By G. Tarok. University of Natural Medicine. 2018.

On the other hand procardia 30 mg otc, you probably know a few folks who view the world through dark purchase procardia 30 mg amex, gloomy shades. Your views of people, events, and even your self-image depend upon which lenses you look through. This chapter helps you realize whether your lenses are dirty, cracked, smoky, colored, or clear. A quiz shows you which lenses you look through and how they may cause you emotional trouble, and the exercises demonstrate how to change problematic life-lenses. For example, it’s not a bad idea to assume that day follows night, taxes must be paid, food is located at grocery stores, most drivers stop at red lights, and hard work usually pays off. Think about how snarled traffic would be if no one assumed that red means stop and green means go. Or just consider how much time you’d waste if you searched for food in department stores, schools, and libraries rather than assuming that you’d find it in grocery stores. These assumptions or beliefs color the way you feel about yourself and the things that happen to you. Or perhaps you have a vulnerable life-lens and thus assume that the world is a dan- gerous place. As we explore assumptions (that is, life-lenses) such as these, you can see that they form the foundation of your most distressing emotions, such as depression, anxiety, worry, irritability, apprehension, and even anger. These themes directly influ- ence the kinds of thoughts you have and, in turn, how you feel about what happens to you. Although Susan and Diane are both well qualified, a nurse from another hospital gets the job. Susan reacts with anger and comments, “I deserved that job; the administration had no right to give that job away. She feels gloomy and says, “I’m sure they made the right deci- sion picking someone else. She believes that she always deserves the best; Susan feels that the world owes her and that if she wants something, it should be hers. She thinks that she’s not good enough and that others have more skill and talent than she does. Diane assumes that she couldn’t do the job even though her supervisor told her she has the appropriate ability and background. Susan’s entitled life-lens makes her prone to tension and anger when her needs aren’t met. Diane’s inadequacy life-lens steers her in the direction of depression when her adequacy is called into question. Susan and Diane apply their respective life-lenses to many different events in their lives. For example, when they’re both caught in an unexpected traffic jam, they view the event through their own life-lenses and thus experience different thoughts and feelings. Susan’s entitled life-lens leads her to feel rage and have thoughts like, “No one in this town knows how to drive. After all, changing the way you feel starts with identifying your problematic life-lenses. If you aren’t aware of your own life-lenses, you’re powerless to do anything about them. The questionnaire in Worksheet 7-1 is designed to clarify which life-lenses may be causing you trouble. After you identify them, we tell you a little more about how they work, where they come from, and most importantly, what you can do about them. Before you start mark- ing the life-lenses in the worksheet that apply to you, consider the following tips: Answer as honestly as possible. Sometimes, people respond how they think they “should” answer rather than responding with honest self-appraisals. Take your time to reflect on various events and situations that have happened to you that are relevant to each lens. For example, in answering questions about abandonment-fearful versus intimacy-avoidant, ponder the relationships you’ve had and how you feel and react to those close to you. Chapter 7: Correcting Your Life-Lenses: A New Vision 101 Base your answer on how you feel and react in situations that relate to each lens. For example, if you frequently feel inadequate but know in your head that you’re actu- ally not inadequate, answer on the basis of how you feel when your adequacy comes into question, such as when you’re asked to make a speech. For example, if you’re a perfectionist, you may also quite often feel inadequate when you make a mistake. Or if you normally feel unworthy and undeserving, you may find yourself feeling quite angry and entitled on occasions when your needs unexpect- edly go unmet. People often flip between opposite lenses, so don’t worry if you seem a little inconsistent. If you see parts of the description that apply and others that don’t, underline the parts that fit and rate your- self on those parts in terms of how often they apply to you. I’d just as soon lost without someone in my life, and I worry stay away from any emotional involvement; I don’t about losing those I care about.

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He is attending a cardiac rehabilitation clinic and he has had no further angina since his surgery generic 30mg procardia with visa. He has a strong family history of ischaemic heart disease order 30 mg procardia otc, with his father and two paternal uncles having died of myocardial infarctions in their 50 s; his 50-year-old brother has angina. He has bilateral corneal arcus, xanthelasmata around his eyes and xanthomata on his Achilles tendons. He has many clinical features to go with the high cholesterol and prema- ture vascular disease. The homo- zygous condition is rare and affected individuals usually die before the age of 20 years due to premature atherosclerosis. Corneal arcus, xanthelasmata and xanthomata on Achilles tendons and the exten- sor tendons on the dorsum of the hands develop in early adult life. The other major causes of hypercho- lesterolaemia are familial combined hyperlipidaemia and polygenic hypercholesterol- aemia. Familial combined hyperlipidaemia differs from familial hypercholesterolaemia by patients having raised triglycerides. Patients with polygenic hypercholesterolaemia have a similar lipid profile to familial hypercholesterolaemia but they do not develop xanthomata. Hypercholesterolaemia may commonly occur in hypothyroidism, diabetes mellitus, nephrotic syndrome and hepatic cholestasis. This patient is at extremely high risk for further vascular events and especially occlusion of his coronary artery bypass grafts. His risk depends on the combination of his risk fac- tors, and all of these need attention. He should be advised to stop smoking, reduce his alcohol intake (which is also affecting his liver as judged from the raised gamma-glutamyl transpeptidase), take more exercise and eat a strict low-cholesterol diet. He should have pharmacological treatment with a statin but may need combined treatment for this level of hyperlipidaemia. His children should have their lipid profile measured so that they can be treated to prevent premature cor- onary artery disease. There is clear evidence from clinical trials that primary prevention of coronary artery disease can be achieved by lowering serum cholesterol. In patients who have evidence of cardiovascular disease secondary prevention is even more important, aiming for a cho- lesterol level as low as possible. He has a 12-year history of chronic cough and sputum production, but she thinks that these symptoms may have increased a little over the last 8 weeks. He has smoked 20 cigarettes daily for the last 50 years and he drinks around 14 units of alcohol per week. Two years ago he became depressed and was treated with an antidepressant for 6 months with good effect. There are no abnormalities to find in the cardiovascular, respiratory or abdominal systems. Addison’s disease might be linked with respiratory problems through adrenal involvement by metastases or tuberculosis. This can be confirmed by measurement of serum and urine osmolarities to show serum dilution while the urine is concentrated. Fluid restriction to 750 mL daily produced an increase in serum sodium to 128 mmol/L with improvement in the confusion and weakness. Such treatment often produces a response in terms of shrinkage of the tumour, improved quality of life and increased survival. Small-cell undifferentiated carcinomas of the lung are fast-growing tumours, usually unresectable at presentation. Her 20-year-old son has asthma and she has tried his salbutamol inhaler on two or three occasions but found it to be of no real benefit. She has tested herself on her son’s peak flow meter at home and she has obtained values of about 100 L/min. On direct question- ing she says that the shortness of breath tends to be worse on lying down but there are no other particular precipitating factors or variations through the day. There is a generalized wheeze heard all over the chest but no other abnormalities. It is similar in both inspiration and expiration as shown in the flow volume loop (Fig. The spirometry trace of volume against time in such cases shows a straight line of the same reduced flow right up to the vital capacity. On examination, this airway narrowing is likely to produce a single monophonic wheeze which may be heard over a wide area of the chest. Differential diagnosis of rigid large-airway obstruction The situation may easily be confused with asthma if the peak flow and the wheezing are accepted uncritically. The wheezing in asthma comes from many narrowed airways of different calibre and mass, and the wheezes are often described as polyphonic. The fixed flow in inspiration and expiration in this case suggest a rigid large-airway nar- rowing.

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Campaigns promoting positive attitudes to- An attitude is a predisposition to respond cogni- wards prenatal care generic 30 mg procardia with mastercard, abstinence from drug use cheap procardia 30 mg visa, smoking tively, emotionally, or behaviorally to a particular cessation, sunscreen use, organ donations, safe sex, can- object, person, or situation in a particular way. In effect, social Attitudes have three main components: cognitive, af- marketing is “selling” attitudes and beliefs and ideally fective, and behavioral. The cognitive as- Changing behavior to influence attitudes pects of attitude are generally measured by surveys, inter- In 1955, clinical psychologist and educator George views, and other reporting methods, while the affective Kelly introduced his psychology of personal constructs. Behavior, on the other vidual looks at the world through his or her own unique hand, may be assessed by direct observation. Behavior does not always conform to a person’s feel- These constructs change and adapt as the individual is ings and beliefs. At the heart of may be suppressed because of a competing attitude, or in Kelly’s theory is the idea that individuals can seek new deference to the views of others who disagree with it. A experiences and practice and adapt new behaviors in classic theory that addresses inconsistencies in behavior order to change their attitudes (or constructs) towards the and attitudes is Leon Festinger’s theory of cognitive dis- world. He recommended that therapists encourage their sonance, which is based on the principle that people pre- patients to try out new behaviors and coping strategies; fer their cognitions, or beliefs, to be consistent with each he and others that followed frequently found that pa- other and with their own behavior. Inconsistency, or disso- tients would adapt these useful new behavior patterns nance, among their own ideas makes people uneasy and subsequently change their attitudes. For example, smokers forced to deal with the sometimes a result of social or peer pressure. While opposing thoughts “I smoke” and “smoking is dangerous” adult behavior generally follows from held attitudes, for are likely to alter one of them by deciding to quit smok- children, attitudes are often shaped by observed behavior. Test subjects ers and, to a degree, build their attitudes and beliefs from in hundreds of experiments have reduced cognitive disso- this learned behavior. There is, however, evi- quire many of their attitudes by modeling their parents’ dence of a direct link between self-esteem and attitude attitudes. People with low self-esteem are often not atten- uli is another method of attitude formation and one widely tive enough to absorb persuasive messages, while those used by advertisers who pair a product with catchy music, with high self-esteem are too sure of their own opinions soothing colors, or attractive people. The most easily ing, which utilizes rewards, is a mode of attitude forma- persuaded individuals tend to be those with moderate tion often employed by parents and teachers. Attitudes are levels of self-esteem, who are likely to pay a reasonable also formed through direct experience. It is known, in fact, amount of attention to what those around them say and that the more exposure one has toward a given object, remain open enough to let it change their minds. The medium of persuasion also influences attitude change (“the medium is the message”). Face-to-face One of the most common types of communication, communication is usually more effective than mass com- persuasion, is a discourse aimed at changing people’s at- munication, for example, although the effectiveness of titudes. The first any one component of communication always involves of these is the source, or communicator, of a message. The effects of persuasion be effective, a communicator must have credibility based may take different forms. Sometimes they are evident on his or her perceived knowledge of the topic, and also right away; at other times they may be delayed (the so- be considered trustworthy. In addition, people may often similarity between communicator and audience, the change their attitudes only to revert over time to their greater the communicator’s effectiveness. This is the original opinions, especially if their environment sup- principle behind politicians’ perennial attempts to por- ports the initial opinion. This practice has come to include dis- veloped by psychologist William McGuire, focuses on a tinguishing and distancing themselves from “Washing- chronological sequence of steps that are necessary for suc- ton insiders” who are perceived by the majority of the cessful persuasion to take place. They must then sage itself, the method by which the message is present- yield to the argument, and retain it until there is an oppor- ed is at least as important as its content. Attitude: Your Most Priceless Posses- provokes fear; and whether it presents its strongest argu- sion. New York: Cambridge University Press, present an identical message to two different groups, the 1986. The Psychology of Attitude Change and still vary because audience variables such as age, sex, Social Influence. Philadelphia: Temple University Press, and intelligence also affect attitude change. Some have at- tributed it to the superior verbal skills of females which may increase their ability to understand and process ver- Attraction, interpersonal bal arguments. Others argue that it is culturally deter- A favorable attitude toward, or a fondness for, an- mined by the greater pressure women feel to conform to other person. The effect of intelligence on attitude change is in- Both personal characteristics and environment play conclusive.

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May take two to four weeks to notice benefits; side effects are rare and include stomach upset order procardia 30mg amex, fatigue cheap 30 mg procardia with visa, itching, sleep disturbance, skin rash, and sun-sensitivity. John’s wort interacts with many drugs, such as oral contraceptives, blood thinners and other anti- depressants; check with your pharmacist. Suntheanine: A patented extract of theanine (an amino acid present in green tea), it re- duces stress and anxiety without causing drowsiness or addiction, and also improves sleep quality. It works quickly to promote calming (30 minutes to one hour), and there are no known side effects. Take 400–1,000 mcg folic acid along with 50–100 mg of other B-vitamins daily to support brain function. Ginkgo biloba: Improves blood flow to the brain; improves memory and cognitive function; may also improve serotonin response. Eat a healthy diet and avoid sugar, refined/processed foods, caffeine, and alcohol. Take fish oils daily for overall brain function and improved mood, and consider Suntheanine to reduce stress and anxiety. According to the Ca- nadian Diabetes Association, over two million Canadians have diabetes, and this figure is expected to rise. When we consume food, it is broken down into glucose, which causes a rise in blood glucose levels. Insulin is a hormone secreted by the pancreas in response to that rise in blood sugar. Insulin’s role is to transport glucose from the bloodstream into the cells to be used for energy. Type 1 diabetes is responsible for approxi- D mately 10 percent of cases and occurs when the pancreas produces little or no insulin. The exact cause of type 1 diabetes is unknown, but it is thought that the immune system attacks and destroys the insulin-producing cells of the pancreas. Type 1 diabetes was previously known as juvenile diabetes or insulin- dependent diabetes because it typically appears during childhood or adolescence, and people who get this form require insulin injections to manage their blood sugar. Type 2 diabetes is the most common form, accounting for about 90 percent of people with diabetes. This form occurs when the pancreas does not produce enough insulin or when your cells become resistant to the action of insulin. Obesity, inactiv- ity, and poor diet (eating too many high-glycemic foods) are some of the causes of type 2 diabetes. The third type of diabetes is gestational diabetes, a temporary condition that occurs during pregnancy. There is no cure for diabetes, but there is much that can be done from a lifestyle perspective to improve blood sugar control and prevent potentially life-threatening complications. However, it is important to realize that many people who have type 2 diabetes have no symptoms until complications develop. Uncontrolled high blood sugar can cause damage to blood vessels throughout the body. In fact, about 75 percent of people who D have diabetes die of some type of heart or blood vessel disease. Other complications include kidney and eye disease, nerve damage (diabetic foot and erectile dysfunction), and increased risk of infection. Aging does not cause diabetes, but people tend to exercise less and gain weight with age. In the past the only way to get insulin was through injection with a needle and sy- ringe. Now there are insulin pen devices and pumps that are more convenient and less painful. There are also several types of insulin that vary in their onset and dura- tion of action. Some people with type 2 diabetes can manage their blood sugar with diet and ex- ercise alone, but in some cases, medication or insulin is required. These drugs work by stimulating the pancreas to produce and release more insulin, inhibiting the production and release of glucose from your liver (so that less insulin is needed to transport sugar into your cells) or increasing tissue sensitivity to insulin. Careful monitoring is essential to ensure that your blood sugar levels are within the recommended range. Depending on your situa- tion, your doctor may advise you to check your blood sugar once a day or more often. In addition to daily blood sugar monitoring, your doctor may recommend an A1C test, which measures your average blood sugar level for the past 120 days. Symptoms include shakiness, lightheadedness, irritability, confusion, racing heart, and sweating. Hypoglycemia can result from not eating at regular intervals, in- tense physical activity, taking too much medication, or drinking alcohol.

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