Lose weight now during the month

Action Weight Loss Custom Plans are the Fastest Way to Lose Weight

Before we tell you more about this program, we need to make a few things clear...this isn't just a diet plan...this is an ACTION plan. This is a blueprint with step by step instructions, designed specifically for your specific height and weight, so you can safely get the best possible results in the shortest time possible. This is the turning point in your life, if you decide to follow this program...you'll finally be able to get in the best shape of your life, once and for all. Yes, these are bold claims, but we are so convinced that this program will work for you, that we actually guarantee results. If you don't lose 10% of your body weight in the first 30 days, simply contact us within 60 days of purchase, and we'll give you a full refund. How can we do this? Simple....you don't have to fear refunds when your product actually works.

Here is the inside scoop, the MAIN reason you are overweight is because you've been eating wrong all these years. And the sad part is that it's not even your fault! Everyone learns how to eat from their parents. When you were young, they picked the times you ate, they picked what you ate, and they picked how much you ate. By the time you started to live on your own, you've been conditioned for decades on the "proper" way to eat...so once your metabolism slowed down, you started gaining weight. It's time to change all that! It's time to learn how to eat properly.

You can free yourself from this conditioning, you can learn how to get in shape once and for all! It's time to take control of your life. You owe it to yourself! And the Action Weight Loss program will help you do it. If you follow our guide, we guarantee that you'll SAFELY lose at least 10% of your body weight in the next 30 days. Safely is a very important word here, there are many "diets" out there that are focused on starving you in order to make you lose weight. But the sad truth is that these crash diets are dangerous! Even if they work...they come with many side effects, such as gallstones, loss of muscle mass and massive hair loss. The cure(if it even works) is worse than the disease! Our action plan on the other hand is designed on getting you to shed the pounds quickly, without putting your health at risk. And hey, guaranteed 10% weight loss every 30 days is nothing to laugh at, that's 18-25 pounds you can safely lose every month, without starving yourself half to death or sacrificing hours at the gym.
Note: If you decide to put in the extra effort, you can lose as much as 15% of your body weight during the 30 day period.

3 Stages to Optimize Your Weight Loss Results

Our program is broken up into three parts:
The first is the reset phase...this is where you'll shed MASSIVE pounds in just 10 days to get a jump start towards losing all that weight. The main reason for this part is to hit your body's reset button, which will help prepare your body for the rest of the program. You can expect to lose about 10-15 pounds during this phase of the program. So if you start the program at 220 pounds, 10 days later, you can be down to 205 pounds. Losing all that weight in just 10 days is very good...in fact, at this point...a lot of programs would call it a day...but not us. We are just getting started!
The second phase of the program is the main event. This is the action plan, which will allow you to stick with the program until you reach your target weight. All you have to do is follow your custom weight loss plan and you'll safely lose 10% of your weight each and every month...like clockwork. Essentially, if you start this phase at 205 pounds, 30 days later...you'll be 185 pounds; 2 months later - you'll weigh 167; and 3 months later your scales will show only 151 pounds.
Just imagine what losing 69 pounds in a little over 3 months will do to you. Imagine all the extra looks you'll get while walking down the street, imagine the massive improvement to your health and self-esteem, and imagine all the minor improvements that will make the rest of your life better. And you'll get all that, without wasting hours at the gym or starving yourself half to death on some crazy starvation diet.
Finally, once you lose all that weight, and are happy with how you look in a bikini, you'll reach the third phase of the program...maintenance. Here the goal is simple...to keep you thin. We are happy to tell you that this is the easiest phase of the program. Why? Simple...you no longer have to put in the effort to eliminate all that stored fat! You'll be shocked at how little you actually have to do, in order to maintain your new body.
As you can see there is something for everyone in this program. If you are looking to quickly lose 10-15 pounds, then you can lose all that in just 10 days, just by following the first phase of the program. If you are looking for serious weight loss, then you can follow the full program. And if you are just looking to learn a quick and easy way to maintain your current figure without wasting hours at the gym, then you can follow the maintenance phase.

A Program Designed Specifically For You

So why is this program so effective? Simple...unlike other programs, we realize that everyone is different...someone who is 250lbs will have different dietary and exercise requirements than someone who is only 180lbs. Which is why, Action Weight Loss optimizes your diet and exercise SPECIFICALLY for YOU! In fact, we have multiple, custom designed action plans for you to follow, so you can use the action plan, which has been specifically optimized for best results for someone with your height and weight. This means that you get better results faster, since every little bit of effort has been specifically designed to get the best gains in someone with that particular height and weight. Don't work harder...work smarter!
These custom plans are the reason why Action Weight Loss works for pretty much EVERYONE who tries it. They give us the ability to make sure that you are putting 100% of your effort towards things that will get you the best results. This is why we can actually guarantee that you'll lose 10% of your weight in just 30 days, because we've seen it happen time and time again. And remember, you don't have to stop there...follow the program, and you'll continue losing 10% of your weight each and every month like clockwork.

Action Weight Loss Works!

Take a look at some of the testimonials sent to us by satisfied customers. We've provided actual screenshots so you can see that these are real testimonials sent to us, and not just some text we made up. This is also why we aren't including any testimonials that used a free email provider like hotmail, yahoo or gmail to contact us. You can see even more reviews by going to our Testimonials page.

Like we said, this is not a starvation diet. The truth is that food is not the enemy. You really can eat pretty much anything you want and still lose weight. The key ingredient to this is to trick your body into releasing the right hormones after each meal. By manipulating these hormones, we minimize the storage of fat, which means you won't have to fight an uphill battle and will quickly lose weight. But we don't stop there. Our diet is paired up with an exercise regiment(~30mins) that has been specifically designed to work with this diet. And since each diet/exercise plan is customized for a specific height/weight, this means that every little thing you do on this program, is specifically optimized towards getting YOU the best possible results in the shortest time. The results speak for themselves.
So go ahead and try our revolutionary program. We are so convinced that this program will work for you...that we actually guarantee that you'll lose 10% of your weight in just 30 days. What other weight loss program guarantees results and not just "satisfaction"? What do you have to lose?
Just focus on one thought, 30 days from now, you will lose 10% of your body weight and will look noticeably thinner in the mirror.
If you tried other programs and failed, there is a reason for it...they weren't designed for you. Other programs take a universal approach, so you waste 95% of your time, doing things that just plain do nothing for you. Meanwhile, our program has a custom plan that was designed specifically for your height/weight, which means that every little bit of effort goes towards getting you the best possible results.
The choice is yours, you can continue doing what hasn't worked for you all these years...or you can try something new, something that has been designed specifically for you, which is guaranteed to work. Remember, if you choose not to begin your custom weight loss action plan today, then you'll be stuck with the same body forever. Unfortunately, it won't change by itself, not until you take the first step and try this program.

It's Time to Act!

One of the main reasons why you haven't lost the weight is procrastination.

You've always put off dieting till sometime in the future. You've said things like "I will start on the 1st", "I'll start after New Year's", "I'll order after I get home from work" or some other tired excuse. You can't do that anymore, not if you actually want to lose weight...you need to actively fight it and take that first step right now! Remember, every journey begins with taking that first step; if you never take the first step...you'll never get thinner and will never have the body of your dreams. Think about it...why would you want to remain overweight until some future "month" or "time of year"? Getting started now, will just give you more time to enjoy your awesome new body. So go ahead and order now...before you once again convince yourself that being overweight is "no big deal".

60% Discount Code

Good news! First Gyms has decided to sponsor the next 50 customers with a 60% discount on the Action Weight Loss program.

Warning: Only 7 discounts left! Order before they run out.

Applied Discount Code: FIRSTGYMS60

Regular Price: $99.90 - Your New Price: $28

You are getting a real bargain! That's less than what you would spend on one month of gym membership, let alone thousands you'd pay for a custom weight loss plan, and unlike those, you are actually guaranteed results!
So go ahead and try it out, what do you really have to lose? Thousands of satisfied customers can't be wrong.
You have only two options here...Option A: you lose weight, and get in the best shape of your life or Option B: you get your money back.
You'll never find a better win/win solution. You owe it to yourself to at least give it a try...you have nothing to lose...except all that weight.
You've suffered enough, it's time to start living again.
So...are you ready to transform your body once and for all? Are you ready to get in the best shape of your life? Are you ready to get the extraordinary body that you deserve? If you've answered yes, then click the button below to take the first step, towards a new you.

Get shopping voucher worth 100

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pregnant !Sex Myths You Shouldn’t Believe

Well, it’s how you got here, isn’t it? For some ironic reason we tend to think of intercourse and pregnancy as mutually exclusive. But just look at yourself: What could be sexier?
 Your partner no doubt thinks so, too. And you certainly don’t have to worry about birth control at this time. Put the following fears aside and go for it. In spite of your increased birth, it’s going to be a lot easier to pull off now that after the baby arrives. (Trust us)

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What can I do to prevent heart disease

You can reduce your chances of getting heart disease by taking these steps:

•  Know your blood pressure. Years of high blood pressure can lead to heart disease. People with high blood pressure often have no symptoms, so have your blood pressure checked every 1 to 2 years and get treatment if you need it.

  

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The First Trimester of Pregnancy

Fetal Development: First Trimester

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Do women need to worry about heart disease?

Yes. Among all U.S. women who die each year, one in four dies of heart dis-ease. In 2004, nearly 60 percent more women died of cardiovascular disease
(both heart disease and stroke) than from all cancers combined. The older a woman gets, the more likely she is to get heart disease. But women of all ages should be concerned about heart disease. All women should take steps to prevent heart disease.
Both men and women have heart attacks, but more women who have heart attacks die from them. Treatments can limit heart damage but they must be given as soon as possible after a heart attack starts. Ideally, treatment should start within one hour of the first symptoms.
If you think you’re having a heart attack, call 911 right away. Tell the operator your symptoms and that you think you're having a heart attack.

What is heart disease?

Heart disease includes a number of problems affecting the heart and the blood vessels in the heart. Types of heart disease include:

•  Coronary artery disease (CAD) is the most common type and is the leading cause of heart attacks. When you have CAD, your arteries become hard and narrow. Blood has a hard time getting to the heart, so the heart does not get all the blood it needs. CAD can lead to:

•  Angina (an-JEYE-nuh). Angina is chest pain or discom-fort that happens when the heart does not get enough blood. It may feel like a pressing or squeez-ing pain, often in the chest, but sometimes the pain is in the shoulders, arms, neck, jaw, orback. It can also feel like indiges-tion (upset stomach). Angina is not a heart attack, but having angina means you are more likely to have a heart attack. 

•   Heart attack. A heart attack occurs when an artery is severely or completely blocked, and the heart does not get the blood it needs for more than 20 minutes. 

•  Heart failure occurs when the heart is not able to pump blood through the body as well as it should. This means that other organs, which nor-mally get blood from the heart, do not get enough blood. It does not mean that the heart stops. Signs of heart failure include:

1.   Shortness of breath (feeling like you can't get enough air)

    2. Swelling in feet, ankles, and legs

    3. Extreme tiredness

•  Heart arrhythmias (uh-RITH-mee-uhz) are changes in the beat of the heart. Most people have felt dizzy, faint, out of breath or had chest pains at one time. These changes in heartbeat are harmless for most people. As you get older, you are more likely to have arrhythmias. Don't panic if you have a few flut-ters or if your heart races once in a while. If you have flutters and other symptoms such as dizzi-ness or shortness of breath, call 911 right away.

headache tratment

1. If headache not associated with warning symptoms as listed above, the following medications may be used.
If headache associated with any warning symptoms is particularly severe, or does not respond to any of the medications below, go to step 2.
Medication is listed in increasing order of strength.

1. Ascriptin (buffered aspirin), Motrin, Voltaren, and Arthrotec are all anti-inflammatory and analgesic agents, and in the doses recommended here are nearly equivalent in pain relief. All may cause mild upset stomach and should be avoided if there is allergy to aspirin. Arthrotec is a combination of antiinflammatory drug and stomach-protective agent, with decreased risk of stomach discomfort and erosions, it should be used if the other agents cannot be tolerated. Use of Arthrotec decreases the risk of developing erosive and ulcerous lesions
of the gastrointestinal tract. Selection is based on crew experience and dosing convenience.

2. Tylenol and Analgin are analgesics. Analgin has minimal and Tylenol has no anti-inflammatory effects. They do not cause upset stomach, and work almost as well for general pain as do the anti-inflammatory agents. Selection is based on crew experience.

3. Vicodin is Tylenol plus a mild narcotic and is the strongest oral pain reliever. It may cause some drowsiness and dizziness. AMP Tylenol (Acetaminophen) (P1-A1,2,3) - Aspirin-free pain reliever (blue)

Dose: 1-2 tablets every 4 to 6 hours as needed.
__-1, Analgin - Non-narcotic analgesic agent
__-2
Dose: 1 tablet 3 times/day Possible side effects Blood clotting defect due to low platelets
AMP Motrin (Ibuprofen) (P1-B5,6) - Oral anti-inflammatory drug and pain (blue) reliever

Dose: 1 tablet every 8 hours with food and drink

NB: Do not take if allergic to aspirin.

Possible side effects
Upset stomach, diarrhea AMP Voltaren (Diclofenac Sodium) (P1-B-10) - Oral anti-inflammatory drug, (blue) effective alternative to Motrin for pain relief of headache, backache, -or- sinus pressure __-1
Dose: 1 tablet 2 to 3 times/day as needed
NOTE
Do not take if allergic to aspirin.
Possible side effects
Abdominal pain, cramps, fluid retention
__-1, Arthrotec (Diclofenac/Misoprostol) - Non-steroidal anti-inflammatory oral
__-3 pain reliever with stomach protective prostaglandin
Dose: 1 tablet 2 to 3 times/day
Possible side effects
Upset stomach, bleeding defects
2. If headache is associated with any warning symptoms, is particularly
severe, or does not respond to any of the medications in step 1, contact
ground and schedule PMC.
Be ready to provide the following information.
Location of pain: _____________________
Duration of pain: _____________________
Description of pain: _____________________
Associated symptoms: _____________________

HEADACHE different causes

1. Headaches can arise from many different causes.
 In the first few days of flight, headward fluid shift and Space Motion Sickness may lead to headaches, which typically is resolved with simple treatment and adaptation to weightlessness. Other potential causes include tension (chronic contraction of scalp
muscles), eye strain (especially associated with dimly lit areas), chronic noise exposure, dental disorders, respiratory illness and fever, and sided effects from certain drugs such as cardiac medications. Commonly, headaches associated with space flight are simple and self-limited, and usually treated with mild to moderate strength pain medications. If there are any other associated warning symptoms such as vision changes, ringing in ears, nausea and vomiting (aside from Space Motion Sickness), personality changes, neck stiffness, light sensitivity, or headache becomes severe or more frequent, schedule a PMC and contact
Surgeon immediately.

2. Environmental factors
must be considered as a cause of headaches. These include toxicity from such agents as carbon monoxide and other combustion products, hypoxia, carbon dioxide toxicity, and chronic noise exposure. It is vital that if more than one crewmember develops a headache at the same time, that the atmosphere be sampled with the Compound Specific Analyzer for Combustion Products (CSA-CP) and the portable Carbon Dioxide Monitor. Also, if headaches develop in a certain region of the ISS, these gas analysis readings must be
obtained in that region. Surgeon will advise if achieved gas samples are indicated. Headaches occurring at night in a sleep station or other more enclosed area is possibly due to local CO2 buildup; if possible, try to increase ventilation to this area.

Five Foods to Help You Fight Stress from Joy Bauer

When we’re stressed out, the foods we typically think of reaching for are not the healthiest, from chips to ice cream. These foods made “feel good” as we eat them, but they’re probably not doing much for biological factors that make us feel stressed out. Instead, try these five foods from Today Show nutritionist Joy Bauer.
1. Grapefruit
We all know vitamin C is important for the immune system, but did you know it can help fight stress? Research has shown that this vitamin can help reduce the affects stress have on the body, such as raising blood pressure. Fresh grapefruit is one of the best ways to get a daily dose.
2. Steel Cut Oats
The carbohydrate in oatmeal stimulates the production of serotonin, which helps you relax and feel good. Steel-cut oats are best because they’re minimally processed, and cause a slow rise in blood sugar, not a spike.
3. Chamomile Tea
Instead of a caffeinated beverage, sip on a cup of chamomile tea. It’s a mild sedative that can ease irritability and even help relieve muscle tension.
4. Dark Hot Chocolate
More than a sweet treat, milk and dark chocolate make for an excellent stress-busting combo. One study found that consuming 1.4 ounces of dark chocolate per day reduces stress hormones, while the peptides found in milk may reduce anxiety by increasing serotonin and lowering blood pressure.
5. Salmon and Chickpea Salad
Folate and Omega-3s are also important for maintaining mental health, and this salad is a great source of both. The salmon provides the omega-3s, while one cup of chickpeas makes up 70 pence of the daily recommended intake for folate.

Vitamin C

Vitamin C is essential for our bodies as it helps with the formation of our bones, muscle, teeth and skin. It is also important to note that unlike most animals, we as humans do not have the ability to make our own vitamin C, and therefore must get it through our diet. Vitamin C helps with resistance to infection and with healing wounds, and in most recent research it has shown that vitamin C is useful in lowering cholesterol and fat levels in blood.
Fruits and vegetables are the best sources for vitamin C; although I myself take a supplement as it ensures I get the right amount my body needs daily. Being that vitamin C may also protect against certain types of cancer and heart disease you should be sure to eat the following foods to get your daily dose:

• Peppers
• Oranges/Orange Juice
• Grapefruit
• Broccoli
• Kale
• Kiwi

Additional good sources include brussel sprouts, cabbage and tangerines.
The recommended dietary allowance is as follows:

• Adolescents 14-18 years old: 65-75mg/day
• Adults 19 years and older: 75-90mg/day
• Pregnancy: 80-85mg/day

Examples of how to reach the daily dietary allowances, although you should check with your doctor to make sure you know your correct allowance, are as follows:

• Medium green or yellow peppers – 225mg/serving
• Medium orange – 80mg/serving
• Medium baked potato – 20mg/serving

How Do We Identify ADHD?

Although toddlers and preschoolers, on occasion, may show characteristics of ADHD, some of these behaviors may be normal for their age or developmental stage. These behaviors must be exhibited to an abnormal degree to warrant identification as ADHD. Even with older children, other factors (including environmental influences) can produce behaviors resembling ADHD.
The criteria set forth by the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) are used as the standardized clinical definition to determine the presence of ADHD (see DSM-IV Criteria for ADHD). A person must exhibit several characteristics to be clinically diagnosed as having ADHD:
Severity. The behavior in question must occur more frequently in the child than in other children at the same developmental stage.
Early onset. At least some of the symptoms must have been present prior to age 7.
Duration. The symptoms must also have been present for at least 6 months prior to the evaluation.
Impact. The symptoms must have a negative impact on the child’s academic or social life.
Settings. The symptoms must be present in multiple settings.
The specific DSM-IV criteria are set forth in the following chart.
DSM-IV Criteria for Attention Deficit/Hyperactivity Disorder
A. According to the DSM-IV, a person with Attention Deficit/Hyperactivity Disorder must have either (1) or (2):
(1) Six (or more) of the following symptoms of inattention have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Inattention
(a) often fails to give close attention to details or makes careless mistakes in school work, work, or other activities
(b) often has difficulty sustaining attention in tasks or play activities
(c) often does not seem to listen when spoken to directly
(d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions)
(e) often has difficulty organizing tasks and activities 3
(f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort (such as schoolwork or homework)
(g) often loses things necessary for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
(h) is often easily distracted by extraneous stimuli
(i) is often forgetful in daily activities
(2) Six (or more) of the following symptoms of hyperactivity-impulsivity have persisted for at least 6 months to a degree that is maladaptive and inconsistent with developmental level:
Hyperactivity
(a) often fidgets with hands or feet or squirms in seat
(b) often leaves seat in classroom or in other situations in which remaining seated is expected
(c) often runs about or climbs excessively in situations in which it is inappropriate (in adolescents or adults, may be limited to subjective feelings or restlessness)
(d) often has difficulty playing or engaging in leisure activities quietly
(e) is often “on the go” or often acts as if “driven by a motor”
(f) often talks excessively
(g) often blurts out answers before questions have been completed
(h) often has difficulty awaiting turn
(i) often interrupts or intrudes on others (e.g., butts into conversations or games)
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 years.
C. Some impairment from the symptoms is present in two or more settings (e.g., at school [or work] and at home).
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E. The symptoms do not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and are not better accounted for by another mental disorder (e.g., Mood Disorder, Anxiety Disorder, Disassociative Disorder, or a Personality Disorder).
Attention Deficit/Hyperactivity Disorder, Combined Type: if both Criteria A1 and A2 are met for the past 6 months.
Attention Deficit/Hyperactivity Disorder, Predominantly Inattentive Type: if Criterion A1 is met but Criterion A2 is not met for the past 6 months.
Attention Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type: if Criterion A2 is met but Criterion A1 is not met for the past 6 months.

What Causes ADHD?

ADHD has traditionally been viewed as a problem related to attention, stemming from an inability of the brain to filter competing sensory inputs such as sight and sound. Recent research, however, has shown that children with ADHD do not have difficulty in that area. Instead, researchers now believe that children with ADHD are unable to inhibit their impulsive motor responses to such input (Barkley, 1997; 1998a).
It is still unclear what the direct and immediate causes of ADHD are, although scientific and technological advances in the field of neurological imaging techniques and genetics promise to clarify this issue in the near future. Most researchers suspect that the cause of ADHD is genetic or biological, although they acknowledge that the child’s environment helps determine specific behaviors.
Imaging studies conducted during the past decade have indicated which brain regions may malfunction in patients with ADHD, and thus account for symptoms of the condition (Barkley,
1998a). A 1996 study conducted at the National Institutes for Mental Health (NIMH) found that the right prefrontal cortex (part of the cerebellum) and at least two of the clusters of nerve cells known collectively as the basal ganglia are significantly smaller in children with ADHD (as cited in Barkley, 1998a). It appears that these areas of the brain relate to the regulation of attention. Why these areas of the brain are smaller for some children is yet unknown, but researchers have suggested mutations in several genes that are active in the prefrontal cortex and basal ganglia may play a significant role (Barkley, 1998a). In addition, some nongenetic factors have been linked to ADHD including premature birth, maternal alcohol and tobacco use, high levels of exposure to lead, and prenatal neurological damage. Although some people claim that food additives, sugar, yeast, or poor child rearing methods lead to ADHD, there is no conclusive evidence to support these beliefs (Barkley, 1998a; Neuwirth, 1994; NIMH, 1999).

IDENTIFYING AND TREATING ATTENTION DEFICIT HYPERACTIVITY DISORDER

We have all had one of these experiences at one time or another. Perhaps it was at the grocery store, watching frustrated parents call their children’s names repeatedly and implore them to “put that down.” Maybe it was a situation at school with a child who could not seem to sit still and was always in motion. Maybe we noticed a child who appears always to be daydreaming in class—the student who will not focus on an activity long enough to finish it. Possibly the child is bored with a task, seemingly as soon as it has begun, and wants to move on to something else. We all puzzle over these challenging behaviors.
Attention Deficit Hyperactivity Disorder (ADHD) has many faces and remains one of the most talked-about and controversial subjects in education. Hanging in the balance of heated debates over medication, diagnostic methods, and treatment options are children, adolescents, and adults who must manage the condition and lead productive lives on a daily basis.
What is ADHD?
Definition
Core Categories
Comorbidity
Social Impact
Prevalence

Attention Deficit Hyperactivity Disorder (ADHD) is a neurological condition that involves problems with inattention and hyperactivity-impulsivity that are developmentally inconsistent with the age of the child. We are now learning that ADHD is not a disorder of attention, as had long been assumed. Rather, it is a function of developmental failure in the brain circuitry that monitors inhibition and self-control. This loss of self-regulation impairs other important brain functions crucial for maintaining attention, including the ability to defer immediate rewards for later gain (Barkley, 1998a). Behavior of children with ADHD can also include excessive motor activity. The high energy level and subsequent behavior are often misperceived as purposeful noncompliance when, in fact, they may be a manifestation of the disorder and require specific interventions. Children with ADHD exhibit a range of symptoms and levels of severity. In addition, many children with ADHD often are of at least average intelligence and have a range of personality characteristics and individual strengths.
Children with ADHD typically exhibit behavior that is classified into two main categories: poor sustained attention and hyperactivity-impulsiveness. As a result, three subtypes of the disorder have been proposed by the American Psychiatric Association in the fourth edition of the Diagostic and Statistical Manual of Mental Disorders (DSM-IV): predominantly inattentive, predominantly hyperactive-impulsive, and combined types (Barkley, 1997). A child expressing hyperactivity commonly will appear fidgety, have difficulty staying seated or playing quietly, and act as if driven by a motor. Children displaying impulsivity often have difficulty participating in tasks that require taking turns. Other common behaviors may include blurting out answers to questions instead of waiting to be called and flitting from one task to another without finishing. The inattention component of ADHD affects the educational experience of these children because ADHD causes them to have difficulty in attending to detail in directions, sustaining attention for the duration of the task, and misplacing needed items. These children

often fail to give close attention to details, make careless mistakes, and avoid or dislike tasks requiring sustained mental effort.
Although these behaviors are not in themselves a learning disability, almost one-third of all children with ADHD have learning disabilities (National Institute of Mental Health [NIMH], 1999). Children with ADHD may also experience difficulty in reading, math, and written communication (Anderson, Williams, McGee, & Silva, 1987; Cantwell & Baker, 1991; Dykman, Akerman, & Raney, 1994; Zentall, 1993). Furthermore, ADHD commonly occurs with other conditions. Current literature indicates that approximately 40–60 percent of children with ADHD have at least one coexisting disability (Barkley, 1990a; Jensen, Hinshaw, Kraemer, et al., 2001; Jensen, Martin, & Cantwell, 1997). Although any disability can coexist with ADHD, certain disabilities seem to be more common than others. These include disruptive behavior disorders, mood disorders, anxiety disorders, tics and Tourette’s Syndrome, and learning disabilities (Jensen, et al., 2001). In addition, ADHD affects children differently at different ages. In some cases, children initially identified as having hyperactive-impulsive subtype are subsequently identified as having the combined subtype as their attention problems surface.
These characteristics affect not only the academic lives of students with ADHD, they may affect their social lives as well. Children with ADHD of the predominantly hyperactive-impulsive type may show aggressive behaviors, while children of the predominantly inattentive type may be more withdrawn. Also, because they are less disruptive than children with ADHD who are   hyperactive or impulsive, many children who have the inattentive type of ADHD go unrecognized and unassisted. Both types of children with ADHD may be less cooperative with others and less willing to wait their turn or play by the rules (NIMH, 1999; Swanson, 1992; Waslick & Greenhill, 1997). Their inability to control their own behavior may lead to social isolation. Consequently, the children’s self-esteem may suffer (Barkley, 1990a).
In the United States, an estimated 1.46 to 2.46 million children (3 percent to 5 percent of the student population) have ADHD (American Psychiatric Association, 1994; Anderson, et al., 1987; Bird, et al., 1988; Esser, Schmidt, & Woemer, 1990; Pastor & Reuben, 2002; Pelham, Gnagy, Greenslade, & Milich, 1992; Shaffer, et al., 1996; Wolraich, Hannah, Pinock, Baumgaertel, & Brown, 1996). Boys are four to nine times more likely to be diagnosed, and the disorder is found in all cultures, although prevalence figures differ (Ross & Ross, 1982).

Gestational diabetes mellitus (GDM)

1 Defining the condition
The widely accepted definition is that given by the American Diabetes Association (ADA) ‘…any degree of glucose intolerance with onset or first recognition during pregnancy’ [5]. The definition is applicable even if ‘the condition persists after pregnancy’. ‘It does not exclude the possibility that unrecognized glucose intolerance may have antedated or begun concomitantly with the pregnancy.’ The widespread acceptance of this definition is in no small part due to the fact that it does not mention any specific diagnostic criteria. Any definition of GDM has to take into account three elements of risk – of perinatal morbidity and mortality in the current pregnancy, of the mother developing type 2 diabetes, and of intra-uterine programming of the developing fetus with subsequent expression of disorders in later life.

2 Diagnosis of GDM
There is a continuum of risk for maternal glucose levels and, at least, adverse pregnancy outcomes [6-11]. Currently there is a lack of international consensus regarding the diagnostic
criteria for GDM. In most parts of the world the diagnostic criteria are based on either the 100 gram 3-hour test as commonly used in the USA or the 75 gram 2-hour World Health Organization (WHO) test. Many national bodies have derived their own criteria based on local experience and their healthcare delivery systems. This lack of consensus may well be addressed by recommendations arising from the International Association of Diabetes in Pregnancy Study Groups (IADPSG), a working group analysing the results of the HAPO study. Any recommendations from this group will then need to be considered by relevant national
bodies and incorporated into the local health service arrangements. This process will take some time. Other than by chance, it is not clear if any diagnostic criteria of GDM
based exclusively on pregnancy outcomes will be applicable to the other two elements of risk.

3 Rationale for treating GDM
It is generally acknowledged that women with GDM are at increased risk of adverse pregnancy outcomes, particularly relating to perinatal mortality and morbidity. It
is also generally acknowledged that treatment of women with GDM, by whatever means, can reduce the risk of these problems. In the developed world an increased perinatal mortality rate is unlikely but can still be demonstrated in a sufficiently large series [12]. However, in
settings where obstetric care does not uniformly reach modern quality standards, perinatal mortality is still an important issue [13].
Perinatal morbidity is an ongoing concern. Macrosomic or large-for-gestational-age (LGA) infants are still common, and can be considered a surrogate marker for at least
some of the effects of intra-uterine programming.  An earlier prospective controlled trial demonstrated that ‘tight’ control, with a high rate of insulin use, improved perinatal
outcomes [14]. Later, a prospective non-randomized intervention study demonstrated for women with GDM that intensive control (versus conventional control) improved
perinatal outcomes to a level that was comparable to a group without GDM [15]. The hazards of a late diagnosis of GDM, and therefore effectively no treatment, have been
outlined [16]. The Australian Carbohydrate Intolerance Study in Pregnancy (ACHOIS), a blinded randomized trial including 1000 women, designed to examine whether the treatment
of women with GDM would reduce perinatal complications, found a significant reduction in serious perinatal complications in the treated group [17]. Recently the results of the
Maternal-Fetal Medicine Unit (MFMU) Network study have become available. Treating women with designated ‘mild’ GDM lowered the risk for many adverse pregnancy outcomes [18].
Limited observational studies in humans strongly suggest that any pregnancy complicated by hyperglycaemia confers a risk to the offspring of developing type 2 diabetes [19-24],
and that improving maternal glycaemic control may reduce this risk. However, the long follow-up necessary makes it unlikely that any randomized controlled trial (RCT) evidence will be forthcoming in the foreseeable future