Wednesday, November 30, 2005

Are Doctors Really Needed Here?

IMHO, I do not think Australia is in dire need of doctors. Judging on the way how they select applicants (like going through a needle's eye), I reckon that the demand for doctors here, is not that urgent.

Today, I emailed all medical recruitment agencies, authorised by the Australian Government to help them find doctors to work here. Almost all replies I got are negative... they do not have job openings, suitable for my credentials at the moment.

Maybe I am "sour-graping" here but pardon me, I just feel that the selection criteria for overseas trained doctors here are so stingy, no one can even qualify.

Just my two cents.

Sunday, November 27, 2005

Another Sad Story...

I chanced upon this blogsite while blogging today and I read one of her post about the plight of Filipino domestic helpers in Hong Kong.

It broke my heart to hear such news. Makes me hate the FIRST GENTLEMAN more and more!

I hope and I pray that someday the Laws of Karma will catch up on you.

Mr. Miyagi Dies At 73

100 Pesoses Collectibles

Meron na ba kayo nyan??? Better than the 100 peso bills with misspelled name of the president

Picture from cathcath's blog

UNSW Badminton Open Tournament - An Unforgettable Experience

I woke up early today (6:30 am), not my usual waking hour but I have to get ready for today's tournament. After a hot cup of coffe and a nice warm shower, I was up and about. Rodel and Marriane fetched me on their way to Art and Norman's house in Blacktown. We waited for Robert and Joy to arrive and at about 9:30 am, our convoy left for a one hour drive to the city.

We reached the University of New South Wales at around 11:00 am. The tournament had started already, the men's singles and women's singles were playing at that time. Lunch time passed by, and we still haven't warmed up yet. Finally at around 2:00 pm, the men's double started.

Rodel and I lost all of our matches but Joy Lopez and Joy Valena saved the day. They brought home the CHAMPSIONSHIP of the women's doubles level d. WOW!!!!

We had dinner at a chinese restaurant near the Uni, John, a Malaysian badminton player joined us. Finally I arrived home at around 12 midnight, thanks to Rodel and Marianne again for driving me home.

CONGRATULATIONS JOY AND JOY!!!! WELL DONE!!! To the rest of the group, we'll get them next time.

Mabuhay FilBCS

Friday, November 25, 2005

UNSW BadmintonTournament Will Be Tomorrow

We will be leaving early for Sydney tomorrow. Rodel will pick me up at around 8 am. It will be a whole day affair. I hope my game will pick up tomorrow.

Good luck to all of us.

Monday, November 21, 2005

President Arroyo Goes To Hongkong Disneyland

Wow! While more than half of the Filipino population are going hungry, with no decent meal on their tables, our own leaders enjoying their rides in Disneyland. How thoughtful they can be!

"Arroyo and her entourage tried out the Dumbo the Flying Elephant ride and the Jungle River Cruise. They also saw shows like Mickey's PhilharMagic, featuring 3-D versions of Disney cartoon characters, and "Festival of the Lion King," a Broadway-style musical."

Tsk.. Tsk.. Tsk..

You should have not publicize your pleasure trips madame president! It will not do your ratings any good. It will make more Filipinos to hate you more.

Saturday, November 19, 2005


Yesterday, Annie texted me. She was crying the whole morning because of self pity. She don't have any money not even for a bus fare to go to her clinic. She has many problems and I am becoming guilty because I can't even help her, console her, give my shoulders for her to cry on because I am here in Sydney, far from her.

Life is so pathetic in the Philippines! Even us doctors are feeling the hardships of life. I can't imagine how much more the poor and the needy are suffering....

I hope the FIRST GENTLEMAN will someday experience this! May you someday die of hunger!

Friday, November 18, 2005

War For A Better Life

I have already lived more than one half of my life (life expectancy of average filipino male is 63 - 65 years) and up to now I do not have anything to call my own. Looking back at 38 years of living in this planet, I don't have any achievements that I can be proud of.

It seems that my life ceased to grow when I took the responsibility of caring for my mom who is a stroke survivor in a vegetative state. I have no regrets for this nor I am blaming this for what I am right now. Sometimes I can't help but think and reflect on what I have accomplished so far.

I am a medical doctor, a paediatrician for that matter. I am still single and with no family of my own. I don't own house nor a car. All I bought for myself is an scooter which I use to go to my place of practise. I can't even propose marriage to my girlfriend because I don't have the means to afford even a simple wedding ceremony. Gosh! Am I really that poor? Oh well, who is not poor nowadays in our country??? Oh, there are a few...the FIRST GENTLEfuckingMAN and his family. The traditional politicians (or should I call them traditional burglars!)

I am not blaming others for what I am now, I know that we are the ones who create our own destiny. I just always tell to myself that the struggle is not yet over, I lost some battles but my war for a better life is not yet over.

I just need to vent this out! Pardon me.

Its a good thing I have this blogsite, here I really can WRITE wnat I cannot SAY.

Thursday, November 17, 2005

Australia Qualifies For The World Cup

After 32 years of waiting, the Australian Socceroos qualifed for the 2006 World Cup in Germany. They beat a highly favored Uruguay National Team, 4 to 2 in a penalty shootout.

It was a very tightly contested match, I am not a fan of soccer but I enjoyed the game.

CONGATULATIONS SOCCEROOS!!! Onwards to Germany 2006.

Monday, November 14, 2005

Knock Knock! Who's There?

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Perils of Wearing A Tube

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Sunday, November 13, 2005

UNSW Badminton Open Tournament

I was chosen by our club the Filipino Badminton Club of Sydney (FilBCS) to be a representative in the UNSW Badminton Open. I will play alongside Rodel Rillera in the Men's Doubles Level D.

Balita ko magagaling daw ang mga sumasali dun, mostly chinese. I need to practise more with my new partner and hope for the best. I need to shape up to, medyo tumaba na ko dito sa Sydney.

Wednesday, November 09, 2005

Holy War Already In Australia?

I have been reading and watching the news about the raids in Melbourne and Sydney, Australia is not a part of the Western World but is a strong ally of it. This news from the Daily Telegraph says it all. We are vulnerable to terror attacks here. I hope nothing bad will happen.


Tuesday, November 08, 2005

Create A Cartoon Strip To Express Your Feelings

Found this site. I thought you might want to try.

Camaraderie... Whats Missing Among Oz????

Camaraderie is from the french word camarade meaning 'a spirit of friendly good-fellowship.'

What I have been experiencing here in Australia is that many Aussies lack this "value." Many of them over react even to small things. One good example happened to my sister last night. She parked her car in front of my brother's rented house, after a few minutes, someone sticked a note on her windshield saying she's illegally parked. That's a lot of B*&^@$!T. Other tenants do that here too and we don't mind them. Why do that to us? Is it because of our brown skin??? Another big B&^%@#(T! Hey, Australia is a land of multicultures. There's no place for discrimination and racism here. For all you know we pay more taxes than you do!

Pardon me for being rude but I am just pissed off!


Friday, November 04, 2005

Homeschooled Fil-Am Wins $10,000 In Jeopardy

by: Ruben V. Nepales
Inquirer News Service
Editor's Note: Published on page A1 of the Nov. 4, 2005 issue of the Philippine Daily Inquirer

LOS ANGELES, California -- Joseph Henares, a homeschooled Filipino-American boy, recently won a "Back to School" edition of "Jeopardy!" -- America's popular TV quiz show.

The 12-year-old Henares received a cash prize of $10,000 in the competition that involved 15 contestants selected from more than 500 kids all over America.

Joseph emerged the winner after five daily episodes were taped at the Sony Pictures Studios in Culver City, California.

Interviewed by phone and e-mail, Joseph credited his "Jeopardy!" triumph to his "mom, who helped me review different topics that we thought would be on the show, and my dad, who helped me with strategy and taught me how to bid in the Final Jeopardy!"

He is the eldest son of John and Jean Henares, both holders of math degrees from the University of the Philippines in Diliman, Quezon City.

Joseph heard about the nationwide tryouts in various cities for 10-to-12-year-old contestants for the "Back to School" tournament back in the spring, the elder Henares recounted.

"I went to and signed him up online for the tryout in New York City. A few weeks later, I got an e-mail that Joseph was scheduled for his tryout in New York on July 16. Joseph was interviewed, given a 30-question test and participated in a mock 'Jeopardy!' game with other applicants."

Odds of getting in slim

"The odds of getting in were quite slim," said John. About 500 kids were trying out for 15 slots.

On Sept. 12, Joseph was on the “Jeopardy!” set at the Sony Pictures Studios for the taping of the show that was aired on national TV on Oct. 13.

When asked how he felt when he learned he had made it to the final 15, Joseph offered his mother's reaction instead: "My mom jumped up and down and screamed." He added, "All my friends were excited." His father was ecstatic.

John Henares reflected on his career as an actuary who calculates insurance reserve liabilities and does financial reporting when he disclosed how he and Jean prepared Joseph for the quiz show hosted by Alex Trebek.

"We drilled Joseph on how to bid, particularly on 'Final Jeopardy!' We came up with various scenarios covering the what ifs. For example, what if you're in first place with $X, and the second and third placers have $Y and $Z, how much should your final bid be?

"We had about less than a month to prepare. So we brainstormed among ourselves what the likely 'kids' categories would be. We came up with Superheroes, recent kid movies, what's on Disney Channel, Nickelodeon and Cartoon Network, among others.

"Then we determined which among those categories Joseph was weak at, and we did online searches on them. We also had Joseph read the latest issue of the Kids' Almanac," said the elder Henares.

Joseph's main worry

"But actually, knowing the correct responses to whatever categories was the least of Joseph's concerns. He knew that he could get his share of correct responses. What he feared more was whether he could buzz in fast enough to make that knowledge count.

"So we had him watch 'Jeopardy!' and take note of the cadence of Alex Trebek's speech and pretend to signal in as soon as Alex was done reading the question. For practice, Joseph used a fat marker as his signaling button."

Joseph and his siblings, Marian, 10, and John Paul, 8, are schooled at home in Avon, Connecticut, primarily by Jean, who was also an actuary before she quit to become a full-time mother.

The Henareses have a younger daughter, Christina, 3. The Henares couple is part of a growing number of parents in the United States who are educating their kids at home. This trend has resulted in the term "homeschool" being accepted as a word entry in the dictionary.

John Henares credited his son's success to his being an avid reader and his ability to retain knowledge and information about things that he encounters.

"His mom does a good job -- and has great patience -- in quizzing him in preparation for 'Jeopardy!' and other contests. But then, any other non-homeschooling mom could have done just as well."


John explained how he and Jean decided to homeschool Joseph and, eventually, their other children. "Jean met some Catholic parents who homeschool their children," he said.

"She was impressed with their dedication and their testimony of very favorable results that they experienced with their children. She observed first-hand how the children functioned and behaved. The image stuck in her mind. When Joseph reached school age, we decided to give it a try. It hasn't been all that easy but we've managed. We are aided by a good Catholic curriculum that we get from Seton Home Study, a homeschool curriculum provider based in Virginia."

It is rare to hear a 12-year-old say that he wants to be an actuary, but that is what Joseph says he would like to be someday.

John, who was raised by Manuel and Sandra Henares in Bacolod City, worked for two years as an instructor at the UP Math Department. He earned his MS degree in Math-Actuarial Science from the University of Connecticut. A fellow of the Society of Actuaries, John works for Genworth Financial in Windsor, Connecticut.

Jean, the eldest child of Fermin and Florentina Alambra, grew up in La Union province. Like John, she also taught at UP after graduation and earned her MS degree in Math-Actuarial Science from the University of Connecticut.

'Star Wars', Lea fan

Math and academics are just some of the interests of Joseph. He sings, acts and plays the piano. Joseph, Marian and John Paul are members of The Company, a children's theater program based at the University of Hartford. Joseph, who last played Linus in The Company's production of "You're A Good Man, Charlie Brown," hopes to meet internationally acclaimed singer-actress Lea Salonga someday.

He also likes to watch the "Star Wars" (the reason he welcomed questions on this film series in "Jeopardy!") and "Lord of the Rings" movies, play soccer and tennis and join chess tournaments, where he has won trophies.

The young Henares had joined other similar contests before, including the Spelling Bee, Geography Bee and American Math Competition.

"I've been the top scorer in the Connecticut Homeschool Network American Math Competition for two years. Last year, I was second in the school level Spelling Bee of the Woodbury Homeschool Group. I was also in the top 10 for the Geography Bee in the state of Connecticut," he said.

Joseph plans to spend some of his cash prize on computer games but he will save most of it to help pay for his college tuition.

Trebek might see a lot of Joseph as this whiz kid grows up. Joseph declared, "I would like to join the teen version, then the college version, before finally moving on to the adult 'Jeopardy!'"

(Ruben V. Nepales is a correspondent in Los Angeles for the Philippine Daily Inquirer)

Cool Game

Click on this link and have an hour or may be more of fun. I hope you'll enjoy.

Thursday, November 03, 2005

2005-2006 MIAMI HEAT

NO Player Pos HT WT DOB College Years
49 Shandon Anderson G/F 6-6 215 12/31/73 Georgia 9
30 Earl Barron C/F 7-0 245 08/14/81 Memphis R
51 Michael Doleac C 6-11 262 06/15/77 Utah 7
40 Udonis Haslem F 6-8 235 06/09/80 Florida 2
24 Jason Kapono F 6-8 215 02/04/81 UCLA 2
33 Alonzo Mourning C 6-10 261 02/08/70 Georgetown 12
32 Shaquille O'Neal C 7-1 325 03/06/72 LSU 13
20 Gary Payton G 6-4 190 07/23/68 Oregan State 15
42 James Posey G/F 6-8 217 01/13/77 Xavier 6
25 Wayne Simien F 6-9 250 03/09/83 Kansas R
3 Dwyane Wade G 6-4 212 01/17/82 Marquette 2
8 Anotoine Walker F 6-9 245 08/12/76 Kentucky 9
44 Matt Walsh G/F 6-6 200 12/02/82 Florida R
55 Jason Williams G 6-1 180 11/18/75 Florida 7
1 Dorell Wright G/F 6-8 205 12/02/85 South Kent Prep 1

I hope they will be wearing the ring next year! GO HEAT!

Vigan Sunset

Taken by the author last December 2004 during our trip to Vigan, Ilocos Sur

Wednesday, November 02, 2005

218th in Pinoy Top Blogs

My site is listed for the first time in the pinoy top blogs website. My site ranked 218th among more than 600 blogsites listed. To all who visited my site, my heartfelt thanks! Please vote for my site.... THANK YOU!

Picky Eaters... A Cause For Concern?

Picky eating occurs on a continuum; there is no defined diagnostic cut-off for when it becomes pathologic. Picky eating that is brought to the attention of the pediatrician is probably best defined as an unwillingness to eat familiar foods or try new foods that is severe enough to interfere with daily routines and cause problems for the parent or child or disrupt the parent-child relationship.

About 20% to 30% of parents report that their preschool-aged child is a picky eater. Half of toddlers are described as not always hungry at mealtime, a third do not seem to enjoy meals, and a third have strong food preferences. One in four often refuses to eat, one in five requests specific foods and then refuses them, and nearly one in two tries to end a meal after a few bites. Almost two thirds of parents report one or more problems with their toddler's eating.

In a small (135 subjects) study comparing parental descriptions of picky preschoolers with those of nonpicky preschoolers, parents who described their child as a picky eater were more likely to report that their child eats a limited variety of foods (79% vs. 16%), wants the food prepared in specific ways (62% vs. 18%), does not accept new foods readily (90% vs. 39%), and has strong dislikes (97% vs. 63%). Vegetables are the foods most often rejected by preschoolers.

Children who are picky eaters seem to differ from nonpicky eaters in more than just eating behavior. Picky eaters are more likely to have negative temperamental traits1 and to be shy and anxious.

The most comprehensive study to date on nutrient intake and parental report of picky eating evaluated 74 children between 2 and 3 years old using questionnaires and diet diaries. Picky eaters were found to have significantly less variety in their diets than matched controls, but no significant differences in overall nutrient intake were noted. In another study, picky eaters between 3 and 5 years old ate significantly fewer foods than their nonpicky counterparts, but the actual difference was small—about 11 foods vs. 12 foods over the course of a day.

Why are children picky eaters?

It is unclear whether picky eating varies by gender, culture, socioeconomic status, or ethnicity. It does seem to peak during the preschool years and decline thereafter. One hypothesis holds that the developmental trajectory of picky eating has evolved as a protective mechanism. Specifically, picky eating seems to increase as children become more mobile. Some investigators theorize that children are "wired" for pickiness to protect them from eating potentially poisonous substances in the environment; children who are inherently reluctant to eat an unfamiliar food, or a variety of foods, will not "wander into the bush and eat a poison berry."

Human beings also seem to have some innate predisposition that guides which foods to accept and which to reject. All food rejections occur for essentially one of three reasons: dislike, fear, or disgust (see "Three reasons why people reject food"). Although children demonstrate some degree of disgust as young as 2 or 3 years old, disgust does not begin to cause food rejection in the adult form until 7 to 8 years of age.

Picky eating seems to run in families. Moderate correlation is seen between a mother's rating of pickiness and her child's rating,3 and high correlations are seen between twins in regard to picky eating.

Gathering the history

A few key interview questions can help rule out underlying medical problems in a child who is a picky eater and facilitate understanding of the family's perception of the problem and how they are dealing with it.

Tell me which foods your child won't eat. A pattern of refusing specific foods, such as milk products or foods with certain textures, raises the possibility of food allergy or intolerance or oral hypersensitivity.

Tell me what your child ate yesterday, starting with breakfast. A diet history can give you a sense of how picky the child is and open a discussion about what foods the child is given, how they are presented, and how the parents respond when the child refuses to eat foods.

What do you do when your child rejects a food at dinner? What sort of rules do the parents have about eating? If they answer that the child is required to remain at the table until his plate is clean, or reveal that the child is coerced to eat a particular food, that is an important finding. Neither approach has been shown to produce long-term improvement in picky eating. Both most likely add stress and negativity to the family mealtime.

What worries you the most about your child's eating? Parents often express concern that their child has a growth or vitamin deficiency. Reassuring them that their child is growing adequately and suggesting that they add a multivitamin with iron to the child's diet often assuages their worry.

Is anyone else in your family a picky eater? This question (to which the answer is nearly always "Yes") can open a discussion about the natural course of picky eating and may provide some insight into why the parent views the behavior as such a problem.

Is the child growing?

When a concern about picky eating is raised, the first and most important piece of information needed to guide management is the child's growth. Carefully measure weight and height (or length) and plot them on the gender-specific National Center for Health Statistics (NCHS) Growth Charts ( Because evaluation of changes in percentiles over time is just as important as current position on the curve, longitudinal growth data are necessary.

A detailed discussion of the analysis of growth patterns with respect to acute and chronic undernutrition is outside the scope of this review. However, a body mass index (calculated as weight in kilograms divided by height in meters squared) or weight-for-length plotted at less than the 5th percentile on the age- and gender-specific NCHS Growth Charts should alert you that a child's picky eating may be a symptom of, or occur in conjunction with, an underlying medical problem. Such a child requires a thorough evaluation for failure to thrive. Discussion of the evaluation of failure to thrive may be found elsewhere.

Picky eaters should also be screened for constipation. The picky eater's diet is often low in fiber, and constipation can cause abdominal discomfort that only makes the eating behavior worse.

"Touching tonsils" may contribute to picky eating by causing a child to gag on large pieces of food, such as meat. Although this problem is relatively rare, it is worth considering because it is easily correctible by surgery.

In some cases, the child's eating behavior may be so far outside the range of normal that it deserves a psychiatric evaluation for "infantile anorexia." This term is applicable when underlying medical causes have been ruled out, and the child's food refusal is severe enough to result in malnutrition. Infantile anorexia typically requires consultation with a specialist for behavior modification in partnership with the parent and, sometimes, evaluation for parent-child interactional disturbances.

Considering the differential

As stated, the picky eater who is also not growing well warrants thorough evaluation because the differential diagnosis is broad. The same is true for a child whose picky eating is accompanied by other signs or symptoms of an underlying medical disorder. When picky eating occurs in an otherwise healthy child whose growth is normal and who has a normal physical exam and a negative review of systems, the differential diagnosis is relatively limited:

Food allergies or intolerance can lead to refusal of specific types of foods, such as eggs and milk. However, be very cautious about relying solely on the parent's history of an adverse reaction such as vomiting or irritability (or food refusal) to make the diagnosis. An appropriate work-up prevents unnecessary parental restriction of the child's diet, which can place the child at risk for nutritional deficiency.

Lactose intolerance causes abdominal discomfort, which can lead to refusal of lactose-containing foods. Lactase deficiency at birth is rare, but lactase activity begins to decline in non-Caucasian children between about 2 and 5 years of age.

Celiac sprue, an intolerance to gluten that occurs in 1% to 2% of the population, most often appears in children between 6 months and 2 years old. These children typically have a poor appetite but also exhibit associated signs and symptoms such as failure to thrive, diarrhea, and vomiting. Given the relatively high prevalence of the condition and the fact that the age of presentation often coincides with parental concern about picky eating, celiac sprue deserves special consideration in the differential diagnosis of picky eating.

Gastroesophageal reflux (GER). About 7% of 3- to 9-year-old children have at least occasional symptoms that suggest GER. Gastroesophageal reflux becomes gastroesophageal reflux disease (GERD) when it is severe or frequent enough to affect the child's daily life or cause associated medical problems, such as wheezing or esophageal injury.

Food refusal in children with GERD has been described as a conditioned aversion to eating caused by pain following ingestion. More recent evidence suggests that the aversion to eating is a conditioned response to nausea associated with the emetic reflex. Indeed, nausea seems to be a more potent cause of conditioned food aversion than pain. A single episode of nausea following ingestion of a particular food can cause an aversion to that food that persists for years. GERD is often found in association with failure to thrive, and severe GERD may well be a causative factor in some cases.

Oral hypersensitivity or post-traumatic feeding disorder of infancy. Some children refuse food because of a conditioned aversion to stimulation to the mouth created by previous adverse oral experiences, such as endotracheal intubation or nasogastric tube feeding. This type of feeding aversion occurs most often in former preterm infants or children with a history of multiple medical procedures. Many of these children have poor oral motor skills. They typically refuse textured foods. For them, diagnosis and treatment remain ill-defined; little or no empirical evidence for the efficacy of any technique can be found in the literature.

When the problem is diagnosed by a speech pathologist or occupational therapist, it is often termed "oral hypersensitivity," and treatment typically focuses on deconditioning—for example, with oral stimulation by brushing or exposure to various textures in association with positive reinforcement. The evidence for such classic behavior modification techniques is solid. The jury is still out, however, on the efficacy of sensory integration therapy for oral hypersensitivity disorders.

When diagnosed by a child psychiatrist, conditioned aversion to stimulation of the mouth is usually termed post-traumatic feeding disorder of infancy, a term coined by Chatoor and reviewed elsewhere. The psychiatric view of the problem is that classic behavior modification techniques have limited efficacy and that therapy should focus primarily on addressing the child's believed underlying anxiety and fear of eating. Unfortunately, the evidence for this type of intervention is also relatively limited.

Problems in parent-child interaction. An unusually strong focus within the family on the child's eating behavior or escalating negative affect in the mother and child may signal a larger problem in the parent-child relationship, which is often associated with separation-individuation and autonomy. Such families may benefit from an appropriate mental health referral.

Unrealistic parental expectations. In the study of eating behavior, it is often noted that no animal or human has ever been born with an inherent preference for bitter or irritating tastes. In other words, preferences for chili peppers and coffee are not inborn but learned. (Why humans should have a preference for exceedingly spicy or bitter foods at all remains an area of active research.) Parents who have a sense of culinary adventure and expect their 3-year-old to have the same zest for the spicier varieties of Chinese, Mexican, and Indian cuisine that they do are likely working against biology. Eating every food presented at the dinner table every evening is a goal that most children probably cannot meet.

Limited resources. It is always important to recognize that a substantial number of children in the United States live in households that are "food insecure"—meaning that they have inadequate access to enough food to lead an active, healthy life. Nearly half of children living in single-parent households in poverty are food insecure. The family may not have adequate financial resources to supply a range of palatable foods at each meal, and any food refusal that results in waste becomes a serious issue. Parents may be concerned that the child's picky eating, combined with a limited choice of foods, is affecting his or her health.

Will she outgrow it?

Pickiness seems to decline with age through early childhood. Children who are still described as picky after about 9 or 10 years old are likely to remain picky, however.

Parents are sometimes concerned that their child's picky eating foretells an impending adolescent eating disorder. A single prospective study of 659 children followed from 1 year to 21 years of age found that picky eating in early childhood (defined by maternal report as not eating enough, being choosy about or disinterested in food, and eating unusually slowly) predicted symptoms of anorexia nervosa in later adolescence. As reviewed by Jacobi and colleagues, however, more than 30 different characteristics have been identified as a possible risk factor for adolescent eating disorders. Because the number of studies describing picky eating as a risk factor is small, it is difficult to make firm statements about an association between picky eating and eating disorders in adolescence until additional research is completed.

What to do

A thorough history and clear definition of the problem are essential to plan intervention. If underlying medical problems and the diagnoses in the differential discussed earlier have been ruled out, the mainstay of management is to demystify the problem for parents. Picky eating, in most children, is a behavior that worsens during the toddler and preschool years and then begins to improve during the early elementary years. In other children, it can be seen as a personality trait. Either way, medical intervention is rarely indicated.

Behavioral interventions should be recommended only when parents are eager to put effort into modifying the behavior. Interventions must be benign and simple and should never be continued if they increase stress or discord at mealtimes. The Guide for Parents ( lists some strategies you can suggest to parents who request them.

It is also important to remember that parents who are concerned about a child's picky eating may be identifying the eating as the problem when it is really a discrete symptom of an overarching concern: a difficult temperament. Although picky eating occurs on a continuum and is a "normal" behavior, do not minimize parents' worries. Helping the parent to understand the child's temperament, and how the picky eating is a symptom of it, will likely benefit the parent-child relationship in the long term.

Ashley, picky eater

In response to the concerns expressed by Ashley's mother at the outset of this article, you show her Ashley's normal growth parameters and growth pattern and reassure her that Ashley does not have signs or symptoms of the short list of possible disorders on the differential. Ashley is not constipated, and her mother already gives her an over-the-counter vitamin (which Ashley happily chews daily without resistance).

You briefly explain that picky eating naturally increases around this age in all children, then tends to diminish through the school years. Ashley's mother notes that her own mother is a very picky eater (but also an outstanding cook and beloved grandmother to Ashley); you acknowledge that, in some children, picky eating persists and is just another personality trait. You reassure her that predicting an eating disorder based on picky eating at 3 years old is impossible and that, because Ashley is suffering no health consequences from picky eating, there is really no cause for concern or need to push her to eat to the point where mealtime becomes unpleasant.

You offer a few suggestions to increase the likelihood that Ashley will accept an increased repertoire of foods. Her mother agrees to try them, pleased that she now has a plan of action that promises to be relatively benign.

Tincture of time

Picky eating is a common concern that parents bring to the pediatric office or clinic. If the history, review of systems, and physical exam (including growth parameters) are unrevealing, the differential diagnosis is short. Although picky eating typically declines with age, strategies to cope with the behavior can be offered to parents in the meantime. Research in children's eating behavior has improved our understanding of the variables that contribute to children's food choices. Translating these findings into advice for parents can be helpful.

Tuesday, November 01, 2005


GREENPEACE is to be fined after its flagship Rainbow Warrior II damaged a coral reef in the central Philippines during a climate change awareness campaign.

The ship and its crew were assessed a 640,000-peso ($15,000) fine after the 55m motor-assisted schooner ran aground at the Tubbataha Reef Marine Park yesterday, park manager Angelique Songco said.
The ship's bow sliced through a reef formation measuring 160sq m, she said.

A Greenpeace official in the Philippines described the incident as accidental, and said it would comply with the marine park authorities' ruling.

Rainbow Warrior II arrived in the reservation in the middle of the Sulu Sea, about 600km south of Manila, last weekend as part of a four-month Asia-Pacific campaign to promote earth-friendly energy sources, Greenpeace campaign manager Red Constantino said.

He said the crew made dive sorties to inspect the effect of global warming on the coral formation, which is listed among the World Heritage sites of the UN Educational, Scientific and Cultural Organisation.

The chart indicated we were a mile and a half" from the coral reef when the ship ran aground, Mr Constantino said. He said the August 2005 navigational map was provided by the mapping office of the Philippine Government.

The ship's own rubber boats safely towed it into deeper water, and it escaped serious damage.

Mr Constantino said the ship was now heading back to the Puerto Princesa on the western island of Palawan to file an incident report with the marine park office.

Originally built in Britain in 1957 as a steam-powered fishing vessel, Rainbow Warrior II replaced its namesake that was sunk by French agents in 1985 in Auckland harbor on its way to Moruroa Atoll to block a French nuclear test.

One crew member drowned and two French secret service agents were later jailed after pleading guilty to charges of manslaughter and wilful damage.

Mr Constantino said that Greenpeace divers on the Tubbataha expedition had found that healthy coral and no evidence of bleaching, believed to be caused by warming sea temperatures.

He said the healthy state of the Tubbataha Reefs did not disprove the theory of global warming, which he described as an "extremely complicated science".

Remembering The Dead And A Horse Race

Its my first time to spend the 1st of November here in Australia, back home we call it All Saint's Day. People go to cemeteries to remember their love ones who already pass away. We offer flowers, candles and prayers to them. Here in Australia, people are busy preparing for the Melbourne Cup, a horse race. Its also a holiday here.

I'd rather remember the dead than watch a horse race which I personally do not understand, but I respect their tradition of celebrating this horse racing day.