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Participating in a fitness regimen with friends can be fun and may By taking care of yourself, you are motivate you to stick with your fitness program; in turn, you can saying that you are worth investing help motivate your friends. Write three other positive state ments that reflect the benefits giving you the opportunity to interact and cooperate with others. More than one in three teens (35 percent) do not participate regularly in vigorous physical activity (that is, for at least 20 minutes three times a week). Regular participation in vigorous physical activity declines significantly during the teen years, from 73 percent of ninth graders to 61 percent of twelfth graders. Clearly, many teens have a sedentary lifestyle,ora way of life that involves little physical activity. The negative effects of a sedentary lifestyle may include unhealthful weight gain, which is linked to several potentially life-threatening conditions, including cardiovascular disease, diabetes For more informa type 2 diabetes, and cancer. Cardiovascular disease is the leading tion on reducing your risk of cause of death among Americans. Diabetes is a serious disorder developing diabetes, see Chapter that prevents the body from converting food into energy. Lesson 1 Physical Activity and Your Health 77 an increased risk of osteoporosis, a condition characterized by a decrease in bone density, producing porous and fragile bones. In children and You can lower your risk of these and many other health problems teens, these weight increases by including more physical activity in your daily life. For example, correspond to higher occur when you go shopping, walk to the store or, if you have to drive, rences of asthma and type 2 park farther away from the entrance. Understanding how the food you eat gets converted into energy can help you maintain a healthy weight. Additional calo ries must be burned through physical activity or they will be stored in the body as fat. When you are physically active, your metabolic rate rises and your body burns more calories than when it is at rest. The number of calories burned depends in part on the nature of the 78 Chapter 4 Physical Activity for Life activity. When you stop being active, your metabolic rate slowly Hiking is a physical returns to normal. For several hours afterward, however, you con activity that you can enjoy tinue to burn more calories than you did before you began the throughout your life. Fitting Physical Activity into Your Life ealth professionals recommend that teens incor H porate 60 minutes of moderate physical activity into their daily lives. Be sure to include some activities that you can partici pate in throughout your life. Hiking, swimming, golfing, biking, racquetball, tennis, and bowling are just a few examples of lifelong activities. Examine and briefly describe the effects of regular younger students about the importance of physical activity on three body systems. Analyze the relationship between regular physical and then participate in the types of activity and disease prevention. Why does it take longer to get the maximum health benefit from a leisurely walk than from swimming laps

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Menopause and Work the effect of menopausal symptoms on women when in the workplace has been highlighted in several reports (please see the reference list at the end). As the population ages the number of women over 45 years of age in employment is increasing, this means that many women will go through the menopause while working full or part time. Reports suggest that for many women retirement is seen as the only option when confronted with a lack of support and understanding of their health needs during the menopause. Menopausal symptoms such as hot flushes, irregular periods, mood swings and poor memory are at odds with the professional image which women want to convey while at work. In a public environment where physical image and presentation matters women may feel exposed and undermined by the often highly visible, unpredictable and unpleasant symptoms of the menopause. For women who have to stand for large parts of the day or carry out 15 | P a g e physical tasks, heavy and irregular periods and period pains can cause discomfort and potential embarrassment. In addition forgetfulness, poor concentration, mood swings and tiredness can undermine confidence. Women may feel that their ability to be in control, to make decisions and to act as a role model deserts them during the menopause. Confidence can be undermined by changes taking place during the menopause and by the impact of menopausal symptoms. Many had not discussed their symptoms with their line manager and many were not comfortable doing so, in particular those whose managers were younger than them or male. By acknowledging the difficulties some women may face in work as a result of the menopause and by being aware of the impact of the environment and practices of the workplace on these women a culture change can take place whereby older employees can feel supported and engaged, where symptoms can be managed and their impact reduced and where these older women can be recognised as the committed, ambitious and resilient members of staff that they are. Natasha North and Hannah Short started the campaign as they believe that women are being failed by health services during and following the menopause. They believe there is a lack of knowledge of post-reproductive health care and confusing and conflicting advice available for women. They ask that other people join them in challenging existing attitudes and raising awareness of menopause related health conditions. Follow the link to join in the conversation, to take action or to get more information on your menopause. Conclusion All women at some point will go through the menopause and individual experiences will differ. The management of the menopause and its symptoms will depend on a number of factors including whether the menopause is natural or caused by surgery or another medical treatment; whether the menopause is early/premature; what symptoms appear and whether their severity impacts on quality of life and whether there are further risks such as osteoporosis as a result of the menopause. For all women lifestyle factors such as diet, exercise, smoking and alcohol will play an important part in promoting general wellbeing and reducing the risks associated with the menopause. Being informed from the start, seeking advice on options available and being supported and understood at work and at home should all help to ensure that this natural part of life passes as smoothly as possible with physical and mental good health being managed and sustained. Taking high doses of opioids may not provide good pain relief over a long period of time. The amount of pain relief from opioids can become less at higher doses because of tolerance. Sometimes people using opioids do not connect certain side effects to the medication. That is why many people who try a gradual taper to lower doses, report less pain, and better mood, function and overall quality of life. Sometimes, it is only after such a taper that patients appreciate how opioids were not helping as much as they thought.

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During motion, the horse is fine on straight lines, but on circles he will be off. If the stress point is very tender the horse will flinch, perhaps trying to pull away from the pressure. This is a sign of excessive tightness and stress; if you feel heat, sus pect inflammation. Stress Point 3 will be felt as a rigid knot three quarters of the way down from the poll, with flinching at the point of shoulder. They attach from the first cervical vertebra and run down and attach to the middle of the anterior edge of the scapula (shoulder blade). In action, the horse resists movement to the direction opposite to the muscle with the stress point. If the stress point is very tender the horse will flinch, perhaps trying to pull away from the pres sure. Stress Point 4 will be felt as a rigid knot in front of the ante rior (closer to the neck) edge of the shoulder blade. Other Tension Areas in the Neck the ligamentum nuchae: Runs from the poll all the way to the withers and provides a strong attachment support for all neck muscles. Muscle squeezing applied along its length will do won ders to relax this strong ligament. The serratus cervicis: Found on both sides of the neck, this mus cle attaches on the upper edge of the scapula and runs forward to attach on the cervical spine. Its contraction causes the scapula to move forward during retraction of the foreleg. The scalene muscles: Found on both sides of the neck, these muscles attach along the cervical vertebrae and run upward to attach to the base of the skull. The contraction of one scalene muscle will cause the head to rotate to the corresponding side. The intervertebral muscles: these small muscles run on each side of the vertebral column and attach on every second vertebra. Their contraction causes the neck to rotate on itself (torque) as well as assists lateral flexion of the neck. Stretching of the neck muscles (see chapter 8) will help bring these deep muscles into relaxation. The Shoulders Powerful, flexible, pain-free shoulders are essential for peak ath letic performance. A horse uses his shoulders to stretch the legs forward while extending the front legs and to fold the legs up tight in front of the body when jumping. Visually noticeable points are: the upper edge of the scapula (by the withers), the scapular spine, the point of shoulder (head of humerus), and the point of elbow (head of the ulna). The scapula is attached by a muscular sling that supports the thorax and reduces concussion from the front legs. The slope of the scapula and the angle formed by its junction with the humerus provides shock absorption and has much to do with the smooth ness of gait of a riding horse. Good flexibility and muscle power at the shoulder joint will ensure a high level of performance from the forelegs during jumping and galloping. After each training session, follow with complete stretching exercises for the foreleg. Watch for discomfort, resistance, or restriction in the range of motion of that limb. Signs and Symptoms: When this muscle is tight, the horse shows pronounced soreness over the withers. During movement, the animal resists the downward movement of his head and lateral movement to the side opposite the tightness. If the stress point is very Body Parts and Their Stress Points 207 tender the horse will flinch, and perhaps try to pull away from the pressure. It is located on the insertion tendon of the spinalis dorsi muscle, along the crest of the withers at the level of the ninth thoracic vertebra. Both muscles draw the scapula upwards and either forwards or backwards, depending on the action in play.

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A national clinical postoperative counselling after diagnostic laparoscopy for guideline. The recognition and initial management of ovarian systematic review of the accuracy of ultrasound in the cancer. Okaro E, Condous G, Khalid A, Timmerman D, Ameye L, Huffel back therapy: what do the data show Magnetic resonance imaging and transvaginal trial of goserelin and medroxyprogesterone acetate in the ultrasonography for the diagnosis of adenomyosis. Ultrasonography compared with magnetic resonance congestion: 1-year randomized controlled pilot study. Diagnostic therapy for suspected endometriosis: a nonsurgical approach accuracy of transvaginal sonography for the diagnosis of to the diagnosis and treatment of chronic pelvic pain. British pain Society, the Faculty of Pain Medicine of the Royal Interventional procedure guidance 234. They present recognised methods and techniques of clinical practice, based on published evidence, for consideration by obstetricians and gynaecologists and other relevant health professionals. The ultimate judgement regarding a particular clinical procedure or treatment plan must be made by the doctor or other attendant in the light of clinical data presented by the patient and the diagnostic and treatment options available. This information does not take the place of talking with your healthcare provider. The implant is a flexible plastic rod about the size of a matchstick that contains a progestin hormone called etonogestrel. It contains a small amount of barium sulfate so that the implant can be seen by X-ray, and may also contain magnesium stearate. Your healthcare provider will insert the implant just under the skin of the inner side of your upper arm. The following chart shows the chance of getting pregnant for women who use different methods of birth control. These medicines will be used when the implant is placed into or removed from your arm. The implant is placed just under the skin on the inner side of your non-dominant upper arm. If the implant is placed after the fifth day of menses, then you should use an additional contraceptive method (such as a condom) for the first 7 days after insertion. If you cannot feel the implant immediately after insertion, the implant may not have been inserted, or it may have been inserted deeply. You may need special tests to check that the implant is in place or to help find the implant when it is time to take it out. If the implant cannot be found in the arm after a thorough search, your healthcare professional may use x-rays or other imaging methods on your chest. Depending on the exact position of the implant, removal may be difficult and may require surgery. Schedule an appointment with your healthcare provider to remove the implant on or before the removal date. In studies, one out of ten women stopped using the implant because of an unfavorable change in their bleeding pattern. You may experience longer or shorter bleeding during your periods or have no bleeding at all. The time between periods may vary, and in between periods you may also have spotting.

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