daniel roper and the panama pacific line declared curran and the strikers mutineers. the line even took out national advertising attacking curran. when the ship docked, federal bureau of investigation agents met the ship and began an investigation into the " mutiny. " curran and other top strike leaders were fined two day ' s pay, fired and blacklisted. perkins was able to keep the strikers from being prosecuted for mutiny, however. seaman all along the east coast struck to protest the treatment of the california ' s crew. curran became a leader of the 10 - week strike, eventually forming a supportive association known as the seamen ' s defense committee. formation of nmu the s. s. california strike was only part of a worldwide wave of unrest among american seamen. a series of port and shipboard strikes broke out in 1936 and 1937 in the atlantic and gulf of mexico. in october 1936, curran called a second strike, in part to improve working conditions and in part to embarrass the isu. the four - month strike idled 50, 000 seamen and 300 ships. curran, believing it was time to abandon the conservation international seamen ' s union, began to sign up members for a new, rival union. the level of organizing was so intense that hundreds of ships delayed their sailing time as seamen listened to organizers and signed union cards. in may 1937, curran and other leaders of his nascent movement formed the national maritime union. the seamen ' s defense committee reconstituted itself as a union. it held its first convention in july, and 30, 000 seamen switched their membership from the isu to the nmu. curran was elected president of the new organization. elected secretary - treasurer of the union was jamaican - born ferdinand smith. thus, from its inception nmu was racially integrated. within six years, nearly all racial discrimination was eliminated in hiring, wages, living accommodations and work assignments. a hallmark of the new union was the formation of hiring halls in each port. the hiring halls ensured a steady supply of experienced seamen for passenger and cargo ships, and reduced the corruption which plagued the hiring of able seamen. the hiring halls also worked to combat racial discrimination and promote racial harmony among maritime workers. within a year, the nmu had more than 50, 000 members, and most american shippers were under contract. stripped of most of its membership, the isu became almost moribund. in july 1937, curran and other seamen ' s union leaders were invited by john l. lewis to come to washington, d. c.


american shippers were under contract. stripped of most of its membership, the isu became almost moribund. in july 1937, curran and other seamen ' s union leaders were invited by john l. lewis to come to washington, d. c., to form a major organizing drive among ship and port workers. the unions comprising the cio had been ejected by the american federation of labor ( afl ) in november 1936, and now lewis wanted to launch a maritime union. his goal was to create, out of the 300, 000 maritime industry ' s workers, a union as large and influential as the steel workers organizing committee. although lewis favored harry bridges, president of the pacific coast district of the international longshoremen ' s association, to lead the new maritime industrial union, the other union leaders balked. curran agreed to affiliate with the cio, but refused to let bridges or anyone else take over his union. his views were reflected among those of the other union leaders, and the cio ' s maritime industrial union never got off the ground. during the next 36 years, joseph curran worked to make american merchant seamen the best - paid maritime workers in the world. nmu established a 40 - hour work week, overtime, paid vacations, pension and health benefits, tuition reimbursement, and standards for shipboard food and living quarters. curran even built a union - run school to retrain union members, and won large employer donations through collective bargaining to build the school. curran was a vociferous advocate of maritime workers ' rights. when joseph p. kennedy advocated legislation to outlaw maritime strikes and make arbitration of labor disputes compulsory, curran called him a " union wrecker ". when kennedy was under consideration as executive director of the united seamen ' s service ( an association which assists, feeds and houses american merchant seamen overseas ), curran successfully opposed the multi - millionaire ' s candidacy. curran put such pressure on kennedy that on february 18, 1938, kennedy resigned as chair of the united states maritime commission. curran was also a strong supporter of far - left - wing causes. in august 1940, he urged unions in the new york city area to support an " emergency peace mobilization " opposing u. s. entry into the war in europe. in 1940, curran was elected a vice president of the cio. when the cio and afl merged in 1955, he was appointed a vice president of the merged organization as well. greater new york industrial union curran was also elected president of the greater new york industrial union. the greater


vice president of the cio. when the cio and afl merged in 1955, he was appointed a vice president of the merged organization as well. greater new york industrial union curran was also elected president of the greater new york industrial union. the greater new york industrial union ( gnyiu ) was organized by the cio in 1940 as a central labor body for new york city. cio - affiliated local unions in new york city and the nearby vicinity were its primary members. at the organization ' s founding convention on july 24, 1940, curran was elected president of gnyiu. saul kills, a member of the american newspaper guild, was elected its secretary - treasurer. the organization had 250 local union affiliates, representing more than 500, 000 workers. by 1948, however, there were serious concerns about communist infiltration of the gnyiu. the united states house of representatives appointed a special investigative subcommittee to look into the matter. several cio unions were investigated, including the united electrical, radio and machine workers of america, the teachers union of the city of new york, the united public workers of america and the department store employees union. cio president philip murray appointed a three - member board in october 1940 to forestall the house investigation. the board members reported to murray that curran, kills and the gnyiu executive board had been advocating pro - communist policies. the gnyiu was on the verge of supporting henry a. wallace in an independent bid for president as well. the national cio executive board revoked the charter of the gnyiu in november 1940. curran denied that he was a communist before both the cio executive board and the joint commerce committee of the u. s. congress. curran became increasingly anti - communist thereafter. in 1946, he pulled the nmu out of a committee for maritime unity which was led by harry bridges. after world war ii, he purged thousands of members and elected leaders he suspected of harboring communist sympathies. curran served on a number of other committees, boards and positions with other organizations. for many years, he was chair of the afl - cio ' s maritime committee. he was also co - chair of the labor - management maritime committee, a body established by afl - cio maritime unions and u. s. shipping companies to discuss and resolve labor issues. curran was also vice chairman of the seafarer ' s section of the international transportworkers federation, an international confederation of maritime unions. curran was also vice president of the united seamen ' s service.


shipping companies to discuss and resolve labor issues. curran was also vice chairman of the seafarer ' s section of the international transportworkers federation, an international confederation of maritime unions. curran was also vice president of the united seamen ' s service. retirement and death curran suffered a heart attack in 1953 which left him somewhat less physically able than before. over the next few years, he gradually cut back his workload, and stopped visiting local unions and attending most union meetings. in the mid - 1960s, he turned over most of the union ' s daily business to secretary - treasurer shannon j. wall. by the mid - 1960s, curran was being criticized for ignoring his members ' needs and concerns. his $ 85, 000 - a - year salary was one of the highest in the american labor movement even though his union was small and shedding members. he enjoyed an unlimited expense account, and traveled by chartered jet and private limousine. he cajoled the union ' s executive board into building a massive, art deco headquarters in manhattan, and had the edifice named after himself. in 1966, with the surreptitious help of nmu staffers, union member james b. morrissey challenged the results of curran ' s 1966 re - election as fraudulent. the department of labor agreed, but a re - run election did not change the outcome. in 1973, shortly after curran won re - election for a thirteenth term as union president, morrissey sued curran and charged him with misappropriating union funds. in a precedent - setting ruling in morrissey and ibrahim v. curran, 650 f. 2d 1267 ( 1981 ), the u. s. court of appeals for the second circuit established a broad right for union members to sue union officers for improper financial practices. morrissey ' s barrage of lawsuits against curran led curran to retire suddenly on march 5, 1973. long - time secretary - treasurer shannon j. wall succeeded him as president. curran retired to boca raton, florida. he died there of cancer on august 14, 1981. curran married retta toble, a former cruise ship waitress, in 1939. the couple had a son, joseph paul curran, jr. retta curran died in 1963. in 1965, curran married florence stetler


the jordan river, which cuts through israel and jordan, largely reflects the scarcity of water in the region. the above picture shows a rare flooding event in the jordan river in the winter of 2003 at the baptist site ( well - known in christianity ). just several months later, during the summer of 2003, the river was dry again, as shown below at a site close to abdalla bridge. courtesy of avner vengosh. data collected from more than 6, 000 selected sampling points reveal that more than 10 percent of the water resources in the mediterranean basin have boron levels exceeding 1 milligram per liter, the new e. u. drinking water standard. we found that the highest values of boron are in areas associated with geothermal activity, such as in tuscany, italy, and chalkidiki, greece. in addition, we discovered high boron levels in the groundwater basins in the central part of cyprus and in the southern coastal aquifer that is shared between israel and the gaza strip. in order to delineate the origin of boron and salinity in these groundwater basins, we investigated the chemical and isotopic compositions of the boron - contaminated groundwater. boron has two stable isotopes that are distributed unevenly among different geological materials and natural water resources. because different sources of water pollution have unique isotopic fingerprints, we were able to use the boron isotopes to identify clearly the source of the water contamination. for example, the boron isotopic ratios in seawater, wastewater and rocks vary significantly. thus, when groundwater is contaminated, the imprinted isotopic signature of these different sources is preserved, serving as a tracer for delineating their origin. similarly, the application of other isotopes such as oxygen, hydrogen and strontium provide a clue to the origin of the polluted water. by integrating these chemical tools, we discovered that the boron contamination in the mediterranean groundwater basins is derived primarily from natural processes. in the cornia basin in tuscany, we found that boron leaching from sediments into local groundwater is associated with seawater intrusion, reflecting a complex history of boron uptake and release by clay minerals. in western chalkidiki, the mixing of groundwater with underlying thermal water rich in boron caused the boron contamination. in cyprus, water - rock interaction is the main mechanism for the boron enrichment in the water. in the southern coastal aquifer of israel and the gaza strip, we discovered that boron pollution is associated with the


caused the boron contamination. in cyprus, water - rock interaction is the main mechanism for the boron enrichment in the water. in the southern coastal aquifer of israel and the gaza strip, we discovered that boron pollution is associated with the migration of saline groundwater from israel into the gaza strip. the chemical and isotopic compositions of the groundwater in these studies clearly indicate that the boron problem in the mediterranean water resources, on the whole, is derived from natural ( geogenic ) sources rather than anthropogenic ones. our results have several implications for the management of national and transboundary groundwater resources in the mediterranean basin and for the remediation of boron. perhaps most importantly, we are challenging the conventional perception that the boron contamination in these countries is a source of human pollution. for years, companies added boron to detergents because it is an excellent bleaching agent thus resulting in the formation of boron - rich sewage. moreover, similar to other inorganic ions, boron is not removed during standard sewage treatment processes and even treated wastewater typically has high boron concentrations. thus, as a precautionary measure, environmental regulators in both cyprus and israel have chosen a particular strategy to reduce boron contamination : mandating regulations that restrict the amount of boron that can be added to detergents. although the reduction in boron in treated sewage may prove to be beneficial for agriculture because there will be less boron contamination in the irrigation water, these regulations will have negligible effects for improving drinking water. for a country that soon will join the european union, such as cyprus, it will only be able meet its obligation to abide by e. u. standards for drinking water by pursuing an alternative strategy that calls for technological intervention to remove boron. to date, israel has yet to adopt an official drinking water standard for boron, despite the new proposals for desalination calling for 0. 5 milligrams per liter boron in desalinated water. thus, israel already faces a similar challenge to cyprus. in short, because boron contamination in all our investigated cases comes from natural geochemical background pollution and hence cannot be prevented, the only way to address the boron problem is through treatment of the drinking water. at present in italy and israel, water authorities mix the boron - rich water with high - quality water to reduce the level of boron in the water supplied for both drinking and agricultural purposes. however, the longevity of dilution as a solution is limited,


in italy and israel, water authorities mix the boron - rich water with high - quality water to reduce the level of boron in the water supplied for both drinking and agricultural purposes. however, the longevity of dilution as a solution is limited, primarily due to the diminishing amount of high - quality water that is available. as a result, our research has focused on the creation of alternative water resources, through the application of technological solutions such as improved desalination and the introduction of new techniques for boron removal from the water. reverse osmosis desalination has tremendous potential for a supply of new water for the 21st century, especially in areas of the world where water is scarce or the quality is inadequate. its widespread application, however, is hampered by the fact that reverse osmosis desalination does not remove boron sufficiently ( only 60 percent ). as a result, desalination of seawater does not reduce the boron level below the new standard for drinking water in the european union ( and will be also problematic for the non - european mediterranean countries adopting a similar drinking water standard for boron ). therefore, additional removal techniques must be introduced in order to bring boron levels down to drinking standards. different partners in the boremed project have developed several independent methodologies for removing boron from water. in cyprus, boremed partners have utilized boron - specific resins combined with a small - scale reverse osmosis to reduce the amount of boron in the groundwater for local users. in israel, boremed partners have succeeded in removing boron by optimization of reverse osmosis processes such as multi - step desalination. other partners from the netherlands have established a new method of boron removal through co - precipitation with hydroxides. in addition, a joint israeli - turkish team invented a new technique for boron removal through reacting seawater with fly ash and coal materials. this method is particularly useful in mediterranean countries such as turkey, where fly ash is abundant and cheap. each of the new different methodologies has its own benefits and costs. ultimately, the e. u. countries that face a boron problem will have to adopt one of these new technologies in order to be in compliance with the new drinking water standard for boron. through an integration of geochemistry, hydrogeology, numerical modeling and policy analysis, we also have devised a potential management solution to the water crisis in the gaza strip. the local aquifer underlying the gaza strip is perhaps one of the most stressed resources


integration of geochemistry, hydrogeology, numerical modeling and policy analysis, we also have devised a potential management solution to the water crisis in the gaza strip. the local aquifer underlying the gaza strip is perhaps one of the most stressed resources in the mediterranean basin in terms of water quantity and quality : chloride concentrations reach 1, 500 milligrams per liter ( six times the e. u. standard ) ; nitrate concentrations reach 400 milligrams per liter ( eight times the e. u. standard ) ; and boron concentrations reach 3. 5 milligrams per liter ( more than three times the e. u. standard ). over the past five decades, the amount of water pumped from the gaza aquifer has far exceeded the natural water replenishment. as the water level has declined, the water quality has become unsuitable for human consumption, owing to the high levels of salinity, boron and nitrate pollution. nevertheless, more than 1 million people depend entirely upon this aquifer for drinking and irrigation water. the boremed project has mapped boron distribution in groundwater from the southern mediterranean coastal aquifer and the gaza strip. the different colors represent boron concentration in milligrams per liter. in most parts of the aquifer and the gaza strip, the boron concentration exceeds the drinking standard of 1 milligram per liter for the european union. courtesy of avner vengosh. our chemical and isotopic data show that most of the salinity phenomenon in the gaza strip is derived from flow of natural saline groundwater from israel towards the gaza strip. as a result, the southern coastal aquifer does not resemble a classic upstream - downstream dispute over a transboundary aquifer : israels upstream pumping of the saline groundwater can potentially reduce the salinization rates of groundwater in the gaza strip rather than cause downstream harm. numerical simulation of different pumping scenarios confirms our hypothesis that increasing pumping along the gaza strip border combined with desalination and supply to the gaza strip, as well as moderate reduction of pumping within the gaza strip, would improve the water quality of groundwater there. moreover, our finding that the salinity problem in the gaza strip is partially natural de - politicizes the water issue and offers a practical solution for the water crisis in the gaza strip that has win - win benefits for both the palestinian territory and israel. clearing the way the promulgation of a new drinking water standard for boron in the european union has forced both e. u


practical solution for the water crisis in the gaza strip that has win - win benefits for both the palestinian territory and israel. clearing the way the promulgation of a new drinking water standard for boron in the european union has forced both e. u. member and non - member states to address boron contamination in drinking water even before a strong causal link has been found between boron contamination and health effects. yet, while new technologies now exist for boron removal, the adoption of this new drinking water standard is complicated by the fact that each country faces different institutional constraints. in italy, the boron problem is a local problem rather than a national one, and as a result, the end - user in conjunction with the regional water authority is responsible for developing its own program for boron removal. in contrast, in the coastal aquifer that is shared between israel and the palestinian authority, the boron and salinity problem will only be resolved through the development of institutions for international cooperation. finally, in cyprus, the boron problem is a national problem, thus requiring a national solution instead of a local or international solution. in the end, the ability to address the boron problem at the local, national and international levels in the mediterranean basin will depend entirely on an integration of science, technology and policy. at the surface, northern africa is one of the driest places on the planet. but underneath the desert, ancient water lies in a complex groundwater system composed of the nubian aquifer. radiocarbon dating techniques have indicated that most nubian aquifer water is at least 50, 000 years old, but a newly developed technique shows that some of the water is 1 million years old adding further complexity to the nubian aquifer system, which waters the region. boron is only one of many geologic materials that occur naturally in the environment and can pose health risks to people. geoscientists are actively involved in studying such substances by monitoring groundwater, surface water and soils, and by mapping their distributions. the findings may help policy - makers devise new strategies for regulation and mitigation. online sources for asbestos, radon, mercury, arsenic, crystalline silica and boron are listed below ; also see link to past geotimes coverage. see this month ' s print issue for more


"... wall upon wall, battlement upon battlement, black, immeasurably strong, mountain of iron, gate of steel, tower of adamant... barad - dur, fortress of sauron the fellowship of the ring ii 10 the breaking of the fellowship the mighty shadow - shrouded stronghold of sauron in the second and third ages. the first building of barad - dur the first building of barad - dur, when sauron first came to mordor, took six hundred years to complete. soon after, tar - minastir of numenor sent a fleet to middle - earth, and sauron ' s forces were driven out of the western lands that they had roamed at will to that time. barad - dur could not be approached by the numenoreans, however, and sauron was able to consolidate his power and extend it into the east. in ii 3262, sauron left his dark tower to travel to numenor with the vast forces of ar - pharazon ; he returned after the downfall of numenor in ii 3319. the last alliance besieged barad - dur in ii 3434, and the tower was taken and destroyed by the forces of elendil and gil - galad, who both perished in the siege, in ii 3441. though barad - dur was destroyed, its foundations were left in place. the second building of barad - dur for much of the third age, sauron ' s stronghold was not in mordor, which was ruled in his stead by the nazgul. rather, the dark lord dwelt in the south of mirkwood at dol guldur. in iii 2941, the white council sent their forces to drive him from mirkwood, and he withdrew to mordor once again. there, he began the rebuilding of the dark tower. given that the tower originally took some six hundred years to raise, it seems surprising that its second building can have taken no more than a few decades. this is perhaps partly explained by the fact that its foundations, laid with the power of the ring, remained in gorgoroth ready to be built upon. barad - dur was constructed as much through the personal power of sauron as through stone and mortar ; when the one ring was destroyed in orodruin, this power was lost and the tower destroyed forever. the appearance of barad - dur the most complete description


was constructed as much through the personal power of sauron as through stone and mortar ; when the one ring was destroyed in orodruin, this power was lost and the tower destroyed forever. the appearance of barad - dur the most complete description we have of barad - dur is that given in the quote at the head of this page. we know, then, that it was black, and constructed mainly of metal. ' adamant ' usually refers to diamond, but it is hard to imagine sauron adding diamond towers to his dark fortress - in this context, it probably has the more general meaning of ' hard, unbreakable substance '. from the steel gate of the tower, a causeway ran out into the plain of gorgoroth, across a mighty bridge. we also know that lava from mount doom was channeled back across that plain to barad - dur. tolkien probably leaves details of the tower ' s construction vague intentionally, as it was hidden by a cloud of shadow and darkness at all times. frodo and sam saw barad - dur as they journeyed to mount doom : '... rising black, blacker and darker than the vast shades amid which it stood, the cruel pinnacles and iron crown of the topmost tower of barad - dur... ' ( the lord of the rings 6 iii : mount doom ). the ' topmost tower of barad - dur ' seems to have been the place where sauron dwelt. at least, the window of the eye, from which the lidless eye stared out across middle - earth, was located there. battle of dagorlad, black pit, black pits, chambers of fire, dark lord, dark throne, dark tower, downfall of barad - dur, ered lithui, eye of barad - dur, eye of mordor, eye of sauron, fall of barad - dur, king of dale, land of shadow, [ see the full list... ] for acknowledgements and references, see the disclaimer & bibliography page. website services kindly sponsored by axiom software ltd. original content © copyright mark fisher 1997 - 2000, 2008. all rights reserved. for conditions of reuse, see the site faq.


map : do you live in a food desert? usda ' s food desert locator map yesterday, the united states department of agriculture unveiled its latest online tool : an eye - opening map of the nation ' s " food deserts. " these food deserts ( marked in pink above ) are places where there is " low income " and " low access " — or places where at least a fifth of the population lives at or below the poverty line and where there isn ' t a supermarket within a one - mile radius ( or within a 10 - mile radius in rural areas ). all things told, about 13. 5 million people nationwide have little or no access to stores selling healthful food. the complete dataset is downloadable, so it should spawn mash - ups. the usda has also created the food environment atlas, which maps factors ranging from food taxes to farmers ' markets ( below ). what correlations can we make about the absence of food deserts and farmers ' markets? the data ' s impressive and certainly opens up opportunities to map other connections : what ' s the impact of healthy corner stores, walkable school districts, or even mcdonald ' s locations on food deserts? could we put the " wal - mart as food desert solution " theory to the test? map : usda ( via alex howard ).


con ed to get the lead out the project will remove about 2, 400 tons of underground lead sheathing through 2009 as part its membership in the u. s. environmental protection agency ' s national partnership for environmental priorities program. the voluntary program aims to reduce or eliminate chemicals that can linger for decades when released into the environment. the private - public program has targeted 31 priority chemicals, such as lead and pcbs. con edison plans to replace 2, 400 sections of underground lead - clad electric feeder cables this year with solid dielectric cables made of copper conductors encased in synthetic rubber. the new cables are easier to splice and better for electricity distribution. in 2009, the company will continue replacing an additional 2, 400 sections, each of which is estimated to have about 1, 000 pounds of encased lead sheathing that will be recycled nearby. eventually the company wants to replace all lead - clad cables - - about 20 percent of the company ' s underground network - - by 2020, which could account for as much as 15, 000 tons of reclaimed lead sheathing. faced with a tide of post - consumer plastic trash, organizations are thinking up innovative ways to profitably harness this potentially vast revenue stream. read more the sixth annual edition of research has been expanded to include data on 1, 600 companies worldwide, as well as on the u. s. - based s & p 500. find out where the world of sustainable business is headed - - and the leading indicators of future progress. read the stories and download the report. simran sethi shares how our psychology and geography shape the ways we engage and share with each other. see our entire video collection


this is a very complex question, but let ’ s go at it another way. the races that we experience today didn ’ t really come from adam and eve. you know why? because everybody on the face of the earth got drowned, except for noah and his three sons, and their wives. so, all the races came from noah and mrs. noah, and the three little junior noahs : shem, ham, and japheth. and they were all, you remember, rescued in the flood, and they came back and began to populate the earth. the best we can tell, shem located with his people in the middle east, and are the semites : jews and arabic people. it ’ s a huge part of the world - - huge population. ham, in most studies ( and i ’ m reflecting back a few years in reading things like oliver buswell iii, and others who dealt with these issues, and some other books on the tables of nations ), it seems that ham became a more servile people and may have moved south and wound up in africa. the descendants of ham and japheth seem to have colonized europe. it ’ s very difficult to know all of that specifically, but they obviously, through the years, adapted themselves to their areas. they of course began to develop and all the races eventually came. but, apart from what might be the scientific and historical explanation, is the statement of acts 17, where it says, “ the god who made the world and all things in it, since he is lord of heaven and earth, does not dwell in temples made with hands ; neither is he served by human hands, as though he have need of anything ; he made, from one, every nation. ” so, that ’ s the best answer. acts 17, verse 26, god, from noah and mrs. noah and shem, ham, and japheth, created the nations. now, one major component in that happened at the tower of babel of course, where god scattered all the nations all over the face of the earth and changed their languages. so, the best answer is right there in acts 17 - - god did it. and god sort of tweaked their ears and tweaked their eyes, and their nose, and the color of the skin, and all those genetic unique things, in his creative power, through the process of providential genetics, to create all the different races. you may reproduce this grace to you content


in 2006, high sea temperatures caused severe coral bleaching in the keppell islands, in the southern part of the reef — the largest coral reef system in the world. the damaged reefs were then covered by a single species of seaweed which threatened to suffocate the coral and cause further loss. a " lucky combination " of rare circumstances has meant the reef has been able to make a recovery. abundant corals have reestablished themselves in a single year, say the researchers from the university of queensland ' s centre for marine studies and the arc centre of excellence for coral reef studies ( coecrs ). " three factors were critical, " said dr guillermo diaz - pulido. " the first was exceptionally high regrowth of fragments of surviving coral tissue. the second was an unusual seasonal dieback in the seaweeds, and the third was the presence of a highly competitive coral species, which was able to outgrow the seaweed. " coral bleaching occurs in higher sea temperatures when the coral lose the symbiotic algae they need to survive. the reefs then lose their colour and become more susceptible to death from starvation or disease. the findings are important as it is extremely rare to see reports of reefs that bounce back from mass coral bleaching or other human impacts in less than a decade or two, the scientists said. the study is published in the online journal plos one. " the exceptional aspect was that corals recovered by rapidly regrowing from surviving tissue, " said dr sophie dove, also from coecrs and the university of queensland. " recovery of corals is usually thought to depend on sexual reproduction and the settlement and growth of new corals arriving from other reefs. this study demonstrates that for fast - growing coral species asexual reproduction is a vital component of reef resilience. " last year, a major global study found that coral reefs did have the ability to recover after major bleaching events, such as the one caused by the el nino in 1998. david obura, the chairman of the international union for conservation of nature climate change and coral reefs working group involved with the report, said : " ten years after the world ' s biggest coral bleaching event, we know that reefs can recover – given the chance. unfortunately, impacts on the scale of 1998 will reoccur in the near future, and there ' s no time to lose if we want to give reefs and people a chance to suffer as little as possible. " coral reefs are


bingo makes you think faster than non - players and keeps you more alert into old age, a researcher told a british psychological society conference. julie winstone, of southampton university, said players were faster and more accurate than non - bingo players on tests measuring mental speed, the ability to scan for information, and memory. her research found older players even outperformed younger counterparts, suggesting keeping the brain active keeps it sharper for longer. the finding came as no surprise to the national bingo association, which said the game was played by three million people with an average age of 49. " the blue rinse brigade dominated it 15 years ago. but then it was taken up by celebrities denise van outen, elle macpherson, robbie williams, catherine zeta - jones, and bianca and jade jagger, " said gloria pattinson, an association spokeswoman. " these acted as role models for younger people, who started going to evening sessions before moving on to clubs and pubs. older people still go to morning and afternoon sessions. " the skill needed in bingo is quite high which is why these findings are no surprise. you have to be a good listener and search for numbers quickly. " ms winstone said : " any mental or physical activity is good for you but bingo involves searching for digits which is particularly sensitive to the ageing process. " she recruited 112 people - half were bingo players - and divided them into the 18 - 40 and 60 - 82 age groups. she added : " i got them to scan a grid for single digits, pairs of digits and then three digits. the older bingo players were both quicker and made less errors than the older non - bingo players - and the younger bingo players. " in bingo it is very important not to miss a number and you have to sustain your attention sometimes for several hours. " concentration has been shown to decline with age so bingo could be helping older people sustain their attention for longer. "


teens using technology - backlit devices can impact on sleep new research from the lighting research center ( lrc ) at rensselaer polytechnic institute, new york, indicates that teenagers who use backlit technology, such as tablet devices, for two hours before bed, may have their sleeping patterns disrupted. at this time of year in australia, many teens are studying for their final hsc exams and using computers for extended periods. being aware of backlit technology ' s possible effects on sleep and melatonin release, may help parents advise their teens on how to ensure they get sufficient sleep. we know that sleep has an impact on learning and information retention so we ' ve written about this topic before. for more information on sleep and teens, please read : backlit devices may interrupt sleeping patterns the new lrc research shows that a two - hour exposure to electronic devices with self - luminous ' backlit ' displays causes melatonin suppression, which might lead to delayed bedtimes, especially in teens. “ our study shows that a two - hour exposure to light from self - luminous electronic displays can suppress melatonin by about 22 %. stimulating the human circadian system to this level may affect sleep in those using the devices prior to bedtime, ” said professor figueiro. and until manufacturers develop more “ circadian - friendly ” electronic devices that increase or decrease light exposure based on time of day, figueiro recommends " dimming these devices at night as much as possible in order to minimize melatonin suppression, and limiting the amount of time spent using these devices prior to bedtime. ” your teens might not want to hear this information during other times of the year when they want to play games on tablet - style devices but perhaps during final exam times, they ' ll be more receptive to this information. morning light helps teens sleep another field study by the lrc in 2010 indicated that teenagers are likley to have better sleep if they have more exposure to morning light. during term time, high schools have schedules requiring teenagers to be in school early in the morning, so teens often miss some morning light. however, during a study break, your teen has an opportunity to change this pattern and possibly benefit from more and better sleep. “ as teenagers spend more time indoors, they miss out on essential morning light needed to stimulate the body ’ s 24 - hour biological system, which regulates the sleep / wake cycle, ” said professor figueiro. in this study it was found that students who wore special glasses to prevent short - wavelength (


accidental poisoning by methadone occurs, particularly as a result of children ingesting a parent ' s methadone. health care professionals have a responsibility to provide information and guidance to methadone users on safe storage of methadone. the objective of the study was to audit the effectiveness of information giving on the safety of methadone consumption, dose measurement and storage, and the effectiveness of sources of advice available for patients. the study was undertaken prior to the introduction of a scheme for the supervised consumption of methadone, in the setting of an nhs methadone clinic serving a district population of 490, 000 in the uk. 185 consecutive patients attending a methadone clinic to collect a methadone prescription were the subject of an anonymous survey. issues of safety of methadone consumption, storage and safety information provisions were assessed. a telephone survey of the community pharmacists dispensing the methadone covered the availability of measuring devices and provision of advice on safety was undertaken. methadone was stored in a variety of locations, a cupboard being most frequent. 95 patients ( 60. 1 % ) had children either living in or visiting their home. all stored their methadone in a bottle with a child resistant lid ; the majority measured doses using either the container supplied by the pharmacist or a plastic measure. 126 patients ( 78 % ) confirmed that a pharmacist provided a measuring container on their first visit, 24 ( 15 % ) were given a measure on every visit to the pharmacist. advice on safe storage was recalled by 30 % of the patients, and advice on measuring methadone by 28 %. methadone was seen as potentially dangerous by 82 % of the patients. the risks resulting from unsafe storage of methadone may be reduced by daily instalment prescribing and provision of measuring containers on request. recall of provision of information on safety issues is poor and the adoption of a standard policy on provision information should be seen as a priority. a re - audit of safety of storage of methadone is recommended following the introduction of a standard policy on information provision. the number of prescriptions per year for methadone in england increased from 425, 400 to 1, 318, 100 between 1990 and 2001. prior to the introduction in 1999 of national guidelines in england with regard to supervised methadone consumption, it was common practice for patients to be prescribed take - home methadone from specialist drug clinics or general practitioners which would be dispense


2001. prior to the introduction in 1999 of national guidelines in england with regard to supervised methadone consumption, it was common practice for patients to be prescribed take - home methadone from specialist drug clinics or general practitioners which would be dispensed at community pharmacies. up to 14 days ' supply could be prescribed on one prescription and the patient would be allowed to store this at home. in practice, prior to the development of supervised methadone schemes, where patients consume their methadone at the pharmacy and are observed by the pharmacist, many prescribers controlled the amount dispensed by prescribing daily instalments or for 2 to 3 days at a time to reduce the risk of diversion of supplies and the risk of storage of high volumes. following the introduction of guidelines for supervised methadone, it became the norm within the uk for patients to have daily methadone prescriptions with supervised consumption at the pharmacy for a minimum of 3 months. providing that they are compliant with treatment, this supervision can then be discontinued and increasing numbers of days ' supply can be dispensed to take home. even within the current supervised schemes, patients will take home at least one day ' s supply for unsupervised consumption as pharmacies are not in general open on sundays. the introduction of national guidelines has produced some changes in the prescribing methods for methadone in the uk. there is still considerable variation in practice between clinicians both in the dose prescribed and the volume dispensed for take - home use the risks relating to methadone are not confined to those prescribed methadone or to adults using illicit supplies. the storage of methadone at home poses a potential risk to children living with the person prescribed methadone if the supply is not safely stored. the value of oral methadone prescribing in the treatment of opiate addicts is confirmed in national clinical guidelines. safety issues relating to storage of methadone at home have been well documented. a report regarding the use of babies ' feeding bottles as measuring devices for methadone highlighted the risks to children of access to methadone. the study recommended that all doctors who prescribe methadone should ask their patients how they measure their daily dose of methadone. it is clear from current guidance that health care professionals have a responsibility to provide information and guidance to methadone users on safe storage of methadone.. we undertook this audit to evaluate the effectiveness


they measure their daily dose of methadone. it is clear from current guidance that health care professionals have a responsibility to provide information and guidance to methadone users on safe storage of methadone.. we undertook this audit to evaluate the effectiveness of the sources of advice that those prescribed methadone may have used with regard to safety of storage and measurement of their methadone dose. audit criteria and standard setting the audit followed a standard audit methodology of selecting appropriate criteria and then selecting standards by which to measure success in achieving the criteria. the following criteria were selected following a review of the literature. 1. all patients prescribed methadone should recall being given information on safe storage of methadone 2. all patients who take home methadone should have it dispensed in a child resistant container 3. all patients prescribed methadone for home consumption should have an accurate measuring device available 4. all patients who have methadone at home should store it a child resistant container within a safe locked location. 5. all patients where children may have access to methadone should be aware of the particular risks to children. 6. all patients prescribed methadone should be aware of the risks of accidental overdose. the standard setting was agreed by the audit team using the following principles. 1. given the high risks posed by accidental methadone overdose criteria 1 – 6 were allocated a 100 % standard development of survey instruments we devised and piloted a questionnaire for anonymous self completion by patients. the content of the questionnaire was planned to cover the following aspects. • volumes of methadone prescribed and stored • frequency of pick up of prescriptions • frequency of doses • location of storage • measurement of methadone • possible access to the stored methadone by children • sources of advice on safe storage and measurement • appreciation of the possible risks of methadone. a checklist for telephone survey of community pharmacists was devised to collect data on the availability of measuring devices and advice on safety aspects of storage and measurement. over a period of three days, consecutive patients attending to collect a methadone prescription from the specialist clinic were invited to complete the questionnaire. of the 185 patients attending, 165 ( 86. 4 % ) completed the questionnaire. all pharmacists recorded in the clinic register as potentially dispensing methadone to patients attending the clinic were contacted by telephone ( n = 48 ). of these, 36 were actually dispensing methadone during the period of the patient survey and


recorded in the clinic register as potentially dispensing methadone to patients attending the clinic were contacted by telephone ( n = 48 ). of these, 36 were actually dispensing methadone during the period of the patient survey and 35 ( 97. 2 % ) agreed to complete the telephone survey closed questions were analysed with descriptive statistics, open questions by content analysis, a χ2 test was used to compare outcomes volume of methadone stored at home the mean daily methadone dose for the 161 patients was 32 mg, ( range 5 mg to 80 mg, sd = 14. 01 ). instalment prescribing is the norm within the clinic and 97 patients ( 63 % ) reported a daily pick up, 52 ( 34 % ) a pick up every 2 days, 3 patients ( 2 % ) picked up twice a week whilst 1 patient ( < 1 % ) reported a weekly pick up. volumes stored at home reflected the range of doses and the type of instalment prescribing. the mean volume stored at home was 51 mg ( range 0 mg to 315 mg, sd = 48. 3 ). of the 11 patients who reported that they did not store any methadone at home, 2 reported that they stored it about their person, 8 consumed all their methadone in the street after it had been dispensed and 1 gave it to a parent for safekeeping. location of storage content analysis of the location of storage revealed a variety of locations ( table 1 ). a cupboard was the most common storage place 49 ( 30. 6 % ), 27 ( 16. 8 % ) stored methadone in the fridge, whilst only 4 patients ( 2. 5 % ) stored methadone in a medicine cabinet. one patient stored methadone in a wastebin table 1. location of storage of methadone in the home safety of storage of the 159 patients who completed the item on security of their place of storage, 43 ( 27 % ) acknowledged that other people would have access to their storage place. the presence of children in the house was assessed in two ways, firstly as an item enquiring as to children resident with the patient and secondly an item regarding children who may visit the patient. from these items a consolidated figure of homes where children may have access to methadone was calculated. 158 patients responded to items on children within the home, of whom 95 ( 60. 1 % ) had children either living in or visiting the home. an assessment by


a consolidated figure of homes where children may have access to methadone was calculated. 158 patients responded to items on children within the home, of whom 95 ( 60. 1 % ) had children either living in or visiting the home. an assessment by these 95 patients of the risk of children knowing where the methadone was stored resulted in 5 patients ( 3. 2 % ) accepting that children would know where they kept their methadone, 10 patients ( 6. 45 % ) reported that they thought children could find their methadone. chi square analysis of methadone storage location and assessment of the ability of others to access the storage site showed no significant difference between the group with children living in or visiting their home and those with no children living in or having access to their home. methadone storage container of the 160 patients who completed the questionnaire, 100 % stored their methadone in the original pharmacists ' container supplied with a child resistant cap. measurement of methadone an open question with regard to containers used to measure out methadone doses revealed a fairly narrow range of containers to be in use ( table 2 ). 140 patients ( 67. 5 % ) used either the container supplied by the pharmacist or a plastic measure supplied by the pharmacist to measure out their methadone ; a minority of 5 patients ( 3. 13 % ) guessed the correct amount without any form of measure. table 2. measuring methadone ( n = 160 ) the need to measure out methadone occurs when more than one days supply is dispensed, such as at weekends or when patients have a less frequent prescription instalment. the need to measure out methadone also occurs when patients split their daily dose. responses to the survey indicated that of the 153 who responded to this item, 100 ( 63 % ) take their methadone as single dose. the remaining patients split their dose, 52 ( 34 % ) taking methadone twice a day, and 4 ( 3 % ) taking it three or more times a day. 126 patients ( 78 % ) confirmed provision of measuring containers on the first visit to a pharmacist. 24 patients ( 15 % ) reported that they were given a measuring container on every visit to the pharmacist and 13 ( 8 % ) reported that they were able to request a measuring device when they needed one sources of advice on storage and measurement only 49 patients ( 31 % ) recalled being given advice on safety of methadone ;


the pharmacist and 13 ( 8 % ) reported that they were able to request a measuring device when they needed one sources of advice on storage and measurement only 49 patients ( 31 % ) recalled being given advice on safety of methadone ; of those who did recall this advice, it had been given by the methadone clinic ( 41. 7 % ), the local drug agency ( 27 % ) or the pharmacist ( 21 % ). advice on ways to measure out methadone was recalled by 45 patients ( 28 % ), this advice had been given by the methadone clinic ( 40 % ), the pharmacist ( 36 % ) or the local drug agency ( 18 % ). knowledge of the risks of methadone in response to the question " is methadone dangerous? ". 131 patients ( 82 % ) replied yes, 25 patients ( 16 % ) replied no and 3 ( 2 % ) did not respond. none of the patients reported having being involved with any accidental use of methadone. of the 35 pharmacists who participated in the survey, 32 ( 91 % ) confirmed that they would provide a measuring device on request. only 5 ( 14. 3 % ) provided a measuring device on each attendance. advice on storage of methadone had been given by 4 pharmacists ( 11 % ) and advice on measuring out methadone by 6 ( 17 % ). the pharmacists were each dispensing for a mean of 5 patients ( range 1 to 20, sd 4. 4 ) performance on criteria 1 to 6 was measured against the defined standards. the results are summarised in table 3. table 3. audit criteria performance only 1 of the standards reached 100 % in the sample studied, that being the dispensing of methadone in containers with child resistant caps. the accidental ingestion of methadone is a well recognised risk of methadone prescribing [ 7, 8 ] the need to store methadone is increased if prescriptions are dispensed in more than daily instalments. a survey of prescribing to opiate addicts in england and wales in 1996 showed that up to 36 % of prescriptions for methadone were dispensed on a weekly basis. the use of inappropriate storage and measuring containers for methadone, such as babies ' bottles by over 25 % of patients in dublin, was perhaps influenced by the fact that over 50 %


methadone were dispensed on a weekly basis. the use of inappropriate storage and measuring containers for methadone, such as babies ' bottles by over 25 % of patients in dublin, was perhaps influenced by the fact that over 50 % of prescriptions for methadone in dublin were dispensed on a weekly basis. the routine supply of measuring containers is not necessary when methadone is dispensed on a daily basis or its consumption is supervised, apart from at weekends and when the patient takes the methadone in divided doses. the pharmacists surveyed in this study were able to provide measuring containers on request and the patients appeared to be aware of this facility and had obtained them when needed. the provision of advice to patients on safe storage and measurement had been received by a minority of patients. pharmacists confirmed that they had only given advice to a small proportion of the patients. the level of advice reported appears to be consistent with that reported by calman et al in 1996, as do the various locations chosen by patients to store methadone. the patients ' responses to the present study do however indicate a high level of awareness of the risks of methadone both to children and to non drug using adults. the risks associated with methadone storage and measurement can be seen to be reduced by daily instalment prescribing, provision of measuring devices on request and the provision of information on the particular risks of methadone to children. the risks to children of unsafe storage of medicines is not of course confined to methadone. studies of accidental poisoning of children from prescribed medications have shown consistently that failure to store medication in a child resistant container in a safe location is a major factor in increasing the risk of accidental poisoning [ 10, 11 ] the responsibility for giving advice on these matters does not appear to be allocated to any one agency and our study reveals that many patients do not recall being given such advice. provision of information on safety issues is poor and the adoption of a standard policy on provision of written information should be seen as a priority. a survey of community pharmacists in scotland undertaken by matheson and bond indicated that pharmacists providing health promotion advice to drug misusers see verbal advice as being " risky ", whereas written information is seen as non - confrontational. the introduction of written information on storage and measurement to be given out at the time of dispensing of methadone may be one possible solution to ensuring that patients remain aware of the


, whereas written information is seen as non - confrontational. the introduction of written information on storage and measurement to be given out at the time of dispensing of methadone may be one possible solution to ensuring that patients remain aware of the risks inherent in irresponsible custody of their methadone and what steps to take to reduce this risk. studies of the relative effectiveness of written versus verbal information on patient information retention and subsequent action do not, however, show any advantage of written over verbal presentation [ 13, 14 ]. the overall view is that providing the information in both forms provides a range of options which may match the patients ' preferred mode of receiving information. the provision of information on the safe storage of methadone is recalled by a minority of patients, and the vast majority of patients do not store their methadone in a locked cupboard or other secure location. the audit we have reported will be repeated following the provision of written information to patients in addition to verbal information at the point that they commence their methadone treatment. this will be reinforced at the point where patients transfer from supervised consumption at the pharmacy to home consumption as part of a progressive relaxation of restrictions in more stable patients. the author ( s ) declare that they have no competing interests. rnb conceived of the audit, devised the methodology and drafted the manuscript rm supervised the data collection and performed the telephone survey ns participated in the design of the study and performed the data analysis all authors read and approved the manuscript the authors extend their thanks to the patients and pharmacists who gave their time to contribute to the audit and to gretta bloor for micro - editing of the final version of the manuscript. bmj 1996, 313 : 1481. pubmed abstract bmj 1999, 318 : 329 - 330. pubmed abstract bmj 1991, 303 : 922 - 923. pubmed abstract bmj 1999, 318 : 1137. pubmed abstract hum toxicol 1987, 6 : 303 - 314. pubmed abstract


| recommended intake | calcium deficiency | calcium toxicity | major food sources | health implications | tips for increasing your calcium intake | taking supplements calcium is the most prevalent mineral in the human body. about 99 % of the body ' s calcium resides in the bones and teeth, and the remaining 1 % is dispersed throughout other body fluids and cells. calcium ' s functions include : - builds bones, both in length and strength - helps bones remain strong by slowing the rate of bone loss with age - helps muscles contract - helps the heart beat - plays a role in normal nerve function, transfers nerve impulses - helps blood clot during bleeding - builds healthy teeth ( in kids ) the institute of medicine offers these recommendations : recommended dietary allowance or • adequate intake ( mg / day ) | birth to 6 months | | 200 milligrams ( mg ) | | 200 mg | | 7 - 12 months | | 260 mg | | 260 mg | | 1 - 3 years | | 700 mg | | 700 mg | | 4 - 8 years | | 1, 000 mg | | 1, 000 mg | | 9 - 18 years | | 1, 300 mg | | 1, 300 mg | | 19 - 50 years | | 1, 000 mg | | 1, 000 mg | | 51 - 70 years | | 1, 200 mg | | 1, 000 mg | | 71 years and older | | 1, 200 mg | | 1, 200 mg | | pregnant or lactating teens | | 1, 300 mg | | n / a | | pregnant or lactating adults | | 1, 000 mg | | n / a | in childhood, not getting enough calcium may interfere with growth. a severe deficiency may keep children from reaching their potential adult height. even a mild deficiency over a lifetime can affect bone density and bone loss, which increases the risk for osteoporosis. if you do not consume enough calcium, your body will draw from the storage in your bones in order to supply enough calcium for its other functions : nerve transmission, muscle contraction, heartbeat, and blood clotting. symptoms of a calcium deficiency include : - intermittent muscle contractions - muscle pain - muscle spasms - numbness or tingling in the hands and feet very large doses over a prolonged period of time may cause kidney stones and poor kidney function. your body may not absorb other minerals, such as zinc, properly. these problems could occur from consuming too much through a calcium supplement, not from milk or other calcium - rich foods. the tolerable upper


cause kidney stones and poor kidney function. your body may not absorb other minerals, such as zinc, properly. these problems could occur from consuming too much through a calcium supplement, not from milk or other calcium - rich foods. the tolerable upper intake level ( ul ) depends on age. upper level intake ( mg / day ) | birth to 6 months | | 1, 000 milligrams ( mg ) | | 1, 000 mg | | 7 - 12 months | | 1, 500 mg | | 1, 500 mg | | 1 - 8 years | | 2, 500 mg | | 2, 500 mg | | 9 - 18 years | | 3, 000 mg | | 3, 000 mg | | 19 - 50 years | | 2, 500 mg | | 2, 500 mg | | 51 years and older | | 2, 000 mg | | 2, 000 mg | | pregnant or lactating teens | | 3, 000 mg | | n / a | | pregnant or lactating adults | | 2, 500 mg | | n / a | major food sources dairy foods — milk, yogurt, and some cheeses — are the best dietary sources of calcium. these foods are also rich in vitamin d, which helps the body absorb calcium. | macaroni and cheese, homemade | | 1 cup | | 362 | | parmesan cheese | | 1 tbsp | | 336 | | eggnog, nonalcoholic | | 1 cup | | 330 | | chocolate milk | | 1 cup | | 300 | | ricotta cheese | | ½ cup | | 300 | | powdered milk | | ¼ cup | | 290 | | cheddar cheese | | 1 ounce | | 250 | | swiss cheese | | 1 ounce | | 250 | | provolone cheese | | 1 ounce | | 215 | | cheese pizza | | 1 / 6 frozen pizza | | 210 | | mozzarella cheese | | 1 ounce | | 175 | | american cheese | | 1 ounce | | 160 | | cottage cheese | | 1 cup | | 120 | | frozen yogurt, soft serve | | ½ cup | | 100 | | ice cream | | ½ cup | | 80 | absorption of calcium from some other dietary sources is not as great as that from dairy foods. specifically, dark green vegetables contain oxalates, and grains contain phytates, which can bind with calcium and decrease their absorption. read food labels to determine the specific calcium levels of


other dietary sources is not as great as that from dairy foods. specifically, dark green vegetables contain oxalates, and grains contain phytates, which can bind with calcium and decrease their absorption. read food labels to determine the specific calcium levels of these foods. | tofu, regular, processed with calcium | | ½ cup | | 435 | | calcium - fortified soy milk | | 1 cup | | 250 - 300 | | salmon, canned with edible bones | | 3 ounces | | 212 | | calcium - fortified orange juice | | ¾ cup | | 200 | | blackstrap molasses | | 1 tbsp | | 172 | | pudding, from cook & serve mix | | ½ cup | | 150 | | dried figs | | 5 pieces | | 135 | | tofu, regular ( processed without calcium ) | | ½ cup | | 130 | | anchovies with edible bones | | 3 ounces | | 125 | | turnip greens, boiled | | ½ cup | | 100 | | milk chocolate bar | | 1. 5 ounce | | 85 | | okra, boiled | | ½ cup | | 77 | | kale, boiled | | ½ cup | | 70 | | mustard greens, boiled | | ½ cup | | 65 | | pinto beans | | ½ cup | | 45 | calcium is essential to build and maintain strong bones at all stages of life. bone growth begins at conception, and bones grow longer and wider until well into the 20s. after this type of growth is complete, bones gain in strength and density as they continue to build up to peak bone mass by about age 35. from this point on, as a natural part of the aging process, bones slowly lose mass. calcium is essential to slow this natural loss and stave off the onset of osteoporosis — a disease in which bones become fragile and more likely to break. tips for increasing your calcium intake - when making oatmeal or other hot cereal, use milk instead of water. - add powdered milk to hot cereal, casseroles, baked goods, and other hot dishes. - make your own salad dressing by combining low - fat plain yogurt with herbs. - add tofu ( processed with calcium ) to soups and pasta sauce. - if you like fish, eat canned fish with bones on crackers or bread. - for dessert, try low - fat frozen yogurt, ice cream, or pudding. - in baked goods, replace half of the fat


and pasta sauce. - if you like fish, eat canned fish with bones on crackers or bread. - for dessert, try low - fat frozen yogurt, ice cream, or pudding. - in baked goods, replace half of the fat with plain yogurt. if you are unable to meet your calcium needs through dietary sources, consider a calcium supplement. some points to remember when choosing and using a calcium supplement include : - check the label because the amount of calcium differs among products. - avoid supplements with dolomite or bone meal ; they may contain lead. - check your vitamin d intake, too. this vitamin is essential for absorption of calcium. milk is a great source of vitamin d, as is sunlight. - if you take both calcium and iron supplements or a multivitamin with iron, take them at different times of the day. they can impair each other ' s absorption. this is also true of chromium, manganese, magnesium, and zinc. - do not take more than 500 mg of calcium at a time. taking the calcium with food can help absorption. academy of nutrition and dietetics the nutrition source harvard school of public health food and nutrition dietitians of canada bowes a, pennington j, church h. bowes & church food values of portions commonly used. philadelphia, pa : lippincott williams & wilkins ; 1998. calcium. ebsco natural and alternative treatments website. available at : http : / / www. ebscohost. com / pointofcare. updated august 2011. accessed august 11, 2012. calcium. office of dietary supplements website. available at : http : / / ods. od. nih. gov / factsheets / calcium. asp. accessed august 11, 2012. calcium intake and supplementation. ebsco dynamed website. available at : http : / / www. ebscohost. com / dynamed. updated june 25, 2012. accessed august 11, 2012. dietary reference intakes for calcium and vitamin d. institute of medicine website. available at : http : / / www. iom. edu / reports / 2010 / dietary - reference - intakes - for - calcium - and - vitamin - d / report - brief. aspx? page = 1. published november 30, 2010. accessed august 11, 2012. food and nutrition information center. us department of agriculture website. available at : http : / / fnic. nal. usd


| risk factors hepatitis b is a liver disease. it can be acute or chronic. acute hepatitis b usually goes away on its own and may not need treatment. chronic hepatitis b is an infection that lasts more than six months. chronic infection can lead to other health problems. hepatitis b is treated with antiviral medications. copyright © nucleus medical media, inc. hepatitis b is caused a virus. the virus causes swelling and irritation in the liver and makes it difficult for the liver to function normally. the hepatitis b virus ( hbv ) is spread by semen, vaginal secretions, saliva, blood, or body fluids from an infected person. the virus can pass from these fluids to your body through an open cut in your skin. a woman with hepatitis can also pass hbv to her baby during childbirth. factors that may increase your chance of hepatitis b include : - illicit drug injection use, especially when sharing needles - unprotected sexual contact, especially with multiple partners - sharing a residence and / or personal items with someone who has hbv - stay in hospital or long - term care facility - work that includes contact with blood or body fluids, such as health care or public safety workers - travel to areas where hbv is common it is possible that someone infected with hbv may never have symptoms of hepatitis b. if symptoms do develop, they appear around 60 - 150 days after exposure. symptoms may include : - fatigue that lasts for weeks or months - loss of appetite - nausea or vomiting - low - grade fever yellowing skin and eyes ( jaundice ) - abdominal pain in the upper right side of the abdomen - joint pain - dark urine and light - colored stool chronic hepatitis can lead to serious health problems including : the doctor will ask about your symptoms and medical history. a physical exam will be done. hepatitis b is diagnosed with blood tests. blood tests are also used to monitor changes in the liver. for chronic cases, a liver may be needed. acute infection may not need any treatment since it usually goes away on its own. chronic hepatitis b may be treated with a combination of different antiviral medications. all medications do not work the same in all people. talk with your doctor about the best treatment plan for you. your doctor may also ask that you : - avoid alcohol - avoid certain medicines, dietary supplements, and herbs - contact recent sexual partners so they can be tested and / or treated to reduce your chance of getting hepatitis b, take these steps : there is a to prevent hepatitis b.


you : - avoid alcohol - avoid certain medicines, dietary supplements, and herbs - contact recent sexual partners so they can be tested and / or treated to reduce your chance of getting hepatitis b, take these steps : there is a to prevent hepatitis b. this vaccine, a series of three injections, is routinely given to newborns. children and teens who were not vaccinated as babies can still receive the shots. other prevention strategies include : or abstain from sex. - limit your number of sexual partners. do not inject drugs. if you use iv drugs, get treatment to help you stop. never share needles or syringes. do not share personal items that may have blood or body fluids on them. - make sure a tattoo artist or piercer properly sterilizes the equipment. wear gloves when touching or cleaning up body fluids on personal items. - cover open cuts or wounds. - if you are pregnant, have a blood test for hepatitis b. infants born to mothers with hepatitis b should be treated within 12 hours after birth. baker cj, pickerling lk, chilton l, et al. advisory committee on immunization practices. recommended adult immunization schedule : united states, 2011. ann intern med. 2011 ; 154 ( 3 ) : 168 - 173. hepatitis b. american liver foundation website. available at : http : / / www. liverfoundation. org / abouttheliver / info / hepatitisb. updated february 17, 2012. accessed may 1, 2013. centers for disease control and prevention website. available at : http : / / www. cdc. gov / hepatitis / hbv. updated may 16, 2012. accessed may 1, 2013. hepatitis b. ebsco dynamed website. available at : http : / / www. ebscohost. com / dynamed / what. updated april 23, 2013. accessed may 1, 2013. vaccine information statement : hepatitis b vaccine. centers for disease control and prevention website. available at : http : / / www. cdc. gov / vaccines / pubs / vis / downloads / vis - hep - b. pdf. accessed may 1, 2013. vaccine - preventable stds. sexually transmitted diseases treatment guidelines, 2010. centers for disease control and prevention website. available at : http : / / www. cdc. gov / std / treatment / 2010 / vaccine. htm. updated january 28, 2013. accessed may 1, 2013. last reviewed may 2013 by marc


monday, april 30 ( healthday news ) - - stress experienced by a mother during the first trimester of pregnancy can lead to iron deficiency in her newborn, putting the infant at risk for physical and mental development delays, a new study says. iron is important in organ - system development, especially for the brain. risk factors for iron deficiency in newborns include iron deficiency and diabetes in their mothers, as well as smoking during pregnancy. preterm birth, low birth weight and multiple pregnancy are also well - known risk factors for low iron. this is the first study to suggest that stress experienced by mothers early in pregnancy is another risk factor for iron deficiency in newborns, according to the researchers. for the study, researchers looked at israeli women who lived in an area where more than 600 rocket attacks took place during their first trimester of pregnancy. this stress group was compared to a control group of women who lived in the same area but became pregnant three to four months after the rocket attacks ceased. tests on umbilical cord blood collected from the newborns showed that the 63 babies born to women in the stress group had significantly lower iron levels than the 77 babies born to women in the control group. " our findings indicate that infants whose mothers were stressed during pregnancy are a previously unrecognized risk group for iron deficiency, " study leader rinat armony - sivan, of ashkelon academic college, said in an american academy of pediatrics news release. " pregnant women should be aware that their health, nutrition, stress level and state of mind will affect their baby ' s health and well - being. " doctors might consider doing additional blood work before the well - child visit at 12 months of age, especially in high - risk populations, in order to detect iron deficiency early and treat it before it becomes chronic and severe, armony - sivan suggested. the study was slated for sunday presentation at the pediatric academic societies annual meeting in boston. data and conclusions presented at meetings should be viewed as preliminary until published in a peer - reviewed journal. although the study found an association between maternal stress and infant iron deficiency, it did not prove a cause - and - effect the nemours foundation has more about children and iron.


the world of plants the existence of plants is essential for the survival of living things on the earth. for the importance of this sentence to be fully grasped, we must ask : " what are the most important elements for human life? " of course, basic needs such as oxygen, water, and nourishment come to mind as the answers to this question. and green plants are the most important factor in ensuring the balance of these basic needs on the earth. and there are other balances in the world, of great importance to all living things, not just human beings, such as temperature control and maintaining the correct proportion of gases in the atmosphere, and again it is green plants which maintain the entire equilibrium. and the activities of green plants do not end there. as is known, the main source of energy for life on earth is the sun. but human beings and animals are unable to make direct use of solar energy, because their bodies lack the systems to use this energy as it is. for this reason solar energy can reach human beings and animals as usable energy only through the food produced by plants. for example, while sipping tea, we are actually sipping solar energy, and as we eat bread, we are munching solar energy. the strength in our muscles is really nothing other than solar energy in a different form. plants store this form of energy for us in the molecules in their bodies by carrying out complicated processes. the position for animals is no different from that of human beings. they are fed by plants, deriving solar energy from the plants ' energy, which they store in packets. plants being able to produce their own nutrition and maintain themselves, in contrast to other living things, is due to their cell structure, which enables them to employ solar energy directly, unlike human or animal cells. with the help of this structure, plant cells turn energy from the sun into energy which people and animals can absorb through nutrition. they store this energy as food through the special procesesses concealed in their structure. these processes are collectively known as photosynthesis. the necessary mechanism, or more accurately the miniature factory, by means of which plants are able to carry out photosynthesis, is found in their leaves. the transportation system, with its own very special features, for carrying necessary materials such as minerals and water, functions within plants ' stems and roots. the reproductive system too has been specially designed in every species of plant. there are complex structures within each and every one of these mechanisms. and these mechanisms function in connection with one another.


as minerals and water, functions within plants ' stems and roots. the reproductive system too has been specially designed in every species of plant. there are complex structures within each and every one of these mechanisms. and these mechanisms function in connection with one another. if one is missing, the others cannot carry out their tasks. as an example let us take a plant which just lacks a transport system. it is impossible for such a plant to carry out photosynthesis, because the vessels necessary to carry the essential water are missing. even if the plant managed to produce food, it would be unable to transport this to other parts of the body, and would eventually die. as in this example, all the systems present in a plant are obliged to function flawlessly. any flaws or defects in the existing structure will mean that the plant cannot carry out its functions, and this will result in the death of the plant and the disappearance of the species. when these structures are studied in detail and in depth in the chapters that follow, a most complex and quite flawless design will emerge. when the variety of plants in the world is considered and evaluated, these extraordinary structures seem even more striking. there are more than 500, 000 types of plant in the world. and each species possesses its own special planning within itself and features particular to that species. together with the same perfect basic systems found in all of them, there is also an unparalleled diversity in terms of reproductive systems, defence mechanisms, colour, and design. the only unchanging thing in all this is the reality that the parts of the plants ( leaves, roots, stems ) and many other mechanisms, must exist at once and with no defects so that the general system, the body, can function. modern scientists attribute to such systems an " irreducible complexity. " in the same way that a motor will not work if one of its cogs is missing, in plants the absence of just one system, or a single functional failure in any one of the parts of the system, will lead to the death of the plant. all of a plant ' s systems have this feature of irreducible complexity. the complex systems, which must all be present at the same time, and this unbelievable variety bring to mind the question : " how did these perfect systems in plants emerge? " once again, let us ask some questions to find the answer to this one. let us think how the functioning of the most important and best known of the mechanisms in plants, photosynthesis, and the transport systems linked


systems in plants emerge? " once again, let us ask some questions to find the answer to this one. let us think how the functioning of the most important and best known of the mechanisms in plants, photosynthesis, and the transport systems linked to it, came about. can the trees and flowers which we see all around us at all times have themselves formed such perfect systems as to bring about a phenomenon such as photosynthesis, some parts of which are still not fully understood, in their own bodies? did plants choose to use carbon dioxide ( co2 ), of the gases in the air, to produce food? did they themselves determine the amount of co2 they would use? could plants have designed those mechanisms which make up the root system and which enable them to take the materials necessary for photosynthesis from the soil? did plants bring about a transport system where different types of tubes are used for transporting nutrients and water? as ever, defenders of the theory of evolution searching for an answer to the question of how plants emerged have resorted to " chance " as their only remedy. they have claimed that from one species of plant which came about by chance, an infinite variety of plants have emerged, again by chance, and that features such as smell, taste, and colour, particular to each species, again came about by chance. but they have been unable to give any scientific proof of these claims. evolutionists explain moss turning into a strawberry plant, or a poplar, or a rose bush, by saying that conditions brought about by chance differentiated them. whereas when just one plant cell is observed, a system so complex will be seen as could not have come about by minute changes over time. this complex system and other mechanisms in plants definitively disprove the coincidence scenarios put forward as evolutionist logic. in this situation just one result emerges. every structure in plants has been specially planned and designed. and this shows us that there is a superior intelligence which drew up this flawless plan. and the owner of this superior intelligence, god, the lord of all the worlds, shows proofs of his flawless creation to human beings. god announces his dominion over living creatures and his incomparable creation in this verse :


residuals from treating acid mine drainage can be used as effective, inexpensive adsorbents for agricultural and wastewater discharges, a new study by scientists from the u. s. geological survey leetown science center has found. when acid mine drainage is remediated it is neutralized with a base such as limestone or lime and an iron - rich sludge is formed. the new study published in the journal water, air, and soil pollution shows the sludge can efficiently remove phosphorus from agricultural and municipal wastewaters. the phosphorus that has been adsorbed by the mine drainage residuals can later be stripped from the residuals and recycled into fertilizer, the study says. " this wonderful result shows the inventive application of some very sophisticated environmental chemistry to create a new life cycle for what otherwise would have been some problematic waste products, " said us geological survey director marcia mcnutt in a december 17, 2012 announcement to media about the study. " it sets the bar high for future studies in environmental remediation. " acid mine drainage is produced whenever sulfide minerals associated with coal and metal deposits are exposed to air and moisture. the resulting acid and dissolved metals are toxic to most forms of aquatic life. the study, fixed bed sorption of phosphorus from wastewater using iron oxide - based media derived from acid mine drainage, is authored by p. l. sibrell and t. w. tucker. lead author sibrell said the findings create a “ win - win ” situation as the mine drainage residuals can be regenerated and reused for a number of additional treatment cycles. " as environmental scientists, we kind of hesitate to use this analogy, but it really is like killing two birds with one stone, " sibrell said in the study ’ s announcement. " this new technology could reduce or eliminate the need to dispose of acid mine drainage sludge, instead making that same sludge useful in addressing the urgent need to reduce the amount of phosphorus going into aquatic ecosystems. ” untreated acid mine drainage has impacted more than 5, 000 miles of streams in the appalachian region, with associated economic impacts of millions of lost dollars in the tourism and sport fishing industries. excess phosphorus releases to the environment from agricultural and municipal wastewaters have resulted in significant impairment of aquatic ecosystems such as the chesapeake bay and other bodies of water worldwide. current technology for the removal of phosphorus from wastewater consists of addition of aluminum or iron salts to precipitate and adsorb phosphorus, but this is too expensive for the low concentrations


- slide 1 of 4 definition of a mid - life crisis or depression the type of depression that accompanies a mid - life crisis is generally caused by internal factors rather than external influences. in some cases, however, menopause is a contributing factor. a typical mid - life depression will manifest differently in men and women with some of the symptoms being as follows : - affairs with younger women - anger and irritability - hostility and conflict - demands respect - restless and agitated - afraid of speaking out doubts and fears - fear of failure - self treats with tv, alcohol, sport and sex - loss of libido - feelings of sadness and worthlessness - avoids conflict - feels like a failure - withdraws from social contact - feelings of guilt and lack of self respect - self treats with food, friends and love - sleep problems a mid - life crisis usually lasts for a few years and results in permanent changes in lifestyle. whether these are positive or negative is an individual choice. - slide 2 of 4 identifying a mid - life crisis depression in mid - life often arises when a person is in their 40s or 50s. it is at this stage of life that men and women realize they are ageing and their physical strength and appearance will be declining gradually. this realization leads to some of the behavior that is often seen during a mid - life depression. men tend to have affairs and women may indulge in plastic surgery and dramatic keep - fit programs. by their 40s, most men and women are financially secure and established in a career. during a mid - life crisis they question if this is all there is to life and may feel bored and let down. others may be disappointed with what they have achieved and frustrated by a loveless marriage. what they do at this point will determine how their lives will look in years to come. - slide 3 of 4 how to overcome depression and a mid - life crisis there are a number of ways men and women can overcome a mid - life depression : - visit your doctor for a checkup. this will determine if there are any health issues that need addressing. some people with this type of depression benefit from a short course of antidepressant medication to tide them through difficult patches. hormone replacement therapy can help women suffering from menopause - related depression. - join the aa or a support group if you are struggling with addictions or are overindulging in food, alcohol, smoking, gambling or sex. it is easier to overcome these problems when sharing how they affect you with people


related depression. - join the aa or a support group if you are struggling with addictions or are overindulging in food, alcohol, smoking, gambling or sex. it is easier to overcome these problems when sharing how they affect you with people who understand your struggles. - confiding in a friend who you know experienced a mid - life depression can be helpful – especially if they had a positive outcome. most people are more than willing to share their experiences and offer support to those going through something similar. - regard a mid - life depression as an opportunity to re - evaluate goals, dreams and ambitions in life. look at job satisfaction, leisure time and relationships, and if necessary, make some changes and plan for positive change. people who lose focus are more susceptible to depression and dreams give them something to reach for. - accept that while ageing is a natural process, it doesn ’ t mean the end of enjoying life. there is nothing wrong with trying to improve matters by dieting, giving up smoking or exercising more, but there must be a realization that ageing does bring limitations and bodily changes. wrinkles, weight gain and hair loss don ’ t have to signal the end of a fulfilling life or career. - joining a gym, taking up a new hobby or meeting different people can give a fresh spark to life. don ’ t sit at home feeling depressed. get out and try a number of new activities until you find one that suits you. - take some time out to do something different with your spouse or loved ones. this can be as simple as a day out in the country or a trip overseas. marital difficulties commonly arise during a mid - life depression and working on love and togetherness can protect against this. - a mid - life depression may coincide with and be exacerbated by children leaving home. use this as a time to do things you have always wanted to do but didn ’ t have the time, money or freedom to enjoy in your younger years. - go on a mission trip or volunteer at a local soup kitchen or homeless shelter. giving of yourself and your time can be extremely inspiring and will certainly change your perspective on life and your appreciation of your personal situation. there is no need to suffer in silence while experiencing mid - life depression. there is help available and individuals can make adjustments that transform this period of life into a positive experience where they set the course for future years. - slide 4 of 4 male health. http : / / www. malehealth. co. uk / node /


walker - warburg syndrome is a congenital disorder of the central nervous system involving fatal neurological lesions. multiple malformations of the brain, eyes, and muscle tissue distinguish wws from similar malformation syndromes. it is also known by the acronym hard + / - e syndrome ( hydroencephalus, agyri, retinal dysplasia, plus or minus " e " for encephalocele ). affected individuals typically show a combination of severe brain, eye, and muscle defects. multiple malformations of the brain include type ii lissencephaly, a condition in which the brain lacks normal convolutions and is unusually smooth without folds. eighty - four percent of the babies with wws have macrocephaly ( an enlarged head ). in half of these cases, the macrocephaly is apparent at birth, and in a quarter of the cases it develops postnatally. hydrocephalus, or excessive accumulation of cerebrospinal fluid around the brain, occurs in 95 % of infants with wws. this fluid fills abnormally large ventricles or spaces in the brain. fifty percent of affected infants have an encephalocele, or gap in the skull that does not seal. the meninges or membranes that cover the brain may protrude through this gap. the formation of an encephalocele may be associated with the failure of the neural tube to close during development of the fetus. a malformed cerebellum characterizes the syndrome as well as distinct muscle abnormalities, including congenital muscular dystrophy. ocular defects occur in 100 % of infants with wws. the most common are abnormally small eyes and retinal abnormalities, which arise from the improper development of the light sensitive area at the back of the eye. cataracts may also be present and more than three quarters of the infants born with wws have a defect in the anterior chamber of the eye. wws syndrome leads to severely retarded mental development and is often lethal in infancy. wws is inherited in an autosomal recessive pattern. offspring of parents who have had one affected infant have a 25 % chance of having wws. the locations of the causitive genes remains unknown. wws is extremely rare. cases described in the literature cite siblings with wws born to consanguineous ( closely related ) parents as well as cases in families not known to be at risk. signs and symptoms clinical


three sibs. " american journal of medical genetics 76 ( march 1998 ) : 107 - 10. hung, n. a., et al. " gonaddoblastoid testicular dysplasia in walker - warburg syndrome. " pediatric developmental pathology 1 ( september - october 1998 ) : 393 – 404. vasconcelos, m. m., et al. " walker - warburg syndrome. report of two cases. " fetal diagnostic therapy 14 ( july - august 1999 ) : 198 – 200. lissencephaly network, inc. 716 autumn ridge lane, fort wayne, in 46804 - 6402. ( 219 ) 432 - 4310. fax : ( 219 ) 432 - 4310. firstname. lastname @ example. org. < http : / / www. lissencephaly. org >. national hydrocephalus foundation. 12413 centralia, lakewood, ca 90715 - 1623. ( 562 ) 402 - 3523 or ( 888 ) 260 - 1789. email @ example. com. < http : / / www. nhfonline. org >. national organization for rare disorders ( nord ). po box 8923, new fairfield, ct 06812 - 8923. ( 203 ) 746 - 6518 or ( 800 ) 999 - 6673. fax : ( 203 ) 746 - 6481. < http : / / www. rarediseases. org >. " fukuyama congenital muscular dystrophy. " omim – online mendelian inheritance in man. < http : / / www. ncbi. nlm. nih. gov / entrez / dispomim. cgi? id = 253800 >. " muscular dystrophy, congenital, with severe central nervous system atrophy and absence of large myelinated fibers. " omim – online mendelian inheritance in man. < http : / / www. ncbi. nlm. nih. gov / entrez / dispomim. cgi? id = 601170 >. " walker - warburg syndrome. " omim – online mendelian inheritance in man. < http : / / www. ncbi. nlm. nih. gov / entrez / dispomim. cgi? id = 236670 >.


coarctation of the aorta ( coa ) is a congenital malformation of the aorta. the condition is also known as aortic coarctation. either name indicates a constriction of the aorta. the aorta is the largest artery in your body. with a diameter about the size of a garden hose, the aorta leaves the left ventricle of the heart and runs through the middle of your body, through the chest and into the abdominal area. there, it branches out to deliver freshly oxygenated blood to your lower limbs. a constriction or narrowing of this important artery can result in decreased flow of oxygen. in coa, the constricted part is generally near the top of the aorta and acts like a kink in a hose. as your heart tries to pump oxygen - rich blood to the body, the blood has trouble getting through the kink. this causes high blood pressure in the upper parts of your body and reduced blood flow to the lower parts of your body. coa is generally diagnosed and treated shortly after birth through surgery. these children usually grow up to lead normal, healthy lives. however, if your child is not diagnosed with coa until he or she is older, your child is at risk for high blood pressure and heart problems. he or she may require close medical monitoring. without treatment, coa patients generally die in their 30s to 40s of heart disease or from complications of chronic high blood pressure. coa is one of several common types of congenital heart malformations. coa may occur alone, or together with other abnormalities in the heart. coa is seen more frequently in boys than girls. it is also associated with other congenital heart defects, such as shone ’ s complex and digeorge syndrome. while it is known that coa begins during fetal development, its causes are still not fully understood. in the past, doctors thought that coa occurred more often in whites than in other races. however, more recent research suggests that differences in the prevalence of coa may be due to different rates of detection. studies suggest and that all races are equally likely to be born with the defect. fortunately, the chances of your child being born with coa are fairly low. coa affects only about 6 to 8 percent of all children born with heart defects. and congenital heart defects only occur in approximately. 009 percent of all babies born each year. symptoms in newborns symptoms in newborns vary with the severity of the constriction of the aorta. about half of newborns with


defects. and congenital heart defects only occur in approximately. 009 percent of all babies born each year. symptoms in newborns symptoms in newborns vary with the severity of the constriction of the aorta. about half of newborns with coa exhibit no symptoms. the rest may have trouble breathing and be poor feeders. other symptoms are sweating, high blood pressure, and congestive heart failure. symptoms in older children and adults in mild cases, children may exhibit no symptoms until later in life. when symptoms do begin to show, they can include : coa is usually discovered during the newborn ’ s first examination. your doctor may detect differences in blood pressure between the baby ’ s upper and lower extremities, or hear characteristic sounds of the defect when listening to your baby ’ s heart. coa is generally treated soon after birth using balloon angioplasty or surgery. balloon angioplasty involves inserting a catheter inside the constricted artery and then inflating a balloon inside the artery to widen it. surgical treatment may involve removing and replacing the “ crimped ” portion of the aorta. the surgeon may instead choose to bypass the constriction with a graft or creating a patch over the narrowed portion to enlarge it. adults who received treatment in childhood may require additional surgery later in life to treat any reoccurrence of coa. additional repairs may be needed to the weak area of the aortic wall. left untreated, persons with coa generally die in their 30s or 40s of heart failure, ruptured aorta, stroke, or other conditions. chronic high blood pressure associated with coa increases the risks of heart damage, aneurysms, stroke, and premature coronary artery disease. chronic high blood pressure can also lead to kidney and liver failure, and loss of eyesight through retinopathy. patients with coa may need to take drugs, such as ace ( angiotensin - converting - enzyme ) inhibitors and beta - blockers to control high blood pressure. coa patients should follow a healthy lifestyle. moderate daily aerobic exercise is helpful for maintaining healthy weight, cardiovascular health, and controlling blood pressure. strenuous exercise, such as weightlifting, put additional stress on the heart and should be avoided. coa patients should minimize their intake of dietary salt and fat. anyone with coa should never smoke any kind of tobacco products.