Flu Vaccination

Why should people get vaccinated against the flu?

Influenza is a potentially serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and influenza infection can affect people differently, but millions of people get the flu every year, hundreds of thousands of people are hospitalized and thousands or tens of thousands of people die from flu-related causes every year. An annual seasonal flu vaccine is the best way to help protect against flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children.

How do flu vaccines work?

Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with the viruses that are in the vaccine.

The seasonal flu vaccine protects against the influenza viruses that research indicates will be most common during the upcoming season. Traditional flu vaccines (called “trivalent” vaccines) are made to protect against three flu viruses; an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus. There are also flu vaccines made to protect against four flu viruses (called “quadrivalent” vaccines). These vaccines protect against the same viruses as the trivalent vaccine and an additional B virus.

What kinds of flu vaccines are available?

CDC recommends use of any licensed, age-appropriate influenza (flu) vaccine during the 2019-2020 influenza season. Options include inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV], or live attenuated influenza vaccine (LAIV). Different vaccines are licensed for different age groups, and some vaccines are not recommended for some groups of people. But where more than one suitable vaccine is available, no preference is expressed for any influenza flu vaccine over another.

Both trivalent (three-component) and quadrivalent (four-component) flu vaccines will be available for 2019-2020. Most vaccines will be quadrivalent.

Trivalent flu vaccines include:

• A high-dose trivalent flu shot, approved for people 65 years and older, which contains a higher dose of antigen (the part of the virus the immune system develops antibodies against), to help create a stronger immune response.
• A trivalent flu shot made with adjuvant, (an ingredient that helps create a stronger immune response), approved for people 65 years and older.

Quadrivalent flu vaccines include:

• Standard-dose quadrivalent flu shots without adjuvant that are manufactured using virus grown in eggs. Several different brands of this type of flu shot are available, and they are approved for different age groups. Some are approved for children as young as 6 months of age. Most flu shots are given in the arm (muscle) with a needle. One quadrivalent flu shot can be given either with a needle (for people aged 6 months and older) or with a jet injector (for people aged 18 through 64 years only).
• A quadrivalent cell-based flu shot containing virus grown in cell culture, which is approved for people 4 years and older.
• A recombinant quadrivalent flu shot (a flu shot that is made without influenza viruses or eggs) approved for people 18 years and older.
• A quadrivalent live attenuated influenza nasal spray vaccine (LAIV4) made with attenuated (weakened) live flu viruses, approved for use in people 2 years through 49 years of age. This vaccine is not recommended for use in pregnancy or for use among people with some specific medical conditions.

Are any of the available flu vaccines recommended over others?

For the 2019-2020 flu season, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza (flu) vaccination for everyone 6 months and older with any licensed, influenza vaccine that is appropriate for the recipient’s age and health status, including inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), or live attenuated nasal spray influenza vaccine (LAIV4) with no preference expressed for any one vaccine over another.

There are many vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional.

Who should get vaccinated this season?

Everyone 6 months of age and older should get an influenza (flu) vaccine every season with rare exception

Vaccination to prevent flu is particularly important for people who are at high risk of developing serious flu complications. 

Who Should Not Be Vaccinated?

Different influenza (flu) vaccines are approved for use in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components.

• When should I get vaccinated?

You should get a flu vaccine before flu viruses begins spreading in your community, since it takes about two weeks after vaccination for antibodies to develop in the body and provide protection against flu. Make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October, if possible. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout the flu season, even into January or later.

Getting vaccinated early (for example, in July or August) is likely to be associated with reduced protection against flu infection later in the flu season, particularly among older adults.

Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.

Where can I get a flu vaccine?

#Flu vaccines are offered in apple clinic international City - France cluster as well as Greece cluster. 

Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else, like a health department, pharmacy, urgent care clinic, and often your school, college health center, or workplace.

Why do I need a flu vaccine every year?

A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and updated as needed to keep up with changing flu viruses. For the best protection, everyone 6 months and older should get vaccinated annually.

Does flu vaccine work right away?

No. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. That’s why it’s better to get vaccinated by the end of October, before the flu season really gets under way.

Can I get seasonal flu even though I got a flu vaccine this year?

Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

• You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
• You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
• Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

What protection does the flu vaccine provide if I do get sick with flu?

Some people who get vaccinated may still get sick. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. A study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated. In addition, it’s important to remember that flu vaccine protects against three or 4 different viruses and multiple viruses usually circulate during any one season. For these reasons, CDC continues to recommend flu vaccination for everyone 6 months and older even if vaccine effectiveness against one or more viruses is reduced.

How much fiber we should eat to prevent disease

A new meta-analysis examines 40 years' worth of research in an attempt to find out the ideal amount of fiber that we should consume to prevent chronic disease and premature mortality.

Researchers and public health organizations have long hailed the benefits of eating fiber, but how much fiber should we consume, exactly?

This question has prompted the World Health Organization (WHO) to commission a new study. The new research aimed to help develop new guidelines for dietary fiber consumption, as well as reveal which carbs protect the most against noncommunicable diseases and can stave off weight gain.

Noncommunicable diseases are also called chronic diseases. They typically last for a long time and progress slowly. According to WHO, there are "four main types of noncommunicable diseases:" cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes.

Prof. Mann explains the motivation for the study, saying, "Previous reviews and meta-analyses have usually examined a single indicator of carbohydrate quality and a limited number of diseases, so it has not been possible to establish which foods to recommend for protecting against a range of conditions."

To find out, the researchers performed a meta-analysis of observational studies and clinical trials.

Daily intake of 25–29 grams of fiber is ideal

Reynolds and colleagues examined the data included in 185 observational studies — amounting to 135 million person-years — and 58 clinical trials which recruited over 4,600 people in total. The studies analyzed took place over almost 40 years.

The scientists investigated the incidence of certain chronic diseases, as well as the rate of premature deaths resulting from them.

These conditions were: coronary heart disease, cardiovascular disease, stroke, type 2 diabetes, colon cancer, and a range of obesity-related cancers, such as breast cancer, endometrial cancer, esophageal cancer, and prostate cancer.

Eating fiber can delay brain aging

Eating fiber can also keep your brain young.

Overall, the research found that people who consume the most fiber in their diet are 15–30 percent less likely to die prematurely from any cause or a cardiovascular condition, compared with those who eat the least fiber.

Consuming foods rich in fiber correlated with a 16–24 percent lower incidence of coronary heart disease, stroke, type 2 diabetes, and colon cancer.

Fiber-rich foods include whole grains, vegetables, fruit, and pulses, such as peas, beans, lentils, and chickpeas.

The analysis also revealed that the amount of fiber that people should consume daily to gain these health benefits is 25–29 grams (g). By comparison, adults in the United States consume 15 g of fiber daily, on average.

The authors also suggest that consuming more than 29 g of fiber per day may yield even more health benefits.

However, they do caution that, while the study in itself did not find any adverse health effects of consuming fiber, eating too much of it may be damaging for people with insufficient iron or minerals.

Eating large amounts of whole grains can further deplete the body of iron, explain the researchers.

Finally, the clinical trials included in the study also revealed that consuming more fiber correlates strongly with lower weight and lower cholesterol levels.

Why fiber is so good for you

Prof. Mann comments on the significance of the findings, saying, "The health benefits of fiber are supported by over 100 years of research into its chemistry, physical properties, physiology, and effects on metabolism."

"Fiber-rich whole foods that require chewing and retain much of their structure in the gut increase satiety and help weight control and can favorably influence lipid and glucose levels," he adds.

"The breakdown of fiber in the large bowel by the resident bacteria has additional wide-ranging effects including protection from colorectal cancer."

"Our findings provide convincing evidence for nutrition guidelines to focus on increasing dietary fiber and on replacing refined grains with whole grains. This reduces incidence risk and mortality from a broad range of important diseases." 

Read more of articles @appleclinicuae.com. 

10 Safe Driving Tips for Truck Drivers

1. 3 Points of Contact: Remember to employ three points of contact at all times when entering or exiting the tractor, trailer, or climbing onto or down from the catwalk. This means always having both hands and one foot or both feet and one hand in contact with your equipment. Making this a habit can prevent slips, trips and falls!

2. Seven Second Rule: Consider seven seconds to be the minimum safe following distance under ideal conditions. Remember to leave extra space if conditions are less than ideal.

3. Cruise Control: Do not use cruise control in less than ideal conditions. Using cruise control can be dangerous on wet or icy roads, as well as in areas where many speed corrections need to be made, such as on winding or hilly roads, in heavy traffic, and in urban areas.

4. Avoid Distractions: Keep both hands on the steering wheel in the 9&3 o’clock position. This allows the maximum steering wheel movement in either direction without having to reposition your hands, giving you the most leverage and control of your vehicle.

5. School Zones/Construction Zones: For everyone’s safety, slow down to posted speeds when approaching school and construction zones and be prepared to stop. Obey all signs and workers who are directing traffic.

6. Tractor & Trailer Lights: Keep your headlights and clearance lights on at all times when driving. Also, always make sure to keep your lights clean. Being visible is extremely important to your safety. Driving with lights on will allow a fellow motorist to see your equipment sooner. This will allow other drivers more time to adjust to any potential hazards.

7. Safe Loading and Unloading Practices: Ensure that vehicles and freight are properly secured when loading or unloading freight. Apply tractor and trailer parking brakes and turn off your tractor. If available, use chock blocks for extra security. Do not pull out of a loading dock until the dock plate has been removed and you have verified that the loading/unloading has in fact been completed and that no equipment or people are still working in the trailer.

8. Seatbelts: Wear a properly adjusted seatbelt at all times. In a team driving environment, as a sleeper-berth occupant, use belts and/or netting during operation of the truck. Do not occupy the upper bunk unless the truck is parked. Seatbelts are the most effective vehicle safety device, saving thousands of lives annually.

9. Speed Limit: To ensure your personal safety and the safety of those around you, travel at or lower than speeds of 62 mph (100 kph) or the otherwise posted speed limit of the roadway being travelled. Always adjust your speed to a safe level as determined by the various driving conditions.

10. Sunglasses: Blinding glare caused by low sun, sunlight reflecting off snow, other vehicles and/or buildings can be potentially lethal. This danger can be greatly reduced by wearing sunglasses with polarized lenses that filter glare. Choose sunglasses that have curved lenses to protect in front and to the sides, and thin frames to free up peripheral vision. Always remove sunglasses when entering tunnels

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How to fight the digital devils

Our modern brains seem to struggle to focus on just one task, constantly jumping from one activity to the next.

Skip rates on music download services like Spotify have never been faster; magazine articles now come with estimated reading times.

And nearly a quarter of people who took part in a British survey said they had been involved in distracted-walking accidents: heads down, staring at smartphones, bumping into lamp posts.

We seem to be facing a distraction crisis, but is there a 'cure' for not paying attention? And who is robbing us of our focus?

Stealing our concentration?

Social media, targeted advertising, YouTube, apps: big tech companies have learned how to monetise procrastination and are stealing our attention systematically and on an industrialised scale.

"There is an entire industry dedicated to stealing our attention, and most of us don't even realise it's happening," says Belinda Parmar, a former tech evangelist who's now so concerned about the effects of tech on our mental health she has become a tech-addiction campaigner.

"The tech industry keeps promising to bring the world closer, but really their prime target is to take time away from us," she says, noting some companies, such as entertainment platform Netflix, don't even disguise it.

"When Reed Hastings, Netflix's CEO, tells you that their biggest competitor is sleep, you've got to think twice," says Parmar, "If you are chronically sleep-deprived, how are you going to pay any attention in life?"

Parmar, now CEO of The Empathy Business, recognises technology has many positives, but points out that "tech also has a dark side".

Another person who switched views on technology is James Williams, a former Google staffer who realised the goals that big tech companies had were not in line with his own values.

Their focus, he says, was on maximising clicks, views and the amount of time people engaged with products. But with so much technology around him, he found it impossible to find space for reflection.

He likens users of technology to serfs and the big tech companies to the lords of the manor. Today, he says, “serfdom isn't the conflict over our physical labour, but over our attention".

Although many digital products may be free to use, they are taking our most precious resource: our time.

Driven to distraction

Tim Wu, Columbia University professor and the author of The Attention Merchants: The Epic Scramble to Get Inside Our Heads, says the need to check our phones constantly is down to the lure of what is called a ‘variable reward schedule’.

B. F. Skinner, a famous psychologist and Harvard University professor, came up with the idea after conducting a series of experiments. He showed that pigeons become more addicted to pecking a button that delivers seeds if they don't know when the seeds will be dispatched.

The inconsistent stimuli of rewards are well understood to be the most addictive, says Wu, just like a slot machine. So, like pigeons pecking at that button, we tap away on our phones, often disappointed but sometimes getting something that we find exciting, like a good article, and that keeps us coming back.

"In this way you will lose hours of your day, days of your week, months of your life on things that you didn't even really care about," he says.

So, is there a way to stop our minds from wandering off?

Taking back time

Nir Eyal, a best-selling author who studies habit formation and an expert on consumer behaviour, knows all the tricks tech companies use to capture our attention. He used to teach them how to do it.

He says you can get back your time and concentration with a certain amount of personal effort. And he says it’s up to individuals, because “our government is not going to save us, and neither are the tech companies".

He has a four-step plan to stop getting distracted by technology.

Step 1 – Manage your internal triggers: When we're distracted, we're normally looking to escape from something uncomfortable. Try to work out what it is and manage it.

Step 2 – Make time for distraction: Set aside time in your day to be distracted – that way it won't feel like your time is being invaded. Give yourself a set hour that's ‘social media time’.

Step 3 – Remove the external triggers: Turn off your notifications and the rings, pings and dings that tell you what to do.

Step 4 – Make pacts to prevent distraction: Get a technology app that tries to limit the amount of time you spend on your phone. The key factor is self-awareness: once you realise you're being distracted by your phone or tablet, you start putting it down.

Go dark

Children and adults alike have become "increasingly dependent on – and dare I say intimate with – our screens at the expense of our interactions with one another", says Susan Maushart, an Australian journalist and mother who was exasperated with her family's tech obsession.

"Technology was affecting the way my family paid attention," she says, so she decided the solution was to remove all devices and live in the dark for six months.

"I wanted people to make eye contact and have conversations. I wanted them to sit around the dinner table and not speed-eat so they could get back to their texting and messaging and YouTubing. I wanted my family back," Maushart says.

So, did it work? There was more time spent actually talking to one another, she says, but there was also a lot of boredom. Although it had made her rethink her relationship with her screens, after six months she was ready to go back. She admits that the day she turned the devices back on felt like Christmas.

So if switching off our screens doesn't work, what else can we do?

Reforming tech companies

James Williams believes that the key to solving the problem is to create a new ethical system that can govern the ‘attention industry’.  

"We should desire worlds where just trying to capture someone's attention for the sake of it is seen as an indignity and something approaching a form of evil," says Williams. "If ethics and the values we have for ourselves aren't guiding technology design, then something else is."

With that in mind, he's started a group called Time Well Spent – together with other attention industry rebels – and is campaigning for app companies to change the way they design their products. "These companies say they want to improve our lives but what they're taking from us when they take attention is far more precious than anything else in the world,” he says.

But what if attention isn't a commodity to be bought and sold, but something we have control over? Maybe it isn't the tech industries that need to change, but us.

"You'll never stand a chance," says Belinda Parmar, who's seen first-hand the effect tech addiction has on mental health, particularly on children and young adults. "You're an individual trying to make what you think is a well-informed choice... but you are unaware that behind each app there is a team of developers, psychologists and gaming experts whose sole object is to steal your attention.”

"You can't fight that on your own, especially if you're a child. How can we fight these digital devils…

#concentration #digital #addiction #socialmedia #appleclinicuae #stressmanagement #children #videogames #computergames #mentalhealth

While both men and women contract various conditions, some health issues affect women differently and more commonly. [1] Furthermore, many women’s health conditions go undiagnosed and most drug trials do not include female test subjects. Even so, women bear exclusive health concerns, such as breast cancer, cervical cancer, menopause, and pregnancy. Women suffer higher heart attack deaths compared to men. Depression and anxiety exhibit more frequently among female patients. Urinary tract conditions present more often in females, and sexually transmitted diseases can cause more harm to women. Among the conditions that present most frequently in women, the following eight illnesses pose considerable health risks.

Heart Disease

In the United States, heart disease causes one in every four deaths among women. [2] Although the public considers heart disease a common issue among men, the condition affects males and females nearly equally. Yet, only 54 percent of women realize that heart disease is the top health condition threatening their gender. In the United States, 49 percent of all consumers suffer from high blood pressure, high cholesterol, or smoke; factors that contribute to heart disease.

Breast Cancer

Breast cancer, which typically originates in the lining of the milk ducts, can spread to other organs, and is the most aggressive cancer affecting the global female population. [3] The condition presents more among female populations in developed nations due to their extended life spans.

Initially, women afflicted with breast cancer may develop breast lumps. Most breast lumps are nonthreatening, but it is important for women to have each one checked by a care provider.

Ovarian and Cervical Cancer

Many people are not aware of the differences between ovarian and cervical cancer. [4] Cervical cancer originates in the lower uterus, while ovarian cancer starts in the fallopian tubes. While both conditions cause similar pain, cervical cancer also causes discharge and pain during intercourse.

While ovarian cancer presents extremely vague symptoms, the condition is very complex. Finally, Pap smears detect cervical but not ovarian cancer.

Gynecological Health

Bleeding and discharge are a normal part of the menstrual cycle. [5] However, added symptoms during menstruation may indicate health issues, and unusual symptoms, such as bleeding between menstruations and frequent urinating, can mimic other health conditions.

Vaginal issues could also indicate serious problems such as sexually transmitted diseases (STDs) or reproductive tract cancer. While care providers might treat mild infections easily, if left unchecked, they can lead to conditions such as infertility or kidney failure.

Pregnancy Issues

Pre-existing conditions can worsen during pregnancy, threatening the health of a mother and her child. [6] Asthma, diabetes, and depression can harm the mother and child during pregnancy if not managed properly.

Pregnancy can cause a healthy mother’s red blood cell count to drop, a condition called anemia, or induce depression. Another problem arises when a reproductive cell implants outside the uterus, making further gestation unfeasible. Fortunately, obstetricians can manage and treat common and rare health issues that emerge during pregnancies.

Autoimmune Diseases

Autoimmune disease occurs when body cells that eliminate threats, such as viruses, attack healthy cells. [7] As this condition continues to escalate among the population, researchers remain baffled as to why the condition affects mostly women. While many distinct autoimmune diseases exist, most share symptoms such as:

● Exhaustion
● Mild fever
● Pain
● Skin irritation
● Vertigo

Most of the autoimmune system rests in the stomach. Duly, many who suffer from this condition have resorted to natural healing practices, such as:

● Consuming less sugar
● Consuming less fat
● Lowering stress
● Reducing toxin intake

However, the best defense against autoimmune disease is early detection.

Osteoporosis
Osteoporosis weakens bones, allowing them to break easily. [8] Several factors can cause the condition that occurs mostly in women, such as:

● Age
● Alcohol consumption
● Certain prescriptions
● Genetics
● Lack of exercise
● Low body mass
● Smoking
● Steroid use

To detect the condition, care providers measure bone density using an X-ray or ultrasound diagnostic. While no cure exists for osteoporosis, care providers can prescribe treatment to impede illness progression, which might include dietary supplements, healthy lifestyle choices, or prescription medication.

Depression and Anxiety

Natural hormonal fluctuations can lead to depression or anxiety. [9] Premenstrual syndrome (PMS) occurs commonly among women, while premenstrual dysmorphic disorder (PMDD) presents similar, but greatly intensified, symptoms. Shortly after birth, many mothers acquire a form of depression called the “baby blues,” but perinatal depression causes similar – but much stronger – concerns, emotional shifts, sadness, and tiredness. Perimenopause, the shift into menopause, can also cause depression. No matter how intense the symptoms, care providers can provide relief with prescription or therapeutic treatments.

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Celebrating International Women’s day March 8th 2019 at #appleclinicuae, Dubai, International City, United Arab Emirates.  
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Here are some ways that a person with diabetes can lower high blood sugar levels and reduce the risk of complications.
1. Monitor blood sugar levels closely
High blood sugar levels often do not cause symptoms until they run well over 200 mg/dL. As such, it is essential for a person with diabetes to monitor their blood sugar several times a day. Doing so will mean that blood sugar levels never get that high.
A person with diabetes can use a home glucose monitor to check blood sugar levels.
Recommendations for how frequently to check glucose levels during the day will vary from person to person. Our doctor at #appleclinicuae or #nooralmadinah medical centre can make the best recommendations regarding blood sugar monitoring to a person with diabetes.
2. Reduce carbohydrate intake
Researchers have carried out studies showing that eating a low-carbohydrate, high-protein diet reduces blood sugar levels.
The body breaks down carbohydrates into sugar that the body uses as energy. Some carbs are necessary in the diet. However, for people with diabetes, eating too many carbohydrates can cause blood sugar to spike too high.
Reducing the amounts of carbohydrates a person eats reduces the amount a person's blood sugar spikes.
3. Eat the right carbohydrates
The two main kinds of carbohydrates — simple and complex — affect blood sugar levels differently.
Simple carbohydrates are mainly made up of one kind of sugar. They are found in foods, such as white bread,

You may also consult our doctors at appleclinics in Dubai for expert support and guidance. 

Hepatitis A & Food Safety Workers

What is hepatitis A?

Hepatitis A is a highly contagious disease that attacks the liver. It is the most common type of hepatitis reported in the United Arab Emirates

Who gets hepatitis A?

Anyone can get hepatitis A, but certain persons are at increased risk of infection, including:

• Children and adults living in areas with increased rates of hepatitis
• Persons traveling to countries where hepatitis A is common (i.e., Central and South America, Africa, the Middle East, Asia and the Western Pacific)
• Men who have sex with men
• Injecting and non-injecting drug users
• Sexual contacts of infected persons
• Household contacts of infected persons

How is the virus spread?

Hepatitis A virus is usually spread from person to person by putting something in the mouth that has been contaminated with the stool of a person with hepatitis A. This type of transmission is called the "fecal-oral" route. For this reason, the virus is more easily spread in areas where there are poor sanitary conditions or where good personal hygiene is not observed.

Most infections in the United Arab Emirates result from contact with a household member or sex partner who has hepatitis A.Hepatitis A virus may also be spread by consuming food or drink that has been handled by an infected person. Waterborne outbreaks are infrequent and are usually associated with sewage-contaminated or inadequately treated water. Casual contact, as in the office, factory or school setting, does not spread the virus.

What are the symptoms of hepatitis A?

The symptoms of hepatitis A may include an abrupt onset of fever, malaise, loss of appetite, nausea, stomach pain, dark-colored urine and jaundice (a yellowing of the skin and whites of the eyes). The disease is rarely fatal and most people recover in a few weeks without any complications. Adults have signs and symptoms of illness more often than children. Infants and young children tend to have very mild symptoms and are less likely to develop jaundice than are older children and adults. Not everyone who is infected will have all of the symptoms.

How soon do symptoms appear?

The symptoms commonly appear within 28 days of exposure, with a range of 15-50 days.

For how long is an infected person able to spread the virus?

The contagious period begins one to two weeks before symptoms appear, and is minimal about one week after the onset of jaundice. Food workers should be excluded from work for at least two weeks after the onset of clinical symptoms of hepatitis A. If jaundiced, food workers should not return to work for at least one week after onset of jaundice.

Does past infection with hepatitis A make a person immune?

Once an individual recovers from hepatitis A, he or she cannot be re-infected. He or she is immune for life and does not continue to carry the virus.

What is the treatment for hepatitis A?

There are no special medicines or antibiotics that can be used to treat a person once the symptoms appear.

How can hepatitis A be prevented?

To prevent person-to-person spread, careful hand washing after using the bathroom, changing diapers and before preparing or eating food, is the single most important means of prevention.

Foodborne hepatitis A outbreaks are relatively uncommon in the United Arab Emirates however, when they occur, intensive public health efforts are required for their control. To prevent the spread of hepatitis A from an infected food worker to co-workers and/or restaurant patrons, food workers should never touch ready-to-eat foods with bare hands, and should carefully wash their hands after using the bathroom, even if the food worker does not feel sick. Food workers should never work while they are sick with stomach (gastrointestinal) illnesses.

Immune globulin shots are effective in preventing the spread of hepatitis A if given within 14 days of exposure. Immune globulin may be recommended for co-workers of infected food workers. Under certain circumstances, particularly when recommended food safety procedures are not followed by food workers, public health officials may recommend that restaurant patrons receive immune globulin.

For long-term protection, hepatitis A vaccine is the best method of prevention.

Who should obtain the hepatitis A vaccine?

Hepatitis A vaccine is recommended for the following persons:

• Travelers to areas with increased rates of hepatitis A
• Men who have sex with men
• Injecting and non-injecting drug users
• Persons with clotting-factor disorders (e.g., hemophilia)
• Persons with chronic liver disease (including persons with chronic hepatitis B or chronic hepatitis C virus infection)
• All children aged 12-23 months; children not fully vaccinated by age two

The hepatitis A vaccine may also be used in certain outbreak situations where ongoing transmission is occurring. Although studies of certain occupational groups (for example, food service workers, health care workers, child care workers, sewerage workers) have not shown an increased risk, such people may consider vaccination if they wish to further reduce their risk or are in communities where ongoing outbreaks are occurring.

Why isn't hepatitis A vaccine required for food service workers?

While food service employers can offer hepatitis A vaccine to their employees if they wish, most public health authorities prefer not to make it mandatory for the following reasons:

• There is no evidence that food service workers are at any greater risk of acquiring hepatitis A than are people in other occupations.
• Only 2-3 percent of all hepatitis A cases are acquired through restaurant food.
• Employee turnover in some segments of the food service industry is high, making it impractical to vaccinate staff.
• Emphasis on careful hand washing, use of disposable gloves and not working when ill are measures that can greatly minimize the risk of spreading hepatitis A and a number of other infections.
• Hepatitis A vaccine would be strongly recommended for food service workers in a county or region where a community-wide outbreak has been recognized.

What about the vaccine?

Currently, there are two hepatitis A vaccines on the market. Both vaccines are safe and highly effective. Two doses given at least six months apart, are recommended. Approximately 99-100 percent of persons vaccinated with hepatitis A vaccine will develop long-lasting immunity.

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Driving licences can be obtained by adult UAE citizens/residents after training from an authorized driving school in Dubai. If you are 18-21 year of age, you can apply for a probationary licence.

Criteria
If you have never driven before or have a driving licence that is not on the approved list of 36 countries then you must undergo training.

Documents Required
Passport (original & copy) with residence stamp, No-Objection Certificate from employer & 8 photos.

Authorized Driving Schools 
Emirates Transport Driving Institute - 04 233 6555

Belhasa Driving School - 04-3243535 (18 branches)
Dubai Driving Center- 04-3455855 (13 branches)
Emirates Driving Institute-04-2631100 (53 branches/mall counters)
Galadari Driving School-04-2676166 (14 branches)
Drive Dubai 04-8855118 

Steps
1. Get an eye test done at apple international polyclinic Easy access through، K14 - International City, Greece Cluster Building No - Manama St - Dubai.
2. The school will handle all paper-work with RTA who may even have a counter at the school.
3. Receive your temporary driving licence, which you must carry in your training car.
4. Once you have passed all internal tests like garage and parking, your school will apply for your theory test followed by your road test.

Theory Test
The theory test is carried out at the five authorized driving schools. Don't forget to carry relevant ID, driving file+ 2 photos and theory test RTA fee of AED 200.

A total of 35 questions on road signals, hazards and guidelines on safe-driving will be asked in either English, Arabic or Urdu, with more languages to be added later. Candidates who cannot read the touch-screen or are not computer literate can take the examination orally. The first segment with 17 questions focuses on general traffic situations, and the candidate will need to answer a minimum of 11 correct to pass. The second segment has 18 questions related to the specific driving license the candidate requires and a minimum of 12 correct answers are required to be eligible for the road test.

From July 2015, a new segment was added to the Theory test. Called Risks Recognition Test, the test contains a few videos that depicts specific environmental conditions and asks the driver how he/she can cope with them.

Road Test
On the date assigned, go with your passport, driving file+ 2 photos to the RTA Licence Section as advised by your driving school. Fill up application form & submit fees (around AED 200 for road test). When your name is called out, go along with the other three candidates and the RTA inspector to the designated car. You will be given just a few minutes to demonstrate your driving and anticipatory skills.

If you fail, you will have to register with your driving school for at least 7 more classes and get a new road-test date.

If you pass, collect the approval paper from your inspector and go to the Pass Counter. Submit along with suitable ID & AED 100. Collect your test file and submit to Control Counter. After processing, pay required fee and proceed to photo area. When your name is called out, have your photo taken. Congratulations. In a few minutes, you will receive your DL and be eligible to drive in Dubai and the UAE.

Do keep in mind that Dubai has a zero-tolerance policy on drinking and driving. Plainclothesmen travel about in unmarked vehicles and can legally stop you at any time to check. Dubai Smart Government recommends that you buckle up your seatbelt and drive safely at all times