Volunteer Health Dictionary

Volunteer: From 1 Different Sources


A person who performs or offers to perform a service of his or her own free will, generally without payment.
Health Source: Community Health
Author: Health Dictionary

Artichoke, Globe

Nutritional Profile Energy value (calories per serving): Low Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: Low Sodium: Moderate to high Major vitamin contribution: Vitamin C Major mineral contribution: Potassium

About the Nutrients in This Food Globe artichokes are prickly plants with partly edible leaves enclosing a tasty “heart.” Their most important nutrients are vitamin C and iron. One medium boiled artichoke has 10.3 g dietary fiber, 8.9 mg vita- min C (12 percent of the R DA for a woman, 10 percent of the R DA for a man), and 0.7 mg iron (4 percent of the R DA for a woman, 9 percent of the R DA for a man). One-half cup artichoke hearts has 7.2 g dietary fiber, 6.2 mg vitamin C (8 percent of the R DA for a woman, 7 percent of the R DA for a man), and 0.5 mg iron (3 percent of the R DA for a woman, 6 percent of the R DA for a man). Raw globe artichokes contain an enzyme that interferes with protein digestion; cooking inactivates the enzyme.

The Most Nutritious Way to Serve This Food Cooked.

Diets That May Restrict or Exclude This Food * * *

Buying This Food Look for: Compact vegetables, heavy for their size. The leaves should be tightly closed, but the color changes with the season—bright green in the spring, olive green or bronze in the winter if they have been exposed to frost. Avoid: Artichokes with yellowed leaves, which indicate the artichoke is aging (the chloro- phyll in its leaves has faded so the yellow carotenes underneath show through).

Storing This Food Do refrigerate fresh globe artichokes in plastic bags. Do refrigerate cooked globe artichokes in a covered container if you plan to hold them longer than a day or two.

Preparing This Food Cut off the stem. Trim the tough outer leaves. Then plunge the artichoke, upside down, into a bowl of cold water to flush out debris. To remove the core, put the artichoke upside down on a cutting board and cut out the center. Slicing into the base of the artichoke rips cell walls and releases polyphenoloxidase, an enzyme that converts phenols in the vegetable to brown compounds that darken the “heart” of the globe. To slow the reaction, paint the cut surface with a solution of lemon juice or vinegar and water.

What Happens When You Cook This Food Chlorophyll, the green plant pigment, is sensitive to acids. When you heat a globe artichoke, the chlorophyll in its green leaves reacts with acids in the artichoke or in the cooking water, forming brown pheophytin. The pheophytin, plus yellow carotenes in the leaves, can turn a cooked artichoke’s leaves bronze. To prevent this reaction, cook the artichoke very quickly so there is no time for the chlorophyll to react with the acid, or cook it in lots of water to dilute the acids, or cook it with the lid off the pot so that the volatile acids can float off into the air.

How Other Kinds of Processing Affect This Food Canning. Globe artichoke hearts packed in brine are higher in sodium than fresh arti- chokes. Artichoke hearts packed in oil are much higher in fat. Freezing. Frozen artichoke hearts are comparable in nutritional value to fresh ones.

Medical Uses and/or Benefits Anti-inflammatory action. In 2006, a report in the Journal of the Pharmaceutical Society of Japan suggested that cynarin might be beneficial in lowering blood levels of cholesterol and that cynaropicrin, a form of cynarin found in artichoke leaves, might act as an anti-inflamma- tory agent, protecting the skin from sun damage, improving liver function, and reducing the effects of stress-related gastritis. Reduced levels of cholesterol. In 2008, researchers at the University of Reading (United King- dom) published a report in the journal Phytomedicine detailing the results of a 150-person study suggesting that an over-the-counter herbal supplement containing extract of globe arti- choke leaf lowers cholesterol in healthy people with moderately raised cholesterol readings. In the study, 75 volunteers were given 1,280 mg of the herbal supplement each day for 12 weeks; a control group got a placebo (a look-alike pill without the herbal supplement). At the end of the trial, those who took the artichoke leaf extract experienced an average 4.2 percent decrease in cholesterol levels, a result the researchers deemed “modest but significant.”

Adverse Effects Associated with This Food Contact dermatitis. Globe artichokes contain essential oils that may cause contact dermati- tis in sensitive people. Alterations in the sense of taste. Globe artichokes contain cynarin, a sweet tasting chemical that dissolves in water (including the saliva in your mouth) to sweeten the flavor of anything you eat next.

Food/Drug Interactions False-positive test for occult blood in the stool. The guaiac slide test for hidden blood in feces relies on alphaguaiaconic acid, a chemical that turns blue in the presence of blood. Arti- chokes contain peroxidase, a natural chemical that also turns alphaguaiaconic acid blue and may produce a positive test in people who do not have blood in the stool.... artichoke, globe

Chocolate

(Cocoa, milk chocolate, sweet chocolate)

Nutritional Profile Energy value (calories per serving): Moderate Protein: Low (cocoa powder) High (chocolate) Fat: Moderate Saturated fat: High Cholesterol: None Carbohydrates: Low (chocolate) High (cocoa powder) Fiber: Moderate (chocolate) High (cocoa powder) Sodium: Moderate Major vitamin contribution: B vitamins Major mineral contribution: Calcium, iron, copper

About the Nutrients in This Food Cocoa beans are high-carbohydrate, high-protein food, with less dietary fiber and more fat than all other beans, excepting soy beans. The cocoa bean’s dietary fiber includes pectins and gums. Its proteins are limited in the essential amino acids lysine and isoleucine. Cocoa butter, the fat in cocoa beans, is the second most highly saturated vegetable fat (coconut oil is number one), but it has two redeeming nutritional qualities. First, it rarely turns rancid. Second, it melts at 95°F, the temperature of the human tongue. Cocoa butter has no cholesterol; neither does plain cocoa powder or plain dark chocolate. Cocoa beans have B vitamins (thiamine, riboflavin, niacin) plus min- erals (iron, magnesium, potassium, phosphorus, and copper). All chocolate candy is made from chocolate liquor, a thick paste pro- duce by roasting and grinding cocoa beans. Dark (sweet) chocolate is made of chocolate liquor, cocoa butter, and sugar. Milk chocolate is made of choc- olate liquor, cocoa butter, sugar, milk or milk powder, and vanilla. White * These values apply to plain cocoa powder and plain unsweetened chocolate. Add- ing other foods, such as milk or sugar, changes these values. For example, there is no cholesterol in plain bitter chocolate, but there is cholesterol in milk chocolate. chocolate is made of cocoa butter, sugar, and milk powder. Baking chocolate is unsweetened dark chocolate. The most prominent nutrient in chocolate is its fat. Fat Content in One Ounce of Chocolate

Saturated fat (g) Monounsaturated fat (g) Polyunsaturated fat (g) Cholesterol (mg)
Dark (sweet)
chocolate 5.6 3.2 0.3 0
Milk chocolate 5.9 4.5 0.4 6.6
Baking chocolate 9 5.6 0.3 0
White chocolate 5.5 2.6 0.3 0
  Source: USDA Nut rient Data Laborator y. Nat ional Nut rient Database for Standard Reference. Available online. UR L : http://w w w.nal.usda.gov/fnic/foodcomp/search /. Because chocolate is made from a bean, it also contains dietary fiber and measurable amounts of certain minerals. For example, one ounce of dark chocolate, the most nutritious “eating” chocolate, has 1.6 g dietary fiber, 0.78 mg iron (4 percent of the R DA for a woman, 10 percent of the R DA for a man), 32 mg magnesium (11 percent of the R DA for a woman, 8 percent of the R DA for a man), and .43 mg zinc (5 percent of the R DA for a woman, 4 percent of the R DA for a man). Cocoa beans, cocoa, and chocolate contain caffeine, the muscle stimulant theobro- mine, and the mood-altering chemicals phenylethylalanine and anandamide (see below).

The Most Nutritious Way to Serve This Food With low-fat milk to complete the proteins without adding saturated fat and cholesterol. NOTE : Both cocoa and chocolate contain oxalic acid, which binds with calcium to form cal- cium oxalate, an insoluble compound, but milk has so much calcium that the small amount bound to cocoa and chocolate hardly matters. Chocolate skim milk is a source of calcium.

Diets That May Restrict or Exclude This Food Antiflatulence diet Low-calcium and low-oxalate diet (to prevent the formation of calcium oxalate kidney stones) Low-calorie diet Low-carbohydrate diet Low-fat diet Low-fat, controlled-cholesterol diet (milk chocolates) Low-fiber diet Potassium-regulated (low-potassium) diet

Buying This Food Look for: Tightly sealed boxes or bars. When you open a box of chocolates or unwrap a candy bar, the chocolate should be glossy and shiny. Chocolate that looks dull may be stale, or it may be inexpensively made candy without enough cocoa butter to make it gleam and give it the rich creamy mouthfeel we associate with the best chocolate. (Fine chocolate melts evenly on the tongue.) Chocolate should also smell fresh, not dry and powdery, and when you break a bar or piece of chocolate it should break cleanly, not crumble. One exception: If you have stored a bar of chocolate in the refrigerator, it may splinter if you break it without bringing it to room temperature first.

Storing This Food Store chocolate at a constant temperature, preferably below 78°F. At higher temperatures, the fat in the chocolate will rise to the surface and, when the chocolate is cooled, the fat will solidif y into a whitish powdery bloom. Bloom is unsightly but doesn’t change the chocolate’s taste or nutritional value. To get rid of bloom, melt the chocolate. The chocolate will turn dark, rich brown again when its fat recombines with the other ingredients. Chocolate with bloom makes a perfectly satisfactory chocolate sauce. Dark chocolate (bitter chocolate, semisweet chocolate) ages for at least six months after it is made, as its flavor becomes deeper and more intense. Wrapped tightly and stored in a cool, dry cabinet, it can stay fresh for a year or more. Milk chocolate ages only for about a month after it is made and holds its peak flavor for about three to six months, depending on how carefully it is stored. Plain cocoa, with no added milk powder or sugar, will stay fresh for up to a year if you keep it tightly sealed and cool.

What Happens When You Cook This Food Chocolate burns easily. To melt it without mishap, stir the chocolate in a bowl over a pot of hot water or in the top of a double boiler or put the chocolate in a covered dish and melt it in the microwave (which does not get as hot as a pot on the store). Simple chemistry dictates that chocolate cakes be leavened with baking soda rather than baking powder. Chocolate is so acidic that it will upset the delicate balance of acid (cream of tartar) and base (alkali = sodium bicarbonate = baking soda) in baking powder. But it is not acidic enough to balance plain sodium bicarbonate. That’s why we add an acidic sour-milk product such as buttermilk or sour cream or yogurt to a chocolate cake. Without the sour milk, the batter would be so basic that the chocolate would look red, not brown, and taste very bitter.

How Other Kinds of Processing Affect This Food Freezing. Chocolate freezes and thaws well. Pack it in a moistureproof container and defrost it in the same package to let it reabsorb moisture it gave off while frozen.

Medical Uses and/or Benefits Mood elevator. Chocolate’s reputation for making people feel good is based not only on its caffeine content—19 mg caffeine per ounce of dark (sweet) chocolate, which is one-third the amount of caffeine in a five-ounce cup of brewed coffee—but also on its naturally occurring mood altering chemicals phenylethylalanine and anandamide. Phenylethylalanine is found in the blood of people in love. Anandamide stimulates areas of your brain also affected by the active ingredients in marijuana. (NOTE : As noted by the researchers at the Neurosci- ences Institute in San Diego who identified anandamide in chocolate in 1996, to get even the faintest hint of marijuana-like effects from chocolate you would have to eat more than 25 pounds of the candy all at once.) Possible heart health benefits. Chocolate is rich in catechins, the antioxidant chemicals that give tea its reputation as a heart-protective anticancer beverage (see tea). In addition, a series of studies beginning with those at the USDA Agricultural Research Center in Peoria, Illinois, suggest that consuming foods rich in stearic acid like chocolate may reduce rather than raise the risk of a blood clot leading to a heart attack. Possible slowing of the aging process. Chocolate is a relatively good source of copper, a mineral that may play a role in slowing the aging process by decreasing the incidence of “protein glycation,” a reaction in which sugar molecules ( gly = sugar) hook up with protein molecules in the bloodstream, twisting the protein molecules out of shape and rendering them unusable. This can lead to bone loss, rising cholesterol, cardiac abnormalities, and a slew of other unpleasantries. In people with diabetes, excess protein glycation may be one factor involved in complications such as loss of vision. Ordinarily, increased protein glyca- tion is age-related. But at the USDA Grand Forks Human Nutrition Research Center in North Dakota, agricultural research scientist Jack T. Saari has found that rats on copper-deficient diets experience more protein glycation at any age than other rats. A recent USDA survey of American eating patterns says that most of us get about 1.2 mg copper a day, considerably less than the Estimated Safe and Adequate Daily Dietary Intake (ESADDI) or 1.5 mg to 3 mg a day. Vegetarians are less likely to be copper deficient because, as Saari notes, the foods highest in copper are whole grains, nuts, seeds, and beans, including the cocoa bean. One ounce of dark chocolate has .25 mg copper (8 –17 percent of the ESADDI).

Adverse Effects Associated with This Food Possible loss of bone density. In 2008, a team of Australian researchers at Royal Perth Hos- pital, and Sir Charles Gairdner Hospital published a report in the American Journal of Clinical Nutrition suggesting that women who consume chocolate daily had 3.1 percent lower bone density than women who consume chocolate no more than once a week. No explanation for the reaction was proposed; the finding remains to be confirmed. Possible increase in the risk of heart disease. Cocoa beans, cocoa powder, and plain dark chocolate are high in saturated fats. Milk chocolate is high in saturated fats and cholesterol. Eating foods high in saturated fats and cholesterol increases the amount of cholesterol in your blood and raises your risk of heart disease. NOTE : Plain cocoa powder and plain dark chocolate may be exceptions to this rule. In studies at the USDA Agricultural Research Center in Peoria, Illinois, volunteers who consumed foods high in stearic acid, the saturated fat in cocoa beans, cocoa powder, and chocolate, had a lower risk of blood clots. In addition, chocolate is high in flavonoids, the antioxidant chemicals that give red wine its heart-healthy reputation. Mild jitters. There is less caffeine in chocolate than in an equal size serving of coffee: A five- ounce cup of drip-brewed coffee has 110 to 150 mg caffeine; a five-ounce cup of cocoa made with a tablespoon of plain cocoa powder ( 1/3 oz.) has about 18 mg caffeine. Nonetheless, people who are very sensitive to caffeine may find even these small amounts problematic. Allergic reaction. According to the Merck Manual, chocolate is one of the 12 foods most likely to trigger the classic food allergy symptoms: hives, swelling of the lips and eyes, and upset stomach.* The others are berries (blackberries, blueberries, raspberries, strawberries), corn, eggs, fish, legumes (green peas, lima beans, peanuts, soybeans), milk, nuts, peaches, pork, shellfish, and wheat (see wheat cer ea ls).

Food/Drug Interactions Monoamine oxidase (MAO) inhibitors. Monoamine oxidase inhibitors are drugs used to treat depression. They inactivate naturally occurring enzymes in your body that metabolize tyra- mine, a substance found in many fermented or aged foods. Tyramine constricts blood vessels and increases blood pressure. Caffeine is a substance similar to tyramine. If you consume excessive amounts of a caffeinated food, such as cocoa or chocolate, while you are taking an M AO inhibitor, the result may be a hypertensive crisis. False-positive test for pheochromocytoma. Pheochromocytoma, a tumor of the adrenal gland, secretes adrenalin, which the body converts to VM A (vanillylmandelic acid). VM A is excreted in urine, and, until recently, the test for this tumor measured the level of VM A in the urine. In the past, chocolate and cocoa, both of which contain VM A, were eliminated from the patient’s diet prior to the test lest they elevate the level of VM A in the urine and produce a false-positive result. Today, more finely drawn tests usually make this unnecessary. * The evidence link ing chocolate to allergic or migraine headaches is inconsistent. In some people, phenylet hylamine (PEA) seems to cause headaches similar to t hose induced by t yramine, anot her pressor amine. The PEA-induced headache is unusual in t hat it is a delayed react ion t hat usually occurs 12 or more hours after t he chocolate is eaten.... chocolate

Clinical Trial

Studies which test drug safety and efficacy prior to registration. 1. Phase I: a study in human volunteers to establish safety of a pharmaceutical agent. 2. Phase II: the first investigation of a new drug in patients to determine the preliminary evidence of efficacy and to confirm safety. 3. Phase III: trials designed to determine long term safety, efficacy and cost-effectiveness of a new drug in large numbers of patients.... clinical trial

Community Health Worker

A trained health worker who works with other health and development workers as a team. The community health worker provides the first contact between the individual and the health system. The types of community health worker vary between countries and communities according to their needs and the resources available to meet them. In many societies, these workers come from and are chosen by the community in which they work. In some countries they work as volunteers; normally those who work part-time or full-time are rewarded, in cash or in kind, by the community and the formal health services.... community health worker

Community Visitor Scheme

A scheme utilizing volunteers to visit, spend time with and become friends with an older person in his/her place of residence.... community visitor scheme

Carob

Nutritional Profile Energy value (calories per serving): Moderate Protein: Moderate Fat: Low Saturated fat: Low Cholesterol: None Carbohydrates: High Fiber: High Sodium: Low Major vitamin contribution: Niacin Major mineral contribution: Calcium

About the Nutrients in This Food Carob flour, which is milled from the dried pod of a Mediterranean ever- green tree, Ceratonia siliqua, looks like cocoa but has a starchy, beanlike flavor. It can be mixed with sweeteners to make a cocoalike powder or combined with fats and sweeteners to produce a candy that looks like and has the same rich mouthfeel as milk chocolate but tastes more like honey. Ounce for ounce, carob, which is also known as locust bean gum, has more fiber and calcium but fewer calories than cocoa. Its carbohydrates include the sugars sucrose, D-mannose, and D-galactose. (D-galactose is a simple sugar that links up with other sugars to form the complex indigest- ible sugars raffinose and stachyose.) Carob also contains gums and pectins, the indigestible food fibers commonly found in seeds.

The Most Nutritious Way to Serve This Food As a substitute for cocoa or chocolate for people who are sensitive to chocolate.

Diets That May Restrict or Exclude This Food Low-carbohydrate diet

Buying This Food Look for: Tightly sealed containers that will protect the flour from moisture and insects.

Storing This Food Store carob flour in a cool, dark place in a container that protects it from air, moisture, and insects. Keep carob candy cool and dry.

Preparing This Food Measure out carob flour by filling a cup or tablespoon and leveling it off with a knife. To substitute carob for regular flour, use ¼ cup carob flour plus ¾ cup regular flour for each cup ordinary flour. To substitute for chocolate, use three tablespoons of carob flour plus two tablespoons of water for each ounce of unsweetened chocolate. Carob flour is sweeter than unsweetened chocolate.

What Happens When You Cook This Food Unlike cocoa powder, carob flour contains virtually no fat. It will burn, not melt, if you heat it in a saucepan. When the flour is heated with water, its starch granules absorb moisture and rupture, releasing a gum that can be used as a stabilizer, thickener, or binder in processed foods and cosmetics. In cake batters, it performs just like other flours (see flour).

Medical uses and/or Benefits Adsorbent and demulcent. Medically, carob flour has been used as a soothing skin powder. As a chocolate substitute. People who are sensitive to chocolate can usually use carob instead. Like cocoa beans, carob is free of cholesterol. Unlike cocoa, which contains the cen- tral-nervous-system stimulant caffeine and the muscle stimulant theobromine, carob does not contain any stimulating methylxanthines. Lower cholesterol levels. In 2001, a team of German nutrition researchers from the Institute for Nutritional Science at the University of Potsdam, the German Institute of Human Nutri- tion, Center for Conventional Medicine and Alternative Therapies (Berlin) Nutrinova Nutri- tion Specialties and Food Ingredients GmbH, and PhytoPharm Consulting, Institute for Phytopharmaceuticals GmbH conducted a study to evaluate carob’s effectiveness in lower- ing cholesterol. For a period of eight weeks, 47 volunteers with moderately high cholesterol levels (232– 302 mg/dL) were fed 15 g of carob per day in breakfast cereal, fruit grain bars, and a drink made from powdered carob pulp as supplements to their normal diet. After four weeks, the volunteers’ total cholesterol levels fell an average of 7 percent and their LDL (low density lipoprotein—“bad” cholesterol) levels fell an average 10.6 percent. At six weeks, the numbers were 7.8 percent and 10.6 percent. There was no effect on HDLs (high density lipoproteins, a.k.a. “good” cholesterol).... carob

Cyamopsis Tetragonoloba

(Linn.) Taub.

Family: Fabaceae; Papilionaceae.

Habitat: Cultivated throughout India, particularly in Haryana, Punjab, Rajasthan, Uttar Pradesh and Orissa.

English: Cluster bean, Guar.

Ayurvedic: Kshudra Shimbi, Gorakshaphalini, Guaar, Gwaalin.

Unani: Guaar phali.

Action: Laxative, antibilious. Gum—hypoglycaemic, hypolipi- daemic, appetite depressor (weight loss not observed), reduces glyco- suria during gum supplementation.

The administration of Guar gum (15 g/day) with normal diet for 6 weeks produced significant reduction in plasma, total cholesterol and LDL-choles- terol. The gum (10 g daily) is reported to decrease blood-glucose level in normal and diabetic volunteers. The supplementation of the gum in the diet of insulin-dependent diabetics failed to improve the long-term diabetic control, but significantly reduced serum cholesterol levels.

Taking Guar gum orally with meals was found to lower post-prandial glucose levels in patients with type 1 diabetes. (Am J clin Nutr, 56, 1992, 10561060.)

Oral administration of an ethanol extract of powdered pods has shown significant antiulcer, antisecretory and cytoprotective effects on various experimentally-induced gastric lesions in rats.

Guarmeal contains galactomannan, 3-epikatonic acid and a saponin.... cyamopsis tetragonoloba

Escort Services

Transportation for older adults to services and appointments. May use buses, taxis, volunteer drivers, or van services that can accommodate wheelchairs and persons with other special needs.... escort services

Sitting Service

A service which involves a worker or volunteer going into an older person’s home to provide care whilst the carer takes a break for up to six hours.... sitting service

Visiting Service / Visitor Programme

Through volunteers or community workers, a service providing companionship and support for older people who may be lonely and isolated.... visiting service / visitor programme

Trial, Clinical

A test on human volunteers of the effectiveness and safety of a drug. A trial can also involve systematic comparison of alternative forms of medical or surgical treatment for a particular disorder. Patients involved in clinical trials have to give their consent, and the trials are approved and supervised by an ethics committee.... trial, clinical

Health Research

Research on all aspects of health, the factors affecting it, and ways of promoting, protecting and improving it. It is an essential part of national health development. It includes medical and biomedical research relating to a wide variety of medical matters and involving various life sciences, such as molecular biology and biophysics; clinical research, which is based on the observation and treatment of patients or volunteers; epidemiological research, which is concerned with the study and control of diseases and of situations that are suspected of being harmful to health; and socioeconomic and behavioural research, which investigates the social, economic, psychological and cultural determinants of health and disease with a view to promoting health and preventing disease. Often a multidisciplinary combination of the above kinds of research is needed to solve a health problem.... health research

Hospital Chaplaincy

A service provided by a religious denomination, primarily aimed at meeting the spiritual and religious needs of patients in hospitals. In the UK, NHS hospital trusts employ both full-time and part-time chaplains, usually representing the mainline Christian churches (Anglican, Free and Roman Catholic). Their duties vary but always at the least involve meeting the speci?cally religious needs of patients as well as of relatives and sta? who may ask for help. Public services in chapels, the bedside administration of the Word and Sacraments, and prayers and radio services are among chaplains’ duties. When requested by patients, chaplains also liaise with representatives of other world faiths.

Chaplains have a broad responsibility for the spiritual health care of all in hospital. They share this with other sta? members, particularly the nursing sta?, for whom the chaplains can be a resource. Chaplains also train and use volunteers from local churches to help with ward visiting and other chaplaincy duties. Much of the time spent with patients takes the form of a listening ministry, helping patients to ?nd their own answers to what is happening to them in hospital and in life generally. Spiritual health can be seen as a quest for the right relationships in four areas – with other people; with oneself; with the world around; and with ‘Life’ itself. The religious person subsumes all that in his/ her relationship to God.

The link between spiritual disease and physical ill-health is well established; the chaplain therefore helps a hospital to provide a HOLISTIC approach to health care. Chaplains also give time to the care of sta? who face increasing levels of stress at work, making use of support groups, counselling, meditation, etc. Chaplains support patients’ relatives facing a crisis, for example, by being with them over the period of a death, and by providing regular bereavement services for those who have lost babies. Some chaplains have a particular expertise in ETHICS and are members of the various hospital ethics committees. A chaplain may have a ‘nonmanagement’ view of the health of the hospital itself, which can be of use to hospital management. (See also SPIRITUAL PAIN.)... hospital chaplaincy

Sex Education

Information given to children and young adults about sexual relationships. Evidence suggests that young people want more information about the emotional aspects of sexual relationships, and about homosexuality and AIDS/HIV. There is growing concern about sexual risk-taking behaviour among adolescents, many of whom feel that sex education was provided too late for them. Although most parents or guardians provide some guidance by the age of 16, friends, magazines, television and ?lms are a more signi?cant source of information. Schools have been targeted as a place to address and possibly limit risky behaviour because they are geared towards increasing knowledge and improving skills, and have a captive audience of young adults. There are concerns that the conditions in schools may not be ideal: class time is limited; teachers are often not trained in handling sensitive subjects; and considerable controversy surrounds teaching about subjects such as homosexuality.

Sex education in schools is regarded as an e?ective way of reducing teenaged pregnancy, especially when linked with contraceptive services. Several studies have shown that it does not cause an increase in sexual activity and may even delay the onset of sexual relationships and lessen the number of partners. Programmes taught by youth agencies may be even more e?ective than those taught in the classroom – possibly because teaching takes place in small groups of volunteer participants, and the programmes are tailored to their target populations. Despite improvements in sex education, the United Kingdom has the highest incidence of teenaged pregnancies in the European Community.

Sex education, including information about AIDS/HIV and other sexually transmitted infections (STIs), is compulsory in all state-maintained secondary schools in England and Wales. The National Curriculum includes only biological aspects of AIDS/HIV, STIs and human sexual behaviour.

All maintained schools must have a written statement of their policy, which is available to parents. The local education authority, governing body and headteacher should ensure that sex education encourages pupils to have due regard to moral considerations and the value of family life. Sex-education policies and practices are monitored by the O?ce for Standards in Education (OFSTED) and the O?ce of HM Chief Inspector of Schools (OHMCI) as part of school inspections.... sex education

Auxiliary

n. a person who volunteers to assist and carry out complementary tasks at hospitals or other medical facilities.... auxiliary

Samaritans

n. a British voluntary organization providing a telephone service for the suicidal and despairing. Started in 1953 by the Rev. Chad Varah in the cellars of a London church (St Stephen, Walbrook) with one telephone, it now has over 200 branches throughout the country manned by some 22,000 volunteers. It offers a free, nonprofessional, confidential, and (if required) anonymous service at all hours. Samaritans offer little advice, believing that their clients will be helped to make their own decisions by talking to someone who cares.... samaritans

Elecampane

Inula helenium

FAMILY: Asteraceae (Compositae)

SYNONYMS: Helenium grandiflorum, Aster officinalis, A. helenium, inula, scabwort, alant, horseheal, yellow starwort, elf dock, wild sunflower, velvet dock, ‘essence d’aunée’.

GENERAL DESCRIPTION: A handsome perennial herb up to 1.5 metres high, with a stout stem covered in soft hairs. It has oval pointed leaves which are velvety underneath, large, yellow, daisy-like flowers and large, fleshy rhizome roots.

DISTRIBUTION: Native to Europe and Asia, naturalized in North America. Cultivated in Europe (Belgium, France, Germany) and Asia (China, India). The oil is mainly produced from imported roots in southern France.

OTHER SPECIES: There are several varieties of Inula; the European and Asian species are slightly different having a harsher scent. Other varieties include golden samphire (I. crithmoides) and sweet inula (I. graveolens or I. odora), which share similar properties.

HERBAL/FOLK TRADITION: A herb of ancient medical repute, which used to be candied and sold as a sweetmeat. It is used as an important spice, incense and medicine in the east. It is used in both western and eastern herbalism, mainly in the form of a tea for respiratory conditions such as asthma, bronchitis and whooping cough, disorders of the digestion, intestines and gall bladder and for skin disorders.

Current in the British Herbal Pharmacopoeia as a specific for irritating cough or bronchitis. Elecampane root is the richest source of inulin.

ACTIONS: Alterative, anthelmintic, anti-inflammatory, antiseptic, antispasmodic, antitussive, astringent, bactericidal, diaphoretic, diuretic, expectorant, fungicidal, hyperglycaemic, hypotensive, stomachic, tonic.

EXTRACTION: Essential oil by steam distillation from the dried roots and rhizomes. (An absolute and concrete are also produced in small quantities.)

CHARACTERISTICS: A semi-solid or viscous dark yellow or brownish liquid with a dry, soft, woody, honey-like odour, often containing crystals. It blends well with cananga, cinnamon, labdanum, lavender, mimosa, frankincense, orris, tuberose, violet, cedarwood, patchouli, sandalwood, cypress, bergamot and oriental fragrances.

PRINCIPAL CONSTITUENTS: Mainly sesquiterpene lactones, including alantolactone (or helenin), isolactone, dihydroisalantolactone, dihydralantolactone, alantic acid and azulene.

SAFETY DATA: Non-toxic, non-irritant; however it is a severe dermal sensitizer. In clinical tests it caused ‘extremely severe allergic reactions’ in twenty-three out of twenty-five volunteers. On the basis of these results it is recommended that the oil ‘should not be used on the skin at all’..

AROMATHERAPY/HOME: USE None.

NB In Phytoguide I, sweet inula (I. odora or I. graveolens), a deep green oil, is described as ‘queen of mucolytic essential oils’, having properties as diverse as: ‘anti-inflammatory, hyperthermic, sedative, cardia-regulative, diuretic and depurative’.. It is described as being an excellent oil for the cardiopulmonary zone including asthma, chronic bronchitis and unproductive coughs. This variety of Inula seems to avoid the sensitization problems of elecampane, at least when it is used as an inhalation or by aerosol treatment.

OTHER USES: Alantolactone is used as an anthelmintic in Europe (it is also an excellent bactericide). The oil and absolute are used as fixatives and fragrance components in soaps, detergents, cosmetics and perfumes. Used as a flavour ingredient in alcoholic beverages, soft drinks and foodstuffs, especially desserts.... elecampane




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