Global Health Tribune - April 2014 issue by Global Health Tribune

C OMPLIMEN TA RY C OPY - TA K E ON E

Sleep: It Does the Body Good

How to Keep Your Fitness Goals on Track

Are You at Risk for Dementia?

Global Health

First Embryonic Stem Cells Cloned From A Man's Skin APRIL 2014 ISSUE

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Dolly's birth set off a huge outpouring of ethical concern â&#x20AC;&#x201D; along with hope that the same techniques, applied to human cells, could be used to treat myriad diseases.

Relay for Life of Wellington held a team party at The White Horse Tavern on March 27.

Wellington Regional Medical centeR

Congressman Ted Deutch Tours The Butterfly House

Approval of powdered alcohol was an error on't expect powdered alcohol to hit store shelves anytime soon.

A product called "Palcohol" gained widespread attention online in recent days after it was reported that the Alcohol and Tobacco Tax and Trade Bureau approved the powdered alcohol, including vodka and rum varieties. But a representative for the federal bureau, Tom Hogue, said in an email to The Earlier in the day, Palcohol said Associated Press late Monday in an email that its founder Mark that the approvals were issued Phillips was traveling and in error. unavailable for an interview. It said it wasn't releasing any Hogue did not immediately information on distribution or respond to requests for further details, including how the error pricing, and the company's occurred. In an email message, website doesn't provide details on how it makes powdered alcohol. Palcohol's parent company Lipsmark said "there seemed to Robert Lehrman, who runs a be a discrepancy on our fill beverage law website that level, how much powder is in the bag." It said it will resubmit initially reported on the product, noted that Palcohol had to have the labels for approval. gone through an extensive According to the website for the process before reaching the label approval stage. Alcohol and Tobacco Tax and Trade Bureau, multiple varieties "An oversight of this nature does of Palcohol received "label not ring true to me," Lehrman approval" on April 8. Palcohol said in a phone interview. He said in an email at around 5 suggested that the bureau may p.m. EDT that it agreed to have heard back from lawmakers surrender the approvals "a few wanting more information on the hours ago." powdered alcohols. The Alcohol and Tobacco Tax The concept of a powdered and Trade Bureau is a part of alcohol isn't new. John Coupland, the Treasury Department.

a professor of food science at Penn State University, noted that there have been multiple patents filed on powdered alcohols over the years. One by General Foods Corp. in the 1970s says the product is made by absorbing the ethanol onto some sort of carbohydrate powder.

On its website, Palcohol says it plans to offer six varieties of powdered alcohol, including vodka, rum and four cocktails â&#x20AC;&#x201D; Cosmopolitan, Mojito, Powderita and Lemon Drop. The site says that a package weighs about an ounce and can fit into any pocket. It warns people that the powder should not be snorted. According to the site, Phillips came up with the idea because he is an "active guy" and wanted a way to enjoy an adult beverage after long hours hiking, biking or camping without having to carry around heavy bottles.

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First Embryonic Stem Cells Cloned From A Man's Skin by Richard Harris

ighteen years ago, scientists in Scotland took the nuclear DNA from the cell of an adult sheep and put it into another sheep's egg cell that had been emptied of its own nucleus. The resulting egg was implanted in the womb of a third sheep, and the result was Dolly, the first clone of a mammal. Dolly's birth set off a huge outpouring of ethical concern — along with hope that the same techniques, applied to human cells, could be used to treat myriad diseases.

But Dolly's birth also triggered years of frustration. It's proved very difficult to do that same sort of DNA transfer into a human egg. Last year, scientists in Oregon said they'd finally done it, using DNA taken from infants. Robert Lanza, chief scientific officer at Advanced Cell Technology, says that was an important step, but not ideal for medical purposes.

"There are many diseases, whether it's diabetes, Alzheimer's or Parkinson's disease, that usually increase with age," Lanza says. So ideally scientists would like to be able to extract DNA from the cells of older people — not just cells from infants — to create therapies for adult diseases. Lanza's colleagues, including Young Gie Chung at the CHA Stem Cell Institute in Seoul, Korea (with labs in Los Angeles as well), now report success.

Writing in the journal Cell Stem Cell, they say they started with nuclear DNA extracted from the skin cells of a middle-age man and injected it into human eggs donated by four women. As with Dolly, the women's nuclear DNA had been removed from these eggs before the man's DNA was injected. They repeated the process — this time starting with

the genetic material extracted from the skin cells of a much older man.

Take Bob’s skin cells

"What we show for the first time is that you can actually take skin cells, from a middle-aged 35year-old male, but also from an elderly, 75-year-old male" and use the DNA from those cells in this cloning process, Lanza says.

"We now have two ways and we're not sure which of the two methods is likely to work best," Lanza says.

Human egg from donor

Insert Bob’s DNA into “empty” donor egg

They look like the cells in a human embryo — in fact, they're called embryonic stem cells. And with a bit of coaxing, these cells could, theoretically, be prodded to turn into any sort of human cell — nerve, heart, liver and pancreas, for example. That's what makes them potentially useful for treating all sorts of diseases.

It also means that finally getting the sheep technology to work with cells from adult humans may not turn out to be a turning point for this technology, after all.

Remove egg’s DNA

skin cell

They injected it into 77 human egg cells, and from all those attempts, managed to create two viable cells that contained DNA from one or the other man. Each of those two cells is able to divide indefinitely, "so from a small vial of those cells we could grow up as many cells as we would ever want," Lanza says.

In the 18 years since researchers cloned a sheep, scientists have found another way to produce cloned human cell lines. And the other technique, which produces "induced pluripotent stem cells," skips the step that requires a human egg cell, so some people find it less fraught, ethically.

Nuclear DNA

source: Mitalipov lab/ohsU credit: adapted for nPR by alyson hurt

Get embryo to grow (this part has been tricky until now.) Embryonic stem cells

Embryo with Bob’s DNA

Liver cells

would make them good DNA donors. He'd like to see a library of cells created with those carefully chosen genes.

In principle, scientists could produce a series of cell lines that would allow a close match for the majority of would-be cell recipients — just as transplant surgeons currently seek a close match for organ donors.

Use Bob’s stem cells to make new therapies for Bob.

DNA from the person who is going to receive the cellular transplant — creating a patientspecific treatment — though that would end up being far more expensive than drawing from a library of ready-made cells.

Ideally he would like to screen millions of adults and choose just a hundred or so whose genes

Physicians could also extract

Paul Knoepfler at the University of California, Davis, School of Medicine is excited about this advance from a medical point of view. But he says this does mean we could be getting closer to

Award for implementing specific quality improvement measures outlined by the American Heart Association/American Stroke Association for the treatment of stroke patients. Get With The Guidelines Stroke helps hospital teams provide the most up-to-date, research-based guidelines with the goal of speeding recovery and reducing death and disability for stroke

patients. Palm Beach Gardens Medical Center attained the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include aggressive use of medications and riskreduction therapies aimed at reducing death and disability and improving the lives of stroke

patients. “We are so pleased to have been recognized by the AHA Get With The Guidelines Program,” said Larry Coomes, hospital CEO. “Our Primary Stroke Center’s talented and dedicated physicians, nurses and staff utilize a team approach that allows us to successfully implement quality measures and provide our patients with the best

Muscle cells Nerve cells

being able to go beyond cloned cell lines to cloning an entire human being.

"I don't think that's coming anytime soon, but certainly this kind of technology could be abused by some kind of rogue scientist," Knoepfler says.

And while many people consider that idea dangerous and repugnant, it is not broadly illegal. outcomes possible.” Palm Beach Gardens Medical Center also received the association’s Target: Stroke Honor Roll for meeting stroke quality measures that reduce the time between hospital arrival and treatment with the clot-buster tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

Palm Beach Gardens Medical Center Receives Quality Achievement Award for Stroke Care

Palm Beach Gardens, Fla. (April 21, 2014) – Palm Beach Gardens Medical Center earns the Get With The Guidelines®-Stroke Gold-Plus Quality Achievement

on 441 near Wellington Green Mall PRIME MEDICAL Immediate rental SHARED OFFICE SPACE CALL (561) 603-6747 leave message AVAILABLE

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GRAPHIC DESIGN / PHOTOGRAPHY Sergio Aguilar (561) 797-2325 ads@globalhealthtribune.com

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Global Health Tribune is a newspaper published every month in Palm Beach County. Copyright 2013, all rights reserved by SEA Publications, Inc. Contents may not be reproduced without the written consent of the publisher. The publisher reserves the right to refuse advertising. The publisher does not accept responsibility for advertisement errors beyond the cost of the advertisement itself. All submitted materials are subject to editing.

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Sleep: It Does the Body Good By Randall F. Laurich, Jr.

Dr. Randall Laurich has been practicing chiropractic care for over 10 years. In 1998, he graduated from Sherman College of Chiropractic in Spartanberg, South Carolina. He has been the proud owner of the Wellness Experience since 2001 and is a licensed Chiropractor serving the Wellington community. He has continued his knowledge in the healthcare field. He has the finest, most innovative chiropractic technology in his office. Dr. Laurich treats cervical/ lumbar herniation, as well as other injuries associated with neck and back pain, with the DRX9000 and ProAdjuster. As a new patient, our team will provide you with a continuum of care beyond your expectations. Dr. Laurich uses a “whole person approach”. This approach to wellness means looking for underlying causes of any disturbance or disruption (which may or may not be causing symptoms at the time) and make whatever interventions and lifestyle adjustments that would optimize the conditions for normal function. Using this unique approach, Dr. Laurich is Head Chairman of the Health and Wellness Medical Committee in Wellington Florida.

hy can’t I fall asleep? Why can’t I stay asleep? Why do I wake up each morning in more pain than the night before? So many people have issues with sleep, but don’t know how to solve this problem. I personally am not a sleep expert, but over the years I have coached many patients to better sleep by asking some very important questions.

1. How old is your mattress? 2. Is your room dark?

3. How many pillows do you use?

4. What position do you sleep in? 5. Do you have a T.V. in your bedroom?

6. Do you drink alcohol before going to sleep? 7. Do you exercise daily?

8. Do you turn or flip your mattress? (If possible) 9. Do you use your phone before bed? 10. Do you work in bed?

11. Do you use a fan in your bedroom?

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These may seem like a lot of questions to ask, but the list is actually larger. The good news is that by answering these questions, we may be able to help you get a better night of sleep, or lead you to the correct medical professionals that can.

Most of the time sleep issues are related to physical discomfort. If the nervous system is not functioning properly, it can be

quite a challenge to sleep. If we don’t sleep well, our bodies have trouble healing. This brings you into a vicious cycle with increased pain, discomfort, and ultimately no sleep. Believe me, it’s not a fun cycle to be involved in. If you are experiencing any problems sleeping, please stop by our office so we can help you to obtain a peaceful night of sleep. The Wellness Experience

is located in Kobosko’s Crossing at 9180 Forest Hill Blvd. in Wellington. You can also give us a call at 561-333-5351 to schedule an appointment.

We offer Acupuncture, Chiropractic, Massage, Nutrition, Aesthetician Services, PreHabilitation, and we will be offering many other services very soon, so keep an eye out for news about our expansion.

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The Patient or any person responsible for payment has a right to refuse to pay, cancel payment, or be reimbursed for payment for any other service, examination, or treatment which is performed as a result of and within 72 hours of responding to the advertisement for the free service, a discounted or reduced fee service, examination, or treatment. This does not pertain to Medicare/Medicaid or Federal Insurance.

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april 2014 3

High-Fat Diet May Boost Breast Cancer Risk or more than three decades, experts have debated whether eating a high-fat diet increases breast cancer risk.

While the study showed an association between a high-fat diet and breast cancer risk, it didn't prove cause-and-effect.

"The results of this large study provide support for the hypothesis that breast cancer development is related to dietary fat," said study author Sabina Sieri, a researcher from the department of preventive & predictive medicine at the Fondazione IRCCS Istituto Naziolale dei Tumori in Milan.

The study is published April 9 in the Journal of the National Cancer Institute. Sieri and her team found that a high intake of total fat and saturated fat was linked to an increased risk of breast cancer subtypes known as estrogen receptor-positive (ER-positive) and progesterone receptorpositive (PR-positive). High-fat diets also were tied to a raised risk of developing HER2negative breast cancer, the investigators noted.

Cancers that are ER- or PRpositive grow in response to those hormones. Cancers that are HER2-negative have tested

negative for the presence of a protein, HER2, which promotes cancer cell growth.

One strength of the new study is its large numbers, said Mia Gaudet, director of genetic epidemiology at the American Cancer Society. The breast cancer subtypes linked with fat intake are common, she said. "The majority of breast cancers in the U.S. and Europe are ERpositive, PR-positive, HER2-negative," she noted.

In the new study, women answered questions about their fat intake and other habits that could affect risk, including smoking, age at first period, pregnancy history, use of hormone therapy and their body mass index (a measurement of body fat based on height and weight).

To correct for measurement errors in the diet questionnaire, the researchers interviewed a random sample of 8 percent of the women, asking for a 24-hour dietary recall.

After an average follow up of 11.5 years, just over 10,000 women were diagnosed with breast cancer.

When the cases of cancer were compared with fat intake, "we

found an association between exposure to saturated-fat intake and breast cancer," Sieri said.

Women in the group eating the most saturated fat averaged 48 grams a day, compared to 15 grams in the group eating the least. A quarter cup of shredded cheddar cheese, for instance, has 10 grams of fat, 5 grams of it saturated. The link can't be explained with certainty, Sieri said, but it's possible that the high-fat intake raises the levels of the body's own estrogen, which can stimulate the growth of breast cancer cells.

"I think it's important these findings be replicated in other studies," Gaudet said. While the researchers ruled out many factors that could explain an increased cancer risk, they didn't rule out all possible factors, she said.

Until more study is done, Sieri tells women: "In general, it is recommended that the percent of total calories from saturated fat should not exceed 10 percent for women."

Gaudet agreed. "If you have a mainly plant-based diet, that is going to help you keep your fat intake low."

Wellington Physical Medicine Within our practice, we have a Physiatrist (Rehabilitation Physician) on staff who is Board certified in Physical Medicine and Rehabilitative services. We can offer you a thorough evaluation of your condition and upon discussing your pain/injury, the physician will discuss your treatment options which will be tailored to your Dr. Jon Arenstein personal needs. interventional Pain Management is also offered to enhance a better and quicker recovery.

We are a Physician-owned practice and as such, we do not need a referral from your primary physician or specialist. Please feel free to give us a call today at 561-275-1020 to set up your consultation/evaluation.

let Wellington Physical Medicine help you start living a pain-free life.

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hile millions of Americans still feel hamstrung by medical expenses, a new government report shows that some people are getting relief.

Now, new research suggests it might boost the chances of three common types of breast cancer.

In a large European study evaluating more than 337,000 women in 10 countries over 11 years, researchers found that women who ate the most saturated fat were about 30 percent more likely to develop breast cancer than those who ate the least.

Fewer Americans Overwhelmed by Medical Bills: Report

The share of people under age 65 in families reporting problems paying medical bills in the past 12 months dropped from 21.7 percent in the first half of 2011 to 19.8 percent in the same period in 2013, according to the U.S. National Center for Health Statistics, which is part of the U.S. Centers for Disease Control and Prevention. "Almost 5 million fewer people than 2-1/2 years ago are in families having problems paying medical bills," said report co-author Robin Cohen, a statistician with the U.S. Centers for Disease Control and Prevention.

That still leaves 52.8 million people who say they or members of their families were having problems paying medical bills, or were unable to pay those bills, in the past year. The report draws data from the long-running National Health Interview Survey, which collects health information from family members in each surveyed household. The new analysis is based on household interviews with nearly 227,000 people.

The decline in medical billpaying pressures over the study period may, in part, reflect an improvement in the nation's economy, said Cheryl Fish-Parcham, private insurance program director at Families USA, a nonprofit health care advocacy group based in Washington, D.C.

"In 2011, we were still in the deeper part of the recession, and so people were still losing employer-sponsored coverage," Fish-Parcham said. "When people know they don't have coverage, they tend to go to the doctor less," and as a result, "they don't have medical bills," she explained. The easing of bill-paying difficulties may also reflect early market reforms under the Affordable Care Act, said Sabrina Corlette, senior research fellow and project director at Georgetown University's Health Policy Institute in Washington, D.C.

Although it's hard to say what proportion of the decline can be attributed to the 2010 health-reform legislation, a ban on lifetime coverage

limits under most health plans and a reduction in annual limits (which were phased out completely this year) may have played a role, she said. One early provision of the Affordable Care Act, allowing young adults to stay on their parents' health plans in many cases, may also have provided some relief, she noted.

The CDC report notes a slight decline -- from 15.7 percent to 14.1 percent -- in the share of people under 65 with private coverage whose families report medical bill-paying problems. It shows a somewhat sharper decline in bill-paying worries among people with public coverage. Those reporting problems dropped from 28 percent in early 2011 to 24.7 percent in early 2013.

Among children through age 17, the percentage of those in families struggling to pay medical bills decreased from 23.7 percent to 21.3 percent during the study period.

Health insurance experts say those numbers may reflect an increase in public coverage, such as Medicaid and the Children's Health Insurance Program. It helps to have health coverage, but it doesn't completely solve people's bill-paying problems, Fish-Parcham noted. Even with public coverage, "you may still have a deductible, you may still have co-payments, you may still have uncovered medical expenses," she said. The report does not reflect the broader health reforms that only took effect this January, Corlette noted. These includes coverage of a minimum set of health benefits, caps on out-of-pocket spending and Medicaid expansions in 26 states and the District of Columbia. As a result of those broader reforms, some 10 million Americans, by the Obama administration's count, have gained coverage through private plans and Medicaid.

"Those folks are going to have an easier time paying medical bills, and then the coverage that they have, particularly in the private market, is more generous than what was previously available," Corlette said.

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KNOWthe10SIGNS EARLY DETECTION MATTERS

Memory loss that disrupts daily life

Challenges in planning or solving problems

Confusion with time or place

Difficulty completing familiar tasks at home, at work or at leisure

Trouble understanding visual images and spatial relationships

New problems with words in speaking or writing

Misplacing things and losing the ability to retrace steps

Delray Medical Center Appoints New Director of Rehabilitation Services

Decreased or poor judgement

Withdrawl from work or social activities

Dykeman-Diaz began her career at Delray Medical Center in March 2000 as a physical therapist at Pinecrest Rehabilitation Hospital. Since joining the hospital, she has been promoted to supervisor of inpatient rehab, and most recently, therapy manager, which includes oversight of the outpatient therapy department.

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“Teressa has been a tremendous asset to Delray Medical Center in her various positions,” said CEO Mark Bryan. “She has proven herself to be a strong leader and team

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Delray Beach, Fla. (April 21, 2014) – Delray Medical Center appoints Teressa Dykeman-Diaz, MPT as director of rehabilitation services. In her new position, she will be responsible for the daily operations of the inpatient and outpatient rehabilitation units, including physical, occupational, speech, vestibular rehab and hand therapies.

Teressa Dykeman-Diaz.

player who will continue to help guide the hospital down a path of excellence.” Dykeman-Diaz earned her master’s degree in physical therapy from Nova Southeastern University in 1999 and holds a bachelor’s in psychology from the University of Buffalo in 1990.

As a comprehensive rehabilitation program, Pinecrest rehabilitation and Outpatient Therapy at Delray Medical Center provides a caring, familyoriented environment where individuals who have suffered an illness or injury have the opportunity to rebuild their lives and achieve their highest level of functional independence.

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april 2014 5

Relay For Life of Wellington

elay for Life of Wellington held a team party at The White Horse Tavern on March 27. If you would like to learn more about Relay For Life, please visit their website at www.relayforlife.org.

Meroe Rabieifar, Mahin Rahanjam, Casey and Jason Heatherly.

Tina Blake, Dr. Randall Laurich, Johnny Meier, and Scott Poritz.

Breana Centofanti, Lorraine Laurich, and Ariana & Shelley Centofanti.

Bill Lerner, Joe Consentino, Lisa Hafer, Roy Siegel and Holly Consentino.

Donna, Elia, and Elio Ricciardi.

6 april 2014

Ryan &â&#x20AC;&#x2C6;Nina Anschuetz, and Dr. Randall Laurich.

Karly & Rosa Justs, Craig Young, and Johnny Meier.

Bill & Peggy Jupp, and Jeff Alexander.

Bill Sowers, Lois Snyder, Steve and Patty Sowers.

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Are You at Risk for Dementia? • Impaired planning and judgment • You experience a significant decline in daily function that impacts your work and social life

When dementia is suspected, your physician may have you perform simple tasks in the office. Those tasks may include drawing the face of a clock or simply asking you to remember and repeat three words. This is known as mini-cog.

There are many methods that your physician may use in order to have you perform mini-cog tests - some quite innovative, including a mini mental stat exam (MMSE). In addition, there are lab tests that can be performed, including a brain image. This will also allow for your physician to determine if it can be reversed.

Dr. Ishan Gunawardene received his medical degree from St. Georges University. Dr. Gunawardene specializes in internal medicine and adult medicine and believes in providing the utmost in patient care and treatment. General consultations are also available.

ementia is an umbrella term that can be used to describe a number of diseases or disorders that affect one’s mental ability to function normally on a day-to-day basis. When brain cells (neurons) die off or function improperly, the result is changes to your memory, behavior, and can eventually lead to loss of bodily functions that we take for granted, such as swallowing.

In 2012, it was determined that 5.4 million people were living with Alzheimer’s in the United States. What’s even more staggering is that one in eight people over the age of 65 have Alzheimer’s disease. Over 45% of Americans over the age of 85 have Alzheimer’s. The United States has twothirds of all cases of dementia worldwide. In order for a physician to determine if a patient has dementia, there is certain criterion that needs to be met.

Dementia symptoms must include a decline in memory upon cognitive testing as well as one of the following:

• Speech: The impaired ability to speak or understand when someone is speaking to you or when something is written. • Recognition: The impaired ability to recognize a person or object.

• Motor Skills: Impaired motor abilities or the inability to execute motor skills, sensory functions, and comprehend the task at hand.

• Think: The lack of ability to think properly, make the proper judgments, and to plan and carry out complex tasks.

In order for a physician to make the diagnosis, they must first find the cause of the dementia-like symptoms. This is necessary as some conditions have symptoms that are similar to that of dementia, however treatable. Again, in order to be diagnosed with Dementia, the abilities and functions must be severe enough that they have a major impact functioning on a day-to-day basis. Some of the most common causes of dementia are Alzheimer’s disease, vascular dementia, and Lewy bodies (DBL).

Alzheimer’s

This is the most common type of dementia with an estimated 60-80% of cases being diagnosed. Some early signs of Alzheimer’s include difficulty in remembering names, recent events, as well as depression and apathy. As time

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How to treat dementia

goes on, symptoms may include; confusion, disorientation, and having a difficulty in speaking, swallowing, and even walking.

Although the cause of Alzheimer’s is not known, there are many factors involved in its development. As a result, it may actually begin up to 20 years prior to exuding symptoms.

The major risk factor for Alzheimer’s is an older patient. Most cases are diagnosed in those beyond the age of 65. However, younger people can have Alzheimer’s as well, which is known as early-onset. There are so many factors that may contribute to predicting dementia and may include one’s level of education, gender, cognitive exercise, and social support. In addition, some of the many risk factors mirror that of a stroke and include: • Family history

• Certain form of a gene apolipoprotein • Mild Cognitive Impairment (MCI) • Cardiovascular disease • Cigarette smokers • Diabetes

• High cholesterol • Diet

Vascular Dementia

Not as common as Alzheimer’s. This disorder occurs when there has been a brain injury with some type of bleeding or a blockage and there is in interruption of blood flow to the brain. The first symptom may be impaired judgment; however the amount of function loss is determined by the location of the brain injury.

How does your physician diagnose dementia?

If any of the following incidents have happened, you may want your physician to take a closer look:

• You experience a rapid decline in function • Loss of short term memory • Difficulty in coming up with the right words • Difficulty in performing a task, such as making toast • Difficulty moving objects

Although there is no treatment that can stop the progression of Alzheimer’s, there are some medications that can improve the symptoms. Acetylcholinesterase inhibitor is one medication that is currently on the market and that combined with medical management can improve the quality of one’s life. You must remember when treating dementia, all family members and caretakers need to be a part of the discussion when it comes to medication.

Finally, one of the most commonly asked questions of family members is whether or not a parent or grandparent can drive? While there is no clear cut answer or single test that can determine their ability to handle a vehicle, you need to be aware of any decline in mental or cognitive ability as well as their judgment.

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Dementia with Lewy Bodies (DLB)

Lewy bodies are small bits of protein that invade brain cells and cause dementia. Why they form or what causes them is unknown. People that have this form of dementia share some of the same symptoms with Alzheimer’s, however early on; they may experience disruptions in sleep, muscle movement problems, and hallucinations.

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Thinking, Memory Problems Tied to Blockages in Neck Artery lockage of the carotid artery in the neck appears to increase the odds for memory and thinking problems, a new study indicates.

For every person who donates their organs after they die, the lives of up to 50 people could be saved or improved, according to a Mayo Clinic news release.

The study is to be presented Wednesday at the American Academy of Neurology (AAN) annual meeting in Philadelphia.

"These results underscore the importance of assessing the status of memory and thinking in people with carotid artery narrowing," Lal added.

In conducting the study, the researchers examined 67 people with symptomless carotid narrowing, or stenosis. For these participants, the diameter of their artery was cut in half. The study also included 60 people who did not have carotid blockage but did have risk factors, such as diabetes, high blood pressure, high blood cholesterol and coronary artery disease.

isconceptions prevent many people from agreeing to donate their organs and potentially save a life, according to a transplant expert. More than 120,000 people are on organ transplant waiting lists in the United States. But a shortage of donated organs means that an average of 18 people die each day while waiting for transplants.

The researchers said their findings suggest more aggressive treatment might be needed for people with this condition, which is caused by plaque buildup in the artery.

"To date, the focus of diagnosis and management of carotid artery blockages has been prevention of stroke since that was the only harm that these blockages were thought to cause to patients," Dr. Brajesh Lal, of the Baltimore VA Medical Center and the University of Maryland School of Medicine, said in an AAN news release.

Transplant Expert Dispels Organ Donation Misconceptions

Researchers tested participants' thinking ability, examining their processing speed, learning, memory, decision-making and language.

They found participants with carotid blockage performed much worse on the thinking tests. They also scored lower on motor and processing speed evaluations as well as learning and memory tests. The researchers said language scores did not differ between the two groups of participants. "If these findings are confirmed in larger studies, they hold

significant implications for new treatment targets and open the door for more questions such as: should these patients be treated more aggressively with medications, cognitive rehabilitation, or even surgery to open up the artery," Lal said in the association news release.

He said he anticipates follow-up studies searching for causes and the best treatment options.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

As part of National Donate Life Month in April, Dr. Brooks Edwards outlines and dispels the myths that get in the way of organ donation. He is a transplant cardiologist and director of the Mayo Clinic's Center for Transplantation and Clinical Regeneration.

Some people mistakenly believe that if they agree to donate their organs, doctors won't work as hard to save their life. The fact is that doctors will do all they can to save your life, Edwards said in a Mayo news release. Other people believe that organ donation is against their religion. But Edwards said that organ donation is consistent with the beliefs of most major religions, including Roman Catholicism, Islam, most Protestant faiths and most branches of Judaism. If you have doubts or concerns, speak

with a member of your clergy, he advised. There are also those who think that people who've donated organs or tissues can't have an open-casket funeral. Since a person's body is clothed for burial, there are no visible signs of organ or tissue donation, Edwards explained.

Some believe they are too old or sick to donate their organs. But the decision to use your organs is based on medical criteria, not age. Also, only a few health conditions automatically disqualify people from donating organs. Sign up to be an organ donor and let doctors decide after you die whether your organs and tissues can be used for transplantation, Edwards suggested. Another misconception is that rich and famous people go to the top of the list when they need a donor organ. But they don't receive preferential treatment, and fame and wealth aren't considered when deciding who gets an organ, Edwards said.

Scribes Are Back, Helping Doctors Tackle Electronic Medical Records

ike many other doctors across the country, Dr. Devesh Ramnath, a Dallas orthopedic surgeon, recently made the switch from paper to electronic medical records. This meant he no longer had to just take notes when he was examining a patient — he also had to put those notes into the computer as a permanent record. "I was really focused on just trying to get the information in, and not really focusing on the patient anymore," Ramnath says.

In fact, he found he was spending an extra two to three hours every clinic just on electronic records. So he hired medical scribe Connie Gaylan. Acting a bit like a court reporter, Gaylan shadows Ramnath at every appointment. As the doctor examines a patient, Gaylan sits quietly in the corner, typing notes and speaking into a handheld microphone. Once she's finished with the records, she gives them to Ramnath to check and approve, saving him hours of administrative work and allowing him to concentrate on his patients. "I would more than happily

8 april 2014

sacrifice a significant chunk of my income for the improved quality of life I have," Ramnath says.

Medical scribes are in high demand nationally. Any doctor who doesn't make the switch from paper to electronic records by 2015 will face Medicare penalties, and this deadline is fueling the demand.

PhysAssist, the country's first scribe staffing company, is on the second expansion of its Fort Worth, Texas, headquarters and has opened another office in Chicago. Alex Geesbreght, the company's CEO, says the firm is growing by 46 to 50 percent every year. In 2008, PhysAssist had 35 scribes; now it has 1,400. The other big scribing companies — Medical Scribe Systems and Scribe America — each have thousands more, and the demand keeps growing.

PhysAssist trains scribes from across the country every week in its Fort Worth mock emergency department, where instructor Brandon Torres shows students the right way to fill out an electronic medical record. There are thousands of record systems,

and scribes need to know how to put in the right billing codes and medical terminology at lightning speed. Torres says it's important not just to be able to multitask, but also to be able to listen to multiple things at the same time. "You're listening to the physician, you're listening to the nurse, you're listening to the patient," Torres says. "And you're gathering all that information and presenting it back to the physician."

That last part's crucial. The physician has to approve the scribe's notes, because ultimately the doctor is responsible for the record. Medical scribes make $8 to $16 an hour. Many of them are medical students who say they find it an invaluable experience. But it's not clear that scribes make things better for patients.

Dr. Ann O'Malley with Mathematica Policy Research in

Washington, D.C., points to one study done in an emergency department in New Jersey that found that doctors with scribes were able to see more patients on average — which means more money for the institution. But that same study found that the amount of time a patient spent in the emergency department didn't decrease. Medical scribing also raises some privacy concerns, O'Malley says. Some patients may not like having an extra person in the exam room.

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TMJ and the Neck - What's the Connection? proper function. It has a profound affect on people because dysfunction of that joint can cause a variety of problems including:

• Sharp/stabbing jaw pain

• Inability to open the jaw properly

• Headaches

• Neck pain

• Painful clicking

Dr. Jonathan Chung is a Doctor of Chiropractic who focuses on Structural Correction and is primarily concerned with Structural Shifts of the spine. He graduated from the University of Central Florida with a B.S. in Microbiology and Molecular Biology. Dr. Chung then went on and received his doctorate from Life University's College of Chiropractic. Dr. Chung is certified in pediatrics from the International Chiropractic Pediatric Association, and is a Structural Chiropractic Researcher who has been published in scientific peerreviewed journals.

ne of the most common and troublesome problems that I'm noticing in my practice is a condition known as Temporomandibular joint dysfuction, or TMD for short. In fact, many of you may have heard someone talk about their TMJ or having TMD, but didn't quite know what it was.

TMD involves the joint that connects your jaw to your head. Proper movement of this joint is critical to

• Teeth grinding

• Clenching

• and much more

trauma. A systematic review of these papers show that people with whiplash/head injury actually have more severe pain and more pronounced dysfunction of the joint.

Another review showed that just treating the TMJ in these whiplash related cases showed poorer outcomes suggesting that the cause of the problem may be outside the joint itself. The whiplash associated cases showed just a 48% improvement compared to the nonwhiplash cases which improved 75% of the time. That leaves a huge amount of people who are still in pain and suffering because the primary insult to the body was not addressed properly.

TMD usually comes in 2 varieties.

1. Muscular dysfunction - the muscles of the jaw (pterygoids, masseter, temporalis) become hypertonic and dysfunctional creating painful musculature and sloppy movement.

It has rapidly become one of the more common reasons for visits to a neurologist and pain clinics, because of the dramatic impact that this sensitive piece of anatomy has on a person's quality of life. Many times, this condition is treated with medications like Neurontin or antidepressants, and in some cases, muscle relaxers or injections to the joint.

What does this have to do with the neck? A search of PubMed will show numerous references for increased incidence of TMD in conjunction with a whiplash injury, or head/neck

2. Articular dysfunction - the joint itself can have problems. Dislodging of the disc, arthritic degeneration, and inflammation can irritate the very sensitive nerve endings that cover the joint.

Not much can be done about arthritic breakdown of a joint. However, this is a less common cause of TMD. The most common causes of TMJ problems stem from muscular imbalance and dislodging of the articular disc. In a way, these two problems are intimately related. When you have bad jaw muscles moving the jaw abnormally, then it leaves more room for the articular disc to shift out of place.

So what can make these jaw muscles

dysfunctional? To know that, we have to know what controls the muscle. Every muscle in your body is controlled by a nerve. Whether it be a big bulky bicep, an achy sore back muscle, the blood pumping heart muscle, and the food digesting stomach.

For the jaw muscles, a special nerve called the Trigeminal Nerve emanates from the skull and provides innervation for the face, jaw muscles, teeth, brain, and other important structures.

The trigeminal nerve is one of twelve specialized nerves called Cranial Nerves. The unique thing about Cranial Nerves is that they do not exit out of the spine. They actually come out of the brain and the brainstem, and exit out of the skull. Therefore, a problem with one of the cranial nerves is usually indicative of a problem at the brain stem.

Atlas Displacement, Whiplash, and the Brain Stem One of the reasons that my office gets referrals from dentists and neurologists for TMJ patients is because of how Atlas Displacement Complex impacts the health and function of the brain stem. While the top of the neck doesn't apply direct pressure to the brain stem, the movement and function of the neck has large implications for this important piece of anatomy. When someone has an episode of

whiplash, there can be substantial damage and injury to the neck, but the more concerning portion is what happens to the nervous system. A phenomenon known as Central Sensitization occurs. This problem happens when the brain stem fires inappropriately to the limbic system and reticular activating system (the places where pain is interpreted in the brain). When this happens, even the slightest touch or movement can trigger a pain sensation in the brain.

This is why many doctors can find no physical damage to the body, but people will suffer with chronic pain issues like fibromyalgia. People recognize this quickly when the pain is stemming from the neck, shoulders or back, but the reality is that this same thing is happening in the jaw muscles.

To get to the root of someone's problems, we have to evaluate this critical, but under studied part of the nervous system. How does Structural Chiropractic address this? 1. Restore healthy biomechanics to the neck - create a state of Normal Structure in the neck so that the proper signals get to the brain.

2. Increase circulation through the brain - proper alignment ensures that blood to and from the brain stem properly. Proper blood flow means better nerve firing.

3. Restore healthy biomechanics to the jaw - Once the neck alignment is restored, most of the time the jaw will reset on it's own. However, sometimes gentle jaw adjustments may be necessary. This can be done with the help of a skilled specialist called a Neuromuscular Dentist.

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• arm Pain • carpal tunnel (Wrist) • canal stenosis • degenerated Joints • digestive disorders • disc herniation • dizziness (Vertigo) • dowager’s hump • Fatigue • Fibromyalgia • headaches • hearing issues • itchiness • low Back Pain • Mid Back Pain • Migraine headaches • Muscle spasm • Muscle tension • neck Pain • numbness/tingling • Pinched nerve • Poor Posture • Rotator cuff • shoulder Pain • sinus conditions • spinal decay • strength issues • thoracic outlet syndrome • tMJ issues • Upper Back Pain www.globalhealthtribune.com

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Keystone chiropractic is focused on structural correction of the spine. We use state of the art technology and techniques to restore full function of the spine and nervous system to allow the innate recuperative capacity of the body to work optimally.

april 2014 9

Young Dads at Risk of Depressive Symptoms, Study Finds

oung fathers may be at increased risk of depression symptoms after their baby arrives, all the way through to the child's kindergarten, a new study suggests.

Researchers found that for men who become fathers in their 20s and live with their children, depression symptoms tend to rise during the first five years of the child's life.

Experts stressed that the findings don't mean that young dads are destined to be clinically depressed. The study didn't prove that early fatherhood causes depressive symptoms -- it only showed an association between the two.

"But this does show us a time period where fathers are at increased risk," said lead researcher Dr. Craig Garfield, an associate professor of pediatrics at Northwestern University Feinberg School of Medicine in Chicago.

The new research was published online April 14 in Pediatrics and in the May print issue of the journal.

Many studies have looked into the risk of postpartum depression for mothers, but research into

fathers' mental health during this period is much newer, Garfield said. Studies so far suggest that 5 percent to 10 percent of new dads develop clinical depression after the baby arrives.

one," he said, "especially around the age at which these men became fathers -- in their mid20s." It's not clear, Lewandowski noted, whether the findings might be different for men who become fathers in their 30s or beyond.

What's more, researchers have found that when fathers are depressed, children tend to have more behavioral problems and weaker reading and language skills.

It's not clear what role dads' depression plays in those problems. But "when parents thrive, children thrive," Garfield said, so both parents' mental health is important.

For the new study, Garfield's team used data from a longrunning project that began following more than 20,000 U.S. teens in the 1990s. Every few years, the participants completed a 10-question screening tool on depression symptoms -- asking whether they felt unhappy, tired or disliked, for example.

Of the more than 10,600 young men in the study, one-third had become fathers by the time they were aged 24 to 32. And, Garfield's team found, dads' depression scores showed a clear shift over time. Among fathers living with their

children, depression scores rose by an average of 68 percent over the first five years of their child's life. Fathers who weren't living with their children showed a different trend: Their depression symptoms rose after high school, and then started to decline after they became fathers.

While that 68 percent rise sounds big, it is an average for the group, Garfield said. And for many men, even that much of a change would not be enough to push them into clinical depression.

"Many men started off with very low [scores], so even with that increase they probably wouldn't screen positive for depression," Garfield noted. "But some would."

Why do some men get depressed after the baby arrives? "We really don't understand the reasons yet," Garfield said. With new moms, experts suspect that depression arises from a mix of stress and the biological changes that come with pregnancy and childbirth. Men's bodies aren't affected by fatherhood, but their lives definitely change, noted Eric Lewandowski, of the Child Study Center at NYU Langone Medical Center in New York City. New fathers may feel added financial strain or stress on their marriage, for example, said Lewandowski, who was not involved in the study. "The transition can be a tough

Both he and Garfield said the results call attention to fathers' mental health. "Parenting is a team sport, and understanding how men transition into fatherhood is important, too," Garfield said.

There are no guidelines on when or how to screen new fathers for depression. But more research into the issue could change that, Garfield said.

For now, Lewandowski said it's important for new parents to be prepared for the reality of having a child. "It's not all roses. It's tough," he noted. On the other hand, he said, there's "the joy of having a child," and it's hard for a scientific study to measure that and "weigh" it against the less positive aspects of parenting. And maybe for most moms and dads, Lewandowski said, the joy and the difficulties can "coexist."

Vegetables in Childhood May Benefit Breast Health

Boeke said she would not recommend supplements since other research has found some harmful effects with supplement use. Other foods that are rich in carotenoids include yams, melons, spinach and kale.

irls who ate the most fruits and vegetables rich in carotenoids were less likely to get benign breast disease, a new study suggests. Carotenoids are a group of pigments that typically produce an orange, red or dark green color. They are believed to have antioxidant properties that may guard against disease.

The most common kind of benign breast disease in teens and young women is a noncancerous tumor known as a fibroadenoma, according to Boeke.

Benign breast disease describes a variety of noncancerous conditions of the breast; some forms raise the risk of breast cancer.

"There have been a number of studies about carotenoids and breast cancer," said lead researcher Caroline Boeke, a postdoctoral fellow at Channing Division of Network Medicine at Brigham and Women's Hospital and Harvard School of Public Health, in Boston.

While the studies have produced mixed results, she said, overall they suggest a protective effect of the carotenoids. So her team decided to analyze the intake of these vegetables by girls enrolled in an ongoing study that began in 1996. For her study, Boeke and her colleagues looked at food reports from 1996 through 1998 and

10 april 2014

then evaluated reports in 2005, 2007 and 2010 from girls who got a diagnosis of benign breast disease from a doctor after having a biopsy. In all, Boeke studied nearly 6,600 girls, and 122 reported a diagnosis of benign breast disease.

When she looked at carotenoid intake, she found high intakes were protective. "The odds of benign breast disease in those who consumed the most beta carotene were about half that of

those who consumed the least," she said. Girls in the highest intake group ate two to three servings of carotenoid-rich foods weekly, she said. The study is published in the May issue of Pediatrics.

"It's an observational study, so we can't say for sure the carotenoids cause the lower risk," Boeke noted. "We can only say there's an association." She did take into account other factors that might affect the risk

of benign breast disease, such as alcohol intake, physical activity, family history and body mass index (a measure of body fat using height and weight).

Why might the fruits and vegetables help? It's not known for sure, but Boeke said it may be due partly to their antioxidant properties. Carotenoids absorb harmful substances known as free radicals which can harm cells. The study looked only at food intake, not supplements, and

The period of time between the start of a girl's period and the first birth is a sensitive one for the breasts, as they are very vulnerable to environmental exposures, according to background information in the study. Not many lifestyle habits have been shown to protect against benign breast disease, said Dr. Joanne Mortimer, director of women's cancer programs and co-director of the breast cancer program at the City of Hope Comprehensive Cancer Center, in Duarte, Calif.

The study has limitations, she said, including the self-report by the girls of a benign breast disease diagnosis by a doctor and the food questionnaires, which are always subject to error since it's difficult to remember exactly what was eaten.

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Looking Back and Reminiscing stop for a quick breakfast in the cafeteria. I lived in the dorm that was connected to the hospital by an underground tunnel. It was quite convenient during those Chicago winters and rainy days. Interestingly enough, there were a number or underground tunnels connecting several buildings to the hospital.

patient. So in a jealous rage, he planned this attack with a group of his friends. So, the small blisters on the forearms of my patient were a result of failed attempts to inject gasoline into the veins and these became small abscesses.

During my first week, I was oncall for three days. Being "on-call" is defined as "staying" in the hospital for 24 hours, admitting a ton of patients, and then working for another few hours to finish what you started and afterward, I could go home.

Shekhar V. Sharma, M.D. Board Certified in Internal Medicine

here are days when I reminisce about my training in Chicago, which was where I did my Residency training in Internal Medicine.

My first admission came around 2:00 A.M. on a very cold night in December. I can remember the wind chill factor being -30, but having that underground tunnel was the best thing that I could have asked for that night. I washed my face and briskly walked with trepidation through the tunnel to the emergency room not knowing what was in store for me. My senior Resident was sleeping and had a strict rule about not being woken up unless it was really necessary, which usually meant - I was on my own!

The hospital was a huge multispecialty facility with 1,100 beds. I am very grateful for the hard work I put in during those three years of arduous and diligent training, diagnosing and managing a spectrum of diseases - some patients walking in to the emergency room while others came in on stretchers. My days in the emergency room in Chicago as a trainee were some of the most interesting and memorable parts of my life as a doctor.

I was doing a Floor Rotation, which is not meant for critical cases. But here was this young gentleman who appeared to be confused, but at the same time he appeared to make some meaningful conversation with me all while flitting his hands

My day started at 5:30 A.M., so I could be at the hospital by 7:00 A.M., which gave me time to

around aimlessly as though he was catching flies! I asked him whether he had any complaints and he just said "Oh, why are these bugs flying around me? Get them away from me!" After spending some time trying to make sense of this and taking into consideration there were no family members who could give me any history and the fact that he was brought in by an Ambulance from his apartment with the diagnosis of "High fever and walking aimlessly outside his Apartment complex" essentially I had nothing else to go on. Well, a CT scan of the Brain revealed multiple abscesses in the brain. He was

started on Intravenous antibiotics. In the meantime, I also found that he had multiple blisters on his forearms, which was an enigma. To make a long story short, we found out later that this unfortunate young man was assaulted by a group of men who wanted to kill him by injecting gasoline intravenously into his arms. Why would anyone want to kill him this way?

The story as it was later told to me was that they attacked him because the ex-girlfriend of one of the men who assaulted my patient was shacking up with my

The above was a bizarre case, but this is just one of those multitudes of cases I encountered and learned along the way. After admitting 12 to 15 patients in a 24-hour period, I used to go to the library in the early-morning hours - not having slept the whole night. This gave me an opportunity to read about such interesting cases so I could make a good presentation to my senior doctors who would come in the next morning to hear our presentations. Eventually, it was seeing and working on amazingly interesting cases like the one above that gave me that surge of adrenaline to move forward in the field of medicine. Starting my medical school training at the age of 18, it took a good nine years of rigorous training which allowed me to be in the position I am today. It was during my training that I realized - Medicine was in my blood (no pun intended) and there was no turning back!

Now I am grateful to this country which gave me the opportunity to render my services as a medical doctor. My pet adage KNOWLEDGE IS POWER.

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april 2014 11

White House: 8 Million People Signed Up for Health Insurance

ight million Americans signed up for private health insurance during the just-concluded first enrollment period under the Affordable Care Act, the White House announced Thursday afternoon.

An estimated 35 percent of those who signed up are younger than 35, and 28 percent are between 18 and 34 years of age. Those numbers are very close to the first-year enrollment numbers Massachusetts saw when it introduced its health reform legislation in 2006, the White House said in a news release.

Younger adults' participation in the Affordable Care Act, sometimes called Obamacare, is considered crucial because they tend to be healthy and their insurance premiums are designed to offset the costs of medical treatment of older, sicker people.

The rising cost of health care also has slowed to the lowest rate on record, Obama administration officials said Thursday. Since the Affordable Care Act became law in 2010, per capita health care spending is "estimated to have grown at the lowest rate on record for any three-year period and less than one-third the longterm historical average stretching back to 1960," the news release said. "This thing [the Affordable Care Act] is working," President Barack Obama said Thursday afternoon during a press briefing at the White House. The first sign-up period for insurance under the Affordable Care Act ended March 31, when an 11-hour surge of consumers pushed initial enrollment estimates to 7.1 million participants.

The prospect of 7 million Americans signing up seemed unlikely as recently as midMarch, when federal officials were saying approximately 6 million people had registered for coverage.

According to the White House, one of the main objectives of the Affordable Care Act is to expand access to affordable health care options for uninsured Americans, estimated last year to be 45 million people.

The law led to the creation of the online marketplaces, or exchanges, where people in each state and the District of Columbia could compare health plans and sign up for coverage. But the law remains controversial. Numerous polls show Americans are sharply divided over it, and Republicans are almost universally opposed to it.

12 april 2014

The enrollment process got off to a terrible start back in October with the botched unveiling of the HealthCare.gov federal registration website. Computer glitches and software problems made the website virtually unusable for long periods of time.

Now that the first enrollment deadline has passed, most Americans won't have another chance to sign up for coverage until the next open enrollment period, which begins Nov. 15. Coverage purchased during that time won't take effect until 2015. With some exceptions, people who are uninsured for most of 2014 may have to pay a penalty during next year's tax season under provisions of the Affordable Care Act. The maximum penalty for 2014 is $95 per adult and half of that for children (up to $285 for a family of three or more) -- or up to 1 percent of household income, whichever is greater.

The problems with HealthCare.gov, which serves 36 states that don't operate their own registration websites, were eventually solved. But it was widely assumed that the registration earlier this month of Health and Human Services Secretary Kathleen Sebelius was due to the early registration problems.

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Ra c e d a y a g e : _ _ _ _ _ _

E - Ma i l: __ _ __ _ __ _ ___ _ _ __ _ __ _ __ _ __ _ _

Em e r g e n c y C o n t a c t Na m e & Nu m b e r : _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ SHIRT SI ZE: ____S _____M ____ L _____ XL KIDS M ILE: _______ 5K RUN:_______ (check one) GENERAL WAIVER AND RELEASE OF LIABILITY AGREE EM ENT : I know that running a road or trail race is a potentially hazardous activity. I should not enter unless I am medically abble and properly trained. I agree to abide by any decision of a race offi ffficial relativ ve to my ability to safely complete the run. I assume all risks ass ociated with running in this event including, but not limited to, falls, contact with other participants, the efffects of weather, including high heat and/or humidity, traff afffi fic and conditions of the road all such risks being kno n wn and appreciated by me. By signing this form, I agree thaat for s afe affety reasons, strollers, baby joggers, bicycles, skate s, and animals are not permitted in this event. Having read the waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the h Okeehe elee Middles School and its teachers, staff, fff, administration and race volunteers, all sponsors, their representatives and successors frrom all claims and liabilities of any kind arising from my participation in this event, although that liability may arise out of negligence or c arelessness on the part of the person named on this waiver. Signa t ur e o f R u n n er _ _ _ _ _ __ _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ __ _ _ __ _ __ _ __ _ __ _ __ _ __ _ __ __ D a t e_ __ _ __ _ __ _ __ _ __ _ __ __ _ _ * * * S i g n a t u r e o f p a r e n t / g u a rd i a n i f r u n n e r i s u n d e r 1 8 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Make check payable to: Okeeheelee Middle School and mail to: OCMS, !""#$"%&$'()*+(,)-.(- 2200 Pinehurst Drive, Greenacres, FL 33413

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Is Detox really Necessary? What I discovered shocked me. My diet may have been good, but my body was not clean. I released toxins and felt uncomfortable in the process. On the fourth day, it was a revelation to feel my body lighter, and more vibrant.

sherri Mraz also known as the cookin’ yogi, works with clients privately and in groups to improve their health. she teaches healthy cooking classes, yoga and is a public speaker. sherri has trained at the institute for integrative nutrition in nyc and is certified through teachers college columbia University and by the american association of drugless Practitioners (aadP). she is also registered with the yoga alliance at the advanced teacher level, a member of the Physicians committee for Responsible Medicine and studied at the hippocrates health institute. she studied ancient nutritional wisdom, and the latest diet and healthy lifestyle trends with renowned experts such as dr. Mehmet oz, deepak chopra, dr. andrew Weil, dr. Walter Willet, dr. anne Marie colbin, and dr. neal Bernard. she is located at Keystone chiropractic in Royal Palm Beach. Please contact her at sherri@cookinyogi.com or visit her website at www.cookinyogi.com

or the longest time, I avoided doing a detox. Being a health coach and food and lifestyle educator, I thought that my diet was so good that I didn’t need it. This past October, I spent a month pouring through research to come up with what I believed to be the perfect detox. I set my goal for three days.

by: Sherri Mraz, the Cookin' Yogi

I began my career in nutrition in 2007 and at that point I was able to heal myself of hypoglycemia and asthma, but still suffered for years with chronic migraines. This was frustrating to me, as I thought I was doing everything right. I am happy to say that after the detox - the migraines are gone!

Detox is usually done with the change of seasons. Now is the ideal time to do a spring detox. I personally repeated the detox this past week. The great news is, it was so much easier this time and I feel great.

Since October, I have had almost a hundred people complete my detox program and virtually all of them have said they felt better afterwards. Some of the benefits I see are:

• Eliminated stored wastes and weight loss

• Improved vitality, energy levels and mental clarity. • Improved circulation through purifying the liver, kidney and blood

• You may stop bad eating habits, allowing your stomach to reduce to a normal size for weight control • People with heart problems may notice a more regular heartbeat

• Blood sugar and cholesterol lowered.

• Reduced Fatigue

• Reduced Bloating

• Eliminates Headaches and brain fog • Reduces belly fat

• Reduced Joint Pain

• Eliminates Itchy Skin

• Eliminates Sleeplessness • Safely rids your body of toxins

• Boosts your immune system & increases energy

Detoxification is a normal process, your body is constantly trying to neutralize and eliminate toxins through the major organs such as your colon, liver, kidneys, lungs, lymphs, and skin. But, what if your self-cleaning system is overloaded and blocked up? Research shows that detoxing may be the missing link to disease prevention, especially

for immune-deficiency diseases like cancer, arthritis, diabetes, chronic fatigue syndrome, and candida.

Even if you have a great diet, cleansing is the perfect way to boost your immune system and protect yourself from toxins with a good internal cleanse.

I guarantee you that you will feel so much better when you are finished. The best part is that you will be more mindful moving forward. You will definitely think twice before putting garbage into your body after a detox. This detox is three days long, in most cases three days is just long enough to get rid of sugar cravings and break caffeine addiction.

There is so much conflicting information out there. Everyday our emails are flooded with a new theory, (at least mine is) and the internet bombards us with information and offers. I believe you have to be wise these days and discern for yourselves

what works. This is hard for people to do. That is where I come in, I teach people how to listen, really listen to their bodies, and mind. Together we create a healthy relationship with food, your thoughts and your core spiritual beliefs. Each and every person is a unique individual and has to be treated as such. There is no one right way to eat.

I have a huge passion for healthy eating and maintaining a healthy lifestyle. I teach my clients that it is not only the food we eat, which is super important, but how we eat and our feelings about food that matters. We are striving for homeostasis which can only be achieved when our body, mind and spirit are all being fed. If you are struggling with health issues or are just looking to improve, email me and mention that you read this article and I will send you my top five favorite nutrition packed recipes. I would love to have the opportunity to help you get to optimal health.

What Your Sleeping Style Reveals About Your Relationship re you a creative person stuck in an unhappy relationship? Or an extrovert who gets along well with your partner? Your preferred sleeping position may reveal the answers to these questions, and other secrets about your personality and relationship.

In a survey, 1,000 people reported their preferred sleeping positions, and also gave information about their personalities and relationship quality. It turned out that the farther apart people in relationships slept from their partners, the worse they rated their relationships.

A full 94 percent of couples who touched each other while sleeping said they were happy in their relationships, whereas 68 percent of couples who didn't touch each other during sleep rated their relationships as happy.

facing each other. Moreover, 12 percent of the couples slept less than an inch apart, and just 2 percent slept more than 30 inches apart. The experiment's findings about the link between sleeping positions and relationship quality may change researchers' perception of what really happens in people's consciousness when they sleep, Wiseman said.

The research also found that extroverts tended to sleep closer to their partners, and creative people usually slept on their left side. "I think it just underlines the point that the night is not downtime," said study researcher Richard Wiseman, a psychologist at the University of Hertfordshire

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in England. Instead, this missing third of our life provides important clues about our waking lives."

"This work suggests that if you have noticed that you are drifting apart from your partner during the night, you might want to take

a look at the quality of your relationship," Wiseman told Live Science.

Wiseman also found that 42 percent of the couples in the survey slept back-to-back, 31 percent slept facing in the same direction and 4 percent slept

"It is great that scientists are starting to explore the night, and realizing that we are just in a different form of consciousness, rather than it being a time when nothing much happens," he said.

Wiseman is discussing the survey's findings today (April 17) at the Edinburgh International Science Festival in Scotland. The results have not been published in a peerreviewed journal.

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Upcoming Charity and Fundraising Events April 18

Palm Beach Autism Festival. This event will take place Downtown at the Gardens at the Carousel Courtyard in Palm Beach Gardens. This event will take place from 6:00-10:00 pm. For additional information, call 561-389-6671 or visit their website at www.autismsociety.org.

April 23

4th Taste of the Nation Palm Beach. This culinary event is just one step in trying to end childhood hunger. The event will be held at the Kravis Center Cohen Pavilion in West Palm Beach with 35 of the area’s top chefs. VIP is $150.00 and enters early at 6:30 -10:00 pm. General admission is $100.00 and is from 7:00 – 10:00 pm. For additional information, visit www.ce.strength.org.

April 26

The Boys & Girls Clubs of Palm Beach County and the West Palm Beach Kiwanis Club. 34th Annual Offshore Challenge Fishing Tournament. The event will take place in Sailfish Marina in Palm Beach Shores. Events include a Launch Party, Captains Meeting and Awards Presentation Participants can catch kingfish, dolphin, or wahoo. For additional information, call Kevin Murray or Lisa Jones at 561-683-3287. Or, you can visit their website at http://www.bgcpbc.org/.

Relay for Life of Lake Worth/Lantana. This event will take place at Palm Beach State College in Lake Worth. For additional information, call Kim Benson at 561 685-1805.

American Cancer Society Hope Gala. This event will be held at the Woodfield Country Club in Boca Raton. The cost is $275.00

to attend. For additional information, contact 561-394-7751.

April 27

Top Hats and Tea Cups Haute Couture Floral Millinery Pageant to benefit Ali’s Alliance. The event will take place at the PGA National Resort in the Bella Lago room in Palm Beach Gardens. Cost is $60.00 for adults and $50.00 for children. For additional information, contact Kelly Seitz at 561-315-5477 or kas99ice@aol.com. You can also visit their website at www.alisalliance.org.

May 3

Relay for Life of Boynton Beach. This event will take place at Boynton Beach Community High School. For additional information, contact Tim Drevins, at 561-3947751 or tim.drevins@cancer.org.

May 10

Benefit for teacher Brian Thomas. Brian is a teacher at Okeeheelee Middle School who has raised money for cancer and now has the disease himself. The event will take place at Okeeheelee Middle School in Greenacres. This benefit includes a 5k, Kids Mile, Food truck invasion, and craft sale so there is something for everyone to enjoy. For additional information, contact 561-762-9069 or fsnut@bellsouth.net. You can also visit their website at http://www.okeeheelee.org/.

May 16 and May 17

the golf classic and luncheon. For additional information, call Kevin Murray or Lisa Jones at 561-683-3287. Or, you can visit their website at http://www.bgcpbc.org/.

May 17

CureSearch Walk for Children’s Cancer. This event will be held at the Meyer Amphitheatre in West Palm Beach. Registration begins at 9:00 a.m. and the walk begins at 10:00. For additional information, visit http://www.curesearchwalk.org.

May 31

Boys & Girls Clubs of Palm Beach County. 25th Annual Golf Classic & Auction. The event will take place at the Lost Tree Club in North Palm Beach. May 16 will consist of an auction dinner party and May 17 will be

Relay for Life of Lake Worth/Lantana. This event will take place at Palm Beach State College in Lake Worth. For additional information, contact Jennifer De Gruccio at 561-394-7751 or jennifer.degruccio@cancer.org.

How to Keep Your Fitness Goals on Track

Start with a workout plan that's a good fit for you, expert says.

he New Year's resolutions many made to get fit have stalled by now. And one expert thinks that's because many people set their goals too high. "The point isn't to become a marathoner in one exercise session or return to your high school athletic glory days all at once," Dr. Jamy Ard, co-director of the Weight Management Center at Wake Forest Baptist Medical Center, said in a center news release.

"The point is to get over the inertia that has taken root in your self-motivation world and remind yourself of why you value being active," he explained.

You'll improve your chances of success if you have a workout program that's a good fit for you, Ard said.

"Physical activity not only needs to be simple and structured enough to meet your lifestyle demands, but also enjoyable enough for you to look forward to it," he added.

Ard offered some advice about how to start and maintain an exercise regimen. It begins with finding something you enjoy,

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whether it's going to the gym, starting a walking program or joining a running group.

You need to start slowly and have a simple plan. That could be a short stroll around the block or a 10-minute walk at work. Your plan should be so easy to do that it will be almost impossible for you to find excuses not to do it.

Keep challenging yourself by adding a little more to your fitness routine on a regular basis. If you're more active today than yesterday, you're moving in the right direction, Ard said.

"Seeing positive change can be extremely reinforcing, no matter how small. And maybe that will be enough to get you springing back sooner rather than later," he said.

Crunchy or Smooth? Food's Texture May Sway Perception of Calories

reamy butter or ice cream versus a crunchy granola bar: A new study suggests that the texture of foods influences people's dieting choices. "We studied the link between how a food feels in your mouth and the amount we eat, the types of food we choose, and how many calories we think we are consuming," wrote study authors Dipayan Biswas and Courtney Szocs, both from the University of South Florida, and others. In one experiment, participants were asked to sample foods that had soft, smooth, hard or rough textures and then estimate their calorie amounts.

In another test, volunteers were asked to watch and rate a number of television ads, thinking that was the test. But they were also given cups with bite-sized brownies as a "thank you" for their time. Half of the

participants were also asked about the amount of calories in the brownies.

Some of the participants received softer-textured brownies while the other half got crunchier brownies. People who had been asked about the calories in the brownies which forced them to focus on caloric intake -- ate more of the crunchy brownies than soft.

On the other hand, those whose minds weren't focused on calories tended to eat more of the soft brownies, the investigators found.

"Understanding how the texture of food can influence calorie perceptions, food choice, and consumption amount can help nudge consumers towards making healthier choices," the researchers concluded.

The study will be published in the August issue of the Journal of Consumer Research.

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Congressman Ted Deutch Tours The Butterfly House

n March 21, Congressman Ted Deutch (21st district) stopped by The Butterfly House for a tour. Led by staff members from Palm Beach County Victim Services and Wellington Regional Medical Center, the tour also consisted of a meeting which highlighted the up-to-date statistics. Having opened its doors in January 2012, The Butterfly House is a dedicated forensic facility where those that were sexually assaulted can come for an exam. The facility is operated by the Palm Beach County Victim Services unit and is

connected to Wellington Regional Medical Center.

From the moment that the victim reports the crime, they are appointed a victim advocate that will be with them every step of the way. They are NOT alone and should never feel as though they are going through this alone.

If you or someone you know has been sexually assaulted, contact the 24-hour rape crisis hotline at 561-833-7273 or 1-866-8917273 and a law enforcement officer will pick you up and transfer you to The Butterfly House.

Dear Deborah

DEAR DEBORAH: I started dating a great guy six months ago and unfortunately, he relocated to another state shortly after for a career opportunity. We have continued to communicate and I visit him every month. This last time that I visited him, I mentioned that I want a commitment. He told me that he was not happy in his new location and is looking at other offers so he can return home. He further stated that he could not make any decision about a commitment now. I really like spending time with him and even though we are not exclusive, I feel very close to him. My concern is whether he will want to commit when he returns home. He’s 52 and I am 54, but do not want to waste a minute of my time. - Commitment Phobe

Dear Commitment Phobe: First of all, you have only been dating this gentleman for six months, most of which has been long distance. You may like him, but you barely see him. You also mentioned that you visit him, but never mentioned if he visits you. If he

wanted or is ready for a commitment, he would have agreed to one. However, you pushed a topic that he was clearly not ready to discuss and brushed it off the best way he could. It sounds to me that you simply want to be in a committed relationship, which is perfectly fine, but he does not. If you really enjoy being with him, do not ask him about a commitment again and let things flow naturally. However, I would keep an eye open for other opportunities because I do not feel he will commit to you.

DEAR DEBORAH: I have been dating this guy for over two years and no one in my family likes him. Granted, they have their reasons and they aren’t wrong in how they feel. I know that he has not made the best choices in life, but that all happened before we met, which included serving six months in jail. We met five years after he was released and I accept that he is a new man, but my family won’t. What can I possibly do to change their minds about how they feel about him and our relationship? - Stuck in the Past

Dear Stuck in the Past: Regardless of whom you decide to date, that person will always be under a microscope. When you are a parent, you always want the best for your child – regardless of their age. No, they are not wrong in how they feel, but you are the one that has to live with your choice in a partner. So, it’s up to you whether or not he is worth the constant pressure and irritation that it causes your family or if it would be better to select someone that has a more innocent past.

Dear Deborah is a monthly advice column written by Deborah Lynn with a common sense approach to dating. If you have any questions or comments, please forward them to: questions@globalhealthtribune.com as we would love to help.

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Spring Cleaning Safety Tips

How to avoid accidental poisonings from chemicals, medications.

hile doing their spring cleaning, families will use a wide range of products that can cause accidental poisonings, an expert says. But taking appropriate precautions will reduce the risk of danger, said Earl Siegel, managing director of the drug and poison information center at Cincinnati Children's Hospital Medical Center in Ohio.

"It is vital that people arm themselves with basic information on poison prevention in the home, such as keeping chemicals out of the reach of children and carefully reading the labels and dosages on all products," he said in a hospital news release.

Read the label before you use a cleaning product. And never mix products together; doing so could create a dangerous gas.

Keep cleaning products in their original bottles or containers. Don't store them in cups, bottles or jars. Never sniff containers to determine what's inside.

If you clean out your medicine cabinet, keep all medicines out of the sight and reach of children while you're working.

Tips for preventing poisonings during spring cleaning are offered by the U.S. Department of Health and Human Services.

Open windows and turn on fans when using cleaners or other chemicals. Also, wear protective clothing -- long sleeves, long pants, socks, shoes and gloves -- if you're spraying pesticides or other chemicals. Stay away from newly sprayed areas for at least an hour, or until the spray has dried.

Keep cleaning products locked up and out of sight and reach of children.

If a poisoning occurs, call the Poison Control Center at 1-800-222-1222 immediately.

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