In the middle of the night in Atlanta, I got a frantic call from my daughter in Chicago. “Daddy, I’m so sorry to wake you, but Michael just ate a little piece of cashew and now his face is swollen and he’s breaking out in a rash all over his body.” Once I realized that her voice wasn’t just part of some bad dream, I gave my doctor’s orders: “Give him Benadryl and take him to the emergency room immediately!”As a board-certified allergist for 25 years, I recognized that my grandson was having a potentially serious allergic reaction and that his symptoms could get worse-much worse. Fortunately, by the time they arrived at the hospital, the swelling had subsided and his hives had resolved.Even though my grandson’s diagnosis was easy to make, food allergies can be one of the most frustrating and complex allergy issues facing physicians, patients, and families. If you consider the unlimited number of foods and additives we consume today, the variable time between ingestion and allergic reaction, and the varied and often-subtle symptoms, it seems miraculous when an allergy-triggering food is actually identified.Food Allergies In Children: A Disturbing TrendAsk anyone who raised children 25 years ago if they ever heard of food allergies back then, and the likely answer will be no. Yet today, who doesn’t know a child-if not several kids-who have severe food allergies? Pediatricians and allergists are observing first-hand that food allergies in infants and children have increased to epidemic proportions over the last few decades. Studies have shown that in the under-18 age group, the prevalence of reported food allergies increased 18% between 1997 and 2007. Approximately 4% of Americans are estimated to have food allergies. That’s more than 12 million individuals. The prevalence of food allergies is even higher-6% to 8%-in infants and young children under three years old.Any type of food can trigger an outbreak, yet the “Big 8″ account for more than 90% of all cases: milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat. Sesame is quickly becoming another common cause of allergies, especially in those with Mediterranean diets. The good news is that the incidence of documented food allergies decreases with age, probably due to the development of tolerance in children allergic to milk, wheat, soy, and eggs. Of the 2.5% of children allergic to milk, approximately 80% will “outgrow” their allergy by age five. Kids with peanut or tree nut allergies aren’t as lucky: Recent studies have shown that only about 10% to 20% of children will lose their allergy as they age.Pediatric Food Allergies: Instantaneous Outbreak Of the two main types of allergies, the “immediate hypersensitivity reaction” gets the most hype, probably because you can see the symptoms (whether it’s hives or swelling) right away. The other kind is aptly named “delayed hypersensitivity reaction.” Otherwise known as IgE-mediated, the immediate allergic reaction is the best understood and the most easily diagnosed. Yet it can also be the most serious. When the proteins in an allergenic food come in contact with an IgE antibody (located in the skin, gut, and airways, or in the blood), a cascade of cellular events occurs resulting in the release of histamine and a multitude of other chemical mediators. The rapid release of the histamine and other chemicals is what causes the allergic reaction. The outbreak, which generally occurs within minutes of ingestion, can be relatively mild or severe. Moderate symptoms might include a rash, generalized itching and redness of the skin, facial or eyelid swelling, abdominal cramping, vomiting and/or diarrhea. These can be treated with a quick-acting antihistamine and tend to run their course over a few minutes to hours. The most severe reaction is called anaphylaxis, which can occur instantaneously or a few minutes after ingestion. As a general rule, the quicker the onset of symptoms, the more serious the reaction is likely to be. Symptoms of anaphylaxis might include those mentioned above, but can also rapidly progress to breathing difficulties and chest tightness (due to bronchial constriction and swelling of the airways), a drop in blood pressure leading to shock-and even death. Epinephrine (also known as adrenalin), which is available for self-injection in the form of an Epipen and other auto-injectors, must be given immediately and repeated if necessary. Foods that commonly cause severe reactions include peanuts, tree nuts, fish, sesame seeds, milk, and eggs. The most serious reaction I ever witnessed resulted from the ingestion of a single pine nut. That tiny seed (it’s not really a nut) transformed a healthy teenager into a critically ill patient within a matter of minutes. Fortunately, the patient recovered, but anaphylaxis can be fatal if not treated immediately and aggressively. If your child has ever had an immediate allergic reaction to a food, you should consult with a board-certified allergist. To identify or confirm the symptom-triggering food, the allergist will likely give a few tests, either through the skin or blood. From there, you and your allergist can come up with a plan to eliminate the food from your child’s diet and discuss prevention and management of future reactions.Delayed Allergic Reactions: Subtle Yet ElusiveWhile less dangerous in terms of one’s immediate health, the “delayed allergic reaction” can be much more difficult to diagnose and treat. As the name implies, it can take hours or even days after ingestion for the symptoms to show up, making it harder to establish a cause-and- effect relationship. The typical symptoms can involve several organ systems and may be quite subtle in their presentation. In addition to the classic allergy symptoms (think nasal congestion, a runny nose, and a rash), delayed reactions may also present with very vague and nonspecific symptoms, such as frequent headaches, recurrent or chronic abdominal pain, fatigue and lethargy, irritability, dark circles under the eyes, leg pains, and recurrent ear or sinus infections.Part of the difficulty in diagnosing these food reactions is that there’s no reliable allergy test that can accurately identify or predict a delayed outbreak. Skin testing and blood tests aren’t helpful because they only measure the IgE antibody, which is responsible for immediate reactions. Research has not yet identified the antibody or antibodies responsible for delayed reactions, although there has been considerable interest and research in the possible role of the IgG antibody. Blood tests to measure this antibody are available, but its reliability as a predictor of delayed allergy has not yet been established.So how can you figure out if your child’s symptoms are the result of something he or she is eating? The best method we have right now is to eliminate the suspected food (or drink) from your kid’s diet for four weeks. If you notice a significant improvement in symptoms, you’re ready for the challenge phase: Serve the food in question for several days straight. If the symptoms start recurring, you can be relatively sure that a cause-and-effect relationship has been established. Even after avoiding the food culprit, it can still take a few weeks for symptoms to completely disappear, so be patient.By far, milk and other dairy products are the most common cause of this type of reaction. Over the years, many teenagers have walked into my office with their parents complaining about stomach discomfort and profound tiredness. By the time they’ve come to see me, they’ve usually been through various tests and have seen multiple physicians, including gastroenterologists, and have often been diagnosed with irritable bowel syndrome. After hearing about their saga and symptoms-and seeing the dark circles under their eyes and their pale, sallow complexion-I can usually tell that it’s a dairy allergy. Fortunately, many responded dramatically to a few weeks off of milk. They couldn’t believe that the innocent act of drinking milk and eating dairy products could make them feel so ill-and that avoiding these products could restore their good health and vitality in such a short time.Food Allergy Cross-ReactivityIf you’re like me, you may have a food allergy that’s directly connected to your sensitivity to tree and weed pollens. Called “oral allergy syndrome,” this condition shows up when there’s a cross-reactivity between tree or weed pollens and corresponding foods that share a common allergen. For example, because ragweed pollen and foods in the gourd family share a common allergen, people allergic to ragweed may exhibit symptoms after ingesting foods such as melons (watermelon, cantaloupe, and honeydew), zucchini, cucumber, and bananas. Because I’m allergic to ragweed pollen, I cannot eat melons or ripe bananas without developing intense itching in my throat. If you’re sensitive to birch tree pollen, you may react to apples, pears, and apricots. Celery may be a problem for those allergic to mugwort pollen.The typical symptoms, which are generally mild and transitory, are itching of the throat, mouth, and tongue. That aggravating throat itch often compels sufferers to rub their tongue against the soft palate, making a characteristic “clucking” sound. The vast majority of patients experience symptoms within five minutes of ingestion. Depending on the time of year, the presentation can be affected by the particular pollen season. The upside of this condition, which is the most common food-related allergy in adults, is that symptoms are only caused by the ingestion of raw or uncooked fruits or vegetables. The heating process that occurs during cooking breaks down the allergic protein, so you can eat boiled, baked, fried, or roasted fruits and veggies without triggering symptoms.Allergies In InfantsBecause of their age, newborns and infants can be especially sensitive to food allergies. Symptoms may include colic, irritability, excessive spitting and vomiting, rashes (including eczema or hives), nasal symptoms (such as congestion and runny nose), coughing or wheezing, and other gastrointestinal symptoms (diarrhea, bloody stools, or constipation). There can also be poor weight gain. Allergies in infants up to age one are almost always caused by food-most commonly cow’s milk. Yet a baby doesn’t have to drink milk straight for symptoms to break out: The proteins in cow’s milk can enter the baby’s system through some commercial formulas, as well as by passing through the mother’s milk during nursing. A small percentage of milk-allergic babies are also allergic to soy.In recent years, researchers have devoted themselves to understanding the disturbing rise of food allergies, especially in infants and kids. What they have discovered is leading allergists and physicians to dramatically revise recommendations on how and when we introduce foods to infants. For many decades, the time-honored and well-established approach was to delay the introduction of highly allergenic foods into the infant’s diet to prevent the emergence of food allergies. For example, solid foods are generally not recommended until six months of age, cow’s milk until one year, eggs until two years, and peanuts, tree nuts, and fish until three years. There is also a widely accepted notion that breast feeding alone for the first six months of life will minimize or delay the onset of food allergies and other allergic diseases (including asthma), as well as atopic dermatitis or eczema.The latest medical evidence, however, is debunking these age-old theories. Indeed, the recommendation to delay the introduction of foods to infants as a means of preventing food allergies may be the wrong approach altogether. Recent studies have revealed very credible scientific evidence to suggest that the common practice of delaying the introduction of cow’s milk, eggs, peanuts, and other foods may increase the child’s risk of developing food allergies. And, even more importantly, there is evidence to suggest that the early introduction of allergenic foods may actually prevent the development of the allergy to that food. As an example, a recent study demonstrated that children in England were ten times more likely to be allergic to peanuts than children in Israel. One very strong hypothesis to explain this finding is the fact that Israeli infants are introduced to peanuts, generally through Bamba (a Peanut flavored snack that is used as a teething food), at about six months of age. On the other hand, children in England are generally not introduced to peanuts in any form until approximately three years of age. This study is just one of many that strongly suggest that an early introduction to certain foods can help babies build desensitization, thereby decreasing the risk of developing a food allergy.Managing Severe AllergiesHistorically, the treatment of serious food allergies has consisted of avoiding exposure and ingestion of the allergenic food, and making antihistamines and epinephrine immediately available. Total abstinence is indeed difficult and often impossible, as evidenced by the large number of accidental ingestions and allergic reactions that have resulted in emergency room visits. Even with strict avoidance measures, the potential for sudden and life-threatening outbreaks can lead to extreme anxiety in both the child-and the parent.Fortunately, medical research has now proven that orally-administered immunotherapy can result in a significant degree of desensitization, or tolerance, to a given food in most allergic patients. This form of therapy, however, is associated with a significant amount of risk and should only be performed under the watchful eye of a board-certified allergist experienced in oral tolerance induction. Presently in the United States, this form of desensitization is being performed at a few highly-acclaimed medical centers.An Allergy-Free FutureWith all the time and money being put into food allergy research, there is excitement in the medical field about the possibility of new breakthroughs in the near future-both in prevention and treatment. I, for one, am optimistic that a safe and effective treatment is close at hand.
Cure Your Financial Lack: Basic Factors to Consider for Becoming Financially Free
Most people can do better financially. Most of us if not all of us meet opportunities on a daily basis that are intended to change our financial fortunes for the better but are unable to recognize them in their camouflaged state. Opportunities of devious magnitudes happen to all men. We are programmed to see and hear only those things that we want to see and hear. What will happen if we can learn to freeze this approach to life and unfreeze the conscious expectation of everything we need to become what we should be, that is, if we fully comprehend and have visualized what we should be? Nothing happens by chance! You have to want it and want it very bad.There is always a starting point to everything and a first time with which to experience things. If we do not start we’ll never get anywhere and the worst that can happen is retrogression. Our dreams which are linked to our desires differ in magnitude. Some people desire to be wealthy and others desire to be well to do, that is, to have their needs met. Some actions have to be initiated for these things to manifest. It is only when you are consciously conscious of who you want to become and what you want to achieve that you will begin to take appropriate and relevant actions to achieving your goals. We all have something to give to others which we can do in exchange for something. This is how battering came about and was highly effective. It was all about meeting the needs of others. Think about what you can do to meet the needs of others and receive compensation for doing that and you will have found an income generating system.For those who are already earning an income, there are some things you can begin to consider to improve your financial status. Make sure that you cover the basic stuff first before considering moving to the next level of financial freedom. Personal financial management is the first hurdle to cross before attempting total financial freedom. If you acquire basic skills for personal financial literacy and manage your personal finances well, you’ll then find business finance management very interesting. The skills of saving, investing, and making your money grow for your future financial needs and of protecting your income are the basis for proper financial planning. Everyone can cure their financial lack.The quest to be financially healthy requires that we be disciplined, responsible, knowledgeable and understanding. Financial literacy is the most important set of life skills that we all need to survive and be successful in the modern world. This is the set of skills that has been acquired by very few people hence there are only few financially successful people in the world today. The lack of this skill results in many people finding it extremely difficult to manage their financial affairs and to successfully plan their financial future.If we spend all our money today we’ll have no provision for tomorrow and we’ll have to work extra hard just to survive. If we save some of our money today, we’ll have something for tomorrow. This is how serious saving and investing a portion of our monies today is. Put your money to good use and let it generate more money for you. If you spend all your money today, then you are giving away your future financial freedom. We cannot just hide our heads in the sand and hope that the future will take care of itself. We have to force ourselves to make hay while the sun is still shining, when age, time, health and resources still allow us to do so. Choosing not to take heed of the advice of the wise will be downright ignorant and foolish.Personal financial management is the launching pad for personal financial freedom and paves a way to personal wealth. We have to start by acknowledging that we are not going to be young forever, that we are not going to be strong physically and mentally forever. We are not going to be able to work forever even though we may wish so. Working, as a business owner or employee, requires strength and energy and aging might be a limiting factor. You need to prepare for an event or time when you will be unable to work any longer. This calls for you to protect your personal income in case you die, become disabled or retire due to old age. You have to consider life and disability assurance while you are still working either as a business owner or employee to protect yourself and your income. Not considering this advice is purely being irresponsible. Consult your financial adviser and engage him or her on this issue. Do the right thing, plan your personal finances. There should be enough money available to pay off debts and in the case of disability, to make changes that will help you cope with your new situation.You have to understand the negative effects of inflation on your savings so that you can craft strategies to counter it. For example, an inflation rate of say 5% a year will half the buying power or value of your money in 10 to 15 years’ time. In other words, if it costs you US$125 a month now to buy your groceries, you will need US$250 to buy those same groceries in 10 to 15 years’ time. Time is the most important factor when it comes to saving and making money grow. The longer time you save, the more interest you will receive out of your savings.Money grows when it is used to make more money. However, investing money is not a sure bet, it involves huge risks. The objective of investing is to make more money. Your goal should be to maximize the returns on your investments with less risk on your capital. It starts from searching and researching companies, funds and business sectors you wish to invest in. There are many different ways of investing money in the economy and each of these different ways has its own levels of risk and return unless you open an investment account with a financial institution (bank). Work on your action plans for short-term, medium term and long-term investment strategies.While it is extremely important to invest in reputable companies, the reputation and integrity of your financial adviser is extremely important. Do not take your adviser’s advice at face value. Go for a second and even a third opinion and do more research. You cannot afford to believe only what your adviser is telling you. Trust is not enough as it will not guarantee you your returns. Research and scrutinize documents before committing yourself. Never put all your eggs in one basket regardless of how tempting it might be.It is extremely important to have a will. Will allows you to register your wishes in writing so that when you pass on, you may have this document speaking for you. Failure to do this will result in your possessions going to people you never wished to have them or going to the state (intestate). Any person of 16 years or older who is mentally capable of understanding what he or she is doing can make a will. Estate laws differ from country to country. Please check laws relevant to your country. Banks, lawyers and trust companies (most of them are insurance companies) can assist with the drawing up of a customer’s will. Ask your banker or financial adviser about the process of setting up a will.Regardless of how prosperous your business and investments are today, you have to provide in advance for the needs of your growing age and the protection of your loved ones. A budget is a plan that deals with the future allocation and utilization of various resources with regard to different organizational activities over a given period. Budgeting is a disciplined way of spending your hard earned income. It is a tool used to translate future plans into quantitative terms.Remember that the wealth you are trying to create is not only for you, it is for your second, third and fourth generations. Budget your expenses in such a way that you may have money available to pay for your necessities. You must also make provision to pay for your entertainment without spending more than ninety per cent of your earnings. Make provision for giving to deserving charities in the ninety per cent available for you to spend. It is important to get used to giving as it is a spiritual and universal law that binds all of us. Make sure that you invest the ten per cent of your income to give you excellent returns. Guard this ten per cent with all diligence for it is a seed that has to generate wealth for you.
Employment Reference Checks – Best Practices When Checking Employee References!
Employment reference checks are considered as one of the best tools to inquire about a prospective employee. Reference checking has always been an important factor for all the companies who want to make the informed decision of hiring the right employee.These days’ applicants are asked to provide employment references, such as previous employers or coworkers, whom employers can contact to learn more about the candidate. Employment reference checks are used to verify truthfulness and accuracy of information applicants provide about themselves and to reveal negative job-related background information hidden by the applicants.Unfortunately, previous employers are increasingly reluctant to provide references or background check information for fear of being sued by previous employees for defamation. If former employers provide potential employers with unsubstantiated information that damages applicants’ chances of being hired, applicants can (and do) sue for defamation. As a result, 54 percent of employers will not provide information about previous employees.This situation is very discouraging for employers as it creates a hindrance in their fair selection process and in determining the true value of an employee. But as we know that there is always a way to handle things with care to get optimum results without a problem. So by remembering the basic goals and using best practices in employment reference checks cannot only save time but also relieve all the fears of defamation.Two Essential Goals for Employment Reference Checks:
To discourage applicants to hide something. An applicant with a serious criminal conviction is less likely to apply in the organizations that announce pre-employment background and referencing.
To encourage applicants to be very honest in their applications and interviews. Since applicants are told there is a background check, they have a motivation to reveal information about themselves they feel may be uncovered with a probable reference check.
Best Practices When Checking Employment References: Employers have a number of options with regard to checking the references of a prospective employee. These can change from having the human resources person or the hiring manager call the former supervisor directly to check the reference, to third party to collect background information on a candidate, including checking references, and then reporting back to prospective employer.If an employer decides for employment reference checks than they should be looking into the following guidelines:
Include a statement on the application for employment directly above the applicant’s signature line stating that all information on the application on the application is subject to verification and that any false or misleading information may result in refusal to hire or, if already hired, the immediate termination of employment.
Require every applicant for employment to sign a waiver and consent form authorizing the prospective employer to check references and authorizing all former employers, supervisors, and managers to release information in response to a request for a reference and/or verification of employment.
Establish a written procedure for reference checking including when in the hiring process reference checks will be conducted, who will conduct the reference checks, and what kinds of documentation will be kept of information obtained through reference check.
Limit questions to information that is job-related; don’t ask for medical information, information about physical characteristics, and/or other personal information that is not related to the employee’s conduct on the job.
Consider preparing a list of job-related questions that will be asked of all finalists for a particular position. This may help avoid claims of discrimination or claims that prospective employer inquired about the information that it was not legally entitled to have.
Be fair and consistent.