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A New Option for Exercise by Cynthia Mascott f a Curves International fitness resistance of confined liquid, it pro- club hasn't already opened in vides an opposing force in both your neighborhood, chances directions, engaging a different set Iare that one soon will. The of muscles depending on whether gym, designed especially for women the user is pushing or pulling. How (but also used by men in some loca- much resistance the machine pro- tions), is one of the fastest-growing vides depends on how hard and franchises in the United States, with how fast the user pushes or pulls.
over 7,000 American locations and For increased resistance (and a more than 8,000 locations world- harder workout), the user increases the speed of the repetitions. This Although each club is owned enables each exerciser to work at a independently, all locations follow comfortable level without having to essentially the same model. Most adjust the machine. Curves clubs are located in large, One drawback to the Cur ves one-room facilities in shopping machines is that the seat heights centers or business districts. The are not adjustable, meaning the facilities contain between 8 and 13 machines may be less comfortable resistance exercise machines set up for people who are not within the in a circle so that all exercisers are average size range. Shorter women, facing toward the center. The gyms however, may be able to modify the typically don't have mirrors, a fea- seat height with a cushion. Another ture that appeals to many of the potential disadvantage of the core Curves clientele—generally machines is that the hydraulic sys- middle-aged women who are new tem means that the exerciser does to exercise and often intimidated not perform the "negative" portion by conventional health clubs. of the resistance exercise. (The The Cur ves machines are "negative" portion is when the designed for a woman's smaller exerciser lowers the weight back to frame and use hydraulic pressure, its starting position in a controlled or the pressure of confined liquid manner. This part of the exercise in a cylinder, rather than metal helps to build muscle in a some- weights to provide resistance.
what different way from the "posi- Because the equipment uses the tive" part of the movement.) Copyright ® 2005 R.A. Rapaport Publishing, Inc. For subscription information, call (800) 234-0923 and mention code5CHI2 or visit Reprinted with permission from Diabetes Self-Management.

The setup
The following eight machines com- pose the standard setup that isfound in all Curves locations:■ Biceps/Triceps: Works the mus-cles in the backs and the fronts ofthe upper arms■ Leg Extension/Leg Curl: Exer-cises the muscles on the fronts andthe backs of the thighs■ Shoulder Press/Lat Pull: Targets muscles in the shoulders and theupper back■ Hip Abductor/Adductor: Focuseson the inner and outer thighs andthe hips■ Chest/Back: Exercises muscles ofthe chest and back■ Squat: Works the fronts of thethighs and the buttocks■ Abs/Back: Targets the musclesrunning vertically along the mid-line of the stomach and the back■ Leg Press: Strengthens muscles inthe fronts of the thighs and the but-tocks In addition, certain locations may have some or all of the follow-ing four machines:■ Dip Shrug: Focuses on the shoul-ders and the back■ Pec Dec: Works muscles in the chest, shoulders, and back Hip Abductor /Adductor ■ Oblique: Targets the sides of theabdomen■ Glute: Strengthens the fronts andbacks of the thighs and the buttocks■ Lateral Lift: Works muscles on thesides of the waist Between ever y two exercise machines is an "aerobic recovery sta-tion"—a small, cushioned platformon which members are encouragedto engage in an aerobic activity suchas dancing, doing jumping jacks, orjogging in place to keep their heartrate elevated while giving their mus-cles a rest. Some facilities have stor-age lockers and changing areas.
Many Curves locations also offersome form of nutrition counseling.
However, the clubs do not offer theamenities found in many traditionalgyms, such as showers, a sauna, orday care for children.

The workout
At their initial visit to the club,members are weighed and theirbody measurements and body fatpercentage are taken. They thenhave the option of repeating theprocess every month to chart theirprogress. A full health history isalso completed at the initial visitand put on file. Before their first workout, mem- bers are given instructions on howto use the hydraulic machines toensure that their form is correct;on visits thereafter, a fitness traineris available for assistance. The exact breakdown of the routine variesslightly from location to location,but generally an exerciser entersthe circuit at any available machineand works out at a low intensity forabout three minutes while pro-gressing from machine to machineas guided by an audio recording.
Starting at a low intensity helps toincrease heart rate and body tem-perature so that there is less chance of stress on the heart orinjur y to the joints or muscles.
After the initial warm-up, the exer-ciser increases the intensity of theworkout.
Each machine is used for approximately 30 seconds, at whichpoint a recorded voice interruptsthe music and instructions aregiven to move to the next station.
The entire workout lasts for about30 minutes which, depending onthe number of machines at thefacility, usually takes exercisers around the circuit two to threetimes. For the last three minutes ofthe workout, exercisers are advisedto slow down a bit to allow theirheart rate to return to normal; theythen wrap up the routine with threeminutes of stretching.
Every eight minutes throughout the routine, members are instructedto check their pulse to ensure thatthey are working within their targetheart rate range. Although manyexercise professionals have movedaway from this idea, according to the Curves philosophy, the goal improving blood glucose control in Cur ves Training Manual. All for people in the general popula- people with Type 2 diabetes. Curves employees are required to tion is to work out at 60% to 80% of be certified in CPR (cardiopul- their maximum heart rate. New monary resuscitation) and first aid.
members are shown how to find their pulse and target heart rate by Hours and rates
There are a number of precautions a Cur ves employee. Maximum that people with diabetes should Hours of operation vary from loca- heart rate is generally determined take to ensure a safe workout.
tion to location, but during week- by subtracting one's age from 220.
Before beginning an exercise pro- days, most facilities open between 6 There are a number of ways to cal- gram, it is a good idea to get clear- AM and 7 AM. At noon, there is culate the target heart rate range, ance from your doctor and possibly generally a brief closure for lunch, but the Curves formula suggests your eye doctor, particularly if it has with doors reopening around 2 PM multiplying the maximum heart been more than a year since your or 3 PM until about 8 PM. Saturday rate by 0.60 and 0.80 to find the last eye exam or if you have been hours are typically limited to the 60% to 80% range. For instance, if diagnosed with or had laser surgery morning, and only a small number you are 60 years old, your approxi- for diabetic retinopathy. of locations are open on Sundays.
mate maximum heart rate would It's also a good idea to check There is a one-time initiation fee of be 160 beats per minute. Your tar- your blood glucose level before $149, although there are often spe- get heart rate would therefore be each workout. If your blood glu- cials available that can reduce this between 96 (160 × 0.60) and 128 cose level is below 100 mg/dl, you price. Monthly dues are generally (160 × 0.80) beats per minute.
may need a snack before getting between $29 and $59; costs var y For people who are just begin- started. Because of the possibility of depending on the package you ning an exercise program or those choose and the facility you go to.
who have a medical condition such monitor your blood glucose level as diabetes, heart disease, or high after your workout as well, espe- Curves ahead
blood pressure, Cur ves suggests cially if you take insulin, a sulfonyl- working out at only 50% of maxi- Any step toward more physical urea such as glipizide (Glucotrol, mum heart rate. A wall chart activity is a step in the right direc- Glucotrol XL), glyburide (DiaBeta, posted in the club helps users easily tion. Even integrating several short Micronase, Glynase), or glimepiride determine whether they are within walks into your day can improve (Amaryl), or the drugs repaglinide their target range. your health. But if you feel that a (Prandin) or nateglinide (Starlix). According to Cur ves founder more structured program as well as Be sure to wear a well-fitting, Gary Heavin, a Curves workout is the opportunity to exercise with comfortable pair of shoes to your an efficient combination of others might help you stick to a workout, and keep a source of car- strength training, aerobics, and regular exercise routine, you may bohydrate, such as glucose tablets stretching. He suggests members want to give Cur ves a tr y. Many or raisins, nearby in case you visit the center three times a week have found that the convenience, and incorporate walking or stretch- camaraderie, and feeling of well- ing into their routine between visits The staff
being gained from exercising at to the club. Although research on Curves keeps them coming back the Curves workout plan is limited, The owners and managers of and sticking to a fitness program Heavin's recommendations are Curves franchises must complete a for the first time in their lives. Look generally in line with both the 40-hour training program at the at the book Cur ves: Permanent American College of Sports Medi- Curves International Headquarters Results Without Permanent Dieting, by cine's recommendation of 2–3 days in Waco, Texas. They are also Gary Heavin and Carol Coleman, per week of resistance training for required to attend quarterly for more information. To find the people who are just starting out on Advanced Camp training. Curves Curves International nearest you, an exercise plan and the Surgeon additionally encourages them to call (800) 848-1096 or log on to General's recommendation to do complete an 18-hour online col- www. ■ at least 30 minutes of moderate lege certification program in Fit- exercise on most days of the week.
ness and Wellness through Thomas And at least one study has shown a Edison State College in New Jersey.
Cynthia Mascott is a freelance circuit training program using a The fitness technicians who work at writer in Sherman Oaks, California. combination of aerobic and resist- Curves must complete a two-week She has had Type 2 diabetes since ance exercise to be effective at training program as outlined in the


Requisitos de seguridad para trabajos en o en proximidad a redes de distribución y transporte Prefacio Este folleto muestra el compromiso de Scottish Power de proteger la salud y seguridad en el trabajo. De acuerdo con la ley de Seguridad y Salud en el Trabajo de 1974, "será el deber de toda persona al mando, asegurar en la medida de lo posible, la salud, seguridad y bienestar en el trabajo de todos sus empleados".

Les effets secondaires de la corticothérapie générale

PREVENTION DES COMPLICATIONS DE LA CORTICOTHERAPIE GENERALE DANS LES PEMPHIGUS DE L'ADULTE Catherine Prost Squarcioni Centre de Références Maladies Rares NET-DBAI-IDF Hôpital Saint Louis et hôpital Avicenne La cortisone, découverte en 1935, a transformé l'évolution de nombreuses maladies inflammatoires et auto-immunes (en particulier celle des pemphigus) qui étaient auparavant constamment mortelles. Depuis, la cortisone a été abandonnée au profit de nouvelles molécules encore plus efficaces et provoquant moins d'effets secondaires ; de nombreux progrès ont été faits pour prévenir ces derniers. Avant d'aborder précisément ce sujet, quelques remarques pour expliquer notre jargon médical et notre démarche thérapeutique dans les pemphigus. La corticothérapie générale s'utilisant de la même manière dans les différentes formes de pemphigus, en particulier dans les pemphigus vulgaires et les pemphigus superficiels, nous parlerons de pemphigus sans plus de précision. • On entend par corticothérapie générale (ou systémique) l'administration de corticoïdes par voie orale (par la bouche), intramusculaire ou intraveineuse (piqûres). En France, nous utilisons indifféremment :