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PeopleImages/iStock(NEW YORK) -- In our world of 24/7 communication, demands and pressure, everyone seems to always be run-down or overwhelmed.

But feelings that go even beyond that, making it hard to do even the simplest of tasks, may be a sign of burnout.

"It means we’re over-allocated," Bea Arthur, a New York City-based licensed therapist, said of how she defines burnout.

"In your mind, and perception is reality, it feels like you can’t drop any balls," she said, adding that you can visualize burnout when you think of your life as a pie chart with everything from work to kids and family taking up all the slivers of the pie.

Burnout is just a "matter of degree" difference from the chronic stress that so many people feel, according to Amy Kurtz, author of the bestselling book Kicking Sick: Your Go-To Guide for Thriving With Chronic Health Conditions.

"We’re told to always be performing at an A level but we aren’t taught, I don’t think at all, that you have to put in ways to unplug and have rituals for yourself or you will burnout," she said. "It’s an epidemic happening especially to millennials because the world is getting faster and faster."

Burnout among millennials was put in the spotlight last month in an essay written by BuzzFeed reporter Anne Helen Petersen, who described how she could excel in her job and some parts of her personal life but felt paralyzed in others.

"I’d put something on my weekly to-do list, and it’d roll over, one week to the next, haunting me for months," Peterson wrote of what she labeled "errand paralysis."

"They are seemingly high-effort, low-reward tasks, and they paralyze me," she wrote.

Ann Shoket, author of The Big Life, said the millennial women she meets are often fixated on small things that distract from their bigger lives.

"The kind of burnout I'm seeing is a fixation on little things making high-achieving, high-performing women with passion projects and side hustles feel overwhelmed," she said. "We feel ashamed that we can’t keep up. To say that's what embarrasses us, it puts us in a dark corner."

Other signs of burnout can include insomnia, chronic fatigue, difficulty concentrating, apathy, irritability, anxiety and getting sick more often.

While burnout is not a medical diagnosis, it can have physical consequences that include everything from respiratory problems to gastrointestinal issues, according to ABC News chief medical correspondent Dr. Jennifer Ashton.

Are you suffering from burnout?

There are four questions you can ask yourself to determine if you are suffering from burnout, explained Ashton.

Rate yourself on each question below using a number one through four, with one being never, two sometimes, three often and four always. Then total your points from all four questions.

1. How often are you tired and lacking energy to go to work in the morning?

2. How often do you feel physically drained, like your batteries are dead?

3. How often is your thinking process sluggish or your concentration impaired?

4. How often do you feel emotionally detached from co-workers (or customers) and unable to be sensitive to their needs?


If you scored less than nine, you are not suffering from burnout.

If you scored between a 10 and 12, you are on the verge of burnout.

If you scored between a 13 and a 16, you are suffering full-on burnout.


How to help burnout

It is up to you to make changes in your life in order to prioritize yourself, experts say.

"Be intentional and force yourself to stop if you’re living on one of these never-ending rides," Arthur said. "It’s not going to stop for a while or just fix itself, so you have to do it."

Arthur recommends starting by removing the urgency from things in your life that are truly not urgent.

"You know what is urgent in your life, like seeing your family and friends more," said Arthur, who tries not to answer work-related emails and calls past 7 p.m. because she knows, in her work, nothing tragic is going to happen if she answers in the morning.

She also schedules her vacations three and six months in advance, which lets her know that she can take a pause.

"Even if the work is still there when you get back from vacation, you’ll come back better," she said.

Shoket recommends being intentional about the type of self-care you give yourself.

"I don't mean get a mani[cure] and facial," she said. "It’s about putting yourself first once in a while. Turn off your phone. Leave work at a reasonable hour. Draw boundaries between your life and your work that allow you to succeed in both.”

Accepting that your life can be big and messy is also good way to move forward, noted Shoket.

"You have to embrace the mess," she said. "Don't get caught up in the idea that things have to be perfect or there has to be a balance. A big, ambitious hungry life is a messy life."

Kurtz, also a health and wellness coach, works with her clients to "flip the script" on burnout by establishing personal rituals.

The rituals Kurtz recommends include everything from practicing meditation to getting exercise, eating a healthy diet, getting proper rest and setting boundaries on your apps and phone.

She also stresses the importance of saying no.

"If its not a heck yes, its a heck no," Kurtz said. "If you’re not totally jazzed about doing something, just say no."

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BrianAJackson/iStock(NEW YORK) -- Starting 2019 on the right foot can quickly lead to foot pain if the shoes you're working out in are not right.

Whether you are running, cross-training or weight lifting, comfort is key, according to Stephanie Blozy, the owner of a Fleet Feet Sports store in West Hartford, Connecticut.

"If the shoe feels comfortable on your foot, it’s probably going to be less likely to cause injury down the road," she said.

Rebecca Kennedy, master tread instructor at Peloton, which launched its at-home tread workouts last year, said women need to be savvy shoe shoppers to feel and look their best.

"The shoe is the barrier between your foot and whatever surface you’re on, so it has the potential to do a lot of good or be detrimental," she said. "If you choose something that’s not right for your foot or the way you move, then you’re going to be susceptible to injury."

Here are eight tips from Kennedy and Blozy on finding the perfect shoe:.

1. Try on more than one shoe so you know what you like and don't like.

2. Buy workout shoes in a half size bigger than your everyday shoe, like a heel, because your feet will swell and expand during exercise.

3. When you find a shoe that fits, try it in a half size bigger and a half size smaller to make sure you have the right size.

4. Don't be swayed by color or price. Go for the shoe that is comfortable, not the one that is best looking. Expect to pay around $120 for a great running shoe.

5. Go to a store that will fit you for a shoe instead of trying to sell you one. "There are plenty of running stores that will get you up on a tread and film your gate and put you in several different brands and sizes and widths to determine what is best," said Kennedy.

6. Buy more than one pair of sneakers, ideally from different brands, so you can rotate them, giving the shoes time to dry after workouts and your feet a chance to use different muscles.

7. Pick a shoe based on your activity, so if you run more than two miles in a workout, you should be in a running shoe. If you are doing a HIIT and strength class, like OrangeTheory, wear a cross-training shoe that is closer to the ground and has more flexibility.

8. Replace your running shoes at least every 300 to 500 miles. "I like to just turn [my shoes] over and see where the wear and tear is, how much of the cushion has gone away, does it seem like I’m running on pavement," Kennedy said.

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iStockBy DR. AZKA AFZAL 

(NEW YORK) -- Can a dog’s nose save a diabetic’s life? Man’s best friends are known to sniff out bombs, drugs and even bedbugs, but can they smell trouble for type 1 diabetics?

A new study done in the U.K. shows that the diabetic “alert” dogs were able to detect 70 percent of episodes of abnormal blood sugar -- incidents that can be dangerous, even deadly, for type 1 diabetics.

How do they do it?

Dogs that are noted to have a better sense of smell, such as golden retrievers, than their counterparts are the ones chosen for training. They use this highly sensitive sense to sniff out changes in the blood that occur when blood sugar becomes too low or too high. Doctors know that when blood sugar becomes too high, for example, it causes a chemical reaction in the blood that creates a fruity or sweet odor on their breath. Doctors may not always be able to smell it, but dogs can -- since their sense of smell is 40 times greater than ours. They can also pick up the scent from sweat and skin.

How are they trained?

The dogs are trained for months to years with positive reinforcement. To the puppy, it’s “play” with a reward for success. The training can then be personalized. For instance, saliva is collected when a diabetic’s blood sugar is nearing the lower range of normal.

The dogs learn that particular scent and how to alert their humans. Typically, they tap their partners with a paw or nose, place their paws on the partner’s shoulders, or any other signal that the two decide on. This prompts the diabetic to check his or her blood sugar and do what’s needed to correct it before it becomes an emergency. The dog and the diabetic both must undergo weeks of training together so that they can work as a team.

Why were the studies done in type 1 diabetics only?

Type 2 diabetes is much more common; it’s the disorder that many acquire later in life, and can be treated with diet, exercise and medication. Type 1 diabetes is an autoimmune disorder that can occur at any time in life when a person’s immune system destroys beta cells in the pancreas that make insulin. Since people with type 1 diabetes can’t make the insulin, they need to control their blood sugar and inject themselves with insulin. That means they are more prone to large fluctuations in blood sugar.

Extremely low or high blood sugar can have frightening symptoms: shaking, sweating, blurry vision, dizziness, seizures and a fast heart rate. This is the body’s way of alerting the brain that something is wrong and the person needs to act quickly. Without immediate treatment, the person will die.

Some diabetics, however, do not have any symptoms. This “hypoglycemia unawareness” is even more dangerous. With no signal that the blood sugar is abnormal, they can’t know to take action. This is where the diabetic alert dog comes in.

How much do they cost?

The process of training and pairing with a dog can be long and expensive. Some groups breed these service dogs for a profit, and others train strays at no charge. The cost from a not-for-profit can be inexpensive or even free, but the waiting list can be two to five years long. Otherwise, a trained dog can cost an average of $20,000. Medical insurance does not typically cover this cost.

A service dog can be a wonderful asset to a type 1 diabetic’s life. Sniffing out a medical problem can’t replace regular blood sugar monitoring, but it’s a sweet and lifesaving addition.

Dr. Azka Afzal is a resident physician at the Baylor College of Medicine in Houston, Texas, and a member of the ABC News Medical Unit.

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Tero Vesalainen/iStockBY: DR. TIFFANY TRUONG

(WASHINGTON) -- Federal approval of a highly anticipated breast cancer drug was delayed by the Food and Drug Administration this week.

The drug, sacituzumab govitecan, which is produced by Immunomedics, was previously designated a "breakthrough therapy" by the FDA “based on preliminary evidence that it demonstrates substantial improvement over existing therapies for a life threatening disease.”

According to Michael Pehl, president and CEO of Immunomedics, the reason the medication was not approved for wide availability was due to “issues...exclusively focused on chemistry, manufacturing and control matters” and that “no new clinical or preclinical data need[s] to be generated.”

He added, “We are going to request a meeting with the FDA as soon as possible … with the goal of bringing this important medicine to patients as soon as possible.”

Dr. Kevin Kalinsky, an assistant professor of medicine at New York-Presbyterian Hospital and Columbia University Medical Center, led the research for the use of sacituzumab in "triple negative" stage IV breast cancer.

This cancer grows and spreads faster than most other types of breast cancer, according to the American Cancer Society.

“We call [sacituzumab] a ‘smart drug’ because it is like a GPS that hones directly to the cancer, able to deliver high doses of chemotherapy right to it," Kalinsky said.

“The response rate of other chemotherapy medications for this most advanced stage of breast cancer is often less than 20 percent when [patients] have already tried other drugs,” he added.

Kalinsky said 30 percent of cancer patients' tumors decreased in size after taking sacituzumab. The change lasted about eight months.

One of Kalinsky’s patients, Renee Seman, 41, from Long Island, New York, has had success with this innovative medication.

In 2014 Seman was diagnosed with stage IV breast cancer. She was 37 and a new mother. No other therapies were working on her cancer when she met Kalinsky.

“I responded very well to the first chemotherapy medication, but I had to stop it because I couldn’t tolerate one of the side effects -- severe joint pain," Seman told ABC News. "My daughter was 10 months old at that time and it made it too difficult to pick her up, carry her and get her in and out of her car seat. It was affecting my ability to parent."

"I didn’t want to have the side effect of that chemotherapy,” she added.

She tried several other therapies before she enrolled in a smaller trial which tested sacituzumab in people with stage IV non-triple negative breast cancer. While on it, her cancer remained stable for one year.

Seman experienced side effects of hair loss and fatigue but was still able to spend time with her family and even started running marathons while on chemotherapy. Five years later, she remains hopeful, though she did have to switch to a different chemotherapy when her cancer grew again. She is now gearing up for her 5th and 6th marathons in Tokyo and London.

Kalinksky said people on sacituzumab do not develop standard chemotherapy side effects like severe numbness and tingling in the hands and feet.

"This is called neuropathy, and it can really impact their quality of life and limit the use of these drugs," he explained. "We don’t really see this side effect with sacituzumab. They might develop diarrhea, fatigue and hair loss, but not neuropathy.”

When asked about FDA approval of sacituzumab, Seman said that she is “really excited because if it can help people like it can help me, its approval can make it available to so many people who might benefit from it.”

Although FDA approval has been delayed there are still many clinical trials available at these locations.

Dr. Tiffany Truong is a resident physician in internal medicine in Houston, and a member of the ABC News Medical Unit.

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Rhiannon Lindley(WASHINGTON) -- A woman who was diagnosed with cancer months after giving birth has received thousands of ounces in breast milk donations from fellow moms she's never met.

Rhiannon Lindley, 27, recently put a call out on her Facebook page asking for milk donations and the response "blew her away."

"It's hard to describe how wonderful it really is, all these women taking the time to feed my child," Lindley of Springfield, Missouri, told "Good Morning America." "She's strong and beautiful and healthy because of them."

Lindley is a nurse, caregiver to her brother Jesse and mom to Adelaide, 1, Ezra, 2, Madalyn, 4, and Dani, 6. She said she was diagnosed with leukemia on Jan. 26, 2018.

At the time, doctors gave her a startling prognosis of three to four months to live, according to Lindley.

"Being told I only had a few months to take care of my children, my brother and my husband, I didn't accept it," Lindley said. "But being so horribly sick...I thought I was going to die. One night I was in the hospital, I sent a video home to my children and my husband saying goodbye, which was really hard."

Lindley said she was transferred to Barnes-Jewish Hospital in St. Louis, where she received chemo until November 2018, when she was released.

Mothers cannot breastfeed while receiving chemotherapy. The drugs are dangerous for nursing babies because "they interfere with the normal, healthy division of cells in the body," according to Memorial Sloan Kettering Cancer Center.

Although Lindley is now considered in remission, she must take chemo for the rest of her life, she said. Lindley breastfed all four of her children but said she had to stop at her youngest when she started chemo.

"I know all the medical benefits to breastfeeding, but for her it's also a comfort," Lindley said. "I didn't want her to have to give that up. Being sick I tried to keep things as normal as possible for my children."

Lindley started out small by reaching out to moms in her area who donated their breast milk. Then on Jan. 8, she shared a public Facebook post in hopes of expanding on her request, writing, "She has been drinking donor milk since my leukemia diagnosis and subsequent start of chemotherapy...If you know anyone willing to donate, please connect us!"

The post was shared nearly 9,000 times and Lindley said she received thousands of ounces of milk donations.

Stephanie Payne, a mom from Phillipsburg, Missouri, said she first met Lindley in March 2018 through mutual friends.

One month prior, Payne was pregnant with a little boy whom she named Ellison Isaiah, but during a Feb. 23 checkup, doctors could not find Ellison's heartbeat. Payne was induced, but Ellison did not survive.

Payne wanted to help fulfill Lindley's request, so she donated 250 ounces of her own breast milk.

"It's such a comfort to me after [Ellison's] loss knowing that I was able to give all of my milk to her," Payne, 25, told "GMA." "That's probably been the biggest blessing is seeing her daughter grow and thrive with the help of my son."

Payne has a 3-year-old son and is expecting a daughter. She hopes to donate more breast milk to a mom in need, she said.

Lindley said she's received donations ranging from 3 ounces to 600 ounces.

"Women who have that big of a heart and care enough about my baby and my family to do that," Lindley said, "I don't even know how to thank them enough."

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noipornpan/iStock(NEW YORK) -- How is a man supposed to act? What is masculinity and when does it become toxic? And how should psychologists approach the concept of masculinity when seeing patients?

These are questions an increasing number of psychologists must consider as dialogue around toxic masculinity, sexual abuse and harassment and the #MeToo movement continues across the country.

Most recently, an ad for the razor company Gillette prompted many men to throw away their Gillette products in a defensive protest. The ad asked men to be better, to stand against toxic masculinity and stop excusing sexual harassment, bullying and fighting as “boys will be boys.”

The ad was released just days after the American Psychological Association (APA) published new guidelines that are meant to help mental health professionals with treating boys and men. They are the latest in a series of guideline updates from the APA dating back to the 1960s, and were not a direct response to the #MeToo movement.

Although the guidelines aren’t intended for the general public, they generated their own controversy after an accompanying APA article said that “traditional masculinity — marked by stoicism, competitiveness, dominance and aggression — is, on the whole, harmful.”

In a tweet linking back to the article, the APA added that these claims were supported by “more than 40 years of research showing that traditional masculinity is psychologically harmful and that socializing boys to suppress their emotions causes damage.”

ABC News spoke to Ryan McKelley, Ph.D., a professor of psychology at the University of Wisconsin and president of the Society for the Psychological Study of Men and Masculinity, the division of the APA that published the guidelines. Here's what he had to say about them:

The guidelines are not 'anti-masculinity.' The APA's view is more nuanced.

McKelley said that the APA’s tweet was viewed as a definitive stance against masculinity, when the APA actually sees masculinity as multifaceted.

“Unfortunately, when the guidelines came out, the tweet said something about traditional masculinity being harmful, and what we saw was that people latched onto that. ... It got out of hand,” he said.

Leadership abilities, confidence, assertiveness and courage. These are all aspects of traditional masculinity that are positive, healthy and pro-social in most circumstances, McKelley said. However, he also said that when these qualities are taken to their extremes -- like many other behaviors and attitudes -- they can cause problems.

Men should also be able to express their emotions more freely, he added. Those who aren’t able to might find themselves acting out harmfully.

“Rigid emotional inexpression, a rigid belief that aggression and violence are ways to solve problems or a rigid belief that you can’t show weakness or ask for help. The men and boys who adhere to these extreme stereotypical attitudes are the ones at most risk for physical, psychological and social problems,” McKelley said.

He emphasized that masculinity isn’t under attack, but also said that “in a perfect world, we wouldn’t describe traits as belonging to one gender or another, because all of these things...all humans experience [them].”

The controversy distracts from real medical and mental health challenges that boys and men face.

Men are more likely to die from cancer and cardiovascular disease than women are, and it’s likely because they aren’t seeing doctors for preventive screenings as much as women, McKelley said, noting that this could be because they are taught to appear strong and that they shouldn’t ask for help when a problem comes their way.

That same train of thought -- in which men suppress their needs and emotions -- might also contribute to the higher rates of suicide among men when compared to women in the U.S.

“That is a public health problem. Men are less likely to seek help along the way or earlier on in the process, so it becomes the last, final resort of overwhelming emotional pain,” McKelley said.

Additionally, more men are perpetrators of violence than women and men are more likely to die by murder than women, McKelley said.

“If some boys and men are socialized to respond to conflicts or extreme emotional stress by reacting with aggression and violence, that puts themselves and others at risk,” he said.

The guidelines are intended to help clinicians adapt to a variety of issues and needs in men.

They are designed to help psychologists think about men in more complex ways and talk to their clients about things they might not have been trained in or thought about before, McKelley said.

“It’s important to recognize that certain masculine traits can be helpful in some situations, but harmful in others," he said. "For example, stoicism and a tough demeanor might help someone who is in a crisis situation, like a first responder… But those same qualities can destroy a romantic relationship. We are encouraging psychologists to think about how to support men in more adaptive ways.”

Like all humans, men are complex. The guidelines, McKelley said, recognize that there are both men who have high amounts of privilege and men who are struggling, men who are overworked and men who experience consistent racial discrimination, bias and oppression.

The guidelines offer psychologists ways to “understand that complexity and open traditional conversation, or ways to think about some of the problems that men and boys face,” he said.

Many men, for example, might not realize that they have depression because of societal expectations to not talk about their feelings.

"If a man comes into my office and says, 'I don't feel right,' and he doesn't look like a classic clinical representation of depression… If I don't pay attention to other ways he might be experiencing distress, such as overworking, substance use, or irritability, I could miss the depression," McKelley said. "The guidelines say, 'If you've got a male client, here are some things to consider.'"

Although the guidelines are for psychologists, there are other organizations working to help men directly.

The Men's Story Project, founded by public health researcher and educator Jocelyn Lehrer, is an organization that uses storytelling and community dialogue to explore ideas around masculinity.

Lehrer told ABC News that she started the organization because she felt that many of society's problems, such as violence, bullying and sexual health, were being impacted by the ways that boys and men are taught about masculinity.

After meeting many boys who had been negatively affected by toxic masculinity -- both as the aggressors and as the victims -- she told ABC News that “people have to realize, they’re not alone.”

The Men’s Story Project allows men to share their personal stories with each other and live audiences and then have a group discussion about them. Representatives in the audience are also available to connect people with resources that pertain to the topics discussed.

"Masculinity is a socially made construct. People tend to learn attitudes and behaviors from peers and role models,” Lehrer said, and her organization offers opportunities for men and boys to do that.

Her organization gives men and boys the opportunity to meet role models who can teach them new ways to cope with their emotions, and she said that since she started the Men’s Story Project in 2008, many other groups have popped up across the U.S. and the world. They are making a positive impact.

One participant at the Men’s Story Project, for example, told Lehrer that the project had made him realize he wasn’t the only man having trouble understanding his masculinity. Another one told her about how he learned that “being a man” doesn’t have to be defined in any specific way.

“I learned more about gender identity and how fluid that can be,” he said, “and I learned more about what it means to be a man, and not the type of man that society has created.”

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ABC News(NEW YORK) -- The Kardashian family is known for their famous curves and there are plenty of fans who want to achieve similar looks.

So when Khloé Kardashian shared some "booty" secrets on her former blog -- crediting kettlebell weights, a boss balance trainer and The DB Method Machine for her figure -- ABC News had to investigate.

The DB Method Machine is "a booty sculptor that you can easily fold up and store out of sight??? Yassss, please!” she wrote enthusiastically to her followers.

What is The DB Method?

The DB Method is a machine that "sets the body in the correct form to do the perfect modified squat," according to the company's website.

Squats are a standard workout move that targets the glutes. The company says the device's "patented design is revolutionary because it shifts your body's center of gravity, setting your body in the correct position to activate and effectively target the primary muscle of the glutes — the gluteus maximus, the muscle responsible for a toned, tight and lifted butt."

Founder Erika Rayman told ABC News' Good Morning America that she came up with the idea for The DB Method after working with a trainer to target her glutes. Realizing there wasn’t an at-home machine for it, she said she "decided to invent it" herself.

Rayman said she designed it to build “toned legs, a lifted rounder booty and a flatter stomach.”

The DB Method can also give you a full body workout, she explained: "Not only is it a squat machine to get your dream butt, but you can use the machine to work your arms, your abs, your obliques, your chest, it’s a full body workout machine in your living room."

With just 10 minutes a day for 30 days, Rayman said you should be able to see noticeable results.

GMA Day producer Dani Kipp tried out the DB Method for 30 days.

She said she "definitely noticed a difference" and she plans to keep using the machine.

Despite Dani's results, personal trainer Mark Langowski, CEO of Body by Mark Wellness, told GMA that you can achieve similar results without buying a machine like this, which costs $299.

"It is absolutely 100 percent possible to get a great booty without the use of machines like this one," Langowski told GMA.

Langowski said squats, lunges and deadlifts will also build the muscles in your lower body. And if you want to imitate the position that the machine puts your body in, hold onto something that's fixed into place.

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zeljkosantrac/iStock(NEW YORK) -- As anyone who has ever worked in a fast food -- or any -- restaurant can tell you, the smell of unhealthy food can put you off the stuff.

Scientists have now confirmed that a great way to fight your craving for fries, pizza and other junk food is to be exposed to the smell of the stuff for a few minutes.

The study, conducted by scientists at the University of Florida and published in the Journal of Marketing Research, used a series of experiments where people of various ages were exposed to the smell of junk food -- specifically, pizza and cookies -- or alternatively, healthy foods, like strawberries and apples.

Some of the test subjects were students, and the scents were piped in through a cafeteria. Other subjects were in a supermarket.

In every case, the test subjects that got a whiff of the junk food made better choices when it came to buying food. Those who smelled the healthier stuff craved the guilty pleasures.

The findings were backed up by the same experiments conducted in a lab.  

"Ambient scent can be a powerful tool to resist cravings for indulgent foods," says lead author Dipayan Biswas, in a release. "In fact, subtle sensory stimuli like scents can be more effective in influencing children’s and adults’ food choices than restrictive policies" -- like diets or mandated healthy school lunches.

The study's authors added, "In essence, if reward structures and areas representing craving in the brain can be satisfied with olfactory inputs instead of actual gustatory consumption of unhealthy foods, this can help with fighting food urges."

In other words, if you're hungry at 3 a.m., instead of ordering pizza, try standing outside a Domino's and just inhaling for five minutes.

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Pixel_away/iStock(SADDLE BROOK, N.J.) -- Two patients from a New Jersey surgical center have tested positive for hepatitis, their attorney said Thursday.

The HealthPlus Surgery Center in Saddle Brook warned thousands of patients last month about potential exposure to dangerous infections after what it called a “lapse in infection control.”

Attorney Michael Maggiano said one of his clients is a patient who tested positive for hepatitis A and the other client is a patient who tested positive for hepatitis B. Both are a blood-borne diseases that can cause serious liver damage if left untreated. Neither strain is immediately deadly but can lead to rare, delayed health consequences.

"All of these people are suffering shame, embarrassment, humiliation, given the news they received over the holidays," Maggiano said at a news conference.

The infections may have come from the lapse in infection control. There are medical laboratory tests that can be done to help indicate whether an infection is more recently acquired or present for a longer time.

There are now at least three patients that have indicated they contracted hepatitis at the facility and that their attorneys were preparing lawsuits, though according to a statement on Thursday from a Healthplus spokesman, “No reported infection is attributable to an exposure at HealthPlus that we know of.”

More than 3,000 patients who underwent a procedure at the HealthPlus center between January and September of 2018 may have been exposed to HIV and hepatitis, the New Jersey Department of Health said last month. Officials urged them to get a blood test. Most of the 3,778 patients possibly exposed are from New York and New Jersey.

Maggiano filed a lawsuit against HealthPlus alleging negligent care but said he has not yet received a response. There are other lawsuits pending in different jurisdictions.

The HealthPlus Surgery Center did not immediately respond to ABC News' request for comment.

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Remains/iStock(NEW YORK) -- The World Health Organization (WHO) has named people who oppose vaccination among the top 10 "threats to global health" this year.

"Vaccine hesitancy -- the reluctance or refusal to vaccinate despite the availability of vaccines -- threatens to reverse progress made in tackling vaccine-preventable diseases," such as measles, polio and cervical cancer, the WHO, the global public health arm of the United Nations, said in a list released this week.

"Vaccination is one of the most cost-effective ways of avoiding disease," the WHO said. "It currently prevents 2 to 3 million deaths a year, and a further 1.5 million could be avoided if global coverage of vaccinations improved."

Vaccine hesitancy is a complex global issue; but complacency, inconvenience in accessing vaccines and lack of confidence are the key underlying reasons, according to a vaccines advisory group to the WHO.

An estimated 100,000 young children have not been vaccinated against any of the 14 potentially serious diseases for which vaccines are recommended, according to a report by the U.S. Centers for Disease Control and Prevention (CDC) published in October. Although most children are routinely vaccinated, the number of children who have received no vaccines by age 2 has been gradually increasing.

The WHO has vowed to ramp up work this year to eliminate cervical cancer worldwide by increasing coverage of the human papilloma virus (HPV) vaccine. The agency said 2019 may also be the year when transmission of wild poliovirus stops in Afghanistan and Pakistan, which are two of only three countries in the world where the highly infectious disease remains endemic and which have come agonizingly close to zero cases.

Meanwhile, polio has been eradicated in the United States since 1979 due to widespread vaccination nationwide, according to the CDC.

The WHO also deemed air pollution and climate change another top threat to global health this year. Nine out of 10 people breathe polluted air every day, according to the agency, which said it considers air pollution "the greatest environmental risk to health" in 2019.

Microscopic pollutants in the air can penetrate the lungs and enter the blood stream, damaging the lungs, heart and brain. An estimated 7 million people die prematurely each year due to exposure to these fine particles in polluted air that lead to diseases such as cancer, stroke, heart disease and lung disease, according to the WHO.

"Around 90 percent of these deaths are in low- and middle-income countries, with high volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and fuels in homes," the agency said.

The main cause of air pollution -- the burning of fossil fuels -- is also a major factor in climate change, which is detrimental to people's health as well.

"Between 2030 and 2050, climate change is expected to cause 250,000 additional deaths per year, from malnutrition, malaria, diarrhoea and heat stress," the WHO said.

Ebola virus disease, which causes an often-fatal type of hemorrhagic fever, was also on the WHO's list of 10 threats to global health in 2019.

The Democratic Republic of Congo saw two separate Ebola outbreaks last year that both spread to major cities. The second outbreak began in August in the eastern part of the nation, just a week after one in the country's west was declared over.

The latest outbreak is ongoing and has become the second-largest, second-deadliest Ebola outbreak in history. One of the outbreak's hot spots where people are infected is in an active conflict zone.

"This shows that the context in which an epidemic of a high-threat pathogen like Ebola erupts is critical," the WHO said. "What happened in rural outbreaks in the past doesn’t always apply to densely populated urban areas or conflict-affected areas."

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Rawpixel/iStock(NEW YORK) -- This year, Good Morning America is bringing you the exclusive Indie Beauty Expo's "Best in Show" 2018 winners.

Indie Beauty Expo was founded by celebrity esthetician Jillian Wright and entrepreneur Nader Naeymi-Rad in 2015 to "recognize, showcase and celebrate independent beauty brands and to support the growth and success of the entrepreneurs behind them." The expo started in New York and has since been expanded to Los Angeles, Dallas and London.

Wright told GMA her goal is to get, "better made beauty into the hands of more people at all different price points."

She also hopes the expos are a place to, "educate people on how they can upgrade their skin care and body routine without necessarily breaking the bank."

More than 280 brands and 350 products were nominated for the 30 categories, from best moisturizer to best clean ingredient brand.

The nominees were selected from those exhibited at the 2018 Indie Beauty Expo shows in Los Angeles, Dallas, New York or London.

According to the Indie Beauty Media Group, a panel of professional beauty experts evaluated the products based on, "functionality, efficacy, texture, durability, packaging, scent, ingredients, performance, design and social responsibility."

For more information on these winning products and where to purchase the full collection made up of more that $1,000 worth of products, visit Indie Beauty Expo.

BEST BAR SOAP


Winner: Level Naturals
Vanilla Activated Charcoal Bar Soap

Price: $8

Soothe your soul with the sweet and smoky sensation of warm vanilla and a deep cleanse of dark charcoal. Pure plant oils and extracts help to relax the senses while detoxing the body.

Nominees: Ari Rose™, Brother’s Artisan Oil, Cosmydor, Indie Goat Soap, The Seaweed Bath Company, Vervan, Woodlot

BEST BATH PRODUCT

Winner: HoneyBelle

Nominees: Enfusia, Holistic Hemp Company, Kanya Life, Laki Naturals, Level Naturals, Magic Organic Apothecary, Makana, Olverum, Shea Terra Organics, The Seaweed Bath Company, Verdant Alchemy

BEST BODY MOISTURIZER

Winner: Restorsea
Retexturizing Body Butter

Price: $120

Specially formulated to provide instant relief and comfort as well as intense, long-lasting nourishment to the most dehydrated areas of the body such as feet, elbows and knees.

Nominees: Ayuna, Basd Bodycare, Ellie Bianca, Kanya Life, Kreyol Essence, Mademoiselle Provence, Max and Me, Olive M, OSEA Malibu, Pistache

BEST BODY SCRUB

Winner: SpaRitual
Instinctual Sand Scrub

Price: $49

Harnessing the rejuvenating powers of Bora Bora White Sand and Volcanic Black Sand, the scrub effectively exfoliates skin, while a blend of organic Moroccan Argan Oil and Coconut Oil deliver a veil of essential moisture.

Nominees: Evolve Beauty, First Salt After Rain, Fytt Beauty, Laki Naturals, Sumbody, True Wild Botanics, Visha

BEST CLEAN INGREDIENT BRAND

Winner: Province Apothecary

Nominees: Au Naturale Cosmetics, Ayuna, Blüh Alchemy, Brother’s Artisan Oil, Ere Perez, Ethique, Fitglow Beauty, Innersense Organic,Beauty, Kaibae, Kanai, Max and Me, Pangea Organics, Shaffali, Shea Terra Organics, Tracie Martyn, YuYo Botantics

BEST COLOR COSMETICS

Winner: Ere Perez
Beetroot Cheek & Lip Tint

Price: $25

A vegan lip and cheek tint that adds a natural pop of color to your complexion.

Nominees: Ellis Faas, Fitglow Beauty, Gabriel Cosmetics, Hue Noir, Jane Iredale, Jet Cosmetics, RealHer, Rouge Bunny Rouge, Saint Cosmetics, Sarya, STARE Cosmetics, The Organic Skin Co

BEST DEODORANT

Winner: Brother’s Artisan Oil
Artisan Oil Deodorant

Price: $24

Be confident in every hot circumstance with Brothers Artisan Oil Deodorant in Jasmine & Geranium. Made with natural ingredients that truly work.

Nominees: Black Chicken Remedies, Cleo & Coco, EiR NYC, Ethique, Everyday for Everybody, Evolve Beauty, FatCo, Honestly Phresh, Kanai, LaVigne Natural Skincare, Little Moon Essentials, Smarty Pits, Sumbody, Type A, WAY OF WILL, Zatik

BEST EYE MAKEUP

Winner: Elate
Elate Cosmetics Essential Mascara

Price: $28

Whether it’s a long day at the office, an afternoon of downward dog, or a night out dancing, this is the only mascara you’ll ever need.

Nominees: Able, Au Naturale Cosmetics, Clove Hallow, Ere Perez, Fitglow, Jane Iredale, RealHer, Saint Cosmetics, Sarya

BEST EYE TREATMENT

Winner: Beauty By Earth

Nominees: Anjali MD, Blüh Alchemy, Circ cell, Herbal Dynamics Beauty, Jenetiqa, Olive M, Restorsea, Zatik

BEST FACE MASK


Winner: Apoem

Nominees: Aveseena, Cocoon Apothecary, Evolve Beauty, Herbal Dynamics Beauty, Lovinah, O’o Hawaii, Pangea Organics, Ranavat Botanics, Shaffali, Shunly, SpaScriptions, taila, Terra Beauty Bars

BEST FACIAL CLEANSER

Winner: Crave Skincare, Code of Harmony

Nominees: Alder New York, Amaranthum, Bryt Skincare, Coco Ensoleille, Emma Hardie, FREEDOM Naturals, Moss Skincare, O’o Hawaii, Sahara, Rose, Scändic, Shunly, SkinKick, Snow Fox

BEST FACIAL MOISTURIZER

Winner: Restorsea

Nominees: Amaranthum, AveSeena, Cannabliss Organic, Dr. Macrene 37 Actives Skin Results, Ethique, Herin, OSEA Malibu, Primal Dermam, Skin Dewi, Snow Fox, Venn

BEST FACIAL SCRUB

Winner: O’o Hawaii
Bird Seed Detoxifying Face Scrub

Price: $95

As the Hawaiian O'o bird would forage for wild seeds, fruits and exotic nuts, our Birdseed Detoxifying Face Scrub features a foraged collection of Hawaiian nutrients that have been formulated into exfoliation magic.

Nominees: Awake Organics, Aavrani, Blüh Alchemy, Kanai, Krisana Vigus, LANATURALE COSMETICS, Pure Nut, Seaweed Bath Company, Shaffali, SkinKick

BEST FACIAL SERUM/OIL

Winner: Dr. Macrene 37 Actives Skin Results

Nominees: Aveseena, Black Chicken Remedies, Blüh Alchemy, Carter and Jane, Code of Harmony, Dr. Wang Herbal Skincare, Everyday for, Everybody, Immunocologie, Le Prunier, Naya, Skin Authority, Skin Dewi, Sunia K., The Sunscreen Company, Undefined Beauty

BEST FOOT CARE

Winner: Way of Will

Nominees: Balade en Provence, IYOU, Parodi, Sparitual

BEST FRAGRANCE

Winner: Flora Remedia

Nominees: 18.21 Manmade, LUA Skincare, Raw Chemistry, Raw Spirit, The LyfeStyle Company, The Sage LifeStyle, Villa of the Mysteries, Zodica

BEST GYM PRODUCT

Winner: Sweat Cosmetics
Skin-Balancing Cleansing Towelettes

Price: $20

Cleanse and balance your skin on the go with these vitamin and mineral-enriched towelettes from Sweat Cosmetics.

Nominees: Alka Glam, Ducalm, EiR NYC, Hum Nutrition, Jane Iredale, Ogee, Olika, SPHYNX, Yuni Beauty

BEST HAIRSTYLING PRODUCT

Winner: Eleni and Chris

Nominees: 18.21 Manmade, ECRU, From Molly With Love, Groh, Copperhed, ikoo, Innersense Organic Beauty, LaVigne Natural Skincare, Loba, Mane, Spoolies, TruHair, Velvette Organics

BEST HAND CREAM

Winner: Elvis & Elvin

Nominees: Balade en Provence, EssenHerb, Gallinee, Karite, Lifetherapy, Mademoiselle Provence, Marin Bee, Parodi, Vervan, Yuni Beauty

BEST IMPULSE BUY

Winner: Olika
Birdie Boy Band

Price: $24.99

Birdie’s function is to help you stay clean. He is 3 inches tall and 2 inches wide. Birdie contains two level of cleaning power: a spray and wipes. Birdie is TSA friendly containing 20 mL of sanitizing liquid.

Nominees: Beauty Steep, Flickable Lip Glosses, Glamcor, Indaia, Kiss Your Cravings Goodbye, Make Up Eraser, My Magic Mud, Petitie Amie, PMD Beauty, Prana SpaCeuticals, SPHYNX, The Good Patch, The Mighty Patch, The Vanity Project

BEST INGESTIBLE

Winner: Hum Nutrition
Daily Cleanse

Price: $25

Helps clear your skin & body from toxins. Cleanses your skin, liver, bowel, kidneys and lungs.

Nominees: Hair Detox, Holistic Hemp Company, La Sirène (Marine Collagen), Ora Organic, SkinTe, The Tonik, Vital Proteins, FiTONIC

BEST LIP COLOR

Winner: Ogee
Ogee Sculpted Tinted Lip Oil

Price: $26

A silky, solid blend of organic cold-pressed Jojoba Oil and Butters that melt instantly onto lips to moisturize and nourish, with an emollient layer of beauty-enhancing, buildable natural color.

Nominees: Au Naturale Cosmetics, Axiology, CLE, CLOVE HALLOW, ECRU, Fitglow Beauty, Hickey Lipsticks, Impromptu, Luk Beautifoods, Muskaan, Nude Envie, RealHer, Saint Cosmetics, STARE Cosmetics, The Organic Skin Co.

BEST MEN'S GROOMING

Winner: Big Boy
Big Boy Beard Balm

Price: $30

The highest quality Beard Balm handcrafted in Sicily, in an Artisan Lab near Palermo.

Nominees: 18.21 Manmade, AndMetics, Brayden, Brother’s Artisan Oil, Groh, Hair Detox, Malechemy, Raw Chemistry, Vitruvian Man, Way of Will

BEST NAIL POLISH

Winner: SpaRitual
Nail Lacquer

Price: $12

SpaRitual Nail Lacquer gives your nails a classic appearance with long-wear.

Nominees: Dermalect Cosmeceuticals, Gloss Naturals, *hype nail, Karma Organic Spa, Piggy Paint, Sara Elizabeth

BEST ORAL CARE

Winner: Alka-White Mouthwash LLC.
Alka-White Alkaline Mouthwash Tablet

Price: $19.99

Rinsing and brushing with the portable effervescent tablets increases salivary pH to create an alkaline oral environment, which strengthens enamel, freshens breath, and makes teeth less sensitive.

Nominees: Black Chicken Remedies, First Salt After Rain, My Magic Mud, Pursonic, Terra Beauty Bars, The Vanity Project, VIP Smiles Dentistry

BEST PACKAGING DESIGN

Winner: Girl Undiscovered
Stumbled Across Paradise Face Mask

Price: $45

Our velvety, energizing exfoliant mask has been formulated to leave your skin blissfully radiant and renewed.

Nominees: Alder New York, Arôms Natur Skincare, Cannabliss Organic, Everyday for Everybody, Flora Remedia, O’o Hawaii, Olika, The Sage, LifeStyle, Zodica

BEST SHAMPOO/CONDITIONER

Winner: Groh

Nominees: ECRU, Eleni and Chris, Elvis Elvin, Ethique, Innersense Organic Beauty, Lena Japon, Loba Mane, Marinella, Ola Tropical, Apothecary, Sumbody

BEST SHEET MASK

Winner: When

Nominees: AVARELLE, Bawdy, Bio Republic, Eleni and Chris, Elvis & Elvin, Florapy Beauty, FROWNIES, IYOU, Kaibae, KNESKO, Knours, MidFlower, Milu, Petite Amie, Snow Fox

BEST SPF

Winner: Prep Cosmetics

Nominees: Beauty By Earth, DNARenewal, EiR NYC, Everyday for Everybody, KlenSkin, Love Sun Body, Moss Skincare, New Heights Naturals, Prana SpaCeuticals, Sara Elizabeth, UnSun, Zatik

BEST UNIQUE INGREDIENT

Winner: Sahajan

Nominees: Adsorb, Cannabliss Organic, IYOU, Kreyol Essence, Lavigne, Lovinah, Magic Organic Apothecary, Naya, Pili Ani, Restorsea, Science Serum, Temana Skincare, Venn, Zaman Skincare

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PeopleImages/iStock(NEW YORK) -- At a time when more than six million people in the U.S. have had the flu so far this season, ABC News' Good Morning America explored some apps that can help keep you and your family informed and healthy this winter.

Of course, always remember to consult your doctor if you're feeling sick and to read the fine print when downloading any app.

Kinsa

Smart thermometers have been increasing in popularity in recent years, and Kinsa is one of many currently available on the market. You have to buy one of their thermometers for $20 (it's available on places like Amazon or Walmart), but you can download the Kinsa app for free.

The app lets you build a profile for you and your family, and it allows you to track their symptoms if they're not feeling well.

You can also plug in symptoms such as cough, earache or fatigue, and it can tell you steps you can be taking to feel better.

The app is especially helpful for parents because you can plug in children's symptoms and it can offer guidance based on their age. For example, it can tell you when you should consult a doctor and give you guidance on how to soothe children's symptoms. A fever for a 1-year-old means something very different than a fever for a 10-year-old, so this app can help give your child the care they need.

Good Rx

If you're not feeling well that might mean you need to go pick up a prescription, and according to one recent study, prescription drug prices are rising faster than inflation rates in the U.S.

Good Rx is an app that can help you save money by finding the cheapest options out there for the drugs you need.

For example, the app can help you find a generic version of common drugs such as Tamiflu, possibly saving you more than $100.

The app is free to download.

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South_agency/iStock(NEW YORK) -- On Monday, police in Mankato, Minnesota, responded to a report of a 2-year-old who was found in the middle of the road and still strapped to a car seat. The child, who was uninjured, was properly fastened to the car seat, but the car seat was not properly installed inside the vehicle, the city said.

Placing a child in a car seat correctly can help decrease the risk of death or serious injury by more than 70 percent, according to nonprofit child safety organization Safe Kids Worldwide and the American Academy of Pediatrics. But installing the car seat properly is equally as important as safely strapping a child in, according to Lorrie Walker, a technical adviser at Safe Kids.

"It's the whole package," Walker told ABC News' Good Morning America. "It's just as important to have the car seat installed correctly in the car as it is to have your child placed and harnessed into the car seat correctly. They work together."

Here are the car seat checkup tips to ensure your child is properly protected, according to the American Academy of Pediatrics (AAP):

Ensure your child's car seat is facing the right direction


In 2018, the AAP issued new car seat safety guidelines encouraging parents to keep their children's car seats in the rear-facing position until they have reached the manufacturer's height or weight limits in order to protect their developing heads, necks and spines in the event of a crash. Previous guidance for rear-facing car seats was age 2.

When a child has outgrown the rear-facing weight or height limit for their car seat, the child should then use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by the car seat manufacturer.

Dr. Benjamin Hoffman, lead author of the AAP policy statement and chair of the AAP council on injury, violence and poison prevention, said that car seat manufacturers now produce seats that allow children to remain rear-facing until they weigh 40 pounds or more, "which means most children can remain rear-facing past their second birthday."

When a child's whose weight or height is greater than the forward-facing limit for their car seat, parents should use a belt-positioning booster seat until the vehicle seat belt fits properly, "typically when they have reached 4 feet 9 inches in height and are 8 through 12 years of age," according to the AAP.

Children should remain in rear seats until the age of 13, the AAP added.

Use LATCH or a seat belt to secure a car seat inside a vehicle

LATCH (lower anchors and tethers for children) is an attachment system that can be used instead of the seat belt to install a car seat. LATCH can be found in nearly all car seats and passenger vehicles made on or after Sept. 1, 2002.

Parents may use LATCH or a seat belt, but Walker said to choose "one or the other" and remember to take your time.

"They're both equally safe, but sometimes you find when you do the installation [one over the other] has a tighter, better fit," she added. "That's the one to go with if it works for your car, car seat and child."

Properly installing the seat

The reality is, and Hoffman agrees, installing a car seat isn't the easiest task.

"We know that over three-quarters of car safety seats are installed with critical errors that may impact the way the car seat works and lead to increased risk of injury for children," Hoffamn told GMA Wednesday. "We know that over 95 percent of families leaving hospitals with newborns also make serious mistakes. This is not the family’s fault, as I said, car seats are hard."

To use LATCH, the AAP advises fastening the lower anchor connectors to lower anchors located in between where the back seat cushions meet. All lower anchors are rated for a maximum weight of 65 pounds, or the total weight of the car seat and child. As always, check the car seat manufacturer's recommendations or car seat label for the maximum weight a child can be to use lower anchors.

Following your car seat's instructions, pull LATCH strap tightly, applying a significant amount of weight into the seat. The same should be done if using a seat belt.

The top tether from the car seat improves safety provided by the seat, the AAP says. Use the tether for all forward-facing seats and check your vehicle owner's manual for the location of tether anchors.

Always follow both the car seat and vehicle manufacturer instructions, including weight limits, for lower anchors and tethers. Weight limits are different for different car seats and different vehicles.

After the car seat is installed, it should not move more than an inch side to side, or front to back. If the car seat shifts, it's not tight enough.

"We want the car to do most of the work in terms of absorbing all of the force in a crash," Hoffman said. "A loose car safety seat will transfer more of that energy to the child, and the risk for injury will go up."

"Each seat in each vehicle are a little different, and there are tricks that can be learned to achieve a tight installation regardless," Hoffman added. "One check that I will often use is to put my knees on the seat and press it into the cushion as I’m tightening either the vehicle seat belt or the lower anchors."

If you install the car seat using the vehicle's seat belt, make sure the seat belt locks to keep a tight fit. Check your vehicle owner's manual and car seat instructions to ensure you are using the seat belt correctly.

On their website, Safe Kids Worldwide offers an ultimate car seat safety guide complete with car seat buying tips, safe installation tips and more. All the information is based on your child's age and weight.

Strapping in your precious cargo

While buckling your child into their car seat, test that the harness is snug enough where you cannot pinch any slack between your fingers and the harness straps over your child's shoulders.

The harness chest clip should be placed at the center of the chest and even with your child's armpits.

The fire station myth

Walker said many parents may have heard the rumor that every fire station knows how to properly install a car seat into a vehicle, but that's not always the case.

Walker said it's important to ask each facility if they have Child Passenger Safety Technicians (CPST) who are certified by the National Highway Traffic Safety Administration (NHTSA) to properly install a car seat. Certified technicians can sometimes be found at fire stations, hospitals, GM dealers, police stations or Safe Kids events, according to Walker.

Know your car seat's history

Both Walker and the AAP say not to use a car seat if you don't know its history.

Walker said that when a car seat has been involved in any sort of crash or collision, it needs to be replaced to ensure it'll meet all safety standards.

"Do not use a car seat that has been in a crash, has been recalled, is too old (check the expiration date or use 6 years from date of manufacture if there is no expiration date), has any cracks in its frame or is missing parts," the AAP states on its website.

You can find out if your car seat has been recalled by calling the manufacturer or the NHTSA vehicle safety hotline at 888-327-4236 or by going to the NHTSA website at www.safercar.gov.

Read more about the AAP's car safety guidelines for children here.

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Cn0ra/iStock(NEW YORK) -- A few weeks into January can be a time New Year's resolutions starts to die.

People are no longer saying "happy New Year," the reality of being back at work and school has sunk in and it's easier to grab a glass of wine than go to the gym or write in your journal.

If you find yourself in that grind, there are four things you can do to reset your 2019, according to Dana Cavalea, author of Habits of a Champion.

Cavalea trained some of the world's top athletes, including Derek Jeter, Alex Rodriguez and Mariano Rivera, in the 12 years he spent as the New York Yankees' performance coach.

He learned goal-setting from the very best, including that you don't have to make it complicated.

Here, in his own words, are Cavalea's four tips to make 2019 your best year yet:

Tip #1: Connect your goal to something bigger

Resolutions almost never work without a true commitment to something greater than vanity goals like making X more money or losing that 10 to 20 pounds you most desire.

You must create links and associations to those goals you desire.

Meaning: I am sluggish and tired most days. I am tired of being sluggish and tired since I know it is costing me my raise at work, the desire to exercise and get fit and the energy to play with my children.

So, if I start eating well, exercising even 20 minutes each day and drinking more water, I will then not be sluggish and tired most days.

This translates consciously and subconsciously, too: By taking care of myself each day, I will have more energy, and as a result, I will work harder, be more productive, feel healthier, get that raise and lose that stubborn 20 pounds.

Just saying you want to lose weight or make more money and not connecting it to anything bigger never works. You must always link your goal to something bigger than just you.

Tip #2: Focus on one goal

We can only focus on one goal and one to two actions at a time max.

For example, say your singular health goal is, "I want to lose 10 pounds over the next 90 days."

Action one is, "I am going to do cardiovascular exercise Monday through Friday for 20 to 30 minutes before work."

Action two is, "Monday through Friday, I will not eat starch and sugar-based carbohydrates like bread, muffins and baked treats."

After 90 days, you will continue doing what you have been doing for your physical health goal, and use the same process again to work on your next set of goals (possibly career, business, family, relationships or faith).

Tip #3: Start with a health goal

I always believe in starting with health goals because if you feel better and look better, you will have the energy and excitement to do more. You will feel so energized and proud of yourself that you will be ready to take on the next set of goals.

Remember, nothing happens over night. Stay patient. The results will showcase themselves with consistent behaviors.

Tip #4: Remember these 4 steps

These are the steps that will take you places you have been dreaming of:

1. Plan for success by determining what it is you most desire and creating clear associations and action steps.

2. Schedule your daily actions (similar to the above example where Monday to Friday you will do your morning cardio and stay starch and sugar free).

3. Do it. Take action on those action steps daily. Do not miss your scheduled action. If something comes up and you have to miss it, make up for it on the weekend. Without consistent action, you will never form the habits you need to become a true goal-setting, resolution achieving champion.

4. Celebrate it. Not just the big victory, but each day that you take action. We love rewards. For many of use, just telling ourselves we did a great job and stuck with the plan is enough. We have to be our biggest fan. Celebrate the process, since the process gets us closer each day to our desired outcomes.

Apply the steps above, along with patience and daily celebration, and you will be surprised how exciting it is to win 2019.

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WoodysPhotos/iStock(NEW YORK) -- New court documents from the Massachusetts attorney general claims to offer proof that the family that owns the company that makes the powerful opioid drug OxyContin was behind years of efforts to deceive doctors and patients about the safety of the drug and increase profits.

The Sackler family, owners of Purdue Pharma, the company that makes OxyContin, “made the choices that caused much of the opioid epidemic,” according to a court document filed by Massachusetts Attorney General Maura Healey.

The Sacklers “directed deceptive sales and marketing practices” at Purdue Pharma for more than a decade and “are responsible for addiction, overdose and death that damaged millions of lives,” the documents say.

Purdue Pharma did not immediately respond to ABC News’ request for comment.

However, in a broader statement, it called the accusations “biased and inaccurate characterizations” of the company and its executives, and said that it would “aggressively defend against these misleading allegations."

“In a rush to vilify a single manufacturer whose medicines represent less than two percent of opioid pain prescriptions rather than doing the hard work of trying to solve a complex public health crisis, the complaint distorts critical facts and cynically conflates prescription opioid medications with illegal heroin and fentanyl,” the company said.

More than 11,000 people in Massachusetts died from opioid-related overdoses in the past decade, and over 100,000 people survived overdoses that were not fatal, “but still devastating,” the documents say, blaming Purdue and other drug companies. Nationally, opioid-related overdoses killed 72,000 people in 2017, according to the National Institute on Drug Abuse.

Several executives at Purdue Pharma pleaded guilty in 2007 to misrepresenting the dangers of OxyContin but the Healey’s lawsuit directly implicates members of the Sackler family. The Sacklers weren’t personally accused of any wrongdoing in that lawsuit.

The lawsuit was filed in June last year but the newly filed documents quote Richard Sackler — the son of the company’s founder — boasting about a “blizzard of prescriptions” at an OxyContin launch party, despite warnings from a Food and Drug Administration official and the drug’s inventor about the need for controls.

“The prescription blizzard will be so deep, dense and white,” he said, according to the court documents.

Years later, evidence of the growing abuse of OxyContin began to surface, according to the lawsuit. A sales representative for Purdue told a reporter that they were directed to lie about the drug. Another sales rep pleaded with Richard Sackler after attending a community meeting at a local high school in January 2001, where mothers spoke out about their children who had overdosed. And a month after that plea, the documents say, a federal prosecutor reported 59 deaths related to OxyContin in a single state.

In response to the mounting evidence, Richard Sackler advised blaming the addicts.

“We have to hammer on the abusers in every way possible,” the lawsuit quoted Sackler as writing in an email. “They are the culprits and the problem. They are reckless criminals.”

From 2007 to 2018, the Sacklers doubled down on pushing for increasing sales, according to the documents, directing sales reps to visit the most “prolific prescribers” and to encourage them to prescribe more of the highest doses of the drug to gain the most profit. They also allegedly studied “unlawful tactics to keep patients on opioids longer.”

Richard Sackler even went into the field to promote the drug to doctors with sales reps, a level of micromanagement that led the vice president of sales and marketing to write to the CEO of Purdue.

“Anything you can do to reduce the direct contact of Richard into the organization is appreciated,” they wrote, according to the documents.

The attached court filing represents the first evidence presented by the attorney general to tie the Sackler family to Purdue Pharma’s campaign of deception. There is a hearing on Jan. 25 to eliminate the remaining redactions.

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