Why Are Americans So Fascinated With Extreme Fitness?

A blond woman in a hot pink spandex tank hoists a sledgehammer over her shoulders, then slams it down with a dull thud onto the big tire in front of her. Beside her, another woman swings her sledgehammer even higher, grimacing and groaning with the effort. Their faces are bright red and dripping with sweat. It’s 9:45 a.m. and 85 degrees, and the sun is glinting off the asphalt of the strip-mall parking lot where the women are laboring.”Swing it higher, above your shoulder!” a woman bellows at them, even as they gasp each time they raise their hammers, each time they let them fall.

As one woman pauses to wipe the sweat from her eyes, she spots me studying her. I’ve been trying not to stare, but it’s a strange spectacle, this John Henry workout of theirs, hammering away in front of a women’s fitness center, just a few doors down from a smoke shop and a hair salon. It looks exhausting, and more than a little dangerous. (What if a sledgehammer slips and flies from one woman’s hands, braining her companion?) It also looks fruitless. Why not join a roofing crew for a few hours instead? Surely, there’s a tunnel somewhere that needs digging, or at least some hot tar that needs pouring.

But paying to simulate backbreaking labor under the watchful eye of a demanding authority figure seems to be a common desire these days. When I type “sledgehammer” into Google later that day, the first suggestion is “sledgehammer workout,” a search term that pours forth half a dozen enthusiastic re-enactments of life on a steel-driving chain gang.

Fitness culture couldn’t have changed more significantly since the late ’60s. Back then, residents of my small Southern hometown would spot my father, an early jogger, and yell out of their car windows, “Keep running, hippie!” These days there aren’t that many joggers in my Los Angeles neighborhood, but every other block there’s another fitness center offering boot-camp classes or Brazilian jiujitsu, with people inside punching, kicking and yelling at one another like drill sergeants. Jim Fixx’s freewheeling running disciples have been replaced by packs of would-be Navy SEALs, sprinting up sandy hillsides with backpacks full of rocks strapped to their shoulders.

Jane Fonda and Richard Simmons once painted exercise as something fun and faintly sexy — a lighthearted trip to a sweaty nightclub in your own living room — but fitness today isn’t supposed to be easy. The “Abdomenizer” and “8-Minute Abs” videos, which practically suggested that exercise could be squeezed in between bites of your hamburger, are now quaint punch lines. By the ’90s, when the soft curves of Ursula Andress had been replaced by the hard bodies of Cindy Crawford and Elle Macpherson, you still worked out to prepare for the beach or the bedroom. These days, though, you aren’t preparing for fun or romance. You’re preparing for an unforeseen natural disaster, or a burning building, or Armageddon.

“We have sought to build a program that

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Florida Healthy Kids | Low Cost Insurance for Kids


Cover your mouth and nose when you cough or sneeze. Keep tissues close by. Cough or sneeze into your shirt sleeve if necessary.

Wash your hands often. Use soap and wash for at least 20 seconds. If soap and water are unavailable, use a hand sanitizer with at least 60% alcohol.

Disinfect shared surfaces daily.

Avoid touching your eyes, nose, and mouth.

Stay home when you are sick. Call your doctor for advice if needed.

If you’re interested in applying for Florida KidCare coverage for your child(ren), use this simple eligibility calculator to estimate what your monthly premium payment would be.

National Children’s Dental Health Month serves as a great reminder for the importance of your child’s oral health. Call your dentist and schedule a routine cleaning and talk to your dentist about a preventive coating called a sealant that can protect your child’s teeth from cavities and decay.

Comprehensive, quality healthcare services for Florida’s children

Covering kids ages 5 through 18 isn’t just what we’re known for, it’s what we’re passionate about. Our comprehensive, child-centered health and dental insurance has your school-aged child covered during each stage of growth and development.

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Dentist Maroochydore & Sunshine Coast

The Country Dentist branch in Maroochydore (Shop 303A Sunshine Plaza) provides an opportunity to deliver outstanding oral health services at the best location on the Sunshine Coast. As a mother of five children, Dr Miller understands the difficulty parents face finding time to have their family members attend the dentist. The dentist Maroochydore in Sunshine Plaza, with its seven day a week trading, including late night shopping on Thursday evenings, provides everyone with the convenience of being able to visit the dentist whilst at the same time being able to enjoy the other attractions that the Sunshine Plaza address offers. The address also allows The Country Dentist to attract the excellent oral health care practitioners and specialists to the practice.


The Murgon Practice has been operating for over 80 years and has a wonderful reputation for serving patients throughout the Burnett Region. Dr Miller, trading as The Country Dentist, purchased the Murgon practice from Dr John Watt who had operated Murgon Dental for over 27 years. Dr Watt, who continues to work at the practice, is a very experienced dentist who is highly respected by his peers and warmly regarded by hundreds of people throughout the community.


Principal of the Country Dentist, Dr Stella Miller trained as a dentist at the University of Adelaide graduating in 1991. Dr Miller received the Austen Beasley award for Oral Medicine and Oral Pathology. Dr Miller then served as a dentist with the Royal Australian Airforce in Edinburgh, South Australia from 1991 to 1994. She later purchased and ran a private practice in Wagga Wagga in New South Wales for 10 years prior to moving to Queensland in 2005. During this time, Dr Miller completed a Graduate Diploma in Oral Implants through the University of Sydney.

Since moving to the Sunshine State, Dr Miller has worked continuously in both the public and private system prior to purchasing an established private practice in the South Burnett area.

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American Osteopathic Association | AOA

American Osteopathic Association | AOA


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News Releases

AOA statement on COVID-19 stay-at-home guidelines

CHICAGO—April 29, 2020—Recently, members have raised concerns regarding statements made in the media either minimizing the seriousness of COVID-19, suggesting the lack of necessity to follow current CDC guidelines and/or suggesting misrepresentation of professional credentials during peaceful assembly. The following statement is the AOA’s official response to these concerns. The American Osteopathic Association (AOA) strongly … Read More


COVID-19 updates from HHS & CMS, week of April 20-24

HHS announced the release of provider relief funds and launched a new telehealth toolkit, while CMS issued additional guidance on prior authorization and utilization management, and Medicare enrollment for hospitals. HHS announces release of additional $70 billion of CARES Act provider relief funds On April 22, the Department of Health and Human Services (HHS) announced … Read More


AOA provides resources on paths towards financial relief for physicians

Based on what we’ve heard from our members, the AOA is providing resources on paths toward financial assistance for physicians. These include two upcoming live CME webinars from the AOIA and an online marketplace created by SoFi, a member value partner, called Lantern on which members can search and apply for loans. Additionally, the AOA’s … Read More

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Student Health Services | Georgetown University

Coronavirus Information from Georgetown University
Coronavirus Information from DC Department of Health

If you are on the Main Campus experiencing a life threatening medical emergency, call the Georgetown Emergency Response Medical Service (GERMS) at 202-687-4357.

If you are on the Law Campus experiencing a life threatening medical emergency, dial 911.

For other student health services on Georgetown University’s main campus, consult the information below.


Dial (202) 444.7243
(ask for the on-call CAPS clinician)

Business Hours:
Dial (202) 687.6985


Dial GERMS (202) 687.4357


MedStar Georgetown Student Health Center The physicians and nurse practitioners at the Student Health Center provide primary medical care for a range of health needs at two locations.

Front Door

Location – Main Campus

Main Campus Modified Hours
Mon    8:30am – 4:30pm
Tue      9:30am – 4:30pm
Wed    8:30am – 4:30pm
Thu     8:30am – 4:30pm
Fri       8:30am – 4:30pm

Appointment Line (Main Campus and Law Center)


For urgent health concerns after hours and during holiday closures, please call the page operator at 202-444-7243 and ask for the Student Health Center provider on call.


Counseling and Psychiatric Service (CAPS)
We provide psychological and psychiatric services for a variety of mental health issues.



Ground Floor, East side of Darnall Hall
Main Campus

Note: Take the footpath to the east side of Darnall Hall.

CAPS maps & directions


For initial visits, call or walk in during business hours.

Ph: (202) 687.6985

After-Hours Emergencies

Call (202) 444.7243 for emergency consults after hours.
Ask for the CAPS clinician on call.

Business Hours

MonFri 9:00am – 5:00pm
Sat and Sun CLOSED




Health Education Services (HES)

If you are coping with a personal student health issue or crisis, our clinicians are available to provide professional advice and guidance. HES also provides health promotion programming and trainings for students.


For non-urgent issues, we request that you schedule an appointment with a Health Education Services clinician. Our clinicians see students around alcohol and other drugs, stress management, sexual assault, relationship violence, stalking, nutrition, body image, eating disorders, sexual health, and pregnancy.
Ph: (202) 687.8949

Business Hours

MonFri 10:00am – 5:00pm
Sat and Sun: CLOSED

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Temporal dynamics in viral shedding and transmissibility of COVID-19

SARS-CoV-2, the causative agent of COVID-19, spreads efficiently, with a basic reproductive number of 2.2 to 2.5 determined in Wuhan1,2. The effectiveness of control measures depends on several key epidemiological parameters (Fig. 1a), including the serial interval (duration between symptom onsets of successive cases in a transmission chain) and the incubation period (time between infection and onset of symptoms). Variation between individuals and transmission chains is summarized by the incubation period distribution and the serial interval distribution, respectively. If the observed mean serial interval is shorter than the observed mean incubation period, this indicates that a significant portion of transmission may have occurred before infected persons have developed symptoms. Significant presymptomatic transmission would probably reduce the effectiveness of control measures that are initiated by symptom onset, such as isolation, contact tracing and enhanced hygiene or use of face masks for symptomatic persons.

Fig. 1: Transmission of infectious diseases.

a, Schematic of the relation between different time periods in the transmission of infectious disease. b, Human-to-human transmission pairs of SAR-CoV-2 virus (N = 77). We assumed a maximum exposure window of 21 days prior to symptom onset of the secondary cases. Detailed information on the transmission pairs and the source of information is summarized in Supplementary Tables 2 and 3. c, Estimated serial interval distribution (top), inferred infectiousness profile (middle) and assumed incubation period (bottom) of COVID-19.

SARS (severe acute respiratory syndrome) was notable, because infectiousness increased around 7–10 days after symptom onset3,4. Onward transmission can be substantially reduced by containment measures such as isolation and quarantine (Fig. 1a)5. In contrast, influenza is characterized by increased infectiousness shortly around or even before symptom onset6.

In this study, we compared clinical data on virus shedding with separate epidemiologic data on incubation periods and serial intervals between cases in transmission chains, to draw inferences on infectiousness profiles.

Among 94 patients with laboratory-confirmed COVID-19 admitted to Guangzhou Eighth People’s Hospital, 47/94 (50%) were male, the median age was 47 years and 61/93 (66%) were moderately ill (with fever and/or respiratory symptoms and radiographic evidence of pneumonia), but none were classified as ‘severe’ or ‘critical’ on hospital admission (Supplementary Table 1).

A total of 414 throat swabs were collected from these 94 patients, from symptom onset up to 32 days after onset. We detected high viral loads soon after symptom onset, which then gradually decreased towards the detection limit at about day 21. There was no obvious difference in viral loads across sex, age groups and disease severity (Fig. 2).

Fig. 2: Temporal patterns of viral shedding.

Viral load (threshold cycle (Ct) values) detected by RT–PCR (PCR with reverse transcription) in throat swabs from patients infected with SARS-CoV-2 (N = 94), overall and stratified by disease severity, sex, age group and link to Hubei province. The detection limit was Ct = 40, which was used to indicate negative samples. The thick lines show the trend in viral load, using smoothing splines. We

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Coupons – Dentist in Palmdale, CA

  • (661)256-2500 – Rosamond
  • (661) 267-5700 – West Palmdale
  • (661) 948-8187 – Lancaster
  • (661) 285-8600 – East Palmdale


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Caffeine Effects on Sleep Taken 0, 3, or 6 Hours before Going to Bed


Caffeine in doses ranging from 200-400 mg have been shown to be effective and are often utilized to sustain performance in the context of sleep deprivation, sedation, and sleep restriction.17 Up to 500 mg of caffeine can be found in commercially available 16-oz servings of brewed coffee.8 The use of similarly high doses of caffeine-containing beverages, including energy drinks has led to a doubling of caffeine-related emergency department visits from 2007-2011.9 The increase in ED visits in association with cardiovascular and other adverse events has been labeled a “rising public health problem in the US” and has led the Food and Drug Administration to investigate the cardiovascular safety of high caffeine content beverages.10 Importantly, the adverse effects of caffeine intake are not limited to the cardiovascular system but also produce significant sleep disruptive effects, particularly when taken later in the day or when multiple doses are utilized.11 One recent population-based study of 18- to 58-year-olds (mean age = 28.5 years of age) estimated that 90% of individuals consume caffeine in the afternoon (12:00-18:00) and 68.5% of people consume caffeine in the evening (18:00-00:00).12

Caffeine content in beverages and foods is increasing in terms of dose and availability, with recent estimates of total daily caffeine consumption suggesting that the average person consumes 319.32 ± 180.94 mg of caffeine per day.12 Information on the sleep-disrupting effects of high doses of caffeine taken in the afternoon and early evening is important, given the increasingly popular use of caffeinated energy drinks and the high caffeine content of premium coffee.13 Such investigations are also critical due to increased caffeine use in younger age groups, where chronic sleep restriction is also increasingly common.8,14,15 Indeed, recent data show that in younger samples, 37% report first use of caffeine during the day at 17:00 or later.16


Current Knowledge/Study Rationale: Despite widespread but often disparate recommendations to refrain from caffeine intake close to bedtime, no studies have investigated the effects of a given dose of caffeine taken at different times before sleep. Understanding the temporal effects of caffeine on sleep are important given the increased utilization of caffeine, and need for empirical data to support specific sleep hygiene recommendations regarding caffeine.

Study Impact: This study demonstrates caffeine consumption even 6 hours before bedtime can have important disruptive effects on both objective and subjective measure of sleep. These findings provide empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of 6 hours prior to bedtime.

The sleep disruptive effects of caffeine administration at bedtime are well documented.17 Indeed, caffeine administration has been used as a model of insomnia.18 Dose-response studies demonstrate that increasing doses of caffeine administered at or near bedtime are associated with significant sleep disturbance.19–21 One of the most common recommendations for appropriate sleep hygiene practices is to avoid caffeine close to bedtime. However, evidence is less clear regarding the consumption of caffeine

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Work, Stress and Health

  • Karina Nielsen, PhD

    National Research Centre for the Working Environment, Denmark

  • Yasumasa Otsuka, PhD

    Hiroshima University, Japan

  • Jae Bum Park, PhD

    Ajou University, South Korea

  • Pamela Perrewe, PhD

    Florida State University

  • Tahira Probst, PhD

    Washington State University Vancouver

  • Wilmar Schaufeli, PhD

    University of Utrecht

  • Peter Schnall, MD, MPH

    University of California, Irvine

  • Norbert Semmer, PhD

    University of Bern

  • Sabine Sonnentag, PhD

    University of Mannheim, Germany

  • Jeanne Stellman, PhD

    Columbia University

  • Masaya Takahashi, PhD

    National Institute of Occupational Safety & Health, Japan

  • Mark Tausig, PhD

    University of Akron

  • Lois Tetrick, PhD

    George Mason University

  • Horacio Tovalin, DrPH

    Universidad Nacional Autónoma de México

  • Akizumi Tsutsumi, MD

    University of Occupational and Environmental Health, Japan

  • Mina Westman, PhD

    Tel Aviv University

  • Haiou Yang, PhD

    University of California, Irvine

  • Dov Zohar, PhD

    Technion – Israel Institute of Technology

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    Dentist Bakersfield CA | Bakersfield Smile Design

    Being a Bakersfield Dentist is a Family Thing


    Bakersfield dentist, Dr. Krauss, takes the same approach in his cosmetic dental practice that he does with his wife and six kids… it’s about family and about quality time. From the moment you enter the doors you’ll be greeted by a comfortable and relaxing atmosphere. The inviting smiles of the Bakersfield Smile Design staff are only outweighed by those of Dr Ken’s adoring patients that cover the wall, shelves and photo albums in seemingly innumerable quantities. Yes, it won’t take long to sink in that you have finally found a cosmetic and general family dentist that knows being a Bakersfield dentist is more than just a trade or career, its an opportunity to bring out the best smile in everyone they meet.

    Our Reputation is Dazzling

    Bakersfield dentist, Dr. Krauss, has been Bakersfield’s number one choice for quality dental care for almost a decade, having established a reputation for providing patients with permanent, beautiful smiles and a truly one-of-a-kind dental experience. Dr Krauss’ results can be seen clearly reflected in the larger than life, dazzling smiles on his patients faces.

    Like what you see so far? Take a look through the before and after photos of some of our more vocal Cosmetic Dentistry patients or hear what they have to say in our video testimonials

    Providing Premier Cosmetic Dentistry

    “It’s not worth doing if you’re not going to do it right” is a principle that Dr Krauss and Bakersfield Smile Design strive to live by. After earning multiple scholarships to attend Loma Linda University School of Dentistry, Dr. Krauss applied that principle and received multiple awards before graduating in 2001 with a Doctor of Dental Surgery (DDS) Degree.   He is a member of the Amarican Dental Association, the California Dental Association and the Tri-County Dental Association.  When Bakersfield dentist, Dr Krauss, began his education in Dentistry, he made a commitment to excellence which is reflected in by his commitment to stay at the forefront of his field by frequently attending educational conventions, seminars and training courses in order to stay current on the latest advancements in the world of dentistry.

    Over the past 10 year Dr. Krauss has remained at the forefront of technology in order to provide his patients with a less painful dental care experience. His continuing education includes advanced training in implant dentistry, full-mouth reconstruction as well as keeping up with the latest innovations in cosmetic dentistry.

    – Dr. Krauss


    “Through the latest advancements in dental technology just about any dental issue with a patients teeth or smile can be corrected; however even the latest high-tech procedures can result in below average results unless they are used by an experienced, skilled and artistic dentist with a keen insight into a patients wants and needs. One of the reasons I love being a dentist is that the possibilities with your teeth are limitless. The high end technology that is available today enables me to give you an amazing, healthy, natural

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