Friday, September 28, 2007

Maintaining a Strong Skeleton

Maintaining a Strong Skeleton

Approximately 95 percent of our skeleton is developed during the first 18 years of life. Periods of rapid growth occur during the first year of life and during the adolescent growth spurt. After adult height is achieved, our bones continue to become more dense as minerals are deposited. This is the consolidation phase. An additional 5-percent increase in bone mass is accumulated by age 30 to 35. At this age, our bones are the most dense and we are in a period of peak bone mass. After age 40, we experience an age-related phase of slow bone loss. The most rapid loss of bone mass for women occurs during the first 4 to 8 years after menopause. This chapter discusses the consequences of bone loss and also the lifestyle factors that protect the skeleton.

Osteoporosis

When enough bone mass is lost that bones become vulnerable to fracture, the individual has developed osteoporosis. Osteoporosis is a debilitating disease that affects over 24 million Americans. Each year in the United States, 1.3 million fractures are attributable to osteoporosis. The most common fractures occur at the wrist, the spine, and the hip. Hip fractures alone result in annual health-care costs of $10 billion. This figure will continue to increase with the increase of the elderly population. Between 15 and 25 percent of persons with a hip fracture enter long-term-care institutions. Hip fractures are associated with a high mortality rate due to surgical deaths and to complications such as thromboembolism, fat embolism, and pneumonia.

Treatment of Osteoporosis

A number of drugs are being investigated for their efficacy in the treatment of osteoporosis. These include calcitonin, bisphosphonates, and 1,25-dihydroxyvitamin D3. These drugs slow bone resorption but have little effect on the stimulation of bone formation. Other agents being researched are fluoride and parathyroid hormone; these may stimulate bone formation but are not proven to reduce the rates of fracture.

Because of the lack of a cure for osteoporosis, the prevention of excessive bone loss is the current focus. Approximately 80 percent of bone mass is genetically determined. The other 20 percent can be modified by lifestyle factors. Adequate calcium intake, weight-bearing exercise, and estrogen-replacement therapy for women who have entered menopause are the primary lifestyle factors associated with reducing the risk of osteoporosis. Factors associated with increased risk of osteoporosis include smoking and abuse of alcohol and caffeine. Thin, small-framed women are more vulnerable to osteoporosis, and Caucasians and Asians are at higher risk than African-Americans. Women are at greater risk than men by a ratio of 4 to 1. Women have less hone mass, experience accelerated loss of bone mass following menopause, and ingest less calcium than do men.

A researcher at the USDA Human Nutrition Research Center at Tufts University (Boston, MA), Bess Dawson-Hughes, has shown that calcium supplements can prevent the usual bone loss associated with aging in women who consume less than 400 milligrams (mg) of calcium per day. Furthermore, two studies have reported that the risk of hip fracture is reduced by as much as 60 percent on higher calcium intakes.

Other nutrients that are important to the skeleton are protein, vitamins C and D, phosphorus, magnesium, manganese, copper, zinc, and boron.

Estrogen-replacement therapy can also prevent or retard bone loss in perimenopausal and postmenopausal women as long as the therapy is continued and the dietary calcium intake is sufficient. Calcium supplementation in combination with estrogen replacement has synergistic positive effects on bone loss; that is, the effectiveness of each treatment is enhanced.

Early-Life Steps To Prevent Osteoporosis

Building bone mass in early life may be the most effective way to prevent osteoporosis in later life. If this opportunity is missed, it probably cannot be made up. Even small increases in bone mass can have a great impact on the risk of fracture. For instance, a 5-percent increase in bone mass can reduce the risk of osteoporotic fracture by 40 percent.

A lifelong habit of drinking milk is associated with increased bone mass. Researchers at the Indiana University School of Medicine in Indianapolis have shown that calcium supplements increase the bone mass in preadolescent children, compared to that in their identical twins who received placebos during a 3-year study.

Getting Enough Calcium

In the American diet, almost 75 percent of dietary calcium comes from dairy products. Few other foods are concentrated sources of absorbable calcium. At Purdue University (West Lafayette, IN) and Creighton University (Omaha, NE), plant foods are being screened for calcium absorption. These include broccoli, bok choy, kale, and tofu made with calcium salts. Calcium is well absorbed from these vegetables and from all dairy products—that is, milk, yogurt, cheese, processed cheese, and their low-fat counterparts. Spinach is a concentrated source of calcium, but this calcium is poorly absorbed because it is complexed with oxalic acid and is therefore indigestible.

Depending on their stage of growth, people need 2 to 5 cups of milk or the calcium equivalent each day. American females more than 12 years old typically consume less calcium than this recommended amount. Calcium intake in American women is 40 to 50 percent below that in men. A 1984 National Institutes of Health consensus-development conference recommended 1,000 mg of calcium per day for premenopausal women and 1,500 mg per day for postmenopausal women. However, 25 percent of American women have an intake below 300 mg per day, which is the amount of calcium in one glass of milk. Calcium supplements are recommended for individuals who cannot get adequate calcium through diet. However, supplements do not contain all the nutrients necessary for building bones, and people often forget to take pills. An alternative source of calcium is the fortified beverages now on the market.

Exercise

Weight-bearing exercise has a positive impact on bone density. An effective exercise program applies weight loading to all parts of the skeleton. For example, the right arm of a right-handed tennis player has a higher bone density than does the left arm. Activities that are exclusively aerobic seem to be the least effective in building peak hone mass. Thus, weight lifters have higher bone density than do swimmers. We do not know if the positive effects of exercise on bone mass are retained when exercise is discontinued.

A partial explanation for bone loss in the elderly is the reduction in physical activity with age. The physical work of the average sedentary elderly adult is 30 percent less than that of the average younger adult. If immobilization occurs, bone loss is accelerated; but bone mass can increase when the individual again becomes ambulatory.

The Known and Unknown

Obtaining adequate dietary calcium, exercise, and estrogen-replacement therapy following menopause are three lifestyle choices for maintaining a strong skeleton. The interaction of these factors is not well understood. Nor do we know the residual positive effect after cessation of treatment. Research to determine the best food sources of absorbable calcium and the most effective exercise programs, in combination with education programs on behavior modification, can help reduce the suffering and the healthcare costs associated with bone loss.

Mike Espy

Stress Can Affect Your Mental Health

Stress Can Affect Your Mental Health

Mental health issues that are caused by stress can range from homicidal or other violent acts towards oneself or drive others to addictions. The range of mental health disorders that are stress related is so broad that it can be difficult to understand how two situations fall in the same category. The days of shock therapy are gone for the most part, but it still is used for certain mental illnesses. Gone, too, is the routine procedure of frontal lobotomies to calm patients into total submissiveness.

A large key to dealing with stress related mental health issues is to know how to relieve stress. We now understand that men who are returning from wars endure thoughts and images that affect them in ways that we have only begun to be aware of. Post traumatic stress disorder which is caused by stress can affect victims of abuse and violence of all types. Only recently have we begun to understand how traumatic events can affect the people who survive them.

Despite the many types of mental health disorders that currently exist because of stress, some of them tend to be much more common than others. Mental health disorders are not discriminatory and affect everyone. They do not choose specific people or races to affect. Mental health disorders are equal opportunity problems. These disorders have been proven to be hereditary in some cases but that is the closest generalization that you can expect.

A very common mental illness that is caused by stress is manic/chronic depressive disorder. This is characterized by extreme highs and lows in moods for no apparent reason. Sufferers are irrational and quick to change, in terms of mood. For example, if you suffer from this disorder you are happy--very happy or sad---very sad for no apparent reason. Stress is a major cause of this problem.

Eating disorders, which are also quite common, include anorexia (not eating), and bulimia (binging and purging) are also caused by stress that arises from self esteem. Anxiety disorders are characterized by having an irrational dread of living one's life, to the point where it is incapacitating.

Obsessive-compulsive disorder (OCD) is a form of anxiety disorder where a person obsesses (thinks about) and is compulsive (does) about a particular action such as washing their hands, to the point where he or she repeats this action an inordinate amount of times. Stress is a major aspect of our lives and can lead to serious mental problems if not taken under control. Learning to contain stress can lead to your overall health.

Abbas Abedi

How To Manage Stress To Get Total Stress Relief?

How To Manage Stress To Get Total Stress Relief?

Stress is a complicated web. If I say, it bothers everyone, from the cradle to the grave, from the womb to the tomb, it won't be an incorrect statement.

Stress has a combined effect, on your body and on your mind. Those who have no jobs are stressed due to unemployment. And ask those who have jobs! They complain about day to day job stress. There may be varied reasons, such as time spent on traveling, low salary, harassment by the boss and lots of outstation tours. To secure relief is the normal expectation of any individual. Nobody wishes to live continuously under stress.

You please note that stress is entirely different from a challenging situation. Difficulties are not to be confused with stress. Stress is mainly your inability to cope up with a particular situation or a cluster of situations.

Can you ever be totally stress-free? In that situation you would not be a human being. You will be an angel in the celestial world! As a human being, you need to know, how to live with a certain level of stress!

I will explain this with an example. A young man wished to take bath in the sea. He went to the sea shore, but saw the waves. He surmised I shall take bath, when all the waves are over. Will such a situation ever come?

The sea has learned the art of living with the waves! You need to know the art of taking bath, swimming in the sea with the waves ever present there!

So, the golden rule is, having gone for a sea bath, don't be afraid of the oncoming waves. If the waves are powerful, duck them, when the waves are friendly, dance with them. When the waves are normal, swim your way further.

There are many strategies for stress relief. Review, yourself and decide whether any lifestyle changes are required. When your body is relaxed, your mind will also be relaxed. Yoga asanas, meditation, breathing techniques, jogging, running and dancing are brilliant techniques of stress relief. Get your body massaged from a professional once in a while. This is a great stress reliever.

The topmost techniques accepted all over the world today for stress relief are meditation, exercise and massage. Each of these serves different purpose, at the same time they contribute to the total purpose of stress relief. They provide you with many additional advantages. Laughter is also one of the best stress relieving methods.

You get ultimate stress relief, when you know the art of working for joy and not from the career view point alone. Work sincerely, by giving the maximum out put, not because your boss is telling you to do it, but only because it is the correct way of life.

Work for a cause- you will have the ultimate stress relief!

Javier Fuller

Does Stress Damage The Immune System?

Does Stress Damage The Immune System?

Does stress damage the immune system? That question can only be answered by first discussing the difference between acute (short-term) stress and chronic (long-term stress). While acute stress causes responses in the body that include boosting the immune system, chronic stress may impair the immune system.

Better questions are "Does stress damage the immune system on the short term?" and "Does stress damage the immune system on the long term?" The body's response to acute stress (a real or immediate threat such as a confrontation with a burglar) which is sometimes called the "fight or flight" response includes changes in all the systems of the body. Since the question is "Does stress damage the immune system?", then we will focus on those responses to acute stress that are temporarily boosting the immune system during this flight or flight scenario.

The most noticeable initial response to the burglar's appearance is an increase in heart rate. Your body is preparing itself for the possibility that you will need to run. The increase in heart rate triggers the spleen to discharge more red and white blood cells. The red blood cells increase your oxygen supply, while the white blood cells will be necessary for boosting the immune system, in case you fall or the burglar attacks you. Portions of the brain trigger the production and release of cortisol, a primary stress hormone, which dampens less important parts of the immune system, so that white blood cells and other infection fighters can be directed to the areas of the body where injury or infection are most likely to occur, namely the skin, bone marrow and lymph nodes, thus effectively boosting the immune system temporarily. Once the immediate danger has passed, the body systems return to normal.

So, the answer to "does stress damage the immune system" on the short-term is "no". Acute stress activates the body's natural defense systems and while this results in boosting the immune system temporarily, it does not "damage" the immune system. Chronic stress, however, is a different story.

Does stress damage the immune system on the long term? It can, if persistent stressful situations, such as a high-pressure job or an unhappy relationship, do not allow the body to return to a normal relaxed state. Instead of boosting the immune system, chronic stress appears to blunt the immune response, increase the risk for infections and impair a person's response to immunizations. Studies have shown that people under chronic stress have lower than normal white blood cell counts, are more vulnerable to colds and other viruses, take longer to recover from them and experience worse symptoms than people who do not have high stress levels.

If you are concerned about the answer to the question; does stress damage the immune system, then you may feel that you are in a stressful situation over which you have no control. It may not be possible to leave a high-pressure job in order to reduce your stress level and if doing so would cause financial problems, you could actually increase your stress level. Good nutrition, regular exercise and certain health supplements may help you protect yourself from the effects of chronic stress by naturally boosting the immune system and allowing the body to return to a more relaxed state.

Patsy Hamilton

Control of Stress and Violent Behavior: The Facts

Control of Stress and Violent Behavior: The Facts

Introduction

Stress is a recognized phenomenon among a majority of Americans. Its affects can be felt in the work place, where it can reduce productivity, and in the home, where it has been associated with family violence. Efforts to assist those in need have been undertaken by both the public and the private sectors. Crisis hotlines and outreach clinics are available to offer assistance for those having problems coping with stress, and most Americans are aware of their services. Violent behavior, including homicide, suicide, rape and family violence is a continuing health problem of major concern. Homicide and suicide are leading causes of death among persons 15-34 years of age.

Prevalence

Stress

An estimated 86% of the adult population believes that psychological stress exists.

84% of males surveyed and 88% of females surveyed reported having experienced stress. 40% of those surveyed reported that they experience at least a moderate amount of stress during an average week.

Among those surveyed, 83% of the college graduates, 71% of the high school graduates and 50% of those persons with less than a high school degree reported having experienced stress.

63% of the blue collar workers, 83% of the professionals, 71% of those unemployed, 67% of the homemakers and 79% of the white collar workers reported having experienced stress.

Of those who reported having experienced stress, 35% believed that stress had a negative impact on their lives. 33% said stress had not had any affect on their lives.

Professionals reported illness due to stress more frequently than any other occupational group (23%). They are followed by part-time employees (21%), unemployed persons (21%), white collar workers (20%), homemakers (18%), blue collar workers (13%) and retirees (9%).

Sources of Stress

Among those surveyed, persons earning more than $30,000 per year cited financial and work-related problems as the most frequent causes of stress.

Those persons earning less than $30,000 per year most often cited problems with friends and family as the primary cause of stress.

47% of the 18-29 year olds surveyed reported being able to solve an upsetting problem during the past year. 65% of those 65 years and older reported that they were able to solve an upsetting problem over the past year.

"The proportion reporting the existence of an upsetting situation is greatest for respondents 18-29 years old (22%). Proportions for the remaining age categories vary from 19% for those aged 30-to 44 to 12% for those aged 55-to 64."

It is estimated that 500,000 or more Vietnam veterans are in need of emotional help. Up to 30% of their drug abuse, violence, emotional instability are alleged to be a direct result of exposure to combat and atrocities.

Public Awareness and Service Delivery

77% of those surveyed did not consider seeking help in dealing with personal or emotional problems; 5% considered, but did not seek help, and an estimated 15% of the population actually sought help from a variety of sources.

Of those surveyed, 17% of the women and 12% of the men sought help. 81% of the men and 74% of the women did not consider seeking help.

Survey respondents who had at least a high school education sought help more readily than those who did not.

Help-seeking behavior did not vary across income levels.

Among those surveyed, 91% had never been a member of a self-help group. 5% had participated in a self-help group during the past year and 3% were currently participating in a self-help group.

Respondents were most often familiar with the following agencies: emergency medicare centers, alcohol and drug abuse centers, community mental health agencies, child abuse services and crisis hotlines or help centers. 45% knew of a suicide prevention hotline.

"A community-based emergency center had been contacted by 30% of those sampled; less than 8% had ever contacted a community mental health agency, an alcohol or drug abuse center, a child abuse service, a crisis hotline or a stress service. 1% had contacted a battered woman's shelter, a rape crisis center, a suicide prevention service or a Parents Anonymous group."

Blue Cross of Western Pennsylvania reports that for 136 persons who used insured outpatient psychiatric benefits, medical costs dropped from $16.47 to $7.06 per month.

A Washington-based health maintenance organization reported that users of mental health counseling benefits reduced their nonpsychiatric physicians visits by 30.7% and lab X-ray services by 29.8%.

According to a study recently conducted by the National Institute for Occupational Safety and Health, the costs of "executive stress" (based on conservative estimates) are as follows: cost of executive work-loss days: $2,861,775,800.; cost of executive hospitalization: $248,316,864.; cost of executive outpatient care: $131,058,235.; cost of executive mortality: $16,470,977,439.

Violent Crime

Police reports collected by the FBI indicate that the number of violent crimes in the nation increased by 4% between 1984 and 1985. Murder increased by 2%, forcible rape by 4%, robbery by 3%, and aggravated assault by 6%.

Each year about 6 million persons—3.2% of all Americans—are the victims of a violent crime.

Violent crime victims are more likely to be:

  • men rather than women (except for the crime of rape),
  • Blacks rather than whites or members of other racial groups,
  • Hispanics rather than non-Hispanics,
  • people with low incomes (less than $7,500 per year).

In 1981, an estimated $223 million in medical expenses was incurred by victims of assaults, robberies, and rapes.

Child Abuse

In 1984 an estimated 1.7 million children were referred to child protective services because of child abuse and neglect in the United States. This represented a 158% increase in the number of such reports between 1976 and 1984.

Neglect, alone or in combination with abuse, accounted for 58% of all reports to child protective services in 1984.

Reports of child sexual abuse have increased by approximately 1600% since 1976. This increase reflects greater public awareness of the existence of the problem, changes in reporting and investigative policies, expansions in definitions of child sexual abuse to include extra-familial abuse, and the increase in the number of treatment programs.

Severe physical child abuse may be decreasing in the United States. Data from two national surveys conducted in 1975-1976 and 1985 indicate a 47% decline in severe violence towards children in intact families with children ages 3 to 17.

Among the possible reasons for the reported decline in severe child abuse are increased use of planned parenthood (including abortion) by the U.S. population, compulsory child abuse and neglect reporting laws in the 50 States, and the appearance of new preventive and treatment programs for child abuse and neglect.

Spouse Abuse

Data from national surveys conducted in 1975-1976 and 1985 indicate that severe violence by husbands against wives has declined. The rate for such violence decreased from 38 per 1,000 couples in the initial survey to 30 per 1,000 couples in 1985. Relative to the 1975-1976 rate, this represents a 26.6% decline in severe wife beating over the 10-year period and comes close to statistical significance.

Severe violence by wives against husbands decreased only slightly between 1975-1976 and 1985. Although the meaning and significance of this violence is poorly understood, it appears that much of it was in self-defense or in retaliation for violence inflicted by husbands.

Murders of wives by husbands, and of husbands by wives, accounted for 8.3% of all murders nationally in 1985.

Although spousal violence is usually thought of in terms of intact marriages, available data suggest that violence of this type is even more frequent among persons who have been divorced or separated from each other.

Homicide

Homicide was the 11th leading cause of death in the United States in 1983. However, the relative rank of homicide as a cause of death varied greatly by race. In 1983, homicide was the 5th leading cause of death among Blacks, the 14th leading cause of death among whites, and the 9th leading cause of death among persons of other races.

Homicide takes its greatest toll among young persons ages 15 to 34. In 1983, homicide was the leading cause of death for Blacks in this age group.

The toll that homicide takes among the young is also reflected in the number of years of potential life lost (YPLL) before age 65. For Blacks in 1983, homicide was the 3rd leading cause of YPLL; for whites and others, it was the 6th leading cause of YPLL.

Males account for nearly 75% of homicide victims. Black males have a 1 in 21 lifetime chance of being murdered; white males have 1 chance in 131.

Most homicides in the United States are committed with firearms. In 1985, firearms accounted for 3 out of 5 homicides nationally. Cutting or stabbing instruments were employed in 1 out of 5 homicides.

Nearly 3 out of every 5 homicides committed in 1985 were perpetrated by persons acquainted with the victim (47%) or by relatives (17%). Arguments are the leading precipitants of homicide and accounted for nearly 40% of homicides nationally during the period 1981-1985.

Rape

In 1983, an estimated 154,000 rapes and attempted rapes occurred nationally, or roughly 1 for every 600 females 12 years of age and older.

Most rape victims are young. The ages with the highest victimization rates for rape and attempted rape are 16 to 24 year olds.

Most victims of rape or attempted rape are white, reflecting the general racial composition of the population. However, the likelihood of being a rape victim is significantly higher for Black women (2.5 per 1,000 annual rate) than for white women (1.5 per 1,000).

Two-thirds of rapes and attempted rapes are committed by men who are strangers to the victim. More than three-fourths of all rapes involve one assailant and one victim. Weapons are used in about one-fourth of rapes and attempted rapes.

Social stigma traditionally attached to rape makes it difficult for many victims to report the crime to police. Only half of the victims of rape and attempted rape surveyed nationally during the period 1973-1982 had reported the crime to police.

Aggravated Assault

Aggravated assault is an unlawful attack by one person upon another for the purpose of inflicting severe or aggravated bodily injury, but not resulting in death.

In 1985, there were 300 reported victims of aggravated assault for every 100,000 persons nationwide. Rates were highest in metropolitan areas (342 per 100,000) and lowest in rural counties (129 per 100,000).

Weapon distribution data for 1985 showed that 21% of reported aggravated assaults involved the use of firearms, and that 31% were committed with blunt objects and other dangerous weapons.

During the five-year period 1981-1985, the reported number of aggravated assaults increased by 9% across the nation.

The term "reported aggravated assaults" refers only to data on such assaults contained in police reports. Recent research has indicated that police reports do not adequately reflect the true extent of aggravated assault in the nation. One study of 41 acute care hospitals in Northeast Ohio found that close to 3 out of 4 cases of assault seen in hospital emergency departments were not reported to police.

Control of Violent Behavior

In 1984, the year end prison population in the United States numbered more than 463,000 persons. This was the largest number of prisoners ever confined in the nation and the 10th consecutive year in which the national year end prison population reached an all-time high.

Since 1980, the national prison population has increased by more than 40%. While an estimated 100,000 new prison beds were added in 1980-1984, the number of prisoners increased by more than 130,000 during the same period.

Although the number of female prisoners has greatly increased in recent years, and reached a total of 20,853 nationally in 1984, women still account for a very small percentage of the total prison population. In 1984, less than 1 in 20 prisoners were female.

A record 223,551 persons were being held in local jails as of June 1983. This represents a 41% increase over the total population recorded in the previous national jail census conducted in 1978.

Relative to the U.S. population, the number of jailed persons rose from 76 per 100,000 in 1978 to 98 per 100,000 in 1983.

With the exception of Massachusetts, every state had more women in jail in 1983 than in 1978, but women still account for only 7% of the national jail population.

The number of juvenile jail detainees is small and relatively stable, totaling 1,736 nationwide in 1983 and 1,611 in 1978.

More than 1.5% of the adult U.S. population is under some form of correctional supervision on a given day. Nearly two-thirds of these are under some form of probation; the remainder are in prison (17%), jail (8%), or on parole (10%).

Steven Parker

How To Conquer Stress And Depression

How To Conquer Stress And Depression

I am quite a fragile person and can quite easily find myself thinking and worrying about the smallest of things. People who know me comment that I am always stressed and that I should attempt to learn to relax more. This is easy for them to say! I have however now learned how to reduce the amount I stress and get depressed and will explain more in this article.

About a year ago I decided that I had had enough of the way I was living my life, up one day and down the next. I was on an emotional rollercoaster, never sure if I would wake up in the morning in a happy mood or in a depressed state. I was also aware that it was not really fair on my family as they did not know from day to day which Steve would appear.

So how was I going to go about improving my life and to conquer this near constant stress and depression? Well, what I thought I should do is to treat it as a project and even a hobby. I was determined to get to the bottom of it but was aware that it would take time and hard work. It was important to think positive about this project and to see it as a hobby rather than a choir as this would be the only way I would be likely to succeed.

The first thing I thought about doing was to write down the periods where I was in a stressed or depressed state. I then asked myself certain questions, such as, am I tired? Have I recently had an argument on my girlfriend? Is work getting me down?

I like to think of myself as quite a sociable person and I have to admit that most of the places and evening outs I go on or to, involve the drinking of alcohol. To be sociable I would always participate in this drinking but never really to excess. This is quite strange in reality as I have never really enjoyed the taste of alcohol or the affect that it has on me.

From my studies I soon realised that nearly all of my stressed and depressed days followed one of these evening outs drinking etc. I also realised that I always felt very low and even sorry for myself when I was tired and that I was always tired the day after drinking alcohol.

It is now quite plain for me to understand, alcohol is no good for me. It is like it creates the wrong chemicals in my brain. To help improve my life, I have now decided to become tee-total and therefore my drinking days are over. I will still socialise but will only be drinking soft drinks from now on.

I must say that I do not miss drinking alcohol at all and that I am a far happier person. I wish I had realised and stopped drinking alcohol years ago.

Steve Hill