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In the third grade I was told I could write a paper on any topic for an English homework assignment. I chose the subject of scurvy as it affected sailors who were away at sea for long periods of time and the resulting discovery of Vitamin C as its cure. I remember the paper well for I was literally transcended from ignorance to a place of awe at the intricacies of the human body and its response to nutrients. Today, antioxidants are the word on the street. They are used to boost energy (forget caffeine - this stuff rocks!) and these antioxidants fight infection, and address a whole range of health issues. Before XanGo, Tahitian Noni, Fruta Vida, (containing, respectively, mangosteen, goji, and acai) and now Amigo Juice (a marriage of all three super foods), we had Vitamin C, E, and A. For many of us, it was all about drinking that cup of orange juice at breakfast or taking a vitamin supplement. But today, we are not talking about just a punch but a real blow to sickness and disease, taking the form of antioxidant rich health beverages that many consumers swear by in their quest for wellness. Living in today's very toxic world, antioxidants deserve a special place in the area of nutritional supplements and are certainly worth examining closer to see what they are all about and learn how we can implement them into our daily routine. Quite simply put, at the molecular and cellular levels, antioxidants serve to deactivate certain particles called free radicals. In humans, free radicals usually come in the form of O2, the oxygen molecule. The oxygen molecule desires to be oxidized, and this oxidation process can sometimes be carcinogenic. Free radicals are the natural by-products of many processes within and among cells. They are also created by exposure to various environmental factors, tobacco smoke and radiation. Of course, this certainly includes air quality and all the junk we put into our bodies that our immune system is forced to combat. If allowed to run amok, these free radicals can cause damage to cell walls, cell structures, and genetic material within the cell. They are the bully on the playground and need to be dealt a firm hand for the resulting damage can eventually lead to disease and ultimately death. Antioxidants play a key role in cleaning up the destruction caused by these free radicals. They clean house before free radicals get a chance to harm the body. Researchers have determined that antioxidants are useful in the prevention of carcinogenic effects of oxidation. To that end, a variety of health companies, most notably in the form of multi-level marketing, have cropped up offering antioxidant rich health drinks, as captured in the "pericarp," "hull," "pulp," "rind," basically the whole fruit, the kitchen and its sink, ground and mixed and served up in tasty 1 oz. servings. Not to mention the mangosteen fruit has introduced an entirely new classification of antioxidants, called Xanthones with professed health benefits too numerous to list, many years of research, and centuries of positive use. These antioxidant rich drinks created three distinct camps. One decided the mangosteen is their drink of choice, goji has its determined followers, and there is also acai (pronounced ah-sigh-ee). It became difficult to navigate through hype and look for substance. According to numerous reports by customers, they all have their benefits. However, in March of this year, one product was introduced, integrating all three important fruits into one single product in a dried formula, omitting any need for pasteurization, cutting back on the cost of shipping, and providing the most bang for the buck. Most importantly, each of the three super foods had very distinct benefits. Now we have a marriage of all three fruits in one drink in Amigo Juice. THE BIG THREE SUPER FOODS The following is a look at the three fruits: acai, mangosteen, and goji. ACAI: The Acai berry, or Acai Fruit grows on majestic palm trees in the Amazon Rainforest and looks like a purple marble or grape. Acai contains high levels of Antioxidants, Omega Fatty Acids (healthy fats), Iron, Amino Acids, Fiber, and many other vitamins and minerals. The people living in the Amazon region in Northern Brazil, have consumed Acai for hundreds of years and its healing and sustaining powers are legendary. Acai Berry is known to harness the following properties: Antioxidant, Antibacterial, Anti-inflammatory, Antimutagenic, Cardiovascular System. Acai berries contain very high amounts of essential fatty acids and omegas proven to lower LDL and maintain HDL cholesterol levels. They also contain a remarkable concentration of antioxidants to help combat premature aging. Acai Berry is a dense source of a particular class of flavonoids called anthocyanins. The ORAC value of Acai Berry is higher than any other edible berry in the world. Acai Berry is also an excellent source of dietary fiber. Acai is extremely rich in organic vegetable protein which does not generate cholesterol during its digestion and is more easily processed and transported to your muscles than animal protein (such as what is found in milk or meat). Besides its outstanding content of protein and unsaturated lipids, Acai is also rich in carbohydrates, providing your body with the necessary energy while working or practicing any kind of sport. There is also an amazingly high concentration of antioxidants useful in combating premature aging. The proanthocyanidine contents in Acai Berries contain 10 to 30 times the anthocyanins (these are the purple colored antioxidants) of red wine per volume. Although the French consume a high fat diet, they have a low incidence of cardiovascular disease compared to the western countries. They contribute this factor to their consumption of red wine. Acai Berries can help promote a healthier cardiovascular system and digestive tract, because of its synergy of monounsaturated fats (these are the healthy fats), dietary fiber, and phytosterols. They provide the body with an excellent source of fiber. Fiber promotes a healthy digestive system. Research studies suggest soluble fibers may help lower blood cholesterol. The insoluble fiber may help to reduce the risk of developing certain types of cancers. Essential amino acid complex along with trace minerals, which are vital for proper muscle contraction and regeneration. MANGOSTEEN: The mangosteen (Garcinia mangostana) is a tropical evergreen tree, believed to have originated in the Sunda Islands and the Moluccas. The tree grows from 7 to 25 meters tall. The edible fruit is deep reddish purple when ripe. In Asia, the mangosteen fruit is known as the "Queen of Fruits." The outer shell of the fruit (pericarp) is rather hard, typically 4-6 cm in diameter, resembling a spherical, black cartoon bomb. Health benefits: Mangosteen has compounds with antioxidant, anti-bacterial, anti-fungal, and anti-tumor activity. Laboratory testing thus far indicates that extracts of mangosteen have activity against several cancer cell lines including breast, liver, and leukemia. Mangosteen also appears to have anti-histamine and anti-inflammatory properties. Most notably, the mangosteen provides powerful anti-inflammatory benefits which play an important role in numerous health conditions. For hundreds of years, the people of Southeast Asia have used the mangosteen, especially the rind, to ward off and treat infections, reduce pain or control fever, and treat various other ailments. Most of the studies with mangosteen have focused on the pericarp, or the dark, woody rind as opposed to the fruit inside the woody rind. The pericarp contains the active xanthone compounds. The fruit itself probably has some beneficial compounds but the compounds within the mangosteen fruit have not been studied as well as the mangosteen rind. Several compounds in mangosteen appear to be active, particularly xanthones. Some of these xanthones include mangostin, mangostenol, mangostenone A, mangostenone B, trapezifolixanthone, tovophyllin B, alpha- and beta-mangostins, garcinone B, mangostinone, mangostanol, and the flavonoid epicatechin. There are numerous studies available for review at www.pubmed.com. Just enter the word "mangosteen" to access a list. GOJI Goji berries have the highest concentration of beta-carotene among all foods on earth. Beta-carotene can be transformed into vitamin A under the influence of human liver enzymes. Therefore, vitamin A ultimately plays a major influence in Lycium's actions. Lycium's function on the eyes is related to this factor. Lycium's vitamin B1 and B2 contents are significant and the vitamin C content of freeze-dried Lycium has been measured to be 73 mg/100 grams. The fruit also contains vitamin C, beta-sitosterol (an anti-inflammatory agent), linoleic acid (a fatty acid), sesquiterpenoids (cyperone, solavetivone), tetraterpenoids (zeaxanthin, physalin), and betaine (0.1%). Lycium contains 18 kinds of amino acids, of which 8 are indispensable amino acids for the human body (such as isoleucine and tryptophan). 50% of Lycium's amino acids are free amino acid. Lycium contains numerous trace elements, of which the main ones are zinc, iron and copper. Mature fruits contain about 11 mg. of iron per 100 grams. Ning Xia Lycium contains 45% glucose, 7% fructose and 5.5% glucose. HEALTH BENEFITS: Goji Berries have been used in Tibet for at least 1,700 years. Tibetan medicine includes these berries in the treatment of kidney and liver problems. They are also used in Tibet to lower cholesterol, lower blood pressure, and cleanse the blood. Goji Berries have a long history of use in the treatment of eye problems, skin rashes, psoriasis, allergies, insomnia, chronic liver disease, diabetes and tuberculosis. Goji Berries are used by the people of Tibet to increase longevity and as a general health strengthening tonic. Science has shown that this bright red berry not only contains extremely high levels of antioxidants, vitamins, and minerals, but also contains many unique phytochemicals, polysaccharides, and complex compounds that scientists are only beginning to understand. Goji Berries contain the following complex compounds: Betaine, which is used by the liver to produce choline, a compound that calms nervousness, enhances memory, promotes muscle growth, and protects against fatty liver disease. Physalin, which is active against all major types of leukemia. It has also been used as a treatment for hepatitis B. Solavetivone, a powerful anti-fungal and anti-bacterial compound. Beta-Sitoserol, an anti-inflammatory agent. It has been used to treat sexual impotence and prostate enlargement. It also lowers cholesterol. Cyperone, a sesquiterpene that benefits the heart and blood pressure. It has also been used in the treatment of cervical cancer. These compounds as found in the Goji Berry are used in the following manner: Betaine, which is used by the liver to produce choline, a compound that calms nervousness, enhances memory, promotes muscle growth, and protects against fatty liver disease. Physalin, which is active against all major types of leukemia. It has also been used as a treatment for hepatitis B. Solavetivone, a powerful anti-fungal and anti-bacterial compound. Beta-Sitoserol, an anti-inflammatory agent. It has been used to treat sexual impotence and prostate enlargement. It also lowers cholesterol. Cyperone, a sesquiterpene that benefits the heart and blood pressure. It has also been used in the treatment of cervical cancer. When navigating through the myriad of choices in determining which product to choose in today's antioxidant saturated market, it is important to consider the following criteria: quality of product; quantity and source of ingredient; reputation of manufacturing company; and cost. At one time, health products did a little bit of this and a little bit of that. As someone who used to pop about 30 different pills each day to get what I felt my body needed for good health, it is exciting to see a number of products offering profound results. These results are allowing individuals to drop their pharmaceutical drug habit, or at the very least drop the dose, giving the body what it craves most, all things natural. 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Dial 1-800/AIDSNYC Every Monday and Wednesday morning, promptly at 10 a.m., I leave behind my daily life and turn to volunteering as an AIDS Hotline counselor at New York City’s GMHC [Gay Men’s Health Crisis], the nation’s largest social service agency for AIDS. For the next four hours, my co-volunteers and I sit in front of a bank of constantly-ringing telephones, talking to men, women, and teens who call in from across the nation with urgent questions about AIDS, the ravaging disease that has left 13.9 million people dead worldwide. After almost 20 years, a whole generation, families are still facing the heartache of tending the sick, while scientists continue to be confounded by this stubborn, ravaging virus. Although the federal government currently spends$4 billion per year on AIDS research, and $15 billion worldwide, there is no cure in sight for the viral infection and no vaccine available. Small wonder that the GMHC AIDS Hotline, the nation’s first, is flooded with more than 40,000 calls each year. Listening to callers 8 hours each week, I often think the Hotline is actually a direct link to the soul of callers--an anonymous forum that allows each to reveal secrets and fears that they might otherwise never discuss with anyone. A Morning in May This is the way it began: “Good morning, GMHC AIDS Hotline, can I help you?” “Yes...I have a question...[hesitantly] My son...he’s 21...and he just found out...he’s HIV-positive [voice breaking] I’m.....alone, divorced. And I need some help...someone to talk to...” “Of course....happy to talk to you...it sounds like this has been devastating for you....” “It’s terrible. He told me two nights ago....he’s...he’s so young....I don’t want him to die. He’s my only child....why did this have to happen?” [crying] Her son, she explains, had sometimes neglected using condoms, convinced he wouldn’t contract HIV infection from his female partners. “How could he be so stupid?” she now asks angrily. “Why didn’t he know how to protect himself? I don’t understand. What am I going to do?” We talk for 35 minutes, and by the end of the conversation, I notice I’m barely breathing. The distraught woman’s anguish is palpable. Her situation is every mother’s worst nightmare.The life of her child is in jeopardy and she feels helpless and afraid. I can’t imagine anything worse. During the call, I do my best to employ the GMHC Hotline protocol of “active listening,” which involves using silence, empathy and gentle probing with open-ended questions. I’m also having my own emotional reaction to the panic in her voice, and I’m worried about whether I’m doing enough. Toward the end of the clal, when she exclaims: “I don’t want my baby to die,” my heart plummets: “I know....I understand that, but there is hope,” I tell her. I find myself on the verge of tears. The Bad News This mother’s story is too common. According to the Centers for Disease Control in Atlanta, Ga., 40,000 Americans (half of them under 25) are newly infected with the AIDS virus each year. Unprotected sex and intravenous drug use remain the principal modes of transmission. “Teenagers,” notes AIDS activist Elizabeth Taylor, “are being very hard hit.” She refers to the three million adolescents who contract a sexually-transmitted disease annually. “Heterosexual teenage football players who are healthy and drink milk can get it too!” says the 71-year-old actress, who has singlehandedly raised $150 million for AIDS research. “But teens are very ignorant and feel invincible. They believe there’s an invisible shield protecting them from the virus, when it’s actually aimed right at them.” Taylor believes in addressing the problem head-on: “Tell your teenage son: ‘Maybe a condom doesn’t feel as good, but if it saves your life, it’s better than being six feet under.’ Intelligence must replace random sex.” Although a new generation of AIDS-fighting medications is prolonging the lives of thousands, nearly half of the 900,000 people infected with HIV in the U.S. cannot afford these drugs. Since the virus was discovered in l981, 410,800 Americans have died from AIDS-related complications, and the disease has left 13.9 million dead worldwide. Who Calls a Hotline? Not long ago I took a call from a 15-year-old boy living in a small town who said he feels guilty about his sexual attraction to other boys and is scared to discuss this with his parents. I ask him if there’s a school counselor or relative he might talk to, but he says he’s too afraid to confide in anyone. Being a teenager is hard enough, I thought, without the pressure of keeping this kind of secret. I felt angry and saddened that this child can’t comfortably discuss his feelings with his own parents. I encourage him to call the Gay Community Center Youth Program in a nearby city. In the meantime, I assured him that he could call our Hotline anytime, that we’d be there for him. This call was typical of the many we get from teenagers,whispering from their parents’ homes, confiding their blossoming sexual feelings and concerns. Our Hotline also receives calls from married men who phone from their offices, worried about extramarital sexual encounters; gay men suffering side effects from medications; mothers caring for a sick child or grieving for one lost to AIDS; even health care professionals themselves confused and requiring burnout support. One particular morning, I’m struck by the number of single women who turn to our hotline for help. At 10:15 a.m. a distraught young woman calls, explaining that she had been dating someone “very charismatic,” after a two- year period of sexual abstinence. “At first we used condoms and I was taking the pill to avoid pregnancy,” she says. But after her partner assured her he was HIV-negative, the couple began having unprotected sex. A few months into the relationship, she recounts, his behavior became “unpredictable,” until he finally admitted he was sleeping with other women and was addicted to heroin. Now she has to withstand the “terror” of waiting 3 months before getting an HIV antibody test. To help her cope, I give her the names of three terapists in her area. The call lasts 43 minutes. At 11:15 a.m. I take a call from a woman who is breathing heavily. She says that four months earlier she’d had a brief affair with a limousine driver, “not out of passion, but because I felt lonely. This was so totally unlike me,” she continues. “I come from a traditional Orthodox Jewish family...” Although they used condoms, and she has since tested negative for HIV, she feels deeply ashamed, and has stopped seeing him. And because she has both a persistent vaginal yeast infection and a rash on her neck, she’s convinced she must be infected by HIV. Although rashes, high fever, swollen lymph glands, heavy night sweats, sore throat, or other flu-like symptoms may indicate HIV, they can just as easily accompany the common cold or flu, or other type of infection. I encourage her to seek medical help and counseling, but the calls ends on a down note. “I must have it [AIDS],” she moans. I’m exasperated because it doesn’t sound that way to me, yet I can’t get through to her. The call lasts 22 minutes. It’s 11.38 a.m. when a well-spoken woman, who says she’s an attorney, calls from her office, asking for the names of anonymous testing sites. At first very businesslike, she calmly takes down all the information. I ask her why she’s considering a test. Total silence. Then she begins to cry: “I....I can’t talk....I’m sorry...you see, I have swollen lymph glands....[crying]....And my doctor wants to rule out HIV...I feel overwhelmed...” Then, abruptly: “Where can I send a donation?” She thanks me and hurries off the phone after just 3 minutes. These were one-time callers, but, as in any epidemic, an element of panic prevails, and our hotline also attracts an army of “chronic” or repeat callers who are intensely fearful no matter how benign their risk, many revealing continued misconceptions and paranoia about a disease that can be effectively prevented. We do our best to help them, but often they’re impervious to counseling. Most poignant are calls we get from AIDS patients, phoning from their hospital beds, attempting to navigate the exhausting labyrinth of insurance and health care matters. One man, in hospice care, said he craved companionship and missed the “good old days” when he was handsome and healthy. That call was a tough one for me as just the day before a close friend of mine, Joe, who had battled HIV for 16 years, had finally succumbed. Although at the end Joe was a mere skeleton, he was nonetheless at peace. “I’ve done what I wanted to,” he told me on our last visit. An avid gardener, he insisted on a final trip to his country house to see his garden one last time. For a moment the caller’s reality and the memory of my deceased friend blurred in my mind and I was overcome. Time for a break. Face to Face One of the most and unique services GMHC offers is called “A-Team Counseling,” a one-time, in-person session that’s free and anonymous. Recently, I was on an A-Team counselling a 26-year-old HIV-infected mother from the Midwest. She had traveled to Manhattan by bus to find her estranged boyfriend, who, she recounted tearfully, had kidnapped her 7-year- old son. Disheveled, painfully thin, the woman was a disturbing sight. She’s learned that the two had already returned home where the boyfriend was, and the child put in his grandmother’s custory. custody of his grandmother. Meanwhile she’d run out of money for the return trip, been refused a loan by her family, lost her ID, gone hungry and spent two nights on the street. Fortunately, this woman was registered at a local AIDS organization in her town. I telephoned her caseworker and persuaded him to buy her a one-way Greyhound bus ticket for $115.00. I also gave her subway tokens, a basket of food, juice and coffee. Smiling shyly, she thanked me for caring. Shaking hands good-bye with this woman was a bittersweet farewell. What will happen to her? I wondered will her health deteriorate or improve? Will she gain control of her life and be able to provide for her son? I’ll never know. One thing I do know: She’d appeared with the sorrow of a difficult life in her eyes, but when she left, she was elated at the thought of being reunited with her child. It seems that with faith and a helping hand, almost anything is possible. * * * * * 10 BIGGEST MISCONCEPTIONS ABOUT AIDS AND HIV (This list would probably be most effective when presented in a vertical chart, the misconception on the left, the correct answer on the right.) 1)The AIDS virus can be transmitted through saliva, sweat, tears, urine or feces; also through deep kissing. 1) HIV can ONLY be transmitted through four bodily fluids: blood, semen, vaginal secretions and breast milk--and can also be transmitted from a mother to her child before birth, during birth, or while breast feeding. The exchange of saliva through kissing is no-risk, unless the saliva has blood in it and both you and your partner are bleeding in the mouth simultaneously. 2) HIV may also be transmitted through casual contact with an infected person. 2) You can’t get infected from toilet seats, phones or water fountains. The virus can’t be transmitted in the air through sneezing or coughing. You can’t get HIV from sharing utensils or food or from touching, or hugging. HIV dies after being exposed to the air. Therefore, touching dried blood on a shaving blade, a toothbrush or a bathroom counter top is no risk. In any case, unbroken skin is impermeable, like a rubber raincoat, and cannot absorb the virus whether it’s alive or dead. Blood transfusions and medical procedures in the U.S. are safe. Giving blood is completely risk-free. The chance of getting HIV from dentists or other health care providers is too low even to measure.You can’t get it from mosquitoes or other insect or animal bites. 3) Oral sex is just as risky as vaginal or anal intercourse. 3) Although not 100% risk-free, oral sex is considered a low-risk activity,except if: you have bleeding gums, recent dental work, open sores such as a herpes lesion, any cut, blister, or burn in the mouth, or if you’ve just brushed or flossed your teeth. Also, oral sex with an infected woman is riskier if she is having her period, since menstrual blood can contain HIV. Overall, latex barriers, (such as condoms or dental dams) used during oral sex reduce the transmission of not just HIV, but other sexual transmitted diseases. 4) Animal skin, latex and polyurethane condoms are all equally effective in preventing HIV infection and you can use ANY lubrication on the condom desired. 4)Only latex or polyurethane condoms may be used, as HIV can pass through an animal skin condom. With latex condoms, only water-based lubricants--like K-Y jelly or H-R jelly--may be used. No lubricants with oil, alcohol, or grease are safe.Petroleum jelly,Vaseline, Crisco, mineral oil, baby oil, massage oil, butter and most hand creams can weaken the condom and cause it to split. However, with polyurethane condoms, petroleum-based lubricants can be used. 5) Women have to rely on men using condoms during intercourse to protect themselves against HIV. 5) Women may employ the “female condom,” a plastic sheath that can be inserted in their vaginas and used for protection against HIV. It can be inserted up to 8 hours before sex, has rings at both ends to hold it in place and can be lubricated with oil-based lubricants that stay wet longer. In addition, women can carry conventional condoms for their male partners’ use. 6) If a woman is HIV-positive, her offspring will automatically be born infected with HIV. 6) With no medical treatment taken, about 25% of HIV-positive women will give birth to infants who are also infected. However, the use of anti-HIV medications has resulted in a significant decrease of mother-to-child transmission of HIV in utero and during delivery to less than 5%. (NYT 10/19/ 99]. 7) AIDS is fundamentally a gay disease contracted by white males. 7) Recent data compiled by the Centers for Disease Control and Prevention indicate that young gay Hispanic and African-American men and heterosexual women are the fastest growing segment of the population being infected with HIV. Women now account for 43% of all HIV infected people over age 15. [NYT 11/24/98] African-American and Hispanic women account for more than 76% of AIDS cases among women in the U.S. 8) Heterosexual men are not really at risk for contracting HIV, even if they don’t use condoms. 8) The inside opening of the penis is composed of highly-absorbent, sponge- like mucous membrane tissues, which can provide a route for HIV-infected vaginal secretions or blood to enter the bloodstream. Proper condom use protects men from infection. 9) The AIDS epidemic is largely over because new AIDS medications like protease inhibitors and others have turned AIDS into a chronic, not a terminal disease. 9) In the U.S., AIDS is the fifth leading cause of death for people 25-44 years old. Roughly half of all those infected with HIV in the U.S. are not receiving any medications or medical care. AIDS now kills more people worldwide than any other infection, including malaria and tuberculosis.[NYT 11/24/98] In 1998 alone, 2.5 million people died of AIDS worldwide. 13.9 million people have died since the virus was discovered in 1981. 10) If you think you’ve been exposed to HIV through unprotected sex, you can take an HIV antibody test 2 weeks later and get an accurate result. 10) The standard “window” or waiting period remains a full 3 months. However, because the widely-used HIV antibody tests (The ELISA and Western Blot) have become so sensitive, about 95% of people will procure an accurate result 4-6 weeks after a possible exposure to the virus. * * * * [Note:The information stated above was reviewed for medical accuracy by Dr. Todd J. Yancey, an infectious disease specialist practicing in New York City and affiliated with New York Presbyterian Hospital, NY, Cornell Campus.] THE CHILD LIFE PROGRAM “Mommy takes a lot of medicine and Mommy’s really tired sometimes and she can’t take you to the park as much as she used to. It’s not that I don’t love you...and that I don’t want to...but Uncle Jack’s going to take you to the park today.” --A mother living with AIDS, a client at GMHC, talking to her 6-year- old son. In New York City alone, 28,000 children have been orphaned by AIDS since the epidemic began [NYT 12/13/98] GMHC’s unique Child Life Program serves HIV-infected parents and their children--who may, or may not, be infected with the virus. “We help families strengthen their ability to cope, relieve the pressure of parenting with support services, and teach parents how to talk to their kids,” says Child Life Program Coordinator Alison Ferst. “Unfortunately, should a parent or child be sick enough to be facing death, we also help them walk through it with grace and dignity---as opposed to feeling alone, isolated and frightened. “We also encourage sick parents to make stable legal plans for their children who may be left behind,” adds Ferst, “and to have disclosure conversations with the children in advance, so you don’t have a child standing at her mother’s funeral, not sure where she’s going next.” When an HIV-infected Mom arrives at GMHC to have lunch, attend a support group, consult with a lawyer, or access the acupuncture clinic, she can leave her children in a spacious playroom, decorated with fanciful murals and a giant tree hand-painted by the famed children’s story writer and illustrator, Maurice Sendak, who donated his art. [see photos] The program provides: child- sitting, nutrition services, a food pantry, art and magic classes, and recreational trips--church picnics, seasonal apple-pumpkin picking, amusement parks, zoos, museums, beaches. Also: homework help sessions, holiday parties, hospital visits, summer sports and weekly support groups for HIV- positive parents and their HIV-negative children. This unique program also features: Cooking classes for kids who sometimes prepare meals for sick parents; Pediatric Buddies, GMHC adult volunteers who play with sick children and also assist with family chores; Fun With Feelings Support Group, Friday Evening Family Time, Birthday parties, and a Holiday Gift Drive. “Children infected or affected by AIDS,” concludes Ferst, “want to be like other kids: They want to play with their friends, want to know that someone will always take care of them, want to know they’re not alone, and often wonder if it’s their fault when Mom or Dad gets sick.” These children need a helping hand and any of us can provide one. penis enlagement cream best penis enlagement pnis enlargement forum penis enlargment surgeries penile enlargment surgery photo easy enlargment free penis surgery way vigrx ingredient top rated penis enlagement pills pnis enlargement surgery picture

Sex is one of the most important feelings in the world, and which is core to every relation in order to restore generation. But, sometimes, problems like impotence can deteriorate one’s sex life badly. But, now as medical advancement has become too broad, cure of impotence is easily available. Kamagra is one among various medicines which helps people suffering from erectile dysfunction and facing problem in keeping an erection when sexually aroused. Kamagra is a medicine to treat erectile dysfunction (ED). The active ingredient in it is citrate salt of Sildenafil. This sexual enhancement drug functions by increasing blood flow to penis. Increased blood flow leads to penis erection in a patient with erectile dysfunction. Kamagra is a preferred alternative to Viagra. It is generic version of treatment for impotence and erectile dysfunction in a male. It is offered in 100mg tablet form, soft tabs and three flavours of Oral Jelly. The oral jelly offers an alternative to tablet use. While using Kamagra, it is imperative to be aware that this drug doesn't give instant erection. It's a drug that is used to improve penile erection in men with erection problems. One should be sexually aroused or stimulated to get an erection. So it is advised to use Kamagra 60 minutes before having sex. The normal dose for Kamagra is one dose a day. But, under the guidance of doctor, one can increase his intake. The effects of the drug generally last around 4 hours. If in case erection does not go away after four hours, one should consult his doctor. User of Kamagra drug must be aware of its side effects which might occur during its usage. Some effects of this drug are, flushing, headache, stomach upset and blurring of vision etc. One must consult his doctor before taking this drug, and should try his utmost to take all possible precautions while using. To avail this drug easily, going online is the best way. Numerous online agents are here to offer some lucrative discount, besides saving plenty of time . natural penis enlargement pill does vigrx really work pnis enlargement excercises plastic surgery penis enlarement penis enargement procedure free penis elargement video cheap penile enlargment penis enlargment pic before and after pnis enlargement surgery picture

Male sexual dysfunction is one of the most common health problems affecting men and is more common with increasing age. Chronic ED affects about 5% of men in their 40s and 15-25% of men by the age of 65. Transient ED and inadequate erection affect as many as 50% of men between the ages of 40 and 70. In around 95% of the cases, a suitable treatment can be found. Erectile dysfunction is treatable at any age, and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments for erectile dysfunction. Viagra, Levitra and Cialis Currently, there are three oral medications approved by the Food and Drug Administration (FDA) for the treatment of erectile dysfunction: sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis). All these agents block the enzyme phosphodiesterase type 5 (PDE-5) and belong to a class of drugs called phosphodiesterase (PDE) inhibitors. Viagra was the first and is probably the most famous of the three PDE-5 inhibitors used to treat erectile dysfunction. Viagra was approved as an effective agent for treating erectile dysfunction in March 27, 1998. Viagra is manufactured by Pfizer, Inc. Levitra was the second PDE-5 inhibitor to come to market in the United States, and it was approved by the FDA in August 19, 2003. Levitra is manufactured by Bayer Pharmaceuticals Corporation. Cialis was the third PDE-5 inhibitor to come to market and was approved by the FDA at the end of November 21, 2003. Cialis is manufactured by Lilly ICOS LLC. The major advantage of PDE-5 inhibitors is that they do not cause an erection at inappropriate times, because they act only in response to sexual stimulation. If there is no sexual stimulation drug remains in the background. All three are taken orally prior to planned sexual activity, acting to increase blood flow in the penis in response to sexual stimulation. However, there are important differences between the three, differences that could influence safety, specificity, duration of action, adverse effects, and ultimately, public acceptance within this class of drug. Mechanism of Action PDE-5 inhibitors do not directly cause an erection of the penis, but they alter the body's response to sexual stimulation by enhancing the effect of the nitric oxide, a chemical that is normally released during stimulation. Nitric oxide causes relaxation of the muscles in the penis, which allows for better blood flow to the penile area. Effectiveness of PDE-5 Inhibitors All 3 PDE-5 inhibitors have demonstrated excellent efficacy. Viagra, at 84%, is slightly more effective than Cialis at 81% and Levitra at 80%. Pharmaceutical Forms, Onset of Action and Duration of Effect Viagra and Levitra differ only minimally in terms of their structure, while Cialis differs markedly from Viagra and Levitra in terms of its molecular structure, which is also reflected in pharmacokinetic differences. Viagra: 25 mg, 50 mg 100 mg tablets Onset of action: 30 minutes (effect delayed if taken with food) Duration of action: 4 to 5 hours Levitra: 2.5 mg, 5 mg, 10 mg, 20 mg tablets Onset of action: 25 minutes (effect delayed by fatty meal) Duration of action: 4 to 5 hours Cialis: 5 mg, 10 mg, 20 mg tablets Onset of action: 16-45 minutes (effect NOT delayed by food) Duration of action: 36 hours All three drugs require sexual stimulation to be effective. Viagra should be taken on an empty stomach it works better if you do not eat a high-fat meal around the time you take it. Levitra may be slightly less effective if you eat a high-fat meal, but a moderate-fat meal does not reduce its effectiveness. Cialis works without regard to what you eat. Viagra and Levitra have similar half-lives, and onset and duration of action. Cialis has a slower onset of action and longer duration of action, which is attributed to its longer half-life. Patients who wish for spontaneity may opt for Cialis, which may allow for successful intercourse up to 36 hours postdose, even though it takes longer to reach peak effect. The considerably longer duration of effect for Cialis will likely allow less frequent dosing and greater impulsiveness between partners, but also could potentially prolong adverse effects. Dosage The recommended dose for Viagra is 50 mg, and the physician may adjust this dose to 100 mg or 25 mg, depending on the patient. The recommended dose for either Levitra or Cialis is 10 mg, and the physician may adjust this dose to 20 mg if 10 mg is insufficient. A lower dose of 5 mg is available for patients who take other medicines or have conditions that may decrease the body's ability to use the drug. Levitra is also available in a 2.5 mg dose. None of these PDE-5 inhibitors should be used more than once a day. Possible Side Effects Although all three drugs are generally well tolerated, side effects are still possible. Most common side effects: Viagra: facial flushing, headache, indigestion Levitra: facial flushing, headache Cialis: headache, indigestion Less Common Side Effects: Viagra: altered vision, dizziness, nasal, congestion Levitra: indigestion, nausea, dizziness, nasal congestion Cialis: back pain, muscle aches, nasal congestion, facial flushing, dizziness Precautions and Contraindications All PDE-5 inhibitors are absolutely contraindicated in persons who take organic nitrates. Alpha-blockers Viagra has precautionary labeling advising against taking 50 mg or 100 mg doses within four hours of taking a alpha-blocker. The 25 mg dose of Viagra has not been shown to significantly decrease blood pressure and in patients who take 25 mg of Viagra, use of any of the alpha-blockers is considered safe. Levitra is contraindicated in patients taking alpha-blockers. Cialis is contraindicated in patients taking alpha-blockers, except for tamsulosin (Flomax). Since both Viagra and Levitra have moderate vasodilatory and hypotensive effects, they should not be given in the presence of marked arterial or orthostatic hypotension, and should only be administered with caution in aortic stenosis or hypertrophic obstructive cardiomyopathy. Men who have had a heart attack or stroke within the past 6 months and those with certain medical conditions (e.g., uncontrolled high blood pressure, severe low blood pressure or liver disease, unstable angina) that make sexual activity inadvisable should not take Cialis. Dosages of the drug should be limited in patients with kidney or liver disorders. Conclusions The differences between the 3 drugs are not great. All appear to be effective and safe. Levitra has less side effects compared to Viagra and lasts about the same time as Viagra in the body. Cialis has few side effects and lasts longer in the body. This allows increased spontaneity and less frequent dosing than either Levitra or Viagra. However, the longer half-life of Cialis imposes increased risk for drug interactions. do pnis enlargement pills work natural penis enlargment and lengthening penile enlargment surgery natural penis enargement technique cheap penis enlargement vimax penis enlargement surgery picture does penis enlagement work com enargement penis penis pump pnis enlargement surgery picture

Crimes committed by women differ from criminality done by men by the nature of a crime, and its’ consequences, as well as by methods, crime weapon, and choice of victim. It is hard to object that crimes committed by women have more emotional characteristic then those committed by men. Women are far less likely than men to commit crime and this pattern seems to hold true all over the world. Only 19% of known offenders are women. Nevertheless, women are far more likely to experience domestic violence. Two women are murdered every week by their current or former partner and 44% of violent incidents against women were domestic. According to the stats of female offenders in prison most were in for drug, theft and handling stolen property offences, this accounted for 60% of known female offenders. 15% of sentenced female prisoners had previously been admitted to a psychiatric hospital and over 40% of sentenced women prisoners have been reported as being dependent on drugs in the year before coming to prison. An estimated 20% of women in prison have spent some time in care. Until recently, criminal behavior has been mostly discussed from a male perspective and has been about men, for men and by men. Various theories have shown why some women commit fewer crimes than males. Lombroso believed that women were evolutionarily inferior to men, a lower form of life. He hypothesized that the “natural” female criminal was perceived to have the criminal qualities of the male plus the worst characteristics of women. This appeared to indicate that criminal women were genetically more male than female, therefore biologically abnormal. Freud (1925) offered an explanation of female crime that, women are universally not able to fully resolve the Oedipus complex, have a great deal of need for the approval of men, so as a rule they do not risk upsetting them by committing crimes. The exceptional female who does offend is seen as suffering from extreme penis envy and, in a desire to be a man, takes an aggressive, non-conforming attitude that may result in criminal behavior. In addition, scientists have suggested that the brain differences between male and female is an essential reason why women are more likely to stay out of harm’s way. Current research has demonstrated that females, on average, have a larger deep limbic system than males. Due to this, women are more in touch with their feelings; they have an increased ability to bond and are connected to others. Furthermore, some criminologists argue that women seldom have the opportunity to be involved in organised and corporate crime of which many men are guilty but not convicted. In terms of the ratio of conviction between females and males, where women have similar opportunities for criminal behavior in relation to males, their respective patterns of crimes appear to be broadly similar. However, while, in theory, women have similar opportunities as men to commit crime these may be limited by other factors. Such as employment related crime, as fewer women than men work, less opportunity exists. Women are also more-likely than men to have primary responsibility for child-care, which restricts opportunities for various types of criminal behavior. Female crime is often explained as women’s usual response to lack of opportunity and school failure. It is as a desperate attempt to escape from poverty rather than, as in the case of many men, an aggressive response to their social situation. Courts may deal more-leniently with females, but when women commit crimes that go against male stereotypes of femininity, such as violence, women tend to be more harshly punished than men. As much female crime is petty, non-violent, like shop-lifting and prostitution, women not imprisoned as often as men. Moreover, female forms of crime may be “less visible” to the police. This is especially true in relation to crimes of violence, where women tend to be the victims rather than the perpetrators. A rather different approach to the issue of gender and crime is society’s concept of masculinity that leads to criminal behavior in boys and men. To be masculine means to assert authority and control over others, to be individualistic, aggressive and independent. To sum up, the relationship between gender differences and criminal behavior is complex and varied, there are no simple answers. A number of factors must be taken into account, and the environmental influences and cultural traditions can be seen as the most important ones.