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If you aren’t very hungry in the morning 35 mg alendronate otc women's health clinic erina, then have a light meal such as yogurt and berries or a protein shake generic 35 mg alendronate women's health center munster indiana. Don’t skip meals generic alendronate 35mg with amex menstruation color, even if you are trying to lose weight generic alendronate 70 mg women's health vernon nj, since this causes fatigue, poor concentration, sluggish metabolism, and triggers food cravings. Water purified by reverse osmosis is best because tap water may contain high amounts of chlorine, which can be harmful to the stomach and bladder. Keep in mind that intense physical activity and heat exposure increases water loss and the need for more fluids. Fibre is critical because it can reduce your risk of chronic diseases, such as diabetes, heart disease, and certain cancers, plus it keeps your bowels regular, improves blood sugar control, and plays a role in weight man- agement. Dietary fibre is found in fruits, vegetables, beans, seeds, and whole grains such as wheat and oat bran. There is naturally occurring salt in dairy, seafood, vegetables, breads, and grains; however, the majority of our salt intake comes from processed and prepared foods, such as deli meats, condiments (ketchup), dressings and sauces (soy), and snack foods (chips, pretzels), so cut back on these foods and season food with herbs or flavoured oils and vinegars rather than using the salt shaker. It is also important for nerve and muscle function and supports cell structure and integrity. To boost potassium intake, eat more bananas, oranges and orange juice, avocado, peaches, and tomatoes. Excessive sugar intake has been linked to diabetes, obesity, elevated triglycerides, tooth decay, poor immune function, emotional swings, and other health problems. Refined (white) sugar contains propyl alcohol, which cannot be broken down in the body. Accumulation of this chemical in the intestines can disrupt diges- tion and be toxic to the body. The World Health Organization recommends restricting consumption of added sugar—including sugar from honey, syrups, and sweetened drinks/juices—to less than 10 percent of calories. Fruit contains natural sugar (fructose), but it also provides vitamins, minerals, and fibre. Artificial sweeteners such as aspartame and saccharin should be avoided because they have been linked to headaches, mental illness, brain damage, and cancer. It can provide up to 300 times the sweet- ening power of sugar without the calories. It is also highly addictive—abrupt withdrawal, even if you drink only one cup of coffee daily, can cause headaches, irritability, and fatigue within hours of missing your usual drink. Black tea and green tea contain approximately 35–45 mg, but the effects of caffeine are blunted by an amino acid (theanine), which has a calming effect. Alcohol and what it is mixed with floods the body with excess calories, which can contribute to weight gain. Next, work on slowly making healthier food choices, such as cutting out fast food, eating more vegetables, drinking more water, or limiting your sugar or caffeine intake. By gradually making changes, you will be more likely to stick with your nutritional plan. Take time to plan your meals, so that you are not reaching for fast food or un- healthy snacks. By following a healthy diet you will notice that you have more energy, a better mood, and an overall improved sense of well-being. You will notice recommendations throughout this book for exercise, as virtually every parameter of health can be im- proved with exercise. Numerous studies have shown that regular exercise cuts your risk of chronic, debilitating diseases such as heart disease (by reducing cholesterol and blood pressure), osteoporosis, cancer, diabetes, and prevents premature death! It is also essential to develop and maintain both a healthy body weight and muscular strength. Plus it offers emotional benefits, as exercise reduces stress and anxiety, and improves sleep and overall emotional well-being. With today’s busy, fast-paced lifestyle, exercise usually falls to the bottom of the priority list while it should be at the top. Lack of time is the most common excuse, so below I show you how to boost the activity in your lifestyle. Many people find they don’t have the energy to exercise, yet they don’t realize that exercise actually gives them more energy. Some are concerned about health problems (arthritis and back problems), yet exercise can actually benefit and improve these problems. Regardless of your health status, age, or current fitness level, there are activities that you can do to improve your health. So now that we have put aside the common obstacles, let’s take a look at the various types of exercise and how to build them into our lifestyle. Examples include brisk walking, swimming, biking, aerobics, dancing, and rollerblading. These exercises help burn calories, and also improve car- diovascular and respiratory (lung) function by conditioning the lungs to use more oxygen while increasing your heart’s efficiency (decreasing heart rate). If you are currently not exer- cising, then start slowly—five minutes on your first day and then increase gradually. Morning is best because you will have more energy and will continue to burn calories for several hours afterward. To determine the intensity level for optimal cardiovascular (and fat-burning) ben- efits, check your heart rate. The activity should increase your heart rate to 60–80 percent of your maximum rate for 30 minutes or longer. Beginners should aim for 60 percent, while more advanced exercisers can aim for 80 percent. For example, if you are 40 years old: 220 – 40 = 180 60–80 percent of 180 = 108–144 You should keep your heart rate between 108 and 144 beats per minute for 30 minutes. Other ways to gauge your intensity level are: Breath sound check: Your breathing should be heavier and audible. For example, when a brisk 30-minute walk becomes easy, add hand weights or walk on hills. This can be achieved with weightlifting, ex- ercise machines, bands/tubes, using your own body weight, or lifting heavy objects. These activities are particularly important for older adults because they help prevent and slow the muscle and bone loss that occurs with aging. Try to spend 20–30 minutes three to four times a week doing resistance activities. For example, do chest and triceps on Monday, back and biceps on Wednesday, and legs and shoulders on Friday. Pick two exercises per body part and do two or three sets of 8–12 repetitions of that exercise. This is largely due to a very powerful amino acid in protein—essential to early muscle repair—called leucine. Stretch slowly and gently, breathe deeply, and hold each position for at least 10 seconds.

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At either side of the vaginal opening are two Bartholin glands that secrete a lubricating mucous purchase 70 mg alendronate otc women's health of westerly. On the outside buy generic alendronate 70 mg online menstruation yeast infections, the female genitalia extends toward the posterior from a mound of soft discount 35mg alendronate with mastercard womens health 5k running plan, fatty tissue called the mons pubis that covers the bone structure called the pubic symphysis generic 70 mg alendronate mastercard menstrual tracker cycle calendar. 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. When fertilization occurs, the new zygote will contain 23 pairs of homologous chromosomes for a total of 46 chromosomes. The zygote then proceeds through mitosis to produce the body’s cells, distributing copies of all 46 chromosomes to each new cell. Zygote Chapter 14: Carrying Life Forward: The Female Reproductive System 225 Think you’ve conquered this process? Fill in the blanks to complete the following sentences: Meiosis produces sperm and ovum, which contributes to making a 41. The number of chromosomes is cut in half during the first meiotic division, producing gametes that are 45. But that doesn’t mean that sexual intercourse outside that time frame can’t lead to pregnancy. Research indicates that spermatozoa can survive up to seven days inside the uterus and Fallopian tubes. If a sperm is still motile — that is, if it’s still whipping its flagellum tail — when an ovum comes down the tube, it will do what it was made to do and penetrate the ovum’s membrane. When the sperm penetrates the ovum, it releases enzymes that allow it to digest its way into the ovum, leaving its flagellum behind. After that first sperm penetrates, the mem- brane instantly solidifies around the ovum, preventing any other sperm from getting inside. Over the next three to five days, the zygote moves through the Fallopian tube to the uterus, undergoing cleavage (mitotic cell division) along the way: Two cells become four smaller cells, four cells become eight smaller cells, and then those eight cells become a solid 16-cell ball called a morula. After five days of cleavage, the cells form a hollow ball of approximately 32 cells called a blastula, or blasto- cyst. The inner hollow region is called the blastocoele, and the outer-layer cells are called the trophoblast. Within three days of its arrival in the uterine cavity (generally within a week of fertiliza- tion), the blastocyst implants in the endometrium, and some of the blastocyst’s cells — called totipotent embryonic stem cells — organize into an inner cell mass called the embryonic disk, or embryoblast. Over time, the embryonic disk differentiates into the tis- sues of the developing embryo (see Figure 14-4). Cells above the disk form the amniotic cavity, and those below form the gut cavity and two primitive germ layers. The layer near- est the amniotic cavity forms the ectoderm while that nearest the gut cavity forms the endoderm. Between the two layers, additional ectodermal cells develop to form a third layer, the mesoderm. The ectoderm forms skin and nerve tissue; the mesoderm forms bones, cartilage, connective tissue, muscles, and organs; and the endoderm forms the linings of the organs and glands. To keep these terms straight, remember that endo– means “inside or within,” ecto– means “outer or external,” and meso– means “middle. In the fourth week of development, the embryonic disk forms an elongated structure that attaches to the developing placenta by a connecting stalk. A head and jaws form while primitive buds sprout; the buds will develop into arms and legs. During the fifth through seventh weeks, the head grows rapidly and a face begins to form (eyes, nose, and a mouth). After eight weeks of development, the embryo begins to have a more human appearance and is referred to as a fetus. The outer cells of the embryo, together with the endometrium of the uterus, form the placenta, a new internal organ that exists only during pregnancy. The placenta attaches the fetus to the uterine wall, exchanges gases and waste between the maternal and fetal bloodstreams, and secretes hormones to sustain the pregnancy. Chapter 14: Carrying Life Forward: The Female Reproductive System 227 Cleavage 8-cell stage 4-cell stage 2-cell stage Zygote Morula Egg nucleus Sperm nucleus Corpus luteum Sperm cells Blastocyst Maturing follicle Figure 14-4: Beginning of Ovary implantation Egg cell Embryonic develop- Fertilization ment. Now that you’ve refreshed your memory a bit about how babies are made (beyond the birds and bees talks), try the following practice questions: 49. Growing from Fetus to Baby Pregnancy is divided into three periods called trimesters (although many new parents bemoan a postnatal fourth trimester until the baby sleeps through the night). The first 12 weeks of development mark the first trimester, during which organogenesis (organ formation) is established. During the second trimester, all fetal systems continue to develop and rapid growth triples the fetus’s length. The overall growth rate slows in the third trimester, but the fetus gains weight rapidly. At the end of the second month (when the terminology changes from “embryo” to “fetus”), the head remains overly large compared to the developing body, and the limbs are still short. The circulatory (cardiovascular) system supplies blood to all the developing extremities, and even the lungs begin to practice “breathing” amniotic fluid. By the end of the third month, the external genitalia are visible in the male (ultrasound technicians call this a “turtle sign”).

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This question is not always easy to answer because there is no clear demarcation between ―normal‖ and ―abnormal‖ behavior alendronate 35mg on line pregnancy 5 weeks 2 days. Most generally generic alendronate 70 mg line pregnancy week 6, you will know that you or others need help when the person‘s psychological state is negatively influencing his or her everyday behavior purchase 70 mg alendronate amex women's health center in orlando, when the behavior is adversely affecting those around the person buy alendronate 70mg low cost women's health options edmonton, and when the problems continue over a period of time. Often people seek therapy as a result of a life-changing event such as diagnosis of a fatal illness, an upcoming marriage or divorce, or the death of a loved one. But therapy is also effective for general depression and anxiety, as well as for specific everyday problems. Begin in your school, community, or church, asking about community health or counseling centers and pastoral counseling. You‘ll probably be surprised at how many people have been to counseling, and how many recommend it. Be sure to ask about the degrees that the therapist has earned, and about the reputation of the center in which the therapy occurs. If you have choices, try to find a person or location that you like, respect, and trust. Your sessions with the help provider will require discussing your family history, personality, and relationships, and you should feel comfortable sharing this information. Remember also that confronting issues requires time to reflect, energy to get to the appointments and deal with consequential feelings, and discipline to explore your issues on your own. The bottom line is that going for therapy should not be a difficult decision for you. All people have the right to appropriate mental health care just as they have a right to general health care. Just as you go to a dentist for a toothache, you may go to therapy for psychological difficulties. Furthermore, you can be confident that you will be treated with respect and that your privacy will be protected, because therapists follow ethical principles in their Attributed to Charles Stangor Saylor. The following provides a summary of these principles as developed by the American Psychological [3] Association (2010). Psychologists do not accept as therapy clients/patients persons with whom they have engaged in sexual intimacies, nor do they have sexual intimacies with former clients/patients for at least 2 years after cessation or termination of therapy. Psychodynamic Therapy Psychodynamic therapy (psychoanalysis) is a psychological treatment based on Freudian and neo-Freudian personality theories in which the therapist helps the patient explore the Attributed to Charles Stangor Saylor. The analyst engages with the patient, usually in one-on- one sessions, often with the patient lying on a couch and facing away. The goal of the psychotherapy is for the patient to talk about his or her personal concerns and anxieties,allowing the therapist to try to understand the underlying unconscious problems that are causing the symptoms (the process of interpretation). The analyst may try out some interpretations on the patient and observe how he or she responds to them. The patient may be asked to verbalize his or her thoughts throughfree association, in which the therapist listens while the client talks about whatever comes to mind, without any censorship or filtering. The client may also be asked to report on his or her dreams, and the therapist will usedream analysis to analyze the symbolism of the dreams in an effort to probe the unconscious thoughts of the client and interpret their significance. On the basis of the thoughts expressed by the patient, the analyst discovers the unconscious conflicts causing the patient‘s symptoms and interprets them for the patient. The goal of psychotherapy is to help the patient develop insight—that is, an understanding of the unconscious causes of the disorder (Epstein, Stern, & Silbersweig, 2001; Lubarsky & Barrett, [4] 2006), but the patient often showsresistance to these new understandings, using defense mechanisms to avoid the painful feelings in his or her unconscious. The patient might forget or miss appointments, or act out with hostile feelings toward the therapist. The therapist attempts to help the patient develop insight into the causes of the resistance. The sessions may also lead to transference, in which the patient unconsciously redirects feelings experienced in an important personal relationship toward the therapist. For instance, the patient may transfer feelings of guilt that come from the father or mother to the therapist. Some therapists believe that transference should be encouraged, as it allows the client to resolve hidden conflicts and work through feelings that are present in the relationships. The therapist listens while the client talks about whatever comes to mind, without any censorship or filtering. The therapist then tries to interpret these free associations, looking for unconscious causes of symptoms. The therapist listens while the client describes his or her dreams and then analyzes the symbolism of the dreams in an effort to probe the unconscious thoughts of the client and interpret their significance. The therapist uses the patient‘s expressed thoughts to try to understand the underlying unconscious problems. The analyst may try out some interpretations on the patient and observe how he or she responds to them. The patient‘s use of defense mechanisms to avoid the painful feelings in his or her unconscious. The patient might forget or miss appointments, or act out with hostile feelings toward the therapist. The therapist attempts to help the patient develop insight into the causes of the resistance. The unconscious redirection of the feelings experienced in an important personal relationship toward the therapist. For instance, the patient may transfer feelings of guilt that come from the father or mother to the therapist. One problem with traditional psychoanalysis is that the sessions may take place several times a week, go on for many years, and cost thousands of dollars. To help more people benefit, modern psychodynamic approaches frequently use shorter-term, focused, and goal-oriented approaches. In these “brief psychodynamic therapies,‖ the therapist helps the client determine the important issues to be discussed at the beginning of treatment and usually takes a more active role than in [5] classic psychoanalysis (Levenson, 2010). Humanistic Therapies Just as psychoanalysis is based on the personality theories of Freud and the neo- Freudians, humanistic therapy is a psychological treatment based on the personality theories of Carl Rogers and other humanistic psychologists. Humanistic therapy is based on the idea that people develop psychological problems when they are burdened by limits and expectations placed on them by themselves and others, and the treatment emphasizes the person‘s capacity for self-realization and fulfillment. Humanistic therapies attempt to promote growth and responsibility by helping clients consider their own situations and the world around them and how they can work to achieve their life goals. In his book, A Way of Being (1980), Rogers argued that therapy was most productive when the therapist created a positive relationship with the client—a therapeutic alliance. The therapeutic alliance is a relationship between the client and the therapist that is facilitated when the therapist is genuine (i. The development of a positive therapeutic alliance has been found to be exceedingly important to successful therapy.

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For each cheap alendronate 35 mg mastercard menstruation 7 weeks post partum, indicate whether you think the behavior is or is not a psychological disorder order alendronate 35mg on line breast cancer quotes. If you‘re not sure buy alendronate 70 mg fast delivery womens health jber, what other information would you need to know to be more certain of your diagnosis? Charlie believes that the noises made by cars and planes going by outside his house have secret meanings buy alendronate 70mg on line women's health center waco. He is convinced that he was involved in the start of a nuclear war and that the only way for him to survive is to find the answer to a difficult riddle. She sometimes stays in her pajamas for the whole weekend, eating chocolate and Attributed to Charles Stangor Saylor. He worries about driving on the highway and about severe weather that may come through his neighborhood. But mostly he fears mice, checking under his bed frequently to see if any are present. A worshipper speaking in “tongues‖ at an Evangelical church views himself as “filled‖ with the Holy Spirit and is considered blessed with the gift to speak the “language of angels. Talking to ourselves out loud is unusual and can be a symptom of schizophrenia, but just because we do it once in a while does not mean that there is anything wrong with us. It is natural to be depressed, particularly in the long winter nights, but how severe should this depression be, and how long should it last? If the negative feelings last for an extended time and begin to lead the person to miss work or classes, then they may become symptoms of a mood disorder. It is normal to worry about things, but when does worry turn into a debilitating anxiety disorder? And what about thoughts that seem to be irrational, such as being able to “speak the language of angels‖? Are they indicators of a severe psychological disorder, or part of a normal religious experience? Again, the answer lies in the extent to which they are (or are not) interfering with the individual‘s functioning in society. Another difficulty in diagnosing psychological disorders is that they frequently occur together. For instance, people diagnosed with anxiety disorders also often have mood disorders (Hunt, [7] Slade, & Andrews, 2004), and people diagnosed with one personality disorder frequently suffer from other personality disorders as well. Comorbidity occurs when people who suffer from one disorder also suffer at the same time from other disorders. Because many psychological disorders are comorbid, most severe mental disorders are concentrated in a small group of people Attributed to Charles Stangor Saylor. Psychology in Everyday Life: Combating the Stigma of Abnormal Behavior Every culture and society has its own views on what constitutes abnormal behavior and what causes it (Brothwell, [9] 1981). The Old Testament Book of Samuel tells us that as a consequence of his sins, God sent King Saul an evil spirit to torment him (1 Samuel 16:14). Ancient Hindu tradition attributed psychological disorder to sorcery and witchcraft. During the Middle Ages it was believed that mental illness occurred when the body was infected by evil spirits, particularly the devil. Remedies included whipping, bloodletting, purges, and trepanation (cutting a hole in the skull) to release the demons. Until the 18th century, the most common treatment for the mentally ill was to incarcerate them in asylums or “madhouses. In France, one of the key reformers was Philippe Pinel (1745–1826), who believed that mental illness was caused by a combination of physical Attributed to Charles Stangor Saylor. Pinel advocated the introduction of exercise, fresh air, and daylight for the inmates, as well as treating them gently and talking with them. In America, the reformers Benjamin Rush (1745–1813) and Dorothea Dix (1802–1887) were instrumental in creating mental hospitals that treated patients humanely and attempted to cure them if possible. These reformers saw mental illness as an underlying psychological disorder, which was diagnosed according to its symptoms and which could be cured through treatment. Despite the progress made since the 1800s in public attitudes about those who suffer from psychological disorders, people, including police, coworkers, and even friends and family members, still stigmatize people with psychological disorders. A stigma refers to a disgrace or defect that indicates that person belongs to a culturally devalued social group. In some cases the stigma of mental illness is accompanied by the use of disrespectful and dehumanizing labels, including names such as ―crazy,‖ ―nuts,‖ ―mental,‖ ―schizo,‖ and ―retard. On a community level, stigma can affect the kinds of services social service agencies give to people with mental illness, and the treatment provided to them and their families by schools, workplaces, places of worship, and health-care providers. Stigma about mental illness also leads to employment discrimination, despite the fact that with appropriate support, even people with severe psychological disorders are able to hold a job (Boardman, Grove, [11] Perkins, & Shepherd, 2003; Leff & Warner, 2006; Ozawa & Yaeda, 2007; Pulido, Diaz, & Ramirez, 2004). The mass media has a significant influence on society‘s attitude toward mental illness (Francis, Pirkis, Dunt, & Blood, [12] 2001). While media portrayal of mental illness is often sympathetic, negative stereotypes still remain in newspapers, magazines, film, and television. Burger King recently ran an ad called ―The King’s Gone Crazy,‖ in which the company’s mascot runs around an office complex carrying out acts of violence and wreaking havoc. The most significant problem of the stigmatization of those with psychological disorder is that it slows their recovery. People with mental problems internalize societal attitudes about mental illness, often becoming so embarrassed or ashamed that they conceal their difficulties and fail to seek treatment. Stigma leads to lowered self-esteem, increased Attributed to Charles Stangor Saylor. Despite all of these challenges, however, many people overcome psychological disorders and go on to lead productive lives. It is up to all of us who are informed about the causes of psychological disorder and the impact of these conditions on people to understand, first, that mental illness is not a ―fault‖ any more than is cancer. The axes are important to remember when we think about psychological disorder, because they make it clear not only that there are different types of disorder, but that those disorders have a variety of different causes. The axes remind us that when making a diagnosis we must look at the complete picture, including biological, personal, and social-cultural factors. For instance, the disorder of mental retardation can be classified as mild, moderate, or severe. In school, he cannot stay in his seat for very long and he frequently does not follow instructions. Zack has poor social skills and may overreact when someone accidentally bumps into him or uses one of his toys. At home, he chatters constantly and rarely settles down to do a quiet activity, such as reading a book. Symptoms such as Zack‘s are common among 7-year-olds, and particularly among boys. Boys mature more slowly than girls at this age, and perhaps Zack will catch up in the next few years. One possibility is for the parents and teachers to work with Zack to help him be more attentive, to put up with the behavior, and to wait it out.

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