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Vytorin

By D. Xardas. Southeastern University.

Trans fats are cre- ated when oils undergo a chemical process called hydrogenation discount vytorin online american express, which solidifies them buy vytorin 20 mg with amex. Trans fat is also found in cookies purchase vytorin without a prescription, crackers, french fries, baked goods, and other snack foods. When trans fats were first introduced into our food supply, they were thought to be a healthier alternative to saturated fats. Trans fats elevate cholesterol levels, increasing the risk for heart disease and heart attack, and are also linked to cancer, particularly breast cancer. The Institute of Medicine has stated that there is no safe limit for trans fats in the diet and that we should reduce consumption of these dangerous fats. It is manu- factured in the liver and also obtained from consuming saturated and trans fats. Cholesterol is not all bad—the body requires it to produce sex hormones, maintain cell membranes, and for a healthy nervous system. It is possible for triglycerides to be high even when blood cholesterol is normal, so get your levels checked regularly. These macronutrients provide us with the energy and nutrients needed for proper growth, development, and many body processes. In a later chapter I will outline principles for a healthy diet—my top recommendations for a nutritional plan for optimal health and disease prevention. They assist in energy-producing reactions, growth and development, protect against free radical damage, and perform many vital functions. Micronutrients are essential for health, and a deficiency can lead to health problems and disease. In this chapter I have outlined the essential vitamins, minerals, and trace elements; their functions in the body; their role in disease prevention and treatment; deficiency symptoms; drugs that deplete; and supplement guidelines. The table at the end of this chapter summarizes food sources, recommended in- take levels, and possible side effects and toxicity for the various nutrients. There are many factors that cause nutrient depletion, such as poor diet, stress, exer- cise, use of prescription drugs, environmental toxicity, and excessive alcohol intake. This is why supplements are so important in making up for short- comings in the diet and preventing deficiencies. The B-vitamins and vitamin C dissolve in water and are easily eliminated from the body. Adverse reactions, even with high-dose supplements, are rare with these vi- tamins. Fat-soluble vitamins (A, D, and E) are not readily excreted from the body and have the potential to accumulate in the tissues and cause adverse effects at high doses. Vitamin A • Found in animal foods and converted from beta-carotene in plant foods. To avoid this risk, choose a multivitamin that contains beta-carotene, which is converted to vitamin A in the liver, but is not as- sociated with health risks. Vitamin B1 (Thiamine) • Required for energy production, nerve and muscle function, enzyme reactions, and fatty acid production. Micronutrients | 15 • Drugs that deplete vitamin B1: furosemide, antibiotics, oral contraceptives, and phenytoin. Vitamin B2 (Riboflavin) • Required for energy metabolism, enzyme reactions, vision, and skin/hair/nail health; functions as an antioxidant; activates vitamin B6, niacin, and folate. Deficiency may impair iron absorption and increase risk of pre-eclampsia in pregnant women. Vitamin B3 (Niacin) • Required for energy metabolism, enzyme reactions, skin and nerve health, and digestion. Vitamin B5 (Pantothenic Acid) • Required for carbohydrate metabolism, adrenal function, enzyme reactions, and production of fats, cholesterol, bile acids, hormones, neurotransmitters, and red blood cells. Pregnant women with deficiency have increased risk of giving birth to a child with neural tube defects. It can also occur in those who consume raw egg white for prolonged periods (weeks to years) because a protein found in egg white (avidin) binds biotin and prevents its absorption or in those given intravenous feeding without biotin supplementation. Micronutrients | 17 Folate (Folic Acid) • Part of the B-vitamin family; known as folate when it occurs in foods, or as folic acid when present in supplements or added to foods. Pregnancy or cancer results in increased rates of cell division and metabolism, in- creasing the need for folate. Vitamin C (Ascorbic Acid) • Required for synthesis of collagen (structural component of blood vessels, tendons, and bone), norepinephrine (neurotransmitter), and carnitine (amino acid involved in energy production); promotes wound healing; supports immune function and gum health; and has antioxidant properties. Symptoms include fatigue, easy bruising, poor wound healing and appetite, anemia, and sore joints. Elderly, dark-skinned, obese people, or those with inflammatory bowel disease and fat-malabsorption syndromes (celiac disease and cystic fibrosis) are also at greater risk. Those with limited sun exposure, osteoporosis, multiple sclerosis, psoriasis, and those over age 65 should consider additional vitamin D. Micronutrients | 19 Vitamin K • Essential for blood clotting; required for bone formation and cell growth. The body cannot make minerals so they must be obtained through the diet and/or supplements. Animals get minerals from the plants they eat, and then we get these minerals indirectly by eat- ing the animal products. There are also some minerals present in drinking water, but this varies with geographic location, as does the mineral content of plants. Calcium, magne- sium, and phosphorus are considered major minerals since we require a substantial amount of these for health and wellness. The trace minerals, which are required in smaller amounts, are chromium, copper, fluoride, iodine, iron, manganese, mo- lybdenum, selenium, and zinc. The minerals potassium and sodium are known as electrolytes, substances that dissociate into ions (charged particles) in solution, mak- ing them capable of conducting electricity. Most multivitamin/mineral supplements provide a small amount of calcium because it is quite bulky. Therefore, a separate calcium supplement may be necessary, especially for those at risk of osteoporosis and those with high blood pressure. Cooking these foods releases calcium that is bound to oxalic acid, thus improving the amount you can absorb. Phytic acid, which is found in wheat bran or dried beans, also reduces calcium absorption. Micronutrients | 21 • Other interactions: Magnesium reduces absorption of digoxin, nitrofurantoin, anti- malarial drugs, quinolone antibiotics, tetracycline, chlorpromazine, alendronate, and etidronate, so separate intake of magnesium from these foods by two hours. Most studies involving chromium were done with the picolinate form, which is readily absorbed and utilized by the body. Certain individuals (diabetics and those at risk for diabetes) may require an additional supplement. Others at risk: Premature and low birth- weight infants with diarrhea; infants fed only cow’s milk formula, which is low in copper; those with malnutrition, malabsorption syndromes (celiac disease), cystic fibrosis, and those receiving intravenous feeding. Iodine • Required to make thyroid hormones, which regulate metabolism, energy produc- tion, and body temperature, and are essential for growth and reproduction.

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There are a variety of measures of emotional intelligence (Mayer order 30mg vytorin otc, Salovey buy vytorin 30 mg cheap, & Caruso trusted vytorin 20 mg, 2008; Petrides & Furnham, [48] 2000). One popular measure, the Mayer-Salovey-Caruso Emotional Intelligence Test (http://www. When his supervisor brought him an additional project, he felt ____ (fill in the blank). Although it has been found that people with higher emotional intelligence are [50] also healthier (Martins, Ramalho, & Morin, 2010), findings are mixed about whether emotional intelligence [51] predicts life success—for instance, job performance (Harms & Credé, 2010). Furthermore, other researchers have questioned the construct validity of the measures, arguing that emotional intelligence really measures knowledge [52] about what emotions are, but not necessarily how to use those emotions (Brody, 2004), and that emotional intelligence is actually a personality trait, a part of g, or a skill that can be applied in some specific work situations— [53] for instance, academic and work situations (Landy, 2005). Although measures of the ability to understand, experience, and manage emotions may not predict effective behaviors, another important aspect of emotional intelligence—emotion regulation—does. Emotion regulation refers to the ability to control and productively use one‘s emotions. Research has found that people who are better able to override their impulses to seek immediate gratification and who are less impulsive also have higher cognitive and social intelligence. Because emotional intelligence seems so important, many school systems have designed programs to teach it to their students. However, the effectiveness of these programs has not been rigorously tested, and we do not yet know whether emotional intelligence can be taught, or if learning it would improve the quality of people‘s lives (Mayer & [55] Cobb, 2000). People who are better able to regulate their behaviors and emotions are also more successful in their personal and social encounters. Give some examples of how emotional intelligence (or the lack of it) influences your everyday life and the lives of other people you know. A method of measuring the development of the intelligence of young children (3rd ed. Mainstream science on intelligence: An editorial with 52 signatories, history and bibliography. Our research program validating the triarchic theory of successful intelligence: Reply to Gottfredson. Parameters of cortical interactions in subjects with high and low levels of verbal creativity. The scientific study of expert levels of performance: General implications for optimal learning and creativity. Creativity: Understanding innovation in problem solving, science, invention, and the arts. The social context of career success and course for 2,026 scientists and inventors. Practical intelligence: The nature and role of tacit knowledge in work and at school. Practical intelligence: The nature and role of tacit knowledge in work and at school. Construct validation of the Sternberg Triarchic abilities test: Comment and reanalysis. A comprehensive meta-analysis of the predictive validity of the graduate record examinations: Implications for graduate student selection and performance. The relationship between the scholastic assessment test and general cognitive ability. The validity and utility of selection methods in personnel psychology: Practical and theoretical implications of 85 years of research findings. Big-brained people are smarter: A meta-analysis of the relationship between in vivo brain volume and intelligence. Intelligence and changes in regional cerebral glucose metabolic rate following learning. The impact of childhood intelligence on later life: Following up the Scottish mental surveys of 1932 and 1947. Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: A 15-year follow-up of low-income children in public schools. How much does schooling influence general intelligence and its cognitive components? Cohort effects in cognitive development of children as revealed by cross-sectional sequences. A comprehensive meta-analysis of the relationship between emotional intelligence and health. Emotional intelligence and transformational and transactional leadership: A meta- analysis. Some historical and scientific issues related to research on emotional intelligence. Regulating the interpersonal self: Strategic self-regulation for coping with rejection sensitivity. Predicting cognitive control from preschool to late adolescence and young adulthood. Willpower in a cognitive-affective processing system: The dynamics of delay of gratification. Explain how very high and very low intelligence is defined and what it means to have them. Define stereotype threat and explain how it might influence scores on intelligence tests. Most people in Western cultures tend to agree with the idea that intelligence is an important personality variable that should be admired in those who have it. But people from Eastern cultures tend to place less emphasis on individual intelligence and are more likely to view intelligence as reflecting wisdom and the desire to improve the society as a whole rather than only themselves (Baral & Das, 2004; Sternberg, [1] 2007). And in some cultures, such as the United States, it is seen as unfair and prejudicial to argue, even at a scholarly conference, that men and women might have different abilities in domains such as math and science and that these differences might be caused by genetics (even though, as we have seen, a great deal of intelligence is determined by genetics). In short, although psychological tests accurately measure intelligence, it is cultures that interpret the meanings of those tests and determine how people with differing levels of intelligence are treated. In a normal distribution, the bulk of the scores fall toward the middle, with many fewer scores falling at the extremes. These sex differences mean that about 20% more men than women fall in the extreme (very smart or very dull) ends of the distribution (Johnson, [2] Carothers, & Deary, 2009). Boys are about five times more likely to be diagnosed with the [3] reading disability dyslexia than are girls (Halpern, 1992), and are also more likely to be classified as mentally retarded. About 1% of the United States population, most of them males, fulfill the criteria for mental retardation, but some children who are diagnosed as mentally retarded lose the classification as they get older and better learn to function in society. Mental retardation is divided into four categories: mild, moderate, severe, and profound.

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Nursing re- Barrett and Caroselli (1998) cheap vytorin 30 mg on line, Barrett vytorin 20mg on line, Cowling vytorin 20mg low price, search must be grounded in a theoretical per- Carboni, and Butcher (1997), Cowling (1986), spective unique to nursing in order for the Smith & Reeder (1996), and Rawnsley (1994) have research to contribute to the advance of nursing all advocated for the appropriateness of multiple science. Irreducible human/environmental energy fields sistent with Rogers’ unitary ontology and participa- are the focus of Rogerian inquiry: Energy fields tory epistemology. Later, Fawcett (1996) also are postulated to constitute the fundamental questioned the congruency between the ontology unit of the living and nonliving. Both human and epistemology of Rogerian science and the as- beings and the environment are understood as sumptions embedded in quantitative research de- dynamic energy fields that cannot be reduced to signs; like Carboni (1995) and Butcher (1994), she parts. Pattern manifestations are indicators of change: may be more congruent with Rogers’ ontology and Pattern is the distinguishing characteristic of an epistemology. This chapter presents an inclusive view of Pattern manifestations are the source of infor- methodologies. Nevertheless, the researcher needs mation emerging from the human/environmen- to present an argument as to how the design of the tal mutual field process and are the only valid study and interpretations of results are congruent reflections of the energy field. Further- of concern in Rogerian inquiry is conceptualized more, nurses interested in engaging in Rogerian and understood as manifestations of human/ research are encouraged to use, test, and refine the environmental energy mutual process. Pandimensional awareness: Rogerian inquiry sistent with the ontology and epistemology of the recognizes the pandimensional nature of reality. Human instrument is used for pattern knowing and modification of the Criteria of Rogerian and appreciation: The researchers use themselves Inquiry developed by Butcher (1994) and the as the primary pattern-apprehending instru- Characteristics of Operational Rogerian Inquiry ment. The criteria may be ment sensitive to, and which has the ability to a useful guide in designing research investigations interpret and understand, pandimensional po- guided by the Science of Unitary Human Beings. A priori nursing science: All research flows from a appreciation is the process of apprehending in- theoretical perspective. Every step of the inquiry, formation or manifestations of patterning including the type of questions asked, the con- emerging from the human/environmental field ceptualization of phenomena of concern, choice mutual process. The process of pattern knowing of research design, selection of participants, se- and appreciation is the same in the research en- lection of instruments, and interpretation of deavor as described earlier in the Rogerian prac- findings is guided by the science of unitary tice methodology. It is important to note that because of the aware of dynamic unpredictability and contin- incongruency between ontology and episte- uous change and is open to the idea that pat- mology of Rogerian science with assumptions terns in the inquiry process may change in the in quantitative designs, Carboni (1995b) ar- course of the study that may not have been en- gues that the researcher must select qualitative visioned in advance. It is essential that the researcher docu- ods with Rogerian science and argue that the ment and report any design changes. Pattern synthesis: Rogerian science emphasizes hence, both qualitative and quantitative meth- synthesis rather than analysis. The separation of parts is not consistent ence is reflected in the nature of questions with Rogers’ notion of integrality and irre- asked and their theoretical conceptualization ducible wholes. However, qualitative designs, the whole emerging from the human/environ- particularly those that have been derived from mental mutual field process. Synthesis allows the postulates and principles of the science for creating and viewing a coherent whole. Shared description and shared understanding: the natural settings where the phenomenon of Mutual process is enhanced by including par- inquiry occurs naturally, because the human ticipants in the process of inquiry where possi- field is inseparable and in mutual process with ble. Any “manipulation” of participants in the study enhances shared “variables” is inconsistent with mutual process, awareness, understanding, and knowing par- unpredictability, and irreducibility. The researcher and the researcher-into are inte- are the best judges of the authenticity and va- gral: The principle of integrality implies that lidity of their own experiences, perceptions, the researcher is inseparable and in mutual and expressions. Participatory action designs process with the environment and the partici- and focus groups conceptualized within pants in the study. Each evolves during the re- Rogerian science may be ways to enhance mu- search process. The researcher’s values are also tual exploration, discovery, and knowing par- inseparable from the inquiry. Evolutionary interpretation: The researcher in- and environmental field are integral to each terprets all the findings within the perspective other. Purposive sampling: The researcher uses pur- the findings are understood and presented posive sampling to select participants who within the context of Rogers’ postulates of en- manifest the phenomenon of interest. Recogni- ergy fields, pandimensionality, openness, pat- tion of the integrality of all that is tells us that tern, and the principles of integrality, reso- information about the whole is available in in- nancy, and helicy. There is be explored is participatory action and cooperative strong support for the appropriateness of phenom- inquiry (Reason, 1994), because of their congru- enological methods in Rogerian science. Reeder ence with Rogers’ notions of knowing participation (1986) provided a convincing argument demon- in change, continuous mutual process, and inte- strating the congruence between Husserlian phe- grality. Cowling (1998) proposed that a case- nomenology and the Rogerian science of unitary oriented approach is useful in Rogerian research, human beings: because case inquiry allows the researcher to attend to the whole and strives to comprehend his or her [G]iven the congruency between Husserlian phenom- enology and the Rogerian conceptual system, a essence. Husserlian flows from the postulates, principles, and concepts phenomenology as a rigorous science provides just relevant to the conceptual system. Creativity, mystical experiences, tran- the findings in a way that is consistent with Rogers’ scendence, sleeping-beyond-waking experiences, notions of unpredictability, integrality, and nonlin- time experience, and paranormal experiences as earity. Emerging interpretive evaluation methods, they relate to human health and well-being are also such as Guba and Lincoln’s (1989) Fourth of interest in this science. Feelings and experiences Generation Evaluation, offer an alternative means are a manifestation of human/environmental field for testing for differences in the change process patterning and are a manifestation of the whole within and/or between groups more consistent (Rogers, 1970); thus, feelings and experiences rele- with the Science of Unitary Human Beings. Discrete stages of theory development, designs that generate particularistic biophysical phenomena are usually descriptive and explanatory knowledge are relevant not an appropriate focus for inquiry because to the Science of Unitary Human Beings. New concepts with power have been found with anxiety, chronic that describe unitary phenomena may be devel- pain, personal distress, and hopelessness (Caroselli oped through research. For example, the metaphor (Butcher, 2002b), caring (Smith, 1999), and energy “I feel at one with the universe” reflects a high de- (Leddy, 2003; Todaro-Franceschi, 1999) are exam- gree of awareness of integrality; “I feel like a worn- ples of concepts that have been reconceptualizied in out shoe” reflects a more restricted perception of one’s potential (Johnston, 1994; Watson et al. Future research may focus on developing an Researchers need to ensure that concepts understanding of how human field image changes and measurement tools used in the inquiry in a variety of health-related situations or how are defined and conceptualized within a human field image changes in mutual process with unitary perspective. Diversity is inherent in the evolution of the a way congruent with Rogers’ principles and postu- human/environmental mutual field process. Researchers need to ensure that concepts and evolution of the human energy field is character- measurement tools used in the inquiry are defined ized by the creation of more diverse patterns re- and conceptualized within a unitary perspective. Two major concepts— lected patterning modalities designed to foster har- “my motor is running” and “my field expansion”— mony and well-being (Hastings-Tolsma, 1992; are rated using a semantic differential technique Watson et al. Examples of indicators of higher veloped within and unitary science perspective that human field motion include feeling imaginative, vi- may be used in a wide variety of research studies sionary, transcendent, strong, sharp, bright, and ac- and in combination with other Rogerian measure- tive. Indicators of relative low human field motion ments include: include feeling dull, weak, dragging, dark, prag- matic, and passive. The tool has been widely used in • Assessment of Dream Experience Scale, which numerous Rogerian studies. Together, the researcher and Carboni (1992), which is a creative qualitative the participants develop a shared understanding measure designed to capture the changing con- and awareness of the human/environmental field figurations of energy field pattern of the healing patterns manifested in diverse multiple configura- human/environmental field relationship. Carboni encouraged to use methods developed specific to (1995b) also developed special criteria of trustwor- the Science of Unitary Human Beings. Three meth- thiness to ensure the scientific rigor of the findings ods have been developed: Rogerian Process of conveyed in the form of a Pandimensional Unitary Inquiry, the Unitary Field Pattern Portrait Research Process Report. Each method a way of creatively measuring manifestations of was derived from Rogers’ unitary ontology and par- field patterning emerging during coparticipation of ticipatory epistemology and is congruent with the the researcher and participant’s process of change.