How to boost your immune system

Diet and lifestyle to support immune function during the COVID crisis.

We thought it would be helpful to share some ideas to improve your personal wellbeing and safety during these challenging times. There is a huge amount of information flying around at the moment, mostly directed at informing us how to help our patients. It is also vital that we keep ourselves and our families safe and healthy too. When testing young, usually fit, patients we invariably find a number of deficiencies - for example almost everybody is deficient in vitamin D, which is essential for many aspects of general health including immune function. Where there are deficiencies and poor dietary intake across a range of nutrients, the cumulative effects are likely to compromise ability to fight infection. It is therefore likely that many of us could benefit from improving our nutritional health, particularly at this time of increased stress, long working hours and limited access to fresh air and exercise. So we thought it would be helpful to summarise some key points on diet and lifestyle to support underlying health and optimise immune function. Whilst some of these things may sound quite basic, taken together, they may make a difference and ensure your body is in the best health to be able to fight and recover from any infection.

1. Vitamin D - official advice is to supplement during the winter months in the UK as our bodies can't produce enough from sunlight and diet tends to be a poor source as food contains only low levels. Vitamin D is an important immune function regulator and being deficient will make you more at risk. A recent meta-analysis also showed that vitamin D protected against acute respiratory tract infection (https://www.bmj.com/content/356/bmj.i6583). Everyone should be supplementing with vitamin D at this time (at least 1,000 units/day depending upon your own level). Long-term supplementation also needs vitamin A and vitamin K2 as co- factors for vitamin D to work effectively in the body. Vitamin D supplementation can reduce vitamin A in the body, which is also important for immune function, so intake of vitamin A-rich foods is important whilst supplementing with vitamin D (eg eggs, cheese, liver, oily fish, cod liver oil). Vitamin A plays a significant role in immune function in a number of ways, including production of lymphocytes, antibodies and cytokine expression.

2. Zinc is also important for immune function and everyone that we test is either deficient or has sub-optimal levels. Zinc deficiency leads to immune dysfunction and increases susceptibility to infectious diseases. Requirements tend to increase as you get older so a short-term course of 15mg ideally of zinc picolinate is likely to be beneficial for most people. Do not supplement with minerals in the long-term without professional supervision as high doses of zinc can drive down copper and iron. Zinc is best taken with protein to improve absorption and away from carbohydrate and fat. A chicken salad is perfect. If showing symptoms, you may benefit from taking a higher dose as evidence suggests high levels of intra-cellular zinc can inhibit viral replication. 50mg-100mg zinc daily for two weeks or as long as symptoms persist may be beneficial. NB This dosage should not be continued in the long-term.

3. Vitamin C - there is some evidence to support its use with studies showing reduced incidence of pneumonia in vitamin C supplemented groups. 500mg - 1g of vitamin C daily during viral outbreaks is worth considering.

4. Fruit and vegetable intake - the Mediterranean diet with good intake of vegetables, fish, lean meat, nuts, beans, olive oil and whole grains is the diet most associated with good health. Junk food diets and western-style breakfasts have been shown to increase circulating pro-inflammatory IL-17, whilst the Mediterranean diet and plantbased foods boost anti-inflammatory IL-10 levels. Aim for 3 portions of fruit and 5 portions of vegetables daily - 8 a day is a basic minimum, not something to aspire towards. Brazil nuts may be a particularly helpful inclusion as they are high in selenium. Selenium deficiency impairs immune response and increases oxidative stress, which can alter a viral genome so that a normally benign or mildly pathogenic virus can become highly virulent. Eat 2-3 brazil nuts daily for a sufficient dietary intake of selenium.

5. Dietary diversity - a diverse diet increases microbiota diversity ("good" bacteria in the gut) and research shows this is associated with improved markers of health including lower inflammatory markers and reduced frequency of infection. Aim for 30 different types of vegetables per week and vary your sources of protein (meat, fish, beans, pulses, eggs, dairy etc), fat and carbohydrate as much as possible. We appreciate food availability has been affected recently, but do what you can within the constraints of the current circumstances.

6. Probiotic foods (not probiotic medication): 70% of immune function resides in the gut and a healthy digestion is important for a healthy immune system. Aim to eat probiotic foods to boost the "good" bacteria and include foods including plain live yoghurt, kefir, sauerkraut, fermented soya and kimchi.

7. Vegetarians usually need to supplement with B12, iodine, omega 3 and often zinc and iron.

8. Stress - take steps to mitigate stress and worry where possible as stress can affect immune function - yoga, meditation and breathing exercises can all help.

9. Exercise - moderate exercise supports good immune function with inactivity and excessive exercise both being potentially detrimental. Aim to get outdoors and exercise if at all possible, being aware of course of the current restrictions.

10. Sleep - poor quality sleep impacts immune function so aim to get adequate, good quality sleep

11. You may also benefit from B-vitamin supplementation, which has been shown to be beneficial in managing workplace stress in otherwise healthy individuals and micronutrient deficiencies generally have been implicated in altered mood states. Our patients routinely report increased feeling of mental and physical wellbeing with improved diet and correction of micronutrient deficiencies.

VIRTUAL COLONOSCOPY. AT LAST.

Virtual colonoscopy is a procedure that is done to look for small polyps or other more serious growths inside your colon. Polyps that grow on the inside lining of the colon may turn into colon cancer. The Cancer Society advises that most men and women begin screening for colon cancer at age 40-50. If you have a family history of colon cancer or are at high risk for other reasons, you may need to have screening even earlier. Virtual colonoscopy every 5 years is 1 of several screening choices.

Procedure overview

Virtual colonoscopy is also called CT colonography. CT stands for computed tomography. A CT scanner takes many X-rays of the colon that are processed by a computer. The computer puts all the X-rays together to create 3-D images of your colon and rectum. These images can then be looked at by your healthcare provider.

Reasons for the procedure

Colon cancer is a common cancer in men and women. The reason for virtual colonoscopy is to find colon cancer at an early stage when it can be treated more easily. Regular colonoscopy is also used to screen for colon cancer. A long, flexible, lighted scope and tiny camera a put into the rectum and up into the colon. This lets the healthcare provider look at the colon directly and remove any polyps that are there. Colon polyps that are found by virtual colonoscopy can be removed with regular colonoscopy before they turn into cancer.

Virtual colonoscopy has some benefits over regular colonoscopy:

• It is less uncomfortable and invasive. It usually does not need to include any pain medicine or anesthesia.

• It takes less time.

• It poses less risk of harming the large intestine.

• It may be used for some people who are not be able to have regular colonoscopy. In certain cases, it may be used in people who have problems such as swelling, bleeding, or breathing problems.

• It may be able to show areas of the large intestine that regular colonoscopy can't reach. This may be the case if part of the intestine is narrowed or blocked.

HOW TO STAY HEALTHY WHILE ABROAD

Staying in shape and healthy while abroad isn’t easy; neither is adjusting to a new country and culture. Whether due to mouthwatering gastronomy, alluring nightlife, or itinerary overload, your health is usually the first to suffer. So how do you explore deeply without sacrificing your wellness? Balance is key when adapting to a new lifestyle during your study abroad experience.

Although studying/travelling abroad fundamentally denotes change, it shouldn’t have to compromise your health. Finding ways to stay in shape overseas is a great way to crawl out of your comfort zone, learn more about your new town, and provide an emotional outlet.

Here are some ways to balance adventure and wellness so you can stay healthy and fit while studying or travelling abroad.

Work Out In The Morning

Don't have enough time to workout? Excluding exercise from your schedule is one of the easiest ways to fall off the wellness wagon. Sometimes it's due to exhaustion after a full day of classes; other times it's because you'd rather hang out with friends on your time off. Regardless, there’s always going to be a reason why you don’t have time to exercise.

As a solution, working out in the early morning can help you create a routine that prioritizes your health, starts your day with a boost, and still offers plenty of time for learning and exploring.

Find A Workout Partner

Accountability is everything. A great way to stay on top of your fitness goals is to find a workout partner. This person may be another student in your study abroad program, your roommate, or a new local friend -- either way, they’ll make your health goals a little more fun and can help you stay on track… as long as you are both committed to it! Use WhatsApp to keep in touch and create a shared calendar to schedule meetups.

Take Walks with Your Backpack

Walking really does help, regardless of your fitness level.

When exploring a new destination I map out my itineraries with walking in mind (which saves me money too). Instead of dropping off my backpack in my room, I lug it along with me, adding a little weight to my exercise. I've been able to lose up to five pounds in under three weeks just from walking with a backpack! Be sure to wear proper footwear and a bag with good shoulder support.

Take Advantage of Good Weather, especially in Barcelona

If your study abroad program is located in a destination with warm, temperate, or dry weather, appreciate it! Go out and “smell the roses”, take breaths of fresh air, and move those limbs. I even refuse transportation when visiting places under two miles away.

If you hate walking, try biking. It’s a great workout and some cities may even offer dedicated bicycle lanes. If you haven’t decided on a study abroad program yet, seek out the most bike-friendly countries during your research -- many people say Amsterdam is #1!

Eat Before Dusk (especially if you´re going out or drinking)

There’s no way I’d ever suggest one forgo food tours, restaurants, and delightful treats for the sake of a waistline. Sampling the local food is one of the reasons why people want to travel and study abroad, so taking that away is almost blasphemous.

Enjoy the flavors of the new city you’re in. Stop by the local bakery. Dine on fresh-caught fish by the sea. Learn about tradition through recipes passed down for generations. Just do it all before dusk! When you eat your meals earlier, you stay in tune with your circadian rhythm, better control your blood sugar, and have more energy to digest your meals. This may promote weight loss and even better sleep.

Cook for Yourself

When you’re not dining out (let’s face it: it can get pricey), think about how you can be a healthier chef and offset the homemade butter you had the day before. If you are lucky enough to have a dorm or apartment with a kitchen, take advantage of it and cook for yourself during the majority of the week.

Cooking at home doesn’t have to be boring -- try looking for neighborhood farmers' markets bustling with locals. Practice cooking some of the dishes you’ve enjoyed most or invite classmates over for a dinner party, splitting the cost of ingredients. Your body will certainly thank you later.

Don’t Rely on the Gym

If you are going to study abroad and think a gym membership is the only way you can stay in shape, think again. Gyms can be expensive or difficult to find abroad. Moreover, if you’re studying abroad for less than a semester, getting a gym membership is often not financially beneficial.

Instead, meet with locals and find out how they keep in shape. While genetics may play a big factor, culture and lifestyle (like traditional dance, meal times, and particular beverages paired with meals for digestion) is also an important element.

Join a Local Team

Sign up for a local team sport and you’ll have an opportunity to meet people, make friends with similar interests, and challenge yourself. Play football in Barcelona, join the Barcelona Gaelic Team or go to La Foixarda for some Saturday Rugby games. Finding a new sport to play will help you stay in shape and learn a unique facet of a foreign culture.

Not traditionally “athletic” enough? Step, capoeira, and table tennis may not be considered “traditional” sports by some but are quite physically challenging and require even more coordination! See what works for you.

Get Up and Dance

Dancing is important to most cultures. It tells a story passed down for centuries and often gives hints to a region’s political history. Take traditional dance lessons or head to a discotheque to do more than lean on the wall and observe. Dancing helps burn calories, while listening to the local music can even help you learn a second language.

And don´t forget to get enough rest, the trip/semester can be long! And if you find yourself sick or in need of a medical consultation, contact Dr. Victoria Howe, through phone, whatsapp or mail. She will help you out.

Source: “https://www.gooverseas.com/blog/how-stay-healthy-and-in-shape-while-studying-abroad”

What medicines should you pack for summer holiday travel? Here's what doctors take

Basic travel health kit

The exact contents of your travel kit will depend on your travel plans. It is always advisable to check with your doctor first and also consult if any condition should persist after 24 hours.

First aid kit

A basic first aid kit includes:

• antiseptic (betadine, clorhexidine)

• painkillers (ibuprofen for pain and inflammation/swelling, paracetamol for pain and fever)

• wound-cleaning gauzes

• bandage tape

• plasters

• tweezers

• scissors

• thermometer

• antihistamines (cetirizine) and decongestants

• sunburn treatment (including cream eg furacin)

• insect repellent

• insect bite treatment (steroid cream, eg tisuderma). Check with your doctor if the area gets hot, red and spreads outwards.

• medication for pre-existing medical conditions

• medication for nausea (metoclopramide, primperan, gravol)

• medication for diarrhea (fortasec, imodium pepto)

• re-hydration sachets (saline)

• antibiotics/antifungal medication: it is always best to consult your doctor before taking this type of medication due to resistances, secondary effects and adequate/personalised use of medication.

Sunscreen

The sunscreen label should have:

• the letters "UVA" in a circular logo and at least 4-star UVA protection

• at least SPF15 sunscreen to protect against UVB.

• SPF50 is recommended.

For country-specific health and safety advice, go to: 

• GOV.UK

• TravelHealthPro

Contact Dr. Victoria Howe, our English speaking doctor in Barcelona (Spain), for both office and online consultations.

SEASONAL ALLERGIES. It´s almost that time of the year again. Immunotherapy.

It's almost that time of year again, when along with an improvement in the weather, millions of people are welcoming the sniffling, sneezing and itchiness of seasonal allergies.

The number of people who suffer from these airborne allergies, a condition known as allergic rhinitis, has been on the rise in recent decades, especially in European cities, where pollen is sticking around for longer than usual.

Fortunately, for allergy sufferers across the globe, there is hope.

How allergies work

The body creates an allergic response by what's called an allergen — for people with seasonal allergies, that would be pollen from trees, grasses and weeds.

When that pollen makes it into the nose of an allergic person, their immune system mistakes it for a harmful foreign invader and goes into overdrive.

It releases antibodies to attack the allergen, which prompts cells in the person's nose, throat and lungs to release chemicals such as histamine, which is what leads to that sniffling and sneezing, or in more severe cases, asthma attacks.

Traditional therapies

There is no cure for seasonal allergies, so treatments have typically focused on managing the symptoms or avoiding allergens in the first place.

For medicinal treatments, the two usual standbys are antihistamines, such as Benadryl or Allegra, along with steroid nasal sprays like Flonase or Nasacort. There is also a new nasal spray that contains both.

Sublingual Immunotherapy

For those who suffer from allergies, tablets containing small doses of the allergen are dissolved under the tongue either daily or a few times a week for a period before and during allergy season. It's based on the idea that by exposing the immune system to small doses of the allergen, you can make your cells more tolerant to it.

This is a whole new type of desensitization which works in principle the same as allergy shots. But they are easier to take, probably safer, and it's done at home instead of the doctor's office It makes it quite easy for children and people who don't like needles to desensitize themselves.

Some studies also suggest that after about three years of daily treatment, sublingual immunotherapy provides a long-lasting effect for many people, basically reprogramming the body to be more tolerant of the allergen.

Injecting antibodies

Another type of treatment, specifically for people with severe asthma, blocks the communication pathways in an allergic response. A patient would receive a shot of antibodies that target the "communication molecules" that lead to inflammation.

That cost is high and it may be reasonable for people with severe allergies or asthma, but probably doesn't make sense for the casual allergy sufferer.

Potential vaccine

New research is showing some early promise for a potential allergy vaccine. The treatment works by essentially teaching the immune system how to respond to allergens in a normal way.

Unlike other immunotherapies that only work on specific allergens, the molecule would be effective for all of them — so it wouldn't matter if you're allergic to pollen, dust, cats or dogs.

Previous studies also showed that researchers could use the molecule to reprogram the immune systems of mice who were already allergic to pollen, a finding that could eventually pave the way towards finding a cure.

The treatment is still in animal testing phase and has a long way to go before it even reaches human clinical trials.

WEEKEND TRIPS FOR STUDENTS ABROAD IN BARCELONA

WEEKEND TRIPS FROM BARCELONA AROUND CATALUNYA

There is plenty to see and do in Catalunya, the autonomous region of which Barcelona is the capital. The secondary cities of Tarragona, with it’s seaside Roman ampitheatre, and Girona, that was featured in Game Of Thrones are both about an hour, and €10 on the train. Here are some other favourites.

COSTA BRAVA 

Barcelona’s own little Mediterranean paradise, complete with the small swimming coves known as calas, pine-covered mountains that run all the way down to the sea, and perfectly azul water. During summer Costa Brava is crowded with tourists from all over Europe, but that completely dies down in September while the weather and water remains warm. Check out Tossa de Mar for its seaside castle (there are castes everywhere up here), which can be reached by bus from Barcelona every hour, for around €15. Alternatively, you could sign up for a kayaking tour that will take you off the tourist trail and to some calas and platjas that are rarely visited by tourists.

PRIORAT 

A small region that produces perhaps the finest red wine in Spain, Priorat is an area of natural beauty and vineyards, small farms and stone villages. Priorat is no more than two hours from downtown Barcelona, but seems like an entirely different land, where narrow streets wind around mountains that are traversed by rivers and broken up where mountains rise above the grapes. The best thing too, apart from discovering a wine region that not many people know about, is sampling, and taking home, the absolutely amazing reds that are produced here.

WEEKEND TRIPS FROM BARCELONA AROUND SPAIN

From Barcelona we are connected to Spain by plane and high-speed train. You can easily do one/two/three night trips from Barcelona to anywhere in the country, especially areas covered by the TGV train network, like Madrid, Andalucia, and really anywhere you want to go.

LA TOMATINA

The famous tomato fight that takes place at the end of August in Valencia. Think 10s of 1000s of travellers, tonnes of tomatoes and a small village’s narrow streets. This friendly fight is a messy delight and amazing stress reliever, where for a couple of hours you’re able to let your inner problem child run wild and throw salad fruit (vegetables?) at friends, foes and complete strangers alike. This festival is one of a kind, and the Stoke Travel La Tomatina experienceincludes huge travellers’ parties with live bands, DJs, beachswims and pool sessions. You might be arriving to your study abroad course a little late to make this fight, in which case you should totally check out Valencia anyway. It’s Spain’s third largest city, the home of paella and some fantastic beaches, art and architecture.

SAN SEBASTIAN 

A short skirt across the top of Spain, just below the Pyrenees, will land you in the Basque Country, of which San Sebastian is the gastronomic and tourism capital. Not only is San Sebastian a foodies paradise, with literally hundred of bars and restaurants serving up the finest quality pintxos, Basque tapas that go above and beyond the already fantastic Spanish food found in the rest of the country. San Sebastian’s Old Town is also one of Spain’s, and Europe’s, best places to party, with something going on every night of the week along it’s narrow, paved streets. There are also lots of waves here, making San Sebastian a place to learn, or practice, your surfing and thus earning the right to eat your weight in Basque food and drink Basque cider afterwards.

WEEKEND TRIPS FROM BARCELONA AROUND EUROPE

From Barcelona you can visit any European city by taking advantage of the many budget airlines that fly in and out of the airport every day. Paris, Milan, London, Berlin, Prague, Stockholm, Amsterdam, Rome, Budapest, the Greek Islands, the Baltic states, the Balkans… the list goes on! Let´s take a look at some of the main cities!

PARIS

Paris is a must. You can visit it for it´s history, for it´s nightlife, for it´s food, for it´s people…. it´s one of the most visited places in the world! Whether it’s hitting the shops long the Champs Elysees, wandering through the Louvre, or climbing to the top of the Eiffel Tower, Paris will never disappoint.

LONDON

The British capital is one of the largest and most influential cities on the continent, and it has a wonderful variety and diversity that makes it a great destination.

You can see buildings such as the Houses of Parliament or Buckingham Palace, or explore the wealth of art galleries and museums, before enjoying the great range of restaurants and night life in the evenings.

Check this ultimate London guide: https://theblondeabroad.com/ultimate-london-travel-guide/

FLORENCE

The cradle of the Renaissance, Florence is one of Europe’s great art cities. Giotto’s frescoes, Michelangelo’s David, canvases by Botticelli, Leonardo da Vinci and a host of other greats in the Uffizi Gallery… there’s so much exquisite art and architecture, it’s difficult to know where to start.

But Florence is also a living city with a vibrant restaurant and nightlife scene, and a lively cultural movida that goes beyond old masters to embrace opera, classical music and contemporary art. Handsome, historic, full of quirky shops and quality crafts, and close to the vine-covered hills of Chianti, it’s one of Europe’s most civilised long weekend destinations.

http://www.florenceforfun.org/LENG/Z2/C15752-1/hhcm-home.html

BERLIN

You will not expect to love Berlin as much as you will do. I am sure you pictured it to be cold and cloudy, and the people to be stand-offish. Don't get me wrong, you´re not entirely wrong and bundled up in blanket scarves as soon as I could. But, you´ll found a lot of history and modern beauty in this city.

From the East Side Gallery to the graffiti on the walls of the restaurants and pubs, Berlin is incredibly #artsy. The Brandenburg Gate is a site you won't want to miss. Be sure to grab a beer and a bratwurst while you walk around Berlin -- although if you want something truly authentic, the currywurst is their signature dish.

AMSTERDAM

Amsterdam is a quaint city nestled in the Netherlands. With bikes lining every street and bridge, and slightly-slanted houses that look like they came out of a storybook, there's a lot of culture in the city that's most definitely worth dropping just a little bit of cash.

During your stay, it would be in your best interest to try a Dutch pancake and pay a visit to the Anne Frank House. Spend your afternoon taking a canal cruise from the Heineken Museum to its gift shop just a mile or so away by boat.

Studying abroad is one big adventure. The best travelers will take some time and wander to places like this.

ROME

Explore the magic of the “Eternal City”. Retrace the footsteps of gladiators at the Colosseum,  skip the line into the Vatican and marvel at the art, drama filled history, and amazing architecture.  You’ll be able to enjoy a walking tour along the Spanish Steps, and toss a coin into the Trevi fountain ensuring this won’t be your last trip to Rome!

PRAGUE

Prague is like a living and breathing Christmas village. Tucked into the culture of the Czech Republic, it is a fairly spread out city with castles that look like they came straight out of those stories with the princesses and dragons.

If you're finding that you're feeling a little homesick, this weekend trip will warm your heart a bit. The city is filled with comfort food like warm bowls of goulash and mulled wine.

Take a walk over the bridge to the other side of the city to see the John Lennon Wall. You'll want to snap a picture of it, because it's constantly changing and being added to. No two trips to Prague will ever be the same for that simple reason.

BRUSSELS

Brussels is the best spot if you're a foodie like, well, most of us. From French fry cones with creative dipping sauces to choose from, to street vendors with fluffy Belgian waffles that are loaded with fresh strawberries and Nutella -- let's just say, I hope you bring your appetite on this weekend trip.

It'll be worth spending a couple extra dimes on an exotic beer, or sticking out your hate for seafood and trying one of their mussel dishes. When you're finally full, explore the city a bit for sights like the Atomium and Grand Place, where you'll find a number of chocolate shops and gilded buildings.

LISBON

As a visitor to Spain, there is no reason to leave without having checked what Portugal has to offer as well, and its capital, Lisbon, in particular. The flight is a bit more than one hour long, and you can find plenty of budget airlines that fly regularly, so there’s no excuse to get going for an awesome weekend in Lisbon. Two days is a perfect amount of time to get to know this thriving city, taste the lovely food choices, walk up to its castle, take gorgeous pictures of the bay and even go for a quick dip on the (cold!) Atlantic Ocean’s waters at one of the city’s many beaches.

https://stoketravel.com/weekend-trips-for-study-abroad-students-in-barcelona/

https://www.wsaeurope.com/

https://www.wsaeurope.com/trips/

Welcome to our WOMEN´S HEALTH SERVICES

Our comprehensive and personalised services are directed to women who are looking for a safe place to talk about their gynecological concerns.

We offer emergency appointments for any urgent matters, together with the following routine services:

• PAP SMEAR

• SWABS/STD TESTING

• ULTRASOUND

• BREAST EXAM/MAMMOGRAM

• PELVIC/IUD EXAMS

• IUD INSERTION

• BIRTH CONTROL

• EMERGENCY CONTRACEPTION

• COLPOSCOPY

• PREGNANCY TERMINATION REFERRALS

Spanish Food and Drink. Basics.

Spain's eating and drinking culture is one of its greatest attractions, and a very sociable one too, with people rubbing shoulders in tapas bars and cafés. An excellent way to understand different facets of Spanish cuisine is to sample tapas: small dishes served to share and typically placed in the middle of the table. They can range from gourmet canapés to simple plates of croquetes, cheeses and cured meats.

Spanish drinks have also brewed up quite a storm worldwide – from the thirst-quenching sangria to bubbly Cava to the sophisticated Rioja wine.

Food

Paella: Originally from Valencia, this rice dish can be loaded with seafood or chicken/rabbit, saffron and vegetables. 
Croquetas: Fried bread-crumbed fritters with a creamy, potato base with different ingredients (ham, chicken, etc). Chipirones/Calamares: Fried Spanish-style squid, usually served with lemon.
Cocido: A fragrant and rich chickpea and meat stew popular in Madrid. 
Tortilla Espaniola (Potatoe omelette): A rich, chunky potato omelette – a staple throughout Spain.
Gazpacho: A chilled tomato-based, tangy vegetable soup from Andalucía. Served in the summer.
Jamón (Spanish Ham): One of many cured Spanish meats, Jamón is a type of finely sliced cured ham.
Pulpo a la gallega: Tender, boiled octopus seasoned with paprika and salt and drizzled in olive oil. Usually served on top of cooked potatoes.
Chorizo: A dried and course pork sausage seasoned with smoked paprika.
Patatas bravas: typical tapa for sharing or to have as an “aperitive”. Albondigas: Fried Spanish-style meatballs, usually smothered in tomato sauce.

Drinks

Sherry: A fortified wine available in several styles: Fino and Manzanilla (pale and dry), amontillado (dry, richer in body and darker in colour), Oloroso (medium, full-bodied, fragrant and golden) and sweet sherries such as Pedro Ximénez.
Red wine - Rioja: Spain’s flagship red wine, made from Tempranillo and Garnacha grapes. White wine - Albariño/Rias Baixas: the one to order from the list.
Cava: A sparkling wine from Catalonia made using the same method used to produce Champagne. Always order Brut Nature.

Things to know

Most restaurants serve a menú del día at lunchtime; this is a three-course meal including water that generally costs from €10 to €20 and can be very good value.

Tipping

Spanish VAT (IVA) of 10% is included in most menu prices and 2-4% is customary.

Drinking age

16 for wine and beer, 18 for spirits.

https://www.worldtravelguide.net/guides/europe/spain/food-and-drink/

STUDY ABROAD: ACCOMMODATION IN BARCELONA

You have decided to move to Barcelona to study from abroad. It is your fist time but some of your friends have been there before and they have given you recommedations. Deciding where to live is key to make the most out of your semester or year abroad and it´s important to inform yourself about the different areas (do you prefer to be near the beach? do you prefer to live with other students? Would you prefer to be in building with all students?

Barcelona is divided into 10 "districts". The most popular areas for student accomodations are: 

1. The City Centre: we find the actual old quarter called Ciutat Vella. Surrounding this quarter are two very popular residential areas called Eixample Dreta (Right Eixample) and Eixample Esquerre (Left eixample). The majority of students stay in this areas.

2. University Area: Eixample esquerre is were many universities (UAB, UB, ESADE, etc) are located. There are also two districts which are popular for students: Corts and Gracia.

DISTRICTS FOR STUDENTS: 

Ciutat Vella

Well, let’s start from the beginning… Ciutat Vella (Old City) is comprised of four different neighborhoods (Barri Gotic, El Raval, Barceloneta, El Born). It is one of the most beautiful and charming areas of the city. If you have ever visited the city before, you probably felt in love with this area and you decided that this was where you wanted to live one day!

This area is jammed with bars, music venues, restaurants, etc. so it might be noisy in some parts, especially in Barri Gotic, where pedestrian streets are quite narrow. If you like to be in the middle of the action you just found your area!
However, when you choose your apartment just make sure that there is not a bar or restaurant terrace below.

This is a very touristy area and, as a consequence, the cost of living might be more expensive, especially for grocery stores and restaurants. In terms of rent, it is an affordable area. The average rent for a two bedroom apartment goes from 500 to 700 € per month.

In general the Old City has great transport connections with the rest of the city. The Gothic Quarter, Raval and El Born are connected with the University Area by the tube Lines 1 and 3. Barceloneta’s connections are not as good, only the tube Line 4 reaches there.

EIXAMPLE

This large area named Eixample is located beyond Plaça Catalunya and is divided in two parts, ‘Eixample Dreta’ and ‘Eixample Esquerra’ by Passeig de Gràcia. In this area the buildings are built in an easily recognizable grid shape designed by the architect Ildefons Cerdà.

Eixample Dreta

Eixample Dreta is one of Barcelona’s most exclusive neighborhoods. It has a great location as you can walk to Plaça Catalunya and Sagrada Familia. You are also close to Passeig the Gracia which is an exclusive shopping area and to the Gothic Quarter where you can enjoy Barcelona’s nightlife. It also has great tube connections as L1, L2, L3, L4 and L5 stop in this neighborhood.

Rent in this neighborhood is generally quite high, still you can find some nice apartments with an affordable rent. Conversely, Eixample Esquerrais a student area.

Eixample Esquerra & Corts

Eixample Esquerra and Corts neighborhood form the University Area (Zona Universitaria), where the majority of students live, since many universities are based there, for instance ‘Universidad de Barcelona’, ‘Universidad Politécnica de Cataluña’ or ESADE.

Corts is also the financial neighborhood of the city, where many international companies, businesses and hotels are located. Nightlife in this area is quiet since the majority of professionals don’t live here and students tend to head towards Eixample, especially around Plaça de la Universitat. In this area there is also the Barcelona FC’s stadium Camp Nou, so if you are a Barça fan you just found your neighborhood!

Transport connections are also great. The tube lines L1 and L3 can take you to ‘Ciutat Vella’ in less than 20 minutes.

Gracia

Gracia is the new hip upcoming neighborhood which used to be a town until 1897, when it got incorporated to the city. It still maintains its bohemian style, with large squares where bars set up their terraces, local markets and independent stores. It has the famous Parc Guell from Gaudi.

Many students are moving to this neighborhood because of its trendy scene. Moreover, it has great connections to the University area by the tube line 3 and to ‘Ciutat Vella’ and Barceloneta beach by line 4. It is also possible to cycle but there is quite a stip hill.

Check these websites for accommodation in BCN

STUDY ABROAD APPARTMENT

RESA HOUSING

UNIPLACES

HOW TO STAY HEALTHY FOR THANKSGIVING

Thanksgiving is upon us once more, and with it comes enticing treats and splurges that we might otherwise pass on during the rest of the year. Will you still be giving thanks after your feast, or will you be left bloated and regretful? If you haven't already set your menu for Thanksgiving -- or even if you have -- take a moment to be mindful of your health and wellbeing.

Though most of us simply buy our food these days instead of working toward and waiting for harvest, Thanksgiving is still a time to be grateful for a bountiful harvest. There is an element of honouring foods as they are found in nature, and the goodness and health they facilitate. What are we saying if we reduce it to a time of indulgence to the point of discomfort, or a spread of artificial replicas of otherwise delicious and nutritious foods?

Five Ways to Stay Healthy This Thanksgiving

1. Keep it real.

Just as a harvest is only as good as the seeds sown, a meal is only as nutritious as its ingredients! Check labels carefully -- really reading them. A study done in the US found that consumers are likely to skim labels and trust whatever "natural" or "healthy" indication is splayed across the front -- even when the ingredients don't reflect that claim. So, if you do choose to use packaged foods or ingredients for your meal, make sure they have as few ingredients as possible and are all recognizable as food. Otherwise, still with real, whole foods, make your Thanksgiving feast. Using recipes for a slow cooker or preparing them in advance can help to make a real-foods spread without taking up too much extra time or effort.

2. Watch portions.

A day off surrounded by food can quickly turn into a day of nothing but food. Watch your portions when you eat, but also before and after the meal. Unless you are already fasting intermittently, skipping meals could actually trick your brain into justifying more indulgence. Instead, eat normal portions throughout the day and then enjoy your Thanksgiving meal as a time of special dishes rather than a time of supersized indulgence.

3. Keep moving.

Nothing keeps you from exercising on or around Thanksgiving or any other holiday. If you've got time off of work, don't divide the time between eating and lazing on the couch. It's a gorgeous time of year -- get outside and get moving! Walking is always beneficial, but if you only have a short amount of time, try high intensity interval training. A 2013 study demonstrated meal-processing benefits of HIIT workouts extending for 48 hours after the workout.

4. Go sprouted (or gluten free!).

Grandma's rolls are the best, and we wouldn't dare presume to do better -- but maybe it's time to nudge the recipe in a different direction. Use sprouted wheat, cultured sourdough, or gluten free recipes to make the nutrients more available and the bread easier for your body to process. Minimizing standard wheat carbohydrates and instead getting them from varied vegetables and grains changes the health factor of your meal significantly!

5. Relax.

Don't stress! It's okay if the main course isn't quite right or you don't have the exact ingredients or a side dish flops. Even when meal choices are good, stress can negate any benefits of the food. So breathe easy! The point of Thanksgiving is to reflect on the year's work with your loved ones surrounding you. Taking it all in with a deep breath and a smile is one of the best ways to stay healthy this Thanksgiving -- no matter how rich the pie may be.

Source: “https://www.huffingtonpost.ca/dr-bj-hardick/thanksgiving-health-tips_b_8230296.html”

Sexual Health: STD/STI. Do I need a test?

THE LINK BETWEEN YOUR DIET AND YOUR SKIN

Beauty comes from the inside. The connection between nutrition and skin condition or rather the effect of nutrition on skin aging has been an interesting research field since ancient times. Skin health and aging consists of two distinct processes:

• The first is intrinsic skin aging, which represents chronological aging and affects skin in the same pattern it affects all internal organs.

• The second is extrinsic skin aging, which we view as aged skin and is the result of external factors and environmental influence, mainly chronic sun exposure and ultraviolet (UV) irradiation but also smoking, pollution, sleep deprivation and poor nutrition.

Prevention is the best and most effective way to work against extrinsic skin aging effects. The best prevention strategy against the harmful action of free radicals is a well regulated lifestyle (caloric restriction, body care and physical exercise for body), with low stress conditions and a balanced nutritional diet, including anti-oxidative rich food.

Frequently researched antioxidants such as carotenoids, tocophenols and flavonoids, as well as vitamins (A, C, D and E), essential omega-3-fatty acids, some proteins and lactobacilli have been referred as agents capable of promoting skin health and beauty. Let´s take a look at them one by one.

VITAMINS

L-ascorbic acid (vitamin C)

Vitamin C, also named L-ascorbic acid, is the most important antioxidant. Vitamin C is not naturally synthesized by the human body and therefore adequate dietary intake of vitamin C is required and essential for a healthy human diet.

The richest natural sources are fresh fruits and vegetables such as citrus fruits, blackcurrant, rose hip, guava, chili pepper or parsley. Stability of the vitamin C molecule depends on aggregate condition and formulation.

Tocopherols (vitamin E)

Higher amounts of tocopherol are available in vegetables, vegetable oils like wheat germ oil, sunflower oil, safflower oil and seeds, corn, soy and some sorts of meat. The intake of natural vitamin E products helps against collagen cross linking and lipid peroxidation, which are both linked to aging of the skin.

Carotenoids (vitamin A, β-carotene, astaxanthin, retinol)

Carotenoids are vitamin A derivates like β-carotene, astaxanthin, lycopene and retinol, which are all highly effective antioxidants and have been documented to possess photoprotective properties.

Carrots, pumpkin, sweet potatoes, mangos and papaya are some examples of β-carotene containing fruits and vegetables.

Upon dietary supplementation, β-carotene can be further enriched in skin, in which it is already a major carotenoid. 

Lycopene is a bright red carotene and carotenoid pigment and phytochemical found in tomatoes and other red fruits and vegetables, such as red carrots, watermelons and papayas (but not strawberries or cherries). Although lycopene is chemically a carotene, it has no vitamin A activity.

β-carotene and lycopene are usually the dominating carotenoids in human blood and tissues and are known to modulate skin properties when ingested as supplements or as dietary products.

Retinol is important for the human body; however the body itself cannot synthesize it. Retinol must derive from diet. Natural retinol and retinol ester are contained in liver, milk, egg yolk, cheese and fatty fish etc. Naturally occurring and synthetic vitamin A (retinol) show similar biological activities. Different retinol products, both for cosmetic (topical) and pharmaceutical (topical, systemic) use can be found on the market.

Vitamin D

In humans vitamin D serves two functions, it acts as a prohormone and the human body can synthesize it itself through sun exposure. Skin is the major site for UV-B mediated vitamin D3, and 1,25-dihydroxy vitamin D3 synthesis. Smaller amounts of vitamin D2 and D3 come from the dietary intake of animal-based foods such as fatty fish or egg yolk. Some products like milk, cereals and margarine can be enriched with vitamin D.

Chang et al. also suggest an association between skin aging and levels of 25(OH)D3, another precursor of vitamin D. It may be possible that low 25(OH)D3 levels in women, who show less skin aging may reflect underlying genetic differences in vitamin D synthesis. Many other studies that tested oral vitamin D treatment showed skin cancer prevention, which is linked to anti-aging effects.

Polyphenols

Polyphenols have drawn the attention of the anti-aging research community over the last decade, mainly because of their antioxidant properties, their great intake amount in our diet and the increasing studies showing their probable role in the prevention of various diseases associated with oxidative stress, such as cancer and cardiovascular and neurodegenerative diseases. They are mostly found in fruits and plant-derived beverages such as fruit juices, tea, coffee, and red wine. Vegetables, cereals, chocolate and dry legumes are also sources for the total polyphenol intake.

Curcumin

Curcumin is the principal curcuminoid of the popular Indian spice turmeric, which is a member of the ginger family (Zingiberaceae) and is frequently found in rice dishes to add yellow color to the otherwise white rice. Curcumin has been shown to protect against the deleterious effects of injury by attenuating oxidative stress and suppressing inflammation.

Green tea polyphenols

Green tea polyphenols have been postulated to protect human skin from the cutaneous signs of photoageing. Studies have shown that green tea extract also possesses anti-inflammatory activity. These anti-inflammatory and anti-carcinogenic properties of green tea are due to their polyphenolic constituents present therein.

Ubiquinol (Coenzyme Q10)

Coenzyme Q10 (CoQ10) is a fat-soluble, endogenous (synthesized by the body), vitamin-like substance that is mainly stored in the fat tissues of our body. Primary dietary sources of CoQ10 include oily fish (such as salmon and tuna), organ meats (such as liver), and whole grains. The amount of CoQ10 needed in human organism can be gained through a balanced diet, however in the market CoQ10 is available in several forms as a supplement, including soft gel capsules, oral spray, hard shell capsules, and tablets. As a fat-soluble substance it is better absorbed when taken with fat rich meals. CoQ10 is also added to various cosmetics.

Pre- and Probiotics

The term probiotic is defined as “living microorganisms, which, when consumed in adequate amounts, confer a health effect on the host.”The most commonly used probiotics in humans and animals are enterococci, lactobacilli and bifidobacteria, which are natural residents of the intestinal tract.

A prebiotic is a non-viable food component that confers a health benefit on the host associated with modulation of the microbiota.

Currently, finding alternatives to antibiotics for skin treatment is receiving a lot of interest in research. It has been found that, similarly to the gut microflora, the skin’s microbiota plays a beneficial role. Thus, the possibility to modulate the microbiota more selectively is highly interesting.

Clinical studies that used probiotic bacteria (Lactobacillus johnsonii NCC 533) to modulate the cutaneous immune homeostasis altered by solar-simulated UV exposure in humans suggest that certain probiotics can help preserve the skin homeostasis by modulating the skin immune system.

Essential Fatty Acids (Vitamin F)

Essential fatty acids cannot be produced in the human body and they have to be consumed through our daily dietary intake. They are present in multiple food sources such as fish and shellfish, flaxseed, hemp oil, soya oil, canola oil, chia seeds, pumpkin seeds, sunflower seeds, leafy vegetables, walnuts, sesame seeds, avocados, salmon and albacore tuna.

The association between nutrient intakes and skin aging has been examined: skin-aging appearance was defined as having a wrinkled appearance, senile dryness, and skin atrophy. Higher linoleic acid intakes were associated with a lower likelihood of senile dryness and skin atrophy. 

For more information, a planned diet for your skin or if you are suffering from skin problems (such as acne, psoriasis, dermatitis, etc), please contact our doctor here.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3583891/

Having trouble sleeping? Melatonin sleep aid supplement.

Melatonin supplements promise sound, natural sleep. Here’s what you need to know about your body’s natural melatonin production and melatonin sleep aids.

Sleeps experts initially give general recommendations, such as keeping the lights low in the evening to help his mind and body prepare for sleep. If you have to work in the evening or answer emails, use filters to screen out the blue and green wavelengths of light emitted by his smartphone and computer. “Your brain associates this light with daytime, and it can interfere with melatonin’s sleep-promoting effects. A filter can help.” Many types of blue-light filters are available online and in stores.

Melatonin sleep aids are growing in popularity, according to a nationwide survey from the Centers for Disease Control and Prevention. If you’re among them or are considering melatonin for sleep, it’s smart to understand exactly how melatonin works.

“Your body produces melatonin naturally. It doesn’t make you sleep, but as melatonin levels rise in the evening it puts you into a state of quiet wakefulness that helps promote sleep,” explains Johns Hopkins sleep expert.

“Most people’s bodies produce enough melatonin for sleep on their own. However, there are steps you can take to make the most of your natural melatonin production, or you can try a supplement on a short-term basis if you’re experiencing insomnia, want to overcome jet lag, or are a night owl who needs to get to bed earlier and wake up earlier, such as for work or school.”

Work with, not against, melatonin’s sleep-inducing signals.

Melatonin levels rise about two hours before bedtime. Create optimputer, smartphonor tablet—the blue and green light from these devices can neutralize melatonin’s effects. If you watch television, be sure you’re at least six feet away from the screen. Turn off bright overhead lights too. Meanwhile you can help program your body to produce melatonin for sleep at the right time of day by getting exposure to daylight during the morning and afternoon. Take a walk outside or sit beside a sunny window.

Consider melatonin sleep help for occasional insomnia.

Even sound sleepers have trouble falling asleep or staying asleep once in a while, You may want to try melatonin or eep if you have difficulty for more than a night or two. Research shows that a supplement may help people with insomnia fall asleep slightly faster and may have bigger benefits for those with delayed sleep phase syndrome—falling asleep very late and waking up late the next day.

Know when to stop.

If melatonin for sleep isn’t helping after a week or two, stop using it. And if your sleep problems continue, talk with your health care provider. If melatonin does seem to help, it’s safe for most people to take nightly for one to two months. After that, stop and see how your sleep is. Be sure you’re also relaxing before bed, keeping the lights low and sleeping in a cool, dark, comfortable bedroom for optimal results.

Do not use melatonin if…

Do not use melatonin if you are pregnant or breastfeeding or have an autoimmune disorder, a seizure disorder or depression. Talk to your doctor  if you have diabetes or high blood pressure. Melatonin supplements may also raise blood-sugar levels and increase blood pressure levels in people taking some hypertension medications.

Use melatonin sleep supplements wisely and safely. Contact our doctor for more information and before taking any medication.

https://www.hopkinsmedicine.org/health/healthy-sleep/sleep-science/melatonin-for-sleep-does-it-work

FLU SEASON IS HERE. GET YOUR FLU SHOT.

It’s the start of fall which means ….. flu season is here.

Last year, flu hospitalizations were the highest they’ve ever been; 106 out of every 100,000 people were hospitalized for the flu in the 2017-18 season, with people over age 65 accounting for 58 percent of those hospitalizations and 180 pediatric deaths.

Flu and the common cold can both make you feel crummy, but they are caused by different viruses. Colds are usually milder and do not result in serious health problems associated with the flu, like pneumonia or hospitalizations.

Right now, being prepared is the best thing you can do before the season hits. Here’s what you need to know.

When does flu season start?

Flu season may start as early as October in North America, but generally, it begins sometime in the fall and ends in March. The flu virus, however, can be detected at any point throughout the year, which is important to know if you ever have symptoms, even in the summer. Experts can’t really predict the severity of each flu season, as different strains of the virus can have different impacts on timing and length of the season.

Should I get the flu shot? When?

Yes. With few exceptions, the Centers for Disease Control and Prevention recommends everyone 6 months of age and older to get vaccinated every year. It is the first line of defense in treating the flu. Although people who are moderately or severely ill should wait to recover before getting the shot. Only people with severe, life-threatening allergies to the vaccine or any of its ingredients should avoid the shot. According to the CDC, anyone who is between 2 and 50 years old should get either the shot or the nasal spray. The American Academy of Pediatrics, however, says the flu shot is the preferred choice over the nasal spray for children

You can get vaccinated at any time as fall approaches, but October is probably the best time to get it done. The CDC recommends that everyone get vaccinated by the end of October, which gives your body the roughly two-week period it needs to develop an immune response to the vaccine prior to the start of peak flu season. If you miss this deadline, however, the vaccine can still offer some benefit. So it's important to get it as long as people are still getting sick.

What if I’m pregnant?

It is highly recommended that all pregnant women get the flu shot. The body changes during pregnancy — heart rate and oxygen consumption increase while lung capacity decreases. That means if a mother-to-be gets the flu, they are more susceptible to life-threatening complications than the general population. So all women who are or expect to be pregnant should get the flu vaccine.

I heard the flu shot makes you sick. Is that true?

No. The flu vaccine contains an inactivated virus, which means that the virus contained in the vaccine can’t actually infect you. It does take one to two weeks for your immune system to protect you from the flu. So, if someone becomes sick after their shot, it is most likely because their body wasn’t protected from the flu yet, not from the vaccine itself.

Similarly, there are sometimes mismatches between the virus strain someone gets sick with and the strains used to make the vaccine. In these cases, the vaccine might be imperfect at fighting all strains of the flu that might exist, but it's still the best defense we have.

How do I know if I have the flu?

Flu symptoms often come suddenly, and can vary significantly depending on the person. These include fever, cough, sore throat, nasal congestion, body aches, headaches, and fatigue. While the flu may seem similar to a common cold, colds are usually slower to develop, and less likely to result in fevers.

Some patients with severe infections may have symptoms — like difficulty breathing and confusion — that are cause for concern and might require immediate medical attention to treat them. Medical attention should also be sought for children with the flu who develop bluish skin, aren't waking up or aren't eating. In all cases, if the person's symptoms suddenly worsen after appearing to initially improve, a visit to a clinician is warranted.

I think I have the flu. What do I do next?

In most cases, if symptoms are mild, staying home and leaving only to get medical care is the best course of action. If you must leave the house, wear a face mask, wash your hands, and cover coughs and sneezes with your elbow.

People with severe symptoms, as well as people at high risk from the flu (young children, people 65 and older and pregnant women), should contact their doctors if they develop symptoms. In some cases, people may get antiviral medications, which can lessen symptoms, shorten the time of illness and reduce complications.

How is the shot made?

Manufacturers have many methods of producing flu vaccines. The most common method is the egg-based vaccine, where strains of the virus are injected into eggs and incubated for several days. They are then weakened or killed and afterward purified to be used in a shot or nasal spray.

The next method is through cell-based technology. In these vaccines, the eggs used to incubate the virus are replaced with animal cells. This method is faster in producing vaccines than the older egg-based method.

Another method uses recombinant technology. In these cases, a certain gene is taken from the flu virus, to be inserted into a different non-flu virus which grows in insect cells. This genetically altered non-flu virus then replicates in insect cells. After the virus has been replicated, manufacturers purify the protein produced from the flu gene, which is used in the vaccine. The advantage of this method is that it doesn't use eggs, so people with severe egg allergies can be vaccinated.

What are the side effects of the flu shot?

Most side effects are mild and resolve quickly on their own. Soreness in the area of the shot is pretty common. In addition, people may have headaches, fevers and nausea. Seek immediate symptoms if someone is showing signs of a severe allergic reaction, such as difficulty breathing, hoarseness or eye and lip swelling.

Where should I get the flu shot?

Get your 2018/2019 flu shot / vaccination here.

https://www.cdc.gov/features/flu/index.html

https://abcnews.go.com/Health/flu-season-flu-vaccine/story?id=58156433

Preventing its spread requires good hygiene and high vaccination rates. If you are experiencing any symptoms, avoid contact with other people. If symptoms are starting to get severe, contact our doctor. Working together will be critical in halting flu season.

Tips for staying healthy while studying abroad

The study abroad experience is very exciting, filled with never before faced adventures and challenges. However, you will also be faced with some challenges to your physical body. In order to make the most of your experience abroad, you need to remain healthy. Even if you have not suffered from a major illness in the past, we recommend that you take the appropriate precautions before embarking on the exciting adventure that awaits you abroad. 

It would be in your best interest to get a physical checkup prior to going abroad checking for any ailments you might be unaware of and seeing your doctor to make sure you get any treatment needed that might not be as easy to find while abroad. Be sure to bring copies of your health records with you, just in case of emergency. Although your school may request a set of these documents, you should prepare an extra set and keep them with you. The following documents written in English (Ask your Physician) should be brought abroad: 

- Personal Medical History
- Immunization/Vaccination Records
- Drug Prescriptions: summary of any regularly used medications. You will need to be issued a prescription in the country you are staying in.  

You will be adjusting to life in a completely new environment inside of a new culture while studying abroad. In making the adjustment away from the familiar lifestyle of your home country, may come some changes which affect your health. Lifestyle changes in your eating habits, sleeping patterns, local climate, and stress level, can also affect your physical health as well as your emotional well being. 

Remember that it takes time to adjust to a new environment and that all of your fellow students are in the same situation. There are many people available to help you in making your adjustment as smooth as possible. Your school''s international student advisor, student health service personnel, and guidance counselors are willing to provide assistance whenever necessary.

Stress Management

Your health has a direct effect on your academic success. If you are healthy, well-rested, and alert, you can achieve peak academic performance. Planning for a successful adjustment into the foreign culture will help you overcome some of the initial challenges of changing your environment. "Culture shock" is the name given to the feeling of disorientation and discomfort associated with initial arrival into a new culture. "Cultural adjustment" is the process of learning about and growing comfortable in the host culture.

During the process of adjusting to a new culture you may experience mixed emotions as well as periods of stress. For example, you may temporarily experience changes in moods or attitudes. Some students report anxiety and loneliness, as well as changes in sleeping and eating patterns. 

Fortunately, this is only a temporary condition and there are many effective ways of reducing this stress! The first and best way to cope with unavoidable stress is to keep your body in good physical condition by eating well, exercising, and getting enough rest. Be sure to make time for activities which you really enjoy, whether alone or with the new friends you have made while abroad.

Another way to reduce "culture shock" is to talk out your worries. If you have made some friends, talk with them about what you are thinking and feeling. If you feel more comfortable talking with a professional, seek assistance from your international student services office or the student counseling center at your school. The important thing is to express what you are feeling. If it gets to much for you, you can contact our doctor for some support and understanding. 

If You Get Sick

Know in advance what to do if you become ill or injured. You can book an urgent or routine appointment with our doctor while studying in Barcelona. If you are not located in Barcelona, our doctor offers online/phone services including digital prescriptions for anyone in need during their stay in Europe. 

Click here to contact us or book an appointment.

http://www.applyesl.com/

Tips for Healthy Travels

Travel Tips

Keep hydrated — It is especially important during the summer holidays to keep hydrated (2 L of water a day) and to maintain a healthy diet, including vegetables, fruits, proteins and carbohydrates. 

Rest - Trips can be quite hectic, especially for those visiting more than one country. It is important to try and rest (7-8 hours night sleep) and to try and nap (30 min) throughout the day. 

Common Cold/Cough — With a/c and changes in temperature, it is common to suffer from a cold, nasal congestion and coughing. It is advised to keep hydrated, rest and take paracetamol/ibuprofen to help with the pain. If any of the following should appear, it is advisable to visit your doctor: 

Fever. Chesty Cough. Night cough. Green Phlegm. White spots on your tonsils. Conjunctivitis. Earache. Persistent headache, especially on your sinuses. Rash.

Traveler's diarrhea — Contaminated food or water, viruses, anxiety and jet lag can contribute to traveler's diarrhea. It often strikes abruptly and causes four to five loose or watery bowel movements each day. In most cases, traveler's diarrhea will go away in a day or two without medical treatment. Most doctors don't recommend preventive medications such as antibiotics or anti-diarrheals (Pepto-Bismol/Fortasec), except in special circumstances. The best prevention is good hand hygiene and food and water safety. International travelers should drink only bottled beverages . For food, the general rule is: "Boil it, peel it, cook it or forget it.", especially in high risk countries. If diarrhea persists more than 48 hours, you experience fever, blood in your stools or have abdominal pain, we recommend you to contact our doctor.

Motion sickness — Travelers susceptible to motion sickness should consult a doctor about over-the-counter or prescription medications. Some natural remedies have been shown to reduce symptoms, too. Options include acupressure wristbands, ginger tea or dietary supplements.

Care before travel — Travelers of all ages leaving the country can benefit from a pretravel medical appointment, ideally four to six weeks before departure. The doctor will perform a physical exam and assess the health risks associated with travel plans.In most cases, the patient's regular doctor can provide this care. Travelers with specific medical conditions who are heading to Asia, Africa or Latin America may benefit from an appointment at a travel medicine clinic. There, care providers often have advanced training or board certification in travel medicine or tropical medicine. While services at these clinics vary, many providers offer a comprehensive overview of health hazards associated with specific travel plans and detailed advice on how to stay well. Contact our doctor if you have any travel consultations.

Jet lag — Older adults may have more severe jet lag and take longer to recover. Travelers can minimize jet lag by shifting to the local schedule as soon as possible. Travelers may be able to avoid jet lag by adjusting sleep schedules a few days before traveling.

TRAVEL VACCINATION SERVICES

Each year thousands of travellers decide to visit countries that require certain types of vaccinations. Our private travel clinic will give you travel health advice, vaccinations and malaria tablets.

For all your vaccination and malaria prevention needs, simply book an appointment for a consultation with our travel health doctor. 

Below is a link to check the vaccines that, during consultation with the doctor, will either be recommended  or must be carefully considered  for travel to your destination:

http://travelvaccination.co.uk/

STUDY ABROAD: ACCOMMODATION IN BARCELONA

You have decided to move to Barcelona to study from abroad. It is your fist time but some of your friends have been there before and they have given you recommedations. Deciding where to live is key to make the most out of your semester or year abroad and it´s important to inform yourself about the different areas (do you prefer to be near the beach? do you prefer to live with other students? Would you prefer to be in building with all students?

Barcelona is divided into 10 "districts". The most popular areas for student accomodations are: 

1. The City Centre: we find the actual old quarter called Ciutat Vella. Surrounding this quarter are two very popular residential areas called Eixample Dreta (Right Eixample) and Eixample Esquerre (Left eixample). The majority of students stay in this areas.

2. University Area: Eixample esquerre is were many universities (UAB, UB, ESADE, etc) are located. There are also two districts which are popular for students: Corts and Gracia.

DISTRICTS FOR STUDENTS: 

Ciutat Vella

Well, let’s start from the beginning… Ciutat Vella (Old City) is comprised of four different neighborhoods (Barri Gotic, El Raval, Barceloneta, El Born). It is one of the most beautiful and charming areas of the city. If you have ever visited the city before, you probably felt in love with this area and you decided that this was where you wanted to live one day!

This area is jammed with bars, music venues, restaurants, etc. so it might be noisy in some parts, especially in Barri Gotic, where pedestrian streets are quite narrow. If you like to be in the middle of the action you just found your area!
However, when you choose your apartment just make sure that there is not a bar or restaurant terrace below.

This is a very touristy area and, as a consequence, the cost of living might be more expensive, especially for grocery stores and restaurants. In terms of rent, it is an affordable area. The average rent for a two bedroom apartment goes from 500 to 700 € per month.

In general the Old City has great transport connections with the rest of the city. The Gothic Quarter, Raval and El Born are connected with the University Area by the tube Lines 1 and 3. Barceloneta’s connections are not as good, only the tube Line 4 reaches there.

EIXAMPLE

This large area named Eixample is located beyond Plaça Catalunya and is divided in two parts, ‘Eixample Dreta’ and ‘Eixample Esquerra’ by Passeig de Gràcia. In this area the buildings are built in an easily recognizable grid shape designed by the architect Ildefons Cerdà.

Eixample Dreta

Eixample Dreta is one of Barcelona’s most exclusive neighborhoods. It has a great location as you can walk to Plaça Catalunya and Sagrada Familia. You are also close to Passeig the Gracia which is an exclusive shopping area and to the Gothic Quarter where you can enjoy Barcelona’s nightlife. It also has great tube connections as L1, L2, L3, L4 and L5 stop in this neighborhood.

Rent in this neighborhood is generally quite high, still you can find some nice apartments with an affordable rent. Conversely, Eixample Esquerrais a student area.

Eixample Esquerra & Corts

Eixample Esquerra and Corts neighborhood form the University Area (Zona Universitaria), where the majority of students live, since many universities are based there, for instance ‘Universidad de Barcelona’, ‘Universidad Politécnica de Cataluña’ or ESADE.

Corts is also the financial neighborhood of the city, where many international companies, businesses and hotels are located. Nightlife in this area is quiet since the majority of professionals don’t live here and students tend to head towards Eixample, especially around Plaça de la Universitat. In this area there is also the Barcelona FC’s stadium Camp Nou, so if you are a Barça fan you just found your neighborhood!

Transport connections are also great. The tube lines L1 and L3 can take you to ‘Ciutat Vella’ in less than 20 minutes.

Gracia

Gracia is the new hip upcoming neighborhood which used to be a town until 1897, when it got incorporated to the city. It still maintains its bohemian style, with large squares where bars set up their terraces, local markets and independent stores. It has the famous Parc Guell from Gaudi.

Many students are moving to this neighborhood because of its trendy scene. Moreover, it has great connections to the University area by the tube line 3 and to ‘Ciutat Vella’ and Barceloneta beach by line 4. It is also possible to cycle but there is quite a stip hill.

Check these websites for accommodation in BCN

STUDY ABROAD APPARTMENT

RESA HOUSING

UNIPLACES

Airplane ear. Flying with a cold or an ear infection.

The stress exerted on your eardrum and other middle ear tissues when there is a difference of pressure between your ear and the environment (e.g. when flying) may damage your ears. You may experience airplane ear at the beginning of a flight when the airplane is climbing or at the end of a flight when the airplane is descending. These fast changes in altitude cause air pressure changes and can trigger airplane ear.

Usually self-care steps — such as yawning, swallowing or chewing gum — can prevent or correct the differences in air pressure and improve airplane ear symptoms. However, a severe case of airplane ear may need to be treated by a doctor.

Symptoms

Airplane ear can occur in one or both ears. Airplane ear signs and symptoms may include:

• Moderate discomfort or pain in your ear
• Feeling of fullness or stuffiness in your ear
• Muffled hearing or slight to moderate hearing loss

If airplane ear is severe or lasts more than a few hours, you may experience:

• Severe pain
• Pressure in your ear similar to being underwater
• Moderate to severe hearing loss
• Ringing in your ear (tinnitus)
• Spinning sensation (vertigo)
• Vomiting resulting from vertigo
• Bleeding from your ear

When to see a doctor

Usually you can do things on your own to treat airplane ear. If discomfort, fullness or muffled hearing lasts more than a few hours or if you experience any severe signs or symptoms, call your doctor.

Request an appointment with Dr. Victoria Howe

Causes

Airplane ear occurs when an imbalance in the air pressure in the middle ear and air pressure in the environment prevents your eardrum (tympanic membrane) from vibrating as it should. Air pressure regulation is the work of a narrow passage called the eustachian tube. One end is connected to the middle ear. The other end has a tiny opening where the back of the nasal cavity and the top of the throat meet (nasopharynx).

When an airplane climbs or descends, the air pressure in the environment changes rapidly, and your eustachian tube often doesn't react quickly enough. Swallowing or yawning activates muscles that open the eustachian tube and allow the middle ear to replenish its air supply, often eliminating the symptoms of airplane ear.

Ear barotrauma also may be caused by:

• Scuba diving
• Hyperbaric oxygen chambers
• Explosions nearby

You may also experience a minor case of barotrauma while riding an elevator in a tall building or driving in the mountains.

Risk factors

Any condition that blocks the eustachian tube or limits its function can increase the risk of airplane ear. Common risk factors include:

• A small eustachian tube, especially in infants and toddlers
• The common cold
• Sinus infection
• Hay fever (allergic rhinitis)
• Middle ear infection (otitis media)
• Sleeping on an airplane during ascent and descent

Frequent or severe airplane ear may damage the tissues of the inner ear or eustachian tube, which increases your chances of experiencing the problem again.

Complications

Airplane ear usually isn't serious and responds to self-care. Long-term complications may occur when the condition is serious or prolonged or if there's damage to middle or inner ear structures.

Rare complications may include:

• Permanent hearing loss
• Ongoing (chronic) tinnitus

Prevention

Follow these tips to avoid airplane ear:

• Yawn and swallow during ascent and descent. Yawning and swallowing activate the muscles that open your eustachian tubes. You can suck on candy or chew gum to help you swallow.
• Use the Valsalva maneuver during ascent and descent. Gently blow, as if blowing your nose, while pinching your nostrils and keeping your mouth closed. Repeat several times, especially during descent, to equalize the pressure between your ears and the airplane cabin.
• Don't sleep during takeoffs and landings. If you're awake during ascents and descents, you can do the necessary self-care techniques when you feel pressure on your ears.
• Reconsider travel plans. If possible, don't fly when you have a cold, sinus infection, nasal congestion or ear infection. If you've recently had ear surgery, talk to your doctor about when it's safe to travel.
• Use filtered earplugs. These earplugs slowly equalize the pressure against your eardrum during ascents and descents. You can purchase these at drugstores, airport gift shops or your local hearing clinic.
• Use an over-the-counter decongestant nasal spray. If you have nasal congestion, use a nasal decongestant about 30 minutes to an hour before takeoff and landing. Avoid overuse, however, because nasal decongestants taken over several days can increase congestion.
• Use oral decongestant pills cautiously. Oral decongestants may be helpful if taken 30 minutes to an hour before an airplane flight. However, if you have heart disease, a heart rhythm disorder or high blood pressure, or if you've experienced possible medication interactions, avoid taking an oral decongestant unless your doctor approves. If you're a man older than age 50, you may experience serious side effects after taking decongestants containing pseudoephedrine (Actifed, Sudafed) such as urinary retention, especially if you have an enlarged prostate. If you're pregnant, talk to your doctor before taking oral decongestants.
• Take allergy medication. If you have allergies, take your medication about an hour before your flight.

If you're prone to severe airplane ear and must fly often, your doctor may surgically place tubes in your eardrums to aid fluid drainage, ventilate your middle ear, and equalize the pressure between your outer ear and middle ear.

Helping children prevent airplane ear

These additional tips can help young children avoid airplane ear:

• Encourage swallowing. Give a baby or toddler a beverage during ascents and descents to encourage frequent swallowing. A pacifier also may help. Have the child sit up while drinking. Children older than age 4 can try chewing gum, drinking through a straw or blowing bubbles through a straw.
• Consider eardrops. Talk to your child's doctor about prescribing your child eardrops that contain a pain reliever and numbing agent for the flight.
• Avoid decongestants. Decongestants aren't recommended for young children.

TOO YOUNG FOR HIGH CHOLESTEROL?

TOO YOUNG FOR HIGH CHOLESTEROL? 

"When researchers studied several groups of young adults and looked at the extent to which high cholesterol in early adulthood is linked to later development of heart disease, they found that high levels of LDL ("bad") cholesterol were 5.5 times as likely to have a buildup of calcium in their coronary arteries (an early indicator of heart disease) than those who had optimal levels.

Most of the time, high cholesterol in young adults occurs for the same reasons it does in older people: obesity, lack of physical exercise and a diet that includes too much sugar and too many junk foods and fast foods.

On the positive side, lifestyle and dietary changes can often help bring cholesterol levels under control. I suggest starting by eliminating processed foods, sugary drinks and quick digesting carbohydrates. That means avoiding manufactured food that contains trans fatty acids (TFAs), which increase total cholesterol, raise LDL and lower HDL ("good") cholesterol. 

The real cause of our high rates of cardiovascular disease could be sugar, rather than saturated fat. We whoudl not only be eating less foods that can increase cholesterol levels, we just also be increasing vegetables and olive oil to our daily diet. 

Losing weight may also help you lower your cholesterol – even modest weight loss can do the trick. Regular exercise is important; it can increase HDL ("good") cholesterol levels. If you smoke, quit. And since emotional stress may prompt the body to release fat into the bloodstream (raising cholesterol), we should also be addressin stress issues.

Victoria Howe, MD. Andrew Weil, MD.

Source: 
Mark Pletcher et al, "Associations of retrospective and concurrent lipid levels with subclinical atherosclerosis prediction after 20 years of follow-up: the Coronary Artery Risk Development in Young Adults (CARDIA) study," Annals of Epidemiology, doi: 10.1016/j.annepidem.2013.06.003.