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July 20th, 2011 by admin

In part, our cultural negativism about sex and romance in the geriatric years is a reflection of an attitude called ageism, a prejudice against people because they are old, that is similar to the more familiar prejudices of racism and sexism in our society. As Butler and Lewis note: “The ageist sees older people in stereotypes: rigid, boring, talkative, senile, old-fashioned in morality and lacking in skills, useless and with little redeeming social value.” These same authors observe that ageism in relation to sexuality is the ultimate form of desexualization: “if you are getting old, you’re finished.”Ageism is not restricted to heterosexuals, either, as this quotation from Gay and Gray: The Older Homosexual Male shows:Many older gay men believe that younger gays react negatively to them. Most older gays feel that young people sometimes take advantage of them, do not welcome their company in bars, clubs, and bathhouses, do not care to associate or form friendships with them, and think they are dull company.It is interesting to note that in a recent study, college students estimated that average married couples in their sixties had intercourse less than once a month and expected that married couples in their seventies had intercourse even less often. As we will see, these are underestimates of actual behavior, showing that young adults are susceptible to ageism in their thinking — at least when it comes to sex.Kinsey and his colleagues were the first to examine systematically the effect of aging on sexual behavior. Although their studies indicated that sex continued well into late adulthood, they also described a general decline in the frequency of sexual activity for both men and women across the adult age range. A number of other studies confirmed these overall trends, with most reports suggesting that the decrease in sexual activity is partly due to diminished health and partly a reflection of cultural attitudes and expectations.More recently, a longitudinal study done at Duke University has found that patterns of sexual activity actually remain relatively stable over middle and late adulthood, with only a modest decline appearing in most individuals. For example, men who were sixty-six to seventy-one years old at the start of this study had no overall decline in sexual activity scores over the next six years, and a majority of men and women in the fifty-six to sixty-five age bracket at the beginning of the study had stable rates of sexual activity during this same time period. However, in those over age sixty-five, 18 percent of the men and 33 percent of the women completely stopped sexual activity with their partners over a six-year period.Various studies of sexual behavior in late adulthood indicate that the male’s declining interest seems to be the major limiting factor to continued sexual activity. This declining interest, however, may say more about cultural expectations which become self-fulfilling prophecies than anything else. While the pattern of sexual activity among aged people varies considerably, coital frequency in early marriage and the overall quality of sexual activity in early adulthood correlate significantly with the frequency of sexual activity in late adulthood.It is interesting to note that most researchers who claim to be studying sexual activity rates in the elderly have actually restricted themselves to studying coital behavior, as though other forms of sexual activity “don’t count.” Many adults over sixty continue to masturbate, although these are almost entirely individuals who masturbated when they were younger. Not surprisingly, elderly people without sexual partners tend to masturbate more frequently. In couples over sixty, other forms of sexual stimulation continue to be utilized (for example, oral sex and manual stimulation); they not only provide some variety, but also can be a source of pleasure and closeness even if the male is unable to obtain or maintain erections. Here is what one seventy-eight-year-old man told us:In my mid-sixties, I had a real problem getting it up. Sexual intercourse became impossible and I got very upset over it at first. But my wife just found other ways to excite me, and after a while — when I relaxed more, I guess — my problem disappeared. Now, even though she doesn’t always want to have intercourse when I do, we still use our mouths and tongues on each other, and we plan to keep doing it, too.In late adulthood, the longer life span of women, combined with their tendency to marry men who are their age or slightly older, frequently creates a situation of widowhood. At the same time that fewer men of the same age are available as new sexual partners, younger men tend to focus their attentions on women under forty. Thus, sexual opportunities and social contacts with men are often extremely limited for these mature women who might otherwise be enthusiastic sexual partners.In the last few years, a new trend is emerging in which not all women in the sixties or older who find themselves widowed or divorced are passively accepting their fate. Some women in this situation are using their ingenuity to find new partners, as shown by the following ad from the personal classified section of a well-known magazine:Tall, handsome intelligent man sixty to sixty-five, wanted for attractive, lively sixty-two-year-old widow with fantastic figure and modern values. If you’re interested in romance more than golf, send a photo and your phone. Box xxx.Although a sixty-five-year-old widow (or widower) may have an interest in sexual activity, social pressures may prevent sexual opportunities or belittle their meaning via snide jokes (e.g., only”dirty old men” are interested in sex, and “dirty old women” should “act their age”). As prolonged abstention from sexual activity in old age leads to shrinking of the sexual organs (just as a healthy arm loses strength and coordination if put in a sling for four months), the older adult is truly faced with a sexual dilemma — “use it or lose it.”An often-neglected aspect of aging in our society is that many elderly persons are relegated to nursing homes or other long-term care facilities for health reasons, to “protect” themselves, or for the convenience4>f their children. Although research on sexual behavior in this population is understandably sparse, a number of authorities have spoken out in favor of making provisions in such facilities (such as making private rooms available) for those who desire sexual interaction. While most nursing home administrators seem opposed to this notion, and some facilities actually insist on segregating men and women even if they’re married, both ethical considerations for protecting the rights of the elderly and more practical considerations having to do with maintaining self-esteem and personal well-being lead us to advocate change in this area. However, it should be noted that permitting sexual expression in the institutionalized elderly is not the entire solution to their plight. Additional steps must be taken to overcome loneliness and boredom in the nursing home environment so that these facilities are not unintentional prisons for our older adults.In the United States, where there is little preparation or education for aging, it is not surprising that many people are uninformed about the physiological changes in their sexual function in their sixties and seventies. They may mistakenly view these normal “slowing down” processes as evidence that loss of function is imminent. Brief preventive counseling during middle age might result in significant change in this area, but changed attitudes toward sex and aging seem even more necessary. What people must recognize is that given good health and the availability of an interested and interesting partner, there is no reason that sexual enjoyment should have to come to an end in late adulthood. Perhaps the ultimate test of whether we have lived through a sexual revolution will be if attitudes toward sexuality in old age are transformed.*102\342\2*

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July 12th, 2011 by admin

Systolic (top number)Less than 130 mm Hg: normal blood pressure; recheck within 2 years130 to 139 mm Hg: high normal; recheck within 1 year140 to 159 mm Hg: mild hypertension*; confirm within 2 months160 to 179 mm Hg: moderate hypertension*; see doctor within 1 month180 to 209 mm Hg: severe hypertension; see doctor within 1 week210 mm Hg or higher: very severe hypertension; see doctor immediatelyDiastolic (bottom number)Less than 85 mm Hg: normal blood pressure; recheck within 2 years85 to 89 mm Hg: high-normal blood pressure; recheck within 1 year90 to 99 mm Hg: mild hypertension; confirm within 2 months100 to 109 mm Hg: moderate hypertension; see doctor within 1 month110 to 119 mm Hg: severe hypertension; see doctor within 1 week120 mm Hg or higher: very severe hypertension; see doctor immediately* Isolated systolic hypertension is defined as a normal diastolic blood pressure of less than 90 mm Hg but an elevated systolic blood pressure of 140 mm Hg or more. It often occurs in elderly people.This information is based on the 1993 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure.*253\252\8*

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July 5th, 2011 by admin

Though menstruation is a natural occurrence in a woman’s life, PMS (premenstrual syndrome) is not. For two to ten days before the onset of menstruation, millions of women are afflicted with the symptoms of PMS, a wide range of physical discomforts and mood disorder that include bloating, blues, insomnia, severe abdominal pain, uncontrolled rages, crying spells, and even suicidal depression.Being nutritionally fit is a woman’s best defence against PMS.As with all illness, which PMS is, stress – and the inability of the body to combat it – is a key factor. Inadequate nutrition not only decreases resistance to stress but can even be the cause of it. Being nutritionally fit is a woman’s best defence against PMS. But if you’re already afflicted with the syndrome, knowing what and what not to eat is one of the most effective ways to fight back.
Avoid These Foods And Beverages:•   Salt and salty foods.•   Licorice (Licorice stimulates the production of aldosterone, which causes further retention of sodium and water.)•   Caffeine in all forms – coffee, chocolate, colas, and so on (Caffeine increases the craving for sugar, depletes В vitamins, washes out potassium and zinc, and increased hydrochloric acid (HC1) secretions, which can cause abdominal irritation.)•   Alcohol (Alcohol adversely affects blood sugar, depletes magnesium levels, and can interfere with proper liver function, aggravating PMS.)•   Astringent dark teas (Tannin binds important minerals and prevents absorption in the digestive tract.)•   Spinach, beet greens, and other oxalate-containing vegetables (Oxalates make minerals non-assimilable, difficult to be properly absorbed.)
Increase These Foods And Beverages:•   Raw sunflower seeds, dates, figs, peaches, bananas, potatoes, peanuts, and tomatoes (rich in potassium)•   Strawberries, watermelon (eat seeds), artichokes, asparagus, parsley, watercress (these are natural diuretics)’•   Safflower, sunflower, sesame, or almond oil (2 tbsp, daily) or fish oil (2 tsp. daily) (Adequate amounts of essential fatty acids are required for the production of steroid hormones and prostaglandins, which have a marked effect on the uterus.)•   Figs, grapefruit, yellow corn, dark-green vegetables, apples (rich in magnesium, necessary for a healthy reproductive system, reduced during menstruation, and found in low levels among PMS sufferers)*16/137/5*

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June 28th, 2011 by admin

In my opinion the analyst should be a model of understanding and flexibility in modes of treatment for other mental health disciplines. However, most analytical interventions are only weakly applicable to psychotic states. It is possible that there are basic assumptions in the way you, the analyst, practice which are limited to normal psychology and which do not apply to extreme states.If you find that your work does not apply to the psychotic states, you normally conclude that the people are unconscious and must wait for enlightenment. Secretly you believe that humankind will never change. You are hopeless. Alternately, you may believe that psychosis is due to social ills, God, the collective unconscious, an undiscovered toxin, early childhood experiences or fatefully weak egos.These beliefs indirectly help to sustain the steady number of psychotic episodes because you, who are best trained to work with these people, defer such work to others. Moreover, your hopelessness acts hypnotically on patients in extreme states by intensifying their own anger and sense of hopelessness. Please let us be aware of our beliefs about psychotic states.*140\227\8*

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June 19th, 2011 by admin

Many hospitals, both community hospitals and teaching hospitals, have established specialized units, informally called AIDS units or wards, for people hospitalized with HIV infection. AIDS units usually deal with all facets of care: they offer not only medical expertise but also social services, psychological support, advice on nutrition, addiction services, and access to AIDS-advocacy groups. In short, they offer the same services to someone in the hospital that comprehensive care programs (discussed previously in this chapter) offer to an outpatient. In many instances, the AIDS unit is part of a comprehensive care program.     The person on an AIDS unit will receive a level of expert medical care not generally available to a person with AIDS on, for example, a general medical ward. In addition, the people providing the care on an AIDS unit have specifically chosen to work with people with HIV infection. The principal disadvantage to being on an AIDS unit is that your diagnosis is obvious to visitors. Hospitals with AIDS units usually offer the person the option of care on this unit or care elsewhere in the hospital.*159\191\2*

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June 5th, 2011 by admin

In all chronic conditions there is a need to “be realistic” and a problem in defining “reality” and in accepting it. One of the most difficult realities of epilepsy is that no one can predict when and where (or even if) a next seizure will occur. This is “the uncertainty factor.” It is this uncertainty factor that differentiates epilepsy from most other chronic conditions. It is this uncertainty factor that is most disturbing to older children with epilepsy as well as to their parents. “Could I have a seizure while crossing the street?” “Is it all right for me to go to school today, or will I be embarrassed by another one of those things?” “Suppose he goes to the prom and has a seizure?” Uncertainty leads to anxiety and worry. Coping with anxiety is the principal task for a parent of a child with epilepsy. Worry must be contained. It cannot be allowed to permeate every waking moment of your life. It cannot be allowed to be the master, dictating overprotection of your child.But how can worry and anxiety be contained? It’s useless to be told not to worry. You need to be helped to see the reality of your child’s epilepsy. For some, that reality may be a few seizures, likely to be controlled, and epilepsy that eventually disappears. For other parents, the reality may be continuing seizures or retardation or other disabilities. No one can predict with absolute certainty what the future holds for a child with epilepsy, any more than we can predict with certainty what the future holds for a child without epilepsy.It is the lack of ability to influence the future that can be the most disturbing to people with epilepsy and to their loved ones.*188\208\8*

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May 23rd, 2011 by admin

Hair styling gelsHair stylings gels are used to keep the hair in place and to provide a film which smoothes out the cuticles, making the hair appear shinier. Hair gels contain a resin called polyvinyl pyrollidone, which is also used in mascara. The main problem is that this chemical attracts water, making it sticky in humid weather. To get around this, a newer chemical, called polyvinyl pyrollidone vinyl acetate (PVPVA), has been incorporated into many gels. The main problem with this is that it builds up on the hair and is often not removed by regular shampooing. If you do use a styling gel, it is important to use a good cleansing shampoo to prevent a build up of flaky gel. Styling gels do not damage the hair, but rather protect it. They are also available as sprays, many of which contain the same glue used in Super Glue, called methyl methacrylate. This is a potent source of allergic reactions.
Hair permsThe desire to have thick, wavy hair has transcended all fashion trends so that hair-perming products remain ever-popular. Most perming solutions are made from a chemical called thioglycollate, which breaks the hair bonds, allowing them to be either curled or straightened. This chemical is also used in hair removal products, and damages the hair shafts.The old-fashioned perms, called alkaline perms, were extremely damaging, but gave a long-lasting, tight curl. More recently, a gentler acid perm has become popular due to its less damaging effects on the hair. However, the curls tend to be looser and do not last as long, and the solution often causes allergic reactions.Home perms, which can be bought from chemists, can be based on either a very weak thioglycollate solution or a sulphite solution. These produce a much weaker curl, but are quite safe for home use. Sulphite perms, however, can cause severe reactions in asthma sufferers.

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May 18th, 2011 by admin

The symptoms of toxoplasmic encephalitis are what physicians call focal neurologic symptoms: paralysis or weakness on one side of the body, loss of speech, loss of coordination, and certain kinds of seizures. Such symptoms occur generally when there is a problem in a specific part of the brain.     Toxoplasmic encephalitis is caused by a parasite called Toxoplasma gondii that is usually acquired by eating undercooked meat or by contact with cat excrement; the parasite is not transmitted from one person to another. About 30 percent of American adults are infected with Toxoplasma gondii, and most of them are, and will remain, unaware of it. The parasite causes severe disease primarily in people with severe immunosuppression. It seems to be most common in people with AIDS when the CD4 count is less than 100.     Toxoplasmic encephalitis can be diagnosed with a blood test that detects antibodies to Toxoplasma gondii, but the test is unreliable in people with AIDS. The alternative test is one of the methods—CAT scans or MRI scans—for imaging the brain. Either of these will show a characteristic pattern of inflammation in the brain. Some people might require a brain biopsy.     The standard treatment for toxoplasmic encephalitis is an antibiotic, pyrimethamine, given in combination with other antibiotics, either sulfonamides or clindamycin. These drugs are given initially by vein and then by mouth in relatively high doses. Most people improve within two weeks; brain scans three to four weeks after treatment begins generally show reduction in the size of the area of inflammation.     Toxoplasmic encephalitis is one of the many infections in people with AIDS that responds well to treatment but recurs when antibiotics are discontinued. For this reason, in the majority of cases, antibiotics are continued indefinitely.*132\191\2*

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May 8th, 2011 by admin

Until recently, the evidence for oral chondroitin sulfate was very weak. However, in 1998, the journal Osteoarthritis and Cartilage published a supplement devoted to updating the science on this supplement. Three double-blind placebo-controlled studies were reported that provide evidence that chondroitin sulfate is an effective treatment for arthritis.One of these was a 6-month double-blind placebo-controlled study that followed 85 participants with osteoarthritis of the knee. In this study, participants received 400 mg of chondroitin sulfate twice a day or an identical-appearing placebo. Researchers evaluated improvement in arthritis symptoms by recording the level of pain as judged subjectively by the patient, the time it took to walk about 22 yards on flat ground, and the overall effectiveness of the treatment as rated by physicians and participants.The results showed that after 1 month of treatment, there was a 23% decrease in joint pain in the chondroitin sulfate group versus only a 12% decrease in the placebo group. By 6 months there was a 43% improvement in the chondroitin sulfate group versus only a 3% improvement in the placebo group (the placebo effect sometimes wears off after a while). Walking speed did not improve over the 6 months with chondroitin sulfate (it stayed the same), while in the placebo group walking speed gradually and steadily declined. Finally, physicians rated the improvement as “good” or “very good” in 69% of those taking chondroitin sulfate but in only 32% of those taking placebo.This was a reasonably long-term study that involved enough participants to be meaningful. However, another study lasted even longer, a full year, but it enrolled only 42 participants. Again, the results showed that chondroitin sulfate produced tangible benefits as compared to placebo, with the differences generally increasing steadily over the entire year.Another study was larger than either of these two, enrolling 127 participants, but it lasted for only 3 months. Again, the results were positive.Finally, an earlier study found that the benefits of chondroitin sulfate, like glucosamine sulfate, persist for months after treatment is stopped. This study compared chondroitin sulfate to the drug diclofenac sodium (Voltaren). Two previous controlled studies also compared chondroitin sulfate to NSAIDs. All together, six controlled trials have been performed in humans, involving a total of over 450 participants.*41/306/5*

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April 29th, 2011 by admin

Brow-lifting also has an anti-gravity effect. The forehead skin and underlying membrane are lifted and re-attached behind the hairline, so that the scar is hidden. Brow-lifting is a good procedure for horizontal frown lines as well as drooping eyebrows, and is often combined with face-lifting and eye-lifting.Traditionally, a cut is made either at or behind the hairline across the entire length of the forehead. The muscle and fat are then pulled upwards and excess skin is removed. At the same time the muscles are cut to try to decrease frowning after the operation.Post-operatively, there is generally considerable swelling and bruising which takes several weeks to disappear. Numbness of the forehead and tenderness along the incision line are usual for several months but will eventually disappear.New advances in laser surgery have meant that brow-lifting can now be performed with certain lasers, for example the KTP laser, with minimal swelling and bruising. Smaller incisions can be made, producing a less visible and uncomfortable scar.

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