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Cis-Monounsaturated Fatty Acids Information is needed to assess energy balance in free-living individuals who have implemented a diet high in monounsaturated fatty acids versus a diet lower in monounsaturated fatty acids (and higher in carbohydrate) erectile dysfunction devices discount 100 mg viagra sublingual with visa. Trans Fatty Acids A comprehensive database needs to be developed for the trans fatty acid content of the United States food supply; this database could then be used to determine the trans fatty acid intakes in different age and socioeconomic groups over the counter erectile dysfunction pills uk 100 mg viagra sublingual sale. The effects of dietary -linolenic acid compared with docosahexaenoic acid on brain erectile dysfunction blog order viagra sublingual 100mg with mastercard, retina erectile dysfunction in young men cheap viagra sublingual 100mg free shipping, liver, and heart in the guinea pig. Fasting serum cholesterol and triglycerides in a tenyear prospective study in old age. Neurodevelopment quotient of healthy term infants at 4 months and feeding practice: the role of long-chain polyunsaturated fatty acids. Developmental quotient at 24 months and fatty acid composition of diet in early infancy: A follow up study. Effects of partially hydrogenated fish oil, partially hydrogenated soybean oil, and butter on serum lipoproteins and Lp[a] in men. Effects of partially hydrogenated fish oil, partially hydrogenated soybean oil, and butter on hemostatic variables in men. Docosahexaenoic acid is the preferred dietary n-3 fatty acid for the development of the brain and retina. Effect of n-3 fatty acid supplementation on lipid peroxidation and protein aggregation in rat erythrocyte membranes. Stearic acid, trans fatty acids, and dairy fat: Effects on serum and lipoprotein lipids, apolipoproteins, lipoprotein(a), and lipid transfer proteins in healthy subjects. Aro A, Van Amelsvoort J, Becker W, van Erp-Baart M-A, Kafatos A, Leth T, van Poppel G. Dietary fat and risk of coronary heart disease in men: Cohort follow up study in the United States. Failure to increase lipid oxidation in response to increasing dietary fat content in formerly obese women. Visual acuity, erythrocyte fatty acid composition, and growth in term infants fed formulas with long chain polyunsaturated fatty acids for one year. Growth and development in term infants fed longchain polyunsaturated fatty acids: A double-masked, randomized, parallel, prospective, multivariate study. The effect of repeated stimulation of the pancreas on the pancreatic secretion in young and aged men. Membrane fatty acids associated with the electrical response in visual excitation. In contrast with docosahexaenoic acid, eicosapentaenoic acid and hypolipidaemic derivatives decrease hepatic synthesis and secretion of triacylglycerol by decreased diacylglycerol acyltransferase activity and stimulation of fatty acid oxidation. Visual acuity and the essentiality of docosahexaenoic acid and arachidonic acid in the diet of term infants. A randomized controlled trial of early dietary supply of long-chain polyunsaturated fatty acids and mental development in term infants. Low plasma cortisol and hematologic abnormalities associated with essential fatty acid deficiency in man. Comparison of the lipid composition of breast milk from mothers of term and preterm infants. Alpha-linolenic acid deficiency in patients on long-term gastric-tube feeding: Estimation of linolenic acid and long-chain unsaturated n-3 fatty acid requirement in man. Alpha-linolenic acid deficiency in man: Effect of essential fatty acids on fatty acid composition. Linseed and cod liver oil induce rapid growth in a 7-year-old girl with n-3 fatty acid deficiency. Pro- and anti-inflammatory cytokines in healthy volunteers fed various doses of fish oil for 1 year. Essential fatty acid deficiency, prostaglandin synthesis and humoral immunity in Lewis rats. Intestinal absorption of stearic acid after consumption of high fat meals in humans.

Intrinsic sugars are defined as sugars that are present within the cell walls of plants erectile dysfunction treatment exercise purchase viagra sublingual 100 mg fast delivery. The terms were developed to help consumers differentiate sugars inherent to foods from sugars that are not naturally occurring in foods erectile dysfunction treatment by acupuncture discount viagra sublingual 100 mg with amex. The Food Guide Pyramid erectile dysfunction due to diabetes 100mg viagra sublingual with mastercard, which is the food guide for the United States which antihypertensive causes erectile dysfunction viagra sublingual 100 mg without prescription, translates recommendations on nutrient intakes into recommendations for food intakes (Welsh et al. Added sugars are defined as sugars and syrups that are added to foods during processing or preparation. Added sugars do not include naturally occurring sugars such as lactose in milk or fructose in fruits. Table 6-1 shows the amounts of added sugars that could be included in diets that meet the Food Guide Pyramid for three different calorie levels. Although added sugars are not chemically different from naturally occurring sugars, many foods and beverages that are major sources of added sugars have lower micronutrient densities compared with foods and beverages that are major sources of naturally occurring sugars (Guthrie and Morton, 2000). Definition of Starch Starch consists of less than 1, 000 to many thousands of -linked glucose units. Amylose is the linear form of starch that consists of -(1, 4) linkages of glucose polymers. The amylose starches are compact, have low solubility, and are less rapidly digested. The amylopectin starches are digested more rapidly, presumably because of the more effective enzymatic attack of the more open-branched structure. Definition of Glycemic Response, Glycemic Index, and Glycemic Load Foods containing carbohydrate have a wide range of effects on blood glucose concentration during the time course of digestion (glycemic response), with some resulting in a rapid rise followed by a rapid fall in blood glucose concentration, and others resulting in a slow extended rise and a slow extended fall. Prolonging the time over which glucose is available for absorption in healthy individuals greatly reduces the postprandial glucose response (Jenkins et al. Holt and coworkers (1997), however, reported that the insulin response to consumption of carbohydrate foods is influenced by the level of the glucose response, but varies among individuals and with the amount of carbohydrate consumed. Adults with type 1 or type 2 diabetes have been shown to have similar glycemic responses to specific foods (Wolever et al. Individuals with lactose maldigestion have reduced glycemic responses to lactose-containing items (Maxwell et al. It is defined as the area under the curve for the increase in blood glucose after the ingestion of a set amount of carbohydrate in an individual food. Thus, glycemic load is an indicator of glucose response or insulin demand that is induced by total carbohydrate intake. This does not imply that it is the best or only system for classifying glycemic responses or other statistical associations. With progressive ripeness of foods, there is a decrease in starch and an increase in free sugar content. Although the glycemic response of diabetics is distinctly higher than that of healthy individuals, the relative response to different types of mixed meals is similar (Indar-Brown et al. For instance, coingestion of dietary fat and protein can sometimes have a significant influence on the glucose response of a carbohydratecontaining food, with a reduction in the glucose response generally seen with increases in fat or protein content (Gulliford et al. For instance, it is important that the incremental area, rather than the absolute area, under the blood glucose curve be measured (Wolever and Jenkins, 1986). The breakdown of starch begins in the mouth where salivary amylase acts on the interior -(1, 4) linkages of amylose and amylopectin. The digestion of these linkages continues in the intestine where pancreatic amylase is released. Amylase digestion produces large oligosaccharides (-limit dextrins) that contain approximately eight glucose units of one or more -(1, 6) linkages. The microvilli of the small intestine extend into an unstirred water layer phase of the intestinal lumen. When a limit dextrin, trisaccharide, or disaccharide enters the unstirred water layer, it is rapidly hydrolyzed by enzymes bound to the brush border membrane.

May not be accepted Medication may be accepted erectile dysfunction treatment spray buy viagra sublingual canada, varies with the individual Extended family-both blood and family friends-will most likely be asked to visit Should take place with the individual and main spokesperson of © HealthCare Chaplaincy Network 2014 Page 48 Discussion Dying Process the family-husband erectile dysfunction tips best viagra sublingual 100 mg, brother erectile dysfunction at age of 20 order 100 mg viagra sublingual otc, uncle impotence at 70 cheap viagra sublingual 100mg with visa, son etc. Death is feared, and any discussion or preparation for approaching death is often strongly discouraged as there is a belief that by talking about it, it will happen. May wish to hear dying person`s last words Traditional belief is that body - and family ­ are polluted until after appropriate mourning rituals are completed Acceptable, however cultural superstitions or religious beliefs regarding need for body to be whole may lead to nonconsent. Death-Special Needs Death-Body Care Organ Donation Prenatal Care Labor C-Section Postpartum and Breastfeeding Genetic Defects and/or Sick Baby Pregnancy, Birth, Postpartum Cultural and religious beliefs may impact care women choose to receive; often include aspects of both in medical care. Older female in the family often present May be accepted, depends on the individual May want placenta for ritual Breastfeeding is common practice Everything should be done to take care of the sick infant Religion Spiritual Healing Religious and Spiritual Practices Christian, Muslim, and Hindu Families will seek out the support, guidance and advice of their religious leaders and members of their religious community. Caribbean Cultures © HealthCare Chaplaincy Network 2014 Page 49 Cuban Culture Important Historical Issues Clothing or Amulets Language Communication, Nonverbal and Greetings Spokesperson and Decision-making, Family structure Food practices/beliefs Time orientation Cultural and Family Structure Cuban revolution still has impact on daily life Afro-Cuban music and dance. Religious items, necklaces, herbs for healing English, Spanish, and Haitian Creole. Handshakes and a light embrace are acceptable Upon first meeting someone, a warm welcome between two parties is acceptable Once one has met an individual(s) of Cuban descent, a light embrace is acceptable May come across as less aware of personal-physical space. This is acceptable within their circle of interaction Traditionally Cuban families are patriarchal. The female head of household typically takes on the role of emotional provider and mediator across generations. Depending on the family, male or female spokespeople may have to be consulted May see physician as a director rather than a partner. Rice, beans, root vegetables, pork and meat make up the bulk of diet Usually present oriented Health, Illness and Death According to traditional Cuban culture, mind, body and spirit are connected. Use of complementary mind-spirit, religious, and herbal practices Physical illness may be thought to be caused by mental stress or supernatural forces. May decline shampooing of hair Doctors and other healthcare providers are seen as having authority and their decisions are respected. Illness beliefs © HealthCare Chaplaincy Network 2014 Page 50 Consents Invasive Procedures Pain Visitors Consent is often given through family consultation and consensus. Important to clarify with patient whether he/she wants information first and who within family can receive it to reduce potential conflicts. Acceptable Often incorporate mind-body modalities Expressed openly, but may be stoic the company of immediate and extended family members is much sought after. Family member may want to stay around the clock In Cuban health care, there is little discussion between physicians and patient/families so this may be a new experience. Families may consult a senior male or female, or one who is most educated or influential in the community when deciding on health care treatment and making end of life decisions. Grief may be expressed loudly Family member may want to stay with body until buried Often buried quickly with funeral/ritual several days later Acceptable to save a life Pregnancy, Birth, Postpartum Traditional women may be fearful of evil eye or having someone they don`t know touch their belly or ask information about pregnancy. Do not discuss negative issues during pregnancy, including potential deformities or risks. Natural delivery or other procedures suggested by healthcare providers to help labor progress are acceptable. Traditionally, only female relative present but this is changing so father is present. Generally accepted Terminal Illness Discussion Dying Process Death-Special Needs Death-Body Care Organ Donation Prenatal Care Labor C-Section © HealthCare Chaplaincy Network 2014 Page 51 Postpartum and Breastfeeding Genetic Defects and/or Sick Baby Traditionally baby dressed in red to ward off evil eye. Breastfeeding common Talk to father first May be feared to have been caused by supernatural forces Religious and Spiritual Practices Roman Catholic, Protestant, or Santeria which is also often practiced alongside Christianity Those individuals who practice Santeria will seek spiritual comfort as a way to ease physical pain Many Cuban Americans seek out the support of their church for spiritual guidance and advice. Religion Spiritual Healing Haitian Culture Important Historical Issues Clothing or Amulets Language Communication, Nonverbal, and Greetings Spokesperson and Decision-making Family structure Cultural and Family Structure the expulsion of the French in 1804, making Haiti the first independently black-ruled nation in the world Religious medallions or other spiritual objects. Handshakes are acceptable Informal introductions are acceptable upon first meeting Females are seen as the decision makers for the family Women are usually thought of as the marketers of the family, so they usually control their husband`s earnings. Households typically are made up of nuclear family members and adopted children or young relatives. The husband is thought of as the owner of the house and must tend to the maintenance of it. Women often hold the authority to make and sign off on © HealthCare Chaplaincy Network 2014 Page 52 Illness beliefs Consents Invasive Procedures Pain Visitors Terminal Illness Discussion Dying Process Death-Special Needs Death-Body Care Organ Donation decisions regarding their families Accepted but frightening, particularly abdominal surgeries Vocal about pain although vague about source; may prefer injections over oral medication Includes both immediate and extended family members. Discussion should occur with immediate family present, and if need be, extended family. The moment of death is marked by ritual wailing among family members, friends, and neighbors.

Syndromes

• Your age
• If you have asthma or another chronic lung condition, use your inhaler (such as albuterol).
• Sarcoidosis
• Toddler fracture (a type of stress fracture that occurs in toddlers)
• Can copy a circle
• Fluids given through a vein (IV)
• Keep your weight in the range that has been recommended. Follow any recommended exercise program.
• You are older than 60

Chest - Sticking pain through right breast near sternum buy erectile dysfunction injections purchase viagra sublingual 100 mg with visa, extending to back near shoulders erectile dysfunction red 7 buy viagra sublingual. Fever - Hectic; profuse and debilitating perspiration; intermittent impotence grounds for annulment cheap 100mg viagra sublingual with visa, with pain in arms erectile dysfunction drugs market share order 100 mg viagra sublingual with visa. Phosphoricum acidum (phosphoric acid) * the common acid "debility" is very marked in this remedy, producing a nervous exhaustion. Stool - Diarrhoea, white, watery, involuntary, painless, with much flatus; not specially exhausting. Relationship - Compare: Oenothera biennis-Evening primrose-(Effortless diarrhoea with nervous exhaustion. Phosphorus (phosphorus) * Phosphorus irritates, inflames and degenerates mucous membranes, irritates and inflames serous membranes, inflames spinal cord and nerves, causing paralysis, destroys bone, especially the lower jaw and tibia; disorganizes the blood, causing fatty degeneration of blood vessels and every tissue and organ of the body and thus gives rise to haemorrhages, and haematogenous jaundice. Tall, slender persons, narrow chested, with thin, transparent skin, weakened by loss of animal fluids, with great nervous debility, emaciation, amative tendencies, seem to be under the special influence of Phosphorus. Great susceptibility to external impressions, to light, sound, odors, touch, electrical changes, thunder-storms. Blood extravasations; fatty degenerations, cirrhosis, caries, are pathological states often calling for Phosphorus. Extremities - Ascending sensory and motor paralysis from ends of fingers and toes. Modalities - Worse, touch; physical or mental exertion; twilight; warm food or drink; change of weather, from getting wet in hot weather; evening; lying on left or painful side; during a thunder-storm; ascending stairs. Physalis alkekengi (alkekengi-winter cherry) * Marked urinary symptoms confirming its ancient uses in gravel, etc. Skin - Excoriation between fingers and toes; pustules on thighs; nodes on forehead. Physostigma venenosum (calabar bean) * this remedy and its active principle, Eserine, form a valuable addition to Materia Medica. Eyes - Night-blindness [Opposite: Bothrops]; photophobia; contraction of pupils; twitching of ocular muscles. Heart - Feeble pulse; palpitation; spasmodic action, with feeling pulsation through the whole body. Relationship - Compare: Eserine-the alkaloid of Physostigma-(slows action of heart and increases arterial tension; in ciliary spasm and spasmodic astigmatismdue to irregular action of ciliary muscles; blepharo-spasms; pupils contracted. Twitching of lids, soreness of eyeballs, blurring of vision after using eyes, pains around eyes and head). Phytolacca decandra (poke-root) * Aching, soreness, restlessness, prostration, are general symptoms guiding to Phytolacca. Back - Aching pains in lumbar region; pains streaking up and down spine into sacrum. Extremities - Shooting pain in right shoulder, with stiffness and inability to raise arm. Relationship - Compare: Tincture of Phytolacca Berry (sore throats and in the treatment of obesity); Bry. Picricum acidum (picric acid) (trinitrophenol) * Causes degeneration of the spinal cord, with paralysis. Jaborandi (jaborandi) * Pilocarpus is a powerful glandular stimulant and the most efficient diaphoretic. Is homoeopathic to abnormal sweats, and has achieved great success in night-sweats of consumptives. Stomach - Nausea on looking at objects moving; vomiting; pressure and pain in stomach. Pinus silvestris (scotch pine) * Has been found of real use in the treatment of weak ankles and tardiness in walking, in scrofulous and rachitic children. Relationship - Compare: Pinus Lambertina-Sugar Pine-(constipation, amenorrhoea, abortion).

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