Asthma is a disease characterized by narrowing of the airways, specifically bronchi, in response to a variety of stimuli (See Image 1.0: Bronchi). It is not a fixed response and a patient can have a sudden worsening in lung function called an “attack.” An asthma attack can be triggered by pollen and other so-called “allergens” such as cold air, irritants in the atmosphere, colds or flu. Asthma affects over 2 million Australians and as of yet the cause is unknown.
The bronchial narrowing in asthma has two effects: one is to decrease the amount of air that can be moved in and out of the lungs. This can reduce exercise capacity — especially for a diver, who already has reduced breathing capacity due to the external resistance of his breathing apparatus and the increased internal resistance due to higher breathing gas density at depth. Secondly, reduced airway caliber could cause trapping of gas in the lung during ascent.
If trapped gas expands at a rate greater than it can be exhaled through the narrowed airways lung rupture can result, causing arterial gas embolism or pneumothorax (collapsed lung). Another related concern with asthma and diving has been the increased propensity of airways in asthmatics to narrow when exposed to the conditions implicit in diving: inhalation of cold, dry air and/or sea water (the latter by losing the mouthpiece or from a leaky regulator). Dr. Mark Harries from the British Medical Olympic Center has pointed out that asthmatics who dive are at risk from exercise limitation, not just peripheral gas-trapping. While exercising on land it is easy enough to stop, rest and catch one’s breath; this may not be possible underwater.
It is recommended that asthmatics maintain a relationship with their specialist for maintenence of their condition during their diving careers.
Strenuous exercise is frequently required of the diver, and there are many opportunities for accidental aspiration of sea water to occur. Inhaling dry air from a tank or fine aerosols of hyperosmolar saline through a faulty valve are stimuli also encountered by the diver. In the last decade there has been a nationwide effort to improve education of doctors and patients about asthma and its treatment through advertising campaigns. Inhaled corticosteroids are more available and more widely used than they were 10 years ago. Lung function tests are more commonly requested and the testing apparatus used in laboratories is more sophisticated, permitting measurements of flow at low lung volumes.
It is now clear that bronchial hyperresponsiveness (BHR) to hyperpnea of dry air, an absolute contraindication for SCUBA diving, can be associated with normal values for resting spirometry.
Currently most laboratories provide a choice of bronchial provocation tests. The role of the bronchial provocation test in the assessment of the diver or intending diver should be to identify those persons who would be at risk from acute airway narrowing during the activities associated with diving.
Those who have demonstrable BHR should be told that they may be at increased risk of pulmonary barotraumas and the details of the possible consequences of this should be explained.
The following questions were asked to people wishing to begin a diving course prior to completing a bronchial provocation test. Subsequently these people were confirmed to have asthma.
How many days in the last 2 weeks have you had morning wheeze or chest tightness? – 21.6 % answered ‘None’
The Mannitol challenge is a type of bronchial provocation test. Mannitol is a naturally occurring sugar alcohol which is a stable compound with few side-effects. Following inhalation, Mannitol is deposited on the airway surface which causes an increase in osmolarity of the airway surface liquid. Water then moves out of the epithelial cells in an attempt to restore balance, causing the epithelial cells to shrink. As the cells attempt to regain their volume, intracellular calcium rises, which is thought to trigger the release of inflammatory mediators such as histamines, prostaglandins and leukotrienes. In sensitive individuals the release of these mediators causes the bronchial smooth muscle to contract and the airways to narrow. This is measured by a fall in FEV1 (Forced Expiratory Volume in one second).
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Sky's racecaller Luke Marlow admits it is with mixed emotions he is leaving Sky Racing to take the number one racecalling job in Singapore next month.
Marlow, 25, started with Sky Racing in 2011 and said he would “forever indebted” to Sky for the opportunities and career development the broadcaster provided.
“Gee it was a hard decision. I love working at Sky and they’ve been so supportive, but it’s the right time in life to jump in and try something new and exciting like this. If I’m going to do it, it’s now,” he said.
“I’m pinching myself really. I’m a kid who grew up in Thangool (almost 600kms north-west of Brisbane), moved to Rockhampton then got the chance to come to Sky in Sydney in 2011.
“I owe so much to Sky. And it all started with the John Tapp Scholarship they ran, which I was part of.”
Marlow is one of a number of Australia’s next wave of racecallers to come through the John Tapp Scholarship, which includes: Sky Racing’s Mitch Manners and Josh Fleming as well as Melbourne’s number one thoroughbred caller, Matt Hill.
“I’ll head to Singapore on the Monday because I want to be there for a few weeks leading into the big international meeting in November.”
Sky Racing’s chief racecaller Darren Flindell, who himself had a 16-year stint calling in Hong Kong, including nine as the number one caller, praised Marlow’s contributions to Sky: “Luke is an outstanding young talent who calls with great passion, balancing accuracy with flair. He’s bound to do Australia proud in Singapore.”
Tabcorp’s EGM of Media and International Darren Pearce added: “Racing is a truly international market now and as sad as we are to lose Luke’s talents to Sky and Australia, there is also an underlying sense of pride in the development Luke has acquired with Sky and that this will be showcased on a global stage in Singapore.”
(Almost) All are 100 words, exactly, as drabbles are supposed to be. Please note any adult ratings. They are all slash, as in M/M relationships.
Staring at himself, Alec dispassionately evaluated the color of his eyes. They changed with his moods, or so he'd been told, from emerald to summer grass and other pretty comparisons he had no use for. Now, as he abandoned his lover in order to save him, it was his dilated pupil he noticed, ringed by an anguished celadon. Soundlessly he turned, drifting across the floor to gaze at Richard one last time as himself, as Alec. Richard refused to listen seriously to him, didn't believe in his own death outside of a swordfight. They had talked this night, spoken a lifetime's worth of desires and memory until words had failed.
Alec felt his world shift and resettle like colored pieces in a kaleidoscope as he looked silently at Richard. The swordsman's face was calm and soft, free of worry, untroubled after several bouts of passion. With desperate, fervent helplessness, Alec whispered the three words that he hadn't spoken earlier, slipping out of their apartment and into the malevolent rain of pre-dawn.
Lord David Alexander Tielman Campion stalked out of Riverside, tears at last mingling with the wet hurling into his face.
Set directly after Alec is returned to St. Vier from being Horn's captive, inspired by this sentence from chapter XVIII:
But late that night, when Alec was drunk and excited and no longer cared, Richard kissed the marks again, and thought of Lord Horn.
"Stop that," Alec sighed, his voice in Richard's ear luxurious and decadent like warmed velvet. "Ticklish."
Richard of course did no such thing, drawing his tongue along the marble expanse of his lover's slender inner arm until he came to the shackle marks. Those he kissed with the devotion of an acolyte reverencing his life's desire, vowing sweet retribution with each whisper of lips.
The word was aged brandy, drawled in Alec's aristocratic tone he usually disguised. His viridian eyes were hooded, the green a mere ring against the desire-dilated pupil. Their groins arched with exquisite friction.
Alec lounged in a chair, limbs unfurled, his ankles crossed and resting on a trunk serving as a makeshift ottoman. In his hand was a green apple which he was eating, noisily, while Richard tried to tune him out as he practised with his sword. The trouble was that Alec in repose made Richard think of sex; even something as innocent as crunching on a tart apple made him stiffen a bit in his trousers. He wrenched his thoughts away, pouring his energies into his movements.
This is obviously set within The Fall of the Kings, set a few hours after this exchange at the end of Chapter XI:
Basil shrouded the book again and restored it to its box, and just in time: a tapping at the door announced Theron, glittering with melting snow and carrying a large basket. [] "I've told Sophia not to expect to see me for two or three days." He looked about him. "This is very cozy."
Amidst the tempest of their passion, Basil paused to feast on the elegant beauty of his lover, flushed and filled with succulent treasures, a cornucopia of carnal delight. Gold-flecked eyes green as forests gazed at him, their arresting colour overwhelmed by his dilated pupils. Theron's dark hair lay untamed and tousled against the shambles of bedcoverings. Basil suffered a stab of jealousy of the ivy and oak which clung to his alabaster skin, a permanent intimacy unlike their temporary gorgings on each other. Pledges of fealty and love clung to the refined architecture of Theron's features; Basil dined his fill.
love the rules of hearts. fabulous post, love. I hope you have a wonderful Valentines Day. if you get a sec, I'd love to hear what you think of my latest. xo
Holy WOW!! I absolutely LOVE My Funky Valentines, and My Purple Valentine is GORGEOUS! Man, when I grow up, I want to do nails like you do! :D