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Dr Roy Swank has provided evidence that a diet low in saturated fats (less than 15 g/day) combined with cod liver oil supplementation buy benzac 20gr mastercard acne los angeles, maintained over a long period of time buy generic benzac 20 gr skin care qvc, tends to retard the disease process, reduce the 23,24 number of attacks and decrease mortality. Oneopen-label pilot clinical trial evaluated the effects of a diet low in saturated fats supplemented with fish oil, vitamin B-complex 25 and vitamin C in subjects with newly diagnosed relapsing-remitting MS. After 2 years of this regimen the study reported a significant decrease from baseline values of relapse rates and disability scores. Preliminary reports from a recent randomized placebo- controlled pilot study evaluating a diet very low in saturated fat (less than 15%) supplemented with fish oil capsules found that, when compared with subjects following the American Heart Diet (less than 30% saturated fat) supplemented with placebo oil capsules, the treatment group had a significant decrease in relapse rate, disability and a 26 decrease in two inflammatory cytokines. These studies suggest that a diet very low in fat combined with fish oil supplementation may help to decrease relapse rates and increase time to disability in people with MS. Nutritional/dietary supplementation Many naturopaths use a variety of nutritional supplements usually as an adjunct to fundamental lifestyle therapies, such as diet, exercise and stress reduction (counseling) to address a specific symptom or condition. Under the DSHEA, dietary supplements are considered foods and not drugs and therefore regulated by the FDA as foods. Examples of substances that are considered dietary supplements include: fish, flax, evening primrose and borage oils, glandulars (usually made from animal sources), enzymes, melatonin and dehydroepiandrosterone (DHEA) (although these are hormones they are regulated and sold as dietary supplements in the USA), garlic capsules, soluble fiber, coenzyme Q10 (CoQ-10), L-carnitine, 5-hydroxytryptophan (5-HTP), etc. Obviously this is just a small fraction of the number and types of existing dietary supplements; the associated effects indicated below are rarely definitive. Cold-water fish and fish oil contain a high proportion of the omega-3 fatty acids and therefore contain a higher relative proportion of DHA and eicosapentaenoic acid. There have been at least two clinical trials evaluating the effectiveness of essential fatty acids (EFA) and DHA supplementation for dementia. The treatment group was given a mix of omega-6/ omega-3 fatty acids at a 4:1 ratio in which they received about 0. There were no cognitive measures in this study, and subjects were rated on 12 behavioral variables by their guardian. Although this study showed a positive benefit from short term EFA supplementation there were no objective measures in this study and no standard testing of cognitive function (e. The second, a double- blind placebo-controlled pilot study, evaluated the effects of 1 year of supplementation of 0. A significant increase in MMSE score was reported after 6 months of supplementation (control=19. There was a significant increase in both serum DHA and eicosapentaenoic acid levels after 3 months of supplementation. Amyotrophic lateral sclerosis: creatine Seven days of supplementation with creatine 20 g resulted in a transient increase in 35 maximal voluntary isometric muscular contraction and fatigue in 28 patients. Naturopathic medicine in neurological disorders 161 Bipolar disorder Four months of treatment with 9. Depression: ethyl-eicosapentaenoic acid There are two double-blind placebo-controlled pilot studies that have reported a significant improvement in depression in people on stable doses of antidepressants after 36,37 1–3 months of ethyl-eicosapentaenoic acid (E-EPA) supplementation. Depression: L-acetylcarnitine Two small studies in elderly depressed patients (n=24 and 28) showed effectiveness 38,39 without adverse effects. Depression: dehydroepiandrosterone There are two small controlled pilot studies of DHEA in depressed adults that have 40,41 reported benefit for that hormone. Epilepsy: melatonin 42–44 A small body of evidence suggests that melatonin may be useful in epilepsy. Melatonin has effects in sleep disorders and perhaps in chronic headache and may prove of use in depression and irritability, suggesting broad CNS effects. Epilepsy: polyunsaturated fatty acids (especially omega-3 fatty acids) In five patients, a reduction in frequency and intensity of epileptic seizures resulted from 45 adding 5 g of a 65% omega-3 fatty acid spread at breakfast for 6 months. Omega-3 fatty acids are increased in epileptic children on the ketogenic diet and correlate with resultant 46 decreased seizure activity. Headache: 5-hydroxytrytophan 5-HTP, a serotonin precursor, showed moderate efficacy and remarkable safety compared 50 to placebo in 31 patients with chronic primary headache and in 78 patients with chronic 51 tension headaches. In preference to methysergide or propranolol, owing to their side- effects, 5-HTP may be useful in reducing the frequency or intensity of migraines for 52,53 some patients. However, all patients on treatment improved, while all patients on placebo deteriorated. Insomnia: melatonin Although melatonin is a hormone, it is sold and regulated as a dietary supplement in the 55–65 USA. There are a fair number of studies demonstrating its effectiveness for insomnia, primarily in improving sleep latency.

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More recently generic 20 gr benzac free shipping acne natural treatment, licorice has been found to offer some Interactions protection against cardiovascular disease discount 20gr benzac fast delivery acne under arms. A team of Is- When licorice is used while taking thiazide diuretic raeli researchers found that licorice root extract added to medications, this may exacerbate potassium loss. Sensitivity the diet lowers blood cholesterol levels as well as the to digitalis glycosides may increase with loss of potassium. Licorice also shows promise as a possible chemo- Resources preventive against cancer. Glycyrrhizin, the glycoside BOOKS credited with many of the beneficial effects of licorice, Blumenthal, Mark. The Complete German Commission E Mon- appears to inhibit the growth of cancer cells as well. Massa- addition, a new polyphenol compound isolated from chusetts: Integrative Medicine Communications, 1998. Licorice contains a compound that induces apop- Light therapy, or phototherapy, is the administration tosis in some types of human cancer cells. Demulcent—A type of medication given to soothe the stomach lining or other irritated mucous mem- Origins brane. Light, both natural and artificial, has been pre- Expectorant—A substance or medication given to scribed throughout the ages for healing purposes. In the late nineteenth and early twentieth Tincture—A herbal preparation made by soaking centuries, bright light and fresh air were frequently pre- the roots, leaves, or other parts of the plant in al- scribed for a number of mood and stress related disor- cohol or a mixture of alcohol and water. In fact, prior to World War II, hospitals were regu- larly built with solariums, or sun rooms, in which pa- tients could spend time recuperating in the sunlight. The Herb Society of America, Encyclopedia of In the 1980s, light therapy began to make an appear- Herbs And Their Uses. New York: Simon & Light therapy is most often prescribed to treat sea- Schuster, Inc. It is also occa- ty of Herbs Commonly Used as Remedies for Menopausal sionally employed to treat such sleep-related disorders as Symptoms. One 2001 holesterolemic Patients: Increased Resistance of LDL to study found that bright light reduced depressive symp- Atherogenic Modifications, Reduced Plasma Lipid Lev- toms 12–35% more than a placebo treatment in nine out els, and Decreased Systolic Blood Pressure. And unlike antidepressants, which can cause a vari- tural and Food Chemistry 50 (February 13, 2002): 677-684. Some Clare Hanrahan side effects are possible with light but are generally not Rebecca J. There are several other different applications for Licorice mint see Agastache light therapy, including: GALE ENCYCLOPEDIA OF ALTERNATIVE MEDICINE 2 1217 The patient sits in front of the box for a prescribed period of time (anywhere from 15 minutes to several hours). For patients just starting on the therapy, initial sessions are usually only 10–15 minutes in length. Some patients with SAD undergo light therapy session two or three times a day, others only once. The time of day and number of times treatment is administered depends on the physical needs and lifestyle of the individual patient. If light therapy has been prescribed for the treatment of SAD, it typically begins in the fall months as the days begin to shorten, and continues throughout the winter and possibly the early spring. Patients with a long-stand- ing history of SAD are usually able to establish a time- table or pattern to their depressive symptoms, and can initiate treatment accordingly before symptoms begin. The light from a slanted light box is designed to focus on the table it sits upon, so patients may look down to read or do other sedentary activities during therapy. Patients using an upright light box must face the light source, and should glance toward the light source occa- sionally without staring directly into the light. The light sources in these light boxes typically range from • Full-spectrum/UV light therapy for disorders of the 2,500–10,000 lux (in contrast, average indoor lighting is skin. A subtype of light therapy that is often prescribed 300–500 lux; a sunny summer day is about 100,000 lux). Some healthcare providers and healthcare supply very low-intensity beams of laser light on the skin, and companies also rent the fixtures.

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These foundational principles are completely context independent buy benzac 20 gr line acne einstein, and have been referred to here as context determining because the context is bound into the wisdom purchase benzac 20 gr visa acne light therapy. A traditional view in finding information is to seek data, and this leads us to seek an appreciation of the relationship between data and information, and indeed between information and knowledge. Here, data can be processed into information (called data information) through the application of Copyright © 2005, Idea Group Inc. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. Knowledge Cycles and Sharing 105 patterns of meaning that relate to organizational purpose. Data processing is also constrained by criteria of what constitutes a processing need. Information also exists phenomenally, through the very microstructural variety differentiation that exists in a structured situation. The model given in Figure 3 leads to questions about our under- standing of knowledge creation, and has consequences for the way in which we see knowledge development in organizations. For instance, how and through what means are the patterns of meaning formed that enable data to be processed, and information to be coalesced. Further exploration of knowledge processes within organizations can be developed within the context of knowledge management. There is a perhaps a better way than that of Figure 3 to describe the relationship between data, information and knowledge, that comes from an ontological model of viable systems that originates from Schwarz (1997). While data is not information, data classifications or classes can be described as entities that, when woven into a relational pattern can become information when conditioned by knowledge within an action setting. This occurs when information is analyzed, interconnected to other information within a thematic context, and compared to what is already known. A relationship between data, information, and knowledge cannot be considered indepen- dently of an agent that is involved in creating that relationship. Our interest lies in the generic relationship, rather than local detailed relationships between commodity ele- ments that will be different for each agent. It presupposes that the agent has a purpose for inquiry and is involved in the process of either quantitative or qualitative measurement. Qualitative measurement involves conceptual assessment brought together with some form of mapping agent that is capable of generating a possibly complex scale of values that can be assessed as though they are quantitative measurements. Relationship between data, information and knowledge Copyright © 2005, Idea Group Inc. Copying or distributing in print or electronic forms without written permission of Idea Group Inc. The ontological relationship between data, information, and knowledge Autopoiesis and Autogenesis and contextual manifestation of thematic principles from constrained inquiring knowledge behaviour Existential domain Virtual domain Phenomenal domain Patterns of Relational information Data from structure and knowledge defining decision measuration defining context processes Autogenesis and Autopoiesis and regeneration of evaluative regeneration of network perceived experience of decision processes through data processing Knowledge M anagement The management of knowledge is becoming an important area of interest. However, the question of what constitutes knowledge management may be posed in different ways (Allee, 1997). A traditional meaning approach discusses questions of ownership, control, and value, with an emphasis on planning. Another view is that knowledge is organic, and has a flow, a self-organizing process, and patterns. Knowledge is increasingly recognized as an important organizational asset (Iles, 1999). Its creation, dissemination and application are often now seen as a critical source of competitive advantage (Allee, 1997; Lester, 1996). Cognitive elements operate through mental models that are working worldviews that develop through the creation and manipulation of mental analogies. Mental models like schemata, paradigms, perspectives, beliefs and viewpoints, according to Nonaka and Takeuchi, help individuals perceive and define their world. The technical element of tacit knowledge includes concrete know-how, crafts, and skills.

Nearly all of the blood leaving the Other important venous sinuses are the cranial ve- brain eventually empties into one of the transverse si- nous sinuses discount 20 gr benzac mastercard acne yogurt, which are located inside the skull and drain nuses purchase benzac 20gr with visa skin care for eczema. The largest internal jugular vein, which then passes through a hole of the cranial venous sinuses are the following: in the skull to continue downward in the neck. In a portal system, however, blood circulates through a second cap- illary bed, usually in a second organ, Superior sagittal sinus before it returns to the heart. A portal Inferior sagittal sinus system is a kind of detour in the path- Cavernous Straight sinus sinus way of venous return that transports materials directly from one organ to Ophthalmic another. Later, Hepatic when this oxygenated blood is pumped Spleen veins to capillaries in other parts of the body, it unloads the oxygen and picks up car- bon dioxide and other substances gen- Liver erated by the cells (Fig. For example, when food is digested, most of the blood into the tissues is the pressure of the blood as it end products are absorbed from the small intestine into flows through the capillaries. The movement of blood through the capillaries is rel- ◗ The Physiology of Circulation atively slow, owing to the much larger cross-sectional Circulating blood might be compared to a train that trav- area of the capillaries compared with that of the vessels els around the country, picking up and delivering passen- from which they branch. The lymphatic system, discussed in Chapter 16, can be regulated by changing the size of the blood vessels collects this extra fluid and protein and returns them to supplying that organ. A vasomotor center in the medulla of the brain stem regulates vasomotor activities, sending The Dynamics of Blood Flow its messages through the autonomic nervous system. Some organs, a precapillary sphincter of smooth muscle that encircles such as the brain, liver, and kidneys, require large quan- the entrance to the capillary (see Fig. Return of Blood to the Heart Blood leaving the capillary networks returns in the venous system to the As evidence of these effects, if a person stands com- heart, and even picks up some speed along the way, de- pletely motionless, especially on a hot day when the su- spite factors that work against its return. Blood flows in a perficial vessels dilate, enough blood can accumulate in closed system and must continually move forward as the the lower extremities to cause fainting from insufficient heart contracts. The force of ventricular nally, the force of gravity works against upward flow from contraction starts a wave of increased pressure that begins regions below the heart. During inhalation, the di- but if a heartbeat is abnormally weak, or if the artery is 15 To heart To heart Proximal Proximal valve opens valve closes Skeletal Skeletal muscle muscle contracts relaxes Vein Vein Distal Distal valve closes valve opens A B Figure 15-12 Role of skeletal muscles and valves in blood return. The basic heart rate is set internally by the SA ing a pulse, it is important to gauge the strength as well node, but can be influenced by the autonomic nervous as the regularity and rate. The sympathetic nervous sys- ◗ The pulse is somewhat faster in small people than in tem can stimulate more forceful heart contractions to large people and usually is slightly faster in women than increase ejection of blood. Because the effects of resistance are whereas during strenuous exercise, the rate may go up seen mostly in small arteries and arterioles that are at a to well over 100 beats/minute. For a person in good distance from the heart and large vessels, this factor is condition, the pulse does not go up as rapidly as it does often described as peripheral resistance. More pressure is generated as you Blood pressure is the force exerted by the blood against the blow, and the balloon is a lot harder to inflate than a walls of the vessels. Just as a milkshake is harder to suck through a straw than milk is, increased Cardiac Output As described in Chapter 14, the out- blood viscosity will increase blood pressure. Increased put of the heart, or cardiac output (CO) is the volume of numbers of red blood cells, as in polycythemia, or a loss of plasma volume, as by dehydration, will increase blood viscosity. The Blood pressure hematocrit test described in Chapter increases 13 is one measure of blood viscosity; it measures the relative percentage of packed cells in whole blood. Blood vessel diameter ◗ Total blood volume, the total Heart rate Cardiac Peripheral Vessel elasticity amount of blood that is in the vascu- Stroke volume output resistance Blood viscosity lar system at a given time. BLOOD VESSELS AND BLOOD CIRCULATION ✦ 321 To summarize, all of these relationships are expressed ◗ Diastolic pressure, which occurs during relaxation of together by the following equation: the heart muscle, averages about 80 mmHg. Because blood pressure decreases as the slowly lets air out of the cuff until the first pulsations are blood flows from arteries into capillaries and finally into heard. They measure two variables: mercury, but alternate types display the readings on a dial, or measure blood pressure electronically and give a ◗ Systolic pressure, which occurs during heart muscle digital reading. Blood pressure is reported as systolic contraction, averages about 120 and is expressed in pressure first, then diastolic pressure, separated by a millimeters of mercury (mmHg). Typically, the monary disorders such as shock, pericarditis, congenital right internal jugular vein is used because it is the shortest heart disease, and heart failure. However, it may persist in sclerosis a number of conditions, including the following: Although medical caregivers often place emphasis on ◗ Kidney disease and uremia (excess nitrogenous waste the systolic blood pressure, in many cases, the diastolic in the blood) or other toxic conditions pressure is even more important. The total fluid volume ◗ Endocrine disorders, such as hyperthyroidism and in the vascular system and the condition of small arteries acromegaly may have a greater effect on diastolic pressure. Table 15- ◗ Arterial disease, including hardening of the arteries 1 lists degrees of hypertension as compared with normal (atherosclerosis), which reduces elasticity of the vessels blood pressure values. BLOOD PRESSURE CLASSIFICATION (ADULTS)* It is important to treat even mild hypertension because this condition CATEGORY SYSTOLIC (mmHg) DIASTOLIC (mmHg) can eventually: Optimal 120 80 ◗ Weaken vessels and lead to saclike Normal 130 85 bulges (aneurysms) in vessel walls High normal 130–139 85–89 Hypertension that are likely to rupture.

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