Archive for June 2011
Symptoms Of Diabetes In Children – Could Your Child Be At Risk?
When you look at a person with diabetes, you’d never know it, they look healthy on the outside.
But it’s what you don’t see that is so bad.
The disease elevates the amount of glucose (sugar) in the blood. As blood sugars remain high, over time, complications such as blindness, kidney failure, amputations, heart disease, and severe nerve damage can occur.
The quality of your child’s life may depend on being able to recognize the symptoms of diabetes in children.
Diabetes in children has reached almost epidemic proportions. The incidence of this chronic and sometimes deadly disease is predicted to continue to rise.
Unfortunately for parents, sometimes it can be hard to identify the symptoms of diabetes in children. Read the list below and you’ll understand why often symptoms of diabetes aren’t recognized early.
When they are, doctors can help immediately with treatment and help you to maintain and control the diabetes.
Symptoms of diabetes in children and adults are:
o Frequent thirst – You may just be thinking your child drinks a lot.
o Frequent infections – Many consider this just a part of childhood.
o Blurred Vision – Your child may not tell you as the blurred vision can come and go. It’s not always constant.
o Cuts/bruises that are slow to heal – It’s easy to think the injury was just a “bad one” and it’s taking longer to heal.
o Tingling/numbness in hands or feet – Again you child may not notice or tell you about it as it’s not usually constant.
o Frequent urination – Many just think it comes from drinking more.
o Extreme hunger – Often parents think their child is going through a “growth spurt” and just requires more food.
o Unusual weight loss – This symptom does normally make parents concerned. If the child has bee overweight, parents sometimes think …..Great, the weight is finally coming off.
o Irritability – Can often be labeled as parent/child confrontations. Also many parents of teens just think it’s a normal part of the teenage years.
You won’t see all of this at once. You will notice one of them, then a month or two latter something else…
What To Do If You See Symptoms Of Diabetes In Children
Get your child tested for diabetes IMMEDIATELY. Don’t wait. The test is simple and painless. The longer you wait the more difficult the disease can be to control.
These symptoms may not even be noticed until the disease in is full force. It’s important to learn to recognize these symptoms. With early detection children with type 2 diabetes can learn to control the disease with diet and exercise.
Left untreated the symptoms of diabetes in children results in more defined and difficult treatment. Medications and insulin must often be used to control diabetes. Diabetes is a disease that should not be taken lightly.
There are two types of diabetes, type 1 and type 2.
Type 1 diabetes occurs when the body no longer produces insulin.
Type 2, the most common type of diabetes occurs when the body develops a resistance to insulin, or does not produce enough insulin. Type 2 diabetes, once labeled adult onset diabetes, has become more and more prevalent in children.
Research has documented two primary factors contributing to the rise in type 2 diabetes in children. The factors are: 1) children today are more inactive, and 2) unhealthy diets in children. Today’s lifestyle of fast-food meals, TV, computers, and hand-held games has put many at risk of developing symptoms of diabetes in children.
Diabetes in children is a serious threat. Take control of your child’s future today. Make sure they have a healthy diet including fresh fruits and vegetables. Keep your children active. They won’t be deprived if they don’t spend hours a day watching TV or playing computerized games. You could be saving their life.
You may get a few weird looks and complaints, but what’s that compared to the health of your child?
By: Mike Herman
Childhood and Juvenile Diabetes Symptoms
What Are Some Child Diabetes Symptoms?
Are you worried that you child might have childhood diabetes? If so you should know that there are many different child diabetes symptoms that you might want to look for. They can often be the same symptoms as many other disorders, so if diabetes is suspected, take the child to the doctor right away.
There are many different symptoms of childhood diabetes. Some of the signs that you might want to look for are fatigue, crankiness, and a lack of interest in activities that your child once enjoyed.
You may also want to look for symptoms like unexplained thirst and a decrease in urination. Your child might also have an upset stomach or maybe even flu like symptoms. It has been said that some parents have noticed a smell of acetoneon on their child’s breath.
If you are noticing any of these symptoms you should definitely talk to your child’s doctor to check for childhood diabetes. Your child could also experience symptoms of being pale and losing weight. They can often indicate other medical problems as well, so check with the child’s doctor if any of the above become evident.
Your child if diagnosed with diabetes might have to check their blood regularly and also might need to be on some form of insulin. If they are old enough, you will find that you probably need to be a constant form of support in their lives as being diagnosed with childhood diabetes can have a major effect on an adult much less a child who has come to have such a major change in their life.
You may also find that letting your child find support from other children who are going through the same changes can help them.It must be remembered this whole situation can be quite confusing and emotionally difficult for them. You will want to make sure that the school and anyone else that cares for your child is aware of the fact that they have diabetes that way should something go wrong they will be better aware of what they may need to do to help your child.
Now let’s have a look at some Important Juvenile Diabetes Symptoms
There is Type 1 juvenile diabetes and type 2 juvenile diabetes. Although the symptoms are similar, they are caused by two different body malfunctions. Juvenile diabetes has no cure, but it is treatable. It is an autoimmune disease. If your child has any of these symptoms, check with your doctor right away.
Increased Urination
In juvenile diabetes the body continues to make glucose, however, the insulin no longer transports the glucose to the cells, so it builds up in the body. The kidneys try to solve the problem by getting rid of the extra glucose. This causes the patient to sense the need to urinate frequently.
Increased Thirst
Most parents think the reason their child is urinating so frequently is because he is constantly drinking water. The opposite is true. The reason they can’t get enough water to drink is because they are constantly getting rid of the liquids in their body by urinating so much.
Constant Hunger
Children that have juvenile diabetes can be continuously hungry regardless of the amount they eat. The reason they feel that way is because they don’t have the necessary insulin to carry the glucose, their body’s fuel, so they never feel properly fed.
Weight Loss or Gain
Juveniles with type 2 diabetes are prone to being overweight, so for them, diabetes is associated with weight gain. On the other hand, type 1 diabetes is just the opposite. Since the body isn’t receiving the fuel it needs, it can’t create fat. So despite the fact that the juvenile is constantly eating they lose weight.
Miscellaneous Symptoms
These symptoms may or may not be present in a person that has juvenile diabetes. They may include dizziness, nausea, confusion, absence of menstruation in young girls, headache, vomiting, a fruity type of breath odor and bed wetting. If children don’t normally wet the bed, and all of a sudden they start doing it regularly, have them checked for juvenile diabetes.
By: Frederik Holdeeze
Managing A Diabetic Diet
As someone who has diabetes and is on a diabetic diet, I can tell you it’s not always easy to stay on it. The foods you once use to eat with great pleasure are now off limits. This, as well as other reasons can make things difficult for anyone. So, what can you do to make things easier?
Starting any type of diabetic diet should only be done with the agreement of your doctor or a dietician. Don’t go this alone. Medical professionals can take into account the causes of your diabetes in setting up a diet plan. Whether it is from obesity, diet, family history, etc. They can get you on a diabetic diet that is specific to your needs.
Regardless of the specifics, any diet plan is going to include reducing carbohydrates and sugars. You’ll be increasing proteins along with eating plenty of fresh fruits and vegetables to reduce blood sugar levels.
Don’t feel that you can never enjoy eating again because you have diabetes. While you will have make changes and cut back, you can still have some of your favorite foods, but with moderation.
How do these foods affect your blood glucose level? You’ll have to monitor yourself and maintain a healthy balance.
Any diabetic diet [http://www.diabetes.infofroma-z.com/Managing_A_Diabetic_Diet.html] will also include exercise in it. It’s vital to your health. We’re not talking about joining a health club, or sweating at the local gym. It can be going for brisk walks 4 times a week for 30 minutes.
Exercise is going to help in dramatically lowering blood sugar levels. It will also help build up your body’s insulin.
While it may be tough for a while to stick with any diabetic diet, your body will benefit in a big way. Your entire health with begin to improve and you’ll feel better for years to come.
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By: Terry Edwards
Type 2 Diabetes – Diet Plans That Can Help Control Blood Sugar Levels and Your Weight!
Type 2 diabetes or not, following a healthy, well-nourishing diet plan can never be over-emphasized. In fact, being a diabetic means that you need to follow a healthy eating plan so you can lower your blood sugar levels, and if you are overweight, help you to lose weight.
There are so many diet plans claiming to be effective for the management and control of your blood sugar level. But, do you know which of them are truly effective? Do you know which of them are backed by extensive scientific research?
Here are some of the most popular diet plans that can give you valuable benefits for your personal battle against Type 2 diabetes:
1. High fiber diet plan:
Eating foods with a high dietary fiber content is essentially the “heart” of the high fiber diet. Foods high in dietary fibers include:
fruits whole grains vegetables and legumes
Dietary fibers give added bulk to plant foods. Your body doesn’t have the ability to digest nor absorb fibers… so sticking to a high fiber diet plan can be really beneficial in controlling your blood sugar and fighting against the possible long-term complications of Type 2 diabetes.
In fact, as mentioned by Mayoclinic.com, soluble fibers coming from your diet have the ability to slow the absorption of sugar, and help to prevent those postprandial blood sugar spikes. On the other hand, insoluble fibers found in foods such as whole grains can reduce the overall risk for even developing diabetes.
According to the March 2010 issue of Circulation, the high dietary fiber content of whole grains can decrease the risk for all-cause mortality in Type 2 diabetics. It was also been pointed out the regular intake of high fiber foods is inversely related to the development of diabetes… this means the higher the dietary fiber intake, the lower the risk for Type 2 diabetes.
2. Mediterranean diet plan:
The Mediterranean diet promotes the high intake of fruits, vegetables and fish, and eating less red meat, processed foods and sugar-rich foods. According to the January 2008 issue of DocNews of the American Diabetic Association, the Mediterranean diet plan has the ability to improve cardiac problems in the high-risk diabetic population. It was also mentioned Type 2 diabetics who regularly ate foods recommended in the Mediterranean diet plan have a 79 percent lesser risk in the development of lethal ischemic heart problems.
3. Low-fat vegetarian diet plan:
In a study published in the August 2006 issue of Diabetic Care, it has been shown diabetics who stick to the low-fat vegetarian diet plan have better blood sugar and fat control compared to diabetics who followed the American Diabetes Association (ADA) Guidelines. In this study, the researchers also discovered diabetics following a plant-based diet gained much better cardiovascular improvements.
Having a healthy diet plan will always be an integral part for effective Type 2 diabetes control. Choosing one healthy diet plan that fits your preferences and lifestyle is a must to combat the possible complications of having Type 2 diabetes. So, what are you waiting for? Choose the best one for you and reap the benefits of having well-controlled blood sugar levels and weight loss.
By: Beverleigh H Piepers
Diabetic Diets – A Single Step to Ensure Lasting Success With Your Diabetic Diet
Managing a diabetic diet can be overwhelming. It was for my mother. But here is what I told her. There is only one thing you must to do for victory. Take a good look at where you sugar is coming from. Most diabetics feel that they do not eat all that much sugar. Admit it, by the time you know of your diabetes you have an ingrained need to eat sweets. This is otherwise known as a craving.
Since we only need enough sugar to keep our brains functioning at tip top speed, let’s consider the amount that is absolutely necessary for your diabetic diet control. Mindful that no one in the free world is ever sugar deprived of the 8 teaspoons or 32grams of sugar per day. Children and young adults need more sugar about 65 grams or 11-12 teaspoon a day. This requirement is to supply the daily energy necessary to grow, change and develop into adults.
So where is all this sugar? My guess is that it is hidden in all the convenience food of a contemporary lifestyle.
The invention of Tomato ketchup is the ring leader with 7 teaspoons in 2Tbs. Then came barbecue sauce, pancake syrup, sodas with as much as 37 teaspoons in one bottle. This followed by ‘health giving’ cans of energy drinks with as much as 68grams of sugar. Stay away from these as if they were the plague, even if your favorite talk show host or celebrity praises their virtues.
Take a reserved attitude about fast food like McDonalds Vanilla shake with 24 teaspoons of sugar. They put the fast in fast blood sugar elevation. Is ‘read the labels of prepared food’ coming to mind here? This little action will put you on a new path – the pathway to awareness and body protection. Once your body and mind pick up this new attitude, two things can happen. You will consciously seek to avoid these foods and happily seek hew healthier alternatives found in fresh food. You will feel contented instead of deprived and in an unhealthy sugar spiral.
The real solution is to quickly switch to natural food. Instead of apple juice, eat a fresh apple. This simple action will give you 3 benefits. It will readjust your sweet palate since a slice of apple has less sugar than a swallow of juice. Chewing will tell your brain that you are eating and that you will be soon satisfied, decreasing your sugar craving, and you will be getting necessary fiber, a factor that is needed to alleviate your complaint and giving you a healthy, happy body.
When seeking to attempt a diabetic diet you might turn to artificial sweeteners. This is not the healthiest idea for a diabetic. Artificial, sweeteners are not recognized by the body as food. The idea of no calories is mesmerizing! However, the science of sweeteners is fuzzy and no one knows the long term effect on brain and body function. This molecule that masquerades as sugar with unrecognizable composition will put a strain on both your digestive system and your immune system, each trying unsuccessfully to breaking down this foreign molecule in your body. This can leave you with bladder issues, aches and pains as unutilized material and inflammation settle in your joints causing you even more discomfort.
One other things to consider; although it is sweet you will still be deprived of the energy coming from real sugar. I think this is too much metabolic stress for a person whose cells refuse to admit sugar leaving it to roam in the blood stream.
There is one other aspect of food that you must consider and that is foods that are easily digested into sugar by natural enzymes in your mouth. Foods made with white flour such as crackers, white bread, rolls and buns have this characteristic. Instead plan to eat high fiber foods diabetics need from whole wheat, oats and fibrous grains. Vegetables like white potatoes which breaks down to sugar in the mouth can be replaced by more fibrous vegetables such as sweet potato.
Giving this simple idea a fearless focus you will easily master this one skill. With this one conscious consideration you might never have to deal with the unstable health care industry. Instead, imagine reversing your diabetes and dying peacefully in your own bed of natural causes at the ripe old age of 103, like my mother.
By: Celia Westberry
Symptoms of Diabetes
Diabetes is a disorder of the body’s sugar-regulation abilities. Most of the time it goes undiagnosed because the symptoms are not very clear. There are many symptoms, but they don’t appear in all cases. The symptoms include frequent urination (polyuria), which occurs because of the high blood sugar levels. High blood sugar levels result in an overflow of glucose from the kidneys, carrying the fluid along with it. Because there is a constant loss of body fluid through urination there is a constant thirsty feeling (polydipsia).
Diabetes is usually accompanied by sudden weight loss, due to the body not being able to utilize the available glucose to generate energy. This can result in the individual being hungry throughout the day (polyphagia), which leads to weakness and fatigue. In diabetes the high sugar levels do not allow some of the body tissues and cells to work normally; hence, it can result in poor or blurred vision. This also results from the shrinking of the lens of the eye due to excess glucose. A diabetic person is prone to yeast and fungal infections, as these organisms can survive well in tissues, which cannot utilize sugar themselves, and therefore have a large amount of extra food for the yeast and fungi to grow.
There is also a tingling feeling or numbness in the hands and feet, which heightens at night. The skin of a diabetic person becomes very dry and flaky due to excessive loss of water, leading to dehydration. This situation may also lead to the person going into a coma. As the basic body fuel, glucose, cannot be converted into energy, the person seems very tired and lethargic most of the time. Also it takes a long time for any sores, cuts or wounds to heal in a person suffering from diabetes. They are also very susceptible to infections, since the immune system is very weak.
Some patients also experience pain in the legs while walking (claudication). There is also a constant itchy feeling (pruritis) in some diabetics.
Though the symptoms are many, it is very difficult to say for sure that you are a diabetic only on the basis of these symptoms, as these symptoms are not exclusive to diabetics. Therefore, to find out if you are diabetic, it is advisable to approach a medical doctor if any of these symptoms are seen, so that he can guide you in the proper direction.
By: Josh Riverside
Food List For Diabetics to Eat – Free Diabetic Meal Plan and Diabetic Recipes For Any of You to Try
Having a healthy balanced diet for anyone whether they are diabetic or not should be a priority however with diabetics this is a must have.
The recommended daily calories for a person with diabetes is between 1200 – 1800 calories which should consist of 50% carbohydrates 20% protein and 30% fats. This would prove to be a balanced and healthy diet for anyone with diabetes however this is very much just a guide line and depending on what your diabetics condition is like as most people suffering with diabetes have unique conditions and situations it will differ from person to person.
A must have for people with diabetes is Alpha-lipoic acid now this is like a vitamin and it helps to enhance the glucose uptake and improve nerve damage.
Another must have for any diabetic is Omega 3 most people have heard of Omega 3 and this helps to protect against hardening arteries.
Both of these are very important and must haves for anyone with diabetes, whether it is type 1 or type 2 diabetes including these two substances in to your diet can benefit your illness largely having great effects on your body and the illness.
There are many factors which help to understand what each person suffering from diabetes needs, this is why when you go to create a diabetic meal plan it is best consulting your doctor as well as they know your medical condition more than anyone else. They are able to give expert advice on how to structure and what to include in your diabetic meal plan.
By: Will Blears
Diabetes Symptoms and Complications
If you have concerns about diabetes, this article discusses the various diabetes symptoms and complications. This information should help you make better decisions to better manage diabetes and improve your quality of life. Diabetes is not a death sentence and managing or overcoming diabetes requires concerted effort.
A. What is Diabetes?
Insulin is a hormone that helps the body use glucose (one of the simplest forms of sugar) for energy. The pancreas makes insulin though some of its cells. When food is eaten, the pancreas breaks down the sugars and starches into glucose which is used as fuel by the cells in the body.
For a diabetic with Type 1 diabetes, the pancreas does not produce any insulin and the diabetic needs daily injections of insulin. This usually starts in childhood.
For a diabetic with Type 2 diabetes, the body does not produce enough insulin or ignores the insulin produced. This is the most common type of diabetes although almost half of the afflicted are unaware of having the disease.
With the lack of insulin production, glucose levels build up in the body and tissue and are excreted by the body through urine thereby leading to a loss of the main source of fuel needed by the body. This loss of glucose leads to diabetes complications.
Another form of diabetes is gestational diabetes experienced by some pregnant women during the third trimester of the pregnancy. This usually resolves itself a few months after childbirth but some of these women will develop Type 2 diabetes later on in life.
B. Symptoms
Early detection of diabetes and proper treatment can usually decrease the chances of developing diabetes related complications.
i. Type 1
- Frequent need to urinate
- Excessive thirst
- Extreme hunger
- Sudden weight loss that is unusual
- Tiredness throughout the day and irritability
ii. Type 2
- Any of the above symptoms
- Getting infections frequently
- Sudden changes in eyesight and vision
- Cuts and/or bruises that are slow to heal
- Tingling and/or numbness in the hands and/or feet
- Very itchy or dry skin
It is important to note that some people with Type 2 diabetes never suffer any symptom which is why it is one of the “silent killers”. This is why it is important to get tested frequently.
C. Complications
Diabetes increases the risks for many health problems that are frequently very serious. However with the proper treatment and lifestyle changes many can delay or prevent any complications. These are some of the complications;
1. Eye complications: Diabetics have a higher risk of vision problems and blindness. Having regular vision checkups is important to treat any problems that develop quickly.
2. Foot Complications: Foot problems occur mainly due to nerve damage in feet that can lead to loss of feeling in feet. Nerve disease also reduces sensation in feet. Most people with diabetes have artery disease which reduces blood flow to feet which is why most people with diabetes are far more likely to need a foot or leg amputation. It is therefore very important to take good care of feet by wearing the proper shoes and see a doctor immediately when foot problems develop.
3. Various skin conditions may develop and it is important to see a doctor immediately once you notice any skin conditions.
4. Heart disease and stroke: It is important to speak with your doctor to discuss steps to reduce your risk as a diabetic to heart disease and stroke.
5. High blood pressure: Two out of three diabetics have high blood pressure which increases the risk for heart attack, stroke, eye problems, and kidney disease. Have your blood pressure checked frequently.
6. Kidney disease: Having diabetes can cause damage to the kidneys and lead to them failing. Failing kidneys lose their ability to filter out the body’s waste products leading to kidney disease.
By: Terry Robbins
Diet Plan For Diabetics – 5 Tips For Diabetic Diet Food
This article would simply guide you to what diabetics can eat and what they cannot.
You must already know that metabolism of each and every person is entirely different. The different metabolism of each and every person guarantees that there is no rule of thumb. Deciding the right diabetic food for a particular person is a matter of hit and try.
The level of sugar in the bloodstream has to be checked after eating different types of foods. If the glucose blood level is high then such foods must be cut out from the diet or at least their portion must be reduced.
Following are the 5 important tips that lay down the foundation of the diabetic diet plan.
Snack Carefully: The diabetics must enter into snaking carefully. Most snack foods have higher carbohydrate content; so such snacks are not good diabetic foods. It is better to avoid eating salted nuts, crisps, cakes, sweets and biscuits. The nest snack choices are vegetables strips like carrots, cucumber, green pepper and celery. Fresh and dried fruits and unsalted nuts are better choices. You can also have a treat with dark chocolate squares that is enriched with coco solids. Unsweetened dark chocolate is also fine.
Eat Whole Grains: Prefer wholemeal bread, pasta, basmati rice and whole grain. Wholemeal choices are much better than processed white options. There are many different types of bread that are available in the shelves of the superstores that contain plenty of whole grains and seeds. These are better choices. Potatoes are not bad form of carbohydrates especially if they are not fried in oil. Dry roasted potato wedges are good if taken with a spoon of cumin seeds. They are not only nutritious but at the same they are crispy and tasty.
Control Consumption of Alcohol: Beer contains plenty of sugar. It is better to avoid beer or select pilsner one as it has all sugar brewed out from it. Cocktails are also not good, it is better to avoid it or have it only if you know exactly what is inside it. It is ok to take some calorie free mixer like cola or tonic but only occasionally. Some doctors strongly recommend consuming a glass of red wine daily as it is full of antioxidants. These antioxidants are good for the health of heart.
Fruits And Vegetables: The diabetics should eat plenty of fruits and vegetables. Veggies do not necessarily means boring as they make best diabetic foods. It is good to mix chopped courgette, red pepper, red onion and aubergine with garlic cloves. You can also sprinkle some seasoning and olive oil on it. This can be roasted in over for 15 to 20 minutes. It is also nice to steam green vegetables as boiling may take goodness out of it. Either cook the fruits or take them as raw desert; if it is necessary then you may add some artificial sweetener.
Drink Plenty Of Water: Drinking plenty of water is good for everyone especially diabetics. It is easy to have a glass of water after every hour. If you work on the computer you can have a reminding pop up or have water bottles ready to drink all around the house. Drinking water keeps the person hydrated so that kidneys keep on functioning well.
By: Tehmina Mazher
Diabetes Symptoms – Understanding What They Are
Knowing what diabetes symptoms are and understanding them is essential for you so that you can effectively manage your diabetes easily. Diabetes is initially diagnosed by a blood test if you show any signs of the symptoms that are related to diabetes or you are in a high-risk group. The blood test will be done to measure the level of your blood glucose.
The major diabetes symptoms are:
Fatigue and tiredness An increase in thirst Blurry vision Constant hunger Increase in urine output Leg cramps Sudden loss in weight, and Skin infections, itching, and wounds that won’t heal
You could be in the high-risk group of undiagnosed diabetes if you fall under any of the following points:
If you are over the age of 55 If you have a family history of diabetes If you are overweight or obese If you have high blood pressure If you developed diabetes during your pregnancy which is known as gestational diabetes
It is quite common for people with type 2 diabetes to go undiagnosed for around 4 to 7 years, and unfortunately it is usually diagnosed because of diabetes complications instead of diabetes symptoms.
The reason people develop diabetes is because the hormone called insulin has stopped producing or is unable to work effectively to break down the glucose in the blood. When this occurs, your body automatically responds by getting rid of the excess glucose into your urine. This is why you will notice an increase in urination output, increased thirst, and constant hunger and weight loss. The most important thing to realise is that you need to be aware that dehydration can occur from these symptoms, which can ultimately cause you a lot of harm if it is left untreated.
Other diabetes symptoms that can occur is a prolonged high blood glucose that causes glucose absorption that can lead to changes in the shape of the lenses of your eyes, which will result in vision changes, if you take control of your glucose levels your lenses can return to their original shape. Blurred vision is a common problem with people that are diagnosed with diabetes.
People that have type 1 diabetes can also get what is called diabetic ketoacidosis, which is a state of metabolic dysregulation characterised by the smell of acetone; other diabetes symptoms are a rapid, deep breathing that is known as kussmaul breathing; nausea, vomiting, and abdominal pain; and an altered state of consciousness.
The main cause of diabetes for people with type 1 diabetes is partly inherited and is also triggered by certain infections; type 2 diabetes is mainly due to lifestyle choices and genetics. Understanding diabetes symptoms and what they are is essential for the management of this disease so that you can achieve optimum health.
By: S Kennedy