Category: Uncategorised

Christmas Spice

It’s hard to believe that this time last year, we were experiencing some of the coldest temperatures on record, with snow and ice covering the ground like a picture from a traditional Christmas card. It has been very mild in comparison so far this winter, which makes it seem strange that Christmas is just around the corner. But for me, nothing evokes that festive feeling more than the wonderful scent of the Christmas spices.
Warming spices such as ginger, cinnamon and cloves are traditionally associated with Christmas time, They have long been used to flavour mince pies, Christmas cakes, plum puddings and mulled wine. It is often the case that there is a wisdom behind such traditions, and the use of aromatic spices at Christmas time is no exception. They are very beneficial at a time of year that is typically associated with cold weather, winter bugs and overindulgence.

Spices such as ginger, cinnamon and cloves have a warming effect on the body. They stimulate the circulation, warming up cold hands and feet and easing joint pain and stiffness. When taken regularly, ginger root (Zingiber officinalis) is particularly effective for improving poor circulation and for treating Raynaud’s disease, which is associated with numbness of the fingers and toes in cold weather. It can be added to food or used to make a tea.

Warming spices such as ginger, cinnamon, and cloves also stimulate the digestive system. They are very useful for combating the effects of overeating and indulging in too many sweet or rich foods. They help to relieve indigestion, nausea, hiccoughs, trapped wind and bloating, which affect so many people during the festive season. The cold weather is also associated with various winter bugs. The aromatic spices kill the bacteria and viruses that cause these infections and help to ease the symptoms of illness.

The inner bark of the cinnamon tree (Cinnamonum zeylonicum) is active against the bacteria and viruses that cause coughs, colds and stomach bugs. A cup of cinnamon tea is a relaxing expectorant, which helps to remove excess phlegm from the lungs and eases coughing. In the digestive system it prevents nausea, vomiting, cramping pains and diarrhoea. Cinnamon also prevents the growth of Helicobactor pylori (the bacteria which causes stomach ulcers) and Candida albicans (a yeast which causes digestive disturbance, thrush and a whole range of other health problems).

The flower buds of the clove tree (Syzygium aromaticum) have similar effects to cinnamon in the respiratory and digestive systems. Whole cloves can be used on their own or with cinnamon to make a tea, but they are more frequently added to hot whiskey, mulled wine or elderberry juice to make a warming winter drink.

Clove oil, which can be purchased from pharmacies and health food stores, is particularly effective against the herpes virus, which causes cold sores. At the first signs of tingling add a few drops of clove oil to a suitable carrier oil (such as olive or almond oil) and dab onto the affected area using a cotton bud. Clove oil also acts as a local anaesthetic which is particularly effective for toothache. Put a few drops onto a small piece of cotton wool and place in the mouth next to the offending tooth. This helps to fight any infection and numb the pain. A few drops of clove oil can also be added to alcohol or to a suitable carrier oil and used as a liniment for arthritis which is often worse in cold weather.

Antibiotic Awareness

The development of antibiotics during the last century was perhaps the most important breakthrough in modern medicine, which revolutionized the treatment of infectious diseases, and saved many lives. However, this advantage could one day be lost forever, due to the development of antimicrobial resistance. Last week, the Health Service Executive (HSE) launched a new campaign to raise awareness about the correct use of antibiotics.
Antibiotics are drugs which kill the bacteria that cause various types of infection in the body. However, when antibiotics are over-used, or used inappropriately, bacteria develop ways of resisting their effects. When an entire strain of bacteria becomes resistant to most antibiotics, it is often referred to as “superbug”; the best known example of which is MRSA (Methicillin-resistant Staphylococcus aureas), which can cause incurable and sometimes fatal infections.

Research published in the Irish Medical Journal last year highlighted the fact that antibiotic use has risen sharply in recent years, and that up to 50% of antibiotic prescribing may be inappropriate. Many GPs have admitted that pressure from patients is often a factor when prescribing antibiotics. However, if antibiotics are being inappropriately prescribed on demand, it really defies the purpose of having them under prescription-only control.

Antibiotics are completely ineffective against the viruses which are responsible for the majority of winter bugs, and they do nothing to support the immune system or to help with the symptoms of the condition.  Recent research has also found antibiotics to be largely ineffective in the treatment of sinusitis and ear infections. Of course antibiotics are absolutely essential in the treatment of serious or life threatening conditions, but they are powerful drugs, which can have some serious side effects.

Antibiotics interfere with the normal balance of microflora, or “friendly bacteria” in the body, causing digestive disturbance, poor absorption of various nutrients, and overgrowth of harmful micro-organisms such as Candida albicans. Antibiotics can also have far-reaching effects on the immune system, and infections which resolve after antibiotic treatment often recur because the immune system has been damaged by the antibiotics.  The most notable examples are cystitis and ear infections, which may return time and time again and take years to fully resolve.  Studies have shown that children who are given broad-spectrum antibiotics before they are 6 months old are almost nine times more likely to develop asthma than other children.

Fortunately, many people are now aware of the dangers of antimicrobial resistance, as well as the potential side-effects of antibiotics: A comment I often hear is: “I tried to do without the antibiotics, but I had to give in the end”. However, in the case of most common infections, what is needed is neither suffering on in silence, nor rushing to the nearest GP for a prescription; but a safer, yet effective approach to dealing with the problem. Patients who attend my clinic for treatment of acute infections are often surprised at how effective herbal treatment can be.

Some herbal remedies have been found to be more effective against a range of bacteria than pharmaceutical antiseptics, and because they are much more complex than orthodox medicines they are less likely to lead to the development of resistant bacteria.  There are also a number of antiviral herbs, which are more appropriate for treating the viruses that cause a large proportion of common infective illnesses, such as respiratory and gastrointestinal infections.

In order to treat the symptoms of the infection, other herbs are used, which help to manage fever, to reduce the production of mucus, to soothe sore throats and coughs, or to ease urinary symptoms or diarrhoea. In addition, herbal medicine focuses on supporting the body’s own immune response in order to fight the infection and to help prevent future attacks.

By visiting a herbalist for the treatment of infections, you can be assured of treatment which is safe and effective for both adults and children.  At the same time you can avoid the side effects of antibiotic treatment and help to ensure that they will be effective if they do become really necessary. 

Movember

Cancer of the Prostate is the most common form of cancer in men, and around 2,700 men are diagnosed with prostate cancer in Ireland every year. During November (or Movember as it is now called), thousands of men around Ireland sprout moustaches to raise awareness about this condition.
The prostate is a small gland, which is located below the bladder in men. It wraps around the urethra (through which the urine flows out of the body), and is responsible for secreting seminal fluid.

The symptoms of prostate cancer are usually due to pressure on the urethra, and include difficulty starting to urinate, weak or interrupted flow, difficulty stopping urination, and needing to urinate more frequently. These symptoms are virtually identical to those caused by benign enlargement of the prostate, which is much more common than prostate cancer. However, it is always worth getting any unusual symptoms checked out.

Since the prostate gland is located very close to the wall of the rectum, assessment can be carried out by a rectal examination. A blood test to measure the level of Prostate Specific Antigen (PSA) may also be used to indicate whether further investigations are necessary, in which case a prostate biopsy may be performed. However, the PSA test is not a specific test for prostate cancer: PSA can be raised due to benign enlargement or inflammation of the prostate, and up to two thirds of men with a raised PSA do not have prostate cancer.

In many cases, prostate cancer causes no symptoms at all in the early stages, and therefore regular checks are important, especially if you are over 50, or if you have a family history of the condition

Fortunately, prostate cancer is usually very slow growing, and it is therefore less likely to spread to other parts of the body than other forms of cancer. However, early detection and treatment are still vital to offer the best chance for a full recovery. There are also many natural ways to help prevent prostate cancer, and to aid recovery for those who have already been diagnosed with the condition.

Avoid wearing tight fitting underwear or trousers, as this restricts lymphatic drainage, which in turn prevents removal of toxins from the area and interferes with healthy immune function.  Make sure you go outside for a walk every day since the main source of vitamin D is the action of sunlight on the skin, and people who are deficient in this vitamin more likely to develop various forms of cancer.

Men who eat a lot of red meat and dairy products have been shown to have a higher chance of developing prostate cancer than those who do not. Therefore it is important to cut down on consumption of red meat and dairy products (such as cheese), and to eat more chicken, turkey and fish, especially oily fish such as mackerel, tuna, salmon and trout.

It is also very important to eat plenty of fresh organic fruit and vegetables, particularly those which are coloured, such as carrots, sweet potatoes, greens, cherries and other berries.  These contain antioxidants and other essential nutrients, which are very important in the prevention and treatment of prostate cancer. One nutrient that has been shown to be particularly beneficial is lycopene, which is found in tomatoes. For maximum absorption, it is best to drizzle fresh, ripe, preferably organic tomatoes with olive oil and grill before eating.

A professional medical herbalist can provide an individually-tailored herbal prescription, and detailed advice about diet and nutritional supplements to help with cancer prevention and improving the chances of recovery.  Of course there is no magic cure for cancer, but taking a holistic approach to healthcare can help to create an environment in the body which does not encourage its growth, and can help to give the immune system the upper hand.

“What’s Ireland Eating?” – Part Two

In last week’s article, I wrote about a documentary that was shown on RTE at the beginning of this month, which posed the question: “What’s Ireland Eating?” The documentary, which is still available to watch on the RTE player, is based on the results of a survey of the grocery-buying habits of thousands of Irish households, and also presents the results of the National Nutrition Survey, which was carried out by Irish University Nutrition Alliance. The documentery raised some very important issues, and in last week’s article, I wrote about the impact our food choices are having on our health. This week I will focus on how the way we shop is affecting our economy.
Once upon a time, people bought their meat from the butchers, fruit and veg from the greengrocers and so on. The food they bought was often locally sourced, supporting not only the local shops, but also local farmers and other food producers. Nowadays, 8 out of every 10 euro we spend on food is spent in supermarkets, most of which are large, multi-national companies who import much of their produce. Over the past ten years, more and more large supermarkets have sprung up, and in the same period, over half of all independent retailers either disappeared or were taken over by chains.

Small retailers struggle to compete with large supermarkets on the edge of their towns. Many people who regularly shop in supermarkets only intend to do part of their shopping there, but would still like to be have access to local shops. However, just a small shift in the shopping habits of local people in favour of large supermarkets often means that local shops can no longer stay in business.

Large supermarkets generally argue that new stores provide jobs to the local area, but studies have actually shown that for every 10 jobs a new supermarket provides, 15 jobs are lost in the area over the floowing 2-3 years. For example, a new supermarket may not only force local butchers and greengrocers to make staff redundancies, or close altogether, but the local farmers and other producers who they buy from will also lose business, and may have to lay off workers or go out of business themselves.

In this country, a small number of large multi-national supermarket chains have become dominant, and they therefore have a great deal of power over their suppliers in terms of prices and terms.

Large multi-national supermarkets generally prefer to stock a few well-known products alongside their cheaper own-brands, effectively squeezing out the smaller producers. This means that most large multinational supermarkets will not stock locally-produced items such as dairy products and honey.

Much of the produce stocked in large multi-national supermarkets is imported from other countries, where production costs are cheaper and standards are lower, and Irish producers are finding it more and more difficult to compete. The real cost to the consumer of this cheap produce is the reduction in quality. For example, cheap imported chicken fillets from Eastern Europe are transported to Ireland in gas-filled packaging and are usually 7-9 days old by the time they reach the shops

Small suppliers, who are dependendent on large retailers to stock their products, are largely powerless to stand up to the supermarkets. The Irish Farmer’s Association estimates that production costs have risen by over 50%, since 1995 yet prices paid to Irish suppliers have dropped by around 7%. Suppliers also have to bear the cost of Supermarket promotions such as “two for one” offers and discounted prices, while the executives and shareholders of the supermarkets reap the all benefits.

So the next time you have a choice between shopping at the supermarket, or at your local butchers, greengrocers or farmer’s market; or the choice between a locally-produced product and a cheap import; remember that you may not be saving as much as you think. Keeping Irish producers in business keeps food closer to home, and keeps money in your local community, and in the country. So the next time you are shopping, make the choice to buy Irish products or local products, or you may find that you ne longer have the choice.

The “What’s Ireland Eating” Documentary is available to watch on the RTE player (www.rte.ie/player) until Tuesday 22nd November.

What’s Ireland Eating?

Over the past few years I have become increasingly alarmed by the number of people I see in my clinic who are suffering from various forms of food intolerance. Problems such as gluten and dairy intolerance, which were once relatively rare, now seem to be affecting more people than ever. Alongside this is the alarming increase in risk factors and incidences of various chronic diseases, such as hypertension, high cholesterol, heart disease and diabetes, and we only need to look around to see that well over half of Irish people are now either overweight or obese. So what is happening to cause such a health crisis in our country?
A documentary on RTE last week posed the question: “What’s Ireland Eating?” and offered some insight into the link between the food we are choosing to eat, and the impact on our health and on our local economy. The documentary, which is still available to watch on the RTE player, is based on the results of a survey of the grocery-buying habits of thousands of Irish households, and also presents the results of the National Nutrition Survey, which was carried out by Irish University Nutrition Alliance.

The survey found that over 40% of the money we spend on food is spent on highly processed food, which is generally much higher in sugar, salt and fat. We buy huge quantities of processed meat, fizzy drinks, and sugary breakfast cereals. Most of the meat we consume is processed, and half of the fish we buy is frozen, breaded and pre-packed. One third of the potatoes we choose are in the form of high-fat, processed products such as chips. And even the “fresh” products we buy, such as salads and other vegetables, are more likely to be washed with chlorine, pre-chopped, and sold in gas-filled packaging to prolong the shelf life. Our consumption of fruit and vegetables is only half of the recommended daily amount, and for every euro we spend on fruit, we spend €1.50 on junk foods such as crisps and sweets.

In Ireland we are consuming on average two and a half times the recommended intake of salt, which is a major contributing factor to higher rates of high blood pressure, heart disease and stroke. Processed pork (such as bacon, sausages and ham), is the highest selling meat in this country, and is a big contributing factor to our high salt intake. Processed meats are pumped with large quantities of water to increase the bulk (and therefore the price) of the product. They also contain numerous additives such as phosphates to help keep the added water in the meat, nitrites to make it pink, dextrose for flavouring, and preservatives such as ascorbate to prolong the shelf life.

Of greatest concern is the result of a study conducted by the World Cancer Research Fund, which found that consuming processed meat significantly increases the risk of bowel cancer, which is the second most common cancer in Ireland. The increased risk is thought to be mainly due to the various additives such as nitrites which make the meat look more pink, and as little as 50g per day of processed meat (which is equivalent to just 2 slices of ham per day), is enough to increase the risk of bowel cancer by 30%.

Addressing the way we shop and eat is not only important for our health, it is also important for our economy, since the annual cost to the health service for the treatment of obesity and obesity-related disease is currently €4billion.

So what can we due to turn this crisis around? Well, it’s really very simple: We need to get back to buying locally-produced, fresh, unprocessed, preferably organic products. Buying cheap processed meat is really a false economy since it can contain up to 50% water. Fresh, unprocessed, meat, chicken and fish bought from local suppliers benefits your health and well-being, as well as supporting local businesses. Likewise, eating plenty of vegetables which are locally-produced, fresh, unprocessed and preferably organic is one of the best things you can do for your health and for the local economy.

There is a huge variety of interesting and delicious types of food available, yet many people choose to eat processed ready meals, or bland chicken fillets or breaded white fish, with boiled carrots and peas every night of the week. Why not choose a delicious moist organic chicken from your local butcher or poultry supplier instead, or some delicious grilled fresh Mackerel or lemon sole from the Farmers Market? How about some tasty parsnips and butternut squash from your local greengrocer or organic farmer, roasted in the oven with some herbs and a little local honey, or some steamed fresh greens such as sprouting brocolli, leeks and kale?

It may sound daunting and time consuming to those who are not used to preparing a variety of intersting meals from scratch and usually just grab lots of processed foods from the supermarket shelves, but local suppliers are generally very willing to offer advice on how to prepare different types of food, and there are lots of ideas and recipes available from books, TV and on the internet. Ultimately, the experience of buying your food in friendly local shops, eating meals made from delicious, fresh unprocessed ingredients, and feeling the benefits to your health, makes it well worth the effort.

The “What’s Ireland Eating” Documentary is available to watch on the RTE player (www.rte.ie/player) until Tuesday 22nd November.

An Apple a Day

Though most people now associate Halloween with pumpkins, it is in fact the apple that is traditionally connected with this time of year. Halloween traditionally marked the end of the apple harvest, as it was thought that any fruits which were not picked and stored by halloween night were spat on by the pooka! In fact the apple tree has long been regarded as sacred, from its appearance in the garden of Eden to the myths and legends of the Celts, and the apple itself has often been described as ‘The Food of the Gods”.
As the old saying goes, “An apple a day keeps the doctor away”, and like most old sayings there is a lot of truth behind it. Apples are full of vitamins, minerals and other important nutrients, in a form that makes them easy to digest and absorb. These nutrients are essential for keeping the body healthy and helping to prevent disease. Stewed apples are an ideal source of nourishment for young children and for anyone recovering from ill health.

As well as being packed full of vitamins and minerals, apples also contain antioxidants, which help to prevent premature ageing, cancer and numerous other health problems. The red-skinned varieties are generally richer in these nutrients than those with green skins. Apples also stimulate the liver to eliminate toxins from the bloodstream and they have a cleansing effect on the entire body. In particular, they help the kidneys to excrete excess uric acid, which can contribute to psoriasis, arthritis and gout.

The slightly acidic taste is due to the fruit acids called malic acid and tannic acid. These stimulate the digestive system and help the body to digest protein and fats. This is one of the reasons why apples are traditionally eaten with pork. The combined action of the fruit acids and soluble fibre also helps to relieve constipation, providing a very safe and natural solution that is particularly effective in children.

The soluble fibre in apples is found in the flesh rather than the skin and is called pectin. Pectin helps to lower cholesterol levels by reducing absorption from the digestive system. In addition, it reduces the absorption of toxic substances such as lead and pesticide residues. It also helps to balance blood sugar levels, which makes an apple an ideal mid-morning or mid-afternoon snack for people who experience sugar cravings.

Apples were traditionally used to treat respiratory problems and modern research has confirmed that they possess an antiviral action, which helps to prevent colds and other respiratory infections. A study conducted a few years ago also demonstrated that eating an apple a day can significantly reduce the frequency and severity of asthma attacks.

Back to School

As we enter the final week of August, the days are getting noticeably shorter and the evenings are getting cooler, as the children get ready to go back at school. For many children, especially those starting school for the first time, the changing weather, mixing with lots of other children, and the sheer stress of it all, adds up to all kinds of troublesome infections. But as the old saying goes, “prevention is better than cure”, and fortunately there are many ways to help increase the body’s resistance to infection.
Essential nutrients for a healthy immune system include selenium and zinc (both of which are found in Brazil nuts). Vitamin C is also important for resistance against infection and is found in combination with immune-boosting flavonoids in fruit and vegetables, particularly coloured foods such as blueberries, oranges and broccoli.

It is often difficult to maintain adequate doses of these nutrients from food alone. Children who buy their own lunches often make poor choices, preferring chips and sweets over healthy dinners; and those who bring packed lunches often return home having eaten very little. Therefore a good quality supplement may be an easier way to ensure a high enough level to benefit the immune system. Choose a supplement which includes a broad range of nutrients in an easily absorbable form, such as Sona Multiplus Junior, or Kangavites.

Probiotics, which are found in live yoghurt and good quality supplements (such as Udo’s Choice Children’s Blend Probiotic), also play an important role in immunity. They are particularly important for children who have taken antibiotics within the past two years

The most damaging factors for the immune system are poor diet, stress, and lack of sleep. Saturated fats, sugar, chemical food additives and caffeine all stress the immune system. These are present in many foods marketed for children, such as processed savoury food, crisps, chocolates, sweets, fizzy drinks and cordials.

It is important for children to stay active and avoid long periods of watching TV or playing computer games, but it is also important that they get enough rest and sleep. Lots of homework coupled with too many after school clubs can leave children exhausted. However, children are often unable to recognise the need to rest and can run on adrenalin which exhausts them further.

One of the most well-known herbs for enhancing immune function and preventing infection is Echinacea, which is available over the counter from pharmacies and health food stores. However, another remedy which is becoming increasingly recognized for its antiviral and immune-stimulating properties, is the common elderberry, which begins to ripen in the hedgerows at this time of year.

Elderberries, which are rich in vitamins A and C and bioflavonoids, are a wonderful tonic for the immune system and they have a specific antiviral action which helps to prevent colds, flu and other viral illnesses. They are very safe and well tolerated, and are ideal for both adults and children.

A number of scientific studies have shown that elderberries stimulate the immune system and are active against a number of different strains of the flu virus. In controlled clinical trials which compared elderberry extract with placebo in the treatment of influenza, patients taking the elderberry extract had significant improvements in their symptoms within two-three days. On average, the flu symptoms lasted about half as long in those taking elderberry extract compared with those taking the placebo

Elderberry extracts are widely available from pharmacies and health food stores. However, home-made elderberry syrup is an excellent alternative, which is very cost effective and easy to make. Simply cover 500g fresh elderberries with water and boil with a stick of cinnamon for about 5 minutes. Squash the berries to extract the juice, and strain to remove the skins. Add 500g honey or brown sugar to the strained juice and heat until it thickens. Bottle in clean, sterilized containers, and take one or two dessertspoonfuls of the syrup in a cup of hot water three times a day during the winter months as a tonic to help prevent viral infections.

AnneMarie Reilly is a qualified medical herbalist practising in Lismore. To make an appointment for a private consultation telephone 058 53200 or 087 934 5910.

By AnneMarie Reilly
BSc(hons), MNIMH, MIIMH, DipCoun

Eczema

There are many different types of eczema, but atopic eczema is by far the most common. This form of eczema usually starts in childhood, most commonly in the first year, and around 10% of all children will develop eczema before the age of five. Fortunately, about two thirds of children with eczema grow out of it by the time they are seven, and three quarters do so by the time they are 16. However, eczema can persist into adulthood and even children who grow out of it can continue to have ‘sensitive’ skin as adults.

In babies, eczema can affect any part of the face or body, and often appears as oval-shaped patches of pink or red, dry, rough skin which are intensely itchy and may weep or bleed when scratched, often leading to frustration, sleep disturbance and infection of the skin. In older children, eczema most commonly affects the creases on the inside of the elbows and the backs of the knees. There may also be patches of eczema elsewhere on the body.

The tendency to develop eczema is genetic, and is linked to asthma and hayfever, but the disease itself is usually precipitated by environmental influences. The environment we live in and the stressors we are exposed to have changed a great deal in recent years, and this has caused more and more children to develop the condition.

Factors which can adversely affect the development of the immune system in early childhood, such as excessive use of antibacterial cleaning products, frequent courses of antibiotics, and stress, may increase the risk of developing eczema. Other triggering factors include anxiety, infection, allergies, pollution, household chemicals, and poor diet.

Conventional treatment of eczema includes emollient creams to reduce skin dryness, topical steroids to reduce itching and inflammation, and antibiotics for infection. While steroid creams are often quite effective in the short term, they only suppress the symptoms and can lead to thinning of the skin when used long term. Frequent or inappropriate use of antibiotics damages the immune system and causes microbial imbalance, which can ultimately make matters worse. Fortunately there are some very effective, natural and safe ways to help keep eczema under control.

It is advisable to avoid cow’s milk and other dairy products, which often exacerbate the condition, and use  rice or goat’s milk products instead. Minimise contact with pets and other animals, and ensure the home is kept as dust-free as possible. Change bedclothes regularly and wash at 60 degrees to kill dust mites and other harmful micro-organisms.

Avoid clothes made from wool and synthetic fibres, and choose cotton clothes and bed-linen instead. Avoid biological washing powders and use a chemical free washing powder such as Fairy Non-Bio or Ecover. Do not use any fabric softeners, which tend to leave chemical residues on clothes.

Keep the skin clean to help reduce the risk of infection, and use emollient creams regularly to keep the skin moist. Make sure bath water is not too hot and do not use any soap, bubble bath or shampoo. Instead, fill a muslin bag (or similar) with oatmeal and place under the hot tap while running the bath, and then add cold water until bath is the appropriate temperature. A dessertspoonful of baking soda added the bath helps to reduce itching.

Natural treatment of eczema is completely safe and generally very effective. Herbs such as Chinese skullcap  reduce allergic responses, and others such as liquorice reduce inflammation of the skin. Herbs such as  heartsease and chickweed help to reduce itching.

Useful supplements include evening primrose oil, vitamin E and zinc, which are important for skin repair. If you or your child suffers from eczema, a qualified medical herbalist can provide an individually tailored herbal prescription together with natural creams and helpful advice about diet and nutritional supplements.

For more information about natural treatment for eczema or to make an appointment for a private consultation telephone 058 53200 or 087 934 5910.

By Marie Reilly
MSc, MNIMH, DipCoun.