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These thoughts may take the form of excessive worry about contamination by germs medicine number lookup generic calcitriol 0.25 mcg on line, chemicals treatment of tuberculosis purchase 0.25mcg calcitriol with mastercard, radiation 4 medications list at walmart generic 0.25 mcg calcitriol with amex, and so on. Other obsessions include concerns about whether doors were left unlocked or appliances were turned off. Compulsions are undesired actions that people find themselves doing over and over in order to temporarily reduce anxiety. Common compulsions include excessive hand washing, over- cleaning, hoarding objects, arranging objects in a particularly rigid manner, checking and rechecking things (such as locks), and creating strict rituals such as counting stairs or put- ting on clothing in the exact same order every day. Lots of people experience a few minor obsessions or compulsions, and that’s no problem. You can find considerably more information about this particular problem in Overcoming Anxiety For Dummies (Wiley). You should only attempt the strategies that follow if your problems are fairly mild; consider using this book in collaboration with your therapist or counselor. However, as you can see in the following sections, there are a few minor differences. Beating obsessions Because obsessions consist of thoughts or mental images, exposure for obsessions typically takes place in the imagination. Also, imagination is the best approach because many obses- sions really couldn’t or shouldn’t be acted out. For example, if your obsession involves strange sexual perversions, we don’t recommend that you “expose” yourself to them! In fact, if you have obsessions that involve unacceptable sexual activities or physically hurt- ing yourself or others, you should consult a mental health professional rather than attempt imaginal or real exposure techniques. Most obsessions are focused on a single idea, so you may not have a Staircase of Fear to climb. However, you can still utilize exposure to help you deal with many different obses- sions. Rank how upsetting the thought or image is to you on a scale of 0 (no upset) to 100. Repeat the thought or image over and over and over and over and over and over and over and over and over and over and over (oops, we’re getting a tad compulsive here aren’t we? Continue repeating the thought or image for 20 to 30 minutes or as long as it takes to reduce your level of upset (in Step 2) by at least 10 to 20 points. Re-rate your thought or image on the same scale (0 [no upset] to 100 [totally disturbing]). They often try to immediately expunge obsessive thoughts and images from their minds when they occur. The problem with that approach is that attempting to suppress thoughts only makes them surface more frequently. Chapter 9: Facing Feelings: Avoiding Avoidance 147 Treating compulsions Treating compulsions, like the treatment of other anxieties and fears, involves exposure as the first step. You gather materials for a Staircase of Fear, arrange your materials into an actual staircase, and start your climb. The only difference in the treatment of compulsions is that you have to do one extra thing: Not only do you expose yourself to the problematic activities or items, but you also must stop yourself from engaging in the compulsive behav- ior. The following example shows you how this treatment procedure works for a particular compulsion. However, the compulsion is ruining her life by unnec- essarily taking up huge amounts of time. In Worksheet 9-16, you see the partial results of her Climb to the Top Exercise, her repeated exposures to problematic events and activities while not washing her hands. In fact, Gina makes a con- certed effort not to wash for at least an hour after the exposure. Worksheet 9-16 Gina’s Climb to the Top Exercise Activity (Exposure without the Anxiety Ratings: 0 (no fear) to 100 (terrified) compulsion) Handling garments at a 30, 20, 15, 10: This was sort of gross at first clothing store because I kept thinking about all the other people who touched them before me.

Abruptly stopping use of these drugs can cause withdrawal symptoms therefore they I should be weaned off slowly (reduce dosage and take every other night) under doctor supervision treatment esophageal cancer order calcitriol 0.25mcg otc. In most cases insomnia is temporary and can be improved with good sleep hygiene habits medications on carry on luggage cheap 0.25 mcg calcitriol with amex. Dietary Recommendations Foods to include: • A small snack before bed of food that contains tryptophan (an amino acid) stimulates the release of serotonin medicine website discount calcitriol 0.25mcg with amex, a brain chemical that facilitates sleep. Foods to avoid: • Caffeine (coffee, tea, pop, and chocolate) can affect sleep quality, and should be avoided eight hours before bed. Leaving only five or six hours may make you feel stressed and affect your ability to fall asleep. Top Recommended Supplements Melatonin: A hormone that is naturally secreted by the brain in response to darkness and regulates sleep/wake cycles. Supplements reduce the time needed to fall asleep, reduce nighttime wakening, and improve sleep quality. It is particularly helpful for those who work shifts or travel to different time zones (jet lag). Valerian: An herb that is widely used for insomnia; it improves many aspects of sleep and is non-addictive. Some formulas combine valerian with hops, passion flower, and other herbs that promote relaxation. Complementary Supplements Calcium and magnesium: Important minerals for muscle and nervous system relaxation. Note: Supplements that promote sleep should be used only occasionally, as it is important to address the underlying factors causing insomnia. It is also one of the most common reasons for a doctor’s appointment, especially among women. It is characterized by abdominal pain or cramping and changes in bowel function, such as bloating, gas, diarrhea, and constipation, which makes it a sensitive topic to discuss. The walls of the intestines are lined with layers of muscle that contract and relax as they move food from your stomach through your intestinal tract to your rectum. With irritable bowel syndrome, the contractions are stronger and last longer, causing food to be forced through your intestines more quickly. In some cases, the opposite occurs and food passage slows, causing dry, hard stools and constipation. Although there is no known cure, there are a number of dietary strategies, supplements, and lifestyle measures that can greatly help to manage this condition. Many people find that their symptoms worsen when they eat certain foods, such as milk, caffeine, wheat, alcohol, artificial sweeteners, or food preservatives. Drugs that regulate gut motility, namely Dicetel (pinaverium bromide) and Modulon (trimebutine maleate), are often prescribed. Anti-diarrheal medications, such as Imodium (loperamide), and laxatives should be used cautiously and only occasionally when under recommendation by your doctor. Fibre supplements, when taken along with adequate fluids, can help control con- stipation and improve bowel function. Anti-spasmodic drugs, such as Bentylol (dicyclomine) and Buscopan (hyoscine), block the transmission of nerve impulses and reduce muscle activity, thus slowing the movement of food through the intestinal tract. Add high-fibre foods to the diet gradually to minimize gas and bloating, and drink plenty of water. Recommended fibre-rich foods include oats, brown rice, milled flaxseed, psyllium, and vegetables. Foods to avoid: • Alcohol, caffeinated beverages, and spicy foods stimulate the intestines and can make diar- rhea and pain worse. Sorbitol and mannitol are found mainly in diabetic and low-carbohydrate foods and snacks. The most commonly implicated foods include wheat, dairy, sugar, and artificial sweeteners. Following an elimina- tion diet (see Appendix D) and using a food and symptom diary can help determine which foods should be avoided. Top Recommended Supplements Digestive enzymes: Help improve food digestion and reduce bloating and gas. Look for a full-spectrum enzyme that contains proteolytic enzymes, lipase and amylase. Flaxseed: Ground flaxseed contains insoluble and insoluble fibres that help reduce consti- pation and promote bowel regularity.

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If the ovum isn’t fertilized medicine 50 years ago generic calcitriol 0.25mcg with amex, the corpus luteum dissolves after 10 to 14 days to be replaced by scar tissue called the corpus albicans medicine doctor cheap calcitriol 0.25mcg on line. If pregnancy does occur symptoms your dog is sick discount 0.25mcg calcitriol overnight delivery, the corpus luteum remains and grows for about six months before disintegrating. Only about 400 of a woman’s primordial follicles ever get a chance to make the trip to the uterus. The rest ripen to various stages before degenerating into what are known as atretic follicles (or corpora atretica) over the course of her lifetime. Fallopian tubes, oviducts, uterine tubes — call them what you will, but they’re where the real business of fertilization takes place. Because an egg must be fertilized within 24 hours of its release from the ovary to remain viable. These small, muscular tubes lined with cilia are nearly 5 inches long and, somewhat surprisingly, aren’t directly connected to the ovaries. Instead, the funnel-shaped end, the infundibulum, of a tube is fragmented into finger-like projections called fimbriae that help to move Chapter 14: Carrying Life Forward: The Female Reproductive System 221 the ovum from the body cavity into the tube. When it’s in the tube, where fertilization takes place, the combined motions of both cilia and peristalsis (the same muscle contractions that move food through the digestive system) propel the ovum toward the uterus for implantation. If a fertilized egg implants anywhere else — say in the hollow of the Fallopian tube itself — the pregnancy is referred to as ectopic and the woman must have immediate surgery to remove the developing embryo before it can damage any vital organs. While not attached to the ovaries, the Fallopian tubes are attached to the pear-shaped uterus, which is located between the urinary bladder and the rectum. Its upper, wide end is called the fundus; the lower, narrow end that opens into the vagina is the cervix; and the central region is the body. Endometrium lines the uterus in varying amounts depending on the stage of a woman’s menstrual cycle or pregnancy. This lining is sup- ported by a thick muscular layer called the myometrium, which is under the control of the autonomic nervous system and comes into play when the uterus contracts, such as during labor. Sperm enter and menstrual fluid leaves through the vagina, a muscular tube that connects the uterus with the outside of the body. Lined with a fold of highly elastic mucous membrane, the vagina can enlarge greatly during childbirth. A folded mem- brane of connective tissue called the hymen lies at the opening of the vaginal canal until it is ruptured or torn, often by sexual intercourse but sometimes by other physical activities. At either side of the vaginal opening are two Bartholin glands that secrete a lubricating mucous. On the outside, the female genitalia extends toward the posterior from a mound of soft, fatty tissue called the mons pubis that covers the bone structure called the pubic symphysis. Behind this, the vulva consists of two flaps of fatty tissue: the outer lips, or labia majora; and the smaller, hairless inner lips, the labia minora. Just above where the inner lips join is a small flap of tissue called the clitoral hood, under which is the clitoris, erectile tissue that swells during sexual arousal. Below the clitoris is the exter- nal opening of the urethra and below that is the introitus, the opening to the vagina. Tunica albuginea Secondary follicle Cortex of stroma Germinal epithelium Follicular fluid Primary follicle Cumulus oophorus Graafian follicle Membrana granulosa Blood vessels Medulla of stroma entering Blood clot hilus of ovary Corpus albicans Early corpus luteum Figure 14-1: Mature Corona radiata The ovary. Pituitary Chapter 14: Carrying Life Forward: The Female Reproductive System 223 11. Use the terms that follow to identify the anatomy of the female reproductive system shown in Figure 14-2. Normal human diploid, or 2N, cells contain 23 pairs of homologous chromosomes for a total of 46 chromosomes each. One chromosome from each pair comes from the individual’s mother, and the other comes from the father. Each homol- ogous pair contains the same type of genetic information, but the expression of this genetic information may differ from one chromosome of the pair to the homologous chromosome. For example, one chromosome from the mother may carry the genetic coding for blue eyes, whereas the homologous chromosome from the father may code for brown eyes. Although all the body’s cells have 46 chromosomes — including the cells that eventu- ally mature into the ovum and the sperm — each gamete (either ovum or sperm) must offer only half that number if fertilization is to succeed. As you see in Figure 14-3, the number of chromosomes is cut in half during the first meiotic division, producing gametes that are haploid, or 1N. The second mei- otic division produces four haploid sperms in the male but only one functional haploid ovum in the female.

The deliberation process seems to cancel out many individual juror biases medicine qid proven calcitriol 0.25mcg, and the importance of the decision leads the jury members to carefully consider the evidence itself treatment viral conjunctivitis purchase calcitriol 0.25 mcg visa. Using Groups Effectively Taken together medicine glossary purchase 0.25 mcg calcitriol visa, working in groups has both positive and negative outcomes. On the positive side, it makes sense to use groups to make decisions because people can create outcomes working together that any one individual could not hope to accomplish alone. In addition, once a group makes a decision, the group will normally find it easier to get other people to implement it, because many people feel that decisions made by groups are fairer than are those made by individuals. Yet groups frequently succumb to process losses, leading them to be less effective than they should be. Furthermore, group members often don‘t realize that the process losses are occurring around them. For instance, people who participate in brainstorming groups report that they have been more productive than those who work alone, even if the group has actually not done that [11] well (Nijstad, Stroebe, Lodewijkx, 2006; Stroebe, Diehl, & Abakoumkin, 1992). The tendency for group members to overvalue the productivity of the groups they work in is known as theillusion of group productivity, and it seems to occur for several reasons. For one, the productivity of the group as a whole is highly accessible, and this productivity generally seems quite good, at least in comparison to the contributions of single individuals. The group members hear many ideas expressed by themselves and the other group members, and this gives the impression that the group is doing very well, even if objectively it is not. And, on the affective side, group members receive a lot of positive social identity from their group memberships. These positive feelings naturally lead them to believe that the group is strong and performing well. Provide rewards for People will also work harder in groups when they feel that they are contributing to the group goal than performance. Keep group member Group members will work harder if they feel that their contributions to the group are known and contributions potentially seen positively by the other group members than they will if their contributions are summed identifiable. Maintain distributive Workers who feel that their rewards are proportional to their efforts in the group will be happier and justice (equity). Larger groups are more likely to suffer from coordination problems and social loafing. Group performance is increased when the group members care about the ability of the group to do a Create positive group good job (e. Leaders must work to be sure that each member of the group is encouraged to present the information Improve information that he or she has in group discussions. Groups take longer to reach consensus, and allowing plenty of time will help keep the group from coming to premature consensus and making an unwise choice. The tendency to perform tasks more poorly or more slowly in the presence of others is known as social inhibition. Group process losses can also occur as a result of groupthink, when group members conform to each other rather than expressing their own divergent ideas. It is important to recognize both the strengths and limitations of group performance and use whatever techniques we can to increase process gains and reduce process losses. If the latter, what might you do now in a group to encourage effective group performance? The social facilitation of a simple task: Field tests of alternative explanations. So right it’s wrong: Groupthink and the ubiquitous nature of polarized group decision making. Effects of straw polls on group decision making: Sequential voting pattern, timing, and local majorities. A fundamental principle of social psychology is that although we may not always be aware of it, Attributed to Charles Stangor Saylor. The physical features of other people—particularly their sex, race, age, and physical attractiveness—are very salient, and we often focus our attention on these dimensions. At least in some cases, people can draw accurate conclusions about others on the basis of physical appearance. Youth, symmetry, and averageness have been found to be cross-culturally consistent determinants of perceived attractiveness, although different cultures may also have unique beliefs about what is attractive. We frequently use people‘s appearances to form our judgments about them, and these judgments may lead to stereotyping, prejudice, and discrimination.