Category: Children’s Health

  • Healthy Eating Tips

    Children’s Health

    Image of young boy eating oranges.

    *  Make half your grains whole. Choose whole-grain food, like whole-wheat bread, oatmeal, and brown rice more often.

    *  Vary your veggies. Go dark green and orange with your vegetables. Eat spinach, broccoli, carrots and sweet potatoes.

    *  Focus on fruits. Eat them at meals. Eat them at snack times, too. Choose fresh, frozen, canned or dried fruits. Go easy on fruit juices.

    *  Go lean with protein. Eat lean or low-fat meat, chicken, turkey, and fish. Also, choose dry beans and peas more often. Add chick peas, nuts, or seeds to a salad. Add pinto beans to a burrito. Add kidney and/or other beans to soup.

    *  Get calcium-rich foods. Have low-fat and fat-free milks, yogurts, and cheeses. If you have soy milks and yogurts, choose ones with calcium. Have broccoli, kale and collard greens. Calcium helps to build strong bones.

    *  Change your oil. Get yours from fish, nuts, and liquid oils, like canola, corn, olive, and soybean. Avoid foods with trans fat. Read food labels.

    *  Don’t sugarcoat it. Choose foods and beverages that do not list sugar, corn syrup and other sugars as one of the first ingredients. Added sugars give calories, but have few, if any, nutrients.

    Page from Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Acne For Children

    Children’s Health

    Acne is a skin condition. With acne you get pimples. The pimples can be white-heads, blackheads, or raised red ones that hurt. Acne can pop up on the shoulders, back, neck, and face. Acne mostly occurs in teenagers and young adults. Many people still have acne or acne scars when they are adults.

    Signs & Symptoms

    You get acne when the glands under your skin make a certain kind of oil. The oil ducts get clogged and mix with bacteria on the skin. Then bumps pop up on the skin.

    Babies 2 to 4 weeks old can get a little acne from their mother’s hormones. These things help cause acne:

    *  Hormone changes in teenagers.

    *  A girl’s hormones before her period or when she is pregnant.

    *  Heavy lotions or greasy makeup.

    *  Stress.

    *  Vitamin pills that have iodine.

    *  Some medicines, such as steroids, and lithium.

    Causes

    Chocolate, nuts, greasy foods, and cola do not cause acne.

    Self-Care Tips treat mild acne. When this is not enough, your child’s doctor can prescribe special creams, lotions, gels, or liquids. Ask the doctor for advice. Don’t do anything special for a baby’s acne. Just wash the skin gently.

    For very bad acne, a doctor may prescribe a strong medicine, such as Accutane®. Know that this kind of medicine may lead to depression and even suicide. It can also cause birth defects.

    Questions to Ask

    Self-Care / Prevention

    *  Keep the skin clean. Wash often with plain soap and water. Use a washcloth. Work the soap into the skin gently for a minute or two. Rinse well. Don’t scrub.

    *  Have your child use a clean washcloth every day. Bacteria grow on a wet washcloth, and they can give your child more pimples.

    *  Have your child try an astringent lotion, degreasing pads, or a face scrub.

    *  Ask your child’s doctor for the name of a good acne soap.

    *  Leave your child’s skin alone! Tell your child not to squeeze, scratch, or poke at pimples. They can get infected and leave scars.

    *  Buy a lotion, cream, or soap that has benzoyl peroxide. Follow what the label states. (Some people are allergic to benzoyl peroxide. Try a little on your child’s arm first to make sure it doesn’t hurt the skin.)

    *  Have your child wash after he or she exercises and sweats.

    *  Have your child wash his or her hair at least every other day.

    *  Have your child use only water- based makeup. Don’t let him or her use greasy or oily creams, lotions, or makeups.

    *  Don’t let your child spend too much time in the sun.

    *  Don’t let your child use a sun lamp.

    Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Hiccups In Children

    Children’s Health

    Signs, Symptoms & Causes

    Hiccups happen when the diaphragm tightens up. (The diaphragm is a muscle used in breathing. It sits like a cap on top of the stomach.)

    Babies usually get hiccups because they swallow air when feeding. The stomach gets bigger and squeezes the diaphragm. Sucking hard or eating too much can make hiccups worse. It helps to burp the baby often when feeding.

    Older children get hiccups from drinking too much soda pop or eating too much too fast. An upset or too-full stomach can lead to hiccups. Hiccups can hurt, but they are usually harmless. And they don’t last very long.

    Questions to Ask

    Self-Care

    *  Give your child 1 teaspoon of sugar. Have him or her swallow it fast. Do it 3 or more times, once every 2 minutes, if the hiccups don’t stop right away. (Note: For younger children, use 1 teaspoon of corn syrup.)

    *  Give babies a swallow of water.

    *  If all that doesn’t work, try this: Gently push down the back of your child’s tongue with the handle of a spoon. Do it 3 or 4 times.

    *  Don’t scare the child to try to make the hiccups stop.

    *  Have your child drink water with their head forward and down.

    *  Here are some old folk cures you can try:

    – Hold your child’s tongue with your clean thumb and index finger. Gently pull on the tongue.

    – Give your child a little cracked ice to swallow.

    – Have your child drink a glass of water fast.

    Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Asthma For Children

    Children’s Health

    Signs & Symptoms

    A lot of children get asthma. Asthma cuts down the air flow in the lungs. This makes it hard to breathe. These are all symptoms of asthma:

    *  Chronic coughing.

    *  Trouble breathing.

    *  Tight feeling in the chest.

    *  Wheezing.

    (Note: Other things can cause wheezing, too. Something may be stuck in the throat or there may be an infection. Always tell the doctor if your child is wheezing.)

    Asthma symptoms come and go. An asthma “attack” can be big or small. Asthma can get worse when your child is upset or worried. But it’s a real physical problem. A doctor should treat your child if he or she has asthma. Asthma runs in families. Children who have eczema or hay fever often have asthma, too. Asthma may be more common in children who live in houses with pets and tobacco smoke.

    Causes

    Asthma attacks can come on with:

    *  Colds, flu, and other infections in the throat and lungs.

    *  Breathing pollen from plants, mold, animal dander, dust, or smoke.

    *  Sulfites. These are additions in some foods.

    *  Taking some medicines, like aspirin.

    *  Breathing cold air.

    *  Exercising too hard.

    *  Getting upset, angry, or “stressed out.”

    Treatment

    The right asthma treatment depends on how bad the attacks are. It’s hard to treat asthma with medicines you buy without a prescription. Your child’s doctor should keep track of how your child is doing. The doctor may prescribe one or more medicines for your child’s asthma. Some kinds of medicines are for your child to take during an asthma attack. Other kinds are taken daily or as prescribed to help prevent asthma attacks. Medicines include:

    *  Bronchodilators. These drugs open up the airways in the body. They come either as a spray or as something you swallow.

    *  Drugs to help with swelling of the airways in the body. They come either as a spray, or as pills you swallow.

    *  Drugs to help with chronic swelling of the airways in the body. They come as pills.

    *  Peak flow meter. This is a device to monitor your child’s asthma at home.

    *  Flu vaccine. This is given once a year.

    Questions to Ask

    Self-Care / Prevention

    *  Don’t smoke or let your child smoke. Don’t allow smoking in the house.

    *  Have your child drink a lot of water, juice, and other fluids. (Ask your child’s doctor how much fluid your child should have each day.)

    *  Find out what triggers your child’s asthma. Get rid of things that bother your child at home, at school, and where he or she plays.

    *  If you don’t have a dog, cat, or other pet, don’t get one. If you have a pet, keep it outside if you can. If not, don’t let it in your child’s bedroom.

    *  Keep things your child is allergic to out of his or her bedroom.

    *  Have your child sleep with no pillow or the kind the doctor says is O.K.

    *  Cover your child’s mattress and pillow with a plastic cover or one that says allergen-free. Wash mattress pads in hot water every week.

    *  Use throw rugs that can be washed often instead of carpets. Pollen, pet dander, mold, and dust mites collect in carpets. Use blinds and curtains that can be washed often, too.

    *  Try not to have stuffed animals kept in your child’s bedroom. Or have only one that can be washed. Wash it in hot water once a week.old, and dust mites collect in carpets. Use blinds and curtains that can be washed often, too.

    *  If you can, use a vacuum with a HEPA filter and double-thickness bags. When you vacuum, have your child wear a filter mask over his or her nose and mouth.

    *  Use air filters with your furnace and air-conditioning unit. Or use portable air cleaners to keep the air clean. Change or wash filters often. Keep the humidifier filter clean, if you use one. Use distilled (not tap) water in humidifiers and vaporizers.

    *  Don’ t hang sheets and blankets outside to dry. Pollen can get on them.

    *  It’s good for your child to do sports like swimming. But tell your child to stop exercising if he or she starts to wheeze.

    *  When outdoors in cold weather, have your child wear a scarf around his or her mouth and nose. The scarf warms the air before your child breathes it in.

    *  Don’t let your child eat foods or medicines that have sulfites. Shellfish, for example, often have sulfites. They bother many people with asthma.

    *  Have your child sit up during an asthma attack. Don’t let your child lie down.

    *  Don’t run out of your child’s asthma medicine. Keep the medicine handy. Have your child take it as soon as he or she starts to feel an attack.

    *  Don’t give your child aspirin! Some people with asthma are allergic to aspirin. Use acetaminophen instead.

    (Note: Aspirin and other medicines that have salicylates have been linked to Reye’s Syndrome, a condition that can kill.)

    Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Lice

    Children’s Health

    Lice are small, wingless insects about the size of a sesame seed. Lice lay up to 3 to 5 eggs a day. The eggs are called “nits.” The nits hatch in 7 to 10 days. In another 7 to 10 days, a female louse matures and begins laying her own eggs.

    Head lice is a common problem in children in day- care centers and schools. Head lice only affect humans. They thrive on human blood and can survive longer than 30 days. In general, head lice can’t survive longer than 24 hours off their human host. Lice can also infest areas of the body other than the scalp. This is called body lice. Lice on the hair around the groin is called pubic lice.

    Signs & Symptoms

    For Head Lice

    *  Nits can be seen on the hair. They are small yellowish-white, oval-shaped eggs that look like dandruff. Instead of flaking off the scalp, they stick firmly to the base of a hair shaft.

    *  Itching of the scalp is intense.

    *  Small, red bumps appear on the scalp and neck.

    *  When hatched, head lice are clear in color, so are hard to see.

    Causes

    Head lice does not imply poor hygiene. It is caused by the spread of the insects through direct contact of the hair or head with someone who has head lice. Sharing hats, towels, combs, helmets, etc. with an infected person can spread lice. Using pillows, head rests, etc. that an infected person used may also spread lice. Head lice don’t fly or jump, so can’t be spread through the air.

    Treatment

    Ask your child’s doctor about safe and nontoxic methods to treat lice. He or she may advise using an over-the-counter or prescribed medicine. Use the product as directed.

    Questions to Ask

    Self-Care / Prevention

    Check everyone in your home for lice and nits. Treat only those who have lice. Lice-killing products won’t prevent lice.

    *  Use an over-the-counter shampoo, lotion, or cream made to get rid of lice and nits. Follow the directions on the package.

    *  Wear plastic or latex gloves. Don’t use too much shampoo. Doing this will make the child’s head too dry.

    Things to Tell Your Child

    *  Don’t share hats, brushes, or combs. If you must share helmets, wipe them with a damp towel and wear a baseball cap under the helmet.

    *  Don’t lie on a pillow that another child uses.

    *  Wash your hair and bathe often.

    To Remove the Nits

    *  Shine a flashlight on the hair roots. Nits are gray and hard to see, especially in blond hair.

    *  Start at one spot and go row by row or even strand by strand. Use the nit comb that comes in the package. Dip the comb in vinegar first. This will help loosen the nits.

    *  Comb the hair from the roots to the ends. Check the comb for nits after each pass, or, break the hair up into 4 or 5 sections with hair clips. Lift about an inch of hair up and out. Put the comb against your child’s head. Comb all the way to the tips of the hair. Keep going until you’ve done the whole head.

    *  Soak all combs, brushes, hair clips, and barrettes for 1 to 2 hours in the insecticidal shampoo. Or, soak them for 1 hour in soap and water, rubbing alcohol, or Lysol.

    *  Check for nits every 2 to 3 days for 2 to 3 weeks until all lice and nits are gone.

    *  A week to 9 days later, use the shampoo for lice again to kill any newly hatched nits. You don’t have to remove nits after treatment is finished except for cosmetic reasons.

    Other Things You Should Do

    *  Vacuum all mattresses, pillows, rugs, and furniture made of cloth, especially where children play. Use the long, thin attachment to suck the lice or nits out of car seats, toys, etc. Put the vacuum cleaner bags outside in the trash.

    *  Wash bedding and clothes right away in water 130ºF or hotter. Put them in the dryer on high for 30 minutes. Heat kills the lice and nits. Dry-clean clothes and hats that you can’t wash.

    *  Don’t use bug spray on lice, furniture, stuffed animals, etc.

    *  As soon as you know your child has lice, call your child’s school, child-care center, parents of your child’s friends, etc.

    *  Check your children for head lice and nits once a week. Check more often if your child scratches his or her head. Look for nits behind the ears and on the back of the neck. Spread hairs apart using a nit comb to look for the nits on the hair shafts.

    Resources

    National Pediculosis Association

    www.headlice.org

    Healthier at Home book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Bed-Wetting

    Children’s Health

    Passing urine during sleep is called “bed-wetting” when it occurs after age 5 or 6. Children are usually expected to have nighttime bladder control by this age. Bed-wetting is a very common problem. In the U.S., 5 to 7 million children have it.

    Enuresis is a medical term for bed-wetting. {Note: Bed-wetting itself, can’t be prevented, but damage to a child’s self- image can. Explain that bed-wetting is not his or her fault and that it will get better in time.}

    Causes

    Children don’t wet the bed on purpose. These are causes of bed-wetting:

    *  A lot of urine is made in the evening and during the night. A full bladder does not wake the child up.

    *  A child’s small bladder does not hold urine for an entire night.

    *  Other conditions, such as a urinary tract infection and diabetes. (Daytime wetting and other symptoms occur with these conditions.)

    *  For children who have been dry at night for 6 or more months, sometimes, emotional upsets and major changes can cause bed-wetting. An example is having a new baby in the house.

    *  Children are more likely to wet the bed if both parents did when they were children.

    Treatment

    Most of the time, children outgrow bed-wetting. Until then, self-care measures help with the problem. Medication can be prescribed when no other treatment works.

    Questions to Ask

    Self-Care / Prevention

    Be patient and give your child lots of support. Children who wet the bed can’t help it. Getting angry only makes the problem worse.

    Until Your Child Outgrows Bed-Wetting

    *  Do not blame or punish your child for wetting the bed.

    *  Limit fluids in the evening, especially 2 hours before bedtime. Ask your child’s doctor how much your child should drink. Don’t give drinks with caffeine, such as colas.

    *  Have your child urinate in the toilet right before getting into bed.

    *  See that your child can easily get to the toilet during the night. Keep the path clear. Use night lights, etc. If needed, put a portable potty close to your child’s bed. Assign a place the potty can be moved to for daytime, if your child wants to do this.

    *  Tell other members of the household that “teasing” about bed-wetting is not allowed. Respect your child’s privacy and feelings.

    *  You may want your child to use pull-up (training) pants when he or she sleeps away from home, camps, etc. On a regular basis, encourage your child to wake up to use the toilet.

    *  Keep a change of pajamas, a flannel covered pad, clean sheets, dry towels, etc., near your child’s bed. Show your child how to use these when he or she wets the bed. Include your child in the clean-up process.

    *  Have your child rehearse getting up from bed and using the toilet. Do this at bedtime. Do it during the day when your child gets the urge to urinate. Have your child lay down in his or her bed, wait a few minutes, and then get up to urinate in the toilet.

    *  If your child is 5 years old or older and he or she agrees to it, get a bed-wetting alarm. The child wears the alarm on his or her underwear. The first drop makes the alarm buzz. This wakes the child up. After awhile, the child learns to wake up when he or she has to urinate. Some of these alarms help prevent wet beds 85 to 90 percent of the time.

    Resources

    National Kidney Foundation

    888.WAKE.DRY (925.3379)

    www.kidney.org

    Healthier at Home book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Nutrition For Children

    Children’s Health

    Image of toddler eating a strawberry.

    Birth to 2 Years Old

    *  Breast-feed your baby from birth to 6 months of age. Breast-feed for the first year, if you can. If you can’t breast-feed or don’t want to, give iron-enriched formula (not cow’s milk) for the first 12 months. After that and up to age 2, use whole cow’s milk to replace formula or breast milk. Don’t limit fat for the first 2 years of life.

    *  Follow your child’s doctor’s advice on breast-feeding and what formula and vitamins to give your baby. Breast-fed babies who do not get regular exposure to sunlight may need vitamin D supplements.

    *  Start solid foods as advised by your baby’s doctor. It is common to do this at 4 to 6 months of age. Iron-enriched infant rice cereal is usually the first food given.

    *  Start new foods one at a time. Wait 1 week before adding each new cereal, vegetable, or other food. Doing this makes it easier to find out which foods your baby has a problem with.

    *  Use iron-rich foods, such as grains, iron-enriched cereals, and meats.

    *  Do not give honey to infants during the first 12 months of life.

    *  Don’t let a baby fall asleep with a bottle that has formula, juice, or milk. The sugars in these can cause tooth decay.

    Two Years and Older

    *  Give a variety of healthy foods for meals and snacks. Follow guidelines from theChooseMyPlate.gov/kidsWeb site. Let your child choose which healthy foods and how much to eat to satisfy his or her hunger.

    *  Help your child maintain a healthy weight. Give proper foods. Promote regular exercise. Lead by example. Children learn from what they see parents do, as well as, from what parents say. Eat with your children. Be a role model for good eating. Exercise, too.

    *  Let your child help plan meals and snacks, shop for food, and prepare foods.

    *  Don’t force your child to eat certain foods. Don’t use food to reward or punish behavior.

    *  Don’t give foods that can lead to choking, such as hard candies and whole grapes.

    *  Teach healthy behaviors in a fun way. For ideas to help get children to eat well and be more active, access the Web sites under “Resources”.

    Resources

    5-2-1-0 Let’s Go!

    www.letsgo.org

    ChooseMyPlate.gov

    www.choosemyplate.gov/kids/index.html

    We Can!™ Ways to Enhance Children’s  Activity & Nutrition

    www.nhlbi.nih.gov/health/educational/wecan

    Page from Healthier at Home book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Children S Health

    Children’s Health

    Health Conditions

    Understanding Autism

    Understanding Dyslexia

    Acne

    Asthma

    Bed-Wetting

    Colds & Flu

    Colic

    Constipation

    Coughs

    Croup

    Diarrhea

    Earaches

    Eye Problems

    Fever

    Hiccups

    Keep Your Child from Getting Fever Seizures

    Lice

    Self-Care Medicines & Supplies for Children

    Signs of Reye’s Syndrome

    Sore Throats

    Swollen Glands

    Vomiting & Nausea

    Know the Signs of Autism

    Whooping Cough: Protect Your Baby

    Too Sick for School?

    Head Lice: Tiny Blood Suckers

    Nutrition for Children

    Healthy Eating Tips for Children

    Getting Your Kids to Eat Right

    ABC’s of Traveling with Children

    A to Z Guide to Help Kids be Healthy & Safe

    © American Institute for Preventive Medicine

  • Signs Of Reye’s Syndrome

    Children’s Health

    Be on the lookout for Reye’s Syndrome after the flu or chickenpox. Reye’s Syndrome does not happen very often. But you should know about it. Look for these signs:

    *  Vomiting over and over again. Or vomiting that does not stop.

    *  Loss of pep and energy.

    *  Acting very, very sleepy.

    *  Acting very, very cranky.

    *  Striking out at others.

    *  Acting strange.

    *  Convulsions.

    (Note: If your child shows signs of Reye’s Syndrome, get medical care fast!)

    Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine

  • Colds & Flu

    Children’s Health

    Colds and flu are infections of the nose and throat. Both are caused by viruses.

    It can be hard to tell if your child has a cold or the flu. Why? They both have the same type of symptoms. But symptoms for the flu are worse than ones for a cold. Flu symptoms come on fast. Ones for a cold come on slower.

    Signs & Symptoms

    Chart showing symptoms of a cold vs a flu.

    Prevention

    Antibiotics do not treat colds and flu. Most colds clear up in about a week. Sometimes, a cold lasts up to 2 weeks.

    Fever and most flu symptoms usually go away after 5 days, but coughing and feeling weak can last up to 2 weeks.

    To Help Prevent Colds and Flu

    *  Take your child for a yearly flu vaccine as advised.

    *  Don’t smoke or let your child smoke.

    *  Keep your child away from persons who have the flu or a cold.

    *  See that your child eats and sleeps well and gets lots of exercise.

    Tell your child to do these things:

    *  Wash your hands often. Keep them away from your nose, eyes, and mouth.

    *  Cover your nose when you sneeze. Use a handkerchief or tissues when you sneeze, cough, or blow your nose. This helps prevent passing germs to others.

    Questions to Ask

    Self-Care

    Have your child do these things:

    *  Rest.

    *  Drink lots of liquids. They help clear out the respiratory tract. This can help prevent other problems, like bronchitis.

    *  Eat chicken soup. It helps clear out mucus.

    If your child’s throat is sore, have him or her do these things:

    *  Gargle every few hours with 1/4 teaspoon of salt in 1/2 cup of warm water, if able to. (A child can usually do this starting at age 6.)

    *  Suck on a piece of hard candy or cough drop once in a while. (Don’t  give these to children under 5 years old.)

    Things you can do:

    *  Try to clear your child’s nose. This is very important in babies under 6 months old, because some can’t breathe through their mouths yet. Also, they can’t breast or bottle-feed if they can’t breathe through the nose. To clear your child’s nose:

    – Use an over-the-counter spray or drops for the nose made of salt and water. An example is Ocean® brand. Follow the label’s advice or that of your child’s doctor.

    – For a baby who can’t blow his or her nose, leave the salt drops in for 1 minute. Then use a soft rubber suction bulb to draw out the mucus. Lie the baby on his or her back. Aim the bulb straight down, not at an angle! (You can get a suction bulb at the drug store.) Or use a cotton swab to wipe the mucus out. Don’t put the suction bulb or cotton swab too far into the nose. You could cause a nosebleed.

    – For a child who can blow his or her own nose, have the child do it 1 minute after the salt drops are in.

    *  Put a cool-mist vaporizer or humidifier in your child’s room. Use distilled (not tap) water. Clean it every day.

    *  For fever and muscle aches, give your child acetaminophen or ibuprofen. Make sure you give the right kind and dose for your child’s weight. (Note: Do not give aspirin. Aspirin and other medicines that have salicylates have been linked to Reye’s Syndrome.

    *  Check with your child’s doctor about using over-the-counter medicines for colds and flu for children under  age 2.

    *  Call your child’s doctor if he or she gets a fever after a cold or after the flu has gone away.

    *  Washing the hands often helps stop spreading the flu. Have your child wash his or her hands:

    – After playing with others.

    – When he or she gets home from school.

    – After blowing his or her nose.

    – After touching toys or other people’s things.

    Signs of Reye’s Syndrome

    Be on the lookout for Reye’s Syndrome after the flu or chickenpox. Reye’s Syndrome does not happen very often. But you should know about it. Look for these signs:

    *  Vomiting over and over again. Or vomiting that does not stop.

    *  Loss of pep and energy.

    *  Acting very, very sleepy.

    *  Acting very, very cranky.

    *  Striking out at others.

    *  Acting strange.

    *  Convulsions.

    (Note: If your child shows signs of Reye’s Syndrome, get medical care fast!)

    Children's Self-Care book by the American Institute for Preventive Medicine. www.HealthyLife.com. All rights reserved.

    © American Institute for Preventive Medicine