There’s a common misconception that beta-carotene found
in fruits and vegetables is the same thing as vitamin A. It’s
not.
Beta-carotene is the precursor (inactive form) of retinol, the
active form of vitamin A. While beta-carotene is converted
into vitamin A in humans, only 3% gets converted in a
healthy adult. And that’s assuming you’re not one of the
45% of adults that don’t convert any beta-carotene into
vitamin A at all.
This means that – contrary to popular wisdom – vegetables
like carrots and red peppers are not adequate food sources
of vitamin A.
Vitamin A is found in significant amounts only in animal
products like liver and grass-fed dairy. You’d have to eat a
huge amount of beta-carotene from plants to meet vitamin
A requirements during pregnancy. For example, 3 ounces of
beef liver contains 27,000 IU of vitamin A. As the chart
below illustrates, to get the same amount of vitamin A from
plants (assuming a 3% conversion of beta-carotene to
vitamin A), you’d have to eat 4.4 pounds of cooked carrots,
40 pounds of raw carrots, and 50 cups of cooked kale!
And remember: that’s assuming you’re not one of the 45%
of people that don’t convert any beta-carotenes into retinol
at all!
Obviously, since we only eat 3-5 pounds of food per day on
average, vegetables aren’t a viable food source of vitamin
A.
Why does this matter? Because vitamin A plays several
crucial roles in reproductive health, and many women (and
men) don’t get enough of it because vitamin A rich foods
like liver and raw dairy aren’t commonly consumed
anymore.
I’ll cover the importance of vitamin A in more detail in a
future post about cod liver oil, which is one of the best
sources of naturally occurring vitamin A.

Not enough
children and teens drink low-fat milk, a new report from the
U.S. Centers for Disease Control and Prevention reveals.
Drinking milk is important for children's bone health, but
CDC experts advise that although young people need the
calcium, vitamin D and other nutrients found in milk,
children aged 2 and older should consume low-fat milk and
milk products to avoid unnecessary fat and calories.
The research, published in a CDC report titled "Low-fat Milk
Consumption Among Children and Adolescents in the United
States, 2007-2008," showed that about 73 percent of
children and teens drink milk, but only about 20 percent of
them say they usually drink low-fat milk (skim or 1
percent).
Meanwhile, the 2007-2008 National Health and Nutrition
Examination Survey also revealed that about 45 percent
drink reduced-fat milk (2 percent) and 32 percent reported
they drink whole milk regularly.
Older children and teens drink low-fat milk more often than
younger children. Although 13 percent of kids aged 2 to 5
usually drink low-fat milk, 21 percent of kids aged 6 to 11
years said they do, along with 23 percent of teens aged 12
to 19.
Ethnicity and income also seem to play a role in the type of
milk children consume. White children drink low-fat milk
more often than black or Hispanic children. About 28
percent of the white participants said low-fat milk was their
usual milk type, compared to just 5 percent of blacks and 10
percent of Hispanics. Meanwhile, children and teens in the
highest income category reported drinking low-fat milk
more often than those in the lowest income group.
In summary, the authors of the report wrote: "The overall
low consumption of low-fat milk suggests the majority of
children and adolescents do not adhere to
recommendations by Dietary Guidelines for Americans,
2010 and the American Academy of Pediatrics for all
children aged 2 years and over to drink low-fat milk.
Recently, First Lady Michelle Obama's 'Lets Move!'
campaign and 'The Surgeon Generals Vision for a Healthy
and Fit Nation 2010' have recommended promoting water
and low-fat milk and reducing sugar-sweetened beverages
as components of comprehensive obesity prevention
strategies."

Kids are watching alarming YouTube videos on cutting and
self-injury, which may encourage the behavior. Here's what
parents need to know about spotting self-harm and helping
teens cope.
An alarming new study found that YouTube videos about
self-injury and self-harm – depicting teens cutting
themselves with razor blades, for example – have been
viewed 2.3 million times, and many of them rated favorably
(watch the example below). Most lacked warnings about
the nature of the content or viewing restrictions, according
to MedPage Today . Study authors worry that such videos
may make self-harm behavior seem normal to children or
even trigger them to attempt it.
So, what is self-injuring behavior, exactly — and could your
child be hurting himself without your knowing?
Self-injuring behavior is more common than you might
realize. Such acts, which include cutting, severe scratching,
burning, poisoning, piercing skin with sharp objects, hitting,
and biting, occur among 14 to 21 percent of children, teens,
and young adults, previous research has found.
Common reasons why teens self-harm are to make
themselves “feel alive” or to distract themselves from
intense emotions such as anger, said Allen Josephson, MD,
chief of the division of child, adolescent, and family
psychiatry at the University of Louisville School of Medicine
in Kentucky, in an Everyday Health article on teen cutting . A
complex problem, cutting is often linked to low self-esteem
and depression, as well as to other emotional health issues
including bipolar disorder , eating disorders , and obsessive
or compulsive behavior.
Though cutting and other self-harming behaviors can be
dangerous, Josephson says they’re usually not related to
suicidal thoughts or suicide attempts.
Could You Spot Warning Signs of Cutting Behavior in Your
Teen?
Though obvious signals include physical proof — such as
scars, cuts, and scratches — other less-noticeable
symptoms include spending a lot of time alone, wearing
long sleeves and pants, and claiming to have frequent
accidents, according to MayoClinic.com.
Is Your Teen at Risk for Cutting?
According to MayoClinic.com, children who have friends
who self-injure, who’ve endured sexual, physical, or
emotional abuse, or who have certain personality traits
(namely, those who are very self-critical, impulsive, or have
poor problem-solving skills) are more likely to self-inure
than others.
What If Your Teen Is Harming Herself?
The worst thing you can do is yell or criticize, say experts,
which may just prompt your child to harm herself further.
Make sure to tell him you love him no matter what, advises
MayoClincic.com. Since self-harm is a complicated
emotional and behavioral issue, your child will probably
need professional help to treat and prevent the problem. If
you’re concerned about your child and not sure how to seek
help, start with his pediatrician or family doctor, according
to MayoClinic.com. Get parent-to-parent advice on cutting
in our Family Health forum.

Exercise doesn't have to be all about calisthenics. These
activities help you make it fun!
Before our lives were so high-tech, family members were
more physically active and got plenty of exercise naturally.
Today, however, we go everywhere by car and sit for hours
in front of the TV or computer. This sedentary lifestyle has
been tied to obesity and a slew of related-health problems
ranging from diabetes to depression.
Related: 10 Cities for an Active Family Vacation
The U.S. Department of Health and Human Services reports
that children who are consistently more active are likely to
be healthier adults. And people who don’t exercise are at
risk of developing high blood pressure, osteoporosis , heart
disease , and other chronic illnesses. Sounds like a
prescription to get moving — now!
Family Exercise: Shift out of Idle
"Childhood obesity is proportional to the amount of time
spent watching TV," says George W. Shannon, MD, a family
physician in Georgia who serves on the board of directors of
the American Academy of Family Physicians. "TV should be
limited to time after supper, to sit down and watch
informative and educational channels such as PBS, the
History Channel, or the Discovery Channel. Limit those TV
hours."
Related: A Guide to Keeping Kids Healthy
Dr. Shannon also suggests limiting any other sedentary
distractions such as sitting at the computer. "Put your
computer in a common area so kids are not in their
bedrooms for hours at a time," he says.
10 Great Family Fitness Exercise Ideas
Now that you've set the ground rules for sedentary
activities, plan some family togetherness time. The idea is
to get 60 minutes of moderate to vigorous exercise every
day . So, how can you get your family moving in a way that's
fun and doesn't feel like a punishment? Here are some easy
ways to reach that goal together.
1. Walk to school. Lace up your walking shoes and
join the kids for a brisk walk to and from school
each day.
2. Check out physical participation video games.
"I'm delighted with some of the newer action
toys such as the [Nintendo] Wii games. People
have the ability to play tennis, bowling, baseball,
skateboarding, and snowboarding," Shannon
says. "Kids love them. I'm generally trying to get
kids away from the TV, but in this case, if they
are swinging a bat or dancing, it's great."
3. Build strong bones. Be sure to include bone-
strengthening exercise as well, such as
hopscotch, jumping rope, gymnastics, or
volleyball — any "weight-bearing" activity, one
that you do standing up.
4. Take a tour of the park. Make going to the park
a reward for a job well done, a good test grade,
or anything that deserves a positive non-food
reward. When you get there, play a fast game of
Frisbee or pitch a ball.
5. Turn birthdays into an active adventure. Make
your presents for birthdays related to activities.
Plan a family ski or snow-tubing day trip or visit
a nearby zoo. A bike makes a great gift for every
family member, as does a basketball hoop in the
driveway and a badminton net in the back yard.
Make sure that Mom and Dad are included in the
bike rides and pick-up games, too.
6. Get to the playground. Muscle-strengthening
exercise doesn't mean just weight lifting . Take
the kids to the playground to swing on the bars,
climb a tree, or play tug-of-war.
7. Go to the head of the class. To learn a new
activity, take a class together, such as martial
arts, dance, or yoga — a favorite among hard-
to-please teen girls.
8. Walk the dog. Treat your dog to daily walks that
include the entire family.
9. Plant a garden. Whether you choose fruit and
vegetables or just some pretty flowers, get the
kids involved in an organic gardening project.
They'll get some brisk exercise digging,
planting, and weeding. Then the whole family
can enjoy the fruits of their labor with fresh
produce and cut flowers.
10. Follow your kids' lead. "This year I bought my
granddaughter the Playskool Dance Cam
because she loves to dance," Shannon says. "It
takes a picture of a child dancing and puts it on
TV dancing with cartoon characters. My basic
words of advice are 'go with the flow.' If your
child shows interest in some activity, such as
dancing, encourage it and go with her to
participate."

Energy in a can or a bottle sounds appeals at any age, but
for children and young adults these drinks raise the risk of
caffeine overdose.
Mon. Feb. 14, 2011 — Popular energy drinks — which may
contain high levels of unregulated ingredients — could pose
a health risk to children, adolescents, and young adults,
who consume many of the drinks sold, a review suggests.
The review found that almost half of 5,448 caffeine
overdoses reported in 2007 involved people under age 19,
according to Sara M. Seifert, BS, of the University of Miami,
and colleagues.
Many energy drinks contain 70 to 80 mg of caffeine per 8-
oz. serving — about three times the concentration in cola
drinks, Seifert and co-authors noted in a special report
published in the March issue of Pediatrics .
10 Ways to Start Your Day Without Caffeine
Surveys suggest that up to half of the energy drinks on the
market are consumed by adolescents and young adults —
and reports in the literature have linked the drinks to
serious adverse effects in young people, including seizures,
diabetes, cardiac abnormalities, and mood and behavioral
disorders, the authors wrote in background to their review.
"Energy drinks have no therapeutic benefit, and many
ingredients are understudies and not regulated," Seifert and
her co-authors concluded. "Both the known and unknown
pharmacology of various ingredients, combined with reports
of toxicity, suggest that these drinks may put some children
at risk for serious adverse health effects."
"In the short term, pediatricians need to be aware of the
possible effects of energy drinks in vulnerable populations
and screen for consumption to educate families," they
added.
Marketed in more than 140 countries, energy drinks
constitute the fastest growing segment of the U.S. beverage
market, with sales expected to exceed $9 billion in 2011.
And about half of the energy drinks sold in the U.S. are
consumed by individuals younger than 25—including
elementary school kids and teens.
Consumption of high doses of caffeine has been associated
with a variety of serious adverse effects, documented
primarily in the popular press but also in sporadic case
reports in the medical literature.
The growing energy-drink market, combined with the
reports of serious adverse events, provided a rationale to
investigate the potential risks, the authors continued.
Children with underlying health problems — including
cardiovascular, renal, or liver disease, seizures, diabetes,
mood and behavioral disorders, or hyperthyroidism — or
those who take certain medications, may be especially
vulnerable to the adverse effects of high doses of caffeine
and other ingredients found in energy drinks.
"Although the U.S. Food and Drug Administration limits
caffeine content in soft drinks, which are categorized as
food, there is no such regulation of energy drinks, which are
classified as dietary supplements," the authors wrote.
"Despite the large, unregulated market for energy drinks
and reports in the literature and popular media of serious
adverse events associated with their consumption, research
into their use and effects has been sparse."
Seifert and colleagues conducted a search of the medical
literature, trade media, and other potential sources of
information about the potential health implications of
energy drinks.
They identified 121 references, two thirds of which were in
the scientific literature.
Although caffeine is the main ingredient in most energy
drinks, various additives can further increase the caffeine
concentration, especially guarana, but also kola nut, yerba
mate, and cocoa.
Every gram of guarana (Paullinia cupana ) contains 40 to 80
mg of caffeine, as well as theobromine and theophylline.
Interaction with other plant compounds has the potential to
increase the half-life of guarana.
Because manufacturers do not have to specify the caffeine
content of other ingredients in energy drinks, the actual
caffeine concentration might exceed the amount on the
label, the authors noted.
The review identified several other ingredients common to
energy drinks, including taurine, L-carnitine, ginseng, and
yohimbine.
The authors also found a potential for drug interactions with
certain energy-drink ingredients, such as 5-hydroxy
tryptophan, vinpocetine, yohimbine, and ginseng.
Overall, the review suggested that 30 percent to 50 percent
of young people consume energy drinks, although the type
of drink and frequency of consumption varied substantially.
Adverse events associated with energy drinks could not be
tracked in the U.S. until recently because exposures were
coded as caffeine or "multisubstance exposure," and
included with caffeine-related adverse events. According to
the authors, the American Association of Poison Control
Centers created a separate reporting code for energy drinks
in 2010.
Among countries that have collected data on adverse effects
associated with energy drinks, Germany has maintained
records since 2002 and documented effects that included
liver damage, kidney failure, respiratory disorders, agitation,
seizures, psychotic conditions, rhabdomyolysis,
tachycardia and cardiac arrhythmias, hypertension, heart
failure, and death.
Ireland documented 17 incidents, including two deaths,
between 1999 and 2005. New Zealand reported 20 energy
drink-associated incidents, including nausea, vomiting,
abdominal pain, "jitteriness," racing heart, and agitation.
Does Caffeine Help You Live Longer?
Seifert and co-authors also reviewed potential and
documented adverse events associated with specific
ingredients found in energy drinks. They called for more
research into the safety of energy drinks, as well as
consideration of regulatory control.
"Until research establishes energy-drink safety in children
and adolescents, regulation, as with tobacco, alcohol, and
prescription medications, is prudent," they wrote in
conclusion.

If you think you're taking care of your skin by shaving and
then throwing on some aftershave, think again. Learn the
basics about skin care for men.
Men don't spend a lot of time worrying about skin care. In
fact, according to a new study by the NPD Group, a
consumer market research company, only one-quarter of
men currently use any facial cleanser, moisturizer, or other
skin product. Most just splash some water on their face,
shave, and go about their business.
But maybe you should think twice about what you're doing
to your face. While men don't go through the elaborate skin
care rituals that women do, there are products you can use
and steps you can take that will protect and nourish your
skin, keeping it looking younger longer.
Great Grooming Products Every Man Needs
There are certain skin care products men should have on
hand for daily skin care:
Face cleanser. You should wash your face twice
a day with a good cleanser. If possible, it should
contain an alpha hydroxy acid to help wash
away dead skin cells, keep the pores clean, and
reveal new skin.
Shaving cream. You'll want to buy a product that
will properly lubricate the skin so the razor
blade will glide over it, preventing razor burn.
You can choose a shaving cream or gel in
pressurized cans, or you can buy shaving soap
that comes in a small tub and is applied with a
brush. Some men believe the brush makes the
hair stand straighter for easier shaving.
Aftershave lotion. Many men use an aftershave
lotion to soothe the skin after shaving. The
lotion may contain an antiseptic to prevent
infection, a moisturizer, or fragrance.
Moisturizer. Skin tends to dry out as its
essential oils diminish with age, but a good
moisturizer can help. You might want to choose
a moisturizer that contains antioxidants like
vitamins A, C, and E, which can protect skin
cells from aging. Steer clear of creams or lotions
with sodium lauryl sulfate, which tends to
remove natural oils from the skin.
Sunscreen. Sunscreen is the best thing you can
do to prevent aging of your skin, and it should
be applied whenever you expect to spend time
outdoors. Some experts even recommend
applying sunscreen right after shaving. Make
sure it has an SPF factor of at least 15.
Shaving for Skin Care
Shaving has hidden advantages — the exfoliation that takes
place every time you shave can keep the skin of your face
looking young and healthy. But if you shave improperly, you
can cause razor burn or razor bumps, which form when
facial hair cut too short curls back into the skin. To shave
properly, follow these steps:
Soften your beard. Thoroughly wet your face
with hot water. Prior to wetting the beard, you
might even want to apply a warm washcloth to
further soften hairs.
Apply shaving cream. Cover your entire beard
with shaving cream. Work it in well to make the
hairs stand up and to lubricate the skin.
Shave. Use a sharp razor, and shave in the
direction the hairs lay. Avoid repeating strokes,
and keep your skin relaxed.
Rinse. Rinse the remaining shaving cream off
your face. Use cool or warm water, as hot water
will dry out your skin.
Saving Face With Anti-Aging Treatments
The best anti-aging product you can use is sunscreen,
which both moisturizes your skin and prevents sun damage.
However, to treat skin that is beginning to show signs of
age, like fine lines and dullness, consider a tretinoin gel or
emollient (Retin-A Micro, Renova). These vitamin-A
derivative topicals enhance the natural production of
collagen and elastic fibers in the skin as they treats
discoloration, wrinkles, and the degeneration of elastic
tissue. They're available only by prescription, so talk to
your doctor.

Prenatal exposure to a
chemical designed to enhance the effect of household
insecticides may harm neurodevelopment , data from a
prospective cohort study of children found.
Data analyzed for almost 350 children found that each unit
increase in exposure to piperonyl butoxide — a chemical
found in fogger type products to kill flying insects or fleas —
was associated with a small but statistically significant
increase in the risk of delayed mental development at age
three, according to Dr. Megan Horton, of Columbia's
Mailman School of Public Health in New York City, and
colleagues.
But the risk increased with exposure and most highly
exposed children had a more than threefold increased
likelihood of slowed mental development Horton and co-
authors reported online ahead of the March issue of
Pediatrics .
Piperonyl butoxide a chemical mixed with pyrethroid
pesticides to improve efficacy.
Although the effects associated with exposure were modest,
the researchers wrote, "they were comparable in magnitude
to reports from studies of other prenatal neurotoxicants that
affect development in young children."
They added, however, that "these findings should be
considered preliminary and may be useful for generating
future hypotheses."
The use of residential pesticides has shifted in recent years
from organophosphorus insecticides — which have been
associated with impaired neurodevelopment — to pyrethroid
insecticides, which have not been evaluated extensively for
potential developmental toxicity.
There is concern because piperonyl butoxide is known to
block the body’s ability to breakdown pyrethroid
insecticides into harmless — detoxified — waste.
Exposure to piperonyl butoxide has also been shown to
generate reactive oxygen species, lending support to the
possibility that oxidative damage could be a mechanism for
altered neurologic development.
In the current study, Horton and her colleagues assessed
exposure to piperonyl butoxide in personal air collected
during the pregnancies of 348 black and Dominican mothers
and to the common pyrethroid pesticide, permethrin, in
personal air and maternal and umbilical cord plasma.
The mothers, from low-income neighborhoods in New York
City, were participating in the Columbia Center for
Children's Environmental Health (CCCEH) Mothers and
Newborns cohort.
The researchers assessed the cognitive and motor
development of the offspring at age 3 years using the
Bayley Scales of Infant Development.
"This finding is worrisome because mental development
index scores are more predictive of school readiness,"
Horton and her colleagues wrote.
Horton and her team acknowledged that their study was
limited by possible residual confounding from unmeasured
factors and by the lack of measurement of piperonyl
butoxide exposure in blood or urine samples.
The study was supported by the National Institute of
Environmental Health Sciences, Environmental Protection
Agency, Educational Foundation of America, John and
Wendy Neu Family Foundation, New York Community Trust,
and Trustees of the Blanchette Hooker Rockefeller Fund.
The authors reported that they had no conflicts of interest.

 Elective surgery for tetralogy of Fallot
can be done early, long before infants develop symptoms,
researchers said here.
There were no in-hospital deaths and the complication rate
was low — about 12 percent over about 15 years — among
asymptomatic patients under six months who were treated
at a single center, according to Roxanne Kirsch, MD, of the
Children's Hospital of Philadelphia, and colleagues.
They reported their findings during a poster session at the
Pediatric and Congenital Cardiovascular Disease meeting
here.
"Patients should be electively referred prior to the
development of symptoms," Kirsch told MedPage Today .
"Waiting for them to develop symptoms is not favorable. It
doesn't alter the ... key problem — the underlying anatomy
that needs surgical repair."
Tetralogy of Fallot is really four defects in the heart that
combine to affect oxygen levels in the blood. Children with
the condition have blue-tinged skin because the blood
flowing through their bodies doesn’t have enough oxygen.
The National Institutes of Health estimates that it affects
about 200,000 people in the United States, so it is
designated a rare condition.
Primary, complete repair of tetralogy of Fallot is an
established practice, the researchers said, and surgical
intervention during infancy has become routine in many
centers — although the optimal timing of elective surgical
intervention is still unclear, especially in asymptomatic
patients.
"We wanted to know if it's a safe and appropriate strategy,"
Kirsch told MedPage Today
So from over 500 patients, Kirsch and colleagues whittled it
down to 277 patients with the condition who'd had elective
repair between 1995 and 2009 at their institution before the
age of six months.
Kirsch said patients were excluded from their retrospective
chart review if they were older than six months when they'd
had the surgery, as well as if they'd had any complications
that could indicate being symptomatic or if they'd had prior
surgery or interventional palliation.
The median age at repair was three and half months and the
babies usually weighed about 3.5 months, and the median
weight was a little over 12 pounds.
The researchers found no in-hospital deaths, although
there were a total of 48 adverse events in 32 patients,
largely involving re-operation for bleeding and pleural/
pericardial drain placement or reintubation.
Still, the complication rate was low, Kirsch said, at less than
12 percent.
The researchers also noted that between 1995 and 2009,
there was a decrease in preoperative cardiac
catheterization and in median hospital length of stay.
Surgical volume increased over the study period, though the
use of ventriculotomy fell.
The total support time declined as well, and the use of deep
hypothermic circulatory arrest fell off significantly, which
Kirsch attributed to a "philosophical change."
When stratified by complications, the researchers saw that
those with more complications had a longer length of stay,
as might be expected. They also had more deep
hypothermic circulatory arrest, "for unclear reasons," Kirsch
said.
She noted that there was no correlation between the number
of complications and patient age.
Though the study was limited by its retrospective nature,
the findings suggest that elective repair for asymptomatic
infants with tetralogy of Fallot is safe and effective, and that
these patients should be referred for surgery early in
infancy, prior to the development of symptoms.
Kirsch said patients should be referred between two and six
months, but literature doesn't yet exist that "delineates
exactly which month is the perfect month. There may not be
a perfect month."
Tetralogy of Fallot is one of three conditions — along with
transposition of the great arteries and single-ventricle
lesions — that is being discussed in-depth here at the
meeting as researchers work to create relevant treatment
guidelines.

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You're scheduled for an MRI. You prepare by taking off your
jewelry, belts and clothing with zippers. But here's what
you need to know that your doc may not mention:
1. An MRI is incredibly loud. Expect clanking and banging
that sounds like a jackhammer during the MRI, and can
range from 82 to 118 decibels. Bring your own foam or
silicone earplugs, or ask for them before you go into the MRI
tube. Children — and some adults — who could be
frightened by the sound may need sedation in order to lie
still during the test.
2. You may be in for way longer than you expected. In some
cases a simple 15-minute procedure can turn into a
seemingly endless hour. So prepare by having a snack
beforehand, and be sure to go to the bathroom first. If you
haven't had a moment to yourself in a while, you might
enjoy the solitude.
3. Anxiety can set in. You may experience fear, or if you
suffer from anxiety , you may feel claustrophobic inside the
MRI machine. It helps to close your eyes before going in and
keep them closed. Try to think of amusing things — or about
people or pets you love. Some people benefit from taking
anti-anxiety medication prior to MRI.
4. Ditch ALL the jewelry. Loose metal objects can injure
you during an MRI when they're pulled toward the very
powerful MRI magnet. This means all jewelry has to come
off, not only what you can see, and this includes belly-
button or toe rings.
RELATED: How MRIs Can Predict Heart Attacks and Stroke
5. Don't wear makeup. Some cosmetics contain metals that
can interact with MRI magnets, so on the day of the MRI
don't wear makeup or nail polish. Also, minimize hair
products and forgo antiperspirants and sunscreens, which
contain metals, just to be safe.
6. Let the doctor know about hidden tattoos. During MRI,
skin or eye irritation — even first degree burns — can result
when dyes in tattoos , even from tattooed eyeliner, heat up.
Covering them isn't likely to help, and if skin irritation or
burning happens, the MRI must be stopped at once to avoid
a burn.
7. Chill out. Because of MRI radio waves, some people
report feeling a little warm during the procedure. Your
temperature may go up by a degree, but don't worry — it's
not dangerous.
8. You may have to do it twice. If you move during the MRI,
the images will have to be taken again and the process
begun again.
9. It's not a CAT scan. An MRI uses strong magnetic fields
and radio waves; it's not a CT, or CAT, scan, which uses X-
rays.
10. Don't worry about radiation. Getting an MRI does not
expose you to radiation like an X-ray, CT or CAT scan
would.

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Try these tips for preparing your child for a new sibling
before and after the baby is born.

There’s a wealth of information available for parents about
bringing home a new baby, but what about when the new
baby isn’t your first? Although the arrival of a new sibling
brings joy and excitement, it can also jeopardize sibling’s
sense of security, leaving them angry and resentful of the
family’s newest addition. Consequently, in addition to
getting your home ready for a new baby, it’s important that
you also focus on preparing the rest of the family.
Before the Baby Is Born
It’s important to involve your child and keep routines as
normal as possible in the weeks before and after your
baby’s arrival. Try these tips:
Postpone your new-baby discussion until you’re
showing, and when you do have it, use a
calendar to mark the days, or talk about how the
baby will arrive in a particular season (when it’s
hot outside), or after an event (when school gets
out for the summer).
Involve siblings as much as they want (let their
questions be the guide).
Be concrete about what the new baby’s arrival
will be like: “Mommy will be very tired,” “The
baby will cry and sleep a lot.”
Invite older siblings to share pictures, stories,
and video of their newborn days. Kids love to
hear stories about what life was like when they
were a baby.
Avoid big transitions like changing caregivers,
moving to a big-girl/boy bed, potty training ,
getting rid of the pacifier or binky , starting
preschool, etc. If siblings must undergo these
changes because of the new baby, start them as
early as possible (at least several weeks
before), so a negative connection doesn’t
develop between the changes and the baby’s
arrival.
Prepare siblings for your absence during the
birth of the new baby (how long you will be
gone, where your child will stay). How you act
lets your child know how to feel. If you seem
sad or anxious, they will feel sad or anxious.
Use role-playing with dolls to talk about
feelings, adjustment, and what life will be like
with a new sibling (best for toddler siblings).
After the Baby Is Born
Allow siblings to visit you and meet the new baby soon after
he/she is born (in the hospital). This will help to reinforce
that it’s a special, family event. Of course, if you feel like
your child will be scared of the hospital setting (e.g., seeing
you in a robe or with an IV), let the big introduction wait
until you get home. A few more helpful hints:
Have big-brother/sister gifts waiting, from the
new baby, when they first meet him/her.
Don’t make comparisons (“he’s much calmer
than you were,” or “you cried a lot more.”)
Don’t be alarmed if siblings don’t express an
interest in the new baby. Sibling relationships
have a lifetime to develop.
Accept that some regression may occur; this is
normal. Baby your big-boy/girl for a while, if
that’s what he/she seems to need.
Remind visitors to pay attention to your older
kids and monitor gift-giving. It can be upsetting
for sibling to see all of the presents that the
newborn receives, especially when people don’t
bring something for them.
Try not to blame the baby for your new
limitations (“Mommy can’t play with you now
because I have to feed the baby,” or “Mommy
needs to change the baby, so you need to read
to yourself.”). Blaming new babies for decreased
time spent with you breeds sibling resentment.
Instead, involve siblings in child care as
helpers.
Create opportunities for older siblings to be
participants and not competitors (e.g., getting a
diaper ready, reading the baby a story, pushing
the carriage).
Remind siblings of the things they can do
because they are older (e.g., eating food,
playing with toys, going to the playground).
Remember to give siblings private time with you
and reinforce the idea that many of the things
they are able to help out with (e.g., errand
running, meal preparation, etc.), are because of
their advanced abilities.
What If Problems Arise?
Research shows that a child’s developmental stage affects
their adjustment to new siblings. Children 2 years of age
and under have more difficulty because they still have
strong needs for parents’ time and closeness. Stress on the
family also makes children’s adjustment harder.
Remember, even the most well-meaning siblings can play
too rough or hug too hard in the beginning, so show them
how to play gently with their new sibling. Focus on the
positive behaviors your child shows to her new sibling (“I
like the way you stroked the baby’s leg.”). Most
importantly, don’t despair. The first few months are a big
adjustment for everyone.

Does it burn when your child urinates? This is one of many
signs of a urinary tract infection.According to the National Institutes of Health, urinary tract
infections are responsible for more than one million yearly
pediatrician visits every year in the United States. A urinary
tract infection, or UTI, occurs when bacteria infect the
kidneys, bladder, urethra, or other parts of the urinary tract.
Bacteria that can cause a UTI can live in the digestive tract,
vagina, or around the urethra, and normally won’t cause a
problem there. But if these bacteria enter the urethra, they
can travel to the bladder, kidneys, and other parts of the
urinary tract. A bladder infection is a type of UTI that affects
the bladder, but has not spread upward toward the kidneys.
The bacteria that lead to UTIs may be eliminated from the
urinary tract before causing an infection, but they can cause
a UTI in people who are prone to them. Girls, for example,
seem to be more likely to get a urinary tract infection than
boys.
Urinary Tract Infection Symptoms
"The most common symptoms of a UTI are a burning
sensation when the child urinates, lower abdominal pain
where the bladder is, frequency of urination — feeling like
you really have to go to the bathroom all the time but only a
little comes out — and urgency — feeling like you have to
urinate right now ," says Barbara Frankowski, MD, MPH,
professor of pediatrics at the University of Vermont College
of Medicine and a pediatrician at Vermont Children's
Hospital in Burlington, Vt.
Dr. Frankowski notes that when the UTI is more serious, the
child may also develop a fever. But most UTIs, including
bladder infections, are not usually associated with fever .
Other signs of a UTI may include:
Foul-smelling urine
Urine that appears milky, cloudy, or reddish
Fatigue
Chills and or fever
UTI symptoms may be harder to recognize in kids than in
adults. Sometimes children do not show classic symptoms
of a UTI, or they may not be able to explain them to their
parents . If your child has the following signs of a possible
UTI, you should immediately contact your health care
provider:
Irritable mood
Irregular eating and appetite
Unexplained and persistent fever
Incontinence (wetting pants or bed if already
toilet-trained)
Diarrhea
Persistent low energy level or just not feeling
well
Urinary Tract Infection Treatment
Tests used to diagnose a UTI usually include a physical
exam and a urine sample. It is important to test urine for
the presence of bacteria, since true UTIs are uncommon in
children, and rawness of the genitals, especially in girls, can
cause UTI-like symptoms such as burning during urination.
When a UTI is diagnosed, your child's doctor will prescribe
antibiotics to kill the bacteria that are causing the infection.
It is important that your child takes the antibiotics as
directed, and takes the complete course — all the medicine,
even if the symptoms get better. The pediatrician may also
order more tests after your child completes treatment.
These tests may be done to be sure there is no abnormality
of your child’s urinary tract, such as a tiny blockage, which
might cause repeated infections.
Urinary Tract Infection Prevention
If your child is prone to getting UTIs, these following tips
can help prevent them:
Push fluids. Make sure your child drinks plenty
of water every day. Cranberry juice can also
lower the risk of UTI.
Encourage frequent bathroom breaks. Teach
your child to urinate when he or she feels the
urge.
Teach your daughter to wipe well from the front
to the back after going to the bathroom.
Choose cotton underwear and avoid dressing
your child in tight-fitting clothes.
These prevention tips are easy to follow and easy on your
wallet. Gentle, steady reminders to your child will help
reinforce these tips, without making the child feel anxious.

Top 10 Tips for Toy SafetyProtect your baby from choking and other dangers by
following these important guidelines every time you shop
for a new toy.Choosing a toy that will brighten your baby's face is fun,
but it's essential to keep safety in mind too.
The American Academy of Family Physicians and the
American Academy of Pediatrics recommend that you first
consider the basics of toy safety, factors that pose an even
greater threat to children than issues recently in the news
about toxic toys.
Top 10 Toy Safety Tips
Avoid toys with sharp points and edges.
Put toys intended for older kids out of reach of
babies and toddlers.
Kids love to yank and pull apart toys, so choose
sturdy toys that don't have loose, moving parts
that can easily come off.
Buy age-appropriate toys. Read the label, and if
it's not recommended for children under a
certain age, then don't buy it for your baby.
Search for toys that are washable or include the
words non-toxic on the label, since so many
toys end up in baby’s mouth.
Reduce choking risk by skipping any games that
include parts that are smaller than 1.75 inches
in diameter for babies and toddlers. A general
rule: Any object that can fit into an empty toilet
paper roll is a choking hazard and should be out
of reach. Toys stuffed with any kind of beans or
pellets should be avoided, too, because a baby
can choke or suffocate if any of those pellets
were to spill out of the toy and end up in your
baby’s mouth.
Stay away from toys with loose string, ribbons,
or cords because they can become tangled
around your baby's neck.
Avoid toy guns or other toys that shoot objects.
Even the simplest versions that shoot plastic
objects can cause eye injuries and present
choking hazards.
Buy electric toys that are UL-approved, and
never permit a child to use a toy with a frayed
cord because it can result in shocks and burns.
Beware of toy chests and toy storage containers.
They can pinch little fingers and a child can
climb in, get trapped, and suffocate.
Another toy safety issue: Avoid crib toys that have ribbons,
ropes, cords, wires, or anything else hanging from them that
could strangle your baby. As a general rule, remove all toys
from your baby's crib when your child is sleeping.
Common-Sense Rules for Toy Safety
The American Academy of Pediatrics reminds parents who
are shopping for toys for older children to take the time to
read the labels. Also, be sure you and your child know how
to use a toy before diving into play. Use common sense,
too, by picking toys that are sturdy rather than flimsy, to
avoid early breakage.
And, as much as you'd like to see your child follow in
Einstein’s footsteps, avoid chemistry sets and other kits
that:
Are not age-appropriate
Are possibly flammable
Include dangerous chemicals
These are toxic toys to children who are too young to
understand the dangers.

Parenting is rewarding, but at times very difficult. With
frequent feedings, constant diaper changes, little sleep, and
anxiety over the new life you're responsible for, you are
most likely exhausted. And if your baby has colic
symptoms, it can compound the stress you are already
feeling.
"There was nothing we could do to get her to stop [crying].
I was falling apart," recalls Chalese Karas of Marblehead,
Mass., whose 2-year-old had colic symptoms as an infant.
If your baby is showing colic symptoms, you are not alone.
"Up to a third of infants have colic," says Jennifer Shu, MD,
co-author of Heading Home with Your Newborn: From Birth
to Reality and a pediatrician with Children's Medical Group
in Atlanta. And while colic may get worse before it gets
better, symptoms usually last only a few months.
Colic Symptoms: What Is Colic?
If your baby is fussy, you may be wondering if it is colic.
Doctors generally diagnose colic when there is no known
reason for prolonged crying. "It tends to be in the evening,"
says Dr. Shu. But the crying can occur at any time with
babies who are just fussy or those with acid reflux, a
condition some babies have in which stomach acid flows up
into the throat.
With colic, there is a "rule of threes," explains Shu. Colic
"starts around three weeks and lasts until about three
months," she says. "The crying lasts for at least three
hours." To figure out whether your baby has colic, consider
keeping a diary, suggests Shu. "Sometimes it helps to write
down how often the baby is crying," she says. "It can seem
like hours, but if you actually put it down on paper, it may
be more like 30 minutes over the period of a day."
Colic Remedies: Handling the Symptoms
"The problem with colic is that we don't know what causes
it, so it can be hard to treat," says Shu, who recommends
doing whatever makes the child feel better. "At that age,
you want to do whatever you can to comfort your baby. You
are not going to spoil them." She suggests that parents try
the “5 S's” that Harvey Karp, MD, recommends in his book,
The Happiest Baby on the Block (Bantam):
Swaddling
Side positioning
Shhhh (a soothing sound)
Swinging
Sucking
If the child show signs of illness, such as refusing to eat,
vomiting, diarrhea, or lethargy, call a doctor, adds Shu.
Otherwise, a simple change in the baby's environment may
help. After making sure the baby is not too hot or too cold
and that his diaper is clean, she recommends the following:
Move the baby to a swing.
Take the baby for a ride in the car.
Walk the baby in a stroller.
Run the vacuum or creating some other type of
background noise.
And, most importantly, take a break if you find yourself
becoming frazzled by your colic baby. "It can be really
frustrating for parents to be around a baby with colic," says
Shu. "If you feel like you are getting really upset with the
colic baby, put her in a crib or bassinet and get someone
else to watch her for a few minutes. If you need a break,
take one."

Parents know how to protect children from dangers like
small toys that can be choking hazards and dangling, frayed
electrical cords that can cause shock. But what about the
dangers you can't see, like lead in the paint of brightly
colored blocks or the chemicals in a plastic sippy cup? Here
are the latest toy safety guidelines you should be aware of.
Toxic Toys: Get the Lead Out
According to George W. Shannon, MD, a family physician in
Georgia who is on the board of directors of the American
Academy of Family Physicians, parents should be most
concerned about protecting their children from paint that
contains lead. "The government agencies that help us in the
U.S. can supervise overseas manufacturers, but you may
want to avoid buying toys [made] overseas because lead
paint can be a problem," warns Dr. Shannon.
New rules from the Consumer Product Safety Commission
(CPSC) are further cracking down on products that contain
lead, especially limiting the amount of lead that's
permissible. A new law is requiring that U.S. toy makers
and importers certify that kids' products meet the stricter
safety rules and the ban on lead. But beware of thrift stores
and consignment shops that resell older toys: They aren't
required to give the same certification. You might also want
to throw out any older toys in your home, especially those
with chipping paint.
Shannon says the symptoms of lead poisoning can include
nausea and vomiting, lethargy, failure to thrive, stagnant
weight, and loss of appetite. "This may evolve over weeks
or even months," he says. "The most important thing is to
be suspicious. And if you decide to take your child to the
pediatrician , bring the suspected toy with you."
Toxic Toys: Better Plastics, Please
There's been a lot of concern and government investigation
into toys and baby bottles that contain bisphenol A (BPA), a
chemical compound used in the manufacturing of many
plastic items. The debate is over whether this substance
has developmental effects in children. The U.S. Food and
Drug Administration claims its regulated products
containing BPA are safe. However, it has also formed a new
BPA task force to do more research.
Another substance that has sent up some red flags are
phthalates, a group of chemicals included in a variety of
products, such as toys made of flexible polyvinyl chloride
plastic (PVC). The CPSC tests for these substances; if you
are unsure about a toy, visit their Web site for a list of all
toy-hazard recalls dating back to the 1970s.
Toy Safety: Flame Retardants and Pesticides
Flame retardants, also known as polybrominated
diphenylethers (PBDEs), are currently under investigation
by the U.S Environmental Protection Agency due to reports
that these substances can become toxic to humans. But
Shannon notes that many flame retardants can be removed
from children's products, like stuffed toys, with repeated
laundering.
Pesticides can also be potentially toxic to children. They
are known to decompose quickly, but can remain in stuffed
toys that have been sprayed or dragged around outside in
the yard. The Children's Environmental Health Institute
suggests a variety of alternatives to using standard
pesticides , including organic and less toxic options such as
insecticidal soaps, and keeping your yard and home cleaner
to prevent pests.
It takes vigilance and some common sense to keep your
baby safe from toxic toys. Staying up to date on efforts to
improve toy safety will give you peace of mind.

Few things are more perfect than a baby's soft, smooth
skin. But because it is so tender and delicate, that sweet
skin can be susceptible to diaper rash, a mild irritation of
the skin that causes redness around the diaper area.
Most cases of diaper rash are caused by excessive moisture
and friction. "Too much moisture breaks down the barrier of
the skin and makes it raw and red, especially if there is a lot
of friction from a diaper," says Jennifer Shu, MD, co-author
of "Heading Home with Your Newborn: From Birth to
Reality" and a pediatrician at Children's Medical Group in
Atlanta.
While diaper rashes are usually not serious, they do cause
discomfort for your child. There are a number of diaper rash
remedies available for use at home. Learn which ones work
for your baby.
Diaper Rash: Spotting the Signs
Diaper rash "tends to [occur] in older kids, about 9 months
and up," says Dr. Shu, explaining that older babies urinate
more, which soaks the diapers and keeps the skin moist. In
addition, older babies have started to eat solid foods , and
the different acids they produce in their urine can lead to
diaper rash.
Typically in the form of a mild red rash with some scaling,
diaper rash most often occurs where the diaper touches
your baby's skin, but it can also spread outside of the area.
In some cases, when the diaper rash gets infected, it can
become bright red and swollen and spread beyond the
original rash in the form of small red patches.
"If [the diaper rash] is bright red, especially if there are
bumps, it could be a yeast infection," says Shu. "The
appearance of pus could mean there is a bacterial
infection." She recommends calling your baby's doctor if
the rash is associated with any of the following symptoms:
Extreme soreness around the irritated skin
Bright redness
Bumpiness
Pus
Persistent irritation that doesn't resolve with
diaper rash remedies
Diaper Rash: Prevention and Remedies
The best ways to avoid diaper rash is to change your child
immediately after a bowel movement and to rinse the area
with warm water. You should also check the diaper
frequently, to avoid prolonged exposure to moisture from a
urine-soaked diaper. If a rash occurs, try the following at-
home remedies.
Keep the diaper as dry as possible. To keep the diaper area
dry, Shu advises "using absorbent diapers and changing
diapers frequently, especially if you use cloth diapers." She
also recommends using over-the-counter diaper rash
cream or ointment. These treatments can keep the diaper
from rubbing against the skin.
Try switching diaper brands. "Some babies are sensitive to
certain materials, like the chemicals or perfumes that are in
some diapers," says Shu. "So if your baby gets a rash with
certain diapers, you may need to change brands."
Let your baby go diaper-free. Take the diaper off your baby
for a little while so the air can thoroughly dry the area. This
will allow for a bit of comfort and also work toward
preventing future diaper rashes.
Lastly, monitor your child's rash. "If you try to treat [the
diaper rash] at home for a few days and it doesn't get
better," says Shu, "call your child's doctor."

Singh Foundation is a national level development
organisation directly benefitting over 300,0 children
and their families every year, through 10
projects on education, healthcare, livelihood and
women empowerment, in more than 700 remote
villages and slums across 2 states of India.
Education is both the means as well as the end to a
better life: the means because it empowers an
individual to earn his/her livelihood and the end
because it increases one's awareness on a range of
issues – from healthcare to appropriate social
behaviour to understanding one's rights – and in the
process help him/her evolve as a better citizen.
Doubtless, education is the most powerful catalyst for
social transformation. But child education cannot be
done in isolation. A child will go to school only if the
family, particularly the mother, is assured of
healthcare and empowered. Moreover, when an elder
sibling is relevantly skilled to be employable and
begins earning, the journey of empowerment
continues beyond the present generation.
Realizing this, Singh Foundation, beginning in the
corridors of education, adopted a lifecycle approach
of development, focusing its interventions on children,
their families and the larger community.
Singh Foundation believes that unless members of the
civil society are involved proactively in the process of
development, sustainable change will not happen.
Following this model of Civic Driven Change, Smile
Foundation sensitizes and engages the civil society,
making it an active partner in all its welfare
initiatives.
Today, 8 million children in India are out of school –
surrounded by poverty, illness and despair; they are
fighting a daily battle for their survival. Together, we
can bring hope in their lives. Together, we can bring
change and make it last.
Donar please contact somnathsingh1977@gmail.com
Thank you

Self-confidence is extremely important in almost every
aspect of our lives, yet so many people struggle to find
it. Sadly, this can be a vicious circle: people who lack
self-confidence can find it difficult to become
successful.
After all, most people are reluctant to back a project
that's being pitched by someone who was nervous,
fumbling, and overly apologetic.
On the other hand, you might be persuaded by someone
who speaks clearly, who holds his or her head high,
who answers questions assuredly, and who readily
admits when he or she does not know something.
Confident people inspire confidence in others: their
audience, their peers, their bosses, their customers, and
their friends. And gaining the confidence of others is
one of the key ways in which a self-confident person
finds success.
The good news is that self-confidence really can be
learned and built on. And, whether you’re working on
your own confidence or building the confidence of
people around you, it’s well-worth the effort!
How Confident do you Seem to
Others?
Your level of self-confidence can show in many ways:
your behavior, your body language, how you speak,
what you say, and so on. Look at the following
comparisons of common confident behavior with
behavior associated with low self-confidence. Which
thoughts or actions do you recognize in yourself and
people around you?
Confident Behavior
Behavior
Associated With
low Self-
Confidence
Doing what you believe
to be right, even if others
mock or criticize you for
it.
Governing your
behavior based on
what other people
think.
Being willing to take
risks and go the extra
mile to achieve better
things.
Staying in your
comfort zone,
fearing failure, and
so avoid taking
risks.
Admitting your mistakes,
and learning from them.
Working hard to
cover up mistakes
and hoping that
you can fix the
problem before
anyone notices.
Waiting for others to
congratulate you on your
accomplishments.
Extolling your own
virtues as often as
possible to as
many people as
possible.
Accepting compliments
graciously. “Thanks, I
really worked hard on
that prospectus. I’m
pleased you recognize
my efforts.”
Dismissing
compliments
offhandedly. “Oh
that prospectus
was nothing really,
anyone could have
done it.”
As you can see from these examples, low self-
confidence can be self-destructive, and it often
manifests itself as negativity. Confident people are
generally more positive – they believe in themselves
and their abilities, and they also believe in living life to
the full.
What is Self-Confidence?
Two main things contribute to self-confidence: self-
efficacy and self-esteem.
We gain a sense of self-efficacy when we see ourselves
(and others similar to ourselves) mastering skills and
achieving goals that matter in those skill areas. This is
the confidence that, if we learn and work hard in a
particular area, we'll succeed; and it's this type of
confidence that leads people to accept difficult
challenges, and persist in the face of setbacksThis overlaps with the idea of self-esteem , which is
a more general sense that we can cope with what's
going on in our lives, and that we have a right to be
happy. Partly, this comes from a feeling that the people
around us approve of us, which we may or may not be
able to control. However, it also comes from the sense
that we are behaving virtuously, that we're competent
at what we do, and that we can compete successfully
when we put our minds to it.
Some people believe that self-confidence can be built
with affirmations and positive thinking . At Mind
Tools, we believe that there's some truth in this, but
that it's just as important to build self-confidence by
setting and achieving goals – thereby building
competence . Without this underlying competence, you
don't have self-confidence: you have shallow over-
confidence, with all of the issues, upset and failure that
this brings.
Building Self-Confidence
So how do you build this sense of balanced self-
confidence, founded on a firm appreciation of reality?
The bad news is that there’s no quick fix, or five-
minute solution.
The good news is that becoming more confident is
readily achievable, just as long as you have the focus
and determination to carry things through. And what’s
even better is that the things you’ll do to build your
self-confidence will also build success – after all, your
confidence will come from real, solid achievement. No-
one can take this away from you!
So here are our three steps to self-confidence, for
which we’ll use the metaphor of a journey: preparing for
your journey; setting out; and accelerating towards
success.
Step 1: Preparing for Your Journey
The first step involves getting yourself ready for your
journey to self-confidence. You need to take stock of
where you are, think about where you want to go, get
yourself in the right mindset for your journey, and
commit yourself to starting it and staying with it.
In preparing for your journey, do these five things:
Look at What You've Already
Achieved
Think about your life so far, and list the ten best things
you've achieved in an "Achievement Log." Perhaps you
came top in an important test or exam, played a key
role in an important team, produced the best sales
figures in a period, did something that made a key
difference in someone else’s life, or delivered a project
that meant a lot for your business.
Put these into a smartly formatted document, which you
can look at often. And then spend a few minutes each
week enjoying the success you’ve already had!
Think About Your Strengths
Next, use a technique like SWOT Analysis to take a
look at who and where you are. Looking at your
Achievement Log, and reflecting on your recent life,
think about what your friends would consider to be your
strengths and weaknesses. From these, think about the
opportunities and threats you face.
Make sure that you enjoy a few minutes reflecting on
your strengths!
Think About What's Important to You,
and Where you Want to Go
Next, think about the things that are really important to
you, and what you want to achieve with your life.
Setting and achieving goals is a key part of this, and
real confidence comes from this. Goal setting is the
process you use to set yourself targets, and measure
your successful hitting of those targets. See our article
on goal setting to find out how to use this important
technique, or use our Life Plan Workbook to think
through your own goals in detail (see the "Tip" below).
Inform your goal setting with your SWOT Analysis. Set
goals that exploit your strengths, minimize your
weaknesses, realize your opportunities, and control the
threats you face.
And having set the major goals in your life, identify the
first step in each. Make sure it’s a very small step,
perhaps taking no more than an hour to complete!
Start Managing Your Mind
At this stage, you need to start managing your mind.
Learn to pick up and defeat the negative self-talk which
can destroy your confidence. See our article on rational
positive thinking to find out how to do this.
Further useful reading includes our article on imagery
– this teaches you how to use and create strong mental
images of what you'll feel and experience as you
achieve your major goals – there’s something about
doing this that makes even major goals seem
achievable!
And Then Commit Yourself to
Success!
The final part of preparing for the journey is to make a
clear and unequivocal promise to yourself that you are
absolutely committed to your journey, and that you will
do all in your power to achieve it.
If as you’re doing it, you find doubts starting to surface,
write them down and challenge them calmly and
rationally. If they dissolve under scrutiny, that’s great.
However if they are based on genuine risks, make sure
you set additional goals to manage these appropriately.
For help with evaluating and managing the risks you
face, read our Risk Analysis and Management article.
Either way, make that promise!
Tip:
Self-confidence is about balance. At one
extreme, we have people with low self-
confidence. At the other end, we have people
who may be over-confident.
If you are under-confident, you’ll avoid
taking risks and stretching yourself; and you
might not try at all. And if you’re over-
confident, you may take on too much risk,
stretch yourself beyond your capabilities,
and crash badly. You may also find that
you’re so optimistic that you don’t try hard
enough to truly succeed.
Getting this right is a matter of having the
right amount of confidence, founded in
reality and on your true ability. With the right
amount of self-confidence, you will take
informed risks, stretch yourself (but not
beyond your abilities) and try hard.
So how self confident are you? Take our
short quiz to find out how self-confident
you are already, and start looking at specific
strategies to improve your confidence level.
Step 2: Setting Out
This is where you start, ever so slowly, moving towards
your goal. By doing the right things, and starting with
small, easy wins, you’ll put yourself on the path to
success – and start building the self-confidence that
comes with this.
Build the Knowledge you Need to
Succeed
Looking at your goals, identify the skills you’ll need to
achieve them. And then look at how you can acquire
these skills confidently and well. Don’t just accept a
sketchy, just-good-enough solution – look for a
solution, a program or a course that fully equips you to
achieve what you want to achieve and, ideally, gives
you a certificate or qualification you can be proud of.
Focus on the Basics
When you’re starting, don’t try to do anything clever or
elaborate. And don’t reach for perfection – just enjoy
doing simple things successfully and well.
Set Small Goals, and Achieve Them
Starting with the very small goals you identified in step
1, get in the habit of setting them, achieving them, and
celebrating that achievement. Don’t make goals
particularly challenging at this stage, just get into the
habit of achieving them and celebrating them. And, little
by little, start piling up the successes!
Keep Managing Your Mind
Stay on top of that positive thinking, keep celebrating
and enjoying success, and keep those mental images
strong. You can also use a technique like Treasure
Mapping to make your visualizations even stronger!
And on the other side, learn to handle failure. Accept
that mistakes happen when you’re trying something
new. In fact, if you get into the habit of treating
mistakes as learning experiences, you can (almost)
start to see them in a positive light. After all, there’s a
lot to be said for the saying “if it doesn’t kill you, it
makes you stronger!”
Step 3: Accelerating Towards
Success
By this stage, you’ll feel your self-confidence building.
You’ll have completed some of the courses you started
in step 2, and you’ll have plenty of success to celebrate!
This is the time to start stretching yourself. Make the
goals a bit bigger, and the challenges a bit tougher.
Increase the size of your commitment. And extend the
skills you’ve proven into new, but closely related
arenas.
Tip 1:
Keep yourself grounded – this is where
people tend to get over-confident and over-
stretch themselves. And make sure you
don’t start enjoying cleverness for its own
sake…
Tip 2:
If you haven't already looked at it, use our
How Self Confident Are You? quiz to find
out how self-confident you are, and to
identify specific strategies for building self-
confidence.
As long as you keep on stretching yourself enough, but
not too much, you'll find your self-confidence building
apace. What's more, you'll have earned your self-
confidence – because you’ll have put in the hard graft
necessary to be successful!
Goal setting is arguably the most important skill you
can learn to improve your self-confidence. If you
haven't already read and applied our goal setting
article, you can read it here .
Key Points
Self-confidence is extremely important in
almost every aspect of our lives, and people
who lack it can find it difficult to become
successful.
Two main things contribute to self-
confidence: self-efficacy and self-esteem.
You can develop it with these three steps:
1. Prepare for your journey.
2. Set out on your journey.
3. Accelerate towards success.
Goal setting is probably the most important
activity that you can learn in order to
improve your self-confidence.
This site teaches you the skills you need for a happy
and successful career; and this is just one of many
tools and resources that you'll find here at Mind Tools.

Tissue or Mechanical Heart Valve?
Mechanical and Tissue Heart Valves
Background:
When heart valve disease progresses to the point that
treatment by medicines does not provide relief from a
patient’s symptoms, surgery to repair or replace the valves
becomes the best alternative. If the surgery is not a repair,
homograft or autograft, the choice is most likely between
carbon-based mechanical valves and biological tissue
valves.
The physician and patient will choose the type of valve,
taking into account the patients’ overall condition and
preference. Some of the patient factors considered are:
Age and life expectancy: Although age is not a rigid
indicator, the American College of Cardiology and
American Medical Association guidelines indicate that
mechanical valves are generally appropriate for a
majority of patients 65 years old and younger, or
patients already on coumadin.
Other diseases: Lung, liver and kidney disease,
diabetes, cancer and other chronic conditions can affect
life expectancy and alter the age criterion.
Heart and vascular system condition: Coronary, carotid
and peripheral artery diseases and heart rhythm
disturbances can affect valve selection.
Patient lifestyle and preference: Life situations or
intangible factors often influence valve selection.
Tissue Heart Valves:
Tissue valves are harvested from pig heart valves (porcine)
or cow heart sac (bovine). These tissues are treated and
neutralized so that the body will not reject them. Some are
mounted on a frame or stent; others are used directly
(stentless).
The lifetime of a tissue valve is typically 10 to 15 years,
often less in younger patients. Over this time the valve will
likely be degenerating to the point of requiring replacement.
Because valve replacement surgery carries a significant
risk of death, patient life expectancy is a major criterion in
considering a tissue valve.
With relatively high pressure gradients, stented tissue
valves do not perform as well as the native valve in terms of
blood flow. Tissue valves without frames (stentless)
improve blood flow, although they are more difficult to put
in place and are not usable in all cases.
The primary advantage of tissue valves is their lower
requirement for anticoagulation therapy, which reduces the
incidence of bleeding. For the majority of tissue valve
patients, taking an aspirin a day is sufficient
anticoagulation therapy. Many patients with tissue valves,
however, do not enjoy this benefit due to anticoagulation
requirements for other heart or vascular conditions.
Mechanical Heart Valves:
The most widely used mechanical valves are made from
pyrolytic carbon, which has been used for over 30 years.
Most are bileaflet designs, meaning that they employ two
carbon “leaflets” to regulate flow to a single direction.
The primary advantage of mechanical valves is that they
will last a patient’s lifetime. Mechanical valves are
preferred for patients with life expectancies beyond 10-15
years because they eliminate the mortality risk inherent in
the replacement of a worn out tissue valve. The best
mechanical valves, such as the On-X valve, have excellent
flow performance, rivaling that of the native valve even in
the small sizes.
The main drawback of mechanical valves has been their
requirement for warfarin anticoagulation therapy, with its
accompanying risk of bleeding. Bleeding events are rare but
are potentially fatal. With properly managed anticoagulation
therapy, rates are low for both bleeding and clotting.
Mechanical valves can sometimes be audible when opening
and closing. The sound level varies with the patient, but
among those noticing it, a small number of patients find the
sound disturbing, while others find it reassuring.
The Choice:
Valve selection is a balancing act between the major
positives and negatives of both valve types:
The limited durability of tissue valves (performance
degradation and the stress or mortality of reoperation).
The requirement for lifelong anticoagulation therapy of
mechanical valves.
The decision is reached differently for each patient as many
factors are considered and weighed but the goal is always
to improve quality of life while minimizing risk.

Medical News Today reported that an Italian surgeon is to announce updated plans to conduct the world's first human head transplant within the next 2 years. Now, a 30-year-old Russian man is set to become the first person to undergo the procedure.

The HEAVEN-GEMINI procedure - which is estimated to take 100 surgeons around 36 hours to complete - will involve spinal cord fusion.

Dr. Sergio Canavero, of the Turin Advanced Neuromodulation Group (TANG) in Italy, first spoke of his plans to carry out the first human head transplantation in July 2013 - a project named HEAVEN-GEMINI.

At the American Academy of Neurological and Orthopedic Surgeons' 39th Annual Conference in Annapolis, MD, in June, Dr. Canavero will present updated plans for the project, addressing some of the previously identified challenges that come with it.

Though researchers have seriously questioned the feasibility of Dr. Canavero's plans, it seems the first human head transplantation is a step closer to becoming a reality; Valery Spiridonov, a 30-year-old computer scientist from Vladimir, Russia, is the first person to volunteer for the procedure.

Spiridonov has Werdnig-Hoffman disease - a rare genetic muscle wasting condition, also referred to as type 1 spinal muscular atrophy (SMA). The condition is caused by the loss of motor neurons in the spinal cord and the brain region connected to the spinal cord. Individuals with the disease are unable to walk and are often unable to sit unaided.

Spiridonov was diagnosed with Werdnig-Hoffman disease at the age of 1 and told MailOnline that he volunteered for HEAVEN-GEMINI because he wants the chance of a new body before he dies.

'"I can hardly control my body now," he said. "I need help every day, every minute. I am now 30 years old, although people rarely live to more than 20 with this disease."

Donor body will be attached to recipient's head through spinal cord fusion

Dr. Canavero told CNN he has received an array of emails and letters from people asking to be considered for the procedure, many of which have been from transgender individuals seeking a new body. However, the surgeon says the first people to undergo the procedure will be those with muscle wasting conditions like Spiridonov.

The procedure - which is estimated to take 100 surgeons around 36 hours to complete - will involve spinal cord fusion (SCF). The head from a donor body will be removed using an "ultra-sharp blade" in order to limit the amount of damage the spinal cord sustains.

"The key to SCF is a sharp severance of the cords themselves," Dr. Canavero explains in a paper published earlier this year, "with its attendant minimal damage to both the axons in the white matter and the neurons in the gray laminae. This is a key point."

The spinal cord of the donor body will then be fused with the spinal cord of the recipient's head. Chemicals called polyethylene glycol or chitosan can be used to encourage SCF, according to Dr. Canavero. The muscles and blood supply will then be sutured.

The recipient will be kept in a coma for around 3-4 weeks, says Dr. Canavero, during which time the spinal cord will be subject to electrical stimulation via implanted electrodes in order to boost the new nerve connections.

The surgeon estimates that - with the help of physical therapy - the patient would be able to walk within 1 year.

Spiridonov admits he is worried about undergoing the procedure. "Am I afraid? Yes, of course I am," he toldMailOnline. "But it is not just very scary, but also very interesting."

"You have to understand that I don't really have many choices," he added. "If I don't try this chance my fate will be very sad. With every year my state is getting worse."

Spiridonov talks more about his decision to participate in HEAVEN-GEMINI in the video below:

Dr. Canavero branded 'nuts'

Dr. Canavero has previously admitted there are two major challenges with HEAVEN-GEMINI: reconnecting the severed spinal cord, and stopping the immune system from rejecting the head. But he claims that recent animal studies have shown the procedure is "feasible."

Unsurprisingly, however, researchers worldwide are highly skeptical of the proposal. Talking to CNN, Arthur Caplan, PhD, director of medical ethics and NYU Langone Medical Center in New York, NY, even called Dr. Canavero "nuts."

Caplan said the procedure needs to be conducted many more times on animals before it is applied to humans, adding that if the technique is feasible then Dr. Canavero should be trying to help paralyzed patients before attempting whole body transplants.

And talking to New Scientist earlier this year, Harry Goldsmith, a clinical professor of neurosurgery at the University of California-Davis, said the project is so "overwhelming" that it is the chances of it going ahead are unlikely.

"I don't believe it will ever work," he added, "there are too many problems with the procedure. Trying to keep someone healthy in a coma for 4 weeks - it's not going to happen."

Spiridonov says he is well aware of the risks, though he is still willing to take a chance on Dr. Canavero.

"He's a very experienced neurosurgeon and has conducted many serious operations. Of course he has never done anything like this and we have to think carefully through all the possible risks," he told MailOnline, but adds that "if you want something to be done, you need to participate in it."

Though it not been confirmed when the procedure will be performed, Spiridonov says it could be as early as next year. Watch this space.

Latest update

In October 2015 we interviewed Dr. Sergio Canavero about his plan to perform the first human head transplant in December 2017 - a procedure he claims will take around 150 surgeons and nurses approximately 36 hours to complete and will cost around $11 million. You can read the full interview here.