Remedies are selected generally for their properties that address specific problems, if or when they arise, like the common cold or stomach flu. They are typically used for a limited period of time and in certain amounts and forms. Some plant remedies can be harmful or cause side effects under certain conditions.

The rule of “simples” does not endorse combination “herbal” products in general. The more ingredients you add, the more likely it is you’ll experience a side effect or undesirable interaction with another ingredient or a prescription medication. Some combination products even have ingredients in them that work directly against each other.

That’s not to say these products are bad, per se, just not really necessary, and may put you at risk. Better to partake of optimum nourishment, choose tonics for support, and know which plants to have on hand as remedies. The simpler the better! Be safe! Be informed! Be nourished!

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There are ways to incorporate all of Mother Earth’s bounties into our nutrition. Nourishing plants, such as oat straw and stinging nettle, may be taken daily in whatever quantity we desire. Plants with a tonic, or strengthening and toning effect, such as motherwort and milk thistle, may be taken 2-3 days a week during wellness,
6-7 days a week during illness or recovery.

Plants that are remedies, such as echinacea and goldenseal, may be taken during times of need, on a once-in-a-while basis. Even some poisonous plants have specific properties useful in specific situations (only in the hands of an absolute expert!).

To be safe and comfortable with all plants, we must know plants to understand what each one offers us. The Wise Woman Tradition encourages us to know which plants are nourishers and tonics, which ones are remedies, and certainly which ones are poisonous so we can avoid them.

We also must know which plants are NOT recommended for children, in pregnancy, combined with prescription medications, etc. With the rule of “simples” most of our plant choices are nourishers, like fresh fruits and vegetables and plants like marigold and dandelion, the flowers and leaves of which are often added to fresh greens and salads, or cooked into soups and stews. Nourishers are food sources!

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Do not drink the local water
Avoid eating raw vegetables
Boil, peel or cook everything you do eat
Brush your teeth with bottled water

Do not use ice cubes made from the local water. Avoid drinking coffee and tea unless it’s made with boiled or bottled water

If you enjoy eating meats, order them well-done
If despite all of your precautions you have diarrhea and then develop a high fever or notice blood in your stool, see a doctor immediately.

The American Heart Association?s current recommendations are stated in practical food-group terms. The basic dietary goals have not changed: 30 percent of your diet should come from fat and less than 10 percent of that fat should be saturated (fat found in animal products and tropical oils), and you should still eat less than 300 milligrams of cholesterol a day. What has changed is the emphasis on preventing obesity and improving overall eating patterns.

The new guidelines outline four main goals:

achieve an overall healthy eating pattern
achieve a healthy body weight
achieve a desirable cholesterol level
achieve a desirable blood pressure level
To obtain a healthy eating pattern, the guidelines suggest eating a variety of fruits, vegetables and grain products, getting at least five servings of fruits and vegetables a day and six servings of whole grains. It recommends choosing low-fat or fat-free dairy products, and smaller portions of lean meats, poultry and grains. For the first time, the AHA guidelines also recommend eating two servings of fatty fish a week (such as tuna and salmon) to reap the benefits of the omega-3 fatty acids, which may lower the risk of heart disease.

Obesity has been shown to increase the risk of heart disease, stroke and diabetes. To avoid this condition, the guidelines stress the importance of obtaining an ideal body weight, and suggest avoiding excess calories, sugar and fat, and selecting foods of dense nutritional quality. The AHA reminds us that large portions contribute to obesity, and that ?low fat? does not necessarily mean ?low calorie.?

The AHA still recommends limiting your cholesterol intake to 300 milligrams a day, or to 200 milligrams a day if you have heart disease or other risk factors. (An egg yolk contains approximately 213 milligrams of cholesterol.) Saturated fats are still considered unhealthy for the heart and transfatty acids also need to be limited. Currently, transfatty acids are not listed on labels, but they are mostly found in food containing hydrogenated vegetable oils such as packaged cookies, crackers, baked goods and prepared fried foods.

Hard margarines contain transfatty acids, but new soft margarines are being formulated differently — check the nutrition claims on the label.

Limiting your sodium intake to 2,400 milligrams per day will help you achieve the AHA guidelines recommendation of achieving a desirable blood pressure. If you are overweight, a weight loss of 5 percent to 10 percent of your body weight has also been shown to lower blood pressure. Alcohol consumption should be limited to one drink a day for women and two a day for men. If you don?t normally drink, don?t start. And the AHA still takes the conservative view that individuals should get their nutrients for food, not supplements.

Considerations

Only 0.3% of all children with scoliosis need treatment 13.

Fewer than 0.1% of United States school children have curves that worsen to over 45 degrees 6.

Braces prevent curves from getting worse.

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In children whose skeleton is still developing (skeletal immaturity):
A curve less than 20 degrees to 30 degrees can be watched to see if it gets worse. Often, no further treatment is needed. X-rays or other tests are done every 4 to 6 months when the teenager is growing rapidly, or every 6 to 12 months in a younger person (age 6 to 12 years), depending on the rate the curve gets worse.
Curves greater than 20 degrees to 30 degrees may require treatment, usually with bracing, to prevent the curve from getting worse. Brace treatment is usually continued until the skeleton stops growing.
Curves greater than 45 degrees to 50 degrees are too severe for bracing and may require surgery 12, 6.

In people whose skeleton is no longer growing (skeletal maturity) 1:
Curves less than 30 degrees usually do not need further testing.
Curves of 30 degrees to 50 degrees usually do not require treatment, but should be X-rayed every 2 to 3 years. If pain is a problem, light braces, exercise, or medications may bring relief.
Curves over 50 degrees should be followed more closely to see if they get worse or to see if complications develop.

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Signs of Acute Glaucoma
severe, sudden eye pain
blurred vision
rainbow halos around lights
nausea and vomiting

Secondary glaucoma occurs in people who have suffered an eye injury in the past, or after certain diseases. Signs of Secondary Glaucoma.

Occurs after an eye injury or after certain disease
blurred vision
halos around lights
headaches

Typically, exercise plans are designed topromote rapid cardiovascular and strength gains. While quick results are what most new exercisers want, they will often be overwhelmed with the associated discomfort of a too-aggressive program. Adjustments need to be made to the “prescribing by the book” method if exercise maintenance is to finally be advanced. ESP holds to the philosophy that, for most individuals, building the exercise habit should be the first project, and making physiological gains the second. If regular exercise is truly being built into the lifestyle, then deferring physiological results forawhile should be of little consequence.

Although recent research has identified after-exercise feeling states that are associated with exercise longevity, the specific affective pattern desired varies based on a number of personal factors. Because many of these factors are “captured”in the computer, the software can suggest to exercise leaders what to look for in an exercise plan so that it is consistent with adherence. For example, members with low scores in the Ability to Tolerate Discomfort Scaleneedan exercise plan that is an energizing, rather than exhausting, experience. Another brief assessment tool, the Exercise-Induced Feeling Inventory (EFI), evaluates just that. As the software captures responses to the EFI both right before, and then right after, a prescribed amount of exercise, the participant’s change in affect is evaluated. Based on research-driven algorithms built into the system, a suggestion is made to the fitness professional regarding the suitability of the assigned exercise for the member’s adherence. Obviously, if the after-exercise feeling states induced are not consistent with long-term maintenance of a member’s program, an appropriate adjustment in intensity and/or duration is suggested and evaluation continues. Data about a member’s exercise preferences, physiological states, goals and self-management resourcesscan also be processed, allowing the computer to play an even larger part in suggesting a suitable beginning program.

Forming exercise groups

Getting new exercisers to participate in group-based exercise promotes their retention. Research demonstrates that when a connection is made by a participant between exercise and interpersonal support systems, adherence is increased. The presence or absence of social support is a major predictor of exercise longevity. Although most fitness facilities have a large array of group exercise offerings, the new, intimidated exerciser often feels too insecure with their abilities and/or physique to participate.

On both a research and practice level, forming small groups of new exercisers around a personal exercise interesthasbeen successful. Because the computer can quicklysort through a lot of information, exercise leaders can now invite beginners to exercise in small groups with other novices with whom they may get along. For example, if fitness professionalswant to better their retention statistics, they may decide to start beginner exerciser groups. They may wish to identify a smaller group within a larger group of 300 that will likely work well together and support each other’s efforts. The software can sort for (a) exercisers of less than three months, (b) who typically exercise in the morning, (c) who are over 35 years old, (d) who have been assessed as at-risk for early dropout and (e) who have an interest in a walking group. After the computer identifies the 18 members who fulfill this set of criteria, the fitness professionals can draft an invitation that the software sends to each member. Once the group meets once or twice, it will hopefullytake on a life of its own.

This is probably the most efficient form of exercise support: members helping other members and building relationships. ESP graduates, after having finally succeededat making exercise a habit, are often happy to lead these cohesive groups.

Self-management methods

A large number of cognitive andbehavioral self-management skills have been shownto be associated with exercise adherence and retention. It may be that these are the most underused exercise maintenance tools available,and many new exercisers lack them. Those assessed to be low in the Self-Management Scale are especially vulnerable. Basically, two choices exist:Either help members learn these critical self-management techniques,or watch them leave shortly after joining.

Very few exercise professionals are skilled in the dissemination of these self-management techniques, however. Typically, they fall under the behavioral science, counseling and psychological domains. While there is no substitute for thorough training in these methods for exercise leaders, the computer can greatly help. A computer programcan select the most-needed method, at the most-needed time, for each type of new exerciser. It can provide on-screen outlines, examples and dialogues for fitness professionals to reference as they are training members in these important skills. For example, as “relapse prevention” is being taught, the software will ensure that critical areas, such as identifying situations that place a member at a high-risk for quitting, or viewing even minor slips in an exercise routine as enough reason to quit, are covered within the session. When “cognitive restructuring” is being taught, the software directs the fitness professional to emphasize essential aspects,such as identifying and stoppingnegative self-talk, and “reframing” destructive self-statements into more positive ones.

About eight or nine of these cognitive/behavioral techniques are available. The computer not only keeps the session ontrack, but ensures a quality delivery. The result is members with a heightened ability to use self-regulation and self-management to persevere in their exercise goals, while having the tools needed to resist relapsing back into a more sedentary state.

Administrative functions

A large number of administrative functions arefacilitated by the software that keep reliance on memory, note taking, journal entries and stacks of paper to a minimum. For example, tasks to be completed within each fitness professional/ exerciser session are derived by the computer from a number of personal, psychological and behavioral factors. The software not only establishes them instantaneously, but presents them as a convenient “checklist” for use by the fitness professional. As the dynamic process of ESP unfolds, the application continually revises and customizes such tasks to be completed within subsequent meetings to best ensure the exerciser’s continued success.

The software also reminds fitness professionals of upcoming member meetings, contacts to be made and when a member’s attendance is waning. Typically,when a member’s exercise attendance falls below 60 percent, there is cause for concern. The software directs such essential contacts, as well as all activities required throughout the workday. The computer also creates and sends messages that reinforce the content of the self-management parts of meetings. Because these are so critical to success, regular reminders are delivered without much time at the computer.

Administrators may automatically review detailed summaries of each member’s attendance and progress, along with the effect an exercise leader is having on their members’ results. Dropout and attendance results may be displayed and sortedin a short time. This is a fair way to evaluate job performance and keep standards high.

Computers maximize success

With the skillful use of computer technology, the effect of behavioral support methods on exercise longevity and retention can be maximized. The product truly becomes exercise support, and those charged with its delivery maximize their impact. When computer technology enhances how to help members help themselves in a lifelong pursuit of good health, it is being put to good use. The personal connection made between an exercise professional and those they seek to help is not replaced, but maximized.Judicious use of information technology can better serve individuals’ needs, public health interests and the fitness industry in the process.

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For the ESP program,new members’ needs are objectively assessed based on their physiological state and exercise experience, as well as behavioral predictors of early exercise dropout. Most aspects of ESP flow from the findings obtained from the 15-item self-report inventory. Computer technology allows a touch screen to deliver the inventory and immediately score responses. Within seconds,(a) an estimate of how much at-risk for dropout the new member is, (b) what factors make this person vulnerable and (c) what course of actions will be taken by the fitness professional to support exercise and prevent dropout can be calculated. The computer retains these results and guides staff through every step of each contact. It can even determine the content and frequency of all meetings, over time.

Recent computer-driven results estimate that 70 to 80 percent of members join fitness centers without the behavioral resources needed to maintain their new exercise regimens for more than a few months. Through this example of a behavioral research/computer science alliance,fitness professionals can determine who these people are andhow to prevent their dropout.

Working with member goals

Research shows that goal-setting and feedback are critical to adopting the exercise habit. People whouse effective goal-setting strategies drop out far less frequently than those whouse no or poorly executed goal-setting methods. The computer allows members to select and document their exercise-related goals. Even more importantly, it requires them to focus on their short-term goals in a directed fashion. The software facilitates a member’s formal acknowledgment of a goal from a pull-down menu, and enables the fitness professional and member to work as a team to break down those goals into manageable, short-term quests.

Through this negotiation process, the member initiallybecomes focused on process goals (e.g., increase time of cardiovascular exercise; maintain a three-time-per-week routine) rather than outcome goals (e.g., reduction in body fat percentage; change in body mass index). Perceived progress towardgoals is depicted by the computer in time-series graphs through the member’s repeated response to a goal survey (the Personal Goal Profile). Because research shows that new exercisers perceive a considerable sense of “mastery” when even a minimalprocess goal is attained, the software is designed to reflect and acknowledge this perceived success. More difficult outcome goal progress is systematically “stepped in” as the participant becomes progressively acclimated to exercise.

Assessing emotional change

One great resultfromexercise is its consistent positive effect on mood, energy level, feelings of self-worth and body image. With few exceptions, this happens regardless of exercise modality or intensity. These aspects can be an important added value for maintaining exercise if presented to the new member in an effective way. While administering, scoring and summarizing a large amount of feelings-based inventories can be a tedious task for an exercise professional, the same is not true for acomputer. Brief, but valid, emotion and energy level inventories can be administeredusing a touch screen in a private office. The computer graphs changes over timein areas such as stress, fatigue, energy level and body esteem. The most progress usually comes in the critical first few months after initiating exercise.

The new exerciser associates these positive findings with their physical activity program, and is further motivated to continue. The fitness professional serves to summarize the importance of these results as part of their overall wellness mission. Because mental health is important not onlyto members, but also their employers and healthcare providers, additional data can further validate and extend the impact of service offerings. Credibility within the community is, thus, increased.

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There is no doubt that computers now play a large part in the fitness center industry. They are used “behind the scenes” for everything from inventory control to setting a facility’s music to billing and collections. More recently, computers have been used directly by members within exercise settings. With the advent of computerized “exercise data collectors,” fitness equipment can now, for example, recall exercise prescriptions, encourage exercisers to stay within a given heart rate range and report estimated caloric expenditures — generally summarizing what has been accomplished by an exerciser. The days of individuals being “dazzled” by computers is, however, gone. Because they are a central part of so many people’s day-to-day routine, it is important tomake certain that computer use within fitness facilities do not become more of a burden than an aid.

Because most fitness facility attrition is directly related to members’ inability to adapt to the demands of their new exercise regimens, fitness professionals need to help members develop the exercise habit. The stagnant, unacceptable attrition rate within the fitness industry can only really be changed when administrators and staff members become dedicated to the task of “facilitating exercise success.”

To take the exercise support processforward, computer technology plays a central role. The process of developing and refining a computer application that is specifically designed to support new and returning exercisersextends the present limits of what technology can bring to the health and fitness industry, and how members’ success can greatly add to that of fitness centers.

The exercise support process

Early results from the exercise support process (ESP) program at the YMCA of Metropolitan Atlantashow that the use of well-positioned computer technology better empowers fitness professionals’ support of members’ ongoing exercise efforts, and adds substantially to the already promising retention results of the exercise support initiative.

Although regular consultation via phone and email is an important aspect, ESP’s main focus is around a pre-set plan of exercise leader/member meetings. The content and frequency of these meetings are based on both an objective assessment of how “at-risk” a member is for early dropout, and what factor(s) are causing them to be unlikely to adhere without directed help. A two-minute, 15-item validated behavioral inventory is the basis of the dropout-risk assessment.

Because research points to a critical period of six months in which we may have our most effect on members’ exercise adherence success, the entire ESP protocol lasts little more than that. This enables a few exercise leaders’ time to be used in aneffective manner. In fact, one full-time fitness professional can effectively support about 300 new and returning exercisers. When ESP participants “graduate,” room is madefor others, hence fitness center staffing rarely needs to be increased.

Because ESP focuses specifically on new and returning exercisers during the first three to six months of their exercise programs, only individuals fulfilling this criteria are involved. Because this initiative is valuable enough,in terms of service to members’ health and well-being, as well as retention, it should not have a fee. Rather, it should simply bewhat fitness professionals do:Support ongoing physical activity for all.

Computer technology and exercise support

Software adds to the efficient delivery of the ESPprogram. Within each exercise leader/member meeting, specific, research-based exercise support tasksare carried out. Recent studies clearly suggest that three overwhelmingly important factors arerelated to exercise longevity or early dropout. Therefore, the personal sessions are designed to focus on them in the proportions specifically indicated. For example, one critical factor tested is the “ability to tolerate discomfort.” Because members low in this variable will tend to quit when a too-intensive exercise program is prescribed, their after-exercise responses toa proposed physical activity amount should be carefully evaluated to make sure feelings such as “rejuvenated” and “refreshed” outweigh feelings such as “exhausted” and “worn-out.”

Another essential factor the initial assessment highlights is “self-management ability.” Those individuals low in self-management skills tend to get discouraged when progress is gradual, or when their exercise routine is temporarily interrupted by, for example, work, travel,illness or injury. Because these individuals have few internal resources to help them adapt to the considerable challenges of maintaining an exercise routine, they must beempoweredwith needed resiliency skills to promote their likeliness of success.

The third critical factor is “social support.” Research consistently shows that when a spouse, significant other, peer group or even informal groupings of people are available to support a new or returning exerciser’s efforts, long-term success is much more likely. For those low in the social support factor,facilities should organize groups of new exercisers with similar interests, abilities, ages, etc. Graduates of ESP (especially the many who are appreciative of success after many previous exercise program starts-and-stops) can help organize and lead beginner exerciser groups.

ESP is more of a self-management approach than an educational initiative. People already know they should be exercising. The reason they quit time after time is because they lack the abilities to adapt to the physical, time and motivational demands of their programs.

Techniques within the ESP system, plusthe computer technology thatserves to administer assessments, summarize findings, interpret their implications and generally support delivery methods, can helpeach individual member’s long-term success with exercise.

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