By P. Iomar. University of Louisville.

During this stage levlen 0.15 mg sale, Freud believed that children develop a powerful but unconscious attraction for the opposite-sex parent order levlen 0.15 mg otc, as well as a desire to eliminate the same-sex parent as a rival. Freud based his theory of sexual development in boys (the “Oedipus complex‖) on the Greek mythological character Oedipus, who unknowingly killed his father and married his mother, and then put his own eyes out when he learned what he had done. Freud argued that boys will normally eventually abandon their love of the mother, and instead identify with the father, also taking on the father‘s personality characteristics, but that boys who do not successfully resolve the Oedipus complex will experience psychological problems later in life. Although it was not as important in Freud‘s theorizing, in girls the phallic stage is often termed the “Electra complex,‖ after the Greek character who avenged her father‘s murder by killing her mother. Freud believed that girls frequently experienced penis envy, the sense of deprivation supposedly experienced by girls because they do not have a penis. The latency stage is a period of relative calm that lasts from about 6 years to 12 years. During this time, Freud believed that sexual impulses were repressed, leading boys and girls to have little or no interest in members of the opposite sex. According to Freud, sexual impulses return during this time frame, and if development has proceeded normally to this point, the child is able to move into the development of mature romantic relationships. But if earlier problems have not been appropriately resolved, difficulties with establishing intimate love attachments are likely. Freud‘s Followers: The Neo-Freudians Freudian theory was so popular that it led to a number of followers, including many of Freud‘s own students, who developed, modified, and expanded his theories. The neo-Freudian theories are theories based on Freudian principles that emphasize the role of the unconscious and early experience in shaping personality but place less evidence on sexuality as the primary motivating force in personality and are more optimistic concerning the prospects for personality growth and change in personality in adults. Alfred Adler (1870–1937) was a follower of Freud who developed his own interpretation of Freudian theory. Adler proposed that the primary motivation in human personality was not sex or aggression, but rather the striving for superiority. According to Adler, we desire to be better than others and we accomplish this goal by creating a unique and valuable life. We may attempt to satisfy our need for superiority through our school or professional accomplishments, or by our enjoyment of music, athletics, or other activities that seem important to us. He argued that children who are either overly nurtured or overly neglected by their parents are later likely to develop an inferiority complex—a psychological state in which people feel that they are not living up to expectations, leading them to have low self-esteem, with a tendency to try to overcompensate for the negative feelings. People with an inferiority complex often attempt to demonstrate their superiority to others at all costs, even if it means humiliating, dominating, or alienating them. Carl Jung (1875–1961) was another student of Freud who developed his own theories about personality. Jung agreed with Freud about the power of the unconscious but felt that Freud overemphasized the importance of sexuality. Jung argued that in addition to the personal unconscious, there was also acollective unconscious, or a collection of shared ancestral memories. Jung believed that the collective unconscious contains a variety of archetypes, or cross-culturally universal symbols, which explain the similarities among people in their emotional reactions to many stimuli. Important archetypes include the mother, the goddess, the hero, and the mandala or circle, which Jung believed symbolized a desire for wholeness or unity. For Jung, the underlying motivation that guides successful personality is self-realization, or learning about and developing the self to the fullest possible extent. Karen Horney (the last syllable of her last name rhymes with “eye‖; 1855–1952), was a German physician who applied Freudian theories to create a personality theory that she thought was more balanced between men and women. Horney believed that parts of Freudian theory, and particularly the ideas of the Oedipus complex and penis envy, were biased against women. Horney argued that women‘s sense of inferiority was not due to their lack of a penis but rather to their dependency on men, an approach that the culture made it difficult for them to break from. For Horney, the underlying motivation that guides personality development is the desire for security, the ability to develop appropriate and supportive relationships with others. Fromm‘s focus was on the negative impact of technology, arguing that the increases in its use have led people to feel increasingly isolated from others. Fromm believed that the independence that technology brings us also creates the need “escape from freedom,‖ that is, to become closer to others. Research Focus: How the Fear of Death Causes Aggressive Behavior Attributed to Charles Stangor Saylor. In this research, people have been made to confront their death by writing about it or otherwise being reminded of it, and effects on their behavior are then observed. The participants in the study had been selected, on the basis of prior reporting, to have either politically liberal or politically conservative views. When they arrived at the lab they were asked to write a short paragraph describing their opinion of politics in the United States. In addition, half of the participants (the mortality salient condition) were asked to ―briefly describe the emotions that the thought of your own death arouses in you‖ and to ―jot down as specifically as you can, what you think will happen to you as you physically die, and once you are physically dead. They were instructed to ―please briefly describe the emotions that the thought of your next important exam arouses in you‖ and to ―jot down as specifically as you can, what you think will happen to you as you physically take your next exam, and once you are physically taking your next exam. Thus one-half of the participants were provoked by the other person by reading a statement that strongly conflicted with their own political beliefs, whereas the other half read an essay in which the other person‘s views supported their own (liberal or conservative) beliefs. At this point the participants moved on to what they thought was a completely separate study in which they were to be tasting and giving their impression of some foods.

People with Down syndrome typically exhibit a distinctive pattern of physical features purchase levlen 0.15mg with amex, including a flat nose cheap levlen 0.15 mg on line, upwardly slanted eyes, a protruding tongue, and a short neck. Societal attitudes toward individuals with mental retardation have changed over the past decades. We no longer use terms such as “moron,‖ “idiot,‖ or “imbecile‖ to describe these people, although these were the official psychological terms used to describe degrees of retardation in the past. Supreme Court ruled that the execution of people with mental retardation is “cruel and unusual [6] punishment,‖ thereby ending this practice (Atkins v. It is often assumed that schoolchildren who are labeled as “gifted‖ may have adjustment problems that make it more difficult for them to create social relationships. This study found, first, that these students were not unhealthy or poorly adjusted but rather were above average in physical health and were taller and heavier than individuals in Attributed to Charles Stangor Saylor. The students also had above average social relationships—for instance, [8] being less likely to divorce than the average person (Seagoe, 1975). Terman‘s study also found that many of these students went on to achieve high levels of education and entered prestigious professions, including medicine, law, and science. Of the sample, 7% earned doctoral degrees, 4% earned medical degrees, and 6% earned law degrees. These numbers are all considerably higher than what would have been expected from a more general population. As you might expect based on our discussion of intelligence, kids who are gifted have higher scores on general intelligence (g). Some children are particularly good at math or science, some at automobile repair or carpentry, some at music or art, some at sports or leadership, and so on. There is a lively debate among scholars about whether it is appropriate or beneficial to label some children as “gifted and talented‖ in school and to provide them with accelerated special classes and other programs that are not available to [10] everyone. Although doing so may help the gifted kids (Colangelo & Assouline, 2009), it also may isolate them from their peers and make such provisions unavailable to those who are not classified as “gifted. The fact that women earn many fewer degrees in Attributed to Charles Stangor Saylor. On the other hand, it is possible that the differences are due to variability in intelligence, because more men than women have very high (as well as very low) intelligence. Women tend to do better than men on some verbal tasks, including spelling, writing, and pronouncing words [12] (Halpern et al. On average, men do better than women on tasks requiring spatial ability, such as the mental [14] rotation tasks shown in Figure 9. Boys tend to do better [15] than girls on both geography and geometry tasks (Vogel, 1996). Although these differences are real, and can be important, keep in mind that like virtually all sex group differences, the average difference between men and women is small compared to the average differences within each sex. There are many women who are better than the average man on spatial tasks, and many men who score higher than the average women in terms of emotional intelligence. Sex differences in intelligence allow us to make statements only about average differences and do not say much about any individual person. Although society may not want to hear it, differences between men and women may be in part genetically determined, perhaps by differences in brain lateralization or by hormones (Kimura & [17] Hampson, 1994; Voyer, Voyer, & Bryden, 1995). As infants, boys and girls show no or few differences in spatial or counting abilities, suggesting that the differences occur at least in part as a result of Attributed to Charles Stangor Saylor. Furthermore, the number of women entering the hard sciences has been increasing steadily over the past years, again suggesting that some of the differences may have been due to gender discrimination and societal expectations about the appropriate roles and skills of women. The bell curves for some groups (Jews and East Asians) are centered somewhat higher than for Whites in general (Lynn, 1996; [20] Neisser et al. Other groups, including Blacks and Hispanics, have averages somewhat lower than those of Whites. The observed average differences in intelligence between groups has at times led to malicious and misguided attempts to try to correct for them through discriminatory treatment of people [22] from different races, ethnicities, and nationalities (Lewontin, Rose, & Kamin, 1984). One of the most egregious was the spread of eugenics, the proposal that one could improve the human species by encouraging or permitting reproduction of only those people with genetic characteristics judged desirable. Eugenics became immensely popular in the United States in the early 20th century and was supported by many prominent psychologists, including Sir Francis Galton. Dozens of universities, including those in the Ivy League, offered courses in eugenics, and the topic was [23] presented in most high school and college biology texts (Selden, 1999). Congress to pass laws designed to restrict immigration from other countries supposedly marked by low intelligence, particularly those in eastern and southern Europe. Fortunately, the practice of sterilization was Attributed to Charles Stangor Saylor. By bias, what psychologists mean is that a test predicts outcomes—such as grades or occupational success—better for one group than it does for another. Another way that tests might be biased is if questions are framed such that they are easier for people from one culture to understand than for people from other cultures. For example, even a very smart person will not do well on a test if he or she is not fluent in the language in which the test is administered, or does not understand the meaning of the questions being asked. But modern intelligence tests are designed to be culturally neutral, and group differences are found even on tests that only ask about spatial intelligence.

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The nature and form of provide an opportunity to ensure common under- informed consent are reviewed cheap levlen 0.15mg online. In these discus- standing of issues order 0.15mg levlen amex, subjective grading systems and sions, the sponsor’s representative is attempting so on. However, investigator meetings tend not to to identify aspects of the study that present diffi- be attended by all the staff who will be involved in culties or problems for the investigator. Inevitably, investigators usually have clear understanding this means that the sponsor’s representative has to and strategy for the above activities. Examples of conduct study initiation activities at the institution the questions that require answering during pre- with some key staff. Some objective measure of the availability of the correct patient population is important during a Conducting study initiation pre-study visit. The sponsor’s representative can often best accomplish this through a chart or hos- The study initiation visit is sometimes confused pital census review. The purpose of the study initiation visit is to orient the study staff (sub- investigators, study coordinators, etc. At the point of the How will the protocol specifically operate at the study initiation visit, the study site should be fully prospective center? All study staff who will have direct involvement How many studies is the investigator conducting in the trial should participate in the study initiation currently? In addition, a monitor needs to have excel- presentation, participants may raise important lent interpersonal communication and problem- medical or logistical issues that have or have not solving skills. It is Clinical monitoring requires clinical, interpretive important to note these concerns and communicate and administrative skills. Quality monitoring will always include tent in the basic medical and scientific issues of and confirm the following activities: the investigational product and protocol, know the target disease or symptoms, be able to train the properly obtained informed consent; investigative staff on the conduct of the study, confirm facility capabilities, conduct the site initia- adherence to the protocol procedures and inclu- tion meeting, describe adverse event reporting sion/exclusion criteria; requirements and be able to resolve protocol issues during and after meeting. Monitoring permits an supplies; in-process assessment of the quality of the data being collected. The frequency of clinical monitoring depends on Monitoring clinical studies involves the act of the actual accrual rate of the subjects. Monitors studies may need to be visited more frequently ensure that the study is conducted, recorded and depending on the accrual rate of subjects, the 3. The monitors should anticipate suffi- Local language Route of administration cient time for good monitoring practices. Name of investigator Dosage Following a monitoring visit, the monitor will Study number Dosage form prepare a monitoring report for sponsor records Bottle number Quantity or volume and follow up correspondence to the trial site. Lot number Storage precautions The monitor may need to plan intervention and Drug name or code Directions for use possible replacement of nonperforming or non- Manufacturer name Note: ‘For Clinical Trial’ compliant trial centers. Manufacturer address Caution statement Local affiliate name Expiry date Managing drug accountability identical within multicenter trials. Regulatory The sponsor is responsible for providing the investi- documents required for investigational drug use gator with investigational product. Both the sponsor in the core countries must be anticipated and and investigator have a role in drug accountability. Once the study is underway, the investigator’s The monitor reconciles investigational product staff must account for the use of the investigational shipped, dispensed and returned, arranges for ship- drug. Subjects should return unused medication ment of investigational product to core country or and empty containers to the investigator. The investigative sites, checks investigational product amount of drug dispensed and the amount used supplies at site against enrollment and withdra- by the patients are compared for discrepancies. Monitors must also check that inventory problems, implements tracking system drug supplies are being kept under the required for investigational product management on a study storage conditions. Failure to do so can result product supplies and ensures final reconciliation in some of the data having to be discarded during of investigational product supplies. This issue can prove to be Good clinical practices require sponsors to be problematic when a single site is studying patients able to account for the drug supplies prepared and at different locations. Finally, the double-blind shipped to the investigator, the investigator’s use of code must not be broken except when essential those supplies and the return and destruction of for the management of adverse events. Planning drug supplies ing of treatment codes can make that patient’s data is a detailed and complex activity. Safety concerns are present throughout the drug Drug packaging should follow as consistent a development process. To be successful, monitors need to be com- Management of safety is a principal responsi- petent in bility of the sponsor monitor. The monitor has responsibility for informing the investigator basic medicine and therapeutics; about the safety requirements of the study. This will include a discussion of expected and unex- recognizing clinical signs and symptoms; pected adverse events, how to report adverse events should they occur and how to characterize interpretation of laboratory findings; the adverse events in terms of project-specific definitions. In source documents, safety issues The sponsor needs to provide ongoing review of may be uncovered in the progress notes of hospital safety data for investigational products.

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They developed a questionnaire entitled the ‘Temptation to not exercise scale’ which measured two forms of barriers ‘affect’ and ‘competing demands’ cheap levlen 0.15mg line. The answers include ‘when I am angry’ and ‘when I am satisfied’ to reflect ‘affect’ and ‘when I feel lazy’ and ‘when I am busy’ to reflect competing interests discount 0.15 mg levlen with visa. The authors argue that such temptations are central to understanding exercise uptake and should be used alongside the stages of change model. Prospective research This has examined which factors predict the uptake of exercise. It has often been carried out in the context of the development of exercise programmes and studies of adherence to these programmes. The results indicated that exercise self-efficacy, attitudes to exercise and health knowledge were the best pre- dictors. They concluded that having realistic aims and an understanding of the possible outcomes of a brief exercise programme were predictive of adherence to the programme. To further understand the predictors of exercise adherence, social cognition models have been used. Riddle (1980) examined predictors of exercise using the theory of reasoned action (Fishbein and Ajzen 1975; see Chapter 2) and reported that attitudes to exercise and the normative components of the model predicted intentions to exercise and that these intentions were related to self-reports of behaviour. Research has also used the health belief model (Sonstroem 1988) and models emphasizing exercise self-efficacy (e. Research has also applied the stages of change model to exercise behaviour (see Chapters 2 and 5). This model describes behaviour change in five stages: precontem- plation, contemplation, preparation, action and maintenance (e. DiClemente and Prochaska 1982) and suggests that transitions between changes is facilitated by a cost benefit analysis and by different cognitions. This suggests that encouraging individuals to focus on the pros of exercise may increase the transition from thinking about exercising to actually doing it. The study included a large sample of adults who completed measures by telephone at baseline and then recorded their exercise stage by mail after one year. The results showed that baseline attitude, intention and subjective norm predicted the transition from precontemplation to contemplation, that progression from contemplation to preparation was predicted by intention, perceived behavioural control, attitudes and social support, that progression from preparation to action was predicted by intention and attitude and that transition from action to maintenance was predicted by intention, attitude and social support. This study was an attempt to test directly the role of two social cognition models in predicting exercise behaviour. Background Social cognition models such as the theory of reasoned action and the health belief model have been used to predict and examine health behaviours such as smoking (see Chapter 5), screening (see Chapter 9) and contraception use (see Chapter 8). Norman and Smith (1995) used the theory of planned behaviour (Ajzen 1988) to predict exercise behaviour over a six-month period. Methodology Subjects Eighteen people were asked to complete open-ended questions in order to identify beliefs about exercise that could then be incorporated into a questionnaire. The questionnaire was distributed to 250 subjects and returned by 182 (a response rate of 72. Because the study used a prospective design, a second questionnaire was sent out after six months; 83 individuals returned it completed. Design The study involved a repeated-measures design with questionnaires completed at baseline (time 1) and after six months (time 2). Measures The questionnaire at time 1 asked for the subject’s age and sex and con- tained questions about the following aspects of the theory of planned behaviour, which were rated on a seven-point Likert scale. At time 2, the subjects were asked about their frequency of exercising (as in prior behaviour). This variable was included in order to examine which variables at time 1 predicted future behaviour at time 2. Results The data were analysed using correlation analysis, which examines associations between the different variables (e. Therefore, fre- quent exercisers at time 2 were more likely at time 1 to believe that they would take regular exercise, to hold a strong desire to exercise, to have a positive attitude towards exercise, to perceive pressure from others to exercise, to believe that taking exercise was under their control, and to have exercised frequently in the past. The results from the regression analysis showed that the strongest predictor of future behaviour after six months was prior behaviour. Conclusions The authors concluded that although most of the variables of the theory of planned behaviour were related to future behaviour, the best predictor of future behaviour was prior behaviour. This suggests that exercise may be under a strong habitual influence, perhaps because its mood-enhancing effects promote further exercise, and/or perhaps because exercise is based on habit and not cognition. These factors are very similar to those that relate to both the initiation and maintenance of exercise behaviour and reflect the role of both non-modifiable and modifiable factors. Research has therefore examined factors that correlate and predict exercise behaviour. Such factors include the social and political climate and the individual’s beliefs. Although interventions aimed to promote exercise do so because of the health benefits, an interest in these benefits does not appear to be the best predictor of initiation or maintenance of exercise behaviour.

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The hepatitis virus inflames the gland buy levlen 0.15mg line, and cirrhosis caused by repeated toxic injury (often through alco- hol or other substance abuse) destroys Kupffer cells and replaces them with scar tissue generic 0.15mg levlen visa. Also, painful gallstones can develop when cholesterol clumps together to form a center around which the gallstone can form. The head is attached to the body of the gland by a slight constriction called the neck, and the opposite end gradually tapers to form a tail. The pancreatic duct extends from the head to the tail, receiving the ducts of various lobules that make up the gland. It generally joins the common bile duct, but some 40 percent of humans have a pancreatic duct and a common bile duct that open separately into the duodenum. Uniquely, the pancreas is both an exocrine gland, meaning that it releases its secretion externally either directly or through a duct, and an endocrine gland, meaning that it produces hormonal secretions that pass directly into the bloodstream without using a duct. However, most of the pancreas is devoted to being an exocrine gland secreting pancreatic juices into the duodenum. The endocrine portion of the gland secretes insulin vital to the control of sugar metabolism in the body through small, scattered clumps of cells known as islets of Langerhans. Because it contains sodium bicarbonate, pancreatic juice is alkaline, or base, with a pH of 8. Enzymes released by the pancreas act upon all types of foods, making its secretions the most important to digestion. Its enzymes include pancreatic amylase, or carbohydrate enzymes; pancreatic lipase, or fat enzymes; trypsin, or protein enzymes; and nuclease, or nucleic acid enzymes. The most commonly known pancreatic disease is called diabetes mellitus, or sugar diabetes, which occurs when the islets of Langerhans cease producing insulin. Without insulin, the body can’t use sugar, which builds up in the blood and is excreted by the kidneys. Chapter 9: Fueling the Functions: The Digestive System 157 Large intestine After chyme works its way through the small intestine, it then must move through 5 feet or so of large intestine. The byproduct of the small intestine’s work enters at the ileocaecal valve and then moves through the following regions of the large intestine: Cecum → Vermiform appendix → Ascending colon→ Transverse colon → Descending colon → Sigmoid colon → Rectum → Anus The large intestine is about 3 inches wide at the start and decreases in width all the way to the anus. As the unabsorbed material moves through the large intestine, excess water is reabsorbed, drying out the material. In fact, most of the body’s water absorp- tion takes place in the large intestine. Peristaltic movement continues, albeit rather feebly, in the cecum and ascending colon. The large intestine has a longitudinal muscle layer in the form of three bands running from the cecum to the rectum called the taenia coli. The muscle that contracts to prevent gastric juices of the stomach from entering the esopha- gus is the a. The enzyme found in the intestinal juices that activates the pancreatic enzyme into an active enzyme that can break down protein is called a. What structure of the small intestine is composed of a network of capillaries with a central lymph vessel or lacteal, which contains a milky-white substance? Microscopical1y, the liver is composed of rows of cuboidal cells with small blood spaces running between the cells called a. Biliary canaliculi Chapter 9: Fueling the Functions: The Digestive System 159 Answers to Questions on the Digestive Tract The following are answers to the practice questions presented in this chapter. Digestion f – Following is how Figure 9-1, the digestive system, should be labeled. Anus q The alimentary tract forms from the following layer(s) of the developing embryo: c. Keep in mind that the tube that becomes the digestive tract develops from endoderm with ectoderm at each end. Mouth → Pharynx → Esophagus → Stomach → Small intestine → Large intestine Although remembering the sequence M-P-E-S-small-large can be helpful, you can also try this phrase to jog your memory: Most Phones Enable Speeches, from Small to Large. Admittedly, the latter answer is just a fancy description of the hard and soft palate, but you need to recognize the fancy descriptions along with the common terms. You can rule out this answer option as false because a cuspid is a type of tooth, so it makes no sense that each tooth would have another type of tooth anchoring it. Pharyngopalatine arch M Arch that starts at the buccal surface of the palate at the base of the uvula and ends alongside the back third of the tongue: d. It facilitates swallowing, initiates the digestion of certain carbohydrates, and moistens and lubricates the mouth and lips. It lies below and in front of the ear, hence the Greek roots para–, meaning “beside,” and ot–, meaning “ear. Fungiform papillae S Large structures, each surrounded by a moat, that form a V-shaped furrow in the tongue: a. Cardiac sphincter 1 The sequential contraction of circular muscles as food moves through the esophagus is called d. A bit of Greek may help you remember this term, which comes from the word peristaltikos, which means “to wrap around. This question calls upon your knowledge of Greek prefixes and suffixes: pyl– means “gate,” and –orus means “guard.

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