Head Injury Prevention in Ice Skating

Introduction

Physical activity is an essential part of being healthy. In children, activity helps build strong bones and muscles, decreases the likelihood of developing obesity, and promotes positive mental health. Children are recommended to have 60 minutes or more of physical activity daily.

In the United States, more than 30 million children and teens participate in sports. Of that number, approximately 3.5 million children and adolescents ages fourteen and under are hurt annually while participating in recreational activities. In 2002, The National Safe Kids Campaign estimated that 13,700 children were treated in hospital emergency rooms for ice skating related injuries. Many of these are preventable head injuries if protective equipment, such as helmets or halos, is used.

Gliding across the ice, with the cool wind whipping across a skater’s face is an exhilarating feeling. One push can propel a skater far down the glistening, snowy surface. Worrying about a head injury is often far from a skater’s mind, as many participants are not aware of the possibility of head injury from ice skating. The goals of this article are to raise awareness about potential head injury from ice skating and to promote the use of helmets in skating, similar to what is required in cycling, skiing, and ice hockey.

Review of Injury Statistics

A concussion is a mild form of head injury, usually due to a blow to the head, which may cause disorientation, memory loss, or unconsciousness. Repeated concussions and loss of consciousness can result in traumatic brain injury or TBI.

An estimated 10% of all head and spinal cord injuries are due to sports related activities. Socially, athletes can feel undue pressure from family, coaches, and teammates to return to play quickly after a head injury. These influences can prevent an athlete from receiving the medical care he or she requires. In particular, parents and coaches can push their children too hard in an attempt to fulfill their own athletic aspirations. Athletes who return to play too soon or who suffer repeated injury to the head can develop chronic traumatic encephalopathy, or CTE, whose symptoms can include slowed speech, confusion, tremors, and mental deterioration. Most recently, CTE gained media attention when a settlement was reached with the National Football League, or NFL and thousands of players and families. The case, which involved more than 4,500 plaintiffs, calls for the NFL to pay for medical exams, compensation, and research related to head injuries sustained while playing professional football. Plaintiffs are committed to making the game safer at all levels and to educate the public; including parents of the four million children who play youth and high school football. Plaintiffs are committed to helping the focus on player safety trickle down to the youth level.

Awareness and education are key factors in injury prevention and return to play decisions. When an athlete suffers a head injury, a sideline assessment using the Standardized Assessment of Concussion should be completed by a medical professional. If a physician is not available, the coach can complete a basic assessment, until medical attention is available. The assessment includes tests of eye response, verbal response, and motor response. Telling a child to “shake it off” could have a grave impact on the child’s long term health.

Research concluded that safety measures in organized sports should include helmet requirements. There are approximately 230,000 cases of hospitalization due to traumatic brain injury annually of which 80,000 suffer long term disability and 50,000 result in fatalities. Five to twenty percent of these injuries are incurred during sports and recreational activities. Organized team sports, in particular football, soccer and ice hockey, have high instances of concussion annually in addition to recreational sports such as skating and bicycling. Helmets that are properly fitted and worn by participants of these activities can help reduce the risk of head injury among participants.

Sports and Helmet Rules

Cycling

In March 2003, professional cyclist Andrey Kivilev collided with two other riders during the Paris Nice ride. Kivilev was not wearing a helmet and catapulted head first off his bicycle. He fell immediately into a coma and was diagnosed with a serious skull fracture. Kivilev underwent surgery, but died shortly thereafter due to the severity of the head injury. He was 29 years old and the leader of the Cofidis cycling team. His death triggered the International Cycling Union, or UCI to implement compulsory wearing of helmets in all endorsed races.

Helmets protect the head by reducing the rate at which the skull and the brain are accelerated and decelerated during an impact effectively acting as a shock absorber between the force of the impact and the brain. Upon impact, the polystyrene liner of the helmet crushes thereby dissipating energy over a wider area. Instituting mandatory helmet policies in sports proves to be a divisive and controversial issue. Although research has demonstrated that helmets reduce injury in low speed crashes, helmet evidence is not conclusive with respect to high speed crashes. Kivilev’s accident occurred at approximately 35 kilometers per hour or about 22 miles per hour which is considered relatively low speed. At the time, he was ranked among the top 100 racers in the world.

Due to his high profile in the global cycling community, Kivilev’s death elevated the helmet debate into the media spotlight. Following this seminal UCI rule change, USA Cycling also revised their helmet policy to provide that in order to host an event sanctioned by USA Cycling, all participants are required to wear helmets.

In recreational cycling in the United States, bicycle helmet laws can vary widely. Currently, only twenty one states and the District of Columbia have instituted helmet laws for bicyclists below a certain age, which is generally 16 years-old. California requires helmets for riders 18 years and younger and only the Virgin Islands requires helmets for all riders. Twenty nine states have no bicycle helmet laws currently in place.

Researchers conducted a study which demonstrates helmet usage. This study directly observed 841 children in Texas who participated in bicycle riding, in line skating, skateboarding, and scooter riding over an eight week period. Whereas helmet rules vary county to county within Texas, most counties require helmets for riders age 16 years-old and younger. This study employed a randomly selected sample of children engaging in such activities from communities with populations equal to or greater than 1000. Children under 6 years-old, females and those riding on specified bike paths were found to wear helmets more frequently than other children.

Several factors often contribute to children not wearing helmets. During warmer months, children complain about high temperatures and accordingly are less inclined or willing to wear their helmets as riders feel they do not have proper ventilation inside the helmet. Parental knowledge and awareness is another contributing factor. Parents are often unfamiliar with applicable helmet laws nor are they informed of the potential risks of injury resulting from the failure to wear proper safety equipment. In a study examining data from1990 2005, there were in excess of 6,000,000 cases of children age 18 years-old and younger treated in emergency rooms for bicycle related injuries.

Skiing

In March 2009, actress Natasha Richardson sustained a head injury while taking a routine, beginner ski lesson. Initially she refused medical attention, however seven hours later, she was admitted to the hospital suffering from an epidural hematoma, a type of traumatic brain injury. She succumbed to her injuries and died the following day. Michael Kennedy, son of Robert F. Kennedy, died in 1997 following a skiing accident in Aspen, Colorado. A week later, Sonny Bono, television star and politician, died on the slopes of South Lake Tahoe. Richardson, Kennedy, and Bono were not wearing helmets.

Researchers studied injury rates at the three largest ski areas in Scotland during three winter seasons. The study found that first day participants are at an increased risk of injury due in part to low skill levels amongst the beginners. They concluded that first day participants should be targeted in educational programs about gear selection and protective equipment.

A study of skiers and snowboarders was conducted in Colorado where approximately 10 fatalities occur annually. Among the fatally injured, head injury proved the cause of death in 87.5% of the cases and none were wearing helmets. Of the 400 skiers and snowboarders admitted to the hospital with traumatic brain injuries, only five were wearing helmets. In the most serious case, the patient ascended off a 40 foot cliff, landed on his head, cracking his helmet in half. Whereas he sustained a severe concussion with unconsciousness, the computed topography, or CT scan proved negative and with inpatient rehabilitation, the patient has made a full recovery and is attending college.

In 2011, New Jersey Governor Chris Christie signed a bill into law requiring all skiers and snowboarders under 18 years to wear helmets with the intent to reduce head injuries on the slopes. California Governor Arnold Schwarzenegger signed a similar bill in 2010 however the measure was nullified following his veto of a companion bill that would have required California ski resorts to submit safety plans and reports to state officials. At the professional levels, the governing body of skiing, the Federation Internationale de Ski, requires a helmet as mandatory equipment for all downhill and Super G events.

Ice Hockey

In 1968, Bill Masterson of the Minnesota North Stars landed headfirst on the ice after being checked by two players from the Oakland Seals. He was not wearing a helmet and as a direct result died due to the severity of his head injury. Prior to this incident, the helmets use had been stigmatized which contributed to a lack of widespread use. However, as a consequence of this incident, the stigma surrounding the use of helmets began to diminish and ultimately in 1979, the National Hockey League, or NHL instituted a mandatory helmet policy. The policy did not apply uniformly at the outset as certain veteran players were grandfathered out of the new requirement. Such players elected to continue playing without helmets alongside new players who were subject the policy. Initially, the NHL and the players themselves faced harsh criticism from fans and the media. Despite the clear evidence of risks associated without helmets, some believed the policy harmed the integrity of the game and diminished the players’ masculinity.

Since the policy was first instituted more than three decades ago, significant research supporting the value and need for helmets has been documented. The hockey community has become supportive of the rule change particularly as a significant number of current hockey enthusiasts have never experienced the sport in which helmets were not employed and required. As with many elements of professional sports, the helmet policy was then instituted within youth hockey. The youth hockey governing board, USA Hockey, not only requires all players to wear helmets, they have mandated that all helmets employed by the players must be approved by the Hockey Equipment Certification Council, or HECC. Additionally, beginning in 2006, USA Hockey extended the helmet requirement to coaches who must wear helmets during on ice practice. The requirement for coaches provides the dual benefit of increased safety for all on ice participants as well as an opportunity for the authority figure to model appropriate safety practices. This continues to reinforce the value and importance of the use of safety equipment and in turn minimizes any residual stigma associated with wearing helmets on the ice.

In order to meet the requirements of the HECC, all helmets must undergo rigorous testing procedures including, without limitation, verifying the sufficiency of the coverage area, the quality of the protective material, and the degree of shock absorption. Aside from the specifications, the age, amount of use and type of each helmet all serve to impact the helmet’s effectiveness. The use of helmets with facial protection has proven effective in order to significantly decrease player injury at the amateur level. Whereas ice hockey is by nature a contact sport and checking is a significant cause of injury, the potential for injury is heightened further due to speed and surface tension. A study was conducted a study of 192 high schools in which 7,257 sports related injuries from 20 different sports were reported. From this total sample, 1,056, or 14.6% of injuries were concussions, 24% of which were sustained during boys’ ice hockey.

Ice Skating

In 1999, United Skates Pairs figure skaters, J. Paul Binnebose and Laura Handy were on track to make the 2002 Olympic team. While training at the University of Delaware, with Coach Ron Luddington, Binnebose fell on the ice, fracturing his skull. He suffered seizures, his heart stopped twice, and he was in a coma. Doctors removed a piece of his skull, allowing his brain to swell without pressure and heal. He was given a 10% chance of survival. Against the odds, he recovered.

Although the media widely publicizes celebrity sports related accidents, J. Paul Binnebose was not a well known star around the world. His story did not receive international media attention, but it is well known within the figure skating world. He and his coach have been working toward a helmet rule in skating for over a decade. They contend that many of the skating related injuries could be prevented or minimized with the use of a helmet.

Research suggests this notion is correct. An examination of pediatric skating related injuries was conducted in the years 1993-2003. The researchers sampled 1,235,467 children from emergency rooms with skating related injuries. Non random, purposeful sampling was used in this study. The data was collected from the National Electronic Injury Surveillance System, or NEISS, and the U.S. Consumer Product Safety Commission, known as CPSC.

The NEISS system has consumer product codes for each type of activity. Injuries were identified as ice skating, roller skating, or in line skating related, and coded accordingly. Ice hockey, roller hockey, and skateboarding were excluded from the study. Variables included the child’s gender and age, site of the injury, type of skating activity, mechanism of injury, use of protective equipment, and the injury diagnosis. Further, the injuries were categorized into 5 regions of the body.

The Centers for Disease Control report during the years 2001-2005, more than 200,000 emergency room visits for concussions and other traumatic brain injuries were recorded annually in the United States. Of those, 65% were found to be children ages 5 18 years-old who were participating in a sport or recreational activity. Children are at a greater risk for traumatic brain injuries with increased severity and a prolonged recovery. Thirty categories of sports and recreation head injuries were examined. Most of the sports demonstrated 2 7% annual emergency room visits for concussions and traumatic brain injuries. However, horseback riding, all terrain vehicle riding, and ice skating reported the highest instances of emergency room visits for traumatic brain injuries, with ice skating at 11.4%. Horseback riding and all terrain vehicle riding are activities where a secondary force carries the participant at a potentially high rate of speed; ice skating is a self propelled activity.

Researchers studied 419 children with injuries from ice skating, skateboarding, roller skating, and in line skating with the focus on head injury. Most injuries were to the face; 23 of 60 cases, 38.3%; and 12 additional injuries were to the head; 20%. Adult supervision was reported in 98.2% of the cases, and 78% reported no protective equipment use. The proportion of head injuries among ice skaters was greater than the participants in other types of skating, for which helmet use is recommended or required. Currently, there are no formal guidelines regarding the use of protective equipment in ice skating; however, studies show helmet use should be mandated for children.

A study of 80 patients who visited the Accident Service at John Radcliffe Hospital in Oxford for ice skating related injuries found that 56% were beginner skaters, defined as having skated less than 10 times. Eighty two and a half percent of the patients were 11 to 25 years-old. The study suggests that children who are beginner skaters are more likely to sustain injury than experienced skaters. Other research studies show similar results. In a study of 43 patients admitted to the Pamela Youde Nethersole Eastern Hospital with ice skating related injuries, 65% were first time skaters. The study found need for increased public awareness about the risk of potential injury from ice skating and for preventative measures to improve safety.

Insurance companies strongly urge skating facilities to post a warning potential of risks at the entrance of the buildings, which releases the facilities from general liability. However, people visiting ice skating rinks are not well informed about the potential risks of the activity before arrival. Often they do not read posted placards. If provided with the background knowledge, ahead of their visit to the ice skating rink, many guests would have the opportunity to bring safety equipment from home. A need exists for a public awareness campaign.

Positive Effect of Sports Involvement

An ice skating rink is a place for children to visit on a regular basis, during their out of school time, to engage in positive, fun exercise. The key to helping the child enjoy their experience, and continue to return to the ice skating rink, is to make sure they have a positive first experience. This may not mean becoming an expert skater, but becoming competent on the ice that he/she can have a positive social experience and be “ice safe.” In order for this to happen, the participants must learn to skate with the proper safety equipment, including helmets. Once they learn the skill, he/she will continue to return to the facility with their friends. Having a positive place to go during out of school time will help the children avoid risky behaviors.

Conclusion

Cycling, skiing, and hockey have made changes in their safety guidelines based on the trends and statistics of head injuries in the sport. As the governing body for skating, the International Skating Union, known as the ISU has to take action to require worldwide helmet use for skaters. Once the ISU takes the first step, member countries can incorporate helmet rules into basic training programs and begin a public awareness campaign. Reducing the incidents of head injury will improve the overall safety of the sport. As safety improves, more people will continue participating in the sport of ice skating.

Official Tibet Travel Guide – Must-See for Beginners (Part 1)

Climate of Tibet:

1. How’s the climate in Tibet? Is it hot in summer? Is it very cold in winter?

Tibet is in a high plateau, and it belongs to typical downy special climate. Climates are quite different in different areas of Tibet. The eastern Tibet which is at a lower elevation is warmer than western Tibet. In some mountain areas, there are four seasons at the same time in different altitude. The weather in a day varies greatly, too. The night is cold while the day is warm. It spans 12-15 degrees centigrade in a single day.

Climate in southeastern Tibet including Nyingchi and Chamdo is balmy with an average temperature of eight degrees centigrade; while in western Tibet (Shigatse and Nagqu) is quite cold with an average temperature below zero degree.

However in the central area of Tibet, the climate of Lhasa and Tsedang is more favorable for traveling. Travelers can visit these two areas all year around, not too hot in summer and not too cold in winter.

2. How is the road condition in rainy season in Tibet? Need I take any rainproof with me?

The rainy season in Tibet is mainly from June to August and it does have a very bad impact on the roads. However, there are many track maintenance workers and local army would also give help to restore the roads. Generally speaking, it only takes a few hours to make the roads feasible again. As for the rainproof, you are suggested to take raincoat, rain-proof trousers and shoes if you want to trek, climb the mountain or ride a bike. If you have group tours organized by some travel agencies, usually you don’t need to take rainproof with you, because Tibet often rains at night and the weather is quite good in the daytime. Besides, the tourist bus is always along with you.

3. What is the best time to travel to Tibet?

Generally speaking, early April is the beginning of travel season, which lasts to mid-June when a large number of Chinese travelers rush to Tibet for summer holiday. Late June to the end of National Holiday is the peak travel season when some important festivals held in Tibet, like Shoton Festival, Gyantse Dawa Festival and Nagqu horse riding Festival. After mid October, Tibet turns to winter and as the visitors reduce greatly, more than half of hotels are closed for the poor reservation.

As for the best time to travel, it depends on your travel requirement.

1. If you want an extremely cheap price, go to Tibet in winter, from December to next March. All the things are quite cheap; even the tourist sites offer 30-50% discount on entrance fee. Hotels are cheap, too. You can enjoy 5 star hotels with less than 100USD including breakfast. Compared with traveling in August, the cost of a winter tour is only 50%-60% of a summer tour. Because of the poor amount of visitors, the Potala Palace allows you to spend even a whole day in it. Besides, the monks are not busy and have spare time to chat with you.

2. If you like trekking, do it at May or September when the monsoon will never bother you and the weather is balmy and pleasant.

3. If you love Mt.Everest and want to see the clear face of it, try to avoid the rainfall season and foggy weather.

4. If you love to visit the grass land in north Tibet, do the tour in July when the flowers bloom in vast grassland and groups of yak and sheep, Tibetan nomad tents spread all over the grassland.

5. Those who want to drive to Tibet through Sichuan-Tibet highway should avoid the rainy season. There will be mudslides, cave-ins and mire on certain sections of the road, blocking the passage of vehicles.

About high altitude sickness

1. What is high altitude sickness? What’s the symptom of high altitude sickness?

High altitude sickness may occur at high altitudes (over 2700m) due to the decreasing availability of oxygen. It usually occurs following a rapid ascent and can usually be prevented by ascending slowly. Symptoms often manifest themselves six to ten hours after ascent and generally subside in one to two days, but they occasionally develop into the more serious conditions. Common symptoms of high altitude sickness include shortness of breath, headache, fatigue, stomach illness, dizziness, and sleep disturbance.

2. How to avoid or relieve high altitude sickness?

  1. Keep a good mood, don’t be too excited or be too worried about high altitude sickness. Before visiting Tibet, get as healthy as possible, both physically and psychologically.
  2. Take care of yourself and avoid catching cold before going to Tibet, and not to take shower at the first two days after you are in Lhasa to avoid being cold, or you will easily suffer from altitude sickness under weak physical condition.
  3. Do not drink any alcohol on the first two days when you are in Tibet. Drink plenty of water and eat light, high-carbohydrate meals for more energy.
  4. Do not run, jump or do some taxing jobs at the first two days. Being peaceful and having a good rest are important.
  5. Once you have the symptoms of altitude sickness, take some medicine (it is said that it’s helpful to have some butter tea if you can adapt to the flavor of it) and don’t go higher. Medication and oxygen also help to prevent altitude sickness. Mild altitude sickness symptoms can be treated with proper medication. If medication and oxygen do not relieve the symptoms, go to hospital or evacuate immediately to a safe altitude!
  6. Oxygen can help you relieve the symptoms of altitude sickness, but do not use it too often in Lhasa while your symptoms of altitude sickness are not serious. If you feel chilly or feel very uncomfortable, you should go to the nearest hospital available in the area.
  7. In addition to the normal medications for traveling it is advisable to bring high altitude medication. Seek suggestions from your doctor.
  8. Tell your tour guide quickly if you don’t feel well and follow the guide’s advice.

3. What should I do if I have high altitude sickness after arriving in Tibet?

There are hospitals in many large cities in Tibet. You may adapt to mild high altitude sickness by yourself slowly and you may go to hospital if it is serious. After you have already had high altitude sickness, you should rest well, do not move too much, keep eating, drink some water with black sugar or take some medicine. If the high altitude sickness is pretty severe, you should go to hospital, or descend to some lower places, or leave Lhasa immediately. High altitude sickness shall disappear after you descend to certain altitude and it has no sequel symptoms.

4. Is high altitude sickness more serious if going to Tibet by plane than by train?

Exactly, but both means have their advantages and disadvantages. You are more likely to have high altitude sickness because you don’t have enough time to adapt to the plateau environment gradually if you go by plane. The altitude change is directly from several hundreds meters to more than 3000 meters. While, if you go to Tibet by train, you can adapt your body to the high plateau environment slowly and gradually. Then, you may relieve or avoid high altitude sickness.

5. People with what kind of diseases can not go to Tibet? Do I need physical practice before travelling to Tibet?

People with the following diseases can not travel to Tibet:

  • People with all kinds of organic heart diseases, severe arrhythmia or resting heart rate over 100per minute, high blood pressure II or above, all kinds of blood diseases and cranial vascular diseases.
  • People with chronic respiratory system diseases, medium degree of obstructive pulmonary diseases or above, such as bronchus expansion, emphysema and so on.
  • People with diabetes mellitus which is not controlled properly, hysteria, epilepsia and schizophrenia.
  • People with bad cold, upper respiratory tract infections, and body temperature above 38F or below 38F while the whole body and the respiratory system have obvious symptoms, are not recommended to travel to Tibet until they’re OK.
  • People who were diagnosed to have high altitude pulmonary edema, high altitude cerebral edema, high altitude hypertension with obvious increase of blood pressure, high altitude heart diseases and high altitude polycythemia.
  • High risk pregnant women.

If you are not sure about your body condition, you may have a physical examination. But you are not supposed to do more exercise before going to Tibet, for exercising will give more burdens to your heart and you’ll need more oxygen, which may easily cause high altitude sickness.

6. Why can not people with cold go to Tibet? What should I do if I catch a cold in Tibet?

Your immune system shall be weak if you catch a cold and you may suffer high altitude sickness easily because of it. Besides, severe cold may easily turn to some more serious high altitude diseases, especially pulmonary edema, which is very dangerous. So you are not supposed to travel to Tibet before you get rid of a cold.

While, if you catch a cold in Tibet, things might not be so serious, because your body has already, to some extent, adapt to the plateau environment and you can go to a doctor and take some medicine

Permits & certificates

1. Are there any limitations or restrictions imposed on foreigners to travel to Tibet? How about overseas Chinese, Taiwan Compatriots and Hong Kong and Macao compatriots? How to handle it and how long does it take?

There are some special requirements for foreign travelers to Tibet. Firstly, foreign tourists to Tibet must be organized by travel agencies, with confirmed routes. Secondly, a Tibet Travel Permit issued by the Tibet Tourism Bureau is indispensable. The Tibet Travel Permit must be obtained before they head to Tibet. What’s more, foreigners are not allowed to travel alone in Tibet by their own, even with the travel permit. They must be accompanied by a licensed tour guide. Tibet travel permit is also required from overseas Chinese and Taiwan Compatriots, while Hong Kong and Macao compatriots can travel to Tibet like other Chinese citizen with valid Home Return Permit. Foreigners, overseas Chinese and Taiwan compatriots can apply for Tibet travel permit from Tibet tourism bureau or certain qualified travel agencies with valid passport (copies), visa (copies) and job certificate. Usually, it can be obtained in one week and 2 to 3 days if you are in urgent need.

2. What is Tibet Entry Permit? How to get a Tibet Entry Permit and what documents are required to get it?

Tibet Entry Permit, also known as Tibet Tourism Bureau (TTB) Permit or Tibet Visa, is the basic document for foreign travellers to enter into Tibet. No foreign visitor can visit Tibet without holding the Tibet Entry Permit in their hands. Foreign tourists are required to show both their Chinese Visa and Tibet Entry Permit when they change for the boarding passes of flying to Tibet or board trains to Tibet.

Tibet Entry Permit is officially issued by Tibet Tourism Bureau, in purpose of restricting the numbers of foreign visitors. With this permit, foreigner tourists can travel in Lhasa region including Lhasa city, Yamdrok Lake, Ganden, Tsurphu, Namtso, Drigung Til and Reting.

Tibet Entry Permit is not available for independent travelers. Foreign travellers have to travel in tour group and ask legitimate travel agency to apply Tibet tour for you.

Documents required:

You can get Tibet entry permit (TTB permit) by sending certain qualified travel agency the first page of your valid passport and a copy of your Chinese visa by fax or by email, and state clearly your occupations (Foreign journalists and diplomats are not allowed to go to Tibet as a tourist). If you are Taiwan Compatriots, send us the copies of your MTP-Mainland Travel Permits or called Taiwan Compatriot Entry Permit/travel document (commonly known as “Tai Bao Zheng”), and tell us your occupations.

If you are the citizens of Hong Kong and Macau SAR, China Re-entry Permit for Hong Kong & Macau Compatriots is enough to travel in Tibet. You are not required to apply for the Tibet Permit.

Pay attention: If you are planning to travel to places officially closed to foreigners in Tibet, an Alien’s Travel Permit is required.

3. What is Alien’s Travel Permit?

Except Tibet Entry Permit, an Alien’s Travel Permit is required if you are planning to travel to places officially closed to foreigners in Tibet, such as Mt. Everest, Rongbuk Monastery, Mt. Kailash and Lake Manasorovar. Alien’s Travel Permit is not needed for places in Lhasa region, towns of Shigatse and Tsetang, or nonstop travel on Friendship Highway.

Alliens’ Travel Permit is required to visit ‘unopened’ areas. Which is issued by the police (Public Security Bureau, “PSB”). Usually you can apply for it once you arrive at Lhasa. For tour groups, our guide will ask you for the passport and TTB permit and submit it to the Foreign Affairs Section of PSB for the Travel Permit. It normally takes several hours and the cost is 50 CNY/person. If you are an individual traveler, you need to join local tours to ‘unopen’ areas, and the local travel agencies will arrange the PSB for you as well. Pay attention, there is no travel agency can provide ‘PSB permit-only’ service.

Notice: If you want to do a Tibet overland tour from Yunnan, Sichuan, Qinghai or Xinjiang province to Tibet, you must got the PSB permit before your tour starts.

4. Which parts of Tibet are listed as the closed areas?

At present, you have to apply for a Travel Permit if you are planning to visit the following places:Tsedang: Samye Monastery, Tomb of Tibetan King, Trundruk Monastery, YumbulakhangShigatse: Sakya Monastery, Mt. Everest, Rongbuk MonasteryGyangtse: Pelkor Chode Monastery & Kubum StupaNgari Region: Mt. Kailash, Lake Manasarovar, Tsaparang, Years, etc. Nyingchi Region: Basum-tso, Pomi, Rawo-tso, etc.Chamdo Region: Chamdo, Riwoche, Tengchen, etc.

5. Are there any other certificates and permits may be required in Tibet?

Except Tibet Entry Permit, Alien’s Travel Permit, there are Military Permit, Foreign-affairs permit and other permits which may be required when traveling in Tibet.

Sensitive border are as such as Mt Kailash and eastern Tibet also require a military permit and a foreign-affairs permit. For Tholing and Tsaparang in western Tibet you will also need a permit from the local Cultural Antiquities Department. All these will be arranged by our travel agency one month before you enter Tibet. The Military Permit is issued by troop while the Foreign-affair’s permit is issued by Foreign affairs office in Lhasa. It normally takes 10-15 working days to get them all.

6. How to deal with the visa from Tibet to Nepal? Can I apply for Nepal visa in Lhasa? Is it fast? Shall I be denied?

Nepal has two embassies in China: one is in Beijing and the other is in Lhasa. It is easier and more convenient to handle the Nepal visa in Lhasa as long as you conform to the certain procedures. And there are seldom any cases of denial. But the visa officers don’t work at regular time, so you are recommended to stay several more days in Lhasa to apply for Nepal visa and it is more secured if you handle the visa first after you arrive in Lhasa. The general consulate of Nepal is in Lhasa, near the Norbulinka Park. Normally you can get the visa in the afternoon of the next working day if you submit the application and necessary documents in the morning of the first day. The time to submit document is from 10am to 12am, Monday to Friday. So, you need plan a couple of days in Lhasa to wait the visa. The time to get visa is usually at 4pm, once you get the visa, you can fly to Kathmandu or set out to Zhangmu border by cars or by bus.

To apply for Nepal visa in Lhasa, you need prepare the original passport, 2 passport size copies and complete a form. Your passport must be valid at least for the next 6 months. There are three kinds of visas according to period you plan to stay in Neal, the 15 days, 30 days and the 3 months. If you are going to stay more than 15 days in Nepal, it is better to get the visa in Lhasa, as the border office issued 15 days visa only and it is relatively expensive to extend the visa in Kathmandu or Gorkaha.

You can also get Nepal visa at the border. Not far away from the Friendship Bridge, you can get the arrival visa of 15 days stay at the border office with 25 USD. You need prepare a passport size photo and complete a form as well.

What to Pack:

1. What drugs to take when traveling to Tibet?

In the first few days after arrival in Tibet, you may experience some degree of altitude reaction. Colds, insomnia and digestive disorders are common. Take an adequate supply of any prescription medication you use regularly, including medicine for cold, headache, stomachache, and insect bite, diarrhea and so on, like the Aspirin, Ibuprofen, Antibiotics, throat lozenges, nasal decongestant and vitamins etc. Most over-the-counter medicines, such as aspirin and anti-diarrheal pills, are available in Lhasa, but are more difficult to obtain outside of urban areas. It is advisable to take anti-altitude sickness drugs to cope with oxygen deficiency. Bring diamox pills which are believed to be able to prevent the altitude sickness effectively. Please consult your doctor prior to your travel to Tibet.

2. What food to take when travelling to Tibet?You may take some chocolate, dried beef, hot pickled mustard tuber, biscuit and other food and snacks you like. You’d better take food with high calorie. You may also take some gum with you, which may help relieve the symptom of syrigmus and headache. When traveling to remote areas of Tibet it is a good idea to pack some food, snacks, and drinking water. It is not always easy to find food or drinkable water in these areas. Water purification equipment, such as hand pump filters, is not necessary, as bottled mineral water and thermoses of boiled water are available everywhere throughout Tibet. Water purification tablets can be useful during trekking. It is a good idea to take a good quality multivitamin to supplement your diet since a supply of vegetables and fruits may not be readily available.

3. The necessary commodities you should take when traveling to Tibet Necessities: sunglasses, hat, sun cream, skin cream, lipstick, long sleeve clothes, sweaters, Passport, visa, money, credit card, camera, film, batteries, toiletries, cosmetics, knife, watch, day bag-pack, big travel bags (soft luggage), water bottle, journal, reading book, writing materials, binoculars, family pictures and snack foods.

4. What kind of clothes and shoes should be taken when traveling to Tibet?

Clothes

The temperatures change greatly on the altiplano. In the north part of Tibet, people wear thick coats all year round (including July and August which are the hottest months in most of the areas in China). The highest temperature is 4-5 degrees centigrade in northern Tibet. It also snows in July and August.

The temperature difference in a single day is big. In Lhasa, the temperature in July arrives at 30 degrees centigrade at daytime, but falls to 10 degrees centigrade at night. Sometimes it will snow or sleet at night, so you’d better take some down garments (those with hats will better), woolen sweaters, warm gloves, warm and wind-proof shoes and socks. Wearing several layers of clothing that can be easily added or removed is the wise choice since temperatures may vary greatly within a single day.

Most hotels in Tibet have no central heating. The air-conditioners in single rooms do not work well in the cold night. In winter, from November to next March, of course you need bring down jackets, warm sweaters, gloves, warm pants, woolen hats. It is very cold in the morning and evening. In summer, wearing a T-shirt in day time but the Jacket is necessary at hotel in the morning and evening.

During the peak tourism season, April, May, September and October, you need to prepare T-shirts, overcoats and jeans, warm sweaters. Besides, frequent rainfall in this season makes waterproof clothing and raingear absolute necessities.

Even in summer, a down coat is necessary for those who are traveling beyond Lhasa and Shigatse into more remote areas such as the Everest Camp. A windbreaker plus a sweater will work nicely for strolling around Lhasa in summer.

Other essentials to pack include four or five pairs of cotton or woolen underwear, four or five pairs of woolen socks, long sleeve cotton or lightweight wool shirts and T-shirts. Women should avoid skirts or dresses.

Also, whenever you visit Tibet, if your plan includes overnight at Everest Base Camp or Namtso Lake, or a several days outdoor trek in mountain area, to keep warm is very important. The winter clothes are a must. However, you do not need to worry too much about clothing, you can buy any kind of clothes you need in Lhasa and clothes is quite cheap.

Shoes

It is very important to have a strong comfortable pair of boots, especially your travel covers remote area and you have to walk for a long distance. For example, if your travel reaches Everest Base Camp, you need to cover 8 km from Rongpuk Monastery to EBC and back. Lightweight boots are fine, but Tibet can be wet and we will do extensive walking, so make sure your shoes fit well and are suitable for cold and puddles. You should also have a pair of comfortable and tough sandals.

5. What certificates and documents should I take with me when I travel to Tibet?

Of course you should take your passport, China visa and Tibet travel permit with you. Or you won’t be allowed not even to get on the plane or the train.

There are overall four documents required for foreign tourists who want to travel freely in Tibet:

Chinese Visa – you can apply for in Chinese Embassy in your country;

Tibet Entry Permit – It is issued by Tibet Tourism Bureau and is a must for foreigners entering Tibet;

Travel Permit: It is required when you are planning to travel to the closed areas in Tibet, and you can obtain it after you arrive in Tibet

Military Permit – you have to obtain if you are planning to travel to some military sensitive areas.

What Causes Muscle Growth?

In order for muscles to grow, three things are required:

1. Stimulus – exercise is needed to make the muscles work, use energy and cause microscopic damage to the fibers.

2. Nutrition – after intense exercise the muscles need to replenish their stores of fuel.

3. Rest – it is during the rest or recovery phase that the muscles repair the microscopic damage and grow.

Muscle size increases due to hypertrophic adaptation and an increase in the cross section area of ​​individual muscle fibers. Intensive exercise affects more on the strength influencing fast twitch type II fibers, therefore the increase in muscle size is accompanied by greater strength.

This will deplete the muscle's energy stores and cause microscopic damage to the muscle tissue. During recovery, these stores of glycogen and phosphocreatine will replenish from carbohydrates and creatine ingested as food or supplements. Amino acids supplied in the diet will trigger the protein synthesis that repairs the damaged muscle and lead to the creation of larger muscle fibers.

To achieve continuous improvement you will need to keep reaching for higher levels of training intensity otherwise the improvement process will grind to a halt. Fortunately, this is reliably easy to plan for provided certain basic principles and rules are clearly followed. Just be sure to build sufficient rest into your training program otherwise the hard work will go to waste. For many bodybuilders and athletes generally, it is the rest element that seems most difficult. Subsequent articles in this series will examine these principles in detail.

In the meantime you can find out more about building muscle by visiting the site listed below.

How Tremendous Stress Leads To Heart Attack?

Stress heart disease

Stress is a term that is not new to the modern man. Everyone is suffering from some sort of stress. Children suffer from the stress of performance and the adults find it stressful to manage their finances. Stress creates a lot of complications and it will lead to the dysfunction of the body. People who are under a lot of stress will have an increased risk of suffering from an attack.

Stress can differ in definition and some types of stress do not cause heart attacks. It has not been scientifically proven that stress causes heart attacks but people under stress do have the risk of suffering a heart attack. Stress can be classified into different modes which include physical stress, emotional stress. These will have different impacts on the body and especially heart. Lack of proper management of stress can lead to physical, emotional and even psychological problems.

When a person is under tremendous stress the blood pressures will shoot up. This is very dangerous as we know that high BP levels are not good for the heart. People under stress also tend to overeat, stop exercising and even start smoking. All these factors are very significant in a heart attack. Chronic stress will expose the body to very high levels of stress hormones like cortisol and also adrenaline.

A lot of studies have also suggested that high stress levels will lead to blood clotting in the arteries and veins. This is a major factor for heart attack due to the blocking of the blood vessels. Stress will cause both physical and also emotional changes inside the body.

Emotional stress

Emotional stress is generally referred while talking about heart attacks. It is said that emotional stress is chronic enough to cause heart complications. It is basically inside the mind and it occurs due to an event or certain environment. It is generally considered as a negative as it will cause complications in the body. A stressful event is followed by adrenaline surge and also other chemical vents that are abnormal to the body.

Stress can cause a lot of problems in the body and it is mainly due to the excessive stress inside the body that will deter the normal functioning of the body. Stressors are known as the reasons why a person will suffer from stress. Stressors can occur due to minor hassles, change in the lifestyle or an event like death of a loved one. These things are the catalyst that leads to stress.

Scientifically there is no proof that stress can be dangerous and can lead to heart attacks. But, it is noticed that people who are under tremendous stress become victims of chronic heart attacks. In general stress is not good for the body and it will cause diseases in the body.

A person should slow down when he is under stress. This helps the body to calm down and return to normal functioning. A person should always notice the signals shown by the body that the stress levels are high. Controlling the stress means keeping heart attacks at bay.

City of Bath, England – History and Ghosts

Bath is one of my favourite English City’s full of history and Ghosts. It is one of the most attractive city’s in layout and history and is famous for it’s Spa and Baths. The archaeological evidence shows that the site of the Roman Baths main spring was treated as a shrine by the Celts, and dedicated to the goddess Sulis. There is a legend that Bath was founded in 860 BC when Prince Bladud, father of King Lear, caught leprosy. He was banned from the court and was forced to look after pigs. The pigs also had a skin disease but after they wallowed in hot mud they were cured. Prince Bladud followed their example and was also cured. Later he became king and founded the city of Bath.

The Romans probably occupied Bath shortly after the Roman Invasion of Britain in 43AD. They knew it as Aquae Sulis (‘the waters of Sul‘), identifying the goddess with Minerva.

In Roman times the worship of Sulis Minerva continued and messages to her scratched onto metal have been recovered from the Sacred Spring by archaeologists. These are known as curse tablets. Written in Latin, and usually laid curses on other people, whom they feel had done them wrong. For example, if a citizen had his clothes stolen at the Baths, he would write a curse on a tablet, to be read by the Goddess Sulis Minerva, and also, the “suspected” names would be mentioned. The collection from Bath is the most important found in Britain.

It has been suggested that Bath may have been the site of the Battle of Mons Badonicus (circa 500 AD), where King Arthur is said to have defeated the Saxons, but this is disputed. The Anglo-Saxon Chronicle mentions Bath falling to the West Saxons in 577 after the Battle of Deorham.

The Anglo-Saxons called the town Baðum, Baðan or Baðon, meaning “at the baths,” and this was the source of the present name. In 675, Osric, King of the Hwicce, set up a monastic house at Bath, probably using the walled area as its precinct. King Offa of Mercia gained control of this monastery in 781 and rebuilt the church, which was dedicated to St. Peter. Bath had become a royal possession. The old Roman street pattern was by now lost, and King Alfred laid out the town afresh, leaving its south-eastern quadrant as the abbey precinct. Edgar of England was crowned king of England in Bath Abbey in 973.

King William Rufus granted the city to a royal physician, John of Tours, who became Bishop of Wells and Abbot of Bath in 1088. It was papal policy for bishops to move to more urban seats, and he translated his own from Wells to Bath. He planned and began a much larger church as his cathedral, to which was attached a priory, with the bishop’s palace beside it. New baths were built around the three springs. Later bishops, however, returned the episcopal seat to Wells, while retaining the name of Bath in their title.

By the 15th century, Bath’s abbey church was badly dilapidated and in need of repairs. Oliver King, Bishop of Bath and Wells, decided in 1500 to rebuild it on a smaller scale. The new church was completed just a few years before Bath Priory was dissolved in 1539 by Henry VIII. The abbey church was allowed to become derelict before being restored as the city’s parish church in the Elizabethan period, when the city revived as a spa. The baths were improved and the city began to attract the aristocracy. Bath was granted city status by Queen Elizabeth 1 and a Royal Charter in 1590. From then on Bath had a mayor and aldermen. There were some improvements in the little town. Bellots almshouses were built in 1609. In 1615 a ‘scavenger’ was appointed to clean the streets of Bath. In 1633 thatched roofs were banned because of the risk of fire.

However like all towns Bath suffered from outbreaks of the plague. It struck in 1604, 1625, 1636 and 1643.

There had been much rebuilding in the Stuart period, but this was eclipsed by the massive expansion of Bath in Georgian times. The old town within the walls was also largely rebuilt. This was a response to the continuing demand for elegant accommodation for the city’s fashionable visitors, for whom Bath had become a pleasure resort as well as a spa. The architects John Wood the elder and his son John Wood the younger laid out the new quarters in streets and squares, the identical facades of which gave an impression of palatial scale and classical decorum. The creamy gold of Bath stone further unified the city, much of it obtained from the limestone Combe Down and Bathampton Down Mines under Combe Down, which were owned by Ralph Allen (1694–1764). The latter, in order to advertise the quality of his quarried limestone, commissioned the elder John Wood to build him a country house on his Prior Park estate. A shrewd politician, he dominated civic affairs and became mayor several times.

The early 18th century saw Bath acquire its first purpose-built theatre, pump room and Assembly Rooms. Master of Ceremonies Beau Nash, who presided over the city’s social life from 1705 until his death in 1761, drew up a code of behaviour for public entertainments.

By the 1801 census the population of Bath had reached 40020 making it amongst the largest cities in Britain.

William Thomas Beckford bought a house in Lansdown Crescent in 1822, eventually buying a further two houses in the Crescent to form his residence. Having acquired all the land between his home and the top of Lansdown Hill, he created a garden over half a mile in length and built Beckford’s Tower at the top.

Bath Spa Rail Station was built in 1840 for the Great Western Railway by Brunel and is a grade II listed building.

Between the evening of 25th April and the early morning of 27th April 1942 Bath suffered three air raids in reprisal for RAF raids on the German cities of Lübeck & Rostock. The three raids formed part of the Luftwaffe campaign popularly known as the Baedeker Blitz: they damaged or destroyed more than 19,000 buildings, and killed more than 400 people. Much damage was done to noteworthy buildings. Houses in the Royal Crescent, Circus and Paragon were burnt out along with the Assembly Rooms, while the south side of Queen Square was destroyed. All have since been reconstructed.

Bath is a very haunted city and below is a list of the more famous ghosts:

The man in the black hat

Easily Bath’s most famous and most-seen ghost, the man in the black hat is dressed in late 18th-century attire and sometimes wears a billowing black cloak. He’s regularly seen around the Assembly Rooms. For the best results, look for him at Saville Row and Bennett Street.

Freezing Hill

Several ghosts have appeared in the vicinity of Freezing Hill, just outside Bath. Most of these phantoms are from the 17th century, when this hill was the site of the bloody Battle of Lansdown.

The best opportunity to see these ghosts is from The Park, a 240 acre estate featuring a Jacobean mansion that is now an hotel. You can also enjoy a fine meal at The Oakwood Restaurant, and play golf at their Crown and Cromwell courses.

The Royal Crescent

It’s not a movie that’s being filmed at the Royal Crescent when you see an elegant coach drawn by four horses. Instead, you’re witnessing a residual haunting, repeating the elopement of Elizabeth Linley of No. 11, with Irish playwright and politician Richard Brinsley Sheridan.

Sheridan was not Miss Linley’s only suitor. Captain Thomas Mathews (a married man) and Lord Sheridan fought two duels–with swords–over the lovely Miss Linley.

Sheridan may have won her hand in marriage, but he later proved unfaithful. Elizabeth contracted tuberculosis and died at age 38. A bronze plaque at number 11 Royal Crescent marks the address from which she eloped.

The Theatre Royal the Garrick’s Head pub

The Theatre Royal and Garrick’s Head are next door to each other. Their ghost stories seem to be interwoven, and the ghosts congenially wander from one building to the other.

At least two ghosts appear in this area. One is an unfaithful wife and the other is her lover, from the 18th century. The lover was killed by the husband, and the wife committed suicide. Look for a woman (some say there are at least two) in a grey dress. The lover is handsome and well-dressed.

A second anomaly is noted at the Theatre Royal: A tortoiseshell butterfly appears there during the pantomime run each year, which is not butterfly season.

Popjoy’s Restaurant

Many visit this former home of Richard “Beau” Nash for the fine food. However, the restaurant hosts at least two ghosts, both of them women. One is Juliana Popjoy, the 18th-century mistress of Beau Nash.

The other ghost is Janice (or perhaps Janet). She is more modern, dressed in attire best suited to the 1960’s. She dines alone and looks perfectly normal until she vanishes.

The Beehive Public House

‘Bunty’, a serving girl from the Victorian Era or slightly earlier, appears in the kitchen of The Beehive, a popular Bath public house.

Crystal Palace Tavern

A hooded figure–perhaps a monk–appears at this tavern when he is concerned that the structure may change, such as during repairs or redecorating. He usually appears briefly and is fairly transparent.

Julia, of Queens Square

This jilted bride has been seen strolling around the Square in her white gown.

Today Bath continues to thrive on it’s tourism. Moreover in 2006 a new spa opened in Bath so perhaps the old glory days will return! Today the population of Bath is 85,000.

Please visit my Funny Animal Art Prints Collection @ http://www.fabprints.com

My other website is called Directory of British Icons: http://fabprints.webs.com

The Chinese call Britain ‘The Island of Hero’s’ which I think sums up what we British are all about. We British are inquisitive and competitive and are always looking over the horizon to the next adventure and discovery.

Copyright © 2010 Paul Hussey. All Rights Reserved.

How Anxiety Disorders Can Be Treated

A wide variety of disorders related to anxiety, tension, worry and fear are generally classified as anxiety disorders. The specific types include panic disorders and phobias or irrational fears. The intensity of the symptoms experienced by people suffering may vary from one individual to another. Stress, traumatic events, and fear are some of the most common factors that can trigger the development of the disorders. A person experiencing may suffer from specific reactions of the body including excessive sweating, heart palpitation, headaches, and extreme fatigue. The more severe the anxiety attack becomes, the weaker the person would be. Persons prone to anxiety disorders should always be accompanied with other people, just in case an anxiety attack takes place anytime, then anxiety disorder treatment can be followed.

Depression, from mild to major, and other psychological disorders have also been linked to anxiety disorders. Anxiety disorder is often caused by overlapping factors, thus, delineating the disorder from other psychological disorders would be difficult. Objects and other people are some of the environmental factors that serve as triggers for the disorders. Even stimuli that are not usually harmful such as butterflies can cause anxiety and extreme fear for individuals experiencing anxiety disorders. Having a disorder would be very much stressful because every encounter would lead with the triggering stimulus would lead to an attack. If you suspect that someone you know is suffering from it, you can observe the commonalities among all his or her attacks for you to identify what specific stimuli triggers the disorder.

The extent of the disorder can be determined by consulting a psychiatrist or a psychologist. Consulting an expert is considered the first step in attempting to treat or cure the disorder. The person suffering undergoes a psychological therapy so that he or she would be able to overcome his or her anxiety or fear every time he or she encounters the triggering stimulus. Treating anxiety disorders is often taken through two different approaches: cognitive or behavioral. The prevalent thoughts of an individual during the anxiety attack serve as the salient point of cognitive approaches in treating the disorders. Through this salient point, the therapist can identify the chain of thought that serves as the prelude to the rise or development of anxiety disorders. The other approach, the behavioral techniques, focuses more on the behavioral reactions of the individual to the specific events or situations triggered by the attack. If these two approaches would be combined, the chances that the disorder would be treated are higher.

Aside from therapy, a psychologist or psychiatrist may also recommend the intake of particular medications. Nevertheless, a major drawback in taking medications as treatment for the disorders and other psychological disorders is the inevitability of side effects. A withdrawal syndrome may also develop once the intake has been stopped. Furthermore, taking medications may also lead the individual to be dependent on the drug, potentially leading to substance abuse.

Dermoid Cysts – the Facts

Of the different kinds of ovarian cysts, the most grotesque and bizarre are dermoid cysts. They are a benign form of teratoma. Teratoma is Greek and means “monster tumor”.

It’s due to this freakish aspect that many misconceptions over the condition have come about. A medical decision about your health should never be based on misconceptions but rather, the facts. In this article, I will deal with 3 common questions that get asked about dermoid cysts.

1.) What are dermoid cysts?

Dermoid cysts may consist of any type of human tissue. This includes teeth, bone, nails, hair, cartilage, nerve tissue, skin, blood, fat, eyes, thyroid tissue and sweat glands.

This is due to the fact that these cysts arise from germ cells that are undifferentiated. These germ cells have the capacity to grow into any of the different tissues that are present in the human body.

2.) Who can be affected by dermoid cysts?

Dermoid cysts on the neck, face, and scalp can afflict anyone regardless of their age or sex. These cysts may be present at birth. But dermoid cysts in the ovaries usually affect women between twenty years of age to about forty. Only one ovary is normally affected but they can grow on both ovaries fifteen percent of the time.

3.) What are the health risks?

Although they have a frightful appearance, dermoid cysts are almost always benign. If the cyst has distinct features such as hair, teeth, etc., there is very little chance of it becoming malignant. These rare cancers will normally affect women in their forties and older.

Health complications of benign dermoids are dependent on cyst size. Small cysts normally present no symptoms and are detected during a medical examination. An MRI, ultrasound, X-ray, or CT scan may be used to diagnose the cyst as dermoid.

If the cyst gets too big, it can become inflamed. It can also cause irritation of the abdominal cavity, a condition called peritonitis.

More commonly, the cyst may get twisted and cut off blood flow to the ovary. There is also the possibility of rupturing with the release of its contents into the abdominal cavity. If a cyst grows too large it can push against and impair the function of the surrounding organs.

Because a dermoid cyst doesn’t go away by itself, surgery may be necessary if any complications arise. However, regardless of size, dermoid cysts need to be closely monitored by your doctor.

Type 2 Diabetes – Social Support Has Been Found Helpful In Preventing Diabetes

Social support helps to prevent many illnesses, and according to the journal Diabetic Medicine, published in January 2016, Type 2 diabetes is one of them. Scientists at the German Research Center for Environmental Health and several other research facilities in Germany, compared participants with good and poor social support over a period of 25 years. They found those with poor social support were more likely to develop Type 2 diabetes.

A total of 8952 participants aged 30 to 74 years old were tested with the Social Network Index, a questionnaire on social contacts. By the end of the study, 904 of the participants had developed Type 2 diabetes. Participants with poor social support were 31 percent more likely to develop the condition than those with good support…

  • among the men with ideal social support, 69 percent developed Type 2 diabetes, compared with 94 percent with poor social support.
  • 43 percent of women with good social support developed the condition, versus 58 percent of women with poor support.

The relationships were seen regardless of other risk factors. The relationship has been particularly high in men with low levels of education…

  • men with a low standard of education had a 50 percent increased risk of developing Type 2 diabetes than men with tertiary education levels.

The University of California in San Francisco, United States, defines social support as “the various types of support (i.e., assistance/help) that people receive from others and is classified into two (sometimes three) main categories…

  • emotional,
  • instrumental, and sometimes
  • informational support.”

1. Emotional support is given when we listen to a friend’s problems with empathy or when we give a reassuring hug.

2. Instrumental support might be providing a cup of soup or a meal, or driving a friend to the doctor.

3. Informational support might be giving someone the URL to a helpful website.

Some people are born into a large family with what seems to be never ending support. Some rely on their spouse. People from dysfunctional families or who have obvious medical problems can have a more difficult task to establish a social network. It is best to begin gradually…

  • greeting the neighbors on your daily walk,
  • bringing cookies around at holiday time and even
  • chatting about the weather with people you meet

is a good start.

The more people you talk to, the more chances you have of finding someone with whom you have something in common. If establishing a social network is particularly challenging, consulting a specialist can help develop insight into the problem. Even for people without many risk factors for developing Type 2 diabetes, being with friends makes life easier and happier.

Weight Loss – Obesity, Diets and Holistic Health

Diets are defined in the traditional sense of following a specific eating plan for weight loss / obesity.

Sure, following any of the hundreds of plans that have been promoted in the last few decades may result in some weight loss, but the benefits typically do not last.

Sadly, there is no magic bullet. No, not even those prescription medications that are common these days. Sure, they may result in shedding some pounds, but I've been observing nasty side effects in people that use them, and unless lifestyle changes are made, the pounds will come back.

The average American keeps getting heavier, especially children, and the new miracle diets keep coming, and the average American keeps getting heavier, especially children, and …

I suspect you get my point.

But wait, I have this diet that works and I offer a guarantee and … Gotcha! Sorry, there are no simple, miracle solutions / plans. There was never any and there never will be.

I am happy to report that what does work for weight management, always has and always will work, is this: careful food selections, self control, occasional splurging (yahoo!), Acceptance of how God made you, and eating slower, smaller more Numerous meals.

This is the holistic approach and it's what I advocate.

Why do not you see this type eating advice advertised on TV or in magazines anywhere? It's because nobody makes any money when you do it. Surprise! In fact, many people will make less money when you follow a healthy holistic eating lifestyle, sometimes doctors because you will likely be ill less often.

Please become aware that the media and it's advertisers are becoming increasingly talented at getting and keeping our attention, particularly when it comes to our physical appearance. They place pictures of beautiful people with gleaming muscles (they are oiled), rippling six pack abdomens (they are airbrushed or do dozens of sit-ups immediately before the picture is taken), or even yet the people are taking steroid type drugs to enhance Their physiques. These "models" are not representative of we typical humans. You and I need to be wise to this, even though we enjoy looking.

Also, be wary of some of the food products, their claims, and what's in them.

The top 10 deceiving "healthy" foods that lead to weight gain and other health problems:

– margarine, because it lacks the essential oils necessary for a healthy cardiovascular system.

– artificial sweeteners, because they contribute to inflammation

– soy, because it can mimics the hormone estrogen

– most granola bars, because they contain excess sugar

– most dehydrated fruits, because they have added sugar

– most juices, because they lack pulp and contain excess added sugars

– whole grain products, because many people have hidden gluten allergies

– commercially grown apples, bell peppers, celery, cherries, and imported grapes because they are the top 5 most chemically treated produce and contain toxins.

– all orange juice, because it is well known to increase inflammation

– commercially raised chicken because it's likely raised indoors, given antibiotics and probably hormones for faster growth

So scrap the diet plans and get the mind set that weight management benefits lifelong "good" eating habits. Simplistic is not it? Better yet it's either difficult or expensive.

So what's a person to do? The answer is this: small changes done consistently. Step one takes getting your thinking right first. Your brain has to change before your body will. Without that, all diets fail long term.

Here are a few tips:

– Eat smaller quantities and more often
– Eat fresher foods
– Eat organic grown varieties
– Eat slower
– Do not drink more than a few sips while eating
– Start a garden
– Eat more variety
– Add more fresh herbs and spices

Get to know the list of the 10 most chemically treated produce (avoid them), some detox / cleansing routines, recipes, and even some tips on simplistic gardening. These realistic weight management tools will produce results that last. Do not hesitate to seek professional guidance if needed.

I also recommend eating a big salad every day, possibly making a meal out of it by adding some quality protein like walnuts, fish, chicken, or beans.

And yes, do not worry, we can still enjoy goodies like ice cream on occasion, but with self control please.

Follow the above guidelines for the best management of weight loss / obesity.

Tips for Playing Disc Golf

Disc golf can be a winning sport, combining all of the fun of disc toss with the scoring and strategy of golf. Load up the disc bag and keep these tips in mind on the next trip out to the course.

Stretch it Out

Disc golf is a real sport, even if it does not involve all of the running of baseball, the contact action of football, or the vicious physical involvement of soccer. It can still be very taxing, physically speaking, for those who do not stretch out before each game. Always be sure to get a good stretch in beforehand to avoid injury and soreness later on.

Pack the Disc Bag up with Plenty of Bottled Water

A few bottles of water in the disc bag is not a bad idea. It's easy to get dehydrated when walking the course and the physical activity of tossing will only make players thirstier. Stay hydrated, especially during times of physical stress.

Use Brightly Colored Discs

It's easy to lose them in trees and on the field. Make sure that they're brightly colored so that they're easier to spot. It's best if the color is the opposite of the general color of the course. For instance, use red on a course with a lot of trees and grass, but green when playing on sandy terrain. Generally speaking, the color should clash with the most common color found on the course.

Wear Comfortable Shoes

Some people like to play in flip-flops. That's great on the beach. When playing in a park with a lot of trees and bushes or brush, it's a good idea to wear some closed-toe shoes so as to make it easier to walk through the cracks and tall grass to retrieve a lost game piece. That's going to happen occasionally, as the slightest breeze can knock the most perfect throw off course and into the greenery.

Pack a Light Lunch

Pack a lunch and make sure it's light. It's easy to take a break and go get some fast-food, but that weighs players down and makes it hard to want to continue the game. Packing a light tuna sandwich or a salad is a good way to keep from getting hungry out on the course without having to weigh oneself down with a heavy stomach and extra calories that will take all day to properly digest.

Frolf is fun, but take the proper precautions and remember that it is a real sport. Prepare for an outing with proper attire, food, water and equipment.

Dealing With Poison Ivy

Now that the autumn season has descended upon us we find that we are more inclined to take a brisk walk and enjoy a bit of nature. The various state forests and parks are excellent places to visit this time of year. The children have an opportunity to observe nature's annual metamorphosis as the trees and plants start to turn in color.

Along with all these positive attributes come a few negative downfalls as well. Since the 1950's, Poison Ivy has become more aggressive with its leaf size increasing and the toxic oils reaching elevated levels. This is not a very encouraging note if you happened to be one of those 350,000 people who became affected by the plant annually.

As always Poison ivy continues to top the plant list as the major plant to be avoided. The oily resin called "Urushiol" binds to the human skin upon contact and in the event that you may be allergic to it chances are great that you will develop a hypersensitivity reaction which is characterized by itching and a series of burning skin eruptions. With contact with this toxin you are condemned for anywhere from one to as much as three weeks of continuous itching and scratching. Upon absorbing the oil into the skin it generally takes approximately 12 to 36 hours for the symptoms to appear. Blisters and itching soon follow.

In 1609 Captain John Smith identified and termed the plant with its current name of "Poison Ivy". It is found typically in most forest areas of the North American continent. It is characterized by its three leaflet groups of leaves observed on small stems which originate from the larger main stem.

Prevention is usually the best course of action when it comes to Poison Ivy. Avoid contact with the plant when possible. Wear long pants, a long sleeve shirt, boots, and gloves in order to minimizeize being exposed to its toxic oils. Keep an active eye out for the plant as you do your daily travels. It has managed to find its way into yards, playgrounds, and other outdoor areas. If you discover a vast amount of the plant growing in your yard it is best to consult with professionals who deal with this plant on a continuous basis. Never "weed whack" the plants as that certainly spreads the Poison Ivy oil around your yard.

For some strange reason most pets are immune to the effects of the plant however, it is not unusual for humans to get the oil on their skin from petting their pet's fur. It is a good policy to bath your dog or cat while wearing a pair of thick rubber gloves. After washing your pet you should wash yourself utilizing only cold water in order to keep your pores closed.

Often when you find a growth of Poison Ivy, nearby you will see another patch of plants called jewelweed. This plant has been traditionally used by the Native Americans for centers to speed the healing process associated with the Poison Ivy infections. Simply pick some jewelweed and slice the plants stem. Next rub the juice from the stem on your skin. It will facilitate irritation from the Poison Ivy and prevent a spreading. If you can locate a product known as Poison Ivy soaps you would do well to purchase it. This soap contains jewelweed along with additional soothing ingredients like pine tar. If your condition is extremely serious or you are allergic to poison ivy you are advised to contact your family physician.

Copyright @ 2010 Joseph Parish
Http://www.survival-training.info

Why Do Blue Veins Appear Around The Mouth?

Have you recently noticed blue veins around your mouth area? What could possibly provoke the veins from appearing on your skin? Why are they visible now?

It is common knowledge that our body is made up of hundreds or thousands of veins. These are used to transport blood. They are properly concealed by our skin. But at one time or another, some of these veins become more obvious. The following are some of the possible causes for this condition:

1. Thinning of skin
As you get older, your skin loses its ability to produce collagen. This is what makes skin strong and thick. Without a reliable production of collagen, you can experience skin thinning. This makes tiny blood vessels and veins under the skin more visible.

2. Poor circulation
If there is a general poor circulation process in your body, this can be a prevalent problem. Poor circulation basically cuts off blood flow. This will make some of the veins thicker and plumper. They are straining to transport blood cells.

This can be aggravated if you sleep on your stomach. Your face is pressed on the pillow. This prevents good flow of blood around the mouth area.

3. Smoking
Cigarettes thin out the skin and impair circulatory functions. The smoke contains nicotine that can damage blood vessels and skin tissues. Cigarette smokers often experience thinning of skin especially around the mouth area.

4. Genetics
Some people are predisposed to this condition because they have inherited it from their parents.

Concealing blue veins around the mouth is easy through the use of cosmetic products. Find the right shade of concealer. Concealers come in different shades. This depends on the color of the blemish you want to hide. For example, red acne marks can be concealed better using green concealers.

Also use an anti aging moisturizer to improve the structure of skin around the mouth area. Look for products that contain CynergyTK, Phytessence Wakame and Nano Lipobelle HEQ10.

CynergyTK is an ingredient extracted from the wool of sheep. This ingredient is comprised of a functional protein called Keratin. Keratin is the same protein used by the body for the regeneration of collagen, hair and nails. This can improve the strength of skin tissues and prevent skin thinning.

Phytessence Wakame is a type of Japanese sea kelp. This sea kelp can protect hyaluronic acid. This is the acid that supplies moisture to collagen proteins. Nano Lipobelle HEQ10 is an antioxidant that can help get rid of harmful free radicals. This antioxidant is comprised of smaller molecular structure so it can protect skin cells deeper.

Medicinal Cayenne Pepper – The Health Benefits of Capsaicin

That cayenne pepper you use for your meals may function as something more than a spice to make your cooking more delicious. Unbeknownst to many, peppers contain a compound known as the capsaicin, which carry numerous health benefits. Here are seven reasons why you should start using more peppers in your meals:

1. It helps prevent cancer. In a study done with mice as subjects, capsaicin has annihilated nearly eighty percent 80% of prostate cells. In fact, the prostate tumors that were treated with it were reduced by almost one-fifth in size compared to those whose tumors have not been treated. According to Dr. H. Phillip Koeffler, director of hematology and oncology at the Cedars-Sinai Medical Center and a well-respected professor of medicine at the University of California, Los Angeles, "Capsaicin inhibits the growth of human prostate cancer cells in petri dishes and mice. " Additional research has also shown that taking capsaicin pills regularly can help prevent the prostate cancer cells from coming back.

2. It relieves congestion and prevents sinusitis. It can be extremely difficult to concentrate when you have a congested nose. Fortunately, eating cayenne peppers can give you potent antibacterial compounds that can protect you from chronic sinusitis. It can also relieve sinus-related allergies and help encourage production of secretions on your nose, which can assist in clearing up mucus and nasal congestion.

3. It alleviates pain. Good news for people who are fond of eating peppers and are diagnosed with osteoarthritis or diabetic neuropathy! This is because capsaicin has been tested and proven to be able to treat the pain associated with these diseases. It can inhibit the Substance P, a neuropeptide responsible for transmitting pain to the brain. It is also responsible for alleviating the swapping of nerve fibers, which leads to sinus symptoms and headaches.

4. It soothes intestinal problems. A study in Duke University has determined that regular capsaicin intake can actually cure inflammatory bowel disease (IBD). It is also being looked at for its potential healing effects on stomach ulcers due to its ability to kill H. pylori, the bacteria that cause one of the most common stomach ulcers.

5. It can help you lose weight. People who are looking to lose weight may want to include more peppers in their diet. You see, capsaicin is a thermogenic agent, which literally means that it has the ability to increase your body's metabolism. Consequently, this makes it ideal for people who have been meaning to lose weight as it can help burn fat as well as calories. In fact, numerous fat-burning pills in the market contain capsaicin.

6. It can fight inflammation. Capsaicin has long been known as a powerful anti-inflammatory agent. Its mechanism of action works mostly because of the inhibition of the Substance P, which is associated with inflammatory processes. In fact, it is currently being researched as a potential treatment method for psoriasis, diabetic neuropathy and arthritis.

7. It can protect your heart. Capsaicin can help lower cholesterol, platelet aggregation and triglycerides, which can promote a healthy heart. It also helps dissolve fibrin, which is a component in blood clot formation.

With all these benefits, you should try and include a few cayenne peppers in your diet. Your body will most assuredly thank you.

The Pros And Cons OF Owning Teacup Pigs

A teacup pig is just a small pig that has the ability to grow up to 12-16 inches tall and can weigh up to 30 to 65 pounds. At birth, it may only weigh 9 ounces which is really small when compared to the traditional pot bellied pigs. Because it is small, lots of people find them very attractive. However, there are both pros and cons of having these cute animals in your house. Discussed below are the various aspects you need to consider.

The Advantages

It has a long lifespan.

If you are really looking for a steady companion, a teacup pig is perfect for you. Its lifespan ranges from 15 to 20 years. However you need to take good care of it to ensure that it will live longer.

It is intelligent.

Despite the general feedback that pigs are dumb, a teacup pig is very smart. Just like other pets such as dogs and cats, it can also be trained to use its litter box and to perform different tricks which can provide entertainment.

It is affectionate by nature.

It is really sweet and affectionate which makes it more appealing to have. It needs your love and care. If you don’t have enough time for him then you might as well choose another type of pet.

It is perfect for those who have respiratory problems or allergy.

Unlike dogs and cats, a teacup pig doesn’t have hair which can cause allergy and other respiratory problems. It only has fine hair that does not shed.

It does not bark or make loud noise.

Since it does not bark, you won’t have problems of causing disturbances to your neighbors.

The Disadvantages

It can be aggressive.

It needs to be trained because it could become aggressive if it is not well disciplined. These animals also tend to open the bottom part of your fridge and pantry just to look for food.

It needs lots of time, love, and care.

If you are a very busy person, a teacup pig may not be the right one for you. You need to frequently play with him, to feed him and to train him. You also need to buy him toys so that he will be entertained.

A teacup pig is a very cute animal to have as a pet and if you have sufficient time to play and cuddle with this cute pet, then this is the right pet for you.

IBS – Symptoms and Treatment with a TWIST!

IBS is a dreadful word for the many people who have to cope with the stress, both physically and mentally that this condition brings. As per IFFGD a registered nonprofit education and research organization irritable bowel syndrome (IBS) affects approximately 10-15% or more of the general population.

Among other things IBS sufferers have to cope with symptoms such as abdominal cramps, stomach ache, diarrhea, constipation, heartburn, back ache, leg ache, headache, chronic fatigue, excessive gas, bloating, irritability, and panic attacks.

What is most concerning is the fact that most sufferers don’t know or have never been properly diagnosed with IBS, even by our own trusted doctors. IBS is characterized as a disorder that generally can not be diagnosed in a traditional way; that is, as an inflammatory, infectious, or structural abnormality that can be seen by commonly used examination, x-ray, or blood test.

And for the lucky few whose IBS symptoms are correctly diagnosed, what solutions and cures are available for such patients? Try to search for a treatment for IBS and you will be flooded with options, most of which are a complete waste of time, resulting in further frustration and misery.

So what is the solution – is IBS not curable?

To answer this we have to look Irritable Bowel Syndrome in more detail and try to understand the real causes that affect an individual to suffer from IBS symptoms. One thing is sure, there is no magic wand that can be waved which will cure your IBS.

Whilst trying to search for best way to manage IBS, we have discovered a very simple and common sense approach to handle IBS treatment, which could help anyone to take control of IBS in one’s own hands. An IBS cure which is 100% safe and natural and won’t require any kind of prescription medications. This could be a revolutionary new approach but what exactly what is this approach?

Become your own IBS Diet Manager

IBS Diet Manager is a programme which will allow you to record everything you eat and drink for every single meal, and then use the repors to see what effects different foods have on your IBS symptoms. The best part is you can start doing it with just a pencil and paper in your hand, just record what you have eaten during the day and their effects on you. By doing this you will quickly learn which foods and food groups cause you the greatest distress. You will learn which foods to avoid and which foods are safe.

Unlike all other IBS diets, if you use this approach, it does not tell you what to eat. Instead it will give you the information to listen to your body, and let your body tell you what works for you. That means you don’t necessarily have to cut out the foods which you like!

What is the Guarantee that this approach will work?

The IBS Diet Manger approach is a tried and tested technique used by people who are themselves long term sufferers of IBS. And the results of discovery about their eating patterns and their effects are so encouraging that these very people made a online reporting system with much more advance list of food categories and IBS reporting system but if you like you can start this reporting with just plain paper and pen and start recording your daily diet along with their effect on your body.

Try this new approach on IBS Diet Management, and the best part is you can use this approach by starting immediately – take out few minutes everyday and write down your daily food intake details and their side effects, (if any) – this approach towards your diet pattern will surly help. As said earlier there is no magic wand which will cure you but here an opportunity exists for all of you, who have suffered the ill effects of IBS symptoms to let your body tell you what works for you. Start recording your diet details today with pen and paper – Now!. It couldn’t be much simpler than this.

Visit our site for IBS Diet Manager which have advanced tools to generate automatic reports of your diet and its side effects