Health check issue 11

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ISSUE 11

Wednesday, December 31, 2014

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SCH WORKSHOP ON VACCINE MANAGEMENT

WORLD AIDS DAY CELEBRATED IN QATAR

T

he Supreme Council of Health (SCH) has organised a training workshop on vaccine management, targeting healthcare providers from all health centres in both the public and private sectors in Qatar.

In his speech to the participants, Sheikh Dr Mohammed Al-Thani, Director of the Public Health Department, noted that the workshop reflects the commitment of the SCH to provide evidence-based services, where the Expanded Program on Immunization or EPI has carried out a successful research study to explore knowledge, attitude, and practices related to vaccine utilisation and coverage, in addition to assessment of cold chain systems across providers at the Primary Health Care settings in Qatar.

Dr. Hamad Al-Romaihi, Manager of Health Protection and Communicable Disease Control at the SCH’s Public Health Department, said that the workshop which was organised in collaboration with the Primary Health Care Corporation, aimed to enhance the participants’ knowledge and skills related to manage vaccine storage, transportation, distribution, and delivery ensuring the highest safety conditions till the administration to the end beneficiary, and delivery of vaccines, as well as its distribution and transportation based on the guidelines set by the World Health Organisation (WHO).

Dr Al-Romaihi also explained that the workshop is deemed one of the steps to preparing the surge capacity of the system to address emergencies by encouraging cooperation between the national EPI at the SCH with other healthcare partners. He added that the workshop also covered some of the operational procedures related to vaccine monitoring like data registration and surveillance of vaccine-preventable diseases.

He noted that the workshop comes within the framework of a research study carried out by the department of EPI at the Health Protection and Communicable Disease Control at the SCH’s Public Health Department. The research was focused on the knowledge, attitudes and practices towards the EPI, and the cold chain system between service providers from the primary health centres working in Qatar covering the year 2013.

T

he State of Qatar joined the world in the celebration of the World AIDS Day this 1st of December, under the slogan “HIV treatment controls the virus. Treat for Life. Prevent for Life.”

Qatar is keen to participate effectively in the global efforts to curb the HIV (Human Immunodeficiency Virus) epidemic and has approved a plan that is in line with international and regional trends.

It has also adopted an integrated preventive and therapeutic strategies such as voluntary and regular

check-up services upon arrival of visitors and citizens to Qatar. In addition, the country is raising health awareness and provides treatment and care for those afflicted with the disease.

Marking the World AIDS Day is an occasion to invigorate the country’s unflinching determination to adopt effective strategies aimed to prevent and control the disease. This year’s programme for marking the day is organised by the Supreme Council of Health (SCH), the Hamad Medical Corporation (HMC), the Primary Health Care

Corporation (PHCC), and other public and private institutions.

The programme included a series of activities for raising societal awareness, and creating programs for building the capabilities of health cadres in the public and private sectors. The programme also included scientific workshops, during which several researches and studies on strategies for fighting the disease are discussed, and where developments in the treatment and prevention of the disease were tackled.

(Continued on page 2...)

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Wednesday, December 31, 2014

... REPORT ...

WORLD AIDS DAY CELEBRATED IN QATAR (Continued from page 1) the necessary technology for its implementation is still lacking in more than half of the countries.

The AIDS and HIV Challenge

Regional Initiatives Efforts to scale-up the beneficiaries of ART (Anti-retroviral Therapy) continue in the Eastern Mediterranean Region. The area has witnessed a 46% increase in the number of people living with HIV and receiving anti-retroviral therapy - from 25,000 in 2012 to over 39,000 in 2013. ART coverage is estimated at 25% of those requiring intervention.

Launched under the name End the HIV Treatment Crisis, there is still a need to increase the coverage to fill this gap within the effort of the regional initiative and this year marks

the beginning of the third year since the initiative was launched.

But it is worthwhile to mention that the Eastern Mediterranean Region is working at several levels to curb HIV, ensuring that the health systems are strong and that access to treatment for all those in need are provided.

Access to treatment starts with enabling people living with HIV to access testing services where people get tested and given access to test results. The initiative ensures that those who test positive are linked to good quality care and treatment and that the services provided for those

who take drugs and for other affected major population groups in the region are enhanced. And because providing treatment services for infants and children pose a unique challenge, health systems need to adapt to make sure that the least privileged and most marginalised individuals are not excluded from getting access to treatment and care services.

Aside from all the aforementioned efforts, there is also a need to monitor the success of treatment in individuals, which is done through viral load testing. Such poses a substantial challenge considering that

AIDS and HIV infection are still among the challenges to Public Health around the world, especially among the low- and middle-income countries. HIV targets the immune system and weakens an individual’s defence systems against infections and some types of cancer. When the virus destroys and impairs the function of immune cells, infected individuals gradually develop immune deficiency. Immunodeficiency results gradually in increased susceptibility to a wide range of infections and diseases.

The most advanced stage of HIV infection is Acquired Immunodeficiency Syndrome (AIDS), which can take about 2 to 15 years to develop, depending on the individual.

AIDS is defined by the development of certain cancers, infections, or other severe clinical manifestations.

Deadly infection is largely attributed to HIV whose implications claimed the lives of more than 39 million people in the past three decades.

There were approximately 35 million people living with HIV

in 2013, with more than 60% of them living in sub-Saharan Africa.

The symptoms of HIV vary depending on the stage of infection. Though people living with HIV tend to be most infectious in the first few months, many are unaware of their status until only during the later stages. The first few weeks after initial infection, individuals may experience no symptoms or an influenza-like illness including fever, headache, rash, or sore throat. As the infection progressively weakens the person’s immune system, the individual can develop other signs and symptoms such as swollen lymph nodes, weight loss, fever, diarrhoea, and cough.

People living with HIV who take ART in the right combination of medicines can control the virus and bring it down to undetectable levels. This keeps the immune system strong enough to fight opportunistic infections and cancers.

Every individual living with HIV can enjoy the highest attainable level of health if provided access to good quality HIV care and treatment. Raising the awareness of the disease, having voluntary checkups, and complying with the regulations of religion, values, and chastity are the most important HIV prevention methods.

HOW HIV/AIDS GET COMPLICATED

H

IV infection weakens the immune system, making infected individuals highly susceptible to numerous infections and certain types of cancers. Infections common to HIV/AIDS include: • Tuberculosis (TB): In resource-poor nations, TB is the most common opportunistic infection associated with HIV and a leading cause of death among people with AIDS. Millions of people are currently infected with both HIV and tuberculosis, and many experts consider the two diseases to be twin epidemics.

• Salmonellosis: You contract this bacterial infection from contaminated food or water. Signs and symptoms include severe diarrhoea, fever, chills, abdominal pain and, occasionally, vomiting.

Although anyone exposed to salmonella bacteria can become sick, salmonello-

sis is far more common in HIV-positive people.

• Cytomegalovirus: This common herpes virus is transmitted in body fluids such as saliva, blood, urine, semen and breast milk. A healthy immune system inactivates the virus, and it remains dormant in your body. If your immune system weakens, the virus resurfaces — causing damage to your eyes, digestive tract, lungs or other organs.

• Candidiasis: Candidiasis is a common HIV-related infection. It causes inflammation and a thick, white coating on the mucous membranes of your mouth, tongue, oesophagus or vagina. Children may have especially severe symptoms in the mouth or oesophagus, which can make eating painful.

• Cryptococcal meningitis: Meningitis is an inflammation of the membranes

and fluid surrounding your brain and spinal cord (meninges). Cryptococcal meningitis is a common central nervous system infection associated with HIV, caused by a fungus found in soil. The disease may also be associated with bird or bat droppings.

• Toxoplasmosis: This potentially deadly infection is caused by Toxoplasma gondii, a parasite spread primarily by cats. Infected cats pass the parasites in their stools, and the parasites may then spread to other animals and humans.

• Cryptosporidiosis: This infection is caused by an intestinal parasite that’s commonly found in animals. You contract cryptosporidiosis when you ingest contaminated food or water. The parasite grows in your intestines and bile ducts, leading to severe, chronic diarrhoea in people with AIDS.

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Wednesday, December 31, 2014

... DOCTOR’S DESK ...

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You’re Sick-Now What?

FLU AND COLD FIGHTERS F

resh fruits, veggies, lean meats and fish will do a body good year-round, but adding certain foods to your diet will give your body’s infection-defeating abilities an extra boost, says Dr Bonnie Taub-Dix, a member of the Family Circle Health Advisory Board. Try some—or all—of these.

• Carrots: A diet rich in beta-carotene—also found in bell peppers, broccoli, sweet potatoes and squash—protects the lining of the nose, which traps germs before they can infect you.

• Green Tea: Science backs up what tea drinkers have known for centuries: going green keeps you healthy. In a study at the University of Florida, people who consumed two cups of green tea daily for three months had 32% fewer colds. “Add a splash of fresh fruit juice if you want to improve the flavour,” suggests Taub-Dix.

EVERYONE NEEDS TO HAVE A HEALTHY DIET. BUT SHOULD THAT BALANCE CHANGE FOR PEOPLE ACTIVELY INVOLVED IN SPORTS?

Non-fat Greek Yoghurt: This rich and tangy variety has three times more protein (which helps increase the number of immune cells in your body) than regular yoghurt. It’s also chock-full of immune-boosting live and active cultures.

• Salmon: This food is a great source of heart-strengthening omega-3 fatty acids, but one serving also contains up to 1,000 IU of vitamin D. A study conducted at the University of Colorado, Denver, found that upping your intake of the vitamin staves off colds.

• Garlic: A compound called allicin fights against bacterial, viral and fungal infections, says Taub-Dix. Plus, in a recent study, people who took a daily garlic supplement had 36% fewer colds over the course of a year than those who were given a placebo.

•

(Reference: Family Circle Magazine)

An Active Diet for Active People!

Sporty individuals should look for wholegrain foods like whole-wheat pasta, brown rice, whole-grain bread and cereal, and plenty of fruits and vegetables.

Drink Up!

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nyone who eat healthy, well-balanced meals and snacks will get the nutrients needed to perform well in sports. The more active individual like an athlete, however, will have higher energy and fluid requirements. In addition to getting the right amount of calories, it takes a variety of nutrients to keep them performing at their best.

• Vitamins and minerals: Calcium and iron are two important minerals for athletes. Calcium helps build strong bones to resist breaking and stress fractures. Calcium-rich foods include low-fat dairy products like milk, yoghurt, and cheese, as well as leafy green vegetables. Iron meanwhile, helps carry oxygen to all the different body parts that need it. Iron-rich foods include lean meat, chicken, tuna, salmon, eggs, dried fruits, leafy green vegetables, and fortified whole grains.

No matter how hard you try to stay healthy, sometimes germs will win.

The best treatment is waiting it out—both colds and flu are caused by viruses, which can’t be remedied with antibiotics. Drink lots of fluids, get some sleep and take an over-the-counter pain reliever until symptoms subside. See your doctor, though, if you suffer from any of the following symptoms: • A cough that disrupts sleep • A fever that won’t go down with medicine • Increased shortness of breath • Intense, burning sinus pain • Worsening of symptoms, high fever, chest pain, or a difference in the mucus you emit, all after feeling better for a short time

• Protein: Strong muscles come from regular training and exercise, and not solely from protein. Too much protein can lead to dehydration and calcium loss. Intake of this nutrient should be in moderation. Protein-rich foods include fish, lean meat and poultry, dairy products, beans, nuts, and soy products.

• Carbohydrates: Carbs provide energy for the body. Some diet plans have urged weight-conscious individuals to steer clear of carbs, but for an athlete, they’re an important source of fuel.

There’s no need for “carb loading” or eating a lot of carbs in advance for a big game, but without carbs in their diet, they will be running on empty.

It’s important for all of us to drink plenty of fluids to prevent dehydration. Even a mild dehydration can affect athletic performance.

Thirst is not a reliable indicator of hydration status so experts recommend that we drink water or other fluids before and every 15 to 20 minutes during physical activity. It’s important to drink afterwards to restore fluid lost through sweat.

Although many sports drinks are available, plain water is usually enough to keep us hydrated. Sports drinks are designed to provide energy and replace electrolytes — such as sodium and potassium — that athletes lose in sweat.

Sports drinks may be a good choice for people who participate in strenuous physical activity for more than 1 hour because after exercising for 60 to 90 minutes, the body has used up its readily available sources of energy. Sports drinks are also a good alternative for anyone who participate in sports but won’t drink enough water.

Diluted juice is another option but avoid sugary drinks and carbonated beverages that can upset the stomach.

The bottom line: water is the best choice for hydration!

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Wednesday, December 31, 2014

... HEALTH QUIZ ...

SMOKING’S IMPACT ON YOUR HEALTH SMOKING TOBACCO IS ONE OF THE MAIN RISK FACTORS FOR CANCER AND HEART DISEASE, OUR TWO BIGGEST KILLERS. TEST YOUR KNOWLEDGE ON THE DANGERS OF SMOKING, HOW IT AFFECTS YOUR BODY AND HOW TO QUIT

Quiz Answers The World Health Organisation says tobacco kills nearly 6 million people every year and of those who use tobacco... a. Nearly all will die because of their use. b. Close to three quarters will die because of their use. c. Up to half will die because of their use. d. Only a small portion will die because of their use.

❶

When you smoke a cigarette, which of the following does not happen?

❷

a. Your blood pressure and heart rate increase. b. Blood flow to your capillaries increases. c. Your blood carbon monoxide levels increase. d. The tiny muscles in your airways contract, constricting them.

If you have been smoking for some time, does quitting still reduce your risk of heart disease and cancer? a. Yes, and the benefits apply to quitters of any age. b. Yes, but only if you quit

❸

when you are still under 35. c. No, quitting makes no difference to your risk. d. Perhaps, but not everyone will benefit.

How long does it take for your sense of taste and smell to start to improve after you quit smoking? a. 12 hours b. Two days c. One week d. Two months

❹

If you want to quit smoking, support from a fellow quitter helps.

Whose support has been shown to help most?

❺ a. b. c. d.

Your co-worker Your sibling Your spouse Your neighbour.

6 ➎

Out of the following, which option is probably the best way to quit smoking? a. Going cold turkey b. Planning your attempt to quit well in advance c. Asking friends and family for advice first d. Increasing the number of cigarettes you are smoke before trying to quit

Question ❶ = c Up to half will die because of their use.

The World Health Organisation states that globally tobacco kills nearly 6 million people every year and up to half of all people who are currently using tobacco will eventually die of tobacco-related disease. It also says tobacco-related illness and death hits low and middle-income countries hardest, as nearly 80 per cent of the world’s one billion smokers live in these countries.

Question ❷ = b

monoxide takes the place of oxygen in some of your red blood cells, and it sticks on to the red cells for days, preventing oxygen from being carried by these cells.

• Other changes happen in our airways: the little finger-like cilia which keep airways clear of phlegm are ‘stunned’ by chemicals in the smoke and tiny muscles in our airways contract, constricting them.

• There are also measurable changes in the immune system.

Question ❸ = a

to your increases.

Yes, and the benefits apply to quitters of any age.

Studies can now measure the immediate changes in our bodies as we smoke a single cigarette, from a rise in blood pressure to a change in the gases in our blood stream.

The good news is that no matter what age you are when you give up cigarettes, by quitting you will reduce your chance of developing lung cancer and heart disease. The Cancer Council says one year after quitting your risk of heart disease rapidly drops and after 10 years your risk of lung cancer is halved.

Blood flow capillaries

Here’s what happens when someone smokes a cigarette: • Although we may feel more relaxed as we smoke, our blood pressure and heart rate both increase, the heart pumps differently, and the blood flow to the capillaries decreases.

• Blood carbon monoxide levels increase. Carbon

Question ❹ = b Two days.

The Cancer Council says your sense of smell begins to return about two days

after you quit smoking.

About 12 hours after you stop smoking nearly all the nicotine is out of your system, and most of its byproducts are gone within five days. Your circulation improves when you quit smoking and after two months, blood flow to your hands and feet improves.

Question ➎ = c Your spouse A US study found that when one spouse stopped smoking, it reduced their partner’s chances of smoking by 67 per cent. Siblings and, in some settings, co-workers can also influence our decision to quit

6 =a Question ➎ Going cold turkey Going cold turkey is probably the most effective way to quit smoking, according to Sydney Medical School Professor Simon Chapman.

It certainly is the method most successful quitters use. But while cold turkey – either stopping dead or cutting down smoking and then stopping – might be the most common way to success, it’s difficult to say for sure whether it’s better than alternatives as no direct comparison has been done through research.

(Source: abc.net.au/health)

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Wednesday, December 31, 2014

... MENTAL HEALTH ...

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DEALING WITH STRESS AT WORK

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tress is one of the leading causes of workplace illness and people being absent from work. Majority of people experience stress at some point during their working life and different people will experience stress in various ways.

Some stress can assist a person to be more alert, energised and motivated about achieving tasks both within work and in their social life. Stress becomes a problem when a person experiences too much of it for a prolonged period of time.

When stress becomes enough of a problem to affect your ability to carry out your work or other day-to-day tasks, or to enjoy things you have previously liked, it is

important to take action.

Learning some good stress management can result in being happier and healthier both at work and outside of work. Some tips include: • Develop good relationships with colleagues so you can build up a network of support • Talk to someone you trust, at work or outside, about what upsets you or makes you feel stressed • Say if you need help • Be assertive – say no if you can’t take on extra demands • Be realistic – you don’t have to be perfect all the time • Write a list of what needs to be done; it only takes a few minutes and can help you to prioritise, focus and get things in perspective. It can also feel satisfying to tick items off once they have been done • If everything starts to feel overwhelming, take a deep breath. Try and get away from your desk or situation for a few minutes • Try and take a walk or get some fresh air during the day. Exercise and daylight are good for your mental health as well as physical health • Try not to work long hours or take work home with you. This may be alright in the short term, if the work has a specific purpose and is clearly defined – a team effort to complete an urgent pro-

ject may be very satisfying. However, working longer hours on a regular basis does not generally lead to better results • If you are provided with opportunities to have some input, particularly in decisions that may impact you, then take advantage of those opportunities • If you are working from home, make the most of opportunities for contact • Maintain a healthy work-life balance – nurture your outside relationships, interests, and the abilities your job does not use • Make sure you drink enough water and that you eat during the day to maintain your energy levels • Learn some relaxation techniques People often worry that if they talk about stress they will be seen as weak or not capable of doing their job. However, stress is not a weakness and it is very common for people to experience stress at work.

Speaking up early about stress provides the opportunity to prevent it from becoming worse, which is helpful for the both individual employee and their workplace.

If you are concerned about the impact stress is having on your physical or mental health, it is important to ask for professional help and support. There are a number of trained mental health professionals and counsellors in Qatar working in public and private organisations, and on hand from the Primary Health Care Centres and from the Hamad Medical Corporation’s Psychiatry Department.

Typical signs of work-related stress: Physical

Psychological

Behavioural

Tiredness

Anxiety

Increased use of Stimulants

A Tight Chest

Tearfulness

Withdrawal Or Aggression

Indigestion

Feeling Low

Lateness

Headaches

Mood Changes

Recklessness

Appetite And Weight Changes

Indecision

Difficulty Concentrating

Joint And Back Pain

Loss Of Motivation Increased Sensitivity Low Self-Esteem

Tips to focusing your mind and multi-tasking at Work

F

ocusing your mind at work may be a little difficult at times especially when you multitask.

While multitasking is an important skill, it also has its downside.

“Multitasking basically reduces our intelligence and literally drops our IQ,” says David Rock, co-founder of the Neuro Leadership Institute and author of Your Brain at Work. Too much tasks at hand tend to make people less efficient and consequently, commit errors. “We make mistakes, miss subtle cues, we lose our temper when we shouldn’t, or spell things wrong.”

To help keep our minds focused, Rock listed down three important tips to keep our minds concentrated on the work at hand.

1. Do the difficult (or more creative) work first.

Typically, we do mindless work first and build up to the toughest or most difficult tasks. That drains our energy and lowers our focus. “An hour into doing your work and you’ve got a lot less capacity than (at the beginning),” according to Rock. “Every decision we make tires the brain.” In order to focus effectively, Rock said that we need to reverse the

order. Check off the tasks that require more thinking or concentration first thing in the morning, and then move on to easier, routine work, later in the day.

2. Allocate your time deliberately.

By studying thousands of people, Rock found that we are truly focused for an average of only six hours per week. “You want to be really diligent with what you put into those hours,” he says. Most people focus best in the morning or late at night, and Rock’s studies show that 90 percent of people do their best thinking outside the office. Notice where and when you focus best, then allocate your toughest tasks for those moments.

3. Train your mind like a muscle.

When multitasking is the norm, your brain quickly adapts. You lose the ability to focus as distraction becomes a habit. “We’ve trained our brains to be unfocused,” Rock says. Practice concentration by turning off all distractions and committing your attention to a single task. Start small, maybe five minutes per day, and work up to larger chunks of time. If you find your mind wandering, just return to the task at hand. “It’s just like getting fit,” Rock says. “You have to build the muscle to be focused.”

(Source: Entrepreneur.com)

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Wednesday, December 31, 2014

... MEDICAL SCIENCE ...

Babies Recognise Real-Life Objects from Pictures as Early as Nine Months, according to Research

T THE INCREASING THREAT OF CARDIOVASCULAR DISEASE IN THE MIDDLE EAST

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apid shifts in lifestyle and public healthcare policies may have contributed to the increase in the prevalence of cardiovascular diseases in the Middle East, according to a research conducted in the region by Gulf – RACE and INTERHEART, a prominent research group who also found that Arabic patients are more likely to suffer from heart attacks at a significantly younger age – 10 to 12 years sooner – compared to their counterparts from other parts of the world.

The heavy burden of cardiovascular disease (CVD) relates to the high prevalence of well-known risk factors such as hypertension, smoking, dyslipidemia (high cholesterol), diabetes, obesity, and sedentary lifestyle.

Epidemiology Basic epidemiologic statistics from the World Health Organisation (WHO) outline a very grim pathway. Hypertension is very common in Lebanon (39%) and in the United Arab Emirates (28%). Six of the world’s top 10 countries with diabetes are in the Middle East – UAE, Kuwait, Qatar, Saudi Arabia, Bahrain, and Lebanon. The number of adults with diabetes are expected to double by year 2030, affecting about 59.7 million individuals.

The incidence of obesity, a risk factor for several health problems as well, is astoundingly high in the Arab female population. 55.2% of Kuwaiti women are obese according to a WHO statistics, making it

the 9th highest ranked nation in the world in terms of female obesity. Egyptian women follow at 48%. Kuwaiti men rank 13th in the world (29.6%) compared to other nations. This epidemic of obesity is prevalent throughout the region. In almost every Arab country, female obesity rates are significantly higher than men and are nearly double that of men in some countries – making women a unique target for intervention.

Other risk factors such as smoking are extremely prevalent in Jordanian males at 61% (8th highest ranked nation). Males in Tunisia follow suit at 58%. Among men, Oman has one of the lowest smoking prevalence in the Arab world (20%) which is still relatively high, and only 5 points lower than the smoking prevalence among males in the United States at 25%. Jordanian women have the highest prevalence at 10%, followed by Lebanon and Tunisia at 7%. Gulf nations such as Kuwait, Saudi Arabia, UAE, and Bahrain report a very low prevalence of 3 - 4%. Moroccan women have an impressively low prevalence of just 0.2%.

If we look at age-standardised cardiovascular death rates in countries such as Iraq, Yemen, Egypt, Lebanon, and Jordan, they are more than double the comparative figures for the United States. On estimate, approximately 25 - 40% of deaths in many Arab countries are due to cardiovascular disease. These risk factors contribute to the growing burden of strokes, heart failure, myocardial infarction and peripheral

he research, published in Child Development, found that babies can learn about a toy from a photograph of it well before their first birth-

day.

“The study should interest any parent or caregiver who has ever read a picture book with an infant,” said Dr Jeanne Shinskey, from the Department of Psychology at Royal Holloway. “For parents and educators, these findings suggest that well before their first birthdays and their first words, babies are capable of learning about the real world indirectly from picture books, especially if presented in very realistic images like photographs.”

vascular disease, leading to amputations, blindness and death.

Collective Research Efforts Excellent research and home grown clinical databases have started to emerge from countries such as the United Arab Emirates, Lebanon, Qatar, Bahrain, and Saudi Arabia and such research efforts collect rigorous datasets and registries providing primary local and regional data for future medical strategies.

Both primary and secondary prevention methods continuously need to be developed so as to help reduce the overall cardiovascular disease burden. And although cardiovascular medical care is effective via medications and surgeries, this is not an effective stand-alone solution to a widespread public health problem in the region. There should be a push for strong primary preventive measures, while having the safety net of medical technology, highly skilled physicians, and therapeutic options ready and available for those that still end up suffering cardiovascular complications.

Reference: Middle East Health Magazine The article was based on a document prepared by Dr Ronney Shantouf from a research study conducted by Gulf – RACE and INTERHEART. Dr Shantouf is a cardiologist residing in Los Angeles, California.

Researchers familiarised 30 eight and ninemonth-olds with a life-sized photo of a toy for about a minute. The babies were then placed before the toy in the picture and a different toy, and researchers watched to see which one the babies reached for first.

In one condition, the researchers tested infants’ simple object recognition for the target toy by keeping both objects visible, drawing infants’ attention to the toys and then placing the toys inside clear containers. In another condition, they tested infants’ ability to create a continued mental idea of the target toy by hiding both toys from view, drawing infants’ attention to the toys and then placing the toys inside opaque containers.

When the toys were visible in clear containers, babies reached for the one that had not been in the picture, suggesting that they recognised the pictured toy and found it less interesting than the new toy because its novelty had worn off. But when the toys were hidden in opaque containers, babies showed the opposite preference -- they reached more often for the one that had been in the photo, suggesting that they had formed a continued mental idea of it.

Dr Shinskey said that these findings show how one brief exposure to a picture of a toy affects infants’ actions with the real toy by the time they are nine-months-old. It also demonstrates that experience with a picture of something can strengthen babies’ ideas of an object so they can maintain it after the object disappears – so out of sight is not out of mind.”

(Source: Science Daily)

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Wednesday, December 31, 2014

... NUTRITION ...

FOODS TO FIGHT...

CARDIOVASCULAR DISEASE

Recipe Oaty Energy Cookies

Prep. Time: 10 mins Cooking Time: 30 mins Nutrition per cookie: kcalories201, protein- 4g, carbs- 28g, fat- 8g, saturates- 5g, fibre- 2g, sugar- 14g, salt- 0.3g.

Ingredients • 50g ready-to-eat dried apricots • 50g soft butter • 50g light brown sugar • 2 tbsp. condensed milk • 50g rolled oats • 85g self-raising flour Method • Heat oven to 150C/130C fan/gas 2. Line a baking tray with baking parchment. Using children’s scissors, cut the apricots into small pieces.

• Put the butter and sugar in a

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TOO MUCH CHOLESTEROL IN THE BLOOD CAN INCREASE YOUR RISK OF GETTING CORONARY HEART DISEASE. CHOLESTEROL IS MADE IN THE LIVER FROM SATURATED FATS IN FOOD. REDUCING THE TOTAL AMOUNT OF FAT YOU EAT CAN HELP REDUCE YOUR TOTAL CHOLESTEROL LEVEL AND PROTECT YOUR HEART. THE RISK IS PARTICULARLY HIGH IF YOU HAVE A HIGH LEVEL OF LDL CHOLESTEROL (BAD) AND A LOW LEVEL OF HDL CHOLESTEROL (GOOD).

What to eat...

mixing bowl and beat well with a wooden spoon. Use very soft butter to make it easy for young wrists to beat the butter and sugar together. Add the condensed milk, beat well, then add the oats and apricots, and mix well again. Finally, add the flour and mix until it starts to disappear – you can use your hands to mix it, too.

• Bring the dough together into one big ball, then break into 6 equal-sized lumps (this ensures the cookies bake at the same time). Roll each into a ball, then squash onto the baking parchment with the palm of your hand.

• Bake for 25-30 mins until golden on the edges. Leave to cool on the tray. The cookies will keep in an airtight container for up to 3 days.

The benefits of ginger tea

To make ginger tea (for nausea): Steep 20-40g of fresh, sliced ginger in a cup of hot water. Add a slice of lemon or a drop of honey if you fancy.

(Source: bbcgoodfood)

Ginger tea is great to drink when you feel a cold coming on. It is a diaphoretic tea, meaning that it will warm you from the inside and promote perspiration.

It is also good when you don’t have a cold and just want to warm up!

• Choosing healthier fats can help protect your heart. Cut back on saturated fats (butter, hard cheese, fatty meat, biscuits, cakes and cream) and replace them with monounsaturated and polyunsaturated fats (oily fish, olive oil, avocado, nuts and seeds).

• Eating a wide variety of fruit and vegetables can help reduce the risk of coronary heart disease.

Fruit and vegetables contain vitamins and phytochemicals that help prevent the oxidation of cholesterol, which reduces the chance of it being deposited in the arteries. They also contain carbohydrates which give the body energy, but are low in fat which can help with weight control.

• Beans, pulses and porridge oats are high in soluble fibre, which encourages the body to excrete cholesterol before it can be reabsorbed into the bloodstream. A high fibre diet also keeps you full up so you are less likely to snack on fattening foods.

• Nuts help increase levels of HDL cholesterol, as does oily fish which contains omega-3 polyunsaturated fats. Omega-3 can help protect the heart by preventing the blood from clotting.

They may help to reduce the risk of heart disease too, by encouraging the muscles lining the artery walls to relax, improving blood flow and regulating heart rhythm.

• There is evidence that substances called ‘plant-sterols’ and ‘stanols’ – which are added to certain foods including margarines, spreads and yoghurts – may reduce blood cholesterol levels. Even if you do eat sterol enriched foods, it is still important to make sure you follow a healthy diet.

• Soya is a source of fibre which may help to lower cholesterol. Soya products – for example soya milk, soya yoghurts, tofu and miso - are of high nutritional value; they contain lots of vitamins, minerals, are high in polyunsaturated fats and low in saturated fat. Recent studies have indicated that eating 25g soya protein a day can lead to a 10% reduction in both total and LDL cholesterol.

• Eat less full-fat dairy products and fatty meats, which contain saturated fats that may encourage the liver to produce LDL cholesterol. Foods con-

taining trans or hydrogenated fats (often found in shop-bought biscuits and cakes) should be avoided as they can also increase LDL cholesterol.

Heart-healthy tips: • Aim for at least five portions of fruit and vegetables a day.

• Have oil-rich fish at least twice a week.

• Choose unsaturated fats rather than saturated.

• Keep your weight within the ideal range.

• Aim to do at least 30 minutes exercise at least five times a week.

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Wednesday, December 31, 2014

... WOMEN’S HEALTH ...

WOMEN MORE LIKELY TO DISMISS CHEST PAIN

W

hen heart symptoms strike, men and women go through similar stages of pain but women are more likely to delay seeking care which can put their health at risk, according to a study presented at the Canadian Cardiovascular Congress.

“The main danger is that when someone comes to the hospital with a more severe or advanced stage of heart disease, there are simply fewer treatment options available,” says Dr Catherine Kreatsoulas, lead author of

the study and a Fulbright Scholar and Heart and Stroke Foundation Research Fellow at the Harvard School of Public Health.

Dr Kreatsoulas, an epidemiologist, says we don’t know enough about how people perceive their heart symptoms and at what stage they are prompted to seek medical care. Her study included patients with suspected coronary artery disease, just prior to undergoing their first coronary angiogram test.

The study was conducted in two parts. In the first part, researchers interviewed cardiac patients about their experience of angina and their decision to seek medical care. A new group of patients was enrolled into the second phase of the study, which quantified by gender the reasons why patients sought care.

Angina is the pain that occurs when your heart doesn’t get as much blood and oxygen as it needs because of a blockage of one or more of the heart’s arteries. This pain is often described as a pressure, tightness or burning feeling. It is a warning signal that you are at increased risk of a heart attack, cardiac arrest

or sudden cardiac death.

The researchers developed the term “symptomatic tipping point” to capture the transitional period someone goes through between experiencing cardiac symptoms and getting medical attention. They identified six transitional stages, common to both men and women. Men, she notes, responded to these symptoms faster.

The six stages, in chronological order, include: • A period of uncertainty (patient attributes their symptoms to another health condition) • Denial or dismissal of symptom • Seeking assistance / second opinion of someone such as a friend or family member • Recognition of severity of symptoms with feelings of defeat • Seeking medical attention, then • Acceptance

Women stayed in the denial period longer than men. While men would consult with a friend or loved one more readily about the symptoms, “women would wait for others to tell them they looked horrible,” says Dr Kreatsoulas. “Women displayed more of an optimistic bias, feeling that the symptoms would pass and get better on their own.”

This is due partly to a perception that coronary artery disease is a “man’s disease,” even though it’s a leading cause of mortality for women. If women aren’t thinking about heart attack, then it’s easier to disregard the symptoms.

(Source: Medical News Today)

Research focuses on the Silent Risk of Motherhood

M

ore than 10% of women in high-income countries experience mental health disorders during the prenatal and postnatal periods - considered a ‘silent risk’ for mothers, according to a new series of articles published recently in the medical journal, The Lancet. The articles are based on a study conducted by a group of medical professionals in the UK. While the articles did not provide information on the rates of prenatal and postnatal mental health problems experienced by women in low and middle-income

countries, the research hypothesise that the rates are likely even higher.

Louise Howard, professor of Women’s Mental Health at the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, and lead author of The Lancet papers, stated that the arrival of a child is a challenging time for many parents. “The stigma around [pre] and postnatal mental illnesses can prevent people from getting the help they need.

It’s important that people seek treatment promptly to prevent suffering and distress for the whole family. We want the public to know that there are effective treatments out there.”

Severe mood disorders triggered by childbirth?

“More research is crucial to understand what triggers psychotic episodes after childbirth so that we can predict women at risk and develop treatments that are safe to be administered for mother and baby,” says another lead author Professor Ian Jones from the Medical Research Council Centre for Neuropsychiatric Genetics and Genomics at Cardiff University, also in the UK. Suicide attempts are one of the leading causes of maternal death in high-income countries according to the research. As such, they recommend that all women with a history of severe mental illness receive proper counselling on risks and what care may be needed both during pregnancy and after childbirth.

Parental mental health disorders could affect child development The links between parental mental health disorders and risk of low birth weight, premature birth and later psychological problems are also examined. Lead author Alan Stein, currently the Head of the Child and Adolescent Psychiatry Unit at the University of Oxford, describes the adverse effects of [prenatal] mental health disorders on children. He said that these effects are not inevitable and many children are not adversely affected. “Early identification and intervention are critical in preventing them. We need to treat both the parents’ symptoms and help with caregiving difficulties. Parents at risk of mental health disorders during or after pregnancy need to be identified early to prevent symptoms from affecting the offspring.”

The links between child development and prenatal health disorders are complex and poorly understood. The authors recommend that much more research is needed to develop appropriate interventions especially in low- and middle-income countries. But the authors emphasise that any adverse effects of prenatal disorders may still be avoided. Important factors such as quality of parenting, social support, and the length and severity of the (parental) disorder should also be taken into consideration.

(Source: Medical News Today)

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Wednesday, December 31, 2014

... MEN’S HEALTH ...

9

STAY HEALTHY AT ANY AGE LEARN ABOUT WHICH SCREENING TESTS TO GET AND STEPS YOU CAN TAKE FOR GOOD HEALTH.

GET THE SCREENINGS YOU NEED Screenings are tests that look for diseases before you have symptoms. Blood pressure checks and tests for high blood cholesterol are examples of screenings.

You can get some screenings, such as blood pressure readings, in your doctor’s office.

Others, such as colonoscopy, a test for colon cancer, need special equipment, so you may need to go to a different office.

After a screening test, ask when you will see the results and who you should talk to about them.

• Abdominal Aortic Aneurysm. If you are between the ages of 65 and 75 and have ever been a smoker, (smoked 100 or more cigarettes in your lifetime) get screened once for abdominal aortic aneurysm (AAA). AAA is a bulging in your abdominal aorta, your largest artery. An AAA may burst, which can cause dangerous bleeding and death.

• Colon Cancer. Have a screening test for colorectal cancer starting at age 50.

If you have a family history of colorectal cancer, you may need to be screened earlier. Several different tests can detect this cancer. Your doctor can help you decide which is best for you.

• Depression. Your emotional health is as important as your physical health.

Talk to your doctor or nurse about being screened for depression, especially if during the last 2 weeks: ✓✓ You have felt down, sad, or hopeless. ✓✓ You have felt little interest or pleasure in doing things.

• Diabetes. Get screened for diabetes (high blood sugar) if you have high blood pressure or if you take medication for high blood pressure.

Diabetes can cause problems with your heart, brain, eyes, feet, kidneys, nerves, and other body parts.

• Hepatitis C virus (HCV). Get screened one time for HCV infection if: ✓✓ You were born between 1945 and 1965. ✓✓ You have ever injected drugs. ✓✓ You received a blood transfusion before 1992.

YOU KNOW YOUR BODY BETTER THAN ANYONE ELSE. ALWAYS TELL YOUR DOCTOR OR NURSE ABOUT ANY CHANGES IN YOUR HEALTH, INIf you currently are an injection drug user, you should be screened regularly.

CLUDING YOUR VISION AND HEAR• High Blood Cholesterol. If you ING. ASK THEM ABOUT BEING are 35 or older, have your blood CHECKED FOR ANY CONDITION cholesterol checked regularly with a YOU ARE CONCERNED ABOUT, blood test. High cholesterol increases your chance of heart disease, NOT JUST THE ONES HERE. stroke, and poor circulation. Talk to IF YOU ARE WONDERING your doctor or nurse about having your cholesterol checked starting at ABOUT DISEASES SUCH AS age 20 if: ALZHEIMER’S DISEASE OR ✓✓ You use tobacco.

SKIN CANCER, FOR EX✓✓ You are overweight or obese.

AMPLE, ASK ABOUT ✓✓ You have diabetes or high blood pressure.

THEM. ✓✓ You have a history of heart disease or blocked arteries. ✓✓ A man in your family had a heart attack before age 50 or a woman, before age 60.

• High Blood Pressure. Have your blood pressure checked at least every 2 years. High blood pressure can cause strokes, heart attacks, kidney and eye problems, and heart failure.

• HIV. If you are 65 or younger, get screened for HIV. If you are older than 65, ask your doctor or nurse whether you should be screened.

• Lung Cancer: Talk to your doctor or nurse about getting screened for lung cancer if you are between the ages of 55 and 80, have a 30 pack-year smoking history, and smoke now or have quit within the past 15 years. (Your pack-year history is the number of packs of cigarettes smoked per day times the number of years you have smoked.) Know that quitting smoking is the best thing you can do for your health.

• Overweight and Obesity. The best way to learn if you are overweight or obese is to find your body mass index (BMI). You can find your BMI by entering your height and weight into a BMI calculator.

A BMI between 18.5 and 24.9 indicates a normal weight. Persons with a BMI of 30 or higher may be obese. If you are obese, talk to your doctor or dietitian about getting intensive counselling and help with changing your behaviours to lose weight. Overweight and obesity can lead to diabetes and cardiovascular disease.

(Source: ahrq.gov)

Take Steps to Good Health YOU CAN MAKE HEALTHY CHOICES EVERY DAY. • Be physically active.

Walking briskly, mowing the lawn, playing team sports, and biking are just a few examples of how you can get moving. If you are not already physically active, start small and work up to 30 minutes a day of moderate physical activity for most days of the week.

• Eat a healthy diet.

Fruits, vegetables, whole grains, and fat-free or low-fat dairy products are healthy choices. Lean meats, poultry, fish, beans, eggs, and nuts are good, too. Try to eat foods that are low in saturated fats, trans fats, cholesterol, salt, and added sugars.

• Stay at a healthy weight.

Try to balance the calories you take in with the calories you burn with your physical activities. As you age, eat fewer calories and increase your physical activity.

• Avoid alcohol.

• Don’t smoke.

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Wednesday, December 31, 2014

... FITNESS ...

5 EXERCISES THAT COMBAT ‘COMPUTER BODY’

Y

our typical typing pose probably isn’t pretty: shoulders rounded forward, chin stuck out, upper back hunched over.

Not exactly the look you’re going for, right? But spending your day frozen in front of your laptop can change the length and composition of your muscles to force poor posture. Enter, ‘computer body’.

When your muscles are placed under low amounts of tension for long periods of time—like your back muscles are when you spend eight hours a day at a computer—the muscle tissue elongates. Your back muscles become locked into a lengthened position, while your pecs, abs, and the front of your hips actually shorten. Plus, the makeup of your muscle tissue changes in a way that makes your muscles stiffer.

Lucky for us desk dwellers, we can cure computer body in 10 minutes per day. Simply stretch out muscles that have shortened—and massage tissues that have tightened. To perform self-massage, you’ll need a foam roller, which you can find for a reasonable price at any sporting goods store or online.

For your best results (posture like a prima ballerina) do each of the five exerBACK cises below every day—we suggest during commercial breaks at night. The whole shebang should take no longer than 10 minutes.

AND NECK

1. Back self-massage Sit on your butt with your feet flat on the floor. Place a foam roller behind you, perpendicular to your body.

Lean back on the foam roller and lift your butt off the ground. Move your hips to press to roller up and down your back. Roll in slow, steady strokes from your lower back to the top of your shoulder blades (avoiding your neck) and back down again. Repeat 10 times. Tip: If that’s too intense, prop your hands up behind you to help control the pressure.

GIVING YOU GRIEF? THAT’S BECAUSE YOUR DESK JOB IS ACTUALLY CHANGING YOUR MUSCLE COMPOSITION.

3. Dumbbell row Hold a pair of dumbbells. Stand with your feet shoulder-width apart and bend your knees slightly. Bend at your hips to lower your torso until it’s almost parallel to the ground. Raise the dumbbells to your sides by bending your elbows and squeezing your shoulder blades together; skim your sides with your elbows as you raise and lower the dumbbells. Lower the dumbbells at a controlled pace. That’s one rep.

Do two to three sets of 10 reps.

5. Floor slide

2. Warrior I pose 4. Pec self-massage

Start standing. Take a big step forward with your right leg, bending your right knee. Turn your left toe outward. Keep your hips facing straight, in line with your shoulders. Raise your arms straight up to the sky. You should feel the stretch in your left hip and thigh. Hold for 20 to 30 seconds, then switch sides.

Lie facedown with a foam roller to the right side of your body, parallel to your torso. Drape your right arm over the roller. Prop your chest up with your left forearm, and angle the roller slightly toward your head. Men: Slowly roll along your pectoral muscle from shoulder to chest and back. Roll 10 times. Women: Reach overhead and rotate your arm to massage your pectoral muscle for about 30 seconds.

Lie on your back with your knees bent and your feet on the ground. Raise your arms above your head with your palms and the back of your upper arms in contact with the floor. Inhale with your nose as you slide your arms along the floor into a ‘W’ position, your elbows near your sides. Exhale with your mouth for five to six seconds as you slide your arms back up to the starting position.

Muscle - your body’s metabolic machine C

hanges within your muscles and loss of muscle mass - due to aging, inactivity, doing the wrong kinds of activity, or some combination of those —have a significant impact on your metabolism. “From age 20 to 60, relatively sedentary adults lose about 30 percent of their muscle mass,” says Tim Fischell, MD, professor of medicine at Michigan State University and author of Burn Calories While You Sleep.

Muscle that hasn’t been actively stressed also burns about 30 per-

cent fewer calories over three to four decades, he adds.

“When you add up the loss of muscle and the loss of metabolic activity in the residual muscle that you have left, you are therefore looking at close to a 45 percent total loss of calorie burning between 20 and 60 to 70 years of age for relatively sedentary adults,” says Fischell. “This is gradual and continuous starting in one’s 20s or 30s.”

Biopsies of sedentary adults in their 70s have also found a surprising discovery: Their muscle cells are actually missing mi-

tochondria, the cellular powerhouses that convert fuel to energy. “As such, you are now not only lacking muscle fibres, but what you have left is metabolically inactive,” concludes Fischell.

Practice regular resistance training Loss of muscle mass and strength is largely preventable and even reversible. However, low-intensity activities like walking while they have other benefits — will have only minimal effects on

muscle loss. “It requires high-intensity muscle stress, with strong muscle contraction and to the state of exhaustion of the muscle fibres, to rebuild metabolically active muscle and to rebuild muscle mass, regrow and retain mitochondria,” explains Fischell.

Research has consistently shown that resistance training, such as weightlifting, is an effective way to prevent these changes. But high-intensity activities like vigorous swimming, running, and power yoga may also delay muscle loss, adds Fischell.

(Source: yahoo.com/health)

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Wednesday, December 31, 2014

... PAEDIATRICS & CHILD HEALTH ...

11

HOW CAFFEINE AFFECTS KIDS

•

M

ost parents wouldn’t dream of giving their kids a mug of coffee, but might routinely serve a can of soda which, unfortunately, also contains caffeine. Foods and drinks with caffeine are everywhere, but caffeine consumption especially in younger kids, should be kept to a minimum.

A stimulant that affects kids and adults similarly, caffeine is naturally produced in the leaves and seeds of many plants. Caffeine is also made artificially and added to certain foods. Considered a drug, caffeine stimulates the central nervous system. At lower levels, it can make people feel more alert and energetic.

In both kids and adults, too much caffeine can cause: • Jitteriness and nervousness • Upset stomach • Headaches

•

•

•

• Difficulty concentrating • Difficulty sleeping • Increased heart rate • Increased blood pressure Especially in young kids, it doesn’t take a lot of caffeine to produce these effects.

Here are some other reasons to limit kids’ caffeine consumption: • Kids often drink caffeine contained in regular sodas. Kids who consume one or more 12-ounce sweetened can of soda per day are 60% more likely to become obese.

• Caffeinated beverages often contain calories that don’t provide any nutrients, and kids who fill up on them don’t get the vitamins and minerals they need from healthy sources, putting them at risk for nutritional deficiencies. In particular, kids who drink too much soda (usually starting between the third and eighth grades) may miss getting the calcium they need from milk to build strong bones and teeth.

Drinking too many sweetened caffeinated drinks could lead to dental cavities from the high sugar content and the erosion of tooth enamel from acidity. How can sodas cause that much damage to kids’ teeth? Consider this: One 12-ounce non-diet, carbonated soft drink contains the equivalent of 10 teaspoons of sugar, as well as 150 calories.

Caffeine is a diuretic that causes the body to eliminate water through urinating, which may contribute to dehydration. Whether the amount of caffeine in beverages is enough to actually cause dehydration is not clear, however. It may depend on whether the person drinking the beverage is used to caffeine and how much caffeine was consumed that day. To be on the safe side, it’s wise to avoid excessive caffeine consumption in hot weather, when kids need to replace water lost through sweating.

Abruptly stopping caffeine may cause withdrawal symptoms - headaches, muscle aches, temporary depression, and irritability - especially for those who are used to consuming a lot of it.

Caffeine can make heart problems or nervous dis-

orders worse, and some kids might not know that they’re at risk.

One thing that caffeine doesn’t do however, is stunt growth. Although scientists once worried that caffeine could hurt growth, this isn’t supported by research.

Foods and Beverages with Caffeine Although kids get most of their caffeine from sodas, it’s also found in coffee, tea, chocolate, coffee ice cream or frozen yoghurt, as well as pain relievers and other over-the-counter medicines. Some parents may give their kids iced tea in place of soda, thinking that it’s a better alternative. But iced tea can contain as much sugar and caffeine as soda. Here’s how some sources of caffeine compare: Item

Amount of Amount of Item Caffeine

Mountain Dew

12 ounces

55.0 mg

Coca-Cola

12 ounces

34.0 mg

Diet Coke

12 ounces

45.0 mg

Pepsi

12 ounces

38.0 mg

7-Up

12 ounces

0 mg

brewed coffee method)

(drip 5 ounces

115 mg*

iced tea

12 ounces

70 mg*

dark chocolate

1 ounce

20 mg*

milk chocolate

1 ounce

6 mg*

cocoa beverage

5 ounces

4 mg*

chocolate milk beverage

8 ounces

5 mg*

cold relief medication

1 tablet

30 mg*

*average amount of caffeine

Parenting Blues: Dealing with potty training regression Parents who have successfully potty trained their child find themselves a little disappointed when their children go back to suddenly having ‘accidents’ in the middle of the night.

These ‘accidents’ are still not considered ‘regression’ if it happens intermittently. And if your 5-year-old forgets to go because he’s captivated by his new video game, that’s really not regression either. Variants like that can be expected. Regression is when the behaviour recurs for several weeks, such as when your 8-year-old regularly wets her bed after being dry at night for years.

Why some kids regress While many kids go back a step back sometimes, true regression is far less common. True regression usually indicates that something needs to be fixed.

Stress is the most common reason for regression. Kids can be stressed by a variety of

reasons, generally characterised as anything new or different - like a new day care, a new house, a new family member, and even a parent’s illness.

As children develop, they learn what to expect from their environment and how to gain some control over it. But learning to cope with a new reality can take a child’s attention and energy away from staying dry because they have new fears or expectations. That’s why they start having ‘accidents’.

It can happen to older, school-age kids, too.

Stressors can include changing schools and being bullied. These factors are mentally and emotionally overwhelming. And the kids may have unintentionally ignored their body’s signals to go to the bathroom.

What Parents should do Parents sometimes worry more than they need to about potty training regression. Instead of

jumping to conclusions, consider all the other factors that may have led to the ‘accidents.’

Think like your child. Is she upset because she did not watch her favourite TV show? Is he worried about spending extra time in the day care? Potty accidents are usually connected to your child’s environment and a perceived loss of control.

But if you are really concerned that your potty-trained kid suddenly is not, see your paediatrician. Even if there were just a couple of accidents, if it worries you, go see a doctor. Getting someone’s assurance that everything is alright with our child is just what we need sometimes as parents.

(Reference: Cleveland Clinic)

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Wednesday, December 31, 2014