Responsibility for Treatment Compliance | World of Psychology

Responsibility for Treatment ComplianceOne of the most difficult challenges to overcome when dealing with a mental illness is the temptation of the excuse.

With a psychiatric diagnosis comes an excuse for everything. Any bad behavior, lack of motivation, or failure can be passed off as a symptom or the result of an episode. The excuse is always available. Don?t take it.

No one?s asking you to take responsibility for having a mental illness. That?s not your fault.

But you have to take responsibility for your actions and for your recovery. Sure, unexpected things happen as a result of serious mental illness, but most of our behavior is within our control, or at least our influence. And the behavior that most influences our wellness is treatment compliance.

If you have a treatment regimen that works, stick with it. If you had one and left it, get back on it.

While many of us bemoan the fact that we?ll never be well, treatment success rates for mental illness are very high. The National Institute of Mental Health has shown success rate of treatment for schizophrenia of 60 percent, depression, 70 to 80 percent, and panic disorder, 70 to 90 percent.

Compare this to treatment success rates for heart disease of only 45 to 50 percent. But treatment only works if the patient complies with the doctor?s orders. So take your medicine as directed, stay away from non-prescribed drugs and alcohol, exercise, sleep, and eat well. Manage stress. Chances are you will get better. But you?ll lose your excuse. Then you?ll have to start taking responsibility for your actions.

Responsibility brings a sense of control. This is important because one who feels he has control over key aspects of his life is most destined for success and well-being. If all things that happen to me, or if my very own behavior, is beyond my control, why should I bother?

But if prescribed treatment brings me a measure of control over events and my behavior, then I can positively influence what happens to me and those I love. I?ll have to get out of bed, get off the disability insurance, go to work, and suffer the challenges that everyone faces. Life may even be a bit more boring. But I can contribute, connect with others, and work toward dreams I may have long ago abandoned. Yes, this can be very hard. I may have to deal with side effects and limitations. I may have to say no when I want to say yes. And compliance can be costly. But wellness is possible.

Unfortunately, access to treatment is not available to everyone. Finding a correct diagnosis and a successful treatment regimen can take years.

But if you have access to treatment, you have a responsibility to work with doctors, counselors, social workers, and any family and friends available to help you to find a successful treatment regimen. And then you have a responsibility to stick with it. Health can be more challenging than illness, but the life that results is always more satisfying.

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George Hofmann is a mindfulness meditation instructor teaching people with mental illness how to manage stress. He also has bipolar disorder 1. He writes about these topics at http://practicingmentalllness.blogspot.com.

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????Last reviewed: By John M. Grohol, Psy.D. on 6 Jan 2013
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APA Reference
Hofmann, G. (2013). Responsibility for Treatment Compliance. Psych Central. Retrieved on January 7, 2013, from http://psychcentral.com/blog/archives/2013/01/06/responsibility-for-treatment-compliance/

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Source: http://psychcentral.com/blog/archives/2013/01/06/responsibility-for-treatment-compliance/

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Six Hidden Windows 8 Features You Can't Live Without

Windows 8 can take some getting used to. While the desktop app works very much like Windows 7, there are plenty of new shortcuts, options, and tricks built into the operating system. Think you know how to use it like a pro? Here are a few Windows 8 features that you probably haven't found yet. More »

Source: http://feeds.gawker.com/~r/gizmodo/full/~3/fOUh__TgPIw/six-hidden-windows-8-features-you-cant-live-without

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RolePlayGateway?


Background

It's the classic motorcycle club tale-- it's '76 in the town of San Ramon, California, population 19,000, where a Vietnam war vet and a few of his old war buddies, united in their mutual love of the open road, rock'n'roll, and the roar of the engine, come together as architects of a new movement. Christened the Burning Steel MC, their only concerns in those early years was to ride, live, and be happy. And all was well in those first ten or so years-- they rode, they lived, and they carved their own lives out in the quiet little town of San Ramon. Found love, settled down some, made families. The founder himself met the woman of his dreams, and in the mid eighties had his first son. Not a few years after, the second followed. All was well for the Burning Steel Motorcycle Club as it burgeoned, expanded, accepted new members of the family they were building.

But the times were changing-- and that change fell hard on little San Ramon, located unobtrusively near the border of the Mexican-American border. Towards the end of the eighties, San Ramon suddenly found itself a hotspot of crime-- a choice stopping point for the burgeoning drug trade funneling in from South of the border, and a convergence point of rising crime levels throughout the area. The town's police department simply fell apart in the face of an unprecedented challenge, unaccustomed to anything much worse than the occasional public or domestic disturbance; those officers who weren't killed in the coming years buried themselves firmly into the pockets of the gangs and syndicates that began to move in, hoping thusly to escape the crossfire, to escape with their lives-- perhaps even to make it out of the chaos with a buck or two in their wallets for the trouble.

Burning Steel would have none of it. This was their town, their home, and their family, and they weren't about to lie down and accept this. Nor were the gangs going to make it easy on them.

It was nothing major at first-- some intimidation, some coercion, whatever the Steel could do to peacefully dismantle the situation. They weren't ready, the club president decided, for open confrontation with the gangs-- not yet. He wanted to explore peaceful avenues before embroiling the town in any more violence than it was already experiencing. The gangs saw this, got a good chuckle or two out of it, and decided the Burning Steel were a doormat and they were gonna walk all over them just to prove the point. And they started it off, one foggy morning in January of 1990, with the kidnapping and murder of the wife of the president.

That was the day the Burning Steel declared war on any violence, any drug trafficking, any gang activity, anything they didn't approve of, in their San Ramon.

Securing firearms and weapons from trusted outside sources, the club, the upper echelons composed of hard-boiled veterans of war, hit back, and hit back hard. It was a year of grueling violence and warfare before eventually, the Steel drove out many of the gangs, many of the traffickers, restored order to the town... and control.

But that's not what this story is about. That's all just background-- history, if you will. Since then, the Steel's taken it upon themselves to protect their homey little town of San Ramon, keep it safe when the law fails to do its duty, as it all too often does. The two brothers born to the club president have grown into men themselves, taken up their father's love of the motorcycle, and made their own names in the Burning Steel. It was a tale much like you see everywhere-- they never really got along. The elder brother was a wanderer, a rebel, a fighter at heart-- he was never happy unless he was fighting something, never content unless the blood was pumping in his veins, and he became violent and uncontrollable. The younger took after his father-- an even-tempered man, prone always to opting for the peaceful option-- an idealist, believing firmly in the good of people in general. It's not to say the younger was always a saint and the older was Satan incarnate-- things are never so black and white-- but they were simply never going to get along. The younger liked vanilla ice cream, the older preferred chocolate. The younger listened to punk, the older was a staunch metalhead. The younger preferred Pepsi, the older swore by Coke. Those kinds of unforgivable sins. For a while, though, they managed-- the tensions brewing between them, tensions brewing beneath the club itself, did not see the light of day under the guidance of the president.

But the president couldn't live forever, and he couldn't keep those tensions in check forever. He held out as long as he could, refused to stop riding until he simply couldn't anymore, and, having accepted the coming end of his years, made it his wish that the younger brother take his place as president, fearing the older brother's temper and impatience would be the undoing of the club.

He underestimated his elder son, however, in both respects. The president's final choice was the spark that at last brought the two brothers into open conflict, and the tensions underlying the Burning Steel rose to rear their ugly faces. The elder brother, refusing to accept that he'd have to be under the authority of his idiot pacifist of a brother, broke away from the Burning Steel in rage. With him came many of the riders once loyal to the BSMC, each with their own reason for breaking away. The Burning Steel had fractured-- many chose to stay loyal to the club, but just as many left, and when they did, they took with them their bikes, the weapons the Steel had been using to fend off crime in San Ramon-- and, just to spite the riders who had once been their brothers in arms, they torched the Burning Steel headquarters on their way out to make the name literal. They declared the birth of an outlaw motorcycle gang, christened themselves the Mot?rheads, and decided San Ramon was theirs now.

San Ramon found itself the stage of a cold war between the two forces. Former brothers and sisters now regarded one another with suspicion, with malice, with outright hate, but outside of one or two isolated incidents, open hostility was not yet the case. But the status quo would not remain so for long. The elder brother was not used to the authority he now wielded-- dangerously unused to it, and what had once been a love of adrenaline and the rush of the fight, now unchecked, it became aggression, hate, and, eventually, war. The older brother wanted the town for the Mot?rheads, wanted it to be his own little 'playground'-- he was sick of defending people when they were either too weak to defend themselves, or wicked (but strong) enough to be the ones doing the bullying. To him, it was the natural order of things.

It's a cold war that could be set off with a single incident-- accidentally, or intentionally.

Source: http://feeds.feedburner.com/RolePlayGateway

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The Professional Descendant: Who belongs on the Family Tree?

Over the last few years I?ve been making an effort to sort out my genealogy files, make sure every statement has a proper source citation and to fill in the gaps in my family tree. As with much in my life, this is a project characterised by lengthy periods of inactivity, punctuated by the occasional bout of intense industry. At times the sheer size of the task can seem overwhelming and, needless to say, it?s nowhere near completion.?

The recent Christmas break has given me the opportunity to do a little more work on my family research and I?ve been concentrating on the ancestors of my paternal grandfather.?

One result of taking (or at least trying to take) a logical, methodical approach to researching and documenting your family history is that it raises questions you may not consider when skipping merrily from branch to branch as the fancy takes you. For me, one of these questions is, ?Just who should I be researching?? Or, to put it another way, ?Who belongs on the family tree???

A gathering of the Sykes family. Only two people in this photograph are actually my ancestors. Do I need to research the rest?

This might seem a simple enough question, but one thing I?ve realised from chatting with other genealogists is that our concept of family can differ greatly. Perhaps because I began my research with very little information and having had few family stories passed down to me, my definition of who belongs on my family tree has generally been quite narrow: direct ancestors and their children only. Until I?ve tied down the people I?m actually descended from (some of whom are pretty elusive), I don?t feel I should be spending time on tracing aunties, uncles, cousins, second-cousins, step-children etc. etc.?

Conversely, some family historians seem to have a much broader view of what constitutes ?their family?. Perhaps having grown up surrounded by a big family or hearing stories about many of their relatives, they are keen to trace the lives of great-aunts and -uncles, cousins and even more distant relations.?

Of course, I realise that it may be helpful to research collateral lines in order to identify your ancestors and to trace earlier generations. I have a few ?problem? ancestors for whom tracing the births, marriages and deaths of all children has been the only way to figure out who they were. This approach can even be extended to researching your ancestors ?FANs? - that is, their Friends, Associates and Neighbours (e.g. identifying the witnesses to your ancestors? marriage, who may turn out to be relatives).?

But problem ancestors aside, where do you draw the line? The abundance of information, especially digitised records, now available online makes this an increasingly pressing question. Once upon a time, finding a marriage record for my English ancestors meant visiting a large reference library and searching through the GRO fiche quarter by quarter, comparing volume and page numbers, then sending off for the certificate and hoping I?d identified the right one. It wouldn?t have occurred to me to do the same thing for each of their brothers and sisters.?

Recently, thanks largely to the fact that both the Church of England parish registers and baptist chapel registers for where my ancestors lived are now available on www.ancestry.co.uk, I was able to locate marriage and death information for all seven children born to one of my ancestral couples in a few hours spent at my computer.?

If time and money were no object, I think most family history enthusiasts would want to trace not only their own ancestors but also the wider families of which they were a part. However, few of us have that luxury and, with limited resources, there is the argument that the more people you have in your genealogy files, the less time you have to research each one, so that your family history risks becoming little more than a collection of names and dates.?

With the start of another year, many genealogy bloggers have been posting their genealogy goals for 2013. Organising the information already collected and focussing efforts on a particular family line or problem are common aims.?

Deciding who to research is the first step in any genealogy plan, so I?m interested to hear from other researchers, how do you decide who belongs on your family tree?

Source: http://professionaldescendant.blogspot.com/2013/01/who-belongs-on-family-tree.html

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TopShape Fitness Studio

Introduction
People of all ages can improve the quality of their lives and reduce the risks of developing coronary heart disease, hypertension, some cancers, and type 2 diabetes with ongoing participation in moderate physical activity and exercise. Daily exercise will also enhance one?s mental well-being and promote healthy musculoskeletal function throughout life. Although habitual physical activity is an attainable goal to a healthier life, only 48% percent of all American adults currently get 30 minutes of moderate intensity exercise per day on at least 5 days/week (CDC, 2005). A formidable challenge facing many personal trainers and health and fitness professionals is finding new approaches to motivate people to improve their well-being with consistent participation in physical activity and exercise. In fact, significant health benefits can be obtained by including moderate amounts of physical activity accumulated on most, preferably all days of the week. Fitness programs involving progressively increasing intensities of exercise will elicit even greater cardioprotective benefits (Swain and Franklin, 2006). There is a growing understanding of how levels of physical activity may positively effect cardiovascular, musculoskeletal, respiratory, endocrine function, and mental health. This article will bring to realization the evidence on 25 significant benefits linking physical activity to health enhancement. Some health benefits have been grouped together because of their physiological or metabolic associations.

1) Cardiovascular disease
The leading health-related cause of mortality for men and women in the U.S is cardiovascular disease (CVD). Meaningful cardiovascular health benefits may be attained with the long-term participation in cardiovascular exercise. To properly address the question of ?how much exercise is enough,? the American College of Sports Medicine has recognized the need for physical activity and exercise, and updated its position stand on the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults (ACSM, 2006) {see Side Bar 1}. Higher levels of cardiovascular fitness are associated with a 50% reduction in risk of CVD in men (Myers et al., 2004). Myers and colleagues demonstrated that increasing physical activity to 1000 kilocalories per week is associated with a 20% reduction of mortality in men. Hu and colleagues (2004) showed that physically inactive (engaging in less than 1 hour of exercise per week) middle-aged women doubled their risk of mortality of CVD as compared to their physically active female counterparts. It should be emphasized that Haskell (2003) notes that CVD is a multifactor process and that ?not smoking, being physically active, eating a heart healthy diet, staying reasonably lean, and avoiding stress and depression are the major components of an effective CVD prevention program.?

2-4) Diabetes, Insulin Sensitivity and Glucose Metabolism
Diabetes has reached endemic proportions, affecting 170 million individuals worldwide (Stumvoll, Goldstein and van Haeften, 2005). One misfortunate health consequence of physical inactivity is the weakening of the body?s insulin regulatory mechanisms. Elevated insulin and blood glucose levels are characteristic features involved in the development of non-insulin-dependent diabetes mellitus. When insulin function starts breaking down there is a rise in the body?s blood sugar levels, with the eventual onset of ?pre-diabetes? and then type 2 diabetes. Diabetes is a growing disease in youth and adults, largely as a result of obesity and inactivity. Regular aerobic exercise meaningfully increases insulin sensitivity and glucose metabolism, which means the body?s cells can more efficiently transport glucose into the cells of the liver, muscle and adipose tissue (Steyn et al., 2004). Improvements in glucose metabolism with strength training, independent of alterations in aerobic capacity or percent body fat, have also been shown (Pollock et al., 2001). Although the mechanisms for improvement are not fully understood, it appears that both resistance training and aerobic exercise offer a strong protective role in the prevention of non-insulin-dependent diabetes mellitus.

5) Hypertension
Hypertension is a major health problem. Elevated systolic and diastolic blood pressures are associated with a higher risk of developing coronary heart disease (CHD), congestive heart failure, stroke, and kidney failure. There is a one-fold increase in developing these diseases when blood pressure is 140/90 mmHg (Bouchard & Despres, 1995). It is necessary for the personal trainer and fitness professional to educate clients that reducing weight and lowering alcohol and salt intake in their diet may also help reduce elevated blood pressure in many cases. Moderate-intensity aerobic exercise (40%-50% of VO2max), performed three to five times per week for a 30 to 60 minute session appears to be effective in blood pressure reduction (when elevated). The evidence that higher intensity exercise is more or less effective in managing hypertension is, at present, inconsistent due to insufficient data. In a recent meta-analysis (a statistical technique that combines the results of several studies) of 54 clinical aerobic exercise intervention trials, findings (in hypertensive men and women) included a reduction in systolic blood pressure by an average of 3.84 mmHg and 2.58 mmHg for diastolic blood pressure (Whelton et al., 2002). Although routine aerobic exercise usually will not affect the blood pressure of normotensive individuals, habitual aerobic exercise may be protective against the increase in blood pressure commonly seen with increasing age (Fagard, 2001).

During resistance exercise, systolic and diastolic blood pressures may show steep increases, which indicates that caution should be observed with persons with known cardiovascular disease or risk factors. These increases in blood pressure are dependent on the intensity of the contraction, the length of time the contraction is held, and the amount of muscle mass involved in the contraction. More dynamic forms of resistance training, such as circuit training, that involve moderate resistance loads and high repetitions with short rests are safe and associated with reductions in blood pressure (Pollock et al., 2001). Although there is relatively little research on blood pressure and resistance exercise as compared to aerobic training/blood pressure studies, one recent meta-analysis in resistance exercise intervention trials found a decrease of 3.2 mmHg and 3.5 mmHg for systolic and diastolic blood pressure, respectively (Cornelissen and Fagard, 2005).

6-8) Blood Triglycerides, HDL-Cholesterol, and LDL-Cholesterol
The link between cholesterol and CHD has been fairly well established through long-term studies of individuals with high levels of blood cholesterol and the incidence of CHD. High-density lipoprotein cholesterol (HDL-C) {the good cholesterol} levels are inversely and independently associated with reduced risk of CHD (Neiman, 2003). It is well established that a sedentary lifestyle contributes significantly to the development of CHD and unfavorable elevation of blood fats and cholesterol levels; physical activity plays an important role in decreasing these health risks.

The exercise thresholds established from longitudinal and cross-sectional training studies indicate that 15 to 20 miles/week of jogging or brisk walking, which is equivalent to 1200 to 2200 kilocalories of energy expenditure, may decrease blood triglycerides by 5 to 38 mg/deciliter (Durstine et al., 2002). That same threshold of exercise (15 to 20 miles/week of jogging or brisk walking) has been shown to elevate HDL-C (a positive alteration) 2 to 8 mg/deciliter. Durstine and colleagues continue that exercise training studies rarely show a decrease in total cholesterol or LDL-C (the bad cholesterol) unless there is a loss of body weight or dietary fat is decreased (or both). The serum level of LDL-C has been shown to be significantly reduced among women (a decrease of 14.5+/-22.2 mg per deciliter) and men (a decrease of 20.0+/-17.3 mg/deciliter) randomly assigned to a diet-plus-exercise group, as compared with to a control group (women had a decrease of 2.5+/-16.6 mg/deciliter; men had a decrease of 4.6+/-21.1 mg/deciliter) (Stefanick et al., 1998).

Although some studies have shown favorable impact of resistance training on blood lipids, others have reported no change. It may be that the resistance programs that best modify blood lipid profiles incorporate larger muscle mass and multi-segment exercises with a high total volume (reps x sets x load) prescription. Additional research needs to be conducted which controls for body composition changes, day-to-day variations in lipoproteins, dietary factors, and possible other training adaptations, to provide a more credible summary of the effect of resistance training on blood lipids and lipoproteins.

9) Stroke
Physical activity exerts at positive effect in lessoning the risk of stroke in men and women. Moderate-to-high physically active individuals have a lower risk of stroke incidence as compared to those persons accumulating little exercise. Statistics show that those who are moderately active have a 20% lower risk of stroke while those who are highly active have a 27% lower risk of stroke (Sacco et al., 2006). Sacco and colleagues suggest that these levels of physical activity tend to lower blood pressure (if high), reduce body weight (if over fat), enhance vasodilation of blood vessels (widening of inside of blood vessels), improve glucose tolerance (how body breaks down glucose) and promote cardiovascular health. The implementation of progressive aerobic exercise (for cardiovascular health) and strength training (for mobility and balance) is recommended to reduce the risk of stroke or recurrent stroke (Sacco et al., 2006).

10-13) Colon, breast, lung and multiple myeloma cancer
Physical activity and exercise are correlated with a lower incidence of colon cancer and breast cancer in men and women, respectively. Lee (2003) reports that moderate-to-vigorous physical activity has a greater protective effect than lower intensities of physical activity. She notes that physically active men have a 30% to 40% reduction of relative risk to colon cancer as compared to their inactive counterparts. It seems that about 30-60 minutes of moderate-to-vigorous exercise per day is needed for this decreased risk, with higher levels of exercise showing even lowered risk. In addition, physically active women have a 20% to 40% reduction in relative risk of breast cancer as compared to their inactive counterparts. It also appears that the 30-60 minutes of moderate-to-vigorous exercise per day is needed to elicit this risk reduction in breast cancer for women. Although more research is needed, it appears that physically active individuals may also have a lower risk of lung cancer, although lung cancer is relatively uncommon in non-smokers (Lee, 2003).

Multiple myeloma cancer is more common in persons after the age of 50 yrs (Robert-McComb, 2007). Robert-McComb explains that with multiple myeloma there is genetic damage to plasma cells, transforming them into malignant or myeloma cells. Chronic fatigue is frequently reported and a distressing side effect of many cancers, including multiple myeloma. However, patients doing 3-5 days of walking for 15-30 minutes per session and light resistance exercise (2-3 times per week) have demonstrated an increased overall quality of life.

The research is clear that there is no association with the incidence of rectal cancer and exercise (Lee, 2003). The data is also somewhat inconsistent whether exercise can have a positive influence on lowering the risk of prostate cancer in men. Clearly, the present research on physical activity and cancer prevention indicates that exercise has a different association with various site-specific cancers.

14) Osteoporosis
Physical activities that stimulate bone growth need to include progressive overload, variation of load, and specificity of load. Specificity of load refers to exercises that directly place a load on a certain region of the skeleton. With osteoporosis, a degenerative disease characterized by a loss of bone mineral density resulting in a susceptibility to bone fractures and health problems, it appears resistance training and weight bearing aerobic exercise may provide the needed stimulus for bone formation (Kohrt et al., 2004). Progressive overload is necessary so the bone and associated connective tissue do not exceed the critical level that would place them at risk. Exercise programs to maintain and increase bone growth should be full-body in nature, including exercises such as squats and lunges, which direct the forces through the axial skeleton and allow for greater loads to be utilized. In addition, evidence does suggest that moderate weight-bearing activity, such as brisk walking done regularly, and for a long-term basis, is effective in averting age-related bone loss. Harder relative intensities of effort and greater volume of physical activity are more effective in increasing bone density. Kohrt and colleagues recommend doing weight-bearing endurance activities 3 to 5 times per week, and resistance exercise 2 to 3 times per seek for a total of 30 to 60 minutes per day to preserve bone health during adulthood.

15-16) Musculoskeletal Health and Sarcopenia
Muscle mass, strength, power and endurance are essential contributing factors for the improvement in musculoskeletal health and the enhancement of movement capabilities (Marcell, 2003). Although these components of musculoskeletal health show substantial decreases with age, it has been suggested that this is due largely to a decrease in physical activity, and not solely age.

Sarcopenia is the age-related loss of muscle mass and strength (Marcell, 2003). Marcell adds that the rate of muscle loss with age is relatively consistent, approximately 1-2% per year starting at age 50. He notes that there is a linear relationship with loss of muscle strength and loss of independence, contributing to falls, fractures and admissions into nursing homes. In addition, there is a decrease in metabolic rate and maximal oxygen consumption (due to the loss of muscle mass).

Improved musculoskeletal health may allow elderly persons to more effectively perform activities of daily living and with less effort (ACSM, 2006). The 2006 ACSM Resistance Training Guidelines for elderly persons suggest performing at least one set of 8 to 10 exercises that use all of the major muscle groups. Each set should include 10 to 15 repetitions that elicit a somewhat hard intensity for the active older exerciser. For sarcopenia prevention, the selection of multi-joint exercises on machines is recommended, because this requires less skill, and may allow the user to more easily control the exercise range of motion.

17-18) Body Composition and Obesity
Obesity has risen to epidemic levels in the U.S., with over 65% of the U.S adults being overweight and 31% obese (ACSM, 2006). According to the Centers for Disease Control (CDC, 2007), overweight and obesity are associated with increased risk for hypertension, osteoarthritis, abnormal cholesterol and triglyceride levels, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, sleep apnea, respiratory problems and some cancers (endometrial, breast, and colon).

The most favorable approach to weight loss is one that includes committed endurance exercise, resistance exercise, and caloric restriction within a sound behavioral modification delivery program. Weight loss achievements are most effective with increasing cardiovascular exercise up to 200 to 300 accumulated minutes of moderate-intensity (somewhat hard) exercise throughout 5 to 7 days per week (which is equivalent to expending 2,000 kilocalories per week exercising) (ACSM, 2006).

Resistance training and circuit training research has shown meaningful changes in body composition (Marx et al., 2001). Thus, one of the noteworthy benefits of resistance exercise, as it relates to body composition, is the positive impact of maintaining, or increasing fat-free body mass while encouraging the loss of fat body weight in a progressive overload resistance training program.

19) Arthritis
Arthritis is a broad term referring to greater than 100 rheumatic diseases. Of the many types of arthritis, osteoarthritis (a degenerative joint disease) and rheumatoid arthritis (an inflammatory disorder affecting multiple joints) are the two most prevalent (Maes and Kravitz, 2004). Arthritis is a health problem commonly characterized by stiffness, pain, and loss of joint function that affects people of all ages, genders and ethnic groups. It may imperil the physical, psychological, social and economic well-being of individuals, depriving them of their lifestyle independence. Physicians commonly prescribe exercise as a modality for the treatment of arthritis. Consistent exercise improves aerobic capacity, muscle strength, joint mobility, functional ability, and mood, without apparent increases in joint symptoms or disease (Finckh, Iversen and Liang, 2003). Exercise has been proposed to have a pain-relieving effect similar to that of a pharmacological treatment for some people. However, Finckh and colleagues suggest guarded caution in the exercise design of patients who have significant joint damage, especially in their weight-bearing joints. The authors continue that high-impact exercise is contraindicated in many cases of arthritis and should be replaced with swimming, aquatic exercise, aquatic walking, and biking, which are much safer on the weight bearing joints. Exercise programming for clients with arthritis should focus on gradually increasing cardiovascular conditioning, progressively overloading resistance exercise, increased flexibility, and steadily increasing flexibility and joint stability (Maes and Kravitz, 2004).

20) Stress
A growing body of research over the last 10 years substantiates that physical activity and exercise also improves psychological well-being (Dubbert, 2002). It is important to clarify that much of the research presented here is correlational, which means that the scientists studied the associations that exist between exercise and mental health variables, and not the causal relationships. Published investigations conclude that individuals with improved levels of fitness are capable of managing stress more effectively than those who are less fit (Hassmen, Koivula & Uutela, 2000). The data suggest an inverse relationship: higher physical fitness is associated with lower levels of stress. It appears that the method of exercise that most benefits stress reduction is cardiovascular exercise. Studies describe the role of exercise as a preventive intervention in managing stress as opposed to a corrective intervention. The research indicates that moderate intensity aerobic exercise, performed three times a week (sessions lasting over 20 minutes) for up to 12 weeks, has the most influence on stress management. Although the specific mechanisms explaining the improved stress levels from aerobic exercise are unclear at this time, it appears that possible theories include the involvement of physiological, biochemical and psychosocial factors (Callaghan, 2004).

21) Mood State
Frequently, personal trainers and fitness professionals hear clients say that they exercise because it ?feels good.? Because mood state is influenced by psychosocial, psycho-physiological, biochemical, and environmental factors, explaining the exercise-induced mechanism is quite difficult. However, it appears that cardiovascular and resistance exercise can positively affect different mood states including tension, fatigue, anger and vigor (a psychological variable defining vitality or energy) in normal and clinical populations (Lane & Lovejoy, 2002; Fox, 1999). In addition, even acute bouts of exercise may improve a person?s present mood state. It has been shown that a single bout of 25-60 minutes of aerobic exercise (at low, moderate or high intensities) increases positive mood feelings while also decreasing negative mood feelings. Implications from these data denote the incorporation of habitual exercise in a person?s lifestyle for the enhancement of a positive mood state. The use of resistance training to improve mood state requires further research.

22) Depression
The antidepressant action is one of the most commonly accepted psychological benefits of exercise. Individuals with clinical depression tend to be less active than healthy active adults and have a reduced capacity for physical exertion (Fox, 1999). As such, it is challenging for the personal trainer and fitness professional to introduce physical activity to this population, as people suffering from depression are not predisposed to participating in exercise. However, patients diagnosed with depression have credited exercise as being a most important element in comprehensive treatment programs for depression (Dunn et al., 2002). Cardiovascular and resistance exercise seem to be equally effective in producing anti-depressive effects (Brosse, Sheets, Lett, & Blumenthal, 2002). Therefore, the inclusion of resistance exercise, circuit training, calisthenics, as well as different modes of aerobic exercise should be encouraged.
It also appears that both acute exercise bouts and chronic exercise training programs have a positive effect on people with clinical depression (Dunn et al., 2002). The research does infer, though, that the greatest anti-depressive effects seem to occur after 17 weeks of exercise, although observable effects begin after 4 weeks (Scully et al., 1998). In addition, the effects of exercise on depression seem equivalent in both genders and are uninhibited by age or health status. Although no research guidelines exist for an actual exercise prescription, the evidence suggests following the ACSM guidelines for the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness and flexibility in healthy adults (see Side Bar 1).

23) Anxiety
According to Webster?s Unabridged Dictionary, anxiety is ?distress or uneasiness of mind caused by fear of danger or misfortune.? It is a stage of apprehension. The results of over 30 published papers substantiate a link between acute and chronic exercise and the reduction of anxiety (Scully et al., 1998). Most of the research on exercise and anxiety involves aerobic training regimens. The few studies involving resistance training and flexibility have also shown a slight decrease in anxiety, but additional research in this area is needed. However, the data does indicate that aerobic exercise is more beneficial for the reduction of anxiety. In reference to the actual aerobic exercise prescription, there appears to be much debate about whether low-intensity, moderate-intensity, or high-intensity exercise is most beneficial. For participant adherence, exercise intensity should be set at an adjustable level agreed upon by the individual in consultation with a personal trainer or fitness professional. It appears that even short bursts of 5 minutes of cardiovascular exercise stimulate anti-anxiety effects. The research also indicates that individuals who train for periods of 10 to 15 weeks receive the greatest beneficial effects.

24) Self-Esteem
As with the other psychological health variables, exercise has a positive influence on improving self-esteem (Callaghan, 2004). The effect of exercise also appears to be more potent in those who have lower self-esteem. Studies indicate that aerobic exercise may have a more pronounced effect than anaerobic exercise, but that may be because there is little research available on resistance training exercise and self-esteem. However, self-esteem is quite complex and studies suggest that certain subcomponents contribute to a person?s self-esteem, including perceived sport competence, physical condition, body image and strength (Scully et al., 1998). Because of the many variables that influence self-esteem, it is important to note that a person may highly value his/her physical condition and yet have a negative evaluation of his/her body. Current research provides little direction regarding the type of exercise and dose recommendation for improved self-esteem (so perhaps follow 2006 ACSM guidelines in Side Bar 1. for now). In relation to exercise, it is interesting to note that important factors influencing a person?s self-esteem are perceptions of their body attractiveness and physical condition (McAuley et al., 2000).

25) The ?Weekend Warrior?
All position statements on physical activity surround their messages around the importance of consistent physical activity and exercise throughout the course of the week. Yet, a sub-population of exercisers are those who do 1 or 2 bouts of exercise a week (perhaps because of time or choice), who have been ?affectionately? labeled ?weekend warriors.? Although many hypothesis and suppositions have been suggested about the health of this subpopulation of exercises, most recently a rather large scientific investigation revealed some interesting findings. I-M Lee and colleagues (2004) found that ?weekend warrior exercisers? who had no major risk factors (and expended at least 1,000 kilocalories in this sporadic exercise pattern) had a lower risk of dying as compared with their sedentary counterparts. However, individuals with one or more risk factors to CHD may not benefit from this sporadic approach to physical activity, and should be encouraged to get their physical activity and exercise throughout the course of most days of the week.

Directions for the Future
As personal trainers and health and fitness professionals expand their professional direction, the core model of the programs we develop and endorse will surely be engrossed in the enhancement of health for our clients. As well, with the rapid growth of the computer and communication technologies, more education and information about health, fitness and quality of life issues is easier to disseminate to our interested and growing audience. As a profession we need to combine our creative capabilities in exercise programming with our highly developed technologies and utilize these research applications into designing new strategies to get more people, of all ages, physically active and exercising.

Side Bar 1. New 2006 ACSM Position Stand on General Exercise Programming
The following is an abbreviated summary of the 2006 position stand by the American College of Sports Medicine for the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults.
Cardiorespiratory Fitness and Body Composition
Frequency: 3 to 5 days per week
Intensity: 55/65% to 90% of maximum heart rate 40/50% to 85% of maximum oxygen uptake (Heart rate reserve or VO2reserve)
Note: The lower intensity levels (55 ? 64% of maximum heart rate and 40 to 49% of maximum oxygen uptake) are applicable for persons with low fitness levels.
12-16 ratings of perceive exertion
Duration: 20 to 60 minutes continuous or a minimum of 10-min bouts of accumulated exercise throughout the day
Mode: Dynamic activities that employ the major muscle groups of the body in a rhythmic and continuous fashion

Muscular Strength and Endurance and Body Composition
Frequency: 2 to 3 times per week
Intensity: To volitional fatigue or stop 2-3 repetitions before volitional fatigue
Sets: 1 set per exercise (minimum)
Repetitions: 3 to 20 repetitions for each exercise (e.g., 3-5, 8-10, 12-15)
Exercises: 8 to 10 exercises for the major muscle groups of the body

Flexibility
Frequency: 2 to 3 days per week; ideal 5 to 7 days per week
Intensity: Stretch to tightness at the end of the range of motion but not to pain
Type: Static stretches
Exercises: For all major muscle groups of the body
Adapted from American College of Sports Medicine (ACSM). 2006. ACSM?s Guidelines for Exercise Testing and Prescription, 7th Edition. Philadelphia, PA: Lippincott Williams & Wilkins.
References
American College of Sports Medicine. (2006). ACSM?s Guidelines for Exercise Testing and Prescription, 7th Edition. Philadelphia, PA: Lippincott Williams & Wilkins.

Bouchard, C., and Despres, J.-P. (1995). Physical activity and health: Atherosclerotic, metabolic, and hypertensive disease. Research Quarterly for Exercise and Sport, 66, 268-275.

Source: http://topshape-fitness-studio.blogspot.com/2013/01/from-university-of-new-mexico.html

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Office Space 2013 - OMEGA Commercial Real Estate, Inc. (610) 616 ...

Natalie Kostelni

The region?s commercial real estate market entered the new year with more buoyancy than it had a year ago, giving many in the industry hope 2013 could be even more robust.

Architects, contractors, leasing brokers and landlords said they saw Center City and suburban commercial real estate fundamentals improve across the board last year and expect that to continue throughout the year, even gaining some steam during the latter half. However, they hesitate to say that everything looks promising.

?If we make a comparison to the last three to four years, the last year or so has been much more positive,? said Michael Armento, vice president of Torcon Inc., a construction company. While so-called eds-and-meds showed resiliency during the downturn, corporate real estate still remains weak, Armento said. However, encouraging signs indicate that could change this year.

?One of the trends we follow, and it comes from talking to architects, is there seems to be a long list of architectural firms back in a hiring mode and that is a good indicator for us and future projects,? Armento said.

That is the case at several architectural firms in the region including Stantec. The architectural and engineering firm is hiring across the board, said?Anton Germishuizen, vice president at Stantec. All disciplines are busy at the firm and its backlog is growing not only in the firm?s Philadelphia office but across the country, Germishuizen said.

?I think 2013 is going to be a pretty strong year for us,? he said.

The company recently won an assignment from Temple University for the design of a new 300,000- to 350,000-square-foot library.

The office market in Center City continues to improve and brokers are seeing concessions down, rental rates moving up, a tightening in trophy and other classes of space as well as a scarcity of large blocks of contiguous space.

?I expect this to continue because business is getting better, we?re starting to see some organic growth from businesses and companies are starting to come in from out of state and the suburbs. Supply keeps shrinking and occupancy increasing. We could be on the verge of new construction.?

Liberty Property Trust?is kicking around a new office building at 19th and Arch streets and?Brandywine Realty Trust?is close to lining up enough anchor tenants to kick off Cira South near 30th Street Station. With the?University of Pennsylvania?already secured to take up roughly 150,000 square feet of office space, Brandywine reportedly wants to snag one more tenant totaling roughly 40,000 to 50,000 square feet before breaking ground on the mixed-use development that would have a residential component.

For tenants, new construction is beginning to make some sense as rents begin to rise, space options dwindle and efficient space use can mean taking and paying for fewer square feet.

Source: http://omegacre.blogspot.com/2013/01/office-space-2013.html

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Report: Syrian journalist dies of wounds

BEIRUT (AP) ? A Syrian journalist for a pro-government television station died of wounds sustained in a shooting attack in the suburbs of Damascus, state media said Saturday, as rebels fighting to topple President Bashar Assad pressed ahead with an offensive on the capital.

The SANA state news agency said that Suheil al-Ali, who worked for the private, pro-regime Dunya TV station, died Friday, four days after he was shot while returning home from work. The agency blamed a "terrorist," the term the government uses for those trying to topple Assad.

Al-Ali is the latest of several journalists working for pro-government media in Syria to have been killed. A cameraman for Syrian state TV and a reporter for the state newspaper Tishrin were among others slain in recent months in killings the Assad regime has blamed on rebels.

Fighting has raged for weeks in the neighborhoods and towns around Damascus that have been opposition strongholds since the Syrian uprising began in March 2011. The revolt started with peaceful protests but morphed into a civil war that has killed more than 60,000 people, according to a recent United Nations recent estimate.

Rebels are trying to push through the government's heavy defenses in Damascus, the seat of Assad's power. The regime has responded with a withering assault including barrages by artillery and warplanes.

Rebels and government troops clashed Saturday in suburbs south of Damascus, including Harasta and Daraya, the Britain-based Syrian Observatory for Human Rights said. Fighting in Daraya alone left 10 dead, including six rebels, according to the Observatory, which relies on reports by activists on the ground.

The army sent new reinforcements in to Daraya, part of an offensive aimed at dislodging rebels from the district, located just a few kilometers (miles) from a strategic military air base west of the capital, the Observatory said.

Regaining control of Daraya would provide a boost to the regime's defense of Damascus.

Government troops had arrested several residents in raids in the suburb of Qatana, the Observatory said. Fighting was also heavy in the central province of Hama, Idlib, and in the southern part of the country, in Daraa, the birthplace of the Syrian uprising. Besides the deaths in Daraya, 35 people were killed around the country, the group said.

Fighting was also reported on the road to the Damascus International Airport, the Observatory said. The airport has not been functioning since last month when clashes erupted on the airport road, and international airlines have not yet resumed flights to the Syrian capital. Airport officials have said the facility is open, but have not said which flights are operating.

Rebels frequently target government officials for assassination, and have killed several regime figures. The most dramatic attack took place in July when they detonated explosives inside a crisis meeting in Damascus, killing four senior officials including Assad's brother-in-law and the defense minister.

Large bombings have been a trademark of Islamic radicals fighting alongside the Syrian rebels, raising concerns about the extremists' role in the civil war.

Last month, a suicide bomber wounded Interior Minister Mohammed al-Shaar in an attack on his ministry building. After the Dec. 12 attack, al-Shaar was secretly sent to neighboring Lebanon for treatment of a back injury, but was rushed out of a Beirut hospital and back home two weeks later for fear of being arrested by Lebanese authorities.

On Saturday, SANA denied reports that al-Shaar had died, saying the minister is "in good health and recovering."

In Tehran, Syrian Deputy Foreign Minister Faisal Mekdad discussed the conflict and ways to end it with Iranian Foreign Minister Ali Akbar Salehi, Iranian State TV said. Iran is one of Syria's strongest allies. Tehran has backed the Assad regime in its brutal crackdown on dissent that turned into a civil war after some opposition supporters took up arms to fight the military.

The conflict has increasingly taken sectarian overtones, with predominantly Sunni Muslim rebels fighting the ruling regime that is dominated by Alawites, an offshoot group of Shiite Islam.

In Riyadh, Saudi Arabia's Foreign Minister Saud al-Faisal said the Assad regime has lost legitimacy "at home and abroad."

Speaking at a press conference after a meeting with his Egyptian counterpart, Mohammed Kamel Amr, al-Faisal said called for an immediate end to the bloodshed in Syria and a peaceful political transition.

Saudi Arabia and Egypt have both called on Assad to step down, and Riyadh has also been an outspoken supporter of the rebels.

Also on Saturday, an Arab League official said the group's foreign ministers will hold an emergency meeting in the coming days in Cairo to discuss ways to assist Syrian refugees in Lebanon. The official spoke on condition of anonymity because he was not authorized to release the information.

More than half a million Syrian fled violence and sought shelter in neighboring countries, including some 130,000 to Lebanon. The country's government has requested $180 million from international donors to help its efforts with refugees.

___

Associated Press Writers Albert Aji in Damascus, Syria, Aya Batrawy in Cairo, Abdullah Shihri in Riyadh, Saudi Arabia, and Ali Akbar Dareini in Tehran, Iran, contributed to this report.

Source: http://news.yahoo.com/report-syrian-journalist-dies-wounds-104934880.html

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Photos: Winners of the 2012 NatGeo Photo Contest

Actors Bradley Cooper and Zoe Saldana have split up for a second time, apparently. Page Six says that the pair, who broke up last March only to get back together this fall, were supposed to spend New Year's Eve in Paris with Cooper's family, but Cooper ended up going it alone, while Saldana spent her evening in Miami with friends. Supposedly the couple couldn't make it work because of their busy schedules, with Cooper doing awards-blitz stuff for Silver Linings Playbook, and shooting a commercial of some sort in Prague, and Saldana doing Star Trek and a movie with Mila Kunis. ...

Source: http://news.yahoo.com/photos/2012-natgeo-photo-contest-winners-slideshow/

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