What s New. New Fitness class. Bank Holiday Closures Monday 31st August. Get in shape for sum-

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1 What s New Welcome to issue four of inter-active, this issue is focusing on the sunnier side of things now that summer is biting at the back of our heels and hopefully bring with it hot hazy lazy days for us all to enjoy. So with summer in mind we have packed this issue full of seasonal info, tips, exercises and advice to give you a kick start to healthy and fun summer. Bank Holiday Closures Monday 31st August New Fitness class Hard Core Abs Friday 6.30 pm pm Get in shape for sum- Hard Core Abs is a new 30 minute class designed to work and tone your abdominal muscles and build core strength. If you fancy giving your abs a blast and want to get them into shape for the summer, then this is the class for you. Book your place at the reception or contact

2 Salmon Burgers Yield: 4 servings (serving size: 1 burger) Give beef a break and try quick, simple salmon burgers. Combine salmon with red onion and fresh basil to make a hearty burger with less than 200 calories. Enjoy on toasted focacciabread for a gourmet meal that s ready in 10 minutes. Summer entertaining just got so much easier. Ingredients 1 cup finely chopped red onion 1/4 cup thinly sliced fresh basil 1/4 teaspoon salt 1/4 teaspoon freshly ground black pepper 1 (1-pound) salmon fillet, skinned and chopped 1 tablespoon hot pepper sauce 1 large egg white Cooking spray 8 (3/4-ounce) slices focaccia, toasted Preparation Combine first 5 ingredients in a large bowl. Combine hot pepper sauce and egg white in a small bowl; add egg white mixture to salmon mixture, stirring well to combine. Divide the mixture into 4 equal portions, shaping each into a 1/2-inch-thick patty. Heat a large non-stick skillet over medium-high heat. Coat pan with cooking spray. Add salmon patties, and cook 3 minutes on each side or until desired degree of doneness. Serve patties on toasted focaccia. Nutritional Information Calories 190 Calories from fat 42 % Fat 8.8 g Satfat 2.1 g Monofat 3.8 g Polyfat 2.1 g Protein 25.2 g Carbohydrate 1.1 g Fibre 0.3 g Cholesterol 58 mg Iron 0.6 mg Sodium 236 mg Calcium 21 mg Fascinating facts Have you ever gone running down the beach longing for a nice cool swim in the sea only to come to a skidding halt at the waters edge after finding the shoreline and the sea already occupied by a mass of jelly fish? Below are some amazing facts about one of our holiday nightmares: 1. A jellyfish is not a fish at all, it is an invertebrate (animal without a backbone). 2. Invertebrates make up 95% of all animals on earth. 3. A jelly is made up of approximately 95% water. 4. A jelly does not have a brain, eyes, bones, teeth, or blood. 5. A jelly reproduces by making clones of itself so it technically never dies. 6. There are 2 main stages to a jelly s life cycle, the sessile (stuck to a surface) polyp, and the free-swimming medusa (what you think of as a jelly). 7. The largest jelly ever found was a Lion s Mane Jelly with a diameter of 7 feet 6 inches (2.29m) and its tentacles trailed 120 feet behind it! 8. The smallest jelly is the Irukandji jelly which is only 1 1/2 inches in diameter. 9. Jellies are found in all the world s oceans. 10. A box jelly (sea wasp) sting can kill you within 2-3 minutes. Lion's Mane Jellyfish: the largest jelly in the ocean

3 Injury clinic Tennis elbow (lateral epicondylitis) Who is affected by tennis elbow? It is estimated that as many as one in three people have tennis elbow at any given time. Each year, in the UK, about five in every 1,000 people go to see their GP about tennis elbow. The condition usually affects adults and is more common in people who are years of age. Men and women are equally affected. Tennis elbow is the common name for a painful condition affecting the outside part of the elbow. Depending on the severity it can take from two months to two years to heal fully. About tennis elbow The medical term for tennis elbow is lateral epicondylitis because it affects the outside of your elbow bone, which is called the lateral epicondyle. The lateral epicondyle is the bony area you can feel on the outside of your elbow. Tennis elbow develops when the tendon that joins the muscles of your forearm to your upper arm bone (the humerus) tears or becomes inflamed. This tendon is called the extensor tendon (see diagram). The elbow joint Tennis elbow most often happens when you have repeatedly overused your arm. This overuse causes inflammation or tiny tears in the tendon. This may become worse if you continue doing the activity that triggered the pain and may cause a more serious tear or rupture your tendon. Symptoms of tennis elbow The main symptom is pain and tenderness on the outside of your elbow and sometimes in the muscles on top of your forearm. Tennis elbow usually affects the arm of your dominant hand (eg your right arm if you're right handed) because this is the arm you use the most. Symptoms usually develop gradually. The pain may get worse when you move your wrist or if you repeat the activity that triggered the pain. The pain may become constant. Your affected arm may also be more painful when you grip or twist something, such as turning a door handle or shaking hands. If you have severe elbow pain, can't move the joint or have any loss of feeling, you should seek urgent medical attention. Many people with mild symptoms of tennis elbow can use self-help measures to reduce their pain. However, if your symptoms don't improve after a couple of weeks, you should visit your GP or physiotherapist for advice. Causes of tennis elbow The most common cause of tennis elbow is repeated overuse of your arm. Playing tennis three times in a week when you haven't played for some time is the sort of overuse that could cause tennis elbow. However, most people who develop tennis elbow haven't been playing tennis. A range of different activities that involve repeated hand, wrist and forearm movements is more often the cause. This includes activities like using a screwdriver, using vibratory work equipment (such as a drill), or even using a keyboard. Rarely, tendon damage can happen after a single and often minor incident, such as lifting something heavy or taking part in an activity which you don't do very often, such as painting and decorating. These activities can cause a tear in your tendon. Diagnosis of tennis elbow Your GP or physiotherapist will ask about your symptoms and examine you. He or she may also ask you about your medical history. Your GP or physiotherapist can usually diagnose tennis elbow from examining your arm and hearing about how your symptoms developed. An X-ray is rarely needed, but your GP/physiotherapist may recommend having one to rule out other conditions, such as arthritis, that can cause elbow pain. For severe tennis elbow that has failed to heal with normal treatment, your GP/physiotherapist might suggest a ultrasound scan. These give images of the soft tissues, including muscles and tendons, inside your arm.

4 Injury clinic Tennis elbow (lateral epicondylitis) continued... Treatment of tennis elbow To make a full recovery, you will need to change the way you use your arm so that your tendon is rested and has time to heal. How you do this will depend on how your tennis elbow developed and how severe it is. Self-help You can treat your symptoms yourself if you have mild tennis elbow. Some of the main self-help treatments are described below. Rest - The most important part of your treatment is to rest your injured tendon and elbow by stopping or changing the activity that is causing the problem. Apply a cold compress to reduce your pain. You can use a cold compress, such as ice or a bag of frozen peas wrapped in a towel as soon as you feel any pain. Hold this against your elbow for 10 minutes every two hours. In the days that follow an injury you can use the ice pack for 10 minutes twice a day. Don't apply ice directly to your skin as it can damage your skin. Wear strapping or a splint. You can wear strapping or a splint around your forearm and elbow to help restrict the movement of your tendon and relieve the strain. Some people find that this helps, although there is no evidence to show how well it works. You can buy arm braces and supports from some physiotherapists, larger pharmacies and sports shops. Don't wear any strapping or a splint continuously - you should leave it off at night time. Change the action that caused the problem. If the problem developed as a result of an activity at work, contact your employer's occupational health advisers, if available, or speak with your employer. They can give advice on how to change the activity that caused the problem, allowing your arm to heal. Medicines You can take paracetamol to relieve the pain, and anti-inflammatory medicines, such as ibuprofen, to reduce inflammation. You can take ibuprofen in the form of a cream or gel that you put directly onto your skin, or you can take it as a tablet. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice. If paracetamol and ibupropen don't ease your pain, your GP may prescribe you a stronger painkiller called codeine. As a last resort, your doctor may also suggest a steroid injection to help relieve pain and inflammation if other treatments don't work, or if your pain is severe. This is an injection of steroid and local anaesthetic directly into the area where your pain is. Physical therapies Your GP will refer you to a physiotherapist if he or she thinks physiotherapy will be beneficial. Your physiotherapist may try various techniques to reduce the pain. These may include exercises, deep tissue massage and acupuncture. You may also be shown exercises to do that stretch your muscles and that can improve the movement and strength of your elbow and wrist. You should start these exercises as soon as possible after any injury, when your pain has eased. Your physiotherapist will be able to advise you on this. Surgery Your GP may advise you to have surgery if your tendon is severely damaged, or if there has been no improvement after many months of rest and rehabilitation. However, very few people need surgery. Prevention of tennis elbow Tennis elbow is usually caused by overuse of your arm, so it can be prevented. A few sensible precautions include: warm up before activity with five minutes of gentle movements - this allows time for your muscles to adjust to the extra stresses and strains try not to do the same activity for long periods of time - take regular breaks seek advice early from your GP or physiotherapist if you notice a problem stop the activity that's causing the problem or find a different way to do it. To prevent an old tennis elbow injury from coming back, you should: give yourself proper rest between sessions don't play sport if your arm is painful get professional advice on your technique if you play racquet sports regularly

5 The Sun and You Have you ever picked up a bottle of sun cream and looked at the label and wondered what the difference between UVA and is, or are you never sure what SPF factor to use. Have a look at the article below hopefully it will shed some light on the subject. (no pun intended). Understanding UVA and For a six billion year old, the sun is certainly in the news a lot lately, mainly because it is still a source of uncertainty and confusion to many of us. The center of this confusion is the sun's ultraviolet A (long-wave) and ultraviolet B (shortwave) rays. Our understanding of exactly what kinds of damage each causes to the skin, and how best to protect ourselves, seems to shift every year as new research comes out. For example, it was once thought that only was of concern, but we keep learning more and more about the damage caused by UVA. And new, improved forms of protection against UVA keep emerging. Keeping up with these new developments is a worthwhile challenge that can help all of us prevent sun damage. UV radiation is part of the electromagnetic (light) spectrum that reaches the earth from the sun. It has wavelengths shorter than visible light, making it invisible to the naked eye. These wavelengths are classified as UVA,, or UVC, with UVA the longest of the three at nanometers (nm, or billionths of a meter). UVA is further divided into two wave ranges, UVA I, which measures nanometers (nm, or billionths of a meter), and UVA II which extends from nanometers. ranges from 290 to 320 nm. With even shorter rays, most UVC is absorbed by the ozone layer and does not reach the earth. Both UVA and, however, penetrate the atmosphere and play an important role in conditions such as premature skin aging, eye damage (including cataracts), and skin cancers. They also suppress the immune system, reducing your ability to fight off these and other maladies.

6 The Sun and You UV radiation and skin cancer By damaging the skin's cellular DNA, excessive UV radiation produces genetic mutations that can lead to skin cancer. Both the U.S. Department of Health and Human Services and the World Health Organization have identified UV as a proven human carcinogen. UV radiation is considered the main cause of non melanoma skin cancers (NMSC), including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). These cancers strike more than a million people each year. Many experts believe that, especially for fair-skinned people, UV radiation also frequently plays a key role in melanoma, the deadliest form of skin cancer. UVA Most of us are exposed to large amounts of UVA throughout our lifetime. UVA rays account for up to 95 percent of the UV radiation reaching the Earth's surface. Although they are less intense than, UVA rays are 30 to 50 times more prevalent. They are present with relatively equal intensity during all daylight hours throughout the year, and can penetrate clouds and glass. UVA, which penetrates the skin more deeply than, has long been known to play a major part in skin aging and wrinkling (photo aging), but until recently scientists believed it did not cause significant damage in areas of the epidermis (outermost skin layer) where most skin cancers occur. Studies over the past two decades, however, show that UVA damages skin cells called keratinocytes in the basal layer of the epidermis, where most skin cancers occur. (Basal and squamous cells are types of keratinocytes.) UVA contributes to and may even initiate the development of skin cancers. UVA is the dominant tanning ray, and we now know that tanning, whether outdoors or in a salon, causes cumulative damage over time. A tan results from injury to the skin's DNA; the skin darkens in an imperfect attempt to prevent further DNA damage. These imperfections, or mutations, can lead to skin cancer. Tanning booths primarily emit UVA. The high-pressure sunlamps used in tanning salons emit doses of UVA as much as 12 times that of the sun. Not surprisingly, people who use tanning salons are 2.5 times more likely to develop squamous cell carcinoma, and 1.5 times more likely to develop basal cell carcinoma. According to recent research, first exposure to tanning beds in youth increases melanoma risk by 75 percent., the chief cause of skin reddening and sunburn, tends to damage the skin's more superficial epidermal layers. It plays a key role in the development of skin cancer and a contributory role in tanning and photo aging. Its intensity varies by season, location, and time of day. The most significant amount of in the UK is between 11 AM and 4 PM from May to September. However, rays can burn and damage your skin year-round, especially at high altitudes and on reflective surfaces such as snow or ice, which bounce back up to 80 percent of the rays so that they hit the skin twice. rays do not significantly penetrate glass.

7 The Sun and You Protective measures Protect yourself from UV radiation, both indoors and out. Always seek the shade outdoors, especially between 11 AM and 4 PM. And since UVA penetrates glass, consider adding flat, tinted UV-protective film to your car's side and rear windows as well as to house and business windows. This film blocks up to 99.9 percent of UV radiation and lets in up to 80 percent of visible light. Outdoors, dress to limit UV exposure: Special sun-protective clothes with UPF (ultraviolet protection factor) indicate how much UV radiation can penetrate the fabric; the higher the UPF, the better. A shirt with an UPF of 30, for example, means that just 1/30th of the sun's UV radiation can reach the skin. Laundry additives can also be washed right into regular fabrics to provide higher UPFs. However, you can enhance your sun safety simply by learning to evaluate everyday fabrics' sun protection qualities and choosing those with the best protection. For instance, bright- or dark-coloured, lustrous clothes reflect more UV radiation than do pastels and bleached cottons; and tightly woven, loose-fitting clothes provide more of a barrier between your skin and the sun. Finally, broad-brimmed hats and UV-blocking sunglasses help shield the sensitive skin on your head, neck, and around the eyes - areas that usually sustain a lot of sun damage Sun protection factor (SPF) and UV radiation Since the advent of modern sunscreens, a sunscreen's efficacy has been measured by its sun protection factor, or SPF. SPF is not an amount of protection per se. Rather, it indicates how long it will take for rays to redden skin when using a sunscreen, compared to how long skin would take to redden without the product. For instance, someone using a sunscreen with an SPF of 15 will take 15 times longer to redden than without the sunscreen. An SPF 15 sunscreen screens 93 percent of the sun's rays; SPF 30 protects against 97 percent; and SPF 50, 98 percent. The Skin Cancer Foundation maintains that SPFs of 15 or higher are necessary for adequate protection. Sunscreen Ingredients Since both UVA and are harmful, you need protection from both kinds of rays. To make sure you're getting effective UVA as well as coverage, look for a sunscreen with an SPF of 15 or higher, plus some combination of the following UVAscreening ingredients: stabilized a avobenzone, ecamsule (a.k.a. Mexoryl TM ), oxybenzone, titanium dioxide, and zinc oxide. You may see the phrases multi spectrum, broad spectrum or UVA/ protection on sunscreen labels, and these all indicate that some UVA protection is provided. However, because there is no consensus on how much protection these terms indicate, such phrases may not be entirely meaningful. There are currently 17 active ingredients approved by the FDA for use in sunscreens. These filters fall into two broad catego-

8 The Sun and You FDA-Approved Sunscreens Range Covered Active Ingredient/UV Filter Name UVA1: nm UVA2: nm : nm Chemical Absorbers: Aminobenzoic acid (PABA) Avobenzone Cinoxate Dioxybenzone Ecamsule (Mexoryl SX) Ensulizole (Phenylbenzimiazole Sulfonic Acid) Homosalate Meradimate (Menthyl Anthranilate) Octocrylene Octinoxate (Octyl Methoxycinnamate) Octisalate ( Octyl Salicylate) Oxybenzone Padimate O Sulisobenzone Trolamine Salicylate UVA1, UVA2 UVA2 UVA2, UVA2, UVA2 Physical Filters: Titanium Dioxide, UVA2 Zinc Oxide,UVA2, UVA1 Prevention Guidelines Seek the shade, especially between 11 AM and 4 PM.(may-sept) Do not burn. Avoid tanning and UV tanning booths. Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses. Use a broad spectrum (UVA/) sunscreen with an SPF of 15 or higher every day. For extended outdoor activity, use a water-resistant, broad spectrum (UVA/) sunscreen with an SPF of 30 or higher. Apply 1 ounce (2 tablespoons) of sunscreen to your entire body 30 minutes before going outside. Reapply every two hours, or immediately after swimming or excessive sweating. Keep newborns out of the sun. Sunscreens should be used on babies over the age of six months. Examine your skin head-to-toe every month. See your physician every year for a professional skin exam.

9 Crossword Corner & Fitness Focus Down 1. Security device (7) 2. Bone (3) 3. Supple (5) 4. Plain (6) 5. Fortification (7) 6. Enlarges (9) 7. Astound (5) 11. Consortium (9) 14. Mode (7) 16. Irksome (7) 17. Wonder (6) 18. Repent (5) 20. Artery (5) 23. Unwell (3) Across 1. Danger (5) 4. Percussion instrument (7) 8. Deliberated (7) 9. Molten rock (5) 10. Marine mollusks (7) 12. Similar (5) 13. Martial art (4,2) 15. Rigorous (6) 18. Assumed name (5) 19. Accumulated (7) 21. Similar to a giraffe (5) 22. Dizziness (7) 24. Perpetual (7) 25. Book of maps (5) Quarterly quotes Now that we are on issue four and you have got into the swing of solving the quotes, it s time to make them a little harder. Below are two quotes but can you solve them this time, as normal there will be some clues to who said them underneath each quote. 1) Don t cry because it s over, smile because it happened. Author and illustrator born in Massachusetts on 2 nd march 1904 and best sellers include The cat in the hat. 2) An eye for an eye only ends up making the whole world blind. Anti-war Activist born in Porbandar India on 2 nd October 1869.he was the primary leader of India s independence movement.