For people whose signs are almost related to exercise, use of an inhaled Beta-agonist, or cromolyn or nedocromil shortly before exercise may help prevent signs. A warm-up period of low to moderate intensity before vigorous exercise can also help. When exercise symptoms are accompanied by symptoms at other times of the day, treatment should be aimed at achieving better overall asthma control, rather than focusing exclusively on the exercise symptoms.

Exposure to cold air and low humidity, which increases heat and moisture loss from the airways, can cause exercise-induced asthma. Other things that can provoke asthma with exercise are nasal blockage, which prevents air from being humidified and warmed in the nose. However, many asthmatics have found that with proper training, care and prescription drugs, they are able to excel at any sport. Drugs administered before exercise, such as metaproterenol, albuterol, terbutaline, nedocromil and cromolyn sodium.

For years, asthmatic children and adults were barred from sports or vigorous activities. Still, some sports can be dangerous for some people with asthma. Scuba diving can be risky. Poorly controlled asthma increases the risk of lung rupture (pneumothorax, or air embolism) while scuba diving, which could have disastrous consequences, including death. But people who have normal lung function and no asthma symptoms can probably scuba dive with little risk. Discuss this with your doctor if you have further questions.

Organize a weekend or evening event where all of your committee members are on-hand to answer questions and provide services. You can do this as a health fair where each physician/committee member is assigned a table and the community can visit, get information, receive free screenings for each specialty, etc. Or, you can create a lecture format with committee members as a panel. You begin asking a few questions, and soon the audience will begin to ask, too.

Invite press and community leaders to these events via specific invitations.

Invite community members via free calendar listings in local papers, paid advertisements, flyers in key locations (supermarkets, libraries, schools, etc.) and promotion materials in committee members’ offices.

While an advisory committee may seem like a lot of work in the beginning, you’ll find the results are worth it. You’ll find that you are seeing new members who may not have considered your facility as an option before; you’ll be called to more community meetings to talk about fitness; you’ll get referrals from all sorts of places; you may even help to convince local corporations and insurance companies to reimburse your members for their dues since they are much healthier than those who do not exercise regularly.

Reader’s Comment: “According to Jed, Jake and Penny had net duty and they apparently lost it on purpose to set Jed and Robb up.”

Follow-up: I read a transcript of Jed’s Early Show interview. The reader is right (but I saw no mention of the set-up). Jed stated that it was he and Robb that dragged the net out, but that the tribe members were going to take turns watching the net. He said Jake and Penny were in charge of watching it after him and Robb and that Jake and Penny were the ones to take a nap and leave the net unwatched.

So, according to Jed, he and Robb didn’t lose it; Jake and Penny did. But Shii Ann clearly thought it was Jed. And Penny sure did a good acting job when Jake told her and Erin that the net was lost.

Unfortunately, the cameras and the editing could’ve showed us exactly what happened and who was responsible for the net. Instead, I guess they’d rather the viewers continue to speculate.

So allow me to review. Robb and Jed, and quite likely the entire Tribe Skateboard, thought that it would be a good idea to drag the net out into the water – this net which had little floating buoys on it – and take a long nap, trusting that the waves and the undertow and the constant movement of the ocean would just leave it where they dropped it off.

And then, in a classic Survivor cameraman/editing moment, as Jed leaves the water unsuccessful in his search, the camera pans up directly behind him to show the net less than 50 yards out. Another shot of the net from above shows it floating peacefully away to a new life of freedom. The fish all wonder if God put it there as some kind of sick joke.

Satcher, who made his comments during a press briefing before addressing the Cleveland City Club, said he also anticipates an increase in suicide attempts and suicides as a result of the attacks. Moreover, he said that responding to this mental health challenge would be difficult for the public health service because mental health services are “a major weakness in the public health system.”

Satcher said the Oklahoma City bombing and the bombings of embassies in Kenya and Tanzania serve as examples of what can be expected after the September 11 attacks. A year after the Oklahoma City bombings, he explained, “there was a significant increase in substance and spousal abuse, divorce and, yes, suicide among rescue workers there.”

He headed up a team of medical specialists who traveled to Kenya and Tanzania to help survivors of the embassy bombings. The team included a psychiatrist who had worked with the Oklahoma City survivors. In the time since, Satcher said, “the one person called back most often is the psychiatrist.”

Touching on bioterrorism, Satcher said that the past two months have provided a unique challenge to the Public Health Service and especially to the Centers for Disease Control and Prevention (CDC).

He admitted that CDC epidemiologists are learning as they go. The teams have fought disease outbreaks all over the world, he added, but the anthrax attacks “are some place that we have not gone before.” That lack of experience led to some initial missteps, Satcher noted, including the assumption that anthrax could not “spread from a sealed envelope as it passed through the postal system. Now we know we were wrong.”

Vardenafil without a prescription it is relatively modern rx medication applied in the cure of erectile dysfunction in men. Patients taking Vardenafil hcl have reported about increased libido and achieving harder erections.

(Note the words, “delegate my duties” which means I told other people to do my work because I’m a lazy-ass. Also notice the downplaying of nap to a “little” nap, thus trying to make it seem like napping wasn’t such a big deal.)

“Me and Robb walked around the beach and searched for it. Basically, whoever last was watching it didn’t delegate off duties and let it drift away.”

(Hmm… The super-sleuth rubs his chin… the repeated use of the word “delegate” raises suspicion…)

Robb continues to live up to his reputation, “We figured if we left the net out of awhile, we may catch some fish and we might eat and feel good. Well, the damn net floated away. We don’t know where the net is!”

The mystery is, who, in addition to Robb, was responsible for the net. Jed said that “whoever last was watching it,” which tells me that maybe it wasn’t him. But being that he and Robb were the most concerned about it being gone…

Let’s ask Shii Ann, “Those boys took the fishing net out.” She changed her voice to dopey mocking, “We’re going to leave it out in the ocean for hours and hours.” And then she solves the mystery, “Because Jed was asleep and unwilling to get up, the fishing net… went bye-bye.”

This is so alliance dude. And Robb refuses to understand the concept of personal responsibility. “The damn net floated away,” as if the net did it all on its own.

Robb is so entirely sitcom. This is exactly something Gilligan would do. Someday, I want to write a sitcom and like most sitcoms I’ll have a duphus. What I’ll do is simply hire Robb to just be there. I won’t have to write anything. Instead, I’ll ask, “OK Robb, what would you do in this situation?” Chances are it’ll be funnier than anything I could come up with on my own.

The Guaranteed Perfection program was created to give the facility “a system to consistently evaluate their personal trainers and their fitness protocol one workout session at a time,” explains Livingston. In addition, it provides clients with a checklist to measure the facility based on each workout.

The program utilizes a 12-point system of evaluation, which includes such factors as beginning each session on time, performing a warm-up, demanding strict adherence to proper form, not interrupting a training session except for emergencies, following personally prescribed routines, encouraging fluid intake and educating the client on at least one fitness or nutritional fact each session. If one of the 12 points are not met, the client is guaranteed his or her money back.

Livingston emphasizes that the facility’s clients are mostly 35- to 55-year-old, health-conscious professionals who understand that quality is the only true value. “Before a client begins to train with us,” explains Livingston, “they know what to expect from each workout session.

Even though some of these points are subjective, we trust our clients to judge our performance fairly.” An average of 1,600 personal training sessions are performed per month, says Livingston, with fewer than 10 rebates, most of which are given for starting sessions late.

“We believe that any guarantee in the fitness business is rare, especially personal training,” adds Livingston.

Derrick Thomas, the lightning-quick linebacker for the Kansas City Chiefs, was driving two friends to the airport last weekend. The weather was treacherous and Thomas lost control of his car. The car skidded onto a median and, according to the Missouri Highway Patrol, flipped over at least twice.

One passenger, Michael D. Tellis, was thrown from the car and died at the scene. Thomas was critically injured — his spine fractured in two places and his legs paralyzed. The third occupant of the car, John C. Hagenbush, walked away from the accident with minor injuries.

The factor that determined the extent of injuries in this accident?

Seat belts. Hagenbush was wearing his. Thomas and Tellis were not.

This example is reminiscent of another celebrity accident more than two years ago: When Princess Diana’s car crashed in that Paris tunnel, only one of the four people in the car — the bodyguard — survived. He was the only one of the four wearing a seat belt.

These examples are vivid and convincing — and the media deserves substantial credit and praise for calling attention to the seat belt factor when reporting about injuries and death in highly publicized car crashes like these.

American consumers’ seat belt use has increased dramatically since auto manufacturers first introduced this life-saving technology in the l950s. Back then, seat belt use was very low — about l0 percent to l5 percent. During the l980s and l990s — with many states passing mandatory seat belt laws and public advocacy for seat belt use escalating — the percentage of users went way up. The most recent national data indicate that nearly 70 percent of Americans now regularly fasten their seat belts in passenger cars. But clearly there is room for improvement.

Do you know a friend, colleague or relative who does not use seat belts regularly? Perhaps they even brag about it, claiming that they don’t really need them or that they are not going to let “public health nannies” make decisions for them. If so, tell them the tale of Derrick Thomas and his two passengers. You may just end up saving a life.

When you, your family need a cheap and safe industrial first aid cabinets and useful survival info, you have come to the best store. Discover everything about accident, medical emergency, first aid.

As equipment for measuring oxygen consumption becomes more automated and user-friendly, it can be used in clubs to offer the utmost in cardiovascular assessment and prescription techniques to members. Some systems feature integrated ECG analysis, allowing clubs affiliated with hospitals or clinics to offer a full graded exercise stress test. Since many clubs now hire graduates of university exercise science programs, they have trainers who can use these sophisticated testing devices.

These assessment systems can be grouped into three categories: stationary, portable and hand-held formats.

Stationary. Traditionally, oxygen consumption testing is performed using laboratory instruments that are connected to the client via a cable or breathing tube, while the test subject exercises on a treadmill or stationary bike. Club members who might be interested in such a test include members looking to achieve a personal best in a sports event, members who wish to optimize their training, triathletes, marathon runners, and participants in clubs and youth programs such as running, swimming and tennis teams.

With the right staff, equipment and expertise, your club can be the high-performance training center that these types of members are looking for. While the immobility of stationary laboratory equipment is somewhat limiting, especially if you want to use the equipment in multiple locations, it does provide a repeatable measure of fitness in a stable environment with standardized protocols. Equipment prices vary from $10,000 to $50,000, depending on features and technology. And you could charge members for such a service, which could eventually pay for the equipment and create a profit center for your club. Assess the equipment’s ease of use before buying, as some software and hardware systems are more user-friendly than others.

Portable. More recently, technological advances have resulted in portable equipment for VO2 analysis. These systems offer more versatility, as they can be used in a lab setting, on the club floor and for assessing real-life activities, indoors and out. Portable systems generally are most useful with wireless transmission of data, meaning that members can move about freely without being connected by wires to the computer display. Imagine having the capacity to test members not only while stationary, but while they are performing the activities they enjoy, such as aerobics, swimming, roller blading, etc. With this equipment, you could show your members exactly how many calories they are burning while they are exercising. This type of technology allows fitness professionals to take the guesswork out of fitness programming.

Portable systems have the same features as stationary systems, with the added advantage of being small, lightweight and transportable. They are also a great choice for clubs that have multiple locations, as it makes sharing equipment possible. These systems fit into a briefcase and weigh less than 1 pound when attached to the test subject.

Prices range from $10,000 to $40,000, depending on features and technology level. Lower-priced systems may sacrifice accuracy and features, but they may be the only choice for clubs on a limited budget. But beware, this is a product where you get what you pay for.

Hand-held. These smaller, hand-held metabolic measurement devices are geared toward the weight-management market in health clubs. The devices monitor members’ unique metabolism — the number of calories they use at rest. Resting metabolic rate (RMR) is the foundation for determining what additional caloric expenditure (exercise and activities of daily living) is needed (when compared to caloric intake) to achieve the desired weight goal. The device helps to make weight management more easily achieveable by making it a basic arithmetic relationship. With the device, members can regularly monitor their RMR, which can change dramatically over time as a result of weight loss, training, etc.

The devices are easy to use and features disposable hygienic masks that attach to a hand-held measuring unit. While at rest, members breathe into the device for five to 10 minutes, and then their RMR is displayed. With this information, members and a personal trainer can calculate the additional caloric expenditure needed to achieve a negative caloric balance, which yields weight loss.

When members rely solely on the estimated caloric expenditure displayed on the consoles of most club equipment, they are missing RMR data. RMR is a key piece of information, currently not available to club members, that can enhance weight-management success.

This Christmas you can make the task easier for your friends and family by giving them gifts to improve and protect their overall health.

Know someone who spends all day at the computer? Why not make sure they’ve got the gear — ergonomically correct mousepads, keyboards and headsets — they need to avoid repetitive stress injuries.

Is your daughter going off to college? Don’t let her leave home without an emergency car kit. Maybe mom would enjoy an eye mask to relieve sinus pain. And the sporting fan in your life would undoubtedly appreciate a specially designed stadium chair to provide back support during those long games.

A socially conscious friend may appreciate a $20 donation in his name to World Visions, which would pay for immunizations for a child in India, or a gift certificate to a store participating in America’s Second Harvest’s program to eliminate domestic hunger.

In other words, “healthy gifts no longer have to be the generic gym membership,” said Tracy Morgan, a former coach and personal trainer.

Alternatives to the Gym Membership
Of course, that doesn’t mean you shouldn’t buy gifts to get your friends and family moving. “But it’s important to give them some type of commitment along with a fitness gift, because that is what is really going to motivate that person,” said Morgan, who serves as director of the Cybex Institute, a manufacturer of strength and cardiovascular equipment.

Morgan, for example, is giving a set of dumbbells and workout bands to a friend, along with two sessions with a personal trainer to teach her how to use the equipment.

But your gift doesn’t have to be as structured. It can be as simple as a homemade gift certificate promising to treat a friend to coffee after the two of you finish a walk through the neighborhood, said Susan Adams, a registered dietician and spokeswoman for the American Dietetic Association.

“Instead of thinking of exercise as the gym, you have to think of ways to build it into your everyday life and ways to make it fun,” said Adams, who added that she would much rather be given a gift of dance lessons than workout equipment.

That’s true of many people, Morgan says. “You should think about what the person likes to do or has always wanted to learn to do. If they enjoy doing something they’re a lot more likely to stick with it — they’ll be getting their exercise and having fun doing it,” she said.

For example, tennis or swimming lessons can make great gifts. Or maybe you know someone who wants to learn to rollerblade — buy them a pair of inline skates and tuck information inside the box about when a local rollerblading group is planning its next outing. Get the whole family involved by giving a gift of hiking gear and yearlong passes to state or national parks.

To say we should all have been vaccinated already seems like pointless harping, sort of an I-told-you-so approach. It’s certainly true that a better-planned approach to vaccination would have forestalled this outbreak (and it is not too late to get your flu shot). But one issue remains clear: Only a small fraction of those who should be vaccinated will be.

A recent study, conducted by Ipro, a quality-assurance monitoring group, found that only 30 percent of New York City Medicare patients had been immunized in 1998, an astoundingly low number, considering the shot is fully covered by Medicare. In other words, it is free. This means that both private-care and government health providers are not doing an effective job of vaccinating those who need to be vaccinated. If these same numbers held for children’s immunizations, it would not be tolerated. Why should it be so for the frail and elderly?

How can this pattern be remedied? As Dr. John Quinley, clinical coordinator of Ipro, points out, “Family doctors should explain the benefits [of being vaccinated] to those who come in for unrelated care. … Strategies that have made childhood vaccinations such a success could be adapted for adults. Public and private senior centers could be used to inoculate the elderly.”

Some people even believe that getting a flu shot can give them the flu, thus they avoid getting one. Public health authorities, as well as community healthcare providers, should aggressively counter such misinformation. Only then will the next flu epidemic be mitigated.

But no one in public health circles recommends that everyone get immunized. Certainly, all those over 65 should do so, as well as anyone with a chronic disease that makes them more susceptible to infection, including those with heart, kidney or (especially) lung problems.

In some countries, all healthcare workers are offered influenza vaccination as part of a plan to reduce the toll of flu-related death among the elderly in hospitals and nursing homes. A study in this week’s The Lancet demonstrated that such vaccination significantly reduced all-cause mortality among the residents of those institutions whose staff was offered the vaccine.

This approach has the potential to make a serious impact on flu-related deaths, because the large majority of such cases are in the elderly. Influenza’s yearly death toll is at least 20,000, and pneumonia adds another 45,000. Pneumonia often follows the flu in those with weakened immune systems.

While there are cheap drugs available to reduce the duration and intensity of illness, they must be taken within 48 hours of the onset of symptoms and must be prescribed by a physician. And the newer drugs are expensive. These drugs may play a role in preventing institutional epidemics someday. For now, the message remains the same: Get your flu shot before the flu gets you.