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If your training has prepared you to do so impotence at age 30 order cheap extra super avana on-line, model the style of various therapy strategies by asking a student volunteer to either think up a fictitious problem or discuss an actual impotence clinics order extra super avana 260 mg visa, but not very significant erectile dysfunction unable to ejaculate purchase extra super avana now, personal concern (for instance erectile dysfunction quiz buy extra super avana master card, trouble getting to sleep at night). Ask the volunteer to leave the classroom while you inform the rest of the class that during the first four to five minutes of the interview you will play the role of a Rogerian therapist and then, without warning, you will change roles and play an operant-conditioning-oriented therapist. The object will be to see whether the student volunteer notices that any change occurred and whether one or the other pattern of therapist behavior was preferred. Then the questions should abruptly take a decidedly behavioral turn (for example, "What exactly are the circumstances that precede sleepless nights? This exercise should keep student interest and illustrate the differences in therapeutic strategies as well as their impact on the client. This activity helps students see how the theoretical orientation of a psychologist guides the development of a treatment plan. The experience also gives you a chance to correct any misperceptions the students may have about the techniques used in the various treatment approaches. In order for the activity to be relevant to a range of therapeutic orientations, choose an adult, nonpsychotic condition such as an anxiety disorder, mood disorder, or form of substance abuse. Have each group develop a treatment plan using the specific techniques of the therapeutic approach they were assigned. Also have the groups examine the potential barriers to successful treatment and their estimation that the client would be successfully treated. Ask each group to report to the whole class the results of their discussions and list their ideas on the board. At the end of the activity, encourage students to think about integrative treatments that might use the best of each approach. Underscore the fact that most therapists approach problems with this kind of eclecticism. You might also suggest that other treatment approaches not discussed-group therapy, family therapy, humanistic-existential- might have been just as valuable. One way to increase student involvement in the class and the material is to have them role-play different therapies. You will need at least four therapists, one each for psychoanalysis, behavior therapy, humanistic-existential therapy, and cognitive therapy. It is a good idea to supply the clients with guidelines on what their problems are. Having some uniformity in the problems the clients present will foster discussion of how different therapies compare and contrast. To add to the entertainment value of this activity, assign the "therapists" to their therapeutic approach in private and tell them not to disclose what form of treatment they will be using. This way, the rest of the class can be involved in trying to guess the kind of therapy being demonstrated. Pair up the clients and therapists randomly and have them perform one after the other before the class. After all the therapy sessions end, ask those in the audience to guess which therapist was demonstrating which form of treatment. Discuss whether the principles of each approach were adhered to and whether techniques were left out because of time constraints. Participants and audience can discuss what they think would be most helpful to the client, including integrative combinations of the approaches. Finally, students will probably want to voice opinions about the therapy they would personally be most comfortable with. Point out that comfort and effectiveness may not come in the same therapeutic approach. Many psychoactive drugs are used to treat people with emotional and behavioral disorders. Develop a list on the board that indicates each general category of drug, when it is prescribed, the generic and brand names for the more commonly used ones, and the side effects or contraindications for each. Stress that each drug has many side effects, some of which are serious but exceedingly rare. Note on the board that each drug is therapeutic in a range of dosages (dependent on weight, age, health status, and condition of the patient). Above this range the drug becomes toxic; below this range the drug is ineffective.
What makes the psychoanalytic perspective different from the other psychological perspectives? If a distribution of scores includes one or more outliers erectile dysfunction drug types order 260 mg extra super avana with mastercard, which of the following measures of central tendency should be used? Which of the following would a researcher need to use to determine if the difference between the mean scores of experimental and control groups was significant? Someone with brain damage who has difficulty making the muscle movements needed to produce accurate speech might have damage to which area of the brain? Which of the following structures is located at the most central and protected part of the brain? An artist doing a pencil drawing could use which of following techniques to add depth to her or his drawing? Why might a researcher use a variable ratio of reinforcement rather than a fixed ratio? Knowledge of different categories of trees and where they grow best is an example of what kind of long-term memory? A psychology teacher who believes that all students want to learn and creates a classroom culture that encourages this intrinsic motivation is using which kind of management style? Which of the following statements best describes an important difference between authoritarian and authoritative parenting styles? Someone who fails an important exam and reacts by spending more time studying in the library and less time socializing probably has which kind of locus of control? Which of the following is the most complete list of the common characteristics of psychological disorders? Which of the following is one of the key factors that differentiate major depression from periods of sadness that everyone experiences? Which of the following techniques would be most helpful in avoiding the problems associated with groupthink? A psychologist who advises a patient to write about his depressed thoughts and prescribes an antidepressant medication is using a combination of which of the following perspectives? Why can experiments determine causal relationships when no other research method can? Which research method would most likely be used to test the following hypothesis: People who conserve energy by buying hybrid cars are more likely to spend more money on organic foods erectile dysfunction treatment urologist discount extra super avana uk. A person suffering from a skin rash finds her pain is temporarily relieved by vigorous itching varicocele causes erectile dysfunction order cheapest extra super avana and extra super avana. She does not perceive the pain from the rash while she is itching erectile dysfunction icd 10 buy extra super avana 260 mg mastercard, but the pain returns soon after she stops itching. Which of the following concepts is most relevant to the differences between their theories? How would Piaget describe the process of learning something new using terminology from his cognitive development theory? Albert Bandura and the social-cognitive personality theorists believe that personality results from the interaction of which factors? What would a psychometrician conclude about a personality test that tells a person she is an extreme extrovert the first time she takes the test and an extreme introvert the next time she takes it? Which of the following statements is true about the relationship between reliability and validity? Many different kinds of psychological researchers spend their careers studying the process of attitude formation. Professor Kester, a developmental psychologist, is investigating the long-term effects of different parenting styles. Her hypothesis is: Children of parents who use the permissive parenting style will be more independent as adults than children of authoritarian or authoritative parents. Include the following elements in your description: Identify the two key variables in this hypothesis and explain a possible operational definition for each variable. The other theorists listed did not specifically focus on operant conditioning in their research. Assignment occurs when participants are assigned to control and experimental groups. Representative sampling and assignment involve purposefully making groups that represent a larger population. The other concepts listed as possible answers do not relate directly to both experimenter and subject bias.
Mitral Stenosis Ninety percent of patients with pure uncomplicated mitral stenosis have a loud S1 impotence in men buy 260mg extra super avana with visa. Mitral stenosis delays closure of the mitral valve because the pressure gradient between the left atrium and left ventricle keeps the leaflets open until the moment of ventricular systole impotence pregnancy extra super avana 260 mg fast delivery. Left Atrial Myxoma Many patients with left atrial myxoma (seven of nine in one series) also have a loud S1 because the tumor falling into the mitral orifice during diastole delays closure of the valve erectile dysfunction treatment brisbane cheap extra super avana master card. Weak Ventricular Contractions (Low dP/dT) Common examples of weak contractions causing a faint S1 are myocardial infarction and left bundle branch block erectile dysfunction causes cancer buy extra super avana 260 mg mastercard. Early Closure of the Mitral Valve Common causes of early mitral closure causing the faint S1 include the following: a. Acute Aortic Regurgitation In patients with the murmur of aortic regurgitation, the faint or absent S1 is an important clue that the regurgitation is acute. Patients with acute aortic regurgitation have much higher left ventricular end-diastolic pressures than those with chronic regurgitation because the acutely failing valve has not allowed time for the ventricle to enlarge, as it does to compensate for chronic regurgitation. The high pressures in the ventricle eventually exceed diastolic left atrial pressures, closing the mitral valve before ventricular systole and thus making S1 faint or absent. In contrast, in patients with irregular rhythms, a changing intensity of S1 has no diagnostic significance, because ventricular filling and dP/dT-and, therefore, S1 intensity-depend completely on cycle length. Definition of findings: For loud P, splitting heard with loud second component19 or S 2 2 louder at left second interspace than right second interspace20; the figures for fixed splitting of S2 apply only to patients having audible expiratory splitting. This finding therefore occurs in patients with right bundle branch block or in left ventricular ectopic or paced beats, all of which delay the onset of right ventricular systole and also cause wide physiologic splitting of S2 (see later). During inspiration, the interval separating A2 and P2 increases by about 20 to 30 ms. Splitting refers to the separation of the aortic component (A2) and the pulmonic component (P2) during expiration (left column) and inspiration (right column). There are two normal patterns (single and physiologic) and three abnormal patterns (wide physiologic, wide fixed, and paradoxic). The dotted lines indicate that all three abnormal forms of splitting are distinguished by audible expiratory splitting. Although the phonocardiogram almost always records both components of S2, the human ear perceives them as a single sound during expiration in over 90% of normal persons. Harvey suggests mimicking the normal expiratory sound by striking a single knuckle against a tabletop and mimicking inspiratory physiologic splitting by striking two knuckles almost simultaneously. A2 and P2 move apart during inspiration, primarily because inspiration delays P2 even more. About half of the inspiratory augmentation of the A2-P2 interval is due to a further increase in the hangout interval in the pulmonary circulation. About 25% of inspiratory augmentation is due to lengthening of right ventricular systole (from increased filling of the right side of the heart during inspiration), and the remaining 25% is due to shortening of left ventricular systole (from a reduction of filling of the left side of the heart during inspiration). Wide Physiologic Splitting Wide physiologic splitting means that splitting occurs during inspiration and expiration, though the A2-P2 interval widens further during inspiration. Wide Fixed Splitting Wide fixed splitting means that splitting occurs during inspiration and expiration, but the A2-P2 interval remains constant. Paradoxic Splitting (Reversed Splitting) Paradoxic splitting means that audible expiratory splitting narrows or melds into a single sound during inspiration. Paradoxic splitting occurs because the order of the S2 components has reversed: A2 now follows P2, and as P2 is delayed during inspiration, the sounds move together. The timing of heart tones (top) is correlated with pressure tracings from the left side of the heart. The solid rectangle at the bottom of the figure depicts the duration of mechanical systole, which is the same for the right and left ventricles. On the right side of the heart, however, hangout is longer (60 ms) because the compliant pulmonary circulation offers so little resistance to continued forward flow. Changes in hangout also explain in part why splitting normally increases during inspiration and why most patients with pulmonary hypertension have a single S2. Therefore, the best screening tool for the abnormal S2 is audible expiratory splitting that persists when the patient sits up. Wide Physiologic Splitting Wide physiologic splitting may result from P2 appearing too late or A2 too early (see Table 38-1). In pulmonic stenosis, the A2-P2 interval correlates well with severity of stenosis (gauged by the right ventricular systolic pressure, r = 0.
Furthermore protein shakes erectile dysfunction cheap extra super avana 260mg without prescription, if the conditions that kept gay genes in the gene pool are no longer true erectile dysfunction treatment clinics buy 260mg extra super avana mastercard, then those genes should vanish impotence forum buy extra super avana us. If so impotence venous leakage ligation purchase extra super avana 260mg on-line, then gay genes might persist, because most of the time genes that can cause homosexuality are in straight rather than gay people-and in straight people, they are evolutionarily helpful. If this hypothesis were true, then the heterosexual siblings of gay men would have more children than most people, because they would have more gay genes. Second, although male homosexuality is associated with other traits, such as femininity, the association is restricted to the gay men themselves. Most other ideas offered to explain how homosexuality has persisted have no more going for them than these do. Scientists have been trying to solve the intellectual problem on the cheap, a few hours at a time, rather than devoting the years it will eventually take to discover the secret. Until they invest the effort and resources that the problem deserves, homosexuality will remain an evolutionary mystery. No matter what causes homosexual orientation, these causes must work ultimately by impinging on the brain. For example, men make testosterone in their testes, but these affect sex drive-and everything else they influence-by Copyright © National Academy of Sciences. If there is a sexual orientation center of the brain, then we might expect it to work this way. Thus, both straight men and lesbians would be expected to have masculine sexual orientation areas, and gay men and straight women to have feminine areas. So one way to proceed would be to find areas of the brain that differ between straight men and women and then see if they differ between straight and gay men. Up to that point, LeVay had had a distinguished career studying how the brain allows us to see. He had become less interested in the neuroscience of vision and more interested in the science of sexual orientation. He saw a paper by Laura Allen and colleagues entitled "Two sexually dimorphic cell groups in the human brain" and became excited. This is just the kind of finding that a neuroscientist interested in sexual orientation hopes for. The hypothalamus has been well established to be involved in sexual behavior in both humans and other animals. Males deprived of testosterone during a critical period of development fail to mount like normal males during Copyright © National Academy of Sciences. Repeating interesting and surprising studies is Copyright © National Academy of Sciences. In 1991 LeVay was in a good position to try to repeat his own study, but he elected to stop being a laboratory scientist and to focus on writing science books for the general public. I first met Bill Byne in 1991, just after Richard Pillard and I published our male-twin study. Although I was wary of Byne, I also recognized his intelligence and appreciated his tenacity. This suggests that those structures may have similar functions, or at least similar evolutionary origins. His results were similar to those of LeVay, although the difference between straight and gay men was not quite as large. I have seen reports that gay people have different fingerprints, more lefthandedness, different inner ear waves, height, and even penis size. The good trend is that people are interested in sexual orientation, especially its causes, so whenever scientists report a finding, the press is eager to report it. In women, the index finger (2D, second digit) tends to be similar in length to the fourth digit (4D). Relatively speaking, this is a small difference-the effect size, d, is only about. Scientists who study 2D:4D argue that the sex difference depends on prenatal androgens, such as testosterone. My first reaction is that if 2D:4D is so androgen-dependent, then why is the difference between men and women so small? In 2000 a report appeared in the journal Nature that lesbians had Copyright © National Academy of Sciences. The chief author of the paper, Marc Breedlove, is a well-known and capable scientist.
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