Fainting Happens To The Best Of Us

“I remember when it happened to me. It was last June during choir rehearsal. We had been standing on the risers practicing for at least an hour, and it was really hot and humid. The first thing I noticed was that everybody sounded really far away–like somebody had turned down the volume. Then I looked at the choir director, and he looked like he was melting into a gray background. The next thing I knew, I was on the floor behind the risers, and everybody in the back row was staring at me. I couldn’t recognize their faces at first, but then I started to focus on people I knew. I was so embarrassed!” Andrea blushed, remembering the incident.

“When it happened to me,” said Dan, “I was at the hospital because my brother had been hurt. My parents and I got to th hospital about the same time as my brother, so we saw him being wheeled into the emergency room. He had been in a motorcycle accident, and he was bleeding badly from a cut on his scalp. I remember looking at him. Then I began to sweat and feel sick to my stomach. I heard this roaring sound in my ears, and then everything went black. I woke up on a couch in the waiting room, but I couldn’t remember how I got there.”

Not Getting Enough Oxygen to the Brain

Physicians call this experience syncope (sin-ko-pe), but most of us call it fainting. It is a frightening experience for the person who faints, as well as for those who faints, as well as for those who observe it. Fainting is caused by a decrease in oxygenated blood reaching the brain. At least 20 percent of us experience it at least once in our life.

There are two systems that work together to ensure that the brain gets enough oxygen: the circulatory system and the nervous system. In the two examples described by Andrea and Dan, the cause was known and fainting was not associated with serious illness.

Andrea had been standing very still for a long time in a warm environment. She may have locked her knees, making it difficult for her circulatory system to get blood from her legs bact to her heart to be reoxygenated and recirculated. Her oxygen-starved brain just blanked out for a few minutes. As soon as she was placed in a prone position, circulation to her brain improved and she began to awaken. Most victims of fainting will regain consciousness shortly after they fall or lie down.

Feeling a Little Light-headed

Many teens experience light-headedness when they stand up quickly. Gravity is the cause. When you stand up, gravity attempts to keep blood in the lower half of your body. To counteract this, the veins constrict through a message from the nervous system. The heart rate increases to achieve sufficient pressure to pump blood “uphill” to the brain. Sometimes, there is a time lapse between standing and the time when your circulatory system gets the message to adjust its pressure and rate of pumping. The result is postural (orthostatic) hypotension–low blood pressure due to the body’s position.

This phenomenon may simply cause light-headedness, followed by a pulsing sensation when the blood pressure surges upward. For some people, it may result in fainting. The solution is to stand up more slowly, allowing the body time to ajust its blood pressure and heart rate to accommodate the new body position.

A Drop in Blood Pressure or Volume

In Dan’s case, emotional shock triggered his fainting. A sudden stimulus, such as shocking news, can cause the vagus nerve to slow the heart rate and decrease the output of the heart. This drops the blood pressure and decreases oxygen to the brain. Result? A sudden loss of consciousness. Pain and fatigue can also trigger this response.

Another cause of fainting may be a sudden drop in blood volume. It’s hard to get sufficient blood to the brain when there isn’t sufficient blood or fluid in the circulatory system. If a lot of blood is lost due to an injury, there would be less to circulate. Similarly, blood volume can drop if the body loses a lot of fluid as a result of vomiting or diarrhea. These causes are all temporary. Once the medical condition is corrected, the fainting episodes should stop.

Serious Fainting

But there are other causes that are more serious. Reactions to certain medications can be responsible, and an adjustment in medication will be necessary. Fainting might also signal a variety of other medical problems, including heart problems, stroke, hypoglycemia, and anemia. Teens who skip breakfast may be prone to fainting. Any unexplained or repeated episode of fainting should be brought to a doctors’ attention immediately.

What You Can Do

Sometimes people who are about to faint recognize the early symptoms and tell someone they feel faint. The greatest risk of injury is falling and sustaining a head or neck injury. So, if someone appears pale, is sweating, and acts disoriented or says he or she feels nauseated and faint, get that person to lie down to avoid a fall. If the person is sitting, make sure the head is lower than the heart. Then ease the victim to the floor and elevate the feet 8 to 12 inches. This encourages better circulation to the head.

Loosen any restrictive clothing, like a tie, belt, or collar. Do not give anything to eat or drink. Since some fainting victims feel nauseated, taking food or water could trigger vomiting. Use your judgment deciding whether to cover the victim with a blanket. If the fainter is sweating and nauseated, adding heat could make matters worse.

The victim should regain consciousness in a few minutes but should not be allowed to stand up right away. (This could precipitate another fainting episode.) If a cause for fainting cannot be determined, summon medical help.

When victims have no warning of fainting and fall, head injuries can occur. Check for signs of head injury, and question the victim after he or she awakens. Look for a medic alert tag that may give a clue to the cause of fainting. If a head injury has occurred, try to keep the victim as still as possible. Do not allow neck or back movement until medical help arrives. Do not elevate feet or move the person in any way if you suspect a neck or back injury.

For Andrea and Dan, embarrassment may have been the worst part of fainting episodes, but, for some, fainting can be a symptom of a more serious problem.

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Preparing Mentally Is Key To Any Competition

fnf“I pictured winning every point,” says tennis champion Gabriela Sabatini. “I visualized winning the whole tournament, never letting Steffi Graf into the match.”

That she did, and as a result accomplished a stunning upset, taking home the United States Open tennis title in 1990 at the age of 19.

The process that Sabatini used to give herself that mental edge is called imaging or visualization. Many top players in a variety of sports are using this process to make themselves ready for competition. In essence, they “run a movie” of a successful performance in their heads.

These successful athletes have learned that preparing for competition requires a combination of physical and mental preparation.

Let’s Get Physical

On the physical side, nutrition, rest, and relaxation all contribute to being optimally prepared to compete.

Anyone who has ever gorged on too much pizza can vouch for the fact that eating right (or wrong) has a direct effect on how you feel. A balanced diet is as important in gaining a competitive edge as physical training. In fact, if you don’t eat sensibly, your body may be extremely uncooperative as you try to push yourself to your limits.

When you want a quick energy boost before practice, DON’T reach for that candy bar. While candy packed with sugar may give you an initial surge of energy, it also brings you down quickly (even lower than your original energy level!). Snacks in the form of fruit, or a peanut butter sandwich, or cheese and crackers, or a bowl of cereal are a smarter choice when you’re gearing up for competition.

On the day of competition, be sure to eat your meal several hours before you are scheduled to compete.

Rest Easy

Adequate rest in an important component in getting ready for competition. The excitement of the coming contest may make it difficult to fall asleep. You may even think that staying up late to get in more practice will give you that competitive edge. It won’t! Instead, lack of much-needed sleep is likely to cloud your mind, dull your senses, and slow your movement. Give yourself a break: Rest.

You Deserve to Relax

Relaxation is another important ingredient in preparing for competition. Watching a movie, listening to music, reading, talking to a friend, anything that puts you at ease and relieves stress helps to promote a healthy state of mind.

Determination Is the Key

While no one is perfect, practicing skills brings them to the highest level we can attain. Determination begins with a goal. Then decide how to achieve that goal. Start from where you are; take pride in what you’re doing; focus on what you can do, not what you can’t do; learn from your mistakes; don’t be afraid to fail; be willing to sacrifice to reach your accomplishments.

Once you get close to the day of a competition, the physical aspect of optimum performance is overshadowed by the importance of mental toughness. At this point, if you’ve prepared well, your body will “automatically know” how to perform. It is your mind that must be tough enough to handle the situation successfully.

Dr. Robert W. Burton, a sports psychiatrist at Northwestern Memorial Hospital in Chicago, emphasizes that being the first to cross a finish line requires much more than strong muscles and good foot speed. To be at top performance, an athlete must be equally strong in mind and body.

More Imaging

“I’ve been doing visualizing exercises since I was 12,” says 19-year-old Jessica Mills from Evanston, Illinois. Jessica is a world-class figure skating champion who captured the Junior World Figure Skating Championship at the age of 14.

“About two weeks before every competition, each night I visualize one of the two routines I will be doing. I go through all the jumps and spins in my mind exactly as I want them to be,” she says. “Then, on the day of the competition, I get to the rink early, stretch, find a quiet corner and visualize my entire upcoming performance. I go through every move, feeling that the performance is flawless.”

It seems to run in the family. Jessica’s 22-year-old sister, Hilary, a National Speed Skater, also uses visualization as a tool to prepare for competition. “On the day of my competition,” she explains, “I usually close my eyes and go through the exact techniques I want to use. When I see the races in my head, I see all my split lap times, which are excellent, of course. Sometimes I see myself from different views,” she continues, “as if I am observing myself from inside out. Other times it’s as if I were a spectator watching myself. The night before a race I try to relax and do something I really like to do–go to a good movie, for instance. But don’t think I won’t be pondering how I’m going to skate tomorrow’s race,” she says with a smile.

Hanging Tough

Robert M. Nideffer, Ph.D., in his book Psyched to Win, offers the following advice on mental toughness.

1. You have the capacity to believe and to have faith in your own abilities. It is your responsibility, however, to develop that faith by making a commitment.

2. Faith is important because it quiets the voice of doubt inside your head. Unless you quiet self-doubt, you cannot become immersed.

3. Believe it is your responsibility to do the very best you can with the tools you have.

4. Accept the fact that faith is a growing process, not an absolute.

5. Faith and your ability to play “in the zone” (at a level of peak performance) grow slowly, hand in hand.

6. Responsibility for your life rests in your own hands.

Olympic sports psychologist Shane Murphy says, “To succeed in anything, think of yourself in a positive way. This means that when you get a negative thought, you must consciously stop and replace it with a positive one. In sports, such phrases as ‘I am a winner’ or ‘I deserve to be here’ are the kinds of thoughts that will enhance your mental outlook and facilitate your best ever!”

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Electrical Burns: The Danger Is Ever Present

ecalb“Tony, I don’t want you changing that outlet without your father here to supervise.”

“Aw, Mom, I’ve done this before, and I know how to replace a simple outlet,” answered Tony.

“Are you sure you turned off the right circuit breaker?” asked his mother.

“Sure. But it wouldn’t matter. Nobody gets hurt on just 120-volt house current.”

Wrong, Tony! Improper use of electrical equipment on a house wiring circuit can transmit a fatal current or cause a serious burn. The severity of electrical injuries is determined by these factors: voltage, current, resistance, and the duration of contact with the current. The voltage Tony referred to is not the most important factor. It is the current that causes the greatest damage. The relationship of voltage and current is similar to the pressure and flow in a garden hose. Voltage would be the pressure of the water; current would be the number of gallons being pumped per minute.

As little as 1 or 2 milliamps of current can be felt by a person. Someone grabbing more than 10 or 15 milliamps will not be able to let go. Cardiac arrhythmia can result from contact with 50 to 500 milliamps; breathing may be stopped by 100 milliamps to 1 amp. More than 500 milliamps may cause serious burns.

A typical electric frying pan can have as much as 10 amps flowing through it during use, so house current can do a lot of damage. It may even be fatal if the current crosses the heart.

The Path of Least Resistance

Most of the harm from electricity occurs in the nerves and blood vessels because they conduct the current better than muscle and bone. An electrical burn that appears small on the surface could have caused extensive damage to blood vessels and internal bleeding.

When electricity enters the body, it travels along the path of least resistance: the nerves and blood vessels. This current travels rapidly and generates heat that causes the destruction of surrounding tissues. The electricity exits wherever the body is in contact with a ground, such as a metal object or water. Sometimes a victim has more than one exit location and suffers burns around all of them. A victim may have serious damage from an explosion at the exit site.

A victim of an electrical injury can have a variety of symptoms. These include burns at the entry and exit sites, paralysis due to nerve damage, and muscle tenderness and twitching. Because electrical shock causes trauma, victims will also show signs of traumatic shock including pale skin, weakness, and loss of consciousness. The most severe electrical shocks can cause respiratory and cardiac arrest, requiring immediate CPR (cardiopulmonary resuscitation).

In addition, electrical contact can cause first-, second-, and third-degree burns Direct contact between the skin and the metal of the wires of an electrical cord, such as when a child bites into a cord, can cause internal bleeding that may not begin until a day or two after the initial injury.

First Aid Facts

To give first aid for electrical burns, your first concern should be safety. Downed power lines are very dangerous. Don’t touch one under any circumstance. If a power line is down, wait for the fire department or power company before touching or going near the victim. Since the human body can conduct electricity, if you touch the victim, you become a victim. If people are trapped in a car by a downed power line, tell them not to move and to stay in the car until the power is turned off.

Once the victim is in a safe place, your next concern is for his or her breathing and heart function, especially if the victim is unconscious. Because electrical current can interfere with normal heart function, checking vital signs is more important than dealing with an obvious burn. If the victim is not breathing, begin rescue breathing. Then do a pulse check and determine if more CPR is needed.

You also will neeed to check for further injuries. Perhaps the victim fell and has injured his neck or spine. Or she may have hit her head. These injuries require first aid before you turn your attention to the electrical burn. Do a survey of the entire body. Electrical current may have entered the body at one point, and an exit wound may need to be discovered.

With most burns that are not electrical in nature, first aid is to cool the burn by applying cool water and then covering the burn with a sterile dressing. With electrical burns, first aid means simply covering the burn with a sterile, dry dressing. Bandage loosely. Do not remove clothing that may have become stuck to the burn. Don’t break blisters that form, and don’t apply any ointment or cream. Treat for traumatic shock by maintaining body temperature and elevating the feet if you are certain there is no neck or back injury.

If the victim has been struck by lightning, begin by extinguishing any flames. Send for help. Then check the victim’s vital signs — breathing and pulse. Give CPR if needed. If the victim is conscious, reassure him or her; check for entrance and exit burns and treat for traumatic shock. Because victims of lightning strikes are often thrown to the ground, be cautious about moving the victim. There may be neck and back injuries.

Respecting electricity is something that comes naturally to those who work with it on a daily basis. Amateurs are the individuals most likely to become injured because, like Tony, they think house current isn’t deadly. They may be dead wrong!

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Are You Fit? Maybe Not!

aufmbnYou play soccer… tennis…hockey. You love to swim and sail. So you’re physically fit, right? Not necessarily.

Participating in all those sports means you’re active, not necessarily fit. It takes specific training to build fitness, using exercises designed to improve flexibility, strength, and endurance. To be physically fit, you’ve got to have all three.

* Strength. This is a measure of how much force you can exert with your muscles. When you’re physically strong, you’re less likely to sustain injury when you do heavy work. You’ll also do better in other activities, including games and sports.

* Endurance. There are two types: heart and lung (cardiorespiratory) and muscular endurance. Cardiorespiratory endurance means you’ve got a strong heart and lungs that can supply your body with nutrients and oxygen. Your muscular endurance is how long your muscles can work.

The greater your endurance, the more energy you’ll have to play sports or games. Your muscles will be trim, and you’ll breathe easily–even during exertion. And the healthier your lungs and heart, the easier you’ll be able to fight off some diseases.

* Flexibility. A flexible person can move all the muscles and joints through their full range of motion. The more flexible you are, the more easily you can reach, bend, and stretch. You’re less likely to injure your muscles and joints. This is an area of fitness tests where girls excel. And girls continue to increase flexibility throughout their teen years.

You also may want to have someone (like a physical education teacher) check your body composition: the proportion of fat to lean mass–muscle, bone, tissue, and organs. But are you aware that weight isn’t always a good indicator of fitness?

Take Bob and Tim. Both weigh about the same, but Tim looks out of shape; Bob is fit and trim. Why? Muscle weighs more than fat. Although they both have the same weight, Bob actually is more fit and looks better. Tim looks bigger, but his bulk comes from fat, which weighs less.

The Workout

You can build up cardiorespiratory endurance with aerobic exercises such as jumping rope, running, walking, and biking. These activities will also help burn off calories. Muscular endurance can be improved by push-ups, leg raises, and curl-ups.

You can improve strength by working out with weights, bar-bells, or special strength-training equipment.

Flexibility can be improved by stretching, including the “V-Sit Reach,” in which you spread your legs and stretch beyond your toes. And stretching also helps release tension and ease stress.

Test Your Fitness

Want to know how good your cardiorespiratory endurance is? Just clock how fast you can run a mile. About half of all girls between the ages of 6 and 17 and 30 percent of boys between ages 6 and 12 can’t run a mile in less than 10 minutes. How well do you stack up?

If you want to test your muscular endurance, count the number of curl-ups you can do. That tests your abdominal muscle strength and endurance. To qualify for the Presidential Physical Fitness Award, boys from 13 to 17 must be able to do 42 to 44 curl-ups (the number increases with age) in one minute. Girls 13 to 17 should be able to do 37 to 33 (this number decreases with age).

You can test your strength by seeing how much weight you can hold in place or how much weight you can move, using either a barbell or strength-training machines. You’ll need to get some expert advice before using this special equipment.

To test for flexibility, see how far you can reach beyond your toes in the V-Sit Reach. To qualify for the Presidential Physical Fitness Award, girls ages 13 to 17 must reach 7 to 8 inches (the number increases with age) beyond their toes; boys ages 13 to 17 must reach 3.5 to 7 inches (the number increases with age).

Get Go-aling

If you want to improve your fitness level, it’s a good idea to set some goals and record your weekly progress. Keep track of the number of curl-ups or pull-ups you do. Log in the number of miles you walk or run.

Keep these pointers in mind:

* Gradually increase the difficulty, the length of time, and the number of times you do each exercise. It should take about six to eight weeks to start seeing improvement, but you’ll feel better right away.

* Set aside a regular time to work out–at least three or four times a week. Don’t wait too long between workouts.

* If you want your muscles to get stronger, you’ll have to work them harder than normal. You want your heart to beat faster and your breathing to increase if you’re doing aerobics. You want to do more repetitions of an exercise or lift more weight. If an exercise seems too easy, it probably is. Add a bit more weight, or add a few more repetitions.

* Each type of exercise is designed to improve a specific aspect of fitness. You won’t build muscle by doing stretches; that builds flexibility.

The Time Is Right

One good time to exercise is about an hour before the evening meal–this helps melt away stress and worries that have built up over the day. Some people like to work out early in the morning before the day begins–to feel more alert and energetic.

Don’t exercise during very hot, humid weather or within an hour of eating. Both heat and digestion make the body’s circulatory system work overtime; exercising on top of this extra work can be too much for your body to handle.

Remember: It’s exercise that gives muscles their shape and helps decrease body fat. The more physically fit you are, the more well-balanced your body will be.

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Knowing The Issues Waste Creates

wtcsHow big is the problem? Consider just one type of hazardous waste: radioactive and toxic wastes generated by America’s nuclear weapons plants. Cleaning up this mess alone would require the largest public works project in U.S. history. The task would take decades. And the cost could run into the hundreds of billions of dollars!

The total scope of the hazardous waste cleanup problem involves nearly 50 years of toxic substances that have been in our soil and water. And even if we can clean up the old waste, how do we keep new hazardous material out of the environment?

The first step is to understand just what hazardous waste is. A commonsense definition says that it is something that has been thrown away or released that could cause or contribute to injury, illness, or death. It could also endanger the environment.

Hazardous Traits

A variety of federal laws list specific substances that are classified as hazardous. In addition, waste with any of the following four key characteristics must be treated as hazardous. These include:

Ignitability. The substance ignites when exposed to air or water or could explode below 140 degrees F. Examples includes fuels, solvents, and other volatile chemicals.

Corrosivity. The substance has a pH of less than 2 (extremely acidic) or greater than 12.5 (extremely alkaline). Acids and other chemicals used in industrial processes can meet this definition.

Reactivity. Includes all materials that react violently with themselves, water, or air by exploding or generating dangerous fumes or gases. Includes volatile chemicals and substances such as phosphorus.

Toxicity. Substances that induce illness or death or otherwise impact the health of living things. Some medical waste, asbestos, pesticides, and heavy metals like lead and cadmium are potentially toxic when dumped into the environment.

Danger in the Dumps

Until the 1970s, we simply dumped paints, solvents, chemicals, and other untreated waste into the ground or water. These substances don’t just disappear when buried or dumped. Chemicals from hazardous waste seep into the ground. They then appear in the water that we drink and the soil in which we grow food.

Today, four main methods are used for safely disposing of hazardous waste:

* Burial in carefully constructed hazardous waste landfills

* Deposit in safe underground spaces such as abandoned salt mines

* Chemical and physical treatment

* Incineration

These methods either change the substance so that it reduces toxicity or they remove it from the environment to minimize human contact with it. Some of these methods may be controversial. For example, while incineration results in nearly total destruction of hazardous wastes, critics say that it releases more toxic materials into the air, creating a “garbage dump in the sky.” And they add that the resulting ashes are often hazardous. If the ashes are stored or handled improperly, the problem hasn’t been solved–it’s just changed in form and been moved around.

The problems with incineration point to a more important solution to the hazardous waste problem: hazardous waste minimization. Many wastes, such as motor oil, that are hazardous when improperly dumped can be safely recycled. Hazardous waste control and minimization is not just for industry and government. One of the most important potential sources of hazardous waste is right at home.

Cleanup Begins at Home

Look around your house. Do you and your family use batteries in your portable CD player? Change a car’s oil? Use furniture cleaners or paint and varnish? All of these products, and many others in your home, contain hazardous substances. The garage holds many sources, including antifreeze, fuels, and transmission fluids. And in the yard, pesticides, fertilizers, and even flea and tick treatments can be hazardous if they are used and disposed of improperly.

Just dumping these materials in the garbage or down the drain creates hazardous waste. In New York state in a single year, for example, residents put nearly 4,000 tons of heavy metals into landfills when they throw batteries in the garbage.

To be part of the hazardous waste solution, follow these simple guidelines:

* Identify the products containing hazardous substances in your home.

* Read the labels carefully to learn what’s in them and whether there is a recommended method of usage and disposal. Don’t put hazardous materials in the garbage or pour them down a drain unless the product label says it is safe.

* Find out what rules apply for disposing of hazardous waste in your area.

* Collect discarded hazardous materials for disposal or recycling according to the product labels and local laws.

* Substitute products that don’t contain any hazardous substances.

Many localities have special waste cleanup days for collecting hazardous home products. Others allow bringing your hazardous materials to the local dump or recycling center. By minizing hazardous waste in our own home, we can make a start at solving one of the toughest environmental problems.

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The Right Choices For Teens Can Mean A Long Life

teensSmoking is considered responsible for 87 percent of all lung cancers.

The truth is, you are faced with life-and-death choices every day, even though you may not realize it. For teens especially, the decisions may not seem as clear-cut as what to do Saturday night or what college to try for, but many of your daily choices can make a big difference today, tomorrow, and for the rest of your life.

The Hit Parade

Heart disease, cancer, stroke, accidents, lung disease, pneumonia and influenza, diabetes, suicide, HIV (AIDS), homicide–when it comes to killers, these are the nation’s Top 10.

According to the latest government statistics (1990), the rankings for Americans between the ages of 15 and 24 are strikingly (and shockingly) different: Number one by a landslide (16,241 deaths that year) is accidents, with motor vehicle accidents making up more than three-quarters of that number. Homicide follows with 7,354 deaths, and suicide comes in third with 4,859. There is a dramatic falloff between these three and the next seven, beginning with cancer, which claimed 1,819 lives in your age group in 1990.

Thinking About Tomorrow

The big three for teens are considered by health officials to be “external causes,” which means these are the ones you can do most to avoid. It’s not a matter of catching a disease or succumbing to a deadly condition that has taken years to develop or one you may even have inherited from your ancestors. Although your choices matter to some degree for most of the other seven (so-called natural causes), you have a lot more control over the external causes.

Choosing not to smoke (or to quit if you’ve begun) and eating a low-fat, high-fiber diet can go a long way toward avoiding the killers. Exercise (which reduces stress while it burns off that double-fudge sundae) is another choice you can make–the earlier in life the better. Avoiding alcohol and other addictive substances reduces the risk for many diseases and is the best defense against accidental death and car crashes. And the best thing about those choices is that, as you will see, they’re general all-around risk reducers.

It’s hard to keep an eye on the future when there’s so much to think about and do today, but that’s part of growing up, of becoming independent, of taking charge of your own life.

The Lineup

Let’s take a look at each of these killers to learn something about how they operate and what you can do to give them the slip.

1. Heart disease kills more than 700,000 Americans every year. Most of them are over 35 years old, with the greatest number dying when they are 75 or older. But because most heart disease takes years to develop, think of it as a disease of old age that begins in adolescence–even in childhood.

The major risk factors are male gender, age, heredity, smoking, high blood pressure, obesity, sedentary lifestyle, and stress. You can’t do anything to change the first three factors, but there’s a lot you can do about the rest. Exercise, eating right, and not smoking are the important choices here.

2. There are 100 different types of cancers. What they have in common is that abnormal cells develop and multiply, eventually overwhelming normal cells and the body’s ability to fight invaders.

The greatest killer cancer among people of all ages is lung cancer. For women, breast and colon cancers come next; for men, colon and prostate cancers are second and third. Even though you might think of cancer as mostly a disease of adults, cancers that kill young people include leukemia (a cancer of the blood), Hodgkin’s disease (the immune system cancer that has stricken hockey great Mario Lemieux), and bone and brain cancers.

Medical scientists don’t know the causes of all cancers or all of the causes of any cancer, but there is evidence that genetics and exposure to environmental poisons are among the culprits. Remember the all-around risk reducers? Since lung cancer is the leading cause of cancer death and smoking is considered responsible for 87 percent of all lung cancers, shunning tobacco looks like a pretty wise choice. (Snuff and chewing tobacco can promote cancers of the mouth and throat, so these are certainly not safe alternatives.) Recent studies tell us that even being around smokers puts a person at risk for developing lung cancer and other lung diseases, which means the choices friends make matter, too.

A low-fat, high-fiber diet can help protect you from colon cancer. Alcohol, nitrites (found in smoked and preserved meats), and fats are suspects in other cancers too, so limiting these is a health choice.

Avoiding excessive sun exposure and wearing sunscreen and protective clothing can decrease the chances of skin cancer. And asking your doctor to show you how to examine your skin, your breasts (for girls), and your testicles (for boys) will help detect cancers that might be developing at an early stage when they are most curable. In fact, doctors say they have a good chance of “checking” Mario Lemieux’s Hodgkin’s disease because it was discovered early.

3. Stroke occurs when the blood supply to the brain is interrupted. A blood clot or a break in a blood vessel could be responsible. Strokes are more common among older people, but they can happen to young people, too. The risk factors for stroke include high blood pressure, high blood cholesterol, heart disease, smoking, alcohol, and obesity. This is another case where your choices can reduce your overall risk.

4. Accidental deaths include many events, such as falls, drownings, diving mishaps, and deaths by fires, but by far the greatest number involve motor vehicles. Among Americans of all ages, car crashes represented more than half the accidental deaths that occurred in 1990; among those ages 15 to 24, they accounted for 78 percent!

You probably already know the choices you can make to reduce your risk of accidental death:

* Use safety equipment: seat belts and helmets for biking, motorcycling, skating, skate-boarding, contact sports.

* Stay away from alcohol and drugs, always, but especially when you are driving or operating machinery of any kind, or swimming or boating.

* Resist peer pressure to engage in risky and self-destructive behavior, and exert positive peer pressure of your own to set a good example among your friends.

5. Lung killers include tuberculosis (TB), emphysema, and asthma. TB is an old disease making a come-back, particularly among the homeless, those who are addicted to drugs, and people with AIDS. Treatment of this infectious disease takes a long time and requires a lot of cooperation from the patient.

Smoking is public enemy #1 with emphysema. Smoking and being around smokers is especially dangerous for people with asthma, too. Medication and lifestyle changes can help people live with this chronic disease.

6. Diabetes is a metabolic disorder. Although it cannot be cured, people with diabetes can do a lot to keep the disease under control. When it goes out of control, it can cause death. Control requires lifestyle changes that include avoiding smoking and alcohol; diet and exercise to maintain a healthy weight and blood glucose level; and, often, taking special medications.

7. Pneumonia and influenza result from exposure to disease organisms. Most people who catch these illnesses get better; those who die from them tend to be very old or very young, or to have poor immune defenses because of another serious disease.

8. Suicide has become too common among American teenagers. In 1990, more than 4,800 15- to 24-year-olds took their own life. You can probably understand what lies behind the numbers better than the experts. Adolescence is a time of change, turmoil, confusion. When the confusion overwhelms more positive feelings, it may become too much for a young person to endure. Drugs, alcohol, and family problems contribute to a feeling of hopelessness. Happily, most teens weather this time with the help of friends and trusted adults.

9. Human immunodeficiency virus (HIV) is the virus that leads to AIDS, a condition that has made its horrible presence well-known in little more than a decade. Some people call AIDS the modern plague; many people think it has nothing to do with them and their friends.

An indication of how serious a public health problem HIV infection is can be seen in a look at the Top 10 causes of death in the United States over a 12-year period. In 1985, HIV infection was not listed as a major cause of death; in 1987, it was listed at #15; by 1989, it had sneaked up to #11; in 1990, to #10; and estimates for 1991 put it at #9. And among teens and young adults under 25, the latest figures rank it #6.

It’s all the more frightening if you look at the age group immediately following–25 to 44–where HIV infection is the #3 cause of death. Because it may take up to 10 years or longer after transmission of HIV to develop AIDS, many in this age group may well have made the choices that mattered while in their teens. Those choices fall into two broad categories: engaging in unprotected and/or promiscuous sex and sharing needles for injecting drugs. You don’t need to be a rocket scientist to understand the dangers.

10. Homicide isn’t something that happens only on TV or in the movies, although it happens there a lot. And some experts wonder whether the amount of violence teens see on the screen and read about in the newspapers is contributing to the horrifying numbers in real life. What do you think?

In 1990, homicide accounted for 7,354 deaths in the 15 to 24 age group. Again, alcohol and drugs, as well as access to weapons, are risk factors. Solutions lie in words: Learning how to talk about angry feelings and to resolve conflicts verbally rather than physically is the best chance for teens–and everyone else, for that matter–to kick this killer off the Top 10.

Here’s the Good News

Death rates from most of the Top 10 killers have declined between your parents’ generation and your own. Hats off to you for making the right choices! Here’s an example: In 1950, 6.8 of every 100,000 people between the ages of 15 and 24 died from heart disease; in 1980, the figure had shrunk to 2.9 per 100,000. By the end of that decade, it was 2.6, with every indication that the decline would continue.

In fact, among the 12 to 17 age group it looks as if a lot of smart choices are being made. In 1974, 25 percent of that age group smoked. By 1991, that figure was down to 11 percent. In 1974 a whopping 34 percent of 12- to 17-year-olds were reported to have used alcohol in the previous month; smart teens of today have reduced that figure to 20 percent.

Teens today are getting the most out of their healthy bodies by making choices that matter. In increasing numbers, they are giving themselves the best chance of growing to a healthy old age, with lots of pleasure and fulfillment in the years between.

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Boys And Girls Just Communicate Differently

bagjcExperts tell us that a chief reason friendships run into trouble is because boys talk to girls differently than girls talk to boys. And their communication styles are based on very different expectations. Learning how others communicate and adjusting your expectations to the differences in styles can help.

The following tips come from psychologists, guidance counselors, and specialists in how people think, feel–and talk.

Boy Talk

We’re all individuals, with our own communication style and our own unique way of expressing ourselves. Yet within the genders are some common points.

* My Turn! Boys expect girls to listen to them, while fewer girls expect boys to do the listening. Because of these expectations, boys generally do more of the talking in boy-girl conversations.

* Yeah, But… Boys interrupt girls more often than girls interrupt boys–or each other.

* How Come? Who Says? Boys ask questions because they want information–and also because they want to let people know they’re in charge.

* Well… Boys are less comfortable than girls in talking about their feelings.

* I Won! Boys especially like to talk about the competitive parts of their life. The excitement of trying and winning is important to boys, and they like to talk about it–who they’re up against, what their chances are, what they have to do to get better.

* Yea, Team! Many boys like to talk about team events–their school, their favorite sports team, professional or amateur. High-tech and sports equipment, cars, and bikes all are very important to many boys.

Girl Talk

* Now, What About You? Girls tend to take turns talking. With women and other girls, many girls observe the unstated but understood rules of sharing: If you listen to me and let me know you’re interested in what I’m saying, I’ll do the same for you.

* Tell Me More. Girls ask questions to display interest in the other person. It’s a way many girls deepen a friendship.

* At Least, I Think So. When they’re stating opinions, girls tend to hedge their statements and make disclaimers. “It seems to me…” “Don’t you think so?” While girls may use this as a way to draw others into the discussion, boys may see it as a sign of uncertainty or insecurity.

What We Have in Common

Girls and boys both want to feel safe in their friendships. That means we want to feel understood for who we are, not for who the other person wants us to be. We need to trust the other person to be there for us–to listen, to respond, and to act on our behalf.

We also want to feel interesting and valued for who we are as human beings, not just for what we look like or seem like but for who we really are. That includes those character traits that nobody else has in quite the same interesting–or even irritating–ways.

Solving Misunderstandings

If you find yourself stumbling again and again over the same roadblock in talking to your friends, the following guidelines may help:

* Clarify Questions: If you don’t understand or don’t agree with what your friend says, try for more information or for another level of meaning. “I’m not sure I understand. Can you explain?” is one way to get at what the other person really means. Paraphrasing is another tactic: “If I understand you, you’re saying that….” Restating and rewording the other person’s comments can overcome misunderstandings and keep a relationship on a firm footing.

* How to Handle Interruptions: If the other person habitually interrupts, it may help to keep talking in spite of the intrusion. If this doesn’t work, increase the volume as you continue to speak. If you’re forced to break off your comments, don’t acknowledge the interruption. At the first break in the flow, continue where you left off. If the other person ignores this tactic, level with him or her. Describe how it feels to be interrupted continually. Ask the other person to let you finish.

* Take the “I” Approach: If your feelings have been hurt by your friend’s actions or words, say so. But confine yourself to how you feel about what happened. Stay away from accusations about what the other person did or speculation about what he or she intended. Don’t use phrases such as “You did” or “You said.” Try instead: “My feelings were hurt.” “I felt like you didn’t care.” “I felt ignored.”

* When in Doubt, Don’t: If you suspect that something you’re about to say could hurt the other person’s feelings, don’t say it. Bite your tongue, sleep on it, write it down, talk it over with others before you say it directly. Taking back your words is generally a lot more difficult than not saying them in the first place.

* Apologize Fast: If you think you’ve unintentionally hurt a friend with your words, apologize as soon as possible. Don’t let the hurt fester in the other person’s mind. “I’m really sorry; I didn’t mean to hurt your feelings. Please forgive me. I hope we can still be friends.”

* Pace the Friendship: Let the friendship progress at a pace that’s comfortable for both of you. If he’s not willing to talk about his feelings, don’t push him into it. He may simply prefer to wait until he knows you better before he trusts you with information that’s important to him. Ease off if you feel him pull back. While you may not understand his reasons, you should respect his desire for privacy.

* Empathize: If you can’t talk clearly and comfortably with a close friend, ask yourself what it must be like for the other person. Trying to understand his or her point of view might help get you both back on track.

Boys and girls may have different expectations from conversation. But understanding these differences can help smooth the disagreements and pave the road to a lasting friendship.

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