A&H October 2017 by The Malta Independent

Inherited fitness and breast cancer

OCTOBER . ISSUE 75

M A LTA â&#x20AC;&#x2122; S B E S T A N D B R I G H T E S T H E A LT H A N D W E L L B E I N G M A G A Z I N E

PLUS

EMMA MUSCAT THE LATEST BOOKS PRODUCT NEWS HEALTH DIRECTORY

FOOD HYPERSENSITIVITY AND HOW TO HANDLE IT

SAVE YOUR SMILE

MARIJUANA health impact of recreational use Mixed blessings

what makes co-ed schools work

SAYS...

hysical ac vity is so important on so many levels, it affects your mental well being, your energy levels and just improves your quality of life in general. This cannot be stressed enough and should be something to embrace; just a simple long dedicated walk with a group of friends or one close friend can be a good place to start. As we close October and Breast Cancer awareness month this issue includes some ground breaking research on how inherited fitness may affect breast cancer risk. As we have all by now heard repeated studies have shown that physical inac vity, and the occurrence of obesity to which it is linked, increases the risk for many chronic diseases, including breast and other cancers. Did you know that aerobic fitness also has a heritable component? Read on in this issue to find out more, and as breast cancer month draws to a close consider having your self checked. Small simple steps, whether going for a physical checkup or becoming more dedicated to doing some sort of physical ac vity, can have huge posi ve benefits in the long run. We’ll be back mid-December with another new issue.

EDITORIAL CONSULTANT Corinne Vella ASSISTANT EDITOR Anna Maria Ga DESIGNER Conrad Bondin – Standard Publica ons Ltd. CONTRIBUTORS Daniela Allen, Marika Azzopardi, Mariella Camilleri, Anna Maria Ga , Corinne Vella PHOTOGRAPHY Standard Publica ons Ltd. & others. PRINTER Print-it DISTRIBUTION Bi-monthly with The Malta Independent on Sunday, and in clinics, hair and beauty salons and pharmacies. ADVERTISING Chris ne Bu gieg – Standard Publica ons Ltd. T 2134 5888 ext 136. cbu gieg@independent.com.mt SALES CO ORDINATOR/ARTWORK COLLECTION Chris ne Bu gieg – Standard Publica ons Ltd. T 2134 5888 ext 136 PUBLISHERS P&D Communica ons Ltd. Standard Publica ons Ltd., Standard House, Birkirkara Hill, St Julian’s STJ1149, Malta. T (356) 2134 5888 F (356) 2134 6062, 2134 3460 The informa on in this magazine should not be used as a subs tute for the care and advice of a health professional. Appropriate treatment varies according to an individual’s par cular condi on and circumstances. Self-diagnosis is risky, especially in the case of serious condi ons. All rights reserved. Reproduc on of this magazine in whole or in part is strictly prohibited without the wri en consent of Standard Publica ons Ltd. A&H’s publishers cannot be held responsible for any ac on taken without the advice of a medical specialist. The opinions expressed in this publica on are not necessarily those of the publishers or the editor. While every a empt has been made to ensure accuracy, the publisher and the editor cannot be held responsible for any errors or omissions from ar cles, adver sing, photographs or illustra ons, for unsolicited manuscripts, photographs or other material, or for submissions of any kind, whether delivered electronically or by conven onal mail, which are lost or damaged in transit.

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IN THIS ISSUEFEATURES 14

MEET EMMA MUSCAT

MIXED BLESSINGS Pros and cons of co-ed schooling

HOW INHERITED FITNESS MAY AFFECT BREAST CANCER RISK

JUNIOR TO SENIOR Easing the transition

30 34

WHY DO IT? SUGAR FREE AND HEALTH taking control of diabetes

REAL LIVES

HOW INHERITED FITNESS MAY AFFECT BREAST CANCER RISK

THIS IS MY SONG Meet Emma Muscat

LEARNING BY DOING Lindsey Cassar on how children learn and and how caregivers can help

RISING TO THE CHALLENGE Special Olympians Matthew and Anne Marie Bugeja

NUTRITION 22 26

EATING IN SEASON

UP IN SMOKE? Recreational marijuana’s health effects

WHEN FOOD IS YOUR FRENEMY Handling hypersensitivity

UP IN SMOKE? Recreational marijuana’s health effects

REGULAR 58 GREAT READS 59-63 PRODUCT NEWS 63-64 A&H DIRECTORY

Feeling healthy and being healthy are two different things. Be proactive about your health. Saint James Hospital tailors screening plans to age, medical history and lifestyle. Call 2329 1000 for more information. www.stjameshospital.com

ISSUE

MIXED BLESSINGS Why mixed schools work

• You learn to deal with and to respect the other gender At the end of compulsory education, irrespective of whether students keep on studying or enter employment, they will find themselves in a mixed environment. Spending their school years in a mixed environment helps them learn how to behave with the opposite gender. They will learn how moods differ, and how to act in different situations.

• Everyone learns about equality Being taught in the same classroom, by the same teacher, and sharing the same space and facilities, tells students that all of them, irrespective of their gender, deserve the same opportunities. Everyone has the right to have the best education possible. Even when it comes to assessment, all students are given the same tasks and are graded according to their ability and not their gender.

• You learn better communication skills At times, boys and girls (and, later, men and women) speak and reason in different ways. Being brought up with people of a different gender helps you to develop your communication skills. Girls are not expected to start thinking like boys do, and boys are not expected to see the world in the same way girls do, but spending hours together both in class and in recreation areas, will help develop a sense of understanding – and, hopefully, acceptance - of how another person sees the world. 6

October 2017

• Students experience healthy competition We face competition at all stages of life. Learning how to cope with competition means learning how to cope with failure along the way. Competition between genders results in a healthy approach to life and to developing one’s ego. It also helps youngsters accept defeat with dignity, helps them to never give up, and to face challenges with determination.

Arguments against mixed schools • There is a greater risk of distraction Distraction is much more common in secondary years because of the psychological and physical changes of puberty. The last three years of secondary school are crucial to shaping a student’s future. This is when distraction should be kept at a minimum. It is also when the distraction of budding romance interferes with learning.

• Higher risk of unethical behaviour The turbulent changes of puberty affect one’s emotions. Girls usually become more sensitive while boys tend to be a become rougher. Certain comments, gossip, and nowadays irregular use of social media, might cause emotional harm which leads to low self-esteem. Educators comment that, in girls’ only schools, these problems were always there, but having boys in class too is resulting in new forms of ‘gangs’ which create new types of stress.

THE ISSUE OF CO EDUCATION PERSISTS. ARE CO EDUCATIONAL SCHOOLS BETTER THAN SEGREGATED SCHOOLS? A&H ASKED EDUCATORS, SCHOOL ADMINISTRATORS, AND PARENTS WHAT THEY THINK.

Being brought up with people of a different gender helps you to develop your communication skills. • Who is the leader in class? There are mixed opinions about whether girls tend to boss boys around, or else the boys, with their noisy attitude at times, create havoc in class. It all depends on the characters and personalities of the respective students. Girls tend to mature before boys and usually speak up more in class, expressing their opinions. On the other hand, boys tend to think and act faster. This means having to learn about balance and self-control. No educational system is perfect, but all should have the same purpose of maximising the potential of students and pupils. Overall, an education system should bridge the gap between girls and boys while offering the same opportunities to everyone, irrespective of gender.

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AWARNESS

HOW INHERITED FITNESS MAY AFFECT

BREAST CANCER RISK

HENRY J. THOMPSON, DIRECTOR CANCER PREVENTION LABORATORY, COLORADO STATE UNIVERSITY

epeated studies have shown that physical inactivity, and the occurrence of obesity to which it is linked, increases the risk for many chronic diseases, including breast and other cancers. In fact, the evidence is so compelling that the lifestyle guidelines of most health agencies, both in the United States and abroad, include a recommendation for obesity prevention via maintenance of an appropriate body weight for height and a physically active lifestyle. However, what if the science behind these recommendations were only about half the story? What if your fitness were influenced not only by your activity level but also by your genes? And, focusing specifically on breast cancer, what if one’s risk of getting breast cancer were influenced by one’s inherited capacity for fitness? A team of investigators, including me, explored these questions in a recently published study and found a surprisingly large role for genetics in fitness and breast cancer.

October 2017

Fit as you can be?

And individuals with high fitness generally fare better not only in having a lower risk for chronic diseases like cancer.

We frequently associate a physically active lifestyle and maintenance of an appropriate weight for a given height (measured as body mass index) with fitness, which is sometimes referred to as cardio-respiratory fitness. And individuals with high fitness generally fare better not only in having a lower risk for chronic diseases like cancer. Even when they are diagnosed and treated, they have a more favorable prognosis for recovery. However, what has generally been overlooked is that aerobic fitness, broadly defined as the ability to transport oxygen and nutrients to the muscles, has a heritable component. That explains why individuals engaged in the same training program have a wide range of improvement in their fitness in response to the same amount of exercise. This inherited capacity for fitness led us to consider whether this capacity affects breast cancer risk. Our question, while simple, would be problematic to study in people because it requires a lifetime of

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AWARNESS sedentary behavior, which is contrary to medical advice for health and well-being. So, the team decided to investigate this question in the laboratory. We worked to isolate the effects of inherent fitness and then studied how they affected breast cancer rates. The fitness model was developed by selecting rats over multiple generations with low or high running activity on a treadmill. Those rats that ran the farthest before tiring were mated with one another and those rats that tired of running early likewise were

October 2017

bred together. This procedure was repeated for many generations, ultimately resulting in pups with large differences in inherited fitness. To study the effects of these differences in inherent fitness, we took female pups born to mothers with high or low fitness and maintained the pups so that we could assess primarily the effects of fitness related to genetics, not to exercise. Before reaching sexual maturity, the pups were exposed to a chemical that triggers the development of breast cancer.

The animals were then monitored for the occurrence of palpable tumors throughout their lives and for tumors too small to detect without the use of a magnifying glass at the time of their death. What we found was striking.

Born fit, and born unfit Rats born with low fitness were four times more likely to develop breast cancer, whereas rats born with high fitness not only had fewer cancers but the cancers occurred later in their lives and were smaller in size.

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When energy and nutrient availability is high, the system is active and promotes the ability of a cell to proliferate.

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AWARNESS

Our study suggests that there is an inborn component to protection that affects one’s exercise performance as well as their risk for breast cancer. 12

October 2017

DIET

These effects were traced, at least in part, to a network of sensors that occur in essentially every cell in the body. This system, referred to as mammalian target of rapamycin, senses the availability of energy and of various nutrients within the cell. When energy and nutrient availability is high, the system is active and promotes the ability of a cell to proliferate; excessive cell division is a hallmark of cancer. We found that this signaling activity in cells in the breast was high in rats born with low fitness, whereas it was reduced in rats with high inherent fitness. Efforts to identify hormones or growth factors in the blood that explained this difference were not successful, suggesting that the responses are coming from deep within the cell.

Next steps: Moving from lab to clinic A growing number of studies in women have

shown a link between exercise and breast cancer risk, and these findings seem to indicate that aerobic fitness alters the inner workings of cells to confer its protective effects. However, our study suggests that there is an inborn component to protection that affects one’s exercise performance as well as their risk for breast cancer. Many questions have been raised by this research. Recognizing that our experiment was done in rodents and that rodents are not people, the stage is set for extending these observations from the laboratory to the clinic. A great amount of work also remains to be done using the rats with low and high inherent fitness. Current studies are focused on how to reduce breast cancer risk in rats born with low fitness. Key questions revolve around identifying the amount and type of exercise needed to break the link between low inherent fitness and the development of breast cancer, since most of us have the ability to raise our innate fitness capacity with exercise.

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INTERVIEW

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SONG BEFORE SHE COULD EVEN TALK, EMMA MUSCAT WAS TAPPING THE KEYS ON THE PIANO. THESE DAYS THE PATTER HAS TURNED INTO MELODIES THAT ENTERTAIN HUNDREDS OF PEOPLE. INTERVIEW BY MARIELLA CAMILLERI

October 2017

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INTERVIEW

“

My earliest memories take me back to early childhood when I sat at the piano and made up my own tunes. Music has always been part of my life and I can’t imagine life without it,” says Emma Muscat when I meet her for coffee on a Monday morning, eager to learn more about the exhilarating world of singing, song writing and piano playing. Emma who has been singing since age four, and playing piano since she was six, begins by telling me about her present day, about the live performances where the dual talented beauty enthrals audience with several music covers which she adapts according to her own style. Accompanied by guitarist Keith Kiko Muscat, the seventeen year old performs at festivals, charity events and live gigs all over Malta. Over the years, she has also taken part in various competitions in Italy, winning ‘Una Stella Sta Nascendo’, and being the runner up in ‘Voci dal Sud’. Emma has also performed in the UK. “The very first time I had to sing and play in front of an audience was at the age of nine at a concert of piano forte. From that challenging performance, I realised that my life was destined to revolve around music. A lot of concentration is required at the piano together with focus on voice and technique. However these days I no longer have to concentrate excessively because it comes more naturally than ever before.”

October 2017

When I ask Emma how she feels about overcoming stage fright, she gives me a small smile and explains how she closes her eyes and pretends she is alone

When I ask Emma how she feels about overcoming stage fright, she gives me a small smile and explains how she closes her eyes and pretends she is alone. She adds that she loves being on stage and feels she is in her element when performing for a crowd. “After some time, I tend to focus on a section of the audience, and then simply rise to the challenge and become one with the music and enter a world of my own. “ Some of her bigger performances include singing the national anthem for the Malta Great Siege anniversary opening ceremony in Valletta, Swieqi Fest, Sliema Fest and taking part in a televised programme on La 5. Emma, who has so far composed two songs, says that her passion is recreating cover versions: “With covers you can express yourself in so many ways, because with piano notes a song can be recreated into something jazzy or bluesy and this gives me the liberty to come up with my own version.” She has a great ability to recreate versions of various songs such as her outstanding cover of Alicia Keys’ ‘If I aint got you’, with a voice that can melt the coldest hearts. Her passion, however, lies in her song writing and music composition. Over the past year she has released two singles, ‘Alone’ and ‘Without You’, which together have reached around a million views over multiple shares. “I am always overwhelmed by the positive feedback because it encourages me to continue writing and compose music.” Emma goes on to tell me about her upcoming exams in both piano and singing where she is set to reach standards at diploma level. She is also about to begin a course in Media and Communication at the Faculty of Media and Knowledge Sciences at the University of Malta. “Combining academic studies and my music is always a challenge, particularly during exams. However, these days I tend to spend less time on rehearsals than I did in previous years.” The young artist adds that for the past twelve years juggling music and studies has been a trying experience. “Coping with both can be stressful. However, by the time I appear on stage, I always feel extremely rewarded and fulfilled.”

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NEXT ISSUE: 17 DECEMBER

with The Malta Independent on Sunday

For advertising opportunities contact Christine Buttigieg on 2134 5888 ext 136 or email cbuttigieg@independent.com.mt

NEW

BEGINNINGS

Crossing

THE BRIDGE

ENTER THE WORLD OF SECONDARY SCHOOL WHERE SATCHELS WEIGH A TON AND TEACHERS INTERCHANGE WITHIN THE HOUR. IT’S A TRANSITION WHERE CHILDREN LEAP FROM THE SAFETY OF A FISH BOWL, INTO THE BIGGER OCEAN WHERE THEY STAND ALONE AGAINST THE SOCIAL, ACADEMIC AND EMOTIONAL CURRENTS THAT WILL FLOW TOWARDS THEM EACH DAY. MARIELLA CAMILLERI REPORTS

espite the long gone days of separation anxiety when children let go their mothers’ hands and entered kindergarten, most students still experience a sense of trepidation when senior school appears on the horizon. 13-year old Emma says that leaving junior school was a bitter sweet experience. “Junior school felt homier than senior school because the environment was friendlier. We had class teachers whom we had grown to love and trust. In senior school teachers walk in and out and the experience is less personal.” 12-year old Andrew also found the move from junior to senior school a daunting experience. “Before we entered secondary school, teachers use to warn us about the workload. They often said that if we didn’t cope with primary school we’d never

October 2017

cope with senior school.” However after the midyearly exams Andrew found that the warnings were overrated. “In junior school teachers spoon feed you and expect you to do really well. In senior school,

most revision is done alone. In a way, the exams were easier than expected.” Josannne Tabone Adami a PSCD teacher from the Church school sector says that most children enter secondary school feeling overwhelmed: “Many are concerned about the extra subjects, extra homework, new languages and teachers’ demands. Suddenly they have several different challenges, and many worry about failing exams or clashing with their teachers.” Ms Tabone Adami goes on to say that form one students also worry about school rules. “Many fear that they’re not aware of ‘new’ rules and panic at the thought of punishments. Often it takes a while until they become accustomed to new regulations. However, after a few months they soon learn to adhere to the guidelines.” Disorganisation is common in the early days of senior school and students often find themselves

NEW

BEGINNINGS

unable to cope with the stress of homework, filing and study work. For 12-year old Mark, the move to secondary school proved to be a struggle: “Last year, I was often kept inside in breaktime because I kept misplacing my homework or forgetting my books at home. Keeping up with a timetable and remembering to pack certain copybooks is still very confusing.” Mark says that, often, his mother would step in to help and ensure that everything was packed. Attention Deficit Disorder and learning difficulties often become more evident in senior school. Ms Tabone Adami says that most students with ADD experience disorganisation, a factor that complicates life in the secondary years: “Besides the filing and timetables, students also need to ensure that notes are filed and in order for revision. Those who misplace their notes struggle during exam time because missing or jumbled notes create added stress.” New languages like French, Italian or German can also be a challenge particularly for dyslexic students. In most schools, pupils are given the option to drop foreign languages and choose other subjects. “Very often, those with learning difficulties find it challenging to take on a new language,” Ms. Tabone Adami says. Sometimes even those without dyslexia can find new languages a challenge, especially when they are learning two new languages at the 20

October 2017

Most students with ADD experience disorganisation, a factor that complicates life in the secondary years same time.” Gilbert, 12, says that coping with two new languages was an ordeal. “Even though we had started Italian and French in year six, they were still quite difficult to pick up. Often, I would confuse French tenses and verbs with those of Italian. It would have probably been easier to learn these new languages at age five just as we did with Maltese and English.” Mixed ability classes can also create obstacles in the senior years. Gilbert says that sometimes teachers would move too fast between one topic and the next and therefore not enough time is allocated for the information to sink in: “In some classes teachers would take too long on a topic and others would just skim past. Some would give notes that didn’t include enough detail so in certain subjects some of the work has to be done alone.”

Besides the school rules and academic pressures most Form one students also fear the possibility of being bullied by older students. 11year old Andy says that mingling with older students who are double his size makes him nervous: “Most feel very cool and think that they can get away with murder simply because they are older.” He adds that students leave primary school as the eldest students however, they enter secondary as the youngest: “It’s strange but to me it felt like I was entering primary school all over again.” Peer pressure increases in the senior years. All students interviewed agree that friendship and bonding is easier in primary school when children are less coerced with crowd following. Emma says that in junior school it was easier to do what is right; however, in senior school students are often shunned when mixing with children who are

timid and less popular: “Popularity means being good at sports, good looks and having more freedom than your peers. In senior school, success means fitting in with the in crowd.” Cyber bullying is another issue that erupts in the secondary years. Ms. Tabone Adami says that by the ages of 10 or 11, most students make use of their own phone. “This is a great tool for communication,” she says, “however it opens the door to a form of bullying where students are often tormented behind a screen. Most need to be educated because they are not really aware of the danger of bullying or of being bullied by others.” She goes on to say the problem has now become widespread: “During class sessions we often teach students skills to handle difficult situations.” Support from parents, teachers and school administration is essential when children move to senior school, since the transition involves social, academic, and emotional challenges. Ms. Tabone Adami concludes by saying that when the first year of secondary school is over most students are relieved to find that they have settled in: “Despite the great transition, students settle well. On the upside, many acquire a new found confidence. They learn to make new friends and to challenge themselves academically. Ultimately, the transition is a natural experience that does wonders for children’s growth.”

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FOOD

Fresh fish have clear bulging eyes, shiny skin, reddish gills, and flesh that springs back when lightly pressed

IN SEASON IF YOU CAN’T STAND THE HEAT AND WANT TO GET OUT OF THE KITCHEN, SPIN A QUICK MEAL OUT OF FRESH FISH, FRUIT, AND VEGETABLES

resh fish is one of the healthiest of convenience foods. Sprinkle a whole fresh fish with olive oil, a squirt of lemon, and a few sprigs of parsley and bake it in a foilwrapped dish for a tasty, healthy meal that’s ready in minutes. Fish is generally high in protein, low in saturated fat and cholesterol, and contains vitamins A and D and minerals including iodine, selenium, phosphorous, potassium, iron and calcium, though the amounts of each vary from species to species. Fish also provides Omega-3 fatty acid, which can help maintain heart health and reduce inflammation.

October 2017

FOOD

FOOD SAFETY Fish spoils quickly but refridgerating it is not enough. Before you place fresh fish in your fridge, remove any plastic wrapping to reduce the growth of bacteria. If the fish stinks, throw it out. To avoid transferring microorganisms from fish to other food, keep one cutting board to use when preparing raw fish (and meat and poultry). This should be made of an absorption-resistant material such as glass. Clean it by sprinkling it with salt and then pouring hot water over it before wiping it down with disposable kitchen paper. Clean all other utensils using hot, soapy water and wash your hands thoroughly. Like any other raw meat, raw fish contains pathogens including parasitic microorganisms that live in the fish, and any bacteria or other microorganisms that may

WHEN BUYING FISH LOOK FOR: • freshness – fresh fish have clear bulging eyes, shiny skin, reddish gills, and flesh that springs back when lightly pressed; • fish fillets that are moist or that are prepared in your presence; • tightly sealed, clean packaging when buying frozen.

AND AVOID: • fish with sunken eyes, as this means that the fish has been around for days; • dry-looking fillets – buy whole fish and ask your fishmonger to fillet them in your presence; • packages of frozen fish that are thickly coated with ice crystals as the package may have defrosted and been refrozen. Freezing slows, but does not stop, deterioration due to microorganisms. Fish which has defrosted and been refrozen may be contaminated although it may look fine.

FRUIT AND VEG Lemons are the perfect dressing for fresh fish, contain have very little sugar, have absolutely no fat and even provide a trace of protein. They're especially high in vitamin C, and contain vitamin B6, calcium, potassium, iron, magnesium, and traces of other elements. They also contain fibre.

Lemon ice cream Using a fork, mash a couple of tablespoonfuls of lemon juice into a small tub of soft ice cream and eat it immediately. Alternatively, drizzle lemon juice over the ice cream and pop it back into the freezer for at least 30 minutes before serving.

Shellfish allergy Shellfish in particular is one of several foods that are likely to trigger food allergy symptoms. The onset can be sudden, even in a person who has not previously shown any signs of food allergy. If, after eating fish, you experience swelling (particularly on the lips and eyes), break out in hives, have difficulty breathing and have an upset stomach, seek medical advice immediately.

Fish bones for calcium Fish bones are a good source of calcium but the only ones that can be eaten safely are the fine bones in cooked, canned fish such as sardines. Do NOT try to eat any other kind of fish bone, even when it is cooked. 24

October 2017

spring onions, and one large beef tomato. Toss all the ingredients together in olive oil, sprinkle with parsley and a pinch of pepper. Serve immediately. This tastes more refreshing if you first cool the solid ingredients in the fridge.

Lemon zest Mint and lemon 'sherbert'

FLASH POINTS

be transferred by food handlers. Heatcooking fish does not simply make it more palatable, it also makes it safer to eat by destroying any parasites and microorganisms that are in the raw flesh. Marinating fish in lemon juice can give it the appearance of being cooked but, unlike fish cooked by heat, marinated fish may contain active parasites. Heat-cooking is safer, particularly for young children and older people. Environmental pollutants can accumulate in fish fat. Generally, the larger the fish, the higher it is up the food chain, and the greater the accumulation of pollutants. As a rule of thumb, choose smaller fish or, if buying steaks from larger fish, trim off the skin and outer fat, and grill it over a pan so that the fat will drip off when cooking.

Mix the juice of six lemons with six spoons of mild honey and a handful of fresh mint leaves. Whizz the juice, honey and mint together in a blender, pour the lot into a jug, top it up with sparkling water, and add crushed ice. Serve it in tall glasses. Alternatively, make up a jugful with still water and keep it in your fridge.

Strawberry lemon shake Mix a handful of strawberries with the juice of half a lemon. Whizz the lot in a blender with a cup of cold milk and add honey to taste. If you don't like milk, leave it out and double the amount of strawberries.

Lemon and tomato salad Peel, deseed and finely chop four lemons, one medium-sized white onion or three

Choose only unwaxed lemons (the ones with shiny, almost smooth skin) if you want to use the essential oil in the skin. To extract the flavour of the oil, grate the top coloured layer of the skin and sprinkle it over green salad, fruit salad or dunk it in your mint and lemon drink.

Lemon dressing Lemon and olive oil is a favourite dressing for green salads, but with more lemon than oil it can also be used to dress a fruit salad. If you don't like the taste of olive oil with fruit, try adding freshly shredded mint leaves, or leave the oil out altogether. A bowl of fresh strawberries dressed with freshly squeezed lemon juice is flavoursome enough, though if you've a sweet tooth you might want to mix in a spoon of honey first.

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DIET

ne child’s food is another one’s poison, even if the food in question is a healthy source. Some people struggle to pin-point the ‘silent killer’, the food or nutrient causing adverse effects on their health. “The terms allergy and intolerance are often misused,” clinical nutritionist Mariella Porter says. This is because through proper testing can Food Hypersensitivity (FHS) be classified as allergic hypersensitivity, where the immune system is involved, and non-allergic sensitivity, which is more commonly known as intolerance, its previous classification. For example, the cause of allergic food hypersensitivity can include gene-environment interaction, although studies have recognised influencing factors which include breastfeeding duration, type of birth delivery, modification in feeding practices, increase in processed food consumption, declining gut microbiota and lower levels of vitamin D. “The fact that only a fraction of children exposed to these environmental triggers develop an allergy indicates that there is an underlying genetic predisposition,” Ms Porter says. In her clinical practice, she has come across cases where a child was not exposed to any of the environmental triggers mentioned above and still developed an allergy. “Most food hypersensitivity occurs on exposure to food at the weaning phase,” she says. “A percentage outgrow their sensitivity as they grow older, yet hypersensitivity to food can occur to anyone at any age, even to food they like and have been consuming for years.” Non-allergic food hypersensitivity (intolerance), is the interaction between genetics and environmental factors and is only understood in a small fraction of cases.

FOOD

FOOD IS A SOURCE OF PLEASURE, NOURISHMENT, SATISFACTION, AND SOCIAL LIFE. FOR SOMEONE WITH HYPERSENSITIVITY, FOOD CAN BE DANGEROUS TOO. DANIELA ALLEN REPORTS.

October 2017

Diagnosis There are various diagnostic tests on the market however most have not been appropriately validated. An example of this, says Mariella is the serum IgG test which is based on an increase in the antibody found in the blood referred to as IgG, which says increases whenever a person consumes the specific food tested for. “A patient can be presented with a list of food items for which a high antibody level was detected and asked to exclude them from the diet, resulting in nutritional deficit and unnecessary stress,” Ms Porter says. “This can be a health hazard especially in young children.”

DIET

Proper testing The proper path to testing for food hypersensitivity is as follows. Following a medical history report and a physical examination, there would be indications as to whether the hypersensitivity is of allergic or non-allergic (intolerance) nature. If an allergic nature is suspected, a blood sample and skin prick tests are useful in diagnosing cases of immediate reaction. At times, this is followed by a food challenge in a clinical setting where the patient is given micro-doses of the allergen. For non-immediate type of allergies, patch tests can be applied to a patient’s skin for 48-to 72 hours, where any effects are evaluated. Exclusion diets are also considered as supportive diagnostic tests in this type of food allergy. In the case of coeliac disease, blood tests are used as an initial marker, followed by a biopsy if serum tests are positive. In most non-allergic FHS, diagnostic exclusion diets can be sufficient to identify the culprit food inducing hypersensitivity. This type of diet should only be followed with the guidance of a health professional specialised in the field.

Managing food hypersensitivity Following diagnosis, Mariella advises patients and parents to compile a list of food and non-food items containing the food the child is hypersensitive to, with the guidance of a health professional specialised in the field. “This should include food at high risk of crosscontamination with the substance causing a reaction. Non-food items can include hand wash and moisturising creams, which may contain nuts oils, and playdough containing wheat,” Ms Porter says. “Furthermore, food labels must be double checked, and food providers at restaurants or parties should be spoken to about the hypersensitivity prior to when the patient consumes the food. It is important that no assumptions are made,” she says. Such information should be shared with other people caring for the child in different settings. This includes other family members, teachers/carers in

It is up to carers, and the education and health sectors to safeguard their health and safety

schools and during other extra-curricular settings. In the case of a nut allergy she explains, “do not assume that people around you are aware that a high number of chocolate or chocolate spreads contain nuts.” In young children, providing them with their own food wherever you are can limit crosscontamination and risk of reaction: “Cross contamination is a subtle way in which children might consume food they are hypersensitive to. Children, especially very young ones, put food and 28

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non-food items in their mouth, rub their eyes and put their hands in mouth, nose and ears. These are all entry points for allergens or other food particles to cause hypersensitivity in the body.” For example, when dealing with allergies such as fish, peanut and nuts, the oils in these foods can easily be transferred on contact with other people or objects. “Hence, especially in the case of young children, the environment needs to be as free as possible from the food causing hypersensitivity tables, play area, and hands are cleaned before eating.” Ms Porter says that patients with a food hypersensitivity should be encouraged to wear a bracelet that indicates their reaction to food. This is especially helpful in young children where verbal communication is still developing, and in adults in case there is a high reaction and the person is unable to communicate. Once a patient has been diagnosed with a food hypersensitivity they should ask their health professional for an action plan. This should include information about the food hypersensitivity, how to deal with it, and how to proceed in case of contact with or consumption of food in question. Very few are aware that past reactions to food are no guarantee of the nature of future ones, especially in those of immediate allergic nature. Hence if a rash resulted on consuming the allergenic food, this does not mean that this is the only reaction the person will always get in the future. “Allergic reactions are very complex, and the less

DIET the allergenic food is consumed, the higher the risk of more adverse reactions occurring including anaphylaxis and death.” Children should be made aware of their hypersensitivity as soon as diagnosis is made, Ms Porter says: “Hypersensitivity is not shameful. The high majority of assertive children with such hypersensitivity are ambassadors on the topic and are capable of sharing information with peers about it.” The discovery of a food hypersensitivity can result in a lot of stress on the patient and those in their care. Ms Porter advises asking for support and help on a practical level: “I encourage those going through this and feeling highly overwhelmed to ask for support and help on a practical level or even psychological support if need be.” She also encourages parents to strike a balance between making their children aware of their hypersensitivity and enjoying life normally: “It is very important that feeding time is not portrayed as an anxious time in case of a reaction. Children pick up our anxious vibes and the least thing we want to cause is further food phobias and restrictions.” In addition, social activities like parties, eating out, and playing with other children do not have to stop. Another example is that while washing hands should be normal practice prior to feeding, “in cases of severe food allergies this is even more important. and the eating area has to be free from the child’s allergen.

Non-food items can include hand wash and moisturising creams, which may contain nuts oils, and playdough containing wheat

“Children with some form of hypersensitivity have the right to enjoy each aspect of food. It is up to carers, and the education and health sectors to safeguard their health and safety.”

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RELATIONSHIPS

WHY DO IT?

PEOPLE WHO ACCESS PORNOGRAPHY ONLINE DO SO FOR VARIOUS REASONS: CURIOSITY, ENTERTAINMENT, STIMULATION, OR AS A FORM OF SEXUAL EDUCATION. THREE READERS TELL ALL.

October 2017

I realised that I was not happy and that I was being used just to satisfy his sexual fantasies and pleasures

*Kenneth, 31, single Everyone watches pornography. Whoever says they never did is lying. Porn is now very accessible, just a click of a button away. When I was a teenager, I remember leafing through magazines and sharing them with my school mates. We used to hide things in different places, which made it difficult for our parents to find them. Why do I watch pornography? I can’t give a clear explanation. I am single, I was never that lucky with girls and women, and i can’t boast of having experienced any great sexual encounters. I watch pornography to try to increase my knowledge of how to please a woman. Women are as sexually knowledgeable as men, and I want to feel prepared when the opportunity arises. I am very choosy about what to watch. I look for sites that depict sex as a form of art, and not simply sex as something to feel pleasure. At times, certain sites depict love making as something that is just there to satisfy one’s needs. Even though I am still single, I consider sex as something precious and I look forward to having some true experiences, which are reciprocal and not just one way.

October 2017

RELATIONSHIPS

*Alex, 35 years old, married with 2 children I believe that pornographic material should be totally censored and banned. Apart from degrading the act of love making, it also shows how cruel mankind can be. The problem is that some people think porn is harmless, and it is this way of thinking that is wrecking the minds of many. Watching porn often results in your hormones being released when you watch an image or a movie, not when you are with your spouse or partner. People might say that I speak like this because till now my marriage has been on the right track. My wife and I got married five years ago, and both of us had other relationships before. This made us appreciate sex and associate it with the build-up of a relationship with a person, not with an object or a simple image. People unfortunately tend nowadays to dissociate the body from intimacy. Watching porn is all about the body. It says nothing about intimacy with someone whom you consider as very

important. I hope that porn producers and manufacturers realise the harm they are causing to victims who end up trying to seek pleasure in surreal things.

*Franny, 27 years old, in a relationship I am currently in a relationship which is quite new. I was in another relationship for three years and it was an extremely turbulent one. Unfortunately I have to blame pornography for a huge chunk of the problems I had with my exboyfriend. At times he was obsessed, not only about watching porn, but also to put his fantasies into practice. He never abused me and didn’t hurt me, but at times he was too demanding. When we started dating, I was still young and I admit that it didn’t bother me that we were quite

adventurous and always trying out something new. But then eventually it became tiresome, and I used to dread when he suggested I go over to his place or else to go on weekend breaks or holidays abroad. It was then that I realised that I was not happy and that I was being used just to satisfy his sexual fantasies and pleasures. It was not easy to end the relationship, because I loved him and I used to imagine a future with him. I wanted him to realise that he was becoming obsessed, and I thought that by ending the relationship, he might miss me and change his attitude. I was wrong because he shut me out completely and never came back. Now, I am in another relationship and I feel glad that I managed to speak out to my new boyfriend about my past. *Names have been changed.

People who access pornography online do so for various reasons: curiosity, entertainment, stimulation, or as a form of sexual education

A&H says... Some couples enjoy watching porn together. As long as the choice is mutual, not coercive, and as long as the pornography itself is not dangerously abusive, this is a matter of personal preference. People who object to porn may do so for moral or social reasons. Others may simply find it voyeuristic. To many, sex is not just physical. They reject porn because it cannot provide the emotional reward of human connection. People who access pornography online do so for various reasons: curiosity, entertainment, stimulation, or as a form of sexual education. While some find the habit distasteful, whether it is harmful in relationships depends on several factors, including the type of porn itself and whether coercion is involved. 32

October 2017

Hardcore porn, involving real physical harm or abuse of the vulnerable - especially children - is toxic in itself. Being forced to watch porn against your will is abusive, as is being forced to act out what you see on screen. In some couples, one partner may like to watch porn while the other feels it interferes with the relationship. If one half of a couple uses porn in secret and is found out, the other person may feel betrayed or threatened. In some cases, pornography can become an unhealthy obsession and, possibly, lead to abuse of sexual partners. Obsessive use of porn may be due to loneliness, depression, or low self-esteem. Whatever the root cause, help exists. Tackling the obsession problem will improve life for the person and and anyone else in their life.

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HEALTH

SUGAR FREE AND HEALTHY WHEN LEFT UNTREATED DIABETES CAN RESULT IN SEVERE COMPLICATIONS, ONES THAT PUT THE LIVES OF THOSE EFFECTED AT RISK. WORDS BY MARIELLA CAMILLERI

lthough there is a lot of awareness about Diabetes, not much is said about its complications and the stress that arises when one suffers from this condition. My father was first diagnosed with borderline Diabetes in his forties and for most of my life I watched him abstain from sugary foods, monitoring his intake of starchy dishes â&#x20AC;&#x201C; this and a rather hectic lifestyle helped to keep his blood glucose levels in check and Diabetes was never viewed as a serious threat to his health. Worldwide, Diabetes afflicts more than 380 million people, and the World Health Organization estimates that by

October 2017

2030, that number of people living with diabetes will more than double. The illness occurs when the pancreas fails to produce the necessary insulin that turns the food we eat into glucose that is needed for energy. There are two types of Diabetes: type I effects children and young adults and occurs when the immune system attacks part of its own pancreas; thus with this type of diabetes no insulin is produced and those effected must use insulin injections to control the levels of glucose in their bodies. With type II, the patient suffers from insufficient insulin or his/her body fails to use insulin effectively. As the conditions gets worse the pancreas fails to produce insulin completely. Unlike

With diabetes there is no such thing as irregular meal patterns.

type I Diabetes where young people experience malaise and weight loss, type II can be very silent and may go undiagnosed for years. Blood sugar in Type II diabetes can rise with little warning as was the case with my father. The severity of his condition was discovered in the winter of 2016 when he taken ill with Pneumonia. He felt unwell, lethargic and his appetite was supressed. Unable to take his antibiotic, my sister and I decided to admit him into a hospital where he could be given his antibiotic intravenously. By the time we reached the A&E he could barely walk, and doctors began to work on him right away. His blood sugar levels where extremely high and his blood pressure had risen to dangerous levels.

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HEALTH

Unfortunately many people fail to go for check-ups and due to its rather elusive symptoms Diabetes can go undetected for years, this results in serious complications; ones that may lead to kidney failure, blindness and loss of lower limbs. 36

October 2017

Before this terrifying episode, my father had minor wounds that took long to heal, he also complained of a dry month; often he awoke at night parched, we told him off for not drinking enough however, his symptoms had little to do with lack of drinking. Later the specialist explained that when the body fails to produce insulin, one becomes dehydrated. We also learned that untreated Diabetes makes a person more susceptible to pneumonia and other common infections. Four days later my father was released from hospital and so began a journey of blood sugar monitoring and round the clock medication. Due to the long recovery process from Pneumonia, my father came to recuperate at our home – a long and arduous experience where we tried our best to make him as comfortable as possible. Initially despite the medication, his blood sugar levels remained abnormally high. A small portion of pasta would cause his blood sugar levels to plummet, this led his doctor to prescribe stronger oral medications to keep his insulin stable. With diabetes there is no such thing as irregular meal patterns. Once the patient is given oral medication or direct insulin (injected) meals cannot be missed. But like most families we learnt through trial and error, and evitable things do happen in the early days of diagnoses. One morning my father took his oral medication later than usual and then went on to have lunch at my sister’s house. Later in the evening just before

dinner he returned in high spirits; he was talking and laughing but there was something strange about the way he was resting against the sofa, he tried to get up but his body gave way. My heart leapt. Fearing a stroke, my husband called a friend who works in A&E and soon an ambulance was sent. A quick blood test check revealed that his sugar levels had dropped dangerously low. Despite several sugared teas, toast and chocolate, his sugar levels failed to rise and my father was taken to Mater Dei were glucose was injected into his arm. Within half an hour he seemed stable again and had regained his balance. We were told that he had gone for a few hours without food and the medication had caused his blood sugar to drop. After this episode his medication was adjusted and soon after his recovery, he became accustomed to his tablets and also with regular meal patters. Hypoglycaemia, low blood sugar levels, is common in Diabetic patients who are on medication, hence meals need to be as regular as possible. After his recovery from pneumonia my father moved back home and went back to living a relatively normal life. Blood glucose monitoring is still an essential part of our lives; I check this once or twice a week and thankfully his Diabetes is under control. Unfortunately many people fail to go for check-ups and due to its rather elusive symptoms Diabetes can go undetected for years, this results in serious complications; ones that may lead to kidney failure, blindness and loss of lower limbs. Diabetes is diagnosed through a blood and/or a urine sample. For accurate results these tests are best done two hours after meals where sugar levels should stabilise at a range between 8-10 on a blood sugar monitor (higher levels should be discussed with a medical practitioner.) Although type I Diabetes is not preventable, the risk of type II Diabetes can be reduced through a healthy lifestyle. A diet rich in protein with fewer carbohydrates and regular exercise can work wonders for those with borderline Diabetes. Type II Diabetes tends to be genetic and thus regular check-ups are highly recommended for those whose family members are effected. Although a Diabetes diagnosis can be a life altering condition, refined

medication and regular doctor follow ups can help to keep the disease under control. Education about the subject is also vital. Last year I googled diabetes regularly; the illness can be complex and confusing however seeking medical advice helped me to clarify several mindboggling facts about this common disease.

WHAT I LEARNT Type II diabetes 1. In patients with type II Diabetes the body doesn’t make proper use of insulin. 2. Being overweight increases your risk of type II however even those with a normal weight gain can develop the condition. 3. When glucose builds up in the blood instead of going into cells, it can cause two problems: right away your cells may be starved for energy and over time, high blood glucose levels may hurt your eyes, kidneys, nerves or heart. 4. Although type II can sometimes be managed with healthy eating and exercise over time most patients will require medication. 5. Type II affects 90% -95% of all Diabetes patients. 6. This kind of Diabetes effects mostly adults however the condition can also occur in children. 7. Diabetes can virtually affect all organs. Bacterial and fungus infections on the skin, neuropathy, nerve damage, hearing impairment, retinal damage, heart attacks, stroke, kidney failure and cardiovascular disease are some complications that may arise from diabetes.

The early symptoms of Diabetes 1. Hunger and fatigue 2. Excessive thirst 3. Cuts and wounds that don’t heal after a few days 4. Dry mouth and itchy skin 5. Blurred vision 6. Numbness in legs or feet 7. Yeast infections

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ORAL

CARE

SAVE YOUR SMILE A&Hâ&#x20AC;&#x2122;S GUIDE TO A HEALTHY MOUTH

ike any sensible adult should, you probably brush your teeth carefully twice a day with fluoride toothpaste and see your dentist every few months. But good oral health means much more than brushing your teeth faithfully every day. Personal care needs change over time and additional treatment is sometimes necessary.

Smoking discolours your teeth and causes bad breath and gum disease.

October 2017

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ORAL

CARE

CARE ESSENTIALS up, work out your personal oral care needs 1First

You need a care plan that suits your particular mouth and teeth and your individual health situation. What happens to your mouth depends on what happens in other parts of your body. Some medical conditions, like heart disease and diabetes, and medical treatments, e.g. for cancer, can affect your oral health. Pregnancy can have an impact as well. Any change to your overall health or regular medication may necessitate a change in how you care for your mouth and teeth. Ask your doctor and dentist for advice on what you need to do.

a routine and stick to it 2Set

Special conditions need special care. Braces, dentures, implants, oral surgery – if you have any of those, your daily routine will include some changes. Post-surgery, for instance, you may need to switch to a softer toothbrush and use a specialised mouth wash. If you develop gum disease, your dentist may recommend a particular type of toothpaste. Whatever your particular needs, make sure you know what to do, using what, and when.

on snacks 3Skimp

We know what rots our teeth, but we do it anyway. Biscuits, ice cream, dried fruit, soft drinks, crisps, pastry, sweets, and cakes are bad news for your teeth because they produce the acid which triggers tooth decay. Avoid these types of snack if you can. And if you can’t resist them, brush your teeth afterwards. Acid softens tooth enamel so wait about twenty minutes before doing that.

WHAT DO YOU NEED TO KNOW? Your dentist should be your primary point of reference on oral health care. That’s where you can ask questions about treatments and procedures, and clear up any lingering doubts. If you have a problem, your dentist will be able to explain your possible treatment options. A good dentist will give you basic information about what is involved and roughly how much the treatments will cost. Don’t feel uncomfortable asking questions. Dental procedures can be uncomfortably and costly and, if different treatments are available, you need to make an informed decision about what to do next. If your dentist says you need treatment, you might

out 4Butt

There are lots of reasons for giving up smoking. Better oral health is one of them. Smoking discolours your teeth and causes bad breath and gum disease. Worse, it increases the risk of cancer in your mouth and throat. Even if you are a light or social smoker, you’re better off not smoking at all.

want to ask the following. • How urgently do I need treatment? Is it essential or can I manage without it? • Do I need the treatment for health reasons or cosmetic reasons? • What treatments are possible and how do they compare in terms of cost and longlasting effects? • What is the overall cost, including additional services like scans, specialist consultation, and medication? • If I need surgery, will it be under general or local anaesthetic? • How painful is it? • If I delay treatment, what will happen? Will my condition get worse?

there are any spots, swelling, cuts, or growths. Examine your tongue, inside cheeks, gums and the inner side of your lips. Stick out your tongue and take a good look at the roof of your mouth too. If you notice any of your teeth are chipped, cracked, discoloured or coming loose, or if your teeth feel strange or painful when you eat, see your dentist as soon as you can.

your dentist regularly 6Visit

Check your mouth regularly

The first symptom of disease or damage is often a change in appearance. Make a habit of looking inside your mouth daily to check whether

Seeing your dentist every six months is standard. Occasionally, you may need to see your dentist more often. If in doubt, talk the matter over at your next appointment.

WHEN SURGERY IS NECESSARY Impacted teeth All your teeth lie buried in your gums until it’s time for them to emerge. Normally, you will have a full set of 28 permanent teeth by the time you are 13. The final set of four teeth – the so-called wisdom teeth – emerge at a later age when there is enough space in your jaw and gum line. Sometimes, the wisdom teeth do not grow properly or do not emerge at all, remaining trapped between the jaw and gum. This can cause painful swelling and infection, and damage the surrounding tissue. The same problem can occur with other 40

October 2017

teeth. Whenever this happens, dentists normally recommend having the teeth removed surgically.

Infections If you have a painful swelling in your mouth, this could be because of infection. Without prompt treatment, a minor infection can develop and become life-threatening. If an infection is present, it may need to be treated surgically. This may involve cutting into the area to drain it.

Repairing injury Jaw fractures may sometimes need surgical intervention.

Removing lesions If you discover a lesion in your mouth, see your dentist. The problem may be benign, but may still need treatment. Normally, a small sample of the tissue will be taken for laboratory testing. If the lesion cannot be treated medically, it will need to be removed surgically.

Sleep apnea Sleep apnea is usually treated using non-surgical methods. When these do not work effectively, surgery can alleviate the problem by removing part of the soft tissue at the back of the mouth.

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STUDY

FUNNY PEOPLE ARE MORE INTELLIGENT THAN THEIR PO-FACED PEERS ALBERT EINSTEIN ATTRIBUTED HIS BRILLIANT MIND TO HAVING A CHILD@LIKE SENSE OF HUMOUR. INDEED, A NUMBER OF STUDIES HAVE FOUND AN ASSOCIATION BETWEEN HUMOUR AND INTELLIGENCE. WORDS BY LOWRI DOWTHWAITE, LECTURER IN PSYCHOLOGICAL INTERVENTIONS, UNIVERSITY OF CENTRAL LANCASHIRE

esearchers in Austria recently discovered that funny people, particularly those who enjoy dark humour, have higher IQs than their less funny peers. They argue that it takes both cognitive and emotional ability to process and produce humour. Their analysis shows that funny people have higher verbal and non-verbal intelligence, and they score lower in mood disturbance and aggressiveness. Not only are funny people smart, they’re nice to be around. Evidence suggests that having a good sense of humour is linked to high emotional intelligence and is a highly desirable quality in a partner. Evolutionary psychologists describe humour as a “heritable trait” that signals mental fitness and intellectual agility to prospective mates. In studies of attractiveness, both men and women rate funny people as more attractive, and cite having a good sense of humour as being one of the most important traits in a long-term partner. In psychology we use the term “positive humour style” to refer to people who use humour to enhance relationships and reduce conflict. This type of humour is associated with relationship satisfaction, extroversion

October 2017

and high self-esteem Having a humorous outlook on life is also a good coping strategy. It helps people better manage stress and adversity. More negative humour styles, such as sarcasm, ridicule and self-defeating humour, do not offer the same benefits. Instead, they tend to alienate people and are more often

which may explain the link between humour and intelligence. Neuropsychological studies have found that experiencing positive emotional states, such as joy, fun and happiness, increases the production of dopamine in the brain. Dopamine not only make us feel great, it also opens up the learning centres of the brain,

Rowan Atkinson has an IQ of 178

associated with depressed mood and aggression. Not only do funny people make other people laugh, they also laugh more themselves. And neurobiology shows that laughter leads to brain changes,

which enables and sustains more neural connections. As a result, we become more flexible and creative in our thinking, and better at solving problems. It also boosts our working memory.

Humour for success Evidence suggests that humour actually boosts perceptions of confidence, competence and status, making funny people very influential. Humour gets people to listen, helps communicate messages and aids learning. It is a powerful tool that many successful leaders use to enhance group cohesiveness and organisational culture. Studies of positive organisations suggest the more fun we have at work the more productive we are, and the less likely we are to suffer burn-out. The “broaden and build” theory also supports the idea that experiencing positive emotions through humour actually alters our thoughts, actions and physiological responses. It creates a virtuous circle effect that enhances well-being. Research on the use of humour in education also supports the notion that humour is an effective aid to learning. Several studies have demonstrated that lessons that are delivered with humour are more enjoyable for students, and also enhance students comprehension and recall of the topic. Given the host of benefits that being funny brings, perhaps we could all benefit from joining a stand-up comedy workshop. It seems like the smart thing to do.

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OUT 12 NOVEMBER

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OPINION

UP IN SMOKE CANNABIS SATIVA, MARIJUANA, POT, GRASS, HASHISH WHATEVER YOU CALL IT, TALK OF LEGITIMISING ITS RECREATIONAL USE SPARKS MORAL OUTRAGE. BUT THAT OBSCURES A FUNDAMENTAL QUESTION WHAT IS THE HEALTH IMPACT OF NON MEDICAL USE? MARIKA AZZOPARDI LOOKS FOR ANSWERS.

arijuana is the most easily available and cheapest drug on the market. The dangers of smoking a joint, including its illegality, have been repeated over and over again. However, following the recent suggestion that recreational use could be legalised, sceptics are beginning to think that it might actually be good for you. Public debate over recreational use has become entangled with talk of legitimising medical use, where the risks of quality-controlled and dosagecontrolled use may be offset by benefits. The net result is that public understanding of health impact of non-essential marijuana use is clouded by confusion. Some people play safe and avoid the drug altogether. Others try it just for kicks. Some get hooked, others don't; still others are eventually told they have irreparable brain damage. Public misunderstanding is compounded by the known risks of synthetic cannabis, long in use in Malta along with commerciallygrown and home-grown natural marijuana.

October 2017

The drug is commonly smoked as a joint created out of the dried leaves, buds, flowers, stems, oil, and seeds of the plant called Cannabis Sativa. The one defining difference between a tobacco cigarette and a cannabis joint is the fact that the latter produces visibly mind-altering qualities. Unlike tobacco, smoking marijuana not only messes up your lungs and other vital organs, it also alters the way your brain functions. Marijuana leaves contain a key psychotropic ingredient called delta-9-tetrahydrocannabinol, or THC in short. This is the cause of several effects which people smoking cannabis may feel - brain fog, feeling stoned, feeling high or euphoric, experiencing an altered sense of perception, increased appetite, mood swings, and impaired body movements. Its effects can be temporary or permanent, depending on the individual. The medical world warns against habitual recreational use of cannabis due to its contribution to lung and other forms of cancer, cardiovascular disease, pulmonary diseases, damage to the reproductive system, and also to babies whose mothers use cannabis during pregnancy. The greatest health concern is the effect on brain function. A key concern is that marijuana use can trigger psychosis in those predisposed to it. Psychosis is a severe mental disorder in which thoughts and emotions are so impaired that the person loses contact with external reality. Speaking to a newspaper, psychiatrist Dr Anton Grech recently advised against smoking cannabis due to its documented link to mental illness. Dr Grech,

who researched the topic widely both in Malta and in the UK, said that "there is a particular component [in cannabis] that could actually be beneficial for mental health. However, scientists had not yet figured out how to extract this." He quoted statistics which show that some 100 new schizophrenia cases are diagnosed in Malta each year. However, he also said that "having a genetic predisposition to schizophrenia did not mean that one will definitely be diagnosed with the disease. If predisposed people do not consume cannabis, they may actually never suffer from the disease," Dr Grech told his interviewer. Meanwhile, the US National Institute of Drug Abuse (NIDA), has published extensive information about marijuana and its use. One interesting finding relates to marijuana's link to drugged driving and serious accidents. As recently as February 2017 NIDA said that, "After alcohol, marijuana is the drug most often found in the blood of drivers involved in crashes." While the study claims that THC can be traced in a person's body fluids several days and weeks after use, the fact that, very often, the user combines it with alcohol and other heavier drugs, greatly compounds risks. NIDA’s research report says that "Drivers with THC in their blood were roughly twice as likely to be responsible for a deadly crash or to be killed than drivers who hadn't used drugs or alcohol." Legal issues apart, as things stand today, the experts seem to all agree on one clear message so far...f you don't want to risk having psychiatric problems in your life, don't mess around with smoke, especially if you're young.

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DR JOSEPH TONNA IS MEDICAL OFFICER AT MALTA’S SUBSTANCE MISUSE OUTPATIENT UNIT AND HAS WORKED IN THE FIELD SINCE 1995. Is it true that smoking cannabis can lead one on to heavier drugs? Over the years I have spoken to hundreds of drug abusers. From their feedback and from scientific research it transpires that there seems to be no direct correlation between smoking cannabis and eventually taking heavier drugs. Some people start smoking cannabis and never experiment further. Addicts do mix all kinds of drugs, irrespectively of what they start experimenting with.

Why do you think so many people are lured into smoking cannabis? First of all, there is a general belief that nobody can become fatally intoxicated with cannabis, so people feel it can be a safe drug. It does affect the brain receptors that lead to pleasure pathways, heightening the senses, increasing appetite, etc. and in some people it could trigger temporary positive sensations.

What actually happens? Cannabis is a mood altering drug and the effects of one joint, or even one puff on a joint, can be different from one person to the next. The effects are not always and not necessarily dose-related. While some people may feel better and less depressed, others may feel withdrawn and experience hallucinations. One must also consider the quality of the cannabis one is smoking.

Are its effects worse on the young? "During puberty and adolescence, the brain is developing and thus very susceptible to damage. Intellectual damage caused by smoking cannabis will have long term effects on memory, on learning, and on reasoning patterns. These effects are dependent on the quality, amount and duration of cannabis used. This brain damage can be long-lasting and persistent even after quitting, especially at a later stage in heavy chronic cannabis users. Moreover brain damage becomes greatly complicated in people who have a tendency to develop mental disorders such as schizophrenia.

Do synthetic cannabinoids exist in Malta? Indeed, yes, and they have been available for many years, unfortunately. This is a very dangerous drug since it produces very bizarre consequences and can actually be fatal. Its effects are totally devastating, making it even worse than heroin. Its makers alter the THC molecule in a way that it can still interact and activate the cannabinoid receptors in a more potent way. This probably explains the more harmful effects not usually seen by natural THC. The problem is that synthetic cannabis is not identifiable from normal cannabis, especially more so to naive individuals. One joint of the synthetic version looks exactly like any other. October 2017

AWARNESS

THE NEED OF A STROKE REHABILITION UNIT

troke is one of the main causes of adult disability, with an estimated 700 people who suffer from a stroke in Malta every year. Stroke, or a brain attack as it is sometimes referred to, involves vascular or blood vessel damage in a particular area of the brain leading to brain cell damage. This occurs when a blood vessel is blocked by a clot or when haemorrhage occurs in the brain and results in diminished movements, spasms, speech problems and other forms of disability. An essential aspect in management of stroke is surely prevention. Eating well, not smoking, not drinking in excess, controlling blood pressure and cholesterol, and exercising regularly all help reduce the risk. However, another factor which determines the outcome of a stroke, is the

Dr Stephen Zammit 46

October 2017

timeliness in which medical attention is sought. By being aware of the symptoms, we can all help save lives, and minimise the negative effects on members of our community. Symptoms can include slurred speech, a dropping face, or an inability to lift one’s arms. And 112 should be contacted immediately.

By being aware of the symptoms, we can all help save lives, and minimise the negative effects on members of our community Acute care across the Maltese Islands is predominantly given at Mater Dei Hospital or VGH Gozo General Hospital. Here patients are stabilised and assessed. Critical decisions focus on the need for intubation, blood pressure control, and determination of benefit of thrombolytic intervention. Medical developments have now made it possible to dissolve blood clots in the early stages to limit the damage incurred on the brain.

From here, patients will need intensive rehabilitation to be able to re-learn certain skills used in day to day life. Up until now much of this care was being given at Mater Dei Hospital and in General Wards at VGH Karin Grech Hospital, which although of a good quality, fell short on many accounts, many of which have long been felt by professionals across the Maltese healthcare system. Professionals at Mater Dei Hospital often struggle with a lack of available acute care beds, care-givers at VGH Karin Grech Hospital lacked the infrastructure and resources needed to give a highquality rehab service, and patients sometimes felt short-changed by the system and the quality of care on offer. The opening of the new Stroke Rehabilitation Unit in VGH Karin Grech Hospital thus comes as positive news, not only to staff within VGH Karin Grech Hospital, who have benefited from specialised training, new equipment, and an improvement in the built environment, but to the whole healthcare community, including those providing care at Mater Dei Hospital. The improvement in resources will help us manage patients more effectively and efficiently, resulting in quicker discharges, better outcomes and higher availability of beds for the public and an all-round better service for the patient The work we are carrying out at Karin Grech Hospital is not intended as a standalone service, but a service which complements and supplements the good work already being done across the island. Together we can work to see that Malta’s resources are utilised in the best way possible which results in better care for local patients and the possibility to once again establish our islands as the nurse of the Mediterranean to foreign patients also needed good quality care. The Stroke Rehabilitation Unit is the one of the first new infrastructural and clinical programmes we have started but surely not the last. Throughout the coming weeks we will continue working to create and develop pathways that improve the level of care given to patients across the Maltese Islands.

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This is a paid advertorial ar cle.

STROKE IS ONE OF THE MAIN CAUSES OF ADULT DISABILITY, WITH AN ESTIMATED 700 PEOPLE WHO SUFFER FROM A STROKE IN MALTA EVERY YEAR. BY DR STEPHEN ZAMMIT, CEO, VITALS GLOBAL HEALTHCARE LTD.

SAFETY

SMART WAYS TO ENSURE

WHEREVER YOU GO YOU CAN ALWAYS BE AT HOME, THANKS TO REMOTE TECHNOLOGY.

ecurity is paramount, especially at night, if you have a large property with several rooms that are quite a way from each other, and when you are leaving the premises for some time. The house need never look empty, and in the event if a break-in everything will be recorded so investigators will have all the evidence they need. In fact, you can also go further and attach tracking devices to essential and valuable possessions, making them easier to trace. A smart security system means you can see, film and record everything that is going on in your home and control appliances during your absence. A meal could be cooking while you are still stuck in a traffic jam,

speech patterns and use the geolocation info on your phone to know if you are at home or not. These can communicate with other similarly programmed devices, and the lenses could be shut down for privacy. You might prefer door locks which work with existing locks, through your Android or iOS smartphone, using low energy Bluetooth instead of Internet access. Some locks can be placed at the bottom of a door to prevent unwanted entry. One model, made of steel and glassreinforced nylon and aluminum, has a Bluetooth-enabled key fob to lock or unlock it and can be integrated with your other home gadgets. The joy of many of these systems is that they can be mixed and matched according to your current requirements and budget. They can also be constantly updated to provide different services as required. You will eventually be able to have image and sound recordings stored in some 'cloud', alarms that shriek like police sirens and lights beaming down on 'intruders like MTV spot lights. All giving you more security than Fort Knox. If the whole idea of handing you castle's fortification over to a smart app, or whatever, sounds slightly terrifying, think how people responded to gas and electricity at first. And think of the potential for science fiction movies. A plot where the ‘herowins’ (the new PC correct way of referring to heroes or heroines) are denied entry to their home is likely being written at this very moment. Phones are being stolen, cloned, signals go down. Programs are hacked leaving people trapped in homes and offices, while their appliances go into meltdown. Lives are at risk. Or there could be a comedy angle too. Meanwhile, just in case some awful chance leaves you with a missing phone one day, the latest stylish smart locks, that can also work with keys might, in the end, might be a life saver.

SECURITY s

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lights can be turned on and off, washing machines will swish into action, curtains and blinds will open and close, motion sensors and activated lighting can be operated. You can even communicate with pets. Just how sophisticated you want your system to be depends on the level of security you need and only you can decide that. Basic tools are smart locks that are unlocked with a smartphone app, CCTV and alarms. But with the demand for ever more sophisticated equipment technology is developing rapidly. There are numerous choices including devices with multiple sensors that warn you of any intrusion so you can inform the authorities directly. Subsound technology listens and learns who should be in your home and who should not, including pets. It provides protection, on every floor, a wide-angle HD camera, with night vision, and temperature and motion sensors. There is even a siren which you can activate from your phone and an app so you can inform the police. There are gadgets which will turn an iOS/Android smartphone or Apple watch into a virtual door key. They automatically lock the door behind you, and every time any keys you assign to family members are used the action is logged in the system, so you can track who comes and goes, As people are identifiable by their individual keys, their comings and goings can be tracked. There is also the means to allow timesensitive access to friends and visitors. Complete home monitoring via a wide-angle HD camera, recorded sound storage, night vision, motion and temperature monitoring, can be provided by sensors attached to all your doors and windows. Some will even turn on the lights if an intruder is suspected. There are also smoke detectors that have similar features. Other systems can recognise faces and

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LIFE LESSONS

LEARNING BY DOING LINDSEY CASSAR ON HOW CHILDREN LEARN AND AND HOW CAREGIVERS CAN HELP

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ANYONE WHO HAS NEVER MADE A MISTAKE HAS NEVER TRIED ANYTHING NEW ALBERT EINSTEIN

insteinâ&#x20AC;&#x2122;s words bring reality to our awareness, a place where mistakes are inevitable giving us the opportunity to learn in an experiential way. Trying something new means being comfortable with making mistakes and failing, while having the opportunity to assess what is being done and what needs to change in light of success. However, this

October 2017

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greatly depends on the mindset we create through a lifetime of experiences with success, mistakes and failures.

Experiencing mistakes In his theory of psychosocial development, Erikson, a developmental psychologist and psychoanalyst known for his theory on psychosocial development, mentions eight stages of development from early infancy to late

adulthood. Our pre-teen years shape up the way we approach learning as adults. During infancy (0-1.5 years), the child develops trust or mistrust depending on the stability and consistency of care by the primary caregiver. If the caregiver is consistent and stable in their care, the infant develops a sense of security, as well as trust that they will always have support when crises arise. If care is harsh or inconsistent, the infant develops a sense of mistrust which leads to diminished confidence in the world around them and in their abilities to influence events. In the next stage (1.5-3 years), the infant becomes interested in exploring and learning about the world around them, trying out a variety of things and making choices.

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LIFE LESSONS The child develops a sense of autonomy if the care giver supports and encourages the child’s will to be independent. This develops the child’s confidence and security in his or her own ability to cope with the world. Conversely, a child who is overly controlled or criticised for failures and mistakes develops a sense of shame, dependency, and lack of self-esteem. At around ages 3-5, the child starts developing a sense of initiative which, if supported, leads to decision-making and leading abilities. On the other hand, a child who is criticised or controlled when taking initiative develops a sense of guilt which leaves him or her acting as followers and lacking initiative and creativity. In stage 4 (5-12 years), the child’s teacher and peer group play an important role. The child starts to develop a sense of pride in personal accomplishments. Children who are encouraged to take initiative and are supported to learn tend to feel confident and industrious in their ability to reach goals. Children who fail to develop the skills demanded by society and are not supported to persist tend to feel inferior, doubt their abilities, and fail to reach their maximum potential.

The caregiver or support worker – nurturing positive learning As caregivers or agents in the helping profession, we must first tolerate ourselves in making mistakes to accept and be nurturing of another person’s mistakes. By becoming aware of our past and understanding it from a psychosocial perspective, we may understand what helped and what

hindered our behaviour towards mistakes and failures. Consequently, we can equip ourselves with the tools needed to help ourselves as well as our youngsters to deal positively with shortcomings.

positively reinforced for your efforts creates a pleasant strife, while punishment provokes anxiety and fear of making mistakes.

Mothering vs empowering

Reward vs punishment When people make moral mistakes such as lying, stealing or cheating, we often see ourselves rushing into judgment. Separating the individual from the mistake and giving space for explanation of their actions helps the person in understanding that it is not they who are wrongful but their actions. This way, the individual is not shamed as a person but the behaviour is not accepted either. Failing to make this distinction may result in the person feeling not only bad about their actions (guilty) or their efforts (regret), but it makes them feel bad about who they are. Shame gets to the core of our identities and the three things that feed it are secrecy, silence, and judgement. In a struggle to manage deep shame, the individual is motivated to avoid failing whatsoever. In her book Daring Greatly, Brene Brown writes that failure is inevitable, and how one handles that failure determines whether one becomes more hurt and defensive or whether they succeed. Being present no matter what by helping the individual understand their wrongdoing gives a better direction for the future. Youngsters who are exclusively rewarded for right answers and good deeds may become afraid of trying new things and learning new tasks. The same applies to individuals who are shunned or punished for

Youngsters who are exclusively rewarded for right answers and good deeds may become afraid of trying new things and learning new tasks making mistakes. On the other hand, youngsters who are praised and rewarded for their efforts rather than results are willing to try harder and are more open to learning new things. A study by Dr. Carol Dweck and colleagues (2014), found that being praised for efforts rather than personal attributes like “you’re smart” yields better results. Patience and perseverance are key because learning rarely happens on our first attempt. Ultimately, being

October 2017

Overprotection suppresses creativity and deprives the person of the chance to explore their ultimate potential. Conversely, an extremely permissive nurture lacks direction and guidance, many times resulting in too many mistakes. The balance between the two is achieved when the caregiver gives room for exploration, trial, and error while being connected and available when needed, without running in for rescue. When the individual owns up to their mistakes rather than covering up flaws, mistakes and weaknesses, s/he develops courage which leads to personal credibility and trust of others. Moreover, engaging in open discussions will provide coping skills and enhance the person’s schema of proper responses for future reference. The learned ability of a person to handle mistakes and failures effectively results in the growth of critical thinking skills, independence, creativity as well as courage, respect and humility. Failure and success are meant to be intertwined. Failure is an element of success. Therefore, rather than trying to ignore or avoid making mistakes and failing, it would be better to take it into account and forecast the number of failures you will endure before reaching your goal. Being praised for efforts rather than results may help in accepting that we are all human and thus by wanting to be perfect we are creating an unrealistic expectation of ourselves. Apart from practicing these techniques with all of our clients at the Inspire Foundation and mentoring parents and carers, these lessons are being passed on to future tutors and job coaches who are following an MQF level 4 rated award in supporting individuals with disabilities at the workplace. This initiative is funded through the voluntary organisations project scheme managed by the Malta Council for the Voluntary Sector on behalf of the Ministry for Social Dialogue, Consumer Affairs and Civil Liberties.

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Lindsey Cassar is senior tutor at The Inspire Foundation

SPORT

Sporty SIBLINGS SPECIAL OLYMPIANS MATTHEW AND ANNE MARIE BUGEJA ON TRAINING HARD, NEVER GIVING UP, AND FOLLOWING THEIR DREAMS

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ur parents Joanne and Joseph have always encouraged us to train hard and to never give up,” Matthew and Anne Marie say. The siblings are enthusiastic when talking about their experiences with Special Olympics. They deserve this since they have achieved a lot and compare well with athletes from other countries. Both are the perfect illustration of the saying “Where there is a will, there is a way”, and they are a source of encouragement for others with special needs. “If a child with special needs is interested in sport, parents should encourage him or her to enrol in Special Olympics. Parents should focus on their child’s ability. I am a person with special needs but I am also a Special Olympic World medallist. Give children a break from school and therapy and let them enjoy their ability whether it’s sport, music, art or drama,” suggests Matthew. Anne Marie started gymnastics when she was five years old. Thanks to her flexibility, she progressed quickly. She is now a pupil at the National Sports School in Pembroke where she trains in gymnastics along with following the standard curriculum. Matthew is as an all-rounder and passionate about different sports: “When I was eight years old, I started gymnastics with my sister. I used to enjoy it a lot, but when I turned 14, I became interested in football and wanted to stop gymnastics.” At the time, Matthew was participating in the 2014 Los Angeles Special Olympics

October 2017

World Summer Games, so the idea of starting football was put aside temporarily. The decision paid off. “During those games I won a gold medal in the rings event,” he says. He then took up athletics and did very well, but football was still what he wanted to do. He fulfilled his dream when he started training in football with Special Olympics Malta and topped that off when he and his team mates won gold in an international competition in Italy last May.

Give children a break from school and therapy and let them enjoy their ability whether it’s sport, music, art or drama

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Olfen contains Diclofenac Sodium 10mg. It is used for the treatment of pain, swelling and inflammation in a variety of conditions affecting the muscles, joints, tendons and soft tissues. It is applied 3-4 times daily and spread onto the affected part of the body (do not rub in). Olfen is for external use on healthy, undamaged skin only. Not for oral use. Olfen Gel should be applied only to intact non-diseased skin, and not to skin wounds or open injuries. Always read the package insert carefully.

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SPORT Over the last ten years Anne Marie has competed in Malta and internationally. “I love competitions,” she says. “Even though European and World Games are very tough, I love the pre-competition vibe. We are treated like VIPs, with security around us, and we also have the chance to meet famous people.” She’s enthusiastic about meeting the ‘perfect 10’ gymnast, Romanian Nadia Comaneci, and receiving a signed copy of her biography. She says that representing Malta in the opening ceremony parade and competing in front of an enthusiastic crowd is an amazing experience. Matthew adds that both he and his sister treasure these experiences, especially when they win medals and end up on the podium. “It’s difficult to describe how it feels to see Malta’s flag, media people taking pictures and videos, the crowd cheering, and my parents excited and crying tears of joy,’ explains Matthew enthusiastically. Both Anne Marie and Matthew appreciate the support of Special Olympics Malta which they consider as their second family. “Special Olympics made me believe in my abilities,” Anne Marie says. “It gave me the chance to go out there and show the world that I am more than a person with special needs. God created everyone with ability. Special Olympics Malta helped me discover and develop this ability. With their patience, love, and dedication I have been able to succeed.” Matthew has words of appreciation for National Director Anna Calleja and all the coaches who care for their athletes, believe in them, and are always there to give them opportunities and to teach them not just about sport, but about life generally. When one engages regularly in sport, the other athletes and the coaches feel like family. “During training, all coaches are strict and aim only for perfection,” Anne Marie explains. “My head coach at Special Olympics, Ms. Elaine Vella Genovese, has been my coach since I started gymnastics. She is also my godmother and I was one of her bridesmaids at her wedding last May. My other coach, Ms. Andreana, was a gymnast herself and she loves us a lot too.” Special Olympics Malta is made up of a team of professionals who continuously monitor the athletes’ development and well-being. National director Anna

Even if it looks impossible, do not be afraid to ask for help and support from the people around you

Calleja and Sports Director Elaine Bonnici make sure that all athletes are both physically and psychologically fit for competitions. Matthew and Anne Marie explain the Healthy Athlete programme where check-ups and follow-ups are done according to the individual athletes’ needs. “Malta’s Special Olympics athletes do really well compared to athletes in other countries. We always win a good amount of medals. That’s because of our high level of training,” says Matthew. Anne Marie trains, on average, four times a week in the morning and three times a week in the evening. Weekends tend to be very busy for both of them. Matthew trains about three times a week, but in the weeks running up to a competition, training sessions 56

October 2017

increase. With good time management, both Anne Marie and Matthew succeed in combining their passion for sport with their school and work commitments. “I do struggle in academic work, but it’s not because of sports,” Anne Marie says. “My hearing is impaired. Everyone knows that if you understand the lesson, it will help you in your homework and study. A hearing student spends an hour on his or her homework. I spend more time, because first my mum has to explain the work to me. Gymnastics helps me relax and release my frustration.” Matthew works with a commercial company. “My employers support me a lot and give me special leave when I have competitions and tournaments both in Malta and abroad. When I won three gold medals in the National Games last year, my employers gave me a surprise. “They took me to Liverpool, because I support Liverpool FC, and I met my idol, Coach Jurgen Kropp. We had dinner together, and it was an experience I will never forget. The next day, we watched a match from the Executive Lounge at Anfield Stadium. I was in a lounge with a chef and two waiters cooking and serving me while I watched the game as a VIP.” Support is fundamental for success in sport, and employers’ support can make a difference to an athlete’s ability to compete in Malta and elsewhere. The adrenaline rush of competitions is exciting, but there is also fear and trepidation. Anne Marie’s greatest fear is that her cochlear implant which helps her hear won’t work well, which might hinder her performance. On the other hand, Matthew’s fear is that if he doesn’t perform well, he will end up disappointing his parents, his coaches, and all the other people who support him. But those concerns do not discourage them and they are already looking ahead to their next events. Both Anne Marie and Matthew aim to qualify for the Summer World Games which are going to be held in Abu Dhabi in 2019. Anne Marie also wishes to take part in mainstream competitions. Matthew’s main dream is to participate in a football team’s training camp abroad. Their determination is admirable. The past year has been tough for Anne Marie because of problems with her cochlear implant. Sport is helping her get through the difficult time. She has had to spend two months at home, and it was sport which helped her ease the frustration. “I was awarded Female Special Olympic Athlete of the year in recognition of my sports results thanks to Special Olympics Malta who nominated me,” explains Anne Marie, adding that sport keeps her physically fit and helps relieve tension. Matthew says that the most important thing in life is to believe in your own abilities and to follow your dreams: “Even if it looks impossible, do not be afraid to ask for help and support from the people around you.” They’re fine words and worth following. No doubt Anne Marie and Matthew will be taking their own advice as they carry on making Malta proud.

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Great READS

BOOKS

AGENDA BOOKSHOP’S PICK OF THE LATEST HEALTH AND WELLBEING BOOKS

THE LEAN MACHINES: EAT WELL, MOVE BETTER AND FEEL AWESOME — JOHN CHAPMAN AND LEON BUSTIN (9781472236265) The Lean Machines are genuine experts in health and happiness and have helped thousands of people get lean and strong through their work as personal trainers and on their hugely popular YouTube channel. Champions of balance, moderation and individuality, their advice is sensible, accessible, and not at all intimidating – eat well, move better and feel awesome. "Our aim is to help as many people as possible get healthy and understand that getting in

great shape doesn’t have to be hard or depressing." Here, they share their secrets in their first book; a fun, fully illustrated guide for becoming the best version of yourself. Featuring easy nutritious recipes, as well as simple workouts, toning tips and mindfulness techniques, the boys prove that having a healthy lifestyle is achievable and fun.

STRONG — ZANNA VAN DIJK (9781472242341) Ditch the fad diets. Step away from the treadmill. There’s another way to get results, and it’s all about balance. Being in great shape doesn’t mean depriving yourself or running your body into the ground. In STRONG, personal trainer and Instagram star Zanna Van Dijk busts these myths and reveals her no-fail formula for a powerful, lean physique and lasting health and happiness. STRONG gives you all the motivation and practical tools you need to get started on your fitness journey. Zanna’s inspiring and achievable approach to

eating well and training effectively features a comprehensive guide to lifting weights, detailed workout routines, sustainable nutrition tips and simple principles of health and wellness. After you’ve worked up a sweat, her mouthwatering, easy recipes prove that nourishing food isn’t just fuel - it can be absolutely delicious and bursting with flavour too. Make your body STRONG. Move it. Nourish it. Thrive.

LEAN IN 15: THE SUSTAIN PLAN: 15 MINUTE MEALS WITH WORKOUTS TO GET LEAN AND STRONG FOR LIFE — JOE WICKS (9781509820221) The third book in the Lean in 15 series by record-breaking bestselling author Joe Wicks. Bestselling author Joe Wicks, aka the Body Coach, has inspired thousands to transform their bodies by shifting unwanted fat and building lean muscle. In Lean in 15 - the Sustain Plan he reveals how to SUSTAIN incredible results while still seeing progress week on week. Fully illustrated

and with a hundred quick-to-prepare meals and four workouts, the plan is perfect for busy people who don’t have time to spend hours in the kitchen or gym. Joe gives advice on how to combine his tasty, nutritious recipes with a brand new training programme to make you leaner, fitter and healthier than ever before. It’s time to make Lean in 15 part of your lifestyle forever.

THE 22-DAY REVOLUTION: THE PLANT-BASED PROGRAMME THAT WILL TRANSFORM YOUR BODY, RESET YOUR HABITS, AND CHANGE YOUR LIFE — MARCO BORGES (9781473618473) A groundbreaking vegan program designed to transform your mental, emotional, and physical health in just 22 days. Founded on the principle that it takes 21 days to make or break a habit, The 22-Day Revolution is a plant-based diet designed to create lifelong habits that will empower you to live a healthier lifestyle, to lose weight, or to reverse serious health concerns. The benefits of a vegan diet cannot be overstated, as it has been proven to help prevent cancer, lower cholesterol levels, reduce the risk of heart disease, decrease blood pressure, and even reverse diabetes. As one of today’s most sought-after health experts, exercise physiologist Marco Borges has spent years helping his exclusive list of high-profile clients permanently change their lives and bodies through his innovative methods. Celebrities from Beyoncé, Jay-Z, Jennifer Lopez, and Pharrell

Williams, to Gloria Estefan, and Shakira have all turned to him for his expertise. Beyoncé is such an avid supporter that she’s partnered with Borges to launch 22 Days Nutrition, his plant-based home delivery meal service. Now, for the first time, Borges unveils his coveted and revolutionary manifesto, featuring the comprehensive fundamentals of starting a plant-based diet. Inside, you’ll find motivating strategies, benefits and tips for staying the course, delicious recipes, and a detailed 22-day meal plan. With this program, you will lead a healthier, more energetic, and more productive life—helping you to live the life you want, not just the one you have.

THE BIKINI BODY 28-DAY HEALTHY EATING & LIFESTYLE GUIDE — KAYLA ITSINES (9781509842094) Kayla Itsines Bikini Body Guide 28-minute workouts are energetic, high-intensity, plyometric training sessions that help women achieve healthy, strong bodies. Itsines’ Sweat with Kayla app is the best-selling fitness app in the world for a reason. The Bikini Body 28-Day Healthy Eating & Lifestyle Guide is full of Kayla’s meal plans, recipes, and motivating information to help you live a healthy and balanced lifestyle. Kayla makes exercising and healthy eating achievable and fun. The Bikini Body 28-Day Healthy Eating & Lifestyle Guide features: • Kayla’s advice for a nutritious and sustainable diet • Over 200 recipes such as: • Berry-Nana Smoothie Bowl 58

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• • • • • • •

Strawberries, Ricotta & Nutella Drizzle on Toast Peachy Keen Smoothie Super Green Baked Eggs Fruit Salad with Chia Seed Dressing Quinoa & Roast Vegetable Salad 7-Day access to the Sweat with Kayla app A 28-Day workout plan that has all the moves to accompany Kayla’s meal plan The Bikini Body 28-Day Healthy Eating & Lifestyle Guide is the ultimate tool to help you achieve your health and fitness goals.

PRODUCT NEWS

SCHNITZER SENSIBLE EATING

BIFRUTAS FUNCTIONAL DRINK Pascual Bifrutas is a complement for your diet to make you feel completely fine through its unique texture and its mixture of fruits. Bifrutas milk and juice is a functional drink made out of Pascual authentic skimmed milk and the best fruits which provide an unmistakable flavour and are a natural source of vitamins A, C and E. Vitamic A is essential for normal bone growth while Vitamins C and E builds antioxidants that protect cells from the damage caused by free radicals and delays ageing. Pascual Bifrutas range includes Tropical, Mediterraneo, Pacifico and Ibiza available in 1L, 330ml or 200ml.

Schnitzer offer healthy organic foods for customers who wish to keep a balanced diet. They also guarantee the highest possible organic quality. The products are not only for the health conscious but also for anyone who enjoys high quality food. All the products offer extra benefits since they are free from gluten, lactose, soya, nuts, egg and yeast. The range consists of bread, muffins, bars, cookies, cakes, pasta, pizza bases and more. Imported by J. Calleja Import & Export Ltd Web: www.jcallejaltd.com Email: storelocator@jcallejaltd.com

PASCUAL YOGIKIDS POUCHES SLIM PASTA Shape up and stay full longer with our delicious range of Slim Pasta. If you’re considering a diet for weight loss, we’re safe, 100% natural and come in penne, fettuccine, noodles, rice and spaghetti variants. Since our products are composed of organic GMO-free konjac flour, we’re even safe for coeliacs and diabetics! Don’t miss out on your favorite foods and get slim! Imported by J. Calleja Caterers & Wholesalers Ltd Web: www.jcallejaltd.com Email: storelocator@jcallejaltd.com

Yogikids is an excellent combination between flavour and texture - the key aspects in children's products. In addition, it is made with Pascual Milk, pureed fruit and vitamins A, E, B9 and D2, the latter necessary in the growing age. Yogikids is designed for children from one year of age, and that is why special care has been taken in developing a nutritious product, with a smooth and creamy texture and a delicious taste. This has been achieved thanks to a combination of 85% yogurt made with Pascual Milk, and the best pureed fruit. Yogikids is presented in two varieties, strawberry and strawberry-banana and is an ideal solution for snacks and lunch breaks. It may be either chilled or stored at room temperature, and can be taken anywhere! Find us on Facebook for more information: www.facebook.com/PascualMalta

PHARMACOS

More stylish than ever, without compromising on all day comfort and fit. The quality materials and modern contemporary styling has been teamed with supreme comfort and a softer toe shape.

PHARMACOS

Our boys school shoes are made to last. Designed to withstand the activities of active feet, they are durable, and flexible, with antiscuff protection, providing all day comfort. October 2017

PRODUCT NEWS

GOOD THINGS PORE FECTLY CLEAR

PHILIPS AVENT

Good Things Pore-fectly Clear is a simple skincare routine that combines active charcoal with caffeine, Willow Bark Extract and Pomegranate to gently but effectively draw out impurities for deeply cleansed, clearer looking skin. This range has been specially formulated with calming yet powerful spot-fighting ingredients to soothe and clear oily, blemish prone skin. Two additional blemish fighting products include Good Things Overnight Serum to help reduce the appearance of blemishes and spots and help prevent future breakouts, and Good Things Spot Clearing Gel to help stop spots in their tracks.

As a mum you’ll want to know what’s best for your baby from day one. With 30 years of clinical experience in baby feeding Philips Avent has been designing and manufacturing products to meet your needs. Products that are inspired by nature and have been developed through extensive research and clinical trials and, even more importantly, by listening to mums like you. Our products will help to support the choices you make, whether breastfeeding, bottle feeding, or combining the two. Then as your baby grows, the range’s interchangeable design features mean the products can be adapted to meet your baby’s developing needs. We are here to give your baby the best start in life. Philips Avent offers a full range of baby products from bottles, cups, soothers, electric and manual pumps, breast pads, monitors and much more.

Good Things Skincare range is found in leading supermarkets and pharmacies. Exclusively distributed by Alfred Gera & Sons Ltd, Tel. 2144 6205

Munchkin offers your child a wide range of colourful, interactive toys that make bath time fun and enjoyable. From a Bath Fun Bubble Blower, Undersea Explorer, Bath Tea and Cupcake Sets and a large selection of bath toys, Munchkin is sure to keep your child entertained. With their bright and vibrant colours Munchkin toys are designed to help engage sensory skills as well as encourage your child to learn how to develop play patterns and interactive play. Munchkin also offers a wide range of feeding bottles, spill proof cups, training cups, flip straw cups, dining sets, door bouncers, safety car mirrors, backpacks and much more. Munchkin is found in leading supermarket, pharmacies and baby shops and is exclusively distributed by Alfred Gera & Sons Ltd, Tel: 2144 6205/6. Munchkin…It’s the little things.

THIS IS NOT A SHAVER. THIS IS PHILIPS ONEBLADE. The new way to trim, edge, and shave any length of hair. Philips OneBlade is the only tool that trims, shapes, and shaves hair of any length with just one single blade . No clogging, no pulling, no water or gel needed, and skin friendly- Philips OneBlade has it all! Its main features: Replaceable blade lasts up to 4 months* Waterproof handle for wet or dry use 3 trimming combs: 1, 3 and 5 mm Long lasting battery, 45 minutes of use Does not shave as close as a traditional blade For further information contact Alfred Gera & Sons Ltd, T. 2144 6205

October 2017

Philips Avent is exclusively distributed by Alfred Gera & Sons Ltd, T 2144 620/5.

MOMMYCARE NATURAL AND ORGANIC SKINCARE RANGE FOR MOTHER AND CHILD Mommy Care specialises in the development and production of skin care products for expecting mothers, babies and children and makes a point of developing natural and safe products for use during the time when skin is most sensitive. Our line of maternity products can be used to prevent stretch marks and help the body retain its shape after pregnancy. Our baby and kids products are especially suitable for the most delicate and sensitive skin. The safety of mother and child is our primary concern at Mommy Care, so at a time when it really matters our customers can feel safe and taken care of while using our products. Mommycare, a natural and organic range of products, never use parabens, petroleum based ingredients, SLS, or any other controversial ingredient and it is our mission to keep developing high quality, safe skin care products that support mums who are looking to make healthy lifestyle choices for themselves and their children. For more information and samples contact Mommycare exclusive distributors, Alfred Gera & Sons Ltd, Tel: 21446205/6

DERCOS AMINEXIL CLINICAL 5 Vichy’s DERCOS AMINEXIL CLINICAL 5 is the antihair loss treatment for both men and women. It helps to rebalance and recreate a healthier scalp, as well as slow down hair loss whatever its cause: hereditary hair loss, stress-related hair loss, seasonal hair loss, post-pregnancy hair loss, and menopause-related hair loss. This is thanks to its combination of five active ingredients; AMINEXIL re-anchors the root, SP94 supports hair survival and growth, ARGININE stimulates micro-circulation for nourished hair from within, OCTEINE rebalances the scalp, and Vichy Mineralizing Water soothes and reinforces it. With AMINEXIL CLINICAL 5 anti-hair loss efficacy is evident after only THREE WEEKS as perceived by 96% of users, with a significant decrease of hair loss after SIX WEEKS validated by dermatologists. AMINEXIL CLINICAL 5 has an easy-to-apply texture that is non-greasy, non-sticky, and non-oily, for a residue-free application on wet or dry hair (no rinse). Available exclusively in pharmacies. For more info email: vichy@prohealth.com.mt

PRODUCT NEWS

PINTAL SYRUP A nonproductive cough is one that does not bring up any mucus. It's also known as a dry cough. You could have a nonproductive cough when you have a cold, the flu or any other upper respiratory illness. Pintal 1.5 mg/ ml syrup is indicated for non-productive cough. Recommended dose - 15 ml up to 4 times daily. Treatment is limited to the symptomatic period. Medical advice should be sought if the cough lasts longer than 4-5 days or if fever, dyspnoea or chest pain develops.

NESTLÉ MATERNA NUTRITION DURING BREASTFEEDING A healthy, well-balanced diet is important during breastfeeding. Although a supplement does not replace a wellbalanced diet, it can provide some extra insurance on those days when taking care of your new baby keeps you from eating as well as you like. It is important to choose a multivitamin that is especially formulated for use during pregnancy and breastfeeding that supports your nutritional requirements adequately as a nursing mother. Nestlé Materna helps provide the vitamins and minerals you need during all stages of your pregnancy. After pregnancy, Nestlé Materna provides both calcium and vitamin D to help meet the nutritional needs while breastfeeding. Available in Pharmacies

NEW NORMADERM 3 IN 1 SCRUB + CLEANSER + MASK Normal/combination, oily, acne-prone skin? Cleanse, exfoliate, and mattify in one go with Vichy's latest arrival – the NEW NORMADERM 3-in-1 Scrub + Cleanser + Mask. This triple action mask helps minimise the appearance of large pores, mattifies skin for up to three days, and reduces acne scars, while fighting pimples and blackheads. Suitable for men and women with sensitive skin, NORMADERM 3-in-1 contains a formula that is hypoallergenic, paraben-free, soap-free, and alcohol-free. It combines 25% Kaolin Clay to absorb oil, Salicylic Acid to eliminate impurities and excess sebum from skin and pores, antibacterial Glycolic Acid to gently peel, Zinc to control sebum production, pumice that acts as a natural exfoliant, and Vichy Mineralizing Water to rebalance, regenerate, and soothe skin. To use as a cleanser and exfoliant, simply lather a small amount onto a wet face, and gently rub over the skin using circular motions. To use as a mask, apply thinly onto the face, and leave on for five minutes, then rinse with clear water. Use NORMADERM 3-in-1 once or twice a week as part of your Normaderm skincare routine. Available exclusively in pharmacies. For more information and samples: vichy@prohealth.com.mt

DIRTY WORKS SKINCARE A British brand, born and bred, Dirty Works loves to create sophisticated products to brighten up any regime. With its fresh, classy appearance Dirty Works offers everything for beautiful skin. Looking after your skin is so important yet so simple and we at Dirty Works believe in keeping things simple. Packed full of hydrating and soothing ingredients, you can't go wrong with this range to ensure skin in kept silky smooth, moisturised and refreshed. Our antioxidant-rich and skin conditioning ingredients featuring nourishing Shea Butter provides skin with a long lasting radiance for younger-looking complexions to boost, tone and lift skin. For more information on the full range of Dirty Works Skincare check out WWW.DIRTYWORKSBEAUTY.COM Dirty Works is found in leading supermarkets and pharmacies. Exclusively distributed by Alfred Gera & Sons Ltd, Tel: 2144 6205/6

SAY GOODBYE TO DANDRUFF WITH DERCOS ANTI DANDRUFF ADVANCED ACTION SHAMPOO! If you need a solution to get rid of your dandruff, try DERCOS ANTI-DANDRUFF shampoo for an advanced action, even against Seborrheic Dermatitis. Available for both dry, and normal to greasy hair, DERCOS ANTI-DANDRUFF shampoo contains Selenium DS to eliminate dandruff, balance the scalp, and relieve it from itching sensations. A shampoo that purifies the scalp, helping it regain comfort, health, and long-lasting regulation with a 6week anti-relapse action! Efficacy tested under dermatological control. 85% of users have said that DERCOS ANTIDANDRUFF makes hair more beautiful and moisturised with 97% saying they like the texture! Exclusively in pharmacies. For more info or sample email: vichy@prohealth.com.mt Facebook sign.

Collonil has been manufacturing the world's premium leather care products since 1909. Decades of ongoing research and development, collaboration with leather manufacturers and close attention to market trends set Collonil apart from the Competition. Collonil customers know that "Made in Germany" means a commitment to providing the world's best care for your shoes, handbags and other valuable leather goods. Available from leading supermarkets and shoe care shops. Follow us on Facebook at GF Ltd or call us on T 2143 7415 to find out more. October 2017

PRODUCT NEWS

MOMA MAKING OATS MORE AWESOME • • • •

Gluten Free High in protein Wholegrain Suitable for vegetarians

Easy to prepare: 1. Remove lid and boil the kettle. 2. Pour hot water to the fill line inside the pot. 3. Stir it up (the water level will drop but do not refill). 4. Wait five minutes then tuck in. Imported by J. Calleja Import & Export Ltd Web: www.jcallejaltd.com Email: storelocator@jcallejaltd.com Having comfortable feet has never been this easy. Tired feet and legs are a thing of the past. Scholl provides insoles for all your shoes, from open to pumps to flats to extreme heels to give you the trainer feel in all your favourite shoes.

SOMEONE’S GOING TO NEED OLFEN GEL Whether you’re an athlete or just accident prone, you’re probably going to need Olfen Gel. If you’re suffering from a sprain, strain, or joint pain, speak to your pharmacist about over-the-counter remedies such as Olfen Gel which actively relieves acute pain and reduces inflammation. Olfen contains Diclofenac Sodium 10mg. It is used for the treatment of pain, swelling and inflammation in a variety of conditions affecting the muscles, joints, tendons and soft tissues. It is applied 3 to 4 times daily and spread onto the affected part of the body (do not rub in). Olfen is for external use on healthy, undamaged skin only. It’s not for oral use. Olfen Gel should be applied only to intact non-diseased skin, and not to skin wounds or open injuries. Always read the package insert carefully.

ARE YOU EXPERIENCING HAIR LOSS? When you approach the menopause, oestrogen levels decline and the negative impact of testosterone rises. This hormonal fluctuation can lead to hair thinning or hair loss. In our study, 70% of women noticed less hair loss in their shower and on their hairbrushes when regularly using Plantur 39 shampoo. How does Plantur 39 work? Plantur 39 shampoo is formulated with a Phyto-Caffeine Complex that penetrates all the way to the follicle. If used regularly, it helps reduce the effect of hormonal fluctuations during and after menopause on the hair roots, which can reduce hair thinning or hair loss. For your nearest pharmacy stockist, please contact us at info@gfsltd.com Follow us on Facebook at GF Ltd or call us on T 2143 7415 to find out more www.plantur39.com

October 2017

CETAPHIL GENTLE SKIN CLEANSER • Cetaphil Gentle Skin Cleanser cleanses, moisturises and gently removes what your skin doesn’t need, without stripping the skin’s natural oils or disturbing the delicate pH balance of the skin. • Suitable for daily use and for all skin types, including sensitive skin. • Non-irritating, non-comedogenic (doesn’t block the pores), fragrance-free and skin-friendly pH. • Ideal for removing make-up. Cetaphil is available at leading pharmacies. Follow us on Facebook at GF Ltd or call us on T 2143 7415 to find out more.

MEN’S HAIR: THE GERMAN ANSWER TO HAIR LOSS Caffeine is the key active ingredient. When the hair becomes weak or threatens to fall out, caffeine can help. This has been proven by researchers at German universities. The shampoo formula of Alpecin is adjusted in such a manner that the caffeine reaches the hair root in exactly the right quantity within 120 seconds of contact. Alpecin Caffeine can work in the hair root, even though the shampoo is rinsed out. The caffeine remains in the scalp, providing adequate support for 24hrs. Follow us on Facebook at GF Ltd or call us on T 2143 7415 to find out more www.alpecin.com

d�ect�y

FRIO is an insulin cooling case that never needs icepacks or refrigeration. It is reusable and you can take it anywhere with you. For FRIO to be activated one shall simply soak it in cold water for 5-15 minutes (depends on size), then the crystals contained in the panels of the wallet will expand into a gel which remains cool for up to 2 days even in high temperatures. If need to re-activate it, simply put it back in water.

ATTARD / BALZAN / IKLIN / LIJA M4 PHARMACY, OLD RAILWAY ROAD ATTARD 21436531 MISRAH KOLA PHARMACY, PITKALI ROAD ATTARD 21434137 ST. CATHERINE PHARMACY, TRIQ ID-DIELJA K/M TRIQ SANTA KATERINA ATTARD 21413442 ST. MARY PHARMACY, 2 ANTONIO SCHEMBRI STREET ATTARD 21436348 BALZAN PHARMACY, 70 ST FRANCIS STREET BALZAN 21444035 MEDICA PHARMACY, NAXXAR ROAD BALZAN 21445741 MILIA’S PHARMACY, 73 COTTONERA STREET, BIRGU 27600126 IKLIN PHARMACY, GERONIMO ABOS STREET IKLIN 21415499 IL-MEHRIEZ PHARMACY, 31 GIOVANNI CURMI STREET IKLIN 21435567 ST. JOSEPH PHARMACY, 164 ANNIBALE PRECA STREET LIJA 21418846 ST. MICHAEL PHARMACY, TRANSFIGURATION AVENUE LIJA 21435875 BAHRIJA BAHRIJA PHARMACY, RADDET IR-ROTI STREET C/W SCHOOL STREET BAHRIJA 21450743 BORMLA / SENGLEA / VITTORIOSA VITTORIOSA PHARMACY, 9 TRIQ IL-MINA IL-KBIRA, BIRGU 21807529 VERDALA PHARMACY, 57 TRIQ IL-GENDUS BORMLA 21824720 WHITE CROSS PHARMACY, SHOP A BLOCK 1 SAN PAWL BORMLA 21821671 SAN FILIPPU PHARMACY, 155 VICTORY STREET SENGLEA 21800681 VICTORY PHARMACY, 32 VICTORY STREET SENGLEA 21801698

Lyprinol, is a potent non-steroidal anti-inflammatory for arthritis pain for patients who cannot tolerate current non-steroidal anti-inflammatory drugs. Lyprinol provides effective relief from the pain of arthritis, swelling and inflammation. Sufferers of both rheumatoid arthritis and osteoarthritis, using Lyprinol, report reduced pain and greater joint mobility within a few weeks. Lyprinol is one of the best natural sources of Omega-3 in the diet, because it contains additional lipids, unique to the Green Lipped Mussel – it’s like fish oil but better.

Improve your quality of life by resuming your diabetes treatment with IPort Advance and benefit from a 3-day puncture free experience! Research has shown that children using an injection port can lower their HbA1c values by almost 1% in just 6 months (Burdick et al, 2009). Reduce the pain and anxiety associated with each insulin injection by using an easy to use injection port. With IPort Advance, multiple daily injections will be avoided!

BIRZEBBUGIA / MARSASCALA / MARSAXLOKK BLOSSOMS PHARMACY, TRIQ IL-GURGIER BIRZEBBUGIA 21652226 BRITANNIA PHARMACY, 5 PRETTY BAY STREET BIRZEBBUGIA 21658622 MARTIN’S PHARMACY, 182 MAIN STREET BIRZEBBUGIA 21651031 BELLAVISTA PHARMACY, 88 TRIQ IL-ĦORTAN MARSASCALA 21633788 SAN GWAKKIN PHARMACY, 1 ST ANNE STREET MARSASCALA 21637994 SAN TUMAS PHARMACY, LAMPUKA STREET MARSASCALA 27023322 ST. ANNE PHARMACY, TRIQ IL-QALIET MARSASCALA 21637615 POMPEI PHARMACY, 28 XATT IS-SAJJIEDA MARSAXLOKK 21651278 BUGIBBA / QAWRA / ST PAUL’S BAY PROMENADE PHARMACY, PIONEER ROAD BUGIBBA 21571530 ST. SIMON PHARMACY, 8 ISLETS PROMENADE BUGIBBA 21571649 EL MEDINA CHEMIST, TRIQ IL-MASKLI QAWRA 21576308 EURO CHEMIST, TRIQ IL-KURAZZA QAWRA 21581876 QAWRA PHARMACY, EARL’S COURT/1 TRIQ L-IMĦAR QAWRA 21585633 PARKES PHARMACY, 582 ST PAUL STREET ST. PAUL’S BAY 21571764 ST. PAUL’S BAY PHARMACY, 504 MAIN STREET ST. PAUL’S BAY 21573406

The magazine is also available for free at the following pharmacies and clinics FGURA / PAOLA / TARXIEN ALPHA PHARMACY, ‘MARIA IMMACULATA’ COTTONER STREET FGURA 21673811 CILIA’S PHARMACY, 303 ZABBAR STREET FGURA 21801962 FGURA PHARMACY, TRIQ IL-KOPPLA FGURA 21675250 BROWN’S PAOLA SQUARE PHARMACY, 64/65 ANTOINE DE PAULE SQUARE PAOLA 21821646 BROWN’S PHARMACY, 45 PAOLA HILL PAOLA 21694818 DE PAOLA PHARMACY, 36 PJAZZA ANTOINE DE PAULE PAOLA 21826408 DISTINCTION PHARMACY, 32 PJAZZA ANTOINE DE PAULE PAOLA 21693412 FLEMING PHARMACY, 61 ZABBAR STREET PAOLA 21696893 ST. MONICA PHARMACY, 157 ST MONICA STREET PAOLA 21667146 SONREN PHARMACY, ZEJTUN STREET TARXIEN 21672757 TARXIEN PHARMACY, 59 TARXIEN STREET TARXIEN 21802986 THERESA JO PHARMACY, 3A TRIQ XINTILL TARXIEN 21672703 FLEUR DE LYS / BIRKIRKARA HERBA PHARMACY, 183 MAIN STREET BIRKIRKARA 21443406 HOLY CROSS PHARMACY, 37 MAIN STREET BIRKIRKARA 21448454 MARRIT PHARMACY, 1ST MAY STREET FLEUR-DE-LYS 21488613 PHARMAPLUS GANU STREET BIRKIRKARA 21492958 RATIONAL PHARMACY, 74/75 VALLEY ROAD BIRKIRKARA 21441513 ST. ANNE PHARMACY, 24 ST HELEN SQUARE BIRKIRKARA 27441913 ST. HELEN PHARMACY, TUMAS FENECH STREET BIRKIRKARA 21441589 ST. JUDE PHARMACY, 213 VALLEY ROAD BIRKIRKARA 21492151 ST. PAUL’S PHARMACY, BRARED STREET BIRKIRKARA 21442135 THE LOCAL DISPENSARY, CAN. K. PIROTTA STREET BIRKIARA 21493549 FLEUR-DE-LYS PHARMACY 32 FLEUR-DE-LYS 21488884 MACKIE’S PHARMACY, L. CASOLANI STREET BIRKIRKARA 21496089 FLORIANA / VALLETTA CHEMIMART LTD., 14 ST ANNE STREET FLORIANA 21239310 ST. PUBLIUS PHARMACY, 48 TRIQ IL-MIRATUR FLORIANA 21225444 VILHENA PHARMACY, 3 ST ANNE STREET FLORIANA 21244114 WATERFRONT DISPENSARY, FORNI 2I PINTO WHARF FLORIANA 21233034 MEDICINE CHEST PHARMACY, DEMITRIJU FARRUGIA ROAD GHARGHUR 21422204 ST. ALBERT PHARMACY, ORATORY STREET GHARGHUR 21413402 CHEMIMART PHARMACY REPUBLIC STREET, 20/21, REPUBLIC STREET, VALLETTA 21246051 CHEMIMART CITY GATE PHARMACY, 24, CITY GATE, VALLETTA, 21238355 COLLIS WILLIAMS PHARMACY, 15 REPUBLIC STREET VALLETTA 21226281 EMPIRE PHARMACY, 77 OLD THEATRE STREET VALLETTA 21225785 EMPIRE PHARMACY BRANCH, 46 MELITA STREET VALLETTA 21225785 NEW BRITISH DISPENSARY, 109/110 ST JOHN STREET VALLETTA 21244813 REGENT PHARMACY, 70 MERCHANTS STREET VALLETTA 21245135 ROYAL PHARMACY, 271 REPUBLIC STREET VALLETTA 21252396

October 2017

d�ect�y GHAXAQ / QRENDI / MQABBA BETA PHARMACY, 50/52 SANTA MARIA STREET GHAXAQ 21663311 CHRYSANTHEMUM PHARMACY, ST NICHOLAS STREET QRENDI 21680828 QRENDI PHARMACY, 6 MAIN STREET QRENDI 21683781 ST. PHILIP PHARMACY, TRIQ IĊ-ĊEPPUN GHAXAQ 21808723 GUDJA / LUQA / MARSA GUDJA PHARMACY, 9 TRIQ SAN ĊIRU GUDJA 21696422 MEDICAID PHARMACY, 62 VJAL IT-TORRI GUDJA 21676294 AIRPORT PHARMACY, GROUND FLOOR ARRIVAL LOUNGE MALTA INTERNATIONAL AIRPORT TERMINAL, LUQA 23696349 CENTRAL PHARMACY, 6 ST JOSEPH STREET LUQA 21692546 ST. ANDREW’S PHARMACY, 51 ST GEORGE STREET LUQA 21820795 SAN RAFFAEL PHARMACY, 247 QORMI ROAD MARSA 21221188 TRINITY PHARMACY, 32 MARSA ROAD MARSA 21235595 VIVIEN PHARMACY, TRIQ PATRI MAGRI MARSA 21221701 HAMRUN / SANTA VENERA BROWN’S PHARMACY, 706 MAIN STREET HAMRUN 21238623 CHEMIMART INTERNATIONAL PHARMACY, 650 MAIN STREET HAMRUN 21236 477 COSMED PHARMACY, SOCCORS VILLAMBROSA STREET HAMRUN 21225991 DARWIN PHARMACY, 152 MAIN STREET HAMRUN 21221512 FRA DIEGO DISPENSARY, 94 VILLAMBROSA STREET HAMRUN 21224898 LISTER PHARMACY, 678 MAIN STREET HAMRUN 21245627 NATIONAL PHARMACY, 17 SANTA MARIA STREET HAMRUN 21225539 ST. GAETAN PHARMACY, KAPPILLAN MIFSUD STREET HAMRUN 21234570 THE CROSS PHARMACY, 859 MAIN STREET HAMRUN 21227682 THOMAS’ PHARMACY, 796 MAIN STREET HAMRUN 21238018 FATIMA PHARMACY, TRIQ IŻ-ŻONQOR SANTA VENERA 21482856 LANTERN PHARMACY, MISRAĦ IL-KEBBIES SANTA VENERA 21444648 ST. BARTHOLOMEW PHARMACY, 230 FLEUR-DE-LYS SANTA VENERA 21492271 ST. VENERA PHARMACY, 532 MAIN STREET SANTA VENERA 21238625 KALKARA KALKARA PHARMACY, NO. 8 MISRAĦ L-ARĊISQOF GONZI KALKARA 21807740 KIRKOP KIRKOP PHARMACY, 9 PARISH STREET KIRKOP 21682028 PRESTIGE PHARMACY, 16 ST JOSEPH STREET KIRKOP 21641328 MELLIEHA BROWN’S PHARMACY, SHOP A GEORGE BORG OLIVIER STREET MELLIEHA 21523554 MELLIEHA PHARMACY, 111 GEORGE BORG OLIVIER STREET MELLIEHA 21523462 BROWN’S VILLAGE PHARMACY, MAIN STREET MELLIEHA 21523536 MĠARR PHARMACY, MAIN STREET C/W VITALE STREET MGARR 21577784 ST. MARY PHARMACY, 71 SIR HARRY LUKE STREET MGARR 21580711 MOSTA / NAXXAR GROGNET PHARMACY, 41 CONSTITUTION STREET MOSTA 21432038 ROTUNDA PHARMACY, 7 EUCHARISTIC CONGRESS ROAD MOSTA 21411197 SANTA MARGHERITA PHARMACY, VJAL IL-QALBIENA MOSTIN SANTA MARGHERITA ESTATE MOSTA 21416426 SGHAJTAR PHARMACY, SGĦAJTAR STREET MOSTA 21415198 ST. JOSEPH PHARMACY, 1 TRIQ IŻ-ŻAKKAK MOSTA 21417593 ST. LOUIS PHARMACY, CALI’ STREET MOSTA 21432802 ST. MARY PHARMACY, 14 PJAZZA ROTUNDA MOSTA 21433833 TAT-TARGA PHARMACY, PLOT NO. 2 CONSTITUTION STREET MOSTA 21433141 BROWN’S CHEMISTS, ST PAUL STREET NAXXAR 21417652 NAXXAR PHARMACY, VJAL IL-21 TA’ SETTEMBRU NAXXAR 21411438 PILLBOX PHARMACY, 63 TRIQ IL-BJAD NAXXAR 21417406 VICTORY PHARMACY, 16 VICTORY SQUARE NAXXAR 21412454 MQABBA KRISTIANNE PHARMACY, TRIQ IC-CAVI MQABBA 21683048 MQABBA CENTRAL PHARMACY, ST CATHERINE STREET MQABBA 21641133 MSIDA / PIETÀ /GZIRA/ TA’ XBIEX DEBY’S PHARMACY, 1 QUARRIES STREET MSIDA 21227920 MAYER PHARMACY, 33 TA’ XBIEX SEAFRONT MSIDA 21331732

October 2017

The magazine is also available for free at the following pharmacies and clinics

REGAL PHARMACY, 39B ANTONIO BOSIO STREET MSIDA 21313115 REGIONAL PHARMACY, E.H. FURSE STREET MSIDA 21312449 BROWN’S PHARMACY, SHOP 10 YACHT MARINA APARTMENTS TRIQ IL-MARINA PIETÀ 21244366 CHARING PHARMACY, MIMOSA STREET PIETÀ 21232954 ST. ANTHONY PHARMACY, 56 ST JOSEPH STREET PIETÀ 21237327 ST. LUKE PHARMACY, ST LUKE STREET PIETÀ 21241293 D’ARGENS PHARMACY, 330 RUE D’ARGENS GZIRA 21330817 O’HEA PHARMACY, 128 MANOEL STREET GZIRA 21330268 ST. MATTHEW’S PHARMACY, 213 THE STRAND GZIRA 21311797 TONY’S PHARMACY, 100 SIR PATRICK STUART STREET GZIRA 21332080 PHARMALAND DISPENSERS, 5 TAGLIAFERRO MANSIONS PRINCESS MARGARET STREET TA’ XBIEX 21346547 PERSONA MED-AESTHETIC CENTRE, 42, MARINA COURT, SIR UGO MIFSUD STREET, TA’ XBIEX 21340366 REMEDIES CHEMISTS, MARINA COURT 49A ABATE RIGORD STREET TA’ XBIEX 21341649 PACEVILLE / SAN GWANN / ST JULIANS POTTER CHEMISTS LTD., WILGA STREET PACEVILLE 21363244 LOURDES PHARMACY, NAXXAR ROAD SAN GWANN 21387479 MARC PHARMACY, 92 MENSIJA STREET SAN GWANN 21373275 MEDICAL PLAZA DISPENSING CHEMISTS, CASS-I-MALL BUILDINGS VJAL IR-RIHAN SAN GWANN 21372195 SAN GWANN PHARMACY, 11 FELIĊ BORG STREET SAN GWANN 21386974 SPIŻERIJA KAPPARA, ŻBIBU LANE SAN GWANN 21381776 BALLUTA PHARMACY, 30 MAIN STREET ST JULIANS 21317888 MELITA PHARMACY, 127 ST GEORGE STREET ST JULIANS 21378657 SPIŻERIJA MERĦBA, SHOP 2 LAPSI STREET TA’ GIORNI ST JULIANS 21333886 ST. JULIANS PHARMACY, 24 GEORGE BORG OLIVIER STREET ST JULIANS 21369426 PEMBROKE / SWIEQI / ST ANDREWS J.V.’S PHARMACY, SWIEQI VALLEY SWIEQI 21371062 KRYPTON CHEMISTS, IBRAGG STREET SWIEQI 21370141 ST ANDREWS PHARMACY, 87 GIUSEPPE MALFEGGIANI STREET ST ANDREWS 21372784 PENNY LANE PHARMACY, SEJJIEĦ STREET SWIEQI 21375373 SAN GIORGIO PHARMACY, MANWEL BUHAGIAR STREET PREMBROKE 21378485 ST. ANDREW’S PHARMACY, TRIQ IL-QASAM ST ANDREWS 21355205 QORMI ANICI PHARMACY, ANICI STREET QORMI 21487162 BROWN’S PHARMACY, 278 VICTORY STREET QORMI 21499697 DRUGSHOP DISPENSARY, VJAL DE LA CRUZ QORMI 21443221 EVANS PHARMACY, 96/98 ST SEBASTIAN STREET QORMI 21487020 PINTO PHARMACY, 43 ST SEBASTIAN STREET QORMI 21487311 ST. GEORGE’S PHARMACY, 21 MAIN STREET QORMI 21443045 TAL-HLAS PHARMACY, TRIQ IL-ĦELSIEN QORMI 21487739 DINGLI / MTARFA / RABAT SANTA MARIJA PHARMACY, FRENĊ ABELA SQUARE DINGLI 21452447 SPIŻERIJA CARMEN, 1 TRIQ MISRAĦ SUFFARA DINGLI 21457128 IMTARFA PHARMACY, 207 ST. DAVID ROAD MTARFA 21451261 MAKE OVER PHARMACY, BLK A TOWN CENTRE HOS MTARFA 21452833 CENTRAL PHARMACY, TRIQ GĦAJN KAJJET RABAT 21455959 IDEAL PHARMACY, 63 MAIN STREET RABAT 21455479 NIGRET PHARMACY, TRIQ IŻ-ŻAHAR RABAT 21450602 NOVA PHARMACY, 142 COLLEGE STREET RABAT 21454247 ST. ANTHONY PHARMACY, 18 MAIN STREET RABAT 21454187 SAFI PASTEUR PHARMACY, TRIQ IT-TELLERIT SAFI 21689944 SAFI PHARMACY, ST. JOHN STREET C/W BIEB IL-GARRA STREET SAFI 21649552 SANTA LUCIA MADDALENA PHARMACY, SHOP 2 TAL-FAQQANI BUILDING TOWER AVENUE SANTA LUCIA 21677037 STA. LUCIA PHARMACY, 1 MISRAĦ DORELL SANTA LUCIA 21890111

SIGGIEWI MENELO PHARMACY, DR NIKOL ZAMMIT STREET SIGGIEWI 21462957 ST. NICHOLAS PHARMACY, 1 PARISH STREET SIGGIEWI 21460828 THE BYPASS PHARMACY, MONS MIKIEL AZZOPARDI STREET SIGGIEWI 21461681 SLIEMA BROWN’S PHARMACY, UNIT 22 TIGNÈ STREET SLIEMA 21313233 CHEMIMART PHARMACY, 4 5 6 IL-PIAZZETTA TOWER ROAD SLIEMA 21338369 DRUG STORE, 382 MANWEL DIMECH STREET SLIEMA 21334627 EDWARD’S PHARMACY, 115 MANWEL DIMECH STREET SLIEMA 21334102 HARLEY PHARMACY, 1 NATHALIE POUTIATINE TABONE STREET SLIEMA 21334635 MRABAT PHARMACY, MRABAT STREET SLIEMA 21313535 NORMAN’S PHARMACY, 133 HIGH STREET SLIEMA 21332243 RUDOLPH PHARMACY, 133 RUDOLPHE STREET SLIEMA 21344722 STELLA MARIS PHARMACY, 34 MILNER STREET SLIEMA 21335217 THE ECONOMICAL DISPENSARY, 86/87 SIR ADRIAN DINGLI STREET SLIEMA 21330376 VICTOR’S PHARMACY, 9 TOWER ROAD SLIEMA 21330352 WALES PHARMACY, 183 MANWEL DIMECH STREET SLIEMA 21335492 ZABBAR ST. ELIAS PHARMACY, TRIQ SAN ELIJA XAGHJRA 21660300 FELICE DISPENSARY, 95 SANCTUARY STREET ZABBAR 21827939 MAY DAY PHARMACY, VICTORY STREET ZABBAR 21826529 MEDIATRIX PLUS PHARMACY, 7 SANCTUARY STREET ZABBAR 27826685 POLYMER PHARMACY, TRIQ IX-XGĦAJRA ZABBAR 21676263 ST. JAMES PHARMACY, 1 MISRAĦ SAN ĠAKBU ZABBAR 21666194 ST. PETER PHARMACY, TRIQ IS-SEBBELLIKA ZABBAR 21663750 ZEBBUG DE ROHAN PHARMACY, 24 ST ANTHONY STREET ZEBBUG 21464128 PLAZA PHARMACY, 86 MAIN STREET ZEBBUG 21467459 SANTA MARIJA PHARMACY, 40 GĦASFURA STREET ZEBBUG 21465346 SPIŻERIJA ĦAL-MULA, DUN SALV CIAPPARA STREET ZEBBUG 21461693 TAL-GRAZZJA PHARMACY, FRANĠISK FARRUGIA STREET ZEBBUG 21462068 BROWN’S PHARMACY, 47 VJAL IL-ĦELSIEN ZEBBUG 21465411 ZEJTUN GERADA PHARMACY, 46 MATER BONI CONSIGLI STREET ZEJTUN 21806009 GREEN CROSS PHARMACY, 31 GREGORIO BONNICI SQUARE ZEJTUN 21693723 HEALTH JUNCTION PHARMACY, ALFRED CACHIA ZAMMIT STREET ZEJTUN 21661644 ST. CATHERINE PHARMACY, PLOT 3 TRIQ IL-QADI ZEJTUN 21678039 ZURRIEQ KRISTIANNE PHARMACY, PIETRU PAWL SAYDON STREET ZURRIEQ 21647391 SALUS PHARMACY, 21 REPUBLIC SQUARE ZURRIEQ 21680761 ZURRIEQ DISPENSARY, 68 MAIN STREET ZURRIEQ 21689971 BRONJA PHARMACY, SONATA BRONJA STREET ŻURRIEQ 21682251 GOZO FONTANA PHARMACY, TRIQ IL-GĦAJN FONTANA 21566979 GĦAJNSIELEM PHARMACY, INDEPENDENCE SQUARE GHAJNSIELEM 27203615 LAURETANA PHARMACY, 36 MGARR STREET GHAJNSIELEM 21563017 SOKKORS PHARMACY, ST GREGORY STREET KERCEM 21553018 TONY’S PHARMACY, “EGRET COURT”VALLEY STREET MARSALFORN 21563617 NADUR PHARMACY, PJAZZA IT-28 TA’ APRIL 1688 NADUR 21563589 VELLA PHARMACY, 15 13TH DECEMBER STREET NADUR 21566431 ST. JOSEPH PHARMACY, 28 ST JOSEPH SQUARE QALA 21555348 ABELA’S PHARMACY, 42 G.P.F. AGIUS DE SOLDANIS STREET RABAT 21556170 AZZOPARDI PHARMACY, CAPUCHIN STREET RABAT 21563233 BATU PHARMACY, 38 PALM STREET RABAT 21551841 CASTLE PHARMACY, 2 INDEPENDENCE SQUARE RABAT 21556970 PALM PHARMACY, 2 PALM STREET RABAT 21566170 TAĊ-ĊAWLA PHARMACY, 7 JUNE 1919 STREET RABAT 21557819 PISANI PHARMACY, NEW BUILDING SANNAT STREET SANNAT 21564447 JOYCE’S PHARMACY, VJAL IT-8 TA’ SETTEMBRU XAGHRA 21561486 XAGĦRA PHARMACY 55 CHURCH STREET XAGHRA 27551140 GOZO CHEMISTS, MGARR ROAD XEWKIJA 21557278 ST. JOHN’S PHARMACY, 85 INDEPENDENCE STREET XEWKIJA 21563052