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On a television soap opera, a self-confident, smooth-talking businessman seduces a beautiful but not too bright female secretary. A children’s book describes a warm, caring, stay-at-home mother while depicting father as an adventuresome traveler. A newspaper advertisement for cigarettes shows a husky young man enthusiastically dousing a shapely, squealing female companion with water, her wet T-shirt clinging to her bust — the headlined caption reads “Refresh Yourself.” Each of these .messages tells us something about stereotypes and sexism.In the past twenty-five years, there has been considerable scientific interest in studying differences and similarities between the sexes for a number of reasons. First, various beliefs about sex differences in traits, talents, and temperaments have greatly influenced social, political, and economic systems throughout history. Second, recent trends have threatened age-old distinctions between the sexes. In 1985, for instance, more than half of American women worked outside the home. Unisex fashions in hairstyles, clothing, and jewelry are now popular. Even anatomic status is not fixed in a day where change-of-sex surgery is possible. Third, the women’s movement has brought increasing attention to areas of sex discrimination and sexism and has demanded sexual equality.As a result of these trends, old attitudes toward sex differences, childrearing practices, masculinity and femininity, and what society defines as “appropriate” gender-role behavior have undergone considerable change. Many of today’s young adults have been raised in families where a progressive attitude toward gender roles has been taught or where parents struggled to break away from stereotyped thinking. Thus, there is a continuum of types of socialization today that ranges from old, traditional patterns to more modern versions.*103\342\2*


High blood pressure is not an “all-or-nothing” problem. There are gradations in severity of high blood pressure; the significance of your blood pressure and the response you and your physician should make to alter it depend on how high it is.The diastolic pressure, the systolic pressure, or both may be elevated. Elevated diastolic pressure promotes damage to the kidneys and to blood vessels throughout the body. High systolic blood pressure is associated with a higher risk of coronary artery disease and stroke.Diastolic blood pressure as low as 50 or 60 mm Hg may be considered normal. A diastolic blood pressure of 85 to 89 mm Hg also is normal, but it is at the high end of the normal range. It warrants a recheck in 1 year.Mildly elevated blood pressure is important because it is more likely to progress to higher levels in the future. Thus, a systolic blood pressure of 140 to 159 mm Hg or  a diastolic blood pressure of 90 to 99 mm Hg requires a recheck in just 2 months.Systolic blood pressure of 160 to 179 mm Hg or more or diastolic blood pressure between 100 and 109 mm Hg is moderate hypertension. It should prompt a visit to the physician within 1 month for further evaluation and treatment measures if confirmed.Severe hypertension is a systolic pressure of 180 to 209 mm Hg or a diastolic pressure of 110 mm Hg or higher. This requires urgent evaluation and treatment.*255\252\8*


Each chromosome also carries along its length tiny organs called genes. These are the heredity bearing elements. That’s why many children later have characteristics similar to those of their parents—and in some cases, those of grandparents.Actually, in recent years, by an ingenious scientific skill called ‘gene mapping’, many of the heredity characteristics can be accurately located. Today, by a delicate microscopic system called chromosomal banding, it is possible to isolate each pair of chromosomes in the cells. These may be numbered accurately, from 1 to 22 (plus the X and Y sex fellows).Each gene on each chromosome has a certain position, or home, called its locus. It is believed that about 50000 of these loci exist. Already, about 1200 of them have been identified and pinpointed. For example, if is known where the ABO blood group (actor Is located, where the Rh factor is situated, plus many more. Of course, an enormous amount of work has vet to W done, but the future is promising.So what; you may ask. In the fullness of lime—probably in the year 2000 or after (bin maybe a lot sooner)— doctors will he able to tell an enormous amount about the baby inside a pregnant woman, simply by examining some of its cells under special microscopes.These cells are obtained by a technique called amniocentesis. A needle is placed through the woman’s abdomen into the uterus. It withdraws some of the amniotic fluid in which baby is swimming before birth. Many of the baby’s cells are present in this fluid; and they can be readily examined by experts specially trained in (his field-It may be possible to detect many inherited factors. Some scientists even believe mat a person’s tendency to diabetes, heart disease and even cancer may be picked up months before birth. Also, some even believe that prospective criminals may also be detected. Of course, they are not criminals before birth, but certain research suggests that chromosomal patterns indicate specific characteristics in those who follow a life of crime.So what then? Already amniocentesis can reveal the presence of certain chemicals, such as one called alpha-feto-protein. This indicates a serious brain and nervous system disorder with the infant, rarefy compatible with normal life. Also, chromosomal patterns indicate if the baby is likely to be born with Down’s syndrome, and probably become mentally defective. Other serious anomalies may also be prenatally diagnosed.The parents are then offered the choice of continuing with the pregnancy, or of undergoing what is now called a legal termination. That means the pregnancy is brought to an end— months before bub is born. This method, rightly or wrongly, can offer the parent a way out from having a defective infant which could only cause heartache and heartbreak for many years ahead.To many would-be mothers, this may seem repugnant. But to many others, especially those already burdened with a defective child, it offers hope for the future and a happy way out from further unnecessary misery.In the same way, the principle of gene mapping and of predetermining the probable health future of the baby-to-be, plus selective terminations, may greatly enhance the quality of the family. To be sure, preselection to this extent has not yet arrived. But mark my words, it is a fairly definite probability for the future.Now let’s get back to the fertilised egg. He, she or it (take your pick) is still sitting mid-way along the Fallopian tube, or oviduct, having just met up with a friendly sperm.*18\45\4*


The foregoing process studies of schizophrenia, mania, depression, heroin and alcohol addictions, mental retardation and sociopathy are only part of the immense topic of extreme states. Missing from the present study are investigations of senile psychoses, extreme states in children and comatose phenomena near death.The client of the city often appears to be the identiried patient of the community; he channels its repressed and unrealized psychology. This shadow is like the city’s dream portraying its neglected gods, the hopelessness it will not admit, its withdrawal from superficial communication, its suicidal tendencies, mania, addictions, murderous rage and hypersensitivity. The shadow reminds us of the smoldering revolution we normally perceive only in the dark of night or in the impinging quality of physical symptoms.None of the above ‘diseases’ appears to be purely random or meaningless pathological behavior; each shows, in all situations, a highly ordered, almost mathematical predictability. One goal of this work has been to demonstrate that the cause-and-effect, illness-and-cure philosophy governing much of psychiatric research and treatment is not the only useful way of either observing or treating the effects of the above syndromes. A process oriented paradigm which studies the various channels of human expression and which deals concretely with both individual and collective issues, normal and extreme states, is sorely needed. The                                                        The ClientClient’s Family                                                                                The NeighborsAnalyst                                                                                             Psychologist Social Worker                                                                                  Psychiatrist Psychological Researcher                                                             Psychiatric Researcher Psychiatric Nurse                                                                            Medical Doctor City Authorities Courts Insurance Agencies                                                          Police
The City
Figure :  The mental health teamnew paradigm blends psychiatry with social work, psychology and politics.The mental health professions of the future will, I imagine, see our present psychiatry, psychology, social work, medicine and politics as specialized and divided approaches to extreme states and social and physical problems. One way of bringing these specialized professionals together today is to see them as one team. This team looks approximately as shown in Figure.*139\227\8*


Another effect the virus has on the brain is to cause motor problems. People begin to drop things, their handwriting deteriorates, their hands tremble. Their legs get weak, they have difficulty walking, and they lose their balance easily. Lisa’s husband, whose hobby was carving wood ducks, “couldn’t get the feathers right any more,” Lisa said. For a while he carved things with less detail, and finally he had to stop carving.     For quite a while, these motor problems are extremely annoying but not disabling. Certainly, however, at this point, people stop driving cars. In the later stages of AIDS dementia complex, people can’t use drinking glasses or spoons, can’t dress themselves or button a shirt. People begin to live on one floor of their homes, or mostly in one room. They keep their clothes in one closet, keep food nearby.     Incontinence-A related problem in the later stages of dementia is bathroom behaviors. One effect the virus has on the brain is to reduce the sensation of needing to go to the bathroom. The necessary signals don’t get through, and the brain doesn’t know when the bladder is full. Caregivers describe how accidents often occur; they take the person they’re helping to the bathroom, leaving the person there until he says he’s finished, and help him back to bed—and then he wets the bed. Eventually, people with AIDS dementia become incontinent and lose control of their bladders and bowels. Again, this is a result of changes in the central nervous system and is not something the person has any control over. Caregivers should try not to take this personally. Urinals and bedpans and bedside commodes should be kept nearby. Some people will need diapers, which are readily available in drugstores and hospital supply stores.     This form of advanced AIDS dementia complex is not common, but it requires extraordinary compassion and understanding from caregivers.*149\191\2*


If your child has staring spells or absence seizures—instances where he or she briefly stops and stares, perhaps with some smacking of his lips, picking at his clothes, or confusion—the chances are that he or she has not had just a single episode. These brief spells are usually diagnosed only after many have occurred. Since you first recognize the problem after the fifth, the tenth, or the one hundredth spell, it is obvious that they are likely to continue to recur unless treated with medication.While less frightening than the tonic-clonic seizure, staring spells cause a particular type of anxiety. Parents are worried that they won’t even know when their child is having a seizure. “Is Jane just daydreaming like all children do, or is she having an absence seizure?” “Should I have yelled at Billy for not taking out the garbage? Did he not hear me? Did he disobey? Or was he having an absence seizure?” Since these seizures are brief and subtle and, therefore, difficult to recognize, it is probably even more important to tell neighbors, friends, grandparents, and the school about the spells. This awareness will permit other people to notice when they occur, to be more tolerant of “daydreaming,” and to be a bit more careful when the child is crossing the street or in a situation where loss of awareness could cause harm. Also, because this type of seizure is likely to occur far more frequently than tonic-clonic seizures (sometimes many times each day or several times per week), staring spells are more likely than the single tonic-clonic seizure to interfere with the child’s functioning.Again, it is important to be truthful, but since the child will be unaware of these spells unless someone tells him, the explanation needs to be handled with sensitivity. “You have little blackouts, episodes where you don’t know what is going on. They’re like static on the radio, a brief second or two when you can’t hear the music.” It is important to use terms appropriate for the age and understanding of the child and to make sure that the words you use are not frightening. Better for you to tell him than for him to be asked awkward questions or be told disturbing stories by other children.*183\208\8*


Cosmetic manufacturers spend billions of dollars developing newer and better products. They also spend billions of dollars promoting these products to people who are told they need them. And indeed it seems consumers have come to believe this, judging by the huge sums of money that are now spent on cosmetic products. Not only that, but people it seems are only too willing to believe cosmetic companies who claim that at long last a great breakthrough has occurred. All major developments in skin treatment, however, come from dermatological circles. These advances are later incorporated where possible by cosmetic companies and are marketed aggressively to the general public.The big breakthrough of the 1970s and 1980s was the use of Retin-A as an anti-ageing preparation. There is no doubt that Retin-A is effective for protection against and treatment for photoageing. Retin-A, however, makes the skin more sensitive, so many cosmetic companies have developed new ‘Retin-A compatible’ products. Some companies are incorporating a Retin-A derivative, called Retinal, into their products. Retinal is weaker and less effective than Retin-A, however, and you are likely to pay a lot more for it.The most important trend in cosmetics this decade is the use of sunscreen chemicals in moisturizers and foundations, since it has been conclusively demonstrated that regular use of broad spectrum sunscreens will prevent photoageing of the skin. Although incorporating sunscreens into cosmetics is a logical step, for some reason cosmetic manufacturers have chosen cinnamate as their sunscreen. Cinnamate is a weak sunscreen which blocks out only ultraviolet В light, and is not as good as much cheaper sunscreens which contain butyl methoxydibenzoyl methane and titanium dioxide.There is also a trend towards using ‘natural’ ingredients in cosmetics. Some natural ingredients, such as silicone, are useful, but others, such as allantoin and aloe vera, have no proven benefit. Anti-oxidants are also increasingly being incorporated into cosmetics. These apparently ‘mop up’ free radicals which are thought to be responsible for skin damage. Whether or not anti-oxidants are useful is not known, however they are a useful marketing strategy.Cosmetic manufacturers have also begun to produce creams for different regions of the face. You can now buy a special cream for your cheeks, another for your eyes, another for your nose, another for your mouth and still another for your throat. There is no proven value in such a regime, except to cosmetic companies who sell you five or six creams instead of one or two.


I is a bacterium related to Mycobacterium tuberculosis, but is not transmitted from one person to another. People who do not have HIV infection also get infections with MAI, but only in the lungs. In people with HIV infection, MAI usually occurs late in the course of the infection when the CD4 count is low, and may spread widely throughout the body. In the liver, MAI can cause hepatitis; in the lung, pneumonia; in the intestines, diarrhea. Accompanying all of these infections are constitutional symptoms.     How MAI is transmitted is unclear. It is not passed from one person to another. It is found in nature, often in water supplies, and contact with MAI is probably universal.     Treatment is difficult because MAI resists most antibiotics. Some physicians advocate using five or six drugs. Other physicians feel that these drugs are not effective enough to warrant the possible side effects. Many physicians treat only those people in whom MAI infection is severe. *139\191\2*


I started taking calcium supplements fifteen years ago, when my aunts started breaking bones. My mother, too, was shrinking dramatically, and I’m lactose intolerant and so I get very little dairy calcium in my diet. Let’s just say I saw the writing on the wall. Along with 1,200 mg of calcium every day, I take a multivitamin that contains vitamin D and magnesium (among other things), as well as a supplement of several B vitamins.I had a bone scan when I was just past 60 that showed that the calcium—and ten years of hormone replacement therapy—had done its job. My bones were of average density and well out of the danger zone. Walking two to three miles a day surely hadn’t hurt, either. I’m doubly glad my bones are strong because one of the inert ingredients in Fosamax is lactose, so I wouldn’t be able to take it!I also had to stop taking HRT when I had breast cancer a few years ago. Now I take Tamoxifen to help prevent a recurrence, and I’m counting on some bone protection from that, although I know there haven’t been studies on that aspect of it. I’ve also started using 100 percent lactose-free milk, and I can tolerate cheddar cheese and yogurt with live cultures. I eat beans a few times a week, but I don’t get nearly enough dark green leafy vegetables. I’m working on that. But for now I’m glad to know supplements can make up for the times I can’t get calcium in my diet.*41\228\2*


The rugged, tanned ‘Aussie’ look which was once so popular is no longer considered attractive in women. Dermabrasion is able to improve sun-damaged skin as well as the textural changes that occur with premature ageing. The purpose of dermabrasion is to resurface the skin, removing fine wrinkles, brown blotches, sunspots.Dermabrasion removes the outer layer of the skin, the epidermis, and the upper dermis, which is the site of sun damage. New skin forms from the depths of the hair follicles where it has been hiding from the sun. Because it has not been sun damaged, this skin is smoother and fresher.Dermabrasion is now done as a day procedure under sedation and healing generally takes seven to ten days. It is performed with a rotating disk in a similar manner to sandpapering an uneven surface. Unlike chemical peeling (see below), dermabrasion is not a ‘blind’ technique. The operator can actually see to what depth he or she is removing the damaged skin and the blemishes and wrinkles disappearing.Improvements in the field of dermabrasion have also occurred. Better instruments are now available and new postoperative dressings allow a much quicker healing time, with less pain and less alteration in the skin’s pigment.Dermabrasion is an excellent procedure for wrinkles around the mouth and for leathery skin, but not for sagging skin or jowls. As with all cosmetic surgery, there are possible although uncommon complications, in particular scarring and pigment change. However, dramatic results can be achieved, and will often last for more than ten years. Dermabrasion usually produces superior results to face-lifting in people with sun-damaged, fine wrinkly skin.

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