteoarthritis, affecting patients’ quality of life and ability to carry out daily routines. Why osteoarthritis is sometimes painful and others painless is yet to be explained. Efforts to develop disease-modifying drugs that could, as a consequence of disease reversion, also alleviate pain have not yet been particularly successful. While such therapies are not available, pain management remains the main clinical concern in osteoarthritis’ treatment. By the time a patient seeks medical help, probably due to pain, osteoarthritis will most likely have been developing for a long time, albeit asymptomatically. Symptomatic osteoarthritis designates the presence of radiographic osteoarthritis in combination with symptoms attributable to osteoarthritis, such as pain, aching, and stiffness. Not all individuals with radiographic osteoarthritis have associated symptoms, allowing it to develop unnoticed. Prevalence The prevalence of symptomatic osteoarthritis is generally lower than that of radiographic osteoarthritis. For example, one study showing a prevalence of radiographic knee osteoarthritis of 19% among adults aged over 45 years also showed that the prevalence of symptomatic knee osteoarthritis was of 7%. Worldwide, according to the World Health Organization, it is estimated that about 10% of the population over 60 years of age suffers from osteoarthritic pain. The risk of developing symptomatic knee osteoarthritis during lifetime is estimated to be of 40% in men and 47% in women. The overall risk increases 60.5% among persons who are obese, a well-known risk factor. A rise in osteoarthritis prevalence in the last years has been estimated, most likely due to aging of the population and increasing prevalence of obesity. Patterns of pain Pain in osteoarthritis is generally considered to be insidious in onset and exacerbated by activity, mostly by movement and by weight bearing on the affected joint. It can often have a diurnal pattern, being relieved by rest, but night pain and pain during inactivity are also reported. Although symptoms are predominantly experienced in or surrounding the affected joint, referred pain and tenderness may also occur. Patients’ description of osteoarthritis pain often include terms such as ‘aching’ and ‘throbbing’, intercalated with moments of ‘sharp’ and stabbing’ pain associated with activity. Joints are richly innervated, containing an array of sensory nerve fibers that convey information to the central nervous system about position and motion of the joint and of forces exerted on articular tissues. Under normal circumstances, joints are fairly insensitive to noxious stimuli. Following the development of osteoarthritis, increased sensitivity to load bearing and to normal movement of the joint can be experienced (allodynia), as well as increased sensitivity to further noxious stimulation (hyperalgesia). Under these circumstances, pain can arise in such innocuous situations as standing or walking. Changes in the joint environment can lead to altered mechanical sensitivity of articular nerves, leading to a reduction of the mechanical activation threshold, such that normal movements of the joint become sufficient to induce pain. Treatments Current pharmacologic treatment of osteoarthritic pain with analgesics and nonsteroidal anti-inflammatory drugs is often unsatisfactory because of lack of efficacy and of adverse effects. Despite treatment with therapeutic doses of such drugs, many patients still have osteoarthritic pain and acquire all the side effects of those drugs, such as nausea, constipation, dizziness, somnolence, and vomiting. In the case of opioid therapy, side-effects also include tolerance, dependence, and respiratory suppression in cases of overdosing or intoxication. Recently, the classical view of osteoarthritis as an inflammatory disease has been shifting towards the possibility of the existence of a neuropathic component in osteoarthritis-associated pain. As a consequence, new approaches have been emerging; antidepressants and anticonvulsants, commonly used to treat neuropathic pain, have shown some promising effects in osteoarthritis. Non-pharmacological treatments such as transcutaneous electrical nerve stimulation or acupuncture have also shown some short-term effects without major side effects. However, there is still little clinical evidence, with studies showing a high variability in their efficacy. A better understanding of the pathophisiology of osteoarthritis is crucial, but most importantly, due to the morbidity and incapacity induced by osteoarthritis-associated pain, understanding its mechanisms is of paramount relevance, so that better therapeutic strategies can arise. References Bijlsma JW, Berenbaum F, & Lafeber FP (2011). Osteoarthritis: an update with relevance for clinical practice. Lancet, 377 (9783), 2115-26 PMID: 21684382 Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F, & National Arthritis Data Workgroup (2008). Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part II. Arthritis and rheumatism, 58 (1), 26-35 PMID: 18163497 Murphy L, Schwartz TA, Helmick CG, Renner JB, Tudor G, Koch G, Dragomir A, Kalsbeek WD, Luta G, & Jordan JM (2008). Lifetime risk of symptomatic knee osteoarthritis. Arthritis and rheumatism, 59 (9), 1207-13 PMID: 18759314 Thakur M, Dickenson AH, & Baron R (2014). Osteoarthritis pain: nociceptive or neuropathic? Nature reviews. Rheumatology, 10 (6), 374-80 PMID: 24686507 WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium (2003). The burden of musculoskeletal conditions at the start of the new millennium. World Health Organization technical report series, 919 PMID: 14679827