Features

In the 1966 science fiction classic “Fantastic Voyage,” a submarine crew is miniaturised so it can squeeze inside a human body and travel to a hot spot where medical assistance is needed.

A team from the Massachusetts Institute of Technology has adapted this idea for real life, replacing the shrunken squad with specially engineered E. coli bacteria and pairing them with a suite of electronics that fit neatly inside an ingestible pill.

They call their creation an IMBED — short for ingestible micro-bioelectronic device — and used it to detect excess blood in the stomachs of pigs. After finding blood, the capsule sent a wireless signal from within the pig’s body that was read by a smartphone and a laptop computer.

Other IMBEDs outfitted with different bacteria were able to detect one molecule that signals inflammation inside the gut and another that is a biomarker for gastrointestinal infections.

The invention is described in the journal Science.

Although IMBEDs are still years away from being used in patients, gastroenterologists say they are already eager to get their hands on them.

“This has the potential to unlock a wealth of information about the body’s structure and function, its relationship with the environment, and the impact of disease and therapeutic interventions,” Peter Gibson and Dr Rebecca Burgell of Australia’s Monash University wrote in a commentary that accompanies the study.

IMBEDs combine advances in synthetic biology with improvements in electrical engineering.

Inside the capsule are four wells that contain genetically engineered Escherichia coli bacteria. These biosensors have been modified to recognize a particular molecule of interest, such as the blood component heme. A semi-permeable membrane traps the biosensors inside the capsules, but allows molecules from the environment to enter and be detected.

Once the target is identified, the bacteria metabolise it in a process that generates light through bioluminescence.

Beneath each well is a tiny electronic photodetector that can register light from the bacteria. A luminometer chip converts it into a digital signal, and a wireless transmitter sends that signal outside the body.

The MIT researchers, led by microbiology graduate student Mark Mimee and electrical engineering researcher Phillip Nadeau, put the IMBEDs through their paces in the stomachs of six pigs.

After the pigs were sedated, the scientists used an endoscope to deliver about one cup of solution into the pigs’ stomachs. Three of the pigs also got a tiny amount of pig blood.

Next, the team placed two IMBEDs in each pig’s stomach and used the endoscope to confirm that they were fully submerged. It took 52 minutes for the biosensors to recognise the blood, generate light and transmit the signal to the scientists. The signals grew stronger until the IMBEDs were removed two hours after the experiment began.

The IMBEDs correctly identified which three pigs had blood in their stomachs and which three did not, according to the study.

Other experiments outside of animals showed that the IMBEDs could recognise — and respond to — molecules that signal problems in the human gut.

The IMBEDs used in the Science study were 30 millimetres long and 10mm across.

Timothy Lu, a senior author of the study and Mimee’s advisor, acknowledged that the devices were “on the larger side,” but added: “I think for someone who’s motivated, they could definitely swallow it.”

Nadeau said he was optimistic that future IMBEDs could be at least one-third smaller than they are today by combining the luminescence detector, the microprocessor and the wireless transmitter onto a single chip. That would make it more palatable for patients.

“The idea would be you would swallow it and it would pass through the GI tract and eventually you would excrete it,” he said.

Lu said IMBEDs might eliminate the need for colonoscopies. Not only are colonoscopies uncomfortable, but the bowel prep required in advance of the exam alters the physiology inside the intestines, potentially masking signs of disease.

Gibson and Burgell described a future in which smaller IMBEDs could be placed into blood vessels to assess conditions in the circulatory system. Other versions could be implanted in solid organs — just like the five heroes of “Fantastic Voyage” who ventured inside a brain to remove a life-threatening blood clot.

“It is exciting to watch where this technology ultimately takes us,” Gibson and Burgell wrote.

Handing kids plates with pictures of fruits and vegetables may nudge them to serve themselves more of these foods and eat more of them, too, a small experiment suggests. 

Researchers conducted the experiment at a preschool in Colorado. At lunchtime on three days in one week, they gave 325 children plates with compartments that had pictures of fruits and veggies, and they observed how much kids put on their plates and ate. Then they compared those days to three days in a previous week when kids ate with their usual plain white plates. 

On average, kids served themselves about 44 grammes of vegetables each day with the experimental plates, compared with about 30 grammes with regular plates, the study found. They also ate more veggies: an average of 28 grammes a day with the experimental plates compared with 21 grammes before. 

With fruits, kids served themselves an average of about 64 grammes a day with experimental plates, up from roughly 60 grammes before. And, kids ate an average of 55 grammes of fruit with the experimental plates, compared with 51 grammes before. 

 “Pictures on lunch plates may indicate a social norm of vegetable and fruit consumption to nudge children’s dietary behaviours in a classroom setting,” said study co-author Emily Melnick, of the University of Colorado Denver. 

“So, these pictures suggest that other children take fruits and vegetables from classroom serving bowls and place them in those compartments and that they should do the same,” Melnick said by e-mail. 

The kids in the study, like children in many preschool classrooms, ate family style meals because this type of dining can encourage kids to regulate their own food intake, feel in control of their food choices, recognise their hunger levels, and learn about food, Melnick said. 

Before the experiment, researchers weighed exactly how much fruit and vegetables children served themselves on plain white plates during three school days over the course of one week. 

For the experiment week, researchers gave children a five-minute presentation explaining the new plates with pictures showing sections for fruits and vegetables at the start of the week. Then children were given the same meals they had before the experiment, and researchers again weighed how much children served themselves and how much they ate. 

While the kids increased both the amount of fruit and vegetables they added to their plates and ate, the difference in fruit consumption was too small to rule out the possibility that it was due to chance. 

It is possible this is because kids were eating so much more fruit than vegetables to begin with, researchers note in JAMA Pediatrics. At the start of the study, children took about 89 per cent of fruits available, compared with about 65 per cent of available vegetables. 

It’s also unclear if this classroom experiment could be replicated with family meals at home or lead to lasting, long-term changes in children’s eating habits, said Vandana Sheth, a spokesperson for the Academy of Nutrition and Dietetics and a dietician and nutritionist in private practice in Los Angeles. 

“If this is repeatable at home, it can be a simple technique practiced by families and have a significant impact on their long-term health,” Sheth, who was not involved the study, said by e-mail. 

“We know that early childhood dietary behaviours can affect their food choices and eating decisions into adulthood and have a long-term effect,” Sheth added. “If something as simple as putting pictures on plates to encourage food choice and amount can work, it’s worth a try.” 

Women who show up in the emergency room with a heart attack are less likely to die if they are treated by a female physician rather than a male, a new study finds. 

Researchers scrutinising data from nearly 582,000 heart attack patients found that women treated by male doctors were 1.52 per cent less likely to survive than men treated by female doctors, according to a report in the Proceedings of the National Academy of Sciences. 

That means if 1,000 women went to the emergency room with a heart attack, 15 more would die if they were treated by a male doctor, study leaded Brad Greenwood of the Carlson School of Management at the University of Minnesota-Twin Cities told Reuters Health. 

Intriguingly, women treated by a male doctor were more likely to survive if there were many female physicians in the ER. 

“The key takeaway is that male physicians appear to have trouble treating female patients,” Greenwood said. “The challenge of [future] research is to figure out how and why this occurs. It’s a tricky question and there’s a lot of speculation that comes into it.” 

Male doctors do seem to learn from their mistakes. “We do see improvement as they spend time in practice,” Greenwood said. “But these later benefits come at the expense of earlier patients.” 

Greenwood allows that the researchers’ calculation may be an underestimate since it only includes patients who were eventually admitted to the hospital. Women who were misdiagnosed and sent home would not have been counted in the analysis. 

Why would women treated by male physicians be dying at a higher rate than those treated by female doctors even though they were admitted to the hospital? 

Greenwood suspects the excess deaths are due to delays in treatment because the male doctors took longer to diagnose the heart attack. 

Greenwood and his colleagues reviewed anonymous medical data on 338,642 men and 243,203 women who were seen in emergency rooms in Florida hospitals between 1991 to 2010. Most — 520,078 — were treated by male doctors, while 61,719 were treated by female physicians. 

The Florida database included information such as patients’ age, race, gender and medical history, along with hospital quality. Even after accounting for these factors, women were still less likely to survive when treated by a male ER doctor. 

While noting that this kind of data is “fraught with potential errors and many unmeasured variables, there’s a growing drumbeat of data suggesting that women physicians have better outcomes,” said Karol Watson, director of the Women’s Cardiovascular Centre at the University of California, Los Angeles. 

There are some possible explanations for the new findings, said Watson. 

“Everybody knows, but nobody has proven, that women are better listeners,” Watson told Reuters Health. “And women physicians spend more time with their patients. I can’t tell you how many times the critical piece of information comes as the patient is walking toward the door.” 

The new study highlights the importance of having “a strong female physician workforce,” said Jennifer Haythe, co-director of Columbia Women’s Heart Centre at the Columbia University Medical Centre. 

“As a doctor who is very aware of gender bias particularly as it relates to cardiac disease, one can’t help but wonder if improved outcomes stem from the fact that female physicians take women’s symptoms more seriously, thereby expediting the workup and cardiac care of these women and improving mortality,” Haythe told Reuters Health. 

Acknowledging that we can’t choose the physician who treats us in the ER, Haythe has some advice for women: “They should certainly feel comfortable asking for their symptoms to be taken seriously. If they are concerned that they may be having a heart attack they should ask the treating physician — man or woman — if they have had an appropriate evaluation to determine this, and if not, why not.”

Parents who talk or text on cell phones while driving with their kids in the car are also more likely to engage in other risky driving behaviours, including not wearing a seat belt or driving under the influence of alcohol, a small study suggests. 

More than half of parents in an anonymous survey admitted to talking on the phone while driving with their young kids in the car. Nearly 15 per cent also did not use appropriate child restraints every time they drove their kids, and these parents were more likely to use their phones and take other chances while driving. 

“There are a lot of people on the road who are driving distracted and, usually, they are engaged in more than one dangerous driving practice at the same time,” said Linda Roney of the Egan School of Nursing and Health Studies at Fairfield University in Connecticut, who was not involved in the study. 

“Unfortunately, a lot of these people are driving children and they are sharing the road with us,” Roney said in an email. 

For the study, Catherine McDonald, a senior fellow at the Centre for Injury Research and Prevention at Children’s Hospital of Philadelphia, and her colleagues used the online crowdsourcing platform Turk Prime to recruit a sample of 760 adults from 47 US states. 

Sponsored

Survey participants were required to be at least 18 years old, to be parents or routine caregivers of children between the ages of Four and 10 and to have driven the oldest of those children at least six times in the preceding three months. 

McDonald told Reuters Health they selected the Four-to-10-year age group because those children normally ride forward-facing and are thus able to observe their parents’ behaviours. This age group also has inconsistent compliance with child restraint use, she noted. 

Survey participants anonymously answered questions about their behaviours when driving with their kids, such as using a cell phone to talk, read, send text messages and use social media. They also answered questions about how regularly they used seatbelts, regardless of whether the child was in the car, and how often they had driven drunk or “buzzed”. 

Researchers found that 52.2 per cent of parents reported talking on a hands-free phone while driving with a young child in the car and 47 per cent had done so with a hand-held phone. Just over a third of parents reported reading text messages while driving their children, while 26.7 per cent said they had sent text messages. Almost 14 per cent reported using social media while driving with children. 

Looking at whether risky driving behaviours go together, the study team also found that the 14.5 per cent of parents who did not consistently use a child restraint system were twice as likely as the ones who did to talk on their phone while driving, and three times as likely to use social media while in a moving vehicle with kids. 

Having a history of driving under the influence and of not consistently wearing a seat belt while driving was also tied to a higher likelihood of using a cell phone while driving with children. 

McDonald emphasised that even parents who did not engage in more traditional risky behaviours still used their cell phones while driving. But the clustering of risky behaviours “points to an opportunity for health education and health promotion with parents”. 

The study is limited by its reliance on participants to report their own behaviours, and the researchers had no information about whether any of the risky behaviours led to car accidents, the authors acknowledge in The Journal of Paediatrics. 

Roney calls the notion that we can multitask a popular misconception. 

“Neuroscience research confirms that we can’t,” she said. “When we do more than one thing at the same time, we actually shift our attention to one task at a time... The same thing goes for distracted driving — your attention shifts to your cell phone and you are no longer paying attention to the road or hazards ahead of you.” 

Activities that take the eyes off the roadway are particularly problematic, McDonald said. 

“Parents inherently want their children to be safe and optimally protected and may not realise that engaging with their cell phones while driving puts everyone in the vehicle — and on the road — at risk.” 

An uncannily familiar and satisfying combination of classic design and modern muscle, the Range Rover Chieftain is Banbury, UK-based Jensen International Automotive’s (JIA) follow-up to the revived, reinvented and modernised Interceptor R. Following a similar path as their updated and thoroughly more luxurious and powerful version of the classic 1966-76 Jensen Interceptor grand touring coupe, the Chieftain is similar in intent, yet a more complex engineering recipe. Based on a more recent and more globally recognised British design icon in the form of the 1970-96 Range Rover, the Chieftain is intended to garner broader, slightly younger and more international clients and appeal.

Expected to appeal to those with fond recollections and aspirations to own the iconic original Range Rover, the Chieftain was also developed with the broader Middle East market firmly in mind, given the general popularity of large, powerful and luxurious SUVs and the Range Rover’s particular regional resonance. A bespoke and highly personalised build from ground up once commissioned by a client, the Chieftain super-SUV is as exclusive as cars come. It is nevertheless developed as an indulgently comfortable high performance daily drive with robust, reliable and easily serviceable mechanicals, rather than as a delicate and temperamental garage-diva to be squirreled away by owners.

Bespoke built

Familiar yet significantly more potent in both brutally-epic supercharged V8 engine and aesthetic treatment, the Chieftain’s powerplant is sourced from the outgoing Cadillac CTS-V. Its design meanwhile retains the original Range Rover’s clean lines and surfacing, clamshell bonnet, iconic fascia, big glasshouse and all-round utility. 

It, however, sits lower, wider with a more intense and urgent demeanour, featuring more sculpted, angular and upright integrated bumpers and massive blistered wheel-arches. Accommodating a wider track inherited from the Land Rover Discovery chassis it is built on, the Chieftain’s muscular wheel-arches also house vast bespoke retro period-style 20-inch alloy wheels, 275/40R20 tyres and larger, more effective AP Racing brakes.

Under its evocatively reinterpreted skin, the Chieftain is built on a 2004-16 generation Land Rover Discovery chassis, including its light, long-geared steering and independent double wishbone air suspension in place of the classic Range Rover’s ruggedly old-school, but less comfortable live axles. Both repaired and restored as necessary, a classic five-door Range Rover body is then grafted onto the Discovery frame.

Under the bonnet, the Chieftain’s modern General Motors LSA 6.2-litre supercharged V8 replaces the original’s significantly less powerful and Buick-derived historic V8. Also using a GM-sourced 6-speed automatic gearbox and four-wheel-drive transfer case, the Chieftain however loses its Discovery donor’s low ratio gear transfer.

Bellowing brute

As visceral and imposing in sound as sight, the Chieftain stirs to life with a resonant crack of thunder and settles to a bass-laden burble at idle. Comparable in power and performance to Land Rover’s latest brutally quick Range Rover Sport SVR, the 2386kg Chieftain develops 556BHP at 6100rpm and 551lb/ft torque at 3800rpm. And with huge reserves of four-wheel-drive traction and grip for even in wet weather conditions, as driven during a Middle East exclusive test drive on UK roads, the Chieftain blasts through the 0-100km/h sprint in just 4.5-seconds. Capable of well over 250km/h, its gloriously rumbling and growling cruising soundtrack rises to a deep bass mid-range staccato.

With a seemingly bottomless torque reservoir, the Chieftain is languidly effortless and flexible at low-end and mid-range. Viciously quick when prodded more meaningfully, the Chieftain’s responses are immediate and accompanied by intensely bellowing top-end acoustics layered with background supercharger whine, as it speed accumulates with relentless urgency against high wind and driving rain, and despite its blocky 1970s aerodynamics. Confidently able to deploy much of its vast capabilities even on slick roads, the Chieftain’s delivery is that of a sweepingly seamless, consistent and progressive torrent. Gear changes a smooth and quick, yet seemed sensitive to kick-down, but the driven demo was due for further gearbox software fine-tuning.

Supple, smooth 

and settled

Designed with on-road use as its primary focus, the only existing Chieftain at time of test drive uses a four-wheel-drive set-up with open differentials, but features a traction control system to help put power down effectively. And while its enormous torque output somewhat compensates for off-road driving, JIA however can install limited-slip or locking differentials for future builds, if commissioned to do so by a client. The antithesis of most modern super-SUV’s slunk, hunkered down cabin, the Chieftain’s airy interior, high upright driving position, low waistline and big glasshouse instead provides significantly better visibility and confidence for placing when driving on- or off-road.

Despite the visual cues that its aggressive body styling and low profile tyres would suggest, the Chieftain is, however, set up for a high level of ride comfort and is a different more relaxed riding vehicle than firm riding modern high performance SUVs. Smooth and supple over imperfect road textures and settled over crests and on rebound, the Chieftain’s comfort-biased air suspension forgivingly soaks up lumps and bumps. Leaning slightly more through corners, the Chieftain nevertheless well contains body roll and feels predictable, tidy and balanced through corners. Confident and more agile through winding switchbacks, the Chieftain’s old school charm soon wins one over.

Exquisitely evocative

Improving on the original Range Rover’s vague steering, the Chieftain’s Discovery-sourced steering could do with being tauter on-centre, but delivers good road feel, accuracy and weighs nicely through corners.

Reassuringly stable at speed, the Chieftain’s four-wheel drive also ensures excellent road holding. Meanwhile well-refined from vibration and harshness, the Chieftain uses new door seals to reduce noise, but given its vintage body and panels, wind noise is more noticeable than in modern competitors, while its evocatively burbling engine and exhaust notes are more audible inside.

Available in right-hand-drive as pictured or left-hand-drive depending on customer requirement, the Chieftain’s cabin is and exquisitely appointed, comfortable and inviting place. Distinctly retro in ambiance inside, the Chieftain’s cabin is however extensively redesigned, refurbished, upgraded and reupholstered with fine leathers, Alcantara roof-lining and Wilton carpeting.

Spacious and offering excellent visibility, the Chieftain’s Monk Design cabin features improved ergonomics electrically-adjustable seats, new centre console and revised switchgear. Additionally, it features a seamlessly integrated period-style dashboard-mounted binnacle with an embedded Apple CarPlay-enabled Alpine infotainment system.

TECHNICAL SPECIFICATIONS

Engine: 6.2-litre, supercharged V8-cylinders

Bore & stroke: 103.25mm/92mm

Compression ratio: 9:1

Valve-train: 16-valve, OHV, fuel injection

Gearbox: 6-speed automatic, 4WD

Power, PS (BHP) [kW]: 564 (556) [415] @6100rpm

Torque lb/ft (Nm): 551 (747) @3800rpm

0-100km/h: 4.5-seconds

Top speed: over 250km/h

Fuel consumption, highway: 14.1l/100km

Weight: 2386kg

Suspension: Double wishbones, air dampers

Brakes: Ventilated discs

Tyres: 275/45R20

Price, UK: starting from GB£250,000

LONDON — Multidrug-resistant “superbugs” that can cause dangerous infections in hospitals are becoming increasingly resistant to alcohol-based hand sanitisers and disinfectants designed to hold them at bay, scientists said. 

In a study of what the researchers described as a “new wave of superbugs”, the team also found specific genetic changes over 20 years in vancomycin-resistant Enterococcus, or VRE — and were able to track and show its growing resistance. 

Their findings were published in the journal Science Translational Medicine. 

VRE bugs can cause urinary tract, wound and bloodstream infections that are notoriously difficult to treat, mainly because they are resistant to several classes of antibiotics. 

In efforts to tackle the rise of hospital superbugs such as VRE and MRSA, or methicillin-resistant Staphylococcus aureus, institutions worldwide have adopted stringent hygiene steps — often involving hand rubs and washes that contain alcohol. 

Tim Stinear, a microbiologist at Australia’s Doherty Institute who co-led the study, said that in Australia alone, use of the alcohol-based hand hygiene has increased tenfold over the past 20 years. “So we are using a lot and the environment is changing,” he said. 

Yet, while rates of MRSA and other infections have stabilised due to heightened hygiene, Stinear said, VRE infection rates have not. This prompted his team to investigate the VRE bug for potential resistance to disinfectant alcohols. 

They screened 139 isolated bacterial samples collected between 1997 and 2015 from two hospitals in Melbourne and studied how well each one survived when exposed to diluted isopropyl alcohol. 

They found that samples collected after 2009 were on average more resistant to the alcohol compared with bacteria taken from before 2004. 

The scientists then spread the bacteria onto the floors of mouse cages and found that the alcohol-resistant samples were more likely to get into, and grow in the guts of the mice after the cages were cleaned with isopropyl alcohol wipes. 

Paul Johnson, a professor of infectious diseases at Austin Health in Australia who also co-led the study, said the findings should not prompt any dramatic change in the use of alcohol-based disinfectants. 

Sophia, or the Beginning of All Tales
Rafik Schami
Translated from German by Monique Arav and John Hannon
US: Interlink Books, 2018
Pp. 444

Homesickness catalyses the plot in Rafik Schami’s latest novel, “Sophie”. Though living mostly happily in Italy for many years, and having a wife, son and successful business there, Salman Baladi longs for his native Damascus. “It wasn’t until much later that he would learn that the Damascus he dreamt of in his loneliness existed only in his imagination.” (p. 122) 

Although the focus is on Damascus, the novel also moves to Homs, Lebanon, Germany and Italy. The narrative spans the timeframe from the 1920s to 2010, alluding to many historical events of the last century and ending as the Arab uprisings begin to break out, accentuating the novel’s themes of honour, dignity, freedom and betrayal. 

Returning home after forty years is complicated for Salman because he had left Syria illegally after the defeat of the underground opposition group of which he was a member. But when a general amnesty is declared in 2010, he is determined to go and visit his parents. They have a relative high-up in the secret service from whom they get assurances that Salman will not be harassed or arrested. Reassured, he travels to Damascus, but promises are not always kept, and he learns that money and fear count more than honour, kinship or friendship. Though many have good intentions, they nonetheless risk getting caught up in or victimised by webs of deceit and corruption. The latter part of the book is something of a thriller: Salman does not know whom he can trust, or if he will be able to return to his wife, Stella, and son Paolo in Rome. 

Like Salman, Schami is a Syrian in exile; through Salman’s eyes, he highlights what is best in Syrian society — and by implication Arab society — as well as what is worst. Parts of the book are like an ode to Damascus, with charming descriptions of people, places and everyday life, particularly in the Old City. But it is also an indictment of what can make life in Syria difficult and sometimes ugly, whether state repression, with its extensive prison and torture network, or the public’s forced complicity. Schami is adept at integrating political and social critique into the narrative without disrupting its literary flow. Sometimes the characters speak for him; at other times, he uses subtle irony to reveal abuses of power, hypocrisy and the perils of the clan system. 

Karim, a friend of Salman’s mother, Sofie, in their youth, is almost destroyed by the clan system; he is expected to kill his sister to restore his family’s “honour” after she marries a Christian. “The whole thing was based on members blindly following their chief — in this case his father — oblivious to the fact that he was leading them to ruin with a pack of lies”. (p. 159)

In the same vein, Salman gets a lecture from his Aunt Amalia, who has lived in Beirut since being disowned by her family: “No change will ever come to Arab countries until the very structure of the clan that enslaves us, body and soul, has been destroyed.” (p. 44) 

Schami spins his story around a set of opposites: exile vs belonging, love vs hate, peacefulness vs. violence and tolerance vs. prejudice. It is not a tight-knit plot; on the contrary, there are stories within stories and many digressions. Schami is known as a storyteller in the Arabic tradition and for having integrated that style into European literature. His “digressions” deepen the themes of the novel, particularly love, which is portrayed in all its types and degrees. 

Such is the story of Aida and Karim, who fall in love as seniors, she from a Christian family and he from a Muslim one. The distinctive thing about their love is not just that it crosses sectarian boundaries but that it inspires them to pursue thwarted childhood dreams. Karim is teaching Aida to ride a bicycle — something she was forbidden to do as a child, while Aida is teaching Karim to play the oud, which along with all music was banned by his father. Aida and Karim become central to the plot because they help Salman when no one else can or will. 

Salman’s and Stella’s marriage shows that different backgrounds can enrich a relationship, while Aida’s and Karim’s love shows that open-mindedness does not have to come from abroad but can happen wherever people are ready for harmony that thrives on difference not sameness. “Only a vivid combination of different — even opposing — colours and tones, only a lively coming together of people of different temperaments and opinions, could give rise to a living harmony. It was a balance of opposites that could only occur among people through respect and love, but above all through reason. Once achieved, such a balance outlasted by far any coercive control.” (p. 289)

Sally Bland

While there is so much discussion among parents about which schools in Jordan to send their children to and how students should be taught, Family Counsellor and Educator Khalil Zeud empathises the role of parental involvement. He says parents having a more powerful influence on students’ academic performance than the school the students attend. 

So what is this involvement? Buying expensive educational toys or digital devices for your child? Rushing from school to extracurricular activities? Supervising homework? Zeud says “no”. What parents need to do with their children is much simpler, he says: communicate.

Parents become so anxious to raise a “successful” child, he says, that they overlook the importance of spending time interacting personally with their child. This is where Zeud stresses the role of fathers in parenting: Too many fathers are absent in their children’s lives.

They see themselves as the financial providers for the family and that parenting rests exclusively on mothers. “He needs you,” Zeud told fathers at Ask Our Experts II* workshop and makes the case that quality time with fathers is as invaluable to a child’s physical, emotional and intellectual growth as time with mothers — and both parents are needed.

This is why Zeud is disillusioned by the rising rates of divorce and domestic abuse as both have long been linked to behaviour problems, anxiety and depression in children. But even among secure families, children can suffer if parents are both working and not making a concerted effort to spend time with their children. Zeud was blunt with fathers and mothers in his session: “If you don’t have time for your kids, don’t have them.”

He also stresses being present in those moments with children, without distractions — running off your to-do-list or fiddling with your smart phone. Eye contact when talking to your child is very important, he says. Talking clearly, simply and asking your child to repeat what you have said to make sure they understand, is important too.

Zeud’s takeaway message for parents: Raising a child is a challenging task and all parents know that. There is no manual that comes with birth, so naturally, parents need to seek help. But Zeud warns against the social trend of turning to laypeople whose advice is subjective and often harmful to families. Families are struggling, many are broken, he notes. It is a good thing that there are experts in Jordan who can help — take advantage of this,” he concludes.

Reprinted with permission from Family Flavours magazine

For middle-aged women who worry about adding on kilogrmmes when they quit smoking, a large study suggests that adding even a modest amount of weekly exercise after quitting can minimize weight gain. 

Nearly 7 of 10 US adult cigarette smokers say they want to quit, according to the Centres for Disease Control and Prevention. The fear of gaining weight discourages many of them. 

“We found even a little bit of physical activity minimised weight gain after women stopped smoking,” study leader Juhua Luo of the School of Public Health at Indiana University in Bloomington told Reuters Health by phone. 

Even walking for a weekly total of about 90 minutes at five kilometres per hour was enough to minimise weight gain after smoking cessation, Juhua said. The best results were seen when women engaged in 150 minutes of moderate intensity activity per week. 

Surprisingly, “women who had low physical activity and then transitioned to increased physical activity after they quit smoking had the same weight benefit as women who were physically active before and after they quit smoking”, she said. 

For three years, the study team tracked 4,717 smokers, ages 50 to 70, who were participating in the long-term Women’s Health Initiative study. The 2,282 women who quit smoking gained an overall average of 3.5 kilogrammes. 

The researchers gauged weekly physical activity levels by the type of activity, how intense or strenuous it was, and how long and how frequently a woman exercised to derive a value in so-called metabolic equivalents of task (MET). For example, one hour of moderate-intensity activities such as biking, easy swimming, folk dancing or using an exercise machine was valued at five METs. High-intensity exercise like aerobics was seven METs and low-intensity activity such as bowling, golf or walking at average speed counted as three METs. 

Quitters who increased their levels of physical activity by 15 MET-hours per week or more, about the equivalent of 150 minutes of moderate-to-intense exercise, gained an average of 2.55kg while those who did no exercise or decreased their activity gained an average 3.88kg. 

Women with a high level of physical activity at the beginning and the end of the study also had low weight gain after quitting smoking, averaging an increase of 2.63kg. 

Increasing physical activity had a stronger beneficial association for women who were obese compared with normal weight women, the researchers found. The association between physical activity and weight gain also appeared slightly stronger for younger women, the study team reports in the journal Menopause. 

“My hope is that women believe this study and it will convince them that stopping smoking doesn’t have to lead to weight gain,” said Dr JoAnn Pinkerton of the University of Virginia, Charlottesville, who is also executive director of the North American Menopause Society. 

“Hopefully they will start an exercise programme and watch their diet when they stop smoking,” Pinkerton, who was not involved in the study, said in a phone interview. 

“There’s no clear gender difference in gaining weight after smoking cessation. I wish there had been men in the study to make it more comprehensive. Weight gain is equally important to men,” noted Dr Qi Sun of the Harvard T.H. Chan School of Public Health in Boston, who was not involved in the study. 

Although the study excluded women over 70, Pinkerton added, “stopping smoking is beneficial to women at any age”.