Cumin

Scientific Name: Cuminum cyminum

Biological Background: A seasoning that is the principal ingredient of curry powder, a blend of powdered Indian spices. Cumin is a member of the parsley family and cumin seeds resemble caraway seeds. The aromatic seed has a characteristic strong, slightly bitter taste. Traditionally cumin has been used to flavor cheese, unleavened bread, chili, and tomato sauce.

Nutritional Information: Due to its use as a spice, cumin provides insignificant amount of nutrients.

Pharmacological Activity: Studies have indicated that cumin has strong anticancer activity, which may be due to its phytochemical cuminaldehyde. Cuminaldehyde also has strong antiinflammatory properties. In addition, cumin contains two phytochemicals, cuminyl ester and limonene, which have been shown to stop aflatoxin from binding to DNA to start the cancer process.

Eating Tips: Use cumin to add an earthy flavor to Indian, Middle Eastern, and Mexican cuisines.

Drink Water to Loose Weight?

Did you know that by drinking around 16 ounces (2 eight ounce glasses) of water before breakfast every day could enable you to loose over 6 pounds a year? Nothing else is required.

Drinking water before a meal helps to curb your appetite. In a study with overweight and obese participants at Virginia Tech they found that the subjects that drank 2 glasses of water before their meal ate 75 calories less than those who didn’t drink the water. Some didn’t even realize they had eaten less.

If you add up these calories, 75 calories a day becomes 27,375 calories a year. And, 27,375 calories (3500 calories per pound) comes to just under 8 pounds. This is without dieting…just drinking that extra water. (Think if you drank 2 glasses of water before lunch or dinner instead?)

Why is this considered important? Well, research shows that small behavioral changes that don’t seem to be a big deal can actually translate into different eating behaviors.

Another small change can be to eat on a smaller plate. And leaving the chicken bones on your plate instead of having the waitress remove them is another.
These little tips have all been shown to unconsciously influence how much you eat. And, all take just about zero effort or willpower!

What other little things can you think of to change your eating habits that would be pertinent to your own lifestyle to help you consume fewer calories?

New Thoughts on How to Loose Weight

Hey, are you tired of the ”same old, same old” weight loss methods? I think most of us who are constantly trying to loose weight are now just about immune to the old conventional ways we’ve been instructed in for shedding those excess pounds.

Ready for a change? Well, here are some refreshing new angles on the age-old need to help us loose weight.

WebMD asked diet experts to come up with some lesser-known diet tips that could make the most jaded dieter drop that cookie and vow, “Oh wow! I’ll try that today.”

Here are nine diet tips you may not have heard yet. Some involve different ways to eat, or adding certain foods to your diet. Others involve learning new behaviors or strategies to help you stay on track.

Weight Loss Tip No. 1: Variety Is Overrated

Who hasn’t heard the advice to “just take a bite of everything” if you’re at a buffet?

But as it turns out, variety doesn’t deserve its good reputation, says Dawn Jackson Blatner, RD, a Chicago dietitian and spokeswoman for the American Dietetic Association.

“We know that variety makes you eat more,” she says, citing several published studies and her own experience in counseling weight loss patients.

For example, researchers in France found that study participants ate more french fries when they were offered catsup and mayonnaise along with them. And when they were given the option of having cream or whipped cream with their brownies, they ate more than when the brownies were offered plain.
Other researchers have found that people who have been able to maintain weight loss tend to eat diets with limited variety.

Weight Loss Tip No. 2: Have Barley for Breakfast

“Barley is the new oatmeal,” says Jackson Blatner.

Barley got its hunger-fighting reputation after Swedish researchers found that eating barley or rye kernels for breakfast kept blood sugar on an even keel. That’s because the carbs in barley and rye kernels are “low glycemic index,” meaning they raise blood sugar more slowly than some other carbohydrate foods. This helps you avoid a spike, and then a drop, in blood sugar, which can leave you feeling famished.

One caveat: “Buy hulled barely, not pearl barley,” Jackson Blatner says. The Swedish researchers used minimally processed hull barley, and they can’t vouch for the same effects for more processed forms, such as pearl barley.

Weight Loss Tip No. 3: Beef Up Your Lunch Salad

One of the most common mistakes dieters make is to eat a vegetable salad with little or no dressing for lunch, says Joan Salge Blake, RD, professor of nutrition at Boston University and a spokeswoman for the American Dietetic Association. “Then they are starving by mid-afternoon,” she says.

A salad is a great choice, she says, if you add some protein and a little fat to help keep you feeling full longer.

Top your greens with a 3 oz piece of chicken breast, and you’ve added about 26 grams of protein but just 140 calories. Add about two tablespoons of light salad dressing, and your salad may be filling enough to get you through the 3 p.m. hunger slump without hitting the vending machine.

Weight Loss Tip No. 4: Stock Up on Frozen Vegetables

Sure, fresh vegetables are delicious and nutritious. But faced with the need to scrape a carrot, wash and slice a zucchini, or cut broccoli into florets, many of us say, “Too much trouble!” and reach for chips instead.

To make things easier, stock your freezer with frozen vegetables, Blake tells dieters.

“They are already clean, chopped and ready to cook in the microwave,” she says. “It’s like having Rachael Ray in the freezer.”

An even better way to be sure you eat more vegetables: Cook the frozen veggies ahead of time. Microwave the whole bag of green beans, for instance. Then keep them in the refrigerator, ready to dump into canned soups, add to a salad, or just eat by the handful.

Weight Loss Tip No. 5: Make Yourself a Party Tray

The type of party tray Jackson Blatner is talking about is a big vegetable platter, maybe with some low-fat dip on the site — the kind you put on the buffet for weight-conscious guests.

But this one is just for you and any interested family members. Keep it in the fridge at eye level, encouraging you to snack healthy and avoid the higher-calorie contents of your refrigerator.

Several studies have found that we tend to eat more when food is within easy reach. Secretaries who placed candy on their desks ate about 48% more than when the candy was 6 feet away, according to research by Brian Wansink, PhD, director of the Food and Brand Lab at Cornell University.

Weight Loss Tip No. 6: Turn Down the Thermostat

Spending time in a chilly house — about 61 degrees Fahrenheit — may boost the fat-burning power of the “brown fat” in your body.

Brown fat is considered “good” fat, as opposed to regular or white fat, which stores calories and tends to accumulate. Researchers believe that lean people have more of the brown type of fat, and that the amount of brown fat a person has declines with age.

Scandinavian researchers found that exposure to these chilly temperatures boosted the metabolic rate of brown fat 15-fold, helping burn more calories.
But Jackson Blatner cautions not to expect too much: “It’s not going to be any kind of a miracle,” she says. And beware if you’re the type who eats more when you feel cold.

Weight Loss Tip No. 7: Downsize Your Dinnerware

Experts say they’ve seen it again and again: The larger your plate, the more you’re likely to put on it. So serving your meals on smaller plates can help you eat less.

But don’t throw out those dinner plates, Blake suggests. Use the smaller, lunch-size plates to serve dinner, and use the dinner plates for salads.

Weight Loss Tip No. 8: Go Out for Treats

If you’re the type who overdoes it on sweets and snacks, Jackson Blatner suggests, make yourself work a little for your favorite indulgences. Don’t keep them in the house, but give yourself permission to go out and get them when you really need to.

Want a brownie? You have to go to the bakery. Craving a frozen yogurt? You must find the nearest frozen yogurt shop.

“The more hassle tasty treats are, the less likely you are to eat them,” says Jackson Blatner, who does this herself and finds her sweets consumption has declined without making her feel deprived.

Weight Loss Tip No. 9: Try on Your Skinny Jeans Every Friday

Find a pair of pants that is tight, but not impossible to zip, Blake suggests to her weight loss patients. “Every Friday morning, try them on,” she says.

Why Friday? Weekends are typically a tougher time to stay on diets, she says. And the Friday morning try-on will motivate you to watch your eating during the weekend.

“If they are loose, you will say to yourself ‘I am making progress, I am staying on track during the weekend,”’ she says.

And if they’re snug? That will provide motivation to stick to your diet so they’ll fit better next week, she says.

EAT Vegetables!

It is well known that the more vegetables you include in your diet, the less susceptible you are to practically every major disease.

Why? Because vegetables are rich in antioxidants and nutrients which are thought to prevent sickness and disease coming to our cells and they also promote healthy cell growth.

Vegetables need to be the centerpiece of our diets. Their amazing nutritional power gives us great health and helps our body cells rejuvenate themselves. It’s been suggested that we eat mostly vegetables, less meat, fish or poultry and some whole grains for better health.

Vegetables, by themselves are naturally low in fat and calories and we need to lay off the cream sauces, margarine, or dips to keep them that way,

Still a veggie skeptic? I hope to convert you with these strategies to help you harness their amazing nutritional power:

Here are some strategies from tennis pro, Martina Navratilova to help you get the most out of your vegetables.

1-Set a goal for the number of veggie servings you will eat daily. Start gradually at the lower range of two servings a day, or try to eat at least one fresh vegetable a day.

2-Go green. The greener the leaf, or the veggie, the more anti-aging compounds it contains. So aim to enjoy one mixed salad a day.

3-Color your plate. Colorful veggies are proven fighters of aging, cancer, and heart disease, because they contain a boatload of nutrients. Try to include several servings of yellow, red, orange, and purple vegetables in your meals each week.

4-Drink your veggies. Juicing is the easiest way to “eat your veggies.” As I do, try to have at least one tall glass of fresh juice daily. If you do not have a juicer, stock organic vegetable juices, and mix them up.

5-Do not fear starchy vegetables. Instead, charge-up your batteries with healthy carbs. Include the following in your weekly diet: corn, potatoes, peas, sweet potatoes, and yams.

6-Season your foods with chopped garlic or onion. They may make your breath lousy for awhile, but these foods are packed with flavor and health-building, disease-fighting phytochemicals.

7-Try a new vegetable every week. Step out of your comfort zone, try a new veggie, and experiment with how to cook it. Did you know, for example, that you can substitute spaghetti squash or julienned zucchini for pasta and never know the difference?

8-Set a veggie goal. You might, for example, aim to include at least two vegetables with lunch and dinner. Then step it up: Double your portion of vegetables at lunch or dinner.

9-Eat vegetables raw whenever possible. Generally, raw produce is healthier. In one interesting study, blood levels of vitamins A and E rose significantly in people who ate raw fruits and vegetables for just one week. One exception to the “raw rule”: When cooked, carrots yield more nutrients.

10-Cook veggies for the shortest amount of time possible. Short-term microwaving, steaming, stir-frying, grilling, and other such quick-cooking methods preserve the greatest amount of nutrients. By contrast, prolonged exposure to heat, water, and air destroys vitamins in vegetables.

11-Veg-up your favorite foods. Sneak veggies into soups and stews. If you love pizza, order one topped with vegetables.

Veggies are probably the best fuel you can put in your body, when you get right down to it. Try a few of my suggestions, and your body will thank you for it.

Schools fight families over autism service dogs

At issue is whether the dogs are true ‘service’ pets or simply companions

Robin Scholz / AP Kaleb Drew, 6, grabs on to the tail of his autism service dog, Chewey, as they play in the backyard of their home after Kaleb's first day of school in Villa Grove, Ill., on Friday, Aug. 21. View related photos

CHICAGO - Like seeing-eye dogs for the blind, trained dogs are now being used to help autistic children deal with their disabilities. But some schools want to keep the animals out, and families are fighting back.

Two autistic elementary school students recently won court orders in Illinois allowing their dogs to accompany them to school. Their lawsuits follow others in California and Pennsylvania over schools' refusal to allow dogs that parents say calm their children, ease transitions and even keep the kids from running into traffic.

At issue is whether the dogs are true "service dogs" — essential to managing a disability — or simply companions that provide comfort.

School districts say they are not discriminating, just drawing the line to protect the safety and health of other students who may be allergic or scared of dogs.

"The school district has 650 students, not just one. So we have to balance," said Brandon Wright, attorney for the Villa Grove district in central Illinois, which objected to 6-year-old Kaleb Drew's plan to bring his yellow Labrador retriever, Chewey, to school.

Kaleb's family won a judge's order in July allowing the dog to come to class until a trial, set to start Nov. 10. That means when Kaleb starts his first full day of first grade Monday, Chewey will be by his side.

Service dogs have long been used by the blind, but training them to help those with autism is relatively new. While there's little research on how these animals affect autistic children, families like Kaleb's say they have seen marked improvement. And the support group Autism Speaks includes a list of dog-training groups among resources on its Web site.

Autism is a developmental disorder that involves behaviors such as poor eye contact, trouble communicating and repetitive movements such as rocking or hand-flapping. Those with the disorder are prone to outbursts and may have trouble with changes in their environment.

Calming canine influence
The dogs are trained to be a calming influence, providing a constant between home, school and other new places. Sometimes, as in Kaleb's case, the dogs are tethered to children to prevent them from running off in dangerous situations.

"It's done so much more than we thought it could," said Kaleb's mother, Nichelle Drew. "We want Kaleb to be able to experience more of life," and the dog has helped him do that, she said.

Chewey does not react when Kaleb "throws a fit" during times of transition from one activity to another, which calms him much more quickly, Drew said.

The tether fitted around Kaleb's waist helps the dog stop Kaleb from running into traffic at pickup time, as he is prone to do.

Under the federal Americans with Disabilities Act, "a person with autism would be considered a person with a disability in nearly all cases, and a service animal is any guide dog, signal dog or other animal individually trained to provide assistance to someone with a disability," said Alejandro Miyar, a spokesman for the Department of Justice.

Miyar declined comment on specific cases but said schools are required to make accommodations for disabled students to use a service animal. Illinois is among several states with similar laws.

Schools, though, can argue that the animals do not provide a functional service. Wright said Kaleb's school already provides him with adequate special services. Officials believe Chewey is more of a companion or comfort dog, not a true service dog.

Elizabeth Emken, vice president of government relations for Autism Speaks, said her 17-year-old autistic son has used a service dog for about two years.

Emken said the dog helps control her son's pacing and circling, but the family opted against allowing the boy to take the dog to school because she did not know if he would be able to manage the dog effectively.

Weighing the pros and cons
"Personally, I can see the pros and cons" of allowing the animals in schools, Emken said, though she believes schools should not ban the assistance.

Families of autistic kids elsewhere have fought similar battles, including recent cases in Manteca, Calif., about 70 miles northeast of San Francisco, and North Franklin Township, Pa., near Pittsburgh.

And cases involving other disabilities, including deafness and diabetes, have cropped up in other states.

On Thursday, a judge sided with a family in Columbia, near St. Louis, that sued over their school district's unwillingness to allow an autism service dog in a special education pre-kindergarten classroom.

Still, 5-year-old Carter Kalbfleisch will not have the dog with him when he starts classes Monday. A hearing is scheduled that day so the school can work out the logistics of accommodating the dog, which his family credits with helping stop the boy from running off and keeping him from eating things like rocks.

The case still could head to trial, though the family's attorney, Clay St. Clair, said Friday the initial ruling is based on the Illinois law allowing service animals in school. The district did not return calls.

"I don't know if it would have been a simpler issue if we were dealing with a guide dog or something the school board was a little more familiar with," St. Clair said.

Copyright 2009 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

CDC: No ‘red flags’ in swine flu vaccine tests

No side effects seen 10 to 14 days after first studies in adults

	A nurse tests a woman for swine flu on Thursday at the Noumea flu treatment center in the French Pacific territory of New Caledonia. View related photos
Marc Le Chelard / AFP - Getty Images

Back-to-school swine flu checklist Aug. 17: What can you do to keep your kids safe and healthy when they return to school? NBC’s chief medical editor, Dr. Nancy Snyderman, has tips to help keep children safe from the swine flu this back-to-school season.

Swine flu vaccine testing on humans CDC: Screen schools for H1N1 Swine flu trials under way Priorities set for swine flu vaccine

Interactive map

Flu activity around the country A state-by-state look at the geographical spread of both seasonal flu and swine flu (H1N1) in the United States.

Q&A

Swine flu Learn about the virus found in pigs and why it is causing concern among health officials. msnbc.com

Community

Discuss: How concerned are you? Tell us: Are you making changes to prevent infection? Vote: Would you wear a face mask? Poll: Have you changed your travel plans? Poll: Would you stay home if swine flu spread to your city? Ask us your questions about swine fl

Clinical trials for the new swine flu vaccine have turned up no "red flags," U.S. health officials said on Friday.

The first results from studies of the new vaccines in adults and the elderly will be available in mid-September, but so far, the only complaints seem to be a bit of local soreness and redness in the arm at the injection site, they said.

"There are no red flags regarding safety," said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, one of the National Institutes of Health.

Fauci said no side effects were seen 10 to 14 days after the first studies in adults, giving health officials the confidence to start trials of the vaccines in children this week.

There is no sign yet of whether the new vaccines will produce enough of an immune response to protect people against the new pandemic H1N1 flu.

Two trials are underway in adults for the safety and effectiveness of two doses of the vaccine. The trials, which are also looking at whether one or two vaccinations will be needed, are nearly fully enrolled.

"We expect first dose data somewhere around mid-September if all goes well, and second dose data by mid-October," Fauci said in a telephone news briefing.

He said first dose data from the trial in children will be available in late September, and second dose data will be ready in late October.

Fauci said studies in pregnant women should begin in early September, as will studies using an immune system booster called an adjuvant. In all, the vaccines will be tested on nearly 4,600 people.

The Centers for Disease Control and Prevention said swine flu is still spreading widely across the United States, with 75 percent of serious cases and 60 percent of deaths among people under the age of 49. Alaska and Maine had "widespread" activity.

CDC has officially confirmed 7,963 hospitalizations and 522 deaths from the pandemic H1N1 flu, said CDC's Dr. Jay Butler. He said there were likely more than a million actual cases, as most patients never get tested.

"It is important to remember that at this time of year we don't normally have influenza," Butler said.

‘Explosion’ in case numbers
On Friday, the World Health Organization warned that the global spread of swine flu will endanger more lives as it speeds up in coming months and governments must boost preparations for a swift response.

WHO's Western Pacific director Shin Young-soo predicted there will soon be a period of further global spread of the virus, and most countries may see swine flu cases double every three to four days for several months until peak transmission is reached, said

"At a certain point, there will seem to be an explosion in case numbers," Shin told a symposium of health officials and experts in Beijing. "It is certain there will be more cases and more deaths."

WHO has declared the swine flu strain a pandemic, and it has killed almost 1,800 people worldwide through last week. International attention has focused on how the pandemic is progressing in southern hemisphere countries such as Australia, which are experiencing winter and their flu season.

WHO earlier estimated that as many as 2 billion people could become infected over the next two years — nearly one-third of the world's population.

Separately, in new advice issued to health officials, the WHO said healthy people who catch swine flu don't need antiviral drugs like Tamiflu. Rather than using it to treat healthy people, the drug should be used to treat people in groups at risk for the virus. That includes children less than five years old and people over age 65, among others.

The new advice contradicts government policies such as those in Britain, which has been giving out Tamiflu to all people suspected of having swine flu.

In the U.S., Fauci said the government expected to have 45 million to 52 million swine flu vaccine doses by mid October, when vaccination is expected to begin, and 195 million by the end of the year.

Fauci said even after people are vaccinated they should be aware they are not immediately protected — the immune response from a vaccine takes about two weeks to develop.

Five companies are making both seasonal and H1N1 flu vaccines for the U.S. market —AstraZeneca's MedImmune unit, CSL, GlaxoSmithKline Plc, Novartis AG and Sanofi-Aventis SA.

Fauci said he expects an upsurge of flu cases in the autumn, as weather cools and students return to school. U.S. government officials have urged schools and businesses to encourage people to stay home when they are sick, to wash their hands frequently and keep workspaces clean.

Butler said reports from Chile that turkeys have become infected with H1N1 virus are not a surprise. "Because of the swine characteristics of this virus, it can have the capacity to infect turkeys," he said.

Hospitals may be overwhelmed
WHO has stressed that most cases of swine flu are mild and require no treatment, but the fear is that a rash of new infections could overwhelm hospitals and health authorities, especially in poorer countries.

Shin said governments must act quickly to educate the public, prepare their health systems to care for severe cases and protect those deemed more vulnerable to prevent unnecessary deaths.

"We only have a short time period to reach the state of preparedness deemed necessary," Shin said. "Communities must be aware before a pandemic strikes as to what they can do to reduce the spread of the virus, and how to obtain early treatment of severe cases."

Pregnant women face a higher risk of complications, and the virus also has more severe effects on people with underlying medical conditions such as asthma, cardiovascular disease, diabetes, autoimmune disorders and diabetes, WHO chief Margaret Chan said in a video address.

Anorectal Abscess

The last phase of the digestive process is the collection of and passing from the body of solid wastes. These wastes (what's left of what we eat after the water and nutrients have been taken by our bodies) collect in the rectum and then are expelled through the anus.

The inside of the anus is lined with glands and four to six crypts or pockets. Sometimes one of these pockets gets filled with stool. This can cause the gland to become infected and develop an abscess.

Symptoms

Signs of an anorectal abscess include:

• Fever
• A vague feeling of being unwell or uncomfortable
• Swelling and discomfort around or near the anus
• Redness around the area
• Drainage of pus or fluid from the area

Causes and Risk Factors

This type of abscess is usually happens when the glands in the area of the anus or rectum become infected. When an infection occurs in a gland, it can create a cavity that fills with pus. The cavity swells and causes constant pain and discomfort. The skin may look red and swollen and drain pus.

Diagnosis

A doctor will take the patient's medical history and do a physical examination. Diagnosis will be based on the symptoms and the presence of pain or tenderness, swelling, redness and possible drainage of pus from the area.

The presence of a fever or an elevated white blood cell count as measured by a blood test can confirm the presence of an infection in the body.

Treatment

Antibiotics alone are rarely enough to treat this type of infection. Usually surgical drainage is required.

In about half the cases where an abscess has drained, a fistula (an opening between the inside of an anal pocket or gland where the infection started and the outside of the body where it drained) can develop. A fistula will not heal without treatment that involves removing the pocket where the infection started.

Resources at Cedars-Sinai

Atrial Fibrillation

Atrial fibrillation occurs when electrical impulses in the upper chambers of the heart (atria) begin in multiple sites in a chaotic pattern and are sent rapidly to the heart's lower chambers, causing them to contract irregularly and quickly. The fibrillation or irregular heartbeat can occur for a few minutes, weeks or can continue for a lifetime. Episodes of atrial fibrillation that are brief or intermittent are termed "paroxysmal" while episodes that last longer requiring treatment are referred to as "persistent."

During atrial fibrillation, the atria do not pump blood as effectively as they normally should. In some cases, blood in the atria, which is not being pumped out effectively, can stagnate and clot. If these clots break up or break off, they may pass into the left ventricle, travel through the blood stream and block a smaller artery. If this happens in the brain, it can cause a stroke. Therefore, diagnosis, careful monitoring and treatment are all important aspects of managing atrial fibrillation.

Symptoms of Atrial Fibrillation

Symptoms of atrial fibrillation depend on how rapidly the heart is beating. If it remains below 120 beats a minute, there may be no symptoms other than the irregular or increased pulse. If the rate is higher, there may be heart palpitations or discomfort felt in the chest.

Other symptoms may include:

• A feeling of weakness
• Dizziness or faintness
• Shortness of breath
• Chest pain, especially in adults who are older than 65
• Rarely, blood pressure may fall and cause shock. This usually only occurs in individuals who also have severe heart disease.

Causes and Risk Factors of Atrial Fibrillation

Atrial fibrillation can be caused by heart diseases, such as coronary heart disease, high blood pressure, congestive heart failure or abnormalities of the heart valves. They can also be caused by another conditions, such as alcohol abuse, an overactive thyroid gland (hyperthyroidism), or a birth defect affecting the heart. Rheumatic fever (which often leads to damage to heart valves) and high blood pressure cause the atria to enlarge, making atrial fibrillation more likely. The risk of atrial fibrillation and atrial flutter also increase with age.

Abdominal Pain - Unexplained

Pain and other abdominal symptoms can signal any number of problems. These range from indigestion to cancer.

Symptoms

Some of the more serious conditions associated with abdominal pain include:

• Acute pancreatitis may cause general, constant and worsening pain in the upper abdomen. Sometimes the pain moves to the upper back. Other possible symptoms are weakness, shortness of breath and nausea.
  
• Appendicitis starts as general abdominal pain that settles into the lower right side.
  
• Biliary colic can cause a steady ache in the upper right abdomen. Sometimes the pain spreads to the upper back. Patients may also experience nausea and vomiting.
  
• Crohn's disease can present symptoms similar to appendicitis. These include pain in the lower right side and bloody diarrhea.
• Diverticulitis can cause moderate pain in the lower left side of the abdomen that grows worse over time.
  
• Gallstones may produce severe, cramping pain in the lower right part of the abdomen. Pain may spread to the back.
• Gastroesophageal reflux disease (GERD) causes a burning sensation or discomfort after eating. This occurs especially when the patient is lying down or bending over. GERD may also produce pain in the chest that awakens the patient at night. Other symptoms can be very similar to those of a heart attack.
  
• Hepatitis may cause pain in the upper right abdomen, nausea and vomiting.
  
• Pancreatic cancer may produce the same symptoms as pancreatitis.
  

Treatment

New technologies, such as video cameras that can be swallowed, are now available. These cameras can help diagnose gastrointestinal problems, including unexplained abdominal pain, bleeding with an unknown cause or anemia.

The tiny video camera is swallowed and then eliminated in about 24 hours. The camera sends data to receivers placed on the patient's body. A recorder worn on the patient's belt collects the data. Using special software, the doctor can process the data and produce a video with information from the digestive tract. The camera itself is disposable. Patients can continue normal daily activities while the camera is working.

Resources at Cedars-Sinai

• Samuel Oschin Comprehensive Cancer Institute
• GI Motility Program
• Inflammatory Bowel Disease Center
• Pancreatic and Biliary Diseases Program
• Pediatric Inflammatory Bowel Disease Center

Why Haven't I Ever Heard of Biotoxins, Neurotoxins or Biotoxin Illness Before?

You probably have heard of it, only it was called something else like Chronic Fatigue Syndrome (CFIDS), Fibromyalgia, Chronic Lyme Disease (CLD), Mold Illness, or ADHD (see "Other Names for Biotoxin Illnesses" below). The discoveries and the science behind how biotoxins and neurotoxins are involved in these illnesses and disorders is fairly new. The goal of this site is to provide information to both patients and physicians, to increase awareness regarding causes of Biotoxin Illness and highlight new clinical treatment discoveries. In the few months our new site has been up, we have reached many people, mainly in the United States and Europe. Many MD's are adopting Dr. Shoemaker's protocols and we are working on providing formal training for those individuals. Biotoxin Illness is still controversial and we are working to publish new peer-reviewed papers that can start to change the way doctors currently think. In the meantime, patients must continue to advocate for their rights and pursue the treatments that they feel are best for them. Ritchie Shoemaker, MD presented some fairly recent Chronic Fatigue research and treatment findings at The International Association for Chronic Fatigue Syndrome conference held in Fort Lauderdale, Florida in January of 2007. We have also just completed a soon to be published ground-breaking study on the health effects of mold exposure. Many progressive doctors around the country endorse the use of our on-line BIRS© test and the cholestyramine-based treatment protocol pioneered by Ritchie Shoemaker, MD. Remember though, that medical advances are ultimately driven through peer-reviewed publication in medical journals. These studies are expensive and time consuming and our recent peer-reviewed publications will help advance these discoveries into mainstream medicine. Many more doctors are becoming aware of biotoxins and the role they play in chronic illness.

That said, many leading experts in mold illness and exposure, chronic fatigue syndrome (CFIDS), fibromyalgia and Acute or Chronic Lyme Disease (CLD) are familiar with, and use our screening test and cholestyramine protocol. For example, Dr. Jacob Teitelbaum, Chief Medical Officer of the Fibro and Fatigue Center Clinics, has included a chapter on Dr. Ritchie Shoemaker's biotoxin discoveries and how they relate to CFIDS and Fibroymylgia in the updated revision of his book titled From Fatigued to Fantastic!, which was published in 2007. Additionally, Dr. Shoemaker testified about the human health effects of mold exposure for the US Congress in January of 2006.

Biotoxins play a large role in Chronic Lyme Disease (CLD) and our research in this area is recognized by many preeminent Lyme Literate MD's (LLMD's). A recent presentation summarizing the role of biotoxins in Lyme Disease was given by ILADS member Eric Gordon, MD and is available by clicking here . Another example is found in the monograph Diagnostic Hints and Treatment Guidelines for Lyme and Other Tick Borne Illnesses , published in 2005 by Joseph Burrascano, MD, (click here for the webcast of Dr. Burrascano speaking about Neurotoxins/Biotoxins in Lyme Disease. He acknowledges that:

"Two groups have reported evidence that Borrelia, like several other bacteria, produce neurotoxins. These compounds reportedly can cause many of the symptoms of encephalopathy, cause an ongoing inflammatory reaction manifested as some of the virus-like symptoms common in late Lyme, and also potentially interfere with hormone action by blocking hormone receptors. At this time, there is no assay available to detect whether this compound is present, nor can the amount of toxin be quantified. Indirect measures are currently employed, such as measures of cytokine activation and hormone resistance. A visual contrast sensitivity test (VCS test) reportedly is quite useful in documenting CNS effects of the neurotoxin, and to follow effects of treatment. This test is available at some centers and on the internet.

It has been said that the longer one is ill with Lyme, the more neurotoxin is present in the body. It probably is stored in fatty tissues, and once present, persists for a very long time. This may be because of enterohepatic circulation, where the toxin is excreted via the bile into the intestinal tract, but then is reabsorbed from the intestinal tract back into the blood stream. This forms the basis for treatment."

Health women health natural health healthy food men's health alternative medicine familys health health diet and nutrition healthy child adoption healthy aging weight loss tips health conditions healthy shopping

Dangers of Iron Supplements

© Leo Galland M.D., F.A.C.N.

Iron is unique among essential minerals, because there is no mechanism for its excretion once absorbed into the body. Whatever iron is absorbed must either be used or stored and excessive storage of iron in the body promotes the generation of free radicals. Excess dietary iron has been implicated by some scientists as a cause of cancer and heart disease. It also increases the risk of bacterial infection. Except for the lactic acid bacteria like Lactobacilli, all microbes require iron for growth. Many of them produce special binding proteins to secure iron from their environments. Humans also produce iron-binding proteins which have as their role the capture of free iron so that microbes can't use it. An excess of iron overcomes this protective mechanism and in-creases susceptibility to bacterial infection. The amount of iron needed for optimal health reflects a delicate balance between deficiency and excess. The best known effect of iron deficiency is anemia, which is the name given to a state in which the number of red blood cells is lower than normal. Anemia is not the same as iron deficiency, however. There are many different causes of anemia, which include folic acid deficiency, vitamin B12 deficiency, disorders of the bone marrow and conditions which increase the rate at which red blood cells are broken down in the spleen. Iron deficiency, when mild, may not produce anemia but may still cause fatigue, im-mune de-fects or fungal infections of skin. There are probably twenty million people in the U.S. who are iron deficient and half of them are not anemic. Wom-en with chronic fatigue and mild iron deficiency who are not anemic improve their energy after taking low doses of iron. Twenty milligrams per day is all that's needed, no more. Low-dose iron supplements can cure people with recurrent boils on the skin, but only if those people have mild iron deficiency. Presumably, correcting iron deficiency improves metabolism and immunity. It is unfortunate that most commercial iron pills contain sixty to three hundred milligrams of iron, far more than are needed or than can even be absorbed from a single pill. High dose iron supplements, taken orally or by injection, increase susceptibility to bacterial infec-tion. Studies in southeast Asia and in Africa demonstrate that even low-dose iron can be harmful. When Indonesian school children who are not iron deficient take iron pills, they fail to grow normally. When iron supplements are given to Somali nomads or Masai tribes-man, their rate of infection increases, even though their iron deficiency is corrected. The high frequency of negative responses to iron supplements in Africa and Asia may reflect the interaction between iron and zinc. Iron in food or pills interferes with zinc absorption and supplemental iron can aggravate zinc deficiency. The recommended daily allowance for zinc (RDA) is based on the assumption that forty per cent of the zinc that is swallowed is absorbed into the body. Actually, zinc absorption is only seventeen to thirty-five per cent and depends upon what is eaten along with zinc. Starch and fiber interfere with zinc absorption, as do calcium and iron. Lack of stomach acid, which may be caused by infection or acid-lowering drugs, also interferes with zinc absorption. Zinc deficiency is common in Africa and Asia, where people consume large quantities of milk, which is high in calcium and low in zinc, and of starches and fibres which inter-fere with zinc absorption. Zinc deficiency profoundly depresses immunity and administering iron to a zinc-deficient person is extremely risky. Not only does iron stimulate bacterial growth, but, by aggravat-ing zinc deficiency, it weakens the immune system of the person being supplemented. No one should ever take iron supplements unless iron deficiency is present, with the possible exception of pregnant women. The best test for iron deficiency is a blood test called the serum ferritin level. Ferritin is a protein that carries iron, and low ferritin levels are a common sign of iron deficiency. Like all laboratory tests, the interpretation of ferritin levels is subject to interpretation. Because the body has a limited capaci-ty for iron absorption, it does not make any sense to administer more than twenty milligrams of elemental iron at a time. Iron should not be taken as part of a multivitamin or multimineral preparation. Iron interferes with the absorption of the essen-tial minerals zinc, manganese and molybdenum; it destroys vitamin E; its own absorption is blocked by calcium and magnesium. Iron is best absorbed after a meal, with a small quantity of vitamin C (between one hundred and five hundred milligrams).

Archived columns by Leo Galland M.D., F.A.C.N.

H1N1 (Swine) Flu Vaccine Recently Announced

Two weeks ago, the Swiss pharmaceutical company Novartis announced that it had produced the first batch of a vaccine to fight the H1N1 (swine) flu virus. Vaccine production is underway, and clinical trials will begin in July. The expectation is that the vaccine will be available to the public in September.

Health Net will follow the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommendations on use of the vaccine when it is available.

We will keep work to keep our members updated as to any further developments. In the meantime, we urge you to take all appropriate steps to stay healthy.

Jonathan Scheff, M.D.
Chief Medical Officer
Health Net, Inc.

What's Adoption?

How is a family created? Often, we think of families being made when a woman gives birth to a child. But adoption is another way families are created. Adoption means a legal process that allows someone to become the parent of a child, even though the parent and child are not related by blood.

In other words, a woman and man are not the kid's "birth parents." The child did not grow inside the woman's body. But in every other way, adoptive parents are the child's parents. By going through this legal process of adoption, they are promising to take care of the child and make him or her part of their family.

Being a parent is a lot of work, but having a family also makes grown-ups very happy. Kids make almost anything more fun, so it's no wonder people want to have them in their lives.

Some people choose to adopt because they have medical problems that make it impossible for them to have their own biological (say: bi-oh-law-jih-kal) children. Some single adults, although they don't have a partner or don't want to get married, really want to be parents.

Other kids might get adopted when one of their parents remarries. The new husband or wife might adopt the kids as a way to show that they are all one family now.

It often takes a lot of time and effort to adopt a child. Some people wait for years to adopt a baby. Adopting a child is not like shopping for a new coat. You don't just pick one off the rack and take it home.

How Does Adoption Work?

Adoptions are usually handled by a government agency or a private group. These groups work hard to investigate the people who say they want to adopt a child. Before letting them adopt a child, adoption workers need to find out a lot of stuff about the adoptive couple. They would want to know if either of them had ever done anything wrong, like committing a crime. They do not want kids to be adopted by people who might not take good care of them.

The adoptive couple also has to meet with social workers and others to explain why they want to adopt a child. They're also asked other questions to find out how they feel about kids and how they might solve problems, such as arguments, that happen in every family. The agency wants to be sure that children are adopted into homes where they will grow up happy and loved.

It's good that many people want to adopt kids, but why do kids need to be adopted? Most kids are not adopted. They grow up with their birth parents. But sometimes, a woman has a baby when she is young and before she's able to take good care of it. Other times, when babies are adopted from other countries, the baby's mom could be older and might even have other children already.

Why Do Kids Need to Be Adopted?

Babies are big responsibilities. You need to have enough money for the diapers, clothes, and other supplies the baby will need. A parent also must be willing to work very, very hard. Parents need to wake up in the middle of the night when the baby needs to eat. They also can't go out with their friends any time they want. Why? Because someone needs to watch the baby. And it can be hard for someone to have a baby and still be in school or college. Even if a woman is willing to care for the baby, raising a child might be very hard — or even impossible — if the woman is poor and lives in a poor country.

It's a very hard choice, but some women decide their babies would have better lives if they lived with adoptive parents. Often, adoptive parents are older and more able to handle the responsibilities that come with being someone's mom or dad. In some cases, an older child may be adopted because his or her birth parents tried to take care of him or her, but did a poor job. The child may have been abused or neglected and it was decided that a new home was needed. Sometimes a child lives with a foster family for a while before being adopted.

With some adoptions, the birth mother or father can stay involved in the kid's life. That doesn't mean the kid would live with the birth mom or dad, but the kid may see him or her once in a while or exchange letters or photographs. Other times, the kid doesn't get to see his or her birth parents.

No matter how this works out, it can be hard to understand. Kids may feel sad about it and have a lot of questions. Don't be afraid to talk about your feelings. Talk with your parents, or if you can't do that, try another relative or even a school counselor.

If You Were Adopted

Kids who were adopted are no different than other kids. But if you were adopted, you may have a little more on your mind than your friends. Sometimes, learning you were adopted may make it hard for you to pay attention in school.

Many kids who were adopted wonder about their birth parents and why they didn't keep them. They may wonder where they came from and what nationalities they are. They might wonder if they look like their birth parents and what their relatives are like. They might think about this stuff a lot, even if they really love their adoptive parents.

You might have questions if your family includes kids who were adopted and kids who weren't. Unfortunately, someone might say that you are not your parents' "real" kid, but that is not true. Adoption makes you a real son or daughter. Again, being able to talk about your feelings can help!

Reviewed by: Richard S. Kingsley, MD

A Guide to The Multiethnic Placement Act of 1994
As Amended by the Interethnic Adoption Provisions of 1996

Chapter 3: Common Questions About MEPA-IEP

1. Since the Constitution and Title VI already prohibit discrimination, what difference will MEPA-IEP make?

   Although the Constitution and Title VI bar discriminatory practices by states and publicly funded entities, many states and child welfare agencies nonetheless assumed that it was lawful to prefer racially and ethnically-matched foster care and adoptive placements for children. MEPA-IEP has made it clear that such preferences are illegal.

   In enacting MEPA-IEP, Congress was concerned about widespread reports that children were being harmed by being removed from stable foster placements simply in order to be placed with someone else of the same race or national origin whom they had never met.

   Reports also suggested that growing numbers of children were being denied a permanent adoptive placement because of efforts, often futile, to find a racially or ethnically matching adoptive home. For example, some agencies required specific waiting periods to search for a same race placement or required social workers to justify a transracial placement.

   Minority children, particularly African-American children, were the most likely to experience lengthy delays in placement and to have fewer opportunities to be adopted as they grew older. Despite differences of opinion about whether these delays were caused primarily by unfair exclusion of minority individuals from being considered as foster or adoptive parents, or by unfair exclusion of whites who sought transracial placements, or by some combination of these and other factors, child welfare experts agreed that something had to be done to prevent the adverse effects on minority children of placement delays and "foster care drift."

   MEPA-IEP can assist states and agencies to remove the vestiges of unlawful discriminatory practices by providing technical assistance through OCR and ACF staff. This assistance will continue to be available to help states review their statutes and administrative codes and to help agencies develop procedures that reflect good social work principles and promote the best interests of children in out-of-home care.

   By requiring diligent recruitment of foster and adoptive parents who reflect the ethnic and racial diversity of children in state care, MEPA-IEP also aims to expand the pool of qualified parents who can meet the needs of children awaiting homes, including those whose specific and well-documented needs may justify an effort to achieve a same-race placement.

2. What are the differences between MEPA, as originally enacted, and the 1996 Interethnic Adoption Provisions?

   The Interethnic Adoption Provisions (IEP) make several important changes to MEPA which clarify the kinds of discriminatory placement activities that are prohibited and, as explained in Chapter 2(7)(a)(3), add sanctions under title IV-E for violations of MEPA-IEP.

   To clarify that the routine consideration of a child’s or prospective parents’s race color, or national origin is impermissible, the IEP amends the basic MEPA prohibitions as follows:

   ...neither the State nor any other entity in the State that receives funds from the Federal Government and is involved in adoption or foster care placements may--

   1. deny to any person the opportunity to become an adoptive or foster parent, on the basis of the race, color, or national origin of the person, or of the child involved or

   2. delay or deny the placement of a child for adoption or into foster care on the basis of the race, color, or national origin of the adoptive or foster parent, or the child involved. [language deleted from original MEPA is indicated with strikeouts]

   In addition, the IEP repeals a section of MEPA that permitted agencies to determine a child’s best interests by considering, as one of a number of factors, "the child’s cultural, ethnic, and racial background and the capacity of the prospective foster or adoptive parents to meet the needs of a child from this background." The deletion of the words "categorically" and "solely" from the Act’s prohibitions and the repeal of the permissible considerations make it clear that the standard for the use of race, color, national origin in foster care and adoptive placements is strict scrutiny. Even where a placement decision is not based on a prohibited categorical consideration, other actions that delay or deny placements on the basis of race, color, or national origin are prohibited. According to the 1997 and 1998 Guidance, agencies may not routinely assume that children have needs related to their race, color, or national origin. Nor may agencies routinely evaluate the ability of prospective foster and adoptive parents to meet such needs.

   As amended by IEP, MEPA does not prohibit agencies from the nondiscriminatory consideration of a child’s cultural background and experience in making an individualized placement decision. However, the 1998 Guidance warns against the use of "culture as a proxy for race, color, or national origin." Any routine use of "cultural assessments" of children’s needs or prospective parent’s capacities would be suspect if it had the effect of circumventing the law’s prohibition against the routine consideration of race, color, national origin.

3. Can race ever be taken into consideration in making placements? When?

   On rare occasions, the distinctive needs of an individual child may warrant consideration of the child’s race, color, or national origin. Any consideration of these factors must pass the strict scrutiny test: Is it necessary to take into account the child’s needs related to race, color, or national origin in order to make a placement that serves this particular child’s best interest? If it appears that the child does have these distinctive needs, caseworkers should document their response to the following questions:

   • What are the child’s special or distinctive needs based on race, color, or national origin? Why is it in the child’s best interests to take these needs into account?

   • Can the child’s needs related to race, color, or national origin be taken into account without delaying placement and placing the child at risk of other harms?

   • Can these needs be met by a prospective foster or adoptive parent who does not share the child’s racial or ethnic background?

   • Can these needs be met only by a same race/ethnic placement? If so, is some delay justified in order to search for a parent of the same race or ethnicity, if an appropriate person is not available in the agency’s current files?

   • In a foster care placement, can the child’s special needs be taken into account without denying the child an opportunity to be cared for in a readily available foster home?

   • What are the child’s other important needs?

   Even when the facts of the particular case allow some consideration related to race, color, or national origin, this consideration should not predominate. Among other needs to be considered and typically to be given the most weight are: the child’s age, ties to siblings and other relatives, health or physical condition, educational, cognitive, and psychological needs, and cultural needs, including religious, linguistic, dietary, musical, or athletic needs. In addition, the child may have personal preferences that he or she can articulate and discuss.

   MEPA-IEP encourages child welfare workers to make decisions on the basis of the individualized needs of each child, and renders suspect any placement decision based on stereotypical thinking or untested generalizations about what children need. From now on, it should be clear that any use of race, color, or ethnicity is subject to the strict scrutiny standard of review, and that the use of racial or ethnic factors is permitted, only in exceptional circumstances where the special or distinctive needs of a child require it and where those needs can be documented or substantiated.

   Consider the following example: A six year old girl in foster care has been attending a school where she is regularly teased because of her race. She is deeply distressed about this and cries inconsolably whenever the teasing occurs. This child needs a foster parent who can enroll her in another school where the teasing is less likely to occur or can work with staff and other parents at her current school to improve the situation there. The foster parent has to help the child understand that the teasing is inappropriate and not a reaction to anything she did that was objectionable.

   While this child has a specific race-based need, the caseworker cannot assume that the only way to meet this need is through a same-race placement. It is an issue to discuss with the foster parent (or a prospective foster parent), regardless of their race. Simply being from the same racial background does not ensure that a particular individual will do any better in helping the child cope with the atmosphere in school than an individual from a different racial background.

   Consider another example: A three year old boy born in Honduras and present in this country for less than six months is suddenly removed from his parents who have allegedly beaten him. His verbal skills are age appropriate but he only speaks and understands Spanish. He needs immediate foster care, preferably in a home where Spanish is spoken. He should not be further traumatized by placing him with caregivers who cannot speak Spanish. Although this child will eventually need to learn English, his immediate needs call for finding a foster parent who speaks Spanish. It would not be appropriate to limit the search to someone from Honduras or some other Latin American country. The placement should be made on the basis of the child’s demonstrable cultural needs, and not on the basis of the child’s national origin.

4. Can state law or policy include a preference for racial or ethnic matching so long as no child or prospective parent is precluded from being considered for placement on the basis of their race, color, or national origin?

   MEPA-IEP does not allow state laws or policies to be based on blanket preferences for racial or ethnic matching. General or categorical policies that do not derive from the needs of a specific child are not consistent with the kinds of individualized decisions required by MEPA-IEP. Statutes or policies that establish orders of preference based on race, color, or ethnicity or that require caseworkers to justify departures from these preferences violate MEPA-IEP and Title VI.

5. Can agencies honor the preferences of a birth parent based on race, color, or national origin?

   Because agencies subject to MEPA-IEP may not deny or delay placements on the basis of race, color, or national origin, they cannot honor a biological parent's preferences for placing the child in a family with a similar racial or ethnic background.

6. Does MEPA-IEP prevent States from having a preference for placing a child with a relative?

   MEPA-IEP does not prohibit a preference for placing a child with relatives, if the placement is in the best interest of the child and not in conflict with the requirement that the child’s health and safety be the paramount concern in child placement decisions.

   In 1996, Congress added a section to the title IV-E State Plan requirements that States are to consider giving preference to an adult relative over a non-related foster or adoptive parent, provided that the relative meets all relevant state child protection standards. Many states include preferences for relatives in their foster care or adoptive placement statutes or administrative regulations. Nonetheless, caseworkers should not use general preferences for placing children with relatives as a device for evading MEPA-IEP. All placement decisions should be specific to the needs of the individual child.

   Generalizations about the wisdom of placing with a relative, even when a relative has not yet been located or evaluated should not necessarily result in removing a child from the child’s current placement. For example, caseworkers should exercise caution before removing a child from a stable, long-term, transracial fost-adopt home in order to make a racially-matched placement with a relative the child may have never met. To avoid this situation, caseworkers should attempt to locate all relatives who might serve as a child’s caregiver as promptly as possible whenever a child is likely to require out-of-home care.

7. Does MEPA-IEP apply to white children?

   MEPA-IEP applies to all children regardless of race or ethnicity. For example, if a worker determines an African American family can best meet the needs of a white child, denying the child that placement on account of race would be illegal.

8. How does MEPA-IEP apply to infants?

   MEPA-IEP applies regardless of the age of the child. The 1995 and 1997 Guidances suggest that the age of the child may be a factor in determining the effect of race or ethnicity on the best interest of the child. For example, an older child may have a strong sense of identity with a particular racial or ethnic community; an infant may not have developed such needs. However, the Guidances emphasize that each decision must be individualized. Further, the 1998 Guidance notes that, regardless of age, racial or ethnic factors can seldom determine where a child will be placed.

9. How should biracial/bicultural and multiracial/multicultural children be treated?

   MEPA-IEP requires that all children be treated equally, without regard to their racial or ethnic characteristics. If a child has a mixed racial ethnic heritage, that heritage does not have to be ignored when assessing the child’s needs, but it cannot become the basis for a placement decision except in those exceptional or distinctive circumstances that would apply to making a placement decision for any other child based on race, color, or national origin.

   Nevertheless, in order to comply with the Indian Child Welfare Act (ICWA), children entering the child welfare system who may have some Native American heritage should have their existing or potential tribal affiliations ascertained immediately so that ICWA notice, jurisdictional, and placement requirements can be followed. Because ICWA is not based on a child’s race as such, but on the child’s cultural and political ties to a quasi-sovereign federally recognized Indian tribe, ICWA is not affected by MEPA-IEP. This means that a child with a certain quantum of "Indian blood" may or may not be subject to ICWA. Caseworkers generally have to rely on tribal determinations whether or not the child is a tribal member or eligible for membership.

10. Does MEPA-IEP apply to private agencies and independent adoptions?

    MEPA-IEP applies to all agencies and entities receiving federal assistance directly or as a subrecipient from another entity. Agencies or entities that do not receive federal assistance are not covered by MEPA-IEP unless a federally assisted agency is also involved in their placement decisions. However, these entities may be covered by other statutes or policies prohibiting discrimination.

11. Can agencies conduct targeted recruitment?

    MEPA-IEP requires diligent recruitment of potential foster and adoptive families that reflect the ethnic and racial diversity of the children who need homes. Therefore, states must develop strategies that reach the communities of these families. At the same time, states and other entities must ensure that they do not deny anyone the opportunity to adopt or foster a child on the basis of race, color or national origin.

    The 1995 federal Guidance discussed targeted recruitment efforts as part of a comprehensive strategy aimed at reaching all segments of the community. The 1995 Guidance provides that information should be disseminated to targeted communities through organizations such as churches and neighborhood centers. It further suggests agencies develop partnerships with community groups that can help spread the word about waiting children and identify and support prospective adoptive and foster parents.

    In addition, the 1998 Guidance states that targeted recruiting cannot be the exclusive means for a state to identify families for particular categories of children. For example, while a state may contract with a private agency to make public announcements in Spanish to recruit Hispanic foster and adoptive parents, the state may not rely exclusively on that private agency to place Hispanic children. Rather, in identifying a potential pool of foster or adoptive parents for a child, the state must consider individuals listed with agencies that recruit parents from all ethnic groups.

12. Do prospective adoptive parents have the right to adopt a particular child?

    Under MEPA-IEP, individuals cannot be denied an opportunity to be considered as a potential adoptive parent. They have a right to an assessment of their suitability as adoptive parents which is not based on discriminatory criteria. If accepted into the pool of qualified applicants for an agency, a state, or an interstate exchange, they have a right to be considered as a possible adoptive parent for children for whom they have expressed an interest, and whose needs they believe they can meet. However, neither they nor anyone else has an absolute right to adopt a particular child.

    When foster parents seek to adopt a child who has been in their care for a significant period of time, the child’s attachment to them and the child’s need for permanence may suggest that they are the most appropriate parents for the child. Nonetheless, this decision must be based on the agency’s and the court’s assessment of the child’s best interests and not on an alleged "right" of the foster parents to adopt this child.

13. What funds are available to implement MEPA-IEP?

    Implementation of MEPA-IEP is an administrative cost of implementing federal foster care mandates. States are entitled to claim MEPA-IEP implementation expenses as part of their administrative costs under title IV-E. Discretionary funds for innovative projects, such as recruitment programs, are also available under the Adoption Opportunities Program authorized by the Child Abuse Prevention and Treatment Act.

NIHSeniorHealth Adds Information on Heart Failure

by Healthy News Service

NIHSeniorHealth (www.NIHSeniorHealth.gov) now offers information about the prevention, detection, and treatment of heart failure, a health condition that affects roughly 5 million older Americans. Designed especially for seniors, NIHSeniorHealth is a joint effort of the National Institute on Aging (NIA) and the National Library of Medicine (NLM), which are part of the National Institutes of Health (NIH). Heart failure tends to be more common in men than in women, but because women usually live longer, the condition affects more women in their 70s and 80s. Blacks are more likely than whites to have heart failure and to suffer more severely from it. It is the number one reason people over age 65 are hospitalized. In heart failure, the heart cannot pump enough blood through the body. Over time as the pumping action of the heart gets weaker, blood and fluid back up into the lungs and fluid builds up in the feet, ankles, and legs. People with heat failure often experience fatigue and shortness of breath. Heart failure is caused by a number of diseases and conditions that damage the heart muscle, including coronary artery disease. People who have had a heart attack are at high risk of developing heart failure. Diabetes and high blood pressure also contribute to heart failure risk. ?There are a number of things you can do to reduce the risk of heart disease and heart failure,? says Elizabeth G. Nabel, M.D., director of the National Heart, Lung, and Blood Institute (NHLBI), which developed the content for the heart failure topic on the NIHSeniorHealth Web site. ?For example, it is important to keep your cholesterol and blood pressure levels healthy, keep your diabetes in check, lose weight if you are overweight, eat right, don?t smoke, and get regular physical activity.? One of the fastest growing age groups using the Internet, older Americans increasingly turn to the World Wide Web for health information. In fact, 66 percent of ?wired? seniors surf for health and medical information when they go online. NIHSeniorHealth, which is based on the latest research on cognition and aging, features short, easy-to-read segments of information that can be accessed in a variety of formats, including large-print type sizes, open-captioned videos, and even an audio version. Additional topics coming soon to the site include heart attack, clinical trials, and falls and fractures. The site links to MedlinePlus, NLM?s premier, more detailed site for consumer health information. The NIA leads the Federal effort supporting and conducting research on aging and the health and well-being of older people. The NLM, the world's largest library of the health sciences, creates and sponsors Web-based health information resources for the public and professionals. The NHLBI supports research in diseases of the heart, blood vessels, lung, and blood, and sleep disorders. All three are components of the National Institutes of Health in Bethesda, Maryland, part of the U.S. Department of Health and Human Services.

Provided by U.S. Department of Health and Human Services on 3/3/2006