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| Acknowledgments | |
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| Introduction | |
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| How to Use This Book | |
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| For the Non-Scientist | |
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| For the Scientist | |
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| Recommended Reading | |
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| The Altitude Challenge | |
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| Human Responses to Altitude | |
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| You Are a Unique Individual | |
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| How High Is "High Altitude"? | |
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| The Air, the Body, and Oxygen | |
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| Altitude and Atmospheric Pressure | |
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| Biological Differences | |
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| The Quest for Oxygen | |
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| Respiratory System | |
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| Mechanics of Ventilation | |
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| The Control of Breathing at Low Altitude | |
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| The Control of Breathing at High Altitude | |
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| Cardiovascular System | |
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| The Structure and Function of the Heart | |
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| The Flow of Blood through the Body | |
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| Blood Pressure, Heart Rate, and Cardiac Output | |
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| Blood | |
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| Transport of Oxygen and Carbon Dioxide | |
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| Carbon Dioxide Transport | |
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| Oxygen Transport | |
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| The Oxygen Cascade | |
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| The Cascade at Sea Level and at Rest | |
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| The Oxygen Cascade at Altitude | |
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| The Effect of Exercise at Low and High Altitudes | |
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| Increasing Oxygen Delivery to the Tissues at Altitude | |
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| The Biology of Exercise | |
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| Skeletal System | |
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| Muscles | |
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| Types of Muscle Fibers | |
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| Muscle Control and Strength | |
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| Arrangement of Muscles, Muscle Actions, and Types of Contractions | |
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| Concepts of Exercise Physiology | |
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| Limits to Performance | |
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| Factors That Determine Performance | |
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| Maximum Oxygen Uptake and Muscle Limitation | |
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| Oxygen Supply to Other Organs | |
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| Muscle Fatigue | |
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| The Brain | |
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| Biomechanics and Economy of Movement | |
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| Lactic Acid and Performance | |
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| So, What Really Limits Performance? | |
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| Fatigue, Will, and Performance | |
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| Direct Environmental Stresses | |
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| Physiological Stresses | |
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| Indirect Psychological Stresses | |
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| Will and Motivation | |
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| Acclimatization | |
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| Factors Affecting Acclimatization | |
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| Changes That Occur during Acclimatization | |
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| Acclimatization versus Deterioration above 5,500 m | |
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| How Quickly Do You Deacclimatize after Return to Lower Altitudes? | |
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| Age and Sex | |
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| Sex | |
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| Older Travelers | |
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| Children | |
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| Acclimatization Strategies | |
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| Preacclimatization | |
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| Practical Advice | |
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| Specific Situations | |
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| Day Hikes/Climbs | |
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| Overnight Backpacking Trips | |
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| Trekking | |
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| Climbing Expeditions | |
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| Drugs as Aids to Acclimatization and Performance | |
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| Altitude Illness | |
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| Encountering Illness at Altitude | |
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| Physicians at Altitude | |
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| A General Approach to the Potentially III | |
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| Primary Symptoms of Altitude Illness | |
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| Prevalence of Altitude Illness | |
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| Risk Factors for Altitude Illness | |
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| Acute Mountain Sickness (AMS) | |
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| High-Altitude Cerebral Edema (HACE) | |
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| High-Altitude Pulmonary Edema (HAPE) | |
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| High-Altitude Retinal Hemorrhage (High-Altitude Retinopathy, HAR) | |
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| Treatments for Altitude Illness | |
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| Other Medical Issues at Altitude | |
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| Experiences at Altitude: Circulation, Respiration, Nervous System, and Immunity | |
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| Circulatory System | |
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| Carbon Monoxide Poisoning | |
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| Respiratory System | |
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| High-Altitude Pulmonary Edema (HAPE) | |
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| Periodic Breathing | |
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| Cough | |
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| Pleurisy | |
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| Smoking | |
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| The Nervous System | |
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| Behavioral Effects | |
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| Critical Altitudes | |
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| Peripheral Nervous System | |
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| Sleep | |
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| Practical Advice | |
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| Daytime Somnolence (Excessive Sleepiness) | |
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| The Immune System | |
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| Practical Advice | |
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| Experiences at Altitude: Food, Digestion, Hydration, and Hygiene | |
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| Appetite, Digestion, and Weight Loss | |
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| Appetite | |
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| Digestion | |
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| Cellular Respiration and Fuel Supplies for the Cells | |
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| Insulin and Other Hormones | |
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| Energy Expenditure by the Body | |
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| Fuel | |
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| Practical Advice | |
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| Diet and Supplements | |
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| Performance-Enhancing Aids | |
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| Oral and Gastrointestinal Experiences | |
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| Mouth and Throat | |
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| Gastrointestinal Issues | |
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| Dehydration and Thirst | |
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| Pathways of Water Loss | |
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| Effects of Dehydration on Performance | |
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| Thirst | |
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| Electrolytes | |
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| Practical Advice | |
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| Food and Water Safety | |
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| Practical Advice | |
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| Alpine Climbs, Hikes, and Backpacking Trips | |
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| Less-Developed Countries | |
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| Treks and Expeditions | |
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| Away from Base Camp or the Kitchen | |
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| Garbage | |
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| Heat and Cold | |
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| Cold | |
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| General Effects of Cold | |
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| Maintaining Temperature Homeostasis | |
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| Nonfreezing Peripheral Cooling | |
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| Frostbite | |
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| Practical Advice | |
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| Hypothermia | |
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| Practical Advice | |
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| Heat and Solar Issues | |
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| Peripheral Heat Injury | |
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| Sunburn | |
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| Canker Sores, Cold Sores, and Fever Blisters | |
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| Snowblindness | |
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| Overheating the Core | |
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| Glacier Lassitude | |
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| Heat Exhaustion | |
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| Heat Stroke | |
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| Interpersonal Relations | |
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| The Team | |
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| Friends versus Strangers | |
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| Guided Trips | |
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| Experience | |
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| Relationships Among Team Members | |
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| Choosing the Team | |
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| Interactions within the Team | |
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| Women and Men | |
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| Interactions with Teams or Individuals from Other Cultures | |
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| Leadership | |
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| Local Cultures | |
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| Theft | |
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| Gender Issues | |
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| Communication Issues | |
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| Other Advice | |
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| Extreme Altitude | |
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| Basic Questions | |
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| How Long Can You Stay in the Death Zone? | |
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| What Factors Influence Your Ability to Function in the Death Zone? | |
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| Supplemental Oxygen | |
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| Is Oxygen Ethical? | |
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| Style and Ethics on 8,000 m Peaks | |
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| Crowding | |
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| Fixed Ropes | |
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| Parasitism | |
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| Speed Climbing | |
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| Rescue at Extreme Altitude | |
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| I'll Rescue You If You'll Rescue Me | |
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| Practical Advice | |
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| Family, Friends, and "Why?" | |
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| Mental Outlook at Extreme Altitude | |
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| Decision Making and Accidents | |
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| Decision-Making Issues | |
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| Direct Effects of Hypoxia | |
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| Emotional Infrastructure | |
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| Indirect Stresses | |
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| Group Dynamics | |
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| Danger versus Effort | |
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| Intuition | |
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| Practical Advice | |
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| Accidents and Tragedy | |
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| Causes of Accidents | |
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| How Accidents Happen | |
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| Inadequate Equipment | |
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| Passion | |
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| Fatigue | |
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| Poor Decision Making | |
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| Luck and Fate | |
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| When Accidents Happen | |
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| After an Accident | |
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| Death | |
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| Your Responsibilities | |
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| After a Death | |
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| Preparing for Altitude | |
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| Limits to Performance | |
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| Response to Training | |
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| Developing a Training Program | |
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| Determine Your Goals | |
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| Determine Your Weakest Link | |
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| Musculoskeletal System | |
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| Cardiovascular System | |
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| Metabolic/Physiological System | |
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| Psychological System | |
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| Construct Your Training Program | |
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| Training | |
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| Debriefing | |
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| Practical Advice for Training | |
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| Where to Train? | |
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| General Pitfalls | |
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| Strength Training | |
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| Aerobic Training | |
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| Training the Ventilatory Muscles | |
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| Overtraining | |
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| Pretrip Body Weight Management | |
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| Before, During, and After Your Trip | |
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| Before Your Trip | |
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| Planning | |
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| Organizing the Trip | |
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| During the Trip | |
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| After Arrival | |
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| Techniques for Backcountry Travel | |
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| The Importance of Rhythm in Movement | |
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| Typical Ascent Rates during Climbs | |
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| Getting Up in the Morning | |
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| Enforced Inactivity | |
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| Dealing with Altitude, Stress, and Emotional Issues | |
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| After the Trip | |
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| Physical Issues | |
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| Immune System | |
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| Some Scientific Background | |
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| The Atmosphere | |
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| The Behavior of Gases | |
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| Biological Concepts | |
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| Homeostasis | |
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| Getting Work Done in the Body | |
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| How Do Substances Move from One Place to Another? | |
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| How Do Molecules Get Assembled and Taken Apart? | |
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| Lake Louise Scoring System for Acute Mountain Sickness (AMS) | |
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| Children's Lake Louise Scoring System for AMS | |
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| Literature Cited | |
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| Recommended Reading | |
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| Index | |
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| About the Author | |
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| Feet and Meters Conversion Chart | |