Friday, 24 June 2011

Want a flat tummy? Avoid low fat foods

Trying to lose weight by adopting a low fat diet? Well, you may be committing the biggest mistake of your ''weight loss regime,'' says an Oz fitness expert. 

Celebrity trainer James Duigan, whose clients include model Elle Macpherson, said, "I see so many people trying their best and it's just not working because they don't understand that it's not fat that makes you fat, it's sugar and it's carbohydrates."

"You need a healthy balanced diet with fish and chicken and meat and vegetables and berries and nuts and things like that. (Low-fat diets) just don't work - it's not sustainable. You need to look at how you can keep yourself happy and healthy throughout your life," Stuff quoted him as saying.

Duigan, whose second book ''Clean & Lean: Flat Tummy Fast!'' is out, has suggested some small steps one can follow for a flattened stomach.

Don't overcook your food as you'll kill off or reduce the nutrient content. Try to make sure around 50 per cent of the food on your plate is raw. If you can stomach it, eat all your vegetables raw.

Don't buy cheap meat - organic meat is more expensive, but it also contains less toxic junk such as antibiotics. If you can afford only one organic thing make sure it's meat.
Don't eat foods that weaken your abdominal wall, as this will make it slack and lead to a protruding stomach. Foods that can weaken your abdominal wall often contain gluten.

Avoid sugar, in all its forms, as it fattens your mid-section.

Make sure you eat enough fibre. A lack of fibre will lead to inflammation in the bowel. Eat plenty of vegetables (ideally raw) and drink at least two litres of still, room temperature water every day.

Duigan has suggested having the occasional ''cheat'' meal, so you can eat a piece of cake or a brownie and actually help your weight loss.

"Feed your soul because you can't live your whole life in denial. And it helps the fat-burning process, it can boost your metabolism and get you leaner the next day. The key is to keep it to one meal," he said.

Another factor for a healthy lifestyle is reducing stress, he added. 


What are the side effects of chemotherapy?

The common side effects include nausea and vomiting, loss of hair, stomach upset, kidney dysfunction, bone marrow suppression, tinnitus (abnormal noises in the ears) and high frequency hearing loss. Also lung disease and infertility may occur.
What is radiotherapy?

  1. Radiotherapy involves the use of high-energy ionising radiation to cause DNA damage and ultimately cell death.
  2. Dose of radiotherapy is measured in Grays (Gy) – this represents the amount of energy deposited in the tissue.
  3. Radiotherapy is given in units called fractions over several day or weeks. To give the dose in one go is too toxic and would cause severe tissue damage and even death. 
  4. The area to be irradiated is referred to as the radiation field. This is always marked out on the skin before treatment and such markings often perisist after the treatment.
  5. Each tissue in the body has a particular tolerance to radiation. This limits the total dose that can be administered to that area.
How is radiotherapy delivered?
There are three major ways in which ionising radiation is delivered.
  1. External beam radiotherapy: This involves the use of a variety of machines to deliver external beam therapy. The source is at a distance from the body.
  2. Brachytherapy: In this the radioactive source is in or close to the area to be treated, or directly into the tumour.
  3. Radioactive isotope: This involves giving a radioactive isotope that is taken up by the target organ. Radioactive isotopes can be injected or given into a vein by an injection.
What are the side effects of radiotherapy?
The common side effects are skin diseases, nausea, lethargy, bone marrow suppression, dairrhoea, hair loss, lung fibrosis, kidney impairment and paralysis.
What is hormonal therapy?

Endocrine therapy (or hormonal therapy) is an important part of managing cancers whose growth is dependent on hormones, namely breast and prostate cancer. The aim of such treatment is to reduce the amount or effect of circulating sex hormones.
Breast cancer
Hormonal manipulation is used when the breast tumour is sensitive to circulating oestradiol i.e when it is positive for oestrogen receptor.

Prostate cancer

The growth of prostatic carcinoma is under the control of male sex hormones. Hence, the aim of hormonal therapy is to reduce testosterone levels or prevent it from binding to the androgen receptor.

What is immunotherapy?
Immunotherapy stimulates the immune system to build a response to the tumour. Interferons are naturally occurring proteins produced in response to viral infections. Three interferons are known to exist alpha, beta, and gamma. Only interferon alpha is used in treatment of cancers. The adverse effects are fluid retention, multi organ dysfunction, bone marrow and liver toxicity and fatigue.
What are the different mode of treatments for cancer?
Non-surgical or medical treatments for different cancers include chemotherapy, radiotherapy, endocrine therapy and immunotherapy 
What is chemotherapy?

  1. Chemotherapy or cytotoxic agents are drugs, which interfere with cell division. They prevent cells from multiplying.
  2. They are non-selective and will affect any cell which is rapidly dividing, whether it is cancerous or non- cancerous.
  3. Cytotoxics are usually given in combination or with drugs which interfere with replication at different phases of the cell cycle. This improves their effectiveness and reduces the likelihood of the development drug resistance.
  4. Chemotherapy is given every 21 to 28 days to allow recovery of the bone marrow.
  5. Each treatment is called a cycle and usually a course of chemotherapy involves a number of cycles.
  6. The toxicities of each agent given in combination should not overlap.

Preventing dehydration

  • Try to avoid the sun in the middle of the day or at noon. Use an umbrella to protect yourself from direct sunlight.

  • Drink water and fresh fruits juices, rich in Vitamin C, at regular intervals on hotter days.

  • Avoid taking alcohol and caffeinated beverages such as coffee and soft drinks as these aggravate the effects of dehydration.

  • When you exercise, be sure that you drink plenty of water before, during, and after.

  • On those warmer days, take plenty of breaks from your daily activities to get in the shade and drink plenty of fluids.

  • Coping with fussy eaters

  • Serve food that is fresh and presented in an attractive way.

  • Create a mealtime that is pleasant and relaxed.

  • Talk about food; this may encourage a child to eat.

  • Whenever possible, allow children to choose from one or two items on the menu (for example, a choice of peas or carrots for vegetables).

  • Give your child the same food you eat.

  • Preventing angina pain

    Angina (also called angina pectoris) is chest discomfort, caused by reduced oxygen supply to the heart muscle, in relation to its needs.

    A regular exercise programme under the doctor's supervision can prevent angina.

    A supervised weight-loss programme in over-weight persons also reduces the chances of angina.

    Eat a healthy, well-balanced diet and avoid foods high in fat and cholesterol.

    The blood pressure should be checked regularly and kept as close as possible to 120/80mmHg.

    Get relaxed sleep at night.

    Always carry the medicines prescribed by the doctor along with the prescription.

    Follow-up regularly with the doctor.

    Avoid stress.

    Diabetics at risk for second stroke

    After suffering a first stroke or transient ischemic attack (TIA), people with type 2 diabetes are at greater risk of having another stroke or a heart attack. But, aggressively lowering cholesterol can help reduce that risk.

    Previous research has shown that type 2 diabetes mellitus is associated with increased risks of both stroke and coronary heart disease (CHD). Metabolic syndrome or insulin resistance identifies individuals at higher risk for developing type 2 diabetes and is also associated with an increase in stroke and cardiovascular disease.  Metabolic syndrome is a group of conditions, including high blood pressure, high blood sugar and high cholesterol that increase the odds of developing diabetes and heart disease.

    Researchers in the United States analysed data from the Stroke Prevention by Aggressive Reduction of Cholesterol Levels Trial, which was designed to look at whether taking high doses of cholesterol-lowering drugs called statins would reduce the risk of having a second stroke or TIA. The trial did find that lowering cholesterol reduced the likelihood of another cardiovascular event in patients with recent stroke or TIA. In their secondary analysis, the researchers also looked at the risk of having another stroke or a heart attack among diabetics and people with metabolic syndrome and whether statin treatment could reduce that risk.

    Of the 4,731 people in the trial who had had a stroke or TIA, the researchers identified 794 diabetics and 642 with metabolic syndrome. Compared with non-diabetics, people with diabetes were more likely to have another stroke, TIA or other cardiovascular event. They were also more likely to need an angioplasty to open blocked arteries, it was found. However, people with metabolic syndrome were not at greater risk of another stroke or TIA or cardiovascular event but were at higher risk of needing an angioplasty. Treatment with the statin did significantly reduce the risk of these events in participants with type 2 diabetes or metabolic syndrome.

    The study results confirm earlier findings but highlight the differences in risks between diabetes and metabolic syndrome while pointing out that statin use is protective in such patients.

    The King’s Speech: Overcoming stammering

    The unprecedented Oscar success of 'King's Speech' has brought much world attention to the baffling speech problem of stammering. In the movie it is Duke of York (the king-to-be of England) who stammers. Through strong but subtle strokes of direction, the film manages to bring out the frustrations experienced by those of us who stammer in our increasingly verbal world.

    In the movie, Albert, the Duke manages to overcome his speech impediment through some very unusual speech therapy.

    Over the last 3 centuries, researchers have tried to understand why stammering occurs and what can be done to 'cure' it. Up until the 19th century, the causes were attributed to everything from the devil upwards. During the 20th century, the focus shifted from calling stammering a disease and instead looked at it as a psychological condition which was caused by behavioural and environmental influences and as such, needed to be handled through psychological readjustments. Counselling became important. Confidence building and overcoming fear was the focus of most speech therapy programmes.

    But the causes of stammering and its treatment have remained only a partially solved jigsaw puzzle.

    Consider the questions:
    1. It affects mostly the first-born male child. 90% of all those who stammer are male. 65% have a family history of stammering. So is it genetic? Is there a ‘stammering’ gene?
    2. People who stammer are generally above average in intelligence and many are rated high in their academic and professional performance. So does it afflict only those  with high IQs?
    3. Even those with severe stammering can sing fluently without any speech blocks. So does it have to do with rhythm?
    4. Most persons who stammer can speak fluently when alone or in comfortable company but lapse into stammering in stressful situations like interviews, presentations or on the telephone. Does fear play a role?
    Having worked with young adults who stammer for over 25 years, chaperoning many up the slippery road to speech fluency, I, like many of my colleagues, have taken my cases through a gamut of therapies – many standard ones and some not so.

    The problem with trying to overcome stammering is not so much in attaining increased speech fluency, as it is in maintaining and stabilizing the achieved change. Most cases show significant improvement during the initial phases of therapy but gradually lapse back into their old habit once the new-ness of the therapy practice wears off, and the initial euphoria abates. To be able to speak fluently in any situation is a fantasy goal in the mind of the person who stammers. There is tremendous glamour attached to the attainment of speech fluency. Such a point of view, although understandable, needs to be discouraged, since fantasies are thrilling and all thrills are emotionally de-stabilizing.

    All our actions, including the act of speech, are neuro-muscular in nature. The brain emits electro-chemical signals that travel through the nerves and ‘order’ the required muscles to execute specific movements. The smooth transmission of these electro-chemical impulses signals can become disturbed when the mind is thrilled or excited. Stammering is a condition which feeds on emotional upheavals (another name for ‘thrills’).

    Most persons who stammer are so desperate for fluency that they will do just about anything to get it. It is this very desperation that takes the goal farther away.

    When someone who stammers says to me that he is ready to work very hard for fluency, my advice to him is to not use any will-power for fluency. He is encouraged not see his self-therapy as an endurance test.

    Good, fluent speakers are masters of timing. They know how to operate their speaking machine most effectively with the least effort. Their system ‘knows’ how to synchronize the flow of their thoughts; how to optimize breathing patterns so as to support a powerful delivery; how to easily move their tongue and lips to facilitate good articulation. Effective therapy to overcome stammering must focus on developing these skills.

    That would involve a daily routine of practice with timing of delivery, pausing, loudness modulation, changing of mouth dynamics’, etc. Regularly, the person who stammers has to practice at honing this skill.

    When his speech becomes fluent (as it often does with this approach of ‘non-doing’), the person is encouraged to take this success in his stride. He is encouraged not to jump with joy every time he is fluent. He should try not to succumb to a feeling of achievement. He has to de-glamorize his speech progress and take it as an everyday, non-thrilling fact of life. The stammering behaviour is thus denied the emotional sustenance it needs to stay alive.

    Over the years, a person who stammers has inevitably devised many strategies to deal with his speech problem. Avoiding certain situations, replacing words which begin with ‘difficult’ sounds, etc. are typical. But now, as he begins to become more fluent, new psychological strategies need to be developed. Where once his ‘mind’ was engrossed in handling his stammered speech, the person now has to help himself develop a mind-set to deal with his newly acquired speech fluency.

    'Speech is the mirror of the mind' and a mind constantly concerned with not stammering will actually trip into dys-fluency more often.

    The ultimate goal, really, would be to reach a state of mind which is not so desperately concerned with either stammering or not stammering. And this need not be an event set sometime far-away into the future. Enlightenment can happen in an instant!. As it did with Albert, Duke of York, when he delivered his speech accepting to become King of England.

    Thursday, 23 June 2011


    What is dementia?
    Dementia is a condition characterised by a chronic decline in mental abilities, especially memory. The higher functions of man include memory, orientation in time and place, intelligence, reasoning, speech, self care etc. Dementia implies global reduction in higher functions. Memory is usually the first to be lost but loss of memory alone is amnesia. When memory is lost and he can’t recognize relations or look after his daily habits then the person is demented. The affected person may have problems doing things he used to do. He may become confused when given too many things to do at the same time. He may also become more aggressive. Dementia also requires the illness to be chronic. If a person is old, has fever and then is confused that is not dementia.
    Is dementia related to age?
    Dementia is not a normal part of the aging process. It may be caused by many disease conditions and can affect the young as well as old but certainly is commoner in older persons.
    What causes dementia?
    The two commonest diseases causing dementia are vascular disease of brain (less blood supply to brain) and a degenerative disorder called Alzheimer’s disease. Several other rare degenerative diseases can also cause dementia. Perhaps more important are conditions that cause reversible forms of dementia:

  • Reactions to medications such as those given for the treatment of hypertension, arthritis and certain neurological problems.

  • Emotional distress caused by major life changes such as retirement, divorce or loss of someone dear. 

  • Metabolic disturbances because of kidney or liver failure, pancreatic diseases or blood electrolyte imbalances.

  • Endocrinal abnormalities such as hypothyroidism or adrenal gland abnormalities.

  • A blood clot on the surface of the brain exerting pressure and causing a state of confusion.

  • Diseases such as brain tumours, nutritional deficiencies, infections and problems of vision and hearing that may lead to conditions similar to dementia. Among infections an important recent cause is HIV disease and the human variant of Mad Cow disease.

  • What are the symptoms?
    Symptoms of dementia are short-term memory loss, inability to think through problems, inability to complete complex tasks without detailed instructions and confusion. The person may have difficulty in concentrating for a long time and may show inappropriate or bizarre behaviour. He may get disoriented about time, people and places and may neglect personal safety, hygiene and nutrition. He may keep forgetting what he did recently whether he has eaten or not etc. Memory consists of 3 types immediate memory (remembering a phone number) short term memory and long term memory of past events. The last one is rarely lost so just because a person remembers what happened 20 years ago does not mean his memory is good. What he remembers of yesterday or today is more important.
    How is the condition diagnosed?
    The first step is to confirm the presence of dementia. This is done by examination and by asking questions about the day, date and month or subtracting one number from the other, telling something and checking after 5 minutes if that could be recalled. The next step is to look for the causes of dementia given in the beginning by careful examination. A MRI or CT Scan will tell if the patient has diseases like tumour, stroke, clot etc. or may suggest degenerative disease by showing atrophy of the brain. Nowadays a test for HIV disease and syphilis should be done. Deficiency of thyroid function (hypothyroid) and deficiency of some vitamins especially B12 and Folate should be checked. Lastly one should be careful of Pseudodementia. 
    What is Pseudodementia?
    This is a condition that looks like dementia but is actually due to psychologic problem like depression. The patient is depressed so he does not look after his clothes and when asked anything will say “ I don’t know”, suggesting he has poor memory and orientation. This repeated “I don’t know” is an important pointer. A patient of Alzheimer disease if asked the name of a month or year will always give an answer eg. Jan 1968 but a depressed person just keeps saying “I don’t know”, “I can’t remember” etc. Pseudodementia may form upto 10% of causes referred for dementia.
    How is dementia treated?
    Treatment includes a combination of medications, behavioural strategies and environmental interventions. A person with dementia should be under the care of a neurologist and a psychiatrist. Care should be taken to prevent deterioration of the condition by controlling the blood pressure and monitoring and treating high blood cholesterol and diabetes. All treatable causes of dementia outlined before should be looked for and treated.

    Drugs may be prescribed to treat behavioural problems such as anxiety, depression, agitation or problems related to sleep.

    A healthy, well balanced diet may help in maintaining an overall good health. Family members and friends may assist such people in their physical activities. They may assist in keeping them informed about the things happening around them by talking to them and giving them a patient hearing. It should be seen that their room is well lit and a proper temperature is maintained to avoid inconvenience to the person. Certain bold colours may be used to denote important areas in the room. Efforts should be directed towards providing the maximum ease and comfort to the person so that behavioural problems are not aggravated.


    What is the treatment?
    Although treatment depends on the cause, severity, and duration of the constipation, in most cases dietary and lifestyle changes will help relieve symptoms and help prevent them from recurring.


    A diet with enough fiber (20 to 35 grams each day) helps the body form soft, bulky stool. A dietitian can help plan an appropriate diet. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, brussels sprouts, cabbage, and carrots. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important.

    Lifestyle Changes

    Other changes that may help treat and prevent constipation include drinking enough water and other liquids, such as fruit and vegetable juices and clear soups, so as not to become dehydrated, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored. If the person is leading a sedentary lifestyle, the doctor will delineate an exercise regime to regulate activity of the alimentary tract. Bowel habits may also need to be improved to prevent another bout in the future.


    Most people who are mildly constipated do not need laxatives. However, for those who have made diet and lifestyle changes and are still constipated, a doctor may recommend laxatives or enemas for a limited time. These treatments can help retrain a chronically sluggish bowel. For children, short-term treatment with laxatives, along with retraining to establish regular bowel habits, helps prevent constipation. People who are dependent on laxatives need to slowly stop using them. For most people, stopping laxatives restores the colon’s natural ability to contract.

    Treatment for constipation may be directed at a specific cause. For example, the doctor may recommend discontinuing medication or performing surgery to correct an ano-rectal problem such as rectal prolapse, a condition in which the lower portion of the colon turns inside out.

    People with chronic constipation caused by ano-rectal dysfunction can use biofeedback to retrain the muscles that control bowel movements. Biofeedback involves using a sensor to monitor muscle activity, which is displayed on a computer screen, allowing for an accurate assessment of body functions. A health care professional uses this information to help the patient learn how to retrain these muscles.

    Surgical removal of the colon may be an option for people with severe symptoms caused by colonic inertia. However, the benefits of this surgery must be weighed against possible complications, which include abdominal pain and diarrhoea.
    What is constipation?
    Bowel movements may vary for each individual and across cultures depending on the intake of fibre in the diet. Normal bowel movements may vary from 3 per day to 3 per week. When a person has infrequent or hard stools or has to exert considerable effort while passing stool, he may be said to have constipation.
    What are the causes?
    Constipation may be due to various physiological and psychological conditions. Most people experience constipation that may be due to dietary changes, but this is temporary and corrects by itself. If it continues over a long period of time and recurs often, permanent dietary modification might be needed. Some of the common causes of constipation are:
    1. Poor diet – diets rich in animal meats but low in fibre are the most common cause of constipation. Fibre helps bowel movements to be easy and regular.
    2. Poor bowel habits - this is a common cause especially in children. Once children are toilet trained, they must be encouraged to go to the toilet regularly everyday. Adults usually suffer from the problem when they ignore the urge to evacuate over a long period of time. This may be because of lack of time or some other reason. After some time they stop getting the urge to use the toilet leading to progressive constipation.
    3. Fissures or haemorrhoids – certain painful conditions like anal fissures or haemorrhoids may prevent a person from wanting to evacuate. Such people have chronic constipation. 
    4. Inadequate physical activity.
    5. Hormonal changes as during pregnancy. 
    6. Anxiety, depression and other emotional conditions may sometimes cause constipation.
    7. Medications – certain medications such as those given for pain relief, depression and some narcotics cause constipation.
    8. Laxatives – many people who become used to taking laxatives for inducing bowel may become dependent on it and may have difficulty in evacuation without a laxative.
    What are the symptoms?
    The most common symptoms a person with constipation may experience are:
    • Infrequent passage of stool
    • Difficulty in bowel movement
    • Bloated feeling in the stomach after a meal
    • Feeling of incomplete evacuation
    • General feeling of discomfort and malaise.
    How is it diagnosed?
    There are no specific tests to diagnose constipation. The patient comes to know himself when he has trouble in passing stool. The doctor is then informed who will prescribe medications.


    Backpack safety
    Backpack safetyBackpacks are a popular and practical way for children and teenagers to carry schoolbooks and supplies. When used correctly, backpacks can be a good way to carry the necessities of the school day. They are designed to distribute the weight of the load among some of the body’s strongest muscles.

    However backpacks that are too heavy or are worn incorrectly can cause problems for children and teenagers. Improperly used backpacks may injure muscles and joints. This can lead to severe back, neck, and shoulder pain, as well as posture problems. Share these guidelines to help your family use backpacks safely.
    Choosing the right backpack
    Choosing the right backpackLook for the following tips while choosing backpack:
    • Wide, padded shoulder straps - Narrow straps can dig into shoulders. This can cause pain and restrict circulation.
    • Padded back - A padded back protects against sharp edges on objects inside the pack and increases comfort.
    To prevent injury when using a backpack
    To prevent injury when using a backpackTo prevent injury when using a backpack, following tips can be considered:
    • Pack light. The backpack should never weigh more than 10 to 20 percent of the student's body weight.
    • Always use both shoulder straps. Slingling a backpack over one shoulder can strain muscles. Wearing a backpack on one shoulder may increase curvature of the spine.
    • Organise the backpack to use all of its compartments. Pack heavier items closest to the centre of the back.
    • Use a rolling backpack. This type of backpack may be a good choice for students who must tote a heavy load. Remember that rolling backpacks still must be carried upstairs. They may be difficult to roll in snow.
    Parents also can help in the following ways
    Parents also can help in the following ways
    • Encourage your child or teenager to tell you about pain or discomfort that may be caused by a heavy backpack.
    • Consider buying a second set of textbooks for your student to keep at home.
    • Do not ignore any back pain in child or teenager. Ask your paediatrician for advice.
    Starting a new school
    Starting a new school
    • Your child may need some extra support if he is starting a new school. Talk with your child about his feelings, both his excitement and his concerns about the new school.
    • Visit the school with your child in advance of the first day. Teachers and staff are usually at school a few days before the children start. Peek into your child's classroom, and if possible, meet the teacher and principal.
    • Try to have your child meet a classmate before the first day so they can get acquainted and play together, and so your child will have a friendly face to look for when school begins.
    • Don't build up unrealistic expectations about how wonderful the new school will be, but convey a general sense of optimism about how things will go for your child at the new school.
    Making the first day easier
    Making the first day easierAlways try to make the first day of your child to school easy. Following are some tips for making the first day easier:
    • Remind your child that she is not the only student who is a bit uneasy about the first day of -school. Teachers know that students are anxious and will make an extra effort to make sure everyone feels as comfortable as possible.
    • Point out the positive aspects of starting school: It will be fun. She'll see old friends and meet new friends. Refresh her memory about previous years, when she may have returned home after the first day with high spirits because she had a good time.
    • Give your child some strategies for coping with bullies. He should not give in to a bully's demands, but should simply walk away or tell the bully to stop. If you have to, talk with the teacher about a persistent bully.
    • Find another child in the neighbourhood with whom your youngster can walk to school or ride with on the bus. If your child is older, have him offer to walk with or wait at the bus stop with a new or younger child.
    • If you feel it is appropriate, drive your child (or walk with her) to school and pick her up on the first day.
    School avoidance
    School avoidance
    • Sometimes when an adolescent loses interest in school, the signs and symptoms of this apathy may go beyond a poor report card. He might have severe anxiety attacks whenever he approaches school. He may complain of stomach pains, backaches, chest pain, and fatigue.
    • The physical symptoms, although real, are occurring in response to psychological distress. Some of the factors that contribute to this school avoidance may be familiar to you by now--from an intimidating bully at school to a problem with a teacher, from relationships with parents and difficulties at home (marital strife) to stress about entering a new school environment (starting junior high or high school).
    • Also, keep in mind that whether your youngster is concerned about violence or difficulties with a teacher, you may not be able to completely prevent him from experiencing pain in such a situation. But you might be able to help him see and choose alternatives that can ease his anxiety or make the problem less stressful.
    • One more point about school violence: if your teenager is the aggressor in such situations, you need to intervene immediately. Teach your youngster, through your words and actions, that violence is never an acceptable form of behaviour.
    School bus safety
    School bus safety
    • Wait for the bus to stop before approaching it from the curb.
    • Do not move around on the bus.
    • Check to see that no other traffic is coming before crossing.
    • Make sure to always remain in clear view of the bus driver.
    Homework tips
    Homework tips
    • Provide a positive homework atmosphere for your child that is free of clutter and distractions, including television.
    • Show your child you are interested in her work. Re-explain assignments if necessary, and check to see that homework is completed.
    • Having trouble fitting homework into your child's schedule? You may need to cut back on his activities, or see that after-school care includes supervised homework time.
    • If your child is struggling with a particular subject, and you aren't able to help her yourself, a tutor can be a good solution. Talk it over with your child's teacher first.
    Before and after school child care
    Before and after school child care
    • During middle childhood, youngsters need supervision. A responsible adult should be available to get them ready and off to school in the morning and watch over them after school until you return home from work.
    • Children approaching adolescence (the eleven-and twelve-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
    • Although being physically present is the best way to supervise a child, sometimes that is not possible. If alternative adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.
    • When evaluating child-care options, determine whether other family members can handle these responsibilities. For example, does a grandparent or other relative live nearby, and is he or she available and willing to help? Is there a responsible teenager-perhaps an older sibling-who can supervise your child for a couple of hours in the afternoon until you arrive home?
    • If you choose a commercial after-school program, inquire about the training of the staff. There should be a high child-to-staff ratio, and the rooms and the playground should be safe.
    Television (TV) tips
    Television (TV) tips
    • Set limits on the amount of TV your child watches. Be firm. Limit children's TV viewing to an hour or two daily. Before children watch television, they should do their homework and chores, but TV should not be used as a reward. Helping children find things to do instead of watching TV, such as sports, hobbies, or family activities, can make setting limits easier.
    • Help your child plan TV viewing in advance. Choose programs from TV listings at the beginning of each week. Keep copies of the family viewing schedule where everyone can see them (by the TV, in her bedroom, or on the refrigerator) as reminders.
    • Know what television shows your child watches. Watch TV with your child. When programs show sex, alcohol or drug abuse, or violence, talk about what you see. Help your child understand what he is watching. This is a good time to reinforce your own family values.
    • Do not permit TV watching during dinner. Dinner is often the only time that families are able to be together during the day. If the TV set is on at the same time, it will get in the way of talking to each other.
    • Do not allow your child to have a TV set in his bedroom. Not only will he tend to watch more TV, but he will probably stay in his room away from other family members. When a child watches TV in his own bedroom, it is harder for parents to guide his programme choices. He may get less sleep, causing him to be tired at school the next day.
    • Set an example of behaviour you wish to instill. If you want your child to read more that is what you should do. If you would like him to go outdoors for physical activity, make it a part of an enjoyable family exercise program.
    • If TV causes arguments or fights, simply unplug it for a while. Children can be creative when TV is not taking up all their time and attention.